TY 2017 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 ................. 0.00	X	X	0	0
(2) WILLIAM KOPF...................................................................... VICE-CHAIRMAN	1.00 ................. 1.00	X	X	0	0
(3) STUART SOROKA MD...................................................................... SECRETARY	1.00 ................. 0.00	X	X	0	0
(4) WILLIAM ABARE EDD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(5) TODD BATENHORST MD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(6) JAMES GRIMES MD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(7) JEFF KAMM...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(8) RAY MATUZA...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0
(9) TODD NEVILLE...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(10) SUSAN PONDER-STANSEL...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(11) BRAD RUNK...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(12) KAREN TAYLOR...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(13) LEN TUCKER...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0
(14) LEN WEEKS...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0
(15) SUSAN YARIAN MD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(16) JASON P BARRETT...................................................................... PRESIDENT/CEO	40.00 ................. 2.00		X	316,840	55,141
(17) MURRAY S MARSH JR...................................................................... CFO	40.00 ................. 2.00		X	59,567	11,068

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) JOSEPH S GORDY........................................................................ CEO - PART YEAR	40.00 .......................1.00	X			508,076	0	92,747
(19) ROGER D CARTER........................................................................ CFO - PART YEAR	40.00 .......................1.00	X			345,073	0	23,581
(20) WILLIAM D RIEGER........................................................................ CHIEF INFORMATION OFFICER	40.00 .......................0.50		X		220,652	0	36,043
(21) DONALD R CRIST........................................................................ VP OF OPERATIONS	40.00 .......................0.50		X		220,233	0	46,323
(22) MARY K MANTESE........................................................................ CHIEF NURSING OFFICER	40.00 .......................0.00		X		192,400	0	28,615
(23) JULIA CLICK........................................................................ EVP, CHIEF HUMAN RESOURCES OFFICER	40.00 .......................0.50		X		166,207	0	50,326
(24) MICHAEL HALL........................................................................ ADMINISTRATOR, PHARMACY AND SUPPORT SERVICES	40.00 .......................0.00		X		156,705	0	47,469
(25) CHRISTOPHER SCHMIDT........................................................................ SENIOR MGMT: QUALITY MANAGEMENT	40.00 .......................0.00			X	277,443	0	31,453
(26) JEFFREY A HURLEY........................................................................ SENIOR MGMT: LEGAL AFFAIRS	40.00 .......................0.50			X	230,140	0	73,629
(27) MICHAEL C SANDERS........................................................................ CHIEF MEDICAL INFORMATICS	40.00 .......................0.00			X	347,806	0	17,250
(28) GREGORY A GIBSON........................................................................ MD	40.00 .......................0.00			X	202,967	0	32,705
(29) MIGUEL A MACHADO........................................................................ VP OF MEDICAL AFFAIRS	40.00 .......................0.06			X	301,921	0	26,448

(A) Name and business address	(B) Description of services	(C) Compensation
ALLSCRIPTS HEALTHCARE 24630 NETWORK PLACE CHICAGO,IL606731246	SOFTWARE SUPPORT	2,269,328
DANA B KENYON COMPANY 5772 TIMUQUANA RD JACKSONVILLE,FL32210	CONSTRUCTION	2,154,404
PERSHING YOAKLEY & ASSOCIATES 2220 SUTHERLAND AVE KNOXVILLE,TN37919	CONSULTING	1,117,680
ANGELICA CORPORATION PO BOX 532268 ATLANTA,GA303532268	CONTRACT SERVICES	956,760
STERICYCLE 4010 COMMERCIAL AVE NORTHBROOK,IL60062	CONTRACT SERVICES	797,107
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 59

- 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.
right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 12, 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 (Form 990 or 990-EZ).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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—2018. 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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

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

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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2019

Page 6

Part V

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

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). 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

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) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

FLAGLER HOSPITAL INC

Employer identification number

59-0675143

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

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

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization FLAGLER HOSPITAL INC

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization FLAGLER HOSPITAL INC		Employer identification number 59-0675143

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization FLAGLER HOSPITAL INC			Employer identification number 59-0675143
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on 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 (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

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) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(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

443,106

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

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

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

443,106

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) 2019

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," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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" on 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" on 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 7/25/06, 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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 FASB 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 on 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 FASB ASC 958 relating to these items:

Revenue included on 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) 2019

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	4,391,344	4,009,626	3,581,146	3,895,387	3,609,062
b	Contributions ...			225,328
c	Net investment earnings, gains, and losses	271,053	381,717	203,153	-314,241	286,325
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	7,100
f	Administrative expenses ....
g	End of year balance ......	4,655,297	4,391,344	4,009,626	3,581,146	3,895,387

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 %

Term endowment SchDMd Bullet

The percentages on 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" on 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" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	9,370,591		9,370,591
b	Buildings ....	166,597,016	97,247,948	69,349,068
c	Leasehold improvements	8,246,160	7,109,861	1,136,299
d	Equipment ....	199,879,289	135,884,288	63,995,001
e	Other .....	16,804,205	4,676,786	12,127,419
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				155,978,378

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on 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........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
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) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	263,880,509
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	869,950
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-15,092,625
e	Add lines 2a through 2d .....................			2e	-14,222,675
3	Subtract line 2e from line 1..................			3	278,103,184
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	186,027
b	Other (Describe in Part XIII.) ...........	4b	-328,662
c	Add lines 4a and 4b....................			4c	-142,635
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	277,960,549

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	247,258,657
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	328,662
e	Add lines 2a through 2d....................			2e	328,662
3	Subtract line 2e from line 1...................			3	246,929,995
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	186,027
b	Other (Describe in Part XIII.) ............	4b	15,412,732
c	Add lines 4a and 4b.....................			4c	15,598,759
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	262,528,754

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 PERPETUITY, 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 XI, LINE 2D - OTHER ADJUSTMENTS:	PROVISION FOR BAD DEBTS -15,412,732. GAIN ON ACQUISITION 354,667. AMOUNT RECEIVED BY FLAGLER HEALTH CARE FOUNDATION NOT RECORDED ON BOOKS -34,560.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	COST OF GOODS SOLD -89,843. RENTAL EXPENSES -238,819.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	COST OF GOODS SOLD 89,843. RENTAL EXPENSES 238,819.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	PROVISION FOR BAD DEBTS 15,412,732.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

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? . . . . . .

