JAY HOSPITAL INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- JAY HOSPITAL INC (EIN 59-2425149)
- Tax period
- 2017-10-01 to 2018-09-30
- Filed
- 2019-08-15
- IRS object ID
- 201942279349301049
- Schema version
- 2017v2.3
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
- Affiliated Group Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-08-15T08:40:26-05:00 | ReturnTs |
| Tax Period End | 2018-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 Walnut Suite 1700 | AddressLine1Txt |
| City | Kansas City | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 641062246 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 592425149 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jay Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % KEITH STRICKLING | InCareOfNm |
| Business Name Control | JAYH | BusinessNameControlTxt |
| Phone | 8504344714 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | POST OFFICE BOX 17500 | AddressLine1Txt |
| City | PENSACOLA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32522 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL GLEASON | PersonNm |
| Person Title | SVP/CFO | PersonTitleTxt |
| Phone | 8504697643 | PhoneNum |
| Signature | 2019-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michael J Engle | PreparerPersonNm |
| PTIN | P00482834 | PTIN |
| Phone | 8162216300 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.126.162 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 43372220192275000010 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-08-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 8EF1097B0777C414CCA6378D7E1DA964BB9E7854 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 355CC2E4B6E27E32DAADC48E1CA8D97843AD7DA8 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRYON SCOTT RAYNES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1717 N E ST STE 320 | AddressLine1Txt |
| City | PENSACOLA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,221,242 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.ebaptisthealthcare.org/JayHospital | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1983 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | DEDICATED TO MEETING THE HEALTHCARE NEEDS IN THE JAY, CENTURY, FLOMATON AND SURROUNDING COMMUNITIES IN THE NORTHWEST FLORIDA-SOUTH ALABAMA AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 164 | TotalEmployeeCnt |
| Total Volunteers | 31 | TotalVolunteersCnt |
| Total Gross UBI | $19,546 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $1,435 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,035,097 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,676,109 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,855 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,029 | CYInvestmentIncomeAmt |
| PY Other Revenue | $256,696 | PYOtherRevenueAmt |
| CY Other Revenue | $536,672 | CYOtherRevenueAmt |
| PY Total Revenue | $12,297,648 | PYTotalRevenueAmt |
| CY Total Revenue | $12,214,810 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $14,100 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $14,800 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,778,040 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,839,632 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,317,827 | PYOtherExpensesAmt |
| CY Other Expenses | $9,570,318 | CYOtherExpensesAmt |
| PY Total Expenses | $15,109,967 | PYTotalExpensesAmt |
| CY Total Expenses | $16,424,750 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,812,319 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,209,940 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,709,020 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,710,947 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,149,101 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,360,968 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$4,440,081 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$8,650,021 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $12,421,344 | ExpenseAmt |
| Revenue | $11,676,109 | RevenueAmt |
| Desc | GENERAL AND SPECIALIZED HEALTH CARE SERVICES INCLUDING INPATIENT, PRIMARY CARE, LONG TERM AND OUTPATIENT HEALTHCARE SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $14,800 | ExpenseAmt |
| Grant | $14,800 | GrantAmt |
| Desc | COMMUNITY BENEFIT OUTREACH ACTIVITIES CONDUCTED BY THE ORGANIZATION INCLUDING HEALTH EDUCATION SEMINARS, HEALTH FAIRS, AND DONATIONS TO OTHER NON-PROFIT ENTITIES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $12,436,144 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 164 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEITH STRICKLING | PersonNm |
