STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

JAY HOSPITAL INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
JAY HOSPITAL INC (EIN 59-2425149)
Tax period
2022-10-01 to 2023-09-30
Filed
2024-08-15
IRS object ID
202422289349301852
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-08-15T10:10:14+00:00ReturnTs
Tax Period End2023-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN440160260PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Forvis Mazars LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11201 Walnut Suite 1700AddressLine1Txt
CityKansas CityCityNm
State AbbreviationMOStateAbbreviationCd
ZIP641062246ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN592425149EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jay Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlJAYHBusinessNameControlTxt
Phone4482278478PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1POST OFFICE BOX 17500AddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32522ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLeonard A TerryPersonNm
Person TitleCFOPersonTitleTxt
Phone4482278478PhoneNum
Signature2024-08-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonApril ArnoldPreparerPersonNm
PTINP01559426PTIN
Phone8162216300PhoneNum
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2024-08-08 14:25:15ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Keith StricklingBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1125 BAPTIST WAY SUITE 6AAddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32503ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$13,314,558GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.ebaptisthealthcare.org/jayhospitalWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1983FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionJAY HOSPITAL'S PRIMARY MISSION IS DEDICATED TO MEETING THE HEALTHCARE NEEDS IN THE JAY, CENTURY, FLOMATON AND SURROUNDING COMMUNITITES IN THE NORTHWEST FLORIDA-SOUTH ALABAMA AREA.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent18VotingMembersIndependentCnt
Total Employee159TotalEmployeeCnt
Total Volunteers29TotalVolunteersCnt
Total Gross UBI$42,487TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$3,585NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$13,481,234PYProgramServiceRevenueAmt
CY Program Service Revenue$13,256,724CYProgramServiceRevenueAmt
PY Investment Income$1,442PYInvestmentIncomeAmt
CY Investment Income-$203CYInvestmentIncomeAmt
PY Other Revenue$36,843PYOtherRevenueAmt
CY Other Revenue$23,982CYOtherRevenueAmt
PY Total Revenue$13,519,519PYTotalRevenueAmt
CY Total Revenue$13,280,503CYTotalRevenueAmt
PY Grants And Similar Paid$13,220PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$13,107CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,723,465PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,219,144CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,319,228PYOtherExpensesAmt
CY Other Expenses$9,144,904CYOtherExpensesAmt
PY Total Expenses$18,055,913PYTotalExpensesAmt
CY Total Expenses$18,377,155CYTotalExpensesAmt
PY Revenues Less Expenses-$4,536,394PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$5,096,652CYRevenuesLessExpensesAmt
Total Assets BOY$4,766,031TotalAssetsBOYAmt
Total Assets EOY$5,351,314TotalAssetsEOYAmt
Total Liabilities BOY$2,605,475TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,448,682TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,160,556NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,902,632NetAssetsOrFundBalancesEOYAmt
MissionHELPING PEOPLE THROUGHOUT LIFE'S JOURNEY: JAY HOSPITAL'S PRIMARY MISSION IS DEDICATED TO MEETING THE HEALTHCARE NEEDS IN THE JAY, CENTURY, FLOMATON AND SURROUNDING COMMUNITITES IN THE NORTHWEST FLORIDA-SOUTH ALABAMA AREA. JAY HOSPITAL IS A 49-BED ACUTE CARE FACILITY AND PART OF AN INTEGRATED NETWORK OF AFFILIATED ORGANIZATIONS. JAY HOSPITAL AND ITS AFFILIATED ORGANIZATIONS ARE COMMITTED TO PROVIDING A BROAD RANGE OF GENERAL AND SPECIALIZED HEALTH CARE SERVICES INCLUDING INPAITIENT, PRIMARY CARE, LONG TERM AND OUTPATIENT HEALTHCARE SERVICES. QUALITY MEDICAL CARE IS PROVIDED TO ALL PERSONS REQUIRING IMMEDIATE TREATMENT REGARDLESS OF THEIR ABILITY TO PAY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$14,029,038ExpenseAmt
Revenue$13,214,237RevenueAmt
DescGENERAL AND SPECIALIZED HEALTH CARE SERVICES INCLUDING INPATIENT, PRIMARY CARE, LONG TERM AND OUTPATIENT HEALTHCARE SERVICES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$13,107ExpenseAmt
Grant$13,107GrantAmt
Revenue$0RevenueAmt
DescCOMMUNITY BENEFIT OUTREACH ACTIVITIES CONDUCTED BY THE ORGANIZATION INCLUDING HEALTH EDUCATION SEMINARS, HEALTH FAIRS, AND DONATIONS TO OTHER NON-PROFIT ENTITIES.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$14,042,145TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee159EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member18IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Keith StricklingBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8506758024PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line114114 Alabama StreetAddressLine1Txt
CityJayCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32565ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
DAVE CLEVELAND
MEMBER/TREASURER1.01.0Yes (X)Yes (X)$0$0$0
KARA CARDONA
MEMBER/VICE CHAIR1.01.0Yes (X)Yes (X)$0$0$0
MARGARET T STOPP
MEMBER/VICE CHAIRMAN1.02.0Yes (X)Yes (X)$0$0$0
RICKY W SMITH
MEMBER/SECRETARY1.01.0Yes (X)Yes (X)$0$0$0
RONALD E JACKSON
MEMBER/CHAIRMAN1.01.0Yes (X)Yes (X)$0$0$0
BRIAN WYER
MEMBER1.01.0Yes (X)$0$0$0
DAVID HAWKINS
MEMBER1.01.0Yes (X)$0$0$0
JARL (JT) YOUNG
MEMBER1.01.0Yes (X)$0$0$0
JOHN HEER
MEMBER1.01.0Yes (X)$0$0$0
JOHN HOSMAN
MEMBER1.01.0Yes (X)$0$0$0
JOHN M KIZZIAH
MEMBER1.01.0Yes (X)$0$0$0
MARCUS PAUL DMD
MEMBER1.01.0Yes (X)$0$0$0
MARJORIE MOORE
MEMBER1.01.0Yes (X)$0$0$0
MARTHA SAUNDERS PHD
MEMBER1.01.0Yes (X)$0$0$0
MICHAEL J MAZENKO
MEMBER1.01.0Yes (X)$0$0$0
SHIRLEY HENDERSON
MEMBER1.01.0Yes (X)$0$0$0
STEVEN SHELL
MEMBER1.01.0Yes (X)$0$0$0
THOMAS F OWENS
MEMBER1.01.0Yes (X)$0$0$0
ANDREW TERRY
SENIOR VP/CFO-INCOMING10.040.0Yes (X)$0$425,152$26,118
BRETT ALDRIDGE
COO & EVP10.040.0Yes (X)$0$438,882$43,709
MICHAEL GLEASON
SENIOR VP/CFO-OUTGOING10.040.0Yes (X)$0$784,097$25,421
MICHAEL HUTCHINS
VP/ADMINISTRATOR40.00Yes (X)$261,944$0$20,714
DANIEL D SHEPPARD
MANAGER PHARMACY40.00$129,289$0$29,779Yes (X)
DEBRA JENKINS
ASST. ADMINISTRATOR40.00$140,775$0$30,333Yes (X)
GREG W PETTY
REHAB MANAGER40.00$109,075$0$12,381Yes (X)
KARIN PARDUE
PHYSICIAN40.00$301,781$0$28,381Yes (X)
KATHRYN R HUNT
PHYSICIAN40.00$138,763$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,081,626TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,648,131TotReportableCompRltdOrgAmt
