SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
FLORIDA HEALTH SCIENCES CENTER INC
 
Employer identification number

59-3458145
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria 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.
4
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"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
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? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (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) .. 		    60,660,172 14,040,622 46,619,550 4.7 %
b Medicaid (from Worksheet 3,
column a) .... 		    174,598,936 154,066,827 20,532,109 2.1 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		    26,940,469 9,585,623 17,354,846 1.8 %
d Total Financial Assistance
and Means-Tested
Government Programs . 		0 0 262,199,577 177,693,072 84,506,505 8.6 %
Other Benefits
     2,497,217   2,497,217 0.2 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    40,554,811 16,386,318 24,168,493 2.4 %
g Subsidized health services
(from Worksheet 6) .. 		    5,025,619 1,171,399 3,854,220 0.4 %
h Research (from Worksheet 7)     2,428,917 2,039,668 389,249 0.1 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    948,776   948,776 0.1 %
j Total. Other Benefits .. 0 0 51,455,340 19,597,385 31,857,955 3.2 %
k Total. Add lines 7d and 7j . 0 0 313,654,917 197,290,457 116,364,460 11.8 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
14,058,869
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
228,725,364
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
236,836,617
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-8,111,253
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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.......................

9b

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) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Florida Health Sciences Center Inc
dba Tampa General Hospital
PO Box 1289
Tampa,FL33601
www.tgh.org 		X X   X   X X      
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Florida Health Sciences Center Inc
Name of hospital facility or facility reporting group dba Tampa General Hospital
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 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 9.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4   No
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7 Yes  
8a 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)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, 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) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 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 includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 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 actions the hospital facility may take upon non-payment?....... 15 Yes  
16 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 patient’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 17 Yes  
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires 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?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section C. 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?6
Name and address Type of Facility (describe)
1 TGH Community Health Education
740 S Village Circle
Tampa,FL33606 		Community health education center.
2 Transplant Abdominal Clinic
409 Bayshore Blvd
Tampa,FL33606 		Transplant clinic.
3 Family Care Center Brandon
214 Morrison Rd
Brandon,FL33511 		Family care clinic.
4 Family Care Center Lois
2106 South Lois Avenue
Tampa,FL33629 		Family care clinic
5 Family Care Center Carrollwood
13860 North Dale Mabry Highway
Tampa,FL33618 		Family care clinic
6 Family Care Center Riverview
10647 Big Bend Road
Suite 212
Riverview,FL33579 		Family care clinic
7
8
9
10
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments 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.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
SchH_P01_S00_L06a Schedule H, Part I, Line 6a TGH completed a Community Benefit report and this information is available at www.tgh.org.
SchH_P01_S00_L07 Schedule H, Part I, Line 7 The hospital's cost accounting system was used to calculate the amounts reported in line 7. For the purpose of computing subsidized services, both direct and indirect costs were considered. For research, only direct costs were considered.
SchH_P03_S0A_L02 Schedule H, Part III, Section A, Line 2 Bad debt results when a patient, who has been determined to have the financial capacity to pay for healthcare services, is unwilling to settle the claim or provide substantiating documentation for any charity and/or discount program. The hospital records a provision for bad debts in the period the services are provided. As accounts age, increasing percentages of bad debt allowances are applied based on ageing category to reflect estimated uncollectable amounts. This method is consistently applied based on established risk parameters.
SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 Receivables are reported net of an allowance for bad debt and contractual adjustment estimates. Although the aggregate amount of receivables may include balances due from patients and third party payers, amounts due from third-party payers for retroactive adjustments of items, such as final settlements or appeals, are reported separately in the financial statements. The adequacy of the allowance for bad debts is evaluated regularly, with adjustments to increase or decrease the allowance by adjustments in the provision for bad debts. As expected payments are determined to be uncollectible, they are written off against the allowance for bad debts.
SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 The $8.0 million shortfall reported at Pt. III line 7 should be considered as a community benefit in that much of the shortfall in Medicare payments relates to the costs associated with the TGH liver, heart, kidney, lung and pancreas organ transplant programs, and medical education programs, which are a significant benefit to all patients in these programs and the community as a whole. Medicare revenue and cost are based on the 2013 Medicare cost report excluding revenues and costs associated with subsidized health services and graduate medical education, which are reported separately in Part I lines 7g and 7f.
SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b Each self pay patient is evaluated to determine if covered by Medicaid, Hillsborough County and/or charity assistance. The financial information provided by this evaluation determines into which category a patient resides. Patients who do not qualify for government assistance are then evaluated in accordance with hospital policy for Charity and Discounted Care. Patient balances will either qualify for a total write-off or a discount based on the patient's household income and family size in relation to the Federal Poverty Limitations. TGH's financial assistance and charity care policy, following the guidelines of the Internal Revenue Section 501(r) requirement: Includes eligibility criteria for financial assistance free and discounted (partial charity) care; describes the basis for calculating discount amounts to patients eligible for financial assistance under this policy; describes the method by which patients may apply for financial assistance; describes how TGH will widely publicize the policy within the community served by the hospital; limits the amounts that the hospital will charge for emergency and other medically necessary care provided to individuals eligible for financial assistance to the amount generally billed for medically necessary care.
SchH_P05_S0B_L01 Schedule H, Part V, Section B, Line 1 In order to provide community input, the Community Health Needs Assessment (CHNA) methodology included both individual interviews and focus groups. Both are qualitative in nature and should be interpreted as reflecting the values and perceptions of those interviewed. This portion of the CHNA process is meant to gather input from persons who represent the broad interest of the community serviced by the hospital facility, as well as individuals providing input who have special knowledge or expertise in public health. It is meant to provide depth and richness to the quantitative data collected. Interview Methodology: Twenty interviews were conducted in-person when possible and via phone when necessary, based on the availability of the interviewee. Interviews required approximately 30 minutes to complete. Interviewers followed the same process for each interview, which included documenting the interviewee's expertise and experience related to the community. Additionally, the following community-focused questions were used as the basis for discussion: * Interviewee's name * Interviewee's title * Interviewee's organization * Overview information about the interviewee's organization * What are the top three strengths of the community? * What are the top three health concerns of the community? * What are the health assets and resources available in the community? * What are the health assets or resources that the community lacks? * What assets or resources in the community are not being used to their full capacity? * What are the barriers to obtaining health services in the community? * What is the single most important thing that could be done to improve the health in the community? * What changes or trends in the community do you expect over the next five years? * What other information can be provided about the community that has not already been discussed? Below is information about the individuals interviewed as part of the CHNA. Interviewee Title/Organization Area(s) Represented Adwale Troutman Executive Director, Public Health Practice and Leadership, Florida Covering Kids and Families Public Health Expert Anne Maynard Program Director, USF Area Health Education Center Public Health Expert Carlos Mercado STD Program Manager, Hillsborough County Health Department Public Health Expert Chloe Cooney Founder, Corporation to Develop Communities of Tampa, Inc. African American Community Representative Donna Peterson Dean, College of Public Health, University of South Florida Public Health Expert Douglas Holt Director, Hillsborough County Health Department Public Health Expert Joyce Thomas Physician, TGH Family Care Center Hospital Staff Leslie "Les" Miller, Jr. County Commissioner, District 3, Hillsborough County Government Official Margaret Ewen Senior Human Resources Manager, Immunizations/Refugee Public Health Expert Margarita Cancio Physician, Infectious Disease Associates of Tampa Bay Hospital Staff Sally Houston Chief Medical Officer, Tampa General Hospital Hospital Administration Deborah Austin Communication and Community Outreach Director, Central Hillsborough Healthy Start Project, REACHUP, Inc. Medically Underserved Community Organization Representative Luis Lopez Past President, Hispanic Alliance of Tampa Bay; Director, Moffit Cancer Center Hispanic Advisory Board Hispanic Community Representative Amy Petrila Director of Programs and Outreach, Children's Board of Hillsborough County Community Health Organization Representative Maureen Chiodini Associate Vice President of Membership and Programs, Tampa Metropolitan Area YMCA Community Health Organization Representative Maria Russ Supervisor, School Health Services, Hillsborough County Public Schools Public Health Expert Focus Groups Focus groups were conducted to allow participants to provide information about their experiences in the community and ways in which they think the services and resources provided to the community can be improved. Participants completed a demographic questionnaire and a consent form agreeing to participate in the focus group. The requested information included: * Gender * Age * ZIP Code * Ethnicity * Race * Education Level * Employment Status * Household Income * Health Insurance Status Focus group participants were notified prior to divulging information that it would be used solely to benefit the public good, and all information would be presented in an anonymous nature. participants were encouraged to share their ideas, opinions