2017-05-15T14:34:10-05:00 2016-06-30 ERNST & YOUNG US LLP 425 HOUSTON STREET SUITE 600 FORT WORTH TX 76102 990 2015-07-01 200925675 Continuecare Hospital at Baptist Health LLC % LISA YOUNG CONT 9729436431 7800 N DALLAS PARKWAY SUITE 200 PLANO TX 75024 JAMES HILL TREASURER 2017-05-15 true MELVA SCOTT P01207335 8173351900 2015 2021-01-29 14:40:06Z SEE SCHEDULE o ALAN COPPOCK 7800 N DALLAS PARKWAY 200 PLANO TX 75024 14741100 false X WWW.CONTINUECARE.ORG X 2004 KY AS A 'HOSPITAL WITH-IN A HOSPITAL', IT IS THE MISSION OF CCH TO ENHANCE COMMUNITY HEALTH THROUGH SERVICE WITH COMPASSION, CARING, ACCOUNTABILITY, RESPECT, AND EMPATHY. 6 5 140 0 0 0 0 14994560 14668308 8851 3019 5684 69773 15009095 14741100 0 0 0 0 6827083 6588637 0 0 0 7109167 6836649 13936250 13425286 1072845 1315814 6680286 8140781 4261085 4517766 2419201 3623015 X AS A 'HOSPITAL WITH-IN A HOSPITAL', IT IS THE MISSION OF CCH TO ENHANCE COMMUNITY HEALTH THROUGH SERVICE WITH COMPASSION, CARING, ACCOUNTABILITY, RESPECT, AND EMPATHY. false false 12358787 0 14738081 CONTINUECARE HOSPITAL AT BAPTIST HEALTH (CCBH) IS A LONG-TERM ACUTE CARE HOSPITAL (LTACH) OPERATING AS A HOSPITAL WITHIN A HOSPITAL AT BAPTIST HEALTH CORBIN IN CORBIN, KENTUCKY. AS AN LTACH, CCBH PROVIDES AN AVENUE OF CARE FOR PATIENTS THAT REQUIRE EXTENDED LENGTHS OF STAY IN AN ACUTE CARE SETIING. TYPICALLY, LENGTHS OF STAY WILL AVERAGE 25 DAYS OR LONGER. CONDITIONS APPROPRIATE FOR TREATMENT IN AN LTACH INCLUDE THE FOLLOWING: MEDICALLY COMPLEX RESPIRATORY DISORDERS INCLUDING TRACHEOTOMY, VENTILATOR DEPENDENT CARDIAC/CARDIOVASCULAR CONDITIONS, RENAL DISEASE, ONCOLOGY, AND WOUND CARE. DURING THE FISCAL YEAR ENDED 6/30/2016, CCBH TOTAL PATIENTS ADMITED WERE 324 AND THE TOTAL NUMBER OF PATIENT CARE DAYS PROVIDED WAS 10,012. THE AVERAGE DAILY CENSUS WAS 27.4 PATIENTS AND THE AVERAGE LENGTH OF STAY OF THE DISCHARGED PATIENTS TOTALED 30.9 DAYS. 12358787 true false false true false false false false false false true false false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 9 0 true 140 true false false false false false false false false false false X 6 5 false true false false true true true true false false false true true true true true true false false false X LISA YOUNG 9729426400 7800 N DALLAS PARKWAY SUITE 200 PLANO TX 75024 Roy Taylor Director 1.0 0.0 X 0 0 0 Michael Williams Director (until 5/16) 1.0 39.0 X 0 1470244 32394 Troy Baxter Director 1.0 0.0 X 0 0 0 Leslie Boney DIRECTOR (start 5/16) 1.0 39.0 X 0 319531 40188 Larry Gray Director 1.0 0.0 X 0 0 0 Shirley Holland Director/Secretary 1.0 0.0 X X 0 0 0 Jeannie Hensley Director 1.0 0.0 X 0 0 0 Alan Coppock President/CEO 40.0 0.0 X 0 186247 35430 James Hill Treasurer 1.0 39.0 X 0 350631 34747 David Butler Assistant Secretary 1.0 39.0 X 0 446457 31538 Della Rains CNO 40.0 0.0 X 0 109769 11936 DEANA JONES CLINICAL SUPERVISOR 40.0 0.0 X 106448 0 0 Jason Bootz Former Director 0.0 0.0 X 0 66568 0 106448 2949447 186233 1 true true false BAPTIST HEALTH CORBIN ONE TRILLIUM WAY CORBIN KY 40701 PURCHASED SVCS; RENT 2494294 CARDINAL HEALTH PO BOX 