2026-08-03T10:13:44-05:00 2025-09-30 593040705 RIVERO GORDIMER & COMPANY PA 201 N FRANKLIN ST SUITE 2200 TAMPA FL 33602 990 2024-10-01 237354477 TAMPA GENERAL HOSPITAL FOUNDATION INC TAMP 8138447250 P O BOX 1289 RM H-149 TAMPA FL 33601 FRANN LEPPLA PRESIDENT 8138443528 2026-08-03 1 1 SAM A LAZZARA P01342929 8138757774 2024 2025-03-06 01:10:19Z FRANN LEPPLA P O BOX 1289 RM H-149 TAMPA FL 33601 63268509 0 X WWW.TGH.ORG/FOUNDATION X 1974 FL TO SUPPORT AND PROMOTE THE PROGRAM SERVICES OF FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL. 25 24 0 45 0 0 50132188 42592927 745 0 1832365 3392018 551824 243646 52517122 46228591 9284239 24711932 0 0 0 0 0 0 127378 580716 247356 9864955 24959288 42652167 21269303 99601378 118708477 1595164 1929845 98006214 116778632 X THE TAMPA GENERAL HOSPITAL FOUNDATION EXCLUSIVELY OPERATES FOR THE PURPOSE OF RAISING FUNDS TO SUPPORT THE RESEARCH, EDUCATION AND SERVICE MISSION OF FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL. TAMPA GENERAL IS A 982 BED, PRIVATE, NOT-FOR-PROFIT, SAFETY NET HOSPITAL AND ONE OF THE MOST COMPREHENSIVE MEDICAL FACILITIES IN WEST CENTRAL FLORIDA SERVING A DOZEN COUNTIES WITH A POPULATION IN EXCESS OF 4 MILLION. 0 0 3153421 3153421 TGH MEN'S CENTER - THE TAMPA GENERAL HOSPITAL FOUNDATION PROVIDES FUNDING FOR THE BUILDOUT OF THE NEW TAMPA GENERAL HOSPITAL MEN'S CONCIERGE MEDICINE CENTER. 2831890 2831890 CANCER INSTITUTE FUND - THE TAMPA GENERAL HOSPITAL FOUNDATION PROVIDES FUNDING FOR ONCOLOGY SERVICE LINE PRIORITIES INCLUDING PHYSICIAN DRIVEN RESEARCH AND CONTINUING EDUCATION OPPORTUNITIES. 2596435 2596435 FUND FOR THE FUTURE - THE TAMPA GENERAL HOSPITAL FOUNDATION PROVIDES FUNDING FOR TEAM MEMBER RESILIENCY AND APPRECIATION INITIATIVES AS WELL AS A COMPREHENSIVE HEALTHCARE PEOPLE DEVELOPMENT INSTITUTE THAT WILL SUPPORT ALL TEAM MEMBERS' CAREER ASPIRATIONS AND EQUIP THEM WITH THE SKILLS TO DRIVE THEIR DEVELOPMENT AND ACHIEVE TGH'S VISION TO BE THE SAFEST, MOST INNOVATIVE ACADEMIC HEALTH SYSTEM IN AMERICA. 16130186 16130186 FUNDED OPERATIONAL, EDUCATIONAL AND/OR CAPITAL PURCHASES SUPPORT TO FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL. SPECIFIC GRANTS INCLUDED NURSING SCHOLARSHIPS, SMALL CAPITAL EQUIPMENT TO IMPROVE PATIENT SERVICES, HOSPITAL EMPLOYEE EMERGENCY ASSISTANCE AND SUPPORT OF HOSPITAL COMMUNITY OUTREACH, EDUCATIONAL SEMINARS AND REHAB PROGRAMS. 16130186 16130186 24711932 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 39 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 25 24 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X X FRANN LEPPLA 8138447250 PO BOX 1289 ROOM H-149 TAMPA FL 336011289 JOHN COURIS EX OFFICIO 1.00 X 0 2897033 47070 GORDON GILLETTE CHAIRMAN 2.00 X X 0 0 0 JOSEPH WILLIAMS VICE CHAIRMAN 2.00 X X 0 0 0 TAMMY KING PT MHS DPT SECRETARY 2.00 X X 0 0 0 MATHEW WASH TREASURER 2.00 X X 0 0 0 RAVIENDER BUKKAPATNAM MD MEMBER AT LARGE 1.00 X 0 0 0 JEFFRIE VAN LOVEREN MEMBER AT LARGE 1.00 X 0 0 0 SUPRIYA TANEJA MEMBER AT LARGE 1.00 X 0 0 0 FRANK HANCOCK MEMBER AT LARGE 1.00 X 0 0 0 SHARON AMEZCUA TRUSTEE 1.00 X 0 0 0 RENU PARKER TRUSTEE 1.00 X 0 0 0 BETHANY PAGLIARULO TRUSTEE 1.00 X 0 0 0 MURRAY SHAMES MD TRUSTEE 1.00 X 0 0 0 TAYLOR K WEST TRUSTEE 1.00 X 0 0 0 CHRISTOPHER KETCHEY MD TRUSTEE 1.00 X 0 0 0 TEALE TAGGART SMITH TRUSTEE 1.00 X 0 0 0 CHIP SCOTT WHITWORTH TRUSTEE 1.00 X 0 0 0 J WADE KIRKLAND JR TRUSTEE 1.00 X 0 0 0 ERIC EBBERT TRUSTEE 1.00 X 0 0 0 RON WEISSER TRUSTEE 