2020-07-15T09:34:11-05:00 2019-08-31 346565596 Ernst & Young US LLP 155 N Wacker Drive Chicago IL 60606 990 2018-09-01 610444707 Baptist Healthcare System Inc BAPT 5028965000 2701 Eastpoint Parkway Louisville KY 40223 Stephen R Oglesby VP, Treasurer, CFO 5028965000 2020-07-15 1 Katherine E Kurtzman P01236691 3128792183 199.180.18.1 2020-07-15 10:27:29 ED P 7BE096BFE7B6DACC0EC05FB73F1791573207774A 7BE096BFE7B6DACC0EC05FB73F1791573207774A 2018 2020-09-23 17:36:50Z Stephen R Oglesby 2701 Eastpoint Pkwy Louisville KY 40223 2299934365 0 X www.baptisthealth.com X 1918 KY Provide quality healthcare services & enhance the health of the people & communities we serve. 15 11 16819 1000 7652560 1428764 2091222 1680671 2044654309 2226421275 36699531 38858032 32814648 32974387 2116259710 2299934365 1764591 2353104 0 0 906723723 947936049 0 0 0 951779008 1047611246 1860267322 1997900399 255992388 302033966 2890128218 3059532712 1260158552 1256700355 1629969666 1802832357 X See Schedule O.The mission of Baptist Healthcare System, Inc., (BHS), is to exemplify our Christian heritage of providing quality healthcare services by enhancing the health of the people and the communities we serve. The vision of BHS is to be nationally recognized as the healthcare leader in Kentucky and Indiana. BHS will live out its Christ-centered mission and achieve its vision guided by integrity, respect, stewardship, excellence and collaboration. 0 0 1757982345 2353104 2241693441 See Schedule O 1757982345 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 1301 0 1 16819 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 KY IN X Stephen R Oglesby 5028965000 2701 Eastpoint Parkway Louisville KY 40223 X Gerard J Colman CEO & Director 40.00 0.00 X X 2278911 0 247615 Aaron Thompson PHD Director 1.00 0.00 X 3000 0 0 Allen Rudd Director 1.00 0.00 X 3000 0 0 Brent Cooper Director 1.00 0.00 X 3000 0 0 Dr Terry T Lester Director 1.00 0.00 X 3000 0 0 Glenn Leveridge Director 1.00 0.00 X 3000 0 0 Kerry M Stemler Director 1.00 0.00 X 3000 0 0 Marcia Milby Ridings Director 1.00 0.00 X 3000 0 0 Ramsey Nassar MD Director 1.00 0.00 X 3000 0 0 Randy Owen MD Director 1.00 0.00 X 3000 0 0 Robert L Hook Jr Director 1.00 0.00 X 3000 0 0 Tammy Zimmerman Director 1.00 0.00 X 3000 0 0 Thomas O Davis Director 1.00 0.00 X 3000 0 0 Victoria Buster Director 1.00 0.00 X 3000 0 0 Dwain Morris Director (Effective 1/1/19) 1.00 0.00 X 0 0 0 Judge Eugene Siler Jr Director (Through 12/31/18) 1.00 0.00 X 0 0 0 Stephen R Oglesby CFO, Treasurer, VP 40.00 0.00 X 585001 0 111375 Janet Norton Secretary & Vice President 40.00 0.00 X 640187 0 36511 Timothy Jahn MD Chief Clinical Officer 40.00 0.00 X 998118 0 20014 Isaac Myers MD Chief Health Integration Officer 40.00 0.00 X 704528 0 135417 Christopher Roty Hospital President 40.00 0.00 X 523484 0 10260 Dennis Johnson Hospital President 40.00 0.00 X 587723 0 37562 Kenneth Anderson MD VP & Chief Medical Officer 40.00 0.00 X 720833 0 31028 Stephen C Hanson President & CEO (Through 3/21/17) 0.00 0.00 X 823224 0 3924 David Gray Vice President (Through 12/31/17) 40.00 0.00 X 1274600 0 35965 William G Sisson Vice President (Through 12/31/17) 40.00 0.00 X 692517 0 39213 William A Brown Vice President (Through 8/8/17) 0.00 0.00 X 954607 0 18744 10822733 0 727628 611 1 1 0 LabCorp 531 South Spring Street Burlington NC 27215 Service Contract 5991049 Siemens Medical Solutions USA Inc 51 Valley Stream Parkway Malvern PA 19355 Service Contract 4135577 Epic Systems Corporation 1979 Milky Way Verona WI 53593 Software and Consulting 3970114 Logans PO Box 643958 Cincinnati OH 45264 Service Contract 3686568 ZirMedWayStar 888 W Market Street Louisville KY 40202 Service Contract 3477731 119 1190226 490445 1680671 Insurance & Patient Pa 621300 1206024945 1199571019 6453926 Medicare & Medicaid Pa 621300 884852059 884852059 Management Fees-Exempt 561000 74232648 74232648 Other Program Service 900099 41790874 41790874 Exempt & MOB Rent 900099 15676241 15676241 3844508 3844508 2226421275 24015657 24015657 14842375 0 14842375 14842375 14842375 Cafe & Coffee Shops 722514 9456229 9456229 Purchasing Partnership 900099 3406742 3236510 170232 Day Care Centers 624410 3404016 1026323 2377693 16707400 12035656 2079 4669665 32974387 2299934365 2235239515 7652560 55361619 2353104 2353104 5144406 5144406 352310 352310 760554370 641836702 118717668 19806992 16882264 2924728 95170784 82016833 13153951 66907187 56760682 10146505 3353289 3117477 235812 3160871 460536 2700335 971766 971766 162234 162234 50034820 40087551 9947269 9078484 63852 9014632 82912583 66282074 16630509 59013911 52007205 7006706 33066483 29548242 3518241 4330755 1806636 2524119 229187 117290 111897 37772320 37772320 113000074 108222086 4777988 19968075 9643659 10324416 Medical Supplies 487374995 485940654 1434341 Purchased Svcs-Non-Med 70302347 59928448 10373899 Provider Tax 43579185 43579185 Administrative Expenses 20740115 12393644 8346471 8559752 6809591 1750161 1997900399 1757982345 239918054 0 36744 34151 287956258 318899077 298732409 322068514 39408535 42442396 18949637 17952237 2323151543 1234016927 1097562652 1089134616 911372726 990536487 14014221 18089420 17360947 19532948 204734089 240842866 2890128218 3059532712 249407566 265790376 978079063 967609657 32671923 23300322 1260158552 1256700355 X 1628248928 1800858515 1720738 1973842 1629969666 1802832357 2890128218 3059532712 X 302033966 5923633 -135094908 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 51000 0 1 111234 162234 0 Part II-B, Line 1: Fees and related expenses paid for lobbyist. Part II-B, Line 1i Lobbying portion of Kentucky Hospital Association and American Hospital Association dues, and an allocation of the expenses of BHS staff. 913093464 120059496 37696832 76030460 2309005 992510327 754058582 132278360 68237615 39440329 2040764 913093464 799870635 61040747 59495543 164068546 2279797 754058582 808699955 33990776 56256745 96524337 2552504 799870635 857141112 22188064 -704296 67115064 2809861 808699955 0.99800 0.00000 0.00200 0 0 143037644 143037644 935087141 443857873 491229268 1197688709 790159054 407529655 47338049 47338049 1089134616 Other Current Assets 50529020 Due From Affiliate 18074843 Trustee Funds-Malpractice 92792206 Trustee Funds-Workers Comp 24230684 Trustee Funds-Under Bond Indenture 186 Unamortized Issue Costs 7374869 Other Investments 22385687 Other Assets 25455371 240842866 Malpractice Liability 139638296 Workers Comp Liability 21620958 Post-Retirement/Miscellaneous 31292296 Third Party Payable 1161018 Intercompany -170412246 23300322 X Part V, Line 4: The endowment funds are used to support and enhance patient care at the hospitals, finance capital improvements and provide educational and financial assistance to hospital employees. Part X, Line 2: Baptist evaluates its uncertain tax positions on an annual basis. A tax benefit from an uncertain position may be recognized when it is more likely than not that the position will be sustained upon examination, including the resolution of any related appeals or litigation processes, based on the technical merit of the position. Baptist has determined that it has no uncertain tax positions that are required to be recorded as of August 31, 2019. Tax years that are open include the years from 2015 to 2018. 1 1 X 1 X 1 X 1 1 0 1 1 17282 46431266 11432482 34998784 0.01750 287790 277194203 244533182 32661021 0.01630 305072 323625469 255965664 67659805 0.03380 269550 4560000 32500 4527500 0.00230 75000 75000 0.00000 7626 35492232 26170424 9321808 0.00470 1075000 1075000 0.00050 1113836 1113836 0.00060 277176 42316068 26202924 16113144 0.00810 582248 365941537 282168588 83772949 0.04190 1 13564358 554384464 610604028 -56219564 X 1 1 6 1 Baptist Health Louisville 4000 Kresge Way Louisville KY 40207 www.BaptistHealth.com 100451 X X X A 2 Baptist Health Lexington 1740 Nicholasville Road Lexington KY 40503 www.BaptistHealth.com 100101 X X X A 3 Baptist Health Paducah 2501 Kentucky Avenue Paducah KY 42003 www.BaptistHealth.com 100313 X X X A 4 Baptist Health Corbin 1 Trillium Way Corbin KY 40701 www.BaptistHealth.com 100417 X X X A 5 Baptist Health LaGrange 1025 New Moody Lane LaGrange KY 40031 www.BaptistHealth.com 100575 X X X A 6 Baptist Health Floyd 1850 State Street New Albany IN 47150 www.BaptistHealth.com 17-005040-1 X X X A Facility Reporting Group - A 0 0 1 X X X X X X X X X 17 1 0 0 1 X https://www.baptisthealth.com X 1 17 1 https://www.baptisthealth.com 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X www.baptisthealth.com X www.baptisthealth.com X www.baptisthealth.com X X X X X X 1 X 0 X X X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Baptist Health Louisville, - Facility 2: Baptist Health Lexington, - Facility 3: Baptist Health Paducah, - Facility 4: Baptist Health Corbin, - Facility 5: Baptist Health LaGrange, - Facility 6: Baptist Health Floyd Group A-Facility 1 -- Baptist Health Louisville Part V, Section B, line 5: Contact was made with the health departments responsible for the counties in the service area. There are four health departments responsible for the counties BHLOU serves: Louisville Metro Public Health & Wellness (Jefferson County); the Bullitt County Health Department; the Oldham County Public Health Department and the North Central District Health Department, which serves both Shelby and Spencer counties. Through these contacts, the public meetings that were held, and public surveys conducted in Jefferson and Oldham counties, BHLOU solicited primary feedback on the health issues confronting its service area. Louisville Metro Public Health & Wellness also brought all of the Louisville-based hospitals, hospital systems & the Kentucky Hospital Association (KHA) together for joint meetings to assist them in the update of the public survey included in the CHNA. Secondary data from demographic & socioeconomic sources, Kentucky vital statistics, disease prevalence records, health indicators & statistics were updated. National, state, & local resources were also used. Group A-Facility 1 -- Baptist Health Louisville Part V, Section B, line 11: Based upon the data collected and analyzed through this assessment, the committee identified the following as the primary health issues that the hospital will focus on over the next three years: obesity, opioid abuse and cancer.Obesity and the related health effects on individuals and families was the consensus among the committee as the most pressing community need. Obesity has a significant impact on overall health and well-being, and can contribute to other health issues such as cardiovascular disease, diabetes, pulmonary disease, & joint deterioration. Through the combined efforts of medical professionals, schools, churches & government agencies, we will be successful in educating & engaging individuals to better care for themselves. Kentucky has some of the highest rates in the nation for preventable health conditions & for behaviors that have been identified as unhealthy. The committee ranked opioid abuse as their second priority in terms of public health issues. Opioid abuse has become an epidemic across the country and locally we are seeing a similar surge of opioid usage admissions & emergency room visits. Similar to obesity, opioid abuse has an impact on overall health & can lead to other co-morbidities. In addition, the service area is seeing a greater presence of drug-addicted newborns who must be sent to neonatal intensive care units to treat withdrawal symptoms. Cancer continues to be a leading cause of death in this service area, leading the committee to rank it as the third priority in terms of public health issues. Mortality levels in our service area are slightly lower than the state & national averages but still claim too many in our communities. The committee acknowledged