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) . . .	7,143,184	958,160	6,185,024	2.530 %
b	Medicaid (from Worksheet 3, column a) . . . . .	22,215,898	18,224,863	3,991,035	1.640 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	29,359,082	19,183,023	10,176,059	4.170 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,732,635		1,732,635	0.710 %
f	Health professions education (from Worksheet 5) . . .	958,611		958,611	0.390 %
g	Subsidized health services (from Worksheet 6) . . . .	7,940,133		7,940,133	3.250 %
h	Research (from Worksheet 7) .	209,272		209,272	0.090 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	378,694		378,694	0.160 %
j	Total. Other Benefits . .	11,219,345		11,219,345	4.600 %
k	Total. Add lines 7d and 7j .	40,578,427	19,183,023	21,395,404	8.770 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

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

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	80,236	62,700	17,536	0.010 %
4	Environmental improvements	10,000		10,000	0 %
5	Leadership development and training for community members
6	Coalition building	10,000		10,000	0 %
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	100,236	62,700	37,536	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

15,412,732

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. ......

778,243

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).....

85,661,855

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

87,496,753

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

-1,834,898

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

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

Schedule H (Form 990) 2019

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?1Name, 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 INC 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086 WWW.FLAGLERHOSPITAL.ORG	X	X	X

Schedule H (Form 990) 2019

Page 4

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 17

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

6 a

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

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): SEE PART V

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 17

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

12b

If "Yes" on 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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

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

Yes

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 200.000000000000%
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)

Was widely publicized 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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

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

Yes

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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

Did the hospital facility or other authorized 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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

