STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

JAY HOSPITAL INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
JAY HOSPITAL INC (EIN 59-2425149)
Tax period
2018-10-01 to 2019-09-30
Filed
2020-08-14
IRS object ID
202042279349302389
Schema version
2018v3.3
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-08-14T16:31:11-05:00ReturnTs
Tax Period End2019-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11201 Walnut Suite 1700AddressLine1Txt
CityKansas CityCityNm
State AbbreviationMOStateAbbreviationCd
ZIP641062246ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN592425149EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jay Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% KEITH STRICKLINGInCareOfNm
Business Name ControlJAYHBusinessNameControlTxt
Phone8504344714PhoneNum

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL GLEASONPersonNm
Person TitleSVP/CFOPersonTitleTxt
Phone8504697643PhoneNum
Signature2020-08-17SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMichael J EnglePreparerPersonNm
PTINP00482834PTIN
Phone8162216300PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id43372220202275000029FederalOriginalSubmissionId
Federal Original Submission Id2020-08-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdFA4F4C84F68B5DDAF0A2DCD3C7CFD580C8845502AtSubmissionCreationDeviceId
At Submission Filing Device Id355CC2E4B6E27E32DAADC48E1CA8D97843AD7DA8AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMichael T HutchinsPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11717 N E ST STE 320AddressLine1Txt
CityPENSACOLACityNm
State AbbreviationFLStateAbbreviationCd
ZIP32501ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$12,681,384GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.ebaptisthealthcare.org/JayHospitalWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1983FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionDEDICATED TO MEETING THE HEALTHCARE NEEDS IN THE JAY, CENTURY, FLOMATON AND SURROUNDING COMMUNITIES IN THE NORTHWEST FLORIDA-SOUTH ALABAMA AREA.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee160TotalEmployeeCnt
Total Volunteers31TotalVolunteersCnt
Total Gross UBI$65,229TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$12,263NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$50,000CYContributionsGrantsAmt
PY Program Service Revenue$11,676,109PYProgramServiceRevenueAmt
CY Program Service Revenue$12,122,955CYProgramServiceRevenueAmt
PY Investment Income$2,029PYInvestmentIncomeAmt
CY Investment Income$32,096CYInvestmentIncomeAmt
PY Other Revenue$536,672PYOtherRevenueAmt
CY Other Revenue$436,599CYOtherRevenueAmt
PY Total Revenue$12,214,810PYTotalRevenueAmt
CY Total Revenue$12,641,650CYTotalRevenueAmt
PY Grants And Similar Paid$14,800PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$13,300CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,839,632PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,543,923CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,570,318PYOtherExpensesAmt
CY Other Expenses$9,050,794CYOtherExpensesAmt
PY Total Expenses$16,424,750PYTotalExpensesAmt
CY Total Expenses$16,608,017CYTotalExpensesAmt
PY Revenues Less Expenses-$4,209,940PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,966,367CYRevenuesLessExpensesAmt
Total Assets BOY$3,710,947TotalAssetsBOYAmt
Total Assets EOY$4,060,215TotalAssetsEOYAmt
Total Liabilities BOY$12,360,968TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,650,879TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$8,650,021NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,409,336NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$12,257,766ExpenseAmt
Revenue$12,122,955RevenueAmt
DescGENERAL AND SPECIALIZED HEALTH CARE SERVICES INCLUDING INPATIENT, PRIMARY CARE, LONG TERM AND OUTPATIENT HEALTHCARE SERVICES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$13,300ExpenseAmt
Grant$13,300GrantAmt
DescCOMMUNITY BENEFIT OUTREACH ACTIVITIES CONDUCTED BY THE ORGANIZATION INCLUDING HEALTH EDUCATION SEMINARS, HEALTH FAIRS, AND DONATIONS TO OTHER NON-PROFIT ENTITIES.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$12,271,066TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee160EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKEITH STRICKLINGPersonNm
Phone8506758024PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line114114 ALABAMA STREETAddressLine1Txt
CityJayCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32565ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Ronald E Jackson
MEMBER/CHAIRMAN1.02.0Yes (X)Yes (X)$0$0$0
KIM JERNIGAN DMD
MEMBER1.01.0Yes (X)$0$0$0
Ricky W Smith
MEMBER/SECRETARY1.01.0Yes (X)Yes (X)$0$0$0
MICHAEL J MAZENKO
MEMBER/TREASURER1.01.0Yes (X)Yes (X)$0$0$0
LUTHER TAYLOR
MEMBER/VICE CHAIRMAN1.02.0Yes (X)Yes (X)$0$0$0
JOHN HEER
MEMBER1.01.0Yes (X)$0$0$0
ADM ROBERT KELLY
MEMBER1.01.0Yes (X)$0$0$0
JOHN M KIZZIAH
MEMBER1.01.0Yes (X)$0$0$0
THOMAS F OWENS
MEMBER1.01.0Yes (X)$0$0$0
DOUG SPRAGUE
MEMBER1.01.0Yes (X)$0$0$0
KARA CARDONA
MEMBER1.01.0Yes (X)$0$0$0
REV LONNIE WESLEY
MEMBER-TERM ENDED 03/31/191.01.0Yes (X)$0$0$0
STEPHANIE WHITE
MEMBER1.01.0Yes (X)$0$0$0
DAVID HAWKINS
MEMBER-TERM START 4/1/191.01.0Yes (X)$0$0$0
SHIRLEY HENDERSON
MEMBER-TERM START 4/1/191.01.0Yes (X)$0$0$0
MICHAEL HUTCHINS
VP/ADMINISTRATOR40.00.0Yes (X)$270,461$0$27,632
MICHAEL GLEASON
SVP/CFO5.045.0Yes (X)$0$751,473$137,170
BYRON SCOTT RAYNES
PRESIDENT-JHI/EXEC VP-BHC10.040.0Yes (X)$0$716,438$144,666
DANIEL D SHEPPARD
PHARMACIST40.00.0$124,049$0$28,136Yes (X)
GEORGIA W AGRAIT
NURSE PRACTITIONER40.00.0$103,182$0$12,275Yes (X)
KARIN PARDUE
PHYSICIAN40.00.0$178,148$0$25,990Yes (X)
GREG W PETTY
REHAB SERVICES DIRECTOR40.00.0$105,493$0$12,049Yes (X)
KATHRYN R HUNT
PHYSICIAN40.00.0$101,795$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$883,128TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,467,911TotReportableCompRltdOrgAmt
Total Other Compensation$387,918TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonMark Elder DOPersonNm

