TY 2012 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Mark Bostick........................................................................ Trustee & Chairman	1.0 .......................1.0	X	X		0	0
(2) William Burns........................................................................ Trustee & Treasurer	1.0 .......................1.0	X	X		0	0
(3) Robert Carter........................................................................ Trustee	1.0 .......................1.0	X			0	0
(4) Todd Dantzler........................................................................ Trustee	1.0 .......................0.0	X			0	0
(5) Eileen Holden........................................................................ Trustee	1.0 .......................1.0	X			0	0
(6) Don Ingram........................................................................ Trustee & Secretary	1.0 .......................1.0	X	X		0	0
(7) Michele McClendon........................................................................ Trustee	1.0 .......................0.0	X			0	0
(8) Charles McPherson........................................................................ Trustee	1.0 .......................0.0	X			0	0
(9) William Murrell........................................................................ Trustee	1.0 .......................1.0	X			0	0
(10) Tommy Oakley........................................................................ Trustee	1.0 .......................0.0	X			0	0
(11) Cindy Price........................................................................ Trustee	1.0 .......................0.0	X			0	0
(12) Richard Straughn........................................................................ Trustee	1.0 .......................1.0	X			0	0
(13) Brian Swain........................................................................ Trustee & Vice Chairman	1.0 .......................1.0	X	X		0	0
(14) Chip Tucker........................................................................ Trustee	1.0 .......................0.0	X			0	0
(15) Lance Anastasio........................................................................ President/CEO	0.0 .......................45.0		X		551,879	62,030
(16) David MacDougall........................................................................ Vice President/CFO	0.0 .......................45.0		X		331,268	71,057
(17) Kaye Hixon........................................................................ VP-Education Services	0.0 .......................45.0			X	214,053	14,968

(A) Name and business address	(B) Description of services	(C) Compensation
Sodexo Inc Affiliates, PO Box 536922ATLANTAGA303536922	Management Services	3,832,963
Doster Construction Co Inc, 8529 South Park Circle Suite 130ORLANDOFL32819	Construction Service	2,830,335
OB Hospitalist Group LLC, 10 Centimeters DriveMAULDINSC29662	Physicians Services	1,409,450
Florida Clinical Practice, PO Box 100247GAINESVILLEFL32610	Physicians Services	1,322,334
Pece of Mind Environmental Inc, 1575 Aber RoadORLANDOFL32807	Demolition Services	813,537
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 58

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	226,407	226,407
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	126,822,528	124,858,148	1,964,380
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	4,453,302	4,384,324	68,978
9	Other employee benefits .......	7,423,648	7,308,662	114,986
10	Payroll taxes ...........	8,666,031	8,515,030	151,001
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	1,934,263		1,934,263
c	Accounting ...........	245,106		245,106
d	Lobbying ...........	142,157	142,157
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	64,527	64,527
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	12,046,801	10,413,332	1,633,469
12	Advertising and promotion ....	961,381	961,381
13	Office expenses .......	7,188,065	7,111,180	76,885
14	Information technology ......	5,299,148	5,296,734	2,414
15	Royalties ..	0
16	Occupancy ...........	4,169,529	4,169,529
17	Travel ............	360,265	342,539	17,726
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	2,843,336	2,843,336
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	15,030,393	15,030,393
23	Insurance ..............	5,207,158	4,239,809	967,349
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	45,009,178	45,009,178
b	BAD DEBT EXPENSE	37,323,183	37,323,183
c	OTHER SRVCS(A),PURCH SRVCS BCD	6,126,283	5,737,940	388,343
d	ASSESSMENTS	2,812,612	2,812,612
e	All other expenses	3,540,695	2,028,637	1,512,058
25	Total functional expenses. Add lines 1 through 24e	297,895,996	288,819,038	9,076,958	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	10,998	1	11,056
2	Savings and temporary cash investments .........	23,838,313	2	20,323,237
3	Pledges and grants receivable, net ...........	0	3	0
4	Accounts receivable, net .............	44,930,528	4	36,005,303
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	6,330,268	8	7,220,148
9	Prepaid expenses and deferred charges ..........	5,502,957	9	4,926,514
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	150,414,895
b	Less: accumulated depreciation .....	10b	1,162,168	103,048,283	10c	149,252,727
11	Investments—publicly traded securities ..........	50,754,821	11	48,518,594
12	Investments—other securities. See Part IV, line 11 .....	0	12	221,953
13	Investments—program-related. See Part IV, line 11 .....	0	13	16,370,783
14	Intangible assets ...............	0	14	7,439,000
15	Other assets. See Part IV, line 11 ...........	23,746,239	15	6,066,890
16	Total assets. Add lines 1 through 15 (must equal line 34)......	258,162,407	16	296,356,205
	17	Accounts payable and accrued expenses .........	33,506,904	17	45,786,893
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	161,403
20	Tax-exempt bond liabilities .............	77,634,964	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	3,377,701	23	4,861,454
24	Unsecured notes and loans payable to unrelated third parties ....	2,700,000	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	27,570,841	25	111,415,867
26	Total liabilities. Add lines 17 through 25.........	144,790,410	26	162,225,617
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	113,371,997	27	134,130,588
28	Temporarily restricted net assets ...........	0	28	0
29	Permanently restricted net assets ...........	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	113,371,997	33	134,130,588
34	Total liabilities and net assets/fund balances ........	258,162,407	34	296,356,205

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

Winter Haven Hospital Inc

Employer identification number

59-0724462

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the supported organization? ................

11g(i)

(ii) A family member of a person described in (i) above? ......................

11g(ii)

(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2011. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2012. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2011. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2012

Name of the organization

Winter Haven Hospital Inc

Employer identification number

59-0724462

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 2

Name of organization Winter Haven Hospital Inc

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 3

Name of organization Winter Haven Hospital Inc

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 4

Name of organization
Winter Haven Hospital Inc

Employer identification number

59-0724462

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Winter Haven Hospital Inc

Employer identification number

59-0724462

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2012

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2012

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Yes

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Yes

122,665

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

19,492

Total. Add lines 1c through 1i ...............................

