2014-05-12T10:56:21-05:00 2013-06-30 KPMG LLP 300 North Greene Street Suite 400 Greensboro NC 27401 990 2012-07-01 590878982 LEESBURG REGIONAL MEDICAL CENTER INC % DIANE HARDENCFO LEES 3523235002 600 EAST DIXIE AVENUE Suite LEESBURG FL 34748 DIANE HARDEN 3523235002 2014-05-09 true 3362753394 2012 2015-11-30 17:44:51Z DON HENDERSON PRESIDENT CEO 600 EAST DIXIE AVENUE LEESBURG FL 34748 238025990 false X WWW.LEESBURGREGIONAL.ORG X 1961 FL TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE PATIENTS AND COMMUNITIES THE ORGANIZATION SERVES. 16 13 2085 239 4235798 0 0 241563730 223178884 2367994 12048866 1885419 2739890 245817143 237967640 371348 246250 0 0 98160452 100515078 0 0 0 131298028 123188938 229829828 223950266 15987315 14017374 334853113 330407286 161302307 145562786 173550806 184844500 X TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE INDIVIDUALS AND COMMUNITIES THE ORGANIZATION SERVES. true false 200895292 246250 219086082 LEESBURG REGIONAL MEDICAL CENTER, PART OF CENTRAL FLORIDA HEALTH ALLIANCE, IS A 322-BED ACUTE CARE HOSPITAL THAT OFFERS WORLD CLASS SERVICES CLOSE TO HOME IN LAKE, SUMTER, AND MARION COUNTIES. LOCATED JUST NORTH OF ORLANDO, FLORIDA, LEESBURG REGIONAL MEDICAL CENTER HAS GROWN FROM A SMALL COMMUNITY HOSPITAL BUILT IN 1963 TO A COMPREHENSIVE MEDICAL CENTER. THE LEESBURG REGIONAL HEART INSTITUTE OFFERS PREMIER CARDIOVASCULAR SERVICES, AND IS RECOGNIZED FOR ITS CUTING-EDGE TECHNOLOGY, OUTSTANDING OUTCOMES, AND CONSISTENTLY HIGH PATIENT SATISFACTION RATINGS. HOME TO ONE OF THE LARGEST OPEN HEART PROGRAMS IN THE STATE, THE LEESBURG REGIONAL HEART INSTITUTE IS PIONEERING MANY GROUNDBREAKING PROCEDURES SUCH AS MINIMALLY-INVASIVE HEART VALVE SURGERY. AT LEESBURG REGIONAL, WE ARE COMMITTED TO PROVIDING QUALITY CARE AND SERVICE EXCELLENCE. OUR HOSPITAL IS THE REGION'S FIRST DESIGNATED STROKE CENTER WITH THE JOINT COMMISSION SEAL OF APPROVAL AND WE PROVIDE A MULTIDISCIPLINARY APPROACE TO NEUROSURGICAL CARE. THE JOINT CENTER AT LEESBURG REGIONAL OFFERS WORLD-CLASS ORTHOPEDIC SERVICES, SUCH AS HIP AND KNEE REPLACEMENTS, AND THE HOSPITAL ALSO FEATURES STATE-OF-THE-ART DIAGNOSTIC IMAGING, EMERGENCY ROOM, LABOR & DELIVER, PEDIATRIC SERVICES, CANCER CARE AND SO MUCH MORE. 200895292 true false false true false false false false false false true true false true true false false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true false false false true 70 0 true 2085 true true true false false false true true true true false false false false false X 16 13 false false false false true true true true true false false true true true true true true true true true true FL X DIANE HARDENCFO 3523235002 600 EAST DIXIE AVENUE LEESBURG FL 34748 X DAVID L SUSTARSIC MD 1.0 1.0 X 40796 2329 0 ROBERT Q WILLIAMS ESQUIRE 1.0 1.0 X X 0 0 0 GREGORY R LEWIS 1.0 1.0 X X 0 0 0 SHIVAKUMAR S HANUBAL MD 1.0 1.0 X 21360 0 0 TIMOTHY I SULLIVAN 1.0 1.0 X 0 0 0 TERRY R UPTON 1.0 1.0 X 0 0 0 DON V HAHNFELDT 1.0 1.0 X X 0 0 0 ROGER W SHERMAN MD 1.0 1.0 X 0 0 0 EVAN RICHARDS 