2013-11-11T17:31:21-06:00 2012-12-31 ERNST & YOUNG US LLP 55 IVAN ALLEN JR BLVD SUITE 1000 ATLANTA GA 30308 990 2012-01-01 592043026 St Anthony's Hospital Inc % CARL TREMONTI STAN 7278251649 1200 7th Avenue North Suite St Petersburg FL 33705 CARL TREMONTI 2013-11-07 4048748300 2012 2016-02-24 21:20:13Z Glenn Waters 1200 7th Avenue North St Petersburg FL 33705 243596639 false X www.BayCare.org X 1980 FL St. Anthony's Hospital will improve the health of all we serve through community-owned health care services that set the standard for high-quality, compassionate care. 22 19 1898 449 337482 279519 392590 440234 194748366 220433376 767322 1081291 3584498 6916329 199492776 228871230 165797 90356 0 0 88976162 97929313 0 0 0 97126558 106159810 186268517 204179479 13224259 24691751 159607665 175863798 129335789 95667993 30271876 80195805 ST ANTHONY'S HOSPITAL WILL IMPROVE THE HEALTH OF ALL WE SERVE THROUGH COMMUNITY-OWNED HEALTH CARE SERVICES THAT SET THE STANDARD FOR HIGH QUALITY, COMPASSIONATE CARE. false false 182057128 90356 226213237 St. Anthony's Hospital (SAH) is a full-service 395-bed community hospital. During 2012, SAH provided inpatient care to 14,362 patients and treated 41,662 patients in the emergency department. Through efforts of the medical assistance program and the hospital's charity care program SAH saw a net community benefit expense of $16.4 million. The hospital also provided other community services totaling more than $1 million. Some of the programs included Services for the St. Pete Free Clinic, Faith Community Nursing, and Health Fairs. REFER TO SCHEDULE H FOR ADDITIONAL INFORMATION. 182057128 true true false true false false false false false false true false true false true false false true false false false false false false false false true true true false true false false false false false false false true false false false false true true true true false false true 245 0 true 1898 true true true false false false false false false false false false X 22 19 true false false false true true true true true false false true true true true true true true true true true X CARL TREMONTI 7278251649 1200 7TH AVE N St Petersburg FL 33705 WILLIAM ULBRICHT 45.0 1.0 X X 611179 0 70850 STEPHEN MASON 1.0 50.0 X 0 4003358 49908 JOHN BILCHAK 1.0 X WORTH T BLACKWELL 1.0 X JOSEPH BOULAY 1.0 X DEBORAH COAKLEY 1.0 3.0 X THOMAS J EGAN 1.0 X PHILIP H GRAHAM 1.0 X MICHAEL G MIKURAK 1.0 1.0 X X GWENDOLYN MURRAY-JOHNSON 1.0 X J DALE OLIVER 1.0 X CHARLES OSTERHOLT 1.0 X CARY PUTRINO 1.0 X GLADYS SHARKEY 1.0 4.0 X MARLENE WEIDENBORNER 1.0 X DAVID MEEHAN 1.0 X THOMAS WHITEMAN 1.0 X CHARLES WENIGER 1.0 X WARREN ABEL 1.0 X TEJINDER GLAMOUR 1.0 X SHRI GOYAL 1.0 X REBECCA MARSHALL 1.0 X SUSAN OLDS 45.0 3.0 X 168380 0 19785 REBECCA ARSENEAU 45.0 1.0 X 70141 10043 PATRICIA SIZEMORE 45.0 2.0 X 332484 0 44004 RONALD COLAGUORI 45.0 X 310680 0 52118 WALTER INMAN 45.0 X 192289 0 15746 CHARLES GUASTELLA 45.0 X 157559 0 20334 TERESA BRADLEY 45.0 X 356582 0 40317 ARCHANA PUDUR 45.0 X 411558 0 20651 ANNE-MARIE JOHNROSE-BROWN 45.0 X 358956 0 40197 HENRY CLARKE 45.0 X 607705 0 33781 ALLAN WEISS 45.0 X 362041 0 41469 CARL TREMONTI 49.0 X 0 394465 42657 3939554 4397823 501860 94 true true false BRASFIELD GORRIE LLC 200 COLONIAL PKY STE 200 LAKE MARY FL 32746 Construction Svcs 5974896 DIAZ FRITZ GROUP INC 13075 TELECOM PKWY NORTH TEMPLE TERRACE FL 33637 Construction Imprvmt 1495667 BAY LINEN INC 11525 47TH ST NORTH CLEARWATER FL 33762 laundry services 1243573 EMERG MED ASSOC OF FLORIDA LLC 500 DR MLK ST N STE 303 ST PETERSBURG FL 33705 medical staffing 918438 PROF HLTH CARE OF PINELLAS INC 1839 CENTRAL AVE ST PETERSBURG FL 33713 medical services 828617 31 110625 119726 209883 440234 HOSPITAL PATIENT CARE 621999 93583037 93583037 MEDICARE/MEDICAID NET REVENUE 621999 126850339 126850339 220433376 811898 337482 474416 0 0 0 0 0 14994802 14715352 10057 279450 -10057 269393 269393 0 0 0 CAFETERIA 722310 1136468 1136468 COMMUNITY AFFAIRS 523000 20297 20297 HITECH ELECTRONIC MEDICAL RECORDS INCENTIVE 900099 4907606 4907606 851958 851958 6916329 228871230 226213237 337482 1880277 90356 90356 0 0 0 2125632 177892 1947740 0 81009987 79020958 1989029 2652386 2587262 65124 6282536 6128282 154254 5858772 5651640 207132 0 147080 147080 895 895 6454 6454 0 64659 64659 7478043 6952667 525376 842580 828669 13911 3745133 1729388 2015745 276122 269038 7084 0 4477355 4383807 93548 395890 199164 196726 0 0 2149149 2149149 0 12868761 12839637 29124 1038558 222452 816106 MEDICAL SUPPLIES 36257705 36249320 8385 BAD DEBT EXPENSE 13702589 13702589 MANAGEMENT FEES 13615505 13615505 MISCELLANEOUS 6868966 6644038 224928 2224366 2224366 204179479 182057128 22122351 0 15265 9269 0 0 0 0 20501017 22523996 0 0 0 0 231967 200944 3616041 4154924 2203441 1703773 285348413 149287097 105884867 136061316 9221436 0 7905495 0 9933573 11181576 0 0 94563 28000 159607665 175863798 16798483 14370025 0 0 908767 240453 0 0 0 0 0 0 0 0 0 0 111628539 81057515 129335789 95667993 X 22476557 71817623 6750373 7235640 1044946 1142542 30271876 80195805 159607665 175863798 X 24691751 1356207 23875971 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 6454 6454 false Schedule C Part II-B, Line 1i Description Of Other Activities Expense Dues were paid to the St. Petersburg Chamber of Commerce,Florida Hospital Association, and the National Association of Pscyhiatric Health Systems. These organizations use a portion of their respective dues to conduct lobbying activities. 465465 465465 150380848 70753184 79627664 305671 296453 9218 103920188 78237460 25682728 30276241 30276241 136061316 INVESTMENT IN RELATED ENTITIES 1256417 F INTEREST IN FDN NET ASSETS 9925159 F 11181576 0 DUE TO AFFILIATES 78174229 ESTIMATED THIRD PARTY SETTLEMENTS 2843228 OTHER LIABILITIES 40058 81057515 230211122 1356207 59480 1415687 228795435 75795 75795 228871230 203781647 203781647 397832 397832 204179479 Schedule D Supplement Information Schedule D, Part XI, Line 2d Unrealized gains on swaps $59,480 Schedule D, Part XI, Line 4b Revenues netted with expenses $397,831 Contributions in tax income, not on books $124,505 Change in net assets of foundation ($446,543) Rounding $2 Total $75,795 Schedule D, Part XII, Line 4b Revenues netted with expenses $397,831 Rounding $1 Total $397,832 true true X true X 250. false true true true false true true 1 10848 12048797 12048797 0.06330 1 10292 23209721 19996060 3213661 0.01690 1 125 172812 2980 169832 0.00090 3 21265 35431330 19999040 15432290 0.08110 33 54353 443818 443818 0.00230 6 213 436658 436658 0.00230 17 5501 116408 116408 0.00060 56 60067 996884 996884 0.00520 59 81332 36428214 19999040 16429174 0.08630 true 13604676 7973194 63315881 71397296 -8081415 X true true Carillon Surgery Cen Health Services 0.00000 0.00000 0.14200 1 1 St Anthony's Hospital Inc

1200 7th Ave North St Petersburg FL 33705

www.stanthonys.com X X X A A-St Anthony's Hospital 1 true true 250. false true X X X X X X X true true X X X true X false X X X X true X false false 2 St Petersburg Endoscopy Ctr LLC