402605 ATLANTA GA 30384 PHARMACY SERVICES 776639 HILL-ROM PO BOX 643592 PITTSBURGH PA 15264 EQUIPMENT RENTALS 392955 MEDLINE INDUSTRIES DEPT 1080 PO BOX 121080 DALLAS TX 75312 SUPPLY SERVICES 391326 CPS LLC PO BOX 638316 CINCINNATI OH 45263 PHARMACY SERVICES 383399 6 0 INPATIENT REVENUE 623000 14668308 14668308 0 0 14668308 3019 3019 0 0 0 0 0 0 0 0 0 OTHER INCOME 900099 69773 69773 0 0 69773 14741100 14738081 0 3019 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5234454 4718753 515701 0 75016 68265 6751 0 874793 796062 78731 0 404374 367980 36394 0 542707 542707 0 5679 0 5679 0 90611 0 90611 0 0 0 0 0 0 0 0 0 0 0 2338385 2307594 30791 11563 11563 0 198081 0 198081 0 97003 97003 0 0 0 0 0 0 435554 435554 0 60683 60683 0 0 0 0 0 10264 10264 0 1000 1000 0 0 0 0 0 0 93876 93876 0 0 101969 101969 0 MEDICAL SUPPLIES 1822355 1822355 0 0 EQUIPMENT LEASE 545945 524695 21250 0 BAD DEBT EXPENSE 271492 271492 0 0 STATE HOSPITAL TAX 209482 209482 0 0 13425286 12358787 1066499 0 3339626 4442390 0 0 0 0 2676048 3062474 0 0 0 0 0 0 162147 159903 123321 163318 451136 138440 378755 312696 0 0 0 0 0 0 0 0 389 0 6680286 8140781 4081535 4492898 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179550 24868 4261085 4517766 X 2419201 3623015 0 0 0 0 2419201 3623015 6680286 8140781 X 1315814 0 0 0 0 -112000 X false true X true false X false false false 0 false 0 false 0 false 0 false 0 false 0 true 455 455 false LOBBYING EXPENSE CONTINUECARE HOSPITAL AT BAPTIST HEALTH PAID $4,935 TO NATIONAL ASSOCIATION OF LONG TERM HOSPITALS IN 2016. THE PORTION OF DUES THAT WERE USED FOR LOBBYING PURPOSES WAS 9.22%. TOTAL DUES PAID FOR LOBBYING ACTIVITIES Was $4,935 X .0922 = $455. 0 71240 26969 44271 367480 111471 256009 12416 12416 312696 0 INTERCOMPANY - CCC & CHC 24868 24868 true true true X true X true false true true 4941 4941 0.00040 209482 209482 0.01590 214423 214423 0.01630 214423 214423 0.01630 true 271492 10061266 8079197 1982069 X true true 1 1 CONTINUECARE HOSP AT BAPTIST HEALTH 1 TRILLUM WAY LOWER LEVEL Corbin KY 40701 WWW.CONTINUECARE.ORG/CORBIN 100417 X X CONTINUECARE HOSP AT BAPTIST HEALTH 1 false false true X X X X X X X X X 13 true false false true X http://continuecare.org/corbin/about-us/ X true 13 true http://continuecare.org/corbin/about-us/ false true X 200. 400. X X true true X X X true X SEE PART V, SECTION C X X X X true X false X X X false X X false false SCHEDULE H, PART V, LINE 5 Interview Methodology: ContinueCARE Hospital at Baptist Health Corbin provided Community Hospital Corporation with a list of persons with special knowledge of public health in Knox, Laurel, Pulaski and Whitley Counties including public health representatives, not-for-profit organization professionals, charities and other individuals who focus specifically on underrepresented groups. From that list, eleven in depth interviews were conducted using a structured interview guide. Extensive notes were taken during each interview and then quantified based on responses, communities and populations (minority, elderly, un/underinsured, etc.) served, and