2011-08-08T16:52:24-07:00 2010-09-30 KPMG LLP 300 N Greene Street Suite 400 Greensboro NC 27401 990 2009-10-01 593458145 FLORIDA HEALTH SCIENCES CENTER INC FLOR 8138447000 PO BOX 1289 TAMPA FL 33601 Steve L Short 8138444805 2011-08-09 1 Donald E Rich Jr 3364337071 2011-08-08 2009 2016-02-24 21:20:13Z TAMPA GENERAL HOSPITAL Ronald A Hytoff PO Box 1289 Tampa FL 33601 1143100872 0 X http://www.tgh.org X 1997 FL Florida Health Sciences Center, Inc. d/b/a "Tampa General Hospital," "Tampa General" or "TGH" is committed to providing the residents of West Central Florida with excellent and compassionate health care ranging from the simplest to the most complex medical services. 14 12 7161 550 1489578 403029 8164629 19358442 935311057 1022143197 5623208 20202430 161439 169433 949260333 1061873502 0 0 0 0 393125205 432731950 0 0 0 534333071 558975042 927458276 991706992 21802057 70166510 1062270935 1151470936 731392607 760070818 330878328 391400118 Tampa General Hospital is committed to providing the residents of West Central Florida with excellent and compassionate health care ranging from the simplest to most complex medical services. As a teaching facility, Tampa General partners with academic and community institutions to support both its teaching and research missions. As the region's leading safety net hospital, Tampa General Hospital reaffirms its commitment to providing high quality health services to all residents. 0 0 781074328 0 983538052 Hospital Patient Services: Tampa General Hospital, a leading safety net, private not-for-profit hospital, is one of the most comprehensive medical facilities in West Central Florida serving a dozen counties with a population in excess of 4 million. As one of the largest hospitals in Florida, Tampa General is licensed for 1,004 beds, and with over 7,000 employees, is one of the region's largest employers. TGH is the area's only level I trauma center and one of just four burn centers in Florida. With five medical helicopters, we are able to transport critically injured or ill patients from 23 surrounding counties to receive the advanced care they need. The hospital is home to one of the leading organ transplant centers in the country, having performed more than 6,000 adult solid organ transplants, including the state's first successful heart transplant in 1985. TGH is a state-certified comprehensive stroke center, and its 32-bed Neuroscience Intensive Care Unit is the largest on the west coast of Florida. Other outstanding centers include cardiovascular, orthopedics, high risk and normal obstetrics, urology, ENT, endocrinology, and the Children's Medical Center, which features a nine-bed pediatric intensive care unit and one of just three outpatient pediatric dialysis units in the state. Services for outpatients are provided in a variety of locations. A range of diagnostic and therapeutic outpatient services are provided on the TGH campus. In addition, TGH provides outpatient rehabilitation services in an offsite facility and primary and specialty physician services in two offsite clinics. As the region's leading safety net hospital, Tampa General is committed to providing area residents with excellent and compassionate health care ranging from the simplest to the most complex medical services. TGH provides medical services to those unable to pay through various means, including the Hillsborough County Health Plan and the State Medicaid program. In addition, TGH provides trauma care on a regional basis as well as other services at no charge to eligible patients through its charity care program. Statistics: Total patient days: 281,426, Emergency room visits: 78,362, Deliveries: 5,372, and Surgeries: 28,110. 22366486 0 15718171 Residents' teaching program (the revenues and expenses disclosed in this section include direct graduate medical education only): Tampa General Hospital has been affiliated with the University of South Florida ("USF") College of Medicine since the school was created in the early 1970s. Tampa General Hospital is the primary teaching affiliate of the University of South Florida College of Medicine. In excess of 300 residents rotate through the hospital each year. The Medicare program funds 209 residents, with the remaining slots funded solely by the hospital. These residents are assigned to Tampa General Hospital for specialty training in areas ranging from general internal medicine to neurosurgery. In addition, medical students, nurses and physical therapy students all receive part of their training at Tampa General Hospital on an annual basis. In excess of 200 medical students rotate through Tampa General Hospital during their third and fourth year of medical school. Faculty of the University of South Florida College of Medicine admit and care for patients at Tampa General Hospital as do community physicians, many of whom also serve as USF adjunct clinical faculty. 1040833 0 600524 Clinical Research: As the region's only Level I Trauma Center and the primary teaching hospital for the University of South Florida College of Medicine, Tampa General Hospital is uniquely poised to conduct cutting-edge clinical trials advancing the state of medicine every day. The Office of Clinical Research (OCR) is committed to supporting investigators, sponsors and patients participating in clinical trials. We provide strategic services, education and training, and comprehensive review processes designed to fulfill the potential of clinical investigators and their research staff. TGH is actively engaged in clinical trials with university physicians, private practice groups, and private physicians. During fiscal year 2010, the OCR provided oversight for a total of 398 active studies including 148 newly approved studies. In addition to the OCR administrative services, the TGH Center for Outpatient Research Excellence (CORE) provides coordination services that begin before site initiation and continue for the duration of the study. Pre-study services include study placement, coordination of pre-study site visit, regulatory work, lab and radiology research pricing, and arrangements for special services. Study coordination services include recruitment, screening, subject enrollment, study visits/procedures, investigational drug services, administration and accountability, packaging, and shipping, source documentation, case report form completion, and long term record storage. 