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
SOUTH LAKE HOSPITAL INC
 
Employer identification number

59-3322533
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
 
No
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
 
 
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) .. 		    3,597,765   3,597,765 2.800 %
b Medicaid (from Worksheet 3,
column a) .... 		    12,263,781 10,430,755 1,833,026 1.430 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    15,861,546 10,430,755 5,430,791 4.230 %
Other Benefits
     858,137   858,137 0.670 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    117,674 67,950 49,724 0.040 %
g Subsidized health services
(from Worksheet 6) .. 		    207,276 109,800 97,476 0.080 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    434,540   434,540 0.340 %
j Total. Other Benefits ..     1,617,627 177,750 1,439,877 1.130 %
k Total. Add lines 7d and 7j .     17,479,173 10,608,505 6,870,668 5.360 %
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
16,754,223
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
12,565,667
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
31,807,234
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
33,857,416
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-2,050,182
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 SOUTH LAKE HOSPITAL
1900 DON WICKHAM DRIVE
CLERMONT,FL347111979
WWWSOUTHLAKEHOSPITALCOM 		X X         X   SURG CTR, REHAB, MRI, HH  
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)
SOUTH LAKE HOSPITAL
Name of hospital facility or facility reporting group  
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   No
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: 200.0%
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: 400.0%
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   No
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?3
Name and address Type of Facility (describe)
1 NATIONAL TRAINING CENTER
1935 DON WICKHAM DRIVE
CLERMONT,FL347111979 		WELLNESS CENTER
2 SOUTH LAKE SURGICAL CENTER
1935 DON WICKHAM DRIVE
CLERMONT,FL347111979 		OUTPATIENT SURGERY
3 SOUTH LAKE HOME HEALTH AGENCY
1935 DON WICKHAM DRIVE
CLERMONT,FL347111979 		HOME HEALTH
4
5
6
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
OTHER TESTING METHODS FOR FREE OR DISCOUNTED CARE PART I LINE 3C IF TOTAL OF ALL OPEN BILLS ACCOUNTS FOR MORE THAN 25 OF THEIR ANNUAL INCOME DISCOUNT WILL BE APPLIED TO REACH THE 25 MARK PROVIDED PATIENTS INCOME DOES NOT EXCEED 400 OF THE FPG
SUBSIDIZED HEALTH SERVICES EXPLANATION PART I LINE 7G SUBSIDIZED HEALTH SERVICES REPRESENT THE OPERATIONAL COSTS FOR THE FREE CLINIC TO CARE FOR INDIGENT PATIENTS OF SOUTH LAKE COUNTY
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE PART I LINE 7 COLUMN F IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN F THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990 PART IX LINE 25 FORM 990 PART IX LINE 25 XXX-XX-XXXX ADD EXPENSES REPORTED IN PART VIII 167989 DENOMINATOR FOR COLUMN F XXX-XX-XXXX
COSTING METHODOLOGY EXPLANATION PART I LINE 7 THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATIONS A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS 2008 SEE ALSO THE DESCRIPTION FOR PART III LINE 4 COSTS FOR PART I LINE 7A AND 7B WERE CALCULATED USING THE RCC CALCULATED IN WORKSHEET 2 OTHER COSTS WERE OBTAINED FROM THE ORGANIZATIONS ACCOUNTING RECORDS
