2019-07-15T15:13:00-05:00 2018-08-31 346565596 Ernst & Young US LLP 1900 Scripps Center 312 Walnut Street Cincinnati OH 45202 990 2017-09-01 610654587 Baptist Health Madisonville Inc BAPT 2708255201 900 Hospital Drive Madisonville KY 42431 Robert Ramey President 5028965000 2019-07-15 1 Tricia M Johnson P00627205 5136121400 199.180.18.1 2019-07-15 15:11:34 ED P FA60C453B91CE9B21EC1A1F550E0928D4421809B 8121CA463AABFA4EFE5158FD2073B628CA1C8F6D 2017 2019-02-21 02:37:17Z Stephen R Oglesby 2701 Eastpoint Pkwy Louisville KY 40223 189395574 0 X www.baptisthealthmadisonville.com X 1956 KY Our mission is to demonstrate the love of Christ by providing and coordinating care and improving health in our communities. Our vision is to lead in clinical excellence, compassionate care, and growth to meet the needs of our patients. Baptist Health Madisonville will live out its Christ-centered mission and achieve its vision guided by integrity, respect, excellence, collaboration and joy. 11 9 1744 72 1519 0 1416685 1840470 148681259 175314924 3263063 2424878 27817776 7275748 181178783 186856020 340682 165659 0 0 85163531 77562590 0 0 0 97926133 95907871 183430346 173636120 -2251563 13219900 177861150 185362108 15253540 16164915 162607610 169197193 X Our mission is to demonstrate the love of Christ by providing and coordinating care and improving health in our communities. Our vision is to lead in clinical excellence, compassionate care, and growth to meet the needs of our patients. Baptist Health Madisonville will live out its Christ-centered mission and achieve its vision guided by integrity, respect, excellence, collaboration and joy. 0 0 161340271 165659 177855947 See Schedule O. 161340271 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 1 1 1 0 0 0 0 0 1 1 1 1 0 1 X 0 0 1744 1 1 1 0 0 0 0 0 0 0 0 0 X 11 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 KY X Stephen R Oglesby 5028965000 2701 Eastpoint Parkway Louisville KY 40223 Linda Thomas PHD Chairman & Director 1.00 0.00 X X 0 3000 0 Steven R Cox Chairman (through 12/31/17) & Dir 1.00 0.00 X X 0 3000 0 Amy Sanderson Director 1.00 0.00 X 0 3000 0 Janet R Berry Director 1.00 0.00 X 0 3000 0 Jason Vincent Director 1.00 0.00 X 0 3000 0 Kent T Mills Director 1.00 0.00 X 0 3000 0 Ron Poole Director 1.00 0.00 X 0 3000 0 Diana Nims Director & Physician 40.00 0.00 X 305002 0 18198 Kevin Ray Cotton Director (Effective 1/1/18) 1.00 0.00 X 0 0 0 Michael Allen Davenport Director (Effective 1/1/18) 1.00 0.00 X 0 0 0 Linda Q Zellich Director (Through 5/22/17) 1.00 0.00 X 0 1500 0 Barry Eveland Vice Chair (1/1/18) & Director 1.00 0.00 X X 0 3000 0 Ursula Dugger Assistant Secretary 40.00 0.00 X 52224 0 2344 Gerard Colman CEO (Effective 1/1/18) 1.00 40.00 X 0 71385 11927 Robert Ramey President 40.00 0.00 X 0 363033 17032 Janet Norton VP and Secretary 1.00 40.00 X 0 628702 33269 Stephen R Oglesby VP and Treasurer 1.00 40.00 X 0 520100 95344 William McColl Medical Physicist 40.00 0.00 X 221211 0 28966 Richard Blair Physician 40.00 0.00 X 219407 0 2548 Robert L Wood Physician 40.00 0.00 X 289210 0 29993 Tara Henson Physician 40.00 0.00 X 218522 0 12317 Kimberly Ashby Vice President of Finance 40.00 0.00 X 205694 0 8540 Stephen C Hanson System CEO (Through 3/17) 0.00 0.00 X 0 1926660 29111 Andy Sears Vice Chair (Through 12/14) 0.00 40.00 X 0 197472 11721 Isaac Myers MD Vice President 0.00 40.00 X 0 600201 126729 1511270 4333053 428039 48 1 1 0 Southeastern Emergency Physicians 3920 Dutchmans Lane Louisville KY 40207 Medical Staffing 2025961 One Anesthesia PLLC 320 Whittington Parkway Louisville KY 40222 Medical Staffing 1599336 Aramark CTS Inc 12483 Collections Center Drive Chicago IL 60693 Hospital Services 1501190 Laboratory Corporation of America 531 South Spring Street Burlington NC 27215 Hospital Services 1484436 Horizon Healthcare Management 6200 E Columbia Street Evansville IN 47715 Medical Staffing 742723 24 1544187 296283 1840470 Patient Service Rev 621110 162342386 162340867 1519 Home Health & Hospice 621610 5522219 5522219 Fam Practice Residency 611600 3774847 3774847 Other 611600 2833457 2833457 Anesthesia Program 611600 842015 842015 175314924 1092174 1092174 4557276 2539554 2017722 2017722 2017722 1185475 147229 0 0 1185475 147229 1332704 1332704 Call Coverage 900001 2473645 2473645 Cafeteria Sales 722210 1818503 1818503 Fitness Center 541700 474903 474903 490975 68897 422078 5258026 186856020 177855947 1519 7158084 X 165659 165659 3332707 3332707 1775 1775 60806989 59763788 1043201 1527816 1509204 18612 7247221 5761684 1485537 4646082 4115979 530103 1627522 977831 649691 47635 47635 10236 10236 30001613 25955850 4045763 33782 31187 2595 3065299 2526910 538389 12800 9000 3800 3529265 2629618 899647 760511 305839 454672 59933 43054 16879 155899 155899 5443206 4833530 609676 3431146 2553257 877889 Medical Supplies 33345571 33345571 Purchased Svcs-Non-Med 10925727 10122366 803361 Provider Tax 2578946 2578946 Dues and Subscriptions 374326 274674 99652 504454 501842 2612 173636120 161340271 12295849 0 13152 13216 6885589 4439195 25470533 26703357 15381 15181 3620174 3682838 2007928 505189 123733846 47589886 76487933 76143960 58064181 63716724 5296279 10142448 177861150 185362108 8700068 11106220 5437352 4635466 1116120 423229 15253540 16164915 X 162492386 168887523 115224 309670 162607610 169197193 177861150 185362108 X 13219900 3195047 -9825364 X 0 1 X 1 1 1 X 0 1 0 0 0 0 0 0 1 10236 10236 0 Part II-B, Line 1: The organization and certain employees are members of various associations that attribute a portion of their dues to lobbying expense. The organization has disclosed a lobbying expense allocation of $10,236 per Form 990. These associations include the American Medical Association, the Kentucky Hospital Association, the Kentucky Medical Association, and various others. 