1099 5th Ave North Suite 100 St Petersburg FL 33705

Surgery Center St Anthony's Rehab Services Outpatient

900 Carillon Pkwy St Petersburg FL 33716

Rehabilitation Services PART I, LINE 3C Patients who are uninsured or underinsured and cannot pay for hospital services are eligible for charity consideration. These patients are screened by designated team members in our Financial Assistance Department. The Agency for Health Care Administration (AHCA) defines charity eligibility at 200 percent of the federal poverty guidelines, unless the total hospital bill is more than 25 percent of the patient's annual income. Medicaid recipients who have exceeded their coverage limits are also considered for charity care. St. Anthony's Hospital, Inc goes above and beyond the AHCA requirements by providing additional "hardship" charity for patients who are at 250 percent of the federal poverty guidelines. In addition, an uninsured discount of 40% is given to any patient who does not have insurance coverage or benefits. There is no income or asset test required for the uninsured discount. Patients receive an additional 10% discount if the account is paid within 30 days. PART I, LINE 6A N/A - The Community Benefit Report is available to the public. PART I, LINE 7 Financial assistance and means-tested government programs costs (lines A through D) are determined using our cost accounting system, which captures all inpatients and outpatients, including emergency room patients. The system also captures all patient pay types - private insurance, Medicare, Medicaid, uninsured and self pay. The costs have been offset by any payments received from Medicaid or any other uncompensated care program. Other benefits at cost (lines E through J, as well as amounts reported in Part II) were compiled by the community health department using the Catholic Health Association guide for planning and reporting community benefits. PART I, LINE 7F Bad Debt expense of $13,702,589 was included on form 990, Part IX, Line 25, Column (a), but subtracted for purposes of calculating the percentage in this column. PART III, SECTION A, LINE 2,3, & 4 The organization's financial statements do not include a footnote directly on bad debt expense. Bad debt expense is reported as total bad debt for the facility. The amount of bad debt expense attributable to patients eligible for financial assistance is calculated as a charge ratio, derived from data sampling. The resulting charge ratio is then applied to total bad debt accounts of the organization, which calculates the bad debt attributable to finance assistance. The state of Florida requires the patient to provide certain documentation in order to qualify for financial assistance. In cases where the patient has not responded to hospital requests or billing statement alerts, those accounts are processed as bad debt, if unpaid. PART III, SECTION B, LINE 8 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 patient 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, hospitalist program, recruitment, etc.), advertising costs, cafeteria costs for meals sold to visitors, etc. The hospital attempts to collect coinsurance and deductibles from Medicare beneficiaries. To the extent collection efforts are unsuccessful, Medicare reimburses the hospital at 70% of unpaid amounts. The following table reconciles the surplus or shortfall from Line 7 to the actual surplus or shortfall. The additional costs were allocated to Medicare based upon Medicare's percentage of total allowable costs. The unpaid coinsurance/deductibles were estimated using historical collection results. Any shortfall amounts have not been treated as community benefit. Line 7 Surplus or (Shortfall) ($8,081,415) Additional non-allowable costs and unpaid/non-reimbursed coinsurance/deductibles ($601,879) Total Surplus or (Shortfall) ($8,683,294) PART III, SECTION C, LINE 9B Patients who are unable to pay are encouraged by BayCare Health System representatives, via personal interviews, signage, on patient billing statements, brochures or Customer Service phone calls, to submit financial information to the Financial Assistance Department to determine eligibility for programs, such as County, Medicaid, Disability, Victims of Crime, Charity, etc. For those patients who provide all the necessary documentation and qualify for charity according to the Financial Assistance policy, (defined in Part I, line 3c), patients' account balance would be written off completely to charity and not billed to the patients. PART V, SECTION B, LINE 11 An uninsured discount of 40% is automatically given to any patient who does not have insurance coverage or benefits. There is no income or asset test required for the uninsured discount. Patients receive an additional 10% discount if the account is paid within 30 days. PART V, SECTION B, LINE 14 Contact information related to financial assistance is posted in the emergency room waiting area, admissions office, and printed on all patient billing. PART V, SECTION B, LINE 16 Lien action related to collections is limited to patients involving auto liability insurance. PART V, SECTION B, LINE 20d Patients who are uninsured or underinsured and cannot pay for hospital services are eligible for charity consideration. These patients are screened by designated team members in our Financial Assistance Department. The Agency for Health Care Administration (AHCA) defines charity eligibility at 200 percent of the federal poverty guidelines, unless the total hospital bill is more than 25 percent of the patient's annual income. Medicaid recipients who have exceeded their coverage limits are also considered for charity care. St. Anthony's Hospital, Inc goes above and beyond the AHCA requirements by providing additional "hardship" charity for patients who are at 250 percent of the federal poverty guidelines. Once a patient is identified as eligible for financial assistance his/her account balance is written off 100% to charity write-offs and are no longer billed for services provided. PART VI, LINE 2 - Needs Assessment St. Anthony's Hospital, Inc is committed to meeting the needs of the community it serves. Our quality philosophy is modeled around understanding our customers' needs in the communities it serves. St. Anthony's Hospital, Inc addresses community health status assessments by accessing existing third party databases profiling health status information for geographies it serves. The assessments provide a profile of health status indicators in comparison to state averages and, if available, national benchmarks. In addition, St. Anthony's Hospital, Inc conducts physician community need studies that outline physician deficits by specialty for the geographic area served. Studies are also conducted to identify gaps in geographic access to services such as primary care, outpatient services and inpatient services. All of the above processes occur on an ongoing basis to assist St. Anthony's Hospital, Inc in