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line12946 GREYSTONE DRAddressLine1Txt
CityPACECityNm
State AbbreviationFLStateAbbreviationCd
ZIP32571ZIPCd
FieldValueIRS element (for citing)
ServicesPhysician ServicesServicesDesc
Compensation$255,424CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
All Other Contributions$50,000AllOtherContributionsAmt
Total Contributions$50,000TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REVENUEDesc
Business621990BusinessCd
Total Revenue Column$12,122,955TotalRevenueColumnAmt
Related Or Exempt Func Income$12,057,726RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$65,229UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$12,122,955TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$406TotalRevenueColumnAmt
Exclusion$406ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$12,710RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$8,044RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$4,666RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,666TotalRevenueColumnAmt
Exclusion$4,666ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$31,690OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$31,690OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,690TotalRevenueColumnAmt
Exclusion$31,690ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA SALES722210$22,883$22,883
MEDICAL RECORDS541900$3,062$3,062
MISCELLANEOUS REVENUE900099$405,988$405,988

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$405,988TotalRevenueColumnAmt
Exclusion$405,988ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$431,933OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,641,650TotalRevenueColumnAmt
Related Or Exempt Func Income$12,057,726RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$65,229UnrelatedBusinessRevenueAmt
Exclusion$468,695ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$13,300TotalAmt
Program Services$13,300ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$293,731TotalAmt
Program Services$234,985ProgramServicesAmt
Management And General$58,746ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,953,798TotalAmt
Program Services$5,391,715ProgramServicesAmt
Management And General$562,083ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$165,654TotalAmt
Program Services$149,225ProgramServicesAmt
Management And General$16,429ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$713,936TotalAmt
Program Services$643,129ProgramServicesAmt
Management And General$70,807ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$416,804TotalAmt
Program Services$375,466ProgramServicesAmt
Management And General$41,338ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,452,248TotalAmt
Program Services$160,868ProgramServicesAmt
Management And General$2,291,380ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$15,819TotalAmt
Management And General$15,819ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,202,978TotalAmt
Program Services$842,818ProgramServicesAmt
Management And General$360,160ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$929TotalAmt
Program Services$929ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$179,919TotalAmt
Program Services$120,488ProgramServicesAmt
Management And General$59,431ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$9,188TotalAmt
Program Services$8,954ProgramServicesAmt
Management And General$234ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$287,629TotalAmt
Program Services$258,219ProgramServicesAmt
Management And General$29,410ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$33,826TotalAmt
Program Services$10,152ProgramServicesAmt
Management And General$23,674ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$463,499TotalAmt
Management And General$463,499ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$400,940TotalAmt
Program Services$340,799ProgramServicesAmt
Management And General$60,141ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$104,282TotalAmt
Management And General$104,282ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT EXPENSE$2,787,261$2,787,261
MEDICAL SUPPLIES$696,676$696,676
INDIGENT ASSESSMENT$120,320$120,320
FOOD COSTS$98,041$96,754$1,287

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$197,239TotalAmt
Program Services$19,008ProgramServicesAmt
Management And General$178,231ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$16,608,017TotalAmt
Program Services$12,271,066ProgramServicesAmt
Management And General$4,336,951ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$66,462BOYAmt
EOY$114,407EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$881,239BOYAmt
EOY$1,424,045EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$131,395BOYAmt
EOY$151,811EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$63,516BOYAmt
EOY$48,576EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,537,394LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$10,216,018LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,568,335BOYAmt
EOY$2,321,376EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
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Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
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Intangible Assets IntangibleAssetsGrp

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BOY$0BOYAmt
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Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,710,947BOYAmt
EOY$4,060,215EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$855,855BOYAmt
EOY$798,457EOYAmt

Grants Payable GrantsPayableGrp

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Deferred Revenue DeferredRevenueGrp

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Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
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Escrow Account Liability EscrowAccountLiabilityGrp

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Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
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FieldValueIRS element (for citing)
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Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
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EOY$594,960EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
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EOY$1,650,879EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$8,650,021BOYAmt
EOY$2,409,336EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$8,650,021BOYAmt
EOY$2,409,336EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,710,947BOYAmt
EOY$4,060,215EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$3,966,367ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$15,025,724OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

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

Total Grassroots Lobbying TotalGrassrootsLobbyingGrp

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

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$2,730FilingOrganizationsTotalAmt
Affiliated Group Total$212,140AffiliatedGroupTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$2,730FilingOrganizationsTotalAmt
Affiliated Group Total$212,140AffiliatedGroupTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$16,605,287FilingOrganizationsTotalAmt
Affiliated Group Total$1,005,353,949AffiliatedGroupTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$16,608,017FilingOrganizationsTotalAmt
Affiliated Group Total$1,005,566,089AffiliatedGroupTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Filing Organizations Total$980,401FilingOrganizationsTotalAmt
Affiliated Group Total$1,000,000AffiliatedGroupTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Filing Organizations Total$245,100FilingOrganizationsTotalAmt
Affiliated Group Total$1,428,773AffiliatedGroupTotalAmt
FieldValueIRS element (for citing)
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Current Year Minus3$1,000,000CurrentYearMinus3Amt
Current Year Minus2$1,000,000CurrentYearMinus2Amt
Current Year Minus1$1,000,000CurrentYearMinus1Amt
Current Year$1,000,000CurrentYearAmt
Total$4,000,000TotalAmt
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$232,507CurrentYearMinus3Amt
Current Year Minus2$246,919CurrentYearMinus2Amt
Current Year Minus1$249,769CurrentYearMinus1Amt
Current Year$212,140CurrentYearAmt
Total$941,335TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Current Year Minus3$250,000CurrentYearMinus3Amt
Current Year Minus2$250,000CurrentYearMinus2Amt
Current Year Minus1$250,000CurrentYearMinus1Amt
Current Year$250,000CurrentYearAmt
Total$1,000,000TotalAmt
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmt

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$0CurrentYearMinus3Amt
Current Year Minus2$0CurrentYearMinus2Amt
Current Year Minus1$0CurrentYearMinus1Amt
Current Year$0CurrentYearAmt
Total$0TotalAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,182,808OtherCostOrOtherBasisAmt
Depreciation$176,381DepreciationAmt
Book Value$1,006,427BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,591,085OtherCostOrOtherBasisAmt
Depreciation$3,692,117DepreciationAmt
Book Value$898,968BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,524,927OtherCostOrOtherBasisAmt
Depreciation$6,304,067DepreciationAmt
Book Value$220,860BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$176,381OtherCostOrOtherBasisAmt
Depreciation$43,453DepreciationAmt
Book Value$132,928BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,321,376TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DUE TO THIRD PARTIES$457,969
ASSET RETIREMENT OBLIGATION$136,991
FieldValueIRS element (for citing)
Total Liability$594,960TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE D, PART XIIIFormAndLineReferenceDesc
ExplanationFinancial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 740, Income Taxes, prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC Topic 740 provides guidance for recognition threshold and measurement attributes for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. There were no material uncertain tax positions as of September 30, 2019 and 2018.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$676,581TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$676,581NetCommunityBenefitExpnsAmt
Total Expense0.04900TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,855,976TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,028,629DirectOffsettingRevenueAmt
Net Community Benefit Expns$827,347NetCommunityBenefitExpnsAmt
Total Expense0.05990TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,532,557TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,028,629DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,503,928NetCommunityBenefitExpnsAmt
Total Expense0.10890TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Total Community Benefit Expns$13,300TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,300NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Total Community Benefit Expns$13,300TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,300NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Total Community Benefit Expns$2,545,857TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,028,629DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,517,228NetCommunityBenefitExpnsAmt
Total Expense0.10990TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$2,787,261BadDebtExpenseAmt
Bad Debt Expense Attributable$674,517BadDebtExpenseAttributableAmt
Reimbursed By Medicare$3,998,762ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$6,324,328CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$2,325,566MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JAY HOSPITALBusinessNameLine1Txt