115224 194271 175 309670 181325 66101 115224 171094 890 171984 164488 5625 -981 171094 164559 4023 4094 164488 1.00000 0 0 9879050 9879050 63495671 8130780 55364891 47318951 39027866 8291085 3040174 431240 2608934 76143960 Reimbursements Receivable 10142448 10142448 Third Party Payables 423229 423229 X Part V, Line 4: Endowment funds are used to support patient care initiatives. Part X, Line 2: Baptist Healthcare System, Inc. 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, 2018. Tax years that are open include the years from 2014 to 2017. 1 1 1 X 1 X 1 1 1 0 1 1 4414890 1433715 2981175 0.01900 35424669 35424669 39839559 36858384 2981175 0.01900 902974 0 902974 0.00580 6383952 530973 5852979 0.03740 8000465 7522049 478416 0.00310 200000 0 200000 0.00130 1111535 0 1111535 0.00710 16598926 8053022 8545904 0.05470 56438485 44911406 11527079 0.07370 1 866332 47788137 45595618 2192519 X 1 1 1 1 Baptist Health Madisonville 900 Hospital Drive Madisonville KY 42431 www.baptisthealthmadisonville.com 100184 X X X Baptist Health Madisonville 1 0 0 1 X X X X X X X X 17 1 0 0 1 X www.baptisthealthmadisonville.com X X 1 17 1 www.baptisthealthmadisonville.com 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X www.baptisthealthmadisonville.com X www.baptisthealthmadisonville.com X www.baptisthealthmadisonville.com X X X X X X 1 X 0 X X X X X 1 X 0 0 Baptist Health Madisonville Part V, Section B, Line 5: Baptist Health Madisonville has formed a community health coalition with other healthcare, civic, governmental and educational organizations in the area for the purpose of working collaboratively to identify and address the medical and socioeconomic factors impacting the health of the people in its region. Bringing these groups together may help avoid duplication of efforts in data collection and resource allocation. Through these contacts and public surveys, Baptist Health Madisonville collected primary data and feedback on the health issues confronting its service area.Baptist Health Madisonville's Community Health Needs Assessment committee met to develop the public survey instrument and identify mechanisms by which the survey would be distributed to reach a representative sample of the population, to include demographic groups often underrepresented in public data gathering and to consider all the information.A survey of area residents, including the hospital employee base, provided primary data.To secure a representative sample, the committee determined that the survey should be made available in both online and printed formats. For the online survey, the group used the Qualtrics system at the University of Kentucky College of Public Health to host the survey, collect and analyze the data.There were also 750 copies of the printed survey distributed by members of the community health coalition to ensure that socioeconomic groups that were unlikely to, or unable to participate in the online survey were represented. The committee decided to design a more detailed survey than in the past that would provide information on not just medical factors, but also socioeconomic factors that influenced health and the ability to access health and health related resources. The final survey consisted of 60 questions and took approximately 10 to 15 minutes to complete. Five hundred sixty four (564) service area residents were surveyed from the April 15, 2018, to June 15, 2018.The committee enlisted the assistance of the University of Kentucky College of Public Health in gathering and processing the information. They discussed the data presented and created a list of the health issues identified in both primary and secondary data sources. After robust interaction, the committee prioritized the list and discussed various ways the hospital could help to meet these needs. Secondary data from demographic and socioeconomic sources, Kentucky vital statistics, disease prevalence records and health indicators and statistics were collected from national, state and local sources. Baptist Health Madisonville Part V, Section B, Line 7d: Availability of CHNA Report:Copies of the 2018 CHNA were distributed internally and externally to those who participated in the needs assessment - both individuals and organizations. Results from the 2018 CHNA have also been communicated in the following methods:--Posting the written report of the assessment on the hospital's website.--Posting on the website of another local organization with a link to Baptist Health Madisonville's assessment.