STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

JAY HOSPITAL INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
JAY HOSPITAL INC (EIN 59-2425149)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-08-17
IRS object ID
201542299349302454
Schema version
2013v4.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-08-17T10:55:02-05:00ReturnTs
Tax Period End2014-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11201 Walnut Suite 1700AddressLine1
CityKansas CityCity
StateMOState
ZIP Code641062246ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN592425149EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jay Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of% KEITH STRICKLINGInCareOfNm
Business Name ControlJAYHBusinessNameControlTxt
Phone8504344714PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1POST OFFICE BOX 17500AddressLine1
Address Line2SuiteAddressLine2
CityPENSACOLACity
StateFLState
ZIP Code32522ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWILLIAM J ROBERTSPersonNm
Person TitleVP FIN/CONTROLLERPersonTitleTxt
Phone8504344714PhoneNum
Signature2015-08-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMichael J EnglePreparerPersonNm
PTINP00482834PTIN
Phone8504344714PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMichael T HutchinsPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11717 N E ST STE 320AddressLine1
CityPENSACOLACity
StateFLState
ZIP Code32501ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$14,592,371GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.ebaptisthealthcare.org/JayHospitalWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1983FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionJay Hospital's primary mission is dedicated to meeting the healtcare needs in the Jay, Century, Flomaton & surrounding communities in the Northwest Florida-South Alabama area.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee139TotalEmployeeCnt
Total Volunteers24TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$9,010PYContributionsGrantsAmt
CY Contributions Grants$8,188CYContributionsGrantsAmt
PY Program Service Revenue$12,106,721PYProgramServiceRevenueAmt
CY Program Service Revenue$13,865,702CYProgramServiceRevenueAmt
PY Investment Income$795PYInvestmentIncomeAmt
CY Investment Income$6,765CYInvestmentIncomeAmt
PY Other Revenue$1,671,171PYOtherRevenueAmt
CY Other Revenue$702,069CYOtherRevenueAmt
PY Total Revenue$13,787,697PYTotalRevenueAmt
CY Total Revenue$14,582,724CYTotalRevenueAmt
PY Grants And Similar Paid$14,400PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$17,032CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,551,742PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,657,383CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$8,891,817PYOtherExpensesAmt
CY Other Expenses$9,365,204CYOtherExpensesAmt
PY Total Expenses$14,457,959PYTotalExpensesAmt
CY Total Expenses$15,039,619CYTotalExpensesAmt
PY Revenues Less Expenses-$670,262PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$456,895CYRevenuesLessExpensesAmt
Total Assets BOY$6,384,329TotalAssetsBOYAmt
Total Assets EOY$6,986,804TotalAssetsEOYAmt
Total Liabilities BOY$3,901,605TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,960,975TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,482,724NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,025,829NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$11,911,139ExpenseAmt
Revenue$13,865,702RevenueAmt
DescGENERAL AND SPECIALIZED HEALTH CARE SERVICES INCLUDING INPATIENT, PRIMARY CARE, LONG TERM AND OUTPATIENT HEALTHCARE SERVICES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$17,032ExpenseAmt
Grant$17,032GrantAmt
Revenue$0RevenueAmt
DescCOMMUNITY BENEFIT OUTREACH ACTIVITIES CONDUCTED BY THE ORGANIZATION INCLUDING HEALTH EDUCATION SEMINARS, HEALTH FAIRS, AND DONATIONS TO OTHER NON-PROFIT ENTITIES.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$11,928,171TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee139EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKEITH STRICKLINGPersonNm
Phone8506758024PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line114114 ALABAMA STREETAddressLine1
CityJayCity
StateFLState
ZIP Code32565ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
RONALD E JACKSON
CHAIRMAN1.01.0Yes (X)Yes (X)$0$0$0
LARRY K HICKS
VICE CHAIRMAN1.01.0Yes (X)Yes (X)$0$0$0
JOHN KIZZIAH
SECRETARY1.01.0Yes (X)Yes (X)$0$0$0
JOHN J BAEHR MD
TREASURER1.01.0Yes (X)Yes (X)$0$0$0
REVEREND LUTIMOTHY MAY
BOARD MEMBER1.01.0Yes (X)$0$0$0
FRANK WHITE
BOARD MEMBER1.01.0Yes (X)$0$0$0
JOHN HOSMAN
BOARD MEMBER1.01.0Yes (X)$0$0$0
KIM JERNIGAN DMD
BOARD MEMBER1.01.0Yes (X)$0$0$0
DAVID KELLEN MD
BOARD MEMBER1.01.0Yes (X)$0$0$0
ADM ROBERT KELLY
BOARD MEMBER1.01.0Yes (X)$0$0$0
MICHAEL J MAZENKO
BOARD MEMBER1.01.0Yes (X)$0$0$0
RICKY SMITH
BOARD MEMBER1.01.0Yes (X)$0$0$0
MARGARET T STOPP
BOARD MEMBER1.01.0Yes (X)$0$0$0
LUTHER TAYLOR
BOARD MEMBER1.01.0Yes (X)$0$0$0
TOM OWENS
BOARD MEMBER1.01.0Yes (X)$0$0$0
MIKE HUTCHINS
VP/ADMINISTRATOR50.00.0Yes (X)$225,865$0$25,409
KERRY VERMILLION
SENIOR VP/CFO4.046.0Yes (X)$0$466,887$89,913
MELANIE STYLES
LABORATORY MANAGER40.00.0$104,340$0$14,697Yes (X)
DANIEL SHEPPARD
PHARMACIST40.00.0$109,729$0$22,190Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$439,934TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$466,887TotReportableCompRltdOrgAmt
Total Other Compensation$152,209TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