the continued need for board-certified oncologists & easier access to cancer-related services, such as preventive screenings, chemotherapy & radiation therapy.Three additional issues identified were health literacy, cardiovascular disease & early intervention. The consensus of the team is that many of these issues are related, & efforts to combat one will result in improvements in one or more of the others.It is not within the scope of Baptist Health Louisville's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships & collaboration with other community stakeholder organizations & agencies that these issues are being addressed. Baptist Health Louisville works collaboratively with other community resources to provide support & to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment & uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city & county governments & county health departments.The consensus of the team conducting the assessment is that many of these issues are related & efforts to combat one will result in improvements in one or more of the others. Health literacy was defined as an increased awareness of the public to their overall healthcare environment, including knowledge of how & when to access care, understanding their personal health status, & the necessity of compliance with medicine & lifestyle regimens assigned by their physicians. Only through the combined efforts of medical professionals, schools, churches & government agencies will we be successful in educating & engaging individuals in caring for themselves. Kentucky has some of the highest rates in the nation for preventable health conditions & for behaviors that have been identified as unhealthy. The committee felt that continued focus on health literacy & personal responsibility would improve the general health of the population more than any other activity. As cancer continues to be a leading cause of death in this service area, the committee ranked it as their second priority in terms of public health issues. Although Jefferson County mortality levels are better than the state average they are still higher than the national average. The committee acknowledged the continued need for board certified oncologists & easy access to cancer related services such as chemotherapy & radiation therapy. Cardiovascular disease ranked as the committee's third priority & encompasses coronary artery disease, heart attack, arrhythmias, heart failure, cardiomyopathy & vascular disease. The discussion focused on education, prevention & treatment. The goal is to expand public awareness of disease root causes & common associated conditions to increase compliance with standard of care protocols. It is not within the scope of BHLOU's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. But it is through networking & partnerships with other community stakeholder organizations & agencies that these issues are being addressed. BHLOU works collaboratively with other community resources to provide support & serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment & uninsured populations are being dealt with by economic development groups, the Kentucky Chamber of Commerce, city & county governments, & county health departments. Group A-Facility 1 -- Baptist Health Louisville Part V, Section B, line 13b: Based on the information provided in the FAP application and/or through the presumptive eligibility process, a patient or guarantor whose income is less than 200% of the current Federal Poverty Guideline for his or her family size is eligible for a full discount under the FAP after all other healthcare resources have been utilized and exhausted. A patient or guarantor whose income is greater than 200% but less than 400% of the current Federal Poverty Guideline for his or her family size is eligible for a sliding scale discount after all other healthcare resources have been utilized and exhausted. Group A-Facility 1 -- Baptist Health Louisville Part V, Section B, line 20e: Billing and Collections:Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance. Group A-Facility 2 -- Baptist Health Lexington Part V, Section B, line 5: A wide variety of community resources were consulted during the CHNA process, as this is a community-driven plan of action which engages the public and develops partnerships.There are numerous health departments in the Baptist Health Lexington service area responsible for the counties Baptist Health Lexington serves. Each health department's community improvement plan was evaluated by the committee and those initiatives were considered throughout the process of determining the goals for the Baptist Health Lexington Community Health Needs Assessment. Baptist Health Lexington also solicited public opinion on community health needs using a survey distributed via social media, the Baptist Health Lexington website and in paper form. Survey responses, coupled with the information from the respective health departments, were considered as primary data. Secondary data obtained from national, state and local demographic and socioeconomic sources was used, including Kentucky vital statistics, disease prevalence studies and health indicators and statistics. Group A-Facility 2 -- Baptist Health Lexington Part V, Section B, line 11: Opioid abuse, cancer, (including breast, colorectal & lung) and cardiovascular disease were the health needs of the community with the highest priorities. The committee agreed that these health issues are creating additional stress on agencies throughout the community, including the hospital.Opioid abuse has become an epidemic across the country and in our community. The committee ranked it as their first priority. Locally we are seeing a surge of opioid usage admissions and emergency room visits similar to those nationwide. Opioid abuse has a negative impact on overall health and can lead to other co-morbidities. In addition, the service area is seeing a greater presence of drug-addicted newborns that must be sent to neonatal intensive care units to treat withdrawal symptoms. As cancer continues to be a leading cause of death in this service area, the committee ranked it as their second priority in terms of public health issues. The committee acknowledged the continued need for board-certified oncologists and easier patient access to cancer-related services such as preventive screenings, chemotherapy and radiation therapy. Cardiovascular disease is the committee's third priority and includes related health issues such as coronary artery disease, heart attack, arrhythmia, heart failure, cardiomyopathy and vascular disease. A focus on education, prevention and treatment will be a priority as the goal is to expand public awareness of disease root causes and common associated conditions to increase compliance with standard-of-care protocols and to decrease the occurrence of these health issues.It is not within the scope of Baptist Health Lexington's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships & collaboration with other community stakeholder organizations & agencies that these issues are being addressed. Baptist Health Lexington works collaboratively with other community resources to provide support & to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment & uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city & county governments & county health departments. Group A-Facility 2 -- Baptist Health Lexington Part V, Section B, line 13b: Based on the information provided in the FAP application and/or through the presumptive eligibility process, a patient or guarantor whose income is less than 200% of the current Federal Poverty Guideline for his or her family size is eligible for a full discount under the FAP after all other healthcare resources have been utilized and exhausted. A patient or guarantor whose income is greater than 200% but less than 400% of the current Federal Poverty Guideline for his or her family size is eligible for a sliding scale discount after all other healthcare resources have been utilized and exhausted. Group A-Facility 2 -- Baptist Health Lexington Part V, Section B, line 20e: Billing and Collections:Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance. Group A-Facility 3 -- Baptist Health Paducah Part V, Section B, line 5: The Purchase District Coalition for Health is a group comprised of representatives from the Purchase District Health Department, which serves Ballard, Carlisle, Fulton, Hickman, and McCracken counties in the Purchase Area Development District; the City of Paducah; the University of Kentucky County Extension offices; United Way of Paducah-McCracken County; Lourdes Hospital and Baptist Health Paducah. Bringing these groups together helps avoid duplication of efforts in data collection and resource allocation. Through these contacts and public surveys, BHPAD collected primary data and feedback on the health issues confronting its service area. Secondary data from demographic and socioeconomic sources, Kentucky vital statistics, disease prevalence and health indicators and statistics were collected from national, state and local sources. Group A-Facility 3 -- Baptist Health Paducah Part V, Section B, line 11: After studying the primary & secondary data, the committee prioritized the three most prevalent community health issues based on their severity & on the ability of Baptist Health Paducah & its partners to help improve them.Obesity prevention & the illnesses related to obesity are the primary health concerns in our community. To increase the awareness of obesity as a health threat to our service area residents & to encourage healthier living through diet, exercise & other means is the top priority. Failing to diminish obesity in the community will lead to higher mortality rates, increased healthcare costs & a decrease in the quality of life for families in our community.The second priority identified was ample access to health care. The ability of individuals in a community to access healthcare resources to preserve & improve health is essential. Access to healthcare has an immediate impact on overall health status, the prevention of disease, quality of life & life expectancy. To ensure service area residents have sufficient access to health care services through primary care & specialist physician planning & office locations; ambulatory care facilities; new services; school clinics, the hospital's call center & education & healthcare screenings will be a primary focus of the hospital.Smoking & lung disease are common problems in our community. The reduction of the number of smokers in the service area will ultimately reduce the incidence of heart disease, cancer, respiratory illnesses & stroke. Baptist Health Paducah supports a statewide smoking ban in public places, offers numerous early screenings tests for cancer & provides a free smoking cessation program.In spite of not having the resources other agencies have to address substance abuse directly, Baptist Health Paducah works to meet the needs of the community in ways that support the efforts of the other agencies. The annual Addiction Symposium focuses on training clinicians on the issues surrounding addiction & care. The educational program has been a catalyst to educate the community as to the circumstances of addiction & the care available for those suffering from this disease. The hospital sponsored a high-level training course for physicians & other prescribers of opiates, & experts were brought in to address questions & prescribing practices to help clinicians better care for their patients. It is not within the scope of Baptist Health Paducah's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships & collaboration with other community stakeholder organizations & agencies