--Providing the website address where the document can be accessed through several media communications.www.baptisthealthmadisonville.com Baptist Health Madisonville Part V, Section B, Line 11: The committee identified and prioritized community needs for the service area that Baptist Health Madisonville can address and affect by implementing programs, increasing the awareness of health issues and their impact and by increasing the availability of educational resources and preventive screenings. The priority issues are:1. Access - Five of the top six survey responses regarding family health issues were related to access. These include access to primary care, access to specialists, the availability of behavioral/mental health treatment resources and the availability of substance abuse treatment programs.2. Obesity - This was the second greatest concern in the community for health issues; all three service area counties had a higher percentage of obesity than the average in Kentucky, which is known for having one of the worst ratings in the U.S. for obesity. Obesity and the many health problems and diseases associated with it, including diabetes, heart disease and cancer have a major impact on the community.3. Cancer - While this was not rated in the top five concerns for family health issues in the survey, it was a greater concern to the committee members based on the survey results and the secondary data gathered.4. Management of Chronic Diseases - Hypertension, diabetes, and heart disease ranked high on the surveys and were combined by the committee into this category.5. Child Abuse/Neglect and Bullying - The committee identified this as an issue and noted that senior abuse and neglect was also a pressing concern of the community.The most notable health needs not addressed at this time are mental health and substance abuse. Unfortunately, most of rural America is without the necessary resources to adequately address the pandemic increase in people who are impacted by these problems. Our service area is no different. According to the Kentucky State Police Annual Report, Hopkins County is ranked in the top 75th percentile for drug arrests in the state of Kentucky. Substance abuse and treatment options were the top rated community health concern in our service area. BHM does not have the resources that would be required to affect the changes that are needed to adequately address the lack of mental health and substance abuse care in its service area. However, we continue to explore potential partnerships and internal strategies to find a way to provide these essential services to our patients, and every effort will be made to assist our existing mental health and substance abuse providers in maintaining and/or expanding the services that they currently provide.The need for inpatient mental health services was partially met when BHM opened an adult psychiatry unit in the fall of 2015 through a services agreement with Horizon Health for a 20 bed inpatient adult behavioral health unit at the hospital which provides an additional 20 inpatient beds for our service area.It is not within the scope of Baptist Health Madisonville'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 and collaboration with other community stakeholder organizations and agencies that these issues are being addressed. Baptist Health Madisonville works collaboratively with other community resources to provide support and 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 and uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city and county governments and county health departments. Baptist Health Madisonville Part V, Section B, Line 13b: Based on the information provided in the FAPapplication and/or through the presumptive eligibility process, a patientor guarantor whose income is less than 200% of the current Federal PovertyGuideline for his or her family size is eligible for a full discount underthe FAP after all other healthcare resources have been utilized andexhausted. A patient or guarantor whose income is greater than 200% butless than 400% of the current Federal Poverty Guideline for his or herfamily size is eligible for a sliding scale discount after all otherhealthcare resources have been utilized and exhausted. Baptist Health Madisonville Part V, Section B, Line 20e: Prior to referring individuals to a collection agency, BHM processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance. Part V, Section B, Line 3e The hospital facility did include a prioritized list of the community's significant health needs in its CHNA report. 3 1 - Baptist Health Sports Medicine & Rehab 500 Clinic Drive Madisonville KY 42431 Rehab Services 2 - Baptist Health Hospice 418 North Scott Street Madisonville KY 42431 Hospice Care 3 - Baptist Health Transitional Care 900 Hospital Drive Madisonville KY 42431 Skilled Nursing Facility Part I, Line 7: Costing Methodology:A cost-to-charge ratio based on the most recent as-filed Medicaid cost report was used to calculate the amounts reported on each line of the table. Part I, Line 7g: No physician clinic costs are included in the costs of subsidized health services. 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:Per the financial statements of Baptist Healthcare System, Inc. (which include the activity of Baptist Health Madisonville), there is no bad debt footnote for the current year. The amount on line 2 was calculated using a cost-to-charge ratio. Part III, Line 8: Treatment of Medicare shortfall as community benefit: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.Medicare Costing Methodology: Medicare 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. Part III, Line 9b: Collection practices: Once a patient has been determined to qualify for charity care, the patient is classified as such for three months. If the patient returns for services within three months, they are automatically qualified for charity care, which improves their access to healthcare services. Part VI, Line 2: NEEDS