and experiences, including any positive or negative feedback. A focus group session required approximately two hours to complete and followed this agenda: * Session Opening - 15 Minutes o Introductions o Explanation of the purpose of the focus group o Overview of the rules governing the session * Nominal Group Technique was utilized to identify priority health needs in the community. The Nominal Group Technique process is as follows: o Participants are instructed to separately write on a piece of paper their top 3 perceived health concerns within the community o Each participant calls out in order the health concerns round robin style until all options for every person have been exhausted o Participants instruct the facilitator on which like items, if any, they would like to combine o Participants are instructed to separately rank the items most important (3) to least important (1) o Each member calls out round robin style their 3's, then 2's and so on until all ranked items have been exhausted and recorded o The facilitator adds up the rankings for each item, ranking the highest to lowest in importance based on the added result, taking the item that has the largest number as highest importance and so on * After this process has been completed, a discussion is facilitated about the results of the process. Examples of these questions include: o Was there anything that surprised you? o Why do you feel these are the top health concerns? o How do you feel these needs could be addressed in the community? * Session Conclusion - 15 minutes o Summary of findings o Closing discussion o Distribution of incentives for participation
SchH_P05_S0B_L03 Schedule H, Part V, Section B, Line 3 This CHNA was conducted following the requirements outlined by the Treasury and the IRS, which included obtaining necessary information from the following sources: Input from persons who represented the broad interests of the community served by TGH, which included those with special knowledge of or expertise in public health; Identifying federal, tribal, regional, state, or local health or other departments or agencies, with current data or other information relevant to the health needs of the community served by TGH, leaders, representatives, or members of medically underserved, low-income, and minority populations with chronic disease needs in the community served by TGH; and, Consultation or input from other persons located in and or serving TGH's community, such as: Healthcare community advocates; Nonprofit organizations; Academic experts; Local government officials; Community based organizations, including organizations focused on one or more health issues; Healthcare providers, including community health centers and other providers focusing on medically underserved populations, low income persons, minority groups, or those with chronic disease needs. For a list of persons that the hospital consulted reference Schedule H, Part V, Section B Line 1.
SchH_P05_S0B_L12 Schedule H, Part V, Section B, Line 12 Family size in combination with household income is used to determine eligibility for either charity or discounted care.
SchH_P05_S0B_L16 Schedule H, Part V, Section B, Line 16 TGH engages in standard collection activities such as statements and telephone calls. As of July 1, 2013, Tampa General no longer reports unpaid debts to the credit bureau or engages in extraordinary collection efforts.
SchH_P05_S0B_L17 Schedule H, Part V, Section B, Line 17 TGH engages in standard collection activities such as statements and telephone calls. As of July 1, 2013, Tampa General no longer reports unpaid debts to the credit bureau or engages in extraordinary collection efforts.
SchH_P05_S0B_L20 Schedule H, Part V, Section B, Line 20 Medicaid rate is used in rare instances for those that are not able to afford amounts generally billed by Medicare and commercial insurance.
SchH_P05_S0B_L22 Schedule H, Part V, Section B, Line 22 We assess total charges to international patients coming for highly specialized elective care.
SchH_P06_S00_L02 Schedule H, Part VI, Line 2 During Fiscal Year 2013, Tampa General Hospital (TGH) completed its Community Health Needs Assessment (CHNA) as required by the Patient Protection and Affordable Care Act signed into law in 2010. A CHNA is a report based on epidemiological, qualitative and comparative methods that assesses the health issues in a hospital organization's community and that community's access to services related to those issues. The CHNA is available to the public on the TGH website (tgh.org) and is included as an attachment to this filing. As required by the Treasury Department ("Treasury") and the Internal Revenue Service (IRS), the TGH CHNA includes the following: * A description of the community served; * A description of the process and methods used to conduct the CHNA, including: (1) A description of the sources and dates of the data and the other information used in the assessment; and, (2) The analytical methods applied to identify community health needs. * A description of information gaps that impacted TGH's ability to assess the health needs of the community served; * The identification of all organizations with which TGH collaborated, if applicable, including their qualifications; * A description of how TGH took into account input from persons who represented the broad interests of the community served by TGH, including those with special knowledge of or expertise in public health and any individual providing input who was a leader or representative of the community served by TGH; and, * A prioritized description of all of the community health needs identified through the CHNA and a description of the process and criteria used in prioritizing those needs. During FY2013, TGH did not complete any additional assessments of the health care community it serves.
