Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 10-01-2013 , 2013, and ending 09-30-2014
BCheck if applicable:
CName of organization
NAPLES COMMUNITY HOSPITAL INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO BOX 413029
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NAPLES, FL341013029
D Employer identification number

59-0694358
E Telephone number

G Gross receipts $ 573,691,113
F Name and address of principal officer:
KEVIN D COOPER
PO BOX 413029
NAPLES,FL341013029
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.NCHMD.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1957
M State of legal domicile: FL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THROUGH THE PROVISION OF CHARITABLE HEALTHCARE, OUR MISSION IS HELPING EVERYONE LIVE A LONGER, HAPPIER, AND HEALTHIER LIFE.
2 Check this box MediumBullet
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 8
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 3,410
6 Total number of volunteers (estimate if necessary) ............. 6 1,078
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 22,672
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -7,649
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 13,219,940 8,181,644
9 Program service revenue (Part VIII, line 2g) ......... 419,845,033 454,393,333
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 12,777,317 6,327,401
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 10,619,341 11,067,558
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 456,461,631 479,969,936
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 6,500 3,500
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) 174,328,176 164,591,371
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet17,335    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 246,818,537 261,573,973
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 421,153,213 426,168,844
19 Revenue less expenses. Subtract line 18 from line 12....... 35,308,418 53,801,092
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 610,383,053 657,776,446
21 Total liabilities (Part X, line 26)............. 239,457,843 235,295,632
22 Net assets or fund balances. Subtract line 21 from line 20..... 370,925,210 422,480,814
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: THROUGH THE PROVISION OF CHARITABLE HEALTHCARE, OUR MISSION IS HELPING EVERYONE LIVE A LONGER, HAPPIER, AND HEALTHIER LIFE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 380,238,212 including grants of $ 3,500 ) (Revenue $ 464,031,392 )
NAPLES COMMUNITY HOSPITAL, INC. (NCH) PROVIDES INPATIENT AND OUTPATIENT HEALTHCARE SERVICES WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY. FROM ITS TWO HOSPITALS, CANCER TREATMENT CENTERS, WOUND CARE CENTERS AND OUTPATIENT REHABILITATION CENTERS, NCH PROVIDED $58,840,269 OF CHARITY CARE TO PATIENTS WHO WERE UNABLE TO PAY AND NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PROGRAM. ADDITIONALLY, NCH WROTE OFF $58,779,488 CLASSIFIED AS BAD DEBTS, MUCH OF WHICH REPRESENTED SERVICES DELIVERED TO INDIGENT PATIENTS, WHO DID NOT RECEIVE A CHARITY CARE DETERMINATION IN ACCORDANCE WITH THE STATE'S CRITERIA.THE SERVICES OFFERED AT NCH ARE EXTENSIVE AND INCLUDE MEDICAL, SURGICAL, OBSTETRIC, PEDIATRIC, REHABILITATIVE, PSYCHIATRIC, DIAGNOSTIC, AND EMERGENCY TREATMENT. A TOTAL OF 533 ACTIVE AND ASSOCIATE PHYSICIANS, 2,305 FULL-TIME EQUIVALENT EMPLOYEES, AND 1,065 VOLUNTEERS COMPRISE THE OUTSTANDING MEDICAL TEAM WORKING TOGETHER TO PROVIDE THESE SERVICES.THE TWO HOSPITALS ARE COMPRISED OF 617 ACUTE CARE BEDS, A 54 BED REHABILITATIVE UNIT, 19 NICU BEDS. AND A 23 BED PSYCHIATRIC UNIT. ADDITIONAL SPECIALTY SERVICES FOR THE CARE OF CERTAIN CRITICAL AND LIFE THREATENING MEDICAL CONDITIONS INCLUDE THE MEDICAL INTENSIVE CARE UNIT, SURGICAL INTENSIVE CARE UNIT, CARDIAC CARE UNIT, CARDIAC CATHERIZATION UNIT AND INTERMEDIATE CARE UNIT. OTHER SPECIALTIES INCLUDE ONCOLOGY, DIAGNOSTIC SERVICES(CARDIO-DIAGNOSTICS, MAMMOGRAPHY, COMPUTERIZED TOPOGRAPHIC SCANNING (CT), AND MAGNETIC RESONANCE IMAGING (MRI), AND SPECIAL PROCEDURES SUCH AS BIOPSY, ANGIOGRAPHY, AND ANGIOPLASTY).DURING THE 2014 FISCAL YEAR, NCH HAD 28,938 INPATIENT ADMISSIONS RESULTING IN 125,585 DAYS OF CARE. ADDITIONALLY, 93,634 PATIENTS WERE TREATED IN OUR EMERGENCY CARE CENTERS.NAPLES COMMUNITY HOSPITAL, INC. RECEIVES VOLUNTEER ASSISTANCE FOR OPERATING ITS HOSPITALITY, GIFT, AND RETAIL SHOPS.NAPLES COMMUNITY HOSPITAL, INC. ALSO PROVIDES HEALTH ENHANCING EDUCATIONAL PROGRAMS IN ADDITION TO MEDICAL CARE. THESE PROGRAMS INCLUDE: WHITAKER WELLNESS CENTER; BETTER BREATHERS CLUB; MENDED HEARTS; DIABETES EDUCATION PROGRAM; CHILDBIRTH CLASSES; HEALTH FAIRS; AND CAREER DAYS. IN ADDITION, NCH SUPPORTS THE FOLLOWING: NURSES IN THE COLLIER COUNTY PUBLIC SCHOOL SYSTEM AND ATHLETIC TRAINERS AT THE LOCAL HIGH-SCHOOLS AND SPORTING EVENTS.
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 expensesMediumBullet380,238,212
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions).... Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II...
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II.................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M............. Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
448
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
3,410
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
Yes
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
14
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
8
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
FL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletKEVIN D COOPER CHIEF OF STAFF350 SEVENTH STREET NORTHNAPLESFL341023029 (239) 624-4003
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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) 		(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) MARIANN MACDONALD........................................................................
CHAIRWOMAN
 .50
.......................1.50 		X   X       0 0 0
(2) THOMAS J GAZDIC........................................................................
1ST VICE CHAIRMAN/TREASURER
 .50
.......................1.50 		X   X       0 0 0
(3) KAY GOW........................................................................
2ND VICE CHAIRWOMAN
 .50
.......................1.50 		X   X       0 0 0
(4) JOHN LEWIS MD........................................................................
SECRETARY
 .50
.......................1.50 		X   X       0 0 0
(5) MICHELLE BARRETT........................................................................
TRUSTEE
 40.50
.......................1.50 		X           72,691 0 26,729
(6) KENNETH BOOKMAN MD........................................................................
TRUSTEE
 .50
.......................41.50 		X           0 459,754 33,173
(7) TERRANCE FLYNN........................................................................
TRUSTEE
 .50
.......................1.50 		X           0 0 0
(8) ELIZABETH FOSTER RN........................................................................
TRUSTEE
 40.50
.......................1.50 		X           67,424 0 12,507
(9) HERMES KOOP MD........................................................................
TRUSTEE
 .50
.......................1.50 		X           0 0 0
(10) STEPHEN LANGE MD........................................................................
TRUSTEE
 .50
.......................1.50 		X           0 0 0
(11) VINCENT MONA........................................................................
TRUSTEE
 .50
.......................1.50 		X           0 0 0
(12) ROBERT MOSES........................................................................
TRUSTEE
 .50
.......................1.50 		X           0 0 0
(13) KEN PLUNKITT MD........................................................................
TRUSTEE
 .50
.......................1.50 		X           0 0 0
(14) GREG RUSSO........................................................................
TRUSTEE
 .50
.......................1.50 		X           0 0 0
(15) CRAIG SMITH MD........................................................................
TRUSTEE
 .50
.......................1.50 		X           0 0 0
(16) RALPH STAYER........................................................................
TRUSTEE
 .50
.......................1.50 		X           0 0 0
(17) ALLEN S WEISS MD........................................................................
PRESIDENT/CEO/TRUSTEE
 40.00
.......................5.00 		X   X       801,974 0 26,886
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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) 		(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) KEVIN D COOPER........................................................................
GENERAL COUNSEL/CHIEF OF STAFF
 40.00
.......................5.00 		    X       467,082 0 34,195
(19) PHILLIP DUTCHER........................................................................
COO, NCH HEALTHCARE SYSTEM, INC.
 40.00
.......................5.00 		    X       471,580 0 11,240
(20) MICHAEL STEPHENS........................................................................
CFO/ASSISTANT TREASURER
 40.00
.......................5.00 		    X       224,747 0 7,628
(21) CHARLES D ARDOIN MDSTRT 1013........................................................................
CHIEF MEDICAL OFFICER
 40.00
.......................5.00 		    X       64,893 0 233
(22) MICHELE THOMAN RN........................................................................
CHIEF NURSING OFFICER
 40.00
.......................5.00 		    X       328,420 0 34,971
