2018-08-13T07:40:07-05:00 2017-09-30 861065772 DELOITTE TAX LLP 1033 DEMONBREUN SUITE 400 NASHVILLE TN 37203 990 2016-10-01 630997281 BAPTIST MEMORIAL HOSPITAL- UNION COUNTY INC BAPT 6625382406 200 HIGHWAY 30 WEST NEW ALBANY MS 38652 JASON M LITTLE PRESIDENT 9012275117 2018-08-13 1 FRANCIS J BEDARD P00752421 6152591811 2016 2022-09-23 18:48:47Z JASON M LITTLE 350 N HUMPHREYS BLVD MEMPHIS TN 38120 62702152 0 X WWW.BAPTISTONLINE.ORG/UNION-COUNTY X 1991 MS SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. 3 3 513 35 48599 0 55427 0 60968714 62354791 -16436 -30993 289651 301002 61297356 62624800 38865 27350 0 0 24095690 24749425 0 0 0 28638578 30790612 52773133 55567387 8524223 7057413 44548947 49083083 10271534 7748257 34277413 41334826 X BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. PROVIDES QUALITY HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR AGE. ITS MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. 0 0 48184848 27350 62354791 BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. PROVIDES QUALITY HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR AGE. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC.,IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES, AND FURTHER, THAT THE MISSION OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION.(SEE CONTINUATION AT SCHEDULE O, PAGE 71)THEREFORE, IN KEEPING WITH ITS COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. PROVIDES THE FOLLOWING:--FREE CARE AND/OR SUBSIDIZED CARE WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST,--CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, AND--HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITYTHESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PROGRAM SERVICES AS OF SEPTEMBER 30, 2017 INCLUDED THE FOLLOWING:--THE SKILLED NURSING DEPARTMENT HAD 11,006 PATIENT DAYS AT A COST OF $9,589,179.--THE SURGERY DEPARTMENT PERFORMED 4,304 PROCEDURES AT A COST OF $7,423,380.--THE RADIOLOGY DEPARTMENT PERFORMED 54,206 PROCEDURES AT A COST OF $2,755,747.--THE PHARMACY DEPARTMENT DISPENSED MEDICATION AT A COST OF $2,421,778.--THE LAB DEPARTMENT PERFORMED 177,988 PROCEDURES AT A COST OF $2,360,005.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY SERVICED 3,024 INPATIENTS AND PROVIDED MORE THAN 63,044 OUTPATIENT VISITS DURING THE FISCAL YEAR 2017.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS FROM WHICH THE HOSPITAL RECEIVES LESS THAN MARKET VALUE REIMBURSEMENT. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO MEDICARE, MEDICAID, AND UNINSURED PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, BAPTIST MEMORIAL HOSPITAL-UNION COUNTY RECOGNIZES THESE AMOUNTS AS CHARITY CARE IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. DURING THE YEAR ENDING SEPTEMBER 30, 2017, THE UN-REIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS $125,343,977.CHARITY CARE IS ALSO PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES WHICH BAPTIST MEMORIAL HOSPITAL-UNION COUNTY BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY HAS PROVIDED A NUMBER OF SERVICES IN THE COMMUNITY, SOME OF WHICH INCLUDE THE FOLLOWING: --HOSPITAL CLINICAL ROTATIONS FOR NEW ALBANY/UNION COUNTY ALLIED HEALTH STUDENTS --PROVIDED REPRESENTATIVES WHO SPOKE FREE OF CHARGE TO VARIOUS COMMUNITY GROUPS, CHURCHES, INDUSTRIES, AND SCHOOLS --PROVIDED MULTIPLE HEALTH FAIRS IN VARIOUS SECTORS OF THE COMMUNITY INCLUDING SCHOOLS AND BUSINESSES.--SPONSORED HEALTHY LIFESTYLE PROGRAMS AS WELL AS 5K RUNS FOR ADULTS AND CHILDREN. --PROVIDED MULTIPLE HEALTH SCREENINGS AND VACCINATIONS FOR THE COMMUNITY AT NO-CHARGE OR REDUCED PRICES. --CONDUCTED FREE LUNCHEONS ON VARIOUS HEALTH-RELATED TOPICS FOR THE COMMUNITY, SUCH AS BREAST CANCER AWARENESS, HEART HEALTH, PALLATIVE CARE, AND NUTRITION FOR BOTH SENIOR ADULTS AND PEDIATRICS. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY ALSO PROVIDED VARIOUS FREE OR REDUCED PRICED CLASSES TO THE COMMUNITY WHICH INCLUDED THE FOLLOWING:--CPR, FIRST AID, AED CLASSES --CHILDBIRTH CLASSES --BREASTFEEDING CLASSES --TOBACCO CESSATION CLASSES--DIABETIC CLASSES BAPTIST MEMORIAL HOSPITAL-UNION COUNTY OFFERS A FREE ANNUAL COMMUNITY HEALTH FAIR. INDIVIDUALS WERE ABLE TO RECEIVE FREE CHOLESTEROL, GLUCOSE, TRIGLYCERIDES, AND PSA RESULTS. FLU VACCINES WERE ALSO PROVIDED FREE AT THE COMMUNITY HEALTH FAIR. OTHER SCREENINGS AVAILABLE FOR FREE INCLUDED: HEIGHT, WEIGHT, BMI, BLOOD PRESSURE, KIDNEY DISEASE, BONE DENSITY, AND FREE EYE SCREENINGS FROM A LOCAL OPTOMETRIST. EDUCATIONAL INFORMATION WAS PROVIDED ON HEALTH ISSUES SUCH AS NUTRITION, ALZHEIMERS, MEN'S HEALTH, WOMEN'S HEALTH, CANCER, COPD, BLOOD PRESSURE, AND BMI. REPRESENTATIVES FROM THE RADIOLOGY DEPARTMENT WERE ALSO ON HAND TO PROMOTE BREAST CANCER AWARENESS EDUCATION AND EARLY DETECTION THROUGH SCREENINGS.IN ADDITION TO THE COMMUNITY HEALTH FAIR, OTHER HEALTH FAIRS PROVIDED ON-SITE FOR THE EMPLOYEES OF BNA BANK, NEW ALBANY SCHOOLS, AND UNION COUNTY SCHOOLS. CHILDREN AGES NEWBORN TO 12 YEARS OLD WERE INVITED TO ATTEND OUR ANNUAL BACK TO SCHOOL HEALTH FAIR. THIS EVENT WAS EXPANDED TO NEWBORNS AND TODDLERS TO PROMOTE LEARNING IN EARLY CHILDHOOD AS PART OF THE EXCEL BY 5 COMMUNITY INITIATIVE. FREE SCREENINGS OFFERED WERE BLOOD PRESSURE, HEIGHT AND WEIGHT, BMI, AND VISION. EDUCATIONAL DISPLAYS FROM VARIOUS COMMUNITY GROUPS AND HOSPITAL REPRESENTATIVES WERE AVAILABLE, INCLUDING NUTRITION, DENTAL, FINGERPRINTING, HANDWASHING, TOBACCO PREVENTION, HOME SAFETY, IMMUNIZATIONS, AND CAR SEAT SAFETY TO NAME A FEW. THE ANNUAL EVENT ALWAYS DRAWS A CROWD OF 600 OR MORE CHILDREN, PLUS ADULTS. PARTICIPANTS ENJOY FREE GAMES AND REFRESHMENTS ALONG WITH MANY GIVEAWAYS AND SCHOOL SUPPLIES.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY HOSTS AN ANNUAL BABY FAIR FOR EXPECTANT MOTHERS. INFORMATION INCLUDES CAR SEAT SAFETY, NUTRITION, WELLNESS, BABY CARE, PREADMISSIONS, LACTATION SPECIALIST, AND WIC. THE EVENT ATTRACTS ABOUT 100 MOTHERS ON AVERAGE.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY RECOGNIZES THAT ITS PEOPLE ARE ITS MOST VALUABLE ASSET. TO SHARE THIS ASSET WITH THE COMMUNITY AT LARGE, ALL PERSONNEL ARE ENCOURAGED TO GET INVOLVED BY VOLUNTEERING. BELOW IS A PARTIAL LISTING OF ORGANIZATIONS AND ACTIVITIES BAPTIST MEMORIAL HOSPITAL-UNION COUNTY SUPPORTED THROUGH ITS VOLUNTEER'S EFFORTS: --NEW HAVEN CENTER FOR SPECIAL NEEDS ADULTS--BOYS AND GIRLS CLUBS--AMERICAN HEART ASSOCIATION - HEART EDUCATION IN SCHOOLS--AMERICAN CANCER SOCIETY'S RELAY FOR LIFE--AMERICAN RED CROSS--CREATE IMAGINE THE POSSIBILITIES CAREER FAIR--NORTHEAST UNION COUNTY FIRE DEPARTMENT FIRE SAFETY HOUSE--NEW ALBANY FIRE DEPARTMENT-FIRE SAFETY--CHARACTER BUILDING BOOKS FOR AREA SCHOOLS--DIABETIC SUPPORT--BREAST CANCER AWARENESS--TALLAHATCHIE 5K RIVER RUN--FOOD DRIVE FOR THE GOOD SAMARITIAN CENTER--UNION COUNTY SENIOR ADULT HEALTH FAIR--NEW ALBANY MAIN STREET ASSOCIATION--MAGNOLIA CIVIC CENTER--FIRST CHOICE FOR WOMEN--NEW ALBANY KIWANIS--NEW ALBANY ROTARY--UNION COUNTY DEVELOPMENT ASSOCIATION--SANCTUARY HOSPICE HOUSE--JUNIOR AUXILIARY--SUSAN G. KOMEN FOUNDATION--MINORITY PUL ALLIANCE--EXCEL BY 5 COALTION--UNION COUNTY SCHOOLS--NEW ALBANY CITY SCHOOLS 48184848 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 X 0 0 1 513 1 1 1 0 0 0 0 0 0 0 0 0 X 3 3 0 1 0 0 1 1 1 1 1 1 0 0 1 1 1 1 1 0 0 0 X KIM HIGH 6625382406 HIGHWAY 30 WEST