2018-08-15T09:29:57-05:00 2017-09-30 420714325 RSM US LLP ONE SOUTH WACKER STE 800 CHICAGO IL 60606 990 2016-10-01 331075317 NCHMD INC NCHM 2396246338 PO BOX 413029 NAPLES FL 341013029 RICK WYLES CHIEF FINANCIAL OFFICER 2396244005 2018-08-14 1 WAYNE HARDER P00294296 3126343400 2016 2022-09-23 18:48:47Z NCH PHYSICIAN GROUP RICK WYLES PO BOX 413029 NAPLES FL 341013029 90930848 0 X WWW.NCHMD.ORG X 2003 FL HELPING EVERYONE LIVE A LONGER, HAPPIER, AND HEALTHIER LIFE. 11 2 697 3 30766 0 0 0 72592000 90888451 -47708 0 213666 42397 72757958 90930848 0 0 0 0 70539980 85586452 0 0 0 24140471 27903861 94680451 113490313 -21922493 -22559465 20703752 36813623 15258363 16004130 5445389 20809493 X HELPING EVERYONE LIVE A LONGER, HAPPIER, AND HEALTHIER LIFE. 0 1 17927178 16550486 FAMILY PRACTICE SERVICES WERE NCH PHYSICIAN GROUP'S LARGEST PROGRAM SERVICE ACCOMPLISHMENT IN 2017. THIS PROGRAM SERVICE OFFERS CARE TO THE WHOLE FAMILY, BY TREATING NOT ONLY ILLNESSES, BUT BY HELPING YOU FIND WAYS TO IMPROVE YOUR HEALTH AND PREVENT DISEASE. OUR FAMILY MEDICINE OFFICES PROVIDE COMPLETE CARE TO INFANTS, CHILDREN, ADOLESCENTS, ADULTS AND THE ELDERLY.WITHIN THIS SERVICE LINE, NCHMD EMPLOYED 53 LICENSED INDEPENDENT PRACTITIONERS AND 82 FULL-TIME EQUIVALENT EMPLOYEES WHO PERFORMED 138,007 RELATIVE VALUE UNITS, PROVIDED $5,286. OF CHARITY CARE AND ALSO WROTE OFF $41,057. OF BAD DEBT. 15907628 11379854 CARDIOLOGY SERVICES WERE NCH PHYSICIAN GROUP'S SECOND LARGEST PROGRAM SERVICE ACCOMPLISHMENT IN 2017. NCHMD, INC., IN CONJUNCTION WITH THE NCH DOWNTOWN NAPLES HOSPITAL, IS HOME TO THE NCH HEART INSTITUTE, ONE OF THE MOST SUCCESSFUL CARDIAC PROGRAMS IN THE NATION. THE NCH HEART INSTITUTE IS RANKED #1 IN FLORIDA AGAIN FOR OVERALL CARDIC CARE AND IS RECOGNIZED FOR ITS CODE SAVE-A-HEART PROGRAM. OUR SERVICES INCLUDE INVASIVE AND NON-INVASIVE CARDIAC PROCEEDURES, CARDIAC REHABILITATION AND WELLNESS PROGRAMS.WITHIN THIS SERVICE LINE, NCHMD EMPLOYED 37 LICENSED INDEPENDENT PRACTITIONERS AND 36 FULL-TIME EQUIVALENT EMPLOYEES WHO PERFORMED 179,815 RELATIVE VALUE UNITS, PROVIDED $507,664. OF CHARITY CARE AND ALSO WROTE OFF $263,426 OF BAD DEBT. 15889122 11856260 SEE SCHEDULE OINTERNAL MEDICINE SERVICES WERE NCH PHYSICIAN GROUP'S THIRD LARGEST PROGRAM SERVICE ACCOMPLISHMENT IN 2017. THE NCH PHYSICIAN GROUP'S INTERNAL MEDICINE PHYSICIANS FOCUS ON ADULT MEDICINE BY EMPHASIZING PREVENTION AND TREATMENT OF ADULT DISEASES WITH STATE OF THE ART TECHNOLOGY IN A COMPASSSIONATE ENVIRONMENT. THESE PHYSICIANS WORK CLOSELY WITH ALL OUR SPECIALISTS AS WELL AS OUR ANCILLARY TESTING DEPARTMENTS SUCH AS RADIOLOGY, AND LABORATORY TO HELP SOLVE DIAGNOSTIC PROBLEMS.WITHIN THIS SERVICE LINE, NCHMD EMPLOYED 69 LICENSED INDEPENDENT PRACTITIONS AND 29 FULL-TIME EQUIVALENT EMPLOYEES WHO PERFORMED 202,548 RELATIVE VALUE UNITS, PROVIDED $660,924 