priorities identified by respondents. Qualitative data from the interviews was also analyzed and reported. Individuals interviewed: Baptist Health Corbin: Lee Richardson, Director of Community Health Services Cumberland River Behavioral Health: Lana Lowe, Assertive Community Treatment Nurse Cumberland Valley Area Development District: Leigh Powell, Aging Program Director Dayspring Family Health Center: Mark Watt, CEO Grace Community Health Center (FQHC): Mike Stanley (group leader), CEO; Alesia Anderson, Director of Operations; Kim Bingham, HR Manager; Libby Campbell, Director of Organizational Quality; Phyllis Platt, Director of Development and Growth Knox County Health Department: Susan Liford (group leader), Director; Judy Broughton, Home Health Clerical Supervisor; Jerrie Campbell, Public Health Supervisor; Rhonda Kollar, Home Health Supervisor KY Cancer Program at the University of Kentucky: Mindy Rogers, KY Cancer Coordinator- Regional Lake Cumberland District Health Department: Tracy Aaron, Health Education Director Lake Cumberland Regional Hospital: Danielle Barlow, Discharge Planner Laurel County Health Department: Brandi Gilley, Health Educator Whitley County Health Department: Gail Timperio, Public Health Director SCHEDULE H, PART V, LINE 11 Hospital leadership decided to address two of the four ranked health needs. The final health priorities that CCH will address through its Implementation Plan are: 1.Prevention, education and services to address high mortality rates, chronic conditions and unhealthy lifestyles 2.Lack of affordable healthcare resources for low income/uninsured Priorities that will not be addressed: ContinueCARE Hospital at Baptist Health Corbin decided not to specifically address the "lack of mental health services and providers"lack of transportation" largely due to their positions (second to last and last) on the prioritized list and the hospital's capacity to address those needs. Mental health services and transportation are not a core business functions of the hospital. ContinueCARE Hospital at Baptist Health Corbin leadership felt that resources and efforts would be better spent addressing the first two prioritized needs. SCHEDULE H, PART V, LINE 16C HTTP://CONTINUECARE.ORG/CORBIN/ABOUT-US/ schedule h, part v, line 22d IF A PATIENT QUALIFIES UNDER ITS CHARITY CARE POLICY, CONTINUECARE HOSPITAL AT BAPTIST HEALTH CORBIN SHALL PROVIDE FREE OR DISCOUNTED CARE FOR THESE SERVICES TO PERSONS WHO ARE UNINSURED OR UNDERINSURED AND MEET THE HOSPITAL'S INDIGENCY GUIDELINES. ALL SERVICES MUST BE MEDICALLY NECESSARY IN ORDER TO QUALIFY FOR A CHARITY CARE DISCOUNT. ELIGIBLE SERVICES WILL BE BASED ON THOSE SERVICES FOR WHICH MEDICARE PROVIDES COVERAGE. Payment of Charity Care IN THE STATE OF KENTUCKY, IT IS NOT PERMISSIBLE TO PAY ANOTHER HEALTH PROVIDER FOR CHARITY CARE TO SATISFY THE CHARITY REQUIREMENTS. Part I, Line 7 STATE PROVIDER TAX PAID FOR DISTRIBUTION PER INDIGENT CARE NEEDS - $17,456.83 TAX IS COLLECTED MONTHLY FROM CONTINUECARE HOSPITAL BAPTIST HEALTH. FEDERAL MATCHING DOLLARS ARE APPLIED, AND THEN DISTRIBUTED BACK TO SHORT TERM ACUTE HOSPITALS ON A PRO-RATED BASIS PER EACH HOSPITAL'S LEVEL OF CHARITY CONTRIBUTION. LTACH'S PAY THE TAX, BUT DO NOT GET THE DISTRIBUTION IN KENTUCKY. Part I, Line 7, column f OUR TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) WAS $13,425,286. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $271,492. THIS LEFT A TOTAL EXPENSE OF $13,153,794 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). SINCE CCH CORBIN IS A LONG TERM ACUTE CARE HOSPITAL, IT WILL HAVE LOWER PERCENTAGES THAN AN ACUTE CARE HOSPITAL. Part III, Line 4 CONTINUECARE HOSPITAL OF CORBIN DOESN'T HAVE ITS OWN AUDIT. RATHER IT IS PART OF COMMUNITY HOSPITAL CORPORATION AND THE BAD DEBT DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS DOES NOT COMPLETELY MATCH THE ORGANIZATION'S PRACTICE. THE BAD DEBT COSTING METHODOLOGY VARIES BY PAYER TYPE. FOR MEDICARE, BAD DEBT IS RECORDED WHEN RECOGNIZED TO THE EXTENT OF 35%. MEDICARE REIMBURSES THE ORGANIZATION FOR ALLOWABLE BAD DEBT AT 65%. MEDICARE BAD DEBT RELATES TO THE PRIVATE PAY PORTION OF CARE SUCH AS CO-PAY AND DEDUCTIBLE AMOUNTS. FOR MANAGED CARE, WE RESERVE BAD DEBT WHEN RECOGNIZED AT 100% OF CO-PAY AND DEDUCTIBLE AMOUNTS. Part III, LIne 8 LONG-TERM ACUTE CARE COST TO CHARGE RATIO Part III, LIne 9b IF A PATIENT OF CONTINUECARE HOSPITAL OF CORBIN QUALIFIES FOR ITS CHARITY CARE POLICY THE PATIENT'S ACCOUNT IS ADJUSTED ACCORDINGLY. PATIENT ACCOUNTS WITH REMAINING BALANCES WILL BE REASSESSED TO DETERMINE THEIR ABILITY TO PAY AND WILL EITHER BE ELIGIBLE TO PARTICIPATE IN A PAYMENT PLAN OR THEIR ACCOUNT BALANCE WILL BE WRITTEN OFF. Needs Assessment Part VI, LIne 2 CCH CORBIN FOLLOWS THE ASSESSMENT RESULTS NOTED IN ITS MOST RECENT CHNA. THE HEALTH CARE PRIORITIES THAT WILL BE ADDRESSED THROUGH ITS IMPLEMENTATION PLAN ARE: -PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC CONDITIONS AND UNHEALTHY LIFESTYLES -LACK OF AFFORDABLE HEALTHCARE RESOURCES FOR LOW INCOME/UNINSURED Patient Education of Eligibility for Assistance Part VI, LIne 3 PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES ARE INFORMED UPON ADMISSION TO CONTINUECARE HOSPITAL OF CORBIN BY HOSPITAL OFFICE ASSOCIATES. THE PATIENT FINANCIAL OBLIGATION IS DISCUSSED WITH THE RESPONSIBLE PARTY. THE HOSPITAL CHARITY CARE POLICY IS DISCUSSED WITH EACH RESPONSIBLE PARTY AND IF IT IS FELT THAT THE PATIENT WOULD QUALIFY FOR THE CHARITY PROGRAM THEN THE NECESSARY DOCUMENTS WOULD BE PRESENTED BY THE RESPONSIBLE PARTY TO THE BUSINESS OFFICE ASSOCIATE FOR REVIEW. THE CHARITY CARE POLICY IS ALSO POSTED IN THE ADMISSIONS OFFICE AND ON ITS WEBSITE. Community Information Part VI, Line 4 CCH CORBIN PRIMARILY SERVES WHITLEY, KNOX, LAUREL, AND PULASKI COUNTIES IN KENTUCKY. 