1.00 X 0 0 0 PATRICIA J EMMANUEL MD TRUSTEE 1.00 X 0 0 0 JUDETTE LOUIS MD MPH TRUSTEE 1.00 X 0 0 0 BRUCE ZWIEBEL MD TRUSTEE 1.00 X 0 0 0 DUANE DRAPER TRUSTEE 1.00 X 0 0 0 WAYNE LEWIS TRUSTEE 1.00 X 0 0 0 FRANN LEPPLA PRESIDENT 50.00 X 0 564902 27447 0 3461935 74517 0 0 1 0 0 1067320 41525607 10850114 42592927 4351308 4351308 16080628 17039918 -959290 -959290 -959290 189482 1067320 0 189482 189482 MANAGEMENT FEE 900099 54164 54164 54164 46228591 0 0 3635664 23299151 23299151 1412781 1412781 32373 32373 214971 87593 127378 12 12 24959288 24711932 119978 127378 7885390 5565492 40608442 51582929 515625 454138 1309 1309 12 0 50591909 61105918 99601378 118708477 147568 428241 232086 504662 1215510 996942 1595164 1929845 X 14460610 9725684 83545604 107052948 98006214 116778632 99601378 118708477 X 21269303 986901 -3483786 X X 0 1 X 1 0 X X X 1 FLORIDA HEALTH SCIENCES CENTER DBA 593458145 3 1 17511932 0 1 17511932 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 PART IV, SECTION D, LINE 3 EVERY GRANT, GIFT AND NEW FUND ESTABLISHED BY THE FOUNDATION DIRECTLY CORRELATES TO THE NEEDS OF THE SUPPORTED ORGANIZATION. NO GIFT IS SOLICITED FOR ANYTHING OTHER THAN THE SUPPORTED ORGANIZATION'S NEEDS. EACH RESTRICTED FUND IS ASSIGNED TO THE TGH VICE PRESIDENT WHO THEN DESIGNATES A FUND OFFICER. THE FUND OFFICER MUST BE EMPLOYED BY TGH AS A MEDICAL STAFF MEMBER, VICE PRESIDENT, DEPARTMENT MANAGER OR DIRECTOR. THE FUND OFFICER AND VICE PRESIDENT ARE DIRECTLY RESPONSIBLE FOR MEETING THE REQUIREMENTS OF THE FUND PURPOSE. DISBURSEMENTS FROM THE FUND MAY ONLY BE MADE WHEN A PROPERLY COMPLETED CHECK REQUEST FORM WITH SUPPORTING DOCUMENTATION HAS BEEN SUBMITTED BY THE FUND OFFICER, APPROVED BY THE ASSIGNED VICE PRESIDENT AND REVIEWED BY THE FOUNDATION EXECUTIVE DIRECTOR TO ENSURE THAT THE REQUEST MEETS THE ORIGINALLY ESTABLISHED FUND CRITERIA. PART IV, SECTION E, LINE 2A THE FOUNDATION IS A SUPPORTING ORGANIZATION WHICH IS ORGANIZED AND OPERATED EXCLUSIVELY TO PROMOTE, SUPPORT, AND ENHANCE THE MISSION AND SERVICES OF FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL (TGH) (EIN 59-3458145). PART IV, SECTION E, LINE 2B IF THE FOUNDATION DID NOT OPERATE TO RAISE THE FUNDS TO SUPPORT TGH'S RESEARCH, EDUCATION, AND SERVICE MISSION, TGH WOULD HAVE TO CONDUCT THESE ACTIVITIES ITSELF. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1942170 5800000 7742170 1822170 120000 1942170 1677495 144675 1822170 1338921 338574 1677495 1521211 15622 197952 1338881 1.00000 0 0 1309 1309 0 0 FUNDS HELD FOR THE BENEFIT OF OTHERS 996942 996942 X 51109260 986901 3926141 4913042 46196218 32373 32373 46228591 32336842 3926141 3483786 7409927 24926915 32373 32373 24959288 PART V, LINE 4: ENDOWMENT FUNDS SUPPORT THE MISSION OF FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL, INCLUDING RESEARCH, EDUCATION, AND HEALTHCARE DELIVERY. PART X, LINE 2: THE FOUNDATION HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A TAX-EXEMPT ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986. INCOME EARNED IN FURTHERANCE OF THE ORGANIZATION'S TAX-EXEMPT PURPOSE IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. THE FOUNDATION IS NOT AWARE OF ANY TAX POSITIONS IT HAS TAKEN THAT ARE SUBJECT TO A SIGNIFICANT DEGREE OF UNCERTAINTY. TAX YEARS AFTER JUNE 30, 2022 REMAIN SUBJECT TO EXAMINATION BY TAXING AUTHORITIES. PART XII, LINE 2D - OTHER ADJUSTMENTS: ALLOWANCE OF UNCOLLECTIBLE PLEDGES 3,483,786. GALA 939586 808687 130899 GOLF 