Total Other Compensation$216,837TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K11IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARK ELDER DOBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line12946 GREYSTONE DRAddressLine1Txt
CityPACECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32571ZIPCd
FieldValueIRS element (for citing)
ServicesPHYSICIAN SERVICESServicesDesc
Compensation$331,587CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE621990$12,843,219$12,800,732$42,487
COVID-19 RECOVERIES621990$100,000$100,000
MEDICAID DHS621990$313,505$313,505

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$13,256,724TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$196TotalRevenueColumnAmt
Exclusion$196ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$23,804RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$33,656RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$9,852RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$9,852TotalRevenueColumnAmt
Exclusion-$9,852ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$399OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other-$399OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$399TotalRevenueColumnAmt
Exclusion-$399ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Business900099BusinessCd
Total Revenue Column$33,834TotalRevenueColumnAmt
Exclusion$33,834ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$33,834OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,280,503TotalRevenueColumnAmt
Related Or Exempt Func Income$13,214,237RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$42,487UnrelatedBusinessRevenueAmt
Exclusion$23,779ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$13,107TotalAmt
Program Services$13,107ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$180,253TotalAmt
Program Services$144,202ProgramServicesAmt
Management And General$36,051ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,471,497TotalAmt
Program Services$6,799,062ProgramServicesAmt
Management And General$672,435ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$154,330TotalAmt
Program Services$140,440ProgramServicesAmt
Management And General$13,890ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$871,292TotalAmt
Program Services$792,876ProgramServicesAmt
Management And General$78,416ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$541,772TotalAmt
Program Services$493,013ProgramServicesAmt
Management And General$48,759ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,888,325TotalAmt
Program Services$110,525ProgramServicesAmt
Management And General$2,777,800ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$37,947TotalAmt
Management And General$37,947ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,082,335TotalAmt
Program Services$2,057,333ProgramServicesAmt
Management And General$25,002ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$15,673TotalAmt
Program Services$15,673ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$115,382TotalAmt
Program Services$106,889ProgramServicesAmt
Management And General$8,493ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$54,680TotalAmt
Program Services$39,370ProgramServicesAmt
Management And General$15,310ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$323,195TotalAmt
Program Services$287,644ProgramServicesAmt
Management And General$35,551ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$78,158TotalAmt
Program Services$7,777ProgramServicesAmt
Management And General$70,381ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$351,587TotalAmt
Program Services$298,849ProgramServicesAmt
Management And General$52,738ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$462,237TotalAmt
Management And General$462,237ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
BAD DEBT EXPENSE$1,600,565$1,600,565
MEDICAL SUPPLIES$958,482$958,482
INDIGENT ASSESSMENT$122,157$122,157
DUES & SUBSCRIPTIONS$23,794$23,794

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$30,387TotalAmt
Program Services$30,387ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$18,377,155TotalAmt
Program Services$14,042,145ProgramServicesAmt
Management And General$4,335,010ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$85,070BOYAmt
EOY$52,487EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,298,654BOYAmt
EOY$2,507,343EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$176,756BOYAmt
EOY$177,351EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$86,711BOYAmt
EOY$58,610EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,056,977LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$9,501,454LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,118,840BOYAmt
EOY$2,555,523EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,766,031BOYAmt
EOY$5,351,314EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,114,857BOYAmt
EOY$1,498,244EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$261,358BOYAmt
EOY$799,234EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,229,260BOYAmt
EOY$1,151,204EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,605,475BOYAmt
EOY$3,448,682EOYAmt

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,160,556BOYAmt
EOY$1,902,632EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,160,556BOYAmt
EOY$1,902,632EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,766,031BOYAmt
EOY$5,351,314EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$5,096,652ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$4,838,728OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Organization Belongs Afflt GrpYes (X)OrganizationBelongsAffltGrpInd

Total Grassroots Lobbying TotalGrassrootsLobbyingGrp

FieldValueIRS element (for citing)
Affiliated Group Total$0AffiliatedGroupTotalAmt

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$2,837FilingOrganizationsTotalAmt
Affiliated Group Total$218,263AffiliatedGroupTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$2,837FilingOrganizationsTotalAmt
Affiliated Group Total$218,263AffiliatedGroupTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$18,354,991FilingOrganizationsTotalAmt
Affiliated Group Total$842,283,071AffiliatedGroupTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$18,357,828FilingOrganizationsTotalAmt
Affiliated Group Total$842,501,334AffiliatedGroupTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Filing Organizations Total$1,000,000FilingOrganizationsTotalAmt
Affiliated Group Total$1,000,000AffiliatedGroupTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Filing Organizations Total$250,000FilingOrganizationsTotalAmt
Affiliated Group Total$250,000AffiliatedGroupTotalAmt

Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt
Affiliated Group Total$0AffiliatedGroupTotalAmt

Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt
Affiliated Group Total$0AffiliatedGroupTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Current Year Minus3$1,000,000CurrentYearMinus3Amt
Current Year Minus2$996,917CurrentYearMinus2Amt
Current Year Minus1$1,000,000CurrentYearMinus1Amt
Current Year$1,000,000CurrentYearAmt
Total$3,996,917TotalAmt
FieldValueIRS element (for citing)
Lobbying Ceiling$5,995,376LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$190,875CurrentYearMinus3Amt
Current Year Minus2$2,008CurrentYearMinus2Amt
Current Year Minus1$128,467CurrentYearMinus1Amt
Current Year$218,263CurrentYearAmt
Total$539,613TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Current Year Minus3$25,000CurrentYearMinus3Amt
Current Year Minus2$249,229CurrentYearMinus2Amt
Current Year Minus1$250,000CurrentYearMinus1Amt
Current Year$250,000CurrentYearAmt
Total$774,229TotalAmt
FieldValueIRS element (for citing)
Grassroots Ceiling$1,161,344GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus1$0CurrentYearMinus1Amt
Current Year$0CurrentYearAmt
Total$0TotalAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$62,193OtherCostOrOtherBasisAmt
Book Value$62,193BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,744,989OtherCostOrOtherBasisAmt
Depreciation$4,142,028DepreciationAmt
Book Value$1,602,961BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,073,414OtherCostOrOtherBasisAmt
Depreciation$5,359,426DepreciationAmt
Book Value$713,988BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$176,381OtherCostOrOtherBasisAmt
Book Value$176,381BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,555,523TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO THIRD PARTIES$670,924
ASSET RETIREMENT OBLIGATION$146,875
LEASE OBLIGATION$333,405
FieldValueIRS element (for citing)
Total Liability$1,151,204TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationFINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES, PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC TOPIC 740 PROVIDES GUIDANCE FOR RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2022 AND 2023.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$620,717TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$620,717NetCommunityBenefitExpnsAmt
Total Expense0.0370TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,672,061TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,099,019DirectOffsettingRevenueAmt
Net Community Benefit Expns$573,042NetCommunityBenefitExpnsAmt
Total Expense0.0342TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$3,292,778TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,099,019DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,193,759NetCommunityBenefitExpnsAmt
Total Expense0.0712TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,108TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,108NetCommunityBenefitExpnsAmt
Total Expense0.0008TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$13,108TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,108NetCommunityBenefitExpnsAmt
Total Expense0.0008TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$3,305,886TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,099,019DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,206,867NetCommunityBenefitExpnsAmt
Total Expense0.0719TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$1,600,565BadDebtExpenseAmt
Bad Debt Expense Attributable$357,086BadDebtExpenseAttributableAmt
Reimbursed By Medicare$4,704,786ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$7,820,399CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,115,613MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JAY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line114114 ALABAMA STREETAddressLine1Txt
CityJAYCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32565ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.EBAPTISTHEALTHCARE.ORG/JAYHOSPITALWebsiteAddressTxt
State License100048StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1JAY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://ebaptisthealthcare.org/community/chnaOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttps://ebaptisthealthcare.org/community/chnaStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.0FPGFamilyIncmLmtFreeCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIESFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIESFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIESFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - JAY HOSPITAL, INC.. The CHNA process was conducted through Achieve Healthy EscaRosa (AHER), our community's collective impact collaboration focused on improving the health of the community so that everyone can live well and thrive. AHER has replaced the former The Live Well Partnership for the roles of conducting the community health needs assessment for Escambia and Santa Rosa Counties in Florida and to support and promote collaborative initiatives that address identified health priorities. This collective effort resulted in 2,937 viable surveys, the largest number of community survey responses to date. An effort was made to involve individuals from many different sectors of the local economy in developing this CHNA. The CHNA Planning Team, comprised of the Florida Department of Health in Escambia and Santa Rosa counties, area hospitals and health providers, educational institutions, area health coalitions, nonprofit organizations and others, was established to provide guidance and input throughout data gathering, analysis, and production of the CHNA. The CHNA Planning Team provided input on their perceptions of health and health services, reviewed health outcomes, narrowed the focus to the top health priorities across both counties, and approved this report. Below is a roster of the CHNA Planning Team. CHNA Planning Committee - responsible for planning, data collection/analysis, communication and report writing * Adrienne Maygarden, Ascension Sacred Heart * Dr. Debra Vinci, University of West Florida * Dr. Patricia Barrington, University of West Florida * Jen Grove, Baptist Health Care * Joy Sharp, Baptist Health Care * Kimberly Pace, Florida Department of Health- Escambia * Laura Gilliam, United Way of West Florida * Matt Dobson, Chair, Florida Department of Health - Santa Rosa * Nicole Gislason, University of West Florida Haas Center * Nicholas Billings, University of West Florida * Sandra Donaldson, Community Health Northwest Florida
Schedule H, Part V, Section B, Line 6a Facility , 1Facility , 1 - JAY HOSPITAL, INC.. The CHNA process was facilitated by AHER, a nonprofit organization whose mission is to unite and align resources to improve the health and well-being of Escambia and Santa Rosa Counties. The CHNA Planning Committee included representation from Baptist Health Care and Ascension Sacred Heart.