NEW ALBANY MS 38652 X LUDWRICK E BROWN DIRECTOR 0.23 0.00 X 0 0 0 REV TOM SUMRALL DIRECTOR 0.23 0.00 X 0 0 0 DR JOHN STANFORD DIRECTOR 0.23 0.75 X 0 0 0 KIMBERLY D HIGH CFO 40.00 0.00 X 127011 0 31039 JASON M LITTLE PRESIDENT 0.23 39.77 X 0 1470615 58636 GREGORY M DUCKETT SECRETARY 0.23 39.77 X 0 707234 63288 PAUL D DEPRIEST MD VICE PRESIDENT 0.23 39.77 X 0 997354 57787 WALTER J GRACE CEO/ADMIN 40.00 0.00 X 0 272989 35450 LARRY RAMSEY PHARMACIST 40.00 0.00 X 118772 0 38982 ROBERT S HATCHER PHARMACIST 40.00 0.00 X 109050 0 41080 RANDY WHITE CNO 40.00 0.00 X 122604 0 35910 TERESA S PETTY LEAD PHARMACIST 1.48 38.52 X 4200 100618 34180 DEBBIE BURCH RN 33.60 6.40 X 85885 17008 18869 567522 3565818 415221 4 0 1 0 MIDSOUTH ANESTHESIA CONSULTANTS 391 SOUTHCREST CIR 108 SOUTHAVEN MS 38671 ANESTHESIA SERVICES 1197089 MORRISON MANAGEMENT SPECIALISTS INC PO BOX 102289 ATLANTA GA 303682289 CAFETERIA MGMT 626207 SHARPS ROBBINS & POPWELL 7480 BARTLETT CORP COVE BARTLETT TN 38133 CONSTRUCTION SERVICES 450190 TEAM HEALTH PO BOX 634850 CINCINNATI OH 452634850 PHYSICIAN SERVICES 434714 MIDSOUTH CREDIT BUREAU INC 1410 INDUSTRIAL PARK RD PARIS TN 38242 CREDIT REPORTS 246341 10 HOSPITAL REVENUES 900099 62276996 62276996 RENT FROM AFFILIATES 900099 77795 77795 62354791 8949 8949 75333 30118 45215 45215 45215 7292 47234 -39942 -39942 -39942 CAFETERIA REVENUE 722210 255787 48599 207188 255787 62624800 62354791 48599 221410 27350 27350 159598 132466 27132 18706752 15526604 3180148 608036 504670 103366 4002112 3321753 680359 1272927 1056529 216398 9374 9374 5459420 4531318 928102 61174 50774 10400 1585258 1315764 269494 986315 818641 167674 51379 20552 30827 16655 6662 9993 308862 256355 52507 2052549 1703616 348933 267764 222244 45520 MEDICAL SUPPLIES 10545652 10545652 0 PAYMENTS TO AFFILIATES 5607677 4654372 953305 MEDICAID ASSESSMENT 2343774 2343774 0 REPAIRS & MAINTENANCE 974098 808501 165597 520661 337251 183410 55567387 48184848 7382539 0 1096 1096 1690078 1629281 7468714 9801838 1579392 1708597 406661 517384 55972303 38340047 18893170 17632256 8205 14585 14501631 17778046 44548947 49083083 2464748 2624622 7806786 5123635 10271534 7748257 X 34226259 41283672 51154 51154 34277413 41334826 44548947 49083083 7057413 0 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 9374 9374 0 Part II-B, Line 1: BAPTIST MEMORIAL HEALTH CARE CORPORATION PAYS MEMBERSHIP DUES TO THE VARIOUS HOSPITAL ASSOCIATIONS SUCH AS THE TENNESSEE HOSPITAL ASSOCIATION, MISSISSIPPI HOSPITAL ASSOCIATION, AND ARKANSAS HOSPITAL ASSOCIATION. A PORTION OF THE MEMBERSHIP DUES IS DESIGNATED AS LOBBYING FEES BY THE HOSPITAL ASSOCATIONS. EACH HOSPITAL ASSOCIATION ALLOCATES A DIFFERENT PERCENTAGE, AND THE PERCENTAGE MAY VARY ANNUALLY. THE HOSPITAL ASSOCIATIONS PAY CONSULTANTS WHO MONITOR AND ADVISE THE ORGANIZATIONS ON LEGISLATIVE AND REGULATORY MATTERS THAT MAY AFFECT THE MEMBER ORGANIZATIONS AND THE MEMBER'S AFFILIATES. THESE CONSULTANTS MAY ADVOCATE POSITIONS WITH LEGISLATIVE AND REGULATORY BODIES OF GOVERNMENT AT LOCAL, STATE & FEDERAL LEVELS. BAPTIST MEMORIAL HEALTH CARE CORPORATION ALLOCATES A PORTION OF THESE FEES AMONG ITS HOSPITALS. 250000 250000 22415819 10190748 12225071 26970645 22852987 4117658 6335839 5296312 1039527 17632256 ESTIMATED SETTLEMENTS WITH THIRD PARTIES 75330 DUE FROM AFFILIATES 17702716 17778046 ESTIMATED SETTLEMENTS WITH THIRD PARTIES 44000 DUE TO AFFILIATES 4169635 INSURANCE RESERVES 910000 5123635 X 62694859 0 62694859 -70059 -70059 62624800 55637446 0 55637446 -70059 -70059 55567387 Part X, Line 2: FROM THE AUDITED FINANCIAL STATEMENT OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC.: AS OF SEPTEMBER 30, 2017 THE HOSPITAL HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS UNDER FASB ASC TOPIC 740, INCOME TAXES, REQUIRING ADJUSTMENTS TO ITS FINANCIAL STATEMENTS. IN THE EVENT THE HOSPITAL WERE TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE RECOGNIZED IN THE FINANCIAL STATEMENTS AS INTEREST EXPENSE. GENERALLY, THE HOSPITAL IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR TAX YEARS PRIOR TO 2013 (FISCAL YEAR ENDED SEPTEMBER 30, 2014). Part XI, Line 4b - Other Adjustments: RENT EXPENSE -30,117. LOSS ON DISPOSAL OF ASSETS -39,942. Part XII, Line 4b - Other Adjustments: RENT EXPENSE -30,117. LOSS ON DISPOSAL OF ASSETS -39,942. 1 1 X 1 X 1 X 1 1 1 0 1 1 5148271 5148271 0.09280 16489584 18559103 0 0.00000 443160 580358 0 0.00000 22081015 19139461 5148271 0.09280 9 3231 105341 5605 99736 0.00180 2 80 32961 0 32961 0.00060 17079230 12126563 4952667 0.08930 5 1483 15972 0 15972 0.00030 16 4794 17233504 12132168 5101336 0.09200 16 4794 39314519 31271629 10249607 0.18480 1 9 167 0 167 0.00000 1 560 688 0 688 0.00000 1 0 2150 0 2150 0.00000 1 16 142 0 142 0.00000 1 9840 16521 0 16521 0.00030 5 10425 19668 19668 0.00030 1 1594740 1069866 9533690 9848492 -314802 X 1 1 1 1 BAPTIST MEMORIAL HOSPITAL-UNION COUNTY 200 HWY 30 WEST NEW ALBANY MS 38652 WWW.BAPTISTONLINE.ORG/UNION-COUNTY/ 16-239 X X X BAPTIST MEMORIAL HOSPITAL-UNION COUNTY 1 0 0 1 X X X X X X X X 15 1 1 0 1 X SEE PART V SECTION C X 1 15 1 SEE PART V SECTION C 0 1 X 100.000000000000 300.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V SECTION C X SEE PART V SECTION C X SEE PART V SECTION C X X X X X X 1 X 0 X 1 X 0 0 BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. Part V, Section B, Line 5: QUANTITATIVE AND QUALITATIVE METHODS, REPRESENTING BOTH PRIMARY AND SECONDARY RESEARCH, WERE USED TO ILLUSTRATE AND COMPARE HEALTH TRENDS AND DISPARITIES ACROSS EACH HOSPITAL'S SERVICE AREA. PRIMARY RESEARCH METHODS WERE USED TO SOLICIT INPUT FROM KEY COMMUNITY STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING EXPERTS IN PUBLIC HEALTH AND INDIVIDUALS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. SECONDARY RESEARCH METHODS WERE USED TO IDENTIFY COMMUNITY HEALTH NEEDS AND TRENDS ACROSS GEOGRAPHIC AREAS AND POPULATIONS. THE FOLLOWING RESEARCH WAS CONDUCTED TO DETERMINE COMMUNITY HEALTH NEEDS: --A REVIEW OF PUBLIC HEALTH AND DEMOGRAPHIC DATA PORTRAYING THE HEALTH AND SOCIOECONOMIC STATUS OF THE COMMUNITY. --A KEY INFORMANT SURVEY WITH 58 COMMUNITY REPRESENTATIVES TO SOLICIT FEEDBACK ON COMMUNITY HEALTH PRIORITIES, UNDERSERVED POPULATIONS, AND PARTNERSHIP OPPORTUNITIES. --A FOCUS GROUP WITH 14 HEALTH CARE CONSUMERS TO IDENTIFY HEALTH NEEDS AND INFORM IMPLEMENTATION STRATEGIES AROUND HEALTH CARE DELIVERY, CANCER SCREENINGS AND CARE, AND CHRONIC CONDITION MANAGEMENT AND PREVENTION. --A PARTNER FORUM WITH COMMUNITY REPRESENTATIVES TO SOLICIT FEEDBACK ON COMMUNITY HEALTH PRIORITIES AND FACILITATE COLLABORATION. LEADERSHIP:THE 2016 CHNA WAS OVERSEEN BY A STEERING COMMITTEE OF BAPTIST MEMORIAL HEALTH CARE REPRESENTATIVES WITH INPUT FROM COMMUNITY REPRESENTATIVES AND PARTNERS. RESEARCH PARTNER:BAPTIST'S CONSULTANT, BAKER TILLY, ASSISTED IN ALL PHASES OF THE CHNA INCLUDING PROJECT MANAGEMENT, QUANTITATIVE AND QUALITATIVE DATA COLLECTION, REPORT WRITING, AND DEVELOPMENT OF THE IMPLEMENTATION STRATEGY. PROJECT MANAGER: COLLEEN MILLIGAN, MBA LEAD RESEARCHER: CATHERINE BIRDSEY, MPHTHE FOLLOWING CONTRIBUTED TO THE CHNA PROCESS AS COMMUNITY PARTNERS: FIRST AMERICAN BANK NEW ALBANY FIRE BNA BANK NEW ALBANY SCHOOLS BANCORPSOUTH COMMUNICARE/NATIONAL ALLIANCE ON MENTAL ILLNESS OXFORD UNION COUNTY DEVELOPMENT ASSOCIATION NEW ALBANY POLICE DEPARTMENT HOME