2014-08-20T09:57:54-05:00 2013-09-30 ERNST & YOUNG US LLP 55 IVAN ALLEN JR BLVD SUITE 1000 ATLANTA GA 30308 990 2012-10-01 590724462 Winter Haven Hospital Inc % JOHN GANTNER WINT 8632931121 200 Avenue F NE Suite Winter Haven FL 33881 CARL TREMONTI 2014-08-12 4048748300 2012 2016-03-07 17:11:31Z Glenn Waters 200 Avenue F NE Winter Haven FL 33881 305789520 false X www.baycare.org/winter-haven-hospital X 1926 FL TO IMPROVE THE HEALTH OF THE PEOPLE WE SERVE, BY PROVIDING THE HIGHEST QUALITY AND MOST EFFECTIVE CARE AND SERVICES AND TO RETURN VALUE TO THE PEOPLE IN OUR COMMUNITIES. 14 14 3172 220 798121 -189121 4836497 3942554 283688378 281745562 1919217 5180822 1411654 9571051 291855746 300439989 0 0 0 0 134880756 147591916 0 0 0 151332423 150304080 286213179 297895996 5642567 2543993 258162407 296356205 144790410 162225617 113371997 134130588 TO IMPROVE THE HEALTH OF THE PEOPLE WE SERVE, BY PROVIDING THE HIGHEST QUALITY AND MOST EFFECTIVE CARE AND SERVICES AND TO RETURN VALUE TO THE PEOPLE IN OUR COMMUNITIES. false false 288819038 0 288809192 Winter Haven Hospital, Inc. (WHH) is a full-service 529-bed community hospital. During the fiscal year 2012, WHH provided inpatient care to 16,778 patients, treated 63,440 patients in the emergency department, and delivered 1,697 babies. Through efforts of the medical assistance program and the hospital's charity care program WHH saw a net community benefit expense totaling more than $21.1 million. 288819038 true true false true false false false false false false true false true false true true false true false false true false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 318 0 true 3172 true true true false false false false false false false false false X 14 14 true false true false true true true true true false false true false true true false true false X JOHN GANTNER 7278208005 2985 DREW STREET CLEARWATER FL 33759 Mark Bostick 1.0 1.0 X X 0 0 0 William Burns 1.0 1.0 X X 0 0 0 Robert Carter 1.0 1.0 X 0 0 0 Todd Dantzler 1.0 0.0 X 0 0 0 Eileen Holden 1.0 1.0 X 0 0 0 Don Ingram 1.0 1.0 X X 0 0 0 Michele McClendon 1.0 0.0 X 0 0 0 Charles McPherson 1.0 0.0 X 0 0 0 William Murrell 1.0 1.0 X 0 0 0 Tommy Oakley 1.0 0.0 X 0 0 0 Cindy Price 1.0 0.0 X 0 0 0 Richard Straughn 1.0 1.0 X 0 0 0 Brian Swain 1.0 1.0 X X 0 0 0 Chip Tucker 1.0 0.0 X 0 0 0 Lance Anastasio 0.0 45.0 X 0 551879 62030 David MacDougall 0.0 45.0 X 0 331268 71057 Kaye Hixon 0.0 45.0 X 0 214053 14968 David Libby 0.0 45.0 X 0 187284 73619 John Parman 45.0 0.0 X 178268 0 48139 Mary Jo Schreiber 0.0 45.0 X 0 226460 22432 Joel Thomas 0.0 45.0 X 0 162731 36941 Celestino Vega 0.0 45.0 X 0 314844 26890 Majd Alsamman 45.0 0.0 X 330275 0 46989 Joseph Lynch 45.0 0.0 X 344538 0 49911 Kenneth Gibbs 45.0 0.0 X 385706 0 35687 George Winny 45.0 0.0 X 238470 0 62997 Takkallapelli Rao 45.0 0.0 X 229502 0 36924 1706759 1988519 588584 79 false true false Sodexo Inc Affiliates PO Box 536922 ATLANTA GA 303536922 Management Services 3832963 Doster Construction Co Inc 8529 South Park Circle Suite 130 ORLANDO FL 32819 Construction Service 2830335 OB Hospitalist Group LLC 10 Centimeters Drive MAULDIN SC 29662 Physicians Services 1409450 Florida Clinical Practice PO Box 100247 GAINESVILLE FL 32610 Physicians Services 1322334 Pece of Mind Environmental Inc 1575 Aber Road ORLANDO FL 32807 Demolition Services 813537 58 1452214 2490340 3942554 HOSPITAL PATIENT CARE 621990 168109896 167334264 775632 MEDICARE/MEDICAID NET REVENUE 621990 113635666 113635666 281745562 3865367 22489 3842878 0 0 969977 183442 786535 0 786535 