142,157

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
Part II-B, Line 1I		Dues were paid to the following organizations; Florida Hospital Association, American Association of Clinical Urologists, American Association for Respiratory Care, American Medical Association, American Occupational Therapy Association, Florida Institute of Certified Public Accountants, & Florida Psychological Association. These organizations use a portion of their respective dues to conduct lobbying activities.

Schedule C (Form 990 or 990EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

Winter Haven Hospital Inc

Employer identification number

59-0724462

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	14,280,000		14,280,000
b	Buildings ................	81,923,239	476,348	81,446,891
c	Leasehold improvements ............
d	Equipment ................	35,329,294	685,820	34,643,474
e	Other .................	18,882,362		18,882,362
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				149,252,727

Schedule D (Form 990) 2012

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)		16,370,783

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes		0
CP deferred compensation plan		369,133
Abandoned property		156,481
Deferred compensation plan		3,820,530
Non current pension obligation		10,465,246
Asset retirement obligation long term		1,361,127
Negative estimated third party settlements		8,865,301
Due to affliates		86,298,049
DEPOSTIS		80,000

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		111,415,867
2. Fin 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
Schedule D Part X Line 2	FIN 48 (ASC 740)	The Hospital files a form 990 (Return of Organization Exempt from Income Tax) annually. When the return is filed, it is certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amounts of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the tax-exempt status of each entity, the continued tax-exempt status of bonds, and various positions relative to the potential sources of unrelated business taxable income.

Schedule D (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization
Winter Haven Hospital Inc

Employer identification number

59-0724462

Part I

General Information on Activities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of the grants or

assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used to award

the grants or assistance? ...................................

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside
the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in region
	Central America and the Caribbean	Investments	3,084,000
















3a	Sub-total .....		3,084,000
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)		3,084,000

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2012

Schedule F (Form 990) 2012

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .... MediumBullet

Enter total number of other organizations or entities ....................... MediumBullet

Schedule F (Form 990) 2012

Schedule F (Form 990) 2012Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2012

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2012

Page 5

Part V

Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

Identifier	ReturnReference	Explanation
Schedule F, Part IV - Foreign Filings	Line 1, 4, and 5	DURING THE TAX YEAR, WINTER HAVEN WAS A US TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION, A SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY, AND ALSO HAD AN OWNERSHIP INTEREST IN A FOREIGN PARTNERSHIP. PER THE INSTRUCTIONS FOR FORMS 926, 8621, AND 8865, WINTER HAVEN DID NOT MEET THE FILING THRESHOLD RELATED TO EACH FORM.

Schedule F (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

Winter Haven Hospital Inc

Employer identification number

59-0724462

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other 0 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

If "Yes," did the organization make it available to the public? ..............

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	11,202,738		11,202,738	4.300 %
b	Medicaid (from Worksheet 3, column a) ....	35,769,935	29,923,817	5,846,118	2.240 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .	3,668,466	2,102,938	1,565,528	0.600 %
d	Total Financial Assistance and Means-Tested Government Programs .	50,641,139	32,026,755	18,614,384	7.140 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4) ..
f	Health professions education (from Worksheet 5) ..	280,793		280,793	0.110 %
g	Subsidized health services (from Worksheet 6) ..
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	75,821		75,821	0.030 %
j	Total. Other Benefits ..	356,614		356,614	0.140 %
k	Total. Add lines 7d and 7j .	50,997,753	32,026,755	18,970,998	7.280 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012

Schedule H (Form 990) 2012

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	77,238	77,238	0.030 %
9	Other	250,000	250,000	0.100 %
10	Total	327,238	327,238	0.130 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

37,500,646

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

74,915,929

Enter Medicare allowable costs of care relating to payments on line 5.....

84,223,838

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-9,307,909

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2012

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?2 Name, address, and primary website address				Facility reporting group
1	WINTER HAVEN HOSPITAL INC 200 AVE F NE WINTER HAVEN,FL33881 www.baycare.org/winter-haven-hospital	X	X	A
2	REGENCY CENTER FOR WOMEN & INFANTS 101 AVE O NE WINTER HAVEN,FL33880 www.baycare.org/winter-haven-hospital	X		A

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	A-Winter Haven Hospital Inc
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Yes

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?9
Name and address		Type of Facility (describe)
1	Blood Banks of Mid-Florida Medical SVC 460 First Street North Winter Haven,FL33881	Blood Bank
2	Family Health Center - Auburndale 2028 Highway 92 West Auburndale,FL33823	Outpatient Physician Clinic
3	Family Health Center - Bartow 1625 North Carpenter Ave Bartow,FL33830	Outpatient Physician Clinic
4	Family Health Center - Dundee 5999 Dundee Road Suite 750 Dundee,FL33884	Outpatient Physician Clinic
5	Family Health Center - Haines City 36245 Highway 27 Haines City,FL33844	Outpatient Physician Clinic
6	Family Health Center - Lake Wales 201 SR 60 West Lake Wales,FL33853	Outpatient Physician Clinic
7	Family Health Center - Winter Haven 100 Avenue I NE Winter Haven,FL33881	Outpatient Physician Clinic
8	Family Health Center - SE Winder Haven 6035 Cypress Gardens Blvd Winter Haven,FL33884	Outpatient Physician Clinic
9	Center for Behavioral Health - Polk Co 1201 First Street South Winter Haven,FL33880	Outpatient Beh Hlth Center
10