BAD DEBT EXPENSE EXPLANATION PART III LINE 4 AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT AND WRITTEN OFF TO BAD DEBT EXPENSE THE AMOUNT INCLUDED ON PART III LINE 3 IS BASED ON HISTORICAL DATA FOR THOSE INDIVIDUALS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITALS POLICY HOWEVER FAILED TO COMPLETE THE APPLICATION PROCESS EXCERPT FROM AUDITED FINANCIAL STATEMENTS ALLOWANCE FOR DOUBTFUL ACCOUNTS ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRDPARTY COVERAGE THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS IF NECESSARY FOR EXAMPLE FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY FOR RECEIVABLES ASSOCIATED WITH SELFPAY PATIENTS WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL THE COMPANY RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE THE DIFFERENCE BETWEEN THE STANDARD RATES OR THE DISCOUNTED RATES IF NEGOTIATED AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST CONTRACTUAL ALLOWANCES AND DISCOUNTS THE HOSPITALS ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELFPAY PATIENTS INCREASED APPROXIMATELY 6 TO 92 OF SELFPAY ACCOUNTS RECEIVABLE AT SEPTEMBER 30 2013 FROM 86 AT SEPTEMBER 30 2012 IN ADDITION THE HOSPITALS SELFPAY WRITEOFFS INCREASED 3903000 FROM 12525000 FOR FISCAL YEAR 2012 TO 16428000 FOR FISCAL YEAR 2013 THIS INCREASE IS THE RESULT OF AN INCREASE IN THE CHARGE MASTER AS WELL AS CHANGES IN THE CHARITY CARE POLICY WHICH RESULTED IN FEWER PEOPLE QUALIFYING AS CHARITY PATIENTS CHARITY CARE WRITEOFFS DECREASED 23 WHICH RESULTED IN ADDITIONAL SELFPAY WRITEOFFS BEING MAPPED TO PROVISION FOR BAD DEBTS
MEDICARE EXPLANATION PART III LINE 8 MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS
COLLECTION PRACTICES EXPLANATION PART III LINE 9B BOTH DISCOUNTS AND PAYMENTS TO ACCOUNTS WILL REDUCE THE BAD DEBT EXPENSE SHOULD THE ACCOUNT BE REPORTED AS BAD DEBT THAT IS TO SAY DISCOUNTS APPLIED TO ACCOUNTS ARE NOT REVERSED PRIOR TO DECLARING ADJUSTING ANDOR WRITING OFF ACCOUNTS AS BAD DEBT ALL ACCOUNTS WHICH ARE ADJUSTED TO OR WRITTEN OFF TO BAD DEBT ARE REVIEWED TO DETERMINE THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE IF SUFFICIENT DOCUMENTATION WAS NOT PROVIDED BY THE ACCOUNT HOLDER SOUTH LAKE USES PREDICTIVE ANALYTICS TO DETERMINE IF THE ACCOUNT WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE THE PREDICTIVE ANALYTICS DESIGNED TO ASSESS FINANCIAL ASSISTANCE FOR ACCOUNTS ADJUSTED TO OR WRITTEN OFF TO BAD DEBT USES DATA DERIVED FROM THIRD PARTIES WHICH INCLUDE BUT ARE NOT LIMITED TO DEMOGRAPHIC VERIFICATION INCOME VERIFICATION HOUSEHOLD SIZE VERIFICATION PAYMENT HISTORY INFORMATION PROPERTY OWNERSHIP INFORMATION OCCUPATION INFORMATION VEHICLE OWNERSHIP HISTORY AND VALUES AND HOME OWNERSHIP HISTORY AND VALUES ONCE THIS DATA LOGIC IS APPLIED IT BECOMES APPARENT IF THE ACCOUNT QUALIFIES FOR FINANCIAL ASSISTANCE IF THE ACCOUNT DOES QUALIFY PREVIOUS UNINSURED DISCOUNTS BAD DEBT ADJUSTMENTS ANDOR WRITE OFFS ARE REVERSED AND THE NEW BALANCE REFLECTED IS RECLASSIFIED AS FINANCIAL ASSISTANCE OR CHARITY