developing initiatives and programs/services to address identified health care needs in the communities it serves. PART VI, LINE 3 - Patient Education of Eligibility for Assistance St. Anthony's Hospital, Inc Financial Assistance team members are dedicated to assisting patients in obtaining assistance through federal, state and local government programs or through the St. Anthony's Hospital, Inc financial assistance policy. Signage and brochures are available, as well as team members whose full responsibility is to assist patients in the emergency room and on inpatient units. The Financial Assistance team interviews patients for all available programs, assists the patients in completing applications to government agencies and for hospital charity care, advises patients regarding available community resources for health care, reviews and approves patient requests for charity care, and provides education and support to the patient throughout the assistance process. In addition to the aforementioned comprehensive process, St. Anthony's Hospital, Inc also informs and educates patients who may be billed for patient care, but may be eligible for charity or other programs, via patient billing statements and customer service representative calls. The goal in using these various means is to effectively communicate with the entire patient population so they are informed and educated about their eligibility for assistance. PART VI, LINE 4 - Community Information St. Anthony's Hospital is in a small city setting serving southern Pinellas county. The average income is lower than both the state and national averages. The population served is predominantly Caucasian and high-school or higher educated. Blacks are the second largest ethnic group representing 16% of the population and 15% of households are below poverty level. St. Anthony's Hospital is part of BayCare Health System that serves west central Florida. The area served by St. Anthony's has 7 hospitals with more For Profits than Not-for Profits. There are 2 federally designated medically underserved areas in St. Anthony's service area. Due to the aging of the population with little to no growth for the under 55 segment in the next five years, the health care needs of our service area are changing. The population served by St. Anthony's Hospital is expected to decline 1.5% in the next 5 years. The expected growth rate for the United States is 3.9%. While overall population growth is declining, the population Age 65+ is expected to grow 9%. The community experiences higher incidence rates compared to the state of Florida in the following areas: adults with asthma, HIV cases, AIDs cases, fully immunized kindergarteners and sexually transmitted diseases. Based on Florida inpatient discharge data for the period of 10/01/11-09/30/12, the payor mix for the geographic area consists of 52.6% Medicare/Medicare HMO, 17.1% Medicaid/Medicaid HMO, 19.9% Commercial Insurance, 7.4% Self-pay, and 3.0% Other. PART VI, LINE 5 - Promotion of Community Health St. Anthony's Hospital St. Anthony's Hospital was founded in 1931 by the Franciscan Sisters of Allegany, NY with a mission to serve the needs of the people and to build a hospital evoking the Franciscan sisters' faith and mission of treating everyone with the utmost kindness and consideration, regardless of circumstances. Through faith dedication and compassionate care, St. Anthony's has grown to become an established community resource. The mission is evident as about 2000 team members and more than 500 highly qualified physicians work daily to achieve St. Anthony's mission of improving the health of the community. Pinellas Hope -- St. Anthony's has always had a strong commitment to the poor as evidenced by its Homeless Task Force Committee, which monitors and responds to the needs of the homeless in our area and who we serve. Realizing the plight of the homeless in the area, the committee collaborated with Catholic Charities of the Diocese of St. Petersburg in 2007 on a pilot project called Pinellas Hope. St. Anthony's team members have always been generous and quick to respond when asked to help a worthy cause and hospital administration and team members were quick to volunteer resources to help make the program a success. The program continues to operate successfully today through strong community support and oversight by Catholic Charities. Pinellas Hope is an emergency shelter that provides meals to the hundreds of homeless residents who seek temporary refuge at the shelter. The project helps homeless adults by giving them a place to live and providing assistance with social services, case management, food, and job placements. In 2012, St. Anthony's donated $12,770 in in-kind services and food for residents at Pinellas Hope. Team Members volunteered their time, twice a month, serving meals to more than 3,750 persons. St. Anthony's Team Members also provide other assistance through such donations as items of clothing, blankets and other supplies. Seeing the need for continued recuperative care after hospitalization for the homeless who would otherwise return to the street, St. Anthony's, in collaboration with Catholic Charities, Morton Plant Mease Hospital and BayCare Health System, opened a 10-unit Medical Respite Center within Pinellas Hope in 2009. Each Medical Respite client resides in a casita, a small one room housing unit, and receives daily care and support coordinated by a case manager. BayCare Home Health Services visit those who need such services as wound care, IV antibiotics or other invasive medical treatment, until they are well enough to be released. Others simply need a stable place to regain their strength. Of the 121 admitted to the program since inception, 28 have transitioned into the general Pinellas Hope program after Respite discharge and 52 to permanent housing in the community. In addition, before discharge from the program, a primary care provider and first visit to the provider is established, as well as securing access to prescribed medications. In 2012, St. Anthony's Mission Integration team provided the following goods and services to the greater community: Over 2,000 persons discharged from the Hospital, the Behavior Health Unit and the Emergency Center were provided with clothing from St. Anthony's Clothing Closet. This year we initiated a Flip Flop Drive in an effort to provide foot covering for patients discharged without shoes. More than 450 pairs were donated by team members for distribution. Two food collections were held and more than 1,000 pounds of food were collected and donated to the St. Petersburg Free Clinic. The Christmas Share project collected holiday gifts that were donated by St. Anthony's team members for 59 families served through Community Action Stops Abuse (CASA), Sanderlin Center, Resurrection House, YWCA, and Catholic Charities. School supplies were collected for over 50 children residing at the Resurrection House. Five blood drives were held at St. Anthony's