2011-08-12T10:22:08-05:00 2010-09-30 DRAFFIN & TUCKER LLP PO BOX 6 ALBANY GA 317020006 990 2009-10-01 593322533 SOUTH LAKE HOSPITAL INC SOUT 3523944071 1900 DON WICKHAM DRIVE CLERMONT FL 34711 LANCE SEWELL 3523944071 2011-08-15 true JACQUELINE G ATKINS 2298837878 2011-08-12 2009 2016-02-24 21:20:13Z X LESLIE LONGACRE CEO 1900 DON WICKHAM DRIVE CLERMONT FL 34711 137667957 false X HTTP://WWW.SOUTHLAKEHOSPITAL.COM/ X 1995 FL HEALTHCARE SERVICES 6 4 1241 180 2157985 -371244 7090810 4806862 122121725 129201137 945097 688494 2797845 2830054 132955477 137526547 65295 0 50048163 50629485 0 142894 65397105 71475338 115445268 122170118 17510209 15356429 172464540 242093774 69389877 123479822 103074663 118613952 HEALTHCARE SERVICES false false 96468616 65295 129201137 OPERATION OF NOT-FOR-PROFIT HOSPITAL PROVIDING INPATIENT, OUTPATIENT, & EMERGENCY CARE FOR RESIDENTS OF SOUTHERN LAKE COUNTY FLORIDA. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. TOTAL PATIENT DAYS EXCEEDED 29,900. 96468616 true true false false false false false false false true true false false false false false false false true false true false true true true false false false false false false false false false false false false false false false true false false false true 0 0 true 1241 true true true false false false false false false false false false false false false false 6 4 false true false false false true false true true false false false true true true true true true true false FL X LANCE SEWELL CFO 3522417104 1900 DON WICKHAM DRIVE CLERMONT FL 34711 X JOHN HILLENMEYER 2.00 X X 0 998093 232433 DR RICHARD HORNICK 2.00 X 0 120406 34563 CATHY HOECHST 2.00 X X 0 0 0 SUSAN MCLEAN 2.00 X X 0 0 0 ROBERT E BERENS JR 2.00 X X 0 0 0 DAVID BATMAN 2.00 X 0 0 0 LESLIE LONGACRE 40.00 X 0 170697 45477 LANCE SEWELL 40.00 X 0 127709 39621 JOHN MOORE 40.00 X 0 124834 41340 DEBORAH CORT 40.00 X 0 111933 28728 BAKKIAM SUBBIAH 40.00 X 402064 0 51462 DOROTHY RICHARDSON 40.00 X 183889 0 26119 THURMEN LILLARD 40.00 X 143295 0 28135 ROBERT DAVIS 40.00 X 138192 0 15236 ANISKA RICHARDSON 40.00 X 119849 0 21083 987289 1653672 564197 13 false true false SODEXHO INC SODEXHO SERVICES FOOD 9801 WASHINTONIAN BLVD GAITHERBURG MD 20878 MGMT SERVICES 968969 TOSIBA AMERICA 2441 MICHELLE DRIVE TUSTIN CA 92780 MTNC & REPAIRS 945734 ORIGIN INC SHIFTWISE 2501 SW 1ST AVENUE SUITE 200 PORTLAND OR 97201 NURSE STAFFING 449754 CROTHALL LINEN SERVICE INC 955 CHESTERBROOK BLVD STE 300 WAYNE PA 19087 LAUNDRY SERVICE 424478 RCOA IMAGING SERVICES INC 16110 JOG ROAD SUITE 200 DELRAY BEACH FL 33446 DIAGNOSTIC IMAG 387775 26 45000 4673276 2358 86228 4806862 PROGRAM SERVICE REVENUE 129201137 129201137 129201137 688494 688494 262374 118513 143861 143861 143861 15067 45000 22897 -7830 -7830 28259 28259 28259 NATIONAL TRAINING CENTER 713940 2157985 2157985 MISCELLANEOUS 476497 476497 COMMUNITY EDUCATION 25771 25771 5511 5511 2665764 137526547 129201137 2157985 1360563 65295 65295 41320585 36720139 4526931 73515 1086612 