that these issues are being addressed. Baptist Health Paducah works collaboratively with other community resources to provide support & to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment & uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city & county governments & county health departments. Group A-Facility 3 -- Baptist Health Paducah Part V, Section B, line 13b: Based on the information provided in the FAP application and/or through the presumptive eligibility process, a patient or guarantor whose income is less than 200% of the current Federal Poverty Guideline for his or her family size is eligible for a full discount under the FAP after all other healthcare resources have been utilized and exhausted. A patient or guarantor whose income is greater than 200% but less than 400% of the current Federal Poverty Guideline for his or her family size is eligible for a sliding scale discount after all other healthcare resources have been utilized and exhausted. Group A-Facility 3 -- Baptist Health Paducah Part V, Section B, line 20e: Billing and Collections:Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance. Group A-Facility 4 -- Baptist Health Corbin Part V, Section B, line 5: To determine the goals and focus of the CHNA, the committee evaluated the Whitley & Laurel County Health Departments' community improvement plans & initiatives and solicited public opinion on community health issues using a survey distributed via social media, the hospital website & in paper form. Survey responses, coupled with the information from the respective health departments, were considered as primary data. Secondary data was obtained and evaluated from demographic & socioeconomic sources, Kentucky vital statistics records, disease prevalence reports, health indicators & statistics, as well as other national, state and local data. Group A-Facility 4 -- Baptist Health Corbin Part V, Section B, line 11: After studying the primary & secondary data, the committee identified the top five health concerns that the hospital will focus on over the next three years. They are: obesity, cancer, cardiovascular disease, mental health & substance abuse and patient transportation.Obesity was determined to be the top priority as it has a significant impact on other health issues, including cardiovascular disease, diabetes, pulmonary disease & joint deterioration. Through the combined efforts of medical professionals, schools, churches & government agencies, we will be successful in educating & engaging individuals to better care for themselves. Kentucky has some of the highest rates in the nation for preventable health conditions & for behaviors that have been identified as unhealthy. Cancer continues to be a leading cause of death in this service area, and a main priority in terms of public health issues. The committee acknowledged the continued need for board-certified oncologists & easy access to cancer-related services, such as preventive screenings, chemotherapy & radiation therapy. Cardiovascular disease ranked as the committee's third priority & encompasses coronary artery disease, heart attack, arrhythmias, heart failure, cardiomyopathy & vascular disease. The efforts to combat these health issues will focus on education, prevention & treatment. The goal is to increase public awareness of the disease, its root causes & commonly associated conditions to increase compliance with standard-of-care protocols. Opioid abuse has become an epidemic across the country. Locally, we are seeing a similar surge of opioid usage admissions & emergency room visits. This health issue is creating additional stress on agencies throughout the community. Similar to obesity, opioid abuse has an impact on overall health & can lead to other co-morbidities. In addition, the service area is seeing a greater presence of drug-addicted newborns who must be sent to neonatal intensive care units to treat withdrawal symptoms. Patient transportation is a major issue in the Baptist Health Corbin service area. Many patients do not own automobiles, & there are very limited resources for public transportation. The committee agreed it was important to explore the possibility of the hospital providing transportation services to patients.It is not within the scope of Baptist Health Corbin's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships & collaboration with other community stakeholder organizations & agencies that these issues are being addressed. Baptist Health Corbin works collaboratively with other community resources to provide support & to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment & uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city & county governments & county health departments. Group A-Facility 4 -- Baptist Health Corbin Part V, Section B, line 13b: Based on the information provided in the FAP application and/or through the presumptive eligibility process, a patient or guarantor whose income is less than 200% of the current Federal Poverty Guideline for his or her family size is eligible for a full discount under the FAP after all other healthcare resources have been utilized and exhausted. A patient or guarantor whose income is greater than 200% but less than 400% of the current Federal Poverty Guideline for his or her family size is eligible for a sliding scale discount after all other healthcare resources have been utilized and exhausted. Group A-Facility 4 -- Baptist Health Corbin Part V, Section B, line 20e: Billing and Collections:Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance. Group A-Facility 5 -- Baptist Health LaGrange Part V, Section B, line 5: A wide variety of community resources were consulted during this process. There are three health departments responsible for the counties Baptist Health La Grange serves: the Oldham County Public Health Department (OCHD), the North Central District Health Department (NCDHD), which serves both Henry & Trimble counties & the Three Rivers District Health Department (TRDHD), which serves Carroll County. Increasing communication between community service providers, enhancing the public's awareness of the agencies & services available & promoting services provided by community partners is a common goal.Baptist Health La Grange also solicited public opinion on community health needs using a survey distributed via social media, the Baptist Health La Grange website & in paper form. Survey responses, coupled with the information from the respective health departments, were considered as primary data. Secondary data, obtained from national, state and local demographic & socioeconomic sources, Kentucky vital statistics, disease prevalence studies & health indicators & statistics was collected. Group A-Facility 5 -- Baptist Health LaGrange Part V, Section B, line 11: The committee identified six community health issues, the top three are obesity, opioid abuse and cancer.Obesity was the top community need according to the assessment committee. Obesity has a significant impact on other health issues such as cardiovascular disease, diabetes, pulmonary disease & joint deterioration. Through the combined efforts of medical professionals, schools, churches, & government agencies, we will be successful in educating & engaging individuals to live healthier lifestyles. Opioid abuse has become an epidemic across the country. The committee ranked it as their second priority. Locally we are seeing a surge of opioid usage admissions & emergency room visits similar to those nationwide. Similar to obesity, opioid abuse has an impact on overall health & can lead to other co-morbidities. In addition, the service area is seeing a greater presence of drug-addicted newborns who need to be cared for in neonatal intensive care units to treat withdrawal symptoms. As cancer continues to be a leading cause of death in this service area, the committee ranked it as its third priority in terms of public health issues. Oldham County mortality levels are better than the state & national averages but are still a significant threat. The committee acknowledged the continued need for board-certified oncologists & easy access to cancer-related services, such as preventive screenings, chemotherapy & radiation therapy.The other three issues identified are health literacy, cardiovascular disease & early intervention. The consensus of the team is many of these issues are related & efforts to combat one will result in improvements in one or more of the others. It is not within the scope of Baptist Health LaGrange's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships & collaboration with other community stakeholder organizations & agencies that these issues are being addressed. Baptist Health LaGrange works collaboratively with other community resources to provide support & to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment & uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city & county governments & county health departments. Group A-Facility 5 -- Baptist Health LaGrange Part V, Section B, line 13b: Based on the information provided in the FAP application and/or through the presumptive eligibility process, a patient or guarantor whose income is less than 200% of the current Federal Poverty Guideline for his or her family size is eligible for a full discount under the FAP after all other healthcare resources have been utilized and exhausted. A patient or guarantor whose income is greater than 200% but less than 400% of the current Federal Poverty Guideline for his or her family size is eligible for a sliding scale discount after all other healthcare resources have been utilized and exhausted. Group A-Facility 5 -- Baptist Health LaGrange Part V, Section B, line 20e: Billing and Collections:Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance. Group A-Facility 6 -- Baptist Health Floyd Part V, Section B, line 5: A wide variety of community resources were consulted during the CHNA process, including the six health departments responsible for the counties Baptist Health Floyd serves: the Clark County Health Department; the Crawford County Health Department; the Floyd County Health Department; the Harrison County Health Department; the Scott County Health Department & the Washington County Health Department. Through these contacts, as well as other public agencies, public surveys & focus groups, Baptist Health Floyd solicited primary feedback on the health issues confronting its service area. Secondary data was obtained from national, state & local demographic & socioeconomic sources, Indiana vital statistics, disease prevalence studies & health indicators & statistics. Group A-Facility 6 -- Baptist Health Floyd Part V, Section B, line 11: Community discussions and survey responses identified multiple community needs that were ranked based on the following criteria: magnitude, severity, opportunity to intervene at a prevention level, degree of success in affecting the problem and resources available. The four community health priorities that were identified are as follows: social determinants of health, (food security, transportation and housing); cardiovascular disease; obesity and substance abuse and addiction. The ability of individuals in a community to access health care resources to preserve and improve health is essential. The goal is to help improve Floyd County residents' access to healthy food and nutrition and to increase health education. Screening tools used to identify food insecurity for Baptist Health Floyd patients and community nutrition and cooking classes will help to promote healthier lifestyles. Reducing the number of patients that do not receive care due to a lack of reliable transportation will help reduce the spread of illness throughout the