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

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2019

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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: THE YEAR-LONG PROCESS FOR THE 2017 COMMUNITY HEALTH NEEDS ASSESSMENT BEGAN IN JULY 2016 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: HTTPS://WWW.FLAGLERHOSPITAL.ORG/PATIENTS-VISITORS.ASPX IN TOTAL, FLAGLER HOSPITAL AND THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL FACILITATED 8 COMMUNTIY FOCUS GROUPS WITH A TOTAL OF 50 PARTICIPANTS TO GAIN A BETTER UNDERSTANDING OF PERCEPTIONS OF COMMUNITY STRENGTHS, NEEDS AND HEALTH CONCERNS. A COMMUNITY-WIDE SURVEY WAS USED TO GATHER RESIDENT'S THOUGHTS AND CONCERNS ABOUT THE QUALITY OF LIFE AND HEALTHCARE SERVICES IN ST. JOHNS COUNTY, FL. THIS SURVEY WAS MADE WIDELY AVAILABLE TO RESIDENTS BOTH THROUGH WEB-BASED SURVEYS AND PAPER-BASED SURVEYS AVAILABLE AT 42 LOCATIONS THROUGHOUT ST. JOHNS COUNTY. MARKETING TOOLS TO INCREASE RESIDENT PARTICIPATION CONSISTED OF SOCIAL MEDIA, PRESS-RELEASES, AND COMMUNITY WORD-OF-MOUTH WITH THE HELP OF THE COUNCIL.PAPER SURVEYS WERE COLLECTED AND MANUALLY ENTERED IN THE WEB-BASED DATABASE. A TOTAL OF 2,721 SURVEYS WERE COLLECTED (1,776 PAPER SURVEYS AND 945 WEB-BASED SURVEYS). MORE THAN 1% OF ST. JOHNS COUNTY RESIDENTS RESPONDED TO THIS SURVEY (2,614). THIS REFLECTS AN ACCURACY RATE OF 2% AT A 95% CONFIDENCE LEVEL AND MORE THAN TWICE THE NUMBER OF SURVEYS COLLECTED IN THE PREVIOUS CYCLES (1,189 RESPONSES WERE COLLECTED DURING 2014 CYCLE).
FLAGLER HOSPITAL	PART V, SECTION B, LINE 6B: ANASTASIA MOSQUITO CONTROL DISTRICT- SJC AZALEA HEALTH BETTY GRIFFIN CENTER CHILDREN'S HOME SOCIETY OF FLORIDA CLINTON HEALTH MATTERS INITIATIVE COMMUNITY HOSPICE AND PALLIATIVE CARE COMMUNITY MANAGEMENT & CONSULTING EPIC BEHAVIORAL HEALTHCARE FLAGLER HOSPITAL FLORIDA ARMY RESERVE NATIONAL GUARD FLORIDA DEPARTMENT OF HEALTH IN ST. JOHNS COUNTY GOOD SAMARITAN HEALTH CENTERS/WILDFLOWER CLINIC HEALTH PLANNING COUNCIL OF NORTHEAST FLORIDA ST JOHNS RIVER RURAL HEALTH NETWORK NEW MT. MORIAH CHRISTIAN MINISTRY NORTHEAST FLORIDA HEALTHY START COALITION PACT PREVENTION COALITION OF ST. JOHNS COUNTY ST. JOHNS COUNTY HEALTH AND HUMAN SERVICES ST. AUGUSTINE BEACH POLICE DEPARTMENT ST. AUGUSTINE YOUTH SERVICES ST. JOHNS COUNTY ADMINISTRATION ST. JOHNS COUNTY BOARD OF COUNTY COMMISSIONERS ST. JOHNS COUNTY COUNCIL ON AGING ST. JOHNS COUNTY EMERGENCY MANAGEMENT SJC HEALTH AND HUMAN SERVICES ADVISORY COUNCIL ST. JOHNS COUNTY MEDICAL SOCIETY ST. JOHNS COUNTY SCHOOL DISTRICT SJC HEAD START PROGRAM/EARLY CHILDHOOD SERVICES ST. JOHNS COUNTY SHERIFF'S OFFICE ST. JOHNS RIVER STATE COLLEGE ST. VINCENT'S MOBILE HEALTH OUTREACH MINISTRY STEWART MARCHMAN - ACT BEHAVIORAL HEALTHCARE THE SONTAG FOUNDATION TOBACCO FREE ST. JOHNS YMCA OF FLORIDA'S FIRST COAST
FLAGLER HOSPITAL	PART V, SECTION B, LINE 7D: FLAGLER HOSPITAL UTILIZED A VARIETY OF APPROACHES TO INFORM THE COMMUNITY ON THE RESULTS OF THE 2017 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT. FLAGLER HOSPITAL INVESTED IN PRINTING 300 HARD COPIES OF THE 147-PAGE PUBLICATION. THESE COPIES WERE PROVIDED TO ALL ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL MEMBERS AND DISPLAYED ON-SITE AT EACH MEMBER AGENCY. FLAGLER HOSPITAL ALSO PRINTED 50 LARGE-FONT VERSIONS OF THE CHNA FOR VISUALLY IMPAIRED COMMUNITY MEMBERS THAT WERE DISTRIBUTED TO THE ST. JOHNS COUNTY COUNCIL ON AGING AND LOCAL LIBRARIES.
FLAGLER HOSPITAL	PART V, SECTION B, LINE 11: REDUCE PERCENTAGE OF LOW BIRTH WEIGHT INFANTSTHE 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 MORTALITYCHRONIC DISEASE WAS RESPONSIBLE FOR OVER 55.6% OF ALL DEATHS IN ST. JOHNS COUNTY IN 2016. 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, 17.9% REPORTED CANCER AS THE MOST CONCERNING HEALTH PROBLEM, RANKING FIFTH AMONG ALL RESPONDENTS. TO RAISE AWARENESS ABOUT THE BENEFITS OF PREVENTION AND EARLY DETECTION OF CANCER, FLAGLER HOSPITAL PARTICIPATED IN OVER 25 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 DIAGNOSES 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 2014-2016, THE BREAST CANCER AGE-ADJUSTED DEATH RATE WAS 22.4/100,000. 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 150 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. EACH YEAR, VARIOUS BREAST CANCER SCREENING PROGRAMS ARE OFFERED IN COLLABORATION WITH COMMUNITY ORGANIZATIONS SUCH AS PINK UP THE PACE AND NORTH FLORIDA SUSAN G. KOMEN. ON AUGUST 26TH, 2017 WE CONDUCTED 29 FREE SCREENING MAMMOGRAMS FOR A "FREE MAMMO DAY." FLAGLER HOSPITAL ALSO PARTICIPATED IN THE PUTP EXPO AND THE FLAGLER COLLEGE EMPLOYEE HEALTH FAIR. AT BOTH OF THESE EVENTS, COMMUNITY MEMBERS WERE GIVEN INFORMATION PERTAINING TO BREAST CANCER AWARENESS. OVER 2,700 COMMUNITY MEMBERS ATTENDED THIS EVENT, AND RECEIVED INFORMATION ON BREAST CANCER SCREENING AND TREATMENT OPTIONS. IN OCTOBER, FOR INSURED WOMEN WHOSE SCHEDULE MAY NOT PERMIT THEM TO GET A MAMMOGRAM DURING NORMAL BUSINESS HOURS, FLAGLER HOSPITAL OPENED THE FLAGLER IMAGING CENTER ON A THURSDAY EVENING AND A SATURDAY MORNING, WHERE A TOTAL OF 29 MAMMOGRAMS WERE COMPLETED. IN ADDITION, FLAGLER HOSPITAL'S CANCER EDUCATION AND SUPPORT CENTER FACILITATES A BREAST CANCER SUPPORT GROUP THAT MEETS ON A MONTHLY BASIS. COLON CANCER: THE ANNUAL COLORECTAL CANCER AWARENESS DAY WAS HELD ON MARCH 4, 2018. THE EVENT WAS COORDINATED BY THE FLAGLER HOSPITAL CANCER EDUCATION AND SUPPORT CENTER TO PROVIDE INFORMATION ON COLORECTAL CANCER PREVENTION AND SCREENING STRATEGIES. THIS EVENT TOOK PLACE IN THE CANCER EDUCATION AND SUPPORT CENTER AND OVER 85 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. FLAGLER HOSPITAL PARTNERS WITH NORTHEAST FLORIDA AREA HEALTH EDUCATION CENTER TO PROVIDE ACCESS TO THE "QUIT SMOKING NOW" SMOKING CESSATION PROGRAM. QUIT SMOKING NOW IS A FREE COURSE THAT CONSISTS OF GROUP SESSIONS FACILITATED BY THE CARDIOPULMONARY DEPARTMENT AND HELD IN THE FLAGLER HOSPITAL WELLNESS CENTER. CLASSES TAKE PLACE ONE PER WEEK FOR 1 HOUR, OVER A SIX WEEK PERIOD. DURING THIS FISCAL YEAR, 8 DIFFERENT QUIT SMOKING NOW PROGRAMS WERE OFFERED WITH 99 PARTICIPANTS. OF THE PARTICIPANTS, 60 COMPLETED THE PROGRAM AND 46 QUIT SMOKING. 