3173031 3173031 22286450 Tampa General Hospital's Other Program Services includes cafeteria and vending sales, parking garage revenues, pharmacy sales to employees, net assets released from restrictions, and other miscellaneous revenue. 3173031 3173031 22286450 807654678 1 1 0 1 0 0 0 0 1 1 1 1 0 0 1 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 1 322 0 1 7161 1 1 1 0 0 0 0 0 0 0 0 1 1 14 12 0 0 0 0 0 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X Steve Short CFO 8138447000 PO Box 1289 Tampa FL 33601 John Brabson 1 X 0 0 0 Margarita Cancio MD 1 X 37739 0 0 Phillip S Dingle 1 X 0 0 0 Devanand Mangar MD 50 X 34426 0 0 John McKibbon 1 X 0 0 0 Eugene McNichols 1 X 0 0 0 Shelton Quarles 1 X 0 0 0 Dana L Shires MD 1 X 0 0 0 John T Sinnott MD 1 X 0 0 0 David A Straz Jr 1 X 0 0 0 Joseph Taggart 1 X 0 0 0 John T Touchton Jr 1 X 0 0 0 Don Wallace 1 X 0 0 0 James W Warren 1 X 0 0 0 John H Bond 50 X 238381 0 27775 Mark W Campbell 50 X 206366 0 25752 Janet H Davis 50 X 251868 0 27854 Robin W DeLaVergne 50 X 301014 0 24122 Cheryl A Eagan 50 X 277189 0 23053 Anthony D Escobio 50 X 211570 0 25007 Sally H Houston 50 X 481159 0 33884 Ronald A Hytoff 50 X 2202817 0 128078 Kathi K Katz 50 X 157563 0 1439 Elizabeth J Lindsay-Wood 50 X 157305 0 0 Marcos F Lorenzo 50 X 421367 0 41069 Veronica B Martin 50 X 217661 0 17495 Jean M Mayer 50 X 397614 0 27917 Deana L Nelson 50 X 758405 0 62710 Maureen Ogden 50 X 599009 0 31333 Ginger K Oliver 50 X X 447824 0 23950 Judith M Ploszek 50 X 439949 0 39021 David K Robbins 50 X 217562 0 23820 Chris A Roederer 50 X 343297 0 25830 Steve L Short 50 X 702027 0 56979 Amy J Paratore 50 X 214626 0 26731 Maja G Gift 50 X 176184 0 25258 Nicholas Martini 50 X 208250 0 31565 Emma C Ocampo 50 X 213038 0 30818 Curtis Seiler 50 X 237057 0 33120 Jennie Yurkovitch 50 X 204672 0 30110 Lucila E Ramiro 50 X 215884 0 27822 10571823 0 872512 286 1 1 0 USF & UMSA PO Box 917492 Orlando FL 32891 Physicians/Residents 49902263 FLORIDA BLOOD SERVICE INC 10100 Dr Martin Luther King Jr St St Petersburg FL 33716 Blood Services/Products 15932336 MORRISON HEALTHCARE INC 10115 Windhorst Road Tampa FL 33619 Food Services 14216842 SKANSKA USA BUILDING INC 4950 W Kennedy Blvd Tampa FL 33609 Construction 11137364 BUCHANAN INGERSOLL AND ROONEY PC 401 EAST JACKSON STREET SUITE 2500 TAMPA FL 33602 LEGAL 10617429 224 0 0 0 13541908 5737068 79466 0 19358442 Patient Revenue -Other Third Party Revenue 622000 683217682 683217682 0 0 Conventional Medicare and Medicaid Revenue 622000 231075727 231075727 0 0 Fees and Contracts From Government Agencies 622000 51461077 51461077 0 0 Disproportionate Share Revenue 622000 33501737 33501737 0 0 Sales to Employees/Pharmacy 446110 4346579 4346579 0 0 18540395 17050817 1489578 0 1022143197 13512219 0 0 13512219 2144332 0 0 2144332 0 0 0 0 0 0 85763749 9500 81227370 0 4536379 9500 4545879 0 0 4545879 0 Rental Income 900099 169433 0 0 169433 0 0 0 0 169433 1061873502 1020653619 1489578 20371863 0 11139518 3977611 7161907 0 329231290 271406230 57825060 24092792 19756089 4336703 44200405 36277255 7923150 24067945 19735715 4332230 2706075 315173 2390902 9438883 9438883 196710 196710 149793 149793 817278 817278 100944986 84041608 16903378 4294570 207153 4087417 245131220 225544879 19586341 17842494 17842494 15112735 9929067 5183668 1387765 507771 879994 0 453697 219333 234364 18965544 12460362 6505182 40150 40150 35992447 23431523 12560924 22285868 22285868 Bad Debt 63989505 63989505 0 0 Assessments 12153723 12153723 0 Dues and Memberships 1638385 168559 1469826 Property Taxes 482454 53890 428564 Recruitment Expenses 437560 38981 398579 4513200 1004590 3508610 991706992 807654678 184052314 0 18700 19345 105625728 92692910 514483 668135 117924586 109180812 18323725 24215498 3294633 3118449 635146238 225829703 384144403 409316535 237625325 328048125 152072197 145546901 7853362 7249258 34873793 31414968 1062270935 1151470936 157291975 161085002 617588 463191 380232771 375232875 970820 4570553 192279453 218719197 731392607 760070818 X 293820102 373098119 36260814 18301999 797412 0 330878328 391400118 1062270935 1151470936 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 100 0 0 1 379602 0 0 379702 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 Tampa General Hospital's lobbying activities focus on communicating the hospital's special status and challenges to elected officials at the County, State, and Federal levels. Given TGH's large share of indigent care in the region, efforts are primarily focused on mantaining existing funding and seeking additional government support to ensure TGH can continue to deliver quality care to its patients. 