786535 6404516 77028 5054722 111367 1349794 -34339 1315455 1315455 0 0 0 OTHER REVENUE 621990 743809 743809 EMR INCENTIVE 621990 4263782 4263782 SALES BLOOD 621990 2045695 2045695 1731230 10344 1720886 8784516 300439989 288033560 798121 7665754 0 0 0 0 226407 226407 0 126822528 124858148 1964380 4453302 4384324 68978 7423648 7308662 114986 8666031 8515030 151001 0 1934263 1934263 245106 245106 142157 142157 0 64527 64527 12046801 10413332 1633469 961381 961381 7188065 7111180 76885 5299148 5296734 2414 0 4169529 4169529 360265 342539 17726 0 0 2843336 2843336 0 15030393 15030393 5207158 4239809 967349 MEDICAL SUPPLIES 45009178 45009178 BAD DEBT EXPENSE 37323183 37323183 OTHER SRVCS(A),PURCH SRVCS BCD 6126283 5737940 388343 ASSESSMENTS 2812612 2812612 3540695 2028637 1512058 297895996 288819038 9076958 0 X 10998 11056 23838313 20323237 0 0 44930528 36005303 0 0 0 0 0 0 6330268 7220148 5502957 4926514 150414895 1162168 103048283 149252727 50754821 48518594 0 221953 0 16370783 0 7439000 23746239 6066890 258162407 296356205 33506904 45786893 0 0 0 161403 77634964 0 0 0 0 0 3377701 4861454 2700000 0 27570841 111415867 144790410 162225617 X 113371997 134130588 0 0 0 0 113371997 134130588 258162407 296356205 X 2543993 3326088 124901 14763609 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 122665 false true 19492 142157 false Part II-B, Line 1I Dues were paid to the following organizations; Florida Hospital Association, American Association of Clinical Urologists, American Association for Respiratory Care, American Medical Association, American Occupational Therapy Association, Florida Institute of Certified Public Accountants, & Florida Psychological Association. These organizations use a portion of their respective dues to conduct lobbying activities. 14280000 14280000 81923239 476348 81446891 35329294 685820 34643474 18882362 18882362 149252727 16370783 0 CP deferred compensation plan 369133 Abandoned property 156481 Deferred compensation plan 3820530 Non current pension obligation 10465246 Asset retirement obligation long term 1361127 Negative estimated third party settlements 8865301 Due to affliates 86298049 DEPOSTIS 80000 111415867 X Schedule D Part X Line 2 FIN 48 (ASC 740) The Hospital files a form 990 (Return of Organization Exempt from Income Tax) annually. When the return is filed, it is certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amounts of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the tax-exempt status of each entity, the continued tax-exempt status of bonds, and various positions relative to the potential sources of unrelated business taxable income. Central America and the Caribbean Investments 3084000 3084000 3084000 true false false true true false Schedule F, Part IV - Foreign Filings Line 1, 4, and 5 DURING THE TAX YEAR, WINTER HAVEN WAS A US TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION, A SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY, AND ALSO HAD AN OWNERSHIP INTEREST IN A FOREIGN PARTNERSHIP. PER THE INSTRUCTIONS FOR FORMS 926, 8621, AND 8865, WINTER HAVEN DID NOT MEET THE FILING THRESHOLD RELATED TO EACH FORM. true true X true X true X 0 true true true false false 11202738 11202738 0.04300 35769935 29923817 5846118 0.02240 3668466 2102938 1565528 0.00600 50641139 32026755 18614384 0.07140 280793 280793 0.00110 75821 75821 0.00030 356614 356614 0.00140 50997753 32026755 18970998 0.07280 77238 77238 0.00030 250000 250000 0.00100 327238 327238 0.00130 true 37500646 74915929 84223838 -9307909 X true true 2 1 WINTER HAVEN HOSPITAL INC

