2024-05-13T12:33:16-05:00 2023-06-30 366055558 GRANT THORNTON LLP 5955 TG LEE BLVD SUITE 200 ORLANDO FL 32822 990 2022-07-01 593238634 H LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL INC HLEE 8137454673 12902 MAGNOLIA DRIVE TAMPA FL 33612 YVETTE TREMONTI EVP/CFAO 8137457862 2024-05-13 1 YVETTE TREMONTI 999009999 0 MICHELE N MELCHIOR P00488037 4074815100 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SARABDEEP SINGH 12902 MAGNOLIA DRIVE TAMPA FL 33612 2024798496 0 X WWW.MOFFITT.ORG X 1994 FL TO CONTRIBUTE TO THE PREVENTION AND CURE OF CANCER. 16 16 5471 570 0 0 17046893 20397306 1735806498 2002650392 -231668 54254 1154431 1649100 1753776154 2024751052 10633932 20660430 0 0 485396218 533208793 0 0 0 913663774 1068604120 1409693924 1622473343 344082230 402277709 351948718 392759623 104682698 106034192 247266020 286725431 X THE PRIMARY PURPOSE OF THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. ("HOSPITAL") IS TO CONTRIBUTE TO THE PREVENTION AND CURE OF CANCER. 0 0 1417122546 20660430 2002852631 H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE HOSPITAL, INC. (THE "HOSPITAL") IS LOCATED ON THE CAMPUS OF THE UNIVERSITY OF SOUTH FLORIDA IN TAMPA, FL. SINCE OPENING IN 1986, THE HOSPITAL HAS BEEN GUIDED BY ONE MISSION, "TO CONTRIBUTE TO THE PREVENTION AND CURE OF CANCER." MOFFITT IS A LEADING NATIONAL CANCER INSTITUTE (NCI) COMPREHENSIVE CANCER CENTER - ONE OF ONLY 49 IN THE NATION TO HOLD THIS DISTINCTION. MOFFITT IS A TOP 10 CANCER HOSPITAL AND HAS BEEN NATIONALLY RANKED BY U.S. NEWS & WORLD REPORT SINCE 1999. WITH MORE THAN 9,000 EMPLOYEES, MOFFITT HAS AN ECONOMIC IMPACT ON FLORIDA OF $2.4 BILLION.RESEARCH IS CRITICAL TO MOFFITT'S MISSION. MUCH OF OUR CLINICAL TRIALS AND STUDIES ARE DONE THROUGH COLLABORATION BETWEEN MOFFITT RESEARCHERS AND PHYSICIANS WHO FOCUS ON COMPREHENSIVE CANCER TREATMENT.THE CLINICAL TRIALS AND STUDIES EXPLORE NEW MEDICAL DISCOVERIES OR NEW WAYS TO USE EXISTING TREATMENTS TO IMPROVE PATIENT CARE. EVERY PARTICIPANT HELPS TAKE US ONE STEP CLOSER TO THAT NEXT BIG BREAKTHROUGH IN CANCER TREATMENT.REIMBURSEMENT IS ALSO CRITICAL TO THE HOSPITAL'S OPERATIONS; HOWEVER, MOFFITT RECOGNIZES ITS RESPONSIBILITY TO PROVIDE SERVICES AND EDUCATION TO THOSE NEEDING SPECIALIZED RESEARCH CAPABILITIES. PATIENTS WHO MEET MOFFITT'S MEDICAL AND SURGICAL PROTOCOLS AND DO NOT HAVE THE ABILITY TO PAY WILL BE TREATED, IF SUCH PROTOCOLS ARE NOT AVAILIABLE IN THEIR COMMUNITY.IT IS THIS COMMITTMENT THAT GUIDES THE HOSPITAL TO:1) PROVIDE CARE FOR PATIENTS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST2) PROVIDE FREE CHARITY CARE FOR THOSE WHO CANNOT PAY3) PROVIDE ONCOLOGY SPECIALIZATION TO THE STATE OF FLORIDA THROUGH INVOLVEMENT IN INVESTIGATIONAL PROTOCOLS, EDUCATION OF FUTURE PHYSICIANS AND CONTINUING PROFESSIONAL EDUCATION FOR PHYSICIANS AND OTHER ALLIED HEALTH CARE PROFESSIONALS4) TAKE A LEADERSHIP ROLE IN CANCER PREVENTION AND SCREENING ACTIVITIES THE HOSPITAL IS A CRITICAL RESOURCE FOR THE STATE OF FLORIDA, WHICH RANKS SECOND IN THE NATION IN BOTH CANCER INCIDENCE AND MORTALITY. MOFFITT IS LICENSED FOR 218 BEDS AND DEVOTES MORE THAN 2 MILLION SQUARE FEET TO RESEARCH AND PATIENT CARE. ADDITIONALLY, MOFFITT PROVIDES A WIDE ARRAY OF OUTREACH AND EDUCATIONAL ACTIVITIES FOR THE GENERAL PUBLIC AND SELECT UNDERSERVED POPULATIONS. IN FISCAL YEAR 2023, THE HOSPITAL RECORDED 618,616 OUTPATIENT VISITS AND 10,961 ADMISSIONS. 1417122546 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 1 1 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 145 0 1 5471 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 16 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X YVETTE M LYONS TREMONTI 8137457862 12902 MAGNOLIA DRIVE TAMPA FL 33612 X BETH A HOUGHTON DIRECTOR, CHAIR 1.00 1.00 X X 0 0 0 THE HON MARK A PIZZO ESQ DIRECTOR, VICE CHAIR 1.00 1.00 X X 0 0 0 JOSEPH CABALLERO DIRECTOR, SEC/TREAS 1.00 2.00 X X 0 0 0 BETH SIMONETTI DIRECTOR 1.00 0.00 X 0 0 0 HAL WALKER DIRECTOR 1.00 0.00 X 0 0 0 JACQUELINE LEWIS DIRECTOR 1.00 0.00 X 0 0 0 JENNIFER MOFFITT DIRECTOR 1.00 0.00 X 0 0 0 KEVIN PLUMMER DIRECTOR 1.00 0.00 X 0 0 0 LANSING SCRIVEN DIRECTOR 1.00 0.00 X 0 0 0 MARY ANNE REILLY DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL BICE DIRECTOR 1.00 0.00 X 0 0 0 NICOLAS PORTER DIRECTOR 1.00 0.00 X 0 0 0 RENEE THOMPSON DIRECTOR 1.00 0.00 X 0 0 0 ROBERT HORTON DIRECTOR 1.00 0.00 X 0 0 0 ROLAND DANIELS DIRECTOR 1.00 0.00 X 0 0 0 VALERIE GODDARD DIRECTOR 1.00 1.00 X 0 0 0 SARABDEEP SINGH HOSPITAL PRESIDENT 25.00 32.00 X 0 618920 89732 ROBERT KEENAN VP-QUALITY/CMO 55.00 0.00 X 750701 0 -82673 G DOUGLAS LETSON EVP-PHYS IN CHIEF 15.00 40.00 X 838552 0 -245481 JANE FUSILERO VP-PATIENT CARE SVS/CNO TO 2/5/23 55.00 0.00 X 496976 0 353 YVETTE M LYONS TREMONTI EVP-CFAO & ASST TREASURER 20.00 39.00 X 0 824270 -345650 HENRY REYES VP-PARTNERSHIP DEVELOPMENT 10.00 46.00 X 0 340850 45443 JOANNA WEISS SVP FINANCE 15.00 40.00 X 0 448836 -91001 EVAN ZASLOW VP PAYER STRATEGIES AS OF 8/1/22 18.00 37.00 X 330341 0 27425 MATTHEW BEDNAR VP-AMBULATORY/VIRTUAL CARE OPS 55.00 0.00 X 341487 0 5574 L DAVID DE LA PARTE EVP-GENERAL COUNSEL; ASST SEC 20.00 39.00 X 0 674699 -330860 TERRENCE WRIGHT VP-FAC & SUP SVCS 25.00 30.00 X 0 294403 45739 KEN KOMORNY VP CHIEF PHARM OFF AS OF 9/4/22 25.00 30.00 X 271110 0 38704 KELLY GONZALVO VP PATIENT CARE/CNO AS OF 2/5/23 55.00 0.00 X 216304 0 16144 MARILYN COSTACHE CHIEF RISK OFFICER 55.00 0.00 X 78014 111530 16565 BRYAN MCIVER DEPUTY PHYSICIAN IN CHIEF 50.00 0.00 X 606810 0 -30302 EDUARDO G MOROS SR MBR PHYSICIST-RAD ONC 50.00 0.00 X 382910 0 -119566 KAREN WARTENBERG VP MOFFITT MEDICAL GROUP 30.00 25.00 X 369715 0 -188061 STUART G WASSERMAN DIR CLINICAL PHYSICS 50.00 0.00 X 303237 0 -163795 GEOFFREY G ZHANG SR MBR PHYSICIST-RAD ONC 50.00 0.00 X 307110 0 -220485 PATRICK HWU FRM HOSPITAL PRESIDENT TO 10/31/21 10.00 47.00 X 0 1161591 102275 5293267 4475099 -1429920 777 1 1 0 AYA HEALTHCARE INC 5930 CORNERSTONE CT W STE 300 SAN DIEGO CA 92121 HEALTHCARE STAFFING SERVICES 11700983 NATIONAL MARROW DONOR PROGRAM 3001 BROADWAY ST NE 500 MINNEAPOLIS MN 55413 DONOR SEARCH SERVICES 9567155 RN NETWORK 2000 NW CORPORATE BLVD STE 150 BOCA RATON FL 33431 RECRUITMENT SERVICES 7395183 UNIVERSITY DIAGNOSTIC INST 3301 ALUMNI DR TAMPA FL 33612 MRI SERVICES 5524711 ASSOC REGIONAL & UNIV PATH 500 CHIPETA WAY SALT LAKE CITY UT 84108 LABORATORY SERVICES 2333376 46 2303578 68641 18025087 20397306 NET PATIENT SERVICE REVENUE 900099 1928981673 1928981673 SPECIALTY PHARMACY 900099 72454793 72454793 CORE LAB REVENUE 900099 540705 540705 EDUCATION CONFERENCES 900099 309248 309248 BMT-NMDP PROGRAM 900099 225280 225280 138693 138693 2002650392 144025 0 144025 144025 144025 101698 47444 54254 54254 54254 REBATES 900099 639333 639333 INTEREST FROM INS COMPANIES 524114 272447 272447 MAGNOLIA'S HAIR SALON 900099 202239 202239 391056 391056 1505075 2024751052 2002650392 0 1703354 X 20660430 20660430 3888509 3634978 253531 426772774 323677419 103095355 17528718 13130612 4398106 55435028 48979827 6455201 29583764 22477197 7106567 3074733 3074733 198748 198748 428983 428983 66126605 46518594 19608011 12153823 30933 12122890 82796361 60523189 22273172 44285398 34057 44251341 21153259 5759371 15393888 4884839 1583380 3301459 242671 242671 7244742 7244742 39493387 15515863 23977524 1541461 1541461 MEDICAL SUPPLIES 728619301 728619301 0 ALLOCATION OF INTERCOMP 0 77777479 -77777479 HCCB ASSESSMENT 20399214 20399214 0 BAD DEBT EXPENSES - PAT 16758134 16758134 0 19202461 10799897 8402564 1622473343 1417122546 205350797 0 2750 750 20489551 19277608 202611501 237381110 31481077 39242844 4546015 3534841 261378845 207139529 55831737 54239316 11848182 11848182 25137905 27234972 351948718 392759623 63815392 73623397 40867306 32410795 104682698 106034192 X 227311927 264924844 19954093 21800587 247266020 286725431 351948718 392759623 X 402277709 -362818298 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 12492 1 17165 0 1 628381 1 25645 1 43058 726741 0 PART II-B, LINE 1: THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. AND ITS FIVE NON-PROFIT SUBSIDIARY CORPORATIONS ("CORPORATION") WERE CREATED TO GOVERN AND OPERATE THE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE ("INSTITUTE") PURSUANT TO SECTION 1004.43, FLORIDA STATUTES. AMONG OTHER THINGS, SECTION 1004.43 FLORIDA STATUTES PROVIDES: (1) THAT THE CORPORATION SHALL ENTER INTO AN AGREEMENT WITH THE STATE BOARD OF EDUCATION FOR THE UTILIZATION OF FACILITIES ON THE CAMPUS OF THE UNIVERSITY OF SOUTH FLORIDA; (2) THAT THE CORPORATION SUBMIT ANNUAL POST AUDITS OF ITS FINANCIAL ACCOUNTS TO THE AUDITOR GENERAL OF THE STATE OF FLORIDA AND THE BOARD OF GOVERNORS FOR THEIR REVIEW; AND (3) THAT THE CORPORATION'S CEO REPORT TO THE BOARD OF GOVERNORS OR ITS DESIGNEE AND PROVIDE COPIES OF THE INSTITUTE'S ANNUAL REPORT TO THE GOVERNOR OF THE STATE OF FLORIDA, THE CABINET, THE PRESIDENT OF THE SENATE, THE SPEAKER OF THE