ServicesServicesDescCompensationCompensationAmt
SCOTT G MOORE MD
Physician Services$248,302
Jeff Kelley MD
Physician Services$234,233
MARK ELDER DO
PHYSICIAN SERVICES$179,905
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
All Other Contributions$8,188AllOtherContributionsAmt
Total Contributions$8,188TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Revenue621990$12,462,202$12,462,202
EHR INCENTIVE PAYMENTS621990$1,403,500$1,403,500
FieldValueIRS element (for citing)
Total Program Service Revenue$13,865,702TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,765TotalRevenueColumnAmt
Exclusion$6,765ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$32,550RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$9,647RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$22,903RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,903TotalRevenueColumnAmt
Exclusion$22,903ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

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

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA INCOME722210$30,302$30,302
MEDICAL RECORDS541900$8,300$8,300
All Other Misc Revenue900099$640,564$640,564

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$640,564TotalRevenueColumnAmt
Exclusion$640,564ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$679,166OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,582,724TotalRevenueColumnAmt
Related Or Exempt Func Income$13,865,702RelatedOrExemptFuncIncomeAmt
Exclusion$708,834ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$17,032TotalAmt
Program Services$17,032ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$252,364TotalAmt
Program Services$201,891ProgramServicesAmt
Management And General$50,473ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,465,549TotalAmt
Program Services$3,929,251ProgramServicesAmt
Management And General$536,298ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$116,990TotalAmt
Program Services$102,470ProgramServicesAmt
Management And General$14,520ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$492,700TotalAmt
Program Services$431,550ProgramServicesAmt
Management And General$61,150ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$329,780TotalAmt
Program Services$288,850ProgramServicesAmt
Management And General$40,930ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,527,754TotalAmt
Management And General$1,527,754ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$570TotalAmt
Management And General$570ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,491,533TotalAmt
Program Services$1,091,832ProgramServicesAmt
Management And General$399,701ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$157,269TotalAmt
Program Services$113,520ProgramServicesAmt
Management And General$43,749ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$17,924TotalAmt
Program Services$17,590ProgramServicesAmt
Management And General$334ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$250,710TotalAmt
Program Services$224,194ProgramServicesAmt
Management And General$26,516ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$55,605TotalAmt
Program Services$10,457ProgramServicesAmt
Management And General$45,148ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$300TotalAmt
Program Services$225ProgramServicesAmt
Management And General$75ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$64,919TotalAmt
Management And General$64,919ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$723,529TotalAmt
Program Services$615,000ProgramServicesAmt
Management And General$108,529ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$96,002TotalAmt
Management And General$96,002ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT EXPENSE$4,052,659$4,052,659
MEDICAL SUPPLIES$622,735$622,735
INDIGENT ASSESSMENT$110,889$110,889
FOOD COSTS$87,227$82,898$4,329

