When Martin County Hospital first opened its doors in 1939, it was made possible through the philanthropy of community leaders who saw a need for access to medical care.

Much has changed in the 69 years since the tiny hospital in Stuart was created. Today, Martin Memorial Health Systems is comprised of two acute-care hospitals and provides cancer and cardiac care, physical rehabilitation and wellness services, and much more.

The Martin Memorial Foundation, celebrating its 25th anniversary in 2008, has played a vital role in helping the health system grow.

Committee members from the 2007 Martin Memorial Foundation Chrysanthemum Ball helped raise $1.2 million for a cardiac catheterization lab. The Chrysanthemum Ball has raised $5 million in the past four years alone.

“Martin Memorial’s success throughout the years is due in large part to the generosity of people in the community,” said Arthur M. “Rusty” Brink Jr., vice president and chief philanthropic officer. “Their gifts allow us to hire and educate excellent staff, keep up with cutting-edge technology and provide life-saving programs.”

In the past two years alone, the Foundation has raised more than $18 million, helping to fund countless projects that have impacted patient care. Among the most significant contributions were capital funding for the new Frances Langford Heart Center, which opened in 2006.

Through the Foundation’s annual Chrysanthemum Ball, which has raised $5 million in the last four years, Martin Memorial has been able to purchase sophisticated medical technologies other community hospitals often do not have access to. That includes two new cardiac catheterization labs, a 64-slice CT scanner and a PET/CT scanner – all of which have been instrumental in helping physicians diagnose and treat patients.

This year’s event raised $1.2 million and attracted more than 500 guests. This year, funding from the ball will be used to purchase a second cardiac catheterization lab for the Frances Langford Heart Center, which opened in 2006.

The Martin Memorial Foundation LifeSavers, a group of young professionals dedicated to ensuring Martin Memorial can provide the best possible care for newborns at the hospital, has raised more than $250,000 for the maternal-child department.

Philanthropy has also funded projects at the Robert and Carol Weissman Cancer Center, including the purchase of technologically advanced radiation therapy equipment, and was vital in the construction of a new emergency department at Martin Memorial Hospital South.

Along the way, the Foundation has provided endowed funds for patient assistance, nursing education and scholarships for community residents pursuing degrees in the medical profession.

Those resources come from a multitude of places. The Foundation’s board of directors developed a leadership annual giving society, which now has more than 180 donor families who donate $10,000 or more to the health system each year.

A group of young professionals, dedicated to ensuring Martin Memorial can provide the best possible care for newborns at the hospital, has raised more than $250,000 for the maternal-child department. And Martin Memorial’s Associates and Auxiliary members have pitched in as well, through giving campaigns, events or fund-raisers. Donations from Associates total more than $600,000 while the Auxiliary has made a $1 million pledge to the Frances Langford Heart Center campaign.



The Heart Center of Excellence is pleased to welcome Mark Henry, RN, MSN, MBA, CCRN, as the Nurse Manager for Invasive/Non-Invasive Cardiac Services at Broward Health Broward General Medical Center.

In his new role, Henry will be responsible for the Cardiac Catheterization, Electrophysiology, Echo, Stress and EKG departments.

Prior to coming here, he was the Director of Critical Care Services at Florida Medical Center, where he oversaw the Coronary Care, CVICU, Neuro/Surgical, Medical/Renal, and inpatient Dialysis departments. Henry brings to Broward Health over 20 years of medical experience and has held a variety of staff and managerial positions during his career. In addition to his clinical expertise, Henry served as the Director of Operations for a temporary nursing service.

Henry graduated from Florida Hospital College of Health Sciences in Orlando Florida where he received his Bachelor of Science in Nursing and went on to University of Phoenix in Orlando, Florida where he received his Masters of Science in Nursing and an MBA.



Linda McFadden, M.D., Emergency Medicine; Phyllis Bulkan, M.D., Physical Medicine & Rehabilitation and Martin Roche, M.D., Orthopedic Surgery, were recognized as Physicians of the Quarter, 4th Quarter 2007, by the Associates’ of Holy Cross Hospital.

Physicians are selected based on submitted ballots and a short narrative exalting their clinical acumen and display of Holy Cross’s Core Values. These are the Super Doctors at Holy Cross Hospital.

“Dr. Bulkan has been a beacon of light to her patients and Associates,” remarks an Associate. “Dr. Bulkan writes clear order that can be easily read. This decreases the chance for errors tremendously. If there is a question about her orders, she returns the call immediately. Her orders are an absolute pleasure to process and she sets the standard for all physicians on how to write a proper order.” Dr. Bulkan is also generous with her time, serving as a past chairwoman of the Holy Cross Hospital Auxiliary Charity Ball.

“Dr. McFadden is one of the most compassionate human beings I have ever had the privilege to know, let alone work with,” said a Chaplain at Holy Cross. “Her care of God’s sick and poor is remarkable. She is a living testament to our Core Values and is held in high esteem by all those who know her.”