which collected 346 units of blood for Florida Blood Services. Community non-profit organizations, such as People That Love Mission, and other such community outreach programs for the homeless, benefit from St. Anthony's food donations on a regular basis. The Mission Integration department works with local partner, Creative Clay, to provide therapeutic art opportunities for rehabilitation patients in our Skilled Nursing Unit, as well as our Oncology and Infusion Units, aiding in their recovery. CASA, Boley Centers, Resurrection House, the Junior League of St. Petersburg and ALPHA House are local non-profit community organizations that receive "rent forgiveness" from St. Anthony's Hospital. CASA (Community Action Stops Abuse) provides advocacy and support services for victims of domestic violence. Boley Centers, Inc. is a private, not-for-profit organization serving individuals with mental disabilities, the homeless and youth in Pinellas, Hillsborough, Manatee, Pasco and Sarasota Counties. Resurrection House is a community and faith-based, transitional housing and self-sufficiency program for motivated families with minor children who are homeless or at risk of being homeless. ALPHA House provides housing and supportive services to homeless pregnant women and teens, new mothers with infants, and families experiencing crisis pregnancies. The Junior League of St. Petersburg is dedicated to promoting volunteer activities and developing women as leaders through various community service projects. The Junior League organizes several events throughout the year including a Back-To-School Care Fair each August and Clothes for Kids, which helps kids from low-income homes have clothes to wear to school each day. These organizations have use of hospital-owned land at no cost. CASA and Resurrection House also benefit from various drives and collections held by St. Anthony's such as the Christmas SHARE baskets; clothing drives and school supplies collection each year. 2012 Overview In 2012 St. Anthony's Hospital prepared to continue its legacy of serving all in the community with care and compassion and celebrated many achievements. New Emergency Center and Patient Care Tower Construction In 2012, St. Anthony's opened a new four-story, 105,000-sq.-ft. Emergency Center and Patient Care Tower. At the end of the year, the Emergency Center construction was completed and plans were underway for a January 2012 opening. With a design to enhance family-centered care and patient privacy, the new, larger Emergency Center has 32 private patient examination rooms, two critical care exam rooms, expedited triage and admissions with the goal of treating patients more quickly and efficiently, spacious waiting room with comfortable seating and wireless connectivity, Meditation Chapel for solace and reflection and an advanced CT scanner, as well as imaging and lab facilities within the emergency center to help expedite diagnosis and treatment. Rooms are designed to accommodate two patients in the event of a major disaster. Patient Care Tower In February 2012, St. Anthony's opened 64 new private patient rooms located on the second and third stories of the new patient care tower on floors above the Emergency Center. Features of the new patient rooms include a pull-out sleeper sofa for family to remain with the patient, two televisions in each patient room (one for a family member and one for a patient), warm woods and soft tones to reflect a tranquil environment, individual temperature controls in each room and carpeted hallways to help keep noise levels low. St. Anthony's Triathlon Celebrates 29th Year The 29th year of the St. Anthony's Triathlon featured one of the most competitive fields of pro athletes in its history. Close to 3,500 athletes swimming, biking and running along scenic areas of St. Petersburg competed in 2012 Triathlon. St. Anthony's Honored for Outstanding Stoke Care For the third year in a row, St. Anthony's Hospital was recognized for its commitment and success in implementing quality care for stroke patients with an American Heart Association/American Stroke Association's Get With The Guidelines Stroke Gold Plus Performance Achievement Award. To receive the award, St. Anthony's achieved 85 percent or higher adherence to all "Get With The Guidelines-Stroke Quality Achievement" indicators for two or more consecutive 12-month intervals. The hospital also achieved 75 percent or higher compliance with six of 10 "Get With The Guidelines-Stroke Quality Measures," which are reporting initiatives to measure quality of care. Electronic Medical Record Implementation As part of BayCare Health System's multi-year, system-wide electronic medical record initiative, St. Anthony's Hospital continued implementation of Phase II and prepared for Phase III, forever changing how clinicians document patient information. Today, entering patient information on the computer is the only way to perform many of the daily functions currently documented PART VI, LINE 5 - Promotion of Community Health Continued Primary Stroke Care Center St. Anthony's stroke care has earned the Gold Seal of Approval for Primary Stroke Care by the Joint Commission. As a National Level Primary Stroke Center, St. Anthony's has been recognized as having the ability to provide top quality care which is the first line of defense for preventing and treating strokes. Online Health Assessments In 2012, the hospitals in BayCare collaborated on free health assessments to provide education and knowledge of early detection and prevention of heart disease, weight loss surgery, orthopedic health, cancer, diabetes, sleep health and more. More than 16,000 free online health assessments have been completed. The free online heart assessment also gives each individual a customized report to learn how to modify his/her lifestyle and become more heart healthy. Volunteer Leadership & Services St. Anthony's Hospital Board of Trustees is comprised of local business executives and local community residents who volunteer their time to oversee the hospital's financial success that drives the hospital's mission of improving the health of all we serve through high quality health care and community programs and services. St. Anthony's Hospital volunteers provide an invaluable service to our community by performing tasks for our hospital, team members and patients that are critical to the operation of our facilities. In 2012, 57,460 volunteer hours were donated to St. Anthony's Hospital by more than 429 adult and teen volunteers. Assistance provided included: patient companion visits, patient representative visits, patient welcome visits, service desk errands, surgery visitor assistance and volunteer-assisted discharges. New programs in 2012 included: Caring with Cookies - delivering baked cookies to family members in waiting rooms. Patient Care Cart - volunteers visited the patient rooms daily with magazines, books, CD player, word search puzzles and cards. Volunteer Concierge Resources