2016-08-10T07:42:09-05:00 2015-09-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 31708 990 2014-10-01 593322533 SOUTH LAKE HOSPITAL INC SOUT 3523944071 1900 DON WICKHAM DRIVE CLERMONT FL 347111979 LANCE SEWELL CFO 3523944071 2016-08-15 true JACQUELINE G ATKINS P00861721 2298837878 2016-08-09 2014 2016-12-15 16:53:06Z JOHN A MOORE PRESIDENT 1900 DON WICKHAM DRIVE CLERMONT FL 347111979 196318625 false X WWW.SOUTHLAKEHOSPITAL.COM X 1995 FL TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE INDIVIDUALS AND COMMUNITIES IN SOUTH LAKE COUNTY. 6 3 1370 148 2928253 -760635 3834739 3541618 142949677 161834810 807505 1540861 5262581 4381988 152854502 171299277 1025456 56994 0 63667495 75219981 0 0 71369421 79149563 136062372 154426538 16792130 16872739 279327846 298931701 108986569 111757267 170341277 187174434 TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE INDIVIDUALS AND COMMUNITIES IN SOUTH LAKE COUNTY. false false 128114525 56994 162115046 OPERATION OF NOT-FOR-PROFIT HOSPITAL PROVIDING INPATIENT, OUTPATIENT, & EMERGENCY CARE FOR RESIDENTS OF SOUTHERN LAKE COUNTY FLORIDA. 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. TOTAL PATIENT DAYS FOR THE FISCAL YEAR WAS APPROXIMATELY 38,000. 128114525 true true false true false false false false false true true false false false true true true false false false false false false false false false true true false true true true true false false false false false false true false false false false false false false true false false false true 168 0 1370 true true true false false false false false false false false false X 6 3 false true false false false true false true true false false false true true true true true false false false FL X LANCE SEWELL CFO 3522417104 1900 DON WICKHAM DRIVE CLERMONT FL 347111979 LUSHANTHA GUNASEKERA MD BOARD MEMBER 40.00 5.00 X 0 695452 51613 MILDRED BEAM VICE PRESIDE 40.00 5.00 X X 0 591190 74287 CARY D'ORTONA TREASURER 40.00 5.00 X X 0 230073 60974 SUSAN MCLEAN BOARD PRESID 2.00 X X 0 0 0 ROBERT E BERENS JR SECRETARY 2.00 X X 0 0 0 DAVID BATMAN BOARD MEMBER 2.00 1.00 X 0 0 0 JOHN MOORE HOSPITAL PRE 40.00 1.00 X 0 313492 79978 LANCE SEWELL CFO 40.00 1.00 X 0 184497 45783 PAUL JOHNS COO 40.00 X 0 156186 32077 LINDA WALTON CNO 40.00 X 0 153171 53804 BRAHMBHATT JAMIN MD PHYSICIAN 40.00 X 442736 0 33225 PAREKATTIL SIJO MD PHYSICIAN 40.00 X 439182 0 33225 ANDREW KAREN MD PHYSICIAN 40.00 X 363651 0 32172 JEROME STURM MD PHYSICIAN 40.00 X 317624 0 34283 JACOB SINDU MD PHYSICIAN 40.00 X 196376 0 16783 SHERRIE SITARIK FORMER PRESI X 0 978146 14406 1759569 3302207 562610 24 true true false ORIGIN DBA SHIFTWISE 2501 SW 1ST AVE PORTLAND OR 972014752 NURSE STAFFING 2598548 OB HOSPITALIST GROUP 10 CENTIMETERS DRIVE MAULDIN SC 296623278 HEALTHCARE SVS 1694221 AVI FOOD SYSTEMS 2590 ELM ROAD NE WARREN OH 444832904 MGMT FOOD SVCS 1169752 BIG TEN LLC 2020 OAKLEY SEAVER DR CLERMONT FL 347111902 MGMT SURGICAL 932025 ROBINS & MORTON GROUP 400 SHADES CREEK PKWY BIRMINGHAM AL 352094454 CONSTRUCTION SV 909705 41 3190439 219049 132130 3541618 PROGRAM SERVICE REVENUE 623000 161834810 161834810 161834810 898238 898238 390866 298199 92667 92667 92667 25319510 44262 24696132 25017 623378 19245 642623 642623 NATIONAL TRAINING CENTER 623000 2928253 2928253 FOOD AND BEVERAGE 722210 1080832 1080832 EHR HOSPITAL 621990 184238 184238 95998 95998 4289321 171299277 162115046 2928253 2714360 X 56994 56994 61028892 55127626 5901266 1491276 1347076 144200 8671330 7832845 838485 4028483 3654336 374147 591 591 375289 375289 252437 252437 21817396 12535907 9281489 329484 68671 260813 15430352 14678746 751606 95976 77011 18965 3016595 2925192 91403 162163 126535 35628 4972665 4972665 10223296 9913530 309766 1588105 1588105 MEDICAL SUPPLIES 15271526 15271526 REPAIRS AND MAINTENANCE 2063163 1740892 322271 PROVIDER FEES 1631660 1631660 RECRUITING 558858 558858 1360007 1125978 234029 154426538 128114525 26312013 0 87427 41234584 51867127 17701205 19597131 1024380 1485863 2481319 2731861 1150617 1271353 234204801 87725742 132973227 146479059 60784830 72260571 51707 77005 4504031 7570655 6701976 6223619 279327846 298931701 21379263 25376914 423925 442725 83185383 81652993 2108019 1928603 1889979 2356032 108986569 111757267 X 168809549 185563306 1531728 1611128 170341277 187174434 279327846 298931701 X 16872739 -156999 117417 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 9451 false true 5229 14680 false SCHEDULE C, PART II-B, LINE 1 THE HOSPITAL PAYS MEMBERSHIP DUES TO A STATE HEALTHCARE ORGANIZATION. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THE STATE HEALTHCARE ORGANIZATION PARTICIPATES. ADDITIONALLY, THE DIRECTOR OF GOVERNMENT RELATIONS SPENDS APPROXIMATALY 10% OF HIS TIME LOBBYING FOR THE ORGANIZATION. 1531728 387542 56714 251428 1611128 1421671 181257 25456 45744 1531728 1322778 230518 67250 64375 1421671 1372263 227295 80246 196534 1322778 1330725 196127 4888 75235 84242 1372263 1.00000 true false 752000 11159435 11911435 141998735 40003433 101995302 4407547 1378489 3029058 71366516 46343820 25022696 4520568 4520568 146479059 THIRD PARTY SETTLEMENTS 1632500 RAC RESERVE 443257 OTHER LIABILITIES 280275 2356032 X 171004256 -156999 355193 198194 170806062 493215 493215 171299277 154336417 298199 298199 154038218 388320 388320 154426538 SCHEDULE D, PAGE 2, PART V, LINE 4 CAPTAIN HOMER N. ALLEN FUND FOR NURSING SCHOLARSHIPS PROVIDES SUPPORT FOR SCHOLARSHIPS FOR RESIDENTS OF SOUTH LAKE COUNTY AND/OR EMPLOYEES OF SOUTH LAKE HOSPITAL WHO WISH TO FURTHER THEIR EDUCATION IN THE FIELD OF NURSING. OTHER RESTRICTED FUNDS ARE AVAILABLE FOR THE ACQUISITION OF FIXED ASSETS AND OTHER OPERATING USES. ORLANDO HEALTH FOUNDATION (AN AFFILIATE OF ORLANDO HEALTH, A RELATED ORGANIZATION) HOLDS AND ADMINISTERS CERTAIN DONOR RESTRICTED FUNDS ON BEHALF OF SOUTH LAKE HOSPITAL. THE AMOUNT HELD WAS 756,057 AS OF SEPTEMBER 30, 2015. SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2015 AND 2014 OR FOR THE YEARS THEN ENDED. FOR FEDERAL INCOME TAX PURPOSES THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. SCHEDULE D, PAGE 4, PART XI, LINE 2D RENTAL EXPENSES 298,199 NET ASSETS RELEASED FROM RESTRICTIONS 56,994 SCHEDULE D, PAGE 4, PART XI, LINE 4B CAPITAL CONTRIBUTIONS 161,889 GRANT EXPENSE NETTED AGAINST REVENUE 331,326 SCHEDULE D, PAGE 4, PART XII, LINE 2D RENTAL EXPENSE 298,199 SCHEDULE D, PAGE 4, PART XII, LINE 4B GRANT EXPENSE NETTED AGAINST REVENUE 331,326 SCHOLARSHIPS RELEASED FROM RESTRICTION 56,994 true true X true X true X true true true false true true 5788280 5788280 0.03740 11979532 16646768 -4667236 11434960 8675816 2759144 0.01780 29202772 25322584 3880188 0.05520 474734 474734 0.00310 100598 56994 43604 0.00030 273345 104042 169303 0.00110 584059 584059 0.00380 1432736 161036 1271700 0.00830 30635508 25483620 5151888 0.06350 true 16832198 12624149 37867928 43521353 -5653425 X true true 1 1 SOUTH LAKE HOSPITAL 1900 DON WICKHAM DRIVE CLERMONT FL 347111979 WWW.SOUTHLAKEHOSPITAL.COM 4180 X X X SURG CTR, REHAB, MRI, HH SOUTH LAKE HOSPITAL 1 false false true X X X X X X X X 13 true false false true X WWW.SOUTHLAKEHOSPITAL.COM X true 13 true WWW.SOUTHLAKEHOSPITAL.COM false false true X 200.000000000000 400.000000000000 true true X X X true X WWWSOUTHLAKEHOSPITALCOM X WWWSOUTHLAKEHOSPITALCOM X WWWSOUTHLAKEHOSPITALCOM X X X X true X true X X X true X false false FACILITY 1, SOUTH LAKE HOSPITAL - PART V, LINE 5 IN ORDER TO DETERMINE THE COMMUNITY'S PERSPECTIVES ON PRIORITY COMMUNITY HEALTH ISSUES AND QUALITY OF LIFE ISSUES RELATED TO HEALTHCARE, TWO RESEARCH METHODS WERE USED: FOCUS GROUPS AND PROVIDERS SURVEYS. THE STEERING COMMITTEE WORKED WITH WELLFLORIDA COUNCIL TO DETERMINE FOCUS GROUP QUESTIONS AND PROVIDER SURVEY QUESTIONS. FOCUS GROUP PARTICIPANTS WERE RECRUITED BY COMMUNITY LEADERS AT ORGANIZATIONS AND AGENCIES HOSTING THE FOCUS GROUPS AS WELL AS BY FLYERS DISTRIBUTED THROUGHOUT THE COMMUNITY, PRESS RELEASES AND E-MAIL BLASTS DISTRIBUTED TO THE SOUTH LAKE HOSPITAL CONTACT LIST. IN TOTAL, 29 COMMUNITY MEMBERS PARTICIPATED IN THE FOCUS GROUPS. THE SOUTH LAKE HOSPITAL STEERING COMMITTEE, REPRESENTING SOUTH LAKE HOSPITAL, WORKED WITH WELLFLORIDA