965634 119045 1933 5388458 4788532 590339 9587 2833830 2530726 297564 5540 235978 235978 224256 224256 13689684 4685409 9004275 274167 2315 271852 23594593 23135255 440010 19328 122159 28650 93509 3263122 1026404 2236718 139166 91554 47122 490 70 70 2842456 2842456 6024321 5433335 590986 1512363 1512363 PROVISIONS FOR BAD DEBTS 14973753 14973753 REPAIRS AND MAINT 1684650 1453931 230719 LOSS ON BOND REFINANCING 1177354 1177354 RECRUITING 934903 934903 COMMUNITY SUPPORT 414702 414702 367641 152912 182228 32501 122170118 96468616 25558608 142894 6228139 8155988 23915000 29199000 16823 15997 13787305 11623330 1160945 1142427 2281612 2118081 1033044 1108571 158297677 47181810 85704656 111115867 27673080 69121955 4519836 4272355 6144100 4220203 172464540 242093774 15199181 16677983 1854352 335843 50706771 102356650 1629573 4109346 69389877 123479822 X 101848803 117217932 1225860 1396020 103074663 118613952 172464540 242093774 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false 1123833 9652800 10776633 77904847 18580071 59324776 1851950 706236 1145714 37336811 27895503 9441308 30427436 30427436 111115867 137526547 122170118 15356429 39287 39287 15395716 137707244 310298 310298 137396946 129601 129601 137526547 122311528 141410 141410 122170118 122170118 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION, AND IS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2010 AND 2009 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S OPEN AUDIT PERIODS ARE FOR TAX YEARS ENDED 2007-2009. RECONCILIATION OF CHANGES - OTHER SCHEDULE D, PAGE 4, PART XI, LINE 8 RENTAL EXPENSES 118,513 NET ASSETS RELEASED FROM RESTRICTIONS 65,295 SPECIAL EVENTS EXPENSES 22,897 UNREALIZE GAIN ON INVESTMENTS 103,593 CAPITAL CONTRIBUTIONS -129,601 RENTAL EXPENSES -118,513 SPECIAL EVENTS EXPENSES -22,897 REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 2D RENTAL EXPENSES 118,513 NET ASSETS RELEASED FROM RESTRICTIONS 65,295 SPECIAL EVENTS EXPENSES 22,897 UNREALIZE GAIN ON INVESTMENTS 103,593 REVENUE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 4B CAPITAL CONTRIBUTIONS 129,601 EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 2D RENTAL EXPENSES 118,513 SPECIAL EVENTS EXPENSES 22,897 GOLF TOURNAMENT 60067 45000 15067 7817 5000 8866 1214 60067 45000 15067 7817 5000 8866 1214 22897 -7830 true true true X false true true false true true 4731425 4731425 0.04460 5301109 5301109 2886209 2119868 766341 0.00720 12918743 7420977 5497766 0.05180 281069 281069 0.00270 137986 65295 72691 0.00070 31956 31956 0.00030 269766 269766 0.00250 720777 65295 655482 0.00620 13639520 7486272 6153248 0.05800 true 3015205 31111335 40668603 -9557268 X true true SOUTH LAKE HOSPITAL

1900 DON WICKHAM DRIVE CLERMONT FL 34711