community. Strategies to address the prevention of cardiovascular disease include the promotion of positive behaviors and an active lifestyle, community-wide screenings and sufficient access to healthcare providers. The reduction of the risk of chronic diseases and the promotion of a healthy and active lifestyle will help reduce the effects of obesity and substance abuse in our communities. It is not within the scope of Baptist Health Floyd's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships & collaboration with other community stakeholder organizations & agencies that these issues are being addressed. Baptist Health Floyd works collaboratively with other community resources to provide support & to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment & uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city & county governments & county health departments. Group A-Facility 6 -- Baptist Health Floyd Part V, Section B, line 13b: Based on the information provided in the FAP application and/or through the presumptive eligibility process, a patient or guarantor whose income is less than 200% of the current Federal Poverty Guideline for his or her family size is eligible for a full discount under the FAP after all other healthcare resources have been utilized and exhausted. A patient or guarantor whose income is greater than 200% but less than 400% of the current Federal Poverty Guideline for his or her family size is eligible for a sliding scale discount after all other healthcare resources have been utilized and exhausted. Group A-Facility 6 -- Baptist Health Floyd Part V, Section B, line 20e: Billing and Collections:Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance. Part V, Section B, Line 3e Each hospital facility did include a prioritized list of the community's significant health needs in its CHNA report. Part V, Section B, Lines 16 a,b,c https://www.baptisthealth.com/Pages/patients-and-visitors/billing- information/financial-assistance.aspx Part V, Section B, Lines 7 a,b and 10a https://www.baptisthealth.com/pages/news/community-health-needs-assessment.aspx Part I, Line 7: COSTING METHODOLOGY:BHS utilizes a sophisticated cost accounting system that identifies the cost of delivering care at the individual procedure and item (supply) level for direct costs and a detailed step-down methodology to allocate overhead costs as accurately as possible. Costs are determined for each patient based upon the specific procedures performed and items used for each patient. Patients are also categorized by: 1. Patient type (inpatient and outpatient), 2. Payer plan (42 unique categories of payer plans. Charity, state-sponsored charity and the uninsured are among the uniquely identified payer plans), and 3. Clinical service (53 unique clinical services). The cost of care for uninsured patients who qualify for "full" charity care (under a State-sponsored or BHS sponsored charity program) is determined by calculating the cost of each uninsured charity patient (at the procedure and item level) and accumulating the cost of each patient. For insured patients who also qualify for partial charity under the BHS sponsored charity program, costs are allocated to each portion (insurance, partial charity, patient payments and bad debt) using the patient's payer plan cost-to-charge ratio (CCR). For example, this CCR is multiplied by the charges covered by insurance to determine the cost of insurance, multiplied by charges covered by partial charity to determine the cost of partial charity, multiplied by patient payments to determine the cost of paid services and multiplied by unpaid charges to determine the cost of bad debt.The cost of care for uninsured patients who do NOT qualify for charity care (full or partial bad debt accounts) are allocated to each portion (patient paid portion and unpaid portion) using the patient's uninsured payer plan CCR. For example, this CCR is multiplied by patient payments to determine the cost of paid services and multiplied by unpaid charges to determine the cost of bad debt. Much care is taken to ensure that costs used for community benefit reporting are directly related to exempt-purpose patient care (excluding physician-related costs) and that costs are reported accurately. For example, the cost of charity and Medicaid are removed from the calculation of the loss on subsidized services. Part I, Line 7g: No physician clinic costs are included in the costs of subsidized health services. Form 990, Part I, Line 6A Each hospital within Baptist Healthcare System, Inc. (BHS), (61-0444707), prepares a Community Benefit Report. In addition, a summary Community Benefit Report is prepared on a consolidated basis for all entities. Part II, Community Building Activities: COMMUNITY CARE: To help Baptist Health accomplish its mission to transform the health of our communities, the entire organization is embracing a new way of thinking. Our providers remain focused on helping people get well and stay well, and the system is investing in new ways to provide quality, personalized care that is both efficient and proactive, preventing individuals from becoming sick in the first place. WELLNESS: Baptist Health's Wellness team is constantly seeking creative new opportunities to change the health of our communities for the better, one individual at a time. The team strives to create a culture of health and accountability, effectively engaging participants to help them reach their health and wellness goals. Baptist's innovative, award-winning wellness programs include smoking-cessation classes, weight-management programs, diabetes prevention, nutritional health, stress management and fitness/physical activity. Partnerships with other like-minded organizations within the community further enhance, support and promote these successful initiatives and programs.COLLABORATIONS: Improving the health of those in the communities we serve at the grassroots level takes partnerships. In Paducah and Corbin, a Congregational Health Network links those just released from the hospital to trained fellow church members willing to help with their care needs. Physically fit youngsters is the goal of the Project Fit America partnership, bringing funding, equipment, teacher training and a curriculum to 33 elementary and middle schools in 21 communities. Baptist Health is among 10 health systems that founded the Kentucky Health Collaborative to share best practices for improving the health of the Commonwealth's citizens.ADVOCACY: Baptist Health is working with community and state leaders, local schools, health departments and other partners to improve the health of our communities. Our efforts focus on the passage of smoke-free legislation to help children breathe clean air; tort reform, which can lower the cost of healthcare; telehealth to make healthcare more accessible; and opportunities to combat substance abuse and addiction. RESEARCH: Baptist Healthcare System's leadership in clinical research is directly linked to our organizational mission of serving the healthcare needs of patients and communities across Kentucky and Southern Indiana. Clinicians in Baptist Health facilities are currently engaged in more than 300 clinical studies, addressing a variety of medical conditions that include:--Cancer --Heart disease --Bone and muscle deformities --Neurological disorders --Communicable diseases --Diabetes Cancer research at Baptist Health has grown tremendously in the last 20 years with continued growth expected through the collaboration of the Baptist Health Cancer Research Network, (BHCRN). The BHCRN is a joint effort among physicians, nurses, patients, caregivers and administrators to improve cancer care at Baptist Health through research. Our program is unique among community research sites because it has always been hospital-based and has improved our ability to provide patients with NCI-sponsored, cooperative-group studies, culminating in our recent designation as a Main Member for NRG and GRN.Our clinicians are also involved in state and national-level research organizations, such as the NCI's National Clinical Trials Network, and the Guardian Research Network (GRN). These organizations bring together leading medical investigators to pool resources, share data and coordinate clinical trials.The Guardian Research Network is a nationwide consortium of high-performing community health systems, including Baptist Health, which created a breakthrough platform for accelerating cures for cancer. The network's objectives are to identify and place patients into clinical trials as fast as possible, cutting weeks and sometimes months off of enrollment timelines. Its searchable database houses hundreds of thousands of cancer patients' medical records. The Grail Study is the first trial launched by GRN and is designed to determine if a blood test can be created to enable the early detection of cancer. Participating hospitals include Baptist Health Lexington, Baptist Health Louisville and Baptist Health Paducah. Clinical research expands our knowledge of diseases allowing us to better understand and more effectively treat the diseases and conditions that affect the human body. Medical advancements hinge upon vigorous research programs and the commitment of healthcare organizations like Baptist Health. Part III, Line 2: As a result of certain changes required by Accounting Standards Update(ASU) 2014-09, the majority of Baptist's provision for uncollectible accounts is recorded as a direct reduction to net patient service revenue instead of being presented as a separate line on the consolidated statements of operations. The core principle of the guidance in ASU No. 2014-09 is that an entity should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. For Baptist's health care operations, the adoption of ASU No. 2014-09 resulted in changes to the presentation for and disclosure of revenue related to uninsured and underinsured patients. Under ASU No. 2014-09, the estimated uncollectible amounts due from these patients are generally considered an implicit price concession and are a direct reduction to patient service revenue. For the year ended August 31, 2019, Baptist recorded approximately $87,454 of implicit price concessions as a direct reduction of patient service revenue that would have been recorded as provision for bad debts prior to the adoption of ASU No. 2014-09. Part III, Line 3: Rationale for including other bad debt amount in community benefit:No other bad debt amounts have been included as community benefit. The hospital educates patients with limited ability to pay regarding financial assistance and for this reason, the organization believes it accurately captures all charity care deductions provided according to the financial assistance policy, and the amount of bad debt expense attributable to patients eligible under the organization's charity care policy is negligible. Part III, Line 4: BAD DEBT EXPENSE FOOTNOTE:A separate footnote for bad debt expense is not included in the audited financial statements. However, beginning in 2012 BHS reported the provision for uncollectible accounts related to patient service revenue as a deduction from patient service revenue. The costing methodology of bad debt is outlined in Schedule H, Part VI, Line 1. Part III, Line 8: MEDICARE COSTING METHODOLOGYMedicare revenues and allowable costs were taken from the "as filed" Medicare cost report. Much care is taken to ensure that all adjustments to remove non-allowable costs are taken. Due to the fact that Medicare rates are non-negotiable and are established by the government, all of the shortfall for Medicare should be included as a community benefit. Part III, Line 9b: COLLECTION PRACTICES:Patients and guarantors who qualify for a "full" charity