COUNCIL TO FORMULATE A PROVIDER SURVEY THAT WOULD TOUCH UPON SOME OF THE SAME TOPICS ADDRESSED DURING THE FOCUS GROUPS. WORKING IN COOPERATION WITH THE FACILITIES REPRESENTED BY STEERING COMMITTEE MEMBERS, THE SURVEYS WERE DISTRIBUTED TO LAKE COUNTY PROVIDERS IN MARCH 2013. RESPONDENTS COMPLETED THE SURVEY USING SURVEY MONKEY TO SUBMIT THEIR RESPONSES. TWENTY-NINE PROVIDERS SUBMITTED RESPONSES TO THE SURVEY. FACILITY 1, SOUTH LAKE HOSPITAL - PART V, LINE 11 PROGRESS ON CHNA INPLEMENTATION STRATEGIES 2014-2015: IN FISCAL YEAR 2015, SOUTH LAKE HOSPITAL FOCUSED ON ADDRESSING THE COMMUNITY HEALTH NEEDS IDENTIFIED IN OUR 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. BELOW IS AN UPDATE ON THE VARIOUS EFFORTS MADE BY THE HOSPITAL THROUGHOUT THE FISCAL YEAR 2015 ON EACH IDENTIFIED NEED. NEED TO ADDRESS: DISPARITY OF NUMEROUS HEALTH FACTORS FOR GROVELAND/MASCOTTE AREA RESIDENTS THE GOAL IS TO EDUCATE RESIDENTS IN THE CITIES OF GROVELAND AND MASCOTTE AND THE SURROUNDING AREAS ABOUT DIABETES, HEART DISEASE AND CHRONIC LOWER RESPIRATORY DISEASE (CLRD) PREVENTION AND IMPORTANT CANCER SCREENINGS. THE HOSPITAL WORKING TO ACHIEVE THIS GOAL THROUGH EDUCATIONAL EVENTS IN COLLABORATION WITH FAITH-BASED AND COMMUNITY ORGANIZATIONS, WORKING WITH LOCAL LEADERS TO ENSURE THAT THEY ARE AWARE OF HEALTH RESOURCES FOR UNINSURED AND UNDERINSURED RESIDENTS AND WORKING IN THE SCHOOLS TO TEACH THE IMPORTANCE OF PREVENTION. IN FISCAL YEAR 2015, SOUTH LAKE HOSPITAL MADE EFFORTS TOWARD THIS GOAL BY: - WORKED WITH GROVELAND AND MASCOTTE ELEMENTARY SCHOOLS TO ATTEND THEIR AFTERCARE PROGRAM FOR THE THIRD YEAR IN A ROW AND PROVIDE AN INTERACTIVE, EDUCATIONAL PROGRAM FOR THEIR STUDENTS. AN EXERCISE PHYSIOLOGIST PRESENTED ON NUTRITION, TEACHING THE CHILDREN ABOUT THE FOOD GROUPS AND HOW TO MAKE A HEALTHY, BALANCED MEAL. THE CHILDREN WERE THEN TASKED WITH PUTTING TOGETHER A BALANCED MEAL USING DIFFERENT FOOD CHOICES (FAKE FOOD MODELS). THEY WERE GIVEN SIMPLE, INEXPENSIVE RECIPES TO TAKE HOME TO ENCOURAGE THEIR PARENTS TO PREPARE BALANCED MEALS. RECIPES WERE FOCUSED ON READILY AVAILABLE, INEXPENSIVE HEALTHY FOOD CHOICES TO MAKE THE MEALS AFFORDABLE AND ACHIEVABLE. ALL PARTICIPANTS WERE ALSO SENT HOME WITH INFORMATION ON CREATING HEALTHY FOOD PLATES AND TIPS FOR EXERCISING AT HOME OR AT LOCAL PARKS. THE STUDENTS THEN PARTICIPATED IN A FUN EXERCISE CLASS SET TO MUSIC TO SHOW THEM HOW EASY IT IS TO GET ACTIVE. THE THIRD PART OF THE PROGRAM TAUGHT THE IMPORTANCE OF HANDWASHING AND AN INTERACTIVE DEMONSTRATION WAS DONE TO ENSURE THE CHILDREN KNEW HOW TO PROPERLY SCRUB AND WASH THEIR HANDS. - VISITED PHYSICIAN PRACTICES THROUGHOUT THE GROVELAND AND MASCOTTE COMMUNITIES, INCLUDING THE LARGE SLIDING SCALE CLINIC - COMMUNITY HEALTH CENTERS - TO ENSURE THEY ALL HAVE INFORMATION TO DISTRIBUTE ON SOUTH LAKE HOSPITAL'S EDUCATIONAL RESOURCES AND PROGRAMS FOR UNINSURED RESIDENTS. THE HOSPITAL OFFERS FREE SMOKING CESSATION CLASSES; FREE DIABETES AWARENESS CLASSES AND SUPPORTS A FREE HEALTH CLINIC FOR UNINSURED RESIDENTS WHO CAN RECEIVE FREE PRESCRIPTION MEDICATIONS AND PREVENTATIVE SCREENINGS. - THE HOSPITAL PARTNERED WITH MASCOTTE ELEMENTARY TO CREATE A "MORNING MILE CLUB." THE CONCEPT WAS PRESENTED TO THE HOSPITAL BY A LOCAL ELEMENTARY STUDENT WHO FELT HER PEERS NEEDED MORE PHYSICAL ACTIVITY. AT ANOTHER SOUTH LAKE COUNTY SCHOOL, SHE OBTAINED SPONSORS AND GOT SCHOOL BUY-IN TO CREATE A MORNING WALKING CLUB THAT REWARDED STUDENTS FOR WALKING ON THE SCHOOL GROUNDS PRIOR TO SCHOOL DAY STARTING. WHEN MILESTONES WERE REACHED IN THE NUMBER OF LAPS, STUDENTS WERE REWARDED WITH CHARMS/TOKENS FOR A MORNING MILE NECKLACE. THE PROGRAM PROVED SUCCESSFUL AND THE STUDENT WANTED SOUTH LAKE HOSPITAL TO PARTNER WITH ANOTHER LOCAL SCHOOL TO HELP GROW THE PROGRAM IN THE COMMUNITY. SOUTH LAKE HOSPITAL AGREED TO FOCUS EFFORTS AT MASCOTTE ELEMENTARY SCHOOL AND HELPED LAUNCH THE PROGRAM IN FALL OF 2015. THE PROGRAM WILL BE EVALUATED AFTER ONE YEAR FOR EFFECTIVENESS AND PARTICIPATION. - IN SUMMER OF 2015, SOUTH LAKE HOSPITAL BEGAN COLLABORATING WITH LOCAL HEALTH