INSTEAD SENIOR CARE BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. Part V, Section B, Line 6a: BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. CONDUCTED ITS CHNA WITH THE FOLLOWING MISSISSIPPI FACILITIES:BAPTIST MEMORIAL HOSPITAL-BOONEVILLE, INC.BAPTIST MEMORIAL HOSPITAL-GOLDEN TRIANGLE, INC.BAPTIST MEMORIAL HOSPITAL-NORTH MISSISSIPPI, INC.PART V SECTION B, LINE 7a: THE MISSISSIPPI CHNA CAN BE FOUND AT:http://www.baptistonline.org/about/CHNAPART V SECTION B, LINE 10a: THE IMPLEMENTATION STRATEGY FOR BAPTIST MEMORIALHOSPITAL-UNION COUNTY, INC. CAN BE FOUND AT:http://www.baptistonline.org/about/CHNA BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. Part V, Section B, Line 11: BAPTIST MEMORIAL HEALTH CARE DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) TO GUIDE COMMUNITY BENEFIT AND POPULATION HEALTH IMPROVEMENT ACTIVITIES ACROSS THE MISSISSIPPI SERVICE AREA. BAPTIST'S CHIP BUILDS UPON PREVIOUS HEALTH IMPROVEMENT ACTIVITIES, WHILE RECOGNIZING NEW HEALTH ISSUES AND CONCERNS AND A CHANGING HEALTH CARE DELIVERY ENVIRONMENT, TO ADDRESS THE REGION'S MOST PRESSING COMMUNITY HEALTH NEEDS. BELOW ARE SPECIFIC ACTIVITIES THAT BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. WILL CARRY OUT IN SUPPORT OF THE SYSTEM-WIDE PLAN.1. BEHAVIORAL HEALTH:THE GOAL IS TO IMPROVE OUTCOMES FOR RESIDENTS WITH A MENTAL HEALTH OR SUBSTANCE ABUSE CONDITION AND THEIR FAMILIES. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. HAS OUTLINED THE FOLLOWING OBJECTIVES: 1) INCREASE THE NUMBER OF RESIDENTS WHO ARE SCREENED FOR DEPRESSION AND MENTAL HEALTH CONDITIONS. 2) DEVELOP OR CONTINUE COLLABORATION WITH COMMUNITY AGENCIES THAT PROVIDE MENTAL HEALTH AND/OR SUBSTANCE ABUSE SUPPORT SERVICES TO REDUCE SUICIDE AND DRUG-INDUCED DEATH RATES. 3) EDUCATE RESIDENTS ABOUT WARNING SIGNS FOR MENTAL HEALTH CONDITIONS AND SUBSTANCE ABUSE, INCLUDING ALZHEIMER'S DISEASE. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. HAS IMPLEMENTED THE FOLLOWING STRATEGIES: 1) WORK WITH COMMUNITY PARTNERS TO IDENTIFY OPPORTUNITIES TO PROMOTE BEHAVIORAL HEALTH EDUCATION AND SCREENINGS. 2) WORK WITH THE NEW ALBANY POLICE DEPARTMENT AND OTHER PARTNERS TO REDUCE DRUG AND ALCOHOL USE AMONG YOUTH,3) PROVIDE EDUCATION AND SUPPORT ABOUT ALZHEIMER'S DISEASE TO INDIVIDUALS AND CAREGIVERS.4) HOST SUPPORT GROUPS FOR ALZHEIMER'S DISEASE CAREGIVERS.2. CANCER:THE GOAL IS TO PROVIDE EARLY DETECTION AND TREATMENT TO REDUCE CANCER MORTALITY RATES AND IMPROVE QUALITY OF LIFE FOR PATIENTS LIVING WITH CANCER. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. HAS OUTLINED THE FOLLOWING OBJECTIVES: 1) PROVIDE FREE OR REDUCED COST SCREENINGS AND SERVICES, ESPECIALLY TARGETING LOW-INCOME, AT-RISK, AND MINORITY POPULATIONS. 2) INCREASE RESIDENTS' AWARENESS OF THE BENEFITS OF CANCER PREVENTION, SCREENINGS, AND EARLY TREATMENT. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. HAS IMPLEMENTED THE FOLLOWING STRATEGIES: 1) PARTNER WITH COMMUNITY ORGANIZATIONS TO INCREASE AWARENESS OF CANCER RISK, PREVENTION, AND SCREENING. 2) PARTICIPATE IN AND/OR HOST EDUCATIONAL FORUMS TO INCREASE AWARENESS OF RISK FACTORS AND PREVENTION ACTIVITIES. 3) PROVIDE FREE OR REDUCED COST CANCER SCREENING FOR AT-RISK AND/OR UNINSURED ADULTS.3. CHRONIC DISEASE MANAGEMENT AND PREVENTION:THE GOAL IS TO REDUCE RISK FACTORS FOR CHRONIC DISEASE AND IMPROVE MANAGEMENT OF CHRONIC DISEASE THROUGH HEALTHY LIFESTYLE CHOICES. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. HAS OUTLINED THE FOLLOWING OBJECTIVES: 1) PROVIDE EDUCATION ABOUT HEALTHY LIFESTYLES AND RISK FACTORS FOR DISEASE. 2) ENCOURAGE PHYSICAL ACTIVITY AMONG RESIDENTS. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. HAS IMPLEMENTED THE FOLLOWING STRATEGIES: 1) PARTICIPATE IN HEALTH FAIRS AND OTHER COMMUNITY EVENTS THAT PROVIDE EDUCATION AND SCREENINGS FOR HEALTH RISK FACTORS RELATED TO CHRONIC DISEASE. 2) COLLABORATE WITH COMMUNITY PARTNERS TO PROMOTE PHYSICAL ACTIVITY. 3) HOST SUPPORT GROUPS FOR CHRONIC DISEASES.4) PROVIDE FREE DIABETES EDUCATION CLASSES.4. MATERNAL AND CHILD HEALTH: THE GOAL IS TO IMPROVE BIRTH OUTCOMES FOR WOMEN AND INFANTS. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. HAS OUTLINED THE FOLLOWING OBJECTIVES:1) INCREASE THE PROPORTION OF WOMEN WHO RECEIVE EARLY AND ADEQUATE PRENATAL CARE. 2) INCREASE THE PROPORTION OF INFANTS WHO ARE BREASTFED. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. HAS IMPLEMENTED THE FOLLOWING STRATEGIES: 1) COLLABORATE WITH COMMUNITY PARTNERS TO PROVIDE PRENATAL EDUCATION.2) PROVIDE FREE CHILDBIRTH EDUCATION AND PARENTING CLASSES FOR NEW PARENTS.3) SUPPORT COMMUNITY PARTNERS TO IMPROVE OUTCOMES FOR MOTHERS AND BABIES. 4) PROVIDE BREASTFEEDING SUPPORT AND EDUCATION TO NEW MOTHERS.5) PARTNER WITH COMMUNITY ORGANIZATIONS TO PROVIDE EDUCATION AND FINANCIAL SUPPORT FOR PREGNANT TEENS.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. HAS ADDRESSED ALL FOUR OF THE PRIORITIZED HEALTH NEEDS IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT. IT WILL CONTINUE TO PLAY A LEADERSHIP ROLE IN ADDRESSING THE HEALTH NEEDS OF THE RESIDENTS IN THE COMMUNITIES IT SERVES. FOR COMMUNITY NEEDS NOT IDENTIFIED AS PRIORITIES, BAPTIST MEMORIAL HOSPITAL-UNION COUNTY WILL CONTINUE TO PLAY A SUPPORT ROLE AS RESOURCES ARE AVAILABLE. AS WITH ALL BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PROGRAMS, THE HOSPITAL WILL CONTINUE TO MONITOR COMMUNITY NEEDS AND ADJUST PROGRAMMING AND SERVICES ACCORDINGLY.BUILDING UPON THE PRIOR CHNA AND IMPLEMENTATION OF THE CURRENT CHNA, THE HOSPITAL CONTINUES TO DO THE FOLLOWING:--PROVIDE DEPRESSION AND MENTAL HEALTH SCREENINGS AMONG PRIMARY CARE PATIENTS --OFFER "LOOK GOOD, FEEL BETTER" CLASSES FOR WOMEN ACTIVELY UNDERGOING CHEMOTHERAPY OR RADIATION --OFFER THE HEALTHY KIDS CAMP AND GET FIT PROGRAM, DESIGNED TO ENCOURAGE CHILDREN TO ADOPT HEALTHIER EATING AND EXERCISE HABITS --PARTICIPATE IN HEALTH FAIRS AND INFORMATIONAL BOOTHS TO PROVIDE HEALTH INFORMATION AND SCREENINGS (BLOOD PRESSURE, BMI, BALANCE, DIABETES, MAMMOGRAPHY, PSA, ETC.) AND PROMOTE HEALTHY LIFESTYLES --PARTICIPATE IN THE UNION COUNTY COMMUNITY HELPER DAY, PROVIDING HEALTHY LIFESTYLE EDUCATION TO PRE-KINDERGARTEN AND FIRST GRADE STUDENTS --PARTNER WITH SAV-A-LIFE, A TEEN PREGNANCY RESOURCE CENTER, TO ADDRESS THE PREVENTION OF TEEN PREGNANCY AND ASSIST TEENS THAT ARE CURRENTLY PREGNANT --PROVIDE MATERNAL AND CHILD HEALTH CLASSES AND PRESENTATIONS ON TOPICS, INCLUDING CHILD BIRTHING, BREASTFEEDING, WOMEN'S HEALTH, CAR SEAT SAFETY, SIBLING SUPPORT, INFANT SKIN CARE, AND NEW PARENTS --PROVIDE CHRONIC CONDITION (ASTHMA, CANCER, COPD, DIABETES, AND HEART DISEASE) EDUCATION SESSIONS, MANAGEMENT CLASSES, AND LUNCHEON SERIES AND SPONSORED COMMUNITY AWARENESS CAMPAIGNS--PROVIDE DRUG AND ALCOHOL PREVENTION PROGRAMS TO YOUTH AND ADULTS--PROVIDE "HEALTH TALK WITH BAPTIST," SEGMENTS ABOUT HEALTHY LIFESTYLE CHOICES AND "THE DOCTOR IS IN" LECTURE SERIES--SPONSOR COMMUNITY AGENCIES/EVENTS, INCLUDING THE AGAPE HEALTH SERVICES, ALBANY POLICE DEPARTMENT, AMERICAN CANCER SOCIETY RELAY FOR LIFE, AMERICAN RED CROSS, DIABETES FOUNDATION, FARMER'S MARKETS, JUNIOR AUXILIARY, LOVE PACKS, MARCH OF DIMES, MYCHOICE PREGNANCY CARE CENTER, NORTH PONTOTOC SCHOOL JUMP ROPE FOR HEART HEALTH, SANCTUARY HOSPICE HOUSE-TUPELO, TANGLEFOOT TRAILS, ETC.