TY 2021 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/1099-NEC)
(1) PAUL HILTZ...................................................................... PRESIDENT/CEO/TRUSTEE	40.00 ................. 5.00	X	X			1,353,470	0	34,580
(2) PHILLIP DUTCHER TERM 0721...................................................................... FORMER CHIEF OPERATING OFFICER SYS	0.00 ................. 0.00				X	924,440	0	13,802
(3) RICK WYLES...................................................................... CFO/ASSISTANT TREASURER	40.00 ................. 5.00		X			721,538	0	35,521
(4) KRISTIN MASCOTTI MD...................................................................... CHIEF MEDICAL OFFICER	40.00 ................. 5.00		X			657,719	0	76,334
(5) JONATHAN KLING...................................................................... CHIEF OPERATIONS OFFICER SYSTEM	40.00 ................. 5.00		X			555,965	0	71,841
(6) CARLOS B QUINTERO MD...................................................................... CHIEF QUALITY OFFICER	1.00 ................. 44.00		X			0	561,965	44,463
(7) JIM MAHON...................................................................... SENIOR VICE PRESIDENT	40.00 ................. 5.00		X			546,695	0	12,327
(8) RENEE M THIGPEN...................................................................... CHIEF HR OFFICER	40.00 ................. 5.00		X			485,952	0	30,767
(9) PAMELA ZIPPERER-DAVIS TRM 0321...................................................................... FORMER CHIEF ADMINISTRATIVE OFFICER	0.00 ................. 0.00				X	468,442	0	19,661
(10) MICHAEL RILEY TERM 1120...................................................................... FORMER CHIEF STRATEGY OFFICER	0.00 ................. 0.00				X	383,519	0	26,237
(11) CHARLES GRAEBER MD...................................................................... PROGRAM DIRECTOR, INT. MED	40.00 ................. 0.00			X		295,015	0	12,626
(12) YOLETTE DONASSIEN...................................................................... R.N.	40.00 ................. 0.00			X		242,574	0	35,943
(13) TIA MEIKLE RN...................................................................... CLINICAL RESOURCE NURSE	40.00 ................. 0.00			X		241,938	0	33,874
(14) ANDREW COOPER START 0822...................................................................... CHIEF INFORMATION OFFICER	40.00 ................. 5.00		X			244,206	0	19,961
(15) JEFFERY SANDER...................................................................... R.N.	40.00 ................. 0.00			X		233,925	0	30,039
(16) GINA TEEGARDEN RN...................................................................... CHIEF NURSING EXECUTIVE	40.00 ................. 5.00		X			242,211	0	18,105
(17) ILIA ECHEVARRIA RN STRT 122...................................................................... CHIEF NURSING OFFICER NNH	40.00 ................. 5.00		X			235,078	0	21,598

(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/1099-NEC)
(18) LINDA YERGER........................................................................ R.N.	40.00 .......................0.00			X		230,282	25,011
(19) MATTHEW STACELL START 0622........................................................................ CHIEF PERFORMANCE MGMT OFFICER	40.00 .......................5.00		X			187,079	32,986
(20) LINDA ROEBACK TERM 0520........................................................................ FORMER CHIEF COUNSEL	0.00 .......................0.00				X	191,807	5,400
(21) THOMAS THORNTON TRM 1121........................................................................ CHIEF ADMINISTRATIVE OFFICER	40.00 .......................5.00		X			176,542	4,879
(22) ZACHARY BOSTOCK TERM 0320........................................................................ FORMER CHIEF ADMINISTRATIVE OFFICER	0.00 .......................0.00				X	145,718	5,232
(23) GARY TOMCIK TERM 0420........................................................................ FORMER CHIEF EXPERIENCE OFFICER	0.00 .......................0.00				X	122,410	8,384
(24) MARGARET DIMOND START 1221........................................................................ CHIEF ADMINISTRATIVE OFFICER	40.00 .......................5.00		X			91,138	431
(25) SCOTT LUTGERT........................................................................ CHAIRMAN	0.50 .......................1.50	X	X			0	0
(26) KEVIN BEEBE........................................................................ 1ST VICE CHAIRMAN/SECRETARY	0.50 .......................1.50	X	X			0	0
(27) MICHAEL WYNN........................................................................ 2ND VICE CHAIRMAN	0.50 .......................1.50	X	X			0	0
(28) DAVEY SCOON........................................................................ TREASURER	0.50 .......................1.50	X	X			0	0
(29) WILLIAM ALLYN TERM 0122........................................................................ TRUSTEE	0.50 .......................1.50	X				0	0
(30) JAY BAKER........................................................................ TRUSTEE	0.50 .......................1.50	X				0	0
(31) LAURIE COWAN PHILLIPS........................................................................ TRUSTEE	0.50 .......................1.50	X				0	0
(32) KERRY EDWARDS........................................................................ TRUSTEE	0.50 .......................1.50	X				0	0
(33) ALAN EINHORN........................................................................ TRUSTEE	0.50 .......................1.50	X				0	0
(34) ANNE MCNULTY........................................................................ TRUSTEE	0.50 .......................1.50	X				0	0
(35) BILL PEREZ........................................................................ TRUSTEE	0.50 .......................1.50	X				0	0
(36) KIMBERLY QUERREY TERM 0122........................................................................ TRUSTEE	0.50 .......................1.50	X				0	0
(37) JANICE TEAL........................................................................ TRUSTEE	0.50 .......................1.50	X				0	0

(A) Name and business address	(B) Description of services	(C) Compensation
DEANGELIS DIAMOND CONSTRUCTION INC 6635 WILLOW PARK DRIVE NAPLES,FL34109	GENERAL CONTRACTOR	15,485,620
SODEXO INC AND AFFLIATES PO BOX 536922 ATLANTA,GA303536922	DIETARY AND ENVIRONMENTAL SERVICES	11,493,375
CERNER CORPORATION PO BOX 412702 KANSAS CITY,MO64141	IT SUPPORT	10,044,527
ENSEMBLE RCM LLC PO BOX 639076 CINCINNATI,OH45263	REVENUE CYCLE SUPPORT	8,327,472
FINTHRIVE PO BOX 736990 DALLAS,TX753736690	MEDICAL RECORDS SUPPORT	8,096,731
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 101

- TIN:

SCHEDULE A
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

NAPLES COMMUNITY HOSPITAL INC

Employer identification number

59-0694358

Part I

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

The organization is not a private foundation because it is: (For lines 1 through 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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 5 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 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. 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—2021. 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—2020. 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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 5 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 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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

Did one or more disqualified persons (as defined on 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 on 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) 2021

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

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 0.015 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 0.035	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) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

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

2021

Name of the organization

NAPLES COMMUNITY HOSPITAL INC

Employer identification number

59-0694358

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

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) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization NAPLES COMMUNITY 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
RESTRICTED	,	$ RESTRICTED	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) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization NAPLES COMMUNITY HOSPITAL INC		Employer identification number 59-0694358

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization NAPLES COMMUNITY HOSPITAL INC			Employer identification number 59-0694358
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) (2021)

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

2021

Open to Public Inspection

Name of the organization

NAPLES COMMUNITY HOSPITAL INC

Employer identification number

59-0694358

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" 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) 2021

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 ....	17,022,434	16,068,607	15,631,211	15,584,397	14,783,076
b	Contributions ...		84,960	117,661	3,907	601,291
c	Net investment earnings, gains, and losses	-1,056,470	868,867	319,735	42,907	200,030
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	15,965,964	17,022,434	16,068,607	15,631,211	15,584,397

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)

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

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

Part VI

Land, Buildings, and Equipment.
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 .....	37,454,700		37,454,700
b	Buildings ....	508,899,129	271,332,541	237,566,588
c	Leasehold improvements	10,219,477	7,253,770	2,965,707
d	Equipment ....	478,761,328	346,165,355	132,595,973
e	Other .....	16,145,947	6,738,150	9,407,797
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				419,990,765

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other 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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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
(1)ASSETS LIMITED AS TO USE				264,383,522
(2)OTHER ASSETS				1,660,140
(3)DEPOSITS				307,368
(4)THIRD-PARTY RECEIVABLE				48,533,525
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				314,884,555

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
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	68,075,619
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) 2021

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
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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

Return Reference

Explanation

PART V, LINE 4:

INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS ALL ENDOWMENT FUNDS MAINTAINED BY NAPLES COMMUNITY HOSPITAL, INC. ARE USED IN FURTHERANCE OF THE ORGANIZATION'S TAX-EXEMPT PURPOSES.

PART X, LINE 2:

THE SYSTEM AND ALL OF ITS NOT-FOR-PROFIT SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE (THE CODE). THE SYSTEM AND ALL OF ITS NOT-FOR-PROFIT SUBSIDIARIES DO NOT HAVE SIGNIFICANT UNRELATED BUSINESS INCOME; HOWEVER, SUCH STATUS IS SUBJECT TO FINAL DETERMINATION UPON EXAMINATION OF THE RELATED INCOME TAX RETURNS BY THE APPROPRIATE TAXING AUTHORITIES. THE SYSTEM IS GENERALLY NO LONGER SUBJECT TO TAX EXAMINATIONS IN THE MAJOR U.S. TAXING JURISDICTIONS IN WHICH THEY OPERATE FOR TAX YEARS PRIOR TO 2018.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right 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

2021

Open to Public Inspection

Name of the organization
NAPLES COMMUNITY HOSPITAL INC

Employer identification number

59-0694358

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990) 2021

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 HOSPITAL BALL (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	1,504,119	1,504,119
2	Less: Contributions . . . .	637,398	637,398
3	Gross income (line 1 minus line 2) . . . . . .	866,721	866,721

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	80,553	80,553
7	Food and beverages . . .	178,564	178,564
8	Entertainment . . . .	46,012	46,012
9	Other direct expenses . . .	132,098	132,098
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		437,227
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		429,494

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2021

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2021

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

2021

Open to Public Inspection

Name of the organization

NAPLES COMMUNITY HOSPITAL INC

Employer identification number

59-0694358

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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? . . . . . . . . .

Yes

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

Yes

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) . . .	26,985,366		26,985,366	3.750 %
b	Medicaid (from Worksheet 3, column a) . . . . .	77,161,421	63,508,487	13,652,934	1.900 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	104,146,787	63,508,487	40,638,300	5.650 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	3,372,248		3,372,248	0.470 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	3,372,248		3,372,248	0.470 %
k	Total. Add lines 7d and 7j .	107,519,035	63,508,487	44,010,548	6.120 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

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

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	576,732	576,732	0.080 %
4	Environmental improvements
5	Leadership development and training for community members	34,567	34,567	0 %
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	611,299	611,299	0.080 %

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. ......