276716 218133 58583 1 40500 40500 1256802 1067320 189482 189482 1 FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 3153421 0 MEN'S CENTER RENOVATION FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 2831890 0 YEATMAN GIFT TO USF/MICROBIOME AWARD/TRAVEL AND EXPENSES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 2596435 0 PDI FEES TO USF/TEAM APPRECIATION DAY FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 2037380 0 CT SCANNER FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 914293 0 EXPENSES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 594051 0 RENOVATION/EX3 LAB/SIGNAGE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 500000 0 INNOVATION CENTER FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 451352 0 BIOPRINTER ROBOT/SALARY REIMBURSEMENT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 300056 0 MRI DREAM THINK/AYA RESEARCH TM SALARY/ FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 275000 0 DCARRE PROJECT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 250000 0 SALARY REIMBURSEMENT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 176519 0 TAVA HEALTH/CPI/K9 EXPENSES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 160301 0 LECTURE SERIES TRAVEL AND MEALS/FELLOWSHIP EDUCATION FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 145682 0 AWARDS/SCHOLARSHIPS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 131170 0 EQUIPMENT FOR 3DPRINT LAB/MATAR SALARY FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 129268 0 EXPENSES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 125500 0 WARRIOR HEALTH & FITNESS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 83760 0 EMPLOYEE SCHOLARSHIP FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 78636 0 PATIENT HARDSHIP ASSISTANCE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 71243 0 TRANSPLANT PATIENT HARDSHIP ASSISTANCE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 64138 0 TRAVEL AND MEALS/INTERVIEW EXPENSES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 57820 0 GAME SYSTEM/PLAYROOM SUPPLIES/REHAB ITEMS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 53478 0 RENOVATION/MURAL PAINTING FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 45523 0 MEDICAL EQUIPMENT/CELEBRATION ITEMS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 43813 0 EMBA EXPENSES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 42114 0 SUPPLIES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 40559 0 W&C CELEBRATION/REFRESH FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 39001 0 CONFERENCE ROOM REFRESH FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 38000 0 PATIENT HARDSHIP ASSISTANCE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 37650 0 FURNITURE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 33588 0 SHIRTS & JACKETS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 33217 0 STC 6 FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 31568 0 EQUIPMENT RENTAL FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 30104 0 EXPENSES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 29804 0 CLOTHES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 29520 0 STUDENT TRAINING PROGRAM FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 29092 0 SURGIFORCE STOOL FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 26250 0 RADIOGRAPHIC SYNDESMOSIS STUDY FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 25246 0 FILM