X IF TOTAL OF ALL OPEN BILLS ACCOUNTS FOR MORE THAN 25% OF THEIR ANNUAL INCOME, DISCOUNT WILL BE APPLIED TO REACH THE 25% MARK, PROVIDED PATIENT'S INCOME DOES NOT EXCEED 400% OF THE FPG. THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". SEE ALSO THE DESCRIPTION FOR PART III, LINE 4. COSTS FOR PART I, LINE 7A AND 7B AND PART III, SECTION A, LINE 2 WERE CALCULATED USING THE RCC CALCULATED IN WORKSHEET 2. OTHER COSTS WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. SUBSIDIZED HEALTH SERVICES REPRESENT THE OPERATIONAL COSTS FOR THE FREE CLINIC TO CARE FOR INDIGENT PATIENTS OF SOUTH LAKE COUNTY. IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 120,992,764 LESS: BAD DEBTS IN PART IX ( 14,973,753) ADD: EXPENSES REPORTED IN PART VIII 22,897 DENOMINATOR FOR COLUMN (F) 106,041,908 EXCERPT FROM AUDITED FINANCIAL STATEMENTS - ALLOWANCE FOR DOUBTFUL ACCOUNTS MANAGEMENT PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON AN EVALUATION OF THE OVERALL COLLECTIBILITY OF THE ACCOUNTS RECEIVABLE. AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE, THEY ARE CHARGED AGAINST THE ALLOWANCE. AMOUNTS ON PART III, LINES 2 AND 3 WERE CALCULATED USING THE RCC AS DEFINED IN WORKSHEET 2. MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. BOTH DISCOUNTS AND PAYMENTS TO ACCOUNTS WILL REDUCE THE BAD DEBT EXPENSE, SHOULD THE ACCOUNT BE REPORTED AS BAD DEBT. THAT IS TO SAY, DISCOUNTS APPLIED TO ACCOUNTS ARE NOT REVERSED PRIOR TO DECLARING, ADJUSTING AND/OR WRITING OFF ACCOUNTS AS BAD DEBT. ALL ACCOUNTS WHICH ARE ADJUSTED TO, OR WRITTEN OFF TO, BAD DEBT ARE REVIEWED TO DETERMINE THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. IF SUFFICIENT DOCUMENTATION WAS NOT PROVIDED BY THE ACCOUNT HOLDER, SOUTH LAKE USES PREDICTIVE ANALYTICS TO DETERMINE IF THE ACCOUNT WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. THE PREDICTIVE ANALYTICS DESIGNED TO ASSESS FINANCIAL ASSISTANCE FOR ACCOUNTS ADJUSTED TO, OR WRITTEN OFF TO, BAD DEBT USES DATA DERIVED FROM THIRD PARTIES WHICH INCLUDE, BUT ARE NOT LIMITED TO DEMOGRAPHIC VERIFICATION, INCOME VERIFICATION, HOUSEHOLD SIZE VERIFICATION, PAYMENT HISTORY INFORMATION, PROPERTY OWNERSHIP INFORMATION, OCCUPATION INFORMATION, VEHICLE OWNERSHIP HISTORY AND VALUES AND HOME OWNERSHIP HISTORY AND VALUES. ONCE THIS DATA LOGIC IS APPLIED, IT BECOMES APPARENT IF THE ACCOUNT QUALIFIES FOR FINANCIAL ASSISTANCE. IF THE ACCOUNT DOES QUALIFY, PREVIOUS UNINSURED DISCOUNTS, BAD DEBT ADJUSTMENTS AND/OR WRITE OFFS ARE REVERSED AND THE NEW BALANCE REFLECTED IS RECLASSIFIED AS FINANCIAL ASSISTANCE OR CHARITY. SOUTH LAKE DOES NOT CURRENTLY CONDUCT A FORMAL ANNUAL HEALTH CARE NEEDS ASSESSMENT. HOWEVER, THE ORGANIZATION DOES ASSESS THE SERVICES NEEDED AS PART OF OUR STRATEGY, PLANNING AND BUDGETING PROCESS AND HAS PROCESSES IN PLACE TO ENSURE THE ORGANIZATION IS REACTIVE TO COMMUNITY HEALTH NEEDS. EXAMPLES OF HOW SOUTH LAKE RESPONDS TO COMMUNITY NEEDS ARE AS FOLLOWS: 1. GOVERNING BOARDS ARE COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE; 2. PARTNERSHIP WITH LOCAL AREA GROUPS AND ASSOCIATES TO ATTEND TO THE HEALTH CARE NEEDS OF THE SOUTH LAKE COMMUNITY; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH FAIRS, COMMUNITY FITNESS, WELLNESS EVENTS AND