OF CHARITY CARE AND ALSO WROTE OFF $256,110 OF BAD DEBT. 57581534 51104378 IN PROVIDING THE OTHER PROGRAM SERVICE LINES, NCHMD EMPLOYED 86 LICENSED INDEPENDENT PRACTITIONERS AND 260 FTES WHO PERFORMED 467,468 RELATIVE VALUE UNITS, PROVIDED $1,518,459 OF CHARITY CARE AND ALSO WROTE OFF $1,217,306 OF BAD DEBT.NCH PHYSICIAN GROUP'S OTHER PROGRAM SERVICE LINES ARE: EXPENSE REVENUELAB AND RADIOLOGY $14,589,319 $16,679,838PULMONARY 9,264,872 6,262,516 INFECTIOUS DISEASE 8,286,146 8,696,373ORTHOPEDICS 7,844,357 5,817,898GASTROENTEROLOGY 4,225,510 3,308,582 GENERAL SURGERY 3,036,737 2,596,482PAIN MANAGEMENT 2,930,232 1,785,941URGENT CARE 1,606,648 1,898,359PSYCHIATRY 1,563,614 922,896PEDIATRICS 1,496,613 1,202,799ENDOCRINOLOGY 971,483 577,483GERIATRICS 618,712 327,277RHEUMATOLOGY 559,767 394,404PRO TIME 366,621 305,257GME 144,654 229,389 WOUND HEALING 48,527 98,884CHRONIC CARE 27,722 0 57581534 51104378 107305462 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 1 72 0 1 697 1 1 1 0 0 0 0 0 0 0 0 0 X 11 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X X RICK WYLES CHIEF FINANCIAL OFFICER 2396244005 350 SEVENTH STREET NORTH NAPLES FL 34102 THOMAS J GAZDIC TRUSTEE 0.50 1.50 X 0 0 0 JOHN LEWIS MD TRUSTEE 0.50 1.50 X 0 0 0 BRYAN MURPHEY MD PHYSICIAN/CHAIRMAN 40.00 X X 459878 0 25634 DAMIAN MCGOVERN MD PHYSICIAN/SECRETARY/TREASURER 40.00 X X 914871 0 26263 GARY SWAIN MD PHYSICIAN/VICE CHAIRMAN 40.00 X X 269042 0 8623 MAZEN ALBELDAWI MD PHYSICIAN/TRUSTEE 40.00 X 1120596 0 41417 MICHAEL FLYNN MD PHYSICIAN/TRUSTEE 40.00 X 635595 0 28520 DAVID LAMON MD PHYSICIAN/TRUSTEE 40.00 X 480218 0 30044 KAREN M HENRICHSENDO PHYSICIAN/TRUSTEE TERM 05/17 40.00 X 268652 0 22941 ALLEN S WEISS MD TRUSTEE/PRESIDENT/CEO 1.00 44.00 X X 0 912173 21876 FRANK ASTOR MD TRUSTEE/CHIEF MEDICAL OFFICER 1.00 44.00 X X 0 467349 22425 KEVIN D COOPER CHIEF OF STAFF 1.00 44.00 X 0 529363 29317 MICHELE THOMANRN TERM 1116 CHIEF NURSING OFFICER 1.00 44.00 X 0 362284 27130 PHILLIP DUTCHER COO, NCH HEALTHCARE SYSTEM 1.00 44.00 X 0 537567 3524 RICK WYLES CHIEF FINANCIAL OFFICER 1.00 44.00 X 0 338594 27896 MICHAEL RILEY CHIEF STRATEGY OFFICER 1.00 44.00 X 0 303612 33976 RENEE M THIGPEN CHIEF HR OFFICER 1.00 44.00 X 0 276470 27426 ELIZABETH MARTIN ASSISTANT SECRETARY 1.00 44.00 X 0 66039 20675 JAMES K MARTIN TERM 517 CHIEF DEVELOPMENT OFFICER 1.00 44.00 X 0 340526 32471 GARY TOMCIK CHIEF EXPERIENCE OFFICER 1.00 44.00 X 0 192512 28013 ZACHARY BOSTOCK CHIEF ADMINISTRATIVE OFFICER 1.00 44.00 X 0 398248 30149 JONATHAN KLINGRN START 1116 CHIEF NURSING OFFICER 1.00 44.00 X 0 173316 30102 HOWARD KAPP MD PHYSICIAN 40.00 0.00 X 1983802 0 16251 JON DOUNCHIS MD PHYSICIAN 40.00 0.00 X 1320136 0 25707 CARLO D SANTOS-OCAMPO MD PHYSICIAN 40.00 0.00 X 1050339 0 29834 DAVID R AXLINE MD PHYSICIAN 40.00 0.00 X 1007257 0 26550 ADAM J