PARTNERS TO BEGIN THE PLANNING PHASE FOR A HEALTH RESOURCE EVENT TO BE HELD JANUARY 2016 IN MASCOTTE. THIS EVENT WILL TARGET RESIDENTS IN GROVELAND, MASCOTTE AND THE SURROUNDING AREA. THE AIM OF THIS EVENT IS TO SELECT KEY PARTNERS THAT CAN PROVIDE PREVENTATIVE SCREENINGS AT NO COST TO RESIDENTS THAT MAY NOT OTHERWISE BE ABLE TO AFFORD THE SCREENINGS AND TO OFFER EDUCATION ON PREVENTION. SCREENINGS WILL INCLUDE FREE CHOLESTEROL AND GLUCOSE SCREENINGS, KIDNEY URINALYSIS SCREENING, MAMMOGRAMS AND FLU SHOTS. PARTNERS INCLUDED THE NATIONAL KIDNEY FOUNDATION, COMMUNITY FOUNDATION OF SOUTH LAKE, LIBBY'S LEGACY, COMMUNITY HEALTH CENTERS AND THE FLORIDA DEPARTMENT OF HEALTH - LAKE COUNTY. NEED TO ADDRESS: TEENAGE BIRTH RATES & LOW BIRTH RATES THE GOAL IS TO REDUCE BOTH THE NUMBER OF TEENAGE BIRTH RATES AND THE NUMBER OF INFANT DEATHS FOR THE SERVICE AREA, PARTICULARLY IN THE AFRICAN AMERICAN POPULATION. INFANT DEATH RATES DIRECTLY CORRELATE WITH LOW BIRTH WEIGHTS SO THE FOCUS IS TO EDUCATION WOMEN ON PROPER PRENATAL CARE TO LEAD TO FULL TERM DELIVERIES. IN FISCAL YEAR 2015, SOUTH LAKE HOSPITAL MADE EFFORTS TOWARD THESE GOALS BY: - SOUTH LAKE HOSPITAL OFFERS NUMEROUS EDUCATION COURSES FOR EXPECTING MOMS THAT EDUCATES ABOUT PRENATAL CARE THAT FOCUSES ON DELIVERING HEALTHY, FULL-TERM BABIES. THE HOSPITAL IDENTIFIED THAT MANY PARENTS THAT MAY BE AT RISK FOR LOW BIRTH RATES ARE UNABLE TO AFFORD THE CLASSES, WHICH ARE ALREADY AT A LOW RATE COMPARATIVELY IN THE CENTRAL FLORIDA MARKET. THE HOSPITAL FOUNDATION APPLIED FOR A GRANT THROUGH THE LOCAL MARCH OF DIMES CHAPTER FOR FUNDS TO PROVIDE FREE EDUCATION CLASSES ON PRENATAL CARE AND WAS AWARDED A 3,000 GRANT. THE GRANT BEGAN IN APRIL 2015 AND ALLOWS ALL RESIDENTS OF LAKE COUNTY TO ATTEND CHILDBIRTH CLASSES, NEWBORN CARE CLASSES AND BREASTFEEDING EDUCATION CLASSES AT NO COST. IN 2015, 74 EXPECTANT MOTHERS ATTENDED FREE CLASSES THANKS TO THE GRANT. THE GRANT FUNDING WAS UTILIZED IN FULL PRIOR TO THE END OF 2015, AT WHICH TIME SOUTH LAKE HOSPITAL CONTINUED TO LET EXPECTANT MOTHERS TO TAKE CLASSES AT NO COSTS AND SERVED AN ADDITIONAL 18 NEW MOTHERS. - IN FISCAL YEAR 2015, SOUTH LAKE HOSPITAL PARTNERED WITH THE FLORIDA DEPARTMENT OF HEALTH - LAKE COUNTY TO ALLOW THEIR LABOR AND DELIVERY PATIENTS TO DELIVER AT SOUTH LAKE HOSPITAL. PRIOR TO THE ARRANGEMENT, THE DEPARTMENT HAD TO SEND ALL OF THEIR PATIENTS TO A HOSPITAL IN THE NORTH END OF LAKE COUNTY, WHICH IS APPROXIMATELY 20 MILES FROM AREAS IN SOUTH LAKE COUNTY. THE HEALTH DEPARTMENT WAS ABLE TO OPEN A PRENATAL CLINIC IN THE SOUTH END OF LAKE COUNTY AS WELL, PROVIDING MORE ACCESSIBILITY FOR RESIDENTS IN THE HOSPITAL'S SERVICE AREA TO PRENATAL CARE, OBSTETRICS EMERGENCY CARE AND DELIVERY SERVICES. PRIOR TO THE OPENING OF THIS PRENATAL CLINIC, PATIENTS ALSO HAD TO TRAVEL TO THE NORTH END OF THE COUNTY FOR PRENATAL CARE, WHICH CAUSED TRANSPORTATION CHALLENGES. THIS NEW PARTNERSHIP PROVIDES EXCELLENT OBSTETRICS CARE TO PATIENTS IN SOUTH LAKE HOSPITAL'S DISTRICT DUE TO THE OBSTETRICS HOSPITALIST PROGRAM, WHICH ENSURES A BOARD-CERTIFIED OBSTETRICIAN IS ONSITE IN THE LABOR AND DELIVERY DEPARTMENT 24 HOURS A DAY, SEVEN DAYS A WEEK. - SOUTH LAKE HOSPITAL PARTNERED WITH THE YOUNG FAMILIES HEALTH INITIATIVE COMMITTEE OF LAKE COUNTY (YFHI) TO SPONSOR AND PROVIDE EDUCATION DURING THEIR 2015 WORLD'S BEST BABY FAIR IN SOUTH LAKE COUNTY. THE EVENT IS AIMED AT FIRST-TIME OR SPECIAL NEEDS PARENTS AND INCLUDES LECTURES ON PRENATAL CARE, NUTRITION, EXERCISE AND SUPPORT RESOURCES FOR EXPECTING MOTHERS AND THEIR FAMILIES. - IN FISCAL YEAR 2015, SOUTH LAKE HOSPITAL COMMITTED RESOURCES TO HOST THE 2016 MARCH OF DIMES MARCH FOR BABIES FOR LAKE AND SUMTER COUNTIES. THE HOSPITAL'S WELLNESS AND SPORTS FACILITIES PLUS STAFF TIME ARE BEING DONATED TO THE EVENT TO HELP RAISE AWARENESS OF THE MISSION OF THE MARCH OF DIMES AND TO CREATE AWARENESS ON THE IMPORTANCE OF PRENATAL CARE FOR FULL-TERM PREGNANCIES. NEED TO ADDRESS: KNOWLEDGE OF AVAILABLE HEALTHCARE RESOURCES AND HEALTHCARE EDUCATION IN THE COMMUNITY THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THAT