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 16, 2017. 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 ALSO TOOK PLACE ON NOVEMBER 16, 2017. 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 ADMINISTRATOR OF COMMUNITY HEALTH IMPROVEMENT SERVES ON THE BOARD OF DIRECTORS OF THE TOBACCO FREE ST. JOHNS PARTNERSHIP, 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. SEE SUPPLEMENTAL INFORMATION FOR CONTINUATION.
FLAGLER HOSPITAL	PART V, SECTION B, LINE 15E: CONTACT INFORMATION IS IN THE PLAIN LANGUAGE SUMMARY LOCATED ON THE HOSPITAL WEBSITE: HTTPS://WWW.FLAGLERHOSPITAL.ORG/FINANCIAL-SERVICES/FAP-PLAIN-LANGUAGE-SUMMARY.ASPX: THERE ARE MANY WAYS TO FIND INFORMATION ABOUT THE FAP APPLICATION PROCESS, OR GET COPIES OF THE FAP OR FAP APPLICATION FORM. TO APPLY FOR FINANCIAL ASSISTANCE YOU MAY: DOWNLOAD THE INFORMATION ONLINE AT FLAGLERHOSPITAL.ORG, KEY WORDS FINANCIAL ASSISTANCE REQUEST THE INFORMATION IN WRITING BY MAIL OR BY VISITING THE FLAGLER HOSPITAL BUSINESS OFFICE AT 100 WHETSTONE PLACE, SUITE 100 ST. AUGUSTINE, FL 32086 REQUEST THE INFORMATION BY CALLING (904) 819-4539 AVAILABILITY OF TRANSLATIONSTHE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND THE PLAIN LANGUAGE SUMMARY ARE OFFERED IN ENGLISH AND SPANISH. FLAGLER HOSPITAL MAY ELECT TO FURNISH TRANSLATION AIDS, TRANSLATION GUIDES, OR PROVIDE ASSISTANCE THROUGH USE OF QUALIFIED BILINGUAL INTERPRETER BY REQUEST. FOR INFORMATION ABOUT FLAGLER HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND TRANSLATION SERVICES, PLEASE CALL A REPRESENTATIVE AT (904) 819-4539.
PART V, SECTION B, LINE 11 CONTINUED:	REDUCE SUBSTANCE ABUSE:JUST AS WAS FOUND IN THE 2014 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT, THE ISSUE OF SUBSTANCE ABUSE WAS LISTED AS THE #1 IMPORTANT HEALTH PROBLEMS BY SURVEY RESPONDENTS IN THE 2017 CHNA. THIS INCLUDES BINGE DRINKING, UNDERAGE DRINKING, CIGARETTE AND MARIJUANA AND OTHER DRUG USE. FLAGLER HOSPITAL'S DIRECTOR OF BEHAVIORAL HEALTH SERVICES 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. FLAGLER HOSPITAL CONTINUES TO PROVIDE A YEARLY $150,000 DONATION IN SUPPORT OF EPIC BEHAVIORAL HEALTHCARE'S 16-BED RECOVERY CENTER. 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. AFTER 4 YEARS OF SERVING THE COMMUNITY, THE EPIC RECOVERY CENTER HAS HAD 3,484 ADMISSIONS, WITH APPROXIMATELY 50% OF ALL DETOX ADMISSIONS RELATED TO OPIATE ABUSE. THE MAJORITY OF EPIC RECOVERY CENTER'S PATIENTS LIVE IN POVERTY (78%), HAVE NO INSURANCE, OR INSURANCE WITH POOR BEHAVIORAL HEALTH BENEFITS, WHICH MAKES FLAGLER HOSPITAL'S SUPPORT ESSENTIAL TO PROVIDING THIS MUCH NEEDED SERVICE TO THE COMMUNITY. 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 CAREACCESS TO DENTAL CARE HAS LONG BEEN AN ISSUE IN ST. JOHNS COUNTY, AS IT IS ACROSS THE STATE. RESPONDENTS OF THE 2017 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 YEAR 765 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 CONTINUED TO DROP BY OVER 10% EACH FISCAL YEAR. FURTHERMORE, DENTAL VISITS TO THE WILDFLOWER CLINIC HAVE INCREASED TO OVER 2,750 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 CAREWITH DEPRESSION AND ANXIETY RANKED AS THE #2 HEALTH PROBLEMS IN ST. JOHNS COUNTY, THE 2017 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 2017 CHNA. TO INCREASE ACCESS TO MENTAL HEALTH CARE, THIS COLLABORATION CENTERS ON 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.
PART V, SECTION B, LINE 11 CONTINUED:	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 DIRECTOR OF COMMUNITY HEALTH IMPROVEMENT 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.INCREASE USE OF AVAILABLE TRANSPORTATIONFROM THE FOCUSES GROUPS CONDUCTED AS PART OF THE 2017 COMMUNITY HEALTH NEEDS ASSESSMENT, A FOCUS OF "A NEED FOR TRANSPORTATION" WAS OBSERVED AS A 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 AND 12.2% IN 2017.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 2017 ST. JOHNS COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT FEEDBACK SHOWED THE CONTINUED NEED FOR A FOCUS ON TRANSPORTATION. THIS YEAR, FLAGLER HOSPITAL SUPPORTED THE STRATEGIC OBJECTIVE OF "INCREASE USE OF AVAILABLE TRANSPORTATION OPTIONS" BY PARTNERING WITH THE ST. JOHNS COUNTY HEALTH LEADERSHIP COUNCIL TO PROVIDE TRANSPORTATION TRAINING TO 14 COMMUNITY ORGANIZATIONS. THIS EDUCATION IS OFFERED TO BOTH COMMUNITY MEMBERS, AND HEALTHCARE PROVIDERS, IN EFFORT TO RAISE AWARENESS AND INCREASE UTILIZATION.
PART V, SECTION B, LINE 7A:	HTTPS://WWW.FLAGLERHOSPITAL.ORG/PATIENTS-VISITORS.ASPX
PART V, SECTION B, LINE 7B:	HTTP://STJOHNS.FLORIDAHEALTH.GOV/PROGRAMS-AND-SERVICES/COMMUNITY-HEALTH-PLANNING-AND-STATISTICS/COMMUNITY-HEALTH-ASSESSMENTS/2017-CHA.HTML
PART V, SECTION B, LINE 10A:	HTTPS://WWW.FLAGLERHOSPITAL.ORG/PATIENTS-VISITORS.ASPX
PART V, SECTION B, LINE 16A:	HTTPS://WWW.FLAGLERHOSPITAL.ORG/FINANCIAL-SERVICES/CHARITY-CARE-AND-FINANCIAL-ASSISTANCE-POLICY.ASPX
PART V, SECTION B, LINE 16B:	HTTPS://WWW.FLAGLERHOSPITAL.ORG/DOCUMENTS/ATTESTATION-CHARITY-APPLICATION.PDF
PART V, SECTION B, LINE 16C:	HTTPS://WWW.FLAGLERHOSPITAL.ORG/FINANCIAL-SERVICES/FAP-PLAIN-LANGUAGE-SUMMARY.ASPX