1.0 1.0 X 0 0 0 JANET BOLIVAR 1.0 1.0 X 0 0 0 DIANE SPENCER 1.0 1.0 X X 0 0 0 JOHN A COWIN MD 1.0 1.0 X 15102 0 0 GEORGE E KAINZ MD 1.0 1.0 X 0 0 0 RUSSEL J D'EMIDIO 1.0 1.0 X 0 0 0 KENNETH A SAMPONG MD 1.0 1.0 X 0 0 0 AMANDA J WETTSTEIN 1.0 1.0 X 0 0 0 SHAHBAZ CHEEMA MD 1.0 1.0 X 0 0 0 ROGER BEYERS 1.0 1.0 X 0 0 0 DON HENDERSON 50.0 0.0 X 562398 0 22869 DIANE HARDEN 50.0 0.0 X 237261 0 4486 TIMOTHY HAWKINS 50.0 0.0 X 504967 0 37045 PHYLLIS BAUM 50.0 0.0 X 371895 0 22303 PHILIP BRAUN 50.0 0.0 X 223320 0 22416 TED WILLIAMS 50.0 0.0 X 206670 0 16654 CYNTHIA GAMACHE 50.0 0.0 X 187445 0 23644 CLIFTON LEE BRIDGES 50.0 0.0 X 350671 0 11530 DAVID RIZZUTO 50.0 0.0 X 361987 0 26316 ORLANDO ICAZA 50.0 0.0 X 364817 0 20200 M FIRAS SIOUFI 50.0 0.0 X 545368 0 25070 CELIA K NELSON 50.0 0.0 X 293233 0 19102 LEE HUNTLEY 50.0 0.0 X 251686 0 0 DALE E HOCKING 50.0 0.0 X 153849 0 0 DANIEL CARLSON 50.0 0.0 X 108396 0 0 MARY PERFUMO 50.0 0.0 X 107702 0 0 4908923 2329 251635 91 true true false LAKE COUNTY ANESTHESIA ASSOCIATES PO BOX 491529 LEESBURG FL 34749 ANESTHESIA SERVICES 2738254 TRANSCEND SERVICES 945 EAST PACES FERRY ROAD ATLANTA GA 30326 TRANSCRIPTION 1986867 EXECUTIVE HEALTH RESOURCES INC PO BOX 822688 PHILADELPHIA PA 191822688 COLLECTION SERVICES 1594545 ANGELICA PO BOX 535122 ATLANTA GA 30353 LINEN SERVICES 1327609 CARDIOVASCULAR ANESTHESIA CONSULTAN PO BOX 3130 OCALA FL 34478 ANESTHESIA SERVICES 1190000 57 0 NET PATIENT SERVICE REVENUE 621400 223178884 219086082 4092802 0 223178884 12033866 0 0 12033866 0 0 629715 58350 571365 0 571365 0 0 571365 15000 15000 15000 0 0 0 DIETARY 900099 959595 0 959595 CHILDCARE LEARNING CENTER REVENUE 900099 605046 142996 462050 OTHER REVENUE 900099 603884 0 603884 2168525 237967640 219086082 4235798 14630760 246250 246250 0 0 0 1581062 1581062 22793 22793 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14017374 -2449608 -274072 X false true X true false X false false false false false false true 15140 false true 24160 39300 false false OTHER ACTIVITIES SCHEDULE C, PART II-B, LINE 1I DUES REMITTED TO TRADE ASSOCIATION, A PORTION OF WHICH CONSTITUTES LOBBYING AND PAYMENTS TO A CONSULTANT THAT PROVIDES LOBBYING SERVICES. 8610003 8610003 99552503 61828960 37723543 34308960 30443269 3865691 145556233 122799657 22756576 14572650 4996146 9576504 82532317 GOVERNMENT SECURITIES 21809883 F FIXED INCOME SECURITIES 15079569 F EQUITY SECURITIES 38402608 F ACCRUED INTEREST 210372 F MUTUAL FUNDS 11290738 F MONEY MARKET FUND 36335897 F 123129067 DEFERRED LOAN COSTS 666104 DUE FROM AFFILIATES 9763681 ASSETS LIMITED TO USE 4604882 INVESTS UNCONSOLIDATED AFFIL 22500148 TRUSTEE HELD FUNDS, OTHER 2988614 GOODWILL SURGERY CTR MT DORA 7770547 GOODWILL ALLIANCE LABS 4533386 52827362 0 DUE TO AFFILIATES 3781 PROFESSIONAL LIABILITY RESERVE 14906111 14909892 X 235302310 -2449608 -215722 -2665330 237967640 237967640 224008616 58350 58350 223950266 223950266 ASC 740 (FIN 48) FOOTNOTE SCHEDULE D, PART XIV THE ALLIANCE AND ITS AFFILIATES, WITH THE EXCEPTION OF VENTURE, ARE