ASSESSMENT: The community served by the hospital was defined by utilizing inpatient and outpatient data regarding patient origin. Population demographics and socioeconomic characteristics of the community were gathered and reported utilizing various third parties. The health status of the community was then reviewed. Information on the leading causes of death and morbidity information was analyzed in conjunction with health outcomes and factors reported for the community by countyhealthrankings.org. Health factors with significant opportunity for improvement were noted. An inventory of health care facilities and resources were prepared and the estimated demand for physician and hospital services were evaluated. Community input was provided through key information interviews and surveys. Information gathered was analyzed and reviewed to identify health issues of uninsured persons, low-income persons, minority groups and the community as a whole. Health needs were ranked utilizing a weighting method and then prioritized taking into account the perceived degree of influence the hospital has to impact the need. Information gaps were identified during the prioritization process and were reported. Part VI, Line 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:The organization identifies uninsured patients by requesting insurance information at the time of the appointment request. If the patient has no insurance benefits, appointment scheduling staff will inform the patient of the self-pay policy. Except for emergency room visits, new patients who are unable to pay at the time of service are provided services by financial counselors for education and assistance. Emergency department patients are not asked for payment or insurance upon registration or admission. During financial counseling, patients will be informed of the Kentucky Physicians Care Program (KPC) in coordination with the Disproportionate Share Hospital (DSH) Program. They will also be counseled on potential eligibility for Medicaid and disability programs. Patients will also be advised of the financial assistance policy and applications will be provided. Part VI, Line 4: COMMUNITY INFORMATION:The organization is based in Madisonville, Kentucky (Hopkins County) near interstate 69, approximately 50 miles south of Evansville, Indiana. The bulk of the community's population is concentrated in and around the city of Madisonville, with portions of the nearby counties of Webster and Muhlenberg also having significant discharge numbers. Approximately 22% of the community's population falls in the under 18 age range and 19% in the over 65 age range. Approximately 50% are female and 50% are male based on 2017 data. The area's healthy business climate boasts strong employment with a 5.72% unemployment rate. Part VI, Line 5: PROMOTION OF COMMUNITY HEALTH:The organization promotes the health of the community through an open medical staff, service on community boards, a 24 hour emergency department, an occupational medicine program, free athletic physicals, health fairs and screenings, courtesy memberships to a fitness center for athletes, police officers and fire department personnel, educational programs, athletic trainers at school events, and a centering pregnancy program.See also Schedule O, Part III, Line 4a for additional detail. Part VI, Line 6: AFFILIATED HEALTH CARE SYSTEM:Baptist Healthcare System, Inc. (BHS), Baptist Health Madisonville's parent company is also a non-profit organization that shares the same mission and supports the promotion of health in the local communities serviced by the organization as a whole. Part VI, Line 7, Reports Filed With States KY 1 Project Fit America PO Box 308 Boyes Hot Springs CA 95416 363730823 501(c)(3) 16756 General Support Hopkins County Board of Education 320 S Seminary Street Madisonville KY 42431 616001319 Government 10000 General Support MadisonvilleHopkins County Chamber of Commerce 15 East Center Street Madisonville KY 42431 610561820 501(c)(6) 18205 General Support Baptist Health Foundation Madisonville Inc 2701 Eastpoint Parkway Louisville KY 40223 472893430 501(c)(3) 115258 General Support 3 1 Part I, Line 2: There is a committee that is responsible for approving all donations. The committee selects the organization based on nonprofit criteria. An annual budget is established to determine the total amount of funds to be distributed each year. 1 1 0 0 0 0 0 1 0 Diana Nims Director & Physician 226974 0 76187 0 1841 0 8100 0 10098 0 323200 0 0 0 Robert Ramey President 0 343662 0 0 0 19371 0 8100 0 8932 0 380065 0 0 Janet Norton VP and Secretary 0 481488 0 50622 0 96592 0 8100 0 25169 0 661971 0 0 Stephen R Oglesby VP and Treasurer 0 441167 0 56558 0 22375 0 70285 0 25059 0 615444 0 0 William McColl Medical Physicist 219166 0 0 0 2045 0 6606 0 22360 0 250177 0 0 0 Richard Blair Physician 188981 0 28724 0 1702 0 0 0 2548 0 221955 0 0 0 Robert L Wood Physician 224751 0 61947 0 2512 0 8100 0 21893 0 319203 0 0 0 Tara Henson Physician 136160 0 82039 0 323 0 3293 0 9024 0 230839 0 0 0 Kimberly Ashby Vice President of Finance 205313 0 0 0 381 0 5820 0 2720 0 214234 0 0 0 Stephen C Hanson System CEO (Through 3/17) 0 342480 0 0 0 1584180 0 7607 0 21504 0 1955771 0 380763 Andy Sears Vice Chair (Through 12/14) 0 189209 0 0 0 8263 0 3082 0 8639 0 209193 0 0 Isaac Myers MD Vice President 0 571652 0 0 0 28549 0 106685 0 20044 0 726930 0 0 Part I, Line 3 Baptist