“She inspires confidence and professionalism in her fellow Associates,” added a Priest at the hospital.

“Dr. Roche is a role model for all physicians due to his excellent bedside manner,” reports an Associate at Holy Cross. “He is kind and compassionate to all his patients. I have always admired how Dr. Roche communicates with his patients, nurses and professionals. He always has the time to answer all the questions and concerns of his patients and family members. He makes patients feel that they have his undivided attention. He is also well-respected and liked by the nurses because he respects them and trusts their judgment. Dr. Roche is an asset to Holy Cross.”

Dr. Roche also was the first surgeon in the world to use the MAKOplastyTM Haptic Guidance SystemTM for unicondylar knee arthroplasty procedures.



Elsie Sterling Howard

Elsie Sterling Howard has redefined the term ‘volunteer’ with her dedication and leadership to the University of Miami Sylvester Comprehensive Cancer Center. Instead of waiting for direction, Howard has grabbed the reigns of projects over the years at UM/Sylvester and now she is embarking on her most ambitious work yet.

Howard is the creator and chairperson of the Well Being/Being Well conference, a one-day educational, integrated approach to healthy living, being held April 22nd. The event, the first of its kind hosted by UM/Sylvester, will feature best-selling author and pioneer in the field of mind and body, Deepak Chopra, and University of Miami President and former U.S. Secretary of Health and Human Services, Donna E. Shalala, as keynote speakers.

“I wanted to come up with an event that not only shared the wealth of resources available at UM/Sylvester, but also conveyed the many ways that all of us can live healthier, more mindful lives,” said Howard. Attendees can customize the conference to their own interests, picking from among 14 breakout sessions on specific topics such as the latest in genetics research, the power of mind over matter, being an informed patient, and women’s and men’s health, among others. Each of the sessions features top UM physicians, along with patients or other professionals addressing real-life concerns.

Howard, who headed up a successful public relations firm, also donates her efforts to a variety of local and national organizations. In 2003 she was awarded the National Volunteer of the Year by the Association of American Colleges and Universities and the Council for Advancement and Support of Education (CASE) with their signature award – “International Volunteer of the Year.” She received UM/Sylvester’s 2004 Caroline W. Halpern Award which exemplifies the tradition of community leadership and excellence.

“It is an honor and a privilege to work on the Well Being conference. With the support of UM/Sylvester, I hope we can inspire people to take the right steps towards achieving lifelong good health,” said Howard.

Tickets for the Well Being/Being Well conference are now on sale at www.sylveter.org/wellbeing/.

Joan B. Scheiner

When Joan B. Scheiner was diagnosed with metastatic soft tissue sarcoma more than 10 years ago, it would not only change her life, it would also leave a lasting imprint at the University of Miami Sylvester Comprehensive Cancer Center. Scheiner has been a life-long community advocate for several not-for-profit organizations, working successfully as both a professional and a volunteer.

Her involvement with UM/Sylvester began when she was diagnosed with and successfully treated for metastatic soft tissue sarcoma. Since that time, Scheiner has dedicated herself to countless fundraising efforts on behalf of the cancer center, always being a champion of the scientists and physicians who work tirelessly to save lives. Scheiner recently strutted down the runway at UM/Sylvester’s “Party in the Park”, at the Village of Merrick Park. The one-of-a-kind event featured a fashion show with patients-turned-models, who walked the red carpet with their physicians. Scheiner now holds a number of key leadership roles, chair of the Board of Governors, chair of UM/Sylvester’s Development Committee, co-chair of the cancer center’s Capital Campaign, and Grand Founder of UM/Sylvester.

As chair of the Board of Governors, Scheiner is behind UM/Sylvester’s premier event, its inaugural Well Being/Being Well conference. “It’s by far, one of the most ambitious projects ever, but one that we wanted to take the lead on as South Florida’s only university-based cancer center,” said Scheiner. Tickets are now on sale for the April event, which will give attendees a chance to get the latest information on an integrated approach to health care.

“This is not a fundraiser,” says Scheiner. “It’s a life-raiser for the people of South Florida. What we’re asking people to do is arm themselves with information so they can live healthier lives. Offering events like these is part of UM/Sylvester’s mission to provide our community with the most comprehensive information about health and cancer research.” Seeing the big picture of the future of health care is what makes Joan B. Scheiner a priceless volunteer.

Jayne S. Malfitano

Donating time and energy to a worthwhile cause is in Jayne S. Malfitano’s genes. Growing up, she watched her father’s generosity, passion and dedication flourish into what is now a place of hope. Malfitano’s father was Harcourt Sylvester Jr., the founder of the University of Miami’s Sylvester Comprehensive Cancer Center, a world-renowned cancer facility.

Sylvester created the Harcourt M. and Virginia W. Sylvester Foundation in 1980, soon after his father’s death from lung cancer. Several years later, when Malfitano was in her early 30’s, her father donated $27.5 million to the University to build a cancer center in honor of his parents. Since that time, Malfitano’s dedication to her father’s dream has turned her into an unwavering supporter of UM/Sylvester, its physicians and scientists.