Schedule H (Form 990) 2019

Page 9

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?1
Name and address		Type of Facility (describe)
1	1 - FLAGLER OUTPATIENT LAB 156-316 ST HWY 312 260-264 ST AUGUSTINE,FL32086	OUTPATIENT LAB SATELLITE DRAW STATION
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

Page 10

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 7:	EXPENSES WERE CALCULATED USING THE COST-TO-CHARGE RATIO FROM WORKSHEET 2.
PART I, LN 7 COL(F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $15,412,732. OF THIS TOTAL, FLAGLER HOSPITAL'S PORTION OF BAD DEBT EXPENSE IS $15,347,773 AND OUTPATIENT SURGERY CENTER OF ST. AUGUSTINE, LLC'S PORTION OF BAD DEBT EXPENSE IS $64,959.
PART II, COMMUNITY BUILDING ACTIVITIES:	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 53 PROGRAMS OF GRAND ROUNDS, MEDICAL SOCIETY MEETINGS, WEBCASTS 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 $378,694 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. EACH YEAR, FLAGLER HOSPITAL PROVIDES GRANT FUNDING 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 $3,000 USING A $3/HOUR CHARGE FOR EACH MEETING SPACE, A FIGURE BASED ON THE SQUARE FOOTAGE OF THE HOSPITAL. COMMUNITY BUILDING ACTIVITIESFLAGLER 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 12TH YEAR, THE ACADEMY HAD 42 THIRD YEAR STUDENTS ROTATING THROUGH VARIOUS DEPARTMENTS AT THE HOSPITAL FOR TRAINING, FOR A COMBINED TOTAL OF 5040 HOURS. STUDENTS SHADOWED IN THE LAB, RADIOLOGY, PHARMACY, OPERATING ROOM, PHYSICAL AND OCCUPATIONAL THERAPY, IN ADDITION TO MULTIPLE NURSING UNITS.
PART III, LINE 3:	BASED ON COMPILED HOSPITAL BAD DEBT DATA FOR FY 18, WE ARE ESTIMATING THAT 50% OF TOTAL CHARGES FOR THE 3,241 PATIENT ACCOUNTS THAT SCORED BETWEEN 200-400% OR THAT WERE NOT SCORED WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE IF THEY WOULD HAVE COMPLIED WITH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY OR HAD BEEN ABLE TO BE PRESUMPTIVELY SCORED.
PART III, LINE 4:	AUDITED FINANCIAL STATEMENTS PAGES 8, 10
PART III, LINE 8:	THE MEDICARE REVENUE AND ALLOWABLE COSTS ON LINES 5 AND 6, RESPECTIVELY, WERE TAKEN FROM THE MEDICARE COST REPORT. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE REIMBURSEMENT ALLOWED, BEFORE REDUCTION OF CO-PAY AMOUNTS, LESS SEQUESTRATION AND ANY OTHER REDUCTIONS ASSOCIATED WITH VALUE BASED PURCHASING REDUCTIONS AS PER THE COST REPORT WORKSHEETS E PART A AND B. MEDICARE ALLOWABLE COSTS RELATING TO PAYMENTS ARE TAKEN FROM THE PART A AND PART B EXPENSES AS DETERMINED BY THE COST REPORT STEP DOWN AND COST APPORTIONMENT METHODOLOGY ON WORKSHEETS D-1 AND D PART V, PLUS THE 65% REDUCTION APPLIED TO MEDICARE BAD DEBTS. THE ENTIRE SHORTFALL IS REPORTED AS COMMUNITY BENEFIT. WE DO NOT RECEIVE ENOUGH IN MEDICARE REIMBURSEMENTS TO COVER OUR COSTS ASSOCIATED WITH THE PROVISION OF THESE SERVICES, YET WE CONTINUE TO PROVIDE MEDICARE SERVICES TO OUR COMMUNITY REGARDLESS OF THE REIMBURSEMENT LEVELS. THEREFORE, WE FEEL JUSTIFIED IN REPORTING THIS AS PART OF OUR COMMUNITY BENEFIT.
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 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 ST. 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 DIRECTOR OF COMMUNITY HEALTH IMPROVEMENT, 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. A LISTING OF THE MEMBERSHIP ORGANIZATIONS AND REPRESENTATIVES IS ATTACHED HERETO AS ATTACHMENT A.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 133 OF THE PUBLISHED "2017 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 THE 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 RESPONSE TO PART I, LINE 3C ABOVE.
PART VI, LINE 4:	ST. JOHNS COUNTY IS PART OF THE JACKSONVILLE METROPOLITAN AREA AND ENCOMPASSES APPROXIMATELY 680 SQUARE MILES OF LAND IN NORTHEAST FLORIDA, SITUATED BETWEEN THE ST. JOHNS RIVER AND MORE THAN 40 MILES OF BEACHES ALONG THE ATLANTIC COAST. ACCORDING TO 2015 U.S. CENSUS DATA, THERE ARE 243,812 RESIDENTS IN FLAGLER HOSPITAL'S DEFINED COMMUNITY OF ST. JOHNS COUNTY.SINCE 2010, ST. JOHNS COUNTY IS ASCRIBED AS THE HEALTHIEST COUNTY OF 67 COUNTIES IN FLORIDA FOR OVERALL HEALTH FACTORS AND HEALTH OUTCOMES IN THE 2017 COUNTY HEALTH RANKINGS REPORT. ST. JOHNS COUNTY SCHOOL DISTRICT RANKS FIRST OF 67 DISTRICTS IN FLORIDA IN TOTAL FLORIDA COMPREHENSIVE ASSESSMENT TEST POINTS. THE CITY OF ST. AUGUSTINE, THE COUNTY SEAT AND NATION'S "OLDEST CITY," ATTRACTED ABOUT 6.8 MILLION VISITORS TO THE COUNTY IN 2016.POPULATION AND AGE DISTRIBUTIONST. JOHNS COUNTY'S POPULATION NEARLY TRIPLED BETWEEN THE YEARS 1990 AND 2016, THIS BEING A POPULATION INCREASE OF OVER 180%. GROWTH FOR ST. JOHNS COUNTY IS OCCURRING AT A RATE THREE TIMES FASTER THAN FLORIDA AND ALMOST SIX TIMES FASTER THAN THE NATION. THE U.S. CENSUS BUREAU ESTIMATES ST. JOHNS COUNTY'S POPULATION FOR 2016 TO BE 235,087 (51.2% FEMALE), AN ESTIMATED 3.7% HIGHER THAN THE 2015 ESTIMATE. ST. JOHNS COUNTY, FL WAS ASCRIBED THE 15TH FASTEST GROWING COUNTY AMONG THE 100 FASTEST GROWING COUNTIES WITH 10,000 OR MORE POPULATION IN THE NATION BETWEEN 2010 AND 2016. USING 2016 ESTIMATES, THE U.S. BUREAU OF ECONOMIC AND BUSINESS RESEARCH PROJECTS ST. JOHNS COUNTY'S POPULATION WILL GROW TO 287,027 BY 2025.ST. JOHNS COUNTY AND FLORIDA HAVE SIMILAR POPULATION AGE DISTRIBUTIONS. HOWEVER, WHEN COMPARED TO THE STATE, ST. JOHNS COUNTY HAS A SLIGHTLY HIGHER PROPORTION OF PEOPLE WITHIN THE GROUP OF PEOPLE FROM 10 YEARS OF AGE TO 19 YEARS OF AGE AND THE ALSO WITHIN THE GROUP OF PEOPLE FROM 35 YEARS OF AGE TO 69 YEARS OF AGE. COMPARING THE 2010 AND 2016 POPULATION AGE DISTRIBUTION ESTIMATES REVEALS AN AGING POPULATION; BETWEEN 2010 AND 2016, ST. JOHNS COUNTY EXPERIENCED HIGHEST POPULATION GROWTH AMONG PEOPLE 65 YEARS OF AGE TO 69 YEARS OF AGE (2.4%), FOLLOWED BY PEOPLE 50 YEARS OF AGE TO 54 YEARS OF AGE (1.1%) AND 40 YEARS OF AGE TO 44 YEARS OF AGE (1.0%). ACCORDING TO THE U.S. CENSUS BUREAU, APPROXIMATELY 19.3% OF ST. JOHNS COUNTY'S POPULATION WAS 65 YEARS OF AGE OR OLDER IN 2016, A SLIGHTLY LOWER PROPORTION THAN THE STATE (19.9%) BUT HIGHER THAN THE NATION (15.2%).VULNERABLE POPULATIONS PERSONS WITH ACCESS AND FUNCTIONAL NEEDS INCLUDE PERSONS WITH PHYSICAL, COGNITIVE, OR DEVELOPMENTAL DISABILITIES, PERSONS WITH LIMITED ENGLISH PROFICIENCY, GEOGRAPHICALLY OR CULTURALLY ISOLATED PERSONS, AND MEDICALLY OR CHEMICALLY DEPENDENT PERSONS. RECENT DISASTERS HAVE SHOWN THE NEED TO BETTER DEVELOP STRATEGIES FOR MEETING THE NEEDS OF MOST AT-RISK POPULATIONS TO PREVENT ADVERSE HEALTH OUTCOMES DURING OR FOLLOWING A DISASTER.
PART VI, LINE 6:	THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.