Healthcare System, Inc., a related organization of Baptist Health Madisonville, Inc., uses the following to establish the compensation of the organization's CEO: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Written employment contract - Compensation survey or study - Approval by the Board or Compensation Committee. Part I, Lines 4a-b Line 4a: One former officer received a severance payment in 2017: Stephen Hanson $809,824 Line 4b: Two current and former officers and executives who participated in the Supplemental Executive Retirement Plan accrued amounts for 2017 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 participated in and accrued amounts from the Supplemental Executive Retirement Plan: Stephen R. Oglesby $62,185 Isaac Myers, MD $98,585 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: Stephen Hanson $767,496 Janet Norton $68,897 Part I, Line 7 Several physicians are compensated based upon an incentive compensation plan. The incentive compensation payments are not contingent upon gross revenues or net earnings of the organization, but are based upon the physician's individual productivity and quality measures. Schedule J: Certain executives receive a cell phone stipend. Gail Eveland Family Member-Dir 1775 Compensation 0 Form 990, Part III, Line 4a: Statement of Program Service Accomplishments: a. Baptist Health Madisonville is an acute care hospital serving numerous rural communities and offering a broad range of inpatient and outpatient services. Baptist Health Madisonville provides a substantial amount of charity care as detailed below in the Community Service section. Baptist Health Madisonville provided care for 6,949 inpatient adult, pediatric, and nursery admissions during fiscal year 2018. Patient days totaled 35,120 and there were 819 live births. Surgery visits totaled 10,355 for fiscal year 2018. Baptist Health Madisonville's Mahr Cancer Center is approved by the American College of Surgeons' Commission on Cancer, receiving the No. 1 overall rating. The Mahr Center provided over 24,000 treatments to patients during fiscal year 2018. b. The Baptist Health Madisonville Residency Program is an educational program in which hospital physicians instruct and work with residents. The Residency Program is affiliated with the University Of Louisville School Of Medicine. Eighteen residents were involved in the Residency Program during 2018. c. The Baptist Health Madisonville Medical Education and Research Center provides numerous educational programs that benefit the communities of Western Kentucky. In addition to the Family Practice Residency Program, the Center collaborates with Murray State University to offer a graduate degree in nurse anesthesia. The program is dedicated to graduating nurse anesthetists of the highest professional competence who are committed to returning to rural areas to practice and had 49 students during the fiscal year. Baptist Health Madisonville serves as the primary clinical site. The Baptist Health Madisonville Education and Research Center also coordinates the West Area Health Education Center (AHEC) program, connecting the academic health centers at the University of Kentucky and University of Louisville with medically underserved communities throughout the state, in an effort to address Kentucky health care access problems. The Center is a regional campus for the University Of Louisville School Of Medicine through the Center's off-campus Teaching Center. The Center provides individualized clinical training in a small-town environment, with a goal toward increasing the number of physicians in rural areas. The Center also is a location for the University of Kentucky's Center for Rural Health, created to improve the health status of the rural population of the state, and also sponsors the Delta Project for 20 counties in Kentucky. The goal of the Delta Project is to improve the health status and health care system in each county served. During the 2018 fiscal year 51,000 students were contacted in approximately 100 different schools. d. Baptist Health Hospice is a program assisting terminally ill patients and their families through the death and bereavement process. The Hospice program provided service for approximately 8,200 hospice days during the fiscal year. 2018 COMMUNITY SERVICE: Community Service Detail: Hours No. of Events Contacts Educational & Health Events: Improvement Events- 9,600 1,000 60,000 Community Events- 1,700 40 6,500 Donations/Support- 4,400 2,220 5,000 Total 15,700 3,260 71,500 CHARITY AND COMMUNITY BENEFIT CARE: Baptist Health Madisonville provides care to patients who meet guidelines established in the organization's charity care policy at no charge or at charges less than established rates. Other uncompensated care relates principally to contractual allowances for government payors, discounts taken by commercial payors and bad debts. The following summary quantifies additional community benefit expense in terms of uncompensated care, services to the indigent and benefits to the broader community during 2018: Uncompensated care: Bad debt expense (at cost) $866,000 Benefits for the poor: Traditional charity care $2,981,000 Total quantifiable benefits for the poor $3,847,000 Benefits for the broader community: Educational & Health Improvement Events $5,900,000 Donations/Support $1,112,000 Research $200,000 Total quantifiable benefits for the broader community $7,212,000 Total