200 AVE F NE WINTER HAVEN FL 33881

www.baycare.org/winter-haven-hospital X X A 2 REGENCY CENTER FOR WOMEN & INFANTS

101 AVE O NE WINTER HAVEN FL 33880

www.baycare.org/winter-haven-hospital X A A-Winter Haven Hospital Inc true X X X X X X X X 12 true false false X X X true false true true 200. true 300. true X X X X X true true X true false true X false false 9 Blood Banks of Mid-Florida Medical SVC

460 First Street North Winter Haven FL 33881

Blood Bank Family Health Center - Auburndale

2028 Highway 92 West Auburndale FL 33823

Outpatient Physician Clinic Family Health Center - Bartow

1625 North Carpenter Ave Bartow FL 33830

Outpatient Physician Clinic Family Health Center - Dundee

5999 Dundee Road Suite 750 Dundee FL 33884

Outpatient Physician Clinic Family Health Center - Haines City

36245 Highway 27 Haines City FL 33844

Outpatient Physician Clinic Family Health Center - Lake Wales

201 SR 60 West Lake Wales FL 33853

Outpatient Physician Clinic Family Health Center - Winter Haven

100 Avenue I NE Winter Haven FL 33881

Outpatient Physician Clinic Family Health Center - SE Winder Haven

6035 Cypress Gardens Blvd Winter Haven FL 33884

Outpatient Physician Clinic Center for Behavioral Health - Polk Co

1201 First Street South Winter Haven FL 33880

Outpatient Beh Hlth Center Part I, Line 3, 6 & 7 Line 3 Patients of Winter Haven Hospital who are uninsured or underinsured and cannot pay for hospital services are eligible for discounted care. Eligibility is determined by using a sliding scale methodology based on the Federal Poverty levels between 200% and 300%. This enables patients of the community to access healthcare services at a reduced cost. Line 6 a-b During this tax year Winter Haven Hospital was undergoing a consolidation with BayCare Health System, Inc. As a result of management, operating, and system changes a report was not completed during this tax year. The Hospital is converting to a new Fiscal Year End and will complete a Community Benefit Report for its FYE 2014. Line 7 Charity Care and Means-Tested Government Programs costs (Line A Through D) are determined using the Hospital's Cost Accounting system to capture Gross Charges by payor type (Charity, Medicaid, Medicaid HMO, Angels Care Center, Haley Center, WE Care, Polk Health Care Plan). These charges are then netted down to an estimated cost of providing care by applying the Medicare cost to charge ratio for the combined I/P Operating and I/P Capital (as calculated from the CMS-2552-10 cost report form). The costs have been offset by any payments received from Medicaid or other uncompensated care program. Other benefits at cost (Line E through J, as well as, amounts reported in Part II) were compiled from actual payments made via the Accounts Payable system or from data collected by individual departments engaged in the Community Building Activities. Part I, Line 7 Col (f): There is $37,323,183 of bad debt expense which is included in Form 990, Part IX, Line 25. This amount was removed in the calculation of the Percent of Total Expense on Schedule H, Part I, Column 7f. Part II The Hospital helps build the community in two major ways. First, if the hospital finds that that there is a shortage in a certain health care specialty, it works to recruit those types of physicians to the area. In the past, the hospital has commissioned a manpower study to determine what the community's needs are. The second major way the hospital helps the community is through subsidizing the cost of anesthesia for women giving birth at the Regency Center for Women and Infants. This benefits the community by allowing those who are less fortunate to have access to anesthesia services. Part III, Line 2, 3 & 4 The organization's financial statements include a footnote that describes bad debt expense on page 10 of the Winter Haven Hospital, Inc. Notes to Consolidated Financial Statements. Bad Debt Expense reported in Part III line 2 is actual accounts written off from the Accounts Receivable, net of any insurance contractual, other assistance discounts, or a 40% uninsured discount. Patients who are unable to pay are encouraged to provide financial information to the financial assistance department to determine if they may be eligible for programs, such as county, Medicaid, disability, charity, etc. For tax year 2012 the Hospital did not have a means to estimate how much of its Bad Debt Expense may be attributable to patients eligible under its Financial Assistance Policy. However, Winter Haven Hospital has undergone a consolidation with BayCare Health System which will result in expanded availability of systems that will enable them to estimate this in the future. The Hospital has excluded Bad Debt Expense from the calculation of community benefit found in schedule H Part 1 in accordance with IRS instructions. Part III, Line 8 The Hospital uses the Cost to Charge Ratio. Any shortfall amounts have not been treated as community benefits. Cost reports were used to report medicare allowable costs. Medicare defines allowable costs as those appropriate and helpful in developing and maintaining the operation of pateient care facilities and activities. It specifically excludes certain costs that are not directly related to patient care. The hospital incurs additional expense related to the provision of care to