US Address USAddress

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1JAY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLebaptisthealthcare.org/community/CHNAOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLwww.ebaptisthealthcare.org/community/CHNAStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Section CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Section CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Section CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5The CHNA process was facilitated by The Live Well Partnership (Live Well), a nonprofit organization whose mission is to sponsor community health status assessments for Escambia and Santa Rosa Counties in Florida and to support and promote collaborative initiatives that address identified health priorities. An effort was made to involve individuals from many different sectors of the local economy in developing this CHNA. The Live Well Board of Directors, which includes health providers, social service organizations and business interests formed the backbone of the CHNA process. A Steering Committee, consisting of the Live Well Board and other community organizations, was established to provide guidance and input throughout data gathering and analysis. The Steering Committee provided input on their perceptions of health and health services, reviewed health outcomes, narrowed the focus to the top four priorities in each county, and approved this report. Below is a roster of both the CHNA Planning Committee and CHNA Steering Committee. CHNA Planning Committee - responsible for planning, data collection/analysis, communication and report writing . Brett Aldridge, Baptist Health Care . Myesha Arrington, Community Health Northwest Florida . Amy Barron, Sacred Heart Health System . Nora Bailey, Live Well Partnership . Paula Bides, Ascension Florida . John Clark, Council on Aging . Carter Craddock, Baptist Health Care . Denice Curtis, University of West Florida, College of Health . Matt Dobson, Florida Department of Health - Santa Rosa . Krystle Fernandez, Baptist Health Care . John Hartman, University of West Florida, College of Health . Michelle Hill, Florida Department of Health - Santa Rosa . Bethany Miller, Sacred Heart Health System . Kimberly Pace, Florida Department of Health - Escambia . Ann Papadelias - Community Health Northwest Florida . Sandra Park-O'Hara, Florida Department of Health - Santa Rosa . Patrick Shehee - Florida Department of Health - Escambia . Chandra Smiley, Community Health Northwest Florida . Daudet Tshiswaka, University of West Florida, College of Health . Versilla Turner, Florida Department of Health - Escambia . Debra Vinci, University of West Florida, College of Health CHNA Steering Committee - responsible for guiding the CHNA process, reviewing data, providing feedback and setting priorities . Achieve Escambia . Ascension Florida . Baptist Health Care . Baptist Hospital . Children's Home Society of Florida . Community Health Northwest Florida . Community Drug & Alcohol Council . Council on Aging of Northwest Florida . Covenant Care . Emerald Coast Utility Authority . Escambia County School District . Ever'man Cooperative Grocery & Caf . Feeding the Gulf Coast . FL Department of Children & Families . FL Dept of Health - Escambia . FL Dept of Health - Santa Rosa . Good Samaritan Clinic . Gulf Breeze Hospital . Gulf Coast African American Chamber . Health & Hope Clinic . Jay Hospital . J L Maygarden Company . Lakeview Center . Live Well Partnership . Manna Food Pantries . Open Doors NW FL . Pensacola Bay Baptist Association . Pensacola News Journal . Sacred Heart Health System . Santa Rosa County . Santa Rosa County School District . Santa Rosa Medical Center . Town of Century . United Way of Escambia . University of West Florida . Walmart . Waterfront Mission . YMCA of Northwest Florida
SCHEDULE H, Part V, Section B, Line 6aThe CHNA process was facilitated by The Live Well Partnership (Live Well), a nonprofit organization whose mission is to sponsor community health status assessments for Escambia and Santa Rosa Counties in Florida and to support and promote collaborative initiatives that address identified health priorities. The CHNA Planning Committee and Steering Committee included representation from Baptist Health Care and its affiliates (including Baptist, Gulf Breeze and Jay Hospitals), Ascension Sacred Heart and Santa Rosa Medical Center.
SCHEDULE H, Part V, Section B, Line 6bNon-hospital stakeholder members of the CHNA Planning Committee and Steering Committee included representatives from the Florida Departments of Health in Escambia and Santa Rosa Counties, Community Health Northwest Florida (a federally qualified health center), the University of West Florida as well as a variety of community organizations including business, social service organizations, school districts, local utility companies, county government, to name a few.
SCHEDULE H, Part V, Section B, Line 11Baptist Health Care recognized that sustained community health improvement happens when organizations from all sectors of the community landscape take ownership of the community's health and work together for improvement. While health providers can lead the charge, all sectors of the community must be engaged and committed to alignment of resources across sectors to better serve families. Following the completion of the 2019 CHNA, Baptist worked with other community partners who had together formed the Live Well Partnership for Healthy Communities to begin working toward an expanded, more comprehensive model for approaching health and wellness in the community. There are two parts in this enhanced collaborative approach: 1. Expansion of the former approach to a true cross-sector collective impact effort that engages others outside of the traditional health provider partners. Health partner meetings led to a convening of cross- sector community leaders to determine if there was an interest among other sectors to engage in this work. With over 75 thought leaders from the community in attendance at a convening in April of 2019, the response was overwhelmingly positive for moving forward with this new approach to health and wellness in the community. Learning from the efforts of Achieve Escambia, a collective impact effort focused on educational outcomes, the group began the process to launch Achieve Healthy EscaRosa, with a purpose of working together to improve the health and well-being of Escambia and Santa Rosa counties so that all can thrive. The Mission of this new organization is to unite and align resources to achieve a healthy community where all can thrive. The Vision is a community where everyone lives well and thrives. 2. Convening community partners in focus groups for each prioritized areas of focus from the 2019 CHNA. The health departments have led the charge on the implementation of these sessions with the purpose of gaining additional insights from partners and developing strategic goals and objectives to truly "move the needle" toward improvement in these areas of focus. In late 2019, in light of additional insights from the community, to be more aligned with the Florida Community Health Improvement Plan (CHIP), and to be more effective with community health improvement efforts, the partners determined it was imperative to align the prioritized areas of focus across counties. Therefore, the updated, aligned prioritized focus areas are: Diabetes Mental health (substance abuse is now a component of this focus area) Child health (infant health is now a component of this focus area) Multiple focus group sessions for each of these focus areas were held in 2019 with hundreds of stakeholders attending the sessions. Feedback has been gathered to identify underlying causes, community concerns and promising practices that can be considered in Community Health Improvement Plans Achieve Healthy EscaRosa creation hosted a community convening in February of 2020, during which hundreds of community members were introduced to the priority focus areas and other health metrics through a data walk. Participants were encouraged to engage in the effort. Input received at the convening is being incorporated into a plan for the formal creation of Achieve Healthy EscaRosa that will then become the governing body for the implementation of community health improvement actions as well as future CHNAs in this community. Current goals for the collaborative include: 1. Develop a successful collective impact model that creates a common agenda, establishes shared measurements, fosters mutually reinforcing activities, encourages continuous communication, and has a strong backbone convener. Strategies to achieve this goal include broad, cross-sector engagement; establishment of strategic plan; and implementation of a governance structure including formalizing the role of the already-existing data team to identify the metrics of focus for each priority focus area to ultimately be a component of a broader online community data dashboard. 2. The Community Health Improvement Planning (CHIP) process will be owned by the community. Strategies to achieve this goal include the February 2020 community convening event; development of marketing tools and additional civic engagement opportunities; and formalization of a communications team to support this work. 3. Identified Priority Focus Areas will be addressed by broad, cross-sector collective action networks (CANs). Strategies to achieve this goal include leveraging the focus groups and their participants to transform from focus groups providing input to action teams taking on project to improve outcomes. Community champions and project managers will be identified and goals and strategic, actionable projects will be implemented in 2020/2021. Baptist Health Care serves as a leader and convener of these efforts, and is actively engaged in multiple ways in this enhanced approached to health and wellness in the communities we serve. The way we are addressing health and wellness in this community is evolving, and we will continue to evolve our practices to support this enhanced approach. This implementation plan includes both the work we are doing with community partners to improve our approach and outcomes from a community perspective (described above) and the actions we are currently engaged in and planning in the hospitals within Baptist Health Care. Access to Care: . Increase access to health education by providing opportunities for community health education . Develop passive education tool to improve understanding of access to care . Participate in collaborative efforts lead by the Partnership for a Healthy Community to increase access to health care
SCHEDULE H, PART V, SECTION C, LINE 16A-CTHE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY CAN BE FOUND AT THE FOLLOWING WEB ADDRESS: https://www.ebaptisthealthcare.org/PatientFinancialResources
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CENTURY MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