quantifiable community benefits $11,059,000 Community benefit expense represents approximately 7.5% of the total organization's expense for the period ended August 31, 2018. In addition to the above, Baptist Health Madisonville provides a wide range of community benefits including coordination of charitable activities by the organization's staff. Form 990, Part III, Line 4a: Statement of Program Service Accomplishments: EDUCATIONAL EVENTS: A component of Baptist Health Madisonville's mission is excellent care, every time. In order to support this mission, the organization strives to be involved in numerous educational programs. The Certified Registered Nurse Anesthesia Program has trained more than 299 nurses to become CRNAs since the program's inception. The University of Louisville/Baptist Health Madisonville Education and Research Center's Medical Campus provided training for 33 medical students, and provided educational activities for high school students interested in a medical career, including shadowing and enhancement classes. Centering Pregnancy Smiles is a partnership between UK, the Baptist Health Madisonville Education and Research Center, the Hopkins County Health Department, the national Centering Pregnancy initiative and other federal, state, and local leaders. The alliance, established to end the cycle of preterm births, low birth weight, and poor oral health in Kentucky, has already saved Kentucky more than $2.0 million in medical procedures needed by those babies at birth. In over 1,000 events, the Center has offered everything from tours to seminars to participation in community educational events. Baptist Health Madisonville maintains a website for consumer health education topics in both English and Spanish which includes daily consumer health news and interactive consumer health tools such as quizzes and calculators. The fees for maintaining this website were $12,000 in 2018. Other educational events sponsored or supported by the organization include the First Step Nursing Program and shadowing opportunities for students. Baptist Health Madisonville served over 3,000 individuals through health fairs and screenings in 2018 The Center provided blood sugar and blood pressure screenings regularly at satellite locations. Working with the Kentucky Cancer Program, The Mahr Cancer Center provided prostate cancer screenings and colorectal screenings. Baptist Health Madisonville provided free sports physicals to over 1,500 high school students in Hopkins, Christian, Crittenden, Caldwell, McLean, Webster, Union, Muhlenburg, Ohio, Trigg, Todd and Lyon counties. The organization also operates a full-time dedicated research center, established to ensure that the community has early access to promising new medicine and medical treatments. The support groups offered at no cost by the organization served over 500 patients and families with over 100 hours of employee time. These groups discuss such topics as Alzheimer's disease, cancer, diabetes, fibromyalgia, multiple sclerosis, asthma, and several others. To enhance access, some support groups are held at satellite locations. Most groups meet once or twice a month, typically at night for optimum patient convenience. This also requires staff to work additional hours above their normal workloads. The organization employs a full-time chaplain for our employees, patients, and guests, as well as a full-time chaplain for the Hospice program. These services, provided at a cost to the organization of over $70,000, include consultation, pastoral care, counseling, and in-service seminars. COMMUNITY EVENTS: Baptist Health Madisonville has always been an organization that the community looks to for support of community events. Whether it is financial support, the human resources of our employees, or both, the people of western Kentucky have come to rely on the organization to help make community events successful. In order to improve the general well-being of the communities served, the organization is involved in numerous community events, working with local organizations, schools and businesses to promote health and education through various events, such as Friday Night Live. Baptist Health Madisonville's real passion is health care. For that reason, we give emphasis to helping organizations with health care missions. BHM supports the March of Dimes, the Salvation Army, the 911 Heroes Run, the Take 10! Program, local 4-H Councils, the Boy Scouts and numerous other organizations. Form 990, Part III, Line 4a: Statement of Program Service Accomplishments: DONATIONS/SUPPORT: Baptist Health Madisonville supported its communities through financial and in-kind donations. Approximately 3,200 events were supported. Examples include giveaways for local school events, tours, in-class speakers, sponsorship of both school and non-school related ball teams, cheerleading, dance teams, community events, high school bands, and similar events, as well as financial support for community events at the Glema Mahr Center for the Arts. Baptist Health Madisonville's Fitness Formula fitness center provided free or discounted memberships during 2018 valued at over $800,000. The free or discounted memberships were given to coaches, athletes, senior citizens, employees, rehab patients, schools and other community organizations. The Sports Medicine Center provided free athletic trainer coverage at 6 area schools for all sports. In 2018, the