797412 15675 821 0 1523 0 812385 762812 34373 3539 0 3312 0 797412 0 1 0 0 1 1 0 31173230 31173230 0 335425237 79970326 255454911 0 5569247 5111702 457545 0 217304515 139417772 77886743 0 45674009 1329903 44344106 409316535 Investments, bonds, and deposits 145546901 F 145546901 County Health Plan Receivable 10291545 Accounts Receivable Disproportionate Share 7138322 Accounts Receivable County Match 5635244 Deferred Bond Issue Costs 3819127 Accounts Receivable Contracts and Deposits 2724100 Due From/To Champus 1000036 Other Receivables 806594 31414968 Accrued Claims Payable Malpractice 82565085 Accrued Retirement Benefits 65476333 Due to Third Party Payor 44362034 Accrued Supplemental Retirement Benefits 14734325 Accrued Postretirement Benefits 7206563 Accrued Workers Compensation 3444975 2006 Bond Arbitrage Payable 929882 218719197 1061873502 991706992 70166510 12655061 0 0 0 -16282785 -3627724 66538786 1058343152 12655061 0 0 0 12655061 1045688091 0 16185411 16185411 1061873502 991804366 0 0 0 97374 97374 991706992 0 0 0 991706992 SchD_P05_S00_L04 Schedule D, Part V, Line 4 Permanently restricted funds were available for hospital projects and educational initiatives. SchD_P10_S00_L00 Schedule D, Part X TGH has been recognized by the Internal Revenue Service as a tax-exempt organization described in Section 501(c)(3) of the Internal Revenue Code. Accordingly, income earned in the furtherance of the TGH's tax-exempt purpose is exempt from federal and state income taxes. TGH applies Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 740 for Income Taxes which clarifies the accounting for uncertainty in income tax position and provides guidance when tax positions are recognized in an entity's financial statement and how the value of these positions are determined. SchD_P11_S00_L08 Schedule D, Part XI, Line 8 This amount represents contributions in the amount of $16,185,411 received from the Tampa General Hospital Foundation and other governmental grants that is not included in the audited financial statements as revenue, but as a change in net assets, and $97,374 associated with expenditures incurred by Florida Health Sciences Center LTD, a subsidiary organization. SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Contributions of $16,185,411 received from the Foundation and other related organizations are included in Part VIII but are not reported in the audited financial statements as revenue. SchD_P13_S00_L02d Schedule D, Part XIII, Line 2d This amount, which is included in the consolidated financial statements, represents expenses associated with Florida Health Sciences Center LTD, a subsidiary of Florida Health Sciences Center, Inc. Central America and the Caribbean 1 2 Program Services Provides professional and general liability services in support of Florida Health Science Center Inc. 97374 1 2 97374 SchF_P01_S00_L03 Schedule F, Part I, Line 3 Florida Health Sciences Center LTD began operations on June 1, 2010 to provide general and professional liability to Florida Health Sciences Center, Inc. 1 1 X 1 X 1 X 1 1 1 0 1 1 53084446 20633820 32450626 0.033 175247388 157955272 17292116 0.017 35194652 18210844 16983808 0.017 0 0 263526486 196799936 66726550 0.067 753514 753514 0.002 22366486 15718171 6648315 0.007 5170309 0 5170309 0.005 1040832 600524 440308 0 1218340 1218340 0 0 0 30549481 16318695 14230786 0.014 0 0 294075967 213118631 80957336 0.081 1 13976652 0 210625319 225464294 -14838975 X 1 1 Florida Health Sciences Center Inc dba Tampa General Hospital

PO Box 1289 Tampa FL 33601

X X X X X N/A The hospital's cost accounting system was used to calculate the amounts reported in line 7. For the purpose of computing subsidized services, both direct and indirect costs were considered. For research, only direct costs were considered. Physician Clinics were included in the subsidized health services calculation resulting in a community benefit expense of $3,659,159. Bad debt of $63,989,505 included in the expense total, is not included in the total operating expense of $991,706,992 which was used to calculate the Table 7 percentages. Receivables are reported net of an allowance for bad debt and contractual adjustment estimates. Although the aggregate amount of receivables may include balances due from patients and third party payers (including final settlements and appeals), amounts due from third-party payers for retroactive adjustments of items, such as final settlements or appeals, are reported separately in the financial statements. The adequacy of the allowance for bad debts is evaluated regularly, with adjustments to increase or decrease the allowance by adjustments in the provision for bad debts. As expected payments are determined to be uncollectible, they are written off against the allowance for bad debts. The $14.9 million shortfall reported at Pt. III line 7 should be considered as a community benefit in that much of the shortfall in Medicare payments relates to the costs associated with the TGH liver, heart, kidney, lung and pancreas organ transplant programs, and medical education programs, which are a significant benefit to all patients in these programs and the community as a whole. Medicare revenues and cost are from the 2010 Medicare cost report, adjusted for the revenues and costs associated with subsidized health services and graduate medical education reported separately in Part I lines 7g and 7f. Each self pay patient is evaluated to determine if covered by Medicaid, Hillsborough County and/or charity assistance. The financial information provided by this evaluation determines into which category a patient resides. Patients who do not qualify for government assistance are then evaluated in accordance with hospital policy for Charity and Discounted Care. Patient balances will either qualify for a total write off or a discount based on the patients household income and family size in relation to the Federal Poverty Limitations. Genesis OB GYN, Family Care Center-Health Park, Pediatric Clinic at Health Park, The Specialty Clinic at Health Park, Family Care Center-Kennedy, TGH Outpatients Rehabilitation Services, TGH Community Health Education Tampa General Hospital (TGH) is a 1,004 bed academic medical center located in Hillsborough County, Florida. TGH serves a 12 county region that includes a population in excess of 4,000,000 people. This population has a broad range of health care needs, and TGH identifies these needs using