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$105,579TotalAmt
Program Services$15,128ProgramServicesAmt
Management And General$90,451ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$15,039,619TotalAmt
Program Services$11,928,171ProgramServicesAmt
Management And General$3,111,448ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$10,477BOYAmt
EOY$66,169EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,051,840BOYAmt
EOY$3,025,406EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$141,170BOYAmt
EOY$155,401EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$54,494BOYAmt
EOY$47,029EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,014,941LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$8,487,188LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,989,339BOYAmt
EOY$3,527,753EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,137,009BOYAmt
EOY$165,046EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,384,329BOYAmt
EOY$6,986,804EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$886,358BOYAmt
EOY$973,501EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$424,434BOYAmt
EOY$342,160EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,590,813BOYAmt
EOY$3,645,314EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,901,605BOYAmt
EOY$4,960,975EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,482,724BOYAmt
EOY$2,025,829EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,482,724BOYAmt
EOY$2,025,829EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,384,329BOYAmt
EOY$6,986,804EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$456,895ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

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

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$3,692FilingOrganizationsTotalAmt
Affiliated Group Total$111,827AffiliatedGroupTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$3,692FilingOrganizationsTotalAmt
Affiliated Group Total$111,827AffiliatedGroupTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$15,039,619FilingOrganizationsTotalAmt
Affiliated Group Total$730,609,527AffiliatedGroupTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$15,043,311FilingOrganizationsTotalAmt
Affiliated Group Total$730,721,354AffiliatedGroupTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Filing Organizations Total$902,166FilingOrganizationsTotalAmt
Affiliated Group Total$5,824,378AffiliatedGroupTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Filing Organizations Total$225,542FilingOrganizationsTotalAmt
Affiliated Group Total$1,456,096AffiliatedGroupTotalAmt
FieldValueIRS element (for citing)
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

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

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$216,698CurrentYearMinus3Amt
Current Year Minus2$213,915CurrentYearMinus2Amt
Current Year Minus1$117,438CurrentYearMinus1Amt
Current Year$111,827CurrentYearAmt
Total$659,878TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