888,122

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. ......

33,038

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).....

371,329,753

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

434,215,097

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

-62,885,344

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) 2021

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	NAPLES COMMUNITY HOSPITAL INC 350 7TH STREET NORTH NAPLES,FL34102 WWW.NCHMD.ORG LICENSE #4113	X	X	X

Schedule H (Form 990) 2021

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)

	NAPLES COMMUNITY HOSPITAL INC
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 21

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

Yes

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

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): HTTP://WWW.NCHMD.ORG/ABOUT-US/ANNUAL-REPORTS

Other website (list url):

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 21

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

Yes

If "Yes" (list url): HTTP://WWW.NCHMD.ORG/ABOUT-US/ANNUAL-REPORTS

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) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	NAPLES COMMUNITY HOSPITAL INC
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):

HTTP://WWW.NCHMD.ORG/PATIENTS-AND-VISITORS/BILLING-INFO

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

HTTP://WWW.NCHMD.ORG/PATIENTS-AND-VISITORS/BILLING-INFO

A plain language summary of the FAP was widely available on a website (list url):
HTTP://WWW.NCHMD.ORG/PATIENTS-AND-VISITORS/BILLING-INFO

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) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	NAPLES COMMUNITY HOSPITAL INC
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) 2021

Page 7

Part VFacility Information (continued)

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

	NAPLES COMMUNITY HOSPITAL INC
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) 2021

