TY 2014 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) MATT BAKER........................................................................ CHAIRMAN	1.00 .......................	X	X	0	0
(2) WILLIAM ABARE........................................................................ DIRECTOR	1.00 .......................	X		0	0
(3) TODD BATTENHORST MD........................................................................ DIRECTOR	1.00 .......................	X		0	0
(4) JEFF KAMM........................................................................ DIRECTOR	1.00 .......................	X		0	0
(5) WILLIAM KOPF........................................................................ DIRECTOR	1.00 .......................1.00	X		0	0
(6) RAY MATUZA........................................................................ DIRECTOR	1.00 .......................	X		0	0
(7) TODD NEVILLE........................................................................ DIRECTOR	1.00 .......................	X		0	0
(8) BRAD RUNK........................................................................ DIRECTOR	1.00 .......................	X		0	0
(9) JAMES GRIMES MD........................................................................ DIRECTOR	1.00 .......................	X		0	0
(10) STUART SOROKA MD........................................................................ DIRECTOR	1.00 .......................	X		0	0
(11) SUSAN PONDER-STANSEL........................................................................ DIRECTOR	1.00 .......................	X		0	0
(12) KAREN TAYLOR........................................................................ DIRECTOR	1.00 .......................	X		0	0
(13) LEN WEEKS........................................................................ DIRECTOR	1.00 .......................1.00	X		0	0
(14) LEN TUCKER........................................................................ DIRECTOR	1.00 .......................1.00	X		0	0
(15) SUSAN YARIAN MD........................................................................ DIRECTOR	1.00 .......................	X		0	0
(16) JOSEPH S GORDY........................................................................ CEO	40.00 .......................		X	531,524	35,000
(17) ROGER CARTER........................................................................ CFO	40.00 .......................		X	233,466	18,720

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(F) Estimated amount of other compensation from the organization and related organizations
(18) JASON P BARRETT........................................................................ CIO & EXECUTIVE VP	40.00 .......................	X			268,071	36,115
(19) CHRISTOPHER SCHMIDT........................................................................ COO	40.00 .......................	X			265,243	34,815
(20) WILLIAM D RIEGER........................................................................ CIO	40.00 .......................	X			266,918	39,235
(21) DONALD R CRIST........................................................................ VP-PROFESSIONAL SVCS	40.00 .......................	X			224,974	36,711
(22) BARBARA DRUMMOND-HUTH........................................................................ CNO	40.00 .......................	X			240,877	0
(23) MARY K MANTESE........................................................................ CNO	40.00 .......................	X			183,204	21,087
(24) JEFFREY A HURLEY........................................................................ VP-HUMAN RESOURCES	40.00 .......................	X			181,350	31,642
(25) MICHAEL C DIBELLA........................................................................ CMO	40.00 .......................		X		353,312	32,779
(26) MIGUEL A MACHADO........................................................................ MD-ER OVERFLOW/CHIEF MEDICAL OFFICER	40.00 .......................20.00		X		296,470	18,720
(27) MICHAEL C SANDERS........................................................................ CHIEF-MEDICAL INFORMATICS	40.00 .......................		X		316,986	20,515
(28) GREGORY A GIBSON........................................................................ PHYSICIAN	40.00 .......................		X		196,825	34,207
(29) BRIAN D RAYMAKER........................................................................ PHYSICIAN	40.00 .......................		X		169,819	20,630
(30) LYNDA I KIRKER........................................................................ FORMER RETIRED CFO	40.00 .......................			X	309,776	0

(A) Name and business address	(B) Description of services	(C) Compensation
ALLSCRIPTS HEALTHCARE LLC 24630 NETWORK PLACE CHICAGO,IL606731246	HEALTHCARE	3,766,668
IMETHODS LLC 10748 DEERWOOD PARK BLVD S STE 150 JACKSONVILLE,FL32256	CONSTRUCTION	2,380,320
TEKNION DATA SOLUTIONS 1431 GREENWAY DR STE 440 IRVING,TX75038	DATA SOLUTIONS	1,177,984
PULMONARY ASSOCIATES 300 HEALTH PARK BLVD STE 4000 ST AUGUSTINE,FL32080	MEDICAL SERVICES	1,040,000
FIRST CITY HOSPITALIST GROUP 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086	PROFESSIONAL FEES	1,016,016
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 47

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 domestic organizations and domestic governments. See Part IV, line 21 ....	524,053	524,053
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............
4	Benefits paid to or for members ....
5	Compensation of current officers, directors, trustees, and key employees ....	2,648,955		2,648,955
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages ....	79,537,139	74,924,307	4,612,832
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,029,624	2,761,933	267,691
9	Other employee benefits .......	12,116,611	11,046,013	1,070,598
10	Payroll taxes ...........	5,978,049	5,449,841	528,208
11	Fees for services (non-employees):
a	Management ......	504,716		504,716
b	Legal .........	614,875		614,875
c	Accounting ...........	139,647		139,647
d	Lobbying ...........	336,000		336,000
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) ....	31,724,223	24,171,480	7,552,743
12	Advertising and promotion ....	725,399		725,399
13	Office expenses .......	4,860,589	3,982,931	877,658
14	Information technology ......	2,418,897		2,418,897
15	Royalties ..
16	Occupancy ...........	3,800,016	3,161,196	638,820
17	Travel ............	457,521	180,587	276,934
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....
20	Interest ...........	3,506,600	3,506,600
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	19,486,651	19,486,651
23	Insurance ..............	5,638,854	5,638,854
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	47,855,631	47,835,066	20,565
b	BAD DEBT	30,165,272	30,165,272
c	INDIGENT TAX	2,731,196	2,731,196
d	OTHER EXPENSES	683,349	263,153	420,196
e	All other expenses	409,268	393,933	15,335
25	Total functional expenses. Add lines 1 through 24e	259,893,135	236,223,066	23,670,069	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	7,124,494	1	8,227,974
2	Savings and temporary cash investments .........		2
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	30,638,755	4	34,302,562
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 .............	4,912,770	7	1,756,827
8	Inventories for sale or use ..............	5,369,142	8	5,940,660
9	Prepaid expenses and deferred charges ..........	1,591,357	9	1,938,903
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	348,348,318
b	Less: accumulated depreciation .....	10b	205,080,812	141,346,374	10c	143,267,506
11	Investments—publicly traded securities ..........	80,747,518	11	84,696,155
12	Investments—other securities. See Part IV, line 11 .....	11,225,011	12	12,018,148
13	Investments—program-related. See Part IV, line 11 .....		13	553,118
14	Intangible assets ...............		14	9,309,271
15	Other assets. See Part IV, line 11 ...........	4,776,803	15	6,430,194
16	Total assets. Add lines 1 through 15 (must equal line 34)......	287,732,224	16	308,441,318
	17	Accounts payable and accrued expenses .........	37,225,761	17	37,170,868
18	Grants payable .................		18
19	Deferred revenue ................	4,112,865	19	3,981,603
20	Tax-exempt bond liabilities .............	82,655,000	20	96,655,000
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 ..	4,602,974	23	5,145,510
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....................	0	25	412,384
26	Total liabilities. Add lines 17 through 25.........	128,596,600	26	143,365,365
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	159,135,624	27	165,075,953
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	159,135,624	33	165,075,953
34	Total liabilities and net assets/fund balances ........	287,732,224	34	308,441,318

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

FLAGLER HOSPITAL INC

Employer identification number

59-0675143

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

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

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2014

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.)..
11	Total support Add lines 7 through 10.

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2014

Page 3

Part III

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2014

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

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

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Schedule A (Form 990 or 990-EZ) 2014

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2014

Page 6

Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1. Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6
7	Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2014

Page 7

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2014 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2014	(iii) Distributable Amount for 2014
1 Distributable amount for 2014 from Section C, line 6
2 Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2014 distributable amount
i Carryover from 2009 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2014 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2014 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2015. Add lines 3j and 4c.
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......
e From 2014.......

Schedule A (Form 990 or 990-EZ) (2014)

Schedule A (Form 990 or 990-EZ) 2014

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

FLAGLER HOSPITAL INC

Employer identification number

59-0675143

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2014

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2014

Page 3

Part II-B

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

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

(a)

Yes

(b)

Amount

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

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

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

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

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

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

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

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

Yes

336,000

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

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

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

336,000

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	DURING THE TAX YEAR, THE ORGANIZATION ENGAGED A PROFESSIONAL LOBBYIST TO MONITOR LEGISLATION DIRECTLY AFFECTING NOT-FOR-PROFIT HOSPITALS/RURAL COMMUNITY PROVIDERS.

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

FLAGLER HOSPITAL INC

Employer identification number

59-0675143

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 value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2014

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No

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


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

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

Part V

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

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	3,895,387	3,609,062	6,007,584	3,428,122	3,516,547
b	Contributions ........				2,341,026	601,813
c	Net investment earnings, gains, and losses	-314,241	286,325	499,217	556,393	-311,346
d	Grants or scholarships .....				317,957	378,892
e	Other expenditures for facilities and programs ........			2,897,739
f	Administrative expenses ....
g	End of year balance ......	3,581,146	3,895,387	3,609,062	6,007,584	3,428,122

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

Yes

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

Yes

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		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	7,135,679		7,135,679
b	Buildings ................	159,955,780	97,294,123	62,661,657
c	Leasehold improvements ............	402,364	244,740	157,624
d	Equipment ................	176,803,652	107,541,949	69,261,703
e	Other .................	4,050,843		4,050,843
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				143,267,506

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther 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.)

Part VIII

InvestmentsProgram 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.)

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









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

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
ESTIMATED THIRD PARTY PAYOR SETTLEMENTS		412,384








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		412,384
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) 2014

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	235,901,745
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-6,005,401
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-30,376,211
e	Add lines 2a through 2d .....................			2e	-36,381,612
3	Subtract line 2e from line 1.....................			3	272,283,357
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	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	272,283,357

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	229,961,415
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	233,552
e	Add lines 2a through 2d......................			2e	233,552
3	Subtract line 2e from line 1.....................			3	229,727,863
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	30,165,272
c	Add lines 4a and 4b.......................			4c	30,165,272
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	259,893,135

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:	THE ORGANIZATION'S ENDOWMENT CONSISTS OF THREE INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ENDOWMENTS ARE ALL DONOR-RESTRICTED AND INTERNALLY CONTROLLED. FLAGLER HEALTH CARE FOUNDATION, A RELATED ORGANIZATION, HOLDS THESE ENDOWMENTS FOR BENEFIT OF FLAGLER HOSPITAL, INC. INVESTMENTS CONTAIN AMOUNTS TO BE HELD IN PERETUITY, THE DIVIDEND AND INTEREST INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTHCARE SERVICES, AND THE REMAINING INVESTMENT INCOME, GAINS, AND LOSSES ARE TO ADJUST THE CORPUS.
PART X, LINE 2:	THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE, AND IS ALSO EXEMPT FROM STATE INCOME TAXES. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE HOSPITAL'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE HOSPITAL HAS ANALYZED THE TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE HOSPITAL BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2012.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	CHANGE IN FAIR VALUE OF DERIVATIVE FINANCIAL INSTRUMENT -542,536. RENTAL EXPENSES NET WITH REVENUES 233,552. BAD DEBT NET WITH REVENUE -30,165,272. NET ASSETS RELEASED FROM RESTRICTION 98,045.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES NET WITH REVENUE 233,552.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT NET WITH REVENUE 30,165,272.

Schedule D (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

FLAGLER HOSPITAL INC

Employer identification number

59-0675143

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

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

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	6,653,686	396,365	6,257,321	2.720 %
b	Medicaid (from Worksheet 3, column a) ....	22,079,244	16,502,093	5,577,151	2.430 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	28,732,930	16,898,458	11,834,472	5.150 %
Other Benefits		1,342,479		1,342,479	0.580 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	1,342,479		1,342,479	0.580 %
f	Health professions education (from Worksheet 5) ..	975,446		975,446	0.420 %
g	Subsidized health services (from Worksheet 6) ..	7,270,263		7,270,263	3.160 %
h	Research (from Worksheet 7)	205,344		205,344	0.090 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	406,214		406,214	0.180 %
j	Total. Other Benefits ..	10,199,746		10,199,746	4.430 %
k	Total. Add lines 7d and 7j .	38,932,676	16,898,458	22,034,218	9.580 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014

Schedule H (Form 990) 2014

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	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	1		500	500	0 %
2	Economic development
3	Community support	2		1,017	1,017	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1		10,000	10,000	0 %
7	Community health improvement advocacy	1		3,185	3,185	0 %
8	Workforce development	1	274	178	178	0 %
9	Other
10	Total	6	274	14,880	14,880

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

30,165,272

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. ......

3,031,747

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

Section B. Medicare

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

85,541,134

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

76,188,220

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

9,352,914

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

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 %	(e) Physicians' profit % or stock ownership %
11 OUTPATIENT SURGERY CENTER OF ST AUGUSTINE LLC	ORTHOPEDIC OP SURGERY	11.470 %	88.530 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2014

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 (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	FLAGLER HOSPITAL 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086	X	X	X

Schedule H (Form 990) 2014

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)

	FLAGLER HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?.......................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C..........

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 12....................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 14

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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

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

Yes

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

Hospital facility’s website (list url):

Other website (list url): SEE PART V

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): SEE PART V

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)? ...........................