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

Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp

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

Schedule D IRS990ScheduleD

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

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$977,439OtherCostOrOtherBasisAmt
Depreciation$176,381DepreciationAmt
Book Value$801,058BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,571,543OtherCostOrOtherBasisAmt
Depreciation$3,160,106DepreciationAmt
Book Value$1,411,437BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,227,385OtherCostOrOtherBasisAmt
Depreciation$5,146,285DepreciationAmt
Book Value$1,081,100BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$176,381OtherCostOrOtherBasisAmt
Depreciation$4,416DepreciationAmt
Book Value$171,965BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,527,753TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ASSET RETIREMENT OBLIGATION$126,845
DUE TO THIRD PARTIES$600,236
DUE TO AFFILIATES$2,918,233
FieldValueIRS element (for citing)
Total Liability$3,645,314TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PART X, LINE 2FormAndLineReferenceDesc
ExplanationFinancial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 740, Income Taxes, prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC Topic 740 provides guidance for recognition threshold and measurement attributes for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. There were no material uncertain tax positions as of September 30, 2014 and 2013.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$352,083TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$352,083NetCommunityBenefitExpnsAmt
Total Expense0.03160TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,589,197TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,537,964DirectOffsettingRevenueAmt
Net Community Benefit Expns$51,233NetCommunityBenefitExpnsAmt
Total Expense0.00470TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$263,177TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$84,432DirectOffsettingRevenueAmt
Net Community Benefit Expns$178,745NetCommunityBenefitExpnsAmt
Total Expense0.01630TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,204,457TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,622,396DirectOffsettingRevenueAmt
Net Community Benefit Expns$582,061NetCommunityBenefitExpnsAmt
Total Expense0.05260TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served14PersonsServedCnt
Total Community Benefit Expns$295TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$295NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,200TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,200NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served14PersonsServedCnt
Total Community Benefit Expns$15,495TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,495NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served14PersonsServedCnt
Total Community Benefit Expns$2,219,952TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,622,396DirectOffsettingRevenueAmt
Net Community Benefit Expns$597,556NetCommunityBenefitExpnsAmt
Total Expense0.05410TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$775,740BadDebtExpenseAmt
Reimbursed By Medicare$3,685,836ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$4,006,305CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$320,469MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JAY HOSPITALBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line114114 ALABAMA STREETAddressLine1
CityJAYCity
StateFLState
ZIP Code32565ZIPCode
FieldValueIRS element (for citing)
Website AddressWWW.EBAPTISTHEALTHCARE.ORG/JAYHOSPITALWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1JAY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.BHCPNS.ORG/JAYHOSPITALOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Exec Community Wide PlanYes (X)ExecCommunityWidePlanInd
Include Operational PlanYes (X)IncludeOperationalPlanInd
Adopt BudgetYes (X)AdoptBudgetInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
Other Needs AddressedYes (X)OtherNeedsAddressedInd
All Needs AddressedYes (true)AllNeedsAddressedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (true)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (true)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care400.FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
Insurance StatusYes (X)InsuranceStatusInd
Uninsured DiscountYes (X)UninsuredDiscountInd