19.3% OF RESIDENTS IN KENTUCKY ARE LIVING IN POVERTY. AS OF 2012, KENTUCKY HAS THE FIFTH HIGHEST POVERTY RATE IN THE COUNTRY COMPARED TO OTHER STATES. RACIAL DEMOGRAPHICS--85.2% WHITE, 8.0% BLACK, 3.6% HISPANIC, 1.3% ASIAN, 0.2% AMERICAN INDIAN, 1.7% OTHER. AS OF 2012, ALL STUDIED AREA COUNTIES HAVE A LOWER MEDIAN HOUSEHOLD INCOME THAN KENTUCKY AND ALL COUNTIES AND KENTUCKY HAVE A LOWER MEDIAN HOUSEHOLD INCOME COMPARED TO OTHER STATES. KNOX, LAUREL, PULASKI, AND WHITLEY COUNTIES HAVE HIGH AGE-ADJUSTED DEATH RATES FOR HEART DISEASE AND CANCER. AT LEAST 25% IN THE SAME AREAS WERE FOUND TO BE OBESE. SMOKING AND TOBACCO USE ARE ALSO HIGHLY PREVALENT ISSUES IN THE AREA. Promotion of Community Health Part VI, Line 5 CONTINUECARE HOSPITAL AT BAPTIST HEALTH CORBIN (CCH CORBIN) PROVIDES VARIOUS CHARITABLE SERVICES TO THE LOCAL COMMUNITY. ANNUALLY IN SEPTEMBER, CCH CORBIN INVITES STAFF TO PARTICIPATE IN A COMMUNITY-WIDE EVENT CALLED LOVE LOUD. THIS EVENT IS ORGANIZED BY 30+ CHURCHES AND COMMUNITY ORGANIZATIONS TO FEED FAMILIES, PROVIDE FREE MEDICAL SCREENINGS, FREE DENTAL SERVICES, FREE LEGAL SERVICES, FREE HAIRCUTS, FREE OIL CHANGES, FREE ACTIVITIES FOR CHILDREN, FREE GAS AT LOCAL GAS STATIONS, ETC. IN ADDITION, CCH CORBIN PAYS A KENTUCKY HOSPITAL PROVIDER TAX, FIXED AT $17,456/MO, TO THE STATE TREASURY. FUNDS FROM THIS TAX ARE THEN DISTRIBUTED BACK TO THE HOSPITALS IN KENTUCKY ON A PRO-RATED BASIS, DETERMINED BY THE LEVEL OF CHARITY CARE THOSE HOSPITALS GIVE EACH YEAR. IN KENTUCKY, LTACH'S PAY THE TAX, BUT DO NOT GET THE DISTRIBUTION. THE FOLLOWING ARE AMONG THE IMPLEMENTATION ACTIVITIES THAT WILL PROMOTE BETTER HEALTH IN THE COMMUNITY: CCH CORBIN PARTICIPATES WITH A COMMUNITY HEALTHCARE COALITION - A COALITION OF LOCAL HEALTHCARE PROVIDERS ACROSS THE CONTINUUM WHO DISCUSS WAYS TO ADDRESS THE TOPICS SUCH AS: -BETTER COMMUNICATION -MEETING QUARTERLY WITH ALL COALITION MEMBERS -IMPROVED COMMUNITY HEALTH-GATHERING DATA FOR BASELINES -WELLNESS IMPROVEMENT INITIATIVES -SHARING BEST PRACTICES FOR EMPLOYEE WELLNESS INITIATIVES ACROSS ORGANIZATIONAL PARTICIPANTS -REDUCING HOSPITAL READMISSIONS COMMUNITY WHERE WE CAN ASSIST IN EDUCATING THE PUBLIC ON HEALTH STATUS AND INITIATIVES -CCH WILL SPONSOR VARIOUS LOCAL SPORTS PROGRAMS TO ENCOURAGE HEALTHY LIFESTYLES FROM PEE WEE SPORTS UP TO LOCAL COLLEGE ATHLETIC PROGRAMS -WILL FORMALIZE A CCH SPONSORSHIP PROGRAM -CCH CORBIN WILL PARTICIPATE IN THE ANNUAL RELAY FOR LIFE WALKATHON THAT AIMS TO RAISE MONEY AND AWARENESS FOR SEVERAL CHARITIES WITHIN THE COMMUNITY -CCH CORBIN PARTICPATES IN THE CHC EMPLOYEE WELLNESS PROGRAM EACH YEAR -HEALTH SAVINGS ACCOUNT -BIOMETRIC SCREENING -SMOKING SCREENING -VARIOUS HEALTH MEASUREMENT METRICS Affiliated Health Care System Part VI, Line 6 CCH CORBIN IS AN AFFILIATE OF BAPTIST HEALTH, A LOUISVILLE, KENTUCKY BASED HEALTH SYSTEM. THE HEALTH PROMOTION ACTIVITIES FOR BOTH ORGANIZATIONS ARE COLLABORATIVE IN ORDER TO HAVE A FAR REACHING EFFECT ON THE COMMUNITY. EACH ORGANIZATION ASSESSES THE NEEDS OF THE COMMUNITY AND THEN WORKS IN WAYS THAT WOULD MEET ANY UNMET NEEDS WITHIN THE COMMUNITY. State Filing of Community Benefit Report Part VI, Line 7 Not Applicable true true false false false false false true false Alan Coppock President/CEO 0 164722 0 16462 0 5063 0 9746 0 25684 0 221677 0 0 James Hill Treasurer 0 225854 0 106823 0 17954 0 7712 0 27035 0 385378 0 0 David Butler