12a

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

If "Yes" to line 12b, 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) 2014

Page

Part VFacility Information (continued)

	FLAGLER HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): SEE PART V

The FAP application form was widely available on a website (list url): SEE PART V

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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 all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	FLAGLER HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other 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?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

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? ................................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2014

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
FLAGLER HOSPITAL	PART V, SECTION B, LINE 5: FLAGLER HOSPITAL AND THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL DECIDED ON TWO DIFFERENT APPROACHES TO GATHER INFORMATION FROM A CROSS-SECTION OF THE COMMUNITY. THE FIRST APPROACH WAS TO CONDUCT COMMUNITY FOCUS GROUPS, AND THE SECOND APPROACH WAS TO DEPLOY A COUNTY-WIDE ASSESSMENT.
FLAGLER HOSPITAL	PART V, SECTION B, LINE 6A: ANASTASIA MOSQUITO CONTROL DISTRICTAZALEA HEALTHBETTY GRIFFIN HOUSEBOYS & GIRLS CLUBS OF NORTHEAST FLORIDACLINTON HEALTH MATTERS INITIATIVENORTHEAST FLORIDA REGIONAL DIRECTORDELORES BARR WEAVER POLICY CENTEREPIC BEHAVIORAL HEALTHCAREEPISCOPAL CHILDREN'S SERVICESFIRST COAST TECHNICAL COLLEGEFLORIDA DEPT. OF HEALTH IN ST. JOHNS COUNTYGOOD SAMARITAN HEALTH CENTERSHAVEN HOSPICEHEALTHY SCHOOLSHOME AGAIN ST. JOHNSLEARN TO READ ST. JOHNSLINCOLNVILLE FARMERS MARKETMOUNT ZION AME CHURCHNEW MT. MORIAH CHRISTIAN MINISTRYNORTHEAST FLORIDA COMMUNITY HOSPICECOMMUNITY RELATIONS REPRESENTATIVEPACT PREVENTION COALITIONST. AUGUSTINE METRO TREATMENT CENTERST. JOHNS COUNTY BOARD OF COMMISSIONERSST. JOHNS COUNTY MEDICAL EXAMINERCHIEF MEDICAL EXAMINERST. JOHNS COUNTY ADMINISTRATIONST. JOHNS COUNTY COUNCIL ON AGINGST. JOHNS COUNTY EDUCATION FOUNDATIONST. JOHNS COUNTY EMERGENCY MANAGEMENTST. JOHNS COUNTY FIRE RESCUEST. JOHNS COUNTY HEALTH AND HUMAN SERVICES ADVISORY COUNCILST. JOHNS COUNTY HEALTH AND HUMAN SERVICESST. JOHNS COUNTY SOCIAL SERVICESFLORIDA DEPARTMENT OF HEALTHST. JOHNS COUNTY MEDICAL SOCIETYEXECUTIVE DIRECTORST. JOHNS COUNTY SCHOOL DISTRICT/HEAD STARTST. JOHNS COUNTY SHERIFF'S OFFICESTEWART-MARCHMAN ACT BEHAVIORAL HEALTHCARETOBACCO FREE ST. JOHNSVELO FEST COMMUNITY INITIATIVEYMCA OF FLORIDA'S FIRST COAST
PART V, SECTION B, LINE 11	FLAGLER HOSPITAL'S IMPLEMENTATION OF STRATEGIC OBJECTIVESREDUCE PERCENTAGE OF LOW BIRTH WEIGHT INFANTS:THE PERCENTAGE OF LOW BIRTHWEIGHT INFANTS IN ST. JOHNS COUNTY CONTINUES TO BE A DISPARITY AMONG COMMUNITY POPULATIONS. FOR THIS REASON, REDUCING THE PERCENTAGE OF LOW BIRTHWEIGHT INFANTS IN ST. JOHNS COUNTY WAS SELECTED AS A STRATEGIC OBJECTIVE CRITICAL ACTIONS INCLUDE THE FORMATION OF A FETAL INFANT MORTALITY REVIEW TEAM AND COORDINATED EFFORTS AMONG COMMUNITY PARTNERS TOWARDS INCREASING THE PERCENTAGE OF WOMEN RECEIVING FIRST TRIMESTER PRENATAL CARE. FLAGLER HOSPITAL'S DIRECTOR OF MATERNITY SERVICES, NEONATAL INTENSIVE CARE MANAGER AND MATERNITY COORDINATOR CONTINUE TO SERVE ON THE ST. JOHNS INFANT MORTALITY TASK FORCE. THE TASK FORCE MEETS QUARTERLY TO ANALYZE MORTALITY RATES FOR NORTHEAST FLORIDA AND DETERMINE LEADING CAUSES FOR LOW BIRTH WEIGHT TO ACHIEVE BETTER OUTCOMES FOR ST. JOHNS COUNTY. THIS TASK FORCE IS PART OF THE NE FLORIDA HEALTHY START COALITION, INC. THE TASK FORCE IS CURRENTLY WORKING TO PROMOTE HEALTHY PREGNANCY AND PREGNANCY BODY MASS INDEX LEVELS, REDUCE TOBACCO USAGE AMONG PREGNANT WOMEN AND HELP INCREASE AWARENESS OF THE IMPORTANCE OF INCREASING THE INTERVAL TIME BETWEEN PREGNANCIES FOR HEALTHY OUTCOMES. FLAGLER HOSPITAL OFFERS FREE PRE-NATAL YOGA CLASSES TO HELP MOMS STAY IN OPTIMUM HEALTH FOR DELIVERY (OPEN TO ALL ST. JOHNS COUNTY MOMS, EVEN IF THEY DON'T PLAN TO DELIVER AT FLAGLER HOSPITAL). REDUCE CHRONIC DISEASE MORBIDITY AND MORTALITY:CHRONIC DISEASE WAS RESPONSIBLE FOR OVER 50% OF ALL DEATHS IN ST. JOHNS COUNTY IN 2012. CANCER IS THE LEADING CAUSE OF DEATH IN ST. JOHNS COUNTY, WITH BREAST, COLON AND LUNG CANCER IDENTIFIED AS BEING THE MOST COMMON TYPES AMONG RESIDENTS. AMONG SURVEY RESPONDENTS, 8.4% REPORTED CANCER AS THE MOST CONCERNING HEALTH PROBLEM, RANKING SECOND AMONG ALL RESPONDENTS. TO RAISE AWARENESS ABOUT THE BENEFITS OF PREVENTION AND EARLY DETECTION OF CANCER, FLAGLER HOSPITAL PARTICIPATED IN OVER 30 HEALTH FAIRS, PROVIDING ST. JOHNS COUNTY RESIDENTS WITH UP-TO-DATE SCREENING GUIDELINES AND THE BENEFITS OF A HEALTHY LIFESTYLE. FURTHER, A THREE YEAR FLAGLER CANCER INSTITUTE COMMUNITY NEEDS ASSESSMENT WAS COMPLETED, WHICH IDENTIFIED THE FOLLOWING AREAS OF NEED WITHIN THE COMMUNITY: MAMMOGRAPHY SCREENING RATES, AGE-ADJUSTED CANCER DEATH RATE FOR BLACK ST. JOHNS COUNTY RESIDENTS, AND TIME BETWEEN LUNG CANCER DIAGNOSIS TO TREATMENT.CANCER PREVENTION PROGRAMS INCLUDED PRESENTATIONS FOR LOCAL CHURCHES AND CIVIC GROUPS, LUNG CANCER AWARENESS EVENTS, COLORECTAL CANCER PREVENTION AND AWARENESS EVENTS AND A SKIN CANCER PREVENTION PROGRAM. IN ADDITION, FLAGLER HOSPITAL PARTNERED WITH OTHER COMMUNITY ORGANIZATIONS SUCH AS GOOD SAMARITAN WILDFLOWER CLINIC, AMERICAN CANCER SOCIETY, LUNG CANCER ALLIANCE, PINK UP THE PACE AND UNITY OUTREACH TO PROMOTE CANCER AWARENESS AND EARLY DETECTION THROUGHOUT THE COMMUNITY.BREAST CANCER: FROM 2011 TO 2013, THE BREAST CANCER AGE-ADJUSTED DEATH RATE WAS 18.3/100,000. THIS RATE IS LOWER THAN STATE AND REGIONAL AVERAGES, AND IDENTICAL TO THE PEER COUNTY STATE AVERAGE. IN ORDER TO REDUCE THE TIME FRAME BETWEEN BREAST CANCER DIAGNOSIS AND TREATMENT, A BREAST CANCER PATIENT NAVIGATOR (BCPN) WAS ADDED TO THE FLAGLER HOSPITAL CANCER INSTITUTE CARE TEAM AND HELPS PATIENTS MOVE THROUGH THE PROCESS OF BREAST CANCER ALL THE WAY THROUGH DIAGNOSIS, SURGERY, TREATMENT AND RECOVERY. THE BREAST CANCER PATIENT NAVIGATOR HELPS PATIENTS FROM THE TIME THERE IS A SUSPICION OF BREAST CANCER UNTIL TREATMENT IS CONCLUDED. OUR PATIENT NAVIGATOR NURSE IS A CERTIFIED BREAST CARE NURSE CBCN AND IS DEDICATED TO THE FOLLOWING: PROVIDING PATIENTS WITH KNOWLEDGEABLE AND COMPASSIONATE SUPPORT; FACILITATING COMMUNICATION BETWEEN THE PATIENT AND PHYSICIANS IN ORDER TO DECREASE FRAGMENTATION OF CARE; AND PROVIDING PATIENTS AND FAMILY MEMBERS WITH INFORMATION ON COMMUNITY-BASED RESOURCES.IN THIS FISCAL YEAR, THE BCPN GUIDED OVER 120 UNIQUE PATIENTS THROUGH THEIR CANCER TREATMENT. THE BREAST CANCER PATIENT NAVIGATOR PARTICIPATES IN MANY COMMUNITY EVENTS, EDUCATING WOMEN ON THE BENEFITS OF EARLY DETECTION AND THE IMPORTANCE OF PERFORMING SELF-EXAMINATIONS. FLAGLER HOSPITAL CONTINUES TO SUPPORT LOCAL NON-PROFIT ORGANIZATIONS THAT FOCUS ON THE PREVENTION AND EARLY DETECTION OF BREAST CANCER IN ST. JOHNS COUNTY. FLAGLER HOSPITAL, IN PARTNERSHIP WITH THE WILDFLOWER CLINIC, HELD A FREE MAMMOGRAM DAY THAT WAS OPEN TO ALL UNINSURED ST. JOHNS COUNTY WOMEN BETWEEN THE AGES OF 40-64. AT THIS EVENT60 WOMEN RECEIVED MAMMOGRAMS, HEALTH SCREENINGS, AND INFORMATION ON AVAILABLE COMMUNITY RESOURCES. COLON CANCER: THE ANNUAL COLORECTAL CANCER AWARENESS DAY WAS HELD ON MARCH 11, 2015. THE EVENT WAS COORDINATED WITH BORLAND-GROOVER CLINIC AND GI ASSOCIATES TO PROVIDE INFORMATION ON COLORECTAL CANCER PREVENTION AND SCREENING STRATEGIES. THIS EVENT TOOK PLACE IN THE CANCER EDUCATION AND SUPPORT CENTER AND OVER 90 PEOPLE VISITED THE EVENT AND ANSWERED THE OPTIONAL SURVEY. THE INFORMATION PROVIDED WAS BASED ON THE NATIONAL COMPREHENSIVE CANCER NETWORK (NCCN) COLORECTAL SCREENING GUIDELINES.LUNG CANCER: REALIZING THAT CIGARETTE SMOKING IS THE NUMBER ONE RISK FACTOR FOR LUNG CANCER, FLAGLER HOSPITAL CONTINUES TO MAINTAIN A SMOKE FREE FACILITY, INCLUDING PARKING LOTS AND LEASED PROPERTIES. FLAGLER HOSPITAL ALSO IMPLEMENTED A TOBACCO SCREENING PROTOCOL THROUGHOUT THE HOSPITAL. UPON ADMISSION, EACH PATIENT IS ASKED IF THEY SMOKE OR USE TOBACCO IN ANY OTHER FORM. THIS INFORMATION IS USED TO TRIGGER A CONSULT FROM THE CARDIOPULMONARY DEPARTMENT, FROM A MEMBER OF THE "QUIT TEAM". QUIT TEAM MEMBERS VERIFY THE PATIENTS WHO USE TOBACCO AND PROVIDE COUNSELING ON TOBACCO CESSATION. IF THE PATIENT IS INTERESTED IN QUITTING, THEY ARE GIVEN INFORMATION ON FREE TOBACCO CESSATION PROGRAMS OFFERED THROUGH FLAGLER HOSPITAL. THE QUIT TEAM ALSO EDUCATED FLAGLER STAFF AND MEDICAL PERSONNEL ON THE IMPORTANCE OF THE MESSAGE THAT CESSATION OPPORTUNITIES ARE BOTH VALUABLE AND EFFICACIOUS. DURING THIS FISCAL YEAR, 90 ST. JOHNS COUNTY RESIDENTS PARTICIPATED IN FLAGLER HOSPITAL'S FREE QUIT SMOKING NOW CLASSES, WHICH ARE OFFERED THROUGH THE WELLNESS CENTER. OF THOSE, 37 PARTICIPANTS SUCCESSFULLY QUIT SMOKING AS A RESULT OF THE CLASS. FLAGLER HOSPITAL SCREENED OVER 15000 PATIENTS FOR TOBACCO USE AND PROVIDED 2150 WITH CESSATION MATERIALS. ALSO, OVER 100 HEALTH PROFESSIONALS FROM AROUND THE COMMUNITY PARTICIPATED IN 8 FREE HEALTHCARE PROVIDER TRAININGS. IN ADDITION TO THE QUIT SMOKING NOW SMOKING CESSATION PROGRAM, FLAGLER HOSPITAL HOSTED TWO LUNG CANCER AWARENESS EVENTS. SHINE A LIGHT ON LUNG CANCER WAS HELD IN THE CANCER EDUCATION AND SUPPORT CENTER ON NOVEMBER 18, 2014. THIS IS A NATIONAL EVENT HELD AT DIFFERENT LOCATIONS ACROSS THE NATION. THE GOAL IS TO BRING ATTENTION, COMPASSION, HOPE AND SUPPORT TO ALL INDIVIDUALS IMPACTED BY LUNG CANCER. LASTLY, THE GREAT AMERICAN SMOKE OUT OCCURRED ON NOVEMBER 20, 2014. THE EVENT WAS HOSTED BY FLAGLER HOSPITAL IN COLLABORATION WITH TOBACCO FREE FLORIDA AND ENCOURAGES SMOKERS TO MAKE A PLAN TO QUIT SMOKING OR PLEDGE TO HELP SOMEONE QUIT SMOKING.THE MANAGER OF COMMUNITY HEALTH AND SOCIAL RESPONSIBILITY SERVES AS THE CHAIRMAN OF THE TOBACCO FREE ST. JOHNS PARTNERSHIP, WHICH IS A COMMUNITY-WIDE LOCALLY ORGANIZED GROUP COLLECTIVELY WORKING TOWARDS ELIMINATING INITIATION AND USE OF TOBACCO AMONG ST. JOHNS COUNTY RESIDENTS, SUPPORTING POLICY CHANGE AND EDUCATING DECISION MAKERS ABOUT THE IMPACT OF TOBACCO ON THE LIVES OF ST. JOHNS COUNTY RESIDENTS AND VISITORS.