Schedule H (Form 990) 2019

Additional Data

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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," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

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" on 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) FLAGLER COLLEGE 74 KING ST ST AUGUSTINE,FL32084	59-1157081	501(C)(3)	10,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(2) INVESTING IN KIDS (INK) 40 ORANGE ST ST AUGUSTINE,FL32084	84-1452282	501(C)(3)	15,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(3) ST JOHNS VOLUNTEERS 1 NEWS PLACE ST AUGUSTINE,FL32086	61-1767988	501(C)(3)	100,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(4) UNIVERSITY OF NORTH FLORIDA FOUNDATION 1 UNF DR BLDG 39 JACKSONVILLE,FL32224	23-7167701	501(C)(3)	39,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(5) ALL AMERICAN AIR CHARITABLE FOUNDATION 425 TRADE WIND LANE ST AUGUSTINE,FL32080	27-4254657	501(C)(3)	10,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(6) EPIC BEHAVIORAL HEALTHCARE 1400 OLD DIXIE HWY ST AUGUSTINE,FL32084	59-1502582	501(C)(3)	150,000	OPERATIONAL SUPPORT AND PROGRAM ASSISTANCE
(7) ST JOHNS COUNCIL ON AGING 180 MARINE ST ST AUGUSTINE,FL32084	59-1525829	501(C)(3)	5,500	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) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

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. THE HOSPITAL HAS A COMMUNITY BENEFITS GROUP THAT WORKS WITH ST. JOHNS COUNTY TO DETERMINE GRANT RECIPIENTS AND MONITOR THE USE OF FUNDS.

Schedule I (Form 990) 2019

Additional Data

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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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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

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

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

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

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

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

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

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

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

Were any amounts reported on 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" on 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) 2019

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 on 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 on 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)
1JASON P BARRETT PRESIDENT/CEO	(i) (ii)	316,480 ------------- 0	0 ------------- 0	360 ------------- 0	35,250 ------------- 0	19,891 ------------- 0	371,981 ------------- 0	0 ------------- 0
2JOSEPH S GORDY CEO - PART YEAR	(i) (ii)	483,202 ------------- 0	0 ------------- 0	24,874 ------------- 0	92,747 ------------- 0	0 ------------- 0	600,823 ------------- 0	0 ------------- 0
3ROGER D CARTER CFO - PART YEAR	(i) (ii)	196,908 ------------- 0	0 ------------- 0	148,165 ------------- 0	10,262 ------------- 0	13,319 ------------- 0	368,654 ------------- 0	0 ------------- 0
4WILLIAM D RIEGER CHIEF INFORMATION OFFICER	(i) (ii)	220,332 ------------- 0	0 ------------- 0	320 ------------- 0	14,268 ------------- 0	21,775 ------------- 0	256,695 ------------- 0	0 ------------- 0
5DONALD R CRIST VP OF OPERATIONS	(i) (ii)	218,839 ------------- 0	0 ------------- 0	1,394 ------------- 0	24,548 ------------- 0	21,775 ------------- 0	266,556 ------------- 0	0 ------------- 0
6MARY K MANTESE CHIEF NURSING OFFICER	(i) (ii)	192,000 ------------- 0	0 ------------- 0	400 ------------- 0	11,969 ------------- 0	16,646 ------------- 0	221,015 ------------- 0	0 ------------- 0
7JULIA CLICK EVP, CHIEF HUMAN RESOURCES OFFICER	(i) (ii)	165,487 ------------- 0	0 ------------- 0	720 ------------- 0	28,551 ------------- 0	21,775 ------------- 0	216,533 ------------- 0	0 ------------- 0
8MICHAEL HALL ADMINISTRATOR, PHARMACY AND SUPPORT	(i) (ii)	155,985 ------------- 0	0 ------------- 0	720 ------------- 0	27,491 ------------- 0	19,978 ------------- 0	204,174 ------------- 0	0 ------------- 0
9CHRISTOPHER SCHMIDT SENIOR MGMT: QUALITY MANAGEMENT	(i) (ii)	265,912 ------------- 0	0 ------------- 0	11,531 ------------- 0	31,453 ------------- 0	0 ------------- 0	308,896 ------------- 0	0 ------------- 0
10JEFFREY A HURLEY SENIOR MGMT: LEGAL AFFAIRS	(i) (ii)	228,651 ------------- 0	0 ------------- 0	1,489 ------------- 0	56,983 ------------- 0	16,646 ------------- 0	303,769 ------------- 0	0 ------------- 0
11MICHAEL C SANDERS CHIEF MEDICAL INFORMATICS	(i) (ii)	327,734 ------------- 0	0 ------------- 0	20,072 ------------- 0	17,250 ------------- 0	0 ------------- 0	365,056 ------------- 0	0 ------------- 0
12GREGORY A GIBSON MD	(i) (ii)	202,162 ------------- 0	0 ------------- 0	805 ------------- 0	12,727 ------------- 0	19,978 ------------- 0	235,672 ------------- 0	0 ------------- 0
13MIGUEL A MACHADO VP OF MEDICAL AFFAIRS	(i) (ii)	300,207 ------------- 0	0 ------------- 0	1,714 ------------- 0	17,250 ------------- 0	9,198 ------------- 0	328,369 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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 THE DISABILITY INSURANCE POLICY PREMIUMS TO CERTAIN OFFICERS, REPORTED ON THE OFFICERS' FORM W-2.
PART I, LINES 4A-B	THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING THE YEAR: ROGER CARTER ($102,939). THE ORGANIZATION CONTRIBUTED $35,000 TO A 457(F) PLAN FOR JOSEPH S. GORDY.

