2015-08-17T10:55:02-05:00 2014-09-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2013-10-01 592425149 Jay Hospital Inc % KEITH STRICKLING JAYH 8504344714 POST OFFICE BOX 17500 Suite PENSACOLA FL 32522 WILLIAM J ROBERTS VP FIN/CONTROLLER 8504344714 2015-08-15 true Michael J Engle P00482834 8504344714 2013 2016-02-25 16:41:14Z Michael T Hutchins 1717 N E ST STE 320 PENSACOLA FL 32501 14592371 false X www.ebaptisthealthcare.org/JayHospital X 1983 FL Jay 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. 15 15 139 24 0 0 9010 8188 12106721 13865702 795 6765 1671171 702069 13787697 14582724 14400 17032 0 0 5551742 5657383 0 0 0 8891817 9365204 14457959 15039619 -670262 -456895 6384329 6986804 3901605 4960975 2482724 2025829 X SEE SCHEDULE O false false 11911139 13865702 GENERAL AND SPECIALIZED HEALTH CARE SERVICES INCLUDING INPATIENT, PRIMARY CARE, LONG TERM AND OUTPATIENT HEALTHCARE SERVICES. 17032 17032 0 COMMUNITY BENEFIT OUTREACH ACTIVITIES CONDUCTED BY THE ORGANIZATION INCLUDING HEALTH EDUCATION SEMINARS, HEALTH FAIRS, AND DONATIONS TO OTHER NON-PROFIT ENTITIES. 11928171 true true 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 true false true false false false false false false false false false false false false false true true true false false true 0 0 139 true false false false false false false false false false false X 15 15 false false false false true true true true true false false true true true true true true true true false X KEITH STRICKLING 8506758024 14114 ALABAMA STREET Jay FL 32565 RONALD E JACKSON CHAIRMAN 1.0 1.0 X X 0 0 0 LARRY K HICKS VICE CHAIRMAN 1.0 1.0 X X 0 0 0 JOHN KIZZIAH SECRETARY 1.0 1.0 X X 0 0 0 JOHN J BAEHR MD TREASURER 1.0 1.0 X X 0 0 0 REVEREND LUTIMOTHY MAY BOARD MEMBER 1.0 1.0 X 0 0 0 FRANK WHITE BOARD MEMBER 1.0 1.0 X 0 0 0 JOHN HOSMAN BOARD MEMBER 1.0 1.0 X 0 0 0 KIM JERNIGAN DMD BOARD MEMBER 1.0 1.0 X 0 0 0 DAVID KELLEN MD BOARD MEMBER 1.0 1.0 X 0 0 0 ADM ROBERT KELLY BOARD MEMBER 1.0 1.0 X 0 0 0 MICHAEL J MAZENKO BOARD MEMBER 1.0 1.0 X 0 0 0 RICKY SMITH BOARD MEMBER 1.0 1.0 X 0 0 0 MARGARET T STOPP BOARD MEMBER 1.0 1.0 X 0 0 0 LUTHER TAYLOR BOARD MEMBER 1.0 1.0 X 0 0 0 TOM OWENS BOARD MEMBER 1.0 1.0 X 0 0 0 MIKE HUTCHINS VP/ADMINISTRATOR 50.0 0.0 X 225865 0 25409 KERRY VERMILLION SENIOR VP/CFO 4.0 46.0 X 0 466887 89913 MELANIE STYLES LABORATORY MANAGER 40.0 0.0 X 104340 0 14697 DANIEL SHEPPARD PHARMACIST 40.0 0.0 X 109729 0 22190 439934 466887 152209 3 false true false SCOTT G MOORE MD Physician Services 248302 Jeff Kelley MD Physician Services 234233 MARK ELDER DO PHYSICIAN SERVICES 179905 3 8188 8188 Net Patient Service Revenue 621990 12462202 12462202 EHR INCENTIVE PAYMENTS 621990 1403500 1403500 13865702 6765 6765 0 0 32550 9647 22903 0 22903 22903 0 0 0 0 CAFETERIA INCOME 722210 30302 30302 MEDICAL RECORDS 541900 8300 8300 All Other Misc Revenue 900099 640564 640564 640564 640564 679166 14582724 13865702 708834 17032 17032 0 0 0 252364 201891 50473 0 4465549 3929251 536298 116990 102470 14520 492700 431550 61150 329780 288850 40930 1527754 1527754 570 570 0 0 0 0 1491533 1091832 399701 0 157269 113520 43749 17924 17590 334 0 250710 224194 26516 55605 10457 45148 0 300 225 75 64919 64919 0 723529 615000 108529 96002 96002 BAD DEBT EXPENSE 4052659 4052659 MEDICAL SUPPLIES 622735 622735 INDIGENT ASSESSMENT 110889 110889 FOOD COSTS 87227 82898 4329 105579 15128 90451 15039619 11928171 3111448 0 10477 66169 0 0 0 0 1051840 3025406 0 0 0 0 0 0 141170 155401 54494 47029 12014941 8487188 3989339 3527753 0 0 0 0 0 0 0 0 1137009 165046 6384329 6986804 886358 973501 0 0 0 0 0 0 0 0 0 0 424434 342160 0 0 2590813 3645314 3901605 4960975 X 2482724 2025829 0 0 0 0 2482724 2025829 6384329 6986804 -456895 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 3692 111827 3692 111827 15039619 730609527 15043311 730721354 902166 5824378 225542 1456096 1000000 1000000 1000000 1000000 4000000 6000000 216698 213915 117438 111827 659878 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 62193 62193 