Medicaid MedicareYes (X)MedicaidMedicareInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, SECTION B, LINE 3The 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. Senior leadership from Baptist Health Care and its affiliates (including Jay Hospital), Sacred Heart Health System, the Florida Department of Health-Escambia County and the University of West Florida also 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. The results were also shared with and reviewed by the Florida Department of Health-Santa Rosa County. 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. In December 2012, a Community Forum was held to share and discuss the results of the assessment with the public. Approximately 75 people representing community constituencies attended the Forum. In addition, the Forum was recorded for public viewing on the PFAHC website. In May 2013, a Community Health Summit was held to involve the key organizations and community leaders whose participation is essential to the development of plans to effectively improve the health status of residents of Escambia and Santa Rosa Counties. Jay Hospital representatives participated in the Summit.
PART V, SECTION B, LINE 4Baptist 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, the Florida Department of Health-Escambia County and the University of West Florida 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.
PART V, SECTION B, LINE 6IIn December 2012, a Community Forum was held to share and discuss the results of the assessment with the public. Approximately 75 people representing community constituencies attended the Forum. In addition, the Forum was recorded for public viewing on the PFAHC website. In May 2013, a Community Health Summit was held to involve the key organizations and community leaders whose participation is essential to the development of plans to effectively improve the health status of residents of Escambia and Santa Rosa Counties. Jay Hospital representatives participated in the Summit.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BAPTIST MEDICAL GROUP - CENTURYBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line18401 NORTH CENTURY BLVDAddressLine1
CityCENTURYCity
StateFLState
ZIP Code32535ZIPCode
FieldValueIRS element (for citing)
FacilityPRIMARY CARE PRACTICEFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 7 IS THE COST TO CHARGE RATIO CALCULATED PURSUANT TO THE IRS SCHEDULE H WORKSHEET 2 INSTRUCTIONS. THE COST OF UNREIMBURSED MEDICAID WAS COMPUTED USING THE COST REPORT.
Part I, Ln 7 Col(f)BAD DEBT EXPENSE IN THE AMOUNT OF $4,052,659 WAS SUBTRACTED FROM TOTAL EXPENSES PER FORM 990, PART IX, LINE 25 FOR PURPOSES OF CALCULATING THE PERCENTAGE FOR LINE 7, COLUMN (F).
Part III, Line 2 and Line 4THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORT HAS BEEN FOLLOWED IN ACCORDANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS, AND SUBSEQUENT RECOVERIES ARE ADDED. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. THE HOSPITAL PROVIDES SERVICES WITHOUT CHARGE, OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, SUCH SERVICES ARE NOT REPORTED AS NET REVENUE. THE HOSPITAL'S CHARITY CARE POLICY UTILIZES THE GENERALLY RECOGNIZED FEDERAL POVERTY INCOME LEVELS. FOR PATIENTS WHO DO NOT APPLY OR DO NOT QUALIFY, THE UNCOLLECTED AMOUNTS ARE RECOGNIZED AS BAD DEBT EXPENSE. ESTIMATED COST OF BAD DEBT IS BASED ON THE RATIO OF COST TO CHARGES AS DETERMINED BY HOSPITAL SPECIFIC DATA.
Part III, Line 8THE MEDICARE SHORTFALL WAS NOT INCLUDED IN THE COMMUNITY BENEFIT COST, AND THE COSTING METHODOLOGY CONSISTED OF INFORMATION FROM THE ORGANIZATION'S 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.
Part III, Line 9bFOR PATIENTS WHO ARE FINANCIALLY OR MEDICALLY INDIGENT (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): A) PATIENTS ARE DEEMED FINANCIALLY INDIGENT IF THEIR INCOME IS BELOW 200% OF FPL. IF A PATIENT MAKES BETWEEN 200% AND 400% OF THE FPL, THEN THEY MAY ONLY RECEIVE A PARTIAL WRITE-OFF. B) PATIENTS MAY BE DEEMED MEDICALLY INDIGENT IF THEIR HOUSEHOLD MEDICAL EXPENSES EXCEED 25% OF THE ANNUAL HOUSEHOLD INCOME REGARDLESS OF INCOME LEVEL. 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.