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
NAPLES COMMUNITY HOSPITAL, INC.	PART V, SECTION B, LINE 5: CHNA TAKING INTO ACCOUNT INPUT FROM THE COMMUNITYTHE NCH LEADERSHIP TEAM IS ACTIVELY INVOLVED AND PARTICIPATES IN MANY COMMUNITY RELATED ORGANIZATIONS AND GROUPS THAT ARE CONTINUALLY ASSESSING UNMET NEEDS WITHIN COLLIER COUNTY. NCH HAS HISTORICALLY WORKED WITH OUR BOARD OF TRUSTEES, COLLIER COUNTY CHILDREN'S ALLIANCE, COLLIER COUNTY PUBLIC SCHOOLS, BLUE ZONES PROJECT OF SWFL AND OTHER AGENCIES THROUGHOUT THE COMMUNITY IN ASSESSING AND COLLABORATING IN EFFORTS TO IMPROVE THE HEALTH OF OUR COMMUNITY.NCH WORKS COLLABORATIVELY WITH THE FLORIDA DEPARTMENT OF HEALTH IN COLLIER COUNTY, THE COUNTY AND CITY GOVERNMENT, THE NAPLES AREA CHAMBER OF COMMERCE AND SEVERAL OTHER COMMUNITY GROUPS TO FORM THE COMMUNITY ASSESSMENT DESIGN GROUP. THE PURPOSE IS TO ASSESS THE COMMUNITY'S STRENGTHS AND OPPORTUNITIES. A NEW COMMUNITY HEALTH ASSESSMENT WAS COMPLETED IN 2022. THE 2020-2023 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PRIORITIES WERE ESTABLISHED IN 2020 BY THE HEALTHY COLLIER EXECUTIVE COMMITTEE BASED ON THE RESULTS FROM THE 2019 CHA. DOH-COLLIER FACILITATED THE CHIP PROCESS BY USING THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) STRATEGIC PLANNING MODEL. USING THE MOBILIZING FOR ACTION THROUGH THE PLANNING AND PARTNERSHIP (MAPP) FRAMEWORK, THE LEADERSHIP FOR COMMUNITY HEALTH IMPROVEMENT PLANNING (LCHIP) COMMITTEE REVIEWED THE 2019 COMMUNITY HEALTH ASSESSMENT (CHA) AND HELD DISCUSSIONS REGARDING GROUP PRIORITIES AND OBJECTIVES GOING FORWARD. THE COMMITTEE AGREED THAT THE RESULTS STRONGLY CORROBORATED THE RESULTS OF OTHER RECENT COMMUNITY ASSESSMENTS AND ACCURATELY REFLECT THE NEEDS OF COLLIER COUNTY.THE 2020-2023 CHIP WAS THEN SHAPED USING THE FIVE HIGHEST RANKED HEALTH PRIORITY AREAS FROM THE CHA RESULTS. THEY INCLUDE MENTAL HEALTH, CHRONIC DISEASES, ACCESS TO CARE, ALCOHOL AND DRUG USE, AND HEALTH OF OLDER ADULTS. MENTAL HEALTH AND ALCOHOL & DRUG USE WERE COMBINED INTO THE MENTAL HEALTH & SUBSTANCE ABUSE WORKGROUP. IN FEBRUARY AND MARCH OF 2020, THE DOH-COLLIER FACILITATORS CONVENED THE HEALTH PRIORITY WOKGROUPS TO FINALIZE THE GOALS, STRATEGIES, AND OBJECTIVES THAT EACH GROUP WILL WORK ON FOR THE NEXT THREE YEARS.HEALTH PRIORITY: MENTAL HEALTH AND SUBSTANCE ABUSEGOAL: IMPROVE IDENTIFICATION AND TREATMENT OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS.OBJECTIVES:1. INCREASE THE COMBINED (HCN AND DLC) PERCENTAGE OF REFERRAL STATUS UPDATES GIVEN TO MEDICAL PROVIDERS WHO REFERRED PATIENTS FOR MENTAL HEALTH SERVICES FROM 47% IN 2021 TO 55% BY DECEMBER 2022. PROGRESS: AT THE END OF 2022, THE PERCENTAGE DECREASED TO 41.07%.2. INCREASE THE NUMBER OF INDIVIDUALS TRAINED PER YEAR IN YOUTH AND ADULT MENTAL HEALTH FIRST AID FROM 1060 IN 2019 TO 1500 BY DECEMBER 2022. PROGRESS: THE NUMBER OF INDIVIDUALS TRAINED IN 2022 WERE 2,937.HEALTH PRIORITY: CHRONIC DISEASESGOAL: DELIVER CULTURALLY RELEVANT HEALTH EDUCATION TO COLLIER COUNTY RESIDENTS IN POPULATIONS WITH DISPARITIES IN HEALTH OUTCOMES.OBJECTIVES:1. INCREASE THE NUMBER OF BLUE ZONES APPROVED WORKSITES FROM 49 IN 2019 TO 85 BY DECEMBER 2022. PROGRESS: TWENTY-ONE NEWLY APPROVED WORKSITES WERE ADDED IN 2022 WHICH RESULTED IN A TOTAL OF 87 APPROVED WORKSITES.2. INCREASE THE NUMBER OF EARLY CARE AND EDUCATION (ECE) SITES TO COMPLETE THE GO NUTRITION AND PHYSICAL ACTIVITY SELF-ASSESSMENT FOR CHILD CARE (GO NAPSACC) FROM 0 IN 2021 TO FIVE BY DECEMBER 2022. PROGRESS: THERE WERE NO NEW ECE SITES TO COMPLETE THE ASSESSMENT IN 2022. DOH-COLLIER'S RESPONSE TO THE COVID-19 PANDEMIC SLOWED PROGRAM DEVELOPMENT AND ONBOARDING.3. REACH A MINIMUM OF 2000 UNDUPLICATED SNAP-ELIGIBLE YOUTH THROUGH NUTRITION EDUCATION BY DECEMBER 2022. PROGRESS: THIS PROGRAM EXCEEDED ITS 2022 TARGET WITH 2,655 SNAP-ELIGIBLE YOUTH. 4. REACH A MINIMUM OF 150 UNDUPLICATED SNAP-ELIGIBLE ADULTS THROUGH NUTRITION EDUCATION BY DECEMBER 2022. PROGRESS: IN 2022, 315 SNAP-ELIGIBLE ADULTS PARTICIPATED IN THE PROGRAM. 5. INCREASE THE NUMBER OF PARTICIPANTS THAT COMPLETE THE HEALTHY FOR GOOD PROGRAM FROM 100 IN 2021 TO 160 BY DECEMBER 31, 2022. PROGRESS: FOR 2022, THERE WERE NO ADDITIONAL PARTICPANTS IN THIS PROGRAM.6. INCREASE THE NUMBER OF STUDENTS IMPACTED BY THE SMARTER LUNCHROOM PSE CHANGES AT SNAP ELIGIBLE SCHOOLS IN COLLIER COUNTY FROM 0 TO 25,000 BY DECEMBER 2022. PROGRESS: RESULT OF THIS OBJECTIVE WAS NOT REPORTED FOR 2022.7. INCREASE THE ANNUAL NUMBER OF REFERRALS TO THE CHILDHOOD OBESITY PROGRAM FROM THE 34142, 34116, AND 34112 ZIP CODES FROM 16 IN 2021 TO 60 BY DECEMBER 2022. PROGRESS: BY THE END OF 2022, THE NUMBER OF REFERRALS INCREASED TO 72.HEALTH PRIORITY: ACCESS TO CAREGOAL: INCREASE ACCESS TO BLOOD PRESSURE SCREENING SERVICES FOR UNINSURED COLLIER COUNTY RESIDENTS.OBJECTIVE:1. INCREASE THE NUMBER OF UNINSURED RESIDENTS PER YEAR IN COLLIER COUNTY WHO RECEIVED A BLOOD PRESSURE SCREENING FROM 12,404 IN 2019 TO 14,000 IN 2022, AN INCREASE OF ABOUT 5% PER YEAR. PROGRESS: WHILE COVID-19 TESTING DROVE PATIENTS TO THE CLINICS IN 2020, WORKGROUP MEMBERS CONCLUDED THAT MASK AND VACCINE REQUIREMENTS CONTINUED TO KEEP SOME AWAY IN 2022. THIS RESULTED IN 10,761 UNINSURED RESIDENTS RECEIVING BLOOD PRESSURE SCREENINGS.HEALTH PRIORITY: HEALTH OF OLDER ADULTSGOAL: INCREASE CAPACITY FOR OLDER ADULTS (AGE 60+) TO COMFORTABLY AND SAFELY AGE IN PLACE WITH APPROPRIATE RESOURCES IN A LIVABLE COMMUNITY.OBJECTIVES:1. INCREASE THE PERCENTAGE OF STEPS COMPLETED TO PRODUCE THE COLLIER COUNTY AGE-FRIENDLY ACTION PLAN FROM 0% IN 2021 TO 100% BY DECEMBER 2022. PROGRESS: 100% OF THE PROJECT WAS COMPLETED BY THE END OF 2022.2. INCREASE THE ANNUAL NUMBER OF COMMUNITY TOUCHPOINTS REGARDING DEMENTIA PRESENTATIONS, OUTREACH, TRAININGS, AND EVENTS FROM 83 IN 2021 TO 100 BY DECEMBER 2022. PROGRESS: AT THE END OF 2022, 78 COMMUNITY TOUCHPOINTS WERE MADE. THE CHIP SERVES AS A ROADMAP FOR CONTINUOUS IMPROVEMENT. THE CHIP WILL CONTINUE TO EVALUATE THE NEEDS OF THE COMMUNITY AND BY WORKING TOGETHER, WE CAN HAVE A SIGNIFICANT IMPACT ON COLLIER COUNTY'S HEALTH AND WELL-BEING AWARENESS.
NAPLES COMMUNITY HOSPITAL, INC.	PART V, SECTION B, LINE 6A: CHNA CONDUCTED WITH ONE OR MORE HOSPITAL FACILITIESAS PART OF AN INTEGRATED HEALTHCARE SYSTEM, THE CHNA FOR NAPLES COMMUNITY HOSPITAL AND MARCO ISLAND HOSPITAL WAS PREPARED JOINTLY.