medicare patients that medicare has deemed non-allowable. This additional expense includes costs of physician services (emergency on-call fees, recruitment, etc.), advertising costs, cafeteria costs for meals sold to visitors, etc. The hospital attempts to collect coinsurance and deductibles from medicare beneficiaries. Part III, Line 9b At any time in the collection process the account can be determined to meet the criteria of medical indigency as defined by the Federal Poverty Guidelines and all further collection efforts may be suspended. Documentation of such criteria will be retained in the files. Part V, Section B, Line 3 & 5 Line 3 Qualitative data was gathered during individual interviews with key stakeholders of Winter Haven Hospital and Regency Center for Women and Infants service areas. These stakeholders were identified by an advisory committee of executive leadership. Each stakeholder was interviewed by Tripp Umbach, a consulting firm representing the Hospitals, and lasted approximately 60 minutes. All respondents were asked the same set of questions (questions and responses can be found in the CHNA Report starting on Page 49) previously developed by Tripp Umbach and reviewed by the individual Hospitals executive leadership project team. Stakeholders included representation from the following Public Health and Community areas: 1. Polk County Public Health Department 2. Auburndale City 3. Florence Villa Community Development Corporation 4. Winter Haven Economic Development Council 5. Winter Haven City 6. Winter Haven Hospital 7. Superintendent of Schools Polk County 8. Director, Polk Health Care Plan/ Indigent Health D.W 9. Central Florida Health Care, Inc. (CFHC) In addition to the Stakeholder, Winter Haven Hospital and Regency Center for Women and Infants gathered qualitative data from residents of their community by conducting facilitated focus groups. The participants were able to provide direct input related to top community needs of themselves, their families, and communities. The goal of the focus group process is that each participant feels comfortable and speaks openly so that they contribute to the discussion. It was explained to participants that there are no wrong answers, just different experiences and points of view. This process ensures that each participant shares their experiences from their point of view, even if it is different from what others have said. Specifically, focus group participants were asked to identify and discuss what they perceived to be the top health issues and/or concerns in their communities. Focus group input is subject to the limitations of the identified target populations (i.e., vocabulary, perspective, knowledge, etc.), and therefore, is not factual and inherently subjective in nature. The focus group audience was residents earning a low-income that are Medicaid-ineligible. Line 5 During tax year 2012 Winter Haven Hospital was undergoing a consolidation with BayCare Health System. As such, Winter Haven Hospital underwent a change in Management, Operations, Systems, Policies, and Procedures which resulted in a period of conversion impacting Winter Haven Hospital's ability to provide its CHNA on its website. Effective for Tax Year 2013 its CHNA can be located at the following URL: http://www.baycare.org/workfiles/Winter%20Haven/CHNA/Winter%20Haven%20Hosp ital%20Commuinty%20Health%20Needs%20Assessment.pdf Part V, Section B, Line 20d: The hospital facility used the average of all of the commercial insurance rates for services at this hospital facility. In addition to this decrease, the hospital provides a discount for prompt payment. Part VI, Line 2 - Needs Assessment The hospital assesses the health care needs of the community by participating in several community organizations that develop community strategic plans such as Winter Haven's "Our Future by Design". The Hospital also works with the Polk County Health Department in order to conduct studies and help set priorities. Additionally, the Hospital works with and utilizes several community health surveys conducted by Polk Healthcare Alliance. Part VI, Line 3 - Patient education of eligibility for assistance All self-pay patients are screened for funding sources (Medicaid, Polk Health Care, Charity, etc.) at the time of admission or in the pre-admission process. The Hospital's Financial Counselors review the patient's family size, income, and estimated hospital bill to determine if the patient is eligible for any assistance. If he or she is not, the hospital offers a variety of payment plans to help accommodate the patient. During tax year 2012 Winter Haven Hospital was undergoing a consolidation with BayCare Health System, Inc. As such Winter Haven Hospital underwent a change in Management, Operations, Systems, Policies, and Procedures which resulted in a period of conversion impacting the Hospital's ability to provide its Financial Assistance policy on its website or in its waiting areas. Effective for Tax Year 2014 its Financial Assistance policy can be located at the following URL: http://www.baycare.org/Financial-Assistance-Policy Part VI, Line 4 - Community Information Winter Heaven Hospital is serving part of Polk County. The average income falls below the state average and the national average. The population served is predominantly Caucasian and