PART V, SECTION B, LINE 11 CONTINUED	INCREASE PERCENTAGE OF POPULATION AT A HEALTH WEIGHT:SURVEY RESPONDENTS OF THE 2014 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT RANKED BEING OVERWEIGHT AND A LACK OF EXERCISE AS TWO OF THE TOP 6 UNHEALTHY BEHAVIORS IN ST. JOHNS COUNTY. ACCORDING TO THE 2016 COUNTY HEALTH RANKINGS REPORT, ST. JOHNS COUNTY RANKS 25TH IN ACCESS TO EXERCISE OPPORTUNITIES. REDUCE SUBSTANCE ABUSE:JUST AS WAS FOUND IN THE 2011 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT, THE ISSUE OF SUBSTANCE ABUSE WAS LISTED AS THE #1 IMPORTANT HEALTH PROBLEM BY SURVEY RESPONDENTS IN THE 2014 CHNA. THIS INCLUDES BINGE DRINKING, UNDERAGE DRINKING, CIGARETTE AND MARIJUANA AND OTHER DRUG USE. FLAGLER HOSPITAL'S MENTAL HEALTH DIRECTOR WORKS CLOSELY WITH EPIC COMMUNITY SERVICES (EPIC WAS CREATED TO PROVIDE SUBSTANCE ABUSE PREVENTION, INTERVENTION, OUTPATIENT TREATMENT AND AFTERCARE SERVICES), PACT, (PREVENTION, ACTION, CHOICES AND TEAMWORK) PREVENTION SERVICES (WHICH ADVOCATES FOR PREVENTION FOR YOUTH), TOBACCO FREE ST. JOHNS AND OTHER GROUPS SUCH AS LAW ENFORCEMENT ON THIS ISSUE. ST. JOHNS COUNTY CONTINUES TO RANK IN THE TOP 5 COUNTIES IN FLORIDA FOR BINGE DRINKING. THE ST. JOHNS COUNTY BEHAVIORAL HEALTH CONSORTIUM CONTINUES TO WORK TOWARDS FINDING A WAY TO GET THESE IMPORTANT HEALTH SERVICES AVAILABLE FOR REFERRAL IN OUR SERVICE AREA. THANKS TO STATE FUNDING AND A SIZEABLE DONATION FROM FLAGLER HOSPITAL, EPIC BEHAVIORAL HEALTHCARE'S 16-BED DETOX CENTER OPENED LAST FISCAL YEAR.THE CENTER OPENED IN JANUARY 2014 AS THE ONLY DETOXIFICATION CENTER IN ST. JOHNS COUNTY. IT OFFERS MEDICAL DETOX, SUBSTANCE ABUSE RESIDENTIAL TREATMENT, SUBSTANCE ABUSE OUTPATIENT TREATMENT, AND MEDICATION MANAGEMENT FOR PEOPLE DIAGNOSED WITH A CO-OCCURRING MENTAL HEALTH DISORDER.DURING ITS FIRST YEAR, THE EPIC RECOVERY CENTER HAS HAD OVER 800 ADMISSIONS, SERVING 653 ADULTS FROM ST. JOHNS COUNTY AND THE SURROUNDING NE FLORIDA COUNTIES AND HAS REMAINED AT 80-85% CAPACITY, EXCEEDING ORIGINAL GOALS BY MORE THAN 4%. APPROXIMATELY 30% OF THE REFERRALS HAVE BEEN FROM FLAGLER HOSPITAL AS A DIRECT EMERGENCY ROOM DIVERSION; 10% WERE FROM OUR VARIOUS LAW ENFORCEMENT AGENCIES AND/OR THE COURT IN LIEU OF INDIVIDUALS BEING PLACED UNDER PROTECTIVE CUSTODY. OTHER REFERRALS WERE FROM FAMILY MEMBERS, THE COURT, OTHER HEALTHCARE PROFESSIONALS (I.E. PHYSICIANS), SOCIAL SERVICE AGENCIES SERVING THE HOMELESS POPULATIONS, OR BY AN INDIVIDUAL THEMSELVES. THE EPIC RECOVERY CENTER HAS BECOME THE CORNERSTONE OF THE ADDICTION TREATMENT SYSTEM OF CARE IN ST. JOHNS COUNTY SERVING SOME OF THE MOST VULNERABLE FLORIDIANS UNINSURED, HOMELESS, THOSE INVOLVED IN THE CHILD WELFARE SYSTEM, CRIMINALLY JUSTICE INVOLVED, AND/OR SUFFERING FROM MULTIPLE CHRONIC HEALTH CONDITIONS. INCREASE ACCESS TO DENTAL CARE:ACCESS TO DENTAL CARE HAS LONG BEEN AN ISSUE IN ST. JOHNS COUNTY, AS IT IS ACROSS THE STATE. RESPONDENTS OF THE 2014 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT REPORTED DENTAL/ORAL CARE AS ONE OF THE TOP HEALTH SERVICE THAT IS DIFFICULT TO OBTAIN. A MAJOR THEME OF ALL FOCUS GROUPS WAS A NEED FOR IMPROVED ACCESS TO DENTAL CARE. TO ADDRESS THIS NEED, FLAGLER HOSPITAL, THE WILDFLOWER CLINIC, AND THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL DURING THE ASSESSMENT YEAR802 DENTAL CASES CAME TO THE FLAGLER HOSPITAL EMERGENCY DEPARTMENT FOR DENTAL CARE, HIGHLIGHTING THE NEED. THE GOOD SAMARITAN WILDFLOWER CLINIC IS THE ONLY CLINIC OFFERING BOTH FREE DENTAL AND FREE HEALTH CARE IN ST. JOHNS COUNTY. FLAGLER CONTINUES TO BE A MAJOR CORPORATE SPONSOR OF THE WILDFLOWER CLINIC AND WORKS CLOSELY WITH THE CLINIC TO SHORTEN THE TIME BETWEEN THE INITIAL CRISES (FLAGLER ER VISIT) AND FOLLOW UP CARE. WITH THE HELP OF GRANTS FROM FLAGLER HOSPITAL, AND OTHER COMMUNITY ORGANIZATIONS, THE WILDFLOWER CLINIC STAFF HAS BEGUN OFFERING REGULAR DENTAL WALK-IN CLINICS EVERY WEEK. WITH CONTINUED COLLABORATION BETWEEN THE WILDFLOWER CLINIC AND FLAGLER HOSPITAL'S EMERGENCY DEPARTMENT ON COORDINATING CARE BETWEEN UNINSURED ST. JOHNS COUNTY RESIDENTS, FLAGLER HOSPITAL EMERGENCY ROOM VISITS FOR DENTAL EMERGENCIES HAVE DROPPED 7.8% THIS FISCAL YEAR. FURTHERMORE, DENTAL VISITS TO THE WILDFLOWER CLINIC HAVE INCREASED TO OVER 2, 000 VISITS. BUILDING ON THIS SUCCESS, PARTNERS CONTINUE TO OPTIMIZE THIS TRANSITION AND FOLLOW-UP PROCESS FROM THE HOSPITAL EMERGENCY ROOM TO THE WILDFLOWER DENTAL CLINIC.INCREASE ACCESS TO MENTAL HEALTH CARE:WITH DEPRESSION AND ANXIETY RANKED AS THE #3 HEALTH PROBLEMS IN ST. JOHNS COUNTY, THE 2014 CHNA REVEALED THAT ACCESS TO MENTAL HEALTH SERVICES CONTINUES TO BE AN ISSUE. IN ADDITION, MENTAL HEALTH COUNSELING WAS REPORTED TO BE THE #2 MOST DIFFICULT TO OBTAIN SERVICE BY SURVEY RESPONDENTS.IN RESPONSE TO AN IDENTIFIED CRITICAL NEED FOR OUTPATIENT MENTAL HEALTH SERVICES IN ST. JOHNS COUNTY, FLAGLER HOSPITAL INTRODUCED AN INTENSIVE OUTPATIENT PROGRAM. THIS PROGRAM WAS SPECIFICALLY DESIGNED TO SUPPORT PATIENTS AFTER BEING RELEASED FROM INPATIENT CARE. THE PROGRAM'S PRIMARY GOAL OF IMPROVING QUALITY OF LIFE AND REDUCE SYMPTOMS TO PREVENT RELAPSE IS ACCOMPLISHED THROUGH GROUP THERAPY, MEDICATION AND SYMPTOM MANAGEMENT AND INDIVIDUAL PSYCHOTHERAPY. ALL NEW PATIENTS PARTICIPATE IN A FORMAL CLINICAL EVALUATION PERFORMED BY A MULTI-DISCIPLINARY TEAM. THIS EVALUATION HELPS THE TEAM DEVELOP A TREATMENT PLAN THAT REFLECTS EACH PATIENT'S INDIVIDUAL STRENGTHS, LIMITATIONS AND GOALS FOR TREATMENT. EVERY PATIENT'S GOALS ARE REVIEWED AND UPDATED WEEKLY IN TEAM MEETINGS AND INDIVIDUAL SESSIONS. MEDICAL STAFF FROM THE INTENSIVE OUTPATIENT PROGRAM ATTENDS COMMUNITY EVENTS TO RAISE AWARENESS ABOUT MENTAL HEALTH AND TO INFORM THE COMMUNITY ON AVAILABLE RESOURCES. A SCHOLARSHIP IS AVAILABLE FOR EACH SESSION, TO ENSURE THAT ACCESS TO MENTAL HEALTH SERVICES IS NEVER DEPENDENT UPON A PATIENT'S ABILITY TO PAY. FLAGLER HOSPITAL IS COMMITTED TO COLLABORATION WITH COMMUNITY PARTNERS TO ADDRESS EACH NEED IDENTIFIED DURING THE 2014 CHNA. TO INCREASE ACCESS TO MENTAL HEALTH CARE, THIS COLLABORATION CENTERS AROUND COORDINATION AND LINKAGE OF MENTAL HEALTH SERVICES BETWEEN FLAGLER HOSPITAL AND COMMUNITY OUTPATIENT PROVIDERS. FLAGLER HOSPITAL CONTINUES TO WORK WITH COMMUNITY PARTNERS TO DEVELOP A COUNTY-WIDE MOBILE CRISIS RESPONSE TEAM (MCRT). THE TEAM'S MISSION WILL BE TO PROVIDE AN ASSESSMENT AT THE FIRST SIGNS OF CHILD BEHAVIORAL RISK TO PREVENT SERIOUS MENTAL ISSUES FROM DEVELOPING. THE TEAM WILL ALSO PROVIDE IMMEDIATE ACCESS TO MENTAL HEALTH SERVICES AND ALLOW THE OPPORTUNITY FOR FAMILIES TO SELECT A SOLUTION THAT WORKS BEST FOR THEM. THE ULTIMATE GOAL OF THE MOBILE CRISIS RESPONSE TEAM PROGRAM WILL BE TO DIVERT CHILDREN FROM COSTLY EMERGENCY SERVICES AND ESTABLISH GREATER COORDINATION OF CARE THAT WILL SERVE THE FAMILY BEYOND THE INITIAL CRISIS. THE MCRT CONSISTS OF THREE STATE LICENSED CLINICIANS, A CERTIFIED CASE MANAGER AND A STATE LICENSED REGISTERED NURSE.LEVERAGE 2-1-1 AS A COMMUNITY RESOURCE TOOL: MANY OF THE ORGANIZATIONS AND PROVIDERS AT THE FOREFRONT OF PROVIDING CARE IN ST. JOHNS COUNTY HAVE THEIR OWN LIST OF COMMUNITY PROVIDERS OR USE PRINTED RESOURCE GUIDES WITH SOON-OUTDATED INFORMATION. NEVER HAS THERE BEEN A VIABLE LIST OF RESOURCES THAT IS EASILY ACCESSIBLE AND UPDATABLE. THE HEALTH LEADERSHIP COUNCIL CONVENED A "RESOURCE TOOL" SUBCOMMITTEE TO IDENTIFY AND EVALUATE PROGRAM OPTIONS. THE MANAGER OF COMMUNITY HEALTH AND SOCIAL RESPONSIBILITY AT FLAGLER HOSPITAL SERVES AS THE CHAIR OF THIS SUBCOMMITTEE, WHICH BEGAN MEETING LAST FISCAL YEAR AS A RESPONSE TO THE CHNA AND CHIP.THE RESOURCE TOOL SUBCOMMITTEE IDENTIFIED UNITED WAY'S 2-1-1 SYSTEM AS THE PRIMARY FOCUS FOR ADDRESSING THE NEED TO INCREASE ACCESS TO AVAILABLE COMMUNITY RESOURCES. THE RESOURCE TOOL SUBCOMMITTEE WILL LEAD THE EFFORT TO ALIGN ALL COMMUNITY RESOURCE PROVIDERS USING THE 2-1-1 SYSTEM IN ORDER TO OFFER RESIDENTS A SINGLE LOCATION FOR AVAILABLE COMMUNITY RESOURCES.FLAGLER HOSPITAL IS A MAJOR CONTRIBUTOR TO NORTHEAST FLORIDA COUNTS (WWW.NEFLORIDACOUNTS.ORG) WHICH SERVES AS A FREE ONLINE HEALTH RESOURCE FOR THE SEVEN COUNTY AREA OF NORTHEAST FLORIDA. THE SITE HELPS PLANNERS, POLICY MAKERS, AND COMMUNITY MEMBERS LEARN ABOUT ISSUES AND IDENTIFY IMPROVEMENTS NECESSARY FOR HEALTHFUL OUTCOMES. THE TOOL IS USED FOR COMMUNITY ASSESSMENT, STRATEGIC PLANNING, COLLABORATION, COMMUNITY CAPACITY DEVELOPMENT, GRANT DEVELOPMENT, AND EDUCATIONAL AND ADVOCACY PURPOSES.
PART V, SECTION B, LINE 11 CONTINUED	INCREASE USE OF AVAILABLE TRANSPORTATION:FROM THE FOCUSES GROUPS CONDUCTED AS PART OF THE 2014 COMMUNITY HEALTH NEEDS ASSESSMENT, A FOCUS OF "A NEED FOR TRANSPORTATION" WAS OBSERVED AS THE PRIMARY THEME FROM FOCUSES GROUPS. FURTHERMORE, SURVEY RESULTS SHOWED A POSITIVE INCREASE IN THE PERCENTAGE OF RESPONDENTS THAT RANKED TRANSPORTATION AS A BARRIER TO CARE, FROM 7.9% IN 2011 TO 9.7% IN 2014.TRANSPORTATION HAS BEEN A FOCUS IN ST. JOHNS COUNTY FOR OVER 15 YEARS. THE 2005 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED IMPROVING ACCESS TO HEALTH SERVICES IN OUTLYING AREAS OF ST. JOHNS COUNTY THROUGH COORDINATION OF PUBLIC TRANSPORTATION AS A HIGH-PRIORITY COMMUNITY NEED. SINCE THAT TIME, A COMMUNITY-WIDE EFFORT TO IMPROVE PUBLIC TRANSPORTATION IN ST. JOHNS COUNTY HAS PICKED UP MOMENTUM. THE ST. JOHNS COUNTY COUNCIL ON AGING, INC. (COA) SERVES AS THE COMMUNITY TRANSPORTATION COORDINATOR FOR ST. JOHNS COUNTY. THE COA PROVIDES DOOR-TO-DOOR NON-EMERGENCY MEDICAL TRANSPORTATION SERVICES TO AMBULATORY AND WHEELCHAIR BOUND CLIENTS WITHIN THE ST. JOHNS COUNTY SERVICE AREA. THE SUNSHINE BUS COMPANY (A DIVISION OF THE COA) IS ST. JOHNS COUNTY'S PUBLIC BUS SERVICE. SINCE ITS INCEPTION IN 2006, THE SUNSHINE BUS COMPANY HAS CONTINUED TO EXPANDED SERVICES TO BETTER SERVE THE COMMUNITY, WITH THE ADDITION OF NEW ROUTES AND AN INCREASED NUMBER OF DAILY TRIPS. THE 2014 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT FEEDBACK SHOWED THE CONTINUED NEED FOR A FOCUS ON TRANSPORTATION. OVER THE NEXT THREE YEARS, FLAGLER HOSPITAL WILL SUPPORT THE STRATEGIC OBJECTIVE OF "INCREASE USE OF AVAILABLE TRANSPORTATION OPTIONS" BY EDUCATING RESIDENTS ON CURRENT TRANSPORTATION OPTIONS. THIS EDUCATION WILL BE OFFERED TO BOTH COMMUNITY MEMBERS, AND HEALTHCARE PROVIDERS, IN EFFORT TO RAISE AWARENESS AND INCREASE UTILIZATION. DURING THIS FISCAL YEAR, FLAGLER HOSPITAL PROVIDED $23,480 IN TRANSPORTATION VOUCHER FOR PATIENTS THAT HAD A FINANCIAL BARRIER TO ACCESSING TRANSPORTATION.
PART V, LINE 16A, FAP, APPLICATION, AND PLAIN LANGUAGE SUMMARY URL	HTTP://WWW.FLAGLERHOSPITAL.ORG/FINANCIAL-SERVICES/CHARITY-CARE-AND-FINANCIAL-ASSISTANCE-POLICY.ASPX
PART V, LINE 7, CHNA AND IMPLEMENTATION STRATEGY URL	HTTP://STJOHNS.FLORIDAHEALTH.GOV/PROGRAMS-AND-SERVICES/COMMUNITY-HEALTH-PLANNING-AND-STATISTICS/COMMUNITY-HEALTH-ASSESSMENTS/_DOCUMENTS/SJC_2014_HEALTH_NEEDS_ASSESSMENT.PDF
PART V, SECTION B, LINE 16	FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
FLAGLER HOSPITAL PART V, SECTION B, LINE 16A WEBSITE:	SEE PART V
FLAGLER HOSPITAL PART V, SECTION B, LINE 16B WEBSITE:	SEE PART V
FLAGLER HOSPITAL PART V, SECTION B, LINE 16C WEBSITE:	SEE PART V

