2023-08-09T15:27:29-05:00 2022-12-31 202153727 SB & COMPANY LLC 10200 GRAND CENTRAL AVE SUITE 250 OWINGS MILLS MD 21117 990 2022-01-01 592330166 FLORIDA HOSPITAL WATERMAN FOUNDATION INC FLOR 3522533270 1500 WATERMAN WAY STE 3506 TAVARES FL 32778 TODD MAZENKO CHAIR 3522533270 2023-08-09 1 TODD MAZENKO 999009999 0 PAMELA GRAY P01237506 4105840060 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z TODD MAZENKO 1500 WATERMAN WAY STE 3506 TAVARES FL 32778 13728088 0 X HTTPS://WWW.ADVENTHEALTH.COM/ADVENTHEALTH-FOUNDAT X 1983 FL TO SUPPORT FLORIDA HOSPITAL WATERMAN IN HEALTHCARE EXCELLENCE THROUGH CHARITABLE GIVING. 21 21 0 95 0 0 3141967 1604075 0 0 668619 1737230 2293811 144270 6104397 3485575 3221311 1571227 0 0 364778 378993 0 0 270839 294494 271228 3880583 2221448 2223814 1264127 37346676 33305639 150604 131470 37196072 33174169 TO SUPPORT FLORIDA HOSPITAL WATERMAN IN HEALTHCARE EXCELLENCE THROUGH CHARITABLE GIVING. 0 0 1573863 1571227 FLORIDA HOSPITAL WATERMAN FOUNDATION SEEKS DONOR CONTRIBUTIONS AND GRANT FUNDS TO SUPPORT AND ENHANCE HEALTHCARE PROGRAMS AND SERVICES AVAILABLE TO OUR COMMUNITY THROUGH FLORIDA HOSPITAL WATERMAN, INC, A 501(C)(3) HOSPITAL IN LAKE COUNTY, FLORIDA. MAJOR AREAS OF FOCUS INCLUDE THE FHW HEART CENTER, EMERGENCY SERVICES, THE FHW COMMUNITY PRIMARY HEALTH CLINIC, FHW CANCER CENTER, AND SCHOLARSHIP PROGRAMS. 1573863 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 X 21 21 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X BRENDA MULHOLLAND 3522533270 1500 WATERMAN WAY STE 3506 TAVARES FL 32778 COLLEEN VAN FLEET TRUSTEE 1.00 X 0 0 0 LINDSAY HOLT TRUSTEE 1.00 X 0 0 0 TED WICKS TRUSTEE 1.00 X 0 0 0 MIKE ROGERS TRUSTEE 1.00 X 0 0 0 JAIMIE WASHO SPIVEY TRUSTEE 1.00 X 0 0 0 DONNA WILSON TRUSTEE 1.00 X 0 0 0 SINE WALLACE TRUSTEE 1.00 X 0 0 0 MIKE WELTER TRUSTEE 1.00 X 0 0 0 DEAN SIMMONS TRUSTEE 1.00 X 0 0 0 ROBERT WHITE TRUSTEE 1.00 X 0 0 0 STEVEN PILLOW TRUSTEE 1.00 X 0 0 0 PETER MARZEK TRUSTEE 1.00 X 0 0 0 ABEL BIRI TRUSTEE 1.00 X 0 0 0 J KNOX BURNS TRUSTEE 1.00 X 0 0 0 SUSAN CADDELL TRUSTEE 1.00 X 0 0 0 TRACY BELTON VICE CHAIR 1.00 X X 0 0 0 TODD MAZENKO CHAIR 1.00 X X 0 0 0 FRANK MUNROE SECRETARY 1.00 X X 0 0 0 MATT HACKLER TREASURER 1.00 X X 0 0 0 BARBARA LANGE FORMER TRUSTEE 1.00 X 0 0 0 DAVID GANTZ FORMER TRUSTEE 1.00 X 0 0 0 MELODY HAYES FORMER TRUSTEE 1.00 X 0 0 0 ANGEL KELLY-SHELBY FORMER TRUSTEE 1.00 X 0 0 0 MABEL VALDIVIA DIAZ EXECUTIVE DIRECTOR 40.00 X 0 89227 0 0 89227 0 0 0 0 0 0 200865 1403210 1256253 1604075 553764 553764 11264370 10080904 1183466 1183466 1183466 103117 31397 71720 71720 202762 130212 72550 72550 3485575 72550 0 1808950 1571227 1571227 89227 35691 53536 289766 115906 173860 20892 14425 6467 187489 187489 8536 6003 2533 10008 31 9977 5260 2104 3156 14487 1449 13038 6190 4643 1547 DUES AND SUBSCRIPTIONS 5764 865 4899 ANNUITIES 2636 2636 POSTAGE AND PRINTING 749 187 562 EQUIPMENT RENTAL 380 380 8837 7953 884 2221448 1573863 376746 270839 91912 419938 2546131 1517949 2490160 2245058 186601 91778 86365 10517 10579 124795 34795 90000 90000 31839577 28935750 37346676 33305639 89297 89803 61307 41667 150604 131470 X 31804615 27720827 5391457 5453342 37196072 33174169 37346676 33305639 1264127 -5286030 0 X X 0 1 X 1 0 X 2105090 288792 2088346 2159240 1469143 8110611 650236 684121 300905 284532 147007 2066801 2755326 972913 2389251 2443772 1616150 10177412 5200 5200 0 5200 5200 10172212 579433 706154 627245 688619 553764 3155215 579433 706154 627245 688619 553764 3155215 3334759 1679067 3016496 3132391 2169914 