| Phone | 8506758024 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14114 ALABAMA STREET | AddressLine1Txt |
| City | Jay | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32565 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Ronald E Jackson | ||||||||
| CHAIRMAN | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KIM JERNIGAN DMD | ||||||||
| VICE CHAIRMAN/BOARD MEMBER | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Ricky W Smith | ||||||||
| SECRETARY | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MICHAEL J MAZENKO | ||||||||
| TREASURER | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LUTHER TAYLOR | ||||||||
| MEMBER/VICE CHAIRMAN | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOHN HEER | ||||||||
| MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| JOHN BAEHR MD | ||||||||
| MEMBER-TERM ENDED 3/18 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| ADM ROBERT KELLY | ||||||||
| MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| JOHN M KIZZIAH | ||||||||
| MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS F OWENS | ||||||||
| MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| MARTHA SAUNDERS PHD | ||||||||
| MEMBER-TERM ENDED 03/18 | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | ||
| DOUG SPRAGUE | ||||||||
| MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| KARA CARDONA | ||||||||
| MEMBER-TERM START 04/18 | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| REV LONNIE WESLEY | ||||||||
| MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| STEPHANIE WHITE | ||||||||
| MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL HUTCHINS | ||||||||
| VP/ADMINISTRATOR | 40.0 | 0.0 | Yes (X) | $246,319 | $0 | $25,505 | ||
| MICHAEL GLEASON | ||||||||
| SVP/CFO | 5.0 | 45.0 | Yes (X) | $0 | $712,013 | $131,591 | ||
| BYRON SCOTT RAYNES | ||||||||
| PRESIDENT-JHI/EXEC VP-BHC | 10.0 | 40.0 | Yes (X) | $0 | $617,622 | $127,096 | ||
| DANIEL D SHEPPARD | ||||||||
| PHARMACIST | 40.0 | 0.0 | $123,006 | $0 | $28,566 | Yes (X) | ||
| GEORGIA W AGRAIT | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $102,225 | $0 | $11,628 | Yes (X) | ||
| KEITH STRICKLING | ||||||||
| CONTROLLER | 40.0 | 0.0 | $106,010 | $0 | $28,811 | Yes (X) | ||
| KARIN PARDUE | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $159,645 | $0 | $25,157 | Yes (X) | ||
| GREG W PETTY | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $104,218 | $0 | $11,403 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $841,423 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,329,635 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $389,757 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Mark Elder DO | |||||
| 2946 GREYSTONE DR | PACE | FL | 32571 | Physician Services | $268,307 |
| JEFF KELLY MD | |||||
| PO BOX 1 | JAY | FL | 32565 | PHYSICIAN SERVICES | $104,740 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $11,676,109 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,656,563 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $19,546 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,676,109 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $868 | TotalRevenueColumnAmt |
| Exclusion | $868 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $22,050 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,432 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,618 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,618 | TotalRevenueColumnAmt |
| Exclusion | $15,618 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,161 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,161 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,161 | TotalRevenueColumnAmt |
| Exclusion | $1,161 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA SALES | 722210 | $27,317 | $27,317 |
| MEDICAL RECORDS | 541900 | $3,130 | $3,130 |
| MISCELLANEOUS REVENUE | 900099 | $490,607 | $490,607 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $490,607 | TotalRevenueColumnAmt |
| Exclusion | $490,607 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $521,054 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,214,810 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,656,563 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $19,546 | UnrelatedBusinessRevenueAmt |
| Exclusion | $538,701 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,800 | TotalAmt |
| Program Services | $14,800 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $277,562 | TotalAmt |
| Program Services | $222,050 | ProgramServicesAmt |