Schedule H, Part V, Section B, Line 6b Facility , 1Facility , 1 - JAY HOSPITAL, INC.. Non-hospital stakeholder members of the CHNA Planning Committee included representatives from the Florida Departments of Health in Escambia and Santa Rosa Counties, Community Health Northwest Florida (a federally qualified health center), the University of West Florida, and the United Way of West Florida. The input process to prioritize focus areas also included input from representatives from over 35 not-for-profit and community-based organizations.
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - JAY HOSPITAL, INC.. Baptist Health Care recognized that sustained community health improvement happens when organizations from all sectors of the community landscape take ownership of the community's health and work together for improvement. As such, AHER hosted a community convening in February of 2022, during which community members were introduced to the priority focus areas and other health metrics through a review of the CHNA. The convening also served as an action planning workshop, in which participants were encouraged to provide input to one of the six priority health focus areas. The AHER Executive Committee has taken the inputs provided and is in the process of developing a draft action plan to share with participants and the broader community. The CHNA results and subsequent planning discussions determined the prioritized focus areas are: Overweight and Obesity Substance abuse Mental health Child abuse Access to healthcare Food insecurity Baptist Health Care serves as a leader and convener of these efforts and is actively engaged in multiple ways in this enhanced approach to health and wellness in the communities we serve. Jennifer Grove, VP External Relations of Baptist Health Care, serves as the Chair of Achieve Healthy EscaRosa, and various other team members participate in the Data, Communications, and CHNA Committees of AHER. In addition, Baptist leaders and team members are actively engaged in the Community Health Improvement Planning process, through which AHER will convene workgroups to build action plans in each of these prioritized focus areas for the community. Baptist already engages in collaborations and direct service in many of these prioritized focus areas, and looks forward to continued collaboration with other community partners to impact the outcomes in these prioritized focus areas. Baptist Health Care Actions in 2023: In the area of Access to Healthcare, Baptist Health Care achieved the following in 2023: * Began operations a new hospital campus to offer an advanced state-of-the-art healthcare experience to those in the communities we serve. Achieved September 23, 2023. * Partner with Escambia County Area Transit to ensure reliable and prompt transportation for all in the community to access quality care at the new Baptist Hospital campus. Achieved September 23, 2023. * Provided $.5M in support for our local FQHC, Community Health Northwest Florida, to ensure access for uninsured and underinsured. Achieved * Began work to expand offerings at Baptist Medical Park - Nine Mile to include a Hybrid Free Standing Emergency Department & Urgent Care facility that replicates the Navarre model. Scheduled to open in 2024. In the area of Mental Health, Baptist Health Care achieved the following in 2023: * Began operations at our new Baptist Hospital behavioral health unit to offer state-of-the-art facilities that allow our team to provide the most advanced, quality care in the region. Achieved * Collaborated with the Share Your Heart Program to provide social and spiritual support to our community using volunteer chaplains. - Baptist Faith Health Network: Goal to train and onboard 26 (one per zip code) - achieved 115 volunteer chaplains. - Goal of 50 families per year served - achieved 165 - 50 closed loop (full continuum of care) referrals per year given by Baptist team members - achieved 165. * Goal to meet immediate behavioral health needs for children and adolescents in Escambia and Santa Rosa counties in crisis through serving as the central and sole Baker Act Receiving Facility in Circuit 1 and continue to collaborate in establishing an adult Baker Act Receiving Facility elsewhere in our community completing the vision of a fully functioning Baker Act receiving system in Circuit 1. Achieved * Provide support services and spiritual care to patients, family members, team members and community through support services and Baptist Health Care's RISE Program . In 2023, BHC achieved 5,775. In the area of Food Insecurity, Baptist Health Care achieved the following in 2023: * Baptist supports target patient populations through community Food Prescription Program for those experiencing food insecurities. Goal of 25 families enrolled in the food prescriptions per year. In 2023, BHC achieved 100. * Baptist's Faith Health Network offers Church to Church Food Pantry Program. Goal of 1,000 households served per year. In 2023, BHC achieved 4,800. * 20 churches take part in the Church-to-Church Program each year. In 2023, BHC achieved 145. In the area of Overweight and Obesity, Baptist Health Care achieved the following in 2023: * Conduct outreach and provide education to community through the Wellness Connection Series at multiple Baptist Health Care locations including Baptist Medical Park - Nine Mile, Baptist Towers, Andrews Institute and at locations throughout the community. In 2023, BHC achieved 33 classes with over 1,513 participants. In the area of Substance Abuse, Baptist Health Care achieved the following in 2023: Goal for Baptist to work with community partners to create and support an updated database of programs and support groups for addiction recovery or intervention in Escambia or Santa Rosa Counties to supply a trusted continuum of care. Achieved through work done as members of the Northwest Florida Mental Health Task Force led by Representative Salzman. In the area of Child Abuse, Baptist Health Care achieved the following in 2023: Baptist Health Care raised awareness for and supported team members to engage in local child abuse training "KNOW" Child Abuse through Gulf Coast Kids House and engaged in Child Safety Matters through Achieve Healthy EscaRosa.