a variety of approaches, including analysis of population demographics, inpatient and outpatient utilization of services by the population, state, local & national data on health status and other factors impacting the need for health care programs and services and consumer survey data. Each of these will be described in more detail below. Utilization Data: The State of Florida collects data on inpatient hospitalizations for all hospitals in the state. Analysis of this data allows TGH to identify patterns of inpatient utilization by the age of the patient, diagnosis and location of residence. This data can be coupled with the demographic data to determine the need for new or expanded inpatient programs. For example, the data can be used to determine population utilization rates by diagnosis and age cohort. If the rates are increasing and the population cohort is growing, services may need to be increased to meet future demand. Analysis of this data is a critical step in all TGH program development. State, Local & National Data: There are many sources of data available from local, state and the federal government that assist TGH in identifying community needs. The inpatient utilization data identified above is an example of data available from the state of Florida. One critical source of information available from the federal government is found in the Healthy People 2010 goals. The Healthy People 2010 goals are based on a nationwide assessment of community health status. These goals provide a roadmap for local communities to use in developing programs based at health promotion and prevention. They also identify specific population access issues that can help in program design. TGH has designed community education, screenings and programs specifically in support of the Health People 2010 goals related to cancer, heart disease and stroke, immunizations, nutrition, and tobacco use. The most complete needs assessment data that TGH utilizes to design community programs is the annual National Research Consumer Health Report. The report is based on surveys of the residents of the Tampa-St. Petersburg-Clearwater, Florida CBSA. The 2008-2009 report, which was the basis of TGH's FY2010 programming, was based on a sample of 3,034 households in the CBSA. Questions in the survey asked consumers to rate their health status, whether they had been diagnosed in the past 12 months with one or more conditions, whether they were insured and what type of preventive activities they engaged in during the past 12 months. The demographic characteristics of the respondents was also collected, which allowed the data to be analyzed by age and income. Analysis of the report provided TGH data to support the development of screenings for hypertension and cholesterol, programs on nutrition and obesity, smoking cessation, diabetes, sleep disorders and osteoporosis. Approximately 47% of the patients discharged from Tampa General Hospital in Fiscal 2010 were considered charity or underinsured and the costs associated with their care exceeded $60 million. These include patients who qualify for free care under TGH's charity care policy or are enrolled in programs for low-income or under insured individuals sponsored by state and local governments. While TGH received reimbursement for some of these patients the amounts are not sufficient to cover the costs of care provided. Free care is provided to patients who qualify based on an evaluation of their income and assets. Individuals with an income that is less than or equal to 200% of the Federal Poverty Level (FPL) are eligible for charity or free care as are individuals whose income is less than 400% of the FPL but whose hospital charges are greater than 25% of their annual income. Financial counselors work with individuals who seek care and are un-insured. Assistance is provided to enroll eligible individuals in government programs such as Medicaid, Medicare Disability or the Hillsborough County Health Plan as well as determining whether they qualify for charity or discounted care. TGH's financial assistance (charity care and discounted care) policy is available to consumers at TGH.org as well as in the hospital admissions area. The information is written in both English and Spanish and the English version is reproduced below. Financial Assistance (Charity and Discounted Care) Tampa General Hospital provides necessary medical care regardless of a patient's ability to pay for services. Patients, who are admitted and are uninsured or underinsured, may qualify for financial assistance and/or discounted care. Uninsured patients who are seeking non-emergent care are given these guidelines and an estimate of charges upon inquiry, prior to admission. (FS 395.301 7.8) Qualifying for assistance is based upon the Federal Poverty Income Guidelines. Our Financial Counseling staff is available to assist patients throughout the qualifying process. Charity eligibility will be considered for six months from the date of eligibility. The following guidelines are used to determine the amount of financial assistance a patient receives. A patient's assets and medical expenses are taken into consideration when determining the level of assistance. Patients will be asked to provide information to the TGH financial counselors in order to determine eligibility for charity or discounted care. * Charity: You will not be billed if your income is between 0 and 200% of the Federal Poverty Level (FPL). * Charity Catastrophic: You will not be billed if your income is under 400% FPL and your hospital charges are greater than 25% of your annual income. * Uninsured Discount Tier 1: Your hospital bill will be discounted by 70% if your annual income is between 200 and 300% of the FPL. * Uninsured Discount Tier 2: Your hospital bill will be discounted by 60% if your