SchH_P06_S00_L03 Schedule H, Part VI, Line 3 For Fiscal Year 2013, the costs associated with charity care, unreimbursed Medicaid, and the unreimbursed costs of other means-tested government programs care exceeded $84.5 million. These include patients who qualify for free care under Tampa General Hospital's (TGH) charity care policy or are enrolled in programs for low-income or under-insured individuals sponsored by state and local governments. While TGH received reimbursement for some of these patients the amounts are not sufficient to cover the costs of care provided. Free care is provided to patients who qualify based on an evaluation of their income and assets. Individuals with an income that is less than or equal to 200% of the Federal Poverty Level (FPL) are eligible for charity or free care as are individuals whose income is less than 400% of the FPL but whose hospital charges are greater than 25% of their annual income. Financial counselors work with individuals who seek care and are uninsured. Assistance is provided to enroll eligible individuals in government programs such as Medicaid, Medicare Disability or the Hillsborough County Health Plan as well as determining whether they qualify for charity or discounted care. TGH's financial assistance (charity care and discounted care) policy is available to consumers at TGH.org as well as in the hospital admissions area. The information is written in both English and Spanish. Guidelines, the patient shall be eligible for a discount that is annually calculated using a "look back" method. Patients eligible for Medicaid or other indigent care programs may be eligible for free or discounted care for non-covered services (including charges for days exceeding any length of stay limit). NON-ELIGIBLE SERVICES AND BALANCES Financial assistance will not apply to the following services or patient responsibilities: * Cosmetic procedures that are not medically necessary * Co-payments and deductible amounts * Balances payable by other insurance (Medicare, Medicaid, automobile insurance, worker's compensation, or liability insurance) * Ventricular Assist Devices * Transplants * Elective procedures for patients residing outside Hillsborough County, Florida DETERMINATION AND SCREENING PROCESS All patients seeking financial assistance are required to complete the TGH Financial Assistance application, a copy of which is attached. Patients will be instructed to complete the forms and return them by mail or in person to a Financial Assistance Specialist. Patients who appear to qualify for government assistance will be offered courtesy assistance with the application process. Unfunded or under-funded patients will be asked to complete a Financial Assistance Application at the time of registration. Financial assistance counseling communication is intended to be clear, concise and considerate of the patient and family members. In addition to income and family information, the patient may be required to provide proof of employment. Some patients may also be asked to provide additional information about their assets, monthly expenses, and any other resources to pay for their care. Determination of eligibility or denial of financial assistance will be communicated to the responsible party within 30 days of receipt of all required documentation. The granting of financial assistance shall be based on an individualized determination of financial need and medical necessity, and shall not take into account age, gender, race, social or immigrant status, sexual orientation or religious affiliation. RELATIONSHIP TO COLLECTIONS AND BILLING POLICY TGH maintains a separate policy outlining its billing and collection procedures. In accordance with its Billing and Collections Policy, TGH will not engage in, nor will it authorize its collection agency to engage in, extraordinary collection actions without verifying that patients have been given the opportunity to apply for financial assistance. COMMUNICATION OF THE AVAILABILITY OF FINANCIAL ASSISTANCE WITHIN THE COMMUNITY Notification about financial assistance available from TGH shall be disseminated by TGH to the community by various means, which may include, but are not limited to, publishing this Policy on the TGH website, placing posters around the hospital, and making brochures available at all patient registration areas. REGULATORY REQUIREMENTS In implementing this Policy, TGH will comply with all other federal, state, and local laws, rules, and regulations that may apply to activities conducted pursuant to this Policy. AVAILABILITY OF FORMS AND POLICY Copies of the Financial Assistance Policy and applications will be made available upon request and without charge by contacting a Financial Assistance Specialist or by submitting a written request to Tampa General Hospital. The hospital's Financial Assistance Specialist is also available to answer any questions about this Policy.