| Management And General | $55,512 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,451,538 | TotalAmt |
| Program Services | $4,963,751 | ProgramServicesAmt |
| Management And General | $487,787 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,453 | TotalAmt |
| Program Services | $155,211 | ProgramServicesAmt |
| Management And General | $16,242 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $549,417 | TotalAmt |
| Program Services | $497,368 | ProgramServicesAmt |
| Management And General | $52,049 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $389,662 | TotalAmt |
| Program Services | $352,748 | ProgramServicesAmt |
| Management And General | $36,914 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,349,930 | TotalAmt |
| Program Services | $140,009 | ProgramServicesAmt |
| Management And General | $2,209,921 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,080 | TotalAmt |
| Management And General | $2,080 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,529,613 | TotalAmt |
| Program Services | $1,169,865 | ProgramServicesAmt |
| Management And General | $359,748 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,717 | TotalAmt |
| Program Services | $1,717 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,729 | TotalAmt |
| Program Services | $126,915 | ProgramServicesAmt |
| Management And General | $53,814 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,395 | TotalAmt |
| Program Services | $12,395 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,966 | TotalAmt |
| Program Services | $247,517 | ProgramServicesAmt |
| Management And General | $26,449 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,350 | TotalAmt |
| Program Services | $10,189 | ProgramServicesAmt |
| Management And General | $30,161 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192 | TotalAmt |
| Management And General | $192 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $263,892 | TotalAmt |
| Management And General | $263,892 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $451,418 | TotalAmt |
| Program Services | $383,705 | ProgramServicesAmt |
| Management And General | $67,713 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,453 | TotalAmt |
| Management And General | $158,453 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $3,242,658 | $3,242,658 | |
| MEDICAL SUPPLIES | $667,246 | $667,246 | |
| INDIGENT ASSESSMENT | $114,906 | $114,906 | |
| FOOD COSTS | $100,825 | $99,939 | $886 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,948 | TotalAmt |
| Program Services | $13,155 | ProgramServicesAmt |
| Management And General | $166,793 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,424,750 | TotalAmt |
| Program Services | $12,436,144 | ProgramServicesAmt |
| Management And General | $3,988,606 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,345 | BOYAmt |
| EOY | $66,462 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $820,796 | BOYAmt |
| EOY | $881,239 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $134,487 | BOYAmt |
| EOY | $131,395 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,828 | BOYAmt |
| EOY | $63,516 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,397,805 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,829,470 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,632,564 | BOYAmt |
| EOY | $2,568,335 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,709,020 | BOYAmt |
| EOY | $3,710,947 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $712,369 | BOYAmt |
| EOY | $855,855 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $378,377 | BOYAmt |
| EOY | $338,104 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,058,355 | BOYAmt |
| EOY | $11,167,009 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,149,101 | BOYAmt |
| EOY | $12,360,968 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,440,081 | BOYAmt |
| EOY | -$8,650,021 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,440,081 | BOYAmt |
| EOY | -$8,650,021 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,709,020 | BOYAmt |
| EOY | $3,710,947 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$4,209,940 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Belongs Afflt Grp | Yes (X) | OrganizationBelongsAffltGrpInd |
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp |
Total Direct Lobbying TotalDirectLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $2,607 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $249,769 | AffiliatedGroupTotalAmt |
Total Lobbying Expend TotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $2,607 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $249,769 | AffiliatedGroupTotalAmt |