income is between 300 and 400% of the FPL. * Insured/Recently Uninsured: If your income is greater than 400% of the FPL and you are recently uninsured you may qualify for a discount equivalent to that of your most recent insurance carrier. * Prompt Payment: If your income is greater than 400% of the FPL, you may qualify for a prompt pay discount. The discount may vary and in no event will exceed 50% of billed charges. Providing false information to defraud a hospital for the purpose of obtaining goods or services is a misdemeanor in the second degree and punishable under Florida Statute 817.50. Tampa General Hospital's primary service area is Hillsborough County, Florida. Seventy percent of the inpatients who are treated at TGH are residents of Hillsborough County. The remaining 30% come from an 11 county region of West Central Florida, as well as other areas of Florida and the United States. The entire region benefits from the warm climate of Florida and is a popular destination for retirees as well as others looking to escape the harsher climates of the Midwest and Eastern parts of the United States. Hillsborough County is a growing area. With a current population of over a million (1,215,757), the County is projected to grow by 9% over the next five years (1,325,417). This growth rate is more than double that of the entire nation. The average age of Hillsborough County population is 37.5 years which is almost identical to the US as a whole (37.7). Individuals over 65 years of age comprise 12.5% of the population while 25% of the population is less than 18 years of age. The County's population is racially and ethnically diverse with 16% of the population Black or African American and 23% of the population either White or Black Hispanic. Household income in Hillsborough County averages $69,052 somewhat less than the US average ($71,071) while per capita income is slightly higher ($27,318 v. $27,034). It is estimated that approximately 10% of the families in the County are below the federal poverty level. The current recession has impacted Hillsborough County as unemployment rates are in excess of 10%. The eleven county region that comprisesTGH's secondary service area has a very different demographic profile. The region extends north of Hillsborough County to Citrus County and south to Charlotte County. The secondary service area includes the following FLorida Counties: Pasco,Hernando, Citrus,Polk, Pinellas, Highlands, Desoto, Manatee,Sarasota, Charlotte and Hardee. The secondary service area has a current population in excess of 3.3 million. Projected grow is expected to be less than the primary service area and is estimated to be 7.1% over the next five years. By 2015, the population of the secondary service area is projected to be 3,586,379. The secondary service area population is older than that of the primary service area with an average age of 43.8 years. Over 23.38% of the secondary service area population is over the age of 65. Many of the secondary service area counties are popular retirement areas for residents of colder parts of the United States. The secondary service area is slightly less diverse than the primary service area. Less than 10% of the secondary service area is Black or African American (8.5%) and only 11.1% consider themselves Latino or Hispanic. The average household and per capita income of the secondary service area is less than that of both the primary service area and the US as a whole. Household income averages $61,702 almost $10,000 less than that of the primary service area. This is a reflection of the large senior population many of whom are on fixed incomes. Per capita income for the secondary service area is slightly less than that of the primary service area ($26,627 v. $27,318). Less than 9% of the families in the secondary service have incomes below the federal poverty level. Unemployment in the secondary service area varies from approximately 10.5% to 15.7%. Educational levels in both the primary and secondary service area are somewhat different than the US as a whole. The percentage of the population with Masters degrees or above in both the primary and secondary service area are less than the national average of 7% for the population over 25. In the primary service area approximately 19% of the population has a Bachelors degree compared to less than 15% in the secondary service area and 17% for the United States as a whole. Tampa General Hospital's commitment to the health of the community it serves is exemplified by its mission statement. The key elements of TGH's mission include the provision of services ranging from the simplest to the most complex to all of the residents of West Central Florida, a commitment to research and education with its physician and medical school partners and recognition of its role in the community as the safety net provider. The TGH Board of Directors reaffirms this mission during the annual review and adoption of the TGH strategic plan. The Board also authorizes the use of surplus funds through the annual budget process to fund enhancements to services, the physical plant, infrastructure and financial support for training physicians, nurses and other health care providers, health education to the community and support of other not-for-profit organizations in the community with complimentary goals and missions. The 15 member board is composed of independent community leaders as well as members of the TGH medical staff. The board bylaws specify that its membership will include the elected medical chief of staff, a representative of the University of South Florida and the chairman of the TGH Foundation. During FY2010, TGH completed the first phase of its new 82 bed Neonatal Intensive Care Unit (NICU). The NICU serves the sickest newborns, many of whom are born into families