(23) MICHAEL RILEY........................................................................
CHIEF STRATEGY OFFICER
 40.00
.......................5.00 		    X       250,765 0 34,971
(24) JOHN MCGIRL TERM 8302014........................................................................
CHIEF HUMAN RESOURCE OFFICER
 40.00
.......................5.00 		    X       247,097 0 29,456
(25) RENEE M THIGPEN START 912014........................................................................
INTERIM CHIEF HR OFFICER
 40.00
.......................5.00 		    X       181,591 0 23,964
(26) HELEN THOMPSON TERM 10182013........................................................................
CHIEF INFORMATION OFFICER
 40.00
.......................5.00 		    X       278,107 0 16,108
(27) ELIZABETH MARTIN........................................................................
ASSISTANT SECRETARY
 40.00
.......................5.00 		    X       57,714 0 15,435
(28) JAMES K MARTIN........................................................................
CHIEF DEVELOPMENT OFFICER
 1.00
.......................44.00 		    X       0 299,519 34,213
(29) ZACHARY BOSTOCK........................................................................
CHIEF ADMINISTRATIVE OFFICER
 1.00
.......................44.00 		    X       0 300,261 32,491
(30) GARY PARSONS MD TERM 122013........................................................................
CHIEF MEDICAL OFFICER NCHMD
 1.00
.......................44.00 		    X       0 387,282 18,851
(31) BRIAN D WILSON MD........................................................................
PHYSICIAN BONITA HEALTH
 40.00
.......................   		        X   184,002 0 23,056
(32) PATRICIA A READ........................................................................
ADMINISTRATIVE DIRECTOR
 40.00
.......................   		        X   178,065 0 22,370
(33) JAMES BATES........................................................................
DIR RADIOLOGY/COO NDIC
 40.00
.......................   		        X   169,908 0 29,812
(34) NOBLE F ARRINGTON........................................................................
CONTROLLER NCH HEALTHCARE SYSTEM
 40.00
.......................   		        X   158,383 0 28,899
(35) LAURIE ZONE-SMITH........................................................................
ASSOCIATE CHIEF NURSING OFFICER
 40.00
.......................   		        X   155,678 0 25,307
(36) AURORA ESTEVEZMDTERM 032013........................................................................
FORMER CHIEF MEDICAL OFFICER
 0.00
.......................0.00 		          X 194,550 0 7,953
(37) VICKI DORR TERM 052013........................................................................
FORMER CHIEF FINANCIAL OFFICER
 0.00
.......................0.00 		          X 454,077 0 33,172
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,008,748 1,446,816 563,620
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet102
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CERNER CORPORATIONPO BOX 412702KANSAS CITYMO64141 IT SUPPORT 10,020,496
SODEXO INC AND AFFLIATESPO BOX 536922ATLANTAGA303536922 DIETARY AND ENVIRONMENTAL SERVICES 8,578,708
PRECYSE SOLUTIONSDEPT 1736 PO BOX 11407BIRMINGHAMAL35246 MEDICAL RECORDS SUPPORT 4,157,364
MEDS MONTI ELIGIBILITY AND DENIAL SOLUTIPO BOX 5783DELTONAFL32725 ELIGIBILITY AND DENIAL SUPPORT 3,504,512
GE HEALTHCAREPO BOX 402076ATLANTAGA303842076 MEDICAL EQUIPMENT SUPPORT 1,790,082
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet61
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 467,502
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		7,714,142
g Noncash contributions included in lines
1a-1f:$ 		2,604,008
h Total. Add lines 1a-1f.......MediumBullet 8,181,644
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUES 621990 454,393,333 454,393,333   0
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 454,393,333
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 6,035,573     6,035,573
4 Income from investment of tax-exempt bond proceeds..MediumBullet 3,976     3,976
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 1,074,501  
b Less: rental expenses 122  
c Rental income or (loss) 1,074,379  
d Net rental income or (loss).......MediumBullet 1,074,379     1,074,379
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 93,710,691 74,350
b Less: cost or other basis and sales expenses 93,427,227 69,962
c Gain or (loss) 283,464 4,388
d Net gain or (loss)..........MediumBullet 287,852     287,852
8a Gross income from fundraising events (not including
$ 467,502
of contributions reported on line 1c). See Part IV, line 18 ..
a 556,314
b Less: direct expenses ...b 223,866
c Net income or (loss) from fundraising events..MediumBullet 332,448   332,448
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...MediumBullet        
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..MediumBullet        
Miscellaneous Revenue Business Code
11a WELLNESS CENTER 900099 3,114,701 3,114,701    
b SCHOOL NURSE 900099 2,611,211 2,611,211    
c DIETARY SERVICES 900099 2,204,674 2,204,674    
d All other revenue .... 1,730,145 1,707,473 22,672  
e Total. Add lines 11a–11d ...... MediumBullet 9,660,731
12 Total revenue. See Instructions......MediumBullet 479,969,936 464,031,392 22,672 7,734,228
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
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    
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 3,500 3,500
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 4,257,373   4,257,373  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 202,174 202,174    
7 Other salaries and wages 138,339,726 118,057,191 20,268,624 13,911
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 3,825,747 3,265,658 559,701 388
9 Other employee benefits ....... 7,625,448 6,509,083 1,114,393 1,972
10 Payroll taxes ........... 10,340,903 8,826,995 1,512,844 1,064
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 916,227 782,091 134,136  
c Accounting ........... 295,212 251,993 43,219  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 43,369,693 37,020,370 6,349,323  
12 Advertising and promotion .... 1,714,672 1,463,644 251,028  
13 Office expenses ....... 14,184,505 12,107,893 2,076,612  
14 Information technology ...... 14,368,015 12,264,538 2,103,477  
15 Royalties ..        
16 Occupancy ........... 8,825,922 7,533,807 1,292,115  
17 Travel ............ 321,187 274,165 47,022  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 7,535,768 6,432,532 1,103,236  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 27,677,972 23,625,918 4,052,054  
23 Insurance .............. 5,082,934 4,338,792 744,142  
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 78,475,072 78,475,072    
b BAD DEBT EXPENSE 58,779,488 58,779,488    
c
d
e All other expenses 27,306 23,308 3,998  
25 Total functional expenses. Add lines 1 through 24e 426,168,844 380,238,212 45,913,297 17,335
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 24,269,883 1 50,865,852
2 Savings and temporary cash investments ......... 23,476,359 2 7,333,207
3 Pledges and grants receivable, net ........... 15,175,511 3 15,368,698
4 Accounts receivable, net ............. 55,354,572 4 52,778,899
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
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
  6  
7 Notes and loans receivable, net ............. 70,890 7 67,551
8 Inventories for sale or use .............. 7,083,402 8 7,015,820
9 Prepaid expenses and deferred charges .......... 2,132,973 9 2,261,648
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 620,118,902
b Less: accumulated depreciation ..... 10b 370,551,017 238,268,786 10c 249,567,885
11 Investments—publicly traded securities .......... 99,114,541 11 114,772,247
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ............... 3,613,372 14 3,104,229
15 Other assets. See Part IV, line 11 ........... 141,822,764 15 154,640,410
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 610,383,053 16 657,776,446
Liabilities 17 Accounts payable and accrued expenses ......... 33,125,094 17 33,056,389
18 Grants payable .................   18  
19 Deferred revenue ................ 334,824 19 365,551
20 Tax-exempt bond liabilities ............. 173,762,670 20 168,510,811
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
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..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
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.................... 32,235,255 25 33,362,881
26 Total liabilities. Add lines 17 through 25......... 239,457,843 26 235,295,632
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 339,970,220 27 388,276,637
28 Temporarily restricted net assets ........... 13,418,799 28 19,438,066
29 Permanently restricted net assets ........... 17,536,191 29 14,766,111
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet 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 ........... 370,925,210 33 422,480,814
34 Total liabilities and net assets/fund balances ........ 610,383,053 34 657,776,446
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
479,969,936
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
426,168,844
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
53,801,092
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
370,925,210
5
Net unrealized gains (losses) on investments ...............
5
6,459,690
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-8,705,178
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
422,480,814
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
NAPLES COMMUNITY HOSPITAL INC
 