NAPLES COMMUNITY HOSPITAL, INC.	PART V, SECTION B, LINE 11: ADDRESSING THE NEEDS IDENTIFIED IN THE CHNATHE CHNA IDENTIFIED PROBLEM AREAS THAT NEEDED TO BE ADDRESSED. THESE INCLUDE SUFFICIENT JOB EMPLOYMENT, ECONOMIC OPPORTUNITIES, ACCESS TO AFFORDABLE HOUSING, DRUG AND ALCOHOL ABUSE, SAFE ROADWAYS FOR BICYCLIST AND PEDESTRIANS, PRIMARY CARE RESOURCES, ACCESS TO AFFORDABLE HEALTHY FOOD, ACCESS TO LONG TERM CARE NEEDS, COMMUNICABLE DISEASE, OBESITY, CHRONIC DISEASE, MENTAL HEALTH, DENTAL HEALTH, ACCESS TO CARE, DISABILITIES AND UNINTENTIONAL INJURIES.UPON REVIEW OF THE FINDINGS OF THE CHNA, THE NCH LEADERSHIP TEAM CAME UP WITH FIVE KEY AREAS TO FOCUS ON WHICH INCLUDED MENTAL HEALTH, CHRONIC DISEASE (ONCOLOGY), MATERNAL AND INFANT HEALTH, HEALTH OF THE OLDER POPULATION AND HEALTH BEHAVIORS AND OUTCOMES. BELOW IS A SUMMARY OF ACTIVITIES AND INITIATIVES NCH ACHIEVED IN THE PAST THREE YEARS IN THESE SPECIFIC KEY AREAS.MENTAL HEALTHIN AN EFFORT TO EXPAND ACCESS OF OUTPATIENT BEHAVIORAL HEALTH SERVICE NCH CO-LOCATED PHYSICIAN PRACTICES AND NCH HAS BEEN PARTICIPATING IN THE COLLIER COUNTY COMMISSIONERS AD HOC TASK FORCE ON MENTAL HEALTH AND ADDICTION NEEDS IN COLLIER COUNTY. THE COMMITTEE SPONSORED A ONE-CENT SALES TAX, WHICH WAS APPROVED FOR $25 MILLION FOR IMPROVING MENTAL HEALTH IN COLLIER. IN RESPONSE TO MANAGING HIGH-RISK PSYCHIATRIC PATIENTS, NCH HAS PLACED CASE MANAGERS IN NCH EMERGENCY DEPARTMENTS TO WORK WITH FREQUENT USERS OF ED AND INPATIENT SERVICES.IN ORDER TO TARGET SEVERE DEPRESSION NCH WILL SOON BE IMPLEMENTING AN ELECTRO CONVULSIVE THERAPY PROGRAM (ECT) AND A TRANS MAGNETIC SIMULATION PROGRAM (TMS), AS WELL AS IV KETAMINE AND INTRA NASAL KETAMINE PROGRAMS WHEN APPROVED BY THE FDA.CHRONIC DISEASE (ONCOLOGY)MAMMOGRAM SCREENINGS ARE OFFERED AND PROVIDED TO UNINSURED AND UNDERINSURED PATIENTS. IN ADDITION, A COMMUNITY FAIR IS SCHEDULED EACH YEAR AT LOCAL CHURCHES, CP-3 SCREENINGS AND AN AMERICAN CANCER ASSOCIATION STUDY HAS ALSO BEEN COMPLETED.NCH HIRED CARDIO THORACIC SURGEONS WHO DEVELOPED A COMPREHENSIVE LUNG CANCER PROGRAM FOCUSING ON SCREENING, NAVIGATION, SURVIVORSHIP AND SURGICAL INTERVENTION.NCH EXPANDED ITS NURSE NAVIGATION PROGRAM WITH FOCUS ON FOLLOWING ONCOLOGY PATIENTS THROUGHOUT THE CONTINUUM OF CARE WITH SPECIAL EMPHASIS ON BREAST AND LUNG PATIENTS AS WELL AS SCREENING ACTIVITIES.MATERNAL AND INFANT HEALTHNCH IMPLEMENTED SKIN TO SKIN IN THE DELIVERY ROOM. THE SKIN TO SKIN RATE IS 96%. ALL REGISTERED NURSES IN LABOR AND DELIVERY, MOTHER/BABY, NEONATAL INTENSIVE CARE UNIT, PEDIATRICS AND PEDIATRICS ED ARE EDUCATED IN BREASTFEEDING. NCH MAINTAINS A BREASTFEEDING RATE OF 58%. NCH EMPLOYS 1 FULL-TIME AND 1 PART-TIME EQUIVALENT LACTATION CONSULTANTS WHICH ARE AVAILABLE 7 DAYS A WEEK 16 HOURS PER DAY. NCH ALSO HOSTS THE COLLIER COUNTY BREASTFEEDING COALITION WITH AN OVERALL GOAL TO INCREASE BREASTFEEDING RATES IN COLLIER COUNTY.NCH IS A HOST MEMBER OF A SUBSTANCE ABUSE COALITION AND SPONSORS REGULAR MEETINGS HELD AT NCH. THE COALITION REPORTS DATA TO THE STATE AND ALSO SUPPORTS NURSE EDUCATIONAL PROGRAMS FOR PARENTS ON THE DETRIMENTAL EFFECTS OF SUBSTANCE ABUSE FOR NEWBORNS. ALL PATIENTS AND PARENTS ARE OFFERED TDAP IMMUNIZATION AND CURRENTLY ON WOMEN AND CHILDREN'S AND PEDIATRIC NURSING UNITS A STANDING ORDER FOR TDAP ADMINISTRATION IF STATUS IS UNKNOWN. IN ADDITION, IN WOMEN AND CHILDREN'S AND PEDIATRIC NURSING UNITS ALL NCH STAFF HAVE RECEIVED THE TDAP VACCINE AS WELL AS ANY NEW STAFF.HEALTH OF THE OLDER POPULATIONNCH HAS GERIATRIC MEDICINE IN MULTIPLE NCH PHYSICIAN PRACTICES.TWO NCH PHYSICIANS ARE MEDICAL DIRECTORS OF TWO SKILLED NURSING FACILITIES IN COLLIER COUNTY.DIABETES MANAGEMENTNCH HEALTHCARE SYSTEM'S VON ARX DIABETES CENTER HAS TWO RECOGNIZED AMERICAN DIABETES PROGRAMS THAT MAINTAIN DATA COLLECTION AND REPORTING REQUIREMENTS. DIABETES SUPPORT GROUPS ARE PROVIDED TO THE COMMUNITY. ALSO, FREE PRE-DIABETES SEMINARS AND COMMUNITY LECTURES ARE OFFERED THROUGHOUT THE YEAR. PHILANTHROPIC FUNDS HAVE BEEN ALLOCATED FOR PEDIATRICS TO ASSURE THEY HAVE APPOINTMENTS SCHEDULED WITH REGISTERED DIETICIANS OR NURSES FOR UNDERINSURED OR UNINSURED CHILDREN. PHILANTHROPIC FUNDS ARE ALSO USED FOR GESTATIONAL PATIENTS PROVIDING EDUCATIONAL CLASSES, AND SUPPLIES. OUR RESULTS INCLUDE 80% OF WOMEN ACHIEVED TARGET RANGES FOR BLOOD GLUCOSE LEVELS AND 85% OF BABIES BORN MET BIRTH WEIGHT GOALS (<9 LBS.).ACCOMPLISHMENTS FOR 2022 INCLUDE, BUT ARE NOT LIMITED TO: I. THE VON ARX DIABETES CENTER SERVED 5,545 OUTPATIENT VISITS; II. SERVICES WERE EXPANDED TO MARCO ISLAND AND BONITA SPRINGS; III. EXPANDED GROCERY STORE TOURS; IV. MAINTAINED ACCREDITATION WITH THE AMERICAN DIABETES ASSOCIATION NCH WORKING WITH THE FLORIDA DEPARTMENT OF HEALTH - COLLIER COUNTY PARTICIPATED AGAIN IN THE COLLIER COUNTY COMMUNITY ASSESSMENT DESIGN GROUP. THE SCOPE OF THE GROUP IS TO DESIGN A COMMUNITY STRENGTHS/OPPORTUNITIES SURVEY. A SURVEY WAS PREPARED AND SENT OUT TO THE HEALTH CARE LEADERS, COMMUNITY FOCUS GROUPS AND HEALTH CARE STAFF. IDENTIFIED PROBLEM AREAS INCLUDED THE FOLLOWING:CHRONIC DISEASE AND MORTALITYINFECTIOUS DISEASEMATERNAL AND INFANT HEALTHINJURIESACCESS TO HEALTHCAREHEALTH BEHAVIORS AND HEALTH STATUSMENTAL HEALTHORAL HEALTHTHE HEALTH OF THE OLDER POPULATIONSUBSEQUENTLY, THE LEADERSHIP FOCUS GROUP MET TO DISCUSS BOTH THE POSITIVE AND NEGATIVE FACTORS THAT INFLUENCED THESE AREAS.THE NEXT STEP IN THE PROCESS WAS TO CONDUCT GEOGRAPHICAL AREA COMMUNITY FOCUS GROUPS. THESE GROUPS WERE CHOSEN TO REFLECT AND INCLUDE THE DIVERSITY OF COMMUNITY LOCATIONS, ETHNICITY, AND SOCIO-ECONOMIC FACTORS. THE DISTINCT AREAS OF THE COUNTY REPRESENTED UNIQUE DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS. THE DIFFERENCES WERE VALUABLE AND USEFUL FOR ASSESSING AND PRIORITIZING HEALTHCARE NEEDS WITHIN OUR COMMUNITY. IN ADDITION, WE PROVIDED INPUT INTO THE ANALYSIS ON VARIOUS HEALTH INDICATORS WHICH INCLUDED THE FOLLOWING: POPULATION SOCIOECONOMIC CHARACTERISTICS INFECTIOUS DISEASE HEALTH BEHAVIORS AND HEALTH STATUS MORTALITY INDICATORS MATERNAL AND INFANT HEALTH HEALTH OF THE OLDER POPULATIONUPON REVIEW OF THE FINDINGS OF THE (CHNA) THE NCH LEADERSHIP TEAM REVIEWED THE FINDINGS. A PRIORITIZATION SESSION WAS COMPLETED WHICH WAS BASED ON THE MISSION, VISION AND CORE VALUES OF THE NCH HEALTHCARE SYSTEM WITH A PRIMARY FOCUS ON THE GOAL OF COLLIER COUNTY BECOMING THE HEALTHIEST COUNTY IN THE UNITED STATES. UPON MUCH DISCUSSION THE TEAM CAME UP WITH FOUR KEY AREAS OF FOCUS WHICH INCLUDE: MENTAL HEALTH ACCESS TO CARE CHRONIC DISEASE HEALTH OF OLDER ADULTSUNADDRESSED IDENTIFIED NEEDSALTHOUGH SEVERAL COMMUNITY NEEDS WERE IDENTIFIED, NCH MUST FOCUS OUR EXISTING CLINICAL STRENGTHS AND INFRASTRUCTURE WHERE WE CAN MAXIMIZE OUR RESOURCES TO BENEFIT THE GREATEST NUMBER OF PEOPLE IN THE COMMUNITY. NCH WILL CONTINUE TO RE-EVALUATE THE UNADDRESSED IDENTIFIED NEEDS AND PURSUE ACTION WHEN AND WHERE RESOURCES ALLOW.
NAPLES COMMUNITY HOSPITAL, INC.	PART V, SECTION B, LINE 13B: NCH HAS A POLICY THAT ALLOWS A DISCOUNT FOR SELF-PAY UNINSURED OR UNDERINSURED PATIENTS WITH INCOME AND ASSETS GREATER THAN 200% OF FPG WHEN THE FAP APPLICATION AND SUPPORTING DOCUMENTATION IS PROVIDED.NCH RETAINS DISCRETION TO PROVIDE FINANCIAL ASSISTANCE TO PATIENTS WHO FALL OUTSIDE THE FPG INCOME GUIDELINES. OTHER CONSIDERATIONS TO INCOME LEVEL ARE PERCENTAGE OF TOTAL AMOUNT CHARGED BASED ON SERVICES PROVIDED TO THE PATIENT COMPARED TO PATIENTS INCOME.
NAPLES COMMUNITY HOSPITAL, INC.	PART V, SECTION B, LINE 13H: NAPLES COMMUNITY HOSPITAL, INC.:BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS.OTHER CRITERIA USED TO DETERMINE ELIGIBILITY ARE PATIENTS WHO ARE ELIGIBLE TO RECEIVE BENEFITS FROM A GOVERNMENTAL AGENCY AS THE VICTIM OF A VIOLENT CRIME OR SEXUAL ASSAULT AND THE TREATMENT IS RELATED TO THE VIOLENT CRIME OR SEXUAL ASSAULT.