SERIES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 25140 0 GRANTS/TRAVEL REIMBURSEMENT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 23210 0 TUTION PAYMENT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 22384 0 ADMINISTRATIVE FELLOWSHIPS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 20177 0 PATIENT ASSISTANCE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 18468 0 CONFERENCE EXPENSES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 18005 0 AEROCHAMBERS/BABY SHOWER SUPPLIES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 16957 0 EXPENSES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 16352 0 FITNESS/TAVA HEALTH FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 15567 0 SOAR DUES/REGISTRATION FEES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 14713 0 HVI EDUCATION EXPENSES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 13346 0 TRAVEL EXPENSES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 12406 0 PATHWAYS EMPLOYMENT FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 11000 0 BECKERS REGISTRATION/SUPPLIES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 10495 0 PROGRAM FEES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 10242 0 PATIENT SUPPORT/SUPPLIES FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 9742 0 JOINT JOURNAL CLUB WITH USF FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 9564 0 EBOOKS/TNCC PROVIDER MANUALS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 9133 0 TRAVEL EXPENSES/RESEARCH STIPEND FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 9024 0 REIMBURSE DR. MATTHEW MIFSUD FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 8548 0 EXPENSE REIMBURSEMENTS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 7167 0 EXPENSE REIMBURSEMENTS/RENT ASSISTANCE FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 7041 0 EXPENSE REIMBURSEMENTS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 5075 0 EXPENSE REIMBURSEMENTS/HANDBOOKS FLORIDA HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL PO BOX 1289 TAMPA FL 33601 593458145 501(C)(3) 0 7200000 FMV BARGIN PURCHASE OF REAL ESTATE FUND FOR FUTURE EXPANSION NURSING SCHOLARSHIPS 7 122553 SURGICAL TECH SCHOLARSHIPS 3 64483 HEALTH AMBASSADOR SCHOLARSHIPS 1 86889 RESPIRATORY SCHOLARSHIP 3 4417 EVS SCHOLARSHIP 2 13232 USFTGPN-PAS SCHOLARSHIP 1 10097 HUMAN RESOURCES EMPLOYEE EMERGENCY ASSISTANCE-MCNICHOLS TEAM MEMBER ASSIST 420 1111110 PART I, LINE 2: THE FOUNDATION EXECUTIVE COMMITTEE ESTABLISHES A RESTRICTED FUND AFTER A CAREFUL REVIEW OF THE FUND'S SPECIFIC PURPOSE AND ANTICIPATED APPROVED EXPENDITURES. EACH RESTRICTED FUND IS ASSIGNED TO A TAMPA GENERAL HOSPITAL (TGH) VICE PRESIDENT WHO THEN DESIGNATES A FUND OFFICER. THE FUND OFFICER MUST BE EMPLOYED BY TGH AS A MEDICAL STAFF MEMBER, VICE PRESIDENT, DEPARTMENT MANAGER OR DIRECTOR. THE FUND OFFICER AND VICE PRESIDENT ARE DIRECTLY RESPONSIBLE FOR MEETING THE REQUIREMENTS OF THE FUND PURPOSE. DISBURSEMENTS FROM THE FUND MAY ONLY BE MADE WHEN A PROPERLY COMPLETED CHECK REQUEST FORM WITH SUPPORTING DOCUMENTATION HAS BEEN SUBMITTED BY THE FUND OFFICER, APPROVED BY THE ASSIGNED VICE PRESIDENT AND REVIEWED BY THE FOUNDATION EXECUTIVE DIRECTOR TO ENSURE THAT THE REQUEST MEETS THE ORIGINALLY ESTABLISHED FUND CRITERIA. ALL LEVELS OF APPROVAL MUST BE OBTAINED BEFORE A CHECK IS PRODUCED. THE EXECUTIVE DIRECTOR PERFORMS A FINAL REVIEW OF THE DOCUMENTATION PRIOR TO SIGNING PRINTED CHECKS, WHILE THE BOARD TREASURER OR ASSISTANT TREASURER MUST APPROVE CHECKS THAT EXCEED $250,000. 