--SPONSOR LOCAL BABY FAIRS AIMED AT GIVING EXPECTANT MOTHERS ACCESS TO LOCAL RESOURCES AND EXPERTS THAT CAN HELP THEM MAKE THE BEST POSSIBLE CHOICES FOR THEIR BABIES. --SPONSOR LOCAL BACK TO SCHOOL HEALTH FAIRS FEATURING SCREENINGS, SAFETY AWARENESS, AND HEALTH EDUCATION --SPONSOR SUPPORT GROUPS, INCLUDING SASSY SPARROWS BREAST CANCER SURVIVOR GROUP, RENEWAL WITH HOPE CANCER NUTRITION GROUP, BARIATRIC SUPPORT GROUP, NEVER ENDING CIRCLE GRIEF SUPPORT GROUP, MENDED HEARTS SUPPORT GROUP, NAMI CONNECTION SUPPORT GROUP, BREASTFEEDING SUPPORT GROUP, DIABETES SUPPORT GROUP, ETC. --SUPPORT ALZHEIMER'S AWARENESS AND EDUCATION BY SPONSORING THE COLOR INVASION 5K AND OFFERING SUPPORT TO CAREGIVERS --SUPPORT THE STOP THE KNOCK CAMPAIGN, AN INITIATIVE AIMED AT DECREASING FATAL CAR CRASHES.BY PROVIDING HEALTH EDUCATION AND OPPORTUNITIES FOR RESIDENTS TO PARTICIPATE IN PROGRAMS TO IMPROVE THEIR HEALTH, BAPTIST MEMORIAL HEALTH CARE HELPED THOUSANDS OF OUR COMMUNITY MEMBERS LEAD HEALTHIER LIVES. WE BELIEVE STRONGLY IN CORPORATE CITIZENSHIP AND RECOGNIZE THE IMPORTANCE OF COLLABORATION WITH LOCAL ORGANIZATIONS TO BUILD STRONGER AND HEALTHIER COMMUNITIES. WE REMAIN COMMITTED TO SUPPORTING COMMUNITY HEALTH IMPROVEMENT IN LINE WITH OUR MISSION AND VISION. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. Part V, Section B, Line 13b: 1. MONEY INCOME: INCLUDES EARNINGS, UNEMPLOYMENT COMPENSATION, WORKERS' COMPENSATION, SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, DISABILITY PAYMENTS, PUBLIC ASSISTANCE, VETERANS' PAYMENTS, SURVIVOR BENEFITS, PENSION OR RETIREMENT INCOME, INTEREST, DIVIDENDS, RENTS, ROYALTIES, INCOME FROM ESTATES, TRUSTS, EDUCATIONAL ASSISTANCE, ALIMONY, CHILD SUPPORT, ASSISTANCE FROM OUTSIDE THE HOUSEHOLD, AND OTHER MISCELLANEOUS SOURCES. WHEN CALCULATING INCOME FROM ANY OF THE PRECEDING SOURCES USE THE GROSS AMOUNT.2. NON-CASH BENEFITS (SUCH AS FOOD STAMPS AND HOUSING SUBSIDIES) DO NOT COUNT AS INCOME. 3. IF A PERSON LIVES WITH A FAMILY, CALCULATE THE TOTAL GROSS INCOME OF ALL FAMILY MEMBERS. A) NON-RELATIVES, INCLUDING HOUSEMATES, DO NOT COUNT. B) A CHILD WHO IS A FULL-TIME STUDENT AWAY FROM HOME IN AN ACCREDITED COLLEGE MAY BE COUNTED. C) MINOR CHILDRENS' EARNED WAGES ARE NOT TO BE INCLUDED IN DETERMINING INCOME.D) COURT-ORDERED OR STATE/FEDERAL ISSUED ASSISTANCE RELATED TO A MINOR SHOULD BE INCLUDED IN DETERMINING INCOME.4. PRIMARY RESIDENCE OF INDIVIDUALS CLAIMED IN A FAMILY UNIT SHOULD BE VERIFIED USING TAX RETURNS OR FEDERAL, STATE OR GOVERNMENTAL COURT DOCUMENTS INDICATING RESIDENCY. PART V SECTION B, LINE 16: LINE 16A:THE FINANCIAL ASSISTANCE POLICY CAN BE FOUND AThttps://www.baptistonline.org/patients-and-visitors/financial-assistanceLINE 16B:THE FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND AThttps://www.baptistonline.org/patients-and-visitors/financial-assistanceLINE 16C:THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT https://www.baptistonline.org/patients-and-visitors/financial-assistance Part I, Line 3c: BAPTIST MEMORIAL HOSPITAL USES FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE ELIGIBILITY FOR FREE OR REDUCED CARE FOR LOW INCOME AND MEDICALLY INDIGENT INDIVIDUALS. IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL USES UNDERINSURED STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. Part I, Line 6a: THE COMMUNITY BENEFIT REPORT IS PREPARED BY THE HOSPITAL'S SOLE MEMBER, BAPTIST MEMORIAL HEALTH CARE CORPORATION. THE COMMUNITY BENEFIT REPORT IS MADE AVAILABLE TO THE PUBLIC BY MAIL AND AVAILABLE AT EACH AFFILIATE OF BAPTIST MEMORIAL HEALTH CARE CORPORATION. Part I, Line 7: OUR COST ACCOUNTING PROCESS REFLECTS FULLY LOADED COST FOR ALL OF OUR PATIENT POPULATIONS. FULLY LOADED COST INCLUDES DIRECT, CAPITAL, AND INDIRECT COST. AFTER WORKING WITH OUR DEPARTMENT DIRECTORS AND CFOS TO MAKE SURE THE DOLLARS IN THE GENERAL LEDGER ARE IN THE CORRECT PLACE TO REFLECT OUR TIME AND EFFORTS SPENT THROUGHOUT THE YEAR, WE DEVELOP RELATIVE VALUE UNITS TO ALLOCATE THE ACTUAL GENERAL LEDGER COST DOWN TO THE PROCEDURE CHARGE CODES FROM OUR PATIENT ACCOUNTING SYSTEM. ALL OVERHEAD IS ALLOCATED DOWN TO THE REVENUE PRODUCING DEPARTMENTS BASED ON VARIOUS STATISTICS. ONCE EVERY CHARGE CODE HAS GONE THROUGH THE COST AND AUDIT PROCESS, WE CAN RUN THE PATIENT LEVEL REPORTS USED FOR THE FORM 990 TO GET TO THE COST INFORMATION NEEDED. Part I, Line 7g: SUBSIDIZED HEALTH SERVICES DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. Part I, Ln 7 Col(f): PART I, LINE 7, COLUMN (F):PER IRS INSTRUCTIONS, BAD DEBT EXPENSE WAS NOT INCLUDED IN THE CALCULATION OF THE PERCENTAGE OF TOTAL CHARITY CARE AND COMMUNITY BENEFITS COST ON SCHEDULE H, LINE 7, COLUMN (F).PART I, LINE 7b, COLUMN (F):DUE TO SOFTWARE LIMITATIONS, THE PERCENT OF TOTAL EXPENSES FOR LINE 7b COLUMN (F) MEDICAID IS REPORTED AS ZERO, BUT THE ACTUAL AMOUNT OF LINE 7b IS -3.73%.PART I, LINE 7c, COLUMN (F):DUE TO SOFTWARE LIMITATIONS, THE PERCENT OF TOTAL EXPENSES FOR LINE 7c COLUMN (F) UNREIMBURSED COSTS-OTHER MEANS TESTED GOVERNMENT PROGRAMS IS REPORTED AS ZERO, BUT THE ACTUAL AMOUNT OF LINE 7c IS -.25%. Part II, Community Building Activities: BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. CONDUCTS SEVERAL HEALTH FAIRS, SEMINARS AND CLASSES THROUGHOUT THE YEAR FOR THE COMMUNITIES IT SERVES. BAPTIST ALSO IS INVOLVED IN LOCAL COMMUNITY AND NON-PROFIT ORGANIZATIONS SUCH AS THE AMERICAN CANCER SOCIETY RACE FOR THE CURE, WALK AMERICA, ST. JUDE, AND MANY OTHERS. NOT ONLY DO WE PROVIDE MONETARY DONATIONS, BUT OUR EMPLOYEES ARE ACTIVE VOLUNTEERS IN THESE WORTHY CAUSES. Part III, Line 2: THE ORGANIZATION'S BAD DEBT EXPENSE WAS DETERMINED AS FOLLOWS: A BAD DEBT REPORT IS RUN TO PULL ALL PATIENTS THAT HAVE BEEN MOVED TO A BAD DEBT ACCOUNT LOCATION. WE THEN TAKE THE TOTAL ACCOUNT BALANCE OF ALL THE PATIENTS IN THE BAD DEBT LOCATION AND DIVIDE IT BY THE TOTAL CHARGES OF THE SAME PATIENT LOCATION. WE MULTIPLY THE RESULTING RATIO BY THE TOTAL COST OF THE SAME PATIENT POPULATION WHICH PROVIDES US WITH THE COST ASSOCIATED WITH THE TOTAL AMOUNT OF THE ACCOUNT BALANCE MOVED TO BAD DEBT STATUS. Part III, Line 3: THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS DETERMINED AS FOLLOWS:WE RUN A QUERY OUT OF OUR INTERNAL DATA WAREHOUSE SYSTEM THAT IDENTIFIES THE PATIENT POPULATION WHO HAVE BEEN IDENTIFIED AS ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THIS INFORMATION IS ENTERED INTO THE STANDARD NOTE SECTION OF EACH PATIENT RECORD. WE ALSO QUALIFY OUR PATIENT QUERY BY THE STANDARD NOTES THAT REPRESENT WHEN A PATIENT REFUSES TO COMPLETE THE FINANCIAL ASSISTANCE PAPERWORK. IF A PATIENT IS DETERMINED TO BE EITHER ELIGIBLE FOR FINANCIAL ASSISTANCE, IF INFORMATION PROVIDED BY THE PATIENT IS INCOMPLETE, OR WHEN A SELF-PAY MINIMUM DISCOUNT NOTE IS ENTERED ON THE PATIENT RECORD, WE THEN TAKE THIS PATIENT POPULATION AND RUN A REPORT WHICH PROVIDES US THE COST ASSOCIATED WITH THE TOTAL AMOUNT OF BAD DEBT ATTRIBUTABLE TO THOSE PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. Part III, Line 4: BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. HAS ADOPTED HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15, VALUATION AND FINANCIAL STATEMENT PRESENTATION OF CHARITY CARE AND BAD DEBTS BY INSTITUTIONAL PROVIDERS.THERE IS NOT A SEPARATE BAD DEBT EXPENSE FOOTNOTE IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. ALLOWANCE