discount will not be billed once the charity determination is made. Patients and guarantors who qualify for a "partial" charity discount will be billed only for the non-discounted portion of their account. Guarantors who have an ability to pay for services will be billed based on the following guidelines: - Patients or guarantors may be asked to pay an estimated patient liability at point of service. - BHS facilities will accept and file claims for all insurances assigned to the organization with adequate proof of coverage. This assignment does not relieve the guarantor of responsibility for payment if the insurer fails to pay as prescribed by regulation, statute or patient-insurance contract. Deductibles, co-payments and non-covered services will be the responsibility of guarantors. - Statements will be sent to guarantors once patient liability is determined for insured or uninsured patients and necessary billing follow-up calls will be made by BHS Patient Financial Services and/or a designated external early out vendor over a period of time averaging from 90 to 120 days. All statements will contain information regarding the availability of financial assistance. If applicable, effort will be made to assist uninsured patients to secure coverage through any governmental or other assistance programs. - Patients requesting detailed charge information will be provided an itemized bill. - BHS Patient Financial Services will provide all patients the same information concerning services and charges. - Patient accounts not resolved at the end of this cycle will be considered for placement with external collection agencies. Collection agencies will continue to pursue patient balances while maintaining compliance with the Fair Debt Collection Practices Act and the ACA International's Code of Ethics and Professional Responsibility. Part VI, Line 2: NEEDS ASSESSMENT:BHS conducts a tri-annual planning process that is driven by the strategic vision to be the health care leader in Kentucky. Key industry and community issues (such as prominent health conditions present within each community, underserved areas and underprovided clinical services) are considered and analyzed for their impact on BHS and the six hospitals. Frequently, outside experts reaffirm the assessment and assist in the development of plans to address the community need. A course of action, including key strategies and goals, is shared with and approved by the BHS Board and the Hospital's administrative boards. Part VI, Line 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:The following is a list of various methods/processes used to inform/educate patients on the availability of financial assistance: - Financial counselors advise and/or screen uninsured patients before or during hospital services, - A third party vendor advises and/or screens uninsured patients during hospital services, - Financial counselors provide follow-up contact for patients missed during services, - The State-sponsored DSH form is provided to all ED uninsured patients, - Telephone calls and in-person visits are handled by staff trained to discuss financial assistance, - Information regarding financial assistance is included in patient statements. - The BHS sponsored charity care program policy is posted in key areas of each hospital. - The BHS sponsored charity care program policy is posted on the website of each hospital and the System. Part VI, Line 4: COMMUNITY INFORMATION:BHS is comprised of six regional hospitals. Each one serves a unique and separate geographic area within Kentucky and Indiana: Baptist Health Louisville (BHLOU) opened in 1975 and is located in St. Matthews, approximately five miles east of downtown Louisville. BHLOU is strategically located near Interstate 64, a main access to downtown, and Interstate 264, a main beltway around Louisville. The primary geographic service area for BHLOU consists of Jefferson, Oldham, Shelby, Spencer and Bullitt counties in Kentucky. BHLOU serves as a general acute care facility, specializing in services such as cardiovascular services, cancer care and comprehensive rehabilitation services that are much needed in the area. In addition, BHLOU operates one of the busiest emergency departments in the state of Kentucky. Approximately 14.5% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 3.9%, matching the national average of 3.9%. Baptist Health Corbin (BHCOR) opened in 1986 in Corbin, Kentucky. It is located one-half mile off of Interstate 75, approximately three miles from downtown Corbin and near U.S. Highway 25, which is a main access to several of the surrounding communities. The primary geographic service area for BHCOR consists of the counties of Knox, Laurel, Whitley, Bell, McCreary and Clay in Kentucky. BHCOR serves as a general acute care facility, specializing in services such as psychiatric, substance abuse, comprehensive rehabilitation and emergency care services. Approximately 18.4% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 6.5%, as compared to the national average of 3.9%. Baptist Health Lexington (BHLEX) opened in 1954 in Lexington, the second largest city in Kentucky. It is located approximately five miles from Interstate 75 and Interstate 64 which provide access for the immediate Lexington metro area patients as well as patients from other areas of central and eastern Kentucky which the hospital serves. The primary geographic service area for BHLEX consists of the Kentucky counties of Bourbon, Clark, Fayette, Franklin, Jessamine, Madison, Scott and Woodford. In addition, BHLEX serves as a regional referral center with approximately 35% of its discharges coming from Kentucky counties outside of the primary service area. As such, BHLEX provides tertiary care services not offered by many hospitals in the surrounding areas including specialty cardiovascular, orthopedic and intensive care services. Approximately 12.6% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 3.7%, as compared to the national average of 3.9%. Baptist Health Paducah (BHPAD) was opened in 1953 in Paducah, Kentucky, the largest city in BHPAD's service area. The hospital is located approximately one and one-half miles from Interstate 64. BHPAD is one of only two hospitals located in Paducah. The primary geographic service area for BHPAD consists of Ballard, Caldwell, Carlisle, Graves, Livingston, Lyon, Marshall and McCracken counties in Kentucky and Massac County in Illinois. BHPAD draws nearly 72% of its discharges from the primary service area. BHPAD serves as a general acute care facility, specializing in services such as cardiovascular services, cancer care and skilled nursing that are much needed in the area. Approximately 19.9% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 5.5%, as compared to the national average of 3.9%. Baptist Health LaGrange, (BHLAG) became part of the BHS system in 1992. Baptist Health LaGrange can serve all of the primary healthcare needs of its service area. BHLAG defines its service area by looking at where the majority of its inpatients reside. Approximately 82% of BHLAG's inpatients come from Oldham, Henry, Trimble, and Carroll counties. Oldham County is a shared service area between Baptist Health Louisville and BHLAG. Approximately 13.2% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 3.9%, matching the national average of 3.9%.Baptist Health Floyd, (BHF) became a member of the Baptist Health system after its acquisition in October of 2016. Since its inception in 1953, Baptist Health Floyd has grown to be an outstanding regional healthcare provider serving the needs of a seven county region, including Floyd, Clark, Crawford, Harrison, Orange, Scott and Washington counties in southern Indiana. Over 41% of the patients served come directly from Floyd County. BHF serves as a general acute care facility, specializing in services such as cardiovascular services, cancer care and comprehensive rehabilitation services. Approximately 16.1% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 5.7%, as compared to the national average of 3.9%. Part VI, Line 5: PROMOTION OF COMMUNITY HEALTH:The BHS Board of Directors is comprised of local representatives who, along with the hospital's management and employees, understand that they are responsible for providing high quality health care services to the communities they serve. Operating healthcare facilities in today's environment requires a delicate balance between producing a sufficient margin to allow for adequate staffing and investment in new technologies, while also providing enough resources to absorb the cost of care for those patients who do not have the ability to pay for the services. In 2019, Baptist was able to re-invest over $113 million into the communities in new technology, construction, renovation and systems improvement. BHS hospitals reach out to the community in many ways through: - Conducting health fairs for local schools, businesses and churches. - Participating in fund-raising and other events to help local agencies such as the American Heart Association, Metro United Way, American Cancer Society, Big Brothers and Big Sisters and the American Red Cross. - Donating hospital space for community group meetings. - Participating on community health assessment teams that are dedicated to identifying and addressing local health needs in each of the counties we serve. - Hosting educational programs, including our pre-natal classes, CPR, smoking cessation, AED training and safe sitter programs. - Maintaining necessary, but unprofitable services that meet community needs. - Helping to recruit physicians to underserved areas and extending medical staff provileges to all qualified physicians in our community for some or all of our departments and specialties.- Helping patients coordinate services with other healthcare providers. - Providing resources for support groups, such as cancer recovery groups. - Promoting and providing preventive care services. - Monitoring clinical outcomes in order to ensure quality care. - Committing resources to improving safety and processes of care. - Providing services conveniently accessible by patients. In addition, BHS employees volunteer thousands of hours in community services and leadership. BHS's support for community activities underscores its commitment to improving the lives of those served. Because BHS and its employees contribute so much of their time, talent and resources to serve others, communities served by BHS are better places to live and work. Quantification of many of the community benefits is detailed elsewhere in this schedule. However, what the quantifiable amount doesn't measure is the economic benefit derived by the community from BHS being one of the major employers in the area. The economic impact of the wages paid to BHS employees is significant considering the dollars they spend on food, housing, services, and other products. The Internal Revenue Service Revenue Ruling 69-545 provides that a hospital can demonstrate it has met the community benefit standard by having a full-time emergency room open to the public regardless of ability to pay for services received. BHS hospitals operate emergency departments that are open 24 hours a day, 365 days a year and treated over 304,000 emergency patients during fiscal year 2019. BHS and its emergency departments post policies stating that patients will be treated regardless of their ability to pay. Depending on the severity of a patient's condition, as a service to the patient BHS may verify insurance prior to rendering services in the emergency department. Under no circumstances is emergency care delayed by discussions regarding insurance coverage or ability to pay for services. In addition, BHS does not convey or