Part VI, Line 2PART OF THE ORGANIZATION'S MISSION IS TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE AND COMMUNITIES SERVED. IN RESPONSE TO THIS MISSION, THE ORGANIZATION HELPS ENSURE THAT ALL CITIZENS ARE AFFORDED ACCESS TO HEALTH CARE BY INVESTING IN COMMUNITY HEALTH, AND BY PARTICIPATING IN AND LEADING COLLABORATIVE, COMMUNITY-WIDE PARTNERSHIPS. FREE HEALTH SCREENINGS, SUPPORT GROUPS, EDUCATION SEMINARS, AND OTHER PROGRAMS THAT ARE OFFERED FOCUS ON AREAS THAT HAVE BEEN IDENTIFIED THROUGH INTERNAL STUDIES AND EXTERNAL SOURCES AS CRITICAL HEALTH CONCERNS IN THE SURROUNDING COMMUNITIES. A FULL COPY OF THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE ACCESSED USING THE FOLLOWING WEBSITE: HTTP://WWW.EBAPTISTHEALTHCARE.ORG/ CONTENT DOCUMENTS/COMMUNITY/CHNA-2012_JAY.PDF
Part VI, Line 3ALL EMPLOYEES WORKING IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS AREAS HAVE BEEN TRAINED TO BE FULLY VERSED IN ALL FINANCIAL ASSISTANCE-RELATED POLICIES, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND BE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE REPRESENTATIVES. FOR NON-EMERGENCY PURPOSES, EVERY FILE FOR A PATIENT THAT HAS PRE-SCHEDULED AN OFFICE VISIT OR PROCEDURE IS REVIEWED BEFORE THE PATIENT ARRIVES AT THE HOSPITAL. A FINANCIAL COUNSELOR IS ASSIGNED TO THAT PATIENT IF IT IS DETERMINED THAT THE INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ETC. ALSO, WHEN A PATIENT RECEIVES A BILL, THE ORGANIZATION INCLUDES PAPERWORK EXPLAINING THAT FINANCIAL ASSISTANCE IS AVAILABLE. JAY HOSPITAL HAS POSTED MULTILINGUAL NOTICES OF FINANCIAL ASSISTANCE POLICIES IN THE EMERGENCY DEPARTMENT. SAID NOTICES HAVE BEEN PUBLISHED IN ENGLISH AND SPANISH, AND HAVE BEEN MADE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. JAY HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM, PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS FOR APPLYING FOR ASSISTANCE. ALSO, JAY HOSPITAL HAS POSTED A SUMMARY OF ITS CURRENT CHARITY CARE POLICY ON ITS INTERNET WEBSITE.
Part VI, Line 4JAY HOSPITAL, INC. OPERATES IN SANTA ROSA COUNTY, FLORIDA. APPROXIMATELY 163,000 INDIVIDUALS RESIDE IN THIS COUNTY, 13.8% OF WHICH LIVE BELOW POVERTY LEVEL. WHEN CONSIDERING THESE FACTORS, MORE THAN 23,000 RESIDENTS COULD BE ELIGIBLE TO QUALIFY FOR CHARITY CARE. APPROXIMATELY 32.6% OF JAY HOSPITAL'S PATIENTS DURING FY2014 WERE UNINSURED OR WERE MEDICAID RECIPIENTS. THREE HOSPITALS, INCLUDING JAY HOSPITAL, ARE LOCATED IN SANTA ROSA COUNTY.
Part VI, Line 5THE ORGANIZATION DOES NOT LIMIT MEDICAL STAFF PRIVILEGES TO THE ORGANIZATION'S EMPLOYED PHYSICIANS BUT EXTENDS THOSE PRIVILEGES TO QUALIFIED PHYSICIANS FOR MOST AREAS OF SERVICE.THE ORGANIZATION'S BOARD OF DIRECTORS PRIMARILY CONSISTS OF COMMUNITY LEADERS 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.
Part VI, Line 6ALTHOUGH THE ORGANIZATION MAY OPERATE IN DIFFERENT SERVICE AREAS WHEN COMPARED TO ITS AFFILIATES, ALL AFFILIATES WORK COLLABORATIVELY TO ENSURE THAT THE NEEDS OF THE COMMUNITIES ARE BEING ADDRESSED. THE ORGANIZATION PARTICIPATES IN MANY FREE HEALTH SCREENINGS, SUPPORT GROUPS, EDUCATION SEMINARS, AND HEALTH FAIRS THAT BENEFIT ALL COMMUNITIES WITHIN THE SYSTEM AND ARE NOT LIMITED TO THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. AFFILIATED ENTITIES INCLUDE: - ANDREWS RESEARCH & EDUCATION INSTITUTE, LLC - LEADS MEDICAL RESEARCH AND EDUCATION INITIATIVES - 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 - ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC. - OPERATES ATMORE HOSPITAL - LAKEVIEW CENTER, INC. AND AFFILIATES - PROVIDE BEHAVIORAL HEALTH AND SUPPORT SERVICES - THE BAPTIST MANOR, INC. - PROVIDES HEALTH CARE SERVICES TO THE ELDERLY AND OTHER PATIENTS - BAPTIST URGENT CARE, LLC - DELIVER AMBULATORY CARE IN A DEDICATED MEDICAL FACILITY OUTSIDE OF A TRADITIONAL EMERGENCY ROOM.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Santa Rosa Community ClinicBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line15520 Stewart StreetAddressLine1
CityMiltonCity
StateFLState
ZIP Code32570ZIPCode
FieldValueIRS element (for citing)
Recipient EIN311746599RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$12,500CashGrantAmt
Purpose Of GrantHealthcare AssistancePurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MIKE HUTCHINS
VP/ADMINISTRATOR$148,325$0$43,072$0$34,468$0$4,140$0$21,268$0$251,273$0$0$0
KERRY VERMILLION
SENIOR VP/CFO$0$317,547$0$127,920$0$21,419$0$72,578$0$17,336$0$556,801$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 4bKerry Vermillion $66,636
PART IITHE RELATED COMPENSATION REPORTED ON FORM 990, PART VII, SECTION A & SCHEDULE J, PART II WAS PAID BY BAPTIST HEALTH CARE CORPORATION, INC., A RELATED TAX-EXEMPT ORGANIZATION.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 1JAY 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 VI, SECTION A, LINE 6BAPTIST HEALTH CARE CORPORATION, A FLORIDA CORPORATION NOT-FOR-PROFIT, IS THE SOLE MEMBER OF JAY HOSPITAL, INC. BAPTIST HEALTH CARE CORPORATION HAS THE RIGHT TO ELECT THE BOARD OF DIRECTORS OF JAY HOSPITAL, INC.