OTHER OUTREACH EVENTS; AND 4. TRANSITION SERVICES POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS TO PREVENT UNNECESSARY ADMISSIONS AND POTENTIAL RE-ADMISSIONS. SOUTH LAKE MEETS THE NEEDS OF THE COMMUNITY THROUGH ITS EDUCATION, RESEARCH AND PATIENT CARE PROGRAMS. THE SPECIFIC NEEDS TARGETED BY THESE PROGRAMS HAVE BEEN IDENTIFIED BY THE EXPERIENCE OF COMMUNITY HOSPITAL ADVISORY COUNCILS, NEIGHBORHOOD OUTREACH AND THROUGH COMMUNITY NEEDS ASSESSMENTS THAT IDENTIFIED HEALTH PROBLEMS IN THE COMMUNITIES SERVED BY THE HOSPITAL. SOUTH LAKE SPONSORS A VARIETY OF PROGRAMS FOR AT-RISK POPULATIONS, FEDERALLY-DESIGNED MEDICALLY UNDERSERVED AREAS AND SPECIAL NEEDS GROUPS, AS WELL AS FOR THE BROADER COMMUNITY. SOUTH LAKE FOLLOWS AN ESTABLISHED PROCESS TO INFORM ALL PATIENTS OF ITS CHARITY CARE AND UNINSURED DISCOUNT POLICIES. DURING PREADMISSION, AT REGISTRATION OR AT BEDSIDE, UNINSURED PATIENTS ARE INFORMED OF THE HOSPITAL'S CHARITY CARE POLICY AND OTHER FINANCIAL ASSISTANCE. FINANCIAL INFORMATION IS SECURED FOR ALL UNINSURED PATIENTS TO SCREEN FOR POSSIBLE ENROLLMENT IN FEDERAL, STATE AND LOCAL PROGRAMS. SOUTH LAKE HAS CONTRACTED DEDICATED ORGANIZATIONS THAT ASSIST THE PATIENT WITH THEIR ENROLLMENT PROCESS ALL THE WAY TO APPROVAL OR DENIAL BY THE RESPECTIVE AGENCIES. FOR UNINSURED PATIENTS THAT ARE DENIED COVERAGE OR DO NOT MEET THE COVERAGE CRITERION FOR A RESPECTIVE AGENCY, SOUTH LAKE THEN SCREENS THE PATIENT FOR CHARITY ELIGIBILITY. IT IS SOUTH LAKE'S OBJECTIVE TO PROVIDE CHARITY CARE TO OUR PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY. SOUTH LAKE CURRENTLY OPERATES IN THE CENTRAL FLORIDA REGION, WHICH HAS OVER TWO MILLION RESIDENTS AND THOUSANDS OF INTERNATIONAL VISITORS ANNUALLY. SOUTH LAKE'S PRIMARY SERVICE AREA IS COMPRISED OF ORANGE, OSCEOLA, SEMINOLE AND LAKE COUNTIES. THE MEDIAN HOUSEHOLD INCOME IN THESE COUNTIES IS 28,355. TEN PERCENT OF HOUSEHOLDS IN CENTRAL FLORIDA ARE BELOW THE FEDERAL POVERTY GUIDELINE. THE PERCENT UNINSURED (AGE 0-64) FOR THE FOUR COUNTY AREAS ARE 23% AND THERE ARE ELEVEN FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS PRESENT IN THE COMMUNITY. COMMUNITY OUTREACH ACTIVITIES INCLUDE SPEAKER'S BUREAU, SUPPORT/EDUCATION GROUPS, WELLNESS ACTIVITIES, HEALTH FAIRS, CLINICAL SCREENINGS AND ASSESSMENTS, MEDICAL EDUCATION, RESEARCH, WOMEN, CHILDREN AND SENIOR HEALTH INITIATIVES, PUBLIC PROGRAM ENROLLMENT ASSISTANCE AND POST-ACUTE CARE FOR HOMELESS AND UNINSURED, SPONSORSHIPS, SCHOOL INITIATIVES, DONATED MEETING SPACE AND SPIRITUAL CARE. SOUTH LAKE HOSPITAL, INC. FURTHERS ITS EXEMPT PURPOSE BY REINVESTING SURPLUS FUNDS IN THE HOSPITAL, EXTENDING ADMITTING PRIVILEGES TO QUALIFYING PHYSICIANS IN THE COMMUNITY AND SURROUNDING AREAS, OPERATING A FREE CLINIC FOR RESIDENTS OF SOUTH LAKE WHO FALL BELOW THE MEDICAID GUIDELINES, OPERATING THE NATIONAL TRAINING CENTER FOR THE OVERALL HEALTH OF THE COMMUNITY AND ENCOURAGING OVERALL COMMUNITY INVOLVEMENT IN THE GOVERNING BODY OF THE ORGANIZATION. true NURSING