13332627 0.76300 0.80000 0.23670 0.20000 X UNUSUAL GRANT AMOUNTS RECEIVED DURING 5 YEAR LOOKBACK PERIOD 2017 $887,932 2017 $181,320 2017 $76,451 2017 $888,048 2017 $999,384 2017 $1,000,000 2017 $753,936 2018 $512,543 2018 $1,212,269 2018 $614,033 2019 $500,000 2019 $364,652 2019 $534,335 2019 $524,445 2019 $460,396 2020 $269,688 2020 $ 77,007 2020 $292,824 2020 $324,608 2021 $244,128 2021 $253,318 2021 $250,523 2021 $234,758 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 90000 90000 6486 6486 0 28309 28309 0 90000 ANNUITY PAYABLE 41667 41667 X -1952799 -5286030 35145 -5250885 3298086 187489 187489 3485575 2069104 35145 35145 2033959 187489 187489 2221448 PART X, LINE 2: THE FOUNDATION IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM FEDERAL INCOME TAXES, OTHER THAN NET UNRELATED BUSINESS INCOME TAXES, UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE UNITED STATES INTERNAL REVENUE CODE AND IS RECOGNIZED AS SUCH BY THE INTERNAL REVENUE SERVICE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA PROVIDE CONSISTENT GUIDANCE FOR THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND PRESCRIBE A THRESHOLD OF "MORE LIKELY THAN NOT" FOR RECOGNITION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE FOUNDATION PERFORMED AN EVALUATION OF UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 AND 2021, AND DETERMINED THERE WERE NO MATTERS THAT WOULD REQUIRE RECOGNITION IN THE ACCOMPANYING FINANCIAL STATEMENTS OR WHICH MAY HAVE ANY EFFECT ON ITS TAX-EXEMPT STATUS. AS OF DECEMBER 31, 2022, THE STATUTE OF LIMITATIONS FOR FISCAL YEARS 2019 THROUGH 2022 REMAINS OPEN WITH THE U.S. FEDERAL JURISDICTION OR THE VARIOUS STATES AND LOCAL JURISDICTIONS IN WHICH THE FOUNDATION FILES TAX RETURNS. IT IS THE FOUNDATION'S POLICY TO RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IF ANY, IN INCOME TAX EXPENSE IN THE STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS. 5K RACE 38533 38533 14549 FALL GOLF TOURNAMENT 61559 61559 14453 1 3025 3025 2395 103117 103117 31397 31397 71720 0 FLORIDA HOSPITAL WATERMAN 1000 WATERMAN WAY TAVARES FL 32778 593140669 501C3 315354 1225873 FMV DRUGS & MEDICAL SUPPLIES HOSPITAL OPERATIONS 1 X 1287018 FMV 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B AT THE SPRING BOARD MEETING, MANAGEMENT AND THE BOARD OF TRUSTEES REVIEW FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD SUBMITS IN WRITING TO THE EXECUTIVE DIRECTOR A LIST OF ALL BUSINESS OF OTHER ORGANIZATIONS A LIST OF ALL BUSINESSES OR OTHER ORGANIZATIONS FOR WHICH HE/SHE IS AN OFFICER, TRUSTEE, MEMBER, OWNER, EMPLOYEE, OR FOR WHICH ONE MAY ACT AS AN AGENT WHICH HAS OR ANTICIPATES ENTERING INTO A BUSINESS RELATIONSHIP OR TRANSACTION WITH THE CORPORATION. IN THE EVENT THERE IS A POTENTIAL CONFLICT, SAID BOARD MEMBER WILL RECUSE HIMSELF/HERSELF FROM ANY VOTE. FORM 990, PART VI, SECTION B, LINE 15 OFFICERS OF THE ORGANIZATION ARE NOT COMPENSATED. ALL KEY STAFF COMPENSATION IS DETERMINED BY ORGANIZATIONAL REVIEW OF EXPERIENCE, COMPARABLE COMPENSATION, AND ORGANIZATIONAL LEVELS FOR SAID ROLE AND APPROVED BY FINANCE COMMITTEE AND THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. PART CII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FLORIDA HOSPITAL WATERMAN 1000 WATERMAN WAY TAVARES FL 32778 593140669 TAX-EXEMPT HOSPITAL FL 501C3 3 N/A 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 FLORIDA HOSPITAL WATERMAN Q 11561 FMV FLORIDA HOSPITAL WATERMAN J 23584 FMV FLORIDA HOSPITAL WATERMAN B 315354 CASH FLORIDA HOSPITAL WATERMAN R 1255873 FMV