Schedule H, Part V, Section B, Line 13 Facility , 1Facility , 1 - JAY HOSPITAL, INC.. IN ADDITION TO THE FPG THE ORGANIZATION USES AN ASSET TEST, MEDICAL INDIGENCY AND INSURANCE STATUS IN DETERMINING FREE OR DISCOUNTED CARE.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CENTURY MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line18401 N CENTURY BLVDAddressLine1Txt
CityCENTURYCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32535ZIPCd
FieldValueIRS element (for citing)
FacilityPRIMARY CARE PRACTICEFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 3c Eligibility criteria for free or discounted careIN ADDITION TO THE FPG THE ORGANIZATION USES AN ASSET TEST, MEDICAL INDINGENCY AND INSURANCE STATUS IN DETERMINING FREE OR DISCOUNTED CARE.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation1600565
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceThe costing methodology used in determining the amount reported on Line 7 is the cost to charge ratio calculated pursuant to the IRS schedule H worksheet 2 instructions.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountTHE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORT HAS BEEN FOLLOWED IN ACCORDANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS, AND SUBSEQUENT RECOVERIES ARE ADDED. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. THE HOSPITAL PROVIDES SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, SUCH SERVICES ARE NOT REPORTED AS NET REVENUE. THE HOSPITAL'S CHARITY CARE POLICY UTILIZES THE GENERALLY RECOGNIZED FEDERAL POVERTY INCOME LEVELS. FOR PATIENTS WHO DO NOT APPLY OR DO NOT QUALIFY, THE UNCOLLECTED AMOUNTS ARE RECOGNIZED AS BAD DEBT EXPENSE. ESTIMATED COST OF BAD DEBT IS BASED ON THE RATIO OF COST TO CHARGES AS DETERMINED BY HOSPITAL SPECIFIC DATA.
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyBAD DEBT IS NOT INCLUDED AS PART OF JAY HOSPITAL'S COMMUNITY BENEFIT. APPROXIMATELY 22.31% OF JAY HOSPITAL'S PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE. THIS MEANS THAT APPROXIMATELY $357,086, OR 22.31%, OF JAY'S HOSPITAL'S BAD DEBT EXPENSE COULD BE INCLUDED AS COMMUNITY BENEFIT HAD THOSE INDIVIDUALS GONE THROUGH THE FINANCIAL ASSISTANCE PROCESS.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsTHE MEDICARE SHORTFALL WAS NOT INCLUDED IN THE COMMUNITY BENEFIT COST, AND THE COSTING METHODOLOGY CONSISTED OF INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE ENTIRE COST OF PROVIDING CARE TO MEDICARE PATIENTS CAUSING THE ORGANIZATION TO USE OTHER SURPLUS FUNDS TO COVER THE SHORTFALL. HOWEVER, THE ORGANIZATION PROVIDES CARE TO MEDICARE PATIENTS REGARDLESS OF THIS SHORTFALL, WHICH RELIEVES THE STATE AND FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR THE CARE OF MEDICARE BENEFICIARIES.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistancePATIENTS ARE DEEMED FINANCIALLY INDIGENT IF (A) THEY ARE UNINSURSED OR UNDERINSURED AND (B) THEIR INCOME IS BELOW 300% OF FPL (BASED UPON THE PATIENT'S HOUSEHOLD INCOME AS DEFINED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES IN THE FEDERAL REGISTER AS THE FEDERAL POVERTY LEVEL (FPL) GUIDELINES). IF A PATIENT IS FOUND TO BE FINANCIALLY INDIGENT OR MEDICALLY INDIGENT, APPROPRITE FINANCIAL ASSISTANCE DISCOUNTS ARE APPLIED TO THE PATIENT'S ACCOUNT. FOR ANY PATIENT THAT QUALIFIES UNDER THE ORGANIZATION'S CHARITY CARE POLICY, THE PATIENT ACCOUNT IS WRITTEN OFF AS CHARITY CARE AND THE ORGANIZATION DOES NOT PURSUE ANY COLLECTIONS.
Schedule H, Part V, Section B, Line 16a FAP website- JAY HOSPITAL: Line 16a URL: https://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES;
Schedule H, Part V, Section B, Line 16b FAP Application website- JAY HOSPITAL: Line 16b URL: https://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- JAY HOSPITAL: Line 16c URL: https://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES;
Schedule H, Part VI, Line 2 Needs assessmentThe organization's mission is helping people throughout life's journey. In response to this mission, the organization helps ensure that all citizens are afforded access to health care by investing in community health, and by participating in and leading collaborative, community-wide partnerships. Free health screenings, support groups, education seminars, and other programs that are offered focus on areas that have been identified through internal studies and external sources as critical health concerns in the surrounding communities. A full copy of the hospital's Community Health Needs Assessment can be accessed using the following website: HTTP://EBAPTISTHEALTHCARE.ORG/COMMUNITY/CHNA
Schedule H, Part VI, Line 3 Patient education of eligibility for assistanceJAY EMPLOYEES WORKING IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS AREAS HAVE BEEN TRAINED TO BE FULLY VERSED IN ALL FINANCIAL ASSISTANCE-RELATED POLICIES, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND BE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE REPRESENTATIVES. FOR NON-EMERGENCY PURPOSES, EVERY FILE FOR A PATIENT THAT HAS PRE-SCHEDULED AN OFFICE VISIT OR PROCEDURE IS REVIEWED BEFORE THE PATIENT ARRIVES AT THE HOSPITAL. A FINANCIAL COUNSELOR IS ASSIGNED TO THAT PATIENT IF IT IS DETERMINED THAT THE INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ETC. ALSO, WHEN A PATIENT RECEIVES A BILL, THE ORGANIZATION INCLUDES PAPERWORK EXPLAINING THAT FINANCIAL ASSISTANCE IS AVAILABLE. JAY HOSPITAL HAS POSTED MULTILINGUAL NOTICES OF FINANCIAL ASSISTANCE POLICIES IN THE EMERGENCY DEPARTMENT. SAID NOTICES HAVE BEEN PUBLISHED IN ENGLISH AND SPANISH, AND HAVE BEEN MADE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. JAY HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM, PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS FOR APPLYING FOR ASSISTANCE. ALSO, JAY HOSPITAL HAS POSTED A SUMMARY OF ITS CURRENT CHARITY CARE POLICY ON ITS INTERNET WEBSITE.
