2012-11-13T08:38:09-06:00 2011-12-31 621517792 PERSHING YOAKLEY & ASSOCIATES PC 2963 GULF TO BAY BLVD STE 267 CLEARWATER FL 337594255 990 2011-01-01 591218020 Bayfront Medical Center Inc BAYF 7278936698 701 Sixth Street South St Petersburg FL 33701 Robert Thornton 7278936698 2012-11-13 1 Terry Haefner P01258953 7274427110 2011 2016-02-24 21:20:13Z Sue Brody 701 Sixth Street South St Petersburg FL 33701 317688758 0 X www.Bayfront.org X 1968 FL See Schedule O for Attached Supplemental Information.Bayfront Medical Center's mission is to provide quality healthcare for all we serve. 13 10 2603 220 792181 -53039 685635 843948 302397992 310459003 7013345 1512359 2040420 4005580 312137392 316820890 136040 2029670 0 0 113094529 115969056 0 0 0 189457350 195550013 302687919 313548739 9449473 3272151 194922858 194587928 116153241 121637735 78769617 72950193 X Bayfront Medical Center's mission is to provide quality healthcare for all we serve. 0 0 261531449 2029670 310463387 See Schedule O for Attached Supplemental Information.For more than 100 years, Bayfront has provided quality healthcare for all we serve. It is our mission and purpose. Our 2,124 team members, 556 of the community's best physicians, 220 volunteers and thousands of patients choose excellence when they choose Bayfront Health System. That choice represents our commitment to innovation, dedication, teamwork, response, compassion and clinical excellence. In 2011, Bayfront provided care, services and education that made a difference in the health of our community, as well as $22.8 million in charitable, uncompensated care to those who needed us most. It is a noble financial commitment that makes us proud. Any profits we do realize are directly reinvested into our facilities and services so we are always ready to care for our patients with the best resources this industry has to offer - from talent to technology. Bayfront strives to be a model corporate citizen, positively impacting our community in a dynamic and meaningful way. We take our role as one of St. Petersburg's longest standing and largest employers seriously and we've made a commitment to generously support other organizations that share our mission and values. Bayfront proudly supports organizations like the American Heart Association, the Susan G. Komen Race for the Cure and the Boys and Girls Clubs. Beyond clinical care, Bayfront serves its community by leading education initiatives, such as professional medical and allied-health education programs and health prevention community outreach. Our organization is also a leader in offering free flu shots through our Convenient Care Clinic network, free support groups, the mammography voucher program for low income uninsured women and free health screenings.Bayfront serves as one of its area's largest employers and sets a high standard for corporate citizenship. In addition to the uncompensated costs of care, Bayfront's business and leadership contributions to the community was $1.9 million in 2011. Bayfront team member outreach initiatives included hundreds of hours of service delivered to the community through efforts such as participation in an annual Back to School Care Fair, toy drives, support for local schools and service on local not-for-profit boards and committees. 261531449 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 260 0 1 2603 1 1 1 0 0 0 0 0 0 0 0 0 X 13 10 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X Robert W Thornton 7278936698 701 Sixth St S St Petersburg FL 33701 Trina Espinola MD 1.00 X 19804 24000 0 Sue G Brody 40.00 X X 0 821417 24228 Raul Montenegro MD 1.00 X 0 0 0 Bernie Young 1.00 X X 0 0 0 Roy Binger 1.00 X 0 0 0 Jeff Hearn 1.00 X 0 0 0 Katie Pemble 1.00 X X 0 0 0 Steven C Dupre ESQ 1.00 X X 0 0 0 Paul McRae MD 1.00 X 25000 0 0 Mark V Wimberly 1.00 X 0 0 0 James R Gillespie 1.00 X 0 0 0 Jay L Miller 1.00 X 0 0 0 Monte Trammer 1.00 X 0 0 0 Robert Thornton 40.00 X 0 482222 37242 Eric Feder 40.00 X 0 527873 37038 Timothy Eixenberger 40.00 X 0 178187 37324 David Weiland MD 40.00 X 0 350484 83762 Jatin Motiwal 40.00 X 237259 0 56234 Steven Epstein MD 40.00 X 494139 0 31737 Jeffery L Johnson MD 40.00 X 367120 0 14113 Nicholas W Price MD 40.00 X 367680 0 16171 Vibhuti Singh MD 40.00 X 499442 0 22934 Amy Koler MD 40.00 X 366720 0 19072 2377164 2384183 379855 62 0 1 0 Bayfront Anesthesia Services PA 