Schedule H (Form 990) 2012

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

Identifier	ReturnReference	Explanation
Part I, Line 3, 6 & 7		Line 3 Patients of Winter Haven Hospital who are uninsured or underinsured and cannot pay for hospital services are eligible for discounted care. Eligibility is determined by using a sliding scale methodology based on the Federal Poverty levels between 200% and 300%. This enables patients of the community to access healthcare services at a reduced cost. Line 6 a-b During this tax year Winter Haven Hospital was undergoing a consolidation with BayCare Health System, Inc. As a result of management, operating, and system changes a report was not completed during this tax year. The Hospital is converting to a new Fiscal Year End and will complete a Community Benefit Report for its FYE 2014. Line 7 Charity Care and Means-Tested Government Programs costs (Line A Through D) are determined using the Hospital's Cost Accounting system to capture Gross Charges by payor type (Charity, Medicaid, Medicaid HMO, Angels Care Center, Haley Center, WE Care, Polk Health Care Plan). These charges are then netted down to an estimated cost of providing care by applying the Medicare cost to charge ratio for the combined I/P Operating and I/P Capital (as calculated from the CMS-2552-10 cost report form). The costs have been offset by any payments received from Medicaid or other uncompensated care program. Other benefits at cost (Line E through J, as well as, amounts reported in Part II) were compiled from actual payments made via the Accounts Payable system or from data collected by individual departments engaged in the Community Building Activities. Part I, Line 7 Col (f): There is $37,323,183 of bad debt expense which is included in Form 990, Part IX, Line 25. This amount was removed in the calculation of the Percent of Total Expense on Schedule H, Part I, Column 7f.
Part II		The Hospital helps build the community in two major ways. First, if the hospital finds that that there is a shortage in a certain health care specialty, it works to recruit those types of physicians to the area. In the past, the hospital has commissioned a manpower study to determine what the community's needs are. The second major way the hospital helps the community is through subsidizing the cost of anesthesia for women giving birth at the Regency Center for Women and Infants. This benefits the community by allowing those who are less fortunate to have access to anesthesia services.
Part III, Line 2, 3 & 4		The organization's financial statements include a footnote that describes bad debt expense on page 10 of the Winter Haven Hospital, Inc. Notes to Consolidated Financial Statements. Bad Debt Expense reported in Part III line 2 is actual accounts written off from the Accounts Receivable, net of any insurance contractual, other assistance discounts, or a 40% uninsured discount. Patients who are unable to pay are encouraged to provide financial information to the financial assistance department to determine if they may be eligible for programs, such as county, Medicaid, disability, charity, etc. For tax year 2012 the Hospital did not have a means to estimate how much of its Bad Debt Expense may be attributable to patients eligible under its Financial Assistance Policy. However, Winter Haven Hospital has undergone a consolidation with BayCare Health System which will result in expanded availability of systems that will enable them to estimate this in the future. The Hospital has excluded Bad Debt Expense from the calculation of community benefit found in schedule H Part 1 in accordance with IRS instructions.
Part III, Line 8		The Hospital uses the Cost to Charge Ratio. Any shortfall amounts have not been treated as community benefits. Cost reports were used to report medicare allowable costs. Medicare defines allowable costs as those appropriate and helpful in developing and maintaining the operation of pateient care facilities and activities. It specifically excludes certain costs that are not directly related to patient care. The hospital incurs additional expense related to the provision of care to medicare patients that medicare has deemed non-allowable. This additional expense includes costs of physician services (emergency on-call fees, recruitment, etc.), advertising costs, cafeteria costs for meals sold to visitors, etc. The hospital attempts to collect coinsurance and deductibles from medicare beneficiaries.
Part III, Line 9b		At any time in the collection process the account can be determined to meet the criteria of medical indigency as defined by the Federal Poverty Guidelines and all further collection efforts may be suspended. Documentation of such criteria will be retained in the files.
Part V, Section B, Line 3 & 5		Line 3 Qualitative data was gathered during individual interviews with key stakeholders of Winter Haven Hospital and Regency Center for Women and Infants service areas. These stakeholders were identified by an advisory committee of executive leadership. Each stakeholder was interviewed by Tripp Umbach, a consulting firm representing the Hospitals, and lasted approximately 60 minutes. All respondents were asked the same set of questions (questions and responses can be found in the CHNA Report starting on Page 49) previously developed by Tripp Umbach and reviewed by the individual Hospitals executive leadership project team. Stakeholders included representation from the following Public Health and Community areas: 1. Polk County Public Health Department 2. Auburndale City 3. Florence Villa Community Development Corporation 4. Winter Haven Economic Development Council 5. Winter Haven City 6. Winter Haven Hospital 7. Superintendent of Schools Polk County 8. Director, Polk Health Care Plan/ Indigent Health D.W 9. Central Florida Health Care, Inc. (CFHC) In addition to the Stakeholder, Winter Haven Hospital and Regency Center for Women and Infants gathered qualitative data from residents of their community by conducting facilitated focus groups. The participants were able to provide direct input related to top community needs of themselves, their families, and communities. The goal of the focus group process is that each participant feels comfortable and speaks openly so that they contribute to the discussion. It was explained to participants that there are no wrong answers, just different experiences and points of view. This process ensures that each participant shares their experiences from their point of view, even if it is different from what others have said. Specifically, focus group participants were asked to identify and discuss what they perceived to be the top health issues and/or concerns in their communities. Focus group input is subject to the limitations of the identified target populations (i.e., vocabulary, perspective, knowledge, etc.), and therefore, is not factual and inherently subjective in nature. The focus group audience was residents earning a low-income that are Medicaid-ineligible. Line 5 During tax year 2012 Winter Haven Hospital was undergoing a consolidation with BayCare Health System. As such, Winter Haven Hospital underwent a change in Management, Operations, Systems, Policies, and Procedures which resulted in a period of conversion impacting Winter Haven Hospital's ability to provide its CHNA on its website. Effective for Tax Year 2013 its CHNA can be located at the following URL: http://www.baycare.org/workfiles/Winter%20Haven/CHNA/Winter%20Haven%20Hosp ital%20Commuinty%20Health%20Needs%20Assessment.pdf