NOT-FOR-PROFIT ORGANIZATIONS AS DESCRIBED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE AND CHAPTER 220.13 OF THE FLORIDA STATUTES, RESPECTIVELY. MANAGEMENT BELIEVES THAT THE UNRELATED BUSINESS INCOME GENERATED BY THE ALLIANCE AND ITS AFFILIATES IS NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. Accounting principles generally accepted in the United States of America require The Alliance's management to evaluate tax positions taken by The Alliance and recognize a tax liability (or asset) if The Alliance has taken an uncertain position that more likely than not would not be sustained upon examination by the Internal Revenue Service. The Alliance has analyzed the tax positions and has concluded that as of June 30, 2013, there are no uncertain positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the consolidated financial statements. The Alliance is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Alliance believes it is no longer subject to income tax examinations for years prior to 2009. SCHEDULE D, PART XI, LINE 2D RENT EXPENSE : 58,350 NONCONTROLLING INTEREST : (274,072) ----------- TOTAL (215,722) SCHEDULE D, PART XII, LINE 2D RENT EXPENSE : 58,350 true true X true X true X true true true false true true 12070958 12070958 0.05390 23857268 17705748 6151520 0.02750 35928226 17705748 18222478 0.08140 224093 224093 0.00100 152560 152560 0.00070 376653 376653 0.00170 36304879 17705748 18599131 0.08310 17271439 17271439 0.07710 17271439 17271439 0.07710 true 1716878 137202419 144757613 -7555194 X true false 1 1 LEESBURG REGIONAL MEDICAL CENTER INC

600 EAST DIXIE AVENUE LEESBURG FL 34748

X X X LEESBURG REGIONAL MEDICAL CENTER INC 1 true X X X X X X X X X 12 true true true X X X X X X X X true false true true 200. true 400. true X X X true true X X X true false X X X X X true X false false 5 ALLIANCE FIRST CARE

3631 W BURLEIGH BLVD TAVARES FL 32778

URGENT CARE WILLIAM G OHME COMP MEDICAL REHAB UNIT

700 NORTH PALMETTO ST LEESBURG FL 34748

REHABILITATION LRMC WELLNESS CENTER

700 NORTH PALMETTO ST LEESBURG FL 34748

WELLNESS LEESBURG REGIONAL AMBULATORY CENTER

601 E DIXIE AVE LEESBURG FL 34748

AMB SURGERY CENTER SURGERY CENTER OF MOUNT DORA

3710 LAKE CENTER DRIVE MT DORA FL 32757

AMB SURGERY CENTER FEDERAL POVERTY GUIDELINES SCHEDULE H, PART I, LINE 3C N/A SINCE THE HOSPITAL USES THE FEDERAL POVERTY GUIDELINES. ANNUAL COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A THE VILLAGES AND LEESBURG REGIONAL MEMORIAL HOSPITAL FILE A COMBINED COMMUNITY BENEFIT REPORT. SUBSIDIZED HEALTH SERVICES SCHEDULE H, PART I, LINE 7G THIS AMOUNT DOES NOT INCLUDE ANY SUBSIDIZED HEALTH SERVICES FROM PHYSICIAN CLINICS. BAD DEBT EXPENSE SCHEDULE H, PART III, LINE 4 THE FOOTNOTE FROM THE AUDITED FINANCIAL STATEMENTS RELATED TO BAD DEBT IS AS FOLLOWS: ALLOWANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS ADDITIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR BAD DEBTS. ACCOUNTS RECEIVABLE ARE WRITTEN-OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE ALLIANCE'S POLICIES. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS, AND SUBSEQUENT RECOVERIES ARE ADDED. THE AMOUNT OF THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENT HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. COSTING METHODOLOGY SCHEDULE H, PART III, LINE 8 LEESBURG REGIONAL MEDICAL CENTER IS THE SECOND LARGEST EMPLOYER IN LAKE COUNTY, EMPLOYING MORE THAN 1,700 TEAM MEMBERS WITH AN ANNUAL PAYROLL OF $84.4 MILLION. THE VILLAGES HEALTH SYSTEM HAS 1,000 TEAM MEMBERS ($54.2 MILLION PAYROLL). COMBINED, CENTRAL FLORIDA HEALTH ALLIANCE PROVIDED JOBS FOR 2,700 PEOPLE IN THE COMMUNITIES WE SERVE. BASED ON COMMUNITY BENEFIT REPORTING: GUIDELINES AND STANDARD DEFINITIONS FOR THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY, VOLUNTARY HOSPITALS OF AMERICA (VHA) AND THE CATHOLIC HEALTHCARE ASSOCIATION (CHA) OF THE UNITED STATES, 2005. CHARITY CARE IS THE TOTAL COST OF SERVICES INCURRED BY CENTRAL FLORIDA HEALTH ALLIANCE TO PROVIDE MEDICAL SERVICES TO THOSE PATIENTS WHO HAVE DEMONSTRATED THEIR INABILITY TO PAY. CHARITY CARE DOES NOT INCLUDE BAD DEBT. THE MEDICARE AND MEDICAID PROGRAMS PAY CENTRAL FLORIDA HEALTH ALLIANCE LESS THAN IT COSTS THE ORGANIZATION TO PROVIDE CARE TO ITS MEDICARE AND MEDICAID PATIENTS. THE AMOUNTS SHOWN ARE THE ACTUAL COSTS TO PROVIDE THESE SERVICES ABOVE REIMBURSEMENT. BAD DEBT IS THE TOTAL COST OF SERVICES INCURRED BY CENTRAL FLORIDA HEALTH ALLIANCE FOR SERVICES PROVIDED TO PATIENTS WHO HAVE NOT PAID THEIR BILLS AND WHO HAVE NOT DEMONSTRATED THEIR INABILITY TO PAY. COLLECTION POLICIES SCHEDULE H, PART III, LINE 9B THE HOSPITAL'S COLLECTION POLICIES DO NOT CONTAIN PROVISIONS RELATING TO COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. THE HOSPITAL WORKS TO MAKE A DETERMINATION EXPEDIENTLY THAT THE PATIENT QUALIFIES FOR CHARITY CARE OR FINANCIAL ASSISTANCE, AND AS SUCH, SHOULD NOT BE PURSUED FOR COLLECTIONS. FACILITY INFORMATION SCHEDULE H, PART V PART V, SECTION B LINE 1J LEESBURG REGIONAL MEDICAL CENTER'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE LOCATED AT HTTP://WWW.LEESBURGREGIONAL.ORG/ABOUT-COMMUNITY-HEALTH.HTML. PART V, LINE 3 IN GENERAL, INPUT FROM THE FOLLOWING PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SERVIED BY THE HOSPITALS: BUSINESS LEADERS, MEMBERS OF LOCAL CHURCHES, COMMUNITY NON-PROFIT ORGANIZATIONS, HEALTH DEPARTMENTS, AND REPRESENTATIVES FROM LOCAL NEIGHBORHOOD COMMUNITIES. MORE SPECIFICALLY, IN ASSESSING OUR COMMUNITIES' HEALTH CARE NEEDS, WE LOOK AT THE POPULATION SERVED AT THE COMMUNITY MEDICAL CARE CENTER (A PRIMARY CARE CLINIC FOR THE UNINSURED OF WHICH CENTRAL FLORIDA HEALTH ALLIANCE HELPS SUPPORT FINANCIALLY AND WITH VOLUNTEERS), ANALYZE DATA BY AND WORK WITH THE LAKE COUNTY HEALTH DEPARTMENT, SERVE ON COMMUNITY TASK FORCES AND BOARDS WITH OTHER HEALTH CARE PROVIDERS, AND SURVEY PARTICIPANTS AT COMMUNITY OUTREACH HEALTH FAIRS, SCREENINGS AND EVENTS. OUR COMMUNITY BENEFIT EFFORT IS A MEASURED APPROACH TO MEETING IDENTIFIED COMMUNITY HEALTH CARE