Other Exempt Purpose Expend OtherExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $16,422,143 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $943,235,397 | AffiliatedGroupTotalAmt |
Total Exempt Purpose Expend TotalExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $16,424,750 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $943,485,166 | AffiliatedGroupTotalAmt |
Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $971,238 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $1,000,000 | AffiliatedGroupTotalAmt |
Grassroots Nontaxable GrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $242,810 | FilingOrganizationsTotalAmt |
| Affiliated Group Total | $1,367,478 | AffiliatedGroupTotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp |
Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $1,000,000 | CurrentYearMinus3Amt |
| Current Year Minus2 | $1,000,000 | CurrentYearMinus2Amt |
| Current Year Minus1 | $1,000,000 | CurrentYearMinus1Amt |
| Current Year | $1,000,000 | CurrentYearAmt |
| Total | $4,000,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $6,000,000 | LobbyingCeilingAmt |
Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $84,612 | CurrentYearMinus3Amt |
| Current Year Minus2 | $232,507 | CurrentYearMinus2Amt |
| Current Year Minus1 | $246,919 | CurrentYearMinus1Amt |
| Current Year | $249,769 | CurrentYearAmt |
| Total | $813,807 | TotalAmt |
Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $250,000 | CurrentYearMinus3Amt |
| Current Year Minus2 | $250,000 | CurrentYearMinus2Amt |
| Current Year Minus1 | $250,000 | CurrentYearMinus1Amt |
| Current Year | $250,000 | CurrentYearAmt |
| Total | $1,000,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $1,500,000 | GrassrootsCeilingAmt |
Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $0 | CurrentYearMinus3Amt |
| Current Year Minus2 | $0 | CurrentYearMinus2Amt |
| Current Year Minus1 | $0 | CurrentYearMinus1Amt |
| Current Year | $0 | CurrentYearAmt |
| Total | $0 | TotalAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $62,193 | OtherCostOrOtherBasisAmt |
| Book Value | $62,193 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,182,808 | OtherCostOrOtherBasisAmt |
| Depreciation | $176,381 | DepreciationAmt |
| Book Value | $1,006,427 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,591,085 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,593,821 | DepreciationAmt |
| Book Value | $997,264 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,385,338 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,023,045 | DepreciationAmt |
| Book Value | $362,293 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $176,381 | OtherCostOrOtherBasisAmt |
| Depreciation | $36,223 | DepreciationAmt |
| Book Value | $140,158 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,568,335 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD PARTIES | $905,297 |
| ASSET RETIREMENT OBLIGATION | $134,591 |
| DUE TO AFFILIATES | $10,127,121 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,167,009 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE D, PART XIII | FormAndLineReferenceDesc |
| Explanation | Financial 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, 2018 and 2017. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $741,365 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $741,365 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05620 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,153,663 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,643,388 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $510,275 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03870 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,895,028 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,643,388 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,251,640 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09490 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $14,800 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,800 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $14,800 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,800 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $2,909,828 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,643,388 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,266,440 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09600 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,242,658 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $924,158 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,163,331 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,176,588 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,013,257 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14114 ALABAMA STREET | AddressLine1Txt |