Part V, Section B, Line 20d:		The hospital facility used the average of all of the commercial insurance rates for services at this hospital facility. In addition to this decrease, the hospital provides a discount for prompt payment.
Part VI, Line 2 - Needs Assessment		The hospital assesses the health care needs of the community by participating in several community organizations that develop community strategic plans such as Winter Haven's "Our Future by Design". The Hospital also works with the Polk County Health Department in order to conduct studies and help set priorities. Additionally, the Hospital works with and utilizes several community health surveys conducted by Polk Healthcare Alliance.
Part VI, Line 3 - Patient education of eligibility for assistance		All self-pay patients are screened for funding sources (Medicaid, Polk Health Care, Charity, etc.) at the time of admission or in the pre-admission process. The Hospital's Financial Counselors review the patient's family size, income, and estimated hospital bill to determine if the patient is eligible for any assistance. If he or she is not, the hospital offers a variety of payment plans to help accommodate the patient. During tax year 2012 Winter Haven Hospital was undergoing a consolidation with BayCare Health System, Inc. As such Winter Haven Hospital underwent a change in Management, Operations, Systems, Policies, and Procedures which resulted in a period of conversion impacting the Hospital's ability to provide its Financial Assistance policy on its website or in its waiting areas. Effective for Tax Year 2014 its Financial Assistance policy can be located at the following URL: http://www.baycare.org/Financial-Assistance-Policy
Part VI, Line 4 - Community Information		Winter Heaven Hospital is serving part of Polk County. The average income falls below the state average and the national average. The population served is predominantly Caucasian and high-school or higher educated. Hispanics are the second largest ethnic group representing 19.2% of the population and 17.5% of households are below poverty level. Winter Heaven Hospital is part of BayCare Health System that serves west central Florida. The area served by Winter Heaven Hospital has 5 hospitals including Winter Haven Hospital & Regency. Winter Haven & Regency are not for profit, the other 3 are for profit. There is one federally designated medically underserved area in Winter Heaven Hospital's service area. With the over 65 population expected to grow 11.8% in the next five years, the health care needs of our service area are expanding and changing. The population served by Winter Heaven Hospital is expected to grow 3.9% in the next 5 years. This is almost the same as the expected growth rate of 3.5% for the United States. The County where Winter Heaven Hospital resides experiences higher incidence rates compared to the state of Florida in the following areas: coronary heart disease, stroke, prostate cancer, lung cancer, colorectal cancer, cervical cancer, breast cancer, melanoma, births to teens, infant death rate, neonatal death rate, post-neonatal death, fetal death rate, adult smokers, asthma hospitalization and domestic violence.
Part VI, Line 5- Promotion of Community Health		Winter Haven Hospital, Inc., located in Winter Haven, Florida, includes a 468-bed acute care hospital and a 61-bed obstetric/gynecological hospital, respectively referred to as Winter Haven Hospital and Regency Center for Women and Infants. Winter Haven Hospital was established in 1926, and today concentrates in the treatment of heart disease, behavioral health, cancer, stroke, and urological conditions. The hospital also provides emergency care, outpatient diabetes education; seven primary care providers; endoscopy and surgical services; neurological, orthopedic and in-patient rehabilitation; outpatient surgery; and imaging services. The Regency, built in 1987, includes a level II neonatal intensive care unit and on-site obstetric services 24 hours a day, 7 days a week. A pre-natal center is also set-up within the Regency for low income pregnant patients who do not have a private physician. On August 30, 2013, Winter Haven Hospital, Inc. joined Clearwater-based BayCare Health System. The consolidation strengthened our commitments to improve the health of the people we serve, and to return value to our surrounding communities. With BayCare, we will continue to provide innovative and advanced services that focus on quality and compassionate care. Community Outreach & Partnerships Outreach Through education, connective resources, and a focus on prevention and early detection, we are building a healthier community while reducing suffering and total health care costs. The Health Connection local and toll-free phone line is a free resource to the community to provide physician referrals and registration or connections to healthcare-related programs, classes, and special events. The Speaker's Bureau program provides speakers to community organizations on a range of medical topics at no charge. The hospital also maintains two medical libraries that are open to the public. The libraries offer books, tapes and online clinical research tools for a variety of health care topics. Printed or copied information can be mailed directly to someone's home address. An onsite Research Information Specialist trained by the National Library of Medicine and the Medical Library Association is available to assist with research at the Winter Haven Hospital library. The second library at the Regency focuses on women and infant related resources. Free or reduced-cost health screenings were provided within the community upon invitation and at Winter Haven Hospital during organized events. These include lectures, support groups, sponsorships/partnerships and health fairs. On-site screenings were provided during our Heart Smart Days events, Breast Cancer awareness days, and at the Diabetes Health Fair. The Heart Smart Days events provide free lectures, blood pressure (BP) screenings, ankle-brachial index (ABI) scores and body mass index (BMI) scores. Blood panel profiles by venipuncture were provided at a reduced cost. On every Tuesday afternoon in October 2012, Winter Haven Hospital offers free Clinical Breast Exams and reduced-cost mammograms. The exams are provided by a Winter Haven Hospital oncologist for women of all ages. Mammograms are targeted to women ages 40 to 64. The Diabetes Health Fair and Self-Management Education are coordinated by Winter Haven Hospital's Center for Diabetes Education. The health fair provided education and free glucose checks to 75 participants. The low-cost Self-Management Education classes are for people with or at-risk for developing diabetes to help them gain the knowledge and skills needed to modify behavior and successfully self-manage the disease and its related conditions. Community-based screening and education is provided by invitation to an assortment of community hosts, such as residential communities, civic groups, churches, and schools. A small sample of events include monthly talks at the Winter Haven Senior Center; Polk State College Health Fair for students and faculty; Bibleway Christian Academy Student Info Seminar; the annual Historic Pughsville May Day Festival; COPIA Education, Health and Wellness Expo; and a Lake Hamilton Women's Club meeting. Through outreach events, Winter Haven Hospital touched more than 10,000 lives from October 2012 to September 2013. In addition, Winter Haven Hospital maintains a