Schedule H, Part VI, Line 4 Community informationJAY HOSPITAL, INC. OPERATES IN SANTA ROSA COUNTY, FLORIDA. APPROXIMATELY 203,000 INDIVIDUALS RESIDE IN THIS COUNTY, 9.4% OF WHICH LIVE BELOW POVERTY LEVEL. WHEN CONSIDERING THESE FACTORS, MORE THAN 19,000 RESIDENTS COULD BE ELIGIBLE TO QUALIFY FOR CHARITY CARE. APPROXIMATELY 22.31% OF JAY HOSPITAL'S PATIENTS DURING FY2023 WERE UNINSURED OR WERE MEDICAID RECIPIENTS. THREE HOSPITALS, INCLUDING JAY HOSPITAL, ARE LOCATED IN SANTA ROSA COUNTY.
Schedule H, Part VI, Line 5 Promotion of community healthTHE ORGANIZATION DOES NOT LIMIT MEDICAL STAFF PRIVILEGES TO THE ORGANIZATION'S EMPLOYED PHYSICIANS BUT EXTENDS THOSE PRIVILEGES TO QUALIFIED PHYSICIANS FOR MOST AREAS OF SERVICE.THE ORGANIZATION'S BOARD OF DIRECTORS PRIMARILY CONSISTS OF COMMUNITY LEADERS AND RESIDENTS WHO ARE INDEPENDENT OF THE ORGANIZATION. THE ORGANIZATION STRIVES TO EDUCATE ALL BOARD MEMBERS REGARDING THE HEALTH NEEDS OF THE COMMUNITY AND HOW THESE NEEDS RELATE TO THE ORGANIZATION'S MISSION AND VALUES.THE ORGANIZATION SEEKS TO STRATEGICALLY ALLOCATE AVAILABLE FUNDS TO BENEFIT THE SURROUNDING COMMUNITIES. FOCUS AREAS INCLUDE INCREASING THE TYPES OF CARE TO BE PROVIDED TO THE COMMUNITY, IMPROVING THE QUALITY OF PATIENT CARE, AND FURTHERING MEDICAL EDUCATION AND RESEARCH.
Schedule H, Part VI, Line 6 Affiliated health care systemALTHOUGH THE ORGANIZATION MAY OPERATE IN DIFFERENT SERVICE AREAS WHEN COMPARED TO ITS AFFILIATES, ALL AFFILIATES WORK COLLABORATIVELY TO ENSURE THAT THE NEEDS OF THE COMMUNITIES ARE BEING ADDRESSED. THE ORGANIZATION PARTICIPATES IN MANY FREE HEALTH SCREENINGS, SUPPORT GROUPS, EDUCATION SEMINARS, AND HEALTH FAIRS THAT BENEFIT ALL COMMUNITIES WITHIN THE SYSTEM AND ARE NOT LIMITED TO THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. AFFILIATED ENTITIES INCLUDE: - BAPTIST HEALTH CARE, INC. - OPERATES BAPTIST HOSPITAL, GULF BREEZE HOSPITAL, AS WELL AS A FREE-STANDING EMERGENCY DEPARTMENT/URGENT CARE. - BAPTIST HEALTH CARE FOUNDATION, INC. - PROVIDES FINANCIAL AND FUNDRAISING ASSISTANCE FOR ALL AFFILIATES - BAPTIST URGENT CARE, LLC - DELIVER AMBULATORY CARE IN A DEDICATED MEDICAL FACILITY OUTSIDE OF A TRADITIONAL EMERGENCY ROOM.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1SANTA ROSA COMMUNITY CLINICBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15520 STEWART STAddressLine1Txt
CityMILTONCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32570ZIPCd
FieldValueIRS element (for citing)
Recipient EIN311746599RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$11,458CashGrantAmt
Purpose Of GrantHEALTHCAREPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2 Procedures for monitoring use of grant funds.FormAndLineReferenceDesc
ExplanationWITHIN ONE YEAR, THE ORGANIZATION REQUESTS DOCUMENTATION FROM THE RECIPIENT REGARDING PROPER USE OF FUNDS PROVIDED FOR INDIGENT PATIENTSExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BRETT ALDRIDGE
COO & EVP$0$353,535$0$58,471$0$26,876$0$7,625$0$36,084$0$482,591$0$0
MICHAEL GLEASON
SENIOR VP/CFO-OUTGOING$0$626,582$0$116,627$0$40,889$0$7,625$0$17,796$0$809,518$0$0
MICHAEL HUTCHINS
VP/ADMINISTRATOR$192,655$0$25,114$0$44,174$0$5,863$0$14,851$0$282,658$0$0$0
ANDREW TERRY
SENIOR VP/CFO-INCOMING$0$333,001$0$67,461$0$24,689$0$7,625$0$18,493$0$451,270$0$0
DEBRA JENKINS
ASST. ADMINISTRATOR$139,590$0$0$0$1,186$0$3,662$0$26,671$0$171,109$0$0$0
KARIN PARDUE
PHYSICIAN$289,208$0$12,030$0$543$0$0$0$28,381$0$330,162$0$0$0
DANIEL D SHEPPARD
MANAGER PHARMACY$129,289$0$0$0$0$0$3,389$0$26,391$0$159,068$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 1a Tax indemnification and gross-up paymentsTHE FOLLOWING OFFICERS/KEY EMPLOYEES RECEIVED TAX GROSS-UP PAYMENTS THAT WERE INCLUDED IN THEIR W-2 TAXABLE WAGES: --MICHAEL HUTCHINS
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planTHE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: BRETT ALDRIDGE MICHAEL GLEASON MICHAEL HUTCHINS THERE WERE NO CONTRIBUTIONS TO THE PLAN DURING THE TAX YEAR.