FRANK MD PHYSICIAN 40.00 0.00 X 823430 0 19541 SARAH RICHARDSON TERM 216 FORMER CHIEF INFORMATION OFFICER 0.00 0.00 X 0 178044 2271 10333816 5076097 638576 128 1 1 0 LOCUMTENENS COM LLC PO BOX 405547 ATLANTA GA 303845547 PHYSICIAN STAFFING SERVICES 1554066 SHERIDAN RADIOLOGY MGMT PO BOX 452796 SUNRISE FL 333232197 RADIOLOGY SERVICES 1282945 CERNER CORPORATION PO BOX 959156 ST LOUIS MO 631959156 IT CONSULTING AND SUPPORT SERVICES 951932 BCBE CONSTRUCTION LLC 3570 ENTERPRISE AVE SUITE 200 NAPLES FL 34104 CONSTRUCTION SERVICES 436490 GE HEALTHCARE IITS 15724 COLLECTIONS CENTER DR CHICAGO IL 60693 IT CONSULTING AND SUPPORT SERVICES 332119 9 OFFICES OF PHYSICIANS 621110 90888451 90888451 90888451 SUBLEASE SPACE/PERS 561000 30766 30766 EMPLOYEE SALES 900099 9104 9104 MISC RECEIPTS 900099 2527 2527 42397 90930848 90890978 30766 9104 X 4555335 4159800 395535 344674 344674 73629962 70358324 3271638 1683881 1605244 78637 1597449 1523005 74444 3775151 3598851 176300 4776159 4260547 515612 215520 215520 2824130 1957027 867103 1466077 1397611 68466 4343324 3699195 644129 111474 110516 958 3039736 2988271 51465 747123 706714 40409 MEDICAL SUPPLIES 8600194 8600039 155 BAD DEBT 1777899 1777899 2225 2225 113490313 107305462 6184851 0 5085992 8229485 736167 785734 745990 527519 39752920 16734820 12211738 23018100 1923865 4252785 20703752 36813623 14059767 14653108 1198596 1351022 15258363 16004130 X 5445389 20809493 5445389 20809493 20703752 36813623 X -22559465 37923569 X 0 1 X 1 0 X 59487869 68075529 70021282 72592000 90888451 361065131 59487869 68075529 70021282 72592000 90888451 361065131 0 0 0 361065131 -4596 -262 9702 -47708 0 -42864 -4596 -262 9702 -47708 0 -42864 911014 1088652 896753 11815 11631 2919865 60394287 69163919 70927737 72556107 90900082 363942132 0.99210 0.98870 0.00000 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: PHYSICIAN ON CALL REVENUE - 2012 AMOUNT: $ 802,140. 2013 AMOUNT: $ 1,085,355. 2014 AMOUNT: $ 889,634. MISC ACCOUNTS REC RECEIPTS - 2012 AMOUNT: $ 5,478. 2013 AMOUNT: $ 452. 2014 AMOUNT: $ 1,074. 2015 AMOUNT: $ 282. 2016 AMOUNT: $ 6. EMPLOYEE SALES - 2012 AMOUNT: $ 2,943. 2013 AMOUNT: $ 2,845. 2014 AMOUNT: $ 6,045. 2015 AMOUNT: $ 8,233. 2016 AMOUNT: $ 9,104. MISC VENDOR RECEIPTS - 2016 AMOUNT: $ 2,521. PHYSICIAN CONTRACT BUYOUT - 2012 AMOUNT: $ 100,453. PATIENT STUDY REGISTRATION SERVICES - 2015 AMOUNT: $ 3,300. 2016 AMOUNT: $ 0. 3559424 3559424 7021260 1291976 5729284 5313206 3711728 1601478 22716487 11731116 10985371 1142543 1142543 23018100 X PART X, LINE 2: THE SYSTEM AND ALL OF ITS NOT-FOR-PROFIT SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE (THE CODE). THE SYSTEM AND ALL OF ITS NOT-FOR-PROFIT SUBSIDIARIES DO NOT HAVE SIGNIFICANT UNRELATED BUSINESS INCOME; HOWEVER, SUCH STATUS IS SUBJECT TO FINAL DETERMINATION UPON EXAMINATION OF THE RELATED