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

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H , PART I, LINE 3CIN ADDITION TO THE FPG THE ORGANIZATION USES AN ASSET TEST, MEDICAL INDINGENCY, INSURANCE/UNDERINSURANCE STATUS, AND RESIDENCY IN DETERMINING FREE OR DISCOUNTED CARE.
SCHEDULE H, PART I, LINE 7The costing methodology used in determining the amount reported on Line 7 is the cost to charge ratio calculated pursuant to the IRS schedule H worksheet 2 instructions.
SCHEDULE H, PART I, LINE 7, COLUMN (F)BAD DEBT EXPENSE IN THE AMOUNT OF $2,787,261 WAS SUBTRACTED FROM TOTAL EXPENSES PER FORM 990, PART IX, LINE 25 FOR PURPOSES OF CALCULATING THE PERCENTAGE FOR LINE 7, COLUMN (F).
SCHEDULE H, PART III, LINE 2 AND 4THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORT HAS BEEN FOLLOWED IN ACCORDANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS, AND SUBSEQUENT RECOVERIES ARE ADDED. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. THE HOSPITAL PROVIDES SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, SUCH SERVICES ARE NOT REPORTED AS NET REVENUE. THE HOSPITAL'S CHARITY CARE POLICY UTILIZES THE GENERALLY RECOGNIZED FEDERAL POVERTY INCOME LEVELS. FOR PATIENTS WHO DO NOT APPLY OR DO NOT QUALIFY, THE UNCOLLECTED AMOUNTS ARE RECOGNIZED AS BAD DEBT EXPENSE. ESTIMATED COST OF BAD DEBT IS BASED ON THE RATIO OF COST TO CHARGES AS DETERMINED BY HOSPITAL SPECIFIC DATA.
SCHEDULE H, PART III, LINE 3BAD DEBT IS NOT INCLUDED AS PART OF JAY HOSPITAL'S COMMUNITY BENEFIT. APPROXIMATELY 24.2% OF JAY HOSPITAL'S PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE. THIS MEANS THAT APPROXIMATELY $674,517, OR 24.2%, OF JAY'S HOSPITAL'S BAD DEBT EXPENSE COULD BE INCLUDED AS COMMUNITY BENEFIT HAD THOSE INDIVIDUALS GONE THROUGH THE FINANCIAL ASSISTANCE PROCESS.
SCHEDULE H, PART III, LINE 8THE MEDICARE SHORTFALL WAS NOT INCLUDED IN THE COMMUNITY BENEFIT COST, AND THE COSTING METHODOLOGY CONSISTED OF INFORMATION FROM THE ORGANIZATIONS MEDICARE COST REPORT. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE ENTIRE COST OF PROVIDING CARE TO MEDICARE PATIENTS CAUSING THE ORGANIZATION TO USE OTHER SURPLUS FUNDS TO COVER THE SHORTFALL. HOWEVER, THE ORGANIZATION PROVIDES CARE TO MEDICARE PATIENTS REGARDLESS OF THIS SHORTFALL, WHICH RELIEVES THE STATE AND FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR THE CARE OF MEDICARE BENEFICIARIES.
SCHEDULE H, PART III, LINE 9BPATIENTS ARE DEEMED FINANCIALLY INDIGENT IF (A) THEY ARE UNINSURSED OR UNDERINSURED AND (B) THEIR INCOME IS BELOW 200% OF FPL (BASED UPON THE PATIENT'S HOUSEHOLD INCOME AS DEFINED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES IN THE FEDERAL REGISTER AS THE FEDERAL POVERTY LEVEL (FPL) GUIDELINES). IF A PATIENT IS FOUND TO BE FINANCIALLY INDIGENT OR MEDICALLY INDIGENT, APPROPRITE FINANCIAL ASSISTANCE DISCOUNTS ARE APPLIED TO THE PATIENTS ACCOUNT. FOR ANY PATIENT THAT QUALIFIES UNDER THE ORGANIZATION'S CHARITY CARE POLICY, THE PATIENT ACCOUNT IS WRITTEN OFF AS CHARITY CARE AND THE ORGANIZATION DOES NOT PURSUE ANY COLLECTIONS.
SCHEDULE H, PART VI, LINE 2Part of the organization's mission is to improve the quality of life for people and communities served. In response to this mission, the organization helps ensure that all citizens are afforded access to health care by investing in community health, and by participating in and leading collaborative, community-wide partnerships. Free health screenings, support groups, education seminars, and other programs that are offered focus on areas that have been identified through internal studies and external sources as critical health concerns in the surrounding communities. A full copy of the hospital's Community Health Needs Assessment can be accessed using the following website: https://www.ebaptisthealthcare.org/community/CHNA
SCHEDULE H, PART VI, LINE 3JAY EMPLOYEES WORKING IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS AREAS HAVE BEEN TRAINED TO BE FULLY VERSED IN ALL FINANCIAL ASSISTANCE-RELATED POLICIES, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND BE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE REPRESENTATIVES. FOR NON-EMERGENCY PURPOSES, EVERY FILE FOR A PATIENT THAT HAS PRE-SCHEDULED AN OFFICE VISIT OR PROCEDURE IS REVIEWED BEFORE THE PATIENT ARRIVES AT THE HOSPITAL. A FINANCIAL COUNSELOR IS ASSIGNED TO THAT PATIENT IF IT IS DETERMINED THAT THE INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ETC. ALSO, WHEN A PATIENT RECEIVES A BILL, THE ORGANIZATION INCLUDES PAPERWORK EXPLAINING THAT FINANCIAL ASSISTANCE IS AVAILABLE. JAY HOSPITAL HAS POSTED MULTILINGUAL NOTICES OF FINANCIAL ASSISTANCE POLICIES IN THE EMERGENCY DEPARTMENT. SAID NOTICES HAVE BEEN PUBLISHED IN ENGLISH AND SPANISH, AND HAVE BEEN MADE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. JAY HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM, PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS FOR APPLYING FOR ASSISTANCE. ALSO, JAY HOSPITAL HAS POSTED A SUMMARY OF ITS CURRENT CHARITY CARE POLICY ON ITS INTERNET WEBSITE.
SCHEDULE H, PART VI, LINE 4JAY HOSPITAL, INC. OPERATES IN SANTA ROSA COUNTY, FLORIDA. APPROXIMATELY 184,000 INDIVIDUALS RESIDE IN THIS COUNTY, 9.5% OF WHICH LIVE BELOW POVERTY LEVEL. WHEN CONSIDERING THESE FACTORS, MORE THAN 18,000 RESIDENTS COULD BE ELIGIBLE TO QUALIFY FOR CHARITY CARE. APPROXIMATELY 24.2% OF JAY HOSPITAL'S PATIENTS DURING FY2019 WERE UNINSURED OR WERE MEDICAID RECIPIENTS. THREE HOSPITALS, INCLUDING JAY HOSPITAL, ARE LOCATED IN SANTA ROSA COUNTY.
SCHEDULE H, PART VI, LINE 5THE ORGANIZATION DOES NOT LIMIT MEDICAL STAFF PRIVILEGES TO THE ORGANIZATION'S EMPLOYED PHYSICIANS BUT EXTENDS THOSE PRIVILEGES TO QUALIFIED PHYSICIANS FOR MOST AREAS OF SERVICE. THE ORGANIZATION'S BOARD OF DIRECTORS PRIMARILY CONSISTS OF COMMUNITYLEADERS AND RESIDENTS WHO ARE INDEPENDENT OF THE ORGANIZATION. THE ORGANIZATION STRIVES TO EDUCATE ALL BOARD MEMBERS REGARDING THE HEALTH NEEDS OF THE COMMUNITY AND HOW THESE NEEDS RELATE TO THE ORGANIZATION'S MISSION AND VALUES. THE ORGANIZATION SEEKS TO STRATEGICALLY ALLOCATE AVAILABLE FUNDS TO BENEFIT THE SURROUNDING COMMUNITIES. FOCUS AREAS INCLUDE INCREASING THE TYPES OF CARE TO BE PROVIDED TO THE COMMUNITY, IMPROVING THE QUALITY OF PATIENT CARE, AND FURTHERING MEDICAL EDUCATION AND RESEARCH.
SCHEDULE H, PART VI, LINE 6ALTHOUGH THE ORGANIZATION MAY OPERATE IN DIFFERENT SERVICE AREAS WHEN COMPARED TO ITS AFFILIATES, ALL AFFILIATES WORK COLLABORATIVELY TO ENSURE THAT THE NEEDS OF THE COMMUNITIES ARE BEING ADDRESSED. THE ORGANIZATION PARTICIPATES IN MANY FREE HEALTH SCREENINGS, SUPPORT GROUPS, EDUCATION SEMINARS, AND HEALTH FAIRS THAT BENEFIT ALL COMMUNITIES WITHIN THE SYSTEM AND ARE NOT LIMITED TO THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. AFFILIATED ENTITIES INCLUDE: - BAPTIST HEALTH CARE CORPORATION - PARENT ORGANIZATION PROVIDING STRATEGIC MANAGEMENT AND SUPPORT SERVICES - BAPTIST HOSPITAL, INC. - OPERATES BAPTIST HOSPITAL AND GULF BREEZE HOSPITAL - BAPTIST HEALTH CARE FOUNDATION, INC. - PROVIDES FINANCIAL AND FUNDRAISING ASSISTANCE FOR ALL AFFILIATES - LAKEVIEW CENTER, INC. AND AFFILIATES - PROVIDE BEHAVIORAL HEALTH AND PROTECTIVE SERVICES, LOW-COST HOUSING, AS WELL AS VOCATIONAL SERVICES AND EMPLOYMENT FOR PEOPLE WITH DISABILITIES. - BAPTIST URGENT CARE, LLC DELIVER AMBULATORY ARE IN A DEDICATED MEDICAL FACILITY OUTSIDE OF A TRADITIONAL EMERGENCY ROOM.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Santa Rosa Community ClinicBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15520 Stewart StreetAddressLine1Txt
CityMiltonCityNm
State AbbreviationFLStateAbbreviationCd
ZIP32570ZIPCd
FieldValueIRS element (for citing)
Recipient EIN311746599RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$12,500CashGrantAmt
Purpose Of GrantHealthcarePurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2FormAndLineReferenceDesc
ExplanationWithin one year, the organization requests documentation from the recipient regarding proper use of funds provided for indigent patients.ExplanationTxt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MICHAEL HUTCHINS
VP/ADMINISTRATOR$172,060$0$53,415$0$44,986$0$11,298$0$16,334$0$298,093$0$0$0
MICHAEL GLEASON
SVP/CFO$0$556,802$0$158,635$0$36,036$0$116,930$0$20,240$0$888,643$0$0
DANIEL D SHEPPARD
PHARMACIST$123,609$0$0$0$440$0$1,248$0$26,888$0$152,185$0$0$0
KARIN PARDUE
PHYSICIAN$89,226$0$88,895$0$27$0$0$0$25,990$0$204,138$0$0$0
BYRON SCOTT RAYNES
PRESIDENT-JHI/EXEC VP-BHC$0$544,735$0$149,871$0$21,832$0$111,989$0$32,677$0$861,104$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1ATHE FOLLOWING OFFICERS/KEY EMPLOYEES RECEIVED TAX GROSS-UP PAYMENTS THAT WERE INCLUDED IN THEIR W-2 TAXABLE WAGES: --MICHAEL HUTCHINS
SCHEDULE J, PART I, LINE 4BACCRUED -------- MICHAEL GLEASON $110,055 MICHAEL HUTCHINS $6,923
SCHEDULE J, PART IITHE RELATED COMPENSATION REPORTED ON FORM 990, PART VII, SECTION A & SCHEDULE J, PART II WAS PAID BY THE FOLLOWING RELATED ORGANIZATION: --BAPTIST HEALTH CARE CORPORATION