Employer identification number

59-0694358
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.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
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)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (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
Yes No Yes No Yes No
Total  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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).  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. 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) 2013

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the organization
NAPLES COMMUNITY HOSPITAL INC
 
Employer identification number

59-0694358
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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
Special Rules
......................... 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 its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
Name of organization
NAPLES COMMUNITY HOSPITAL INC
  		Employer identification number

59-0694358
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, RESTRICTEDRESTRICTED

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
Name of organization
NAPLES COMMUNITY HOSPITAL INC
  		Employer identification number

59-0694358
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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
Name of organization
NAPLES COMMUNITY HOSPITAL INC
  		Employer identification number

59-0694358
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 (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2013)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
NAPLES COMMUNITY HOSPITAL INC
 
Employer identification number

59-0694358
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .......................................
9
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.
1a
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.
b
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 $  
2
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:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?........
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
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 .... 17,536,191 15,249,881 11,353,908 11,619,405 10,901,463
b Contributions ........ 529,058 604,497 2,315,160 69,635 161,158
c Net investment earnings, gains, and losses   1,347,505 1,740,813 -175,132 716,784
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		3,299,138 -334,308 160,000 160,000 160,000
f Administrative expenses ....          
g End of year balance ...... 14,766,111 17,536,191 15,249,881 11,353,908 11,619,405
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   16,364,476 16,364,476
b Buildings ................   320,946,229 159,254,038 161,692,191
c Leasehold improvements ............   6,806,465 6,143,351 663,114
d Equipment ................   265,745,920 205,153,628 60,592,292
e Other .................   10,255,812   10,255,812
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 249,567,885
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (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.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) OTHER ASSETS 1,268,835
(2) DEPOSITS 36,367
(3) ASSETS LIMITED AS TO USE 147,618,321
(4) UNAMORTIZED BOND ISSUE COST 1,446,929
(5) UNAMORTIZED BOND DISCOUNTS 1,016,821
(6) CASH SURRENDER VALUE OF LIFE INSURANCE POLICY 180,551
(7) THIRD-PARTY RECEIVABLE 3,072,586


Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 154,640,410
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
SELF-INSURANCE LIABILITIES 9,956,697
ACCRUED INTEREST 3,078,213
DUE TO RELATED ORGANIZATIONS 16,643,331
PUBLIC MEDICAL FUND PAYABLE 2,650,612
OTHER LIABILITIES 1,034,028




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 33,362,881
2. Liability for uncertain tax positions 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) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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
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.
Return Reference Explanation
PART V, LINE 4: INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS ALL ENDOWMENT FUNDS MAINTAINED BY NAPLES COMMUNITY HOSPITAL, INC. ARE USED IN FURTHERANCE OF THE ORGANIZATION'S TAX-EXEMPT PURPOSES.
PART X, LINE 2: THE SYSTEM AND ALL OF ITS NOT-FOR-PROFIT SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE (THE CODE) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE SYSTEM AND ALL OF ITS NOT-FOR-PROFIT SUBSIDIARIES DO NOT HAVE SIGNIFICANT UNRELATED BUSINESS INCOME; HOWEVER, SUCH STATUS IS SUBJECT TO FINAL DETERMINATION UPON EXAMINATION OF THE RELATED INCOME TAX RETURNS BY THE APPROPRIATE TAXING AUTHORITIES. THE SYSTEM IS NO LONGER SUBJECT TO TAX EXAMINATIONS IN THE MAJOR U.S. TAXING JURISDICTIONS IN WHICH THEY OPERATE FOR TAX YEARS PRIOR TO 2010.
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
NAPLES COMMUNITY HOSPITAL INC
 
Employer identification number

59-0694358
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

HOSPITAL BALL
(event type) 		(b) Event #2

 
(event type) 		(c) Other events

 
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 1,023,816     1,023,816
2 Less: Contributions . . 467,502     467,502
3 Gross income (line 1
minus line 2) . . . 		556,314     556,314
VerticalDirectExpenses 4 Cash prizes . . .        
5 Noncash prizes . .        
6 Rent/facility costs . . 15,386     15,386
7 Food and beverages . 121,337     121,337
8 Entertainment . . . 17,960     17,960
9 Other direct expenses . 69,183     69,183
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 223,866
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow 332,448
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
%
%
%
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 3
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
%
b
An outside facility ........................
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2013
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
NAPLES COMMUNITY HOSPITAL INC
 
Employer identification number

59-0694358
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: .........
3b
Yes
 
%
c
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.
4
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"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
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? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (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) .. 		    18,893,772   18,893,772 5.140 %
b Medicaid (from Worksheet 3,
column a) .... 		    43,838,805 36,558,671 7,280,134 1.980 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    62,732,577 36,558,671 26,173,906 7.120 %
Other Benefits
     1,133,086   1,133,086 0.310 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    34,720   34,720 0.010 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		           
j Total. Other Benefits ..     1,167,806   1,167,806 0.320 %
k Total. Add lines 7d and 7j .     63,900,383 36,558,671 27,341,712 7.440 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
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.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support     153,175   153,175 0.040 %
4 Environmental improvements            
5 Leadership development and training for community members     93,858   93,858 0.030 %
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development     2,947   2,947 0 %
9 Other            
10 Total     249,980   249,980 0.070 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
13,502,210
3
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. ......
3
892,496
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
218,412,847
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
217,059,668
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
1,353,179
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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.......................