organization provided direct financial support as well as insurance coverage for Baptist Health Madisonville care providers volunteering at the local community clinic. This clinic provides health care for the working poor. EMERGENCY: The Baptist Health Madisonville Emergency Department operates 24 hours a day, 365 days a year. In 2018, the department served over 25,403 patients. The department served as the area referral center for serious or traumatic injuries and disease. Care is provided regardless of ability to pay for medically necessary, non-elective care. VOLUNTEER DEPARTMENT: In 2018, Baptist Health Madisonville volunteers gave over 15,000 hours to the community. This program exists solely for service and is not a fund-raising group for the organization. Volunteers provide help to community members who use the hospital including the gift shop, waiting rooms, information desk, patient mail delivery and other areas. The program also offers nursing scholarships. Part V, Line 2b All employment tax returns are filed by Baptist Healthcare System, Inc., FEIN 61-0444707. Part I, Line 7g No physician clinic costs are included in the costs of subsidized health services. Part V, Line 1 Form 1096 is filed by Baptist Healthcare System, Inc., FEIN 61-0444707. Form 990, Part VI, Section A, line 6 Members or stockholders: The organization's sole member is Baptist Healthcare System, Inc. ("BHS"), a non-profit, tax-exempt corporation organized under and pursuant to the provisions of the law of the Commonwealth of Kentucky. Form 990, Part VI, Section A, line 7a Power to elect or appoint members: The Board of Directors of Baptist Health Madisonville, Inc. is appointed by Baptist Healthcare System, Inc., (BHS). Form 990, Part VI, Section A, line 7b Decisions reserved to members or stockholders: The consent & approval of the sole member shall be required for all major corporate actions, and any act the result of which would be to: a. Approve the mission, vision, and value of the corporation and amendments thereto; b. Approve amendments to the articles of incorporation and the bylaws of the corporation; c. Approve the strategic plan of the corporation; d. Approve the transfer or disposition of all or substantially all of the corporation's assets or investment or interest in any business enterprise; any merger, combination, or reorganization of the corporation; any liquidation, reorganization, or recapitalization of the corporation; or any agreement to do the foregoing; e. Approve the capital expenditure and operating budgets of the corporation, and any unbudgeted expenditures over $500,000; f. Selection of the corporation's auditor; g. Approve the incurrence of debt of the corporation above $500,000 or other amount established by BHS and the making of any capital expenditure above $500,000 or other amount established by BHS; h. Approve the appointment, removal, and evaluation of the president or chief executive officer of the corporation acting through the president and chief executive officer of BHS; i. Appoint or remove, with or without cause, the members of the board of directors of the corporation. Appointment and removal shall not require a recommendation of the corporation's board; j. Appoint or remove, with or without cause, the chair of the board of the corporation. Appointment and removal shall not require a recommendation of the corporation's board; k. Authorize execution of any contract, agreement, or similar instrument by which the corporation may be obligated to pay more than an amount established by BHS; l. Acquire any stock of any corporation or any equity in another corporate form, or invest in or acquire any interest in any business enterprise. Form 990, Part VI, Section B, line 11b Process used to review the Form 990: The internally prepared Form 990 is reviewed and approved by tax consultants. Copies are given to each voting member of the Board of Directors prior to filing for their review. The Form 990 is then presented at a monthly meeting of the hospital's Board of Directors. Form 990, Part VI, Section B, line 12c Monitoring and enforcement of compliance with conflict of interest policy: Conflict of Interest statements are completed for each board member, principal officer, and committee member with board delegated powers. The chairman of the Board of Directors is responsible for being familiar with the statements and identifying existing or contemplated transactions or relationships which may give rise to a conflict of interest. Affected board members, officers, and committee members are also responsible for bringing conflicts which they may be a part of to the attention of the Board. Such affected parties are required to withdraw from the meetings for the time in which the matter continues under discussion. If the matter is brought to a vote, the affected party will not vote on it. If the matter requires a special called meeting, the affected party will not be counted in establishing a quorum. The Board will also appoint a non-interested person to investigate alternatives to the proposed transaction. Form 990, Part VI, Section B, line 15 Compensation determination process: The President of Baptist Health Madisonville, Inc. is not an employee of Baptist Health Madisonville, Inc. but is an employee of Baptist Healthcare System, Inc., a tax-exempt 501(c)(3) organization which is the sole member of Baptist Health Madisonville, Inc. The President is compensated by Baptist Healthcare System, Inc. Annually in September, the Baptist Healthcare System, Inc. Compensation Committee reviews the compensation, including base compensation and incentive compensation for the President. The Baptist Healthcare System, Inc. 