12225 28th Street North A St Petersburg FL 33716 Anesthesia Services 2539699 Optimal Reading Service Group 2850 19th Street South Birmingham AL 35209 Radiology Services 2527059 SLS of Tampa Bay Inc 735 Arlington Avenue 112 St Petersburg FL 33701 Lab Services 1534027 All Florida Orthopaedic 4600 4th Street North St Petersburg FL 33703 Orthopaedic Services 1312897 DVA Healthcare Renal Care Inc PO Box 403008 Atlanta GA 303843008 Dialysis Services 1030106 36 653154 169987 20807 843948 Patient Service Revenu 621990 310304663 310304663 Gov't Fees & Contracts 621990 154250 154250 Membership Dues 621990 90 90 310459003 1768458 1768458 4384 47178 0 0 4384 47178 51562 4384 47178 611769 867868 0 -867868 611769 -256099 -256099 EHR Incentive Payments 900099 1668370 1668370 Cafeteria 722210 997215 997215 All Other Revenue 900099 697036 153606 543430 591397 591397 3954018 316820890 310463387 792181 4721374 1981625 1981625 48045 48045 306063 306063 96291790 78650428 17641362 2553913 2087500 466413 9913737 8103222 1810515 6903553 5630134 1273419 5100327 51003 5049324 56553 56553 76648 76648 24873987 19393656 5480331 870646 783581 87065 54842888 52032560 2810328 4921603 4429443 492160 13258582 238615 13019967 253088 253088 540402 486362 54040 10385320 9346788 1038532 3887068 3498361 388707 Bad Debts 58179808 58179808 Helicopter Contract 8353466 8353466 Maintenance Contracts 3422312 3080081 342231 Medical Assistance Asse 3290922 2961830 329092 3236393 1635790 1600603 313548739 261531449 52017290 0 11179781 11352294 35571677 43113179 2655953 2383102 6522362 6690804 3656161 5188057 302967654 233144134 69543434 69823520 61037848 51207012 200000 200000 4555642 4629960 194922858 194587928 34202805 35707616 551208 406968 81399228 85523151 116153241 121637735 X 76314969 70091971 2454648 2858222 78769617 72950193 194922858 194587928 X 3272151 -9091575 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 0 0 0 Part IV, Supplemental Information: Lobbying activities include, but are not limited to, participation in local legislative forums, communication with elected officials on matters integral to Bayfront's mission, and membership and activities affiliated with the Florida Hospital and American Hospital Associations. Bayfront Medical Center employs two people in the Department of Corporate Communications who have Government Relations responsibilities integrated into their job duties. The Government Relations team specifically communicates with elected officials in an ongoing effort to define and explore local funding solutions for the indigent care needs of our community, as served by Bayfront Medical Center in fulfillment of our mission. Bayfront conducted a targeted e-blast campaign via employees, board members and physicians to state legislators - to reduce the level of Medicaid cuts to hospitals. Bayfront has active memberships in both the Florida Hospital Association and the American Hospital Association. Our President and CEO serves on the Florida Hospital Association's Board of Trustees and is Chair of the Florida Hospital Association's Workplace Violence Task Force. Locally, the President and CEO serves on the American Heart Association's Heart Ball Executive Committee; St. Petersburg Chamber of Commerce Board of Governors; St. Petersburg Downtown Partnership Board of Directors; Health and Human Services Coordinating Council's Health and Behavioral Health Network; and the Pinellas Education Foundation's Career Education Fund Board. The Florida Hospital Association's Political Action Committee is supported by the hospital's senior management team. Bayfront Medical Center works diligently to communicate its mission of providing quality healthcare for all we serve, regardless of ability to pay. Bayfront communicates this mission, and the integral role it plays in the community to its elected officials at all levels of government: St. Petersburg City Council members, Pinellas County Commissioners, State Senators and Representatives, and Federal Senators and Representatives. 