| City | JAY | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32565 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 100048 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | ebaptisthealthcare.org/community/CHNA | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.ebaptisthealthcare.org/community/CHNA | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Section C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | The CHNA process was facilitated by The Partnership for a Healthy Community (PFAHC), a nonprofit tax-exempt organization whose mission is to sponsor community health status assessments for the two counties and to support and promote collaborative initiatives that address priority health problems. Collaborating partners in the completion of this report include representatives from the Florida Departments of Health in Escambia and Santa Rosa Counties, Baptist Health Care and its affiliates (including Jay Hospital), Sacred Heart Health System, Escambia Community Clinics (a federally qualified health center) and the University of West Florida. With the Florida Department of Health as a partner, the Mobilizing for Action through Planning and Partnerships (MAPP) process was utilized to conduct the CHNA. The MAPP process is a community-driven strategic planning process for improving community health and is comprised of four individual assessments. In August 2015, twenty-two diverse stakeholders, representing the Northwest Florida Partnership for a Healthy Community, Baptist Health Care and its affiliates (including Jay Hospital), Sacred Heart Health System, the Florida Department of Health-Escambia, Florida Department of Health-Santa Rosa, Escambia and Santa Rosa Community Clinics, Santa Rosa Medical Center, Santa Rosa School District, Healthy Start of Santa Rosa County, SMI Consultants, United Way of Escambia County, the University of West Florida, Ascendant Healthcare Partners, Interfaith Ministries/Good Samaritan Clinic, non-profit organizations and others, served as members of a PFAHC workgroup that designed the CHNA process, assimilated the results and provided recommendations to the PFAHC's Board of Directors. PFAHC's Board of Directors provided oversight and input throughout the development of the assessment and establishment of priority health needs by way of discussions at Board meetings. These directors included representatives from the County's Department of Health and other organizations representing the broad interest of the community. |
| SCHEDULE H, Part V, Section B, Line 6a | Baptist Health Care (Jay Hospital's parent company), Sacred Heart Health System, and Escambia Community Clinics, a federally qualified health center, were lead organizations and funders of the CHNA process. Senior leadership from Baptist Health Care, Sacred Heart Health System, the Florida Department of Health-Escambia, Florida Department of Health-Santa Rosa, Escambia and Santa Rosa Community Clinics, Santa Rosa Medical Center and Interfaith Ministries/Good Samaritan Clinic also served as members of a PFAHC workgroup that designed the CHNA process, assimilated the results and provided recommendations to the Partnership Board of Directors. |
| SCHEDULE H, Part V, Section B, Line 6b | Non-hospital stakeholders, including the University of West Florida, Santa Rosa School District, Healthy Start of Santa Rosa County, SMI Consultants, United Way of Escambia County, Ascendant Health Care Partners, as well as several non-profit and other organizations were part of the diverse PFAHC workgroup that designed the CHNA process, assimilated the results and provided recommendations to the Partnership Board of Directors. |
| SCHEDULE H, Part V, Section B, Line 11 | The Partnership completed this process with a holistic review of the data gathered in each of the assessments to identify overarching themes and health issues. The issues were discussed by the Partnership Board of Directors who represents a diverse group of community partners from each county. The discussion affirmed that the health issues selected in 2012 continue to be primary community health concerns. As such, the Board adopted as the 2016 Community Health Priorities for the communities of Escambia and Santa Rosa Counties the following health priorities: - Tobacco Use - Healthiest Weight - Access to Care Jay Hospital, working through its parent company, Baptist Health Care, in collaboration with other hospitals in the system, 