NEEDS, PARTICULARLY IN THE UNINSURED AND UNDERSERVED. THE COMMUNITY POPULATION IS PRIMARILY MEDICARE (APPROXIMATELY 75%) WITH THE REMAINDER MEDICAID, SELF PAY AND OTHER. WE VERBALLY INFORM PATIENTS OF OUR CHARITY CARE PROGRAM, THERE IS VERBIAGE ON OUR WEBSITE AND STATEMENTS REGARDING THE CHARITY CARE PROGRAM. ALSO, WE PROVIDE PATIENTS WITH THE "PATIENT CHARITY CARE POLICY" IF REQUESTED. OTHER COMMUNITY OUTREACH ACTIVITIES WHICH PROMOTE HEALTH OF THE COMMUNITY INCLUDE: - FREE DOC TALK PREVENTATIVE EDUCATION SERIES, - FREE OR REDUCED COST HEALTH SCREENINGS (RANGING FROM PERIPHERAL ARTERIAL DISEASE SCREENINGS TO BLOOD PRESSURE, CHOLESTEROL AND GLUCOSE CHECKS), - HOSTING AND MAKING AVAILABLE (AT NO CHARGE) HOSPITAL SPEAKERS FOR A VARIETY OF SUPPORT GROUPS AND ORGANIZATIONS (AS WELL AS DONATED MEETING SPACE), - PARTNERING AND AFFILIATING WITH OUTSIDE GROUPS TO IDENTIFY HEALTH PRIORITIES AND ENHANCE THE HEALTH AND QUALITY OF LIFE FOR THE COMMUNITIES WE SERVE, AND - PROVIDING HEALTHY HEROES (EMPLOYEE VOLUNTEERS) WHO CONTRIBUTE COUNTLESS HOURS TO THE COMMUNITY OUTSIDE OF OUR HOSPITALS BY PARTICIPATING IN MANY DIFFERENT PREVENTATIVE HEALTH EVENTS. IN ADDITION, MANY OF OUR LEADERS AND TEAM MEMBERS VOLUNTEER THEIR TIME TO A VARIETY OF COMMUNITY BOARDS AND ORGANIZATIONS. ADDITIONALLY, THE HOSPITAL GENERALLY MAINTAINS AN OPEN MEDICAL STAFF. PARTN V, LINE 4 LEESBURG REGIONAL MEDICAL CENTER THE VILLAGES TRI-COUNTY MEDICAL CENTER Part V, Section B, Line 14g The hospital facility publicizes its written financial assistance policy through its website, copies available at the patient registration desks and financial counselors also have it for distribution to patients. It is also available to anyone who requests it. Part V, Section B, Line 18e All self pay patients that come through the Emergency Department or are a direct admit as urgent or emergent are seen by a financial counselor/patient discharge cashier and/or a representative from the hospital facility's Medicaid eligibility company. The hospital facility always attempts to collect from a patient first but if they state they are unable to pay, we look for other sources of funding - Medicaid or Florida's Health Care Responsibility Act ("HCRA").The hospital facility has a detailed application process for charity. All of the hospital facility's communication with the patient/family is documented its patient health management system. The hospital facility will take the following actions before initiating any of the collection efforts indicated in Line 18 as follows. The hospital facility first sends a statement to self-pay patients from its patient accounting system. If after 30 days, the patient has not satisfied the balance, the account is sent to one of the hospital facility's two early out agencies for 90 days that work to identify additional sources for payment and to prompt patients to pay, thereby eliminating the need for extensive collection activity. If after this 90 day period, the account still has a balance, it is then sent