HOUSE AND THE CHAIR OF THE BOARD OF GOVERNORS. ALTHOUGH THE CORPORATION IS A PRIVATE ENTITY, IT IS NONETHELESS SUBJECT TO THE STATE OF FLORIDA'S PUBLIC RECORDS AND THE PUBLIC MEETINGS LAWS. THE CORPORATION ALSO RELIES ON ANNUAL APPROPRIATIONS BY THE LEGISLATURE OF THE STATE OF FLORIDA AND GRANTS FROM VARIOUS LOCAL, STATE AND FEDERAL AGENCIES FOR OPERATION AND MAINTENANCE OF ITS FACILITIES AND FOR SPECIFIC RESEARCH AND CLINICAL PROGRAMS. FOR THESE REASONS, THE CORPORATION FROM TIME TO TIME ENGAGES LOBBYISTS AND OTHER CONSULTANTS: (1) TO ASSIST IT IN COMPLYING WITH ITS REPORTING REQUIREMENTS TO THE STATE OF FLORIDA UNDER SECTION 1004.43, FLORIDA STATUTES; (2) TO MONITOR LEGISLATIVE AND EXECUTIVE BRANCH ACTION AT LOCAL, STATE AND FEDERAL LEVELS OF GOVERNMENT WHICH IMPACT ITS OPERATION AND THE FULFILLMENT OF ITS MISSION; AND (3) TO INFLUENCE LEGISLATION IN FURTHERANCE OF ITS MISSION IN THE AREAS OF CANCER RESEARCH AND TREATMENT, THE TEACHING AND TRAINING OF HEALTH CARE PROFESSIONALS AND COMMUNITY EDUCATION AND OUTREACH ACTIVITIES. THE CORPORATION DOES NOT ENGAGE IN ANY ACTIVITIES TO SUPPORT OR OPPOSE ANY CANDIDATE FOR PUBLIC OFFICE. PART II-B, LINE 1I, OTHER ACTIVITIES THE OTHER ACTIVITIES AMOUNT LISTED ON LINE 1I IS COMPRISED OF EXPENSES RELATED TO ORCHESTRATING CONTACT BETWEEN GRASSROOTS SUPPORTERS (WHO ARE VOLUNTEERS) AND ELECTED OFFICIALS TO PROMOTE THE INSTITUTION'S LEGISLATIVE OBJECTIVES. 1188 1188 281110 281110 0 255892718 206858419 49034299 5203829 5203829 54239316 RECEIVABLE-OTHER 2167296 RIGHT OF USE ASSET-OPERATING LEASES 3267089 INTEREST IN NET ASSETS OF FOUNDATION 21800587 27234972 HCCB ASSESSMENT 29395292 OPERATING LEASE LIABILITY 1505406 ESTIMATED THIRD PARTY PAYABLES 1510097 32410795 X PART X, LINE 2: H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC. DID NOT HAVE ANY UNCERTAIN POSITIONS IN ITS AUDITED FINANCIAL STATEMENTS. THE ASC-740 FOOTNOTE READS AS FOLLOWS: SIGNIFICANT JUDGMENT IS REQUIRED TO EVALUATE UNCERTAIN TAX POSITIONS. THE CANCER CENTER EVALUATES ITS UNCERTAIN TAX POSITIONS ON A REGULAR BASIS. ITS EVALUATIONS ARE BASED ON A NUMBER OF FACTORS, INCLUDING CHANGES IN FACTS AND CIRCUMSTANCES, CHANGES IN TAX LAW, AND CORRESPONDENCE WITH TAX AUTHORITIES. THE CANCER CENTER ACCOUNTS FOR UNCERTAIN TAX POSITIONS BY RECOGNIZING A TAX BENEFIT OR LIABILITY AT THE LARGEST AMOUNT THAT, IN ITS JUDGMENT, IS MORE THAN 50% LIKELY TO BE REALIZED OR PAID BASED UPON TECHNICAL MERITS OF THE POSITION. THE CANCER CENTER CURRENTLY HAS NO TAX BENEFITS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. SOUTH ASIA 0 1 MAINTAINING OFFICES, EMPLOYEES, OR AGENTS 194313 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES SEMINARS 1733 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICES SEMINARS 3962 0 1 0 0 0 1 200008 0 200008 0 0 0 0 0 0 PART I, LINE 3: ACCRUAL METHOD OF ACCOUNTING WAS USED TO ACCOUNT FOR EXPENDITURES ON SCHEDULE F CONSISTENT WITH THE AUDITED FINANCIAL STATEMENTS. PART III ACCOUNTING METHOD: 1 1 1 X 1 X 1 1 1 0 1 1 26674853 26674853 0.01660 32856607 5849 32850758 0.02050 59531460 5849 59525611 0.03710 2015455 2015455 0.00130 4367630 4367630 0.00270 253015 253015 0.00020 13028 13028 0.00000 6649128 6649128 0.00420 66180588 5849 66174739 0.04130 1 2304 2304 0.00000 1 1166 1166 0.00000 1 25026 25026 0.00000 3 28496 28496 0.00000 1 3710474 384998054 442363477 -57365423 X 1 1 1 1 H LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE HOSPITAL 12902 MAGNOLIA DRIVE TAMPA FL 33612 WWW.MOFFITT.ORG 4334 X H LEE MOFFITT CANCER CENTER & RESEARCH 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE PART V, SECTION B, LINE 10A X 1 22 1 WWW.MOFFITT.ORG/PUBLICATIONS/COMMUNITY-BENEFIT 0 1 X 200.000000000000 400.000000000000 X X X X X X X 1 1 X X X X 1 X PART V, SECTION B, LINE 16C X PART V, SECTION B, LINE 16C X PART V, SECTION C X X X X X X X 1 X 0 X X X X X 0 X X X 0 0 H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE PART V, SECTION B, LINE 5: MOFFITT CONTRACTED WITH CARNAHAN GROUP ON AUGUST 31, 2021 TO CONDUCT THE CURRENT CHNA. THE INFORMATION COLLECTED WAS OBTAINED FROM THREE DIFFERENT SOURCES: 1) PUBLICALLY-AVAILABLE DATA RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY PUBLISHED BY FEDERAL, REGIONAL, STATE, AND LOCAL HEALTH DEPARTMENTS OR AGENCIES. 2) INTERVIEWS WITH PERSONS LOCATED WITHIN MOFFITT'S COMMUNITY INCLUDING HEALTH COMMUNITY ADVOCATES, OTHER NONPROFIT ORGANIZATIONS, LOCAL GOVERNMENT OFFICIALS, COMMUNITY BASED ORGANIZATIONS, AND HEALTHCARE PROVIDERS FOCUSING ON MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS, AND THOSE WITH CHRONIC DISEASE NEEDS.3) ONLINE COMMUNITY HEALTH SURVEY IN ENGLISH AND SPANISH MADE AVAILABLE TO PERSONS REPRESENTING THE BROAD INTERESTS OF THE SURROUNDING COMMUNITY, WHICH INCLUDED THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; SURVEY OUTREACH FOCUSED ON ORGANIZATIONS SERVING ETHNIC AND GENDER MINORITIES.WE WOULD LIKE TO ACKNOWLEDGE EACH OF THE FOLLOWING ORGANIZATIONS AND MOFFITT DEPARTMENTS WHO PARTICIPATED IN AN INTERVIEW FOR THIS ASSESSMENT. THEY CONTRIBUTED IMMEASURABLE VALUE IN THE FORMATION OF THIS REPORT, PROVIDING PROFESSIONAL KNOWLEDGE, EXPERT INFORMATION, AND INFORMED PUBLIC POLICY DIRECTION. WE THANK ALL PARTICIPANTS, WHETHER THEY PARTCIPATED VIA INTERVIEW OR SURVEY, FOR THEIR GENEROUS TIME AND CONTRIBUTIONS TO THIS ASSESSMENT.COMMUNITY STAKEHOLDER ORGANIZATIONS:ADVENTHEALTH, AMERICAN CANCER SOCIETY, BAYCARE, CANCER CONTROL COLLABORATIVE - EAST CENTRAL REGION, CAN COMMUNITY - NORTH PORT, COMMUNITY HEATLH CENTERS, INC., FACES OF COURAGE FOUNDATION, INC., FEEDING TAMPA BAY, FLORIDA DEPARTMENT OF HEALTH (BREVARD, CHARLOTTE AND GLADES, CITRUS, COLLIER, DESOTO, HENDRY, HERNANDO, HIGHLANDS, HILLSBOROUGH, LAKE, LEE, MANATEE, MARION, ORANGE, OSCEOLA, PASCO, PINELLAS, POLK, HARDEE, SARASOTA, SEMINOLE, & SUMTER COUNTIES), FRONT PORCH COMMUNITY DEVELOPMENT ASSOCIATION, INC., GOOD SAMARITAN HEALTH CLINIC, GULF COAST SOUTH AHEC, INC., HAITIAN AMERICAN FOUNDATION OF TAMPA BAY, HEALTH CHOICE NETWORK, INTERCULTURAL ADVOCACY INSTITUTE, LATIN COMMUNITY HEALTH ADVISORS, INC., LATINAS UNIDAS POR UN NUEVO AMANECER, LEE DAVIS COMMUNITY RESOURCE CENTER, LEUKEMIA & LYMPHOMA SOCIETY - NORTH FLORIDA, METROPOLITAN MINISTRIES, MID FLORIDA COMMUNITY SERVICES, ORLANDOHEALTH, PREMIER COMMUNITY HEALTHCARE GROUP, POLK COUNTRY INDIGENT HEALTHCARE DIVISION, SALVATION ARMY REHAB CENTER, SUNCOAST COMMUNITY HEALTH CENTERS, TAMPA FAMILY HEALTH CENTERS, TAMPA GENERAL HOSPITAL, UNITED WAY (CHARLOTTE, COLLIER & THE KEYS, LEE, HENDRY, & GLADES COUNTIES), AND UNITED WAY SUNCOAST.MOFFITT DEPARTMENTS & PROGRAMS:SOCIAL WORK & PATIENT FAMILY SERVICE, PATIENT FAMILY ADVISORY COUNCIL, CLINICAL TRIALS OFFICE, TAMPA BAY COMMUNITY CANCER NETWORK (TBCCN), MOFFITT PONCE U54 PARTNERSHIP, MOFFITT DIVERSITY, AND STRATEGIC COMMUNICATIONS. H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE PART V, SECTION B, LINE 6A: IN OCTOBER 2015, MOFFITT COLLABORATED WITH THE FLORIDA DEPARTMENT OF HEALTH, HILLSBOROUGH COUNTY, TO ESTABLISH HEALTHY HILLSBOROUGH. HEALTHY HILLSBOROUGH IS A COMMITTEE OF LOCAL HOSPITALS, THE COUNTY HEALTH DEPARTMENT, AND FEDERALLY QUALIFIED HEALTH CENTERS. THE PURPOSE OF HEALTHY HILLSBOROUGH IS TO COMPLETE A COMPREHENSIVE CHNA AND TO IDENTIFY OPPORTUNITIES FOR COLLABORATION TO COLLECTIVELY IMPACT AND IMPROVE THE HEALTH OF HILLSBOROUGH COUNTY. THE ORGANIZATIONS INVOLVED ARE:FLORIDA DEPARTMENT OF HEALTH - HILLSBOROUGH COUNTYADVENTHEALTH WEST FLORIDA DIVISIONMOFFITT CANCER CENTERBAYCARE HEALTH SYSTEMSUNCOAST COMMUNITY HEALTH CENTERSTAMPA FAMILY HEALTH CENTERSTAMPA GENERAL HOSPITALIN 2019, THE HEALTHY HILLSBOROUGH COMMITTEE EXTENDED THE PARTNERSHIP TO THE COUNTY HEALTH DEPARTMENTS IN PINELLAS, PASCO, AND POLK TO COLLABORATE ON THE CHNA. THE FOUR COUNTY COLLABORATION IS CALLED ALL4HEALTHFL. THE ALL4HEALTHFL COLLABORATIVE COMPLETED A GENERAL COMMUNITY CHNA AND CHILD-FOCUSED CHNA, BOTH OF WHICH WERE COMPLETED IN 2022. MOFFITT CANCER CENTER COMPLETED ITS OWN CHNA AND IMPLEMENTATION STRATEGY SEPARATE FROM THE ALL4HEALTHFL COLLABORATIVE, BUT MOFFITT'S COMMUNITY BENEFIT COORDINATOR ASSISTED WITH ALL STAGES OF THE ALL4HEALTHFL CHNA AND IMPLEMENTATION STRATEGY. ASSISTANCE INCLUDED SURVEY DEVELOPMENT, FOCUS GROUP QUESTION DEVELOPMENT, SERVING AS FOCUS GROUP MEDIATOR AND NOTE TAKER FOR THE COUNTY SPECIFIC PRIORITIZATION SESSIONS FOR THE ADULT AND CHILD-FOCUSED CHNAS, AND PROVIDING GUIDANCE ON THE ALIGNMENT OF THE IMPLEMENTATION STRATEGIES OF BOTH MOFFITT AND ALL4HEALTHFL TO FACILICATE INCREASED COLLABORATION AMONG THE MEMBER ORGANIZATIONS. H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE PART V, SECTION B, LINE 6B: INCLUDED WITH THE HOSPITALS LISTED ABOVE, ARE OTHER HEALTH ORGANIZATIONS MOFFITT COLLABORATED WITH IN ORDER TO DETERMINE THE NEEDS OF THE COMMUNITY. THOSE ORGANIZATIONS ARE AS FOLLOWS:-FLORIDA DEPARTMENT OF HEALTH (HILLSBOROUGH, PINELLAS, PASCO, AND POLK COUNTIES)-SUNCOAST COMMUNITY HEALTH CENTERS-TAMPA