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. Baptist Health Care affiliate hospitals and their partners organized work groups around each of the three health improvement priorities and provided broad community leadership, as well as commitment of resources to accomplish the following goals and achieve collective impact: Tobacco Use: - Implement community based tobacco cessation program by hosting on-site tobacco cessation classes - Participate in collaborative efforts lead by the Partnership for a Healthy Community to reduce tobacco use. Healthy Weight: - Because of limited resources, Jay Hospital will not address this priority beyond its involvement in the collaborative efforts lead by the Partnership for a Healthy Community. 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. Healthy Community to increase access to health care. |
| SCHEDULE H, PART V, SECTION C, LINE 16A-C | THE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY CAN BE FOUND AT THE FOLLOWING WEB ADDRESS: https://www.ebaptisthealthcare.org/PatientFinancialResources |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTURY MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8401 N CENTURY BLVD | AddressLine1Txt |
| City | CENTURY | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32535 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | PRIMARY CARE PRACTICE | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H , PART I, LINE 3C | IN ADDITION TO THE FEDERAL POVERTY GUIDELINES THE ORGANIZATION USES AN ASSET TEST, MEDICAL INDINGENCY, INSURANCE/UNDERINSURANCE STATUS, AND RESIDENCY IN DETERMINING FREE OR DISCOUNTED CARE. |
| SCHEDULE H, PART I, LINE 7 | The 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 $3,242,658 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, LINES 2 AND 4 | THE 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 WITH THE POLICY FOR UNCOLLECTIBLE PATIENT ACCOUNTS, AND SUBSEQUENT RECOVERIES ARE ADDED. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. THE HOSPITAL PROVIDES SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, SUCH SERVICES ARE NOT REPORTED AS NET REVENUE. THE HOSPITAL'S CHARITY CARE POLICY UTILIZES THE GENERALLY RECOGNIZED FEDERAL POVERTY INCOME LEVELS. FOR PATIENTS WHO DO NOT APPLY OR DO NOT QUALIFY, THE UNCOLLECTED AMOUNTS ARE RECOGNIZED AS BAD DEBT EXPENSE. ESTIMATED COST OF BAD DEBT IS BASED ON THE RATIO OF COST TO CHARGES AS DETERMINED BY HOSPITAL SPECIFIC DATA. |
| SCHEDULE H, PART III, LINE 3 | BAD DEBT IS NOT INCLUDED AS PART OF THE ORGANIZATION'S COMMUNITY BENEFIT. APPROXIMATELY 28.5% OF JAY HOSPITAL'S PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE. HOWEVER, IT IS NOT KNOWN HOW MUCH OF THE ORGANIZATION'S BAD DEBT EXPENSE WOULD BE INCLUDED AS COMMUNITY BENEFIT HAD THOSE PATIENTS COMPLETED THE FINANCIAL ASSISTANCE PROCESS, THOUGH IT IS BELIEVED THAT SOME PORTION WOULD QUALIFY FOR FINANCIAL ASSISTANCE. ASSISTANCE. |
| SCHEDULE H, PART III, LINE 8 | THE 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 9B | PATIENTS 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 2 | Part 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 3 | JAY 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 AND FINANCIAL ASSITANCE APPLICATIONS ON ITS INTERNET WEBSITE. |
| SCHEDULE H, PART VI, LINE 4 | JAY HOSPITAL, INC. OPERATES IN SANTA ROSA COUNTY, FLORIDA. APPROXIMATELY 179,000 INDIVIDUALS RESIDE IN THIS COUNTY, 10.2% OF WHICH LIVE BELOW POVERTY LEVEL. WHEN CONSIDERING THESE FACTORS, MORE THAN 18,000 RESIDENTS COULD BE ELIGIBLE TO QUALIFY FOR CHARITY CARE. APPROXIMATELY 28.5% OF JAY HOSPITAL'S PATIENTS DURING FY2018 WERE UNINSURED OR WERE MEDICAID RECIPIENTS. THREE HOSPITALS, INCLUDING JAY HOSPITAL, ARE LOCATED IN SANTA ROSA COUNTY. |
| SCHEDULE H, PART VI, LINE 5 | THE 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 6 | ALTHOUGH 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Santa Rosa Community Clinic | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5520 Stewart Street | AddressLine1Txt |
| City | Milton | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 32570 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 311746599 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $12,500 | CashGrantAmt |
| Purpose Of Grant | Healthcare Assistance | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 | FormAndLineReferenceDesc |
| Explanation | Within one year, the organization requests documentation from the recipient regarding proper use of funds provided for indigent patients. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL HUTCHINS | ||||||||||||||
| VP/ADMINISTRATOR | $167,461 | $0 | $41,689 | $0 | $37,169 | $0 | $10,773 | $0 | $14,732 | $0 | $271,824 | $0 | $0 | $0 |