Schedule H (Form 990) 2014

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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?2
Name and address		Type of Facility (describe)
1	FLAGLER AFTER HOURS CARE AT MURABELLA 52 TUSCAN WAY STE 203 ST AUGUSTINE,FL32092	OUTPATIENT CARE
2	FLAGLER OUTPATIENT LAB 156-316 ST HWY 312 260-264 ST AUGUSTINE,FL32086	OUTPATIENT LABS
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2014

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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
PART I, LINE 3C:	FLAGLER HOSPITAL USES THE FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE WHETHER A PATIENT QUALIFIES FOR CHARITY. FLAGLER HOSPITAL PROVIDES FREE CHARITY CARE FOR ALL PATIENTS WITH INCOME UP TO 150% OF THE FPG (INCREASED TO 200% DURING FISCAL YEAR 2015). FLAGLER HOSPITAL ALSO PROVIDES SIGNIFICANT DISCOUNTS TO PATIENTS THAT MEET THE FOLLOWING:1) 151% TO 400% OF THE FPG, 2) RETIRED AGE 55-65 WITH NO INSURANCE, 3) UNINSURED WORKERS, AND 4) UNDER INSURED. ADDITIONALLY, THE HOSPITAL INCLUDES PATIENTS WITH MEDICAID AND HOMELESS PATIENTS TO BE ELIGIBLE FOR CHARITY CARE. IN ORDER TO DETERMINE A FINANCIAL NEED, OUR POLICY STATES THAT WE WILL "TAKE INTO ACCOUNT THE PATIENT'S AVAILABLE ASSETS AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT". THE HOSPITAL ALSO PROVIDES DISCOUNTS FOR PROMPT PAYMENT WHICH IS REQUIRED TO BE PAID WITHIN 10 BUSINESS DAYS OF THE SERVICES BEING RENDERED. THE HOSPITAL CONTRACTS WITH A THIRD PARTY VENDOR WHO SCREENS ALL SELF PAY PATIENTS ADMITTED TO THE HOSPITAL. THE VENDOR ALSO SCREENS ER AND OUTPATIENT SURGICAL PATIENTS THAT MAY FALL WITHIN SPECIFIC CRITERIA. THIS VENDOR WILL ASSIST THE PATIENT IN APPLYING FOR ANY FEDERAL, STATE, OR COUNTY PROGRAMS THEY MAY BE ELIGIBLE FOR. PATIENTS NOT SEEN BY THE VENDOR ARE SEEN BY DESIGNATED FLAGLER HOSPITAL STAFF MEMBERS THAT WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR FINANCIAL ASSISTANCE. THEY DISCUSS THE INCOME DOCUMENTS NEEDED, PREPARE THE APPLICATION, AND FOLLOWS UP WITH THE PATIENT ON WHAT THEY'RE ELIGIBLE FOR.
PART I, LINE 7:	THE ORGANIZATION USED WORKSHEET 2 OF THE 2014 SCHEDULE H INSTRUCTIONS TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID AT COST FOR THE PURPOSE OF PART I, LINE 7.
PART I, LINE 7G:	FLAGLER HOSPITAL PROVIDES ESSENTIAL FUNDING TO A LOCAL FEDERALLY QUALIFIED HEALTH CLINIC (AZALEA HEALTH) THAT PROVIDES PRIMARY CARE SERVICES TO THE UNINSURED AND MEDICAID POPULATION OF ST JOHNS COUNTY. FLAGLER HOSPITAL ALSO SUBSIDIZES MANY SUBSEQUENT PHYSICIAN REFERRAL COSTS ASSOCIATED WITH THE CONTINUATION OF CARE OF THE UNINSURED PATIENTS AND ANCILLARY TESTS PERFORMED. AMOUNTS REPORTED ON LINE 7G ALSO INCLUDE ER SPECIALTY CALL COVERAGE AND PROFESSIONAL FEES FOR INDIGENT CARE.
PART I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 30,165,272.
PART I, LINE 6A	FLAGLER HOSPITAL PRODUCES A NUMBER OF PUBLICATIONS THAT FEATURE MANY OF THE HEALTH IMPROVEMENT INITIATIVES THAT THE HOSPITAL HAS IMPLEMENTED THROUGHOUT ST. JOHNS COUNTY. FOR EXAMPLE, THE ANNUAL CANCER REPORT DETAILS CANCER EDUCATION AND OUTREACH ACTIVITIES, SCREENING INFORMATION, AVAILABLE SUPPORT GROUPS, CLASSES AND EVENTS. THE HOSPITAL ALSO PRODUCES A QUARTERLY MAGAZINE DEDICATED TO ADDRESSING HEALTH CONCERNS THAT PROVIDES INFORMATION ABOUT MANY OF THE HOSPITAL'S OFFERINGS AND COMMUNITY BENEFIT ACTIVITIES SUCH AS SMOKING CESSATION, FREE PHYSICALS, PRENATAL YOGA CLASSES, DIABETES EDUCATION AND THE FLAGLER HEALTH CARE ACADEMY.
PART I, LINE 7, OTHER BENEFITS DESCRIPTIONS	COMMUNITY BENEFIT OPERATIONSFLAGLER HOSPITAL HAS A FULL TIME MANAGER OF COMMUNITY HEALTH AND SOCIAL RESPONSIBILITY TO COORDINATE HOSPITAL-WIDE COMMUNITY BENEFIT FUNCTIONS IN ACCORDANCE WITH NATIONAL STANDARDS AND PUBLIC REPORTING REQUIREMENTS. THE MANAGER OF COMMUNITY HEALTH AND SOCIAL RESPONSIBILITY USES CBISA SOFTWARE TO TRACK AND REPORT COMMUNITY BENEFIT ACTIVITIES AND PROVIDE AN ANNUAL REPORT ON COMMUNITY BENEFIT NUMBERS TO THE DIRECTOR OF ACCOUNTING FOR THE HOSPITAL'S 990 H. COMMUNITY HEALTH IMPROVEMENT SERVICESIN ADDITION TO NEEDS ASSESSED BY THE HEALTH LEADERSHIP COUNCIL, FLAGLER HOSPITAL IS IN A POSITION TO KNOW THE OTHER HEALTH ISSUES WHICH COST THE COMMUNITY AND ITS CITIZENS THE MOST TIME AND MONEY. WHILE DEATH FROM DIABETES IS ON THE DECLINE, INCIDENCE OF DIABETES IS RISING, DUE TO OBESITY CAUSED BY DIET AND LIFESTYLE. DURING THIS FISCAL YEAR, FLAGLER HOSPITAL PARTNERED WITH THE WILDFLOWER CLINIC, A NON-PROFIT DEDICATED TO PROVIDING FREE MEDICAL AND DENTAL CARE TO QUALIFYING ST. JOHNS COUNTY RESIDENTS, TO ESTABLISH WILDFLOWER CHRONIC CARE CLINIC (CCC). THE CHRONIC CARE CLINIC PROVIDES INVALUABLE CARE TO UNINSURED, CHRONICALLY ILL, LOW-INCOME RESIDENTS OF ST. JOHNS COUNTY. THE FLAGLER CCC FOCUSES ON CHRONIC DISEASE MANAGEMENT, WITH AN EMPHASIS ON DIABETES MANAGEMENT. THIS CLINIC IS AVAILABLE TO ANY PATIENT WITH AN UNMANAGED, CHRONIC CONDITION WHO MEETS THE GOOD SAMARITAN HEALTH CENTERS PATIENT QUALIFICATIONS. PATIENTS RECEIVE SERVICES FREE OF CHARGE.THE CHRONIC CARE CLINIC IS STAFFED WITH A NURSE PRACTITIONER, WHO IS AVAILABLE BY PHONE, PAGER, AND EMAIL, 24 HOURS A DAY/7 DAYS A WEEK. ALL CHRONIC CARE CLINIC PATIENTS ARE PROVIDED WITH HER CONTACT INFORMATION AND INSTRUCTED TO CONTACT HER DIRECTLY IF THEY HAVE ANY QUESTIONS OR CONCERNS BETWEEN VISITS, ESPECIALLY IF THEY ARE NOT FEELING WELL. THROUGH TELEMEDICINE OR ADDITIONAL VISITS BETWEEN SCHEDULED APPOINTMENTS, THE NURSE PRACTITIONER CAN ADD OR ADJUST MEDICATIONS, ORDER LAB WORK, AND MANAGE ANY SITUATIONS FOR WHICH A PATIENT MAY HAVE OTHERWISE RESORTED TO THE FLAGLER HOSPITAL EMERGENCY CARE CENTER FOR A NON-EMERGENT VISIT. BY PAIRING 24-HOUR ACCESS TO A NURSE PRACTITIONER WITH ACCESS TO MEDICATIONS THAT WOULD BE OTHERWISE UNAFFORDABLE AND EDUCATION ABOUT THEIR CHRONIC ILLNESSES, THE WILDFLOWER CHRONIC CARE CLINIC HAS EFFECTIVELY KEPT COUNTLESS PATIENTS FROM SEEKING CARE IN THE FLAGLER HOSPITAL EMERGENCY CARE CENTER. DURING THE LAST FISCAL YEAR, FLAGLER HOSPITAL HAS PROVIDED THE WILDFLOWER CLINIC $419,932 IN FREE LABORATORY SERVICES AND $11,772 IN CHRONIC CARE CLINIC SUPPORT. THE HEART CENTER AT FLAGLER HOSPITAL PROVIDES A CRITICAL SERVICE TO RESIDENTS OF ST. JOHNS COUNTY AND THE SURROUNDING AREAS. FLAGLER HOSPITAL'S STATE-OF-THE-ART HEALTHCARE ENCOMPASSES THE ENTIRE CONTINUUM OF CARE FOR HEART PATIENTS, INCLUDING CLOSE COLLABORATION WITH ST. JOHNS COUNTY FIRE RESCUE, INCLUDING TRANSMISSION OF EKGS DIRECTLY FROM AMBULANCE TO HOSPITAL, CARDIAC CATH LABS, WORLD-CLASS PHYSICIANS AND STAFF, QUALITY ASSURANCE PLANS, AND COMMUNITY OUTREACH AND EDUCATION PROGRAMS. ONCE A PATIENT IS DISCHARGED WITH A DIAGNOSIS OF HEART FAILURE, A NURSE PRACTITIONER FOLLOWS UP WITH THE PATIENT TO REVIEW DISCHARGE MEDICATIONS, VITAL SIGNS, THE IMPORTANCE OF WEIGHT MANAGEMENT AND FLUID RESTRICTIONS. ONCE IN THE HOME, THE NURSE PRACTITIONER REVIEWS THE FOODS THAT ARE IN THE PATIENT'S HOMES AND DISCUSSES HOW THAT FOOD SHOULD BE USED IN THE DIET OR NOT USED AT ALL. SHE USES CUPS THAT ARE IN THE PATIENT'S HOUSE TO SHOULD HOW MUCH FLUID SHOULD GO IN AND HOW MANY A DAY SHOULD BE USED. THIS OFFERS THE PATIENT A PRACTICAL APPROACH TO CARING FOR THEMSELVES AT HOME. THIS SERVICE COMES AT NO CHARGE TO THE PATIENT AND HELPS THEM UNDERSTAND WHAT THE DOCTOR EXPECTS FROM THEM. THIS SERVICE GOES BEYOND HOSPITAL EDUCATION AND IS TRUE COMMUNITY/HOME EDUCATION. FLAGLER HOSPITAL MAINTAINS A CANCER RESOURCE LIBRARY, OPEN TO ALL IN THE COMMUNITY, ALONG WITH A WIG AND PROSTHESIS CLOSET. THERE IS A FREE COMPUTER KIOSK FOR THE DISSEMINATION OF HEALTH INFORMATION. IT IS STAFFED BY OUR CANCER EDUCATION AND SUPPORT COORDINATOR AND VOLUNTEERS EACH WEEKDAY FROM 9:00 UNTIL 4:00.HEALTH PROFESSIONS EDUCATIONFLAGLER HOSPITAL DONATED PAID STAFF HOURS IN ONE-ON-ONE PROGRAMS TO PRECEPT NURSING STUDENTS AND ARNP STUDENTS FROM JACKSONVILLE UNIVERSITY, ST. JOHNS RIVER STATE COLLEGE, UNIVERSITY OF CENTRAL FLORIDA, UNIVERSITY OF FLORIDA, DAYTONA