and Services - provides a listing of in-house and community resources to our patients and family members. Outpatient Care As part of its mission to improve the health of the community, St. Anthony's also strives to provide access to health care in additional locations. For that purpose, the St. Anthony's Outpatient Center (Carillon) is located in a central business district of Pinellas County. Physician offices, imaging, outpatient surgery, laboratory, physical therapy and rehabilitation, a wellness center and nutrition services are available in one convenient location. Primary Care To provide the community with better access to physicians, St. Anthony's Primary Care is a non-profit group of Board-certified or Board-eligible primary care physicians serving central and south Pinellas County. Physicians are required to be board-certified in their specialty. In 2012, St. Anthony's Primary Care was nationally recognized as a Level Three Patient-Centered Medical Home from the Physician Practice Connections - Patient-Centered Medical Home and the National Committee for Quality Assurance (NCQA). The honor for the 12 offices came just months after St. Anthony's Primary Care at BayWalk became the first in the group to earn this recognition in late 2011. Level 3 is the NCQA's highest attainable level of recognition for a Patient-Centered Medical Home. SAPC was recognized for using evidence-based, patient-centered techniques that focus on highly coordinated care and long-term patient/physician relationships. The Patient-Centered Medical Home identifies practices that promote partnerships between individual patients and their personal physicians, instead of treating patient care as the sum of several episodic office visits. Each patient's care is tended to by a physician-led care team, who provides for all the patient's health care needs and coordinates treatments across the health care system. Concussion Management Program for Student Athletes St. Anthony's sports medicine program for student athletes reached a milestone in 2012, screening 600 student athletes in south Pinellas County, Florida, with ImPACT, (Immediate Post-Concussion Assessment and Cognitive Testing) an objective measurement tool used for concussion screenings. ImPACT is a neurocognitive test that measures visual and verbal memory, reaction time, visual motor time, and impulse control. The baseline test is compared to a follow up test after a concussion occurs to determine if there are any changes in the brain, whether or not the student athlete needs to be sidelined for a period of time, and when an athlete can return to practice and play. Staff Volunteerism and Presence in the Community Leadership members at St. Anthony's also participate as board members, members, or in advisory capacities to many local organizations including St. Petersburg Chamber of Commerce, Leadership St. Pete, American Heart Association, Catholic Charities Board, Pinellas Homeless Network, Pinellas County Homeless Leadership Network, Pinellas County, CASA, Domestic Violence Task Force, St. Petersburg Free Clinic, Historic Uptown Neighborhood Association, The Children's Home, etc. St. Anthony's also has a Mission Integration Community Affairs Committee, which is comprised of leaders from various civic, religious, educational, and health related organizations/agencies, which share the needs of the community. By collaborating with our community partners, we are able to leverage the positive effects of health improvement activities. A community-based approach allows us to build on existing strengths. Investment in periodic community-needs assessments enables us to concentrate our efforts in areas of greatest need. St. Anthony's Hospital continuously seeks opportunities to identify and fill gaps in needed services. PART VI, LINE 6 - Affiliated Health Care System St. Anthony's Hospital, Inc is part of BayCare Health System, a leading, community-based health system in the Tampa Bay area with 20,100 employees, 10 not-for-profit hospitals, 14 outpatient centers, and a complete range of services, such as imaging, laboratory, behavioral health, and home care. BayCare hospitals include 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, and St. Joseph's Hospital-North. St. Joseph's hospitals operate as one entity and file one Form 990. BayCare was founded in 1997 when the area's top not-for-profit hospitals came together, united by a common mission to improve the health of their communities and continue caring for all patients regardless of their ability to pay. In 2012, BayCare provided $188.6 million in community benefits, which includes $86.2 million in traditional charity care, $91.5 million in Medicaid and other means-tested programs, and $10.9 million in unbilled community services. All of these are measured in unreimbursed cost. BayCare's financial stability and centralization of shared services in finance, information technology and human resources strengthens each hospital's ability to allocate resources to meet the needs of its communities. BayCare's hospitals are located in three geographic regions, each with its own Boards of local leadership focused on its community's specific needs. BayCare also meets the needs of the community by being one of the largest employers in the Tampa Bay region, spending $1.2 billion on payroll and benefits for 20,100 employees. In 2012, BayCare added 500 new employees during a tough economy when unemployment rates in other areas remained high. To meet the health care needs of the community, BayCare provides expert medical care through a network with more than 200 access points connecting patients to a complete range of preventive, diagnostic and treatment services for any health care need. BayCare's network includes primary care and specialist physicians, urgent/immediate care centers, imaging, wellness centers, and 21 laboratory locations providing general, specialized and molecular testing. In addition, BayCare's home care division is one of the largest in Florida, providing 622,000 home health visits in 2012, helping patients leave the hospital sooner and recover at home where they are more comfortable. Recognizing the community's need for mental health services, BayCare also continues to be the largest, not-for-profit provider of behavioral health services in west central Florida. BayCare Behavioral Health offers inpatient, outpatient, in-home treatment, support group and case management services. BayCare's designated Baker Act-receiving facilities in Hillsborough, Pinellas, and Pasco counties provide inpatient crisis stabilization and partial hospitalization programs as part of the continuum of mental health care. BayCare also operates the only private, freestanding Baker Act-receiving hospitals in Hillsborough and Pasco counties. In 2012, BayCare began the process of assisting each hospital with a Community Health Needs Assessment (CHNA) as required by the Patient Protection and Affordable Care Act. As part of the process, BayCare