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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 Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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		04-04-2012	30,000,000	SEE PART VI		X		X		X
B	ST JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY	59-2146640		09-28-2017	71,400,000	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	12,000,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	30,000,000		71,400,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............			338,361
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	30,000,000		592,158
11 Other spent proceeds .............			53,517,222
12 Other unspent proceeds .............			16,952,259
13 Year of substantial completion .............	2012		2019
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........
16 Has the final allocation of proceeds been made? ..........	X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2019

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

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
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X	X
b Exception to rebate? ........	X			X
c No rebate due? .........		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
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2019

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

Part Ⅵ

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

Return Reference	Explanation
PART I, LINE A, COLUMN F	FINANCING OF FACILITIES IMPROVEMENT PROJECTS, ACQUISITION AND INSTALLATION OF NEW ELECTRONIC MEDICAL RECORDS SYSTEM.
PART I, LINE B, COLUMN F:	CURRENT REFUNDING OF SERIES 2010A AND SERIES 2010B BONDS, FINANCING OF FACILITIES IMPROVEMENT PROJECTS AND EQUIPMENT ACQUISITIONS.
PART II, LINE 11, COLUMN B:	BOND PROCEEDS APPLIED TOWARD CURRENT REFUNDING OF SERIES 2012A AND SERIES 2010B BONDS.

Schedule K (Form 990) 2019

Additional Data

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Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

FLAGLER HOSPITAL INC

Employer identification number

59-0675143

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2019

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) THOMPSON BAKER AGENCY INC	MATT BAKER, CHAIRMAN, IS MAJORITY SHAREHOLDER OF THOMPSON BAKER AGENCY INC	1,137,352	INSURANCE PAYMENTS		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2019

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

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 6	COASTAL COMMUNITY HEALTH, INC. IS THE SOLE MEMBER OF THE ORGANIZATION. ON NOVEMBER 30, 2018, COASTAL COMMUNITY HEALTH, INC. DISASSOCIATED AND IS NO LONGER A MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	DURING THE FISCAL YEAR, THE SOLE MEMBER HAD THE AUTHORITY TO APPOINT THE BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B	DURING THE FISCAL YEAR, THE SOLE MEMBER HAD 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'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 ENCUMBERANCE IN EXCESS OF THE GREATER OF $10,000,000 OR 10% OF THE CAPITAL BUDGET 12) INCURRENCY 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 11B	THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTANT AND REVIEWED AND APPROVED BY INTERNAL MANAGEMENT AND SHARED WITH EACH BOARD MEMBER PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION REQUIRES ALL TRUSTEES TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. ANY CONFLICTS THAT DEVELOP AFTER SUBMISSION MUST BE DISCLOSED IN WRITING TO BOARD OF TRUSTEES. EXISTING CONFLICTS OF INTEREST MAY REQUIRE ABSTAINING FROM DISCUSSING OR VOTING UPON MATTERS RELATED TO OR AFFECTED BY THE CONFLICT, OR RECUSING ONESELF FROM PARTICIPATING IN RELATED MATTERS.
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. THE COMPENSATION COMMITTEE EVALUATES THE DATA, THEN DEBATES AND DOCUMENTS ITS RECOMMENDATION OF REASONABLE COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19	PHOTOCOPIES OF THE ORGANIZATION'S FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICES. 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	CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 13,059,467. MANAGEMENT AND GENERAL EXPENSES 4,930,591. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,990,058. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,509,809. MANAGEMENT AND GENERAL EXPENSES 727,541. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,237,350. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 9,807,387. MANAGEMENT AND GENERAL EXPENSES 1,355,252. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,162,639. OTHER FEES: PROGRAM SERVICE EXPENSES 1,522,549. MANAGEMENT AND GENERAL EXPENSES 772,478. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,295,027.
FORM 990, PART XI, LINE 9:	GAIN ON ACQUISITION 354,667. AMOUNT RECEIVED BY FLAGLER HEALTH CARE FOUNDATION NOT RECORDED ON BOOKS -34,560.
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) 2019

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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
(1) OUTPATIENT SURGERY CENTER OF ST AUGUSTINE LLC 1 ORTHOPAEDIC PL ST AUGUSTINE,FL32086 20-2047704	OUTPATIENT SURGERY	FL	4,175,799	1,633,257	FLAGLER HEALTH ENTERPRISE
(2) FLAGLER HEALTH NETWORK LLC 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086 82-1579477	INVESTMENT HOLDING	FL	-65,379	319,621	FLAGLER HOSPITAL INC
(3) FLAGLER HEALTH ENTERPRISES LLC 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086 82-1588529	INVESTMENT HOLDING	FL	1,092,205	15,867,205	FLAGLER HOSPITAL INC

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 INC 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086 59-2440537	SUPPORTING ORGANIZATION	FL	501(C)(3)	LINE 12A, I	FLAGLER HOSPITAL	Yes
(2)COASTAL COMMUNITY HEALTH INC 841 PRUDENTIAL DR STE 1604 JACKSONVILLE,FL32207 47-1322041	SUPPORTING ORGANIZATION	FL	501(C)(3)	LINE 12A, I	N/A		No
(3)FLAGLER HOME CARE LLC 301 HEALTH PARK BLVD ST AUGUSTINE,FL32086 82-1562462	HOME CARE SERVICES	FL	501(C)(3)	LINE 10	FLAGLER HEALTH NETWORK LLC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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	(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 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

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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	FLAGLER HOSPITAL INC	C	1,860,742	3,839,380	100.000 %	Yes
(2) HEALTH PARK OWNERS ASSOCIATION 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086 59-2869538	PROPERTY MANAGEMENT	FL	FLAGLER HOSPITAL INC	C	43,721	573,657	100.000 %	Yes
(3) ANDERSON GIBBS CONDOMINIUM ASSOC 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086 59-3223458	PROPERTY MANAGEMENT	FL	FLAGLER HOSPITAL INC	C			100.000 %	Yes
(4) FLAGLER PROFESSIONAL HEALTH CARE SERVICES INC 400 HEALTH PARK BLVD ST AUGUSTINE,FL32086 36-4860252	HEALTHCARE	FL	FLAGLER HOSPITAL INC	C	12,422,392	5,848,405	100.000 %	Yes

Schedule R (Form 990) 2019

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) ............................

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

Yes

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) ......................