9b

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) 2013
Schedule H (Form 990) 2013
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?1
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 NAPLES COMMUNITY HOSPITAL INC
350 7TH STREET NORTH
NAPLES,FL34102
WWW.NCHMD.ORG
4113 		X X         X      
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
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)
NAPLES COMMUNITY HOSPITAL INC
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 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.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests 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 .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 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 ........ 7   No
8a 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)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c 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) 2013
Schedule H (Form 990) 2013
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: 200.000000000000%
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: 400.000000000000%
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
b
c
d
e
f
g
h
i
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
b
c
d
e
f
g
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 individual’s eligibility under the facility’s FAP:
a
b
c
d
e
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 individual’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
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
NAPLES COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 3: CHNA TAKING INTO ACCOUNT INPUT FROM THE COMMUNITYTHE NCH LEADERSHIP TEAM IS ACTIVELY INVOLVED AND PARTICIPATES IN MANY COMMUNITY RELATED ORGANIZATIONS AND GROUPS THAT ARE CONTINUALLY ASSESSING UNMET NEEDS WITHIN COLLIER COUNTY. NCH HAS HISTORICALLY WORKED WITH OUR BOARD OF TRUSTEES, COLLIER COUNTY CHILDREN'S ALLIANCE, COLLIER COUNTY PUBLIC SCHOOLS, THE IMMOKALEE FOUNDATION, CHILDREN'S MEDICAL SERVICES, AND OTHER AGENCIES THROUGHOUT THE COMMUNITY IN ASSESSING AND COLLABORATING IN EFFORTS TO IMPROVE THE HEALTH OF OUR COMMUNITY.EVERY THREE YEARS NCH WORKS COLLABORATIVELY WITH THE FLORIDA DEPARTMENT OF HEALTH IN COLLIER COUNTY, THE COUNTY AND CITY GOVERNMENT, THE NAPLES AREA CHAMBER OF COMMERCE AND SEVERAL OTHER COMMUNITY GROUPS TO FORM THE COMMUNITY ASSESSMENT DESIGN GROUP. THE PURPOSE IS TO ASSESS THE COMMUNITY'S STRENGTHS AND OPPORTUNITIES. THE LAST ANALYSIS WAS DONE DURING THE FALL OF 2012 AND SPRING OF 2013. THE NEXT STUDY IS PLANNED TO START THE FALL OF 2015 AND BE COMPLETED IN THE SPRING OF 2016. A SURVEY WILL BE PREPARED AND SENT OUT TO HEALTH CARE LEADERS, COMMUNITY FOCUS GROUPS AND HEALTH CARE STAFF. IDENTIFIED AREAS INCLUDE SUFFICIENT EMPLOYMENT, ECONOMIC OPPORTUNITIES, ACCESS TO AFFORDABLE HOUSING, DRUG AND ALCOHOL ABUSE, SAFE ROADWAYS FOR BICYCLISTS AND PEDESTRIANS, PRIMARY CARE RESOURCES, ACCESS TO AFFORDABLE FOOD, ACCESS TO LONG TERM CARE BEDS, COMMUNICABLE DISEASE, OBESITY, CHRONIC DISEASE, MENTAL HEALTH, DENTAL HEALTH, HEALTH OF THE ELDERLY, ACCESS TO CARE, DISABILITIES AND UNINTENTIONAL INJURIES.THE NEXT STEP IN THE PROCESS WILL BE TO CONDUCT GEOGRAPHICAL COMMUNITY FOCUS GROUPS. THE GROUPS WILL BE CHOSEN TO REFLECT AND INCLUDE THE DIVERSITY OF COMMUNITY LOCATIONS, ETHNICITY, AND SOCIO-ECONOMIC FACTORS. THE DISTINCT AREAS OF THE COUNTY REPRESENT UNIQUE DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS. RESULTS FROM THE FOCUS GROUPS WILL BE USED TO ASSESS AND PRIORITIZE HEALTHCARE NEEDS WITHIN THE COMMUNITY. IN ADDITION TO THE INFORMATION OBTAINED BY THE SURVEYS AND FOCUS GROUPSALL OTHER INFORMATION OBTAINED REGARDING THE HEALTH AND WELL BEING OF THE COMMUNITY DISCOVERED FROM THE BLUE ZONE PROJECT WILL BE INCORPORATED INTO THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. BLUE ZONE PROJECTTHE NCH HEALTHCARE SYSTEM'S MISSION AND FOCUS ON POPULATION HEALTH PROVIDES AN EXCELLENT FOUNDATION FOR THE INTRODUCTION OF THE BLUE ZONES PROJECT IN SOUTHWEST FLORIDA. NCH IS SPONSORING THIS DECADE LONG INITIATIVE IN PARTNERSHIP WITH HEALTHWAYS WHICH SUPPORTS THE VISION TO MAKE OUR COMMUNITY AN EVEN HEALTHIER, HAPPIER AND MORE VIBRANT PLACE TO LIVE.THE NCH HEALTHCARE SYSTEM AND HEALTHWAYS SHARE A COMMITMENT TO IMPROVING THE WELL-BEING OF SOUTHWEST FLORIDA, THEREBY LOWERING HEALTHCARE COSTS, INCREASING PRODUCTIVITY, AND IMPROVING THE ECONOMY AND QUALITY OF LIFE FOR ALL RESIDENTS.THE CURRENT EFFORTS UNDERWAY WITH POLICY LEADERS, SCHOOLS, WORKSITES, HEALTHCARE, AND CIVIC ORGANIZATIONS, COMBINED WITH COMMITMENTS OF EARLY ADOPTERS, DEMONSTRATE A COMMUNITY PRIMED FOR TRANSFORMATION AND IMPROVED WELL-BEING. COMMUNITY STAKEHOLDERS FROM SOUTHWEST FLORIDA DEMONSTRATE TREMENDOUS SUPPORT AND COLLABORATIVE SPIRIT IN SUPPORT OF THE BLUE ZONES PROJECT.THE NCH SPONSORED INITIATIVE IS FOCUSING EFFORTS ON BECOMING A CATALYST FOR CHANGE INCLUDING:> IMPROVING WELL-BEING, AS MEASURED BY THE GALLUP-HEALTHWAYS WELL-BEING INDEX BEYOND BEST COMPARABLE RESULTS IN FLORIDA AND THE REGION> GENERATING SIGNIFICANT MEDICAL COST SAVINGS AND PRODUCTIVITY IMPROVEMENT OVER THE PROJECT TERM> LOWERING THE OBESITY RATE> LOWERING SMOKING RATES> INCREASING VEGETABLE CONSUMPTION> BOOSTING ECONOMIC VITALITY> INCREASING DAILY PHYSICAL ACTIVITY LEVELS > POSITIONING SOUTHWEST FLORIDA AS NATIONWIDE INNOVATORS AND LEADERS IN PREVENTATIVE HEALTHPRIOR TO THE DEVELOPMENT OF THE STEERING COMMITTEES AND SUB COMMITTEES, HEALTHWAYS WORKING CLOSELY WITH NCH AND COMMUNITY LEADERS COMPLETED A HEALTH ASSESSMENT FOR THE SERVICE AREA SERVED BY NCH. A COPY OF THAT ASSESSMENT IS ON OUR WEBSITE HTTP://WWW.NCHMD.ORG.
NAPLES COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 4: CHNA CONDUCTED WITH ONE OR MORE HOSPITAL FACILITIESAS PART OF AN INTERGRATED HEALTHCARE SYSTEM, THE CHNA FOR NAPLES COMMUNITY HOSPITAL AND MARCO ISLAND HOSPITAL WAS PREPARED JOINTLY.
NAPLES COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 7: ADDRESSING THE NEEDS IDENTIFIED IN THE CHNATHE FIRST CHNA AND IMPLEMENTATION PLAN WAS ADOPTED SEPTEMBER 30, 2013. THE CHNA IDENTIFIED PROBLEM AREAS THAT NEED TO BE ADDRESSED. THESE INCLUDE SUFFICIENT JOB EMPLOYMENT, ECONOMIC OPPORTUNITIES, ACCESS TO AFFORDABLE HOUSING, DRUG AND ALCOHOL ABUSE, SAFE ROADWAYS FOR BICYCLISTS AND PEDESTRIANS, PRIMARY CARE RESOURSES, ACCESS TO AFFORDABLE HEALTH FOOD, ACCESS TO LONG-TERM CARE BEDS, COMMUNICABLE DISEASE, OBESITY, CHRONIC DISEASE, MENTAL HEALTH, DENTAL HEALTH, ACCESS TO CARE, DISABILITIES, AND UNINTENTIONAL INJURIES.UPON REVIEW OF THE FINDINGS OF THE CHNA, THE NCH LEADERSHIP TEAM HELD A PRIORITIZATION SESSION WHICH WAS BASED ON THE MISSION, VISION, AND CORE VALUES OF THE THE NCH HEALTHCARE SYSTEM WITH A PRIMARY FOCUS ON THE GOAL OF BECOMING THE HEALTHIEST COUNTY IN THE UNITED STATES. THE TEAM CAME UP WITH FIVE KEY AREAS TO FOCUS ON WHICH INCLUDES CARDIOVASCULAR HEALTH, CANCERS, DIABETES, MATERNAL AND INFANT HEALTH, AND OBESITY. CARDIOVASCULAR HEALTH1. ALIGNED WITH POPULATION HEALTH, THE GOAL OF THE SOUTHWEST FLORIDA BLUE ZONES PROJECT INITIATIVE IS TO BE INCLUSIVE OF ALL AREAS FROM BONITA SPRINGS TO MARCO ISLAND. FOLLOWING AN INITIAL LAUNCH AND EXECUTION IN NAPLES AND BONITA SPRINGS, THIS PROJECT IS DESIGNED TO EXPAND TO ALL AREAS. THE WELL-BEING INDEX, AN IMPORTANT METRIC IN THE BLUE ZONES ASSESSMENT, IS AN AVERAGE OF SIX SUB-INDEXES INCLUDING PHYSICAL HEALTH. SCREENINGS, A KEY COMPONENT IN ASSESSING BASELINE PHYSICAL HEALTH, INCLUDING CARDIAC ISSUES, ARE ALSO USED FOR MEASURING IMPROVEMENTS. 