Neighborhood Services Center and employs a full time director in order to coordinate speakers, entertainment, and health fairs primarily for senior citizens at the off-site center. Partnerships Our community partners are critical to helping us improve the health and well-being of eastern Polk County. Together, we combine resources and strengths, positively impacting the greatest number of people. By working closely with community leaders, we also build a greater sense of community and a shared commitment toward our common goal of improving the community's health. We're proud of working with the following community partners: Polk Healthcare Alliance - A senior hospital employee served as the liaison with the Polk Healthcare Alliance. As a member of a five person Executive Committee for the Polk Healthcare Alliance, the Liaison reviews progress toward the organization's Community Health Improvement Plan (CHIP). The Haley Center - Winter Haven Hospital was instrumental in the development of a free clinic in Winter Haven called the Haley Center. The First Baptist Church of Winter Haven asked for assistance from the county health departments, WHH, the Community Health and Social Services Department and others to ensure the free clinic's success. It has been operational since December 2005 with the hospital providing free lab, X-ray and pulmonary function testing. We Care - The hospital participates in the Polk County Medical Association's We Care program. Through a network of 215 medical specialists, We Care helps provide specialty medical care for low income, uninsured residents of Polk County. Angel Care Center of Eloise - This center, operated by a local church, offers a free diabetic clinic the second Wednesday of each month for persons whose income does not exceed 200 percent of the federal poverty level, who are not eligible for Medicaid or Medicare and who does not have private medical insurance. Hospital volunteers also provide their time to assist with free medical attention. Polk Healthcare Plan - The Hospital participates in and accepts the Polk Healthcare Plan. Polk HealthCare Plan is a public/private partnership that allows for a comprehensive managed health care program for eligible Polk County residents. The Plan provides an integrated system of health care and social services through a wide range of primary and preventive medical care, specialty medical care, hospitalization, diagnostic testing, ancillary services and pharmaceuticals. In essence, the Plan functions as a County-operated HMO for qualified Polk County residents. A senior hospital employee attends the Citizen Oversight Committee, an Advisory body on health issues for the Polk Healthcare Plan. The hospital joined with Polk Healthcare and other area hospitals to participate in an initiative that increases primary care services to low income residents of Polk County. Physician Recruitment - The hospital has a full-time physician recruiter and actively recruits physicians in primary care and specialty care areas where it has identified a community need. The hospital also works closely with physician groups to assist them in recruiting new physicians to our area. Sponsorships - Winter Haven Hospital and its employees provided sponsorship and fund raising for several community organizations and events, including: The American Heart Association's Polk Heart Walk, a three-mile walk designed to provide awareness of and raise funds to fight the nation's #1 cause of death, heart disease. The walk also encourages people to take steps toward a heart-healthy lifestyle. Winter Haven Hospital is a consistent sponsor and walking team company leader. In the October 2012 event, Winter Haven Hospital sponsored $2,500 and raised more than $4,000 for walking teams. Winter Haven Hospital employees also contributed more than $6000 to the AHA through a employee giving program, and sponsored the Polk Heart Ball. Winter Haven Hospital partnered with the American Cancer Society to sponsor the Winter Haven annual "Relay for Life" event (an event to raise money to fight cancer and provide services to cancer patients and their families). All proceeds from the event will be used to provide educational and patient services, as well as critical dollars used to fund cancer research. WHH sponsored the 2013 event at $2,500 and raised additional funds during the event. Polk Senior Games provides an annual two-week series of Olympic-style sports and games for men and women 50 years of age and over; more than 2,400 seniors participate. The games inspire an active lifestyle, promote a positive image of seniors, and encourage volunteerism. As a $2,500 sponsor of the event,
Part VI, Line 6 - Affiliated health Care System		The Hospital is affiliated with the University of Florida Medical School and continually draws on its expertise. Emergency Department physicians and the physician director of the Cancer Center and the Center for Robotics and Urology are from the University of Florida. The University of Florida staff plays a significant role in providing continuing education for medical and nursing staff. This continuing education allows the hospital to improve the way it cares for patients. In addition to this affiliation, Winter Haven Hospital consolidated with BayCare Health System, Inc.(BayCare) effective August 30, 2013. BayCare is a not-for-profit corporation that operates an integrated health care delivery system in the tampa bay region of Florida. BayCare provides a full continuum of care through its five clinical divisions which are supported by a comprehensive suite of centralized corporate services. BayCare's hospitals are Mease Countryside, Mease Dunedin, Morton Plant, Morton Plant North Bay, St. Anthony's, South Florida Baptist, St. Joseph's, St. Joseph's Women's, St. Joseph's Children's, St. Joseph's Hospital-North, and Winter Haven Hospital. As an integrated health system, BayCare's hospital members benefit from centralization of shared services in Finance, Business Office, Information Technology, Human Resources and Materials Management which strengthens each hospital's ability to serve the health needs of their local communities and provide traditional charity care and unbilled community services to uninsured and underinsured residents. BayCare's strategy is focused on establishing the framework and foundation to enable population health management and improve access to affordable, high-quality health care. Developing the infrastructure to manage risk and population health has been a multi-year initiative that encompasses aligning physicians, acquiring insurance competencies, and expanding care management capabilities. With 284 access points across its four-county service area, BayCare is focused on establishing a geographic footprint across the Tampa Bay region to promote access to its comprehensive services, regardless of a patient's ability to pay.
Part VI Line 7 State Filing of CBR & Line 8 Facility reporting groups		Line 7 N/A: Winter Haven Hospital, Inc did not prepare a community benefit report for Tax year 2012. During this tax year Winter Haven Hospital was undergoing a consolidation with BayCare Health System, Inc. As a result of management, operating, and system changes a report was not completed during this tax year. The Hospital is converting to a new Fiscal Year End and will complete a Community Benefit Report for its FYE 2014. Line 8 All answers provided in Part VI pretain to Facility Group A which includes Winter Haven Hospital, Inc. and Regency Center for Women and Infants.