705760 705760 116739129 81297569 35441560 1822636 1187405 635231 183635358 150659160 32976198 64771 64771 69823520 Worker's Compensation Liability 261377 Retirement Cost Payable 642576 Due to Affiliates 62985037 Capital Leases 2387902 Accrued Trauma Physicians Contract 45700 Unclaimed Checks 141331 Accrued Pension 18312511 Accrued SERP 746717 85523151 Description of Uncertain Tax Positions Under FIN 48: Part X: Deferred income taxes reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting and the amounts used for income tax purposes. As of December 31, 2011 and 2010, the System had deferred tax assets of $1,869,000 and $3,963,000, respectively, relating principally to net operating loss carryovers. ASC Topic 740, Income Taxes, requires a valuation allowance to reduce the deferred tax assets reported if, based on the weight of the evidence, it is more likely than not that some portion or all of the deferred tax assets will not be realized. After consideration of all the evidence, both positive and negative, management determined that a $1,326,000 and $3,324,000 allowance at December 31, 2011 and 2010, respectively, was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. The change in the valuation allowance for the current year is a decrease of $1,998,000. At December 31, 2011, the System has available net operating loss carryforwards of $4,966,000, which begin expiring in the year 2012. 1 1 X 1 X 1 X 1 1 1 0 1 1 1 5424 8846505 8846505 0.03460 1 30794 45381433 37218932 8162501 0.03200 1 3174 9960425 4194825 5765600 0.02260 3 39392 64188363 41413757 22774606 0.08920 40 3039700 3039700 0.01190 4 348259 348259 0.00140 1 10000 10000 0.00000 1 51389 15600 35789 0.00010 28 231250 231250 0.00090 74 3680598 15600 3664998 0.01430 77 39392 67868961 41429357 26439604 0.10350 2 24943 24943 0.00010 1 24973 24973 0.00010 1 3623 3623 0.00000 4 53539 53539 0.00020 1 11886135 59934469 55718898 4215571 X 1 1 1 Bayfront Home Health LLC Home Healthcare Services 1.00000 2 Bayfront Physician Specialty Services LLC Physician Services 1.00000 1 1 Bayfront Medical Center

701 Sixth Street South St Petersburg FL 33701

X X X X Bayfront Medical Center Inc 1 0 1 1 200.000000000000 1 300.000000000000 1 X X X X 1 1 X X X X 1 0 1 X 0 0 2 Bayfront Family Health Center

700 Sixth Street South St Petersburg FL 33701

Outpatient Clinic Bayfront Wound Care & Hyperbaric Ctr

7000 Fourth Street North St Petersburg FL 33701

Wound Care & Hyperbaric Services Part I, Line 7: Cost to charge ratio is the costing method used for charity care. Procedure level costing is the cost method used for Medicaid and County accounts. Part I, Line 7g: Inpatients and outpatients who receive emergency care that are found to be ineligible for either Government Assistance or one of the Charity Care Programs offered by the Hospital, will receive a discount (minimum of 25%) according to a sliding scale based on their income. Outpatients who receive non-emergency care are offered a standard discount of 25% without reference to their financial means. These outpatients who wish to receive a larger discount are asked to complete a form to determine if they are eligible for Medical Assistance or any other funding program. If they are not eligible, they are offered a discount according to a sliding scale based on their income. Part I, L7 Col(f): Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $58,179,808. Part II: Our hospital is involved in numerous community building activities which promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve, and we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are included in Part I, Line 7 as opposed to Part II. In order to promote the health of the community we serve, our hospital participates in several community building activities such as Habitat for Humanity, Healthy Start, Healthy Families and the Health and Behavioral Health Network of the Health and Human Services Coordinating Council for Pinellas County. These activities are also included in Part I, Line 7. Part III, Line 4: Cost to charge ratio is the costing methodology method used for bad debts. In addition, the provision for bad debt expense is based on a combination of the aging of receivables and management's assessment of historical and expected net collection indicators. Management continuously assesses the adequacy of the allowances for uncollectible accounts based upon historical write-off experience and payment trends by payor category.Patient accounts are also continuously monitored and, if necessary, past due accounts are placed with collection agencies in accordance with guidelines established by Bayfront Medical Center. Accounts receivable are written off after collection efforts, in