intimate in any way to any emergency medical transportation service an unwillingness to treat any particular patient in need of medical attention. Part VI, Line 6: AFFILIATED HEALTH CARE SYSTEM:Baptist Healthcare System, Inc., (BHS), is a nonprofit, tax-exempt organization that owns and operates six hospitals. Baptist Health Richmond, Inc. is a nonprofit, tax-exempt affiliate that owns and operates a hospital in Richmond, KY. Baptist Health Madisonville, Inc. is a nonprofit, tax-exempt affiliate that owns and operates a hospital in Madisonville, KY. Baptist Health Medical Group, Inc. is a nonprofit, tax-exempt affiliate that owns and operates physician practices and other healthcare facilities. Baptist Healthcare Foundation, Inc., Baptist Health Foundation of Greater Louisville, Inc., Baptist Health Foundation Corbin, Inc., Baptist Health Foundation Richmond, Inc., Baptist Health Foundation Madisonville, Inc., Baptist Health Foundation Lexington, Inc., and Baptist Health Foundation Paducah, Inc. are nonprofit, tax-exempt affiliate corporations. Baptist Physicians' Surgery Center is a limited liability corporation, of which Baptist Community Health Services, Inc. owns 55%. Baptist Eastpoint Surgery Center, LLC is a limited liability company of which Baptist Community Health Services, Inc. owns 84%. Baptist Health Network Partners, LLC. (BHNP), (formerly known as Purchase Health Quality Collaborative, LLC "PHQC"), formed in 2011, is a non-profit limited liability company whose sole member is BHS. BHNP was formed to support a physician/hospital network established by PHP, working with BHPAD to engage in clinical integration activities. Baptist Health Care Partners, LLC. (BHCP), formed in 2015, is a non-profit limited liability company whose sole member is BHS. BHCP was formed to participate in the CMS Medicare Shared Savings Program, (MSSP), as an Accountable Care Organization (ACO).Mercy Regional Emergency Medical System, LLC ("MREMS"), formed in 1996, is a non-profit taxable corporation, which owns and operates an ambulance service in McCracken County, Kentucky in the service area of BH Paducah. BHS owns a 50% interest in MREMS and the remaining 50% interest is owned by Mercy Health System, Inc. D.B.A. Lourdes Hospital. All related entities are located in the Commonwealth of Kentucky or the state of Indiana. All entities described in Schedule H, Part VI, Line 6 contributed a combined community benefit amount as follows: Charity Care at Cost $32,536,000 Unreimbursed Medicaid 33,093,000 Community Health Improvement 4,528,000 Health Professions Education 75,000 Subsidized Health Services 5,784,000 Research 832,000 Cash and In-Kind Contributions 1,114,000 Total Community Benefit $77,962,000 Part VI, Line 7, Reports Filed With States KY,IN 1 Alzheimer's Association 6100 Dutchmans Lane Suite 401 Louisville KY 40205 133039601 501 (c)(3) 5100 General Support American Cancer Society 1504 College Way Lexington KY 40502 131788491 501 (c)(3) 30000 General Support American Diabetes Association 2451 Crystal Drive Suite 900 Arlington VA 22202 131623888 501 (c)(3) 5000 General Support American Heart Association 240 Whittington Parkway Louisville KY 40222 135613797 501 (c)(3) 64500 General Support American Red Cross 431 18th Street NW Washington DC 20006 530196605 501 (c)(3) 5250 General Support Arthritis Foundation 2908 Brownsboro Road Suite 117 Louisville KY 40206 042113261 501 (c)(3) 5000 General Support Bluegrass Care Navigators (fka Hospice of the Bluegrass) 2312 Alexandria Drive Lexington KY 40504 610978097 501 (c)(3) 5023 General Support Center for Women and Families PO Box 2048 927 South Second St Louisville KY 40201 610444846 501 (c)(3) 5500 General Support Childrens Charity Fund of the Bluegrass 230 Lexington Green Circle Lexington KY 40503 311078176 501 (c)(3) 87500 General Support Commerce Lexington Inc 3300 E Main Street Lexington KY 40507 610258800 501 (c)(3) 8322 General Support Foundation for a Healthy Kentucky Inc 1640 Lyndon Farm Court Louisville KY 40223 311784753 501 (c)(3) 5000 General Support Greater Paducah Economic Development Center Inc PO Box 1155 Paducah KY 42002 611181577 501 (c)(6) 40000 General Support Hope Center Inc PO Box 6 Lexington KY 40588 611107296 501 (c)(3) 61500 General Support Ironcology 1185 Indian Mound Road Lexington KY 40502 825111678 501 (c)(3) 20000 General Support Kentucky and Southern Indiana Stroke Association 3425 Stony Brook Circle Louisville KY 40220 611335267 501 (c)(3) 7000 General Support Kentucky CancerLink 2425 Regency Road Lexington KY 40503 262704188 501 (c)(3) 5000 General Support Kentucky Chamber Foundation Inc 464 Chenault Road Frankfort KY 40601 611284992 501 (c)(3) 9999 General Support Kentucky Nurses Association 305 Townepark Circle Suite 100 Louisville KY 40243 610444713 501 (c)(3) 6000 General Support Kentucky-Southeast Indiana MS Society 1201 Story Avenue Suite 200 Louisville KY 40206 135661935 501 (c)(3) 7000 General Support KY Baptist Convention 13420 Eastpoint Center Drive Louisville KY 40223 610549873 501 (c)(3) 90436 General Support Leukemia and Lymphoma Society 3 International Drive Rye Brook NY 10573 135644916 501 (c)(3) 6770 General Support Lexington Cancer Foundation 1504 College Way Lexington KY 40502 562472701 501 (c)(3) 10000 General Support Lexington Rotary Club Endowment Fund 401 W Main Street Lexington KY 40507 310942139 501 (c)(3) 5000 General Support Lexington Strides Ahead Foundation 330 E Main Street Suite 205 Lexington KY 40507 611322448 501 (c)(6) 25000 General Support March of Dimes 196 W Lowry Lane Lexington KY 40503 131846366 501 (c)(3) 38000 General Support Mark Lehmann Spirit of Service Award Foundation 215 Breckinridge Lane Louisville KY 40207 474511676 501 (c)(3) 6750 General Support McCracken County High School 6530 Old Highway 60 Paducah KY 42001 463183133 Government 15100 General Support Mission Lexington 230 S MLK Boulevard Lexington KY 40508 202824933 501 (c)(3) 25000 General Support National Multiple Sclerosis Society 1201 Story Avenue Suite 200 Louisville KY 40206 135661935 501 (c)(3) 7000 General Support Oldham County Chamber and Economic Development 112 S First Avenue LaGrange KY 40031 611243293 501 (c)(6) 6465 General Support One Southern Indiana 4100 Charlestown Road New Albany IN 47150 204176026 501 (c)(6) 15600 General Support Paducah Area Chamber of Commerce 300 South 3rd Street Paducah KY 42002 610210420 501 (c)(6) 5425 General Support Paducah Junior College PO Box 7380 Paducah KY 42002 616001156 501 (c)(3) 50000 General Support Paducah Symphony Orchestra 222 Kentucky Avenue Paducah KY 42003 610965156 501 (c)(3) 30591 General Support Refuge Clinic 2349 Richmond Road 220 Lexington KY 40502 371547506 501 (c)(3) 75000 General Support Southern KY Chamber of Commerce PO Box 1566 Corbin KY 40702 270825308 501 (c)(3) 7500 General Support Start the Heart Foundation 7611 Wolfpen Ridge Court Prospect KY 40059 463998988 501 (c)(3) 10000 General Support The Carson Center 100 Kentucky Avenue Paducah KY 42001 611293428 501 (c)(3) 52500 General Support Twisted Pink Inc 8016 Vinecrest Avenue 2 Louisville KY 40222 471140389 501 (c)(3) 5000 General Support Women Leading Kentucky 620 Euclid Avenue 105 Lexington KY 40502 861120254 501 (c)(3) 10000 General Support YMCA of Greater Louisville 545 South 2nd Street Louisville KY 40202 610444843 501 (c)(3) 39590 General Support 36 5 Part I, Line 2: Baptist Healthcare System provides only direct contributions and other general support; therefore, no monitoring of charitable contributions is performed. X X X X X X 1 1 0 0 0 0 0 0 0 Gerard J Colman CEO & Director 1223114 0 956264 0 99533 0 219085 0 28530 0 2526526 0 0 0 Stephen R Oglesby CFO, Treasurer, VP 487929 0 83170 0 13902 0 83164 0 28211 0 696376 0 0 0 Janet Norton Secretary & Vice President 530104 0 93559 0 16524 0 8250 0 28261 0 676698 0 0 0 Timothy Jahn MD Chief Clinical Officer 170543 0 0 0 827575 0 2962 0 17052 0 1018132 0 0 0 Isaac Myers MD Chief Health Integration Officer 585123 0 102881 0 16524 0 113033 0 22384 0 839945 0 0 0 Christopher Roty Hospital President 453304 0 58558 0 11622 0 8250 0 2010 0 533744 0 0 0 Dennis Johnson Hospital President 439406 0 136695 0 11622 0 8250 0 29312 0 625285 0 0 0 Kenneth Anderson MD VP & Chief Medical Officer 401598 0 313692 0 5543 0 8250 0 22778 0 751861 0 0 0 Stephen C Hanson President & CEO (Through 3/21/17) 0 0 0 0 823224 0 0 0 3924 0 827148 0 0 0 David Gray Vice President (Through 12/31/17) 518516 0 0 0 756084 0 8250 0 27715 0 1310565 0 0 0 William G Sisson Vice President (Through 12/31/17) 583461 0 85579 0 23477 0 8250 0 30963 0 731730 0 0 0 William A Brown Vice President (Through 8/8/17) 0 0 424628 0 529979 0 0 0 18744 0 973351 0 0 0 Part I, Lines 4a-b Line 4a: Three former officers received severance payments in 2018: William Brown $535,806 Stephen Hanson $818,004 David Gray $259,477 Line 4b: Three officers and executives who participated in the Supplemental Executive Retirement Plan accrued amounts for 2018 which is a portion of the amount reported as deferred compensation in Schedule J, Column C. Other retirement and deferred compensation reported in Schedule J, Column C include amounts for the Retirement Accumulation Plan and Thrift Plan. The following individuals participate in and accrued amounts from the Supplemental Executive Retirement Plan: Gerard J. Colman $219,085 Isaac Myers, MD $104,783 Stephen R. Oglesby $74,914 The following individuals received a payout from the Supplemental Executive Retirement Plan, a nonqualified deferred compensation plan, as they are fully vested in the plan: David Gray $489,212 Timothy Jahn $350,560 Schedule J: Certain executives receive a cell phone stipend. A KY Economic Development Finance Authority 610600439 49126KFM8 2009-02-09 502227848 See Part VI 0 0 0 B KY Economic Development Finance Authority 610600439 49126KHR5 2011-12-14 136101238 See Part VI 0 0 0 C KY Economic Development Finance Authority 610600439 2015-12-15 18682500 See Part VI 0 0 0 D KY Economic Development Finance Authority 610600439 49126KLD1 2017-05-31 234927003 See Part VI 0 0 0 A 502247678 4753545 661234 99994925 396837974 2010 1 0 1 1 B 136716070 13542795 1482800 121712708 1617 2015 0 0 1 1 C 18682500 18682500 1 0 1 1 D 234927003 2108234 212763739 212769739 2017 0 0 0 0 A 0 0 1 1 0 0.00100 0.00100 0 0 1 B 0 0 0 0 0 0 1 C 0 1 1 0 0 0.02190 0.02190 0 0 1 D 0 0 1 1 0 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 1 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 Schedule K, Part I, Line A Description of Purpose: Series 2009A and 2009B Revenue Bonds were issued to redeem the 1/99, 1/05, and 12/05 bonds, and for the costs of acquiring and constructing hospital facilities, and for the purchase of equipment. Schedule K, Part I, Line B Description of Purpose: Series 2011 fixed rate Hospital Revenue Bonds were issued for the costs of certain hospital projects, including a portion of the costs of constructing and equipping a new medical structure connected to the existing hospital building at Baptist Health Lexington, (fka Central Baptist Hospital). Schedule K, Part I, Line C Description of Purpose: The series 2015a Bonds were issued to refinance the Series 2010 Variable Rate Demand Hospital Revenue Bonds issued by Baptist Health Madisonville. Schedule K, Part I, Line D The Series 2017A Bond was issued primarily for the purpose of refinancing a portion of the bridge loan used as a component of the financing of the Baptist Health Floyd acquisition and to pay all or a portion of the cost of issuance. The Series 2017B Bond was issued primarily for the purpose of paying and reimbursing the costs of construction, acquisition, installation, renovation and equipping health care and health related properties and facilities, and to pay all or a portion of the costs of