FOR DOUBTFUL ACCOUNTS IS DISCUSSED IN A SEPARATE PARAGRAPH BEGINNING ON PAGE 6 OF THE AUDITED FINANCIAL STATEMENTS. Part III, Line 8: THE SHORTFALL, IF ANY, IS NOT TREATED AS COMMUNITY BENEFIT.WE CAN'T GET THE PAYMENT AND MEDICARE ALLOWABLE COST INFORMATION FROM THE COST REPORT IN THE FORMAT THAT WE NEED, SO WE DO THE FOLLOWING. FOR LINE 5, WE TAKE THE TOTAL PAYMENTS FOR MEDICARE PATIENTS FROM SCHEDULE 6 PATIENT POPULATION AND DIVIDE THAT BY THE TOTAL HOSPITAL MEDICARE PAYMENTS. WE MULTIPLY THE RESULTING RATIO BY THE REVENUE NUMBERS THAT COME FROM THE COST REPORT. FOR LINE 6, WE USE THE SAME CONCEPT TO GET THE COST INFORMATION. WE GET THE TOTAL COST OF MEDICARE PATIENTS FROM SCHEDULE 6 AND DIVIDE THAT NUMBER BY THE TOTAL COST OF THE TOTAL MEDICARE PATIENT POPULATION OF THE HOSPITAL. WE THEN MULTIPLY THIS RATIO BY THE COST INFORMATION FROM THE COST REPORT. Part III, Line 9b: THE HOSPITAL'S COLLECTION AGENCY, WILL DETERMINE IF THE PATIENT HAS A CHARITY APPLICATION ON FILE AND WAS DEEMED TO BE A CHARITY CASE BY THE HOSPITAL. IF IT WAS DETERMINED THAT THE PATIENT IS A CHARITY CASE, THEN THE COLLECTION AGENCY WILL REVIEW THE REMAINING UNPAID BALANCE AFTER THE APPLICATION OF THE CHARITY DISCOUNT, AND PURSUE APPROPRIATE COLLECTION EFFORTS. DEPENDING UPON THE CIRCUMSTANCES AT THE TIME, THE ENTIRE AMOUNT OWED MAY BE WRITTEN OFF.OTHER PATIENTS, WHO ARE NOT CHARITY PATIENTS, GENERALLY ARE NOT OFFERED A DISCOUNT ON THE AMOUNT OWED IF THE ACCOUNT IS 0-6 MONTHS OLD. THE HOSPITAL'S COLLECTION AGENCY WILL TRY TO SET UP A PAYMENT PLAN. IF THE PATIENT HAS INSURANCE AND THE BILL WAS FILED WITH THEIR INSURANCE COMPANY, THE PRIOR PPO ADJUSTMENT IS GIVEN. THE AMOUNT OF DISCOUNT INCREASES AS THE AGE OF THE DEBT INCREASES. AS THE AGE OF THE DEBT INCREASES, DETERMINING FACTORS ARE ALSO CONSIDERED SUCH AS THE ABILITY OF THE PATIENT TO PAY, THE AGE AND HEALTH OF THE PATIENT, FAMILY CIRCUMSTANCES, CREDIT SCORE, ETC.RISK FACTORS ARE ALSO CONSIDERED WHEN DETERMINING WHETHER TO SETTLE AN ACCOUNT. RISK FACTORS INCLUDE HARDSHIP AND CATASTROPHE, OTHER DEBTS, AND FUTURE EXPECTANCIES. Part VI, Line 2: BAPTIST MEMORIAL HEALTH CARE CORPORATION, THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC., PROVIDES NEEDS ASSESSMENTS THROUGH THE HEALTH SERVICES RESEARCH DEPARTMENT. IN ADDITION, LOCAL ADVISORY BOARDS PROVIDE FEEDBACK TO THE LOCAL HOSPITAL ADMINISTRATORS. THE HEALTH SERVICES RESEARCH DEPARTMENT USES VARIOUS TOOLS TO ASSIST THEM IN THE ASSESSMENTS.ONE OF THESE TOOLS USED BY HEALTH SERVICES RESEARCH DEPARTMENT IS YACOUBIAN RESEARCH, INC. COMMUNITY OPINION SURVEY. THIS IS A QUARTERLY RANDOM-DIGIT DIALING TELEPHONE SURVEY. SURVEYS INCLUDE QUESTIONS ASKING RESPONDENTS TO GRADE THE QUALITY OF HEALTH CARE SERVICES IN THEIR COMMUNITY. THE SERVICES ARE GRADED FROM A-F. IF A SERVICE IS GIVEN A RATING OF C OR BELOW, THE RESPONDENTS ARE ASKED FOR IDEAS FOR IMPROVEMENT. THESE CAN BE REVIEWED BY AREA, COUNTY, TOWN, ZIP CODE, AGE, GENDER, AND RACE. THE IMPROVEMENTS REQUESTED GENERALLY INVOLVE REQUESTS FOR MORE AND BETTER DOCTORS AND STAFF, AND LESS WAIT TIME. MEDICAL STAFF SURVEYS ARE ALSO USED TO ASSESS NEEDS. THESE ARE CONDUCTED BY MAIL OR INTERNET (WHICH EVER IS PREFERRED BY THE RESPONDENT) BY PRESS-GANEY, A NATIONALLY KNOWN RESEARCH COMPANY FOR BOTH PATIENT SATISFACTION AND PHYSICIAN SATISFACTION. IN THIS SURVEY, CONDUCTED EVERY OTHER YEAR, RESPONDENTS ARE QUESTIONED ABOUT THE NEED FOR NEW SERVICES OR PHYSICIAN SPECIALTIES IN THE HOSPITAL OR COMMUNITY. THERE ARE USUALLY MULTI-PHYSICIAN RECOMMENDATIONS FOR ADDITIONAL EQUIPMENT AND CERTAIN TYPES OF PHYSICIAN SPECIALISTS. THIS IS USED AS A STARTING POINT FOR DETERMINING POTENTIAL PRIORITIES FOR PHYSICIAN RECRUITING.COMMUNITY NEEDS ASSESSMENT FOR ADDITIONAL PHYSICIANS IN THE COMMUNITY IS ALSO CONDUCTED. POPULATION-BASED DEMAND ESTIMATES ARE OBTAINED FROM THE MEDSTAT INFORUM MEDI-EDGE SOFTWARE, AND TAKES INTO ACCOUNT THE AGE AND GENDER OF THE POPULATION. THIS IS THEN COMPARED TO THE SUPPLY OF PHYSICIANS AS DETERMINED THROUGH SEVERAL DIFFERENT SOURCES-INCLUDING OUR OWN CALLING OF OFFICES TO DETERMINE THE FULL TIME EQUIVALENT OF PHYSCIANS AVAILABLE IN THE SPECIALTY OF INTEREST. THE DEMAND MINUS THE SUPPLY GIVES THE "NET NEED" CURRENTLY, AND IN 5 YEARS. THE REQUEST FOR THESE ANALYSES ARE MADE BY THE HOSPITAL'S CHIEF EXECUTIVE OFFICERS' BASED ON THE PRIORITIES GIVEN BY THE MEDICAL STAFF AND ACCORDING TO KNOWLEDGE OF CERTAIN PHYSICIANS THAT ARE LIKELY TO BE LEAVING THE AREA IN THE NEXT YEAR OR TWO. GENERALLY THE DEMAND AND SUPPLY ESTIMATES ARE FOR A GEOGRAPHIC AREA DEFINED BY THE HALF-WAY MARK BETWEEN OUR FACILITY AND THE COMMUNITY HAVING A SIMILAR SIZED MEDICAL FACILITY OF A COMPETITOR. IN LARGER MARKET AREAS, THE PHYSICIAN NEEDS ARE GENERALLY CONCENTRATED AROUND HIGHLY SPECIALIZED PHYSICIANS WHO MAY BE LEAVING OR RETIRING. THE SOFTWARE PACKAGE HAS MODULES THAT ARE USED TO DETERMINE THE NEED FOR NEW FACILITIES, SUCH AS HOSPITALS, URGENT CARE CENTERS, EXPANDED EMERGENCY ROOMS, ETC. THIS IS REVIEWED IF THERE IS AN INCREASE IN POPULATION GROWTH.PATIENT SATISFACTION SURVEYS ARE ANOTHER TOOL USED TO ASSESS NEED. PRESS GANEY MAILS SURVEYS EVERY TWO WEEKS TO A RANDOM SAMPLE OF DISCHARGED PATIENTS. THE GOAL IS TO GET APPROXIMATELY 350 COMPLETED SURVEYS PER YEAR IN EACH OF THE VARIOUS CARE SETTINGS PER FACILITY. THESE CARE SETTINGS INCLUDE INPATIENT, OUTPATIENT, EMERGENCY ROOMS, OUTPATIENT SURGERY, OUTPATIENT DIAGNOSTICS, HOME HEALTH CARE, URGENT CARE CENTERS, ETC. BASED ON THESE SURVEYS, THE NEED FOR SPECIFIC CHANGES IN PROCESSES OR TYPES OF PERSONNEL ARE ASSESSED TO MEET THE NEEDS OF THE COMMUNITIES WE SERVE.NATIONAL RESEARCH CORPORATION IS A RESEARCH COMPANY THAT INTERVIEWS 600 PEOPLE IN OUR COMMUNITY SERVICE AREA EACH YEAR VIA THE INTERNET. THESE PEOPLE ARE A PART OF A PANEL SELECTED TO REPRESENT THE CHARACTERISTICS OF THE COMMUNITY. THIS SURVEY PROVIDES AN ON-LINE TOOL FOR DETERMINING SELF-REPORTED PERCENTAGES WITH CHRONIC CONDITIONS AND USE OF PREVENTIVE SERVICES IN AREAS OF SIMILAR SIZE AND CHARACTERISTICS AROUND THE COUNTRY. Part VI, Line 3: PATIENTS ARE INFORMED OF THEIR ELIGIBILTY FOR ASSISTANCE IN PERSON UPON ENTERING THE HOSPITAL FACILITY. EACH PATIENT IS ASSIGNED AN ADMISSIONS PERSON WHO PROVIDES WRITTEN INFORMATION AS WELL AS VERBAL INFORMATION. IN ADDITION THE PATIENT MAY OBTAIN INFORMATION AS FOLLOWS:(A) A COPY IS GIVEN TO THE PATIENT DURING THE ADMISSIONS AND/OR DISCHARGE PROCESS FOR EACH VISIT FOR MEDICAL TREATMENT.(B) A COPY IS SENT WITH THE FIRST POST-DISCHARGE BILLING STATEMENT.(C) COPIES ARE POSTED AND AVAILABLE UPON REQUEST AT ALL ADMISSIONS, EMERGENCY AND BUSINESS OFFICE DEPARTMENT AREAS AT ALL BAPTIST FACILITIES.(D) THEY ARE ALSO AVAILABLE FOR DOWNLOAD AND PRINTING ONLINE ON THE BAPTIST WEBSITE UNDER "FINANCIAL ASSISTANCE OR BY CONTACTING THE FACILITY WHERE SERVICES WERE RECEIVED AND REQUESTING A COPY BY MAIL OR EMAIL AT FAP@BMHCC.ORG.