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 1HELPING PEOPLE THROUGHOUT LIFE'S JOURNEY: JAY HOSPITAL'S PRIMARY MISSION IS DEDICATED TO MEETING THE HEALTHCARE NEEDS IN THE JAY, CENTURY, FLOMATON, AND SURROUNDING COMMUNITIES IN THE NORTHWEST FLORIDA-SOUTH ALABAMA AREA. JAY HOSPITAL IS A 55-BED ACUTE CARE FACILITY AND PART OF AN INTEGRATED NETWORK OF AFFILIATED ORGANIZATIONS. JAY HOSPITAL AND ITS AFFILIATED ORGANIZATIONS ARE COMMITTED TO PROVIDING A BROAD RANGE OF GENERAL AND SPECIALIZED HEALTH CARE SERVICES INCLUDING INPATIENT, PRIMARY CARE, LONG TERM AND OUTPATIENT HEALTHCARE SERVICES. QUALITY MEDICAL CARE IS PROVIDED TO ALL PERSONS REQUIRING IMMEDIATE TREATMENT REGARDLESS OF THEIR ABILITY TO PAY.
FORM 990, PART V, LINE 1AALL 1099'S ARE ISSUED ON THE ORGANIZATION'S BEHALF BY BAPTIST HOSPITAL INC., A RELATED TAX EXEMPT ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 2MICHAEL GLEASON AND MICHAEL HUTCHINS HAVE A BUSINESS RELATIONSHIP. THE BUSINESS RELATIONSHIP IS AN EMPLOYER/EMPLOYEE RELATIONSHIP AT RELATED TAX-EXEMPT ORGANIZATIONS. RONALD E. JACKSON AND LUTHER TAYLOR HAVE A BUSINESS RELATIONSHIP WITH MICHAEL GLEASON. RONALD E. JACKSON AND LUTHER TAYLOR ARE BOARD MEMBERS OF BAPTIST HEALTH CARE CORPORATION AND MICHAEL GLEASON IS AN OFFICER OF BAPTIST HEALTH CARE CORPORATION, CREATING AN EMPLOYER/EMPLOYEE RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6BAPTIST HEALTH CARE CORPORATION, A FLORIDA CORPORATION NOT-FOR-PROFIT, IS THE SOLE MEMBER OF JAY HOSPITAL, INC. BAPTIST HEALTH CARE CORPORATION HAS THE RIGHT TO ELECT THE BOARD OF DIRECTORS OF JAY HOSPITAL, INC.
FORM 990, PART VI, SECTION A, LINE 7ABAPTIST HEALTH CARE CORPORATION, BEING THE SOLE MEMBER OF JAY HOSPITAL, INC. HAS THE RIGHT TO ELECT THE GOVERNING BODY OF JAY HOSPITAL, INC.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING SHALL REQUIRE APPROVAL BY THE BAPTIST HEALTH CARE CORPORATION, THE SOLE MEMBER, BOARD OF DIRECTORS: A. ELECTION OF THE DIRECTORS OF THE CORPORATION AT THE ANNUAL MEETING OF THE MEMBERS FROM AMONG THOSE PERSONS NOMINATED BY THE BAPTIST HEALTH CARE CORPORATION NOMINATING COMMITTEE. B. REMOVAL OF A DIRECTOR OF THE CORPORATION WITH OR WITHOUT CAUSE WHENEVER SUCH ACTION WOULD BE IN THE BEST INTEREST OF THE CORPORATION C. ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE. D. APPOINTMENT OF THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION E. ANY CONTRACT OR PURCHASE ORDER IN EXCESS OF $1,000,000 IN ADVANCE F. THE INCURRENCE BY THE CORPORATION OF ANY INDEBTEDNESS IN EXCESS OF $1,000,000 BEFORE SUCH INDEBTEDNESS IS CONTRACTED AND BEFORE EVIDENCE OF SUCH INDEBTEDNESS IS ISSUED G. ANNUAL CAPITAL AND OPERATING BUDGETS OF THE CORPORATION H. TRANSFER ASSETS BY THE CORPORATION DURING ANY FISCAL YEAR OF ASSETS EXCEEDING $100,000 IN NET VALUE
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS PREPARED BY A FLORIDA LICENSED CPA WHO IS AN EMPLOYEE OF A RELATED TAX-EXEMPT ORGANIZATION, BAPTIST HEALTH CARE, INC., AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM.THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S MANAGEMENT PERSONNEL. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S MANAGEMENT PERSONNEL HAS ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN MADE AVAILABLE TO THE EXECUTIVE COMPENSATION COMMITTEE AND ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990 WITH THE IRS. ALL BOARD MEMBERS ARE INFORMED THAT A PAPER COPY OF THE FORM 990 IS AVAILABLE AT THE ORGANIZATION'S PRINCIPAL OFFICE.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS AND OFFICERS RECEIVE CORRESPONDENCE EACH YEAR THAT MUST BE COMPLETED AND SIGNED. THE CORRESPONDENCE INCLUDES A CONFLICTS OF INTEREST QUESTIONAIRE. OFFICERS AND KEY STAFF ALSO RECEIVE AN ATTESTATION FORM THAT MUST BE SIGNED CONFIRMING THAT THEY WILL DISCLOSE ANY CONFLICTS THAT VIOLATE THE ORGANIZATION'S POLICY. THE BOARD REVIEWS ALL CONFLICTS AND DETERMINES IF FURTHER ACTIONS NEED TO BE TAKEN.
FORM 990, PART VI, SECTION B, LINE 15AEACH YEAR, THE COMPENSATION COMMITTEE OF THE BAPTIST HEALTH CARE CORPORATION BOARD UTILIZES INDEPENDENT COMPENSATION STUDIES THAT REFLECT THE CURRENT MARKET VALUE OF SPECIFIC KEY MANAGEMENT POSITIONS AS BENCHMARK DATA. ALL COMPENSATION OF KEY INDIVIDUALS MUST BE APPROVED BY THE BAPTIST HEALTH CARE COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION HAS ALL GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE ANNUAL FINANCIAL STATEMENTS ON FILE IN THE ACCOUNTING AND ADMINISTRATION DEPARTMENTS. ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9EQUITY TRANSFER $15,025,724