“My father dreamed the cancer center would be wonderful,” says Malfitano, “but I don’t think any of us could have imagined what it would become.” Malfitano is president of the board of directors of the Harcourt M. and Virginia W. Sylvester Foundation and she and her sister, Laura Cameron, are both directors of the family foundation which has now contributed more than $50 million to Miller School of Medicine programs.

The Harcourt M. and Virginia W. Sylvester Foundation is a sponsor of one of the cancer center’s boldest events ever, the inaugural Well Being/Being Well conference. The one day event intends to arm people in South Florida with knowledge about living healthier lives, while giving them access to the wealth of resources available at UM/Sylvester.

Malfitano’s involvement started with her father’s historic financial donation, but it is her heart and hard work that continue his legacy. She is a member of the UM/Sylvester Board of Governors and sits on UM/Sylvester’s marketing and board services committees. “UM/Sylvester has given a future to so many. I want to help continue that commitment.”



Bringing your project into alignment with your financial goals

With healthcare demand on the rise nationwide, many hospitals are feeling the pinch for expanded medical office space to accommodate growing outpatient needs. As the U.S. has entered into a seeming economic downturn it is increasingly important for hospitals to preserve good credit standing and minimize risk. For many, this means utilizing an off-balance sheet financing approach for certain projects in order to maintain borrowing capacity.

Off-balance sheet financing is an attractive solution for a number of reasons. First, an off-balance sheet status for a new project minimizes project risk for the hospital as all risk and liability stays with the project itself. Additionally, off-balance sheet financing may provide an opportunity to utilize more flexible financing methods since the project can establish its own line of credit rather than relying on the hospital’s credit rating.

Attaining off-balance sheet status is a complex and delicate process. For many hospitals, it requires the experience and insight of an experienced developer to navigate the maze of accounting rules to accomplish their real estate development objectives. Following are some of the principle concerns for a hospital when utilizing an off-balance sheet approach for an outpatient development.

The Basics

The primary accounting guidance in the construction of a medical office building (MOB) is the Financial Accounting Standards Board’s Emerging Issues Task Force (EITF) 97-10, which relates to The Effect of Lessee Involvement in Construction Development Transactions. This guidance applies to MOB projects when a hospital or a related party is a lessee that leases more than 10% of the MOB.

Fundamentally, EITF 97-10 establishes an “ownership” test. The deemed owner of a project must record the asset on their books. It is important to be aware of these rules early in the project’s development. Agreements need to be structured to address first dollar needs such as engineering, architectural and legal fees, cost accounting, and direct construction costs in a manner to comply with EITF 97-10.

Avoidable Pitfalls

Shared resources are a detriment to off-balance sheet financing. During the feasibility stage, costs and investments that benefit both the hospital and the proposed medical office building (for example- a parking garage) need to be evaluated.

Owner/tenant guarantees, financings, cash advances, reimbursements, early lease payments, tenant provided land and pre-construction costs are just a few of the many risk transfer and financing techniques utilized by developers.

Alternatively, a well-capitalized developer may assume construction risks of a project and accordingly be the owner of the project from the early feasibility stages through completion. In this case, the developer may not require equity investments or guarantees from tenants or a hospital in the construction of a medical office building.

Award of Development (Pre-Construction):

The construction period, as defined by accounting guidance, begins with the earlier of the date of inception of the lease, the date of the construction arrangement is agreed to, or when hard costs are incurred or ground is broken. At the award of development, if the developer has assumed the construction risk, the hospital will not provide any construction indemnities including pre-existing environmental indemnities, and the hospital will not have the right or obligation to take title of the project.

During Construction:

If the hospital incurs costs greater than 10% of the total construction costs incurred to date and is not reimbursed under normal terms, the hospital could be deemed the owner of the project. In addition, the hospital could be considered the owner of a project if it is responsible for paying costs other than normal tenant improvements, which, as defined by accounting literature, exclude structural elements of a project.

Project Leasing:

In addition to the EITF 97-10 considerations discussed above, leases are also subject to review in the off-balance sheet process. The Financial Accounting Standards Board Statement No. 13 (SFAS 13) has established standards for financial accounting and reporting for leases which must be evaluated during the lease structuring process. The goal for an off-balance sheet structure is to compose the lease in such a way that, by SFAS 13 standards, it is considered an operating lease rather than a capital lease, which will allow the hospital to maintain off-balance sheet status. Many factors are considered in this process including lease term, buy-back options, property value and residual guarantees by the lessee.

In Conclusion

According to FMI Corp., a management consulting and investment banking firm, by decade’s end annual U.S. healthcare construction spending could surpass $60 billion. As construction spending grows, so will the demand for intelligent financing solutions to maximize the hospital’s financial viability. While off-balance sheet financing can often be a tedious process with many moving parts, an experienced partner can help guide you to the financial status you desire to achieve your financial and real estate goals.