accordance with our policies, have been exhausted. Part III, Line 8: For reporting of Medicare allowable costs, cost reports were used. Part III, Line 9b: Patients who are unable to pay are encouraged by Bayfront Medical Center representatives to submit financial information to the Medical Assistance department to determine eligibility for federal, state, or local government programs as well as our charity care program. Patients are encouraged to apply via personal interviews, patient billing mailers, and signage in the Emergency Room, registration areas, and patient counseling offices. For those patients who provide all necessary documentation and qualify for charity according to the Bayfront Medical Center charity care policy, the patient's account would be written off to charity and not billed to the patient. Bayfront Medical Center, Inc. Part V, Section B, Line 19d: Inpatients and outpatients who receive emergency care that are found to be eligible for either government assistance or one of the Charity Care Programs offered by the Hospital, will be allowed a 100% discount on charges. Accordingly, all individuals whose income falls below 200% of the federal poverty guidelines ("FPG") for their family size will receive free emergency care.In addition, patients receiving emergency care that do not qualify for the 100% Charity Care Program discount will receive a discount (minimum of 25%) according to a sliding scale based on their income. This sliding scale has a range of a 25% discount for anyone with income greater than 300% of the FPG and up to a 65% discount for anyone with income greater than 200% of the FPG.All outpatients who receive non-emergency care are offered a standard discount of 25%. If outpatients wish to receive a larger discount, they are asked to complete a form to determine if they are eligible for Medical Assistance or any other funding program. If they are not eligible, they are offered a discount according to a sliding scale based on their income. Part VI, Line 2: Bayfront Medical Center works closely with the city, county and state organizations and analyzes admission trends to determine the ongoing needs of its community. From these ongoing partnerships and analyses, the need for services is determined and the hospital regularly expands existing services to meet the community's needs, such as aligning with primary care and specialty practices, offering a sports medicine residency program and offering expanded prenatal and childbirth education. Our CEO serves on the St. Petersburg Downtown Partnership's Board of Directors; St. Petersburg Chamber of Commerce's Board of Governors; Pinellas Education Foundation's Career Education Fund Board; the American Heart Association; and the Health and Behavioral Health Network. Participation in these forums serves to assess, address and monitor the health needs of the community. The hospital actively contributes to the process and engages in the identified priorities that match its mission and capacity. In addition to these organized community efforts, Bayfront continually monitors community needs specific to its service lines and the resources it can tap to address them. Part VI, Line 3: The patient financial counseling department of Bayfront Medical Center attempts to visit all self pay inpatients to determine their potential eligibility for financial assistance under federal, state, or local government programs as well as our charity care program. In the event that a patient is not counseled on site, a financial education package that explains the financial assistance programs that are available and information on how to obtain them is mailed to the patient. In addition to direct financial counseling, our charity care policy notices are posted in the Emergency Room, registration areas, and patient financial counseling offices. Part VI, Line 4: Bayfront Medical Center sits in an urban setting and serves as the largest hospital provider, and only trauma center, in St. Petersburg, serving the southern half of Pinellas County. The population includes a significant number of retired and active military personnel and a large minority population, including African-Americans and Hispanics. We also serve a large un- or under-served population totaling $39.9 million in uncompensated care in 2011. The hospital is located in the greater