issuance. Schedule K, Part II, Line 3, Column A The difference between Part I, Column (E), and Part II, Line 3, is due to investment earnings of $19,830. Schedule K, Part II, Line 3, Column B The difference between Part I, Column (E), and Part II, Line 3, is due to investment earnings of $614,833. Schedule K, Part II, Line 7-8, Column A The amounts reported on the 8038 represented estimates of the issuance costs and the credit enhancement fees. The amounts reported here are actual amounts paid from the proceeds. Schedule K, Part II, Line 7-8, Column B The amounts reported on the 8038 represented estimates of the issuance costs and the credit enhancement fees. The amounts reported here are actual amounts paid from the proceeds. Cary Lester Family of Director 110707 Wages 0 Susan D White Family of Director 135594 Wages 0 Jacob Archibald Family of Director 63941 Wages 0 Form 990, Part III, Line 4a Since its inception in 1924, Baptist Healthcare System, Inc. ("Baptist") has been dedicated to providing accessible, quality healthcare to all patients regardless of their ability to pay. The hospitals owned and operated by Baptist under tax identification number 61-0444707 include: Baptist Health Louisville, located in Louisville, Kentucky; Baptist Health Corbin, located in Corbin, Kentucky; Baptist Health Lexington, located in Lexington, Kentucky; Baptist Health Paducah, located in Paducah, Kentucky; Baptist Health LaGrange, located in LaGrange, Kentucky, and Baptist Health Floyd, located in New Albany, Indiana. VISION: The vision of Baptist is to be the healthcare leader in Kentucky and Indiana. Having earned a reputation of providing high quality patient care and utilizing the latest in medical technology, patients seek out Baptist facilities for their care. According to state statistics in 2018, Baptist is one of the largest healthcare providers in the state of Kentucky. KENTUCKY 2019 HOSPITAL STATISTICS: LICENSED BEDS: 2,759 beds - the second largest number of beds of any health system in Kentucky. EMPLOYEES: 16,819 employees at end of the fiscal year - one of the top employers in Kentucky. INPATIENT CARE: 88,934 admissions/414,446 days - the largest number of admissions in Kentucky at a system-owned or managed hospital. One out of every seven inpatients receiving care in Kentucky received care at a system-owned or managed hospital. OBSTETRIC (DELIVERIES): 11,793 babies - the largest number of babies delivered in Kentucky at a system-owned or managed hospital. Almost one in five babies in Kentucky was delivered at a Baptist owned or managed hospital. EMERGENCY VISITS: 304,777 registrations - the second largest number of emergency visits in Kentucky at a system-owned or managed hospital. One in eight ER patients was treated at a system-owned or managed hospital. OUTPATIENT VISITS: 1,771,522 hospital visits - one in eleven outpatients in Kentucky receiving care in an acute-care setting was seen at a system-owned or managed hospital. MISSION: As indicated by its mission statement, Baptist strives to continue its "Christian heritage of service and to enhance the health of the people and the communities we serve." Baptist is organized and operated exclusively for the benefit of each community and each hospital is considered a valuable community asset. The Baptist Boards of Directors are comprised of local representatives who, along with the hospitals' management and employees, understand that they are responsible to the communities for providing high quality health care services. Over the years, Baptist has gained a reputation for providing compassionate, high quality, cost efficient, patient friendly care. RESPONSIVE TO COMMUNITY NEEDS: Operating healthcare facilities in today's environment requires a delicate balance between producing a sufficient margin to allow for adequate staffing and investment in new technologies, while also providing enough resources to absorb the cost of care for those patients who do not have the ability to pay for the services. During the 2019 fiscal year, Baptist was able to re-invest over $113 million into the communities in new technology, construction, renovation and systems improvement. Because of the need to generate a modest margin while caring for all patients, Baptist strives to fulfill its community responsibility of collecting appropriate reimbursement from all patients who have the necessary resources while providing a generous, yet accountable charity care policy to assist those patients who do not have the means to pay for the services rendered. (See "Charity Care Policy" later in this section for further discussion). From a broad perspective, Baptist hospitals consistently provide a high level of quality care to every patient and enhance the health of the people it serves through health promotions, health screenings, medical research, and training of health professionals. OTHER COMMUNITY BENEFITS INCLUDE: - Maintaining necessary, but unprofitable services that meet community needs - Helping to recruit physicians to underserved areas - Helping patients coordinate services with other healthcare providers - Providing resources for support groups - Promoting and providing preventive care services - Monitoring clinical outcomes in order to ensure quality care - Committing resources to improving safety and processes of care - Providing services conveniently accessible by patients. In addition, Baptist employees volunteer thousands of hours in community services and leadership. Baptist's support for community activities underscores its commitment to improving the lives of those served. Because Baptist and its employees contribute so much of their time, talent and resources to serve others, communities served by Baptist are better places to live and work. Quantification of many of the community benefits is detailed later in this section. However, what the Statement of Program Service Accomplishments doesn't measure is the economic benefit derived by each community from Baptist being one of the largest employers in the state. The economic impact of the wages paid to Baptist employees is significant considering the dollars they spend on food, housing, services, and other products. Continued: CHARITY CARE POLICY: To further the mission of enhancing the health of the people and communities it serves, Baptist provides medically necessary inpatient and outpatient care to patients regardless of race, religion, sex, national origin, disability, age or their ability to pay. Recognizing that not all patients have the ability to pay, Baptist has a charity care policy to accurately evaluate a patient's ability to pay for services received. Baptist relies solely on the physician order to determine whether treatment is medically necessary and whether the patient is treated on an inpatient or outpatient basis. Neither the patient's financial condition nor their ability to pay for services has any bearing upon whether, or how, the patient is treated in a Baptist facility. Patients are transferred only when Baptist does not provide the specialized service that is required, or by specific request of the patient. Baptist has notices posted throughout the hospital that clearly communicate Baptist's charity care policy. Baptist employees are instructed in the application of the charity care policy and are trained to recognize situations that indicate the financial resources of a patient may be inadequate. These employees freely and willingly volunteer information regarding the charity care policy to any patient who may express a concern regarding the ability to pay for services. The policy provides that: 1. Patients/guarantors with resources of less than 200% of the Poverty Guideline for their family size will receive full charity. 2. Patients/guarantors with resources of 200% but less than 400% of the Poverty Guideline for their family size will qualify for partial charity. The ratio of resources up to 400% of the Poverty Guideline determines the percentage of the bill that will be the responsibility of the applicant. However, the liability is capped at 10% of the resources. 3. Patients/guarantors with resources of 400% of the Poverty Guideline for their family size but no more than 1200% of the Poverty Guideline for their family of one will qualify for partial charity if the liability exceeds 20% of their resources. In these situations, the patient/guarantor will be responsible for an amount not to exceed 20% of their resources. 4. If eligible for a charity discount, a patient will receive the discount regardless of whether they pay the balance on the bill. If necessary, payment arrangements may be made on the balance of the patient's bill in accordance with hospital procedures. In accordance with the provisions of Section 501(r), if charity care eligibility cannot be determined, good stewardship requires that the hospital initially begin the collection process. However, immediately upon determining that the guarantor is eligible for charity care, collection efforts on the balance eligible for charity will cease and the appropriate balance will be designated as charity. TAX-EXEMPT STATUS REQUIREMENTS: The Internal Revenue Service Revenue Ruling 69-545 provides that a hospital can demonstrate it has met the community benefit standard by having a full-time emergency room open to the public regardless of ability to pay for services received. Baptist operates Emergency Departments that are open 24 hours a day, 365 days a year and treated 304,777 emergency patients during fiscal year 2019. Baptist facilities and emergency departments post policies stating that patients will be treated regardless of their ability to pay. Depending on the severity of a patient's condition, as a service to the patient, Baptist may verify insurance prior to rendering services in the emergency department. Under no circumstances is emergency care delayed by discussions regarding insurance coverage or ability to pay for services. In addition, Baptist does not convey or intimate in any way to any emergency medical transportation service an unwillingness to treat any particular patient in need of medical attention. ACCOUNTABILITY TO THE BROADER COMMUNITY: As previously noted, the Baptist Board of Directors embraces its responsibility to represent the broader community in guiding Baptist in its provision of healthcare services. The Board meets periodically to provide oversight as to how best to continue to serve each community. Regularly scheduled meetings of the full Board and its Committees are described below: Board of Directors Quarterly Audit Committee Quarterly Executive Committee As needed Compensation Committee As needed Finance Committee Monthly Governance Effectiveness Committee Quarterly Enterprise Risk Committee Quarterly Quality and Mission Effectiveness Committee Quarterly Continued: One of the key functions of the Board is to ensure Baptist not only utilizes sound financial management, but also embraces a culture of compliance that permeates throughout the healthcare system. This is best demonstrated by Baptist's commitment of resources for compliance activities including the designation of a Compliance Officer. The compliance function reports to the Audit Committee (established in 1994) which is comprised of three independent members of the Board who are not members of either the Executive or Finance Committees. Additionally, at least one member has the expertise to be considered a financial expert in the public sector. Another key function of the Board is to ensure that compensation paid to executives is reasonable and meets the guidelines set forth by the Internal Revenue Service. Through the Compensation Committee, (CC), the Board ensures that: 1) members of the CC do not have any conflicts of interest, i.e., they