0 0 0 0 0 0 0 0 0 JOHN COURIS EX OFFICIO 0 1447130 0 1207250 0 242653 0 17250 0 29820 0 2944103 0 0 FRANN LEPPLA PRESIDENT 0 346568 0 171408 0 46926 0 6740 0 20707 0 592349 0 0 PART I, LINE 3 TAMPA GENERAL HOSPITAL (TGH) PAYS THE COMPENSATION FOR THE CEO, OFFICERS, EXECUTIVE GROUP AND KEY EMPLOYEES. TGH UTILIZES COMPENSATION COMMITTEES, INDEPENDENT COMPENSATION CONSULTANTS, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEYS AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THESE INDIVIDUALS. X 7 3470205 MARKET PRICING X 1 7200000 FAIR MARKET VALUE X 3 40143 RETAIL PRICING X GIFT CARDS/PRIZES 16 49929 RETAIL PRICING X FURNITURE 1 31988 RETAIL PRICING X TOYS/GAMES/BOOKS 17 29160 RETAIL PRICING X MEALS/TICKETS TO EVENTS 8 26129 RETAIL PRICING X SERVICES 2 2560 RETAIL PRICING 0 1 0 FORM 990, PART VI, SECTION A, LINE 7A TWO TRUSTEES ARE APPOINTED FROM TAMPA GENERAL HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE FINANCE COMMITTEE. ONCE SATISFIED WITH THE RETURN, IT WAS PRESENTED TO THE BOARD OF TRUSTEES AT A BOARD MEETING FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C EACH FOUNDATION TRUSTEE, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS IS REQUIRED TO SIGN AN "ANNUAL DISCLOSURE STATEMENT (CONFLICT OF INTEREST AND IRS MATTERS)." ON THE FORM THE PERSON AFFIRMS THAT HE/SHE HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; HAS READ AND UNDERSTANDS THE POLICY; HAS AGREED TO COMPLY WITH THE POLICY; AND UNDERSTANDS THAT THE FOUNDATION IS A CHARITABLE, TAX EXEMPT ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. ADDITIONALLY, HE/SHE DISCLOSES ALL KNOWN POTENTIAL OR ACTUAL CONFLICTS. UPON COMPLETION, THE ANNUAL DISCLOSURE STATEMENT IS PROVIDED TO THE FOUNDATION'S EXECUTIVE DIRECTOR, WITH A COPY TO LEGAL COUNSEL. TO ENSURE THAT THE FOUNDATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS ARE CONDUCTED AT LEAST ANNUALLY AND ON A CHANGE OF CIRCUMSTANCE. THE MINUTES OR OTHER RECORDS OF THE BOARD AND ALL COMMITTEES WITH BOARD DELEGATED POWERS CONTAIN THE NAMES OF ANY PERSONS WHO ABSTAIN FROM VOTING DUE TO A REAL OR POTENTIAL CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 TAMPA GENERAL HOSPITAL FOUNDATION, INC. HAS ADOPTED THE FOLLOWING PROCEDURES FROM FLORIDA HEALTH SCIENCES CENTER, INC. DBA TAMPA GENERAL HOSPITAL ("TGH") AND DEPENDS ON TGH TO PROVIDE THE ANALYSIS DESCRIBED. 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 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 MERCER TO PROVIDE EXPERT INFORMATION REGARDING INDUSTRY-WIDE COMPENSATION NORMS. IN ADDITION, THE HOSPITAL UTILIZES AN OUTSIDE CONSULTING FIRM TO REVIEW THE COMPENSATION ARRANGEMENTS OF EMPLOYED PHYSICIANS FOR COMPLIANCE WITH ALL APPLICABLE LAWS. FORM 990, PART VI, SECTION C, LINE 19 TAMPA GENERAL HOSPITAL FOUNDATION, INC. 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; AND (5) IRS FORM 990. THE FOREGOING DOCUMENTS WILL BE AVAILABLE TO THE PUBLIC UPON REQUEST AND AFTER PAYMENT OF REASONABLE COPYING FEES. FORM 990, PART XI, LINE 9: ALLOWANCE FOR UNCOLLECTIBLE PLEDGES -3,483,786. FORM 990, PART XII, LINE 2C THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. FL HEALTH SCIENCES CENTER INC DBA TAMPA GENERAL HOSPITAL 1 TAMPA GENERAL CIRCLE TAMPA FL 33606 593458145 1,007 BED PRIVATE, NOT-FOR-PROFIT HOSPITAL FL 501(C)(3) 3 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0