Assistant Secretary 0 286488 0 133548 0 26421 0 6032 0 25506 0 477995 0 0 Jason Bootz Former Director 0 0 0 0 0 66568 0 0 0 0 0 66568 0 0 Michael Williams Director (until 5/16) 0 665522 0 507455 0 297267 0 9078 0 23316 0 1502638 0 0 Leslie Boney DIRECTOR (start 5/16) 0 208102 0 98100 0 13329 0 17872 0 22316 0 359719 0 2991 Supplemental Compenation Information THE ORGANIZATION DOES NOT COMPENSATE THE PRESIDENT OF THE ORGANIZATION. THE ORGANIZATION REIMBURSES CHC COMMUNITY CARE LLC (CCC) FOR THE PRESIDENT'S COMPENSATION. CCC FOLLOWS THE COMPENSATION POLICY OF COMMUNITY HOSPITAL CORPORATION (CHC). CHC ENGAGED SULLIVAN COTTER TO CONDUCT A COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITY, AND CURRENT INCUMBENTS' COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING.THE ORGANIZATION FOLLOWED THIS PROCESS FOR THE YEAR ENDED JUNE 30, 2016 FOR ITS OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER MANAGEMENT OFFICIALS. Schedule J, Part I, Line 4a A FORMER DIRECTOR OF THE ORGANZIATION RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION DURING Fiscal year 2016. Schedule J, Part I, Line 4b Nonqualified Retirement Plan Participation was paid to: MICHAEL WILLIAMS - $259,340 DAVID BUTLER - $17,376 JAMES HILL - $13,911 Schedule J, Part I, LIne 7 A PORTION OF THE DISCRETIONARY INCENTIVE COMPENSATION PROGRAM WAS BASED ON THE HOSPITAL'S EARNINGS BEFORE INTEREST DEPRECIATION AND AMORTIZATION (EBIDA) OF CHC. Doing Business As FORM 990, BOX C CONTINUECARE HOSPITAL AT BAPTIST HEALTH LLC DOES BUSINESS AS CONTINUECARE HOSPITAL AT BAPTIST HEALTH CORBIN. DESCRIPTION OF MANAGEMENT ARRANGEMENT FORM 990, PART VI, QUESTION 3 CHC COMMUNITY CARE, LLC PROVIDES CERTAIN FINANCIAL, TECHNICAL AND MANAGERIAL SUPPORT SERVICES TO THE HOSPITAL. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 THE SOLE MEMBER OF CONTINUECARE HOSPITAL AT BAPTIST HEALTH CORBIN IS CHC COMMUNITY CARE, LLC, ('CCC'). DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, QUESTION 7A THE SOLE MEMBER SHALL MAINTAIN A MINORITY VOTING INTEREST OF THE BOARD OF DIRECTORS. THE BOARD OF MANAGERS SHALL BE COMPRISED OF SIX VOTING MEMBERS, 1 FROM CHC, 1 FROM ITS COOPERATIVE PARTNER, BAPTIST HEALTH, AND FOUR COMMUNITY MEMBERS. EACH VOTING MEMBER CARRIES EQUAL WEIGHT AND CONSIDERATION WHEN TAKING ANY OFFICIAL BOARD ACTION. DESCR CLASSES OF PERSONS/DECISIONS REQUIRING APPR/TYPE OF VOTING RIGHTS FORM 990, PART VI, QUESTION 7B THE BOARD OF DIRECTORS MAY RECOMMEND, BUT SHALL NOT, WITHOUT EXPRESS WRITTEN CONSENT OF THE SOLE MEMBER, HAVE THE POWER TO TAKE ANY OF THE FOLLOWING ACTIONS: 1. ANY FUNDAMENTAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE HOSPITAL 2. THE INCURRANCE OF DEBT, INCLUDING WITHOUT LIMITATION, BORROWINGS, GUARANTEES, LOANS, ENCUMBRANCES, OPERATING LEASES, PURCHASE OR LEASE OF REAL ESTATE, AND CAPITAL LEASES 3. ANY MERGER OR CONSOLIDATION TO WHICH THE HOSPITAL IS A PARTY 4. THE SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE HOSPITAL 5. POLICY CHANGES PERTAINING TO CHARITY CARE 6. APPOINTMENT AND REMOVAL OF CORPORATE DIRECTORS 7. ANY