FAMILY HEALTH CENTERS H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE PART V, SECTION B, LINE 11: BASED ON THE RESULTS OF THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, AFTER CAREFUL CONSIDERATION OF THE DATA OBTAINED, THE FOLLOWING LIST OF SIGNIFICANT HEALTH NEED TOPICS WAS ESTABLISHED:-ACCESS TO CARE-BEHAVIORAL HEALTH-CANCER-FINANCIAL BARRIERS AND POVERTY-HEALTH EQUITY-HEALTH PROMOTION, EDUCATION & OUTREACH-HEALTHY WEIGHT-PREVENTATIVE CARE-SOCIAL DETERMINANTS OF HEALTH-SMOKING/TOBACCO-TRANSPORTATIONON APRIL 20, 2022 AND APRIL 21, 2022, 1.5-HOUR VIRTUAL MEETINGS WERE HELDWITH MOFFITT STAFF AND A VARIETY OF INTERNAL AND EXTERNAL STAKEHOLDERSWITHIN THE PATIENT AND FAMILY ADVISORY COUNCIL AND THE TAMPA BAY COMMUNITYCANCER NETWORK IN ORDER TO REFINE THIS LIST OF SIGNIFICANT HEALTH NEEDS.EACH VIRTUAL PRIORITIZATION SESSION INCLUDED AN INTRODUCTION TO THECOMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND BRIEF OVERVIEW OF EACH OFTHE SIGNIFICANT HEALTH TOPICS THE GROUPS WOULD RATE FOR PRIORITIZATION.THE SIMPLEX METHOD WAS UTILIZED TO QUANTIFY FEEDBACK FROM THE TWOPRIORITIZATION SESSIONS. THIS INCLUDED A SHARED QUESTIONNAIRE WITH POLLQUESTIONS ASKING PARTICIPANTS ABOUT THE PERCEIVED IMPORTANCE OF A GIVENNEED, THEN ASKING HOW FEASIBLE IT WOULD BE TO ADDRESS THIS NEED.PARTICIPANTS COULD RANK THE NEED IN TERMS OF THE BURDEN, SCOPE, SEVERITY,OR URGENCY FROM 1 (NOT IMPORTANT) TO 5 (VERY IMPORTANT) AND THEFEASIBILITY IN TERMS OF HOW POSSIBLE IT WOULD BE TO ADDRESS FROM 1 (VERYDIFFICULT) TO 3 (VERY EASY). FOLLOWING THE COMPLETION OF THE MEETINGS, THEPOLL DATA WAS COMPILED INTO A QUADRANT CHART WITH THE AVERAGE IMPORTANCERANKING QUANTIFIED ON THE X-AXIS AND THE AVERAGE FEASIBILITY RANKINGQUANTIFIED ON THE Y-AXIS.MOFFITT LEADERSHIP AND KEY INTERNAL STAKEHOLDERS REVIEWED THE DATA WITHCONSIDERATION OF THE EXISTING PROGRAMMING, CAPACITY, RESOURCES, ANDMOFFITT'S STRATEGIC PLAN, LEVERAGING OPPORTUNITIES FOR COMBINING MULTIPLENEEDS INTO ONE PRIORITY AREA. THE FOLLOWING THREE AREAS WERE SELECTED ASTHE TOP PRIORITIZED HEALTH NEEDS FOR THE COMMUNITY:-PREVENTION, EDUCATION, AND OUTREACH-ACCESS TO SCREENING AND EARLY DETECTION-HEALTH EQUITYLEADERSHIP DECIDED TO ADD A FOURTH DOMAIN AS A RESULT OF THE COMMUNITYBENEFIT INVENTORY: COMMUNITY HEALTH IMPROVEMENT; WHERE LEADERSHIP SAW THENEED TO FURTHER STRENGTHEN THE FUNCTION OF COMMUNITY BENEFIT PROGRAMS.MOFFITT IS NOT ABLE TO ADDRESS ALL OF THE HEALTH NEEDS IDENTIFIED,ALTHOUGH MANY WERE ABLE TO BE COMBINED WITH OTHER NEEDS TO BE ADEQUATELYPRIORITIZED. THE REMAINING IDENTIFIED NEEDS FROM THE ORIGINAL LIST WILLNOT BE A STRATEGIC FOCUS IN THE EXECUTION OF THE 2023-2025 IMPLEMENTATIONPLAN DUE TO FACTORS AFFECTING FEASIBILITY INCLUDING CAPACITY, RESOURCES,AND THE PRIORITIZATION OF NEEDS WITH HIGHER URGENCY. THE FOLLOWING HEALTHNEEDS DO NOT ALIGN WITH THOSE CRITERIA AND ARE NOT BEING DIRECTLYADDRESSED BY MOFFITT:-BEHAVIORAL HEALTH-FINANCIAL BARRIERS AND POVERTY-SOCIAL DETERMINANTS OF HEALTHPART OF THE IMPLEMENTATION STRATEGY DEVELOPMENT INCLUDED A COMPREHENSIVECOMMUNITY BENEFIT INVENTORY OF ALL COMMUNITY BENEIFT PROGRAMS THAT AREACTIVE AT MOFFITT CANCER CENTER. RATIONALE FOR THIS PROCESS CAME FROM ANEED TO STREAMLINE THE REPORTING OF COMMUNITY BENEFIT ACTIVITY ANDFACILITATE ALIGNMENT OF THOSE INITIATIVES WITH THE NEW IMPLEMENTATIONSTRATEGY. THE INVENTORY IDENTIFIED 33 ACTIVE COMMUNITY BENEFIT PROGRAMS ATMOFFITT. THE COMMUNITY BENEFIT SPECIALIST MET WITH THE REPORTERS ANDLEADERSHIP FOR EACH COMMUNITY BENEFIT PROGRAM TO GET UPDATED INFORMATIONABOUT THE PROGRAM, INFORM THEM ABOUT NEW REPORTING REQUIREMENTS (MORE DATAGRANULARITY), AND DISCUSS ANY PLANNED INITIATIVES THEY HAVE FOR THE NEXT 3YEARS THAT WE CAN INCLUDE IN THE NEXT IMPLEMENTATION STRATEGY. THEINVENTORY WAS WELL RECEIVED AND RESULTED IN THE MOST COMPREHENSIVEIMPLEMENTATION STRATEGY THAT THE CANCER CENTER HAS PRODUCED SO FAR.PREVENTION, EDUCATION, AND OUTREACH: MOFFITT'S OFFICE OF COMMUNITY OUTREACH, ENGEMENT, & EQUITY, ALSO KNOWN AS "COEE", HOSTED 149 HEALTH EDUCATION EVENTS AND HEALTHS FAIRS, SERVING 5,047 PEOPLE IN FY23. ACCESS TO SCREENING AND EARLY DETECTION: GOVERNMENT RELATIONS PARTICIPATED OR HOSTED IN 17 COALITION BUILDING OR ADVOCACY GROUPS, THIS INCLUDES A TRIP TO WASHINGTON DC TO ADVOCATE FOR INCREASED FUNDING FOR CANCER PREVENTION AND SCREENING. THERE WAS 16 MOFFITT FACULTY/STAFF PARTICIATED IN THE STATE CANCER DATA WORKGROUP, WHICH ALSO INCLUDED REPRESENTIVIES FROM FLORIDA DEPARTMENT OF HEALTH (DOH), FLORIDA HOSPITAL ASSOCIATION, UNIVERISTY OF MIAMI, UNIVERISTY OF FLORIDA, FLORIDA CANCER DATA SYSTEM (FCDS), FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION (AHCA). IN FY23 MOLE PATROL PARTICIPATED IN 14 SCREENING EVENTS, SERVING 1,137 PEOPLE. IN FY23 20 PEOPLE RECEIVED LOW-COST/NO-COST LUNG CANCER SCREENINGS. HEALTH EQUITY: -16 MOFFITT FACULTY AND STAFF SIT ON 4 WORKGROUPS FOCUSED ON INCREASINGACCESS TO, PROTECTING THE PRIVACY OF, AND ENHANCING THE RICHNESS OF THEFLORIDA CANCER REGISTRY DATA. WORKGROUPS INCLUDE: OBJECTIVE 2.2: CANCERBIOLOGY DATA; OBJECTIVE 2.3 SOCIAL DETERMINANTS AND PATIENT DEMOGRPAHICS;OBJECTIVE 2.4 COLLECING CANCER SCREENING DATA; AND OBJECTIVE 2.6 ACCESSAND UTILIZATION OF CANCER DATA. THESE GROUPS MEET MONTHLY TO DISCUSSOPPORTUNTIES FOR IMPROVING FCDS DATA INTEGRITY AND ACCESS.LANGUAGE SERVICES USED VENDORS IN 36 DIFFERENT LANGUAGES, INCLUDING LANGUAGES THAT LESS THAN 1,000 RESIDENTS IN THE CATCHMENT AREA SPEAK. HEALTH EQUITY TRAIN THE TRAINER PROGRAM IS A COLLABORATION OF ORLANDO HEALTH, MOFFITT CANCER CENTER AND UNITED WAY OF BROWARD COUNTY. THE PROGRAM PROVIDES HEALTH CARE PROFESSIONALS WITH THE KNOWLEDGE NECESSARY TO SUPPORT HEALTH EQUITY WITHIN THEIR PRACTICES. THE PROGRAM PRODUCED 141 GRADUATES, INCLUDING 13 COHORT GRADUATES. IN TOTAL, THE PROGRAM ENGAGED 39 ORGANIZATIONS INCLUDING 15 COHORTS, 55 MOFFITT DEPARTMENTS, 98 MOFFITT TEAM MEMBERS, AND 66 GRADUATE MOFFITT TEAM MEMBERS. COMMUNITY HEALTH IMPROVEMENT:IN MAY 2023 COEE HIRED A NEW COMMUNITY BENEFIT SPECIALIST. THE TEAM MEMBER COMPLETED THE COMMUNITY BENEFIT 101 TRAINING PROVIDED BY CATHOLIC HEALTH SERVICES. H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE PART V, SECTION B, LINE 13B: PATIENTS WHO ARE MEDICALLY NEEDY MAY STILL APPLY FOR FINANCIAL ASSISTANCE, BUT WILL PRESUMPTIVELY QUALIFY FOR FINANCIAL ASSISTANCE IF THEY CANNOT MEET THEIR SHARE OF COST AS DETERMINED BY THE FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES. THE LEVEL OF ASSISTANCE WILL BE DETERMINED BY WHICH INCOME LEVEL THE PATIENT'S SHARE OF COST FALLS ON THE FEDERAL POVERTY GUIDELINES. IN ADDITION, PATIENTS WHO QUALIFY UNDER THE POLICY AS MEDICALLY INDIGENT ARE ENTITLED TO 100% ADJUSTMENT UNDER THE POLICY. H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE PART V, SECTION B, LINE 13H: CRITERIA USED TO DETERMINE ELIGIBILITY NOT ONLY INCLUDES INCOME LEVEL, ASSET LEVEL, INSURANCE OR UNDERINSURANCE STATUS AND RESIDENCY, BUT MAY ALSO INCLUDE INFORMATION RELATED TO EMPLOYMENT STATUS, NUMBER OF DEPENDENTS IN HOUSEHOLD AND FINANCIAL SUPPORT BY ANY OTHER PERSON OR PROGRAM. H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE PART V, SECTION B, LINE 15E: METHOD BY WHICH PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE:A. PATIENTS THAT REQUEST FINANCIAL ASSISTANCE OR WHO HAVE BEEN IDENTIFIED AS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE REFERRED TO THE CENTER'S FINANCIAL COUNSELORS.B. PATIENTS MAY CONTACT THE MOFFITT CANCER CENTER BUSINESS OFFICE AT 12902 MAGNOLIA DRIVE, MCB-BO, TAMPA, FLORIDA 33612, OR CALL 1-800-456-3434 EXT. 8422 OR THE DIRECT NUMBER AT 813-745-8422 FOR INFORMATION AND ASSISTANCE REGARDING THE FINANCIAL ASSISTANCE APPLICATION.C. PATIENTS WILL BE INFORMED OF THE PROCESS AND PROCEDURES INVOLVED FOR A FINANCIAL ASSISTANCE APPLICATION EITHER BEFORE RECEIVING SERVICES OR DURING THE BILLING AND COLLECTION PROCESS.D. THE PATIENT AND/OR THE PATIENT'S FAMILY WILL BE ADVISED OF ALL DOCUMENTATION REQUIRED TO MAKE A DETERMINATION AS TO ELIGIBILITY FOR FINANCIAL ASSISTANCE.E. A FINANCIAL COUNSELOR WILL INTERVIEW THE PATIENT OR THE PATIENT'S RELATIVES WHO ARE LEGALLY RESPONSIBLE FOR THE PATIENT'S SUPPORT IN COMPLIANCE WITH HIPAA GUIDELINES. DURING THE INTERVIEW, THE FINANCIAL COUNSELOR WILL GATHER INFORMATION ABOUT THE PATIENT'S CIRCUMSTANCES AND ABILITY TO PAY AND, IF REQUESTED, MAY ASSIST THE PATIENT OR PATIENT'S FAMILY IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION.F. A PATIENT AND/OR A PATIENT'S FAMILY MAY ALSO MEET WITH THE CENTER'S PHARMACY REPRESENTATIVE TO APPLY FOR AVAILABLE ASSISTANCE PROGRAMS FOR PHARMACEUTICAL CARE.G. A REQUEST FOR FINANCIAL ASSISTANCE AND A DETERMINATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE SHOULD OCCUR PRIOR TO RENDERING NON-EMERGENT MEDICALLY NECESSARY SERVICES. HOWEVER, THE DETERMINATION MAY BE DONE AT ANY POINT IN THE COLLECTION PROCESS.H. IF THE MARITAL STATUS OF A MINOR CANNOT BE DETERMINED, OR