high-school or higher educated. Hispanics are the second largest ethnic group representing 19.2% of the population and 17.5% of households are below poverty level. Winter Heaven Hospital is part of BayCare Health System that serves west central Florida. The area served by Winter Heaven Hospital has 5 hospitals including Winter Haven Hospital & Regency. Winter Haven & Regency are not for profit, the other 3 are for profit. There is one federally designated medically underserved area in Winter Heaven Hospital's service area. With the over 65 population expected to grow 11.8% in the next five years, the health care needs of our service area are expanding and changing. The population served by Winter Heaven Hospital is expected to grow 3.9% in the next 5 years. This is almost the same as the expected growth rate of 3.5% for the United States. The County where Winter Heaven Hospital resides experiences higher incidence rates compared to the state of Florida in the following areas: coronary heart disease, stroke, prostate cancer, lung cancer, colorectal cancer, cervical cancer, breast cancer, melanoma, births to teens, infant death rate, neonatal death rate, post-neonatal death, fetal death rate, adult smokers, asthma hospitalization and domestic violence. Part VI, Line 5- Promotion of Community Health Winter Haven Hospital, Inc., located in Winter Haven, Florida, includes a 468-bed acute care hospital and a 61-bed obstetric/gynecological hospital, respectively referred to as Winter Haven Hospital and Regency Center for Women and Infants. Winter Haven Hospital was established in 1926, and today concentrates in the treatment of heart disease, behavioral health, cancer, stroke, and urological conditions. The hospital also provides emergency care, outpatient diabetes education; seven primary care providers; endoscopy and surgical services; neurological, orthopedic and in-patient rehabilitation; outpatient surgery; and imaging services. The Regency, built in 1987, includes a level II neonatal intensive care unit and on-site obstetric services 24 hours a day, 7 days a week. A pre-natal center is also set-up within the Regency for low income pregnant patients who do not have a private physician. On August 30, 2013, Winter Haven Hospital, Inc. joined Clearwater-based BayCare Health System. The consolidation strengthened our commitments to improve the health of the people we serve, and to return value to our surrounding communities. With BayCare, we will continue to provide innovative and advanced services that focus on quality and compassionate care. Community Outreach & Partnerships Outreach Through education, connective resources, and a focus on prevention and early detection, we are building a healthier community while reducing suffering and total health care costs. The Health Connection local and toll-free phone line is a free resource to the community to provide physician referrals and registration or connections to healthcare-related programs, classes, and special events. The Speaker's Bureau program provides speakers to community organizations on a range of medical topics at no charge. The hospital also maintains two medical libraries that are open to the public. The libraries offer books, tapes and online clinical research tools for a variety of health care topics. Printed or copied information can be mailed directly to someone's home address. An onsite Research Information Specialist trained by the National Library of Medicine and the Medical Library Association is available to assist with research at the Winter Haven Hospital library. The second library at the Regency focuses on women and infant related resources. Free or reduced-cost health screenings were provided within the community upon invitation and at Winter Haven Hospital during organized events. These include lectures, support groups, sponsorships/partnerships and health fairs. On-site screenings were provided during our Heart Smart Days events, Breast Cancer awareness days, and at the Diabetes Health Fair. The Heart Smart Days events provide free lectures, blood pressure (BP) screenings, ankle-brachial index (ABI) scores and body mass index (BMI) scores. Blood panel profiles by venipuncture were provided at a reduced cost. On every Tuesday afternoon in October 2012, Winter Haven Hospital offers free Clinical Breast Exams and reduced-cost mammograms. The exams are provided by a Winter Haven Hospital oncologist for women of all ages. Mammograms are targeted to women ages 40 to 64. The Diabetes Health Fair and Self-Management Education are coordinated by Winter Haven Hospital's Center for Diabetes Education. The health fair provided education and free glucose checks to 75 participants. The low-cost Self-Management Education classes are for people with or at-risk for developing diabetes to help them gain the knowledge and skills needed to modify behavior and successfully self-manage the disease and its related conditions. Community-based screening and education is provided by invitation to an assortment of community hosts, such as residential communities, civic groups, churches, and schools. A small sample of events include monthly talks at the Winter Haven Senior Center; Polk State College Health Fair for students and faculty; Bibleway Christian Academy Student Info Seminar; the annual Historic