at or below the federal poverty level. Approximately 70% of the babies in the NICU are on Medicaid. Surplus funds paid not only for the construction of the NICU (total cost when completed will be approximately $35 million) but also training of pediatricians and neonatologists. This is but one example of how TGH utilizes its surpluses to provide services to those members of the community in the greatest need. In addition to utilizing surplus funds for the development of inpatient services, TGH uses these funds to subsidize outpatient services for underserved members of the community. TGH operates a number of outpatient clinics that provide primary and specialty care for the uninsured and under-insured. Services include adult primary and specialty care, pediatrics and high risk obstetrics. While many of these patients have some funding either through Medicaid or the Hillsborough County Health Plan, the revenue from these sources is insufficient to cover the costs of providing the services. In FY2010, TGH's clinics provided 94,291 patient visits. The TGH medical staff is open to any physician that meets the requirements of the medical staff bylaws and rules and regulations. The medical staff is composed of community physicians with private practices and physicians on the faculty of the University Of South Florida College of Medicine (USFCOM). Both community and USFCOM physicians are involved in research and training. Many of the community physicians hold clinical appointments with USFCOM and all staff physicians may participate in research. In FY2010, the TGH Office of Clinical Research supported 398 research studies at a net cost of $600,000. These studies received funding from a variety of public and private agencies, including the Department of Defense and the National Institute of Child Health Development and were led by both community and university physician principle investigators. The research centered on a range of topics, including a Phase III study of effective drug cocktails for HIV positive patients to an evidenced based clinical decision support system to predict survival and life expectancy of hospice patients. These research initiatives have immediate benefits to the patients who participate in them as well as long term benefits to the community. TGH is considered a statutory teaching hospital under Florida Law. This designation is only available to hospitals who have made a significant commitment to graduate medical education. In FY2010, TGH hosted over 300 full time equivalent residents and fellows in over 40 specialties. The Medicare program funds 209 residents, with the remaining slots funded solely by the hospital out of surplus funds. In addition to a robust medical education program, TGH is also committed to the training of nurses, pharmacists and other clinical staff. TGH provides financial support for nursing education at both the University of South Florida and the University of Tampa. Students and residents in a variety of clinical programs (pharmacy, pastoral care and other programs) rotate through TGH or in some cases are assigned to TGH for their training. Finally, TGH sponsors continuing medical education (CME) for physicians in the community and in outlying areas. In FY2010, TGH CME sponsorships provided CME education to 578 physicians, none of whom were on the TGH medical staff. The cost of CME sponsorships exceeded $125,000. Tampa General's commitment to improving the health status of the community is evident in the vast array of educational programs, screenings and support groups it provides to the community. In FY 2010, TGH provided 88 free programs and screenings to 4,917 members of the community. Educational programs focused on everything from preventing the flu, to smoking cessation to stress management. Programs were provided in a variety of locations. For example, programs of particular interest to seniors were provided at several senior living facilities within the primary service area including Sun City, University Village and Grand Court of Tampa. In FY 2010, TGH developed two programs in collaboration with its community partners. Health & Fit for Life is a program for kids and their parents that focuses on making healthy food choices and increasing exercise as a way of maintaining and controlling weight. Health & Fit was designed with More Health, a community based health education program for children in Hillsborough & Pinellas Counties. This program was provided in multiple locations including TGH's subsidized clinic locations. The Chronic Disease Self Management Program is a multi-week program aimed at individuals with chronic illnesses. This program was provided in conjunction with the Area Agency on Aging. Screenings range from blood pressure and diabetes to screenings for peripheral vascular disease and abdominal aortic aneurysms. TGH has a dedicated staff responsible for developing programs as well as identifying high risk areas within the county that might benefit most from screenings and health prevention and promotion programs. TGH nurses volunteer their time to help with these programs and screenings as part of their clinical ladder. In addition to providing educational programs and screenings, TGH also provides financial support to other community not-for-profit organizations. This funding is another way that TGH utilizes its surplus funds to support the community health and well being. In FY2010, TGH provided financial support to over 60 not-for-profit organization. This support ranged from donations under $1000 to commitments in excess of $250,000. Three organizations in particular receive significant support from TGH-More Health Inc., Ronald McDonald Mobile Health Van and Tampa Community Health Center. For more than 20 years, TGH has been the largest single sponsor of More Health, Inc. More