Schedule J, Part IITHE RELATED COMPENSATION REPORTED ON FORM 990, PART VII, SECTION A & SCHEDULE J, PART II WAS PAID BY THE FOLLOWING RELATED ORGANIZATIONS: --BAPTIST HEALTH CARE, INC.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 1aMOST 1099'S ARE ISSUED ON THE ORGANIZATION'S BEHALF BY BAPTIST HEALTH CARE, INC. (EIN: 59-0657322), A RELATED TAX EXEMPT ORGANIZATION.
Form 990, Part VI, Line 2 PART VI, LINE 2MICHAEL GLEASON, ANDREW TERRY, BRETT ALDRIDGE, AND MICHAEL HUTCHINS, HAVE A BUSINESS RELATIONSHIP. THE BUSINESS RELATIONSHIP IS AN EMPLOYER/EMPLOYEE RELATIONSHIP AT RELATED TAX-EXEMPT ORGANIZATIONS. ALL BOARD MEMBERS OF JAY HOSPITAL, INC. HAVE A BUSINESS RELATIONSHIP WITH MICHAEL GLEASON, ANDREW TERRY, AND BRETT ALDRIDGE. ALL MEMBERS ALSO SERVE ON THE BOARD OF BAPTIST HEALTH CARE, INC. AND MICHAEL GLEASON, ANDREW TERRY, AND BRETT ALDRIDGE ARE EMPLOYED OFFICERS OF BAPTIST HEALTH CARE, INC.
Form 990, Part VI, Line 15a & 15b PROCESS TO ESTABLISH COMPENSATIONEACH YEAR, THE COMPENSATION COMMITTEE OF THE BAPTIST HEALTH CARE, INC. BOARD UTILIZES INDEPENDENT COMPENSATION STUDIES THAT REFLECT THE CURRENT MARKET VALUE OF SPECIFIC KEY MANAGEMENT POSITIONS AS BENCHMARK DATA. ALL COMPENSATION OF KEY INDIVIDUALS MUST BE APPROVED BY THE BAPTIST HEALTH CARE COMPENSATION COMMITTEE.
Form 990, Part VI, Line 4 Significant changes to organizational documentsEffective October 1, 2022, Baptist Health Care, Inc. (f/k/a Baptist Hospital, Inc.), became the sole member of Jay Hospital, Inc.
Form 990, Part VI, Line 6 Classes of members or stockholdersBAPTIST HEALTH CARE, INC., A FLORIDA CORPORATION NOT-FOR-PROFIT, IS THE SOLE MEMBER OF JAY HOSPITAL, INC. BAPTIST HEALTH CARE, INC. HAS THE RIGHT TO ELECT THE BOARD OF DIRECTORS OF JAY HOSPITAL, INC.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyBAPTIST HEALTH CARE, INC., BEING THE SOLE MEMBER OF JAY HOSPITAL, INC. HAS THE RIGHT TO ELECT THE GOVERNING BODY OF JAY HOSPITAL, INC.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersTHE FOLLOWING SHALL REQUIRE APPROVAL BY THE BAPTIST HEALTH CARE INC., THE SOLE MEMBER, BOARD OF DIRECTORS: A. ELECTION OF THE DIRECTORS OF THE CORPORATION AT THE ANNUAL MEETING OF THE MEMBERS FROM AMONG THOSE PERSONS NOMINATED BY THE BAPTIST HEALTH CARE, INC. NOMINATING COMMITTEE. B. REMOVAL OF A DIRECTOR OF THE CORPORATION WITH OR WITHOUT CAUSE WHENEVER SUCH ACTION WOULD BE IN THE BEST INTEREST OF THE CORPORATION C. ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE. D. APPOINTMENT OF THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION E. ANY CONTRACT OR PURCHASE ORDER IN EXCESS OF $1,000,000 IN ADVANCE F. THE INCURRENCE BY THE CORPORATION OF ANY INDEBTEDNESS IN EXCESS OF $1,000,000 BEFORE SUCH INDEBTEDNESS IS CONTRACTED AND BEFORE EVIDENCE OF SUCH INDEBTEDNESS IS ISSUED G. ANNUAL CAPITAL AND OPERATING BUDGETS OF THE CORPORATION H. TRANSFER ASSETS BY THE CORPORATION DURING ANY FISCAL YEAR OF ASSETS EXCEEDING $100,000 IN NET VALUE
Form 990, Part VI, Line 11b Review of form 990 by governing bodyFORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S MANAGEMENT PERSONNEL. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S MANAGEMENT PERSONNEL HAS ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN MADE AVAILABLE TO THE EXECUTIVE COMPENSATION COMMITTEE AND ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990 WITH THE IRS. ALL BOARD MEMBERS ARE INFORMED THAT A PAPER COPY OF THE FORM 990 IS AVAILABLE AT THE ORGANIZATION'S PRINCIPAL OFFICE.