STATE COLLEGE. ADDITIONALLY, STUDENTS IN THE FIELDS OF EMT TRAINING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, MEDICAL ASSISTING, LAB SCIENCES, SOCIAL WORK, HEALTH INFORMATION MANAGEMENT, CARDIOVASCULAR TECHNOLOGY, RADIOLOGY, NUCLEAR MEDICINE AND MENTAL HEALTH WERE TRAINED WITH ONE-ON-ONE CONTACT WITH STAFF AT FLAGLER HOSPITAL.FLAGLER HOSPITAL HAS A FULL TIME STAFF MEMBER DEDICATED TO OFFERING CONTINUING MEDICAL EDUCATION TO ALL PHYSICIANS IN THE ST. JOHNS COUNTY COMMUNITY, REGARDLESS OF THEIR AFFILIATION WITH THE HOSPITAL. THIS HELPS ENSURE THAT OUR LOCAL RESIDENTS HAVE ACCESS TO PHYSICIANS WHO ARE UP TO DATE ON THE LATEST ADVANCEMENTS IN MEDICAL CARE. THE CME COORDINATOR WORKED WITH PHYSICIANS TO PRESENT 80 PROGRAMS OF GRAND ROUNDS, MEDICAL SOCIETY MEETINGS, WEBCASTS, AND ICD-10 TRAININGS DURING THIS FY.RESEARCHFLAGLER HOSPITAL EMPLOYS TWO FULL-TIME EMPLOYEES TO MANAGE A CANCER PATIENT DATABASE, LOG INFORMATION THAT CAN BE USED TO DETECT CANCER EARLIER, IMPROVE TREATMENTS AND ULTIMATELY, INCREASE CANCER SURVIVAL RATE. REGISTRARS DETERMINE A PATIENT'S ELIGIBILITY FOR THE CANCER REGISTRY, RECORD THE PATIENT'S DIAGNOSIS, AND TRACK THEIR TREATMENT PLAN. BY COLLECTING, TRACKING AND EVALUATING THIS DATA, WE ARE ABLE TO ADVANCE OUR KNOWLEDGE ON RISK FACTORS FOR CERTAIN CANCERS. BECAUSE DATA ENTERED IN THE CANCER REGISTRY IS AVAILABLE TO THE PUBLIC, OUTCOMES AND TREATMENT PLANS FOR PATIENTS IN ST. JOHNS COUNTY HAVE AN IMPACT NATION-WIDE. FINANCIAL AND IN-KIND CONTRIBUTIONSFLAGLER HOSPITAL MADE FINANCIAL AND IN-KIND CONTRIBUTIONS TOTALING $460,464 TO MANY AREA NON-PROFIT ORGANIZATIONS THAT FOCUS ON PROVIDING HEALTH PROGRAMS TARGETING COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED THROUGH THE ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT. ONE OF THE BIGGEST DETERMINANTS OF HEALTH THAT COMMUNITY ORGANIZATIONS HAVE INFLUENCE ON IS ACCESS TO HEALTHCARE. DURING THIS LAST FISCAL YEAR, FLAGLER HOSPITAL GAVE A $50,000 GRANT TO THE ST. JOHNS COUNCIL ON AGING TO PROVIDE STAFF TO ASSIST SENIOR CITIZENS IN ST. JOHNS COUNTY IN APPLYING FOR FREE OR REDUCED RATE PRESCRIPTION DRUGS FROM PHARMACEUTICAL COMPANIES. THIS PROGRAM CONTINUES TO SERVE OVER 300 SENIORS. BECAUSE THE GRANT PROVIDED PAID STAFF TO RUN THIS PROGRAM, COUNCIL ON AGING VOLUNTEERS WERE ABLE TO FOCUS OVER 600 VOLUNTEER HOURS ON COUNSELING, CLIENT NOTIFICATION AND DOCTOR'S OFFICE VISITS TO HELP EXPEDITE PAPERWORK. FLAGLER HOSPITAL ALSO DONATED MEETING ROOMS AND IN SOME CASES FOOD/CATERING CHARGES FOR VARIOUS NON-PROFIT, SUPPORT AND SELF-HELP GROUPS IN THE COMMUNITY. THIS TOTALED OVER $29,544 USING A $3/HOUR CHARGE FOR EACH MEETING SPACE, A FIGURE BASED ON THE SQUARE FOOTAGE OF THE HOSPITAL.
PART III, LINE 2:	PATIENT ACCOUNT BALANCES ARE RECOGNIZED AS BAD DEBT EXPENSE WHEN BEING TRANSFERRED TO A COLLECTION AGENCY.
PART III, LINE 3:	ASSUMED A THIRD OF THE BAD DEBT ACCOUNTS COULD QUALIFY FOR FINANCIAL ASSISTANCE. APPROXIMATELY 50% OF THOSE ACCOUNTS HAVE BEEN ADJUSTED BY 50% THROUGH AN ADMIN/SELF PAY ADJUSTMENT. COST ESTIMATED USING THE COST TO CHARGE RATIO WITHIN WORKBOOK. THE ASSUMED BAD DEBT ACCOUNTS THAT COULD QUALIFY FOR FINANCIAL ASSISTANCE WAS UPDATED TO A THIRD FROM A HALF DUE TO THE IMPLEMENTATION OF A PRESUMPTIVE CHARITY POLICY.
PART II, COMMUNITY BUILDING ACTIVITIES DESCRIPTION	FLAGLER HOSPITAL DONATED PAID STAFF TIME FOR EMPLOYEES WHO SERVED ON VARIOUS BOARDS FOR COMMUNITY EVENTS AND COMMITTEES WHICH OFFERED COMMUNITY SUPPORT, COALITION BUILDING WITH OTHER AGENCIES AND HEALTH AND WELFARE PROVIDERS, AND COMMUNITY HEALTH IMPROVEMENTS ADVOCACY. THROUGH ITS PARTICIPATION IN THE HEALTH PLANNING COUNCIL OF NORTHEAST FLORIDA, FLAGLER HOSPITAL COMMITTED TO SUPPORT THE NORTHEAST FLORIDA COUNTS WEBSITE AS A SITE SPONSOR, PLEDGING $10,000 YEARLY. THIS WEBSITE PROVIDES KEY HEALTH INFORMATION TO THE COMMUNITY AND ADDRESSES THE ISSUE OF ACCESSIBILITY TO DATA AND SERVES AS A ROADMAP FOR COLLABORATIVE COMMUNITY IMPROVEMENT BY HIGHLIGHTING WHERE WE HAVE BEEN, OUR CURRENT STATUS AND DIRECTING WHERE WE NEED TO GO. IT IS A FREE ONLINE HEALTH RESOURCE FOR A SEVEN COUNTY AREA, WHICH INCLUDES OUR OWN SERVICE AREA OF ST. JOHNS COUNTY (WWW.NEFLORIDACOUNTS.ORG).THROUGH A PARTNERSHIP WITH THE HOSPITAL, THE ST. JOHNS COUNTY SCHOOL DISTRICT CREATED THE FLAGLER HOSPITAL ACADEMY OF MEDICAL AND HEALTH CAREERS AT PEDRO MENENDEZ HIGH SCHOOL IN 2007-2008. IT IS OPEN TO STUDENTS THROUGHOUT THE SCHOOL SYSTEM. IT FOCUSES ON PROVIDING SKILLS AND EXPERIENCE NECESSARY TO ATTAIN ENTRY LEVEL JOBS IN HEALTH, MEDICAL AND RELATED FIELDS, AND PROVIDES ACADEMIC PREPARATION TO CONTINUE TRAINING THROUGH CLINICAL EXPERIENCE, COMMUNITY COLLEGE AND UNIVERSITY PROGRAMS. NOW IN ITS EIGHTH YEAR, THE ACADEMY HAD 42 THIRD YEAR STUDENTS ROTATING THROUGH VARIOUS DEPARTMENTS AT THE HOSPITAL FOR TRAINING, FOR A COMBINED TOTAL OF 5292 HOURS. STUDENTS SHADOWED IN THE LAB, RADIOLOGY, PHARMACY, OPERATING ROOM, PHYSICAL AND OCCUPATIONAL THERAPY, IN ADDITION TO MULTIPLE NURSING UNITS. PHYSICAL IMPROVEMENTS AND HOUSINGFLAGLER HOSPITAL ALSO COLLABORATED WITH THE ST. JOHNS HOUSING PARTNERSHIP BY DONATING PAINT AND SUPPLIES FOR MAKE A DIFFERENCE DAY, WHERE VOLUNTEERS FROM AROUND THE COUNTY COMPLETED PROJECTS FOR OVER 30 FAMILIES. COMMUNITY SUPPORTTO ENHANCE COMMUNITY SUPPORTS NETWORKS, MANY OF FLAGLER HOSPITAL'S STAFF, DURING PAID TIME, ARE ACTIVE IN COMMUNITY ORGANIZATION BOARDS AND EVENT PLANNING COMMITTEES SUCH AS: SCHOOL HEALTH ADVISORY COMMITTEE AND THE TRANSPORTATION DISADVANTAGED COORDINATING BOARD. COALITION BUILDINGTHROUGH PARTICIPATION IN THE HEALTH PLANNING COUNCIL OF NORTHEAST FLORIDA, FLAGLER HOSPITAL COMMITTED TO SUPPORT THE NORTHEAST FLORIDA COUNTS WEBSITE AS A SITE SPONSOR, PLEDGING $10,000 YEARLY. THIS WEBSITE PROVIDES KEY HEALTH INFORMATION TO THE COMMUNITY AND ADDRESSES THE ISSUE OF ACCESSIBILITY TO DATA AND SERVES AS A ROADMAP FOR COLLABORATIVE COMMUNITY IMPROVEMENT BY HIGHLIGHTING WHERE WE HAVE BEEN, OUR CURRENT STATUS AND DIRECTING WHERE WE NEED TO GO. IT IS A FREE ONLINE HEALTH RESOURCE FOR A SEVEN COUNTY AREA, WHICH INCLUDES OUR OWN SERVICE AREA OF ST. JOHNS COUNTY (WWW.NEFLORIDACOUNTS.ORG). COMMUNITY HEALTH IMPROVEMENT ADVOCACYTHE DIRECTOR OF MATERNITY SERVICES SITS ON THE EARLY LEARNING COALITION OF NORTHEAST FLORIDA, WHICH MANAGES AND EVALUATES EARLY CHILD CARE AND EDUCATION PROGRAMS THROUGH A QUALITY SCHOOL AND READINESS DELIVERY SYSTEM. THROUGH THIS WORK, THE COALITION AIMS TO IMPROVE PERFORMANCE AND UTILIZE BEST PRACTICES IN THE ADMINISTRATION OF EARLY EDUCATION PROGRAMS FOR THE FAMILIES OF NORTHEAST FLORIDA.WORKFORCE DEVELOPMENTTHROUGH A PARTNERSHIP WITH THE HOSPITAL, THE ST. JOHNS COUNTY SCHOOL DISTRICT CREATED THE FLAGLER HOSPITAL ACADEMY OF MEDICAL AND HEALTH CAREERS AT PEDRO MENENDEZ HIGH SCHOOL. IT IS OPEN TO STUDENTS THROUGHOUT THE SCHOOL SYSTEM. IT FOCUSES ON PROVIDING SKILLS AND EXPERIENCE NECESSARY TO ATTAIN ENTRY LEVEL JOBS IN HEALTH, MEDICAL AND RELATED FIELDS, AND PROVIDES ACADEMIC PREPARATION TO CONTINUE TRAINING THROUGH CLINICAL EXPERIENCE, COMMUNITY COLLEGE AND UNIVERSITY PROGRAMS. FLAGLER HOSPITAL'S PARTICIPATION IN THIS PROGRAM IS SPEARHEADED BY THE HOSPITAL'S CHIEF LEARNING OFFICER.
PART III, LINE 4:	THE ORGANIZATION'S FINANICAL STATEMENTS DO NOT HAVE A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. BAD DEBT IS REPORTED AT GROSS CHARGES FOR PURPOSES OF PART III, LINE 2.TO ESTIMATE THE AMOUNT OF BAD DEBT THAT RELATES TO PATIENTS THAT WOULD HAVE BEEN ELIGIBLE FOR CHARITY CARE, FLAGLER HOSPITAL SORTS BAD DEBTS BETWEEN PATIENTS THAT HAVE INSURANCE AND PURELY SELF PAY PATIENTS. BAD DEBTS RELATED TO PATIENTS WITH INSURANCE WERE CONSIDERED TO BE INELIGIBLE FOR CHARITY CARE EVEN THOUGH MANY HAVE HIGH DEDUCIBLE AND CO-INSURANCE PLANS AND COULD POSSIBLY QUALIFY. REMAINING BAD DEBTS REPRESENT ENTIRELY SELF PAY ACCOUNTS. MANY OF THESE ACCOUNTS ARE REDUCED BY MORE THAN 50% USING A SELF PAY ADJUSTMENT CODE FOR NONCOMPLIANCE AND THE REMAINING AMOUNT IS WRITTEN OFF TO BAD DEBT; THEREFORE, ONLY A PORTION OF THE ACCOUNT IS INCLUDED IN THE BAD DEBT AMOUNT. WE HAVE ASSUMED THAT APPROXIMATELY 50% OF THE SELF PAY BAD DEBTS WOULD HAVE BEEN CHARITY IF THE PATIENT WOULD HAVE BEEN IN COMPLIANCE IN COMPLETING THE CHARITY APPLICATION PROCESS. THIS ESTIMATE IS CONSIDERED TO BE CONSERVATIVE AND IS BASED ON THE EXPERIENCE OF OUR COLLECTIONS STAFF.