KEY STAKEHOLDERS LACKED THE INFORMATION NECESSARY TO UNDERSTAND WHAT HEALTH CARE RESOURCES ARE AVAILABLE IN THE SOUTH LAKE HOSPITAL SERVICE AREA AND THE COUNTY AS A WHOLE. THIS INCLUDES INFORMATION ON HOW TO ACCESS TRANSPORTATION SERVICES, AVAILABLE INDIGENT CARE FACILITIES, FINANCIAL ASSISTANCE PROGRAMS AND PHARMACEUTICAL PROGRAMS. IN FISCAL YEAR 2015, SOUTH LAKE HOSPITAL MADE EFFORTS TOWARD THIS GOAL BY: - SOUTH LAKE HOSPITAL CONTINUED TO UTILIZE AND PROMOTE CENTRAL FLORIDA UNITED WAY'S 211 PROGRAM AND ENSURE THAT THEY HAVE ACCURATE INFORMATION ABOUT SOUTH LAKE HOSPITAL'S COMMUNITY EDUCATION PROGRAMMING AS WELL AS SERVICES FOR THE UNDER AND UNINSURED RESIDENTS. THE HOSPITAL STAFF WAS EDUCATED ON 211 AND HOW IT CAN BE UTILIZED BY HOSPITAL STAFF, PATIENTS AND FAMILY MEMBERS FOR IDENTIFYING HEALTH CARE RESOURCES. IN ADDITION, SOUTH LAKE HOSPITAL PARTNERED WITH UNITED WAY DURING OPEN ENROLLMENT TO ASSIST RESIDENTS IN NAVIGATING THE HEALTHCARE EXCHANGES SO THAT THOSE WITHOUT INSURANCE COULD RECEIVE HELP IN IDENTIFYING AFFORDABLE CARE OPTIONS. THE HOSPITAL DONATED SPACE FOR A HEALTHCARE NAVIGATOR TO MEET WITH RESIDENTS AND PROMOTED THE USE OF UNITED WAY'S 211 PROGRAMS FOR CONSOLATIONS. - SOUTH LAKE HOSPITAL FOCUSES ITS OUTREACH EFFORTS TO LOCAL SCHOOLS, THE LOCAL HEALTH DEPARTMENT, FAITH BASED ORGANIZATIONS A 3 NATIONAL TRAINING CENTER 1935 DON WICKHAM DRIVE CLERMONT FL 347111979 WELLNESS CENTER SOUTH LAKE SURGICAL CENTER 1935 DON WICKHAM DRIVE CLERMONT FL 347111979 OUTPATIENT SURGERY SOUTH LAKE HOME HEALTH AGENCY 1935 DON WICKHAM DRIVE CLERMONT FL 347111979 HOME HEALTH PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE IF TOTAL OF ALL OPEN BILLS ACCOUNTS FOR MORE THAN 25% OF THEIR ANNUAL INCOME, DISCOUNT WILL BE APPLIED TO REACH THE 25% MARK, PROVIDED PATIENT'S INCOME DOES NOT EXCEED 400% OF THE FPG. PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION SUBSIDIZED HEALTH SERVICES REPRESENT THE OPERATIONAL COSTS FOR THE FREE CLINIC TO CARE FOR INDIGENT PATIENTS OF SOUTH LAKE COUNTY. PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 154,426,538 ADD: EXPENSES REPORTED IN PART VIII 298,199 DENOMINATOR FOR COLUMN (F) 154,724,737 PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE ORGANIZATION USES THE COST TO CHARGE RATIO USING THE IRS' RECOMMENDED FORMAT IN WORKSHEET 2. OTHER COSTS IN PART I, LINES 7E THROUGH 7I WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. THE AMOUNT INCLUDED ON PART III LINE 3 IS BASED ON HISTORICAL DATA FOR THOSE INDIVIDUALS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY; HOWEVER, FAILED TO COMPLETE THE APPLICATION PROCESS. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS SEE THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE ON PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8 - MEDICARE EXPLANATION MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION BOTH DISCOUNTS AND PAYMENTS TO ACCOUNTS WILL REDUCE THE BAD DEBT EXPENSE, SHOULD THE ACCOUNT BE REPORTED AS BAD DEBT. THAT IS TO SAY, DISCOUNTS APPLIED TO ACCOUNTS ARE NOT REVERSED PRIOR TO DECLARING, ADJUSTING AND/OR WRITING OFF ACCOUNTS AS BAD DEBT. ALL ACCOUNTS WHICH ARE ADJUSTED TO, OR WRITTEN OFF TO, BAD DEBT ARE REVIEWED TO DETERMINE THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. IF SUFFICIENT DOCUMENTATION WAS NOT PROVIDED BY THE ACCOUNT HOLDER, SOUTH LAKE USES PREDICTIVE ANALYTICS TO DETERMINE IF THE ACCOUNT WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. THE PREDICTIVE ANALYTICS DESIGNED TO ASSESS FINANCIAL ASSISTANCE FOR ACCOUNTS ADJUSTED TO, OR WRITTEN OFF TO, BAD DEBT USES DATA DERIVED FROM THIRD PARTIES WHICH INCLUDE, BUT ARE NOT LIMITED TO DEMOGRAPHIC VERIFICATION, INCOME VERIFICATION, HOUSEHOLD SIZE VERIFICATION, PAYMENT HISTORY INFORMATION, PROPERTY OWNERSHIP INFORMATION, OCCUPATION INFORMATION, VEHICLE OWNERSHIP HISTORY AND VALUES AND HOME OWNERSHIP HISTORY AND VALUES. ONCE THIS DATA LOGIC IS APPLIED, IT BECOMES APPARENT IF THE ACCOUNT QUALIFIES FOR FINANCIAL ASSISTANCE. IF THE ACCOUNT DOES QUALIFY, PREVIOUS UNINSURED DISCOUNTS, BAD