Schedule H (Form 990) 2021

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2021

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 3C:	NCH USES OTHER FACTORS OTHER THAN FPG TO DETERMINE ELIGIBILTY FOR PROVIDING FREE OR DISCOUNTED CARE AS DESCRIBED BELOW.PRESUMPTIVE ELIGIBILITYPATIENTS MAY BE ELIGIBLE FOR A DISCOUNT OF THE FULL UNPAID BALANCE IN THE ABSENCE OF A COMPLETED FINANCIAL ASSISTANCE APPLICATION FORM IF THE PATIENT MEETS ONE OF THE FOLLOWING:1. IS HOMELESS2. IS DECEASED AND HAS NO KNOWN ESTATE AVAILABLE TO PAY MEDICAL BILLS3. IS CURRENTLY ELIGIBLE FOR MEDICAID (AS PRIMARY INSURANCE) BUT WAS NOT AT DATE OF SERVICE OR MEDICAID BENEFITS ARE EXHAUSTED.4. IS ELIGIBLE TO RECEIVE BENEFITS FROM A GOVERNMENTAL AGENCY AS THE VICTIM OF A VIOLENT CRIME OR SEXUAL ASSAULT AND THE TREATMENT IS RELATED TO THE VIOLENT CRIME OR SEXUAL ASSAULT.5. A DEMONSTRATED INABILITY TO PAY FOR SERVICES BASED ON ALL AVAILABLE ASSETS. PATIENTS RECEIVING CARE IN OR FROM THE EMERGENCY DEPARTMENT WHO ARE WITHOUT FINANCIAL RESOURCES MAY BE ELIGIBLE FOR THE FAP IF THEY ARE UNEMPLOYED OR SELF-EMPLOYED AND CANNOT PROVIDE INCOME AN INCOME TAX STATEMENT, ARE INDIGENT WITHOUT ACCESS TO THE REQUIRED APPLICATION DOCUMENTATION MAY STILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE.
PART I, LINE 6A:	RELATED PARTY DISCLOSURENAPLES COMMUNITY HOSPITAL, INC. ("NCH") IS AN AFFILIATE OF NCH HEALTHCARE SYSTEM, INC. ("NCHS"). NCHS PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND INCLUDES THIS REPORT WITH ITS FORM 990 TAX RETURN FILING.THE COMMUNITY BENEFIT REPORT PREPARED INCLUDES ALL ORGANIZATIONS OF THE SYSTEM, INCLUDING NAPLES COMMUNITY HOSPITAL, INC.
PART I, LINE 7:	COSTING METHOD USEDTHE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINE 7 ARE BASED ON THE COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM FORM 990, SCH. H, WORKSHEET 2.
PART I, LN 7 COL(F):	BAD DEBT EXPENSE INCLUDED FORM 990, PART IX, LINE 25THE BAD DEBT EXPENSE AMOUNT INCLUDED ON FORM 990, PART IX, COLUMN 25(A) WAS $888,122 FOR THE YEAR ENDED SEPTEMBER 30, 2022. THIS AMOUNT HAS BEEN SUBTRACTED FOR THE PURPOSE OF CALCULATING THE PERCENTAGE REPORTED ON THE SCHEDULE H, PART I, LINE 7 TABLE.
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIESSHARING OUR SPACEWHEN SPACE IS AVAILABLE, NCH PROVIDES SPACE AT NO COST TO NEEDY, NOT-FOR-PROFIT ORGANIZATIONS. THE TELFORD EDUCATION CENTER IS AVAILABLE TO NOT-FOR-PROFIT HEALTHCARE RELATED GROUPS SUCH AS MENDED HEARTS AND THOSE THAT PROVIDE SUPPORT FOR STROKE AND KIDNEY PATIENTS. RESIDENTS OF MARCO BENEFITED WITH THE USE OF OUR FACILITY FOR COMMUNITY EDUCATION AND THE HOSPICE SUPPORT GROUP.CLINICAL NURSING SCHOOLTHE CLINICAL NURSING SCHOOL OF FLORIDA SOUTHWESTERN STATE COLLEGE IS PROVIDED HERE AT NCH. FOR YEARS, NCH HAS ALWAYS WELCOMED STUDENTS OF FLORIDA SOUTHWESTERN STATE COLLEGE AND LORENZO WALKER INSTITUTE OF TECHNOLOGY TO OUR FACILITIES. NCH PROVIDES ON-SITE CLASSROOMS FOR CLINICAL EDUCATION.NURSING AND RADIOLOGY SCHOLARSHIPS ARE GENEROUSLY FUNDED AT BOTH FLORIDA SOUTHWESTERN STATE COLLEGE AND FGCU.SHARING OUR EXPERTISEMEMBERS OF NCH MANAGEMENT SERVE ON COMMUNITY BOARDS IN VARIOUS CAPACITIES. WE ALSO PROVIDE EXPERTISE TO OTHER COMMUNITY ISSUES SUCH AS WORKFORCE HOUSING AND WORKFORCE DEVELOPMENT.EMPLOYING THE COMMUNITYNCH IS GROWING OUR OWN HEALTHCARE PROFESSIONALS, AND HELPING OTHERS SEEKING WORK, TO FIND IT. CAREER DAYS, JOB SHADOWING, AND LECTURES AT LOCAL MIDDLE AND HIGH SCHOOLS ENLIGHTEN STUDENTS ABOUT THE MANY OPPORTUNITIES IN THE HEALTHCARE WORLD.
PART III, LINE 2:	BAD DEBT EXPENSE, COSTING METHODOLOGY USEDBAD DEBT EXPENSE IN THE FINANCIAL STATEMENTS IS DETERMINED BY PATIENTS THAT HAVE FILED FOR BANKRUPTCY AND/OR HAVE LOSS OF EMPLOYMENT AFTER THE DATE OF SERVICE.
PART III, LINE 3:	BAD DEBT EXPENSETHE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 2 IS BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM FORM 990, SCH. H, WORKSHEET 2.
PART III, LINE 4:	BAD DEBT FOOTNOTEBAD DEBTS REPRESENT CHARGES DEEMED UNCOLLECTIBLE DUE TO EITHER: (A) A PATIENT'S INABILITY TO QUALIFY AS CHARITY, WELFARE, OR MEDICAID, YET CLEAR FINANCIAL INDICATIONS EXIST THAT DEMONSTRATE AN INABILITY TO PAY, OR (B) A PATIENT'S REFUSAL TO PAY FOR SERVICES PROVIDED AND THE SYSTEM'S DECISION TO CEASE FURTHER COLLECTION EFFORTS. BAD DEBT EXPENSE IN THE FINANCIAL STATEMENTS IS DETERMINED BY PATIENTS THAT HAVE FILED FOR BANKRUPTCY AND/OR HAVE LOSS OF EMPLOYMENT AFTER THE DATE OF SERVICE. THE BAD DEBT EXPENSE FOOTNOTE DISCLOSURES CAN BE FOUND ON PAGES 17 AND 18 OF THE ATTACHED CONSOLIDATED FINANCIAL STATEMENTS FOR THE NCH HEALTHCARE SYSTEM, INC. AND SUBSIDIARIES.
PART III, LINE 8:	COSTING METHODOLOGY, MEDICARETHE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM FORM 990, SCH. H, WORKSHEET 2.CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF NCH AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, THE HOSPITAL PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE. SUCH CARE IS PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY THE HOSPITAL TO PROVIDE SUCH SERVICES.AS A RESULT, NAPLES COMMUNITY HOSPITAL, INC. VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION.
PART III, LINE 9B:	COLLECTION PRACTICESNAPLES COMMUNITY HOSPITAL, INC. PROVIDES URGENT/EMERGENT MEDICAL SERVICES WITHOUT REGARD TO ABILITY TO PAY. NAPLES COMMUNITY HOSPITAL, INC. ALSO PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET SPECIFIC CRITERIA UNDER THE STATE'S CHARITY CARE GUIDELINES. BECAUSE NAPLES COMMUNITY HOSPITAL, INC. DOES NOT PURSUE COLLECTION OF ACCOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS REVENUE.
PART VI, LINE 2:	NEEDS ASSESSMENTTHE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES IN VARIOUS WAYS. OUR LEADERSHIP TEAM IS ACTIVELY INVOLVED AND PARTICIPATES IN MANY COMMUNITY RELATED ORGANIZATIONS AND GROUPS THAT ARE CONTINUALLY ASSESSING UNMET NEEDS WITHIN COLLIER COUNTY. WE HAVE HISTORICALLY WORKED WITH OUR BOARD OF TRUSTEES, COLLIER COUNTY CHILDREN'S ALLIANCE, COLLIER COUNTY PUBLIC SCHOOLS, THE IMMOKALEE FOUNDATION, CHILDREN'S MEDICAL SERVICES, AND OTHER AGENCIES THROUGHOUT OUR COMMUNITY IN ASSESSING AND COLLABORATING IN EFFORTS TO IMPROVE THE HEALTH OF OUR COMMUNITY.NCH PROVIDES MANY HEALTH-ENHANCING EDUCATIONAL PROGRAMS AND RESOURCES IN PROMOTING HEALTH TO THE COMMUNITY. THE CURRENT PROGRAMS AND RESOURCES PROVIDED TO THE COMMUNITY INCLUDE THE FOLLOWING: HEALTH SEMINARS, COMMUNITY HEALTH FAIRS, FREE DIAGNOSTIC AND SCREENING TESTING, THE NEIGHBORHOOD HEALTH CLINIC, HEART PROGRAMS, CANCER SURVIVAL AWARENESS, PATIENT SUPPORT GROUPS, TWO WELLNESS CENTERS, VON ARX DIABETES CENTER, PASTORAL CARE SERVICES, AND SPONSOR AND SUPPORT CLINICAL NURSING SCHOOLS.IN ADDITION TO THE PROGRAMS LISTED, WE ARE ALSO WORKING WITH THE SAFE AND HEALTHY CHILDREN'S COALITION OF COLLIER COUNTY TO DEVELOP PROGRAMS FOR DROWNING PREVENTION, CHILDHOOD OBESITY, SAFE SLEEP EFFORTS, AND BREASTFEEDING PROGRAMS.DURING 2022, WE COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND HAVE POSTED THIS REPORT ON OUR WEBSITE (HTTP://WWW.NCHMD.ORG/ABOUT-US/ANNUAL-REPORTS). WE ARE COMMITTED TO PROMOTING EXISTING AND POTENTIAL NEW PROGRAMS TO THE COMMUNITY IN RESPONSE TO THE COMMUNITY HEALTH NEEDS ASSESSMENT. PLEASE REFER TO THIS REPORT AND DETAILED PLAN WHICH WAS REVIEWED BY THE NCH HEALTHCARE SYSTEM BOARD OF TRUSTEES AND APPROVED AT THE SEPTEMBER 27, 2022 BOARD OF TRUSTEE MEETING. INCLUDED IN THE 2022 REPORT IS THE BLUE ZONE PROJECT WHICH BEGAN IN 2015 AND IS SPONSORED BY NCH. THE BLUE ZONE PROJECT IS A COMPREHENSIVE WELL-BEING IMPROVEMENT INITIATIVE DESIGNED TO HELP PEOPLE LIVE LONGER AND BETTER BY BUILDING STRONG SOCIAL NETWORKS AND ENCOURAGING SUSTAINABLE CHANGES THROUGHOUT THE COMMUNITY THAT LEADS TO HEALTHIER CHOICES.
PART VI, LINE 3:	INFORMATION REGARDING PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCENAPLES COMMUNITY HOSPITAL, INC. RECOGNIZES ITS RESPONSIBILITY TO COMMUNICATE ITS FINANCIAL POLICIES AND EXPECTATIONS TO PATIENTS. THE HOSPITAL INFORMS AND EDUCATES PATIENTS BY PROVIDING PATIENTS WITH THE NCH HEALTHCARE SYSTEM PATIENT RIGHTS AND RESPONSIBILITIES. INCLUDED IN THESE RIGHTS IS THE RIGHT TO BE GIVEN, UPON REQUEST, FULL MEDICAL INFORMATION AND FINANCIAL COUNSELING. IN ADDITION, A PATIENT REPRESENTATIVE WILL CONTACT PATIENTS PRIOR TO SERVICES TO EVALUATE THE PATIENT'S ABILITY TO PAY. THIS PROCESS INCLUDES OBTAINING THE PATIENT'S CURRENT FINANCIAL INFORMATION, OBTAINING A CREDIT REPORT AND REVIEWING THE PATIENT'S PAYMENT HISTORY WITH NAPLES COMMUNITY HOSPITAL, INC. PERSONS REQUIRING ASSISTANCE WITH THE UNFUNDED PORTION OF THEIR BILLS ARE ENCOURAGED TO REQUEST A CHARITY EVALUATION. NCH ALSO PROVIDES ASSISTANCE FOR PATIENTS TO APPLY FOR MEDICAID COVERAGE OR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS WHICH MAY ASSIST WITH PAYMENT FOR MEDICAL SERVICES.
PART VI, LINE 4:	COMMUNITY INFORMATIONNAPLES COMMUNITY HOSPITAL, INC. SERVES A DIVERSE AND SEASONAL COMMUNITY. THE POPULATION IS APPROXIMATELY 386,598. THE MEDIAN AGE OF RESIDENTS IS 51. THE ESTIMATED MEDIAN HOUSEHOLD INCOME IS $70,217. THE UNEMPLOYMENT RATE IS APPROXIMATELY 4.4%. THE PERCENTAGE OF RESIDENTS BELOW THE POVERTY LEVEL IS APPROXIMATELY 12.65%.
PART VI, LINE 5:	INFORMATION REGARDING PROMOTION OF COMMUNITY HEALTHNAPLES COMMUNITY HOSPITAL, INC. PROVIDES HEALTH-ENHANCING EDUCATIONAL PROGRAMS AND RESOURCES IN PROMOTING THE HEALTH OF OUR COMMUNITY. THE TYPE OF PROGRAMS/RESOURCES PROVIDED INCLUDE: HEALTH SEMINARS, COMMUNITY HEALTH FAIRS AND TESTING, REGISTERED NURSES EDUCATING FUTURE PATIENTS, SUPPORTING THE NEIGHBORHOOD HEALTH CLINIC, PHYSICIAN LED ACCESS NETWORK OF COLLIER COUNTY, HEART PROGRAMS, CANCER SURVIVAL AWARENESS, SUPPORT OF PATIENT FAMILIES, DR. JOHN BRIGGS WELLNESS CENTER, AS WELL AS THE SHARING OF SPACE AT NO COST TO NEEDY, NOT-FOR-PROFIT ORGANIZATIONS. THE ORGANIZATION ALSO SPONSORS AND SUPPORTS THE CLINICAL NURSING SCHOOLS IN THE COMMUNITY.THE ORGANIZATION'S CIVIC INVOLVEMENT INCLUDES MEMBERS OF NCH MANAGEMENT SERVING ON COMMUNITY BOARDS IN VARIOUS CAPACITIES. THE HOSPITALS HAVE ALWAYS PROVIDED EXEMPLARY PASTORAL CARE SERVICES. NCH IS ENCOURAGING THEIR OWN HEALTHCARE PROFESSIONAL BY SPONSORING CAREER DAYS, JOB SHADOWING, AND LECTURES AT LOCAL MIDDLE AND HIGH SCHOOLS ON THE MANY OPPORTUNITIES IN THE HEALTHCARE FIELD. FOR ADDITIONAL COMMUNITY ACTIVITIES THAT NAPLES COMMUNITY HOSPITAL, INC. SUPPORTS, PLEASE REFER TO FORM 990, SCHEDULE O, PART III, PROGRAM SERVICES.
PART VI, LINE 6:	AFFILIATED HEALTHCARE SYSTEM INFORMATIONNAPLES COMMUNITY HOSPITAL, INC. IS AN AFFILIATE OF THE NCH HEALTHCARE SYSTEM, INC. NCH HEALTHCARE SYSTEM, INC. PROVIDES HEALTH-ENHANCING EDUCATIONAL PROGRAMS AND RESOURCES IN PROMOTING THE HEALTH OF OUR COMMUNITY. IN ADDITION TO NAPLES COMMUNITY HOSPITAL, INC., THE NCH HEALTHCARE SYSTEM ALSO INCLUDES THE FOLLOWING NON-PROFIT ORGANIZATIONS:> MARCO ISLAND HOSPITAL, INC., OPERATES AN 11 1/2-HOUR/7-DAYS A WEEK URGENT CARE FACILITY AND SERVICES PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. DURING FYE 09/30/2022, 8,555 PATIENTS WERE TREATED. OF THESE PATIENTS, 7.32 % WERE CLASSIFIED AS MEDICAID, CHARITY, OR BAD DEBTS.> COLLIER HEALTH CARE, INC. OWNS AND LEASES HEALTHCARE FACILITIES IN NAPLES AND IMMOKALEE, FLORIDA. > NCHMD, INC. OWNS AND OPERATES PHYSICIAN MEDICAL PRACTICES AND OUTPATIENT RADIOLOGY SERVICES IN COLLIER AND LEE COUNTY, FLORIDA.
PART VI, LINE 7, REPORTS FILED WITH STATES	FL

Schedule H (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

Complete if the organization answered "Yes" 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

2021

Open to Public Inspection

Name of the organization

NAPLES COMMUNITY HOSPITAL INC

Employer identification number

59-0694358

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 .....