PART III, LINE 8:	THE HOSPITAL'S PAYER MIX IS APPROXIMATELY MEDICARE 60%, MEDICAID 12%, MANAGED CARE 17%, SELF PAY 7%, AND 4% OTHER. THAT MEANS THAT OVER 79% OF THE HOSPITAL'S BUSINESS GENERATES MORE EXPENSES THAN REVENUES. MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE AND THE MAJORITY OF SELF PAY RESULTS IN CHARITY. SINCE PROVIDING CARE FOR THE ELDERLY, SERVING MEDICARE AND MEDICAID PATIENTS, AND SERVING ALL PATIENTS REGARDLESS OF ABILITY TO PAY IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD, AS WELL AS OUR MISSION IN OUR COMMUNITY, WE SERVE THESE PATIENTS WITHOUT REGARD TO THE PAYMENT SHORTFALL.
PART III, LINE 9B:	1. FLAGLER HOSPITAL BUSINESS OFFICE STAFF REVIEW UNPAID PATIENT ACCOUNTS ON A REGULAR BASIS TO IDENTIFY THOSE ACCOUNTS THAT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. ATTEMPTS TO CLASSIFY THESE PARTICULAR INDIVIDUALS START AT THE TIME THAT THEY ARE STILL IN-HOUSE. PATIENTS ARE ALSO CONTACTED AFTER DISCHARGE THROUGH PHONE CALLS OR MAIL. COMPLIANT INDIVIDUALS WHO MEET THE HOSPITAL'S FINANCIAL ASSISTANCE GUIDELINES ARE GRANTED THE APPROPRIATE DISCOUNT BASED ON WHERE THEY FALL IN RELATION TO THE FEDERAL POVERTY GUIDELINES. MANY PATIENTS DUE TO FAILURE TO PRODUCE THE APPROPRIATE DOCUMENTATION RECEIVE A REDUCED NON-COMPLIANT HOSPITAL ADJUSTMENT. THESE PARTICULAR INDIVIDUALS MAY HAVE RECEIVED A HIGHER WRITE-OFF IF THEY WERE IN FACT COMPLIANT. 2. REGARDLESS OF THE PATIENTS FINANCIAL CLASS OR STATUS, IF A BILL REMAINS UNPAID FOR MORE THAN 120 DAYS FROM THE DATE IT WAS FIRST MAILED TO THE PATIENT, AND REASONABLE COLLECTION ATTEMPTS HAVE FAILED, THE PATIENT IS SCREENED FOR PRESUMTIVE CHARITY AT 200% OR BELOW THE FEDERAL POVERTY GUIDELINE; IF PRESUMTIVE CHARITY LEVEL IS NOT MET THE DEBT IS SENT TO A PRIMARY BAD DEBT COLLECTION AGENCY FOR FURTHER COLLECTION EFFORTS.
PART VI, LINE 2:	ST. JOHNS COUNTY IS FORTUNATE TO HAVE STRONG AND PROACTIVE LEADERSHIP WITHIN ITS PUBLIC HEALTH SYSTEM, AND A HISTORY OF SUCCESSFUL COLLABORATION. CHAMPIONED BY FLAGLER HOSPITAL AND THE FLORIDA DEPARTMENT OF HEALTH IN ST. JOHNS COUNTY, THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL WAS ESTABLISHED IN 2010 FOR THE SPECIFIC PURPOSE OF BRINGING TOGETHER KEY LEADERS FROM THE LOCAL COMMUNITY TO ASSESS AND ADDRESS THE HEALTH NEEDS OF OUR RESIDENTS. IN MAY 2014, THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL ACHIEVED NATIONAL ROLE MODEL STATUS, WHEN IT WAS SELECTED BY THE UNIVERSITY OF KENTUCKY (UK) COLLEGE OF PUBLIC HEALTH TO BE INCLUDED IN A NATION-WIDE STUDY OF HIGHLY SUCCESSFUL PUBLIC HEALTH COLLABORATIVE. THE PURPOSE OF THE UK STUDY WAS TO IDENTIFY, COMPARE AND CONTRAST EXCEPTIONAL MODELS OF COLLABORATION INVOLVING COMMUNITY HOSPITALS, PUBLIC HEALTH DEPARTMENTS AND OTHER STAKEHOLDERS, WHO SHARE A COMMITMENT TO IMPROVING COMMUNITY HEALTH, AND TO DETERMINE THE KEY LESSONS LEARNED FROM THEIR EXPERIENCES. THE T. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL WAS ONE OF ONLY TWELVE COLLABORATIVE SELECTED BY THE UK STUDY TEAM FROM OVER 150 NATIONAL APPLICATIONS. FLAGLER HOSPITAL'S CEO, VP OF PATIENT ENGAGEMENT AND MANAGER OF COMMUNITY HEALTH AND SOCIAL RESPONSIBILITY, ALONG WITH REPRESENTATIVES FROM 41 OTHER AGENCIES PARTICIPATED IN THIS HIGHLY COLLABORATIVE EFFORT WITH FLAGLER HOSPITAL IN THE FOREFRONT OF EVERY PHASE FROM DEVELOPING SURVEY QUESTIONS, CREATING SURVEY TOOLS, IDENTIFYING FOCUS GROUPS, ANALYZING DATA, ESTABLISHING ACTION PLANS AND REVIEWING RESULTS. THE YEAR-LONG PROCESS FOR THIS ASSESSMENT BEGAN IN JULY 2013 AND UTILIZED A COMMUNITY-WIDE STRATEGIC PLANNING PROCESS CALLED "MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS OR "MAPP", WHICH WAS DEVELOPED BY THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS PLANNED BY THE HEALTH LEADERSHIP COUNCIL AS A COLLECTION OF DATA GATHERED TO IDENTIFY AND ANALYZE HEALTH STATUS, HEALTH FACTORS AND HEALTH OUTCOMES WITHIN THE COMMUNITY.USING MAPP GUIDELINES, FOCUS GROUPS WERE FORMED TO DETERMINE HOW RESIDENTS FELT ABOUT THE QUALITY OF LIFE IN ST. JOHNS COUNTY. THESE FOCUS GROUPS WERE FACILITATED BY LEADERS OF THE HEALTH LEADERSHIP COUNCIL WITH THE INTENT OF COVERING A VARIETY OF GEOGRAPHIC AND DEMOGRAPHIC SECTORS OF THE COUNTY. SECOND, A SURVEY WAS DISPERSED COUNTY-WIDE AND MADE AVAILABLE ONLINE. THIS DATA AND DATA FROM THE NATIONAL AND STATE COUNTY HEALTH RANKINGS AND HEALTHY PEOPLE 2020, SERVED AS A BASIS FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). NOTE: THE COMPLETE "COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN" IS PUBLISHED AND AVAILABLE ON THE FLAGLER HOSPITAL WEBSITE: WWW.FLAGLERHOSPITAL.ORG. FLAGLER HOSPITAL'S BOARD OF DIRECTORS APPROVED THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN AT THEIR MEETING ON MARCH 24, 2015.TO IMPLEMENT THE FINDINGS AND GOALS DETERMINED THROUGH THE CHNA, THE MAPP PROCESS USES A THREE YEAR CYCLE WITH EACH IDENTIFIED NEED HAVING AN "OWNER" TO TRACK PROGRESS. WHILE VARIOUS MEMBERS OF THE HEALTH LEADERSHIP COUNCIL TOOK "OWNERSHIP" OF VARIOUS ASPECTS OF THE HEALTH NEEDS ASSESSMENT'S IMPLEMENTATION, FLAGLER HOSPITAL PARTICIPATES IN EACH PART OF IMPLEMENTATION. THE SHARED VISION AND COMMON VALUES OF MEMBERS PROVIDE A FRAMEWORK FOR PURSUING THE LONG RANGE GOALS, SO FLAGLER HOSPITAL IS PROUD TO PARTNER WITH MANY MEMBERS OF THE HEALTH LEADERSHIP COUNCIL, IN ORDER TO BROADEN COMMUNITY PARTICIPATION. FLAGLER HOSPITAL ACKNOWLEDGES AND AGREES WITH THE SPECIFIED GOALS OF THE CHNA. A COMMUNITY BALANCED SCORECARD WAS CREATED TO TRACK AND EVALUATE EACH OF THE STRATEGIC OBJECTIVES AND ACTS AS THE COMMUNITY HEALTH IMPROVEMENT PLAN. THE CRITERIA AND RATIONALE FOR EACH OF THE OBJECTIVES AND GOALS IS CONTAINED ON PAGE 116 OF THE PUBLISHED "2014 COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN".
PART VI, LINE 3:	THE HOSPITAL COMMUNICATES ITS CHARITY CARE POLICY, OR PATIENT-FRIENDLY SUMMARY THEREOF, IN THE FOLLOWING WAYS: - POSTED ON THE FLAGLER HOSPITAL WEBSITE - POSTED AT THE RECEPTION DESKS IN ALL REGISTRATION AREAS - POSTED AT ALL FINANCIAL COUNSELORS' DESKSWHEN UNINSURED OR UNDERINSURED PATIENTS ARE ADMITTED TO THE HOSPITAL, THEY ARE SCREENED FOR FINANCIAL ASSISTANCE. AT THE TIME OF SCREENING, THE PATIENT IS PROVIDED A FINANCIAL ASSISTANCE APPLICATION TO COMPLETE. THEY ARE THEN ASKED TO SUBMIT THE REQUIRED FINANCIAL DOCUMENTS (I.E., BANK STATEMENTS, PAY STUBS, TAX RETURNS, ETC.). THOSE PATIENTS DISCHARGED PRIOR TO SCREENING ARE CALLED BY BUSINESS OFFICE AND ARE SCREENED OVER THE PHONE. THE PATIENT IS INFORMED OF THE ELIGIBILITY REQUIREMENTS AND THE FINANCIAL DOCUMENTS NEEDED FOR VERIFICATION. UNINSURED PATIENTS TREATED IN THE EMERGENCY DEPARTMENT WHO MEET CERTAIN CRITERIA ARE SCREENED BY PHONE BY THE BUSINESS OFFICE. THE PATIENT IS INFORMED OF THE ELIGIBILITY REQUIREMENTS AND THE FINANCIAL DOCUMENTS NEEDED. A SEPARATE SCREENING IS PERFORMED TO DETERMINE ELIGIBILITY FOR COUNTY PROGRAMS AND MEDICAID.IN ADDITION, THE HOSPITAL UTILIZES A THIRD-PARTY VENDOR TO SCREEN SELF PAY PATIENTS FOR POSSIBLE DISCOUNTS AND FINANCIAL ASSISTANCE OPTIONS. FOR DETAILS, PLEASE SEE THE REPONSE TO PART I, LINE 3C ABOVE.
PART VI, LINE 4:	FLAGLER HOSPITAL IS THE ONLY HOSPITAL LOCATED IN ST. JOHNS COUNTY, FLORIDA AND SERVES AS THE PRIMARY HEALTH CARE PROVIDER FOR LOCAL RESIDENTS. ACCORDING TO 2015 U.S. CENSUS DATA, THERE ARE 226,640 RESIDENTS IN FLAGLER HOSPITAL'S DEFINED COMMUNITY OF ST. JOHNS COUNTY.
PART VI, LINE 6:	THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.
FORM 990, SCHEDULE H, PART VI, COMMUNITY HEALTH PROMOTION	PLEASE SEE PART V LINE 11 DESCRIPTION FOR PROMOTION OF COMMUNITY HEALTH