Tampa/St. Petersburg/Clearwater metropolitan area. With the service area expanding northwards and the population expected to grow in the next five years, the health care needs of our service area are expanding and changing. A projected growth in the Hispanic and Asian populations challenges us to accommodate diverse language and cultural needs. Part VI, Line 5: Bayfront Medical Center's Board of Trustees is made up of medical and business professionals, almost all of whom reside in the hospital's primary service area. These volunteers give countless hours of service to the hospital in their oversight role. They are involved in the community needs assessment process, fundraising, advocating for Medicaid funding and general stewardship. Medical staff privileges are offered to all qualified physicians in the community. The hospital utilizes surplus funds to maintain access to patient services and to expand access points of care to patients throughout the community including, but not limited to, the following: 1) educational programs that provide classes and information on childbirth, infant care, early pregnancy and more; 2) 275 free back-to-school physicals; and 3) sliding fee rates for 689 people to receive reduced-cost primary care services and 96 people to receive reduced-cost obstetric care services. Part VI, Line 6: Bayfront Health System, Inc. is the parent company to Bayfront Medical Center, a 501(c)(3) corporation. Other affiliates include a same day surgery center, a foundation, Bayfront Enterprises, Inc. (six convenient care clinics), Bayfront Insurance Solutions, LTD (the Captive) and Bayfront Home Health Care. In addition to community benefit activities of the hospital, Bayfront Health System funds the community benefit and community wellness initiatives of these affiliates. Bayfront Health System coordinates community benefits programs for the system through planning, developing, implementing and funding programs that address community needs. On behalf of the system, the parent company also funds the majority of the cash contributions to unrelated organizations that promote community health and wellness. Reports Filed With States Part VI, Line 7 FL 1 Bayfront Health Foundation Inc 701 Sixth Street South St Petersburg FL 33701 311492316 501(c)(3) 94125 N/A Scholarships/Special Projects Pinellas County Department of Health & Human Services 2189 Cleveland Street Suite 230 Clearwater FL 33765 596000800 1887500 County Health Program 1 1 Scholarships 55 45045 N/A Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: To Organizations: Each year, the Auxiliary of Bayfront Medical Center receives information from Bayfront Medical Center on the areas of greatest need for grant funding. The Auxiliary Board meets and approves the grant amounts to be distributed to Bayfront Health Foundation. Based on Auxiliary earnings, the contributions to Bayfront Health Foundation include a $10,000 scholarship fund, and all remaining funds earned in the prior year excluding a small amount held for operating expenses are given in a separate check. To Individuals: The organization awards scholarships at various times during the year. Eligible individuals submit an application to Human Resources. To be eligible to submit an application, an individual must have been an employee for at least one year or a dependent of an eligible employee. If an employee submits an application, it must be for a course which will lead to improvement in knowledge and/or skills that are related to the applicant's present position or positions currently needed within the organization. Dependent children will be given preference if the child is to be enrolled in a health related profession. The scholarships are awarded by a committee of at least five members who evaluate each applicant. X X X X X 0 1 0 0 0 0 0 0 0 Sue G Brody 0 570284 0 89984 0 161149 0 6095 0 18133 0 845645 0 0 Robert Thornton 0 340886 0 60941 0 80395 0 16233 0 21009 0 519464 0 0 Eric Feder 0 331496 0 51202 0 145175 0 4363 0 32675 0 564911 0 0 Timothy Eixenberger 0 111586 0 17519 0 49082 0 26602 0 10722 0 215511 0 0 David Weiland MD 0 304770 0 45000 0 714 0 67015 0 16747 0 434246 0 0 Jatin Motiwal 211352 0 20748 0 5159 0 40051 0 16183 0 293493 0 0 0 Steven Epstein MD 338839 0 108333 0 46967 0 10743 0 20994 0 525876 0 0 0 Jeffery L Johnson MD 348789 0 17500 0 831 0 12900 0 