FORM 990, PART VI SECTION A, LINE 7ABAPTIST HEALTH CARE CORPORATION, BEING THE SOLE MEMBER OF JAY HOSPITAL, INC., HAS THE RIGHT TO ELECT THE GOVERNING BODY OF JAY HOSPITAL, INC.
FORM 990, PART VI SECTION A, LINE 7BTHE FOLLOWING SHALL REQUIRE APPROVAL BY THE BAPTIST HEALTH CARE CORPORATION, THE SOLE MEMBER, BOARD OF DIRECTORS: A. Election of the directors of the corporation at the annual meeting of the member 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 interests 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 11AN 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 PROVIDED ELECTRONICALLY TO 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 PRINCIPLE OFFICE.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS AND OFFICERS RECEIVE CORRESPONDENCE EACH YEAR THAT MUST BE COMPLETED AND SIGNED. THE CORRESPONDENCE INCLUDES A CONFLICTS OF INTEREST QUESTIONNAIRE. 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 15THE COMPENSATION COMMITTEE OF THE ORGANIZATION'S BOARD UTILIZES INDEPENDENT COMPENSATION STUDIES THAT REFLECT THE CURRENT MARKET VALUE OF SPECIFIC KEY MANAGMENT POSITIONS AS BENCHMARK DATA. ALL COMPENSATION OF KEY INDIVIDUALS MUST BE APPROVED BY THE COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION HAS ALL GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE ANNUAL FINANCIAL STATEMENTS ON FILE IN THE ACCOUNTING AND ADMINISTRATION DEPARTMENTS. ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
BAPTIST HEALTH CARE CORPORATION
1717 N E STREETPENSACOLAFL32501592425151HEALTHCAREFL501(c)(3)11cNAfalse
BAPTIST HEALTH CARE FOUNDATION
1717 N E STREETPENSACOLAFL32501590192265FUNDRAISINGFL501(c)(3)7BHCYes (true)
BAPTIST HOSPITAL INC
1000 WEST MORENO STREETPENSACOLAFL32501590657322HEALTHCAREFL501(c)(3)3BHCYes (true)
CMHC HERNANDEZ HOUSE INC
1221 WEST LAKEVIEW AVEPENSACOLAFL32501592041794LOW COST HOUSFL501(c)(3)9LCIYes (true)
ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPIT
401 MEDICAL PARK DRIVEATMOREAL36502631143638HEALTHCAREAL501(c)(3)3BHCYes (true)
LAKEVIEW CENTER INC
1221 WEST LAKEVIEW AVENUEPENSACOLAFL32501590737872HEALTHCAREFL501(c)(3)7BHCYes (true)
LAKEVIEW PLACE INC
1221 WEST LAKEVIEW AVEPENSACOLAFL32501592804577LOW COST HOUSFL501(c)(3)9LCIYes (true)
LAKEVIEW VILLA INC
1221 WEST LAKEVIEW AVEPENSACOLAFL32501592842486LOW COST HOUSFL501(c)(3)9LCIYes (true)
THE BAPTIST MANOR INC
10095 HILLVIEW RDPENSACOLAFL32514592455515HEALTHCAREFL501(c)(3)9BHCYes (true)
ANDREWS RESEARCH & EDUCATION INSTITUTE
1040 GULF BREEZE PARKWAYGULF BREEZEFL32561263263612RESEARCHFL501(c)(3)9BHCYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmtGeneral Or Managing PartnerGeneralOrManagingPartnerInd
BAPTIST MEDICAL PARK SURGERY CENTER LLC
9400 UNIVERSITY PKWYPENSACOLAFL32514593535262AMBULATORY SUFLNANONE$0$0false$0false
ENDOSCOPY CENTER OF GULF BREEZE LLC
1116 GULF BREEZE PKWYGULF BREEZEFL32561432086670AMBULATORY SUFLBHINONE$0$0false$0false
PHYSICIANS LABORATORIES
14 WEST JORDAN STREET STE APENSACOLAFL32501590879739LABORATORY SVFLNANONE$0$0false$0false
ANDREWS INSTITUTE ASC LLC
1040 GULF BREEZE PKWYGULF BREEZEFL32561352274952AMBULATORY SUFLBHINONE$0$0false$0false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Entity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtControlled OrganizationControlledOrganizationInd
BAPTIST HEALTH VENTURES INC
1717 NORTH E STPENSACOLAFL32501592415910ADMINISTRATIVFLBHVC CORP$0$0Yes (true)
PENSACOLA POB INC
1717 NORTH E STPENSACOLAFL32501592462399LEASING AGENTFLBHVC CORP$0$0Yes (true)
MOBILE DIAGNOSTICS INC
1717 NORTH E STPENSACOLAFL32501592864191MEDICAL SERVIFLBHVC CORP$0$0Yes (true)
MEDICAL PROFESSIONAL AGENCY INC
1717 NORTH E STPENSACOLAFL32501592555835MEDICAL SERVIFLBHVC CORP$0$0Yes (true)
THE TOWERS PHARMACY INC
1717 NORTH E STPENSACOLAFL32501592667929RETAIL SALESFLBHVC CORP$0$0Yes (true)
LANGHORNE CARDIOLOGY CONSULTANTS INC
1717 NORTH E STPENSACOLAFL32501592874324MEDICAL SERVIFLBHIC CORP$0$0Yes (true)
LAKEVIEW ASSOCIATED ENTERPRISES-PHASE I
1221 W LAKEVIEW AVEPENSACOLAFL32501611711170FRANCHISINGFLBHVC CORP$0$0Yes (true)
LAKEVIEW ASSOCIATED ENTERPRISES-PHASE II
1221 W LAKEVIEW AVEPENSACOLAFL32501465458197FRANCHISINGFLBHVC CORP$0$0Yes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Baptist Hospital Inc
D$2,918,233FMV
Baptist Hospital Inc
M$135,276FMV
Baptist Hospital Inc
R$52,298FMV