(E) IN ADDITION, BAPTIST WILL PROVIDE ALL OF THE FAP-RELATED DOCUMENTS ELECTRONICALLY TO ANY INDIVIDUAL WHO INDICATES THAT IS THEIR PREFERENCE. Part VI, Line 4: BAPTIST MEMORIAL HOSPITAL-UNION COUNTY SERVICES THE UNION COUNTY, MISSISSIPPI AREA. SOME PATIENTS COME FROM OTHER MISSISSIPPI COUNTIES SURROUNDING THE UNION COUNTY AREA. THE AFRICAN-AMERICAN COMMUNITY COMPRISES ABOUT 16.3% OF OUR PRIMARY SERVICE AREA. HISPANICS MAKE UP ABOUT 5.3%, AND CAUCASIANS ARE ABOUT 76.2%.DEMOGRAPHIC SNAPSHOTS ARE PROVIDED BY THE INDEPENDENT OUTSIDE FIRM OF CLARITAS, INC. OUR OWN HEALTH SERVICES RESEARCH DEPARTMENT AT BAPTIST MEMORIAL HEALTH CARE CORPORATION (OUR PARENT) CALCULATES THE DISTRIBUTION OF INPATIENT DISCHARGES (EXCLUDING NEWBORNS) BY COUNTY. THIS IS SORTED IN DESCENDING NUMBER PER COUNTY AND DETERMINES THOSE COUNTIES WITH UP TO 75-77% OF THE DISCHARGES AND THESE CONTIGUOUS COUNTIES COMPRISE THE PRIMARY MARKET AREA. COUNTIES COMPRISING 78-95% OF THE DISCHARGES ARE DESIGNATED THE SECONDARY MARKET, WHILE THE REMAINING 5% IS THE TERTIARY MARKET.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY'S PRIMARY MARKET SERVICE AREA HAS 85,858 PERSONS WITH THE COMBINED PRIMARY AND SECONDARY AREA HAVING 309,438 PERSONS. OTHER ITEMS SUCH AS AGE, HOUSEHOLD INCOME, AND RACE/ETHNICITY PERCENTAGES, AS COMPARED TO THE NATION AS A WHOLE, ARE ALSO USED IN THE MIX.DUNN AND BRADSTREET DATA IS ALSO USED TO DETERMINE THE COMMUNITIES LARGEST EMPLOYERS. Part VI, Line 5: THE HOSPITALS HAVE OPEN MEDICAL STAFFS, COMMUNITY BOARD INVOLVMENT, SUPPORT SERVICES, FREE AND/OR REDUCED MAMMOGRAMS, HEALTH FAIRS, DONATION OF SUPPLIES AND MONEY, AND MANY OTHER THINGS. Part VI, Line 6: BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. IS AN AFFILIATE OF BAPTIST MEMORIAL HEALTH CARE CORPORATION. BAPTIST MEMORIAL HEALTH CARE CORPORATION IS THE PARENT ORGANIZATION OF A NUMBER OF HOSPITALS, MINOR MEDICAL CENTERS, HOME CARE AND HOSPICE SERVICES, AND PHYSICIAN SERVICES IN WEST TENNESSEE, NORTH MISSISSIPPI, AND EAST ARKANSAS. EACH FACILITY PROVIDES HEALTH CARE SERVICES TO MEET THE NEEDS OF THE COMMUNITIES SERVED. 1 BLUE MOUNTAIN COLLEGE PO BOX 160 BLUE MOUNTAIN MS 38610 640325640 501(C)(3) 5000 SCHOLARSHIPS AND CHAPLAIN INTERNSHIP PROGRAM 1 Part I, Line 2: ALL ORGANIZATIONS ARE REQUIRED TO SUBMIT PROOF OF TAX EXEMPT STATUS THAT'S VERIFIED BY THE IRS DATABASE BEFORE THEY CAN PROCEED WITH THEIR REQUEST. THEY MAY USE OUR ONLINE CHARITABLE REQUEST APPLICATION TO SUBMIT A REQUEST. IF THEY ARE NOT A 501 (C)(3) ORGANIZATION, THEY ARE REQUIRED TO SUBMIT A COPY OF THEIR DETERMINATION LETTER FROM THE IRS VALIDATING THEIR EXEMPT STATUS BEFORE WE CAN PROVIDE ANY IN-KIND GIVEAWAYS OR SERVICES. WE ALSO MONITOR THE FUNDS TO ENSURE THEY ARE USED FOR THE PURPOSE GRANTED. WE MAKE EVERY EFFORT TO DIRECT OUR FUNDING TO A PROGRAM FOR A SPECIFIC PURPOSE. ORGANIZATIONS ARE ASKED TO SHOW RESULTS AND DOCUMENTATION ANNUALLY BEFORE THEIR REQUEST CAN BE CONSIDERED FOR FUTURE FUNDING. THE REQUESTS ARE REVIEWED AND APPROVED BY VARIOUS INDIVIDUALS DEPENDING UPON THE TYPE AND AMOUNT OF THE REQUEST. SMALL AMOUNTS MAY BE APPROVED BY THE SYSTEM COORDINATOR, CASH SPONSORSHIPS MAY BE APPROVED BY THE SYSTEM DIRECTOR OF COMMUNICATIONS, ANYTHING OVER $10,000 MAY BE APPROVED BY THE BAPTIST MEMORIAL HEALTH CARE FOUNDATION SENIOR V.P. AND ANYTHING OVER $50,000 NEEDS APPROVAL BY THE CORPORATE PRESIDENT/CEO. FOR MORE INFORMATION ABOUT BAPTIST CHARITABLE GIVING GUIDELINES, PLEASE VISIT https://www.bmhgiving.org/ 0 1 0 0 0 0 0 1 0 KIMBERLY D HIGH CFO 113892 0 12914 0 205 0 15448 0 15591 0 158050 0 0 0 JASON M LITTLE PRESIDENT 0 851732 0 493430 0 125453 0 31250 0 27386 0 1529251 0 0 GREGORY M DUCKETT SECRETARY 0 417673 0 199147 0 90414 0 33125 0 30163 0 770522 0 0 PAUL D DEPRIEST MD VICE PRESIDENT 0 585958 0 311053 0 100343 0 30625 0 27162 0 1055141 0 0 WALTER J GRACE CEO/ADMIN 0 176605 0 52985 0 43399 0 23813 0 11637 0 308439 0 0 LARRY RAMSEY PHARMACIST 117353 0 0 0 1419 0 14801 0 24181 0 157754 0 0 0 ROBERT S HATCHER PHARMACIST 107880 0 0 0 1170 0 18011 0 23069 0 150130 0 0 0 RANDY WHITE CNO 109272 0 13017 0 315 0 14906 0 21004 0 158514 0 0 0 Part I, Line 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION'S HUMAN RESOURCE DEPARTMENT, THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS, AND AN INDEPENDENT COMPENSATION CONSULTING FIRM PERFORM ANNUAL REVIEWS EACH DECEMBER AND APPROVE THE COMPENSATION OF THE ORGANIZATION'S CEO AND OTHER TOP MANAGEMENT PERSONNEL. THEY USE COMPARABILITY DATA AND OTHER SOURCES AS NEEDED. THE CEO AND OTHER TOP MANAGEMENT USE THE SAME TYPE OF INFORMATION TO APPROVE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. Part I, Line 4b ELIGIBLE EXECUTIVES PARTICIPATE IN VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO PAYMENTS WERE MADE TO LISTED PERSONS IN PART VII UNDER THE VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS DURING THE YEAR. Part I, Line 7 THE BAPTIST MEMORIAL HEALTH CARE SYSTEM HAS ESTABLISHED A MANAGEMENT ACCOUNTABILITY AND FINANCIAL INCENTIVE PLAN THAT ENCOURAGES MANAGEMENT PARTICIPATION IN THE SIGNIFICANT IMPROVEMENTS OF THE QUALITY, FINANCIAL, GROWTH, AND HUMAN RESOURCE RELATED OPERATIONS OF THE ORGANIZATION. AN INCENTIVE BONUS IS PAID TO ALL MANAGEMENT BASED ON ATTAINMENT OF GOALS IN THE AREAS OF 1) PATIENT SATISFACTION; 2) EMPLOYEE SATISFACTION; 3) PHYSICIAN SATISFACTION; 4) QUALITY AND SAFETY; 5) OPERATIONAL PREFORMANCE METRICS; AND 6) OPERATING INCOME MARGIN. PARTICIPANTS RECEIVE POINTS UNDER A PLAN SCORING SYSTEM FOR MEETING THEIR PREDETERMINED GOALS. THE POINTS ARE THEN ENTERED INTO THE PLAN FORMULA TO DETERMINE THE INCENTIVE COMPENSATION. PART V: STATEMENTS REGARDING OTHER IRS FILINGS & TAX COMPLIANCE: LINE 1a: ALL FORMS 1099 ARE PREPARED BY THE ACCOUNTS PAYABLE DEPARTMENT OF THE SOLE MEMBER, BAPTIST MEMORIAL HEALTH CARE CORPORATION. ALL FORMS 1099 ARE ISSUED USING THE FEDERAL TAX IDENTIFICATION NUMBER OF BAPTIST MEMORIAL HEALTH CARE CORPORATION. THE 1099S ARE NOT PROCESSED BY ENTITY, BUT BY VENDOR GROUP. MANY VENDORS PERFORM SERVICES FOR MULTIPLE BAPTIST ENTITIES, SO ONLY ONE 1099 IS ISSUED PER VENDOR WITH THE TOTAL AMOUNT PAID FOR SERVICES. THIS NUMBER IS REPORTED ON BAPTIST MEMORIAL HEALTH CARE CORPORATION'S FORM 990, PART V, LINE 1a. LINE 2a: THE PAYROLL FUNCTION IS CENTRALIZED AT THE PAYROLL DEPARTMENT OF THE SOLE MEMBER, BAPTIST MEMORIAL HEALTH CARE CORPORATION. THE CORPORATE PAYROLL DEPARTMENT IS RESPONSIBLE FOR ALL SALARIES AND WAGES OF THE EMPLOYEES FOR ENTIRE THE BAPTIST SYSTEM. THE W-3s AND W-2s ARE SUBMITTED ELECTRONICALLY TO THE IRS USING BAPTIST MEMORIAL HEALTH CARE CORPORATION'S FEDERAL TAX IDENTIFICATION NUMBER, ACCORDING TO THE GUIDELINES ASSOCIATED WITH COMMON PAYMASTER. HOWEVER, THE EMPLOYEE INFORMATION IS ALLOCATED TO ITS RESPECTIVE FACILITY FOR FINANCIAL REPORTING PURPOSES AND THEY ARE REPORTED TO THE STATE BY EACH FACILITY. THUS, THE AMOUNT REPORTED ON PART V, LINE 2a REFLECTS THE NUMBER OF EMPLOYEES AT THIS FACILITY WHO RECEIVED A W-2. THE TOTAL NUMBER OF W-2S FOR ALL BAPTIST ENTITIES IS REPORTED ON THE BAPTIST MEMORIAL HEALTH CARE CORPORATION W-3. LINE 7g: THE ORGANIZATION DID NOT RECEIVE ANY CONTRIBUTIONS OF QUALIFIED INTELLECTUAL PROPERTY REQUIRING IT TO FILE A FORM 8899. Line 7h: THE ORGANIZATION DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES, OR OTHER VEHICLES REQUIRING IT TO FILE A FORM 1098-C. Form 990, Part VI, Section A, line 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION AS SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. PROVIDES CERTAIN LEGAL, FINANCE, QUALITY, AND PERSONNEL SERVICES PURSUANT TO A SHARED SERVICES AGREEMENT. Form 990, Part VI, Section A, line 6 BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. IS A NON-STOCK CORPORATION WHOSE SOLE MEMBER IS BAPTIST