1213 0 381233 0 0 0 Nicholas W Price MD 348627 0 17500 0 1553 0 9211 0 6960 0 383851 0 0 0 Vibhuti Singh MD 381747 0 0 0 117695 0 8058 0 14876 0 522376 0 0 0 Amy Koler MD 348859 0 17500 0 361 0 12784 0 6288 0 385792 0 0 0 Part I, Line 4b Sue Brody - Participated in a supplemental nonqualified deferred compensation plan. She had $112,486 in benefits vest in 2011. This amount is included in Part II Column B(iii). She also had $3 of earnings vest in 2011. This amount is included in Part II Column C. Robert Thornton - Participated in a supplemental nonqualified deferred compensation plan. He had $60,941 in benefits vest in 2011. This amount is included in Part II Column B(iii). He also had $13,472 of earnings vest in 2011. This amount is included in Part II Column C. Eric Feder - Participated in a supplemental nonqualified deferred compensation plan. He had $111,621 in benefits vest in 2011. This amount is included in Part II Column B(iii). He also had $18,216 of earnings vest in 2011. This amount is included in Part II Column C. Timothy Eixenberger - Participated in a supplemental nonqualified deferred compensation plan. He had $29,444 in benefits vest in 2011. This amount is included in Part II Column B(iii). He also had $10,432 of earnings vest and $14,324 of benefits that accrued but did not vest in 2011. Both of these amounts are included in Part II Column C. David Weiland - Participated in a supplemental nonqualified deferred compensation plan. He had $54,880 in contributions that are not vested in 2011. This amount is included in Part II Column C. Jatin Mowal - Participated in a supplemental nonqualified deferred compensation plan. He had $31,122 in contributions that are not vested in 2011. This amount is included in Part II Column C. Form 990, Part VI, Section A, line 3 Management duties for certain areas are delegated to the following management companies: 1) Cerner Corporation for management of Business Office (billing/collections). 2) Sodexo, Inc. for management of hospitality departments (housekeeping/food & nutrition). 3) Wound Partners, LLC for management of wound care facility. 4) United Home Health Management Services, Inc. for management of Home Health department. 5) Aramark Healthcare for management of Biomedical Engineering department. 6) DaVita, Inc. for management of Dialysis department. Form 990, Part VI, Section B, line 11 A copy of Form 990 is mailed to the members of the Finance Committee, and then it is reviewed at a Finance Committee meeting prior to it being filed with the IRS. Form 990, Part VI, Section B, line 12c Conflict of interest statements are reviewed by the Corporate Compliance Office. For enforcement of the policy, there is a discussion with the employee or board member and appropriate action is taken if necessary. Form 990, Part VI, Section B, line 15 Compensation for the CEO and top management is determined by use of a compensation committee, independent compensation consultants, Form 990 of other organizations, and compensation surveys. The compensation committee meets annually to discuss and approve the compensation plans. Form 990, Part VI, Section C, line 19 Bayfront Medical Center makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -284,218. Cumulative effect of FASB 136 563,293. FAS 158 adjustment -9,370,650. Total to Form 990, Part XI, Line 5: -9,091,575. Bayfront Home Health LLC 2860 Scherer Dr Ste 650 St Petersburg FL 33716 113722443 Home Healthcare Services FL 294459 2426572 Bayfront Physician Specialty Services LLC 701 6th St S St Petersburg FL 33701 260762089 Physician Services FL -1499740 2314911 Bayfront Health System Inc 701 Sixth Street South St Petersburg FL 33701 592592846 Services to Affiliates FL 501(c)(3) 3 N/A 0 Bayfront Health Foundation Inc 701 Sixth Street South St Petersburg FL 33701 311492316 Fundraising FL 501(c)(3) 11A - Type 1 Bayfront Health System Inc 0 Bayfront Same Day Surgery Center LLC 701 Sixth Street South St Petersburg FL 33701 731637544 Surgery Center FL Bayfront Health System Inc N/A 0 0 Bayfront Enterprises Inc 701 Sixth Street South St Petersburg FL 33701 592592872 Physician Services FL Bayfront Health System Inc C Bayfront Insurance Solutions LTD PO Box 69 720 West Bay Rd Grand Cayman CJ KY1-1102 980680280 Insurance Services CJ Bayfront Health System Inc C 0 1 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1