Affiliated Group Schedule AffiliatedGroupSchedule

Affiliated Schedule AffiliatedScheduleGrp (11 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINTotal Grassroots LobbyTotalGrassrootsLobbyAmtTotal Direct LobbyTotalDirectLobbyAmtTotal Lobby ExpenditureTotalLobbyExpenditureAmtOther Exempt Purpose ExpendOtherExemptPurposeExpendAmtTotal Exempt Purpose ExpendTotalExemptPurposeExpendAmtLobby NontxLobbyNontxAmtGrassroots NontxGrassrootsNontxAmtTotal Lobby Grssroot Mns NontxTotalLobbyGrssrootMnsNontxAmtTot Lbby Expend Mns Lobby NontxTotLbbyExpendMnsLobbyNontxAmtShare Excess Lobby ExpendShareExcessLobbyExpendAmtElecting OrganizationElectingOrganizationInd
ANDREWS RESEARCH & EDUCATION
1040 GULF BREEZE PARKWAYGULF BREEZEFL32561263263612$0$0$0$2,138,117$2,138,117$256,906$64,227$0$0$0
BAPTIST HEALTH CARE CORPORAT
PO BOX 17500PENSACOLAFL325227500592425151$0$44,973$44,973$48,282,189$48,327,162$1,000,000$250,000$0$0$0Yes (X)
BAPTIST HEALTH CARE FOUNDATI
PO BOX 17500PENSACOLAFL325227500590192265$0$0$0$1,775,206$1,775,206$238,760$59,690$0$0$0Yes (X)
BAPTIST HOSPITAL INC
PO BOX 17500PENSACOLAFL325227500590657322$0$55,879$55,879$435,052,493$435,108,372$1,000,000$250,000$0$0$0
CMHC HERNANDEZ HOUSE INC
1221 W LAKEVIEW AVENUEPENSACOLAFL325011836592041794$0$0$0$43,778$43,778$8,756$2,189$0$0$0
ESCAMBIA COUNTY ALABAMA COMM
PO BOX 17500PENSACOLAFL325227500631143638$0$7,283$7,283$24,060,630$24,067,913$1,000,000$250,000$0$0$0
JAY HOSPITAL INC
PO BOX 17500PENSACOLAFL325227500592425149$0$3,692$3,692$15,035,927$15,039,619$901,981$225,495$0$0$0
LAKEVIEW PLACE INC
1221 W LAKEVIEW AVENUEPENSACOLAFL325011836592804577$0$0$0$80,277$80,277$16,055$4,014$0$0$0
LAKEVIEW VILLA INC
1221 W LAKEVIEW AVENUEPENSACOLAFL325011836592842486$0$0$0$723,665$723,665$133,550$33,388$0$0$0
THE BAPTIST MANOR INC
PO BOX 17500PENSACOLAFL325227500592455515$0$0$0$2,367,404$2,367,404$268,370$67,093$0$0$0
LAKEVIEW CENTER INC
1221 W LAKEVIEW AVENUEPENSACOLAFL325011836590737872$0$0$0$201,049,841$201,049,841$1,000,000$250,000$0$0$0