to one of the hospital facility's collection agencies. If after 120 days there is a balance, it is returned to the hospital facility as uncollectible and closed. Part V, Section B, Line 20d The hospital determines the amounts billed to patients who did not have insurance covering emergency or other medically necessary care by using a discount against of gross charges, usually a 40% or greater discount, at the time of service. true AMERICAN CANCER SOCIETY PO BOX 102454 Atlanta GA 30368 131788491 501(c)(3) 10000 N/A N/A donation COMMUNITY MEDICAL CARE CENTER OF LEESBURG 1210 WEST MAIN STREET LEESBURG FL 34748 593585112 501(C)(3) 131250 N/A N/A DONATION LAKE-SUMTER COMMUNITY COLLEGE FOUNDATION INC 9501 US HIGHWAY 441 LEESBURG FL 34788 591990323 501(C)(3) 100000 N/A N/A Donation 3 0 MONITORING THE USE OF GRANT FUNDS FORM 990, SCHEDULE I, PART I, QUESTION 2 THE GRANTS MADE BY THE ORGANIZATION WERE MADE TO PUBLIC CHARITIES FOR USE IN THEIR EXEMPT MISSION. ACCORDINGLY, THE ORGANIZATION EXPECTS THE CHARITIES TO USE THE FUNDS FOR PROPER PURPOSES, AND AS SUCH, DOES NOT SUBSEQUENTLY MONITOR THE GRANTS. X X X X X X false false false false false false false true false LEE HUNTLEY 0 0 0 0 251686 0 0 0 0 0 251686 0 93055 0 TIMOTHY HAWKINS 319328 0 99300 0 86339 0 28315 0 8730 0 542012 0 0 0 PHYLLIS BAUM 279976 0 67126 0 24793 0 12968 0 9335 0 394198 0 0 0 DALE E HOCKING 0 0 0 0 153849 0 0 0 0 0 153849 0 72808 0 DANIEL CARLSON 0 0 0 0 108396 0 0 0 0 0 108396 0 67386 0 MARY PERFUMO 0 0 0 0 107702 0 0 0 0 0 107702 0 36966 0 PHILIP BRAUN 178532 0 44077 0 711 0 8225 0 14191 0 245736 0 0 0 CLIFTON LEE BRIDGES 297143 0 25000 0 28528 0 11530 0 0 0 362201 0 0 0 DAVID RIZZUTO 315647 0 45000 0 1340 0 12125 0 14191 0 388303 0 0 0 ORLANDO ICAZA 317761 0 45000 0 2056 0 8010 0 12190 0 385017 0 0 0 M FIRAS SIOUFI 395209 0 149879 0 280 0 10879 0 14191 0 570438 0 0 0 CELIA K NELSON 254323 0 38452 0 458 0 9767 0 9335 0 312335 0 0 0 TED WILLIAMS 162897 0 39789 0 3984 0 7319 0 9335 0 223324 0 0 0 CYNTHIA GAMACHE 148961 0 36964 0 1520 0 4869 0 18775 0 211089 0 0 0 DON HENDERSON 434782 0 65626 0 61990 0 14327 0 8542 0 585267 0 0 0 DIANE HARDEN 188212 0 13831 0 35218 0 1160 0 3326 0 241747 0 0 0 COMPENSATION TO DIRECTOR FORM 990, PART VII, SECTION A DURING THE ROUTINE COURSE OF BUSINESS, DR. DAVID L. SUSTARSIC, MD, PA EARNED $40,796 IN COMPENSATION FROM LRMC AND $2,329 FROM TVRH DURING CALENDAR YEAR 2012 RELATED TO MEDICAL CARE HIS PRACTICE PROVIDED TO PATIENTS OF THOSE ORGANIZATIONS DURING THE YEAR. COMPENSATION TO DIRECTOR FORM 990, PART VII, SECTION A DURING THE ROUTINE COURSE OF BUSINESS, SHIVAKUMAR S HANUBAL, MD EARNED $21,360 IN COMPENSATION FROM LRMC DURING CALENDAR YEAR 2012 RELATED TO MEDICAL CARE HIS PRACTICE PROVIDED TO PATIENTS OF THE ORGANIZATION DURING THE YEAR. COMPENSATION TO DIRECTOR FORM 990, PART VII, SECTION A DURING THE ROUTINE COURSE OF BUSINESS, JOHN A COWIN, MD EARNED $15,102 IN COMPENSATION FROM LRMC DURING CALENDAR YEAR 2012 RELATED TO MEDICAL CARE HIS PRACTICE PROVIDED TO PATIENTS