NEEDS ASSESSMENT PART VI SOUTH LAKE DOES ASSESS THE SERVICES NEEDED AS PART OF OUR STRATEGY PLANNING AND BUDGETING PROCESS AND HAS PROCESSES IN PLACE TO ENSURE THE ORGANIZATION IS REACTIVE TO COMMUNITY HEALTH NEEDS EXAMPLES OF HOW SOUTH LAKE RESPONDS TO COMMUNITY NEEDS ARE AS FOLLOWS 1 GOVERNING BOARDS ARE COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY COMMUNITY LEADERS AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE 2 PARTNERSHIP WITH LOCAL AREA GROUPS AND ASSOCIATES TO ATTEND TO THE HEALTH CARE NEEDS OF THE SOUTH LAKE COMMUNITY 3 SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH FAIRS COMMUNITY FITNESS WELLNESS EVENTS AND OTHER OUTREACH EVENTS AND 4 TRANSITION SERVICES POSTDISCHARGE PATIENT FOLLOWUP RELATED TO THE ONGOING CARE AND TREATMENT OF PATIENTS TO PREVENT UNNECESSARY ADMISSIONS AND POTENTIAL READMISSIONS SOUTH LAKE MEETS THE NEEDS OF THE COMMUNITY THROUGH ITS EDUCATION RESEARCH AND PATIENT CARE PROGRAMS THE SPECIFIC NEEDS TARGETED BY THESE PROGRAMS HAVE BEEN IDENTIFIED BY THE EXPERIENCE OF COMMUNITY HOSPITAL ADVISORY COUNCILS NEIGHBORHOOD OUTREACH AND THROUGH COMMUNITY NEEDS ASSESSMENTS THAT IDENTIFIED HEALTH PROBLEMS IN THE COMMUNITIES SERVED BY THE HOSPITAL SOUTH LAKE SPONSORS A VARIETY OF PROGRAMS FOR ATRISK POPULATIONS FEDERALLYDESIGNED MEDICALLY UNDERSERVED AREAS AND SPECIAL NEEDS GROUPS AS WELL AS FOR THE BROADER COMMUNITY DURING THE FISCAL YEAR 2013 THE ORGANIZATION ALONG WITH THE EFFORTS OF WELLFLORIDA COUNCIL INC CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT THE CHNA CAN BE FOUND AT HTTPWWWSOUTHLAKEHOSPITALCOMLINKCLICKASPX FILETICKETHTPVBVVSMBC3DTABID56 THE IMPLEMENTATION STRATEGY PLAN CAN ALSO BE FOUND ON THE ORGANIZATIONS WEBSITE AT HTTPWWWSOUTHLAKEHOSPITALCOMLINKCLICKASPXFILETICKET7JBQ6Z26MUK 3DTABID56
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI SOUTH LAKE FOLLOWS AN ESTABLISHED PROCESS TO INFORM ALL PATIENTS OF ITS CHARITY CARE AND UNINSURED DISCOUNT POLICIES DURING PREADMISSION AT REGISTRATION OR AT BEDSIDE UNINSURED PATIENTS ARE INFORMED OF THE HOSPITALS CHARITY CARE POLICY AND OTHER FINANCIAL ASSISTANCE FINANCIAL INFORMATION IS SECURED FOR ALL UNINSURED PATIENTS TO SCREEN FOR POSSIBLE ENROLLMENT IN FEDERAL STATE AND LOCAL PROGRAMS SOUTH LAKE HAS CONTRACTED DEDICATED ORGANIZATIONS THAT ASSIST THE PATIENT WITH THEIR ENROLLMENT PROCESS ALL THE WAY TO APPROVAL OR DENIAL BY THE RESPECTIVE AGENCIES FOR UNINSURED PATIENTS THAT ARE DENIED COVERAGE OR DO NOT MEET THE COVERAGE CRITERION FOR A RESPECTIVE AGENCY SOUTH LAKE THEN SCREENS THE PATIENT FOR CHARITY ELIGIBILITY IT IS SOUTH LAKES OBJECTIVE TO PROVIDE CHARITY CARE TO OUR PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY
COMMUNITY INFORMATION PART VI SOUTH LAKE CURRENTLY OPERATES IN THE CENTRAL FLORIDA REGION WHICH HAS OVER TWO MILLION RESIDENTS AND THOUSANDS OF INTERNATIONAL VISITORS ANNUALLY SOUTH LAKES PRIMARY SERVICE AREA IS COMPRISED OF ORANGE OSCEOLA SEMINOLE AND LAKE COUNTIES THE MEDIAN HOUSEHOLD INCOME IN THESE COUNTIES IS 59710 TEN PERCENT OF HOUSEHOLDS IN CENTRAL FLORIDA ARE BELOW THE FEDERAL POVERTY GUIDELINE THE PERCENT UNINSURED AGE 064 FOR THE FOUR COUNTY AREAS ARE 23 AND THERE ARE ELEVEN FEDERALLYDESIGNATED MEDICALLY UNDERSERVED AREAS PRESENT IN THE COMMUNITY COMMUNITY OUTREACH ACTIVITIES INCLUDE SPEAKERS BUREAU SUPPORTEDUCATION GROUPS WELLNESS ACTIVITIES HEALTH FAIRS CLINICAL SCREENINGS AND ASSESSMENTS MEDICAL EDUCATION RESEARCH WOMEN CHILDREN AND SENIOR HEALTH INITIATIVES PUBLIC PROGRAM ENROLLMENT ASSISTANCE AND POSTACUTE CARE FOR HOMELESS AND UNINSURED SPONSORSHIPS SCHOOL INITIATIVES DONATED MEETING SPACE AND SPIRITUAL CARE