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

Yes

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) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1PAUL HILTZ PRESIDENT/CEO/TRUSTEE	(i) (ii)	970,917 ------------- 0	211,754 ------------- 0	170,799 ------------- 0	11,600 ------------- 0	22,980 ------------- 0	1,388,050 ------------- 0	0 ------------- 0
2PHILLIP DUTCHER TERM 0721 FORMER CHIEF OPERATING OFFICER SYS	(i) (ii)	216,973 ------------- 0	146,400 ------------- 0	561,067 ------------- 0	11,600 ------------- 0	2,202 ------------- 0	938,242 ------------- 0	0 ------------- 0
3RICK WYLES CFO/ASSISTANT TREASURER	(i) (ii)	504,131 ------------- 0	114,408 ------------- 0	102,999 ------------- 0	11,600 ------------- 0	23,921 ------------- 0	757,059 ------------- 0	0 ------------- 0
4KRISTIN MASCOTTI MD CHIEF MEDICAL OFFICER	(i) (ii)	588,582 ------------- 0	47,354 ------------- 0	21,783 ------------- 0	59,410 ------------- 0	16,924 ------------- 0	734,053 ------------- 0	0 ------------- 0
5JONATHAN KLING CHIEF OPERATIONS OFFICER SYSTEM	(i) (ii)	440,933 ------------- 0	93,480 ------------- 0	21,552 ------------- 0	48,738 ------------- 0	23,103 ------------- 0	627,806 ------------- 0	0 ------------- 0
6CARLOS B QUINTERO MD CHIEF QUALITY OFFICER	(i) (ii)	0 ------------- 525,327	0 ------------- 16,642	0 ------------- 19,996	0 ------------- 19,203	0 ------------- 25,260	0 ------------- 606,428	0 ------------- 0
7JIM MAHON SENIOR VICE PRESIDENT	(i) (ii)	374,637 ------------- 0	81,333 ------------- 0	90,725 ------------- 0	11,600 ------------- 0	727 ------------- 0	559,022 ------------- 0	0 ------------- 0
8RENEE M THIGPEN CHIEF HR OFFICER	(i) (ii)	333,643 ------------- 0	77,240 ------------- 0	75,069 ------------- 0	11,600 ------------- 0	19,167 ------------- 0	516,719 ------------- 0	0 ------------- 0
9PAMELA ZIPPERER-DAVIS TRM 0321 FORMER CHIEF ADMINISTRATIVE OFFICER	(i) (ii)	141,028 ------------- 0	35,670 ------------- 0	291,744 ------------- 0	0 ------------- 0	19,661 ------------- 0	488,103 ------------- 0	0 ------------- 0
10MICHAEL RILEY TERM 1120 FORMER CHIEF STRATEGY OFFICER	(i) (ii)	316,582 ------------- 0	64,739 ------------- 0	2,198 ------------- 0	8,979 ------------- 0	17,258 ------------- 0	409,756 ------------- 0	0 ------------- 0
11CHARLES GRAEBER MD PROGRAM DIRECTOR, INT. MED	(i) (ii)	263,031 ------------- 0	29,274 ------------- 0	2,710 ------------- 0	11,600 ------------- 0	1,026 ------------- 0	307,641 ------------- 0	0 ------------- 0
12YOLETTE DONASSIEN R.N.	(i) (ii)	227,716 ------------- 0	0 ------------- 0	14,858 ------------- 0	9,975 ------------- 0	25,968 ------------- 0	278,517 ------------- 0	0 ------------- 0
13TIA MEIKLE RN CLINICAL RESOURCE NURSE	(i) (ii)	231,079 ------------- 0	0 ------------- 0	10,859 ------------- 0	10,030 ------------- 0	23,844 ------------- 0	275,812 ------------- 0	0 ------------- 0
14ANDREW COOPER START 0822 CHIEF INFORMATION OFFICER	(i) (ii)	206,115 ------------- 0	29,305 ------------- 0	8,786 ------------- 0	9,911 ------------- 0	10,050 ------------- 0	264,167 ------------- 0	0 ------------- 0
15JEFFERY SANDER R.N.	(i) (ii)	223,052 ------------- 0	0 ------------- 0	10,873 ------------- 0	7,131 ------------- 0	22,908 ------------- 0	263,964 ------------- 0	0 ------------- 0
16GINA TEEGARDEN RN CHIEF NURSING EXECUTIVE	(i) (ii)	217,036 ------------- 0	16,050 ------------- 0	9,125 ------------- 0	8,705 ------------- 0	9,400 ------------- 0	260,316 ------------- 0	0 ------------- 0
17ILIA ECHEVARRIA RN STRT 122 CHIEF NURSING OFFICER NNH	(i) (ii)	211,173 ------------- 0	15,754 ------------- 0	8,151 ------------- 0	9,484 ------------- 0	12,114 ------------- 0	256,676 ------------- 0	0 ------------- 0
18LINDA YERGER R.N.	(i) (ii)	220,532 ------------- 0	0 ------------- 0	9,750 ------------- 0	9,322 ------------- 0	15,689 ------------- 0	255,293 ------------- 0	0 ------------- 0
19MATTHEW STACELL START 0622 CHIEF PERFORMANCE MGMT OFFICER	(i) (ii)	167,289 ------------- 0	12,108 ------------- 0	7,682 ------------- 0	7,727 ------------- 0	25,259 ------------- 0	220,065 ------------- 0	0 ------------- 0
20LINDA ROEBACK TERM 0520 FORMER CHIEF COUNSEL	(i) (ii)	0 ------------- 0	0 ------------- 0	191,807 ------------- 0	0 ------------- 0	5,400 ------------- 0	197,207 ------------- 0	0 ------------- 0
21THOMAS THORNTON TRM 1121 CHIEF ADMINISTRATIVE OFFICER	(i) (ii)	67,778 ------------- 0	70,000 ------------- 0	38,764 ------------- 0	0 ------------- 0	4,879 ------------- 0	181,421 ------------- 0	0 ------------- 0
22ZACHARY BOSTOCK TERM 0320 FORMER CHIEF ADMINISTRATIVE OFFICER	(i) (ii)	0 ------------- 0	0 ------------- 0	145,718 ------------- 0	0 ------------- 0	5,232 ------------- 0	150,950 ------------- 0	0 ------------- 0
23GARY TOMCIK TERM 0420 FORMER CHIEF EXPERIENCE OFFICER	(i) (ii)	0 ------------- 0	0 ------------- 0	122,410 ------------- 0	0 ------------- 0	8,384 ------------- 0	130,794 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

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, LINES 4A-B

PART I, LINE 4A: CHIEF ADMINISTRATIVE OFFICER RESIGNED 03/20 AND RECEIVED A SEVERANCE PAYMENT OF $145,718 FOR CALENDAR YEAR 2021. GENERAL COUNSEL RESIGNED 05/20 AND RECEIVED A SEVERANCE PAYMENT OF $191,807 FOR CALENDAR YEAR 2021. CHIEF EXPERIENCE OFFICER RESIGNED 04/20 AND RECEIVED A SEVERANCE PAYMENT OF $122,410 FOR CALENDAR YEAR 2021. CHIEF OPERATING OFFICER RESIGNED 07/21 AND RECEIVED A SEVERANCE PAYMENT OF $436,519 FOR CALENDAR YEAR 2021. CHIEF ADMINISTRATIVE OFFICER RESIGNED 03/21 AND RECEIVED A SEVERANCE PAYMENT OF $282,056 FOR CALENDAR YEAR 2021. CHIEF ADMINISTRATIVE OFFICER RESIGNED 11/21 AND RECEIVED A SEVERANCE PAYMENT OF $33,889 FOR CALENDAR YEAR 2021. PART I, LINE 4B: THE FOLLOWING EXECUTIVES PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: PAUL HILTZ PRESIDENT AND CEO PHILLIP DUTCHER FORMER CHIEF OPERATING OFFICER RICK WYLES CHIEF FINANCIAL OFFICER KRISTIN MASCOTTI, M.D. CHIEF MEDICAL OFFICER JONATHAN KLING CHIEF OPERATING OFFICER JIM MAHON SENIOR VICE PRESIDENT RENEE THIGPEN CHIEF HR OFFICER CARLOS QUINTERO, M.D. CHIEF QUALITY OFFICER THE FOLLOWING EXECUTIVES RECEIVED A DISTRIBUTION FROM THE 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN IN CALENDAR YEAR 2021: PAUL HILTZ PRESIDENT AND CEO $144,750 PHILLIP DUTCHER FORMER CHIEF OPERATING OFFICER $ 91,500 RICK WYLES CHIEF FINANCIAL OFFICER $ 76,950 JIM MAHON SENIOR VICE PRESIDENT $ 56,250 RENEE THIGPEN CHIEF HR OFFICER $ 51,150

PART I, LINE 7

PROVISIONS OF NON-FIXED PAYMENTS THIS ORGANIZATION IS AN AFFILIATE OF NCH HEALTHCARE SYSTEM, INC. ("THE SYSTEM"). THE SYSTEM MAY PROVIDE DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES. COMPENSATION PAYMENTS FOR ALL EMPLOYEES EXCLUDING THE CEO AND SENIOR LEADERSHIP TEAM IS DETERMINED BY THE SYSTEM BOARD OF TRUSTEES HUMAN RESOURCES COMMITTEE AND/OR CEO. COMPENSATION PAYMENTS MADE TO ANY DISQUALIFIED PERSON IS APPROVED BY THE SYSTEM THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15.

Schedule J (Form 990) 2021

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

2021

Open to Public
Inspection

Name of the organization
NAPLES COMMUNITY HOSPITAL INC

Employer identification number
59-0694358

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(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	COLLIER CTY INDSTL DEVLMT AUTHORITY	59-1695679		03-31-2020	50,000,000	NEW CAPITAL FOR FACILITIES AND EQUIPMENT		X		X		X
B	COLLIER CTY INDSTL DEVLMT AUTHORITY	59-1695679		03-30-2021	90,767,000	REFINANCE 2011 BONDS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................			6,246,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	50,000,000		90,767,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............			90,616,726
7 Issuance costs from proceeds ...............	250,525		150,274
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	49,749,475
11 Other spent proceeds .............
12 Other unspent proceeds .............
13 Year of substantial completion .............	2022		2021
	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 2020, a current refunding issue)? ........		X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X
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

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

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
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 ....
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 .........
6 Total of lines 4 and 5 .............
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

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
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? ........
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
FORM 990, SCHEDULE K, PART II, LINE 3	FOR COLLIER COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY-SERIES 2020, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $250,525 IN BOND ISSUANCE COSTS. FOR COLLIER COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY-SERIES 2021, THE TOTAL PROCEEDS OF ISSUE REPORTED INCLUDES $150,274 IN BOND ISSUANCE COSTS AND $90,616,726 IN PRIOR TAX-EXEMPT BONDS REFUND.