DEBT ADJUSTMENTS AND/OR WRITE OFFS ARE REVERSED AND THE NEW BALANCE REFLECTED IS RECLASSIFIED AS FINANCIAL ASSISTANCE OR CHARITY. PART VI, LINE 2 - NEEDS ASSESSMENT SOUTH LAKE DOES ASSESS THE SERVICES NEEDED AS PART OF OUR STRATEGY, PLANNING AND BUDGETING PROCESS AND HAS PROCESSES IN PLACE TO ENSURE THE ORGANIZATION IS REACTIVE TO COMMUNITY HEALTH NEEDS. EXAMPLES OF HOW SOUTH LAKE RESPONDS TO COMMUNITY NEEDS ARE AS FOLLOWS: 1. GOVERNING BOARDS ARE COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE; 2. PARTNERSHIP WITH LOCAL AREA GROUPS AND ASSOCIATES TO ATTEND TO THE HEALTH CARE NEEDS OF THE SOUTH LAKE COMMUNITY; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH FAIRS, COMMUNITY FITNESS, WELLNESS EVENTS AND OTHER OUTREACH EVENTS; AND 4. TRANSITION SERVICES POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS TO PREVENT UNNECESSARY ADMISSIONS AND POTENTIAL RE-ADMISSIONS. SOUTH LAKE MEETS THE NEEDS OF THE COMMUNITY THROUGH ITS EDUCATION, RESEARCH AND PATIENT CARE PROGRAMS. THE SPECIFIC NEEDS TARGETED BY THESE PROGRAMS HAVE BEEN IDENTIFIED BY THE EXPERIENCE OF COMMUNITY HOSPITAL ADVISORY COUNCILS, NEIGHBORHOOD OUTREACH AND THROUGH COMMUNITY NEEDS ASSESSMENTS THAT IDENTIFIED HEALTH PROBLEMS IN THE COMMUNITIES SERVED BY THE HOSPITAL. SOUTH LAKE SPONSORS A VARIETY OF PROGRAMS FOR AT-RISK POPULATIONS, FEDERALLY-DESIGNED MEDICALLY UNDERSERVED AREAS AND SPECIAL NEEDS GROUPS, AS WELL AS FOR THE BROADER COMMUNITY. DURING THE FISCAL YEAR 2013, THE ORGANIZATION, ALONG WITH THE EFFORTS OF WELLFLORIDA COUNCIL, INC., CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT. THE CHNA CAN BE FOUND AT HTTP://WWW.SOUTHLAKEHOSPITAL.COM/ABOUT-US/COMMUNITY-OUTREACH. THE IMPLEMENTATION STRATEGY PLAN CAN ALSO BE FOUND ON THE ORGANIZATION'S WEBSITE AT HTTP://WWW.SOUTHLAKEHOSPITAL.COM/ABOUT-US/COMMUNITY-OUTREACH/COMMUNITY- HEALTH-NEEDS-ASSESSMENT-IMPLEMENTATION-PLAN. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SOUTH LAKE FOLLOWS AN ESTABLISHED PROCESS TO INFORM ALL PATIENTS OF ITS CHARITY CARE AND UNINSURED DISCOUNT POLICIES. DURING PREADMISSION, AT REGISTRATION OR AT BEDSIDE, UNINSURED PATIENTS ARE INFORMED OF THE HOSPITAL'S CHARITY CARE POLICY AND OTHER FINANCIAL ASSISTANCE. FINANCIAL INFORMATION IS SECURED FOR ALL UNINSURED PATIENTS TO SCREEN FOR POSSIBLE ENROLLMENT IN FEDERAL, STATE AND LOCAL PROGRAMS. SOUTH LAKE HAS CONTRACTED DEDICATED ORGANIZATIONS THAT ASSIST THE PATIENT WITH THEIR ENROLLMENT PROCESS ALL THE WAY TO APPROVAL OR DENIAL BY THE RESPECTIVE AGENCIES. FOR UNINSURED PATIENTS THAT ARE DENIED COVERAGE OR DO NOT MEET THE COVERAGE CRITERION FOR A RESPECTIVE AGENCY, SOUTH LAKE THEN SCREENS THE PATIENT FOR CHARITY ELIGIBILITY. IT IS SOUTH LAKE'S OBJECTIVE TO PROVIDE CHARITY CARE TO OUR PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY. PART VI, LINE 4 - COMMUNITY INFORMATION SOUTH LAKE CURRENTLY OPERATES IN THE CENTRAL FLORIDA REGION, WHICH HAS OVER TWO MILLION RESIDENTS AND THOUSANDS OF INTERNATIONAL VISITORS ANNUALLY. SOUTH LAKE'S PRIMARY SERVICE AREA IS COMPRISED OF ORANGE, OSCEOLA, SEMINOLE AND LAKE COUNTIES. THE MEDIAN HOUSEHOLD INCOME IN THESE COUNTIES IS 59,710. TEN PERCENT OF HOUSEHOLDS IN CENTRAL FLORIDA ARE BELOW THE FEDERAL POVERTY GUIDELINE. THE PERCENT UNINSURED (AGE 0-64) FOR THE FOUR COUNTY AREAS ARE 23% AND THERE ARE ELEVEN FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS PRESENT IN THE COMMUNITY. COMMUNITY OUTREACH ACTIVITIES INCLUDE SPEAKER'S BUREAU, SUPPORT/EDUCATION GROUPS, WELLNESS ACTIVITIES, HEALTH FAIRS, CLINICAL SCREENINGS AND ASSESSMENTS, MEDICAL EDUCATION, RESEARCH, WOMEN, CHILDREN AND SENIOR HEALTH INITIATIVES, PUBLIC PROGRAM ENROLLMENT ASSISTANCE AND POST-ACUTE CARE FOR HOMELESS AND UNINSURED, SPONSORSHIPS, SCHOOL INITIATIVES, DONATED MEETING SPACE AND SPIRITUAL CARE. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH SOUTH LAKE HOSPITAL, INC. FURTHERS ITS EXEMPT PURPOSE BY REINVESTING SURPLUS FUNDS IN THE HOSPITAL, EXTENDING ADMITTING PRIVILEGES TO QUALIFYING PHYSICIANS IN THE COMMUNITY AND SURROUNDING AREAS, OPERATING A FREE CLINIC FOR RESIDENTS OF SOUTH LAKE WHO FALL BELOW THE MEDICAID GUIDELINES, OPERATING THE NATIONAL TRAINING CENTER FOR THE OVERALL HEALTH OF THE COMMUNITY AND ENCOURAGING OVERALL COMMUNITY INVOLVEMENT IN THE GOVERNING BODY OF THE ORGANIZATION. GOVERNING BOARDS ARE COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM SOUTH LAKE HOSPITAL, INC. (HOSPITAL) IS PART OF AN AFFILIATED HEALTH CARE SYSTEM WHICH ALSO INCLUDES ORLANDO HEALTH (OH), SOUTH LAKE HOSPITAL FOUNDATION (FOUNDATION), AND SOUTH LAKE COUNTY HOSPITAL DISTRICT (DISTRICT). THE HOSPITAL, LOCATED IN CLERMONT, FL, IS A NOT-FOR-PROFIT HOSPITAL PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SOUTHERN LAKE COUNTY, FL AND SURROUNDING AREAS. OH PROVIDES TRAUMA AND ACUTE CARE TO PATIENTS THROUGHOUT THE CENTRAL FLORIDA AREA AND OFFERS PEDIATRIC AND ADULT PATIENT SERVICES. THE FOUNDATION WAS FOUNDED AND OPERATES TO SUPPORT THE SERVICES OF SOUTH LAKE HOSPITAL. THE FOUNDATION OFFERS SUPPORT TO PATIENTS OF SOUTH LAKE HOSPITAL AS WELL AS THE CHILDREN IN THE COMMUNITY FOR WELLNESS. THE DISTRICT LEVIES AD VALOREM TAXES AND HAS USED THE TAXES COLLECTED TO SUPPORT THE HOSPITAL. true NURSING SCHOLARSHIPS 24 56994 SCHEDULE I, PAGE 1, PART I, LINE 2 NURSING SCHOLARSHIP POLICY IS TO PROVIDE TUITION REIMBURSEMENT FOR ANY APPLICANT WHO MEETS CERTAIN CRITERIA REGARDING EMPLOYMENT, GRADES AND QUALIFICATIONS AS WELL AS SUPERVISORY RECOMMENDATIONS. PROOF OF GRADE AND PAYMENT MUST BE PRESENTED AT THE TIME OF REIMBURSEMENT. true true false false false false false false false LUSHANTHA GUNASEKERA MD BOARD MEMBER 396596 297164 1692 28550 23063 747065 MILDRED BEAM VICE PRESIDENT 372750 140104 78336 58311 15976 665477 52286 CARY D'ORTONA TREASURER 182600 38749 8724 38911 22063 291047 JOHN MOORE HOSPITAL PRESIDENT 217330 84373 11789 57646 22332 393470 8641 LANCE SEWELL CFO 145300 27123 12074 22731 23052 230280 8956 PAUL JOHNS COO 126332 23040 6814 9745 22332 188263 LINDA WALTON CNO 125704 23607 3860 36898 16906 206975 BRAHMBHATT JAMIN MD PHYSICIAN 442352 384 16442 16783 475961 PAREKATTIL SIJO MD PHYSICIAN 438702 480 16442 16783 472407 ANDREW KAREN MD PHYSICIAN 315892 47429 330 17500 14672 395823 JEROME STURM MD PHYSICIAN 266726 49733 1165 17500 16783 351907 JACOB SINDU MD PHYSICIAN 188952 7424 16783 213159 SHERRIE SITARIK FORMER PRESIDENT 978146 14406 992552 SCHEDULE J, PAGE 1, PART I, LINE 3 NONE OF THE INDIVIDUAL BOARD MEMBERS OR OFFICERS ARE COMPENSATED BY THE FILING ORGANIZATION. THE FILING ORGANIZATION, INSTEAD, RELIES ON THE METHODS USED BY THE RELATED ORGANIZATION AND PROVIDER OF MANAGEMENT SERVICES, ORLANDO HEALTH INC. (OH), TO ESTABLISH COMPENSATION OF THE CEO AND EXECUTIVE OFFICERS. COMPENSATION DETERMINATION BY OH INCLUDES AN INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, AND BOARD APPROVAL. THESE METHODS ARE WELL DOCUMENTED. SCHEDULE J, PAGE 1, PART I, LINE 4 MILDRED BEAM 0 55,061 0 CARY D'ORTONA 0 12,600 0 JOHN MOORE 0 31,500 0 LANCE SEWELL 0 9,918 0 PAUL JOHNS 0 7,700 0 LINDA WALTON 0 8,750 0 SHERRIE SITARIK 787,985 0 0 SCHEDULE J, PART III THE 457F DEFERRED COMPENSATION PLAN IS A RETENTION PLAN WHEREBY 7% OF THE EXECUTIVE'S BASE SALARY IS DEPOSITED INTO A LINCOLN ACCOUNT. EACH YEAR'S DEPOSIT IS SUBJECT TO A THREE YEAR VESTING SCHEDULE. UPON VESTING THE ACCOUNT IS TAXED AND PAID OUT LESS ANY 403B DEDUCTIONS. IF THE EXECUTIVE VOLUNTARILY SEPARATES FOR ANY REASON, ALL UNVESTED AMOUNTS ARE FORFEITED. BONUS PLAN DEPARTMENT DIRECTORS RECEIVE AN INCENTIVE FOR THE ACHIEVEMENT OF CERTAIN FINANCIAL, PERSONNEL, CUSTOMER SATISFACTION AND QUALITY GOALS. PHYSICIANS ARE ELIGIBLE FOR BONUS/INCENTIVE PAYMENTS. THESE PAYMENTS ARE BASED ON VARIOUS ORGANIZATIONAL GOALS OF WHICH RELATIVE VALUE UNIT (RVU) EXPECTATIONS MAKE UP ONE OF THE COMPONENTS. A SOUTH LAKE COUNTY HOSP HLTH DIST BOARD OF TRUSTEES 590571600 838640DL1 2010-01-06 52335000 CONSTRUCTION/RENOVATION false true false B SOUTH LAKE COUNTY HOSP HLTH DIST BOARD OF TRUSTEES 590571600 838640DX5 2010-06-03 34330000 REDEMPTION OF 1999 BONDS false true false A 1810000 51998222 5199822 998399 45800001 2011 false false false true B 2610000 