Schedule H (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
FLAGLER HOSPITAL INC

Employer identification number
59-0675143

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) EPIC COMMUNITY SERVICES 1400 OLD DIXIE HWY STE C ST AUGUSTINE,FL32084	59-1502582	501(C)(3)	150,700	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(2) RURAL HEALTH CARE INC FAMILY MEDICAL AND DENTAL 1302 RIVER STREET PALATKA,FL32177	59-1792958	501(C)(3)	150,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(3) ST JOHNS COUNCIL ON AGING 180 MARINE STREET ST AUGUSTINE,FL32084	59-1525829	501(C)(3)	100,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(4) FLORIDA HOSPITAL ASSOCIATION RESEARCH AND EDUCATION FOUNDATION INC 306 EAST COLLEGE AVE TALLAHASSEE,FL32301	59-6151162	501(C)(3)	20,833	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(5) PROJECT SOS INC 4417 BEACH BLVD STE 103 JACKSONVILL FL 32207-4728 JACKSONVILLE,FL322074728	59-3179894	501(C)(3)	15,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(6) ST JOHNS COUNTY EDUCATION FOUNDATION 2744 US 1 SOUTH ST AUGUSTINE,FL32086	59-3221115	501(C)(3)	15,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(7) BETTY GRIFFIN HOUSE PO BOX 3319 ST AUGUSTINE,FL320853319	59-3028497	501(C)(3)	10,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(8) GOOD SAMARITAN HEALTH CENTER INC 268 HERBERT ST ST AUGUSTINE,FL32084	52-2125419	501(C)(3)	9,020	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(9) UNIVERSITY OF NORTH FLORIDA 4567 ST JOHNS BLUFF RD JACKSONVILLE,FL322242645	59-2976169	GOVERNMENT	8,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(10) CARING HANDS - CARING COMMUNITY 161-A MARINE ST ST AUGUSTINE,FL32084	59-0737904	501(C)(3)	7,500	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(11) VELOFEST COMMUNITY INITIATIVE PO BOX 1718 ST AUGUSTINE,FL32085	45-2966332	501(C)(3)	7,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(12) ST FRANCIS HOUSE 70 WASHINGTON ST ST AUGUSTINE,FL32084	59-2475614	501(C)(3)	6,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(13) FLAGLER COLLEGE INC 74 KING STREET ST AUGUSTINE,FL32084	59-1157081	501(C)(3)	5,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(14) CROOKSHANK ELEMENTARY 1455 N WHITNEY ST ST AUGUSTINE,FL32084		GOVERNMENT	5,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(15) ROTARY INTERNATIONAL ST AUGUSTINE SUNRISE ROTARY CLUB PO BOX 295 ST AUGUSTINE,FL320850295	59-2871724	501(C)(3)	5,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(16) TAKE IT TO HEART CAMPAIGN 3550 UNVERSITY BLVD S SUITE 302 JACKSONVILLE,FL32216	20-5544146	501(C)(3)	5,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(17) NORTH FLORIDA CARDIOVASCULAR FOUNDATION 501 RIVERSIDE AVENUE SUITE 800 JACKSONVILLE,FL32202	20-1773470	501(C)(3)	5,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2014

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

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

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	THE FLAGLER HEALTH CARE FOUNDATION, A SUPPORTING ORGANIZATION OF THE HOSPITAL, REPORTS ITS FINANCIAL ACTIVITIES TO THE CFO OF FLAGLER HOSPITAL.

Schedule I (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

FLAGLER HOSPITAL INC

Employer identification number

59-0675143

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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? ..

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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

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

Yes

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

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

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

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

Yes

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2014

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 in column(B) reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JOSEPH S GORDYCEO	(i) (ii)	514,941 ............................... 0	0 ............................... 0	16,583 ............................... 0	35,000 ............................... 0	0 ............................... 0	566,524 ............................... 0	0 ............................... 0
2ROGER CARTERCFO	(i) (ii)	219,389 ............................... 0	0 ............................... 0	14,077 ............................... 0	0 ............................... 0	18,720 ............................... 0	252,186 ............................... 0	0 ............................... 0
3JASON P BARRETTCIO & EXECUTIVE VP	(i) (ii)	267,831 ............................... 0	0 ............................... 0	240 ............................... 0	20,515 ............................... 0	15,600 ............................... 0	304,186 ............................... 0	0 ............................... 0
4CHRISTOPHER SCHMIDTCOO	(i) (ii)	261,003 ............................... 0	0 ............................... 0	4,240 ............................... 0	20,515 ............................... 0	14,300 ............................... 0	300,058 ............................... 0	0 ............................... 0
5WILLIAM D RIEGERCIO	(i) (ii)	213,225 ............................... 0	44,113 ............................... 0	9,580 ............................... 0	20,515 ............................... 0	18,720 ............................... 0	306,153 ............................... 0	0 ............................... 0
6DONALD R CRISTVP-PROFESSIONAL SVCS	(i) (ii)	204,361 ............................... 0	0 ............................... 0	20,613 ............................... 0	17,991 ............................... 0	18,720 ............................... 0	261,685 ............................... 0	0 ............................... 0
7BARBARA DRUMMOND-HUTHCNO	(i) (ii)	42,383 ............................... 0	0 ............................... 0	198,494 ............................... 0	0 ............................... 0	0 ............................... 0	240,877 ............................... 0	0 ............................... 0
8MARY K MANTESECNO	(i) (ii)	172,301 ............................... 0	0 ............................... 0	10,903 ............................... 0	13,767 ............................... 0	7,320 ............................... 0	204,291 ............................... 0	0 ............................... 0
9JEFFREY A HURLEYVP-HUMAN RESOURCES	(i) (ii)	177,794 ............................... 0	0 ............................... 0	3,556 ............................... 0	14,458 ............................... 0	17,184 ............................... 0	212,992 ............................... 0	0 ............................... 0
10MICHAEL C DIBELLACMO	(i) (ii)	345,535 ............................... 0	0 ............................... 0	7,777 ............................... 0	20,515 ............................... 0	12,264 ............................... 0	386,091 ............................... 0	0 ............................... 0
11MIGUEL A MACHADOMD-ER OVERFLOW/CHIEF MEDICAL OFFICER	(i) (ii)	294,886 ............................... 0	0 ............................... 0	1,584 ............................... 0	0 ............................... 0	18,720 ............................... 0	315,190 ............................... 0	0 ............................... 0
12MICHAEL C SANDERSCHIEF-MEDICAL INFORMATICS	(i) (ii)	270,610 ............................... 0	41,090 ............................... 0	5,286 ............................... 0	20,515 ............................... 0	0 ............................... 0	337,501 ............................... 0	0 ............................... 0
13GREGORY A GIBSONPHYSICIAN	(i) (ii)	196,402 ............................... 0	0 ............................... 0	423 ............................... 0	15,487 ............................... 0	18,720 ............................... 0	231,032 ............................... 0	0 ............................... 0
14BRIAN D RAYMAKERPHYSICIAN	(i) (ii)	169,616 ............................... 0	0 ............................... 0	203 ............................... 0	12,686 ............................... 0	7,944 ............................... 0	190,449 ............................... 0	0 ............................... 0
15LYNDA I KIRKERFORMER RETIRED CFO	(i) (ii)	7,947 ............................... 0	0 ............................... 0	301,829 ............................... 0	0 ............................... 0	0 ............................... 0	309,776 ............................... 0	0 ............................... 0

Schedule J (Form 990) 2014

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 1A	THE ORGANIZATION PROVIDES GROSS UP PAYMENTS FOR THE VALUE OF DISABILITY INSURANCE POLICY PREMIUMS TO CERTAIN OFFICERS, REPORTED ON THE OFFICERS' FORM W-2.
PART I, LINES 4A-B	THE ORGANIZATION CONTRIBUTED $35,000 TO A 457(F) PLAN FOR JOSEPH S. GORDY. LYNDA I. KIRKER RECEIVED SERVERANCE PAYMENTS FROM THE ORGANIZATION IN THE AMOUNT OF $309,776.
PART I, LINE 5	THE ORGANIZATION PAYS A BONUS BASED ON FINANCIAL, PATIENT SATISFACTION AND QUALITY MEASURES.
PART I, LINE 6	THE CEO, ROGER CARTER, RECEIVES A BONUS BASED ON A PERFORMANCE PLAN.

Schedule J (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

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

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
FLAGLER HOSPITAL INC

Employer identification number
59-0675143

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	ST JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY	59-2146640		12-09-2010	30,000,000	REFUNDING 1996 SERIES BONDS		X		X		X
B	ST JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY	59-2146640		12-09-2010	28,275,000	REFUNDING 2009 SERIES BONDS		X		X		X
C	ST JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY	59-2146640		01-21-2011	12,500,000	REFUNDING 1996 SERIES BONDS		X		X		X
D	ST JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY	59-2146640		04-04-2012	30,000,000	RENOVATION PROJECTS, IMPLEMENTATION OF NEW EMR		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	2,920,000		2,920,000		9,200,000
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	30,000,000		28,275,000		12,500,000		30,000,000
4 Gross proceeds in reserve funds . . . . . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .
8 Credit enhancement from proceeds . . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	30,000,000						30,000,000
11 Other spent proceeds . . . . . . . . . . . . . .	30,000,000		28,275,000		12,500,000
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	2003		2009		2003		2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		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		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2014

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		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		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 . .	0 %		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 . . . . . . .	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		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		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		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X		X
b Exception to rebate? . . . . . . . .	X		X		X		X
c No rebate due? . . . . . . . .		X		X		X		X
If "Yes" to 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	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		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) 2014

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		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		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		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		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
PART II, LINE 11: OTHER SPENT PROCEEDS:	AMOUNTS PRESENTED ON LINE 11 REPRESENT AMOUNTS FROM BOND PROCEEDS USED TO REFUND THE PRIOR ISSUES AS INDICATED IN THE DESCRIPTION OF EACH INDIVIDUAL ISSUE.
PART III	THE BONDS LISTED ON PART 1 LINES "A AND "C" WERE USED TO REFUND ISSUES DATED PRIOR TO 1/1/2003, THEREFORE PART III IS NOT APPLICABLE.