Health provides health education in Hillsborough and Pinellas County public and private school. Innovative, hands on instruction for all grades is a key feature of More Health and more than a million children have benefited from the education provided by More Health. TGH, in conjunction with USFCOM and the Ronald McDonald Foundation supports a mobile medical van that provides medical and dental services to underserved children in the region. TGH also provides financial support to Tampa Community Health Center (TCHC). TCHC is a federally qualified health center that provides significant amounts of service to underserved populations in Hillsborough County. TGH's donation allows them to expand primary care and other services. In addition TGH supports a variety of other not-for-profits including the American Heart Association, March of Dimes, Ronald McDonald Foundation, Wheels of Success, the Epilepsy Foundation, Joshua House, the Spring and many others. In addition to financial support, many TGH employees volunteer their time and participate in fundraising events like the Heart Walk for the American Heart Association. FL X X 1 1 X X X X X X 0 1 0 0 0 1 0 1 0 Amy J Paratore 150332 0 56674 0 7620 0 15763 0 10968 0 241357 0 0 0 Anthony D Escobio 137788 0 54650 0 19132 0 14789 0 10218 0 236577 0 0 0 Cheryl A Eagan 196069 0 77513 0 3607 0 15383 0 7670 0 300242 0 0 0 Chris A Roederer 237197 0 92661 0 13439 0 18389 0 7441 0 369127 0 0 0 David K Robbins 147150 0 56674 0 13738 0 15683 0 8137 0 241382 0 0 0 Deana L Nelson 422319 0 189816 0 146270 0 58393 0 4317 0 821115 0 0 0 Ginger K Oliver 253101 0 99261 0 95462 0 13703 0 10247 0 471774 0 0 0 Janet H Davis 163607 0 62145 0 26116 0 21915 0 5939 0 279722 0 0 0 Jean M Mayer 226136 0 88633 0 82845 0 21915 0 6002 0 425531 0 0 0 Curtis Seiler 235888 0 0 0 1169 0 22189 0 10932 0 270178 0 0 0 Emma C Ocampo 200573 0 11000 0 1465 0 19801 0 11017 0 243856 0 0 0 Lucila E Ramiro 199123 0 11000 0 5761 0 20394 0 7428 0 243706 0 0 0 Nicholas Martini 208059 0 0 0 192 0 20633 0 10932 0 239816 0 0 0 Jennie Yurkovitch 203283 0 0 0 1389 0 19180 0 10930 0 234782 0 0 0 John H Bond 158015 0 60431 0 19935 0 16793 0 10982 0 266156 0 0 0 Judith M Ploszek 254581 0 101687 0 83681 0 34857 0 4165 0 478971 0 0 0 Maja G Gift 149222 0 20792 0 6170 0 16700 0 8558 0 201442 0 0 0 Marcos F Lorenzo 246711 0 98230 0 76426 0 33588 0 7481 0 462436 0 0 0 Mark W Campbell 140052 0 54650 0 11664 0 14789 0 10963 0 232118 0 0 0 Maureen Ogden 177023 0 67114 0 354872 0 23689 0 7643 0 630341 0 0 0 Robin W DeLaVergne 214878 0 84197 0 1939 0 16682 0 7440 0 325136 0 0 0 Ronald A Hytoff 809672 0 412135 0 981010 0 116469 0 11608 0 2330894 0 0 0 Sally H Houston 345034 0 134963 0 1162 0 26784 0 7100 0 515043 0 0 0 Steve L Short 419849 0 189816 0 92362 0 46100 0 10879 0 759006 0 0 0 Veronica B Martin 150465 0 56674 0 10522 0 11571 0 5925 0 235157 0 0 0 Elizabeth J Lindsay-Wood 69708 0 74239 0 13358 0 7933 0 856 0 166094 0 0 0 Kathi K Katz 108238 0 21455 0 27870 0 0 0 1439 0 159002 0 0 0 SchJ_P01_S00_L01a Schedule J, Part I, Line 1a TGH pays membership dues for the University Club of Tampa for Mr. Ronald Hytoff as well as dues for the Governor's Club for Dr. Marcos F. Lorenzo. Any international travel by an executive is booked with a first class ticket. SchJ_P01_S00_L03 Schedule J, Part I, Line 3 Schedule J, Part I, Line 3 - Within the framework of applicable law, Tampa General Hospital will establish and maintain compensation goals, policies, and programs that enable the hospital to recruit, develop, and retain the most qualified and talented staff. Tampa General Hospital strives to effect a strategic investment in the people who support the hospital's mission. Compensation goals, policies and programs are guided by and reflect our values and principles, which are consistent with the high quality of the hospital's achievement in the furtherance of medical science. Differences in pay will not be based upon such factors as race, religion, gender, national origin, ancestry, age, marital status, or disability. To ensure that TGH is paying reasonable compensation and not violating the private inurement prohibition, the Compensation Committee of the Board of Directors annually reviews and sets the compensation of officers, the executive group and key employees. The Committee utilizes the outside consulting firm of Towers Watson to provide expert information regarding industry-wide compensation norms. SchJ_P01_S00_L04 Schedule J, Part I, Line 4 Tampa General Hospital provides the executive staff with a supplemental retirement plan (SERP). Participants of this plan are listed on Statement 4, column C3 (Officers). As these participants become vested, the incremental amount of vested benefits is included on Form W-2; however, distributions are not made until either the participant retires or leaves the organization. The compensation reported in the 2009 W-2's includes the following vested amounts: Ronald A. Hytoff: $919,452; Maureen Ogden: $352,675; Deana Nelson: $104,116; Ginger Oliver: $83,335; Marcos Lorenzo: $67,178; Steve Short: $63,483; Jean Mayer: $61,762; Judith Plozek: $54,991; Janet Davis: $15,315. SchJ_P01_S00_L06 Schedule J, Part I, Line 6 The bonus and incentive program combines financial and quality measures and sets targets for achievement. The amount of incentive awarded is based upon the achievement of those targets. SchJ_P01_S00_L07 Schedule J, Part I, Line 7 Schedule J, Part I, Line 7 - 33.33% of the total bonus and incentive is based on achieving financial targets. The remaining bonus is based on the achievement of certain quality indicators and other non-financial metrics. Hillsborough County Industrial Development Authority 591293512 43233ACA2 2003-05-29 208601867 Hospital Expansion and Refunding 1992 Bond Issue 0 0 Hillsborough County Industrial