33956621 33276360 680262 2010 true false true true A false true true true false false false true B false true true true false false false true A false false false false false false false false false B false false false false false false false false false A false B false ROBERT BERENS JR BOARD MEMBER 388334 BANK OFFICER; CASH false SCHEDULE L, PART V ROBERT E. BERENS, JR., CURRENTLY SERVING AS SECRETARY OF THE GOVERNING BOARD, IS A VICE PRESIDENT AT SEACOAST NATIONAL BANK AND OWNS LESS THAN 1% OF THE BANK'S STOCK. THE BANK HOLDS A CD VALUED AT APPROXIMATELY 388,000 FOR THE FILING ENTITY. FORM 990, PAGE 6, PART VI, LINE 3 ORLANDO HEALTH (OH) PROVIDES THE HOSPITAL'S PRESIDENT, CFO, COO AND CNO PURSUANT TO A MANAGEMENT AGREEMENT WITH THE HOSPITAL. FORM 990, PAGE 6, PART VI, LINE 7A FIFTY PERCENT OF THE BOARD MEMBERS ARE APPOINTED BY OH WHILE THE REMAINING MEMBERS ARE APPOINTED BY SOUTH LAKE MEMORIAL HOSPITAL, INC. ON BEHALF OF SOUTH LAKE COUNTY HOSPITAL DISTRICT ("DISTRICT"), A RELATED ORGANIZATION. THE DISTRICT LEVIES AD VALOREM TAXES AND HAS USED THE TAXES COLLECTED TO SUPPORT THE HOSPITAL. NEITHER RELATED ORGANIZATION HAS TECHNICAL CONTROL OF THE HOSPITAL. FORM 990, PAGE 6, PART VI, LINE 11B THE BOARD CHAIR REVIEWS THE FORM 990 WITH THE CFO IN DETAIL PAYING PARTICULAR ATTENTION TO ANY NEW SCHEDULES AND THE RECONCILIATION TO THE AUDITED FINANCIAL STATEMENTS PRIOR TO FILING WITH THE IRS. THE PUBLIC INSPECTION COPY (WITHOUT CONTRIBUTORS' NAMES AND ADDRESSES) IS THEN ELECTRONICALLY CIRCULATED TO THE CURRENT VOTING BOARD MEMBERS BY SURVEY MONKEY AS AN ATTACHMENT, PRIOR TO FILING WITH THE IRS. FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY, THE COMPLIANCE OFFICER FOR OH PROVIDES A QUESTIONNAIRE TO THE LEADERSHIP, BOARD OF DIRECTORS, DISTRICT BOARD OF TRUSTEES AND MEDICAL STAFF LEADERSHIP FOR DISCLOSURE IN REGARDS TO POTENTIAL CONFLICTS OF INTEREST. THE OH COMPLIANCE OFFICER EVALUATES EACH QUESTIONNAIRE AND WILL REQUEST ADDITIONAL INFORMATION SHOULD IT BE REQUIRED. ANY VOTING RIGHTS OR COMPENSATION RECEIVED IN RELATION TO ANY COMPETING ENTITIES IS QUESTIONED AS WELL AS OWNERSHIP IN ANY VENDOR STOCK DIRECTLY. IF ANY CONFLICT OF INTEREST OCCURS, THAT INDIVIDUAL IS RECUSED FROM THAT PORTION OF THE MEETING REGARDING THE CONFLICTED TRANSACTION. FORM 990, PAGE 6, PART VI, LINE 19 FINANCIAL STATEMENTS ARE MADE AVAILABLE THROUGH CONTINUING DISCLOSURE AGREEMENT WITH DIGITAL ASSURANCE CORPORATION (DAC). GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE SUNSHINE LAW. FORM 990, PART IX, LINE 11G CONTRACT SERVICE 5,253,849 1,067,752 0 REFERENCE LAB 887,461 0 0 PROFESSIONAL FEES 4,585,343 0 0 OTHER FEES 573,977 22,926 0 PURCHASED SERVICES 510,117 5,368,660 0 COURIER 25,353 2,301 0 CONSULTING FEES 13,478 170,625 0 COLLECTION 248,176 2,649,225 0 UBTI - OTHER FEES 438,153 0 0 FORM 990, PART XI, LINE 9 RENTAL EXPENSES 298,199 NET ASSETS RELEASED FROM RESTRICTIONS 56,994 CAPITAL CONTRIBUTIONS -161,889 GRANT EXPENSE NETTED AGAINST REVENUE -331,326 RENTAL EXPENSE -298,199 GRANT EXPENSE NETTED AGAINST REVENUE 331,326 SCHOLARSHIPS RELEASED FROM RESTRICTION 56,994 FORM 990, PART XI, LINE 9 NET ASSETS RELEASED FROM RESTRICTIONS -56,994 CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 57,868 CAPITAL CONTRIBUTION 164,444 TOTAL INCREASE IN NET ASSETS 117,417 ORLANDO HEALTH 1414 KUHL AVENUE ORLANDO FL 328062008 591726273 HEALTHCARE FL 501C3 3 NA false SOUTH LAKE COUNTY HOSPITAL DISTRICT 1900 DON WICKHAM DRIVE CLERMONT FL 347111979 590571600 LEVY TAX FL 501C3 6 NA false SOUTH LAKE HOSPITAL FOUNDATION 1935 DON WICKHAM DRIVE CLERMONT FL 347111915 900805455 FUNDRAISIN FL 501C3 7 NA false HEALTHCARE PURCHASING ALLIANCE LLC 1417 S KUHL AVENUE SUITE 100 ORLANDO FL 328062010 591726273 PURCHASING FL OH ORLANDO HEALTH INC RELATED 439220 279231 false false 0.07540 false false true false true false false false false false true false true true true true false true true SCHEDULE R HEALTHCARE PURCHASING ALLIANCE, INC. IS OWNED 7% BY THE FILING ENTITY WITH THE REMAINING 93% OWNED BY ORLANDO HEALTH, INC., A RELATED ORGANIZATION.