Schedule H (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

Winter Haven Hospital Inc

Employer identification number

59-0724462

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)Lance AnastasioPresident/CEO	(i) (ii)	0 485,412	0 46,900	0 19,567	0 36,053	0 25,977	0 613,909	0 0
(2)David MacDougallVice President/CFO	(i) (ii)	0 300,614	0 27,300	0 3,354	0 43,521	0 27,536	0 402,325	0 0
(3)Kaye HixonVP-Education Services	(i) (ii)	0 192,240	0 18,700	0 3,113	0 11,077	0 3,891	0 229,021	0 0
(4)David LibbyVP-Operations	(i) (ii)	0 166,109	0 16,500	0 4,675	0 47,967	0 25,652	0 260,903	0 0
(5)John ParmanVP/Corporate Attorney	(i) (ii)	176,869 0	0 0	1,399 0	21,864 0	26,275 0	226,407 0	0 0
(6)Mary Jo SchreiberVP-ICU & Cardiology	(i) (ii)	0 203,900	0 19,400	0 3,160	0 22,432	0 0	0 248,892	0 0
(7)Joel ThomasVP-Community Health/Marketing	(i) (ii)	0 146,260	0 14,100	0 2,371	0 10,483	0 26,458	0 199,672	0 0
(8)Celestino VegaVP & MD-Physician Group	(i) (ii)	0 274,124	0 27,900	0 12,820	0	0 26,890	0 341,734	0 0
(9)Donald GaleVP-Physician Affairs	(i) (ii)	0 272,315	0 27,500	0 5,973	0 31,405	0 3,088	0 340,281	0 0
(10)Majd AlsammanMedical Director	(i) (ii)	317,072 0	9,540 0	3,663 0	38,849 0	8,140 0	377,264 0	0 0
(11)Joseph LynchPhysician Intensivist	(i) (ii)	341,428 0	0 0	3,110 0	20,895 0	29,016 0	394,449 0	0 0
(12)Kenneth GibbsPhysician	(i) (ii)	377,822 0	0 0	7,884 0	6,256 0	29,431 0	421,393 0	0 0
(13)George WinnyMedical Director	(i) (ii)	236,793 0	0 0	1,677 0	27,842 0	35,155 0	301,467 0	0 0
(14)Takkallapelli RaoPsychiatrist	(i) (ii)	143,892 0	82,000 0	3,610 0	9,858 0	27,066 0	266,426 0	0 0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Identifier	Return Reference	Explanation
Part I, Line 3		The filing organization does not use any of the options listed in Schedule J, Part I, Line 3 to establish the compensation of the CEO/Executive Director. However, the related organization, Mid-Florida Medical Services Inc, uses Compensation committee, Independent compensation consultant, Compensation survey or study and Approval by the board or compensation committee as a means to establish the CEO's compensation of the filing organization.