SchH_P06_S00_L04 Schedule H, Part VI, Line 4 Tampa General Hospital's primary service area is Hillsborough County, Florida. As part of the CHNA completed during FY 2013, a complete assessment of the service area's demographics was completed and is attached to this filing. The highlights from the assessment are detailed below. * The primary service area population is currently 1,314,699 * Slight population growth is expected for individuals aged 18-44 (3.2%). Moderate population growth is expected for individuals aged 0-17 (5.8%) and 45-64 (9.2%). The population of women at childbearing age is expected to grow slightly (2.8%). By 2017, substantial population growth is expected for individuals 65 years and older (21.2%). * The most common race/ethnicity in the service area is white (51.8%), followed by Hispanic (26.5%), black/African American (15.6%), Asian (3.7%), individuals of two races (1.9%) and other (0.5%). * Minority and other race populations are expected to grow faster than the white population. Substantial growth is expected for the Asian (20.6%), Hispanic (17.5%), individuals of two races (15.0%) and black/African American (10.7%) populations. The population of other race individuals is expected to grow moderately (5.3%), while marginal growth is expected for the white population (0.5%). * According to the 2011 annual average unemployment rates reported by the U.S. Bureau of Labor Statistics, Hillsborough County's unemployment rate (10.5%) is equal to Florida's. * According to the U.S. Census 2010 American Community Survey (ACS), Hillsborough County has a slightly higher median household income ($47,677) than Florida ($46,077). Poverty thresholds are determined by family size, number of children and age of the head of the household. A family's income before taxes is compared to the annual poverty thresholds. If the income is below the threshold, the family and each individual in it are considered to be in poverty. In 2010, the poverty threshold for a family of four was $22,314. The ACS estimates indicate that 14.2% of Hillsborough County residents and 15.0% of Florida residents are living below poverty level. Children in Hillsborough County are slightly less likely to be living below poverty level (19.9%) compared to all children in Florida (21.3%). * The American Community Survey (ACS) publishes estimates of the highest level of education completed for residents 25 years and older. The ACS 2008-2010 estimates indicate that the percentages of individuals 25 years and older with less than a high school degree in Hillsborough County and in Florida are similar (14.2% and 14.5%, respectively). In Hillsborough County and Florida, approximately 85% of residents have either a high school degree or equivalent or a bachelor's degree. * Fourth and eighth grade math and reading proficiencies are all slightly lower in Hillsborough County compared to Florida and fall between the 25th and 50th percentiles. * Domestic violence and homicide rates are slightly lower in Hillsborough County than in Florida, while the aggravated assault, forced sex offense and robbery rates are substantially lower in Hillsborough County compared to Florida.
SchH_P06_S00_L05 Schedule H, Part VI, Line 5 Tampa General Hospital's commitment to the health of the community it serves is exemplified by its mission statement. The key elements of TGH's mission include the provision of services ranging from wellness and primary care to the most complex specialty and post acute services to all of the residents of West Central Florida, a commitment to a patient centered approach and benchmark performance. With our unique blend of academic and other healthcare partners, TGH plays a special role in supporting medical education and research in the region. The Board also authorizes the use of surplus funds through the annual budget process to fund enhancements to services, the physical plant, infrastructure and financial support for training physicians, nurses and other health care providers, health education to the community and support of other not-for-profit organizations in the community with complimentary goals and missions. The 15 member board is composed of independent community leaders as well as members of the TGH medical staff. The board bylaws specify that its membership will include the elected medical chief of staff, a representative of the University of South Florida and the chairman of the TGH Foundation. TGH utilizes its surplus funds for the development of inpatient services and to subsidize outpatient services for underserved members of the community. TGH operates a number of outpatient clinics that provide primary and specialty care for the uninsured and under-insured. Services include adult primary and specialty care, pediatrics, and high risk obstetrics. While many of these patients have some funding either through Medicaid or the Hillsborough County Health Plan, the revenue from these sources is insufficient to cover the costs of providing the services. In fiscal year 2013, TGH's clinics provided 175,400 patient visits. The TGH medical staff is open to any physician that meets the requirements of the medical staff bylaws and rules and regulations. The medical staff is composed of community physicians with private practices and physicians on the faculty of the USF Health Morsani College of Medicine (USFHMCOM). Both the community and USFHMCOM physicians are involved in research and training. Many of the community physicians hold clinical appointments with the USFHMCOM and all staff physicians may participate in research. In FY2013, the TGH Office of Clinical Research supported 518 research studies at a net cost of $1.8 million. These studies received funding from a variety of public agencies and private sponsors, including the Department of Defense and the Children's Oncology Group. Studies were led by both