RELEASE OR CANCELLATION OF INDIVIDUAL CLAIMS IN EXCESS OF $25,000 DOCUMENTATION OF MEETINGS OF COMMITTEES FORM 990, PART VI, QUESTION 8B THERE WERE NO COMMITTEES OF THE GOVERNING BODY. DESCRIBE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, QUESTION 11B THE DETAILED REVIEW OF THE FORM 990 IS CONDUCTED BY THE HOSPITAL'S MANAGEMENT FOLLOWING THE PREPARATION AND REVIEW OF THE RETURN BY THE ORGANIZATION'S PAID PREPARER. AN ELECTRONIC COPY OF THE FINAL FORM 990 IS EMAILED TO EACH BOARD MEMBER PRIOR TO FILING WITH THE IRS. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C THE ORGANIZATION FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADOPTED BY ITS SOLE MEMBER, CHC COMMUNITY CARE, LLC, WHICH IN TURN FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADMINISTERED BY ITS PARENT, COMMUNITY HOSPITAL CORPORATION, WHICH REQUIRES ALL OFFICERS, DIRECTORS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES AND OTHER MANAGEMENT OFFICIALS ('COVERED PERSONS') TO DISCLOSE POTENTIAL CONFLICTS. THE ORGANIZATION'S BOARD FORMALLY ADOPTED CHC'S CONFLICT OF INTEREST POLICY FOR YEAR ENDED 6-30-14. PURSUANT TO THE POLICY, A DISCLOSURE STATEMENT IS CIRCULATED ANNUALLY TO COVERED PERSONS IN WHICH THE INDIVIDUAL MUST DISCLOSE TRANSACTIONS THAT MAY RESULT IN A CONFLICT. COVERED PERSONS ARE ALSO ENCOURAGED TO NOTIFY THE BOARD, APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICER, GENERAL COUNSEL OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. WHEN NECESSARY, THE BOARD CHAIR OR APPROPRIATE BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND RECOMMEND ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT OR OTHERWISE DETERMINE IF THE CONFLICT CAN BE RESOLVED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE MAKES THE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. ANY MEMBER OF THE BOARD OPERATING UNDER A CONFLICT IS NOT PERMITTED TO BE PRESENT OR OTHERWISE PARTICIPATE IN THE VOTE ON ANY MATTER TO WHICH THE CONFLICT RELATES. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND AFTER INVESTIGATION THE BOARD OR COMMITTEE DETERMINES THAT THE COVERED PERSON FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE ORGANIZATION TAKES APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION, WHICH MAY INCLUDE, TERMINATION OF THE INDIVIDUAL'S MEMBERSHIP, EMPLOYMENT OR CONTRACT. GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AVAILABLE TO PUBLIC FORM 990, PART VI, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE AT ITS BUSINESS OFFICE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES - MEDICAL 2,210,591 PURCHASED SERVICES - IT 97,003 PURCHASED SERVICES - DATA PROCESSING AND ADMINS 30,791 --------- TOTAL 2,338,385 PART XI, LINE 9 OTHER CHANGES IN NET ASSETS DISTRIBUTION TO MEMBERS - ($112,000) BAPTIST HOSPITAL SE TEXAS PO BOX 1591 BEAUMONT TX 77701 741303720 HOSPITAL TX 501(c)(3) 3 SWCH INC false BAPTIST PHYSICIANS NETWORK 3080 COLLEGE ST BEAUMONT TX 77701 760453250 PRIMARY CARE TX 501(c)(3) 3 BHSET false BHSETX FOUNDATION 810 HOSPITAL DRIVE 235 BEAUMONT TX 77701 611557670 SUPPORT ORG