SCHOLARSHIPS 23 65295 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 NURSING SCHOLARSHIP POLICY IS TO PROVIDE TUITION REIMBURSEMENT FOR ANY APPLICANT WHO MEETS CERTAIN CRITERIA REGARDING EMPLOYMENT, GRADES AND QUALIFICATIONS AS WELL AS SUPERVISORY RECOMMENDATIONS. PROOF OF GRADE AND PAYMENT MUST BE PRESENTED AT THE TIME OF REIMBURSEMENT. X X false true false true false false false false false JOHN HILLENMEYER 740881 246039 11173 219528 12905 1230526 DR RICHARD HORNICK 120085 321 20312 14251 154969 LESLIE LONGACRE 147994 11380 11323 39004 6473 216174 LANCE SEWELL 118100 9519 90 20443 19178 167330 JOHN MOORE 114163 10587 84 27008 14332 166174 BAKKIAM SUBBIAH 400584 1368 112 41250 10212 453526 DOROTHY RICHARDSON 182502 1368 19 12249 13870 210008 THURMEN LILLARD 142951 344 7547 20588 171430 ROBERT DAVIS 137972 220 6900 8336 153428 SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 JOHN HILLENMEYER 0 209,116 0 LESLIE LONGACRE 0 10,500 0 LANCE SEWELL 0 8,715 0 JOHN MOORE 0 8,400 0 DEBORAH CORT 0 7,560 0 BAKKIAM SUBBIAH 0 41,250 0 DOROTHY RICHARDSON 0 12,249 0 COMPENSATION CONTINGENT UPON REVENUES OF ORGANIZATION SCHEDULE J, PAGE 1, PART I, LINE 5A DIRECTORS RECEIVE AN INCENTIVE FOR THE ACHIEVEMENT OF CERTAIN FINANCIAL, PERSONNEL, CUSTOMER SATISFACTION AND QUALITY GOALS. OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III THE 457F DEFERRED COMPENSATION PLAN IS A RETENTION PLAN WHEREBY 7% OF THE EXECUTIVE'S BASE SALARY IS DEPOSITED INTO A LINCOLN ACCOUNT. EACH YEAR'S DEPOSIT IS SUBJECT TO A THREE YEAR VESTING SCHEDULE. UPON VESTING THE ACCOUNT IS TAXED AND PAID OUT LESS ANY 403B DEDUCTIONS. IF THE EXECUTIVE VOLUNTARILY SEPARATES FOR ANY REASON, ALL UNVESTED AMOUNTS ARE FORFEITED. SOUTH LAKE COUNTY HEALTH DISTRICT 2003 REVENUE BONDS 593322533 838640DB3 2003-09-01 17900000 CONSTRUCTION AND REN false true SOUTH LAKE COUNTY HEALTH DISTRICT 593322533 838640DC1 2010-01-06 52335000 CONSTRUCTION/RENOVAT false false SOUTH LAKE COUNTY HEALTH DISTRICT 593322533 838640DS6 2010-04-01 34330000 REDEMPTION OF 1999 B false false 16401806 1344763 354415 16721011 2004 false false true true 51998222 5199822 22407507 998399 23398006 2011 false false false true 33956622 33276360 680262 2010 true false true true false true true false true 0.02150 0.02150 true false true true false true true false true true false true 0.00260 0.00260 true false false false false false false false false false false false false false false false false false false MANAGEMENT DELEGATED FORM 990, PAGE 6, PART VI, LINE 3 ORLANDO HEALTH ("OH"), A RELATED ORGANIZATION, PROVIDES THE HOSPITAL'S CEO, CFO, COO AND CNO PURSUANT TO A MANAGEMENT AGREEMENT WITH THE HOSPITAL. ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A FIFTY PERCENT OF THE BOARD MEMBERS ARE APPOINTED BY OH WHILE THE REMAINING MEMBERS ARE APPOINTED BY SOUTH LAKE MEMORIAL HOSPITAL, INC. ON BEHALF OF SOUTH LAKE COUNTY HOSPITAL DISTRICT ("DISTRICT"), A RELATED ORGANIZATION. THE DISTRICT LEVIES AD VALOREM TAXES AND HAS USED THE TAXES COLLECTED TO SUPPORT THE HOSPITAL. NEITHER RELATED ORGANIZATION HAS TECHNICAL CONTROL OF THE HOSPITAL. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11 THE BOARD CHAIR WILL REVIEW THE FORM 990 WITH THE CFO WITH ALL QUESTIONS AND NEW SCHEDULES BEING REVIEWED AS WELL AS THE RECONCILIATION TO THE AUDITED FINANCIAL STATEMENTS PRIOR TO FILING WITH THE IRS. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY, THE COMPLIANCE OFFICER FOR OH PROVIDES A QUESTIONNAIRE TO THE LEADERSHIP, BOARD OF DIRECTORS, DISTRICT BOARD OF TRUSTEES AND MEDICAL STAFF LEADERSHIP FOR DISCLOSURE IN REGARDS TO POTENTIAL CONFLICTS OF INTEREST. THE OH COMPLIANCE OFFICER EVALUATES EACH QUESTIONNAIRE AND WILL REQUEST ADDITIONAL INFORMATION SHOULD IT BE REQUIRED. ANY VOTING OR COMPENSATION RECEIVED FROM COMPETING ENTITIES IS QUESTIONED AS WELL AS OWNERSHIP IN ANY VENDOR STOCK DIRECTLY. IF ANY CONFLICT OF INTEREST OCCURS, THAT INDIVIDUAL IS RECUSED FROM THAT PORTION OF THE MEETING REGARDING THE CONFLICTED TRANSACTION. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS USED TO DETERMINE COMPENSATION IS ARRIVED BY THE COMPENSATION COMMITTEE BY OH. THE YEAR IN WHICH THIS PROCESS LAST TOOK PLACE WAS 2007 WITH THE EXECUTIVE RESTRUCTURING. THE EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY OH AS PART OF THE MANAGEMENT AGREEMENT. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B THE PROCESS USED TO DETERMINE COMPENSATION IS ARRIVED BY THE COMPENSATION COMMITTEE BY OH. THE YEAR IN WHICH THIS PROCESS LAST TOOK PLACE WAS 2007 WITH THE EXECUTIVE RESTRUCTURING. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 FINANCIAL STATEMENTS ARE MADE AVAILABLE THROUGH CONTINUING DISCLOSURE AGREEMENT WITH DIGITAL ASSURANCE CORPORATION (DAC). GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE SUNSHINE LAW. ADDITIONAL INFORMATION SCHEDULE O MANAGEMENT AGREEMENT ORLANDO HEALTH (OH) PROVIDED VARIOUS SERVICES PURSUANT TO THE MANAGEMENT AGREEMENT WITH THE HOSPITAL. DURING THE YEAR ENDED SEPTEMBER 30, 2010, OH PROVIDED SERVICES IN THE AMOUNT OF 5,732,000; HOWEVER, NO PAYMENT WAS REQUIRED ON 4,673,000 DUE TO AN AGREEMENT ASSOCIATED WITH THE INTERGOVERNMENTAL TRANSFER. THE COST OF THE SERVICES IS RECORDED IN OPERATING EXPENSES. CONVERSELY THE AMOUNT OF THE COST OF SERVICES CONTRIBUTED BY OH IS RECORDED AS A CONTRIBUTION. AS PER THE MANAGEMENT AGREEMENT WITH THE HOSPITAL, OH PROVIDES BILLING AND COLLECTION SERVICES. ADDITIONALLY, ORLANDO HEALTH FOUNDATION (AN AFFILIATE OF OH) HOLDS AND ADMINISTERS CERTAIN DONOR RESTRICTED FUNDS ON BEHALF OF THE HOSPITAL. THE AMOUNT HELD BY ORLANDO HEALTH FOUNDATION ON THE HOSPITAL'S BEHALF WAS 793,000 IN 2010 AND IS INCLUDED IN OTHER RECEIVABLES. ORLANDO HEALTH 1414 KUHL AVENUE ORLANDO FL 32806 591726273 HEALTHCARE FL 501 3 NA SOUTH LAKE COUNTY HOSPITAL DISTRICT 1900 DON WICKHAM DRIVE CLERMONT FL 34711 590571600 LEVY TAX FL 501 6 NA true false true false true false true false false true false true true true true false true true