OF THOSE ORGANIZATIONS DURING THE YEAR. BONUS AWARDS SCHEDULE J, PART I, LINE 7 THE ORGANIZATION AWARDS BONUSES ON THE BASIS OF QUALITY AND OTHER PERFORMANCE FACTORS. A CITY OF LEESBURG FLORIDA 596000362 524360FE9 2003-06-26 46391163 HOSPITAL REV BONDS, SERIES 2003 false false false B CITY OF LEESBURG FLORIDA 596000362 2011-10-06 20840000 HOSP REV REFDG BONDS, SERIES 2011 false false false A 0 0 46391163 0 0 45727319 663845 0 0 0 0 0 2003 true true false true B 0 0 20840000 0 0 20840000 0 0 0 0 0 0 2011 true false true true A false false true true false 0.01430 0.00000 0.01430 false false false false B false false true true false 0.01770 0.00000 0.01770 false false false false A false false false false false false 0 false false false 0 false false B false false false false true false 0 false false false 0 false false A B DECISIONS SUBJECT TO MEMBER APPROVAL FORM 990, PART VI, SECTION A, LINES 6, 7A, AND 7B CENTRAL FLORIDA HEALTH ALLIANCE ("CFHA") IS THE SOLE MEMBER OF THE ORGANIZATION. AS SUCH, CFHA APPOINTS THE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY AND CERTAIN DECISIONS OF THE ORGANIZATION, AS DEFINED IN THE ORGANIZATION'S BYLAWS, ARE SUBJECT TO CFHA APPROVAL. PROCESS USED TO REVIEW 990 FORM 990, PART VI, SECTION B, LINE 11 DURING APRIL 2014, MANAGEMENT DISTRIBUTED A DRAFT OF THE 2012 FORM 990 TO FINANCE COMMITTEE FOR ITS REVIEW. THE FINANCE COMMITTEE MEMBERS HAD AN OPPORTUNITY TO PROVIDE COMMENTS AND ASK QUESTIONS WITH RESPECT TO THE DRAFT. BASED ON FEEDBACK PROVIDED FROM THE COMMITTEE MEMBERS, MANAGEMENT UPDATED THE DRAFT FORM 990. UPON FINALIZATION OF THE RETURN, MANAGEMENT PROVIDED A FINALIZED COPY OF THE RETURN TO THE BOARD OF DIRECTORS PRIOR TO FILING. MONITORING AND ENFORCING CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS ESTABLISHED A CONFLICT OF INTEREST POLICY WHICH HAS BEEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE ORGANIZATION'S POLICY REQUIRES CERTAIN INDIVIDUALS TO DISCLOSE PARTICIPATION IN ACTIVITIES OR CIRCUMSTANCES THAT MAY PRESENT A CONFLICT OF INTEREST ON AN ANNUAL BASIS OR IF AT ANY TIME SUCH INDIVIDUAL BECOMES AWARE OF CIRCUMSTANCES THAT MAY PRESENT A CONFLICT OF INTEREST. THESE DISCLOSURES ARE REVIEWED BY THE BOARD. INDIVIDUALS COVERED BY THE CONFLICT OF INTEREST POLICY MUST ABSTAIN FROM DELIBERATIONS AND VOTING WITH RESPECT TO TRANSACTIONS WHEREIN A CONFLICT IS DEEMED TO EXIST. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, SECTION B, LINE 15B THE BOARD OF THE ORGANIZATION APPOINTS THE COMPENSATION COMMITTEE. THE INDIVIDUALS SERVING ON THE COMPENSATION COMMITTEE ALSO SERVE ON THE EXECUTIVE COMMITTEE OF THE ORGANIZATION. THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION FOR THE PRESIDENT AND CEO AS WELL AS THE VICE PRESIDENTS AND SENIOR VICE PRESIDENTS. THE COMPENSATION COMMITTEE HAS A COMPENSATION CHARTER AND PHILOSOPHY. THE ORGANIZATION UTILIZES COMPARABLE COMPENSATION INFORMATION FROM COMMUNITY HOSPITAL CORPORATION AS ITS THIRD PARTY NEUTRAL SOURCE TO PREPARE AND GATHER MARKET INFORMATION