conducted primary research with community stakeholders and focus groups, and secondary research to analyze the area's health status indicators, morbidity, mortality prevalence rates, socio-economic factors, behavioral risk factors, community needs scores, and prevention quality indicators. BayCare will use this information to develop reports for each hospital, implementation plans to address identified community needs, and specific measures to monitor progress. BayCare also continued developing its clinically integrated network, known as BayCare Physician Partners. This is a new model of care designed to improve the clinical coordination between employed physicians, independent physicians and health system resources. The goal of BayCare Physician Partners is to improve the overall health and patient experience of populations served by the network. More than 1,100 physicians joined BayCare Physician Partners in 2012. The network also approved 17 clinical performance measures for all of its member physicians and attained contractual agreements with three major health plans, affecting about 50,000 patient lives in the area. In addition to the strong growth of physician membership in 2012, BayCare Physician Partners continued developing the administrative and technology infrastructure needed to deliver the network's improved care coordination and overall population health in 2013. To meet the health care needs of a growing but medically underserved area in southern Hillsborough, BayCare has started construction on St. Joseph's Hospital South, a 352,000-square-foot, 90-bed, acute-care community hospital. The $237-million facility, which includes an 86,000-square-foot medical office building, is scheduled to open in 2015. In 2012, BayCare also successfully completed its seven-year implementation of a system-wide, electronic medical record at its 10 hospitals. With the completion of the project, all ancillary, nursing and physician staff members now document clinical information electronically, providing the entire care team with a more complete and more accurate care record, available in real time. BayCare hosted its largest annual Quality Sharing Day event in 2012, with more than 600 employees taking part in a full day of learning about best practices from Six Sigma and performance improvement projects throughout the health system. The event featured 13 teams presenting summaries of successful process improvements and 80 storyboard exhibits on projects recognized for quality contributions. Since BayCare began its Six Sigma program in 2004, thousands of employees have participated in performance improvement projects that have helped drive process efficiency and cost savings throughout the organization. To help educate future nurses and health care professionals, BayCare collaborates with Hillsborough Community College, University of Tampa, St. Petersburg College, Pasco Hernando Community College, and the Pinellas Technical Education Center. In 2012, BayCare also supported more than 90 community organizations and charities, big and small, through event sponsorships as part of the health system's commitment to the community. These organizations include the American Heart Association, Susan G. Komen for the Cure, American Cancer Society, the Tampa Bay Partnership: ONE BAY Healthy Communities, and local economic development councils and chambers of commerce. PART VI, LINE 7 - State Filing St. Anthony's Hospital, Inc does not file a community benefit report. PART VI, LINE 8 - Facility Reporting Groups All answers provided in Part VI, Line 1 pertain to Facility Group A which includes St. Anthony's Hospital, Inc. true SUNCOAST COMMUNITY HEALTH CENTERS 13110 ELK MOUNTAIN DRIVE RIVERVIEW FL 33579 591741303 501(c)(3) 35154 THE AMERICAN STAGE CO PO BOX 1560 ST PETERSBURG FL 33731 591777189 501(c)(3) 10150 SPONSORSHIP KOMEN FLORIDA SUNCOAST RACE FTC PO BOX 14452 ST PETERSBURG FL 33733 752870702 501(c)(3) 8167 SPONSORSHIP ST PETE AREA CHAMBER OF COMMERCE 100 2ND AVE N STE 150 ST PETERSBURG FL 33701 594193839 501(c)(6) 6000 SPONSORSHIP 3 1 Form 990, Schedule I, Part I, Line 2 Description of Organization's Procedures for Monitoring the Use of Grants ALL GRANTS ARE MADE TO NOT FOR PROFIT ORGANIZATIONS AND ARE REVIEWED ON AN INDIVIDUAL BASIS BY MANAGEMENT TO ENSURE THAT THEY SUPPORT THE HOSPITAL'S MISSION. THE LEVEL OF APPROVAL APPROPRIATE TO THE SIZE OF THE GRANT AND DOCUMENTATION OF NON PROFIT STATUS ARE REQUIRED BEFORE PAYMENT IS MADE. THE REQUESTING TEAM MEMBER OVERSEES THE GRANT TO MAKE SURE THAT THE ACTIVITY OR EVENT HAS OCCURED. false true false false false false false false false WILLIAM ULBRICHT 358171 0 166259 0 86749 0 37711 0 33139 0 682029 0 0 0 TERESA BRADLEY 193815 0 102896 0 59871 0 32980 0 7337 0 396899 0 0 0 PATRICIA SIZEMORE 215069 0 72834 0 44581 0 38476 0 5528 0 376488 0 0 0 RONALD COLAGUORI 206789 0 70679 0 33212 0 29514 0 22604 0 362798 0 0 0 WALTER INMAN 168430 0 18527 0 5332 0 7653 0 8093 0 208035 0 0 0 SUSAN OLDS 149087 0 18746 0 547 0 8171 0 11614 0 188165 0 0 0 ARCHANA PUDUR 221589 0 188037 0 1932 0 12500 0 8151 0 432209 0 0 0 ANNE-MARIE JOHNROSE-BROWN 218296 0 138320 0 2340 0 17334 0 22863 0 399153 0 0 0 HENRY CLARKE 602410 0 0 0 5295 0 13282 0 20499 0 641486 0 0 0 ALLAN WEISS 262581 0 97104 0 2356 0 20686 0 20783 0 403510 0 0 0 STEPHEN MASON 0 1091361 0 662350 0 2249647 0 24790 0 25118 0 4053266 0 583588 CARL TREMONTI 0 254694 0 87048 0 52723 0 30752 0 11905 0 437122 0 0 CHARLES GUASTELLA 140012 0 9451 0 8096 0 7525 0 12809 0 177893 0 0 0 Supplemental Compensation Information Schedule J, 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, BayCare Health System Inc, uses Compensation committee, Independent compensation consultant, Written employment contract, 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. Supplemental Compensation Information Schedule J, Part I, Line 4b Teresa Bradley - Participated in a supplemental nonqualified deferred compensation plan. She had $51,965 in benefits vest in 2012. This amount is included in Part II (B)(iii) Other compensation. Her earnings on the plan in 2012 were $11,480. This amount is included in Part II (C) Retirement and other deferred compensation. The plan made cash distribution of $18,941 in 2012. Ronald Colaguori - Participated in a supplemental nonqualified deferred compensation plan. He had $23,904 in benefits vest in 2012. This amount is included in Part II (B)(iii) Other compensation. He also had $18,622 of nonvested benefits accrue during 2012 and his earnings on the plan in 2012 were $8,282. These amounts are included in Part II (C) Retirement and other deferred compensation. The plan made cash distribution of $8,713 in 2012. Stephen Mason - Participated in a supplemental nonqualified deferred compensation plan. He became 100% vested in his benefits in 2012. He had $2,212,111 in benefits vest in 2012. This amount is included in Part II (B)(iii) Other compensation. The plan made cash distribution of $806,314 in 2012. Patricia