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
BAPTIST HEALTH CARE CORPORATION
1717 N E STREETPENSACOLAFL32501592425151HEALTHCAREFL501(c)(3)12cNAfalse
BAPTIST HEALTH CARE FOUNDATION
1717 N E STREETPENSACOLAFL32501590192265FUNDRAISINGFL501(c)(3)7BHCYes (true)
BAPTIST HOSPITAL INC
1000 WEST MORENO STREETPENSACOLAFL32501590657322HEALTHCAREFL501(c)(3)3BHCYes (true)
CMHC HERNANDEZ HOUSE INC
1221 WEST LAKEVIEW AVEPENSACOLAFL32501592041794LOW COST HOUSFL501(c)(3)10LCIYes (true)
LAKEVIEW CENTER INC
1221 WEST LAKEVIEW AVENUEPENSACOLAFL32501590737872HEALTHCAREFL501(c)(3)7BHCYes (true)
LAKEVIEW PLACE INC
1221 WEST LAKEVIEW AVEPENSACOLAFL32501592804577LOW COST HOUSFL501(c)(3)10LCIYes (true)
LAKEVIEW VILLA INC
1221 WEST LAKEVIEW AVEPENSACOLAFL32501592842486LOW COST HOUSFL501(c)(3)10LCIYes (true)
GLOBAL CONNECTIONS TO EMPLOYMENT INC
1221 WEST LAKEVIEW AVEPENSACOLAFL32501472592811VOC TRAININGFL501(C)(3)7LCIYes (true)
ABLE FORCES INC
1221 WEST LAKEVIEW AVEPENSACOLAFL32501270881311VOC TRAININGVA501(C)(3)10GCEYes (true)
CHAUTAUQUA OFFICES OF PSYCHOTHERAPY AND
1221 WEST LAKEVIEW AVEPENSACOLAFL32501591469145COUNSELINGFL501(C)(3)7LCIYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
BAPTIST MEDICAL PARK SURGERY CENTER LLC
9400 UNIVERSITY PKWYPENSACOLAFL32514593535262AMBULATORY SUFLNAN/A
ANDREWS INSTITUTE ASC LLC
1040 GULF BREEZE PKWYGULF BREEZEFL32561352274952AMBULATORY SUFLNAN/A
LIGHTHOUSE HEALTH PLAN LLC
1717 NORTH E STREET STE 320PENSACOLAFL32501823182832HEALTH INS. PFLNAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
BAPTIST HEALTH VENTURES INC
1717 NORTH E STPENSACOLAFL32501592415910ADMINISTRATIVFLNAC CORPYes (true)
PENSACOLA POB INC
1717 NORTH E STPENSACOLAFL32501592462399LEASING AGENTFLNAC CORPYes (true)
MOBILE DIAGNOSTICS INC
1717 NORTH E STPENSACOLAFL32501592864191MEDICAL SERVIFLNAC CORPYes (true)
MEDICAL PROFESSIONAL AGENCY INC
1717 NORTH E STPENSACOLAFL32501592555835MEDICAL SERVIFLNAC CORPYes (true)
THE TOWERS PHARMACY INC
1717 NORTH E STPENSACOLAFL32501592667929RETAIL SALESFLNAC CORPYes (true)
LANGHORNE CARDIOLOGY CONSULTANTS INC
1717 NORTH E STPENSACOLAFL32501592874324MEDICAL SERVIFLNAC CORPYes (true)
LAKEVIEW ASSOCIATED ENTERPRISES-PHASE I
1221 W LAKEVIEW AVEPENSACOLAFL32501611711170FRANCHISINGFLNAC CORPYes (true)
LAKEVIEW ASSOCIATED ENTERPRISES-PHASE II
1221 WEST LAKEVIEW AVEPENSACOLAFL32501465458197FRANCHISINGFLNAC CORPYes (true)
PARCEL 27 LAND CONDOMINIUM ASSOC INC
1221 W LAKEVIEW AVEPENSACOLAFL32501821313799CONDO ASSOCIAFLNAC CORPYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1BAPTIST HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeMTransactionTypeTxt
Involved$194,092InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt

Affiliated Group Schedule AffiliatedGroupSchedule

Affiliated Schedule AffiliatedScheduleGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINElecting OrganizationElectingOrganizationIndTotal Grassroots LobbyTotalGrassrootsLobbyAmtTotal Direct LobbyTotalDirectLobbyAmtTotal Lobby ExpenditureTotalLobbyExpenditureAmtOther Exempt Purpose ExpendOtherExemptPurposeExpendAmtTotal Exempt Purpose ExpendTotalExemptPurposeExpendAmtLobby NontxLobbyNontxAmtGrassroots NontxGrassrootsNontxAmtTotal Lobby Grssroot Mns NontxTotalLobbyGrssrootMnsNontxAmtTot Lbby Expend Mns Lobby NontxTotLbbyExpendMnsLobbyNontxAmtShare Excess Lobby ExpendShareExcessLobbyExpendAmt
BAPTIST HEALTH CARE CORPORAT
PO BOX 17500PENSACOLAFL325227500592425151Yes (X)$0$111,681$111,681$66,778,845$66,890,526$1,000,000$250,000$0$0$0
BAPTIST HEALTH CARE FOUNDATI
PO BOX 17500PENSACOLAFL325227500590192265Yes (X)$0$0$0$2,113,409$2,113,409$255,670$63,918$0$0$0
BAPTIST HOSPITAL INC
PO BOX 17500PENSACOLAFL325227500590657322$0$37,729$37,729$611,449,757$611,487,486$1,000,000$250,000$0$0$0
CMHC HERNANDEZ HOUSE INC
1221 W LAKEVIEW AVENUEPENSACOLAFL325011836592041794$0$0$0$49,263$49,263$9,853$2,463$0$0$0
JAY HOSPITAL INC
PO BOX 17500PENSACOLAFL325227500592425149$0$2,730$2,730$16,605,287$16,608,017$980,401$245,100$0$0$0
LAKEVIEW PLACE INC
1221 W LAKEVIEW AVENUEPENSACOLAFL325011836592804577$0$0$0$99,909$99,909$19,982$4,996$0$0$0
LAKEVIEW VILLA INC
1221 W LAKEVIEW AVENUEPENSACOLAFL325011836592842486$0$0$0$141,166$141,166$28,233$7,058$0$0$0
LAKEVIEW CENTER INC
1221 W LAKEVIEW AVENUEPENSACOLAFL325011836590737872$0$60,000$60,000$133,548,273$133,608,273$1,000,000$250,000$0$0$0
GLOBAL CONNECTIONS TO EMPLOY
1221 WEST LAKEVIEW AVEPENSACOLAFL32501472592811$0$0$0$169,149,006$169,149,006$1,000,000$250,000$0$0$0
CHAUTAUQUA OFFICES OF PSYCHO
59-1469145PENSACOLAFL32501591469145$0$0$0$5,419,034$5,419,034$420,952$105,238$0$0$0