Pughsville May Day Festival; COPIA Education, Health and Wellness Expo; and a Lake Hamilton Women's Club meeting. Through outreach events, Winter Haven Hospital touched more than 10,000 lives from October 2012 to September 2013. In addition, Winter Haven Hospital maintains a Neighborhood Services Center and employs a full time director in order to coordinate speakers, entertainment, and health fairs primarily for senior citizens at the off-site center. Partnerships Our community partners are critical to helping us improve the health and well-being of eastern Polk County. Together, we combine resources and strengths, positively impacting the greatest number of people. By working closely with community leaders, we also build a greater sense of community and a shared commitment toward our common goal of improving the community's health. We're proud of working with the following community partners: Polk Healthcare Alliance - A senior hospital employee served as the liaison with the Polk Healthcare Alliance. As a member of a five person Executive Committee for the Polk Healthcare Alliance, the Liaison reviews progress toward the organization's Community Health Improvement Plan (CHIP). The Haley Center - Winter Haven Hospital was instrumental in the development of a free clinic in Winter Haven called the Haley Center. The First Baptist Church of Winter Haven asked for assistance from the county health departments, WHH, the Community Health and Social Services Department and others to ensure the free clinic's success. It has been operational since December 2005 with the hospital providing free lab, X-ray and pulmonary function testing. We Care - The hospital participates in the Polk County Medical Association's We Care program. Through a network of 215 medical specialists, We Care helps provide specialty medical care for low income, uninsured residents of Polk County. Angel Care Center of Eloise - This center, operated by a local church, offers a free diabetic clinic the second Wednesday of each month for persons whose income does not exceed 200 percent of the federal poverty level, who are not eligible for Medicaid or Medicare and who does not have private medical insurance. Hospital volunteers also provide their time to assist with free medical attention. Polk Healthcare Plan - The Hospital participates in and accepts the Polk Healthcare Plan. Polk HealthCare Plan is a public/private partnership that allows for a comprehensive managed health care program for eligible Polk County residents. The Plan provides an integrated system of health care and social services through a wide range of primary and preventive medical care, specialty medical care, hospitalization, diagnostic testing, ancillary services and pharmaceuticals. In essence, the Plan functions as a County-operated HMO for qualified Polk County residents. A senior hospital employee attends the Citizen Oversight Committee, an Advisory body on health issues for the Polk Healthcare Plan. The hospital joined with Polk Healthcare and other area hospitals to participate in an initiative that increases primary care services to low income residents of Polk County. Physician Recruitment - The hospital has a full-time physician recruiter and actively recruits physicians in primary care and specialty care areas where it has identified a community need. The hospital also works closely with physician groups to assist them in recruiting new physicians to our area. Sponsorships - Winter Haven Hospital and its employees provided sponsorship and fund raising for several community organizations and events, including: The American Heart Association's Polk Heart Walk, a three-mile walk designed to provide awareness of and raise funds to fight the nation's #1 cause of death, heart disease. The walk also encourages people to take steps toward a heart-healthy lifestyle. Winter Haven Hospital is a consistent sponsor and walking team company leader. In the October 2012 event, Winter Haven Hospital sponsored $2,500 and raised more than $4,000 for walking teams. Winter Haven Hospital employees also contributed more than $6000 to the AHA through a employee giving program, and sponsored the Polk Heart Ball. Winter Haven Hospital partnered with the American Cancer Society to sponsor the Winter Haven annual "Relay for Life" event (an event to raise money to fight cancer and provide services to cancer patients and their families). All proceeds from the event will be used to provide educational and patient services, as well as critical dollars used to fund cancer research. WHH sponsored the 2013 event at $2,500 and raised additional funds during the event. Polk Senior Games provides an annual two-week series of Olympic-style sports and games for men and women 50 years of age and over; more than 2,400 seniors participate. The games inspire an active lifestyle, promote a positive image of seniors, and encourage volunteerism. As a $2,500 sponsor of the event, Part VI, Line 6 - Affiliated health Care System The Hospital is affiliated with the University of Florida Medical School and continually draws on its expertise. Emergency Department physicians and the physician director of the Cancer Center and the Center for Robotics and Urology are from the University of Florida. The University of Florida staff plays a significant role in providing continuing education for medical and nursing staff. This continuing education allows the hospital to improve the way it cares for patients. In addition to this affiliation, Winter Haven Hospital consolidated with BayCare Health System, Inc.