Sizemore - Participated in a supplemental nonqualified deferred compensation plan. She had $35,231 in benefits vest in 2012. This amount is included in Part II (B)(iii) Other compensation. Her earnings on the plan in 2012 were $8,773. This amount is included in Part II (C) Retirement and other deferred compensation. The plan made cash distribution of $12,842 in 2012. Carl Tremonti - Participated in a supplemental nonqualified deferred compensation plan. He had $33,747 in benefits vest in 2012. This amount is included in Part II (B)(iii) Other compensation. He had $18,473 of nonvested benefits accrue during 2012 and his earnings on the plan in 2012 were $9,459. These amounts are included in Part II (C) Retirement and other deferred compensation. The plan made cash distribution of $12,301 in 2012. William Ulbricht - Participated in a supplemental nonqualified deferred compensation plan. He had $65,922 in benefits vest in 2012. This amount is included in Part II (B)(iii) Other compensation. His earnings on the plan in 2012 were $14,159. This amount is included in Part II (C) Retirement and other deferred compensation. The plan made cash distribution of $24,028 in 2012. MFP Inc dba Financial Credit Servi See Part V 165942 Fees for collection services false Relationship between interested person and the organization Schedule L, Part IV, Column B Stephen Mason, ex-officio trustee of the filing organization, and William Ulbricht, ex-officio trustee and president of the filing organization, serve as board members at MFP, Inc. Part VI Part VI, Line 2 - Description of Family or Business Relationship William Ulbricht, Susan Olds, Stephen Mason and Rebecca Arseneau are board members/officers of the organization, as well as board members of a taxable entity, which is an affiliate of the filing organization. Part VI, Line 6 - Description of Classes of Members or Stockholders Catholic Health East, a Pennsylvania nonprofit corporation is the sole member of St. Anthony's Hospital, Inc. Part VI, Line 7a - Description of Classes of Persons and the Nature of Their Rights The members of the Board of Trustees of the Corporation shall be appointed by the Member Catholic Health East (CHE). Part VI, Line 7b - Descr Classes of Persons, Decisions Requiring Appr & Type of Voting Rights The taxpayer is a Participant, as defined in the Second Restated Joint Operating Agreement dated as of May 23, 2006, as amended (the "JOA"). Under the JOA, BayCare health System, Inc. is responsible for the operations of the Participants. The JOA Participants include the taxpayer and other hospitals and non-hospital organizations. Notice of the JOA was previously provided to the Internal Revenue Service by letter dated July 1, 1997. CHE shall reserve to itself in its capacity as the Corporate Member of the Corporation the following two categories of actions: Class I Member Reserved Rights and Class II Member Reserved Rights. A. Class I Member Reserved Rights. 1. Addition, deletion or reconfiguration of services of the Corporation. 2. Establishment of overall capital and operating budgets and strategic plans applicable to the Corporation, including the use of the funds of the Corporation. 3. Exclusive authority to enter into managed care contracts on behalf of the Corporation. 4. Approval of contracts on behalf of the Corporation (but the Class I Member may establish policies from time to time providing that only specific types of contracts or contracts involving obligations in excess of specified levels need to be approved by the Class I Member). 5. Authority to establish fees and charges on behalf of the Corporation. 6. Determination of whether the Corporation should join any networks or alternative or integrated delivery systems. 7. Establishment of employment and other policies applicable to all personnel employed by the Corporation. 8. Approval of the philosophy, mission statement and purposes of the Corporation. 9. Approval of changes in the Articles of Incorporation or in the Bylaws of the Corporation. 10. Approval of the merger, consolidation, dissolution, sale or other transfer of substantially all assets of the Corporation, or other change in corporate form, causing a fundamental reorganization of the Corporation. 11. Approval of the incurrence of indebtedness by the Corporation above certain limits established by the Class I Member. 12. Approval of the establishment of additional affiliates or subsidiaries of the Corporation. 13. Adoption of strategic plans or major changes in programs or services of the Corporation. 14. Approval of the purchase, sale, transfer, or other encumbrance of assets of the Corporation above specified levels established by the Class I Member. B. Class II Member Reserved Rights. 1. Approval of the philosophy, mission statement and purposes of the Corporation. 2. Approval of the merger, consolidation, dissolution, sale or other transfer of substantially all assets of the Corporation, or other change in corporate form, causing a fundamental reorganization of the Corporation. 3. Approval of the closure of a hospital facility of the Corporation. 4. Approval of any sale, long term lease, mortgage, encumbrance or disposition of property of the Corporation constituting an 'alienation' under principles of canon law. 5. Approval of matters relating to the implementation of and compliance with the Ethical and Religious Directives. 6. Change in the name of the hospital facility of the Corporation. 7. Approval of substantive changes in the Articles of Incorporation of the Corporation and these Bylaws provided that prior notice of any change in the Articles of Incorporation of the Corporation or these Bylaws shall be provided to CHE and, if such change, as a result of CHE being a Catholic entity, must be approved by CHE, such change, regardless of whether it is substantive as a matter of civil law, shall be subject to the approval of the Member. 8. With regard to any assets of the Corporation no longer required in the operations of the Corporation, approval of any sale or other disposition of any assets not in the ordinary course which have a value in excess of $3 million, and with regard to all other assets of the Corporation used in the operations of the Corporation, approval of any sale or other disposition of such assets not in the ordinary course (but the foregoing is not intended to limit any transfer of the location of the assets from the Corporation to another entity in connection with a duly authorized reconfiguration of services). 