2. A DOZEN COMMUNITY LECTURES RELATED TO CARDIOVASCULAR HEALTH AND PREVENTION WERE PRESENTED TO THE COMMUNITY AT VARIOUS LOCATIONS THROUGHOUT SOUTHWEST FLORIDA. TOPICS INCLUDED: "KEEPING YOUR HEART HEALTHY", "PREVENTING CORONARY HEART DISEASE", AND "HEALTHY LIFESTYLE". LECTURES ARE PROVIDED BY CARDIOLOGISTS, PRIMARY CARE PHYSICIANS, REGISTERED DIETITIANS, AND OTHERS.3. CARDIOVASCULAR SCREENING PROGRAMS AT DISCOUNTED RATES HAVE BEEN IMPLEMENTED AT DESIGNATED TIMES THROUGHOUT THE YEAR. MEDICAL SPECIALISTS PROVIDED SAME-DAY, ONE-ON-ONE CONSULTATIONS BASED ON SCREENING RESULTS WITH EVERY PARTICIPANT. FUTURE PLANS INCLUDE THE POSSIBILITY OF ESTABLISHING OR PARTNERING WITH A MOBILE UNIT TO PROVIDE ADDITIONAL SCREENINGS AND OUTREACH TO THE COMMUNITY.CANCERS1. MAMMOGRAM SCREENING: ONGOING SERVICES OFFERED AND PROVIDED TO UNINSURED AND UNDERINSURED. A COMMUNITY FAIR IS SCHEDULED AT LOCAL CHURCHES THIS YEAR. 2. CP-3 SCREENING: ACA RESEARCH STUDY. NCH PROVIDED CAMPUS LOCATION FOR BLOOD DRAWS AND ENCOURAGED PARTICIPATION OF STAFF. DIABETES MANAGEMENT1. VON ARX DIABETES CENTER : WE HAVE TWO ADA RECOGNIZED PROGRAMS, MAINTAINING DATA COLLECTION AND REPORTING REQUIREMENTS. FOUNDATION FUNDS ARE ALLOCATED FOR PEDIATRICS TO ASSURE THEY HAVE APPOINTMENTS WITH THE REGISTERED DIETICIAN OR THE NURSE FOR CHILDREN UNINSURED OR UNDERINSURED. FUNDS WILL ALSO BE UTILIZED FOR GESTATIONAL DIABETES PATIENT EDUCATION (THIS INCLUDES CLASSES, SUPPLIES AND EDUCATIONS). 2. HEALTHY LIFESTYLE SUPPORT GROUPS: THE SUPPORT GROUP IS OFFERED PERIODICALLY BASED ON THE NEED AND REQUEST OF PATIENTS. THE LAST CLASS WAS HELD IN JANUARY 2015 WITH 8 PARTICIPANTS. 3. FREE PRE-DIABETES SEMINAR: COMMUNITY LECTURES ARE OFFERED THROUGHOUT THE YEAR, ON AVERAGE 30 COMMUNITY RESIDENTS ATTEND THESE LECTURES AT LOCAL LIBRARIES. MATERNAL AND INFANT HEALTH1. INITIAL LATCH MEASUREMENT IS 80%. NCH IS BEGINNING A PROCESS FOR SKIN TO SKIN IN THE DELIVERY ROOM. WE RECENTLY RECEIVED $10K GRANT AWARDED FROM FLORIDA DEPARTMENT OF HEALTH TO ATTAIN "BABY FRIENDLY USA" HOSPITAL DESIGNATION. 2. EXCLUSIVE BREASTFEEDING RATES = 68%. CURRENTLY WE HAVE 2.2 FTE LACTATION CONSULTANTS HIRED AND WORKING. LACTATION CONSULTANT AVAILABILITY 7 DAYS A WEEK A MINIMUM OF 8 HOURS A DAY. 7A-11P AND TO 2AM WHEN CENSUS DICTATES; WEEKEND COVERAGE IS BASED UPON THE CENSUS. 3. PHONE CALL PROGRAM: FOLLOW-UP CALLS TO MOTHERS ARE BEING PERFORMED AT THIS TIME. 4. SUBSTANCE ABUSE: NCH IS CURRENTLY A HOST MEMBER OF THIS COALITION AND HOST MEETINGS REGULARLY AT NCH. COALITION COLLECTS NUMBERS AND REPORTS TO STATE. NURSES ARE EDUCATING PARENTS ON DETRIMENTAL EFFECTS OF SUBSTANCE ABUSE TO NEWBORNS. 5. PEDS AND ADULT IMMUNIZATION: 100% OF PATIENTS/PARENTS ARE OFFERED THIS IMMUNIZATION. TDAP IS NOW AVAILABLE IN ACUDOSE (MEDICATION ADMINISTRATION CABINET) ON THE NURSING UNIT AT ALL TIMES AND THERE IS A STANDING ORDER FOR TDAP ADMINISTRATION IF STATUS IS UNKNOWN. PARENTS MAY REFUSE IF DESIRED. ALL OF THE STAFF IN WOMEN'S AND CHILDREN'S AND PEDIATRICS NURSING UNITS HAVE RECEIVED THE TDAP VACCINE AND ANY NEW EMPLOYEES RECEIVE THE TDAP VACCINE. OBESITY1. GROCERY STORE TOURS: GROCERY STORE TOURS ARE DONE 8 TIMES A YEAR. ATTENDEES OF GROCERY STORE TOURS LEARN HEALTHY NUTRITIOUS EDUCATION AND SELECTION TIPS AT THE SUPERMARKET. 2. SHAC: THE VON ARX STAFF ARE MEMBERS OF THE SHAC COUNCIL THAT MEET QUARTERLY AND ADDRESS SCHOOL NUTRITION AND IMMUNIZATION AND DIET AND EXCERCISE FOR HEALTHY LIVING FOR STUDENTS.3. YOUTH OBESITY SUPPORT PROGRAM: CURRENTLY ONGOING WITH REGISTERED DIETICIAN. APPROXIMATELY 6 PEDIATRIC PATIENTS ARE SEEN AT THE VON ARX DIABETES AND NUTRITION CENTER A MONTH.
NAPLES COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 12I: BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTSANOTHER FACTOR NAPLES COMMUNITY HOSPITAL, INC. USES IN DETERMINING AMOUNTS CHARGED TO PATIENTS IS FAMILY SIZE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. 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?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
NAPLES COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 3: CHNA TAKING INTO ACCOUNT INPUT FROM THE COMMUNITYTHE NCH LEADERSHIP TEAM IS ACTIVELY INVOLVED AND PARTICIPATES IN MANY COMMUNITY RELATED ORGANIZATIONS AND GROUPS THAT ARE CONTINUALLY ASSESSING UNMET NEEDS WITHIN COLLIER COUNTY. NCH HAS HISTORICALLY WORKED WITH OUR BOARD OF TRUSTEES, COLLIER COUNTY CHILDREN'S ALLIANCE, COLLIER COUNTY PUBLIC SCHOOLS, THE IMMOKALEE FOUNDATION, CHILDREN'S MEDICAL SERVICES, AND OTHER AGENCIES THROUGHOUT THE COMMUNITY IN ASSESSING AND COLLABORATING IN EFFORTS TO IMPROVE THE HEALTH OF OUR COMMUNITY.EVERY THREE YEARS NCH WORKS COLLABORATIVELY WITH THE FLORIDA DEPARTMENT OF HEALTH IN COLLIER COUNTY, THE COUNTY AND CITY GOVERNMENT, THE NAPLES AREA CHAMBER OF COMMERCE AND SEVERAL OTHER COMMUNITY GROUPS TO FORM THE COMMUNITY ASSESSMENT DESIGN GROUP. THE PURPOSE IS TO ASSESS THE COMMUNITY'S STRENGTHS AND OPPORTUNITIES. THE LAST ANALYSIS WAS DONE DURING THE FALL OF 2012 AND SPRING OF 2013. THE NEXT STUDY IS PLANNED TO START THE FALL OF 2015 AND BE COMPLETED IN THE SPRING OF 2016. A SURVEY WILL BE PREPARED AND SENT OUT TO HEALTH CARE LEADERS, COMMUNITY FOCUS GROUPS AND HEALTH CARE STAFF. IDENTIFIED AREAS INCLUDE SUFFICIENT EMPLOYMENT, ECONOMIC OPPORTUNITIES, ACCESS TO AFFORDABLE HOUSING, DRUG AND ALCOHOL ABUSE, SAFE ROADWAYS FOR BICYCLISTS AND PEDESTRIANS, PRIMARY CARE RESOURCES, ACCESS TO AFFORDABLE FOOD, ACCESS TO LONG TERM CARE BEDS, COMMUNICABLE DISEASE, OBESITY, CHRONIC DISEASE, MENTAL HEALTH, DENTAL HEALTH, HEALTH OF THE ELDERLY, ACCESS TO CARE, DISABILITIES AND UNINTENTIONAL INJURIES.THE NEXT STEP IN THE PROCESS WILL BE TO CONDUCT GEOGRAPHICAL COMMUNITY FOCUS GROUPS. THE GROUPS WILL BE CHOSEN TO REFLECT AND INCLUDE THE DIVERSITY OF COMMUNITY LOCATIONS, ETHNICITY, AND SOCIO-ECONOMIC FACTORS. THE DISTINCT AREAS OF THE COUNTY REPRESENT UNIQUE DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS. RESULTS FROM THE FOCUS GROUPS WILL BE USED TO ASSESS AND PRIORITIZE HEALTHCARE NEEDS WITHIN THE COMMUNITY. IN ADDITION TO THE INFORMATION OBTAINED BY THE SURVEYS AND FOCUS GROUPSALL OTHER INFORMATION OBTAINED REGARDING THE HEALTH AND WELL BEING OF THE COMMUNITY DISCOVERED FROM THE BLUE ZONE PROJECT WILL BE INCORPORATED INTO THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. BLUE ZONE PROJECTTHE NCH HEALTHCARE SYSTEM'S MISSION AND FOCUS ON POPULATION HEALTH PROVIDES AN EXCELLENT FOUNDATION FOR THE INTRODUCTION OF THE BLUE ZONES PROJECT IN SOUTHWEST FLORIDA. NCH IS SPONSORING THIS DECADE LONG INITIATIVE IN PARTNERSHIP WITH HEALTHWAYS WHICH SUPPORTS THE VISION TO MAKE OUR COMMUNITY AN EVEN HEALTHIER, HAPPIER AND MORE VIBRANT PLACE TO LIVE.THE NCH HEALTHCARE SYSTEM AND HEALTHWAYS SHARE A COMMITMENT TO IMPROVING THE WELL-BEING OF SOUTHWEST FLORIDA, THEREBY LOWERING HEALTHCARE COSTS, INCREASING PRODUCTIVITY, AND