| MICHAEL GLEASON | ||||||||||||||
| SVP/CFO | $0 | $536,076 | $0 | $140,919 | $0 | $35,018 | $0 | $112,304 | $0 | $19,287 | $0 | $843,604 | $0 | $0 |
| DANIEL D SHEPPARD | ||||||||||||||
| PHARMACIST | $122,566 | $0 | $0 | $0 | $440 | $0 | $3,212 | $0 | $25,354 | $0 | $151,572 | $0 | $0 | $0 |
| KARIN PARDUE | ||||||||||||||
| PHYSICIAN | $0 | $0 | $159,645 | $0 | $0 | $0 | $0 | $0 | $25,157 | $0 | $184,802 | $0 | $0 | $0 |
| BYRON SCOTT RAYNES | ||||||||||||||
| PRESIDENT-JHI/EXEC VP-BHC | $0 | $494,373 | $0 | $101,582 | $0 | $21,667 | $0 | $96,599 | $0 | $30,497 | $0 | $744,718 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1A | THE FOLLOWING OFFICERS/KEY EMPLOYEES RECEIVED TAX GROSS-UP PAYMENTS THAT WERE INCLUDED IN THEIR W-2 TAXABLE WAGES: - MICHAEL HUTCHINS - BYRON (SCOTT) RAYNES |
| SCHEDULE J, PART I, LINE 4B | ACCRUED -------- MICHAEL GLEASON $104,688 MICHAEL HUTCHINS $6,436 BYRON (SCOTT) RAYNES $86,316 |
| SCHEDULE J, PART II | THE 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 ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 1 | HELPING 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 1A | ALL 1099'S ARE ISSUED ON THE ORGANIZATION'S BEHALF BY BAPTIST HEALTH CARE CORPORATION, THE SOLE MEMBER AND RELATED 501 (C)(3) TAX EXEMPT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 2 | MICHAEL GLEASON, MICHAEL HUTCHINS, AND BYRON (SCOTT) RAYNES HAVE A BUSINESS RELATIONSHIP. THE BUSINESS RELATIONSHIP IS AN EMPLOYER/EMPLOYEE RELATIONSHIP AT RELATED TAX-EXEMPT ORGANIZATIONS. RONALD E. JACKSON, KIM JERNIGAN, D.M.D., MARTHA SAUNDERS, PH.D., AND LUTHER TAYLOR HAVE A BUSINESS RELATIONSHIP WITH MICHAEL GLEASON. RONALD E. JACKSON, KIM JERNIGAN, D.M.D., MARTHA SAUNDERS, PH.D., AND LUTHER TAYLOR ARE BOARD MEMBERS OF BAPTIST HEALTH CARE CORPORATION AND MICHAEL GLEASON IS AN EMPLOYED OFFICER OF BAPTIST HEALTH CARE CORPORATION. RONALD E. JACKSON, KIM JERNIGAN, D.M.D., RICKY W. SMITH, MICHAEL J. MAZENKO, LUTHER TAYOLR, JOHN HEER, JOHN BAEHR, M.D., ADM. ROBERT KELLY, JOHN M. KIZZAH, THOMAS F. OWENS, MARTHA SAUNDERS, PH.D., DOUG SPRAGUE, KARA CARDONA, REV. LONNIE WESLEY, STEPHANIE WHITE, AND BYRON (SCOTT) RAYNES HAVE A BUSINESS RELATIONSHIP. ALL EXCEPT BYRON (SCOTT) RAYNNES ARE BOARD MEMBERS OF BAPTIST HOSPITAL, INC. WHERE MR. RAYNES IS AN EMPLOYEE. |
| FORM 990, PART VI, SECTION A, LINE 6 | BAPTIST 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 7A | BAPTIST 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 7B | THE 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 11 | AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. 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 12C | BOARD 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 15A | EACH 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 19 | THE 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 VII, SECTION A, LINE 1A | THE FOLLOWING BOARD MEMBER CHANGED THEIR POSITION WITHIN THE BOARD DURING THE TAX YEAR AS A RESULT OF THE TIMING OF BOARD MEMBER ELECTIONS: 10/01/17 - 03/31/18 04/01/18 - 09/30/18 KIM JERNIGAN, D.M.D. VICE CHAIRMAN BOARD MEMBER LUTHER TAYLOR BOARD MEMBER VICE CHAIRMAN |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| BAPTIST HEALTH CARE CORPORATION | ||||||||||
| 1717 N E STREET | PENSACOLA | FL | 32501 | 592425151 | HEALTHCARE | FL | 501(c)(3) | 12c | NA | false |
| BAPTIST HEALTH CARE FOUNDATION | ||||||||||
| 1717 N E STREET | PENSACOLA | FL | 32501 | 590192265 | FUNDRAISING | FL | 501(c)(3) | 7 | BHC | Yes (true) |
| BAPTIST HOSPITAL INC | ||||||||||
| 1000 WEST MORENO STREET | PENSACOLA | FL | 32501 | 590657322 | HEALTHCARE | FL | 501(c)(3) | 3 | BHC | Yes (true) |
| CMHC HERNANDEZ HOUSE INC | ||||||||||
| 1221 WEST LAKEVIEW AVE | PENSACOLA | FL | 32501 | 592041794 | LOW COST HOUS | FL | 501(c)(3) | 10 | LCI | Yes (true) |
| LAKEVIEW CENTER INC | ||||||||||
| 1221 WEST LAKEVIEW AVENUE | PENSACOLA | FL | 32501 | 590737872 | HEALTHCARE | FL | 501(c)(3) | 7 | BHC | Yes (true) |
| LAKEVIEW PLACE INC | ||||||||||
| 1221 WEST LAKEVIEW AVE | PENSACOLA | FL | 32501 | 592804577 | LOW COST HOUS | FL | 501(c)(3) | 10 | LCI | Yes (true) |
| LAKEVIEW VILLA INC | ||||||||||
| 1221 WEST LAKEVIEW AVE | PENSACOLA | FL | 32501 | 592842486 | LOW COST HOUS | FL | 501(c)(3) | 10 | LCI | Yes (true) |
| GLOBAL CONNECTIONS TO EMPLOYMENT INC | ||||||||||
| 1221 WEST LAKEVIEW AVE | PENSACOLA | FL | 32501 | 472592811 | VOC TRAINING | FL | 501(C)(3) | 7 | LCI | Yes (true) |
| ABLE FORCES INC | ||||||||||
| 1221 WEST LAKEVIEW AVE | PENSACOLA | FL | 32501 | 270881311 | VOC TRAINING | VA | 501(C)(3) | 10 | GCE | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|---|