WHERE THERE IS NOT SUFFICIENT DOCUMENTATION TO CONFIRM A MINOR'S EMANCIPATION, ELIGIBILITY OF FINANCIAL ASSISTANCE WILL BE BASED ON THE INCOME AND ASSETS OF THE PARENT/PARENTS OR LEGAL GUARDIAN OF THE MINOR. DOCUMENTATION PROVIDED FOR THE FINANCIAL ASSISTANCE APPLICATION MUST BE CONSISTENT WITH ALL OTHER DOCUMENTATION PRESENTED FOR REVIEW.I. THERE ARE INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR FINANCIAL ASSISTANCE, BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT, THROUGH CONTRACTUAL AGREEMENTS WITH OTHER PROVIDERS, OR THROUGH OTHER SOURCES, WHICH COULD PROVIDE SUFFICIENT EVIDENCE TO PROVIDE THE PATIENT WITH FINANCIAL ASSISTANCE. IN THE EVENT THERE IS NO FORMAL WRITTEN APPLICATION TO SUPPORT A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE, OR THE PATIENT DOES NOT HAVE A FINANCIAL ASSISTANCE FORM ON RECORD, THE CENTER MAY USE EXTERNALLY AVAILABLE INFORMATION IN DETERMINING ESTIMATE INCOME AMOUNTS FOR THE BASIS OF DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY. THE CENTER MAY APPLY FOR FINANCIAL ASSISTANCE ON BEHALF OF THE PATIENT. THE SAME ELIGIBILITY CRITERIA SET FORTH IN THE FINANCIAL ASSISTANCE POLICY WILL BE USED TO DETERMINE ELIGIBILITY BASED ON ALL AVAILABLE INFORMATION OBTAINED. IN ORDER TO FACILITATE THE APPLICATION, THE INSTITUTION WILL USE THE INFORMATION RETURNED FROM AN EXTERNAL CREDIT REPORTING AGENCY AS SUPPORT FOR APPROVAL OR DENIAL OF FINANCIAL ASSISTANCE. H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE PART V, SECTION B, LINE 16J: REFERENCE TO THE POLICY IS ADDED TO THE BILLING INVOICE STATING THAT A MOFFITT REPRESENTATIVE CAN HELP EVALUATE ELIGIBILITY FOR FINANCIAL ASSISTANCE IF THE PATIENT IS UNABLE TO PAY. HOSPITAL'S BILLING AND COLLECTIONS AREA OF ITS WEBSITE ALSO STATES THAT IF A PATIENT IS UNDERINSURED OR UNABLE TO PAY, A PATIENT ACCOUNT REPRESENTATIVE OR A SOCIAL WORKER WILL HELP IDENTIFY ASSISTANCE PROGRAMS THAT OFFER HELP IN MEETING FINANCIAL OBLIGATIONS. IN ADDITION, NOTIFICATION IS PLACED CONSPICUOUSLY AT PATIENT ACCESS LOCATIONS IN THE HOSPITAL FACILITY. H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE PART V, SECTION B, LINE 20E: MOFFITT HOSPITAL DID NOT INITIATE ANY OF THE ACTIONS DESCRIBED IN SCHEDULE H, PART V, SECTION B, LINE 19. HOWEVER, IF THE HOSPITAL HAD UNDERTAKEN ANY OF THE LISTED ACTIONS, IT WOULD HAVE FIRST NOTIFIED PATIENTS OF ITS FINANCIAL ASSISTANCE POLICY ON ADMISSION, PRIOR TO DISCHARGE, AND IN COMMUNICATIONS WITH THE PATIENTS REGARDING THEIR BILLS. MOFFITT HOSPITAL DOCUMENTS ITS DETERMINATION OF WHETHER PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY. CONTINUOUS EFFORT IS MADE TO QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE, SUCH AS ASSISTING WITH THE APPLICATION PROCESS TO DETERMINE ELIGIBILITY AS WELL AS IDENTIFYING OTHER PROGRAMS THAT MAY PROVIDE ASSISTANCE. H. LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE PART V, SECTION B, LINE 21D: THE CANCER CENTER IS A SPECIALTY HOSPITAL AND THEREFORE, DOES NOT PROVIDE EMERGENCY MEDICAL TREATMENT WITHIN THE MEANING OF SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). IF, HOWEVER, AN INDIVIDUAL SEEKING SUCH CARE ENTERS THE CANCER CENTER'S FACILITY, THE CANCER CENTER WITHOUT DISCRIMINATION WILL STABILIZE THE PATIENT AND ASSIST THE PATIENT AND/OR THE PATIENT'S FAMILY IN OBTAINING TRANSPORTATION FOR THE PATIENT TO A LOCAL HOSPITAL EQUIPPED FOR EMERGENCY MEDICAL CARE. PART V, SECTION B, LINE 16C WEBSITE ADDRESS FULL URL: HTTPS://MOFFITT.ORG/PATIENT-FAMILY/INSURANCE-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE/ 3 1 - MOFFITT CANCER CTR MCKINLEY OUTPATIENT 10920 MCKINLEY DRIVE TAMPA FL 33612 OUTPATIENT 2 - MOFFITT CANCER CTR AT WESLEY CHAPEL 2590 HEALING WAY WESLEY CHAPEL FL 33544 OUTPATIENT 3 - MOFFITT CANCER CTR AT INT'L PLAZA 4101 JIM WALTER BLVD TAMPA FL 33607 OUTPATIENT PART I, LINE 3C: CHARITY ADJUSTMENTS ARE PROVIDED BY THE CANCER CENTER AS FOLLOWS:A. PATIENTS WHO HAVE FAMILY INCOME AND ASSETS AT OR BELOW 200% OF THEFEDERAL POVERTY GUIDELINES FOR THE PATIENT'S FAMILY SIZE SHALL BEENTITLED TO 100% FINANCIAL ASSISTANCE ON QUALIFYING BALANCES.B. PATIENTS WHO HAVE FAMILY INCOME AND ASSETS BETWEEN 201%-400% OF THEFEDERAL POVERTY GUIDELINE FOR THE PATIENT'S FAMILY SIZE SHALL BECLASSIFIED AS "SELF PAY TIER 1" STATUS AND ARE ENTITLED TO FINANCIALASSISTANCE OF 65% ON QUALIFYING BALANCES.C. PATIENTS WHO ARE MEDICALLY NEEDY MAY STILL APPLY FOR FINANCIALASSISTANCE, BUT WILL PRESUMPTIVELY QUALIFY FOR FINANCIAL ASSISTANCE IFTHEY CANNOT MEET THEIR SHARE OF COST AS DETERMINED BY THE FLORIDADEPARTMENT OF CHILDREN AND FAMILIES. THE LEVEL OF ASSISTANCE WILL BEDETERMINED BY WHICH INCOME LEVEL THE PATIENT'S SHARE OF COST FALLS ON THEFEDERAL POVERTY GUIDELINES. PART I, LINE 7: THE METHODOLOGY USED TO CALCULATE CHARITY CARE, MEDICAID, AND OTHER MEANS-TESTED EXPENSES IS COST TO CHARGE RATIO, USING PATIENT EXPENSES TO GROSS CHARGES, WHILE THE DIRECT COST METHOD IS USED TO DETERMINE OTHER COMMUNITY BENEFITS/PROGRAMS EXPENSES. PART I, LN 7 COL(F): TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN A FOR THE HOSPITAL IS $1,622,473,343. THE TOTAL BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $16,758,134. AFTER BAD DEBT WAS DEDUCTED FROM THE TOTAL EXPENSES THE AMOUNT OF TOTAL EXPENSES USED TO CALCULATE THE PERCENT IN LINE 7, COLUMN F WAS $1,605,715,209. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING - ADVOCACYIN FY23 MOFFITT PARTICIPATED IN A CONGRESSIONAL MEETING (WASHIGNTON D.C.): ALICE HASTINGS PROGRAM FOR ADVANCE CANCER SCREENING. THE MEETING DISCUSS ACCESS TO SCREENING AND EARLY DETECTION. THE MEETING COMPRISED OF CONGRESSIONAL STAFF AND MOFFITT LEADERSHIP. IN FY23 MOFFITT PARTICIPATED IN A VIRTUAL EVENT DISCUSSING MEDICARE/MEDICAID COVERAGE FOR MOLECULAR TESTING. THIS EVENT WAS TO PROMOTE LEGISLATION TO MANDATE MEDICARE AND MEDICAID TO COVER MOLECULAR TESTING FOR ALL CANCER PATIENTS. THE MEETING WAS COMPRISED OF CONGRESSIONAL STAFF, HEALTHCARE PROFESSIONALS AND COMMUNITY ORGANIZATIONS. COMMUNITY BUILDING - PARTNERSHIPS THE TAMPA BAY COMMUNITY CANCER NETWORK (TBCCN), ONE OF MOFFITT'S TWOCOMMUNITY ADVISORY BOARDS, HAD A RETREAT AND FOUR QUARTERLY MEETINGS WITH MEMBERS TO CONTINUE STRENTHENING PARTNERSHIP AMONG MEMBERS ORGANIZATIONS. THE REGIONAL CANCER CONTROL COLLABORATIVE HAS MONTHLY MEETINGS WITH ALL 6 REGION COLLABORTIVES, MOFFITT CANCER CENTER AND UNIVERISTY OF MIAMI SYLVESTER COMPREHENSIVE CANCER CENTER. THE PURPOSE OF THE COLLABORATIVE IS TO MEET ON A MONTHLY BASIS AND IMPLEMENT CANCER CONTROL EFFORTS AMONG PUBLIC AND PRIVATE PARTNERS. THIS IS RUN BY FLORIDA DEPARTMENT OF HEALTH. MOFFITT IS REPRESENTED AS A CONSULTANT. THE REGIONAL COLLABORATIVES INCLUDE: NORTHWEST REGION (UNIVERSITY OF WEST FLORIDA), NORTHEAST REGION (NORTHEAST FLORIDA AHEC), EAST CENTRAL REGION (HEALTH COUNCIL OF EAST CENTRAL FLORIDA, INC), NORTH CENTRAL REGION (WELLFLORIDA COUNCIL, INC), SOUTHWEST REGION (UNIVERISTY OF SOUTH FLORIDA COLLEGE OF NURSING), SOUTHEAST REGION (HEALTH COUNCIL OF SOUTH FLORIDA, INC). COMMUNITY BUILDING - COMMUNITY SUPPORTMOFFITT PARTICIPATED IN THE BIG BROTHERS BIG SISTERS SCHOOL TO WORKPROGRAM THAT PROVIDES ONE-ON-ONE MENTORING IN THE WORKPLACE FOR HIGHSCHOOL JUNIORS AND SENIORS TO HELP IMPROVE GRADUATION RATES. IN FY23,MOFFITT TEAM MEMBERS IN 12 DEPARTMENTS MENTORED 12 STUDENTS, TOTALING 106HOURS.COMMUNITY BUILDING - WORKFORCE DEVELOPMENTMOFFITT DEVELOPED A MENTORING PROGRAM CALLED "VOLUNTEEN" WHERE HIGH SCHOOLSTUDENTS CAN VOLUNTEER AT MOFFITT. THE PROGRAM IS DESIGNED TO EXPOSE TEENSTO HEALTHCARE CAREERS, EDUCATE THEM ON THE IMPORTANCE OF PROVIDINGHEALTHCARE TO THE COMMUNITY, AND HOW MOFFITT AND OTHER HEALTHCAREORGANIZATIONS PLAY A ROLE IN MEETING THE NEEDS OF THE COMMUNITY. THEVOLUNTEERS ARE GUIDED THROUGH VARIOUS DEPARTMENTS THROUGHOUT THEORGANIZATION AND RECEIVE HANDS ON EXPERIENCE IN THE AREAS ASSIGNED. INFY23, 34 MOFFITT DEPARTMENTS RECEIVED ASSISTANCE FROM STUDENTS WHOVOLUNTEERED FOR 3,088 HOURS. PART III, LINE 2: THE METHODOLOGY USED TO CALCULATE BAD DEBT EXPENSE WAS CALCULATING THE COST TO CHARGE RATIO, USING PATIENT EXPENSES TO GROSS CHARGES, AND APPLYING IT TO THE BAD DEBT PROVISION IN PART III, LINE 4. PART III, LINE 4: ADDITIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ARE MADE BY MEANSOF THE PROVISION FOR BAD DEBTS. ACCOUNTS ARE WRITTEN OFF WHEN DEEMED TOBE UNCOLLECTIBLE AND ARE DEDUCTED FROM THE PATIENT'S ACCOUNTS RECEIVABLE BALANCE.THE AMOUNT OF THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'SASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS ANDECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENT HEALTHCARECOVERAGE AND OTHER COLLECTION INDICATORS. ONE TOOL USED IN MANAGEMENT'SASSESSMENT IS A DETAILED REVIEW OF HISTORICAL COLLECTIONS AND WRITE-OFFSAT THE CANCER CENTER THAT REPRESENT A MAJORITY OF THE CANCER CENTER'SREVENUES AND ACCOUNTS RECEIVABLE. THE RESULTS OF THE DETAILED REVIEW OFHISTORICAL COLLECTIONS AND WRITE-OFFS