INCOME TAX RETURNS BY THE APPROPRIATE TAXING AUTHORITIES. THE SYSTEM IS GENERALLY NO LONGER SUBJECT TO TAX EXAMINATIONS IN THE MAJOR U.S. TAXING JURISDICTIONS IN WHICH THEY OPERATE FOR TAX YEARS PRIOR TO 2013. X X X X 1 0 0 0 0 0 0 1 0 BRYAN MURPHEY MD PHYSICIAN/CHAIRMAN 440171 0 1437 0 18270 0 0 0 25634 0 485512 0 0 0 DAMIAN MCGOVERN MD PHYSICIAN/SECRETARY/TREASURER 657435 0 239166 0 18270 0 0 0 26263 0 941134 0 0 0 GARY SWAIN MD PHYSICIAN/VICE CHAIRMAN 250321 0 1333 0 17388 0 4677 0 3946 0 277665 0 0 0 MAZEN ALBELDAWI MD PHYSICIAN/TRUSTEE 832725 0 269871 0 18000 0 10600 0 30817 0 1162013 0 0 0 MICHAEL FLYNN MD PHYSICIAN/TRUSTEE 497478 0 121099 0 17018 0 2703 0 25817 0 664115 0 0 0 DAVID LAMON MD PHYSICIAN/TRUSTEE 460491 0 1457 0 18270 0 1727 0 28317 0 510262 0 0 0 KAREN M HENRICHSENDO PHYSICIAN/TRUSTEE TERM 05/17 249558 0 2610 0 16484 0 4805 0 18136 0 291593 0 0 0 ALLEN S WEISS MD TRUSTEE/PRESIDENT/CEO 0 756585 0 136709 0 18879 0 0 0 21876 0 934049 0 0 FRANK ASTOR MD TRUSTEE/CHIEF MEDICAL OFFICER 0 405570 0 42591 0 19188 0 0 0 22425 0 489774 0 0 KEVIN D COOPER CHIEF OF STAFF 0 431967 0 78982 0 18414 0 0 0 29317 0 558680 0 0 MICHELE THOMANRN TERM 1116 CHIEF NURSING OFFICER 0 286878 0 59244 0 16162 0 2351 0 24779 0 389414 0 0 PHILLIP DUTCHER COO, NCH HEALTHCARE SYSTEM 0 438299 0 78982 0 20286 0 0 0 3524 0 541091 0 0 RICK WYLES CHIEF FINANCIAL OFFICER 0 319880 0 0 0 18714 0 0 0 27896 0 366490 0 0 MICHAEL RILEY CHIEF STRATEGY OFFICER 0 240129 0 44295 0 19188 0 4471 0 29505 0 337588 0 0 RENEE M THIGPEN CHIEF HR OFFICER 0 219797 0 37899 0 18774 0 5745 0 21681 0 303896 0 0 JAMES K MARTIN TERM 517 CHIEF DEVELOPMENT OFFICER 0 271766 0 49572 0 19188 0 5383 0 27088 0 372997 0 0 GARY TOMCIK CHIEF EXPERIENCE OFFICER 0 173857 0 0 0 18655 0 0 0 28013 0 220525 0 0 ZACHARY BOSTOCK CHIEF ADMINISTRATIVE OFFICER 0 324700 0 55368 0 18180 0 3059 0 27090 0 428397 0 0 JONATHAN KLINGRN START 1116 CHIEF NURSING OFFICER 0 162816 0 10230 0 270 0 4366 0 25736 0 203418 0 0 HOWARD KAPP MD PHYSICIAN 1917447 0 47167 0 19188 0 0 0 16251 0 2000053 0 0 0 JON DOUNCHIS MD PHYSICIAN 1263787 0 38079 0 18270 0 0 0 25707 0 1345843 0 0 0 CARLO D SANTOS-OCAMPO MD PHYSICIAN 799806 0 231759 0 18774 0 0 0 29834 0 1080173 0 0 0 DAVID R AXLINE MD PHYSICIAN 879185 0 109658 0 18414 0 0 0 26550 0 1033807 0 0 0 ADAM J FRANK MD PHYSICIAN 609834 0 195326 0 18270 0 0 0 19541 0 842971 0 0 0 SARAH RICHARDSON TERM 216 FORMER CHIEF INFORMATION OFFICER 0 23068 0 37533 0 117443 0 1467 0 804 0 180315 0 0 PART I, LINE 4A DETAIL OF SEVERANCE PAYMENTS: SARAH RICHARDSON, FORMER CHIEF INFORMATION OFFICER RESIGNED 2/2/16, AND RECEIVED A SEVERANCE PAYMENT OF $115,877 FOR CALENDAR YEAR 2016. PART I, LINE 7 PROVISIONS OF NON-FIXED PAYMENTS THIS ORGANIZATION IS AN AFFILIATE OF NCH HEALTHCARE SYSTEM, INC. ("THE SYSTEM"). THE SYSTEM MAY PROVIDE DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES. COMPENSATION PAYMENTS FOR ALL EMPLOYEES EXCLUDING THE CEO AND SENIOR LEADERSHIP TEAM IS DETERMINED BY THE SYSTEM BOARD OF TRUSTEES HUMAN RESOURCES COMMITTEE AND/OR CEO. COMPENSATION PAYMENTS MADE TO ANY DISQUALIFIED PERSON IS APPROVED BY THE SYSTEM THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15. RASAI ERNST MD FMLY MEMBER/TRUSTEE 333597 EMPLOYED PHYSICIAN 0 ALYSSA J SCHLOTMANN FMLY MEMBER/OFFICER 11077 EMPLOYEE 0 FORM 990, SCHEDULE L, PART IV MAZEN ALBELDAWI M.D., BOARD TRUSTEE IS THE SPOUSE OF RASAI ERNST, M.D. AN EMPLOYED PHYSICIAN OF NCHMD. FORM 990, SCHEDULE L, PART IV ALYSSA J. SCHLOTMANN IS THE DAUGHTER OF RENEE THIGPEN, CHIEF HUMAN RESOURCES OFFICER. FORM 990, PART III, LINE 3 RHUEMATOLOGY AND CHRONIC CARE SERVICE LINES WERE DISCONTINUED DURING 2017 FORM 990, PART III, LINE 4, PROGRAM SERVICES NCHMD, INC. ("NCH PHYSICIAN GROUP") PROVIDES OUTPATIENT HEALTHCARE SERVICES WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY. DURING 2017, NCHMD, INC. PROVIDED $2,692,333 OF CHARITY CARE TO PATIENTS WHO WERE UNABLE TO PAY AND NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PROGRAM. ADDITIONALLY, NCHMD, INC. WROTE OFF $1,777,899 CLASSIFIED AS BAD DEBTS. THE SERVICES OFFERED WITHIN THE NCH PHYSICIAN GROUP ARE EXTENSIVE AND INCLUDE A VARIETY OF MEDICAL SPECIALTIES SUCH AS CARDIOLOGY, PULMONARY, FAMILY MEDICINE, PEDIATRICS, INTERNAL MEDICINE, RADIOLOGY AND URGENT CARE. A TOTAL OF 565 FULL-TIME EQUIVALENT EMPLOYEES, WHICH INCLUDE 245 LICENSED INDEPENDENT PRACTITIONERS, COMPRISE THE OUTSTANDING MEDICAL TEAM WORKING TOGETHER TO PROVIDE THESE SERVICES IN 2017. FORM 990, PART VI, SECTION A, LINE 6 GOVERNING BODY AND MANAGEMENT NCH HEALTHCARE SYSTEM,INC. IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A GOVERNING BODY AND MANAGEMENT NCH HEALTHCARE SYSTEM, INC. SOLE MEMBER OF THIS ORGANIZATION, ELECTS THIS ORGANIZATION'S DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B GOVERNING BODY AND MANAGEMENT ALL OF THE GOVERNANCE DECISIONS FOR NCHMD, INC. ARE RESERVED TO THE GOVERNING BODY OF NCH HEALTHCARE SYSTEM, INC. FORM 990, PART VI, SECTION B, LINE 11B REVIEW PROCESS INFORMATION RELATED TO NCHMD, INC.'S ("NCHMD") FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO RSM US LLP FOR REVIEW. AFTER THE REVIEW BY RSM US LLP THE TAX RETURN IS REVIEWED BY THE NCH HEALTHCARE SYSTEM CHIEF OF STAFF AND CHIEF FINANCIAL OFFICER. THE TAX RETURN IS THEN REVIEWED BY THE CHAIRMAN OF THE NCH FINANCE COMMITTEE AND OUTSIDE COUNSEL FOR THE BOARD. PRIOR TO BOARD APPROVAL, THE 990 IS PROVIDED TO ALL OF THE BOARD OF TRUSTEES FOR THEIR REVIEW VIA THE BOARD PORTAL. AT THE CONCLUSION OF THIS REVIEW PROCESS THE FORM 990 IS APPROVED BY THE BOARD OF TRUSTEES (EXECUTIVE COMMITTEE) PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY ANNUALLY, ALL NCH HEALTHCARE SYSTEM, INC. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE INTERESTS THAT COULD POTENTIALLY GIVE RISE TO CONFLICTS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. MANAGEMENT SHALL DISCLOSE OTHER POTENTIAL CONFLICTS WITH THE COMPLIANCE OFFICER. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINED UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. THE COMPLIANCE OFFICER WILL DETERMINE IF A MANAGEMENT TEAM MEMBER OR EMPLOYEE SHOULD BE EXCUSED FROM A DISCUSSION OR PARTICIPATE IN A DECISION IN WHICH THERE MAY BE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS THIS ORGANIZATION IS AN AFFILIATE OF THE NCH HEALTHCARE SYSTEM, INC. ("THE SYSTEM"). COMPENSATION ARRANGEMENTS INVOLVING OUR CEO AND SENIOR LEADERSHIP TEAM ARE ESTABLISHED BY THE SYSTEM BOARD OF TRUSTEES COMPENSATION COMMITTEE PURSUANT TO A PROCESS THAT SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR SECTION 4958 EXCESS BENEFIT TRANSACTION TAX PURPOSES (WHICH REQUIRES A REVIEW OF COMPENSATION DETERMINATION BY DISINTERESTED PERSONS, USE OF APPROPIATE COMPARABILITY DATA, AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS). FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE TO THE PUBLIC THE FORMS 1023 AND 990, GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY OF NHSI ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO AVAILABLE VIA OUR WEBSITE: HTTP://WWW.NCHMD.ORG/ABOUT-US/ANNUAL-REPORTS. DOCUMENTS AVAILABLE FOR REQUEST ARE AVAILABLE PURSUANT TO THE PERIOD OF DISCLOSURE PROVIDED IN SECTION 6104(D). FORM 990, PART IX, LINE 9, OTHER EMPLOYEE BENEFITS BENEFIT EXPENSES CONTAIN A NON-CASH PAYMENT TRANSFER FROM NAPLES COMMUNITY HOSPITAL OF $2,215,181. FORM 990, PART XI, LINE 9: TRANSFERS FROM AFFILIATES 37,923,569. NCH HEALTHCARE SYSTEM INC PO BOX 413029 NAPLES FL 34101 592314655 HOLDING CO FL 501(C) (3) LINE 12B, II N/A 0 NAPLES COMMUNITY HOSPITAL INC PO BOX 413029 NAPLES FL 34101 590694358 HEALTHCARE FL 501(C) (3) LINE 3 NCH SYSTEM 0 MARCO ISLAND HOSPITAL INC 40 HEATHWOOD DRIVE MARCO ISLAND FL 34145 592315435 HEALTHCARE FL 501(C) (3) LINE 3 NCH SYSTEM 0 COMMUNITY HOME SERVICES INC PO BOX 413029 NAPLES FL 34101 592440516 SUPPORT ORG. FL 501(C) (3) LINE 12B, II NCH SYSTEM 0 COLLIER HEALTH CARE INC PO BOX 413029 NAPLES FL 34101 650244276 HEALTHCARE FL 501(C) (3) LINE 3 NCH SYSTEM 0 HEALTH RESOURCES CORPORATION 350 7TH STREET NORTH NAPLES FL 34102 592568003 HOLDING COMPANY FL NCH SYSTEM C 0 AMBULATORY SURGICAL CARE CENTER INC 350 7TH STREET NORTH NAPLES FL 34102 592568029 OUTPAT. SURGERY FL HRC C 0 COMMUNITY HOME CARE INC 350 7TH STREET NORTH NAPLES FL 34102 592372966 HOME HEALTH FL HRC C 0 COMMUNITY IMAGING INC 350 7TH STREET NORTH NAPLES FL 34102 592446336 RADIOLOGY LAB FL HRC C 0 1 1 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 1