community and university physician principal investigators. This year's research centered on a range of topics, including Phase I studies in the treament of pediatric cancer and conducting of an evidence based clinical decision support system to predict survival and life expectancy of hospice patients. These research initiatives have immediate benefits to the patients who participate in them as well as long term benefits to the community. TGH is considered a statutory teaching hospital under Florida Law. This designation is only available to hospitals that have made a significant commitment to graduate medical education. In fiscal year 2013, TGH funded approximately 300 GME full time equivalent slots in over 50 specialties. The Medicare program funds a portion of approximately 200 of these GME slots, with the remaining slots funded solely by TGH out of hospital operating funds. In addition to a robust medical education program, TGH is also committed to the training of nurses, pharmacists, and other clinical staff. TGH provides financial support for nursing education at both the University of South Florida and the University of Tampa. Students and residents in a variety of clinical programs (pharmacy, pastoral care, and other programs) rotate through TGH or in some cases are assigned to TGH for their training. Finally, TGH sponsors continuing medical education (CME) for physicians in the community and in outlying areas. In fiscal year 2013, TGH CME sponsorships provided CME education to 983 physicians, none of whom were on the TGH medical staff. The cost of CME sponsorships exceeded $70,500. In all cases, surplus funds are dedicated to the educational mission of TGH. Tampa General's commitment to improving the health status of the community is evident in the vast array of educational programs, screenings and support groups it provides to the community. In fiscal year 2013, TGH provided 403 free programs and screenings to 7,503 members of the community. Educational programs focused on everything from preventing the flu, to smoking cessation to stress management. Programs were provided in a variety of locations. For example, programs of particular interest to seniors were provided at several senior living facilities within the primary service area including Sun City, University Village, Bayshore Presbyterian and Tampa Baptist Manor. In fiscal year 2013, TGH participated in three programs in collaboration with its community partners. Health, & Fit for Life is a program for kids and their parents that focus on making healthy food choices and increasing exercise as a way of maintaining and controlling weight. Health, & Fit was designed with More Health, a community based health education program for children in Hillsborough & Pinellas Counties. This program was provided at the University Area Community Development Center. Living Healthy and Matter of Balance are both multi-week programs aimed at individuals with chronic illnesses or balance concerns. These programs were provided in conjunction with the Florida's West Coast Area Agency on Aging. Our commitment to provide our community with free resources to improve their health was demonstrated by the addition of two new programs, "Active Living Every Day" and "Healthy Living Every Day". Eight weeks each, these programs focus on the importance of being active and eating healthy. Screenings provided during fiscal year 2013 ranged from blood pressure and diabetes to screenings for memory loss, hearing, peripheral vascular disease and abdominal aortic aneurysms. TGH has a dedicated staff responsible for developing programs as well as identifying high risk areas within the county that might benefit most from screenings and health prevention and promotion programs. In addition to providing educational programs and screenings, TGH also provides financial support to other community not-for-profit organizations. This funding is another way that TGH utilizes its surplus funds to support the community health and well being. In fiscal year 2013, TGH provided financial support to numerous not-for-profit organizations. This support ranged from donations under $1,000 to commitments in excess of $250,000. Three organizations in particular receive significant support from TGH: More Health Inc., Ronald McDonald Mobile Health Van and Tampa Community Health Center. For more than 20 years, TGH has been the largest single sponsor of More Health, Inc. More Health provides health education in Hillsborough and Pinellas County public and private schools. Innovative, hands on instruction for all grades is a key feature of More Health and more than a million children have benefited from the education provided by More Health. TGH, in conjunction with the USF Health Morsani College of Medicine and the Ronald McDonald Foundation supports a mobile medical van that provides medical and dental services to underserved children in the region. TGH also provides financial support to Tampa Community Health Center (TCHC). TCHC is a federally qualified health center that provides significant amounts of service to underserved populations in Hillsborough County. TGH's donation allows them to expand primary care and other services. In addition TGH supports a variety of other not-for-profits including the American Heart Association, March of Dimes, Ronald McDonald Foundation, Wheels of Success, the Epilepsy Foundation, Joshua House, the Spring and many others. In addition to financial support, many TGH employees volunteer their time and participate in fundraising events like the Heart Walk for the American Heart Association.
SchH_P06_S00_L06 Schedule H, Part VI, Line 6 Not Applicable
SchH_P06_S00_L07 Schedule H, Part VI, Line 7 Florida
SchH_P06_S00_L08 Schedule H, Part VI, Line 8 Not Applicable
Schedule H (Form 990) 2012
Additional Data


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