EXPERIENCE, ADJUSTED FOR CHANGES INTRENDS AND CONDITIONS, ARE USED TO EVALUATE THE ALLOWANCE AMOUNT FOR THECURRENT PERIOD. PART III, LINE 8: THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT OF MEDICAREALLOWABLE COSTS IS THE STEP-DOWN METHOD WHICH DISALLOWS CERTAIN COSTS TOBE CONSIDERED AS COSTS RELATED TO PATIENT CARE. MEDICARE SHORTFALLS WHICHARE COSTS INCURRED BY THE HOSPITAL TO PROVIDE QUALITY CARE AND TREATMENT OF ITS PATIENTS SHOULD BE TREATED AS COMMUNITY BENEFIT. TO NOT INCUR THESE COST WOULD POTENTIALLY LIMIT OR EVEN COMPROMISE THE QUALITY OF SERVICE PROVIDED TO THE ELDERLY OR DISABLED. PART III, LINE 9B: PATIENTS ARE SCREENED DURING THE ADMISSIONS PROCESS TO ASSESS THE NEEDFOR FINANCIAL ASSISTANCE. HOWEVER, IF AT ANY POINT IN THE COLLECTIONPROCESS IT IS DETERMINED THAT THE PATIENT MAY BE UNABLE TO MEET HIS ORHER OBLIGATION, THE PATIENT WILL BE SENT AN APPLICATION FOR FINANCIALASSISTANCE OR CHARITY ADJUSTMENT. IF PATIENT DOES NOT EXPRESS THEINABILITY TO PAY PRIOR TO BILLING, AN INVOICE IS SENT TO THE PATIENTWHICH INCLUDES CONTACT INFORMATION FOR A PATIENT SERVICE REPRESENTATIVEIF THE PATIENT NEEDS FINANCIAL ASSISTANCE. A HOSPITAL REPRESENTATIVE WILLMAKE EVERY EFFORT TO WORK WITH THE PATIENT TO DETERMINE WHETHER FINANCIALASSISTANCE IS NEEDED. IF THE PATIENT DOES NOT STATE THE NEED OR DOES NOTQUALIFY FOR FINANCIAL ASSISTANCE THEREAFTER, AND PAYMENTS ARE NOT MADE ASAGREED, THE HOSPITAL REPRESENTATIVE MAY OFFER REASONABLE PAYMENT PLANS TOHELP PATIENTS MEET THEIR FINANCIAL OBLIGATIONS. PART VI, LINE 2: MOFFITT CANCER CENTER IS HEAVILY INVOLVED IN THE COMMUNITY WITH OUTREACH/EDUCATION EFFORTS (E.G., COEE, LUNG AND THORACIC TUMOR EDUCATION PROGRAM (LATTE), HEAD AND NECK CANCER EDUCATION PROGRAM, TBCCN), COMMUNITY-BASED PARTICIPATORY RESEARCH, PARTICIPATION IN COMMUNITY COMMITTEES OR COALITIONS (E.G., HEALTHY HILLSBOROUGH, ALL4HEALTHFL COLLABORATIVE, FLORIDA CANCER CONTROL & RESEARCH ADVISORY COUNCIL (CCRAB)) AND PARTNERSHIPS WITH FEDERALLY-QUALIFIED HEALTH CENTERS AND FREE CLINICS. THESE EFFORTS ENSURE THE ORGANIZATION IS CONTINUOUSLY ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITY. MOFFITT'S CHNA REPORT EXPLAINS THE PROCESS OF ASSESSING THE NEEDS OF THE COMMUNITY. WE ENGAGED COMMUNITY MEMBERS THROUGH EXTENSIVE ANALYSIS OF SECONDARY DATA, AN ONLINE SURVEY IN ENGLISH AND SPANISH, AS WELL AS INTERVIEWS WITH KEY COMMUNITY AND PUBLIC HEALTH STAKEHOLDERS DURING THE COMPLETION OF THE NEEDS ASSESSMENT. THE REPORT CAN BE FOUND ON OUR WEBSITE. TO ENHANCE MOFFITT'S ABILITY TO ADDRESS COMMUNITY HEALTH NEEDS, THE CENTER WENT THROUGH A COMPREHENSIVE COMMUNITY BENEFIT INVENTORY TO GET A COMPLETE VIEW OF THE COMMUNITY BENEFIT PROGRAMS THE HOSPTIAL CURERNTLY PROVIDES, AND TO INDENTIFY AREAS TO IMPROVE. THE COMMUNITY BENEFIT INVENTORY RESULTED IN THE MOST COMPREHESIVE LINKAGE OF MOFFITT'S COMMUNITY BENEFIT PROGRAMS TO OUR MOST RECENT IMPLEMENTATION STRATEGY. WE TRACK PROGRESS MADE IN EACH OF THE PRIORITIZED HEALTH AREAS, GOALS, AND ACTIVITES BY THE QUARTER AND FISCAL YEAR. MOFFITT'S COMMUNITY OUTREACH, ENGAGEMENT, AND EQUITY (COEE) TEAM DEVELOPED OUR SECOND VERSION OF MOFFITT CANCER CENTER'S CATCHMENT AREA PROFILE THAT HIGHLIGHTS CANCER RELEVANT DATA INCLUDING INCIDENCE, RISK FACTORS, AND PREVENTION BEHAVIORS TO HELP STAKEHOLDERS MAKE INFORMED DECISIONS ABOUT THEIR RESEARCH, EDUCATION, AND OUTREACH PRIORITIES RELATED TO MOFFITT'S 23-COUNTY CATCHMENT AREA. THE CATCHMENT AREA PROFILE SERVES AS A SYNTHESIS OF HEALTH-RELATED PRIORITIES MOFFITT CANCER CENTER WORKS ON, AND PROVIDES THE OPPORTUNITY FOR FACULTY AND COMMUNITY MEMBERS TO REQUEST ANY DATA (DE-IDENTIFIED WHERE APPLICABLE) LISTED IN THE CATCHMENT AREA PROFILE FOR THEIR OWN USE. THE OFFICE OF COEE FACILITATES DATA REQUESTS FOR THE CANCER AND NON-CANCER RELATED DATA WITHIN THE CATCHMENT AREA PROFILE, AVAILAIBLE TO THE COMMUNITY. PART VI, LINE 3: PUBLICATION OF THE POLICY: A. THE CENTER HAS PLACED SIGNAGE IN THE ADMISSION AREAS OF THE HOSPITALINFORMING PATIENTS OF FINANCIAL ASSISTANCE AND MAKES ITS POLICY, THEFINANCIAL ASSISTANCE APPLICATION, AND THE PLAIN LANGUAGE SUMMARY OF THEPOLICY WIDELY AVAILABLE ON ITS WEBSITE. INDIVIDUALS WITH ACCESS TO THEINTERNET CAN ACCESS, DOWNLOAD, VIEW, AND PRINT A HARD COPY OF THISPOLICY, THE FINANCIAL ASSISTANCE APPLICATION, AND THE PLAIN LANGUAGESUMMARY OF THIS POLICY FROM THE WEBSITE: I. WITHOUT REQUIRING SPECIAL COMPUTER HARDWARE OR SOFTWARE (OTHER THANSOFTWARE THAT IS READILY AVAILABLE TO MEMBERS OF THE PUBLIC WITHOUTPAYMENT OF ANY FEE); II. WITHOUT PAYING A FEE TO THE CENTER; AND III. WITHOUT CREATING AN ACCOUNT OR BEING OTHERWISE REQUIRED TO PROVIDEPERSONALLY-IDENTIFIABLE INFORMATION. B. THE CENTER PROVIDES INDIVIDUALS WHO ASK HOW TO ACCESS A COPY OF THEPOLICY, THE FINANCIAL ASSISTANCE APPLICATION, AND THE PLAIN LANGUAGESUMMARY OF THE POLICY ONLINE WITH THE DIRECT WEBSITE ADDRESS, OR URL, OFTHE WEB PAGE WHERE THE POLICY, THE FINANCIAL ASSISTANCE APPLICATION, ANDTHE PLAIN LANGUAGE SUMMARY OF THE POLICY ARE POSTED. C. THE CENTER WILL MAKE PAPER COPIES OF THIS POLICY, THE FINANCIALASSISTANCE APPLICATION, AND THE PLAIN LANGUAGE SUMMARY OF THIS POLICYAVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH BY MAIL AND IN PUBLICLOCATIONS AT THE CENTER, INCLUDING ANY ADMISSIONS AREAS. D. THE CENTER WILL NOTIFY AND INFORM PATIENTS WHO RECEIVE CARE AT THECENTER ABOUT THIS POLICY NOT ONLY BY SIGNAGE IN THE ADMISSION AREAS BUTALSO BY OFFERING A PAPER COPY OF THE PLAIN LANGUAGE SUMMARY OF THEFINANCIAL ASSISTANCE POLICY AS PART OF THE INTAKE OR DISCHARGE PROCESS.IN ADDITION, THE CANCER CENTER REPRESENTATIVE WILL ALSO GUIDE A PATIENTTO THE WEBSITE OR URL WHERE COPIES OF THIS POLICY, THE FINANCIALASSISTANCE APPLICATION, AND THE PLAIN LANGUAGE SUMMARY OF THIS POLICY MAYBE OBTAINED. THE CENTER ALSO INCLUDES A CONSPICUOUS WRITTEN NOTICE ONBILLING STATEMENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THEAVAILABILITY OF FINANCIAL ASSISTANCE UNDER THIS POLICY ALONG WITH THETELEPHONE NUMBER OF THE OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATIONRELATED TO THE POLICY AND THE FINANCIAL ASSISTANCE APPLICATION PROCESS. E. AT ANY TIME DURING THE PATIENT'S TREATMENT THE PATIENT MAY REQUEST ACOPY OF THIS POLICY, THE FINANCIAL ASSISTANCE APPLICATION, OR THE PLAINLANGUAGE SUMMARY OF THIS POLICY. F. IF A MEMBER OF THE WORKFORCE BECOMES AWARE OF THE PATIENT'S NEED FORFINANCIAL ASSISTANCE DURING THE ADMISSION PROCESS, THE PATIENT SERVICEREPRESENTATIVE WILL PROVIDE THE PATIENT WITH THE NECESSARY INFORMATIONNEEDED TO APPLY FOR FINANCIAL ASSISTANCE. G. THE CENTER WILL ALSO TRANSLATE THIS POLICY, THE FINANCIAL ASSISTANCEAPPLICATION, AND THE PLAIN LANGUAGE SUMMARY OF THIS POLICY INTO THEPRIMARY LANGUAGES SPOKEN BY ALL SIGNIFICANT POPULATIONS SERVED BY THECENTER. PART VI, LINE 4: MOFFITT'S PRIMARY SERVICE AREA, BASED ON THE PATIENT NUMBERS, IS COMPRISED OF 4 COUNTIES IN WEST CENTRAL FLORIDA: HILLSBOROUGH, PASCO, PINELLAS, AND POLK. BASED ON AMERICAN COMMUNITY SURVEY 2021 5-YEAR ESTIMATES, THIS PRIMARY SERVICE AREA HAS OVER 3.7 MILLION RESIDENTS: 75.63% WHITE RESIDENTS, 15.81% BLACK RESIDENTS, AND 21.66% HISPANIC RESIDENTS. THE AVERAGE HOUSEHOLD INCOME IS $60,408, AND 12.79% OF INDIVIDUALS IN THE PRIMARY SERVICE AREA ARE BELOW THE POVERTY LEVEL. THE RURAL POPULATION MAKES UP 4.27% OF THE TOTAL POPULATION. SENIORS (AGE 65+) MAKE UP 19.28% OF THE POPULATION.IN JANUARY 2022, MOFFITT LEADERSHIP SAW A NEED AND OPPORTUNITY TO EXPAND MOFFITT'S CATCHMENT AREA FROM 15 COUNTIES TO 23 COUNTIES, WHICH NOW COVERS 100% OF 2 OF FLORIDA'S CANCER CONTROL COLLABORATIVE REGIONS: SOUTHWEST REGION, EAST CENTRAL REGION. COUNTIES INCLUDE BREVARD, CHARLOTTE, CITRUS, COLLIER, DESOTO, GLADES, HARDEE, HENDRY, HERNANDO, HIGHLANDS, HILLSBOROUGH, LAKE, LEE, MANATEE, MARION, ORANGE, OSCEOLA, PASCO, PINELLAS, POLK, SARASOTA, SEMINOLE, AND SUMTER. THIS EXPANDED CATCHMENT AREA HAS OVER 10 MILLION RESIDENTS: 78.18% WHITE RESIDENTS, 14.49% BLACK RESIDENTS, AND 21.82% HISPANICS. AVERAGE HOUSEHOLD INCOME IS $81,857, AND A LITTLE OVER 13.3% OF INDIVIDUALS IN THE PRIMARY SERVICE AREA ARE BELOW THE POVERTY LEVEL. THE RURAL POPULATION MAKES UP 8.31% OF THE TOTAL POPULATION. SENIORS (AGE 65+) MAKE UP 23.96% OF THE POPULATION. WHEN DETERMINING THE PRIORITY HEALTH NEEDS IN THE 2022 CHNA, ALL THREE DATA SOURCES (SECONDARY DATA ANALYSIS, KEY INFORMANT INTERVIEWS WITH PUBLIC HEALTH AND COMMUNITY STAKEHOLDERS, AND AN ONLINE SURVEY IN ENGLISH AND SPANISH) INCLUDE THE EXPANDED 23 COUNTY CATCHMENT AREA AS THE SERVICE AREA. MOFFITT LEADERSHIP DECIDED THIS BASED ON THE NEED TO UNDERSTAND THE NEEDS, CHANGES TO THE DEMOGRAPHIC MAKE-UP, CANCER INCIDENCE, AND MORTALITY BURDEN, AND IDENTIFY OPPORTUNITIES FOR EXPANDING COMMUNITY PARTNERSHIP WITHIN THE NEW CATCHMENT AREA. THE 2023-2025 IMPLEMENTATION STRATEGY INCLUDES ACTIVITIES TO INCREASE PARTNER REPRESENTATION IN THE EXPANDED CATCHMENT AREA, MEASURED OVER A 3 YEAR PERIOD. PART VI, LINE 5: MOFFITT'S CHNA IMPLEMENTATION PLAN OUTLINES THE ORGANIZATIONAL EFFORTS INPROMOTING THE HEALTH OF OUR COMMUNITY AND ADDRESSING CANCER PREVENTION ANDEARLY DETECTION. THE M-POWER OUTREACH TEAM IS DEDICATED TO ADDRESS THECANCER NEEDS OF UNDERSERVED POPULATIONS THROUGH EDUCATION, COMMUNITYCOLLABORATIONS, AND NAVIGATION OF SERVICES. BELOW ARE ACCOMPLISHMENTS ANDACTIVITES IN FISCAL YEAR 2023:COMMUNITY INVOLVEMENTMOFFITT HAS 2 COMMUNITY ADVISORY BOARDS AND BOTH HAVE COMMUNITY REPRESENTATION. THE TAMPA BAY COMMUNITY CANCER NETWORK (TBCCN) HAS 29 PARTNERS COVERING 11 OF 23 COUNTIES IN OUR CATCHMENT AREA, BUT PROVIDING SERVICES TO RESIDENTS IN MORE THAN THOSE 11 COUNTIES. WITHIN TBCCN THERE ARE WORKGROUPS THAT REPRESENT DIFFERENT INTERESTS AMONG THE MEMBERS AND INITIATIVES THAT MOFFITT IS FOCUSING ON, BACKED BY DATA. WORKGROUPS INCLUDE: CANCER SURVIVORSHIP; SCREENING, BIOBANKING AND VACCINATION; YOUTH IN ACTION; AND PEOPLE WITH HIV (PWH). MEMBERS INCLUDE: AMERICAN CANCER SOCIETY, ADVENT HEALTH, BEST: BRAIN EXPANSIONS SCHOLASTIC TRAINING, CONCORDE CAREER INSTITUTE, FACES OF COURAGE FOUNATION, INC., FARMER'S SELF-HEALTH, INC., HAITIAN ASSOCIATION OF TAMPA BAY, INC., FLORIDA VOICES FOR HEALTH, INC., FLORIDA DEPARTMENT OF HEALTH (HILLSBOROUGH, PINELLAS, PASCO), HILLSBOROUGH ORGANIZATION FOR PROGRESS AND EQUITY (HOPE), INC., JAMES B. SANDERLIN NEIGHBORHOOD FAMILY CENTER, LATINAS UNIDAS POR UN NUEVO AMANECER, INC (LUNA INC), THE LEUKEMIA & LYMPHOMA SOCIETY, BAY CARE MORTON PLANT HOSPITAL - CANCER PATIENT SUPPORT SERVICES (CAPSS), PREMIER COMMUNITY HEALTHCARE GROUP, INC., SISTAHS SURVIVING BREAST CANCER, SUNCOAST COMMUNITY HEALTH CENTERS, SUNCOAST HOSPICE/EMPATH HEALTH, TAMPA FAMILY HEALTH CENTERS, UNIVERISTY AREA DEVELOPMENT CORPORATION, FRONT PORCH COMMUNITY DEVELOPMENT ASSOCIATION, INC., TAMPA BAY HEALTH CARE COLLABORATIVE, CENTRAL FLORIDA HEALTHCARE, INC., WORKGROUP ENHANCING COMMUNITY ADVOCACY & RESEARCH ENGAGEMENT (WE-CARE), YMCA OF THE SUNCOAST, UNITED WAY SUNCOAST, HEALTH CHOICE NETWORKS, INC., USF INFECTIOUS DISEASE FELLOWSHIP PROGRAM, USF MORSANI COLLEGE OF MEDICINE, USF COLLEGE OF PUBLIC HEALTH, AND YBOR YOUTH CLINIC. THE PATIENT AND FAMILY ADVISORY COUNCIL (PFAC) IS COMPOSED OF 29 MEMBERS SPANNING VARIOUS MOFFITT DEPARTMENTS, BUT IMPORTANTLY 55% REPRESENT PATIENTS AND FAMILIES OF PATIENTS, WITH 12 PATIENT ADVISORS AND 4 FAMILTY ADVISORS (FAMILTY MEMBERS OF PATIENTS) TO GUIDE THE DEVELOPMENT OF PATIENT-FOCUSED INIATIVES AT MOFFITT CANCER CENTER. MOFFITT'S 2022 CHNA INCLUDED 64 INTERVIEWS WITH KEY PUBLIC HEALTH AND COMMUNITY STAKEHODLERS. COMMUNITY PARTNERS REPRESENTED 86% OF THE KEY STAKEHOLDER INTERVIEWS, INCLUDING MEMBERS OF TBCCN AND PFAC AS ALL 23 OF THE COUNTY HEALTH DEPARTMENTS IN MOFFITT'S 23 COUNTY CATCHMENT AREA. ALTHOUGH MOFFITT CANCER CENTER CONDUCTED ITS OWN INDEPENDENT CHNA, MOFFITT'S COMMUNITY BENEFIT SPECIALIST PROVIDED SUPPORT AND EXPERTISE TO THE ALL4HEALTHFL COLLABORATIVE'S JOINT 2022 CHNA, PROVIDING OVER 480 HOURS OF SUPPORT (25% OF TOTAL TIME) SPECIFICALLY TO ALL4HEALTHFL AND THE HEALTHY HILLSBOROUGH STEERING COMMITTEE IN FY22.ECONOMIC IMPACTIN FY23, SUPPORT FOR COMMUNITY ORGANIZATION RESEARCH ENGAGEMENT (SCORE) PARTNERED WITH YMCA OF THE SUNCOAST TO CREATE THE YMCA SURVIVORSHIP & WELLNESS PROGRAM POWERED BY MOFFITT. THIS PROGRAM IS A RESEARCH-BASED PHYSICAL ACTIVITY AND WELL-BEING PROGRAM THAT IS DESIGNED TO HELP ADULT CANCER SURVIVORS. THE PROGRAM HELPS REDUCE THE SEVERITY OF THERAPY SIDE EFFECTS, PREVENT UNWANTED WEIGHT CHANGES, AND IMPROVE ENERGY LEVELS. THE YMCA OF THE SUNCOAST WILL BE OFFERING THIS PROGRAM TO RESIDENTS OF PINELLAS, PASCO, HERNANDO, AND CITRUS COUNTIES (CITRUS MEMORIAL HEALTH FOUNDATION, CLEARWATER YMCA, GREATER PALM HARBOR, GREATER RIDGECREST, HERNANDO COUNTY, JAMES P. GILLS, JOHN GEIGLE YMCA IN NORTH PINELLAS). GOOD NEIGHBORSFREEDOM DAY JUNETEENTH: FOR THE THIRD YEAR IN A ROW MOFFITT CANCER CENTER HAS RECOGNIZED JUNETEENTH, WHICH RECOGNIZED THE END OF SLAVERY IN THE UNITED STATES. MOFFITT RAISED THE JUNETEENTH FLAG AT THE MCKINLEY CAMPUS ON JUNE 19TH. HTTPS://ENDEAVOR.MOFFITT.ORG/ARCHIVE/JUNETEENTH-FLAG-TO-FLY-OVER-MOFFITTS-MCKINLEY-CAMPUSRECOGNITIONFDA APPROVES HEPZATO KIT TO TREAT METASTATIC OCULAR MELANOMA: MOFFITT LED THE INTERNATIONAL TRIAL, WHICH BEGAN IN 2016 AND INCLUDED 40 OTHER INSTITUTIONS IN THE UNITED STATES AND EUROPE. PERCUTANEOUS HEPATIC PERFUSION STANDS APART FROM CONVENTIONAL CHEMOTHERAPY BY EMPLOYING SPECIALIZED CATHETERS AND BALLOONS TO ISOLATE THE LIVER FROM THE BODY'S GENERAL CIRCULATION. THIS METHOD FACILITATES THE DIRECT ADMINISTRATION OF HIGH-DOSE CHEMOTHERAPY EXCLUSIVELY TO THE LIVER, WITHOUT AFFECTING OTHER ORGANS. AFTER EXITING THE LIVER, BLOOD IS COLLECTED AND FILTERED EXTERNALLY THROUGH A BYPASS CIRCUIT TO ELIMINATE ANY RESIDUAL CHEMOTHERAPY. PATIENTS TYPICALLY UNDERGO UP TO SIX SESSIONS OF PERCUTANEOUS HEPATIC PERFUSION, SPACED APPROXIMATELY SIX TO EIGHT WEEKS APART.HTTPS://WWW.MOFFITT.ORG/NEWSROOM/NEWS-RELEASES/FDA-APPROVES-HEPZATO-KIT-TO-TREAT-METASTATIC-OCULAR-MELANOMA/ARTS IN MEDICINE CELEBRATES 25 YEARS: THE PROGRAM STARTED IN 1998 WITH ONE ARTIST MEETING WITH PATIENTS AT THEIR BEDSIDE. THE MISSION WAS TO USE ART TO PROMOTE HEALING AND SELF-DISCOVERY. BY OFFERING INSPIRATION, COMFORT AND EMPOWERMENT DURING CHALLENGING TIMES. HTTPS://ENDEAVOR.MOFFITT.ORG/ARCHIVE/ARTS-IN-MEDICINE-CELEBRATES-25-YEARS/RESPONDING TO NEEDSIN FY23, COEE RESOURCE SPECIALIST AND COMMUNITY NAVIGATOR FACILIATED THE USE OF 451 BREAST CANCER SCREENING VOUCHERS FOR COMMUNITY MEMBERS TO ACCESS FREE BREAST CANCER SCREENING. THE MAJORITY OF RECIPIENTS WERE HISPANIC (95.1%) WITH AN AVERAGE AGE OF 45 YEARS. THE PARTICIPATING COMMUNITY CLINICS WERE SUNCOAST COMMUNITY HEALTH CENTERS, USF BRIDGE CLINIC, CATHOLIC CHARITIES, AND TAMPA FAMILY HEALTH CLINIC. THE CRITERIA FOR THE BREAST CANCER VOUCHER PROGRAM IS EXPANDING TO INCLUDE RESIDENTS IN HILLSBOROUGH AND PINELLAS COUNTIES. THE THORACIC ONCOLOGY PROGRAM WAS ABLE TO PROVIDE 20 LUNG CANCER SCREENING VOUCHERS TO RECEIVE FREE CT LUNG SCREENING.MOFFITT CANCER CENTER IN FY23 PARTICIPATED IN 234 HEALTH EDUCATION EVENTS (HEALTH EDUCATION WORKSHOPS, SUPPORT GROUPS, MEET THE EXPERT, HEALTH FAIRS) WITH 141 EVENTS IN ENGLISH AND 93 IN SPANISH WITHIN THE TAMPA BAY AREA, SERVING 8,062 PEOPLE. MOFFITT'S MOLE PATROL SKIN CANCER SCREENING MOBILE UNIT AND THE HEAD AND NECK DEPARTMENT PARTICIPATED IN 20 SCREENING EVENTS, BY PROVIDING FREE CANCER SCREEING TO 1,513 PEOPLE WITHIN THE TAMPA BAY AREA. SOCIAL IMPACTENGAGING WITH THE MOONSHOT INITIATIVE: MOFFITT CANCER CENTER AND UNIVERSITY OF GHANA ARE WORKING TOGETHER TO STRENGTHEN AND EXPAND CAPACITY TO CONDUCT CANCER RESEARCH IN GHANA. WITH A TOTAL OF OVER $1.3 MILLION INVESTED OVER THE NEXT FIVE YEARS, APPROXIMATELY 125-150 FELLOWS AND JUNIOR FACULTY WILL BE TRAINED, AND A SUSTAINABLE CANCER RESEARCH TRAINING PROGRAM EMBEDDED AT THE SCHOOL. BY ENGAGING EXPERTS FROM MULTIPLE DISCIPLINES, THE PROGRAM WILL STRENGTHEN GHANA'S EXISTING NATIONAL AND MULTIDISCIPLINARY CANCER-SPECIFIC RESEARCH TEAMS BY FOCUSING ON TWO HORMONE-RELATED CANCERS (BREAST AND PROSTATE) AND TWO HPV-RELATED CANCERS (CERVICAL AND HEAD AND NECK), ALL OF WHICH WERE IDENTIFIED AS PRIORITIES IN THE GHANA NATIONAL CANCER CONTROL PLAN. HTTPS://WWW.WHITEHOUSE.GOV/OSTP/NEWS-UPDATES/2022/12/14/FACT-SHEET-CANCER-MOONSHOT-ANNOUNCES-NEW-ACTIONS-AIMED-TO-REDUCE-THE-CANCER-BURDEN-IN-AFRICA-AS-PART-OF-THE-U-S-AFRICA-LEADERS-SUMMIT/ VOLUNTEER ACTIVITIESIN FY23, 313 MOFFITT FACULTY AND STAFF DONATED BLOOD, TOTALING 327 HOURS OF DONATED TIME. THERE WERE 48 MOFFITT FACULTY AND STAFF THAT DONATED 219.5 HOURS OF VOLUNTEER TIME OFF (VTO). PART VI, LINE 6: TO FURTHER THE MISSION OF CONTRIBUTING TO THE PREVENTION AND CURE OF CANCER, MOFFITT CANCER CENTER COLLABORATES WITH RESPECTED ACADEMIC, HOSPITAL SYSTEMS, REGIONAL CARE CENTERS, AND PHYSICIANS' GROUPS KNOWN AS THE "MOFFITT ONCOLOGY NETWORK." WHOLLY COMMITTED TO MOFFITT'S MODEL OF PATIENT-CENTERED, INTEGRATED CANCER CARE, THE MOFFITT ONCOLOGY NETWORK IS HELPING MOFFITT DEVELOP A PREMIER CANCER CARE DELIVERY SYSTEM, FOCUSED SOLELY ON PROVIDING PATIENTS THE BEST PERSONALIZED CANCER CARE. THE MOFFITT ONCOLOGY NETWORK IMPLEMENTS MOFFITT'S CLINICAL CARE MODEL, INCLUDING MULTIDISCIPLINARY CANCER CARE, PEER REVIEW, CLINICAL PATHWAYS AND QUALITY ASSURANCE.THE COMMUNITY HEALTH NEEDS ASSESSMENT DETERMINED OPPORTUNITIES THAT CAN BE ADDRESSED BY THE CANCER CENTER AS A WHOLE. THE CANCER CENTER'S NON-HOSPITAL FACILITIES DEDICATED TO SERVING INDIVIDUALS WHO ARE IN NEED OF FINANCIAL ASSISTANCE, HELPING TO DEVELOP AND FUND COMMUNITY PROGRAMS AND PERFORM TRANSLATIONAL RESEARCH TO BENEFIT THE COMMUNITY, INCLUDE MOFFITT FOUNDATION, MOFFITT MEDICAL GROUP, AND MOFFITT RESEARCH. MOFFITT FOUNDATION SOLICITS FUNDS TO SUPPORT THE WORK OF THE CANCER CENTER. DONATIONS MAINTAINED BY THE FOUNDATION MAY BE USED FOR A SPECIFIC PROGRAM OR MAY BE USED TO FURTHER THE OVERALL NEEDS