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI SOUTH LAKE HOSPITAL INC FURTHERS ITS EXEMPT PURPOSE BY REINVESTING SURPLUS FUNDS IN THE HOSPITAL EXTENDING ADMITTING PRIVILEGES TO QUALIFYING PHYSICIANS IN THE COMMUNITY AND SURROUNDING AREAS OPERATING A FREE CLINIC FOR RESIDENTS OF SOUTH LAKE WHO FALL BELOW THE MEDICAID GUIDELINES OPERATING THE NATIONAL TRAINING CENTER FOR THE OVERALL HEALTH OF THE COMMUNITY AND ENCOURAGING OVERALL COMMUNITY INVOLVEMENT IN THE GOVERNING BODY OF THE ORGANIZATION
AFFILIATED HEALTH CARE INFORMATION PART VI SOUTH LAKE HOSPITAL INC HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM WHICH ALSO INCLUDES ORLANDO HEALTH OH SOUTH LAKE HOSPITAL FOUNDATION FOUNDATION AND SOUTH LAKE COUNTY HOSPITAL DISTRICT DISTRICT THE HOSPITAL LOCATED IN CLERMONT FL IS A NOTFORPROFIT HOSPITAL PROVIDING INPATIENT OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SOUTHERN LAKE COUNTY FL AND SURROUNDING AREAS OH PROVIDES TRAUMA AND ACUTE CARE TO PATIENTS THROUGHOUT THE CENTRAL FLORIDA AREA AND OFFERS PEDIATRIC AND ADULT PATIENT SERVICES THE FOUNDATION WAS FOUNDED AND OPERATES TO SUPPORT THE SERVICES OF SOUTH LAKE HOSPITAL THE FOUNDATION OFFERS SUPPORT TO PATIENTS OF SOUTH LAKE HOSPITAL AS WELL AS THE CHILDREN IN THE COMMUNITY FOR WELLNESS THE DISTRICT LEVIES AD VALOREM TAXES AND HAS USED THE TAXES COLLECTED TO SUPPORT THE HOSPITAL
SOUTH LAKE HOSPITAL LINE NUMBER 1 PART V LINE 3 PART V LINE 3 IN ORDER TO DETERMINE THE COMMUNITYS PERSPECTIVES ON PRIORITY COMMUNITY HEALTH ISSUES AND QUALITY OF LIFE ISSUES RELATED TO HEALTHCARE TWO RESEARCH METHODS WERE USED FOCUS GROUPS AND PROVIDERS SURVEYS THE STEERING COMMITTEE WORKED WITH WELLFLORIDA COUNCIL TO DETERMINE FOCUS GROUP QUESTIONS AND PROVIDER SURVEY QUESTIONS FOCUS GROUP PARTICIPANTS WERE RECRUITED BY COMMUNITY LEADERS AT ORGANIZATIONS AND AGENCIES HOSTING THE FOCUS GROUPS AS WELL AS BY FLYERS DISTRIBUTED THROUGHOUT THE COMMUNITY PRESS RELEASES AND EMAIL BLASTS DISTRIBUTED TO THE SOUTH LAKE HOSPITAL CONTACT LIST IN TOTAL 29 COMMUNITY MEMBERS PARTICIPATED IN THE FOCUS GROUPS THE SOUTH LAKE HOSPITAL STEERING COMMITTEE REPRESENTING SOUTH LAKE HOSPITAL WORKED WITH WELLFLORIDA COUNCIL TO FORMULATE A PROVIDER SURVEY THAT WOULD TOUCH UPON SOME OF THE SAME TOPICS ADDRESSED DURING THE FOCUS GROUPS WORKING IN COOPERATION WITH THE FACILITIES REPRESENTED BY STEERING COMMITTEE MEMBERS THE SURVEYS WERE DISTRIBUTED TO LAKE COUNTY PROVIDERS IN MARCH 2013 RESPONDENTS COMPLETED THE SURVEY USING SURVEY MONKEY TO SUBMIT THEIR RESPONSES TWENTYNINE PROVIDERS SUBMITTED RESPONSES TO THE SURVEY
SOUTH LAKE HOSPITAL LINE NUMBER 1 PART V LINE 7 PART V LINE 7 THE SOUTH LAKE HOSPITAL CHNA IDENTIFIED ADDITIONAL NEEDS IN THE SERVICE AREA THAT ARE NOT ADDRESSED AS A PRIORITY IN THIS CURRENT IMPLEMENTATION PLAN IN CONSIDERING WHAT NEEDS NOT TO ADDRESS THE HOSPITAL COMMITTEE WEIGHED THE LEVEL AT WHICH THESE NEEDS ARE ALREADY BEING ADDRESSED BY OTHER COMMUNITY PARTNERS THE HOSPITAL ANDOR WHETHER THE HOSPITAL HAD THE EXPERTISE TO EFFECTIVELY ADDRESS THE NEED TO THAT END THE HOSPITAL WILL NOT ADDRESS SOME OF THE NEEDS IDENTIFIED IN THE 2013 ASSESSMENT BECAUSE 1 THE HOSPITAL ADDRESSES THE NEED BUT CURRENTLY HAS NO PLANS TO EXPAND SERVICES 2 OTHER PROVIDERS ARE ALREADY ADDRESSING THE NEEDS AND 3 THE NEED IDENTIFIED IS BEYOND THE SCOPE OF THE HOSPITAL
Schedule H (Form 990) 2012
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