IMPROVING THE ECONOMY AND QUALITY OF LIFE FOR ALL RESIDENTS.THE CURRENT EFFORTS UNDERWAY WITH POLICY LEADERS, SCHOOLS, WORKSITES, HEALTHCARE, AND CIVIC ORGANIZATIONS, COMBINED WITH COMMITMENTS OF EARLY ADOPTERS, DEMONSTRATE A COMMUNITY PRIMED FOR TRANSFORMATION AND IMPROVED WELL-BEING. COMMUNITY STAKEHOLDERS FROM SOUTHWEST FLORIDA DEMONSTRATE TREMENDOUS SUPPORT AND COLLABORATIVE SPIRIT IN SUPPORT OF THE BLUE ZONES PROJECT.THE NCH SPONSORED INITIATIVE IS FOCUSING EFFORTS ON BECOMING A CATALYST FOR CHANGE INCLUDING:> IMPROVING WELL-BEING, AS MEASURED BY THE GALLUP-HEALTHWAYS WELL-BEING INDEX BEYOND BEST COMPARABLE RESULTS IN FLORIDA AND THE REGION> GENERATING SIGNIFICANT MEDICAL COST SAVINGS AND PRODUCTIVITY IMPROVEMENT OVER THE PROJECT TERM> LOWERING THE OBESITY RATE> LOWERING SMOKING RATES> INCREASING VEGETABLE CONSUMPTION> BOOSTING ECONOMIC VITALITY> INCREASING DAILY PHYSICAL ACTIVITY LEVELS > POSITIONING SOUTHWEST FLORIDA AS NATIONWIDE INNOVATORS AND LEADERS IN PREVENTATIVE HEALTHPRIOR TO THE DEVELOPMENT OF THE STEERING COMMITTEES AND SUB COMMITTEES, HEALTHWAYS WORKING CLOSELY WITH NCH AND COMMUNITY LEADERS COMPLETED A HEALTH ASSESSMENT FOR THE SERVICE AREA SERVED BY NCH. A COPY OF THAT ASSESSMENT IS ON OUR WEBSITE HTTP://WWW.NCHMD.ORG.
NAPLES COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 4: CHNA CONDUCTED WITH ONE OR MORE HOSPITAL FACILITIESAS PART OF AN INTERGRATED HEALTHCARE SYSTEM, THE CHNA FOR NAPLES COMMUNITY HOSPITAL AND MARCO ISLAND HOSPITAL WAS PREPARED JOINTLY.
NAPLES COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 7: ADDRESSING THE NEEDS IDENTIFIED IN THE CHNATHE FIRST CHNA AND IMPLEMENTATION PLAN WAS ADOPTED SEPTEMBER 30, 2013. THE CHNA IDENTIFIED PROBLEM AREAS THAT NEED TO BE ADDRESSED. THESE INCLUDE SUFFICIENT JOB EMPLOYMENT, ECONOMIC OPPORTUNITIES, ACCESS TO AFFORDABLE HOUSING, DRUG AND ALCOHOL ABUSE, SAFE ROADWAYS FOR BICYCLISTS AND PEDESTRIANS, PRIMARY CARE RESOURSES, ACCESS TO AFFORDABLE HEALTH FOOD, ACCESS TO LONG-TERM CARE BEDS, COMMUNICABLE DISEASE, OBESITY, CHRONIC DISEASE, MENTAL HEALTH, DENTAL HEALTH, ACCESS TO CARE, DISABILITIES, AND UNINTENTIONAL INJURIES.UPON REVIEW OF THE FINDINGS OF THE CHNA, THE NCH LEADERSHIP TEAM HELD A PRIORITIZATION SESSION WHICH WAS BASED ON THE MISSION, VISION, AND CORE VALUES OF THE THE NCH HEALTHCARE SYSTEM WITH A PRIMARY FOCUS ON THE GOAL OF BECOMING THE HEALTHIEST COUNTY IN THE UNITED STATES. THE TEAM CAME UP WITH FIVE KEY AREAS TO FOCUS ON WHICH INCLUDES CARDIOVASCULAR HEALTH, CANCERS, DIABETES, MATERNAL AND INFANT HEALTH, AND OBESITY. CARDIOVASCULAR HEALTH1. ALIGNED WITH POPULATION HEALTH, THE GOAL OF THE SOUTHWEST FLORIDA BLUE ZONES PROJECT INITIATIVE IS TO BE INCLUSIVE OF ALL AREAS FROM BONITA SPRINGS TO MARCO ISLAND. FOLLOWING AN INITIAL LAUNCH AND EXECUTION IN NAPLES AND BONITA SPRINGS, THIS PROJECT IS DESIGNED TO EXPAND TO ALL AREAS. THE WELL-BEING INDEX, AN IMPORTANT METRIC IN THE BLUE ZONES ASSESSMENT, IS AN AVERAGE OF SIX SUB-INDEXES INCLUDING PHYSICAL HEALTH. SCREENINGS, A KEY COMPONENT IN ASSESSING BASELINE PHYSICAL HEALTH, INCLUDING CARDIAC ISSUES, ARE ALSO USED FOR MEASURING IMPROVEMENTS. 2. A DOZEN COMMUNITY LECTURES RELATED TO CARDIOVASCULAR HEALTH AND PREVENTION WERE PRESENTED TO THE COMMUNITY AT VARIOUS LOCATIONS THROUGHOUT SOUTHWEST FLORIDA. TOPICS INCLUDED: "KEEPING YOUR HEART HEALTHY", "PREVENTING CORONARY HEART DISEASE", AND "HEALTHY LIFESTYLE". LECTURES ARE PROVIDED BY CARDIOLOGISTS, PRIMARY CARE PHYSICIANS, REGISTERED DIETITIANS, AND OTHERS.3. CARDIOVASCULAR SCREENING PROGRAMS AT DISCOUNTED RATES HAVE BEEN IMPLEMENTED AT DESIGNATED TIMES THROUGHOUT THE YEAR. MEDICAL SPECIALISTS PROVIDED SAME-DAY, ONE-ON-ONE CONSULTATIONS BASED ON SCREENING RESULTS WITH EVERY PARTICIPANT. FUTURE PLANS INCLUDE THE POSSIBILITY OF ESTABLISHING OR PARTNERING WITH A MOBILE UNIT TO PROVIDE ADDITIONAL SCREENINGS AND OUTREACH TO THE COMMUNITY.CANCERS1. MAMMOGRAM SCREENING: ONGOING SERVICES OFFERED AND PROVIDED TO UNINSURED AND UNDERINSURED. A COMMUNITY FAIR IS SCHEDULED AT LOCAL CHURCHES THIS YEAR. 2. CP-3 SCREENING: ACA RESEARCH STUDY. NCH PROVIDED CAMPUS LOCATION FOR BLOOD DRAWS AND ENCOURAGED PARTICIPATION OF STAFF. DIABETES MANAGEMENT1. VON ARX DIABETES CENTER : WE HAVE TWO ADA RECOGNIZED PROGRAMS, MAINTAINING DATA COLLECTION AND REPORTING REQUIREMENTS. FOUNDATION FUNDS ARE ALLOCATED FOR PEDIATRICS TO ASSURE THEY HAVE APPOINTMENTS WITH THE REGISTERED DIETICIAN OR THE NURSE FOR CHILDREN UNINSURED OR UNDERINSURED. FUNDS WILL ALSO BE UTILIZED FOR GESTATIONAL DIABETES PATIENT EDUCATION (THIS INCLUDES CLASSES, SUPPLIES AND EDUCATIONS). 2. HEALTHY LIFESTYLE SUPPORT GROUPS: THE SUPPORT GROUP IS OFFERED PERIODICALLY BASED ON THE NEED AND REQUEST OF PATIENTS. THE LAST CLASS WAS HELD IN JANUARY 2015 WITH 8 PARTICIPANTS. 3. FREE PRE-DIABETES SEMINAR: COMMUNITY LECTURES ARE OFFERED THROUGHOUT THE YEAR, ON AVERAGE 30 COMMUNITY RESIDENTS ATTEND THESE LECTURES AT LOCAL LIBRARIES. MATERNAL AND INFANT HEALTH1. INITIAL LATCH MEASUREMENT IS 80%. NCH IS BEGINNING A PROCESS FOR SKIN TO SKIN IN THE DELIVERY ROOM. WE RECENTLY RECEIVED $10K GRANT AWARDED FROM FLORIDA DEPARTMENT OF HEALTH TO ATTAIN "BABY FRIENDLY USA" HOSPITAL DESIGNATION. 2. EXCLUSIVE BREASTFEEDING RATES = 68%. CURRENTLY WE HAVE 2.2 FTE LACTATION CONSULTANTS HIRED AND WORKING. LACTATION CONSULTANT AVAILABILITY 7 DAYS A WEEK A MINIMUM OF 8 HOURS A DAY. 7A-11P AND TO 2AM WHEN CENSUS DICTATES; WEEKEND COVERAGE IS BASED UPON THE CENSUS. 3. PHONE CALL PROGRAM: FOLLOW-UP CALLS TO MOTHERS ARE BEING PERFORMED AT THIS TIME. 4. SUBSTANCE ABUSE: NCH IS CURRENTLY A HOST MEMBER OF THIS COALITION AND HOST MEETINGS REGULARLY AT NCH. COALITION COLLECTS NUMBERS AND REPORTS TO STATE. NURSES ARE EDUCATING PARENTS ON DETRIMENTAL EFFECTS OF SUBSTANCE ABUSE TO NEWBORNS. 5. PEDS AND ADULT IMMUNIZATION: 100% OF PATIENTS/PARENTS ARE OFFERED THIS IMMUNIZATION. TDAP IS NOW AVAILABLE IN ACUDOSE (MEDICATION ADMINISTRATION CABINET) ON THE NURSING UNIT AT ALL TIMES AND THERE IS A STANDING ORDER FOR TDAP ADMINISTRATION IF STATUS IS UNKNOWN. PARENTS MAY REFUSE IF DESIRED. ALL OF THE STAFF IN WOMEN'S AND CHILDREN'S AND PEDIATRICS NURSING UNITS HAVE RECEIVED THE TDAP VACCINE AND ANY NEW EMPLOYEES RECEIVE THE TDAP VACCINE. OBESITY1. GROCERY STORE TOURS: GROCERY STORE TOURS ARE DONE 8 TIMES A YEAR. ATTENDEES OF GROCERY STORE TOURS LEARN HEALTHY NUTRITIOUS EDUCATION AND SELECTION TIPS AT THE SUPERMARKET. 2. SHAC: THE VON ARX STAFF ARE MEMBERS OF THE SHAC COUNCIL THAT MEET QUARTERLY AND ADDRESS SCHOOL NUTRITION AND IMMUNIZATION AND DIET AND EXCERCISE FOR HEALTHY LIVING FOR STUDENTS.3. YOUTH OBESITY SUPPORT PROGRAM: CURRENTLY ONGOING WITH REGISTERED DIETICIAN. APPROXIMATELY 6 PEDIATRIC PATIENTS ARE SEEN AT THE VON ARX DIABETES AND NUTRITION CENTER A MONTH.
NAPLES COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 12I: BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTSANOTHER FACTOR NAPLES COMMUNITY HOSPITAL, INC. USES IN DETERMINING AMOUNTS CHARGED TO PATIENTS IS FAMILY SIZE.
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
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, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
NAPLES COMMUNITY HOSPITAL INC
 