Form 990, Part VI, Line 12c Conflict of interest policyBOARD MEMBERS AND OFFICERS RECEIVE CORRESPONDENCE EACH YEAR THAT MUST BE COMPLETED AND SIGNED. THE CORRESPONDENCE INCLUDES A CONFLICTS OF INTEREST QUESTIONAIRE. OFFICERS AND KEY STAFF ALSO RECEIVE AN ATTESTATION FORM THAT MUST BE SIGNED CONFIRMING THAT THEY WILL DISCLOSE ANY CONFLICTS THAT VIOLATE THE ORGANIZATION'S POLICY. THE BOARD REVIEWS ALL CONFLICTS AND DETERMINES IF FURTHER ACTIONS NEED TO BE TAKEN. WHEN A CONFLICT DOES EXIST, THE INTERESTED PERSON MUST SUBMIT A DISCLOSURE NOTICE TO THE BOARD AND ABSTAIN FROM MAKING MOTIONS, VOTING, NEGOTIATING, EXECUTING AGREEMENTS, OR TAKING ANY OTHER DIRECT ACTION ON BEHALF OF THE ORGANIZATION WHERE THE CONFLICT MIGHT PERTAIN.
Form 990, Part VI, Line 19 Required documents available to the publicTHE ORGANIZATION HAS ALL GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE ANNUAL FINANCIAL STATEMENTS ON FILE IN THE ACCOUNTING AND ADMINISTRATION DEPARTMENTS. ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue- Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other FeesPROFESSIONAL FEES - Total Expense: 509332, Program Service Expense: 509332, Management and General Expenses: , Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 1508103, Program Service Expense: 1508103, Management and General Expenses: , Fundraising Expenses: ; OTHER PROFESSIONAL FEES - Total Expense: 64900, Program Service Expense: 39898, Management and General Expenses: 25002, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesTRANSFER FROM AFFILIATE - 4838728;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
BAPTIST HEALTH CARE FOUNDATION
125 BAPTIST WAY SUITE 6APENSACOLAFL32503590192265FUNDRAISINGFL501(c)(3)7BHCIYes (true)
BAPTIST HEALTH CARE INC
125 BAPTIST WAY SUITE 6APENSACOLAFL32503590657322HEALTHCAREFL501(c)(3)3NAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtAddress Line2USAddress/AddressLine2Txt
BAPTIST MEDICAL PARK SURGERY CENTER LLC
9400 UNIVERSITY PKWYPENSACOLAFL32541593535262AMBULATORY SURGERYFLNAN/A
ANDREWS INSTITUTE ASC LLC
1040 GULF BREEZE PKWYGULF BREEZEFL32561352274952AMBULATORY SURGERYFLNAN/A
LIGHTHOUSE HEALTH PLAN LLC
1717 NORTH E STREETPENSACOLAFL32501823182832HEALTH INSURANCEFLNAN/ASTE 320
BHI-INTUITIVE HEALTH OF ESCAMBIA COUNTY LLC
5700 GRANITE PARKWAYPLANOTX75024843637126FREESTANDING EDFLNAN/ASTE 456

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
BAPTIST HEALTH VENTURES INC
1717 NORTH E STPENSACOLAFL32501592667929ADMINISTRATIVEFLNAC CorporationYes (true)
THE TOWERS PHARMACY INC
1717 NORTH E STPENSACOLAFL32501592667929RETAIL SALESFLNAC CorporationYes (true)
LCC HOLDING COMPANY INC
1717 NORTH E STPENSACOLAFL32501592874324MEDICAL SERVICESFLNAC CorporationYes (true)
LAKEVIEW ASSOCIATED ENTERPRISES-PHASE I
21 W LAKEVIEW AVEPENSACOLAFL32501611711170FRANCHISINGFLNAC CorporationYes (true)
PARCEL 27 LAND CONDOMINIUM ASSOC INC
1221 W LAKEVIEW AVEPENSACOLAFL32501821313799CONDO ASSOCIATIONFLNAC CorporationYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Affiliated Group Schedule AffiliatedGroupSchedule

Affiliated Schedule AffiliatedScheduleGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINElecting OrganizationElectingOrganizationIndTotal Grassroots LobbyTotalGrassrootsLobbyAmtTotal Direct LobbyTotalDirectLobbyAmtTotal Lobby ExpenditureTotalLobbyExpenditureAmtOther Exempt Purpose ExpendOtherExemptPurposeExpendAmtTotal Exempt Purpose ExpendTotalExemptPurposeExpendAmtLobby NontxLobbyNontxAmtGrassroots NontxGrassrootsNontxAmtTotal Lobby Grssroot Mns NontxTotalLobbyGrssrootMnsNontxAmtTot Lbby Expend Mns Lobby NontxTotLbbyExpendMnsLobbyNontxAmtShare Excess Lobby ExpendShareExcessLobbyExpendAmt
Jay Hospital Inc
POST OFFICE BOX 17500PENSACOLAFL32522592425149Yes (X)$0$2,837$2,837$18,354,991$18,357,828$1,000,000$250,000$0$0$0
BAPTIST HEALTH CARE INC
PO BOX 17500PENSACOLAFL325227500590657322Yes (X)$0$215,426$215,426$819,854,477$820,069,903$1,000,000$250,000$0$0$0
BAPTIST HEALTH CARE FOUNDATION
PO BOX 17500PENSACOLAFL325227500590192265Yes (X)$0$0$0$4,073,603$4,073,603$353,680$88,420$0$0$0