TX 501(C)(3) 7 BHSETX false Careplus Rural Health Clinic 998 South Highway 25W Suite 1 Willamsburg KY 40769 474831322 Rural health KY 501(c)(3) 3 JCH false CAROLINAS COMMUNITY CARE 7800 N DALLAS PKWY STE 200 PLANO TX 75024 465590355 SUPPORT ORG DE 501(c)(3) 11B-II CHC false CAROLINAS CONTINUECARE HOSPITAL 7800 N DALLAS PKWY STE 200 PLANO TX 75024 463796709 HOSPITAL DE 501(c)(3) 3 CAR CC false CHC COMMUNITY CARE LLC 7800 N DALLAS PKWY STE 200 PLANO TX 75024 371485773 SUPPORT ORG DE 501(c)(3) 11C-III-FI CHC false COMMUNITY HOSPITAL CORPORATION 7800 N DALLAS PKWY STE 200 PLANO TX 75024 752638469 SUPPORT ORG TX 501(C)(3) 11C-III-FI NA false CONTINUECARE HOSP AT BAPTIST HLT PADUCAH 2501 KENTUCKY AVENUE 5TH FL PADUCAH KY 42003 465032999 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSP AT HENDRICK MED CTR 1900 PINE ST 5TH FL ABILENE TX 79601 463607347 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSP BPTST HLT MADISONVILLE 900 HOSPITAL DRIVE 4TH FL MADISONVILLE KY 42431 465033192 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSPITAL AT BAKERSFIELD 7800 N DALLAS PKWY STE 200 PLANO TX 75024 465236524 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSPITAL AT ODESSA INC 500 W 4TH STREET ODESSA TX 79761 473539943 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSPITAL AT PALMETTO HEALTH 7800 N DALLAS PKWY STE 200 PLANO TX 75024 813048423 HOSPITAL TX 501(C)(3) 3 CCC false CONTINUECARE HOSPITAL OF MIDLAND 4214 ANDREWS HIGHWAY MIDLAND TX 79703 463053684 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSPITAL OF SOUTHEAST TEXAS 7800 N DALLAS PKWY STE 200 PLANO TX 75024 201150480 HOSPITAL TX 501(c)(3) 3 CCC false CONTINUECARE HOSPITAL OF TYLER 800 E DAWSON ST TYLER TX 75701 200991990 HOSPITAL DE 501(c)(3) 3 CCC false CRAWLEY MEMORIAL HOSPITAL 706 KINGS STREET KINGS MOUNTAIN NC 28086 560691100 HOSPITAL NC 501(c)(3) 3 CAR CC false JELLICO COMMUNITY HOSPITAL INC 188 HOSPITAL LANE JELLICO TN 37762 620924706 HOSPITAL TN 501(c)(3) 3 CHC false MERCY RESTORATIVE CARE HOSPITAL INC 10648 PARK ROAD CHARLOTTE NC 28210 753054855 HOSPITAL NC 501(c)(3) 3 CAR CC false SOUTHWEST COMMUNITY HOSPITAL INC 7800 N DALLAS PKY STE 200 PLANO TX 75024 752725353 SUPPORT ORG TX 501(c)(3) 11D-III-O CHC false ST MARK'S MEDICAL CENTER ONE ST MARKS PLACE LA GRANGE TX 78945 743019849 HOSPITAL TX 501(c)(3) 3 CHC false YOAKUM COMMUNITY HOSPITAL 1200 CARL RAMERT DR YOAKUM TX 77995 742323822 HOSPITAL TX 501(c)(3) 3 CHC false YOAKUM COMMUNITY HOSPITAL FOUNDATION 1200 CARL RAMERT DRIVE YOAKUM TX 77995 453609830 SUPPORT ORG TX 501(C)(3) 11A-1 YCH Community Health Assurance SPC Ltd Cayman Islands POB 69GT Grand Cayman CJ Captive insurance CJ CHC C Corp false Community Hospital Consulting 7800 N Dallas Parkway Suite 200 Plano TX 75024 204710183 MGMT CONSULTING TX CHC C Corp false false false false false false false false false false false false false false false true true false false false Community Hospital Corporation p 1420960 Cost CHC Community Care LLC p 570156 Cost CHC Community Care LLC o 239998 Cost CHC Community Care LLC r 45000 Cost