Schedule K (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ 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

2014

Open to Public
Inspection

Name of the organization

FLAGLER HOSPITAL INC

Employer identification number

59-0675143

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 4	THE FOLLOWING CHANGES WERE MADE TO THE ORGANIZATIONS BYLAWS EFFECTIVE 9/1/2015. THE SOLE MEMBER OF THE CORPORATION IS COASTAL COMMUNITY HEALTH, INC., A FLORIDA NOT FOR PROFIT CORPORATION. THE POWERS OF THE SOLE MEMBER ARE DISCLOSED ON LINE 7.
FORM 990, PART VI, SECTION A, LINE 6	COASTAL COMMUNITY HEALTH, INC. IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE MEMBER HAS THE AUTHORITY TO APPOINT THE BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B	THE SOLE MEMBER HAS THE AUTHORITY TO: 1. ADOPT OR REVISE A STRATEGIC PLAN 2. AMEND THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS 3. CONDUCT MERGERS, ACQUISITIONS AND SALES OF ALL OR SUBSTANTIAL PART OF CORPORATION'S ASSETS 4. LIQUIDATION AND DISSOLUTION 5. ELECTION AND REMOVAL OF THE CORPORATION'S OFFICERS AND DIRECTORS INCLUDING THE CHIEF EXECUTIVE OFFICER AND THE CHAIRMAN OF THE CORPORATION'S BOARD OF DIRECTORS 6. APPROVAL OF CAPITAL AND OPERATING BUDGETS 7. ANY ACTIONS AFFECTING THE CORPORATION'S TAX EXEMPT STATUS 8. FUNDAMENTAL CHANGES IN MISSION OR DIRECTION 9. ENTRY INTO A MATERIAL AGREEMENT THAT INVOLVE ANNUAL PAYMENTS THAT EXCEED 2% OF THE CORPORATION'S TOTAL ANNUAL BUDGETED OPERATING EXPENSES, A SIGNIFICANT JOINT VENTURE, PROVIDES MANAGEMENT FOR THE CORPORATION, OR INSURANCE WITH A PROJECTED ANNUAL VALUE OF 5% OR MORE OF THE CORPORATION'S ANNUAL NET PATIENT REVENUE 10. INCURRENCE, REFINANCING, PREPAYMENT OR DEFEASANCE OF DEBT IN THE EXCESS OF THE GREATER OF $10,000,000 OR 10% OF THE CORPORATION'S OUTSTANDING DEBT 11. SECURING A MORTGAGE, DEED OF TRUST, OR OTHER ENCUMBRANCE IN EXCESS OF THE GREATER OF $10,000,000 OR 10% OF THE CAPITAL BUDGET 12. INCURRENCE OF ANY UNBUDGETED CAPITAL EXPENSE IN EXCESS OF THE GREATER OF $5,000,000 OR 5% OF THE CORPORATION'S ANNUAL CAPITAL BUDGET 13. A CAPITAL EXPENDITURE OVERRUN IN EXCESS OF THE GREATER OF $5,000,000 OR 5% OF THE BUDGETED CAPITAL EXPENSE 14. INCURRENCE OF ANY UNBUDGETED OPERATING EXPENSE IN EXCESS OF 1% OF THE CORPORATION'S TOTAL ANNUAL OPERATING EXPENSES 15. SELECTION OF THE CORPORATIONS INDEPENDENT AUDITOR 16. ADOPTION OR REVISION OF CHARITABLE CARE POLICIES 17. DONATION OF MATERIAL FUNDS TO A PERSON OR ENTITY NOT AFFILIATED WITH THE SOLE MEMBER OR ANY OF ITS SUBSIDIARIES PROVIDED THAT THE SOLE MEMBER SHALL NOT BE REQUIRED TO REVIEW OR AUTHORIZE CONTRIBUTIONS TO A LOCAL CHARITY THAT DID NOT EXCEED $250,000 IN ANY YEAR. 18. FORMATION OF A NEW MATERIAL ENTITY AS A SUBSIDIARY 19. ACTIONS TAKEN TO CURE ANY BREACH OF OR FAILURE TO COMPLY WITH COVENANTS IN BOND AND OTHER DEBT AGREEMENTS
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTANT AND WAS EXTENSIVELY REVIEWED BY THE ORGANIZATION'S INVESTMENT AND FINANCE COMMITTEE. AFTER THIS REVIEW, THE FORM 990 WAS POSTED TO THE ORGANIZATION'S WEBSITE PORTAL. EACH BOARD MEMBER ACCESSED THE WEBSITE FOR THEIR PERSONAL REVIEW OF THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION TAKES AN ANNUAL QUERY WITH A COPY OF THE CONFLICT OF INTEREST POLICY TO EACH BOARD MEMBER AND THE EXECUTIVE STAFF TO CONFIRM NO CONFLICTS EXIST.
FORM 990, PART VI, SECTION B, LINE 15	THE COMPENSATION PACKAGE FOR THE CEO POSITION IS SET AND APPROVED BY THE COMPENSATION COMMITTEE, WHICH CONSISTS OF THE CURRENT AND PAST CHAIRPERSONS OF THE HOSPITAL, FLAGLER HEALTH CARE SYSTEM, AND FLAGLER HEALTH SERVICES BOARDS. INDEPENDENT SALARY SURVEYS ARE OBTAINED FROM INDUSTRY EXPERTS TO DETERMINE COMPENSATION AND BENEFITS. THOSE INDEPENDENT SALARY SURVEYS ARE ALSO USED TO DEVELOP COMPENSATION PACKAGES FOR THE SENIOR MANAGEMENT TEAM.
FORM 990, PART VI, SECTION C, LINE 18	PHOTOCOPIES OF THE ORGANIZATION'S FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICES. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G	OTHER FEES: PROGRAM SERVICE EXPENSES 24,171,480. MANAGEMENT AND GENERAL EXPENSES 7,552,743. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,724,223.
FORM 990, PART XI, LINE 9:	CHANGE IN FAIR VALUE OF DERIVATIVE FINANCIAL INSTRUMENT -542,536. NET ASSETS RELEASED FROM RESTRICTION 98,045.
FORM 990, PART XII, LINE 2C:	THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

FLAGLER HOSPITAL INC

Employer identification number

59-0675143

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) FLAGLER HEALTH CARE FOUNDATION 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086 59-2440537	SUPPORTING ORGANIZATION	FL	501(C)(3)	11 (TYPE I)	FLAGLER HOSPITAL	Yes
(2) COASTAL COMMUNITY HEALTH INC 841 PRUDENTIAL DR STE 1604 JACKSONVILLE,FL32207 47-1322041	SUPPORTING ORGANIZATION	FL	501(C)(3)	11 (TYPE I)			No

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

Cat. No. 50135Y

Schedule R (Form 990) 2014

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) OUTPATIENT SURGERY CENTER OF ST AUGUSTINE LLC 1 ORTHOPAEDIC PL STE 200 ST AUGUSTINE,FL32086 20-2047704	OUTPATIENT SURGERY	FL	N/A	RELATED	171,339	227,643		No		Yes		11.470 %

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	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) FLAGLER HEALTH SERVICES INC 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086 59-2484352	REAL ESTATE LEASING	FL	N/A	C			Yes
(2) HEALTH PARK OWNERS ASSOCIATION 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086 59-2869538	BUILDING ASSOCIATION	FL	N/A	C			Yes
(3) ANDERSON GIBBS CONDOMINIUM ASSOC 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086 59-3223458	BUILDING ASSOCIATION	FL	N/A	C			Yes

Schedule R (Form 990) 2014

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

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 . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

Yes

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

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

Yes

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

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

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

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

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

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

Yes

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

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

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

Yes

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

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

Yes

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

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

Yes

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

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

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
(1) FLAGLER HEALTH CARE FOUNDATION INC	A	23,209	FMV
(2) FLAGLER HEALTH SERVICES INC	J	69,169	FMV
(3) FLAGLER HEALTH CARE FOUNDATION INC	M	670,767	FMV
(4) FLAGLER HEALTH CARE FOUNDATION INC	Q	231,474	FMV
(5) FLAGLER HEALTH SERVICES INC	Q	918,354	FMV

Schedule R (Form 990) 2014

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2014

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) 2014

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDE EXCELLENT HEALTHCARE SERVICES AND BE RECOGNIZED AS A LEADING PROVIDER IN NORTHEAST FLORIDA.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	2,341
6	Total number of volunteers (estimate if necessary) .............	6	290
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	161,898
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	30,812

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	241,183,482	262,194,423
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,405,031	5,602,646
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	4,527,919	4,486,288
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	250,116,432	272,283,357
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	195,400	524,053
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)	97,538,912	103,310,378
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	146,266,154	156,058,704
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	244,000,466	259,893,135
19	Revenue less expenses. Subtract line 18 from line 12.......	6,115,966	12,390,222
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	287,732,224	308,441,318
21	Total liabilities (Part X, line 26).............	128,596,600	143,365,365
22	Net assets or fund balances. Subtract line 21 from line 20.....	159,135,624	165,075,953

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 236,223,066 including grants of $ 524,053 ) (Revenue $ 262,032,525 )
	RICH HISTORY MIXED WITH INNOVATIVE TECHNOLOGY IS AN INTEGRAL PART OF FLAGLER HOSPITAL IN HISTORIC ST. AUGUSTINE, FLORIDA.SINCE IT'S FOUNDING IN 1889, OUR PRIVATE, NOT-FOR-PROFIT FACILITY HAS GROWN INTO A 335-BED, ACUTE CARE CENTER THAT IS CONSISTENTLY RECOGNIZED NATIONALLY FOR OVERALL CLINICAL EXCELLENCE. THE HOSPITAL HAS CONSISTENTLY RANKED AMONG THE TOP 5% IN THE NATION FOR CLINICAL EXCELLENCE AND PATIENT SAFETY FOR NEARLY A DECADE AND WAS NORTHEAST FLORIDA'S FIRST HOSPITAL TO RECEIVE THE ANCC MAGNET HOSPITAL AWARD. MOST RECENTLY, THE HOSPITAL EARNED FIVE STARS FOR HEART ATTACK TREATMENT, THE GOLD SEAL OF APPROVAL FROM THE JOINT COMMISSION FOR PRIMARY STROKE CARE CENTERS, CENTER OF EXCELLENCE DESIGNATION FOR ITS BARIATRIC SURGERY CENTER, AND NATIONAL ACCREDITATION FOR TOTAL KNEE AND TOTAL HIP REPLACEMENT SURGERY.HOSPITAL SERVICES PROVIDED TO INPATIENT AND OUTPATIENT INCLUDING CHARITY CARE TO INDIGENT AND OTHER PATIENTS. PLEASE SEE SCHEDULE H FOR DETAILS ON COMMUNITY BENEFITS.

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 expenses236,223,066

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	4,038,815	0	380,176

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

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

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......
			Business Code
2a	NET PATIENT SERVICE		623000	262,194,423	262,032,525	161,898
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			262,194,423
3	Investment income (including dividends, interest, and other similar amounts).......			4,378,045			4,378,045
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	1,576,362
b	Less: rental expenses	233,552
c	Rental income or (loss)	1,342,810
d	Net rental income or (loss).......			1,342,810			1,342,810
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	1,223,317	1,284
b	Less: cost or other basis and sales expenses	0	0
c	Gain or (loss)	1,223,317	1,284
d	Net gain or (loss)..........			1,224,601			1,224,601
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
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...
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..
Miscellaneous Revenue			Business Code
11a	MISCELLANEOUS		900099	1,991,881			1,991,881
b	FOOD & NUTRITION SALES		722210	990,397			990,397
c	PATIENT RECORD TRANSCRIPTION		900099	161,200			161,200
d	All other revenue ....
e	Total. Add lines 11a–11d ......			3,143,478
12	Total revenue. See Instructions......			272,283,357	262,032,525	161,898	10,088,934


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			7,124,494	1	8,227,974
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			30,638,755	4	34,302,562
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 .............			4,912,770	7	1,756,827
8	Inventories for sale or use ..............			5,369,142	8	5,940,660
9	Prepaid expenses and deferred charges ..........			1,591,357	9	1,938,903
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	348,348,318
b	Less: accumulated depreciation .....	10b	205,080,812	141,346,374	10c	143,267,506
11	Investments—publicly traded securities ..........			80,747,518	11	84,696,155
12	Investments—other securities. See Part IV, line 11 .....			11,225,011	12	12,018,148
13	Investments—program-related. See Part IV, line 11 .....				13	553,118
14	Intangible assets ...............				14	9,309,271
15	Other assets. See Part IV, line 11 ...........			4,776,803	15	6,430,194
16	Total assets. Add lines 1 through 15 (must equal line 34)......			287,732,224	16	308,441,318
17	Accounts payable and accrued expenses .........			37,225,761	17	37,170,868
18	Grants payable .................				18
19	Deferred revenue ................			4,112,865	19	3,981,603
20	Tax-exempt bond liabilities .............			82,655,000	20	96,655,000
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 ..			4,602,974	23	5,145,510
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....................			0	25	412,384
26	Total liabilities. Add lines 17 through 25.........			128,596,600	26	143,365,365
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			159,135,624	27	165,075,953
28	Temporarily restricted net assets ...........				28
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			159,135,624	33	165,075,953
34	Total liabilities and net assets/fund balances ........			287,732,224	34	308,441,318