| BAPTIST MEDICAL PARK SURGERY CENTER LLC | ||||||||
| 9400 UNIVERSITY PKWY | PENSACOLA | FL | 32514 | 593535262 | AMBULATORY SURG. | FL | NA | N/A |
| ANDREWS INSTITUTE ASC LLC | ||||||||
| 1040 GULF BREEZE PKWY | GULF BREEZE | FL | 32561 | 352274952 | AMBULATORY SURG. | FL | NA | N/A |
| LIGHTHOUSE HEALTH PLAN LLC | ||||||||
| 1717 NORTH E STREET STE 320 | PENSACOLA | FL | 32501 | 823182832 | HEALTH INS. PLAN | FL | NA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| BAPTIST HEALTH VENTURES INC | |||||||||
| 1717 NORTH E ST | PENSACOLA | FL | 32501 | 592415910 | ADMINISTRATIVE | FL | NA | C CORP | Yes (true) |
| PENSACOLA POB INC | |||||||||
| 1717 NORTH E ST | PENSACOLA | FL | 32501 | 592462399 | LEASING AGENT | FL | NA | C CORP | Yes (true) |
| MOBILE DIAGNOSTICS INC | |||||||||
| 1717 NORTH E ST | PENSACOLA | FL | 32501 | 592864191 | MEDICAL SERVI | FL | NA | C CORP | Yes (true) |
| MEDICAL PROFESSIONAL AGENCY INC | |||||||||
| 1717 NORTH E ST | PENSACOLA | FL | 32501 | 592555835 | MEDICAL SERVI | FL | NA | C CORP | Yes (true) |
| THE TOWERS PHARMACY INC | |||||||||
| 1717 NORTH E ST | PENSACOLA | FL | 32501 | 592667929 | RETAIL SALES | FL | NA | C CORP | Yes (true) |
| LANGHORNE CARDIOLOGY CONSULTANTS INC | |||||||||
| 1717 NORTH E ST | PENSACOLA | FL | 32501 | 592874324 | MEDICAL SERVI | FL | NA | C CORP | Yes (true) |
| LAKEVIEW ASSOCIATED ENTERPRISES-PHASE I | |||||||||
| 1221 W LAKEVIEW AVE | PENSACOLA | FL | 32501 | 611711170 | FRANCHISING | FL | NA | C CORP | Yes (true) |
| LAKEVIEW ASSOCIATED ENTERPRISES-PHASE II | |||||||||
| 1221 WEST LAKEVIEW AVE | PENSACOLA | FL | 32501 | 465458197 | FRANCHISING | FL | NA | C CORP | Yes (true) |
| PARCEL 27 LAND CONDOMINIUM ASSOC INC | |||||||||
| 1221 W LAKEVIEW AVE | PENSACOLA | FL | 32501 | 821313799 | CONDO ASSOCIA | FL | NA | C CORP | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Baptist Hospital Inc | ||
| E | $10,127,121 | FMV |
| Baptist Hospital Inc | ||
| M | $173,841 | FMV |
Affiliated Group Schedule AffiliatedGroupSchedule
Affiliated Schedule AffiliatedScheduleGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Electing OrganizationElectingOrganizationInd | Total Grassroots LobbyTotalGrassrootsLobbyAmt | Total Direct LobbyTotalDirectLobbyAmt | Total Lobby ExpenditureTotalLobbyExpenditureAmt | Other Exempt Purpose ExpendOtherExemptPurposeExpendAmt | Total Exempt Purpose ExpendTotalExemptPurposeExpendAmt | Lobby NontxLobbyNontxAmt | Grassroots NontxGrassrootsNontxAmt | Total Lobby Grssroot Mns NontxTotalLobbyGrssrootMnsNontxAmt | Tot Lbby Expend Mns Lobby NontxTotLbbyExpendMnsLobbyNontxAmt | Share Excess Lobby ExpendShareExcessLobbyExpendAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BAPTIST HEALTH CARE CORPORAT | |||||||||||||||
| PO BOX 17500 | PENSACOLA | FL | 325227500 | 592425151 | Yes (X) | $0 | $144,497 | $144,497 | $63,065,367 | $63,209,864 | $1,000,000 | $250,000 | $0 | $0 | $0 |
| BAPTIST HEALTH CARE FOUNDATI | |||||||||||||||
| PO BOX 17500 | PENSACOLA | FL | 325227500 | 590192265 | Yes (X) | $0 | $4,535,943 | $4,535,943 | $0 | $4,535,943 | $376,797 | $94,199 | $0 | $4,159,146 | $0 |
| BAPTIST HOSPITAL INC | |||||||||||||||
| PO BOX 17500 | PENSACOLA | FL | 325227500 | 590657322 | $0 | $35,165 | $35,165 | $579,640,886 | $579,676,051 | $1,000,000 | $250,000 | $0 | $0 | $0 | |
| CMHC HERNANDEZ HOUSE INC | |||||||||||||||
| 1221 W LAKEVIEW AVENUE | PENSACOLA | FL | 325011836 | 592041794 | $0 | $0 | $0 | $42,209 | $42,209 | $8,442 | $2,111 | $0 | $0 | $0 | |
| JAY HOSPITAL INC | |||||||||||||||
| PO BOX 17500 | PENSACOLA | FL | 325227500 | 592425149 | $0 | $2,607 | $2,607 | $16,422,143 | $16,424,750 | $971,238 | $242,810 | $0 | $0 | $0 | |
| LAKEVIEW PLACE INC | |||||||||||||||
| 1221 W LAKEVIEW AVENUE | PENSACOLA | FL | 325011836 | 592804577 | $0 | $0 | $0 | $82,269 | $82,269 | $16,454 | $4,114 | $0 | $0 | $0 | |
| LAKEVIEW VILLA INC | |||||||||||||||
| 1221 W LAKEVIEW AVENUE | PENSACOLA | FL | 325011836 | 592842486 | $0 | $0 | $0 | $141,532 | $141,532 | $28,306 | $7,077 | $0 | $0 | $0 | |
| LAKEVIEW CENTER INC | |||||||||||||||
| 1221 W LAKEVIEW AVENUE | PENSACOLA | FL | 325011836 | 590737872 | $0 | $67,500 | $67,500 | $121,816,688 | $121,884,188 | $1,000,000 | $250,000 | $0 | $0 | $0 | |
| GLOBAL CONNECTIONS TO EMPLOY | |||||||||||||||
| 1221 WEST LAKEVIEW AVE | PENSACOLA | FL | 32501 | 472592811 | $0 | $0 | $0 | $157,145,026 | $157,145,026 | $1,000,000 | $250,000 | $0 | $0 | $0 | |
| ABLE FORCES INC | |||||||||||||||
| 1221 W LAKEVIEW AVENUE | PENSACOLA | FL | 32501 | 270881311 | $0 | $0 | $0 | $343,335 | $343,335 | $68,667 | $17,167 | $0 | $0 | $0 | |