(BayCare) effective August 30, 2013. BayCare is a not-for-profit corporation that operates an integrated health care delivery system in the tampa bay region of Florida. BayCare provides a full continuum of care through its five clinical divisions which are supported by a comprehensive suite of centralized corporate services. BayCare's hospitals are Mease Countryside, Mease Dunedin, Morton Plant, Morton Plant North Bay, St. Anthony's, South Florida Baptist, St. Joseph's, St. Joseph's Women's, St. Joseph's Children's, St. Joseph's Hospital-North, and Winter Haven Hospital. As an integrated health system, BayCare's hospital members benefit from centralization of shared services in Finance, Business Office, Information Technology, Human Resources and Materials Management which strengthens each hospital's ability to serve the health needs of their local communities and provide traditional charity care and unbilled community services to uninsured and underinsured residents. BayCare's strategy is focused on establishing the framework and foundation to enable population health management and improve access to affordable, high-quality health care. Developing the infrastructure to manage risk and population health has been a multi-year initiative that encompasses aligning physicians, acquiring insurance competencies, and expanding care management capabilities. With 284 access points across its four-county service area, BayCare is focused on establishing a geographic footprint across the Tampa Bay region to promote access to its comprehensive services, regardless of a patient's ability to pay. Part VI Line 7 State Filing of CBR & Line 8 Facility reporting groups Line 7 N/A: Winter Haven Hospital, Inc did not prepare a community benefit report for Tax year 2012. During this tax year Winter Haven Hospital was undergoing a consolidation with BayCare Health System, Inc. As a result of management, operating, and system changes a report was not completed during this tax year. The Hospital is converting to a new Fiscal Year End and will complete a Community Benefit Report for its FYE 2014. Line 8 All answers provided in Part VI pretain to Facility Group A which includes Winter Haven Hospital, Inc. and Regency Center for Women and Infants. false false false false false false false false Lance Anastasio 0 485412 0 46900 0 19567 0 36053 0 25977 0 613909 0 0 David MacDougall 0 300614 0 27300 0 3354 0 43521 0 27536 0 402325 0 0 Kaye Hixon 0 192240 0 18700 0 3113 0 11077 0 3891 0 229021 0 0 David Libby 0 166109 0 16500 0 4675 0 47967 0 25652 0 260903 0 0 John Parman 176869 0 0 0 1399 0 21864 0 26275 0 226407 0 0 0 Mary Jo Schreiber 0 203900 0 19400 0 3160 0 22432 0 0 0 248892 0 0 Joel Thomas 0 146260 0 14100 0 2371 0 10483 0 26458 0 199672 0 0 Celestino Vega 0 274124 0 27900 0 12820 0 0 26890 0 341734 0 0 Donald Gale 0 272315 0 27500 0 5973 0 31405 0 3088 0 340281 0 0 Majd Alsamman 317072 0 9540 0 3663 0 38849 0 8140 0 377264 0 0 0 Joseph Lynch 341428 0 0 0 3110 0 20895 0 29016 0 394449 0 0 0 Kenneth Gibbs 377822 0 0 0 7884 0 6256 0 29431 0 421393 0 0 0 George Winny 236793 0 0 0 1677 0 27842 0 35155 0 301467 0 0 0 Takkallapelli Rao 143892 0 82000 0 3610 0 9858 0 27066 0 266426 0 0 0 Part I, Line 3 The filing organization does not use any of the options listed in Schedule J, Part I, Line 3 to establish the compensation of the CEO/Executive Director. However, the related organization, Mid-Florida Medical Services Inc, uses Compensation committee, Independent compensation consultant, Compensation survey or study and Approval by the board or compensation committee as a means to establish the CEO's compensation of the filing organization. Part VI Part VI, Line 2 - Description of Business Relationship William Murrell and Mark Bostick have a family relationship. PART VI, LINE 4 - SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS Effective August 30, 2013 BayCare health System, Inc. became the sole corporate member of Winter Haven Hospital, Inc. THE ARTICLES OF INCORPORATION WERE AMENDED TO CHANGE THE MEMBER FROM MID florida medical services, inc. to baycare health system, inc. The bylaws were amended to change, the number of trustees from a range of 9-17 trustees to a total of 14 trustees. PART VI, LINE 6 - DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS THE CORPORATION SHALL HAVE ONE MEMBER WHICH SHALL BE BAYCARE HEALTH SYSTEM, INC. PART VI, LINE 7A - DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS THE TOTAL NUMBER CONSTITUTING THE MEMBERS OF THE BOARD SHALL BE FOURTEEN VOTING TRUSTEES AS FOLLOWS: (I) EIGHT TRUSTEES APPOINTED BY THE SOLE MEMBER, UPON PRIOR CONSULATION WITH THE MID-FLORIDA MEDICAL SERVICES, INC. ACTING IN ITS CAPACITY OF BEING THE SOLE MEMBER OF MID FLORIDA MEDICAL SERVICES FOUNDATION, INC. (MFMS FOUNDATION) AND (II) SIX TRUSTEES APPOINTED BY THE MFMS FOUNDATION DESIGNEE. PART VI, LINE 7B - DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE SOLE MEMBER SHALL HAVE THE RIGHT TO MAKE ALL DECISIONS REGARDING THE GOVERNANCE, STRATEGY, FINANCES AND OPERATIONS OF THE CORPORATION, INCLUDING, WITHOUT LIMITATION, THE