MEMORIAL HEALTH CARE CORPORATION. Form 990, Part VI, Section A, line 7a BAPTIST MEMORIAL HEALTH CARE CORPORATION AS THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. ELECTS ITS BOARD OF DIRECTORS. Form 990, Part VI, Section A, line 7b BAPTIST MEMORIAL HEALTH CARE CORPORATION AS THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. APPROVES THE BOARD OF DIRECTORS ACTIONS. Form 990, Part VI, Section B, line 11b THE FORM 990 IS REVIEWED BY BAPTIST MEMORIAL HEALTH CARE CORPORATION'S EXEC. V.P./CFO, AND THE HOSPITAL CFO. IN ADDITION, THE FORM 990 IS REVIEWED ON A ROTATING BASIS OF EVERY FOUR YEARS BY AN OUTSIDE INDEPENDENT ACCOUNTING AND TAX FIRM. THE FORM 990 WAS NOT REVIEWED BY THE BOARD OF DIRECTORS BEFORE SUBMITTING IT TO THE IRS. HOWEVER, BAPTIST MEMORIAL HEALTH CARE CORPORATION, AS SOLE MEMBER, HAS A FINANCE, AUDIT AND COMPLIANCE COMMITTEE THAT IS APPOINTED BY ITS BOARD OF DIRECTORS. THE FINANCE, AUDIT AND COMPLIANCE COMMITTEE WILL REVIEW THE FORM 990 AFTER SUBMITTING IT TO THE IRS. THE COMMITTEE REPORTS THE COMPLETION OF THE REVIEW TO THE CORPORATE BOARD OF DIRECTORS. Form 990, Part VI, Section B, line 12c BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. REQUIRES THAT ALL EMPLOYEES, INCLUDING OFFICERS AND KEY EMPLOYEES, PERIODICALLY COMPLETE A CERTIFICATION AND ACKNOWLEDGEMENT OF THE BAPTIST MEMORIAL HEALTH CARE CORPORATION (THE SOLE MEMBER) STANDARDS OF CONDUCT, WHICH INCORPORATES THE CONFLICT OF INTEREST POLICY. BOARD MEMBERS DISCLOSE AND SIGN A CONFLICT OF INTEREST STATEMENT EACH DECEMBER. IN THE EVENT THAT AN EMPLOYEE OR BOARD MEMBER BECOMES AWARE OF A POTENTIAL CONFLICT OF INTEREST, HE/SHE IS REQUIRED TO REPORT IT TO THEIR CHIEF EXECUTIVE OFFICER BEFORE TAKING ANY ACTION. IF HE/SHE IS THE CHIEF EXECUTIVE OFFICER, THEN HE/SHE IS TO REPORT TO THE CHAIRMAN OF THE BOARD OF DIRECTORS. THE SIGNED CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE SENIOR V.P. AND CORPORATE COUNSEL, AND ARE MAINTAINED IN THE BAPTIST MEMORIAL HEALTH CARE CORPORATION LEGAL DEPARTMENT. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, IT WILL BE THE RESPONSIBILITY OF THE CEO, WITH THE INVOLVEMENT OF THE BAPTIST MEMORIAL HEALTH CARE CORPOATION LEGAL DEPARTMENT, TO RESOLVE THE ISSUE. Form 990, Part VI, Section B, line 15 BAPTIST MEMORIAL HEALTH CARE CORPORATION'S HUMAN RESOURCE DEPARTMENT, THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS, AND AN INDEPENDENT COMPENSATION CONSULTING FIRM PERFORM ANNUAL REVIEWS EACH DECEMBER AND APPROVE COMPENSATION OF THE CEO AND OTHER TOP MANAGEMENT PERSONNEL. THEY USE COMPARABILITY DATA AND OTHER SOURCES AS NEEDED. THE CEO AND OTHER TOP MANAGEMENT USE THE SAME TYPE OF INFORMATION TO APPROVE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. ON DECEMBER 14, 2015 THE COMPENSATION WAS REVIEWED AND APPROVED FOR THE CALENDAR YEAR ENDING DECEMBER 31, 2016 FOR THE PRESIDENT, THE VICE PRESIDENTS, AND THE CEO/ADMINISTRATOR. Form 990, Part VI, Section C, line 18 BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. MAKES COPIES OF ITS FORMS 1023, 990, AND 990T AVAILABLE FOR PUBLIC INSPECTION TO ANYONE WHO REQUESTS THEM AS REQUIRED BY THE IRS. Form 990, Part VI, Section C, line 19 BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VII Contact Addresses for Officers, Directors, Etc JASON M. LITTLE - 350 N. HUMPHREYS BLVD, MEMPHIS, TN 38120-2177. GREGORY M. DUCKETT - 350 N. HUMPHREYS BLVD, MEMPHIS, TN 38120-2177. PAUL D. DEPRIEST, M.D. - 350 N. HUMPHREYS BLVD, MEMPHIS, TN 38120-2177. PART XII, LINE 2c: FINANCIAL STATEMENTS AND REPORTING: BAPTIST MEMORIAL HEALTH CARE CORPORATION, AS SOLE MEMBER, HAS AN AUDIT COMMITTEE THAT CHOOSES THE AUDIT FIRM, OVERSEES AND REVIEWS THE AUDIT REPORTS, AND THEN FOLLOWS UP ON ANY NECESSARY CHANGES AND RECOMMENDATIONS. THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS. BAPTIST MEMORIAL HEALTH CARE CORPORATION 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 581521475 MANAGEMENT, ADMINISTRATIVE & FINANCIAL SERVICES FOR AFFILIATES TN 501(c)(3) 509(a)(3) N/A 0 BAPTIST MEMORIAL HEALTH CARE SYSTEM INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 581456556 CARRY OUT THE HEALTH CARE MISSIONS OF THE BAPTIST CONVENTIONS OF AR, MS, TN TN 501(c)(3) 509(a)(3) N/A 1 BAPTIST MEMORIAL COLLEGE OF HEALTH SCIENCES INC 1003 MONROE MEMPHIS TN 38104 621599670 EDUCATION OF HEALTH CARE PROFESSIONALS TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HOSPITAL INC 1 BAPTIST MEMORIAL HEALTH SERVICES INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 621509127 PROVISION OF HEALTH CARE PROVIDERS & HOME MEDICAL EQUIPMENT/SERVICES TN 501(c)(3) 509(a)(2) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL HOSPITAL INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 620123940 HEALTH CARE FACILITY/HOSPITAL TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 MEDICAL FINANCIAL SERVICES INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 621112364 COLLECTION AGENCY FOR BAPTIST ENTITIES TN 501(c)(3) 509(a)(3) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL HOSPITAL-BOONEVILLE INC 100 HOSPITAL ST BOONEVILLE MS 38829 640663760 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL HOSPITAL-DESOTO INC 7601 SOUTHCREST PKWY SOUTHAVEN MS 38671 640682111 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL HOSPITAL-GOLDEN TRIANGLE INC 2520 FIFTH ST COLUMBUS MS 39703 621519754 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL HOSPITAL-HUNTINGDON INC 631 RB WILSON DR HUNTINGDON TN 38344 621166050 HEALTH CARE FACILITY/HOSPITAL TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST CLINICAL RESEARCH INSTITUTE INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 453032246 FACILITATE MEDICAL & SCIENTIFIC RESEARCH TN 501(c)(3) 509(a)(3) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL HOSPITAL-NORTH MISSISSIPPI INC 1100 BELK BLVD OXFORD MS 38655 640772726 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL HOSPITAL-TIPTON INC 1995 HWY 51 SOUTH COVINGTON TN 38019 621113167 HEALTH CARE FACILITY/HOSPITAL TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL HOSPITAL-UNION CITY INC 1201 BISHOP ST UNION CITY TN 38261 621138045 HEALTH CARE FACILITY/HOSPITAL TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL REGIONAL REHABILITATION SERVICES INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 581645396 HEALTH CARE FACILITY/HOSPITAL TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL HOME CARE INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 581562973 HOME HEALTH CARE & HOSPICE SERVICES TN 501(c)(3) 509(a)(2) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL MEDICAL GROUP INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 621545731 PROVISION OF HEALTH CARE PROVIDERS FOR BAPTIST FACILITIES TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST PATIENT SAFETY ORGANIZATION INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 453032372 ESTABLISHING, MAINTAINING & MANAGING A PATIENT SAFETY ORGANIZATION TN 501(c)(3) 509(a)(3) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL MEDICAL MINI EMP HLTH & WELFARE TRUST 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 621407946 BAPTIST EMPLOYEE HEALTH PLAN TN 501(c)(9) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MINOR MEDICAL CENTERS INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 621538114 NON-EMERGENCY MEDICAL CLINICS TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL MEDICAL GROUP INC 1 BAPTIST MEMORIAL HEALTH CARE FOUNDATION INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 581544781 SOLICIT, RAISE, MANAGE, APPLY, & INVEST FUNDS IN SUPPORT OF BAPTIST ENTITIES TN 501(c)(3) 509(a)(3) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST MEMORIAL HOSPITAL-JONESBORO INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 261214372 HEALTH CARE FACILITY/HOSPITAL AR 501(c)(3) 509(a)(1) NEA BAPTIST HEALTH SYSTEM INC 1 NEA BAPTIST HEALTH SYSTEM INC 4800 E JOHNSON AVE JONESBORO AR 72401 271799652 HEALTH CARE SERVICE PROVIDER AR 501(c)(3) 509(a)(3) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION INC 4802 E JOHNSON AVE JONESBORO AR 72401 710850123 HEALTH CARE SERVICE PROVIDER AR 501(c)(3) 509(a)(1) NEA BAPTIST HEALTH SYSTEM INC 1 THE STERN CARDIOVASCULAR FOUNDATION INC 8060 WOLF RIVER BLVD GERMANTOWN TN 38138 274396698 HEALTH CARE SERVICE PROVIDER TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL MEDICAL GROUP INC 1 BAPTIST CANCER CENTER PHYSICIANS FOUNDATION INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 452842963 HEALTH CARE SERVICE PROVIDER TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL MEDICAL GROUP INC 1 INTEGRITY ONCOLOGY FOUNDATION INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 453303687 HEALTH CARE SERVICE PROVIDER TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL MEDICAL GROUP INC 1 MEMPHIS LUNG PHYSICIANS INC 6025 WALNUT GROVE RD MEMPHIS TN 38120 452832975 HEALTH CARE SERVICE PROVIDER TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL MEDICAL GROUP INC 1 BOSTON BASKIN CANCER FOUNDATION INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 453303607 HEALTH CARE SERVICE PROVIDER TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL MEDICAL GROUP INC 1 GASTROINTESTINAL SPECIALISTS FOUNDATION INC 80 HUMPHREYS CENTER MEMPHIS TN 38120 352461541 HEALTH CARE SERVICE PROVIDER TN 501(c)(3) 170(b)(1)(A)(iii) BAPTIST MEMORIAL MEDICAL GROUP INC 1 BMG FAMILY PHYSICIANS GROUP FOUNDATION INC 2859 VAN LEER DR BARTLETT TN 38134 461953140 HEALTH CARE SERVICE PROVIDER TN 501(c)(3) 170(b)(1)(A)(iii) BAPTIST MEMORIAL MEDICAL GROUP INC 1 MISSISSIPPI HOSPITAL FOR RESTORATIVE CARE INC 1225 NORTH STATE STREET JACKSON MS 39202 640833383 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) MISSISSIPPI BAPTIST HEALTH SYSTEMS INC 1 MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI 1225 NORTH STATE STREET JACKSON MS 39202 753068151 CLINICS MS 501(c)(3) 509(a)(1) MISSISSIPPI BAPTIST HEALTH SYSTEMS INC 1 MISSISSIPPI BAPTIST MEDICAL CENTER INC 1225 NORTH STATE STREET JACKSON MS 39202 640881013 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) MISSISSIPPI BAPTIST HEALTH SYSTEMS INC 1 BAPTIST MEDICAL CENTER-LEAKE INC 1225 NORTH STATE STREET JACKSON MS 39202 452896080 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) MISSISSIPPI BAPTIST HEALTH SYSTEMS INC 1 BAPTIST MEDICAL CENTER-YAZOO INC 1225 NORTH STATE STREET JACKSON MS 39202 640844470 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) MISSISSIPPI BAPTIST HEALTH SYSTEMS INC 1 MJMH IMPROVEMENT CORPORATION 1225 NORTH STATE STREET JACKSON MS 39202 800812322 HOLDING COMPANY MS 501(c)(3) 509(a)(1) MISSISSIPPI BAPTIST HEALTH SYSTEMS INC 1 MISSISSIPPI BAPTIST HEALTH SYSTEMS INC 1225 NORTH STATE STREET JACKSON MS 39202 640306253 HOLDING COMPANY MS 501(c)(3) 509(a)(3) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST HEALTH FOUNDATION INC 1225 NORTH STATE STREET JACKSON MS 39202 473403762 SOLICIT, RAISE, MANAGE, APPLY, & INVEST FUNDS IN SUPPORT OF BAPTIST ENTITIES MS 501(c)(3) 509(a)(3) MISSISSIPPI BAPTIST HEALTH SYSTEMS INC 1 BAPTIST MEMORIAL HOSPITAL - CALHOUNINC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 813257997 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(3) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST NURSING HOME - CALHOUN INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 813655778 HEALTH CARE FACILITY MS 501(c)(3) 509(a)(3) BAPTIST MEMORIAL HEALTH CARE CORPORATION 1 BAPTIST-DESOTO SURGERY CENTER 40 BURTON HILLS BLVD STE 500 NASHVILLE TN 37215 200804946 AMBULATORY SURGERY MS N/A BAPTIST-EAST MEMPHIS SURGERY CENTER 80 HUMPHREYS CENTER 101 MEMPHIS TN 38120 621846584 AMBULATORY SURGERY TN N/A BAPTIST-GERMANTOWN SURGERY CENTER LP 40 BURTON HILLS BLVD STE 500 NASHVILLE TN 37215 621829424 AMBULATORY SURGERY TN N/A BAPTIST & PHYSICIANS OP SURGERY CENTER OF N MS 40 BURTON HILLS BLVD STE 500 NASHVILLE TN 37215 640925692 AMBULATORY SURGERY MS N/A BAPTIST N MS IMAGING SERVICES LLC 504 AZALEA DR OXFORD MS 38655 262641267 DIAGNOSTIC SERVICES MS N/A EAST MEMPHIS UROLOGY CENTER LP 40 BURTON HILLS BLVD STE 500 NASHVILLE TN 37215 621810940 AMBULATORY UROLOGICAL SERVICES TN N/A MEDICAL ALTERNATIVES 6949 APPLING FARMS PKWY STE 109 MEMPHIS TN 38133 621488427 HOME INFUSION PRODUCTS & SERVICES TO PATIENTS TN N/A MIDTOWN SURGERY CENTER LP 40 BURTON HILLS BLVD STE 500 NASHVILLE TN 37215 621619344 AMBULATORY SURGERY TN N/A NORTHWEST TENNESSEE SURGERY CENTER LLC 1722 E REELFOOT UNION CITY TN 38261 621685508 AMBULATORY SURGERY TN N/A SM-B BUILDING LLC 5900 POPLAR AVE STE 100 MEMPHIS TN 38119 621834236 PHYSICIAN OFFICES TN N/A WOLF RIVER MEDICAL CENTER LP 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 621510287 MEDICAL OFFICE BLDG. TN N/A CANCER CARE CENTER OF UNION CITY LP 322 HOSPITAL BLVD JACKSON TN 38305 263425045 CANCER CARE SERVICES TN N/A MAYS & SCHNAPP PAIN CENTER 55 HUMPHREYS CENTER BLVD STE 200 MEMPHIS TN 38120 621512849 PAIN MANAGEMENT SERVICES TN N/A CONVENIENT CARE DIAGNOSTIC CENTER PLLC 555 HWY 6 EAST BATESVILLE MS 38606 640914382 RADIOLOGY & DIAGNOSTIC SERVICES MS N/A BAPTIST MEMORIAL REHABILITATION HOSPITAL GP 380 FOURTH STREET LOUSIVILLE KY 40202 461613457 REHABILITATION SERVICES TN N/A BAPTIST OUTPATIENT IMAGING LLC 1107 HIGHLAND COLONY PKWY STE 209 RIGELAND MS 39157 452968057 MEDICAL SERVICES MS N/A HEALTH TECH AFFILIATES INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 621278576 BUYING AND LEASING REAL & PERSONAL PROPERTY TN N/A C 1 BAPTIST HEALTH SERVICES GROUP OF THE MIDSOUTH INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 621534210 HEALTH INSURANCE CONTRACTING TN N/A C 1 SOUTHCREST PROPERTY OWNERS ASSOCIATION 7601 SOUTHCREST PKWY SOUTHAVEN MS 38671 640768703 BOOKKEEPING & DATA PROCESSING FOR SOUTHCREST DEVELOPMENT MS N/A C 1 GERMANTOWN BUSINESS PARK OWNERS ASSOCIATION 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 201158216 BOOKKEEPING & DATA PROCESSING FOR GERMANTOWN BUS. PARK DEVELOPMENT TN N/A C 1 MISSISSIPPI BAPTIST MEDICAL ENTERPRISES INC 1225 NORTH STATE STREET JACKSON MS 39202 640776164 INVESTMENTS MS N/A C 1 MEDICAL PRACTICE SOLUTIONS 1225 NORTH STATE STREET JACKSON MS 39202 640833731 MEDICAL CONSULTING MS N/A C 1 MISSISSIPPI REAL ESTATE ENTERPRISES INC 1225 NORTH STATE STREET JACKSON MS 39202 640746856 INVESTMENTS MS N/A C 1 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 1 1 1 BAPTIST MEMORIAL HEALTH CARE CORPORATION M 4873512 CASH BAPTIST MEMORIAL MEDICAL MINISTRIES EMPLOYEE HEALTH & WELFARE TRUST R 3716793 CASH BAPTIST MEMORIAL HEALTH CARE CORPORATION E 378405 CASH BAPTIST MEMORIAL MEDICAL GROUP INC R 734165 CASH BAPTIST MEMORIAL HEALTH CARE FOUNDATION INC Q 216478 CASH MEDICAL FINANCIAL SERVICES INC S 97385 CASH