Schedule J (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

Winter Haven Hospital Inc

Employer identification number

59-0724462

Identifier	Return Reference	Explanation
Part VI		Part VI, Line 2 - Description of Business Relationship William Murrell and Mark Bostick have a family relationship. PART VI, LINE 4 - SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS Effective August 30, 2013 BayCare health System, Inc. became the sole corporate member of Winter Haven Hospital, Inc. THE ARTICLES OF INCORPORATION WERE AMENDED TO CHANGE THE MEMBER FROM MID florida medical services, inc. to baycare health system, inc. The bylaws were amended to change, the number of trustees from a range of 9-17 trustees to a total of 14 trustees. PART VI, LINE 6 - DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS THE CORPORATION SHALL HAVE ONE MEMBER WHICH SHALL BE BAYCARE HEALTH SYSTEM, INC. PART VI, LINE 7A - DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS THE TOTAL NUMBER CONSTITUTING THE MEMBERS OF THE BOARD SHALL BE FOURTEEN VOTING TRUSTEES AS FOLLOWS: (I) EIGHT TRUSTEES APPOINTED BY THE SOLE MEMBER, UPON PRIOR CONSULATION WITH THE MID-FLORIDA MEDICAL SERVICES, INC. ACTING IN ITS CAPACITY OF BEING THE SOLE MEMBER OF MID FLORIDA MEDICAL SERVICES FOUNDATION, INC. (MFMS FOUNDATION) AND (II) SIX TRUSTEES APPOINTED BY THE MFMS FOUNDATION DESIGNEE. PART VI, LINE 7B - DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE SOLE MEMBER SHALL HAVE THE RIGHT TO MAKE ALL DECISIONS REGARDING THE GOVERNANCE, STRATEGY, FINANCES AND OPERATIONS OF THE CORPORATION, INCLUDING, WITHOUT LIMITATION, THE EXCLUSIVE AUTHORITY TO AUTHORIZE, APPROVE, AND/OR PERFORM THE FOLLOWING: (A)THE APPROVAL OF THE CORPORATION'S STRATEGIC PLAN, OPERATING BUDGETS AND CAPITAL BUDGETS; (B)THE APPROVAL OF THE CORPORATION'S PHILOSOPHY, MISSION STATEMENT AND PURPOSES; (C)THE ADDITION, DELETION OR RECONFIGURATION OF THE SERVICES AMONG THE CORPORATION AND ITS AFFILIATES; (D)THE ESTABLISHMENT OF THE FEES AND CHARGES ON BEHALF OF THE CORPORATION; (E)THE EXECUTION OF MANAGED CARE CONTRACTS ON BEHALF OF THE CORPORATION; (F)THE APPROVAL OF NON-BUDGETED EXPENDITURES AND INCURRENCE OF INDEBTEDNESS ABOVE LIMITS APPROVED BY THE SOLE MEMBER'S GOVERNING BOARD FORM TIME TO TIME; (G)THE HIRING, FIRING, DISCIPLINE AND DISCHARGE OF THE COPRORATION'S PRESIDENT; (H)THE PURCHASE, SALE, TRANSFER, LEASE, LOAN, OR OTHER ENCUMBRANCE OF THE CORPORATION'S ASSETS ABOVE A CERTAIN THRESHOLD APPROVED BY THE SOLE MEMBER'S GOVERNING BOARD FROM TIME TO TIME; (I)THE TERMINATION OR MATERIAL MODIFICATION OF THE BOSTICK HEART CENTER, CASSITY CANCER CENTER, OR THE CENTER FOR ROBOTIC SURGERY AFTER THE SEVENTH ANNIVERSARY OF THE EFFECTIVE DATE OF THESE AMENDED AND RESTATED BYLAWS; (J)AMENDMENT OF THESE BYLAWS AND THE CORPORATIONS ARTICLES OF INCORPORATION; (K)THE FILING OF A VOLuntary PETITION IN BANKRUPTCY OR OTHER APPLICATION FOR JUDICIAL RELIEF FROM THE CREDITORS OF THE CORPORATION; AND (L)THE DEVELOPMENT OR ACQUISITION OF NEW FACILITIES AND/OR THE CLOSURE OR RELOCATION OF ANY FACILITY OPERATED BY THE CORPORATION. PART VI, LINE 11B - DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY THE ORGANIZATION AND REVIEWED BY THE CFO, AS WELL AS THE ORGANIZATION'S PAID PREPARER. PRIOR TO FILING WITH THE IRS, A FINAL COPY OF THE FORM 990 WAS PROVIDED TO THE ENTIRE BOARD VIA A WEB PORTAL. PART VI, LINE 12C - DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTREST THE CHAIRMAN OF THE BOARD OF DIRECTORS INQUIRES AT LEAST ANNUALLY IF THERE ARE ANY CONFLICTS OF INTEREST. IN ADDITION ALL OFFICeRS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY.
Part VI		Part VI, Line 15a & 15b - Process used for compensation review and approval. The Executive Compensation Committee of the Board of Directors sets compensation for the president and vice presidents of the hospital. The executive compensation committee consists of four board members, all of whom are independent. the executive compensation committee has used the consulting firm of Sullivan and Cotter to advise them about executive compensation and to provide them with comparability data. Minutes of the executive compensation committee meetings are kept and retained at the Hospital. Part VI, Line 19 - Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public The financial statements of Winter Haven Hospital, Inc. are made available to the public upon request. The organization's governing documents and conflict of interest policy are not made available to the public.
Part X	Line 20 - Bond Debt	DURING THE TAX YEAR, WINTER HAVEN HOSPITAL WAS AQUIRED BY BAYCARE HEALTH SYSTEM, INC. THROUGH THIS AQUISITION, THE RELATED WINTER HAVEN OUTSTANDING BOND DEBT OF APPROX. $77.6M WAS PAID OFF.
Part XI Line 9		Other changes in net assets or fund balances Pre-acquisition Transfer of assets $12,627,297 Other $ 2,136,312 Total $14,763,609

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

Winter Haven Hospital Inc

Employer identification number

59-0724462

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) BayCare Health System Inc 2985 Drew St Clearwater,FL33759 59-2796965	Health Srvcs	FL	501(C)(3)	3	N/A		No
(2) BayCare Behavioral Health Inc 7809 Massachusetts Ave New Port Richey,FL34653 59-1371752	Health Srvcs	FL	501(C)(3)	7	Baycare	Yes
(3) BayCare Emergency Assistance Program Inc 2985 Drew St Clearwater,FL33760 59-2697770	Emerg Assist	FL	501(C)(3)	9	Baycare	Yes
(4) BayCare Home Care Inc 8452 118th Ave North Largo,FL33773 59-3582520	Home Hlth Srv	FL	501(C)(3)	9	Baycare	Yes
(5) Behavioral Health Management Srvcs Inc 323 Jeffords Street Clearwater,FL33756 59-3279573	Health Srvcs	FL	501(C)(3)	9	BC Beh Hlth	Yes
(6) Winter Haven Hospital Auxiliary Inc 200 Ave F Northeast Winter Haven,FL33881 23-7190109	Volunteer Srv	FL	501(C)(3)	3	N/A		No
(7) Winter Haven Hospital Foundation Inc 200 Ave F Northeast Winter Haven,FL33881 03-0406130	Fundraising	FL	501(C)(3)	PF	N/A		No
(8) Mid-Florida Medical Srvs Foundation Inc 200 Ave F Northeast Winter Haven,FL33881 03-0406130	Fundraising	FL	501(C)(3)	11a	WH Hospital	Yes
(9) Mid-Florida Medical Services Inc 200 Ave F Northeast Winter Haven,FL33881 59-2486580	Health Srvcs	FL	501(C)(3)	11a	WH Hospital	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) BC Employ Health Cl 8452 118th Ave Largo,FL33773 46-1533183	Health Srvcs	FL	NA	NA
(2) BC Purchas Pt LLC 8731 Fl Mining Tampa,FL33634 64-0950837	Group Purch	FL	NA	NA
(3) BC Surgery Cntr LLC 8452 118th A N Largo,FL33773 46-0591430	Surgery Centers	FL	NA	NA
(4) Care Ride LLC 4625 Bay Clearwater,FL33764 59-3565490	Transport Srv	FL	NA	NA

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) Bay Vista Claims Service Inc 2985 Drew St Clearwater,FL33759 74-3168200	Claims Admin	FL	NA	C-Corp
(2) BCHS Insurance Inc 720 W BAY RD BUCKLING SQR KY-1-110 BUCKLING SQR,GRAND CAYMANKY1-1102 CJ	Insurance Captive	CJ	NA	C Corp
(3) Medspecialists Inc 2985 Drew St Clearwater,FL33759 68-0587533	payroll srvcs	FL	NA	c-corp