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. A final copy of the Form 990 was reviewed by a subcommittee of the Board of Directors. Prior to filing with the IRS, a final copy of the Form 990 will be made available to the entire Board via a web portal. Part VI, Line 12c - Description of Process to Monitor Transactions for Conflicts of Interest St. Anthony's Hospital, Inc. has two separate conflict of interest procedures; one that relates to Board members and another that relates to non-board member employees. Both groups are required on an annual basis to complete, sign and file an annual disclosure statement detailing existing or potential conflicts of interests. For Board members, the review of conflicts or potential conflicts occurs at the Board or committee level. After disclosure of the Board Member's or Committee Member's actual or potential conflict, the following procedures for addressing the conflict of interest will be adhered to by each Board and all Committees with Board delegated powers, without exception: 1. The interested Director or Committee member shall leave the Board or Committee meeting while the conflict of interest issue is discussed. 2. The remaining Board or Committee Members shall decide if a conflict of interest exists. 3. If a conflict of interest is deemed to exist: a. The Chairperson of the Board or Committee shall, if appropriate, appoint a disinterested individual or committee to investigate the proposed transaction or arrangement. b. The Board or Committee shall determine whether the BayCare entity can obtain a more advantageous transaction or arrangement with reasonable efforts from an individual or entity that would not give rise to a conflict of interest. c. If a more advantageous transaction or arrangement is not reasonably available, the Board or Committee shall determine whether the transaction or arrangement is in the BayCare entity's best interest, and whether the transaction is fair and reasonable to BayCare. An interested Director or Committee Member shall not vote, participate in, influence or attempt to influence any determination or proceedings. The Director or Committee Member may, however, respond to questions posed by the Board or Committee regarding the contract or transaction. Any such contract or transaction must be authorized by a vote of at least two-thirds (2/3) of the Directors or Committee Members entitled to vote at a meeting at which a quorum was present. Any interested Director or Committee Member may not be counted in determining the existence of a quorum. For employees, the review of conflicts of interest or potential conflicts goes to the Conflict of Interest Determination Committee. This committee consists of BayCare Chief Compliance Officer, the Corporate Responsibility Officers, and the BayCare Vice President of Team Resources. This committee shall determine if an actual conflict exists and any action required to address the conflict of interest situation. Part VI Part VI, Lines 15a & 15b - Process used for Compensation Review and Approval The organization uses an independent compensation committee, appointed by the Board of Directors. The Compensation Committee's purpose is to provide oversight for the organization's executive compensation program, review and approve compensation and benefits for all "disqualified persons" subject to the Intermediate Sanctions regulations issued under Section 4958 of the Internal Revenue Code (including the Chief Executive Officer, Chief Operating Officer & CFO, other system and entity executives, and other disqualified persons as defined in the Intermediate Sanctions regulations (i.e., voting members of the governing body, family members, former officers)), and establish the compensation philosophy for all other executives. This committee engages nationally recognized compensation consultants to assist them in review of executive compensation. The compensation consultants provide a review of each vice president and above in the system to determine if that employee's compensation is reasonable when compared against market standards. The data reviewed comes from compensation studies that include comparable compensation for similarly qualified persons in functionally comparable positions at similarly situated organizations. The organization keeps contemporaneous minutes of the compensation committees meetings and decisions. External consultants review compensation every other year with the last review occurring in 2011 but the compensation committee regularly monitors compensation and all other procedures are followed annually. Part VI, Line 16b - Procedure to evaluate Joint Venture Arrangements The organization has a joint venture committee of subject matter experts who review potential arrangements with taxable joint ventures. Included in its review are a review for compliance with relevant tax laws and a review of whether the joint venture furthers the organization's exempt purpose. Part VI, Line 19 - How and If the Governing Documents, Conflict of Interest Policy and Financial Statements are Made Available to the Public St. Anthony's Hospital, Inc. publishes its financial statements with the Agency for Health Care Administration. Governing documents and policies are not available for public inspection. Part XI, Line 9 Contributions in tax income, not on books ($124,505) Unrealized gains on swaps $59,480 Change in net assets of foundation $1,147,322 Transfer of ownership of affiliates $22,793,674 Total $23,875,971 St Anthony's Primary Care LLC 1200 Seventh Ave North St Petersburg FL 33705 030575868 Health srvcs FL 8047873 1486770 SAHSJHCC St Anthony's Specialists LLC 1200 Seventh Ave North St Petersburg FL 33705 743168197 Health srvcs FL 3390419 435904 SAHSJHCC BayCare Health System Inc 16255 Bay Vista Dr Clearwater FL 33760 592796965 Support srvcs FL 501(C)(3) 11A na false Mark Sheppard Trust Fund 1200 Seventh Ave North St Petersburg FL 33705 592223579 Educ support FL 501(C)(3) 11A SAHC Found true St Anthony's Health Care Found Inc 1200 Seventh Ave North St Petersburg FL 33705 592128991 Fundraising FL 501(C)(3) 11C SAH true St Anthony's Hospital Auxiliary Inc 1200 Seventh Ave North St Petersburg FL 33705 590201974 Volunteer srv FL 501(C)(3) 11C na false St Anthony's Professional Build & Srvs 1200 Seventh Ave North St Petersburg FL 33705 592018848 Owns property FL 501(C)(3) 9 SAH true Carillon Surgery Center LLC 900 Carillon Pkwy St Petersburg FL 33762 261116740 Health servic FL na n/a St Anthony's Physicians Surgery Center 705 16th Street North St Petersburg FL 33705 010861245 Health servic FL na n/a St Anthony's Ancillary Services Inc 1200 Seventh Ave North St Petersburg FL 33705 592128990 inactive FL SAH C corp 1.00000 true false false true true false false true true false false true false true true true false false true true ST ANTHONYS HEALTH CARE FOUNDATION C 110625 FMV ST ANTHONYS PROFESSIONAL BUILDING & SERVICES k 1081071 FMV ST ANTHONYS PROFESSIONAL BUILDING & SERVICES s 1210115 FMV Related Tax Exempt Organizations Part II St. Anthony's HealthCare's Foundation's exempt status was automatically revoked by the IRS for failure to file tax returns. The Foundation operates as an integrated auxiliary of a church, and, as such, does not have a filing requirement. St Anthony's HealthCare Foundation, Inc. has requested reinstatement of its tax-exempt status and is operating under the assumption that reinstatement will be retroactive back to the date of revocation.