Employer identification number

59-0694358
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
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:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)KENNETH BOOKMAN MDTRUSTEE (i)
(ii)		 0
429,878 		0
12,376 		0
17,500 		0
10,200 		0
22,973 		0
492,927 		0
0
(2)ALLEN S WEISS MDPRESIDENT/CEO/TRUSTEE (i)
(ii)		 668,806
0 		115,668
0 		17,500
0 		10,200
0 		16,686
0 		828,860
0 		0
0
(3)KEVIN D COOPERGENERAL COUNSEL/CHIEF OF STAFF (i)
(ii)		 382,756
0 		66,826
0 		17,500
0 		10,182
0 		24,013
0 		501,277
0 		0
0
(4)PHILLIP DUTCHERCOO, NCH HEALTHCARE SYSTEM, INC. (i)
(ii)		 387,254
0 		66,826
0 		17,500
0 		10,200
0 		1,040
0 		482,820
0 		0
0
(5)MICHAEL STEPHENSCFO/ASSISTANT TREASURER (i)
(ii)		 198,974
0 		15,000
0 		10,773
0 		0
0 		7,628
0 		232,375
0 		0
0
(6)MICHELE THOMAN RNCHIEF NURSING OFFICER (i)
(ii)		 264,605
0 		46,315
0 		17,500
0 		10,200
0 		24,771
0 		363,391
0 		0
0
(7)MICHAEL RILEYCHIEF STRATEGY OFFICER (i)
(ii)		 198,242
0 		35,023
0 		17,500
0 		10,200
0 		24,771
0 		285,736
0 		0
0
(8)JOHN MCGIRL TERM 8302014CHIEF HUMAN RESOURCE OFFICER (i)
(ii)		 219,172
0 		10,425
0 		17,500
0 		4,850
0 		24,606
0 		276,553
0 		0
0
(9)RENEE M THIGPEN START 912014INTERIM CHIEF HR OFFICER (i)
(ii)		 154,199
0 		23,140
0 		4,252
0 		7,358
0 		16,606
0 		205,555
0 		0
0
(10)HELEN THOMPSON TERM 10182013CHIEF INFORMATION OFFICER (i)
(ii)		 214,784
0 		9,284
0 		54,039
0 		2,935
0 		13,173
0 		294,215
0 		0
0
(11)JAMES K MARTINCHIEF DEVELOPMENT OFFICER (i)
(ii)		 0
240,076 		0
41,943 		0
17,500 		0
10,200 		0
24,013 		0
333,732 		0
0
(12)ZACHARY BOSTOCKCHIEF ADMINISTRATIVE OFFICER (i)
(ii)		 0
244,899 		0
37,862 		0
17,500 		0
10,200 		0
22,291 		0
332,752 		0
0
(13)GARY PARSONS MD TERM 122013CHIEF MEDICAL OFFICER NCHMD (i)
(ii)		 0
315,228 		0
54,554 		0
17,500 		0
10,200 		0
8,651 		0
406,133 		0
0
(14)BRIAN D WILSON MDPHYSICIAN BONITA HEALTH (i)
(ii)		 184,002
0 		0
0 		0
0 		7,488
0 		15,568
0 		207,058
0 		0
0
(15)PATRICIA A READADMINISTRATIVE DIRECTOR (i)
(ii)		 164,787
0 		0
0 		13,278
0 		7,085
0 		15,285
0 		200,435
0 		0
0
(16)JAMES BATESDIR RADIOLOGY/COO NDIC (i)
(ii)		 169,908
0 		0
0 		0
0 		7,000
0 		22,812
0 		199,720
0 		0
0
(17)NOBLE F ARRINGTONCONTROLLER NCH HEALTHCARE SYSTEM (i)
(ii)		 156,358
0 		0
0 		2,025
0 		6,447
0 		22,452
0 		187,282
0 		0
0
(18)LAURIE ZONE-SMITHASSOCIATE CHIEF NURSING OFFICER (i)
(ii)		 154,441
0 		0
0 		1,237
0 		6,432
0 		18,875
0 		180,985
0 		0
0
(19)AURORA ESTEVEZMDTERM 032013FORMER CHIEF MEDICAL OFFICER (i)
(ii)		 118,364
0 		70,802
0 		5,384
0 		7,953
0 		0
0 		202,503
0 		0
0
(20)VICKI DORR TERM 052013FORMER CHIEF FINANCIAL OFFICER (i)
(ii)		 160,312
0 		66,826
0 		226,939
0 		9,719
0 		23,453
0 		487,249
0 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
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.
Return Reference Explanation
PART I, LINE 4A DETAIL OF SEVERANCE PAYMENTS VICKI D. ORR, CHIEF FINANCIAL OFFICER/ASSISTANT TREASURER RESIGNED 05/22/2013 AND RECEIVED A SEVERANCE PAYMENT OF $219,536 FOR CALENDAR YEAR 2013. HELEN THOMPSON, CHIEF INFORMATION OFFICER RESIGNED 10/18/2013 AND RECEIVED A SEVERANCE PAYMENT OF $39,232 FOR CALENDAR YEAR 2013.
PART I, LINE 7 PROVISIONS OF NON-FIXED PAYMENTS NCH MAY PROVIDE DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES. PAYMENTS MADE TO ANY DISQUALIFIED PERSON IS APPROVED BY THE NCH COMPENSATION COMMITTEE THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
NAPLES COMMUNITY HOSPITAL INC
 
Employer identification number
59-0694358
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A COLLIER CTY INDSTL DEVLMT AUTHORITY
  		59-1695679   12-30-2010 30,000,000 NEW CAPITAL EQUIPMENT   X   X   X
B COLLIER CTY INDSTL DEVLMT AUTHORITY
  		59-1695679 194641AK2 04-14-2011 100,955,824 REFINANCE 93/96 BONDS & NEW CAPITAL EQUIPMENT   X   X   X
C COLLIER CTY INDSTL DEVLMT AUTHORITY
  		59-1695679   10-31-2011 46,340,000 REFINANCE 02/04 BONDS   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 5,994,189 2,685,000 1,265,000  
2 Amount of bonds legally defeased . . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . . 30,050,966 101,013,628 46,343,029  
4 Gross proceeds in reserve funds . . . . . . . . . . . . 4,316,991 4,316,991    
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . . 49,222,562 49,222,562 46,160,000  
7 Issuance costs from proceeds . . . . . . . . . . . . 159,198 1,414,549 180,000  
8 Credit enhancement from proceeds . . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 29,891,768 46,029,299    
11 Other spent proceeds . . . . . . . . . . . . . .        
12 Other unspent proceeds . . . . . . . . . . . . . . 30,227 30,227 3,029  
13 Year of substantial completion . . . . . . . . . . . . 2013 2014 2011
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X X   X      
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X    
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X      
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X   X   X    
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X    
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0 % 0 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0 % 0 %  
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 0 % 0 %  
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X    
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X    
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X      
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X    
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X    
b Exception to rebate? . . . . . . . . X   X   X      
c No rebate due? . . . . . . . .   X   X   X    
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .   X   X X      
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X    
b Name of provider . . . . . . . . .  
  		 
  		 
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X    
b Name of provider . . . . . . . . .  
  		 
  		 
  		 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X    
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X      
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X      
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
FORM 990, SCHEDULE K, PART II, LINE 3 FOR COLLIER COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY- SERIES 2010, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $50,966 IN INVESTMENT EARNINGS. FOR COLLIER COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY- SERIES 2011 PUBLIC, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $1,159,176 IN NET ORIGINAL ISSUE DISCOUNTS AND $30,227 IN INVESTMENT EARNINGS. FOR COLLIER COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY- SERIES 2011 BANK QUALIFIED, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $3,029 IN INVESTMENT EARNINGS.
Schedule K (Form 990) 2013

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
NAPLES COMMUNITY HOSPITAL INC
 