Schedule R (Form 990) 2012

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Mid-Florida Medical Services Inc	i	642,409	FMV
(2) Mid-Florida Medical Services Inc	k	206,250	FMV
(3) Mid-Florida Medical Services Inc	o	542,636	FMV
(4) Mid-Florida Medical Services Inc	r	13,945,781	FMV
(5) Mid-Florida Medical Services Inc	r	8,152,279	FMV

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2012

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH OF THE PEOPLE WE SERVE, BY PROVIDING THE HIGHEST QUALITY AND MOST EFFECTIVE CARE AND SERVICES AND TO RETURN VALUE TO THE PEOPLE IN OUR COMMUNITIES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	3,172
6	Total number of volunteers (estimate if necessary) .............	6	220
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	798,121
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-189,121

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,836,497	3,942,554
9	Program service revenue (Part VIII, line 2g) .........	283,688,378	281,745,562
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,919,217	5,180,822
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,411,654	9,571,051
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	291,855,746	300,439,989
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	134,880,756	147,591,916
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	151,332,423	150,304,080
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	286,213,179	297,895,996
19	Revenue less expenses. Subtract line 18 from line 12.......	5,642,567	2,543,993
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	258,162,407	296,356,205
21	Total liabilities (Part X, line 26).............	144,790,410	162,225,617
22	Net assets or fund balances. Subtract line 21 from line 20.....	113,371,997	134,130,588

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 288,819,038 including grants of $ 0 ) (Revenue $ 288,809,192 )
	Winter Haven Hospital, Inc. (WHH) is a full-service 529-bed community hospital. During the fiscal year 2012, WHH provided inpatient care to 16,778 patients, treated 63,440 patients in the emergency department, and delivered 1,697 babies. Through efforts of the medical assistance program and the hospital's charity care program WHH saw a net community benefit expense totaling more than $21.1 million.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses288,819,038

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) David Libby........................................................................ VP-Operations	0.0 .......................45.0	X		0	187,284	73,619
(19) John Parman........................................................................ VP/Corporate Attorney	45.0 .......................0.0	X		178,268	0	48,139
(20) Mary Jo Schreiber........................................................................ VP-ICU & Cardiology	0.0 .......................45.0	X		0	226,460	22,432
(21) Joel Thomas........................................................................ VP-Community Health/Marketing	0.0 .......................45.0	X		0	162,731	36,941
(22) Celestino Vega........................................................................ VP & MD-Physician Group	0.0 .......................45.0	X		0	314,844	26,890
(23) Majd Alsamman........................................................................ Medical Director	45.0 .......................0.0		X	330,275	0	46,989
(24) Joseph Lynch........................................................................ Physician Intensivist	45.0 .......................0.0		X	344,538	0	49,911
(25) Kenneth Gibbs........................................................................ Physician	45.0 .......................0.0		X	385,706	0	35,687
(26) George Winny........................................................................ Medical Director	45.0 .......................0.0		X	238,470	0	62,997
(27) Takkallapelli Rao........................................................................ Psychiatrist	45.0 .......................0.0		X	229,502	0	36,924

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,706,759	1,988,519	588,584

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e		1,452,214

f	All other contributions, gifts, grants, and similar amounts not included above1f		2,490,340

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			3,942,554
			Business Code
2a	HOSPITAL PATIENT CARE		621990	168,109,896	167,334,264	775,632
b	MEDICARE/MEDICAID NET REVENUE		621990	113,635,666	113,635,666
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			281,745,562
3	Investment income (including dividends, interest, and other similar amounts).......			3,865,367		22,489	3,842,878
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	969,977
b	Less: rental expenses	183,442
c	Rental income or (loss)	786,535	0
d	Net rental income or (loss).......			786,535			786,535
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	6,404,516	77,028
b	Less: cost or other basis and sales expenses	5,054,722	111,367
c	Gain or (loss)	1,349,794	-34,339
d	Net gain or (loss)..........			1,315,455			1,315,455
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	OTHER REVENUE		621990	743,809	743,809
b	EMR INCENTIVE		621990	4,263,782	4,263,782
c	SALES BLOOD		621990	2,045,695	2,045,695
d	All other revenue ....			1,731,230	10,344		1,720,886
e	Total. Add lines 11a–11d ......			8,784,516
12	Total revenue. See Instructions......			300,439,989	288,033,560	798,121	7,665,754


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			10,998	1	11,056
2	Savings and temporary cash investments .........			23,838,313	2	20,323,237
3	Pledges and grants receivable, net ...........			0	3	0
4	Accounts receivable, net .............			44,930,528	4	36,005,303
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			6,330,268	8	7,220,148
9	Prepaid expenses and deferred charges ..........			5,502,957	9	4,926,514
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	150,414,895
b	Less: accumulated depreciation .....	10b	1,162,168	103,048,283	10c	149,252,727
11	Investments—publicly traded securities ..........			50,754,821	11	48,518,594
12	Investments—other securities. See Part IV, line 11 .....			0	12	221,953
13	Investments—program-related. See Part IV, line 11 .....			0	13	16,370,783
14	Intangible assets ...............			0	14	7,439,000
15	Other assets. See Part IV, line 11 ...........			23,746,239	15	6,066,890
16	Total assets. Add lines 1 through 15 (must equal line 34)......			258,162,407	16	296,356,205
17	Accounts payable and accrued expenses .........			33,506,904	17	45,786,893
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	161,403
20	Tax-exempt bond liabilities .............			77,634,964	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			3,377,701	23	4,861,454
24	Unsecured notes and loans payable to unrelated third parties ....			2,700,000	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			27,570,841	25	111,415,867
26	Total liabilities. Add lines 17 through 25.........			144,790,410	26	162,225,617
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			113,371,997	27	134,130,588
28	Temporarily restricted net assets ...........			0	28	0
29	Permanently restricted net assets ...........			0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			113,371,997	33	134,130,588
34	Total liabilities and net assets/fund balances ........			258,162,407	34	296,356,205

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If “Yes,”the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If “Yes,” the organizationmay be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................	Yes	No