Yes

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

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

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

Yes

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

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	C	612,845	FMV
(2) FLAGLER HEALTH SERVICES INC	J	408,008	FMV
(3) FLAGLER HEALTH CARE FOUNDATION INC	M	573,645	FMV
(4) FLAGLER HEALTH SERVICES INC	P	201,086	FMV
(5) FLAGLER PROFESSIONAL HEALTH SERVICES INC	P	9,225,568	FMV
(6) FLAGLER HOME CARE LLC	P	873,847	FMV
(7) FLAGLER HEALTH CARE FOUNDATION INC	A	35,891	FMV

Schedule R (Form 990) 2019

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) 2019

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) 2019

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	14
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	2,331
6	Total number of volunteers (estimate if necessary) .............	6	228
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	4,369,465
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	1,145,431

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,512,787	612,845
9	Program service revenue (Part VIII, line 2g) .........	240,669,542	262,425,152
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	5,342,279	7,275,677
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	3,084,218	7,646,875
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	250,608,826	277,960,549
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	288,104	367,618
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)	109,957,064	104,629,630
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)....	150,389,985	157,531,506
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	260,635,153	262,528,754
19	Revenue less expenses. Subtract line 18 from line 12.......	-10,026,327	15,431,795
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	341,511,188	352,538,512
21	Total liabilities (Part X, line 26).............	176,899,461	171,304,933
22	Net assets or fund balances. Subtract line 21 from line 20.....	164,611,727	181,233,579

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 236,483,006 including grants of $ 367,618 ) (Revenue $ 262,425,152 )
	SINCE ITS FOUNDING IN 1889, OUR PRIVATE, NOT-FOR-PROFIT FACILITY HAS GROWN INTO A DIVERSE CLINICAL ENTERPRISE THAT IS CONSISTENTLY RECOGNIZED NATIONALLY FOR CLINICAL EXCELLENCE BY HEALTHGRADES, TRUVEN, AND OTHER COMPARATIVE QUALITY DATA ORGANIZATIONS. HOSPITAL SERVICES ARE PROVIDED TO INPATIENTS AND OUTPATIENTS, INCLUDING CHARITY CARE TO THE 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 expenses236,483,006

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,546,030	0	572,798

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	612,845
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		612,845

		Business Code
2a	NET PATIENT SERVICE REVENUE	623000	258,249,600	258,249,600
b	ANCILLARY SERVICES	623000	4,163,071	4,163,071
c	EHR MEANINGFUL USE	623000	12,481	12,481
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		262,425,152

3 Investment income (including dividends, interest, and othersimilar amounts) ......			4,717,036			4,717,036
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		2,282,049	6a
b	Less: rental expenses		238,819	6b
c	Rental income or (loss)		2,043,230	6c
d	Net rental income or (loss).......			2,043,230			2,043,230
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	10,150	60,727,804	7a
b	Less: cost or other basis and sales expenses	40,982	58,138,331	7b
c	Gain or (loss)	-30,832	2,589,473	7c
d	Net gain or (loss).........			2,558,641		-2,937	2,561,578
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a	187,442
b	Less: cost of goods sold ..		10b	89,843
c	Net income or (loss) from sales of inventory..			97,599			97,599
Business Code			Miscellaneous Revenue
11a	OSC REVENUE		623000	4,178,736		4,178,736
b	FOOD AND NUTRITION SALES		722210	721,388			721,388
c	QUEST LAB TESTS		541380	193,666		193,666
d	All other revenue ....			412,256			412,256
e	Total. Add lines 11a–11d ......			5,506,046
12	Total revenue. See instructions.....			277,960,549	262,425,152	4,369,465	10,553,087

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	365,618	365,618
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	2,000	2,000
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 ...........	2,883,764		2,883,764
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........	80,352,622	75,027,248	5,325,374
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,913,207	2,913,207
9	Other employee benefits .......	12,322,745	12,432,980	-110,235
10	Payroll taxes ...........	6,157,292	6,157,292
11	Fees for services (non-employees):
a	Management ......	176,885		176,885
b	Legal .........	569,400		569,400
c	Accounting ...........	170,027		170,027
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	186,027		186,027
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	35,685,074	27,899,212	7,785,862
12	Advertising and promotion ....	729,482	6,187	723,295
13	Office expenses .......	4,481,923	3,820,801	661,122
14	Information technology ......	2,082,731	635	2,082,096
15	Royalties ..
16	Occupancy ...........	6,304,614	5,792,666	511,948
17	Travel ............	595,331	154,919	440,412
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	4,882,020	934,740	3,947,280
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	22,559,807	22,559,807
23	Insurance ...	4,454,342	4,454,342
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	38,665,082	38,645,185	19,897
b	BAD DEBT EXPENSE	15,412,732	15,412,732
c	OSC EXPENSES	3,018,635	2,576,541	442,094
d	INDIGENT TAX	3,011,992	3,011,992
e	All other expenses	14,545,402	14,314,902	230,500
25	Total functional expenses. Add lines 1 through 24e	262,528,754	236,483,006	26,045,748	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).

1	Cash–non-interest-bearing ........			2,563,469	1	13,712,041
2	Savings and temporary cash investments .........			49,249,978	2	17,819,961
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			26,904,258	4	28,028,631
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........			2,840,484	7	2,310,761
8	Inventories for sale or use ............			6,719,765	8	7,636,048
9	Prepaid expenses and deferred charges ......			2,090,758	9	1,869,555
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	400,897,261
b	Less: accumulated depreciation	10b	244,918,883	144,955,574	10c	155,978,378
11	Investments—publicly traded securities .			83,871,748	11	76,248,181
12	Investments—other securities. See Part IV, line 11 .....			6,404,863	12	6,826,129
13	Investments—program-related. See Part IV, line 11 ..			-14,825	13	2,166,825
14	Intangible assets ...............			10,019,271	14	24,439,604
15	Other assets. See Part IV, line 11 ...........			5,905,845	15	15,502,398
16	Total assets. Add lines 1 through 15 (must equal line 33)...			341,511,188	16	352,538,512

17	Accounts payable and accrued expenses .....	33,831,970	17	33,718,337
18	Grants payable ...		18
19	Deferred revenue .........	3,719,080	19	3,587,819
20	Tax-exempt bond liabilities .........	136,823,303	20	129,847,529
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	2,525,108	23	4,151,248
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		25
26	Total liabilities. Add lines 17 through 25..	176,899,461	26	171,304,933

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	164,611,727	32	181,233,579
33	Total liabilities and net assets/fund balances ........	341,511,188	33	352,538,512