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 Baptist Healthcare System, Inc. The compensation of officers is either reviewed and approved by the Compensation Committee of the Baptist Healthcare System, Inc. Board or is reviewed and approved by the Baptist Healthcare System, Inc. President and CEO or the Baptist Health Madisonville President and CEO. The organization makes every effort to ensure that the compensation of all employees is reasonable and appropriate for the value of the services received by the organization. Form 990, Part VI, Section C, line 19 Process for making documents available to the public: The organization's governing documents, conflict of interest policy and financial statements are available upon request in the organization's administrative office. Form 990, Part IX, line 11g Adminstrative Services: Program service expenses 25,955,850. Management and general expenses 4,045,763. Fundraising expenses 0. Total expenses 30,001,613. Form 990, Part XI, line 9: Capitalized Interest 11,772. Physician Entity Funding -20,573,598. IS Depreciation 4,519,315. Other -4,402,536. InterCompany 10,619,683. Baptist Community Health Services Inc 2701 Eastpoint Parkway Louisville KY 40223 611141242 Medical Services KY 501(c)(3) Schedule A, Line 12a Baptist Healthcare System Inc 1 Baptist Health Foundation Corbin Inc 2701 Eastpoint Parkway Louisville KY 40223 473033550 Fundraising KY 501(c)(3) Schedule A, Line 12a Baptist Healthcare System Inc 1 Baptist Health Foundation Lexington Inc 1740 Nicholasville Rd Lexington KY 40503 611480774 Fundraising KY 501(c)(3) Schedule A, Line 12a Baptist Healthcare System Inc 1 Baptist Health Foundation Madisonville Inc 2701 Eastpoint Parkway Louisville KY 40223 472893430 Fundraising KY 501(c)(3) Schedule A, Line 12a Baptist Healthcare System Inc 1 Baptist Health Foundation of Greater Louisville Inc 4000 Kresge Way Louisville KY 402074604 200292291 Fundraising KY 501(c)(3) Schedule A, Line 12a Baptist Healthcare System Inc 1 Baptist Health Foundation Paducah Inc 2501 Kentucky Ave Paducah KY 42003 264057759 Fundraising KY 501(c)(3) Schedule A, Line 12a Baptist Healthcare System Inc 1 Baptist Health Foundation Richmond Inc PO Box 1600 Richmond KY 40476 311506378 Fundraising KY 501(c)(3) Schedule A, Line 12a Baptist Healthcare System Inc 1 Baptist Health Medical GroupInc 2701 Eastpoint Parkway Louisville KY 40223 205497203 Physician Services KY 501(c)(3) Schedule A, Line 3 Baptist Healthcare System Inc 1 Baptist Health Richmond Inc 801 Eastern Bypass Richmond KY 40475 610461940 Hospital KY 501(c)(3) Schedule A, Line 3 Baptist Healthcare System Inc 1 Baptist Healthcare Foundation Inc 2701 Eastpoint Parkway Louisville KY 40223 311122867 Fundraising KY 501(c)(3) Schedule A, Line 12a Baptist Healthcare System Inc 1 Baptist Healthcare System Inc 2701 Eastpoint Parkway Louisville KY 40223 610444707 Hospital KY 501(c)(3) Schedule A, Line 3 N/A 0 Medical Center Ambulance Services Inc 629 Lafoon Street Madisonville KY 42431 610946210 Ambulance Services KY 501(c)(3) Schedule A, Line 10 N/A 1 Mercy Regional Emergency Medical System LLC 126 Lone Oak Road Paducah KY 42001 611310466 Ambulance Services KY 501(c)(3) Schedule A, Line 12a Baptist Healthcare System Inc 1 Pattie A Clay Hospital Auxiliary PO Box 1600 Richmond KY 40476 510172717 Support Hospital KY 501(c)(3) Schedule A, Line 12a Baptist Healthcare System Inc 1 Baptist EastMilestone LLC 750 Cypress Station Dr Louisville KY 40207 611355065 Fitness Center KY N/A N/A 0 0 Baptist Physicians' Surgery Center LLC 1720 Nicholasville Rd 101 Lexington KY 405031490 043665929 Ambulatory Surgery Center KY N/A N/A 0 0 Baptist Eastpoint Surgery Center LLC 2400 Eastpoint Parkway Louisville KY 40223 260834852 Ambulatory Surgery Center KY N/A N/A 0 0 Medical Associates of Middletown LLC 4000 Kresge Way Louisville KY 40207 200399400 Medical Office Building KY N/A N/A 0 0 Baptist Health Performance Training LLC 2701 Eastpoint Parkway Louisville KY 40223 473567887 Sports Training KY N/A N/A 0 0 Cumberland Valley Surgical Center LLC PO Box 1620 Corbin KY 40701 611348280 Ambulatory Surgery Center IN N/A N/A 0 0 Baptist Ventures Inc 2701 Eastpoint Parkway Louisville KY 40223 611217018 Management KY N/A C 1 Baptist Health Plan Inc 651 Perimeter Park Ste 300 Lexington KY 40517 611241101 Insurance KY N/A C 1 Hopkins County Credit Services Inc 2701 Eastpoint Parkway Louisville KY 40223 610660705 Collection Agency KY N/A C 1 MS Community Health LLC 2701 Eastpoint Parkway Louisville KY 40223 611303514 Health Clinic KY N/A C 1 Baptist Medical Management Services Inc 2701 Eastpoint Parkway Louisville KY 40223 371519513 HC MSO KY N/A C 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 1 Baptist Healthcare System Inc R 3995307 Cost Baptist Healthcare System Inc P 24800516 Cost Baptist Health Medical Group Inc S 14789555 Cost Baptist Health Medical Group Inc P 558391 Cost Baptist Health Medical Group Inc J 3949115 Cost Baptist Health Foundation Madisonville Inc S 64517 Cost Baptist Health Foundation Madisonville Inc B 115258 Cost Baptist Health Foundation Madisonville Inc C 142222 Cost Baptist Community Health Services Inc R 108653 Cost