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

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

2021

Open to Public Inspection

Name of the organization

NAPLES COMMUNITY HOSPITAL INC

Employer identification number

59-0694358

Part I

Excess Benefit Transactions (section 501(c)(3), 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
(1) PAUL HILTZ	CEO/PRESIDENT	RETAIN - RETENTION INCENTIVE		X	50,000	20,000		No	Yes		Yes





Total ............... $						20,000

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) 2021

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) KARAH RILEY VELIKY	FMLY MEMBER/FORMER OFFICER	85,567	PYMT COMP		No
(2) WYNN PROPERTIES	OWNER/TRUSTEE	108,898	RENTAL PAYMENTS		No
(3) MEGAN RILEY	FMLY MEMBER/FORMER OFFICER	56,004	PYMT COMP		No
(4) SUNSHINE ACE HARDWARE	OWNER/TRUSTEE	43,465	PURCHASES		No
(5) ROBIN LEE WYLES	FMLY MEMBER/OFFICER	2,665	CONSULTANT		No

Part V

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

Return Reference

Explanation

FORM 990, SCHEDULE L, PART IV

KARAH RILEY VELIKY IS THE DAUGHTER OF MICHAEL RILEY, FORMER CHIEF STRATEGY OFFICER. MEGAN RILEY IS THE DAUGHTER OF MICHAEL RILEY, FORMER CHIEF STRATEGY OFFICER.MICHAEL WYNN IS A TRUSTEE AND AN OWNER OF WYNN PROPERTIES WHICH NCH PAYS FOR RENTAL SPACE.MICHAEL WYNN IS A TRUSTEE AND AN OWNER OF SUNSHINE ACE HARDWARE WHERE NCH PURCHASES SUPPLIES.ROBIN LEE WYLES IS THE SPOUSE OF RICK WYLES, CHIEF FINANCIAL OFFICER.

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

NAPLES COMMUNITY HOSPITAL INC

Employer identification number

59-0694358

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..	X		420	FMV
5 Clothing and household goods .......	X		1,913	FMV
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	25	270,196	FMV
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( DINNER/ENTERTAINMENT )	X	22	28,200	FMV
26 Other ( JEWELRY )	X	1	10,000	FMV
27 Other ( HOME ACCESSORIES )	X	3	1,950	FMV
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2021)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
PART I, COLUMN (B):	NAPLES COMMUNITY HOSPITAL, INC. IS REPORTING IN PART I, COLUMN (B) THE NUMBER OF CONTRIBUTIONS.

Schedule M (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

NAPLES COMMUNITY HOSPITAL INC

Employer identification number

59-0694358

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	GOVERNING BODY AND MANAGEMENT NCH HEALTHCARE SYSTEM, INC. IS THE SOLE MEMBER OF THIS ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	GOVERNING BODY AND MANAGEMENT NCH HEALTHCARE SYSTEM, INC. SOLE MEMBER OF THIS ORGANIZATION, ELECTS THIS ORGANIZATION'S DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	GOVERNING BODY AND MANAGEMENT ALL OF THE GOVERNANCE DECISIONS FOR NAPLES COMMUNITY HOSPITAL, INC. ARE RESERVED TO THE GOVERNING BODY OF NCH HEALTHCARE SYSTEM, INC.
FORM 990, PART VI, SECTION B, LINE 11B	REVIEW PROCESS INFORMATION RELATED TO NAPLES COMMUNITY HOSPITAL, INC.'S ("NCH") FORM 990 FILING IS GATHERED BY FINANCE STAFF AND PROVIDED TO RSM US LLP, FOR REVIEW. AFTER THE REVIEW BY RSM US LLP, THE FORM 990 IS REVIEWED BY THE NCH HEALTHCARE SYSTEM CHIEF FINANCIAL OFFICER. THE FORM 990 IS THEN REVIEWED BY OUTSIDE COUNSEL FOR THE BOARD. PRIOR TO BOARD APPROVAL, THE FORM 990 IS PROVIDED TO ALL OF THE FINANCE COMMITTEE BOARD OF TRUSTEES FOR THEIR REVIEW VIA THE BOARD PORTAL. AT THE CONCLUSION OF THIS REVIEW PROCESS THE FORM 990 IS APPROVED BY THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY ANNUALLY, ALL NCH HEALTHCARE SYSTEM, INC. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE INTERESTS THAT COULD POTENTIALLY GIVE RISE TO CONFLICTS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. MANAGEMENT SHALL DISCLOSE OTHER POTENTIAL CONFLICTS WITH THE COMPLIANCE OFFICER. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINED UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A GREATER THAN TWO-THIRDS VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. THE COMPLIANCE OFFICER WILL DETERMINE IF A MANAGEMENT TEAM MEMBER OR EMPLOYEE SHOULD BE EXCUSED FROM A DISCUSSION OR PARTICIPATE IN A DECISION IN WHICH THERE MAY BE A CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION PROCESS THIS ORGANIZATION IS AN AFFILIATE OF THE NCH HEALTHCARE SYSTEM, INC. ("THE SYSTEM"). COMPENSATION ARRANGEMENTS INVOLVING OUR CEO AND SENIOR LEADERSHIP TEAM ARE ESTABLISHED BY THE SYSTEM BOARD OF TRUSTEES COMPENSATION COMMITTEE PURSUANT TO A PROCESS THAT SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR SECTION 4958 EXCESS BENEFIT TRANSACTION TAX PURPOSES (WHICH REQUIRES A REVIEW OF COMPENSATION DETERMINATION BY DISINTERESTED PERSONS, USE OF APPROPRIATE COMPARABILITY DATA, AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS).
FORM 990, PART VI, SECTION C, LINE 19	DOCUMENTS AVAILABLE TO THE PUBLIC THE FORMS 1023 AND 990, GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY OF NHSI ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO AVAILABLE VIA OUR WEBSITE: HTTP://WWW.NCHMD.ORG/ABOUT-US/ANNUAL-REPORTS. DOCUMENTS AVAILABLE FOR REQUEST ARE AVAILABLE PURSUANT TO THE PERIOD OF DISCLOSURE PROVIDED IN SECTION 6104(D).
FORM 990, PART IX, LINE 11G	PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 2,299,465. MANAGEMENT AND GENERAL EXPENSES 554,532. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,853,997. RECRUITING: PROGRAM SERVICE EXPENSES 1,031,300. MANAGEMENT AND GENERAL EXPENSES 248,705. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,280,005. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 63,804,694. MANAGEMENT AND GENERAL EXPENSES 15,386,933. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 79,191,627. COLLECTION FEES: PROGRAM SERVICE EXPENSES 896,017. MANAGEMENT AND GENERAL EXPENSES 216,080. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,112,097. CONSULTING FEES: PROGRAM SERVICE EXPENSES 2,210,975. MANAGEMENT AND GENERAL EXPENSES 533,192. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,744,167. MEMBERSHIP FEES: PROGRAM SERVICE EXPENSES 478,047. MANAGEMENT AND GENERAL EXPENSES 115,284. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 593,331. PUBLIC MEDICAL ASSISTANCE TRUST FUND (FL) FEES: PROGRAM SERVICE EXPENSES 15,447,345. MANAGEMENT AND GENERAL EXPENSES 3,725,232. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,172,577.
FORM 990, PART XI, LINE 9:	TRANSFERS TO RELATED ORGANIZATIONS -56,985,131.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

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

2021

Open to Public Inspection

Name of the organization

NAPLES COMMUNITY HOSPITAL INC

Employer identification number

59-0694358

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(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)NCH HEALTHCARE SYSTEM INC PO BOX 413029 NAPLES,FL341013029 59-2314655	NOT-FOR-PROFIT HOLDING COMPANY	FL	501(C)(3)	LINE 12B, II	N/A		No
(2)MARCO ISLAND HOSPITAL INC 40 HEATHWOOD DRIVE MARCO ISLAND,FL34145 59-2315435	HEALTHCARE	FL	501(C)(3)	LINE 3	NCH SYSTEM	Yes
(3)COLLIER HEALTH CARE INC PO BOX 413029 NAPLES,FL341013029 65-0244276	HEALTHCARE	FL	501(C)(3)	LINE 3	NCH SYSTEM	Yes
(4)COMMUNITY HOME SERVICES INC PO BOX 413029 NAPLES,FL341013029 59-2440516	SUPPORT ORGANIZATION	FL	501(C)(3)	LINE 12B, II	NCH SYSTEM	Yes
(5)NCHMDINC PO BOX 413029 NAPLES,FL341013029 33-1075317	HEALTHCARE	FL	501(C)(3)	LINE 10	NCH SYSTEM	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) PROSCAN NCH IMAGING LLC 350 7TH STREET NORTH NAPLES,FL34102 86-1212843	RADIOLOGY SERVICES	DE	N/A					No			No
(2) NCH-VH JOINT VENTURE LLC 350 7TH STREET NORTH NAPLES,FL34102 87-4042152	SURGICAL SERVICES	FL	NAPLES COMMUNITY HOSPITAL INC	N/A				No			No	51.000 %

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	(h) Percentage ownership	Yes	No
(1) HEALTH RESOURCES CORPORATION 350 7TH STREET NORTH NAPLES,FL34102 59-2568003	HOLDING COMPANY	FL	NCH HEALTHCARE SYSTEM	C				Yes
(2) COMMUNITY HOME CARE INC 350 7TH STREET NORTH NAPLES,FL34102 59-2372966	HOME HEALTH	FL	HEALTH RESOURCES CORPORTATION	C				Yes
(3) COMMUNITY IMAGING INC 350 7TH STREET NORTH NAPLES,FL34102 59-2446336	RADIOLOGY LAB	FL	HEALTH RESOURCES CORPORTATION	C				Yes
(4) AMBULATORY SURGICAL CARE CENTER INC 350 7TH STREET NORTH NAPLES,FL34102 59-2568029	OUTPATIENT SURGERY	FL	HEALTH RESOURCES CORPORTATION	C				Yes
(5) GREATER COLLIER INSURANCE LTD 350 7TH STREET NORTH NAPLES,FL34102	INSURANCE	FL	N/A	C					No