Development Authority 591293512 43233ACT1 2006-09-28 190910329 Hospital Expansion 0 0 131886722 15752985 0 0 2872749 2414982 110846006 2007 0 0 1 1 201343374 0 0 0 2184896 0 199158479 2009 0 0 1 1 0 0 0 0 0 0.005 0 0.005 0 0 0 0 0 0 0.005 0 0.005 0 0 0 0 1 Societe Generale Note-this GIC was terminated 7/7/2010-below is the original term 7.2 1 0 0 0 0 0 1 Transamerica Life This GIC was terminated 2/1/2009 2.25 1 0 0 DeLaVergne & Company Business own by spouse of Robin DelaVergne 32150 Real Estate Commission 0 F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a USF designates one individual to participate in FHSC's board. In addition, the Chairman of the Board of the Tampa General Hospital Foundation is also a member of FHSC's board. F990_P06_S0A_L07b Form 990, Part VI, Section A, Line 7b The Hillsborough County Hospital Authority has the right to approve amendments to FHSC's Articles of Incorporation. F990_P06_S0B_L11 Form 990, Part VI, Section B, Line 11 The IRS Form 990 is prepared by the Finance Department and sent to Tampa General Hospital's tax accountants for review. Following the revisions made at the suggestion of Tampa General Hospital's tax accountants, the IRS Form 990 is provided to the Chief Financial Officer (CFO) and the President/Chief Executive Officer (CEO) for comment and recommended changes. The Finance Department makes all appropriate revisions. The CFO reviews the Form 990 with the Audit Committee and considers any changes recommended by the Audit Committee. Any agreed-upon changes are incorporated and the draft Form 990, along with the Mission Statement, is distributed to the Board of Directors for review and approval. Upon approval by the Board, the Form 990 is filed with the IRS. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The monitoring and enforcing of the conflict of interest policy is a joint effort between Corporate Compliance and Human Resources. All new hires are required to review, complete, and sign the conflict of interest statement (COI). The leadership group is required to review, complete and sign the COI annually. In addition, existing employees are required as part of their annual performance evaluation to review, complete, and sign the COI. All the COI's are reviewed by Human Resources. If there is a COI disclosed on the form, additional information is requested from the employee and in some cases Corporate Compliance is included where additional input or guidance is needed by Human Resources. Employees are also advised to disclose COIs that may arise during the course of the year. Employees and other TGH healthcare partners can similarly report COIs to Corporate Compliance using the compliance line, email, phone, etc. Periodically, in newsletters issued by Corporate Compliance, reference is made to COI. It is the responsibility of Corporate Compliance to initiate investigations of allegations of COIs. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 Within the framework of applicable law, Tampa General Hospital has established and maintained compensation goals, policies, and programs that enable the hospital to recruit, develop, and retain the most qualified and talented staff. Tampa General Hospital strategically invests in the people who support the hospital's mission. Compensation goals, policies, and programs are guided by and reflect our values and principles, which are consistent with the high quality of the hospital's achievement in the furtherance of medical science. Differences in pay will not be based upon such factors as race, religion, gender, national origin, ancestry, age, marital status, or disability. To ensure that TGH is paying reasonable compensation and not violating the private enurement prohibition, the Compensation Committee of the Board of Directors annually reviews and sets the compensation of officers, the executive group and key employees. The Committee utilizes the outside consulting firm of Towers Watson to provide expert information regarding industry-wide compensation norms. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Florida Health Sciences Center, Inc. d/b/a Tampa General Hospital ("TGH") will make the following documents available to the public: (1) Articles of Incorporation and Amendments thereto; (2) Bylaws, (3) Conflict of Interest Policy; (4) Audited Financial Statements; (5) IRS Form 990 and IRS Form 1023: and (6) Community Benefits Report. The preceding documents will be available to the public either through (a) the website at www.tgh.org or (b) upon request made to the TGH Public Relations Office, after payment of reasonable copying fee. SchK_P03_S00_L07 Schedule K, Part III, Line 7 Effective June 2011, Management approved the Private Use of Bond Financed Property policy that directs the organization to comply with all IRS laws and regulations applicable to the Private Business Use in tax-exempt financed facilities. Hospital leadership is responsible for ensuring that any space in debt-financed buildings allocated to Private Business does not exceed the legal limits. Tampa General Hospital Foundation Inc PO Box 1289 Tampa FL 33601 237354477 Fundraising to support TGH's mission FL 501(c)(3) Line 7 N/A Florida Health Sciences Center LTD c/o Marsh Management Svcs 23 Lime Tree Bay Av Bd 4 Fl 2 Georgetown Grand Cayman CJ KY1-1102 980695992 Professional liability & general liability coverage to TGH on a claims made basis. CJ Florida Health Scences Center Inc C 0 27572456 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 Tampa General Hospital Foundation Inc c 13775665 Tampa General Hospital Foundation Inc n 418026 Tampa General Hospital Foundation Inc b 3900 Tampa General Hospital Foundation Inc m 32354 Tampa General Hospital Foundation Inc n 325136 Florida Health Sciences Center LTD o 26951 Florida Health Sciences Center LTD q 146951