are not employed or receive compensation subject to approval by the executives, 2) the compensation is approved in advance by the CC, 3) the CC obtains and relies upon appropriate comparability data in making decisions, 4) every form of compensation and benefit is included in the comparisons, 5) the CC documents the basis for its decision concurrently with making the decision, and 6) based upon the data, the compensation is reasonable. The following is a summary of Baptist's community service for the year ended August 31, 2019, in terms of services to the poor and indigent and the benefits provided to the communities it serves. QUANTIFIABLE COMMUNITY BENEFIT: Baptist is fully committed to its responsibility as a charitable organization and commits extensive resources to fulfill that obligation to the community. To the extent possible, Baptist has quantified the benefits provided to the communities it serves: Description Amount Benefits for the Poor and Indigent: Unreimbursed Cost of Charity Care $ 34,999,000 Unreimbursed Cost of Medicaid 32,661,000 -------------- Total Benefits for the Poor and Indigent $ 67,660,000 Benefits for the Broader Community: Net Loss on Subsidized Health Services $ 9,322,000 Community Health Improvement Services 4,527,000 Health Professions Education 75,000 Research 1,075,000 Financial & In-Kind Contributions 1,114,000 --------------- Total Benefits for the Community $ 16,113,000 ---------------- Total Quantifiable Community Benefit $ 83,773,000 GLOSSARY OF COMMUNITY BENEFIT TERMS: BENEFITS FOR THE POOR AND INDIGENT: Describes services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured. This includes those patients that qualify for Charity, Medicaid, Kentucky's Children Health Insurance Program (KCHIP), Kentucky Hospital Care Program (KHCP) and other citizens whose income is inadequate (based on each patient's individual circumstances). 1. Unreimbursed cost of charity care describes the services provided to persons who cannot afford to pay. It also includes the Health Care Provider Tax (Kentucky Revised Statutes 142.303) that is assessed on all hospital patient revenues received for the purpose of funding state Medicaid, KHCP and KCHIP programs. The amounts reflect the net cost of these services after reducing the costs for contributions and other revenues received by Baptist as direct assistance for the provision of care. 2. Unreimbursed cost of Medicaid reflects costs of treating Medicaid beneficiaries not reimbursed by government programs. BENEFITS FOR THE BROADER COMMUNITY: Describes services provided to other needy populations that may not qualify as indigent but that need special services and support. The benefits include the cost of health promotion and education, health clinics and screenings, and medical research that benefits the community. 1. Net loss on subsidized health services reflects the loss from services that would be discontinued if the decision were based on profit motives only. 2. Other community benefit includes costs incurred by Baptist in providing support and coordination of health education and awareness events as well as the cost of employees paid time to attend, staff, and coordinate these activities. 3. Baptist makes cash and in-kind donations on behalf of the poor and needy to community agencies and to special funds used for charitable purposes. Form 990, Part VI, Section A, line 2 The Board of Directors is made up of executives from related organizations. The following individuals have a business relationship in that they serve on the Board of Directors of the organization and are officers and/or directors of a related organization: Gerard Colman, Janet Norton, Stephen Oglesby, and Victoria Buster. Form 990, Part VI, Section B, line 11b The internally prepared Form 990 is reviewed by an outside accounting firm. A copy of the IRS Form 990 is provided to the Board of Directors prior to the filing of the return. Any questions or comments are addressed by explanation or a change to the form. Form 990, Part VI, Section B, line 12c DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST: Annually the Secretary of BHS sends out a Conflict of Interest questionnaire to each of the directors and officers serving on the Board of BHS. After completion, they are returned to the Secretary and reviewed by the Board or the Governance Effectiveness Committee for any potential conflicts. A conflict of interest is any circumstance, relationship (financial or otherwise), activity or decision (made in the course of governance, management or professional responsibilities or otherwise) that adversely influences or appears to adversely influence the ability of a covered person to: 1) make objective decisions on behalf of BHS and/or 2) act in the best interests of BHS in a manner consistent with the tax-exempt purposes of BHS. The Board or Committee will determine by a majority vote of disinterested directors whether the disclosed financial or special interest may result in a conflict of interest. Form 990, Part VI, Section B, line 15 COMPENSATION DETERMINATION PROCESS: Annually in September, the BHS Compensation Committee reviews the compensation, including base compensation and incentive compensation, for the CEO and all officers and key employees of BHS. The BHS Compensation Committee is comprised of independent Board Members. The Committee retains a Compensation Consultant to advise the Committee and who provides data as to comparable compensation for similarly qualified persons in functionally comparable positions at similarly situated healthcare organizations. The Committee reviews this information in approving annual base and incentive compensation and other items of reportable compensation described on Schedule J of the IRS Form 990. The decisions of the Committee regarding compensation are contemporaneously documented in the minutes of the Committee. Annually, the Committee Chairperson and the Compensation Consultant provide a report on executive compensation to the full Board of Directors of BHS. Form 990, Part VI, Section C, line 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO GENERAL PUBLIC: In adherence to the Master Trust Indenture among BHS and U.S. Bank National Association, as Master Trustee, dated as of February 1, 2009, BHS reports its financial results on a quarterly basis to the Master Trustee who in turn makes them available through Electronic Municipal Market Access. Additionally, the organization will provide any documents open to public inspection upon request. Form 990, Part VII HOURS WORKED FOR RELATED ORGANIZATION: Officers for BHS provide services to BHS and its subsidiaries. Hours worked are not tracked on an entity by entity basis. Therefore, all officers' hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week for all entities. Form 990, Part XI, line 9: MIS Funding 15,805,464. Capitalized Interest -12,301. Transfer JV Fund 1,574,939. Physician Entity Funding -143,975,587. Other Changes -2,732,800. IS Depreciation -8,445,333. Post Retirement Change -6,209,852. Balance Sheet Transfer 6,071,526. Capital Released 2,829,036. Baptist Health Network Partners LLC 2501 Kentucky Avenue Paducah KY 42001 454290974 Physician Network KY 1334714 0 BHSI Baptist Health Care Partners LLC 2701 Eastpoint Parkway Louisville KY 40223 474067700 ACO KY 0 0 BHSI Baptist Health Medical Group Inc 2701 Eastpoint Parkway Louisville KY 40223 205497203 Physician Services KY 501(c)(3) Line 3 BHSI 1 Baptist Health Richmond Inc PO Box 1600 Richmond KY 40476 610461940 Hospital KY 501(c)(3) Line 3 BHSI 1 Baptist Health Madisonville Inc 900 Hospital Drive Madisonville KY 42431 610654587 Hospital KY 501(c)(3) Line 3 BHSI 1 Mercy Regional Emergency Medical Systems 126 Lone Oak Road Paducah KY 42001 611310466 Ambulance Service KY 501(c)(3) Line 12a, I BHSI 1 Medical Center Ambulance Services Inc 629 Lafoon Street Madisonville KY 42431 610946210 Ambulance Service KY 501(c)(3) Line 10 N/A 1 Baptist Health Foundation Richmond Inc 2701 Eastpoint Parkway Louisville KY 40223 311506378 Fundraising KY 501(c)(3) Line 12a, I BHSI 1 Baptist Health Foundation Madisonville Inc 2701 Eastpoint Parkway Louisville KY 40223 472893430 Fundraising KY 501(c)(3) Line 12a, I BHSI 1 Baptist Health Foundation Corbin Inc 2701 Eastpoint Parkway Louisville KY 40223 473033550 Fundraising KY 501(c)(3) Line 12a, I BHSI 1 Baptist Health Foundation Lexington Inc 1740 Nicholasville Road Lexington KY 40503 611480774 Fundraising KY 501(c)(3) Line 12a, I BHSI 1 Baptist Health Foundation Paducah Inc 2501 Kentucky Avenue Paducah KY 42003 264057759 Fundraising KY 501(c)(3) Line 12a, I BHSI 1 Baptist Health Foundation Greater Louisville Inc 4000 Kresge Way Louisville KY 40207 200292291 Fundraising KY 501(c)(3) Line 12a, I BHSI 1 Baptist Healthcare Foundation Inc 2701 Eastpoint Parkway Louisville KY 40223 311122867 Fundraising KY 501(c)(3) Line 12a, I BHSI 1 Pattie A Clay Hospital Auxiliary PO Box 1600 Richmond KY 40476 510172717 Hospital Support KY 501(c)(3) Line 12a, I BHSI 0 Baptist East Milestone Fitness Center 750 Cypress Station Road Louisville KY 40207 611355065 Fitness Center KY BHSI Excluded 350039 3526646 0 0 0.50230 Baptist Physicicans Surgery Center 1720 Nicholasville Road Lexington KY 40503 043665929 Ambulatory Surgery Center KY BHSI Related 1070102 2874199 0 0 0.53380 Baptist Eastpoint Surgery Center 2400 Eastpoint Parkway Louisville KY 40223 260834852 Ambulatory Surgery Center KY BHSI Related 20030 581959 0 0 0.84000 Medical Associates of Middletown 4000 Kresge Way Louisville KY 40207 200399400 Medical Office Building KY BHSI Related 7174 791031 0 0 0.35000 Baptist Health Performance Training 2701 Eastpoint Parkway Louisville KY 40223 473567887 Sports Training KY BHSI Related -28795 0 1 Cumberland Valley Surgical Center LLC PO Box 1620 Corbin KY 40701 611348280 Ambulatory Surgery Center IN BHSI Related 471890 4062397 0 0 0.51000 1931 West Street 2701 Eastpoint Parkway Louisville KY 40223 831709486 Real Estate KY BHSI Related 0 0 1.00000 Baptist Ventures Inc 2701 Eastpoint Parkway Louisville KY 40223 611217018 Management KY BHSI C 91712 1 Baptist Health Plan Inc 651 Perimeter Park Lexington KY 40517 611241101 Insurance KY BHSI C -5417534 1.00000 1 MS Community Health Inc 2701 Eastpoint Parkway Louisville KY 40223 611303514 Health Clinic KY BHMG C 1.00000 1 0 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 Baptist Community Health Services Inc J 1897434 Cost Baptist Community Health Services Inc O 120418 Cost Baptist Community Health Services Inc Q 193459 Cost Baptist Community Health Services Inc R 143105 Cost Baptist Health Care Partners Inc Q 197007 Cost Baptist Health Employer Solutions Inc Q 60000 Cost Baptist Health Foundation Corbin Inc B 88340 Cost Baptist Health Foundation Lexington Inc C 270395 Cost Baptist Health Foundation Madisonville Inc R 282792 Cost Baptist Health Foundation of Greater Louisville Inc C 390074 Cost Baptist Health Foundation of Greater Louisville Inc B 588213 Cost Baptist Health Foundation Paducah Inc C 383477 Cost Baptist Health Foundation Paducah Inc B 319862 Cost Baptist Health Foundation Richmond Inc R 60004 Cost Baptist Health Madisonville Inc S 1090673 Cost Baptist Health Madisonville Inc Q 26891260 Cost Baptist Health Madisonville Inc P 76195 Cost Baptist Health Medical Group Inc J 7477571 Cost Baptist Health Medical Group Inc Q 30441109 Cost Baptist Health Medical Group Inc R 36496184 Cost Baptist Health Medical Group Inc O 583671 Cost Baptist Health Medical Group Inc P 26891043 Cost Baptist Health Plan Inc S 211593 Cost Baptist Health Richmond Inc Q 16937602 Cost Baptist Health Richmond Inc S 6087308 Cost Baptist Healthcare Foundation Inc B 497844 Cost Baptist Ventures Inc R 850088 Cost Cumberland Valley Surgical Center LLC S 200719 Cost