Schedule R (Form 990) 2021

Page 3

Part V

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

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

Yes

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

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

Yes

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

Yes

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

Yes

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) COLLIER HEALTH CARE INC	Q	124,940	FMV
(2) MARCO ISLAND HOSPITAL INC	Q	123,825	FMV
(3) NCHMD INC	P	51,706,652	FMV
(4) NCH HEALTHCARE SYSTEM INC	P	5,897,317	FMV

Schedule R (Form 990) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: HELPING EVERYONE LIVE A LONGER, HAPPIER, AND HEALTHIER LIFE.OUR VISION IS TO BE A WORLD-CLASS LEADER OF EXCELLENCE IN HEALTHCARE AND TO PROVIDE EXCELLENCE IN EVERY PATIENT EXPERIENCE.NAPLES COMMUNITY HOSPITAL, INC. LOCATED IN COLLIER COUNTY, FLORIDA,CONSISTS OF TWO HOSPITALS WITH 713 BEDS. THE DOWNTOWN HOSPITALCAMPUS IS A 391-BED ACUTE CARE FACILITY AND NORTH NAPLES HOSPITALCAMPUS IS A 322-BED ACUTE CARE FACILIY. THE HOSPITAL ALSO HAS A BLOODCENTER AND VARIOUS OTHER OUTPATIENT CENTERS LOCATED THROUGHOUT THE COMMUNITY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	4,395
6	Total number of volunteers (estimate if necessary) .............	6	312
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	61,045,386	18,065,030
9	Program service revenue (Part VIII, line 2g) .........	605,616,065	673,888,747
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	17,306,212	48,352,649
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	13,083,344	24,949,764
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	697,051,007	765,256,190
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	4,000	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	276,592,994	318,308,563
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 8,896
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	333,384,717	402,627,916
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	609,981,711	720,936,479
19	Revenue less expenses. Subtract line 18 from line 12.......	87,069,296	44,319,711
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,097,611,582	927,903,972
21	Total liabilities (Part X, line 26).............	328,328,071	286,237,206
22	Net assets or fund balances. Subtract line 21 from line 20.....	769,283,511	641,666,766

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 595,461,383 including grants of $ ) (Revenue $ 696,183,920 )
	SEE SCHEDULE ONAPLES COMMUNITY HOSPITAL, INC. (NCH) PROVIDES INPATIENT AND OUTPATIENT HEALTHCARE SERVICES WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY. FROM ITS TWO HOSPITALS, CANCER TREATMENT CENTERS, WOUND CARE CENTERS AND OUTPATIENT REHABILITATION CENTERS, NCH PROVIDED $119,298,533 OF CHARITY CARE TO PATIENTS WHO WERE UNABLE TO PAY AND NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PROGRAM. ADDITIONALLY, NCH WROTE OFF $888,122 CLASSIFIED AS BAD DEBTS, MUCH OF WHICH REPRESENTED SERVICES DELIVERED TO INDIGENT PATIENTS, WHO DID NOT RECEIVE A CHARITY CARE DETERMINATION IN ACCORDANCE WITH THE STATE'S CRITERIA.THE SERVICES OFFERED AT NCH ARE EXTENSIVE AND INCLUDE MEDICAL, SURGICAL, OBSTETRIC, PEDIATRIC, REHABILITATIVE, PSYCHIATRIC, DIAGNOSTIC, AND EMERGENCY TREATMENT. A TOTAL OF 587 ACTIVE AND ASSOCIATE PHYSICIANS, 2,839 FULL-TIME EQUIVALENT EMPLOYEES, AND 302 VOLUNTEERS COMPRISE THE OUTSTANDING MEDICAL TEAM WORKING TOGETHER TO PROVIDE THESE SERVICES.THE TWO HOSPITALS ARE COMPRISED OF 617 ACUTE CARE BEDS, A 54 BED REHABILITATIVE UNIT, 19 NICU BEDS, AND A 23 BED PSYCHIATRIC UNIT. ADDITIONAL SPECIALTY SERVICES FOR THE CARE OF CERTAIN CRITICAL AND LIFE THREATENING MEDICAL CONDITIONS INCLUDE THE MEDICAL INTENSIVE CARE UNIT, SURGICAL INTENSIVE CARE UNIT, CARDIAC CARE UNIT, CARDIAC CATHETERIZATION UNIT AND INTERMEDIATE CARE UNIT. OTHER SPECIALTIES INCLUDE ONCOLOGY, DIAGNOSTIC SERVICES (CARDIO-DIAGNOSTICS, MAMMOGRAPHY, COMPUTERIZED TOPOGRAPHIC SCANNING (CT), AND MAGNETIC RESONANCE IMAGING (MRI), AND SPECIAL PROCEDURES SUCH AS BIOPSY, ANGIOGRAPHY, AND ANGIOPLASTY).DURING THE 2022 FISCAL YEAR, NCH HAD 29,015 INPATIENT ADMISSIONS RESULTING IN 145,987 DAYS OF CARE. ADDITIONALLY, 114,311 PATIENTS WERE TREATED IN OUR EMERGENCY CARE CENTERS.NAPLES COMMUNITY HOSPITAL, INC. RECEIVES VOLUNTEER ASSISTANCE FOR OPERATING ITS HOSPITALITY, GIFT, AND RETAIL SHOPS.NAPLES COMMUNITY HOSPITAL, INC. ALSO PROVIDES HEALTH ENHANCING EDUCATIONAL PROGRAMS IN ADDITION TO MEDICAL CARE. THESE PROGRAMS INCLUDE: WHITAKER WELLNESS CENTER; BETTER BREATHERS CLUB; MENDED HEARTS; DIABETES EDUCATION PROGRAM; CHILDBIRTH CLASSES; HEALTH FAIRS; AND CAREER DAYS. IN ADDITION, NCH SUPPORTS THE FOLLOWING: NURSES IN THE COLLIER COUNTY PUBLIC SCHOOL SYSTEM AND ATHLETIC TRAINERS AT THE LOCAL HIGH-SCHOOLS AND SPORTING EVENTS.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses595,461,383

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,977,663	561,965	620,002

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	637,398
d	Related organizations		1d	20,000
e	Government grants (contributions)		1e	5,734,304

f	All other contributions, gifts, grants, and similar amounts not included above		1f	11,673,328

g	Noncash contributions included in lines 1a - 1f:$		1g	312,679

h Total. Add lines 1a-1f.......		18,065,030

		Business Code
2a	NET PATIENT SERVICE REVENUE	621990	673,888,747	673,888,747
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		673,888,747

3 Investment income (including dividends, interest, and othersimilar amounts) ......			9,703,103			9,703,103
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		2,333,606	6a
b	Less: rental expenses		108,510	6b
c	Rental income or (loss)		2,225,096	6c
d	Net rental income or (loss).......			2,225,096			2,225,096
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	34,862	350,585,292	7a
b	Less: cost or other basis and sales expenses	128,607	311,842,001	7b
c	Gain or (loss)	-93,745	38,743,291	7c
d	Net gain or (loss).........			38,649,546			38,649,546
8a	Gross income from fundraising events (not including $ 637,398of contributions reported on line 1c). See Part IV, line 18 ....
			8a	866,721
b	Less: direct expenses ...		8b	437,226
c	Net income or (loss) from fundraising events..			429,495			429,495
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
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	DIETARY		722514	3,056,501	3,056,501
b	WELLNESS CENTER		713940	2,833,622	2,833,622
c	SCHOOL NURSE		621990	2,426,377	2,426,377
d	All other revenue ....			13,978,673	13,978,673
e	Total. Add lines 11a–11d ......			22,295,173
12	Total revenue. See instructions.....			765,256,190	696,183,920	0	51,007,240

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	6,177,236		6,177,236
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	1,166,901	141,570	1,025,331
7	Other salaries and wages........	268,867,093	216,626,217	52,232,887	7,989
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	6,425,369	5,176,920	1,248,449
9	Other employee benefits .......	17,789,926	14,333,343	3,456,287	296
10	Payroll taxes ...........	17,882,038	14,407,558	3,473,869	611
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	10,445,908		10,445,908
c	Accounting ...........	386,174		386,174
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	106,947,801	86,167,843	20,779,958
12	Advertising and promotion ....	4,490,059	3,617,641	872,418
13	Office expenses .......	26,528,030	21,373,635	5,154,395
14	Information technology ......	30,626,891	24,676,086	5,950,805
15	Royalties ..
16	Occupancy ...........	11,861,528	9,556,833	2,304,695
17	Travel ............	595,186	479,541	115,645
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	2,039,339	1,643,095	396,244
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	50,367,793	40,581,331	9,786,462
23	Insurance ...	8,250,558	6,647,475	1,603,083
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	148,910,490	148,910,490
b	BAD DEBT EXPENSE	888,122	888,122
c
d
e	All other expenses	290,037	233,683	56,354
25	Total functional expenses. Add lines 1 through 24e	720,936,479	595,461,383	125,466,200	8,896
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 ........			55,020,200	1	14,895,954
2	Savings and temporary cash investments .........			2,827,237	2	4,349,075
3	Pledges and grants receivable, net ......			26,144,784	3	22,064,947
4	Accounts receivable, net .............			99,282,239	4	80,890,447
5	Loans and other receivables from 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 .......
				30,000	5	20,000
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 ...........			11,288	7	31,453
8	Inventories for sale or use ............			13,643,460	8	17,406,398
9	Prepaid expenses and deferred charges ......			6,309,885	9	7,680,539
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,051,480,581
b	Less: accumulated depreciation	10b	631,489,816	396,577,748	10c	419,990,765
11	Investments—publicly traded securities .			71,025,644	11	22,867,379
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			27,378,461	14	22,822,460
15	Other assets. See Part IV, line 11 ...........			399,360,636	15	314,884,555
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,097,611,582	16	927,903,972

17	Accounts payable and accrued expenses .....	82,763,254	17	83,667,589
18	Grants payable ...		18
19	Deferred revenue .........	201,184	19	264,861
20	Tax-exempt bond liabilities .........	133,133,169	20	134,229,137
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 ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	112,230,464	25	68,075,619
26	Total liabilities. Add lines 17 through 25..	328,328,071	26	286,237,206

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	706,712,203	27	579,354,814
28	Net assets with donor restrictions ...........	62,571,308	28	62,311,952
	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 ...........	769,283,511	32	641,666,766
33	Total liabilities and net assets/fund balances ........	1,097,611,582	33	927,903,972