EXCLUSIVE AUTHORITY TO AUTHORIZE, APPROVE, AND/OR PERFORM THE FOLLOWING: (A)THE APPROVAL OF THE CORPORATION'S STRATEGIC PLAN, OPERATING BUDGETS AND CAPITAL BUDGETS; (B)THE APPROVAL OF THE CORPORATION'S PHILOSOPHY, MISSION STATEMENT AND PURPOSES; (C)THE ADDITION, DELETION OR RECONFIGURATION OF THE SERVICES AMONG THE CORPORATION AND ITS AFFILIATES; (D)THE ESTABLISHMENT OF THE FEES AND CHARGES ON BEHALF OF THE CORPORATION; (E)THE EXECUTION OF MANAGED CARE CONTRACTS ON BEHALF OF THE CORPORATION; (F)THE APPROVAL OF NON-BUDGETED EXPENDITURES AND INCURRENCE OF INDEBTEDNESS ABOVE LIMITS APPROVED BY THE SOLE MEMBER'S GOVERNING BOARD FORM TIME TO TIME; (G)THE HIRING, FIRING, DISCIPLINE AND DISCHARGE OF THE COPRORATION'S PRESIDENT; (H)THE PURCHASE, SALE, TRANSFER, LEASE, LOAN, OR OTHER ENCUMBRANCE OF THE CORPORATION'S ASSETS ABOVE A CERTAIN THRESHOLD APPROVED BY THE SOLE MEMBER'S GOVERNING BOARD FROM TIME TO TIME; (I)THE TERMINATION OR MATERIAL MODIFICATION OF THE BOSTICK HEART CENTER, CASSITY CANCER CENTER, OR THE CENTER FOR ROBOTIC SURGERY AFTER THE SEVENTH ANNIVERSARY OF THE EFFECTIVE DATE OF THESE AMENDED AND RESTATED BYLAWS; (J)AMENDMENT OF THESE BYLAWS AND THE CORPORATIONS ARTICLES OF INCORPORATION; (K)THE FILING OF A VOLuntary PETITION IN BANKRUPTCY OR OTHER APPLICATION FOR JUDICIAL RELIEF FROM THE CREDITORS OF THE CORPORATION; AND (L)THE DEVELOPMENT OR ACQUISITION OF NEW FACILITIES AND/OR THE CLOSURE OR RELOCATION OF ANY FACILITY OPERATED BY THE CORPORATION. PART VI, LINE 11B - DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY THE ORGANIZATION AND REVIEWED BY THE CFO, AS WELL AS THE ORGANIZATION'S PAID PREPARER. PRIOR TO FILING WITH THE IRS, A FINAL COPY OF THE FORM 990 WAS PROVIDED TO THE ENTIRE BOARD VIA A WEB PORTAL. PART VI, LINE 12C - DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTREST THE CHAIRMAN OF THE BOARD OF DIRECTORS INQUIRES AT LEAST ANNUALLY IF THERE ARE ANY CONFLICTS OF INTEREST. IN ADDITION ALL OFFICeRS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. Part VI Part VI, Line 15a & 15b - Process used for compensation review and approval. The Executive Compensation Committee of the Board of Directors sets compensation for the president and vice presidents of the hospital. The executive compensation committee consists of four board members, all of whom are independent. the executive compensation committee has used the consulting firm of Sullivan and Cotter to advise them about executive compensation and to provide them with comparability data. Minutes of the executive compensation committee meetings are kept and retained at the Hospital. Part VI, Line 19 - Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public The financial statements of Winter Haven Hospital, Inc. are made available to the public upon request. The organization's governing documents and conflict of interest policy are not made available to the public. Part X Line 20 - Bond Debt DURING THE TAX YEAR, WINTER HAVEN HOSPITAL WAS AQUIRED BY BAYCARE HEALTH SYSTEM, INC. THROUGH THIS AQUISITION, THE RELATED WINTER HAVEN OUTSTANDING BOND DEBT OF APPROX. $77.6M WAS PAID OFF. Part XI Line 9 Other changes in net assets or fund balances Pre-acquisition Transfer of assets $12,627,297 Other $ 2,136,312 Total $14,763,609 BayCare Health System Inc 2985 Drew St Clearwater FL 33759 592796965 Health Srvcs FL 501(C)(3) 3 N/A false BayCare Behavioral Health Inc 7809 Massachusetts Ave New Port Richey FL 34653 591371752 Health Srvcs FL 501(C)(3) 7 Baycare true BayCare Emergency Assistance Program Inc 2985 Drew St Clearwater FL 33760 592697770 Emerg Assist FL 501(C)(3) 9 Baycare true BayCare Home Care Inc 8452 118th Ave North Largo FL 33773 593582520 Home Hlth Srv FL 501(C)(3) 9 Baycare true Behavioral Health Management Srvcs Inc 323 Jeffords Street Clearwater FL 33756 593279573 Health Srvcs FL 501(C)(3) 9 BC Beh Hlth true Winter Haven Hospital Auxiliary Inc 200 Ave F Northeast Winter Haven FL 33881 237190109 Volunteer Srv FL 501(C)(3) 3 N/A false Winter Haven Hospital Foundation Inc 200 Ave F Northeast Winter Haven FL 33881 030406130 Fundraising FL 501(C)(3) PF N/A false Mid-Florida Medical Srvs Foundation Inc 200 Ave F Northeast Winter Haven FL 33881 030406130 Fundraising FL 501(C)(3) 11a WH Hospital true Mid-Florida Medical Services Inc 200 Ave F Northeast Winter Haven FL 33881 592486580 Health Srvcs FL 501(C)(3) 11a WH Hospital true BC Employ Health Cl 8452 118th Ave Largo FL 33773 461533183 Health Srvcs FL NA NA BC Purchas Pt LLC 8731 Fl Mining Tampa FL 33634 640950837 Group Purch FL NA NA BC Surgery Cntr LLC 8452 118th A N Largo FL 33773 460591430 Surgery Centers FL NA NA Care Ride LLC 4625 Bay Clearwater FL 33764 593565490 Transport Srv FL NA NA Bay Vista Claims Service Inc 2985 Drew St Clearwater FL 33759 743168200 Claims Admin FL NA C-Corp BCHS Insurance Inc 720 W BAY RD BUCKLING SQR KY-1-110 BUCKLING SQR GRAND CAYMAN CJ KY1-1102 Insurance Captive CJ NA C Corp Medspecialists Inc 2985 Drew St Clearwater FL 33759 680587533 payroll srvcs FL NA c-corp false false false false false false false false true true true false false false true false true true true Mid-Florida Medical Services Inc i 642409 FMV Mid-Florida Medical Services Inc k 206250 FMV Mid-Florida Medical Services Inc o 542636 FMV Mid-Florida Medical Services Inc r 13945781 FMV Mid-Florida Medical Services Inc r 8152279 FMV