Employer identification number

59-0694358
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2013
Schedule L (Form 990 or 990-EZ) 2013
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) BRITTNEY THOMAN FMLY MEMBER/OFFICER 44,270 PYMT COMP   No
(2) JODI S COOPER FMLY MEMBER/OFFICER 129,099 PYMT COMP   No
(3) ASHLEY THIGPEN FMLY MEMBER/OFFICER 28,805 PYMT COMP   No
(4) JAMES ORR MD FMLY MEMBER/OFFICER 496,679 RENTAL INC   No
(5) UPPER MIDWEST CONSOLIDATED SERVICES
  		TRUSTEE/MAYO EE 568,477 PYMT INVEST   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
FORM 990, SCHEDULE L, PART IV BRITTNEY THOMAN IS THE DAUGHTER OF MICHELE THOMAN, CHIEF NURSING OFFICERJODI S. COOPER, DIRECTOR OF THE LABORATORY, IS THE SPOUSE OF OFFICER KEVIN D. COOPER, GENERAL COUNSEL/CHIEF OF STAFF.ASHLEY THIGPEN IS THE DAUGHTER OF RENEE M. THIGPEN, INTERIM CHIEF HUMAN RESOURCES OFFICER.JAMES ORR, M.D. IS THE SPOUSE OF VICKI D. ORR, FORMER CFO/ASSISTANT TREASURER. HE HAS A MINORITY EQUITY INTEREST IN 21ST CENTURY ONCOLOGY WHICH PAYS NCH RENTAL INCOME FOR THE LUTGERT EAST BUILDING.STEPHEN LANGE, M.D., IS AN EMPLOYEE OF MAYO CLINIC WHICH IS AFFLIATED WITH UPPER MIDWEST CONSOLIDATED SERVICES, LLC AND NCH IS AFFLIATED WITH MAYO CLINIC.
Schedule L (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
NAPLES COMMUNITY HOSPITAL INC
 
Employer identification number

59-0694358
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		X 510,288 FMV
6 Cars and other vehicles .. X 1 3,000 FMV
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 17 1,910,561 FMV
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies . X 1 100,000 FMV
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( ENTERTAINMENT ) X 41 39,324 FMV
26 Other Right pointing arrow large image ( CC/GOLF ) X 2 25,000 FMV
27 Other Right pointing arrow large image ( JEWELRY ) X 3 15,835 FMV
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that
it must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2013)
Schedule M (Form 990) (2013)
Page 2
Part II
Supplemental Information. Provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
Schedule M (Form 990) (2013)
Additional Data


Software ID:  
Software Version:  
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.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
NAPLES COMMUNITY HOSPITAL INC
 
Employer identification number

59-0694358
Return Reference Explanation
PAGE 1, BOX B THE RETURN HAS BEEN AMENDED TO CORRECT SCHEDULE H, PART III, SECTION B, LINES 5 AND 7. AN INADVERTENT OMISSION LED TO LINE 5 PREVIOUSLY FILED WITH $21,841,284 OF TOTAL REVENUE RECEIVED FROM MEDICARE. THE TRUE VALUE CORRECTED NOW IS $218,412,847. A CARRY-THROUGH CALCULATION HAS UPDATED THE RESULTING LINE 7 AS WELL.
FORM 990, PART VI, SECTION A, LINE 6 GOVERNING BODY AND MANAGEMENT NCH HEALTHCARE SYSTEM, INC. IS THE SOLE MEMBER OF THIS ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A GOVERNING BODY AND MANAGEMENT NCH HEALTHCARE SYSTEMS, INC. SOLE MEMBER OF THIS ORGANIZATION, ELECTS THIS ORGANIZATION'S DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B GOVERNING BODY AND MANAGEMENT ALL OF THE GOVERNANCE DECISIONS FOR NAPLES COMMUNITY HOSPITAL, INC. ARE RESERVED TO THE GOVERNING BODY OF NCH HEALTHCARE SYSTEM, INC.
FORM 990, PART VI, SECTION B, LINE 11 REVIEW PROCESS INFORMATION RELATED TO NAPLES COMMUNITY HOSPITAL INC.'S ("NCH") FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO MCGLADREY LLP FOR REVIEW. THE 2013 FORM 990 FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2014 WAS REVIEWED AND APPROVED BY THE CHAIRMAN OF THE NCH FINANCE COMMITTEE, NCH HEALTHCARE SYSTEM CHIEF OF STAFF, AND OUTSIDE COUNSEL FOR THE BOARD PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY ANNUALLY, ALL NCH HEALTHCARE SYSTEM, INC. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE INTERESTS THAT COULD POTENTIALLY GIVE RISE TO CONFLICTS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. MANAGEMENT SHALL DISCLOSE OTHER POTENTIAL CONFLICTS WITH THE COMPLIANCE OFFICER. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINED UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. THE COMPLIANCE OFFICER WILL DETERMINE IF A MANAGEMENT TEAM MEMBER OR EMPLOYEE SHOULD BE EXCUSED FROM A DISCUSSION OR PARTICIPATE IN A DECISION IN WHICH THERE MAY BE A CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS COMPENSATION ARRANGEMENTS INVOLVING OUR CEO AND SENIOR LEADERSHIP TEAM ARE ESTABLISHED BY NCH PURSUANT TO A PROCESS THAT SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR SECTION 4958 EXCESS BENEFIT TRANSACTION TAX PURPOSES (WHICH REQUIRES A REVIEW OF COMPENSATION DETERMINATIONS BY DISINTERESTED PERSONS, USE OF APPROPRIATE COMPARABILITY DATA, AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS).
FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE TO THE PUBLIC THE FORMS 1023 AND 990, GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY OF NAPLES COMMUNITY HOSPITAL, INC. ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO AVAILABLE VIA OUR WEBSITE: WWW.NCHMD.ORG. DOCUMENTS AVAILABLE FOR REQUEST ARE AVAILABLE PURSUANT TO THE PERIOD OF DISCLOSURE PROVIDED IN SECTION 6104(D).
FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 3,943,355. MANAGEMENT AND GENERAL EXPENSES 676,320. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,619,675. EDUCATION SERVICES: PROGRAM SERVICE EXPENSES 623,224. MANAGEMENT AND GENERAL EXPENSES 106,889. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 730,113. RECRUITING: PROGRAM SERVICE EXPENSES 276,102. MANAGEMENT AND GENERAL EXPENSES 47,354. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 323,456. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 24,493,540. MANAGEMENT AND GENERAL EXPENSES 4,200,860. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,694,400. COLLECTION FEES: PROGRAM SERVICE EXPENSES 2,493,727. MANAGEMENT AND GENERAL EXPENSES 427,697. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,921,424. CONSULTING FEES: PROGRAM SERVICE EXPENSES 183,304. MANAGEMENT AND GENERAL EXPENSES 31,438. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 214,742. MEMBERSHIP FEES: PROGRAM SERVICE EXPENSES 416,798. MANAGEMENT AND GENERAL EXPENSES 71,484. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 488,282. PUBLIC MEDICAL ASSISTANCE TRUST FUND (FL) FEES: PROGRAM SERVICE EXPENSES 4,590,320. MANAGEMENT AND GENERAL EXPENSES 787,281. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,377,601.
FORM 990, PART XI, LINE 9: TRANSFERS TO RELATED ORGANIZATIONS -8,705,178.
FORM 990, PART XI, LINE 9 DETAIL OF OTHER CHANGES IN NET ASSETS TRANSFERS TO RELATED ORGANIZATIONS $8,705,181 --------- TOTAL OTHER CHANGES IN NET ASSETS $8,705,181
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
NAPLES COMMUNITY HOSPITAL INC
 
Employer identification number

59-0694358
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on 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" on 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?
Yes No
(1) NCH HEALTHCARE SYSTEM INC

PO BOX 413029

NAPLES,FL341013029
59-2314655 		NOT-FOR-PROFIT HOLDING COMPANY FL 501 (C) (3) LINE 11B, II N/A
 
No
(2) MARCO ISLAND HOSPITAL INC

40 HEATHWOOD DRIVE

MARCO ISLAND,FL34145
59-2315435 		HEALTHCARE FL 501 (C) (3) LINE 3 NCH SYSTEM
 
 
No
(3) COLLIER HEATH CARE INC

PO BOX 413029

NAPLES,FL341013029
65-0244276 		HEALTHCARE FL 501 (C) (3) LINE 3 NCH SYSTEM
 
 
No
(4) COMMUNITY HOME SERVICES INC

PO BOX 413029

NAPLES,FL341013029
59-2440516 		SUPPORT ORGANIZATION FL 501 (C) (3) LINE 11B, II NCH SYSTEM
 
 
No
(5) NCHMDINC

PO BOX 413029

NAPLES,FL341013029
33-1075317 		HEALTHCARE FL 501 (C) (3) LINE 9 NCH SYSTEM
 
 
No




For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on 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 V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on 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
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) HEALTH RESOURCES CORPORATION

350 7TH STREET NORTH
NAPLES,FL34102
59-2568003 		HOLDING COMPANY FL NCH HEALTHCARE SYSTEM
  		C         No
(2) AMBULATORY SURGICAL CARE CENTER INC

350 7TH STREET NORTH
NAPLES,FL34102
59-2568029 		OUTPATIENT SURGERY FL HEALTH RESOURCES CORPORTATION
  		C         No
(3) COMMUNITY HOME CARE INC

350 7TH STREET NORTH
NAPLES,FL34102
59-2372966 		HOME HEALTH FL HEALTH RESOURCES CORPORTATION
  		C         No
(4) COMMUNITY IMAGING INC

350 7TH STREET NORTH
NAPLES,FL34102
59-2446336 		RADIOLOGY LAB FL HEALTH RESOURCES CORPORTATION
  		C         No






Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on 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
No
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 . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on 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) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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 V?UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


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