FOR REVIEW BY THE COMPENSATION COMMITTEE. DETAILED MINUTES ARE KEPT OF ALL ACTIONS. INVESTMENT IN JOINT VENTURE FORM 990, PART VI, SECTION B, LINE 16B BEFORE PARTICIPATING IN A JOINT VENTURE, THE ORGANIZATION WILL ENSURE THAT THE JOINT VENTURE FURTHERS THE ORGANIZATION'S EXEMPT PURPOSES AND WILL NEGOTIATE AT ARM'S LENGTH CONTRACTUAL AND OTHER TERMS OF PARTICIPATION THAT SAFEGUARD THE ORGANIZATION'S EXEMPTION FROM FEDERAL INCOME TAX. SUCH TERMS SHALL BE IN WRITING IN THE OPERATING AGREEMENT OF THE JOINT VENTURE. THE ORGANIZATION PARTICIPATES IN JOINT VENTURES THAT ARE BENEFICIAL TO THE HEALTH CARE OF THE COMMUNITY. MAKING DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART VI, SECTION C, LINE 19 GENERALLY, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. HOWEVER, THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE PUBLICLY AVAILABLE THROUGH FLORIDA'S SECRETARY OF STATE WEBSITE WWW.SUNBIZ.COM. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 9 NON CONTROLLING INTEREST (274,072) ALLIANCE LABS LLC 1456 WILLIAM STREET LEESBURG FL 34748 264322547 LAB SERVICES FL 6126799 5732523 LRMC PATHOLOGY SERVICES ALLIANCE LLC 1456 WILLIAM STREET LEESBURG FL 34788 270749750 LAB SERVICES FL 0 0 LRMC LRMC PHYSICIAN SERVICES LLC 600 EAST DIXIE AVENUE LEESBURG FL 34748 263978727 MEDICAL SRVCS FL 0 0 LRMC THE VILLAGES TRI-COUNTY MEDICAL CENTER 1451 EL CAMINO REAL THE VILLAGES FL 32159 593527036 MEDICAL SRVCS FL 501(C)(3) 3 CFHA false ALLIANCE HEALTHCARE FOUNDATION INC 600 EAST DIXIE AVENUE LEESBURG FL 34748 591800743 SUPPORT HOSP FL 501(C)(3) 11 CFHA false CENTRAL FLORIDA HEALTH ALLIANCE 600 EAST DIXIE AVENUE LEESBURG FL 34748 331197054 PARENT HOSP. FL 501(C)(3) 11 NA false CF CARDIOVASCULAR CO-MANAGEMENT CO LLC 600 E DIXIE AVE LEESBURG FL 34748 270781065 HEALTHCARE SE FL LRMC RELATED 408801 132312 false 0 true 0.38298 CF ONCOLOGY CO-MANAGEMENT CO LLC 600 E DIXIE AVE LEESBURG FL 34748 272818513 HEALTHCARE SE FL LRMC RELATED 99335 39696 false 0 true 0.25000 SURGERY CENTER OF MOUNT DORA 3710 LAKE CENTER DRIVE MT DORA FL 32757 262446297 HEALTHCARE SE FL LRMC RELATED 331718 4818430 false 0 false 0.51000 VENTURE HEALTH CARE CORPORATION INC 600 EAST DIXIE AVENUE LEESBURG FL 34748 592689702 MANAGEMENT SR FL NA C CORP false false false false false false false false false false false false false false true true true true true DISCLOSURE OF RELATED ENTITIES SCHEDULE R, PART III AND PART IV THE FILING ORGANIZATION, A CENTRAL FLORIDA HEALTH ALLIANCE RELATED ORGANIZATION, HAS REPORTED THE DETAILS OF INCOME, ASSETS AND OWNERSHIP PERCENTAGE FOR THE ENTITIES IN WHICH IT HOLDS DIRECT OWNERSHIP. IN CERTAIN CASES, THE FILING ORGANIZATION'S OWNERSHIP PERCENTAGE IS LESS THAN FIFTY PERCENT. HOWEVER, THOSE ENTITIES ARE BEING REPORTED ON SCHEDULE R, PART III AND IV BECAUSE THE REPORTING ENTITY'S AND ITS RELATED ORGANIZATIONS' CUMMULATIVE OWNERSHIP PERCENTAGE EXCEEDS FIFTY PERCENT. PLEASE REFER TO THE FORMS 990 RELATED ORGANIZATION FOR MORE DETAILS ON THE RESPECTIVE DIRECT OWNERSHIP PERCENTAGES.