OF THE COMMUNITY. MOFFITT MEDICAL GROUP EMPLOYS PHYSICIANS THAT STAFF THE HOSPITAL AND PROVIDE CLINICAL RESEARCH TO THE CANCER CENTER HEALTH CARE SYSTEM. THESE PHYSICIANS PROVIDE MEDICAL SERVICES TO THOSE PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. IN ADDITION, PHYSICIANS PARTICIPATE IN COMMUNITY RELATED PROGRAMS PROVIDING EDUCATION AND TRAINING. MOFFITT'S CANCER RESEARCH FACILITY PERFORMS STUDIES AND INVESTIGATIONS TO GENERATE GENERALIZABLE KNOWLEDGE AVAILABLE TO THE PUBLIC. THE RESEARCH FACILITY IS ALSO THE PARENT COMPANY OF THE CANCER CENTER HEALTH CARE SYSTEM THAT PLANS, DEVELOPS, AND IMPLEMENTS COMMUNITY BENEFIT PROGRAMS TO ADDRESS COMMUNITY NEEDS SEPARATELY FROM, AS WELL AS IN COLLABORATION WITH, THE HOSPITAL. COMMUNITY BENEFIT EXPENSES PERFORMED BY RELATED ENTITIES:MOFFITT MEDICAL GROUP:FINANCIAL ASSISTANCEMOFFITT MEDICAL GROUP OFFERS ADDITIONAL CHARITY CARE IN THE FORM OF FINANCIAL ASSISTANCE TO PATIENTS BILLED BY THE MEDICAL GROUP.FINANCIAL ASSISTANCE AT COST WAS $1,941,045PERCENT OF TOTAL MMG ENTITY EXPENSE: .66%PERCENT OF COMBINED EXPENSE: .088%MOFFITT MEDICAL GROUP'S BAD DEBT EXPENSE AT COST: $418,492HEALTH PROFESSIONAL'S EDUCATIONMOFFITT MEDICAL GROUP FACULTY CONTINUE TO DEVOTE THEMSELVES TO THE DEVELOPMENT OF GRADUATE MEDICAL STUDENTS.HEALTH PROFESSIONALS EDUCATION COSTS TOTALED $7,817,548PERCENT OF TOTAL MMG ENTITY EXPENSE: 2.65%PERCENT OF COMBINED EXPENSE: .36%MOFFITT RESEARCH:MOFFITT RESEARCH PERFORMS ONGOING STUDIES THAT BENEFIT THE SURROUNDING COMMUNITIES NOW AND INTO THE FUTURE.DIRECT AND INDIRECT RESEARCH COSTS TOTALED $106,636,876PERCENT OF TOTAL RESEARCH ENTITY EXPENSE: 35.34%PERCENT OF COMBINED EXPENSE: 4.84%HEALTH PROFESSIONAL'S EDUCATION:CERTAIN MOFFITT RESEARCH FACULTY ALSO DEVOTE THEMSELVES TO THE DEVELOPMENT OF GRADUATE MEDICAL STUDENTS.HEALTH PROFESSIONAL'S EDUCATION COSTS TOTALED $154,766PERCENT OF TOTAL MMG ENTITY EXPENSE: .05%PERCENT OF COMBINED EXPENSE: .01%CARING FOR PATIENTS WHO CANNOT AFFORD TO PAY FOR QUALITY CANCER CARE IS AN IMPORTANT PART OF MOFFITT'S COMMITMENT TO FLORIDA'S CITIZENS AND IT IS THE INTENTION OF MOFFITT TO OFFER FINANCIAL ASSISTANCE TO ITS MOST MEDICALLY AND FINANCIALLY NEEDY PATIENTS. AS SUCH, MOFFITT PRIDES ITSELF IN OFFERING TREATMENT TO PATIENTS WITH A DIVERSE RANGE OF FINANCIAL CONDITIONS. WITH THE RISING COST OF LABOR DUE TO INFLATION AND THE NEED TO COMPETE TO MAINTAIN CLINICAL STAFF, TOTAL EXPENSES HAVE INCREASED IN EXCESS OF 31% FROM THE PRIOR YEAR, DILUTING MOFFITT'S COMMUNITY BENEFIT PERCENTAGE IN COMPARISON TO THE PRIOR YEAR. IN ADDITION, MOFFITT'S SEGMENTED STRUCTURE CAUSES COMMUNITY BENEFIT COSTS SUCH AS RESEARCH AND HEALTH PROFESSIONAL EDUCATION TO BE GROSSLY UNDERSTATED ON SCHEDULE H, AS THE MAJORITY OF THESE ACTIVITIES ARE PERFORMED BY OTHER NON-HOSPITAL NONPROFIT ENTITIES WITHIN OUR ORGANIZATIONAL STRUCTURE. FOR THE CURRENT TAX YEAR, IF COMMUNITY BENEFIT FIGURES WERE RESTATED TO BE INCLUSIVE OF OUR AFFILIATE ENTITIES MOFFITT MEDICAL GROUP AND MOFFITT RESEARCH, THE TOTAL COMMUNITY BENEFIT EXPENSE PERCENTAGE IS PROJECTED TO EXCEED 8%. PART I, LINE 7 TOTAL COMMUNITY BENEFIT PERCENTAGE SEE ADDITIONAL INFORMATION IN PART VI, LINE 6 TO LEARN HOW THE MOFFITT AFFLIATED HEALTH SYSTEM AS A WHOLE PROVIDES COMMUNITY BENEFIT IN EXCESS OF 8%. PART VI, LINE 7 THE HOSPITAL DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH ANY U.S. STATE. 1 H LEE MOFFITT CC&RI INC 12902 MAGNOLIA DRIVE TAMPA FL 33612 592451713 501(C)(3) 20576930 0 INTERCOMPANY SUPPORT USF FOUNDATION INC 4202 E FOWLER AVE ALC 1000 TAMPA FL 33620 590879015 501(C)(3) 82000 0 SPONSORSHIP 2 0 PART I, LINE 2: THE GRANT LISTED AS INTERCOMPANY SUPPORT IN SCHEDULE I, PART II, IS ONLY MADE TO A RELATED ORGANIZATION TO SUPPORT ITS OPERATIONS. THE ORGANIZATION MAY ALSO, FROM TIME TO TIME, GIVE DONATIONS OR SPONSORSHIPS TO OTHER ORGANIZATIONS THAT ALIGN WITH OUR MISSION. THE ORGANIZATIONS ARE VETTED AND APPROVED BEFORE THE GRANT OR SPONSORSHIP IS GIVEN AND UNLESS OTHERWISE NOTED, THESE AMOUNTS ARE GRANTED FOR GENERAL PURPOSES AND DO NOT REQUIRE SPECIFIC MONITORING AS TO USE. X 0 1 0 1 0 0 0 1 1 0 0 PATRICK HWU FRM HOSPITAL PRESIDENT TO 10/31/21 0 1142684 0 610 0 18297 0 101682 0 3941 0 1267214 0 0 SARABDEEP SINGH HOSPITAL PRESIDENT 0 614018 0 0 0 4902 0 57658 0 36171 0 712749 0 0 ROBERT KEENAN VP-QUALITY/CMO 632141 0 57150 0 61410 0 -105080 0 25553 0 671174 0 0 0 G DOUGLAS LETSON EVP-PHYS IN CHIEF 757687 0 4510 0 76355 0 -266587 0 26089 0 598054 0 0 0 BRYAN MCIVER DEPUTY PHYSICIAN IN CHIEF 574704 0 24582 0 7524 0 -51409 0 26089 0 581490 0 0 0 JANE FUSILERO VP-PATIENT CARE SVS/CNO TO 2/5/23 413925 0 37595 0 45456 0 -20753 0 24192 0 500415 0 0 0 YVETTE M LYONS TREMONTI EVP-CFAO & ASST TREASURER 0 740894 0 0 0 83376 0 -379274 0 36971 0 481967 0 0 HENRY REYES VP-PARTNERSHIP DEVELOPMENT 0 307896 0 28353 0 4601 0 24337 0 26497 0 391684 0 0 JOANNA WEISS SVP FINANCE 0 385948 0 35662 0 27226 0 -123119 0 36156 0 361873 0 0 EVAN ZASLOW VP PAYER STRATEGIES AS OF 8/1/22 241023 0 38791 0 50527 0 -423 0 30219 0 360137 0 0 0 MATTHEW BEDNAR VP-AMBULATORY/VIRTUAL CARE OPS 311602 0 28821 0 1064 0 -21273 0 30358 0 350572 0 0 0 L DAVID DE LA PARTE EVP-GENERAL COUNSEL; ASST SEC 0 617340 0 595 0 56764 0 -356164 0 28652 0 347187 0 0 TERRENCE WRIGHT VP-FAC & SUP SVCS 0 266214 0 24300 0 3889 0 27153 0 24534 0 346090 0 0 KEN KOMORNY VP CHIEF PHARM OFF AS OF 9/4/22 240075 0 11163 0 19872 0 6586 0 33754 0 311450 0 0 0 EDUARDO G MOROS SR MBR PHYSICIST-RAD ONC 372134 0 3605 0 7171 0 -150440 0 34087 0 266557 0 0 0 KELLY GONZALVO VP PATIENT CARE/CNO AS OF 2/5/23 205867 0 8698 0 1739 0 15550 0 3654 0 235508 0 0 0 MARILYN COSTACHE CHIEF RISK OFFICER 69838 111171 7986 0 190 359 5245 -15148 9386 18341 92645 114723 0 0 KAREN WARTENBERG VP MOFFITT MEDICAL GROUP 320059 0 28441 0 21215 0 -189545 0 4316 0 184486 0 0 0 PART I, LINE 1A HOSPITAL PAYS MEMBERSHIP DUES TO A SOCIAL CLUB FOR G.D. LETSON. THE AMOUNT PAID IS INCLUDED IN G.D. LETSON'S TAXABLE WAGES. PART I, LINE 1B: PAYMENTS MADE FOR SOCIAL CLUB DUES ARE INITIALLY APPROVED BY EXECUTIVE LEADERSHIP AND HUMAN RESOURCES AND REVIEWED/APPROVED BY THE JOINT EXECUTIVE COMPENSATION AND BENEFITS COMMITTEE (JE&BC), APPOINTED BY THE BOARD TO APPROVE SUCH PAYMENTS AND ASSOCIATED AMOUNTS. PART I, LINE 3 FOR TAX YEAR 2022 SARABDEEP SINGH, HOSPITAL'S PRESIDENT, WAS PAID BY A RELATED ORGANIZATION. THE COMPENSATION IS ESTABLISHED BY RELYING ON AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS OR STUDIES, AN EXECUTIVE COMPENSATION COMMITTEE, AND THE APPROVAL BY THE BOARD OR THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. PART I, LINE 4B TO BE ELIGIBLE TO PARTICIPATE IN THE 457(F) NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), PARTICIPANTS MUST ELECT TO CONTRIBUTE AT LEAST 10% ACROSS THE 403(B) AND 457(B) PLANS, AND ARE VESTED AFTER 10 YEARS OF SERVICE. LUMP SUM DISTRIBUTIONS FROM THE ACCOUNT ARE MADE UPON NORMAL RETIREMENT OR TERMINATION. BELOW ARE INDIVIDUALS LISTED ON HOSPITAL'S 2022 FORM 990 PART VII, SECTION A, THAT PARTICIPATED IN THE 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN AND THEIR RESPECTIVE AMOUNTS OF COMPENSATION CONSTRUCTIVELY RECEIVED IN TAX YEAR 2022 FROM THE PLAN: MATTHEW P. BEDNAR-$0 LOUIS D. DE LA PARTE-$47,390 JANE FUSILERO-$33,244 PATRICK HWU-$0 ROBERT KEENAN-$52,266 KEN KOMORNY-$0 G. DOUGLAS LETSON-$61,034 YVETTE M. LYONS TREMONTI-$78,474 EDUARDO G. MOROS-$1,500 HENRY REYES-$0 SARADEEP SINGH-$0 KAREN WARTENBERG-$13,993 STUART G. WASSERMAN-$1,354 JOANNA WEISS-$25,889 TERRANCE WRIGHT-$0 GEOFFREY ZHANG-$1,500 PART I, LINE 6 IN GENERAL, INCENTIVE COMPENSATION IS BASED ON MOFFITT'S ACHIEVEMENT AGAINST SPECIFIC ORGANIZATIONAL GOALS RELATED TO NET OPERATING INCOME AND ON DIVISION OR INDIVIDUAL GOALS. NET OPERATING INCOME MUST MEET OR EXCEED A CERTAIN THRESHOLD IN ORDER TO TRIGGER A PAYOUT FOR THE ORGANIZATIONAL GOAL COMPONENTS. SCHEDULE J COLUMN C THE AMOUNT OF RETIREMENT AND DEFERRED COMPENSATION FOR CERTAIN EXECUTIVES IN SCHEDULE J, COLUMN (C) INCLUDES A DECREASE IN ACTUARIAL VALUE OF THE DEFINED BENEFIT PLAN THAT OCCURRED DURING THE YEAR. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING DIRECTORS AND OFFICERS, THAT JOINTLY SERVE ON THE HOSPITAL AND A FOR-PROFIT RELATED ENTITY, QUALIFY AS HAVING A BUSINESS RELATIONSHIP. HOSPITAL & MOFFITT TECHNOLOGIES CORPORATION (MTC): LOUIS D. DE LA PARTE, HOSPITAL OFFICER & MTC OFFICER YVETTE LYONS TREMONTI, HOSPITAL OFFICER & MTC OFFICER HOSPITAL & ONCOBAY INC.: LOUIS D. DE LA PARTE HOSPITAL OFFICER & ONCOBAY DIRECTOR YVETTE LYONS TREMONTI HOSPITAL OFFICER & ONCOBAY DIRECTOR FORM 990, PART VI, SECTION A, LINE 6 H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. IS THE SOLE MEMBER OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER OF THE HOSPITAL, H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. SHALL HAVE THE POWER TO APPROVE, DISAPPROVE OR REMOVE ANY MEMBER OF THE BOARD OF DIRECTORS OR OFFICER OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. AS THE SOLE MEMBER OF THE CORPORATION SHALL ALSO HAVE THE FOLLOWING POWERS: A. APPROVE, DISAPPROVE OR RECOMMEND THE ADOPTION, CHANGE, AMENDMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OF THE CORPORATION; B. APPROVE, DISAPPROVE OR RECOMMEND THE ADOPTION, CHANGE, AMENDMENT OR REPEAL OF THE BYLAWS OF THE CORPORATION; C. APPROVE, DISAPPROVE OR RECOMMEND THE SELECTION OF A QUALIFIED AUDIT FIRM AND THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; D. APPROVE OR DISAPPROVE THE TRANSFER, SALE, LEASE OR DISPOSITION OF ANY ASSET OF THE CORPORATION IN EXCESS OF TWO HUNDRED THOUSAND DOLLARS ($200,000.00); E. APPROVE OR DISAPPROVE THE CONFERRING OF ANY LIEN OR SECURITY INTEREST IN ASSETS OF THE CORPORATION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000.00), WHETHER SAME SHALL BE IN CONNECTION WITH EITHER PUBLIC OR PRIVATE FINANCING, OR OTHERWISE; F. APPROVE OR DISAPPROVE ALL DONATIONS OR CHARITABLE CONTRIBUTIONS BY THE CORPORATION IN EXCESS OF TWENTY THOUSAND DOLLARS ($20,000.00) PER CONTRIBUTION OR ANNUAL CONTRIBUTION EXCEEDING FIFTY THOUSAND DOLLARS ($50,000.00) IN THE AGGREGATE; G. APPROVE, DISAPPROVE OR RECOMMEND THE ADOPTION OF THE CORPORATION'S MISSION AND PHILOSOPHY STATEMENT; H. APPROVE OR DISAPPROVE CAPITAL EXPENDITURES BY THE CORPORATION IN EXCESS OF ONE MILLION DOLLARS ($1,000,000.00) PER EXPENDITURE OR ONE MILLION DOLLARS ($1,000,000.00) IN THE AGGREGATE ANNUALLY; AND I. APPROVE, DISAPPROVE OR REMOVE ANY MEMBER OF THE BOARD OR OFFICER OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO ELECTRONICALLY FILING FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX), A COPY OF THE RETURN IS PROVIDED TO THE GOVERNING BODY, GIVING EACH BOARD MEMBER TIME TO REVIEW THE RETURN. BOARD MEMBERS HAVE THE OPPORTUNITY TO ASK QUESTIONS RELATED TO THE INFORMATION PROVIDED ON THE RETURN. THE HOSPITAL'S FORM 990 IS ALSO PROVIDED TO THE CHIEF FINANCIAL OFFICER FOR REVIEW. BASED ON THE REVIEW ANY SUGGESTED COMMENTS OR CHANGES ARE DISCUSSED PRIOR TO SIGNING. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS A PRESENTATION IS MADE TO HOSPITAL BOARD MEMBERS TO REVIEW THE CONFLICT OF INTEREST POLICY AND PROCEDURES FOR DISCLOSING ANY POTENTIAL CONFLICTS. EACH DIRECTOR, OFFICER, COMMITTEE MEMBER, AND KEY EMPLOYEE SHALL COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM ATTACHED TO THE POLICY. ANY DIRECTOR, OFFICER, COMMITTEE MEMBER, OR KEY EMPLOYEE WHO REASONABLY BELIEVES THAT HE OR SHE MAY HAVE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST MUST DISCLOSE THE EXISTENCE OF AND THE MATERIAL FACTS OF THE NATURE OF HIS/HER INTEREST ON THE FORM. THE FORM IS SUBMITTED TO THE CORPORATE COMPLIANCE OFFICE, WHICH REVIEWS THE FORMS, GATHERS ADDITIONAL RELEVANT INFORMATION WHERE NECESSARY, AND PREPARES A SUMMARY OF THE DISCLOSURES TO BE REVIEWED BY THE CONFLICT OF INTEREST WORK GROUP. IF A DIRECTOR OR COMMITTEE MEMBER DISCLOSES THAT HE/SHE HAS A POTENTIAL CONFLICT OF INTEREST AT A BOARD OR COMMITTEE MEETING, SUCH DIRECTOR OR COMMITTEE MEMBER MUST DISCLOSE THE NATURE OF THE INTEREST AND ANY RELATED INFORMATION AND RESPOND TO QUESTIONS AS MAY BE REQUIRED BY THE REMAINING MEMBERS. BASED ON THE INFORMATION DISCLOSED, THE REMAINING BOARD MEMBERS WILL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT EXISTS THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER AN ALTERNATIVE TRANSACTION OR ARRANGEMENT THAT WOULD NOT GIVE RISE TO A CONFLICT IS EQUALLY ADVANTAGEOUS. IF AN ALTERNATIVE TRANSACTION IS NOT EQUALLY ADVANTAGEOUS THE DIRECTOR OR COMMITTEE MEMBER WHO IS THE SUBJECT OF THE CONFLICT SHALL NOT VOTE ON, NOR USE HIS/HER PERSONAL INFLUENCE ON, NOR PARTICIPATE IN DISCUSSIONS OR DELIBERATIONS WITH RESPECT TO THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 MOFFITT'S BOARD OF DIRECTORS HAS AN ESTABLISHED SUB-COMMITTEE, THE JOINT EXECUTIVE COMPENSATION & BENEFITS COMMITTEE (JEC&BC) THAT IS MADE UP ENTIRELY OF INDEPENDENT, OUTSIDE DIRECTORS. THIS COMMITTEE IS CHARGED WITH THE OVERSIGHT OF THE PERFORMANCE AND COMPENSATION OF MOFFITT AND ITS SUBSIDIARIES' EXECUTIVES AND DISQUALIFIED PERSONS. THESE POSITIONS INCLUDE THE CEO, EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, VICE PRESIDENTS AND DEPARTMENT CHAIRPERSONS. TO ACCOMPLISH ITS MISSION, THE COMMITTEE CAN AS NEEDED AND DOES AT ITS DISCRETION, ENGAGE INDEPENDENT, OUTSIDE ADVISORS INCLUDING, BUT NOT LIMITED TO ATTORNEYS AND COMPENSATION CONSULTANTS. ON AN ANNUAL BASIS THE JEC&BC ENGAGES A NATIONALLY KNOWN, THIRD PARTY CONSULTING FIRM TO PROVIDE A DETAILED STUDY OF THE CASH COMPENSATION FOR EACH EXECUTIVE, DISQUALIFIED PERSON AND INDIVIDUAL IN KEY POSITIONS. THE CONSULTANT USES A VARIETY OF PUBLISHED SURVEYS COMPILED BY INDEPENDENT FIRMS TO PROVIDE THE SOURCE DATA FOR THE STUDY. USING FUNCTIONALLY COMPARABLE POSITIONS IN OTHER SIMILARLY SIZED, NOT-FOR-PROFIT AND FOR-PROFIT HEALTHCARE, ACADEMIC AND RESEARCH ORGANIZATIONS, THE CONSULTING FIRM PRODUCES A STUDY THAT COMPARES EACH DESIGNATED POSITION TO ITS APPROPRIATE MARKET EQUIVALENT. THE RESULTING DATA IS PROVIDED TO THE DIRECTOR OF COMPENSATION, WHO IS NOT INCLUDED IN THE EXECUTIVE OR DISQUALIFIED PERSON CATEGORIES, FOR USE IN THE FORMULATION OF RECOMMENDATIONS FOR COMPENSATION CHANGES TO MAINTAIN MARKET COMPETITIVENESS OR TO REWARD PERFORMANCE. THESE RECOMMENDATIONS ALONG WITH THE CONSULTANT'S COMPARABILITY DATA ARE PRESENTED TO THE JEC&BC FOR IT TO CONFIRM ITS REASONABLENESS, MAKE MODIFICATIONS AS IT DEEMS NECESSARY AND PROVIDE FINAL APPROVAL. EVERY THIRD YEAR THE INDEPENDENT CONSULTANT ANALYZES THE TOTAL EXECUTIVE COMPENSATION PROGRAM, USING THE SAME METHODOLOGY AS DESCRIBED ABOVE, THAT INCLUDES THE VALUE OF ALL BENEFITS AND PERQUISITES (CASH AND NON-CASH) PROVIDED AS COMPENSATION TO THE EXECUTIVES AND DISQUALIFIED PERSONS. THE PURPOSE OF THE ANALYSIS IS TO PROVIDE AN OPINION ON THE REASONABLENESS OF EACH OF THE INDIVIDUAL COMPENSATION COMPONENTS AND THE AGGREGATE COMPENSATION TOTAL. THIS MORE COMPREHENSIVE ANALYSIS IS PROVIDED TO THE JEC&BC FOR THEIR USE IN THE ANNUAL REVIEW PROCESS. MINUTES ARE KEPT AT EACH OF THESE ANNUAL MEETINGS DETAILING THE RECOMMENDATIONS PRESENTED AND THE DECISIONS MADE BY THE COMMITTEE. THESE MINUTES ARE PUBLISHED TO THE COMMITTEE AT THE NEXT MEETING AND REPORTED BACK TO THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES AVAILABLE ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS TO THE PUBLIC THROUGH DAC BOND, A THIRD PARTY VENDORS' WEBSITE AND MOFFITT'S WEBSITE. IN ADDITION, FORM 990 IS MADE AVAILABLE ON GUIDESTAR AS WELL AS MOFFITT'S WEBSITE. ALL ORGANIZING AND GOVERNING DOCUMENTS SUCH AS FORM 1023, CONFLICTS OF INTEREST POLICY, AND BYLAWS AS WELL AS FORM 990 AND AUDITED FINANCIAL STATEMENTS ARE ALSO MADE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A: EMPLOYEES WHO ARE LISTED ON MOFFITT HOSPITAL'S FORM 990 ARE EMPLOYEES WHOSE W-2'S WERE ISSUED BY MOFFITT INSTITUTE, THE COMMON PAYMASTER AND RELATED ENTITY. PROCEDURES TO REPORT COMPENSATION OF EMPLOYEES ON FORM 990 PART VII AND ON SCHEDULE J ARE IN ACCORDANCE WITH IRS INSTRUCTIONS FOR EACH RESPECTIVE SECTION. FORM 990, PART IX, COLUMN D: THERE ARE NO FUNDRAISING EXPENSES BECAUSE H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE FOUNDATION, INC. HANDLES ALL FUNDRAISING ACTIVITIES FOR H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC. AND ITS SUBSIDIARIES. FORM 990, PART IX, LINE 24B CERTAIN MOFFITT CANCER CENTER INTERCOMPANY OVERHEAD HAS BEEN ALLOCATED FROM THE PARENT ENTITY TO THE HOSPITAL AND THOSE AMOUNTS ARE INCLUDED IN COLUMN (C) AND THEN REALLOCATED ON LINE 24B TO THE PROPER FUNCTIONAL CATEGORIES. FORM 990, PART XI, LINE 9: CHANGES IN NET ASSETS PREDOMINANTLY RELATES TO THE CLOSE OUT OF INTERCOMPANY ACCOUNTS PAYABLE AND RECEIVABLES (DUE TO/DUE FROM) IN THE AMOUNT OF -$362,818,298 TO NET ASSETS. H LEE MOFFITT CANCER CTR & RESEARCH INSTITUTE FOUNDATION INC 12902 MAGNOLIA DRIVE TAMPA FL 33612 593238636 FUNDRAISING FL 501(C)(3) LINE 7 H LEE MOFFITT CC&RI INC 0 H LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE INC 12902 MAGNOLIA DRIVE TAMPA FL 33612 592451713 PARENT-RESEARCH FL 501(C)(3) LINE 7 N/A 0 H LEE MOFFITT CC& RI LIFETIME CANCER SCREENING CENTER INC 12902 MAGNOLIA DRIVE TAMPA FL 33612 593238640 PRACTICE MANAGEMENT FL 501(C)(3) LINE 10 H LEE MOFFITT CC&RI INC 0 MOFFITT REAL ESTATE HOLDING CORP (EFF 010123) 12902 MAGNOLIA DRIVE TAMPA FL 33612 923387708 HOLDING TITLE FL 501(C)(2) H LEE MOFFITT CC&RI INC 0 MOFFITT LIFESCIENCES CAMPUS MANAGEMENT CORPORATION (EFF 010123) 12902 MAGNOLIA DRIVE TAMPA FL 33612 923388291 REAL ESTATE PROPERTY MANAGEMENT FL 501(C)(3) LINE 12A, I H LEE MOFFITT CC&RI INC 0 MOFFITT TECHNOLOGIES CORPORATION 12902 MAGNOLIA DRIVE TAMPA FL 33612 300332914 TECHNOLOGY MANAGEMENT FL N/A C 0 ONCOBAY CLINICAL INC (UNTIL 012023) 10902 N MCKINLEY DRIVE TAMPA FL 33612 843412796 RESEARCH & PRODUCT DEVELOPMENT FL N/A C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0