977439 176381 801058 4571543 3160106 1411437 6227385 5146285 1081100 176381 4416 171965 3527753 0 ASSET RETIREMENT OBLIGATION 126845 DUE TO THIRD PARTIES 600236 DUE TO AFFILIATES 2918233 3645314 SCHEDULE D, PART X, LINE 2 Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 740, Income Taxes, prescribes the accounting for uncertainty in income tax positions recognized in financial statements. ASC Topic 740 provides guidance for recognition threshold and measurement attributes for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. There were no material uncertain tax positions as of September 30, 2014 and 2013. true true X true X true X true true true false true true 352083 352083 0.03160 1589197 1537964 51233 0.00470 263177 84432 178745 0.01630 2204457 1622396 582061 0.05260 1 14 295 295 0.00010 15200 15200 0.00140 1 14 15495 15495 0.00150 1 14 2219952 1622396 597556 0.05410 true 775740 3685836 4006305 -320469 X true true 1 1 JAY HOSPITAL 14114 ALABAMA STREET JAY FL 32565 WWW.EBAPTISTHEALTHCARE.ORG/JAYHOSPITAL X X X JAY HOSPITAL 1 true X X X X X X X X 12 true true true X WWW.BHCPNS.ORG/JAYHOSPITAL X X X X X X X X X X true false true true 200. true 400. true X X X X X X true true X X X true false X X X X true X false false PART V, SECTION B, LINE 3 The CHNA process was facilitated by The Partnership for a Healthy Community (PFAHC), a nonprofit tax-exempt organization whose mission is to sponsor community health status assessments for the two counties and to support and promote collaborative initiatives that address priority health problems. 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 4 Baptist Health Care (Jay Hospital's parent company), Sacred Heart Health System, and Escambia Community Clinics, a federally qualified health center, were lead organizations and funders of the CHNA process. Senior leadership from Baptist Health Care, Sacred Heart, 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 6I 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. 1 BAPTIST MEDICAL GROUP - CENTURY 8401 NORTH CENTURY BLVD CENTURY FL 32535 PRIMARY CARE PRACTICE Part I, Line 7 THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 7 IS THE COST TO CHARGE RATIO CALCULATED PURSUANT TO THE IRS SCHEDULE H WORKSHEET 2 INSTRUCTIONS. 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 4 THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORT HAS BEEN FOLLOWED IN ACCORDANCE 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 8 THE 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 9b FOR 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 2 PART OF THE ORGANIZATION'S MISSION IS TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE AND COMMUNITIES SERVED. IN RESPONSE TO THIS MISSION, THE ORGANIZATION HELPS ENSURE THAT ALL CITIZENS ARE AFFORDED ACCESS TO HEALTH CARE BY INVESTING IN COMMUNITY HEALTH, AND BY PARTICIPATING IN AND LEADING COLLABORATIVE, COMMUNITY-WIDE PARTNERSHIPS. FREE HEALTH SCREENINGS, SUPPORT GROUPS, EDUCATION SEMINARS, AND OTHER PROGRAMS THAT ARE OFFERED FOCUS ON AREAS THAT HAVE BEEN IDENTIFIED THROUGH INTERNAL STUDIES AND EXTERNAL SOURCES AS CRITICAL HEALTH CONCERNS IN THE SURROUNDING COMMUNITIES. A FULL COPY OF THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE ACCESSED USING THE FOLLOWING WEBSITE: HTTP://WWW.EBAPTISTHEALTHCARE.ORG/ CONTENT DOCUMENTS/COMMUNITY/CHNA-2012_JAY.PDF Part VI, Line 3 ALL 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 4 JAY 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 5 THE ORGANIZATION DOES NOT LIMIT MEDICAL STAFF PRIVILEGES TO THE ORGANIZATION'S EMPLOYED PHYSICIANS BUT EXTENDS THOSE PRIVILEGES TO QUALIFIED PHYSICIANS FOR MOST AREAS OF SERVICE.THE ORGANIZATION'S BOARD OF DIRECTORS PRIMARILY CONSISTS OF 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 6 ALTHOUGH THE ORGANIZATION MAY OPERATE IN DIFFERENT SERVICE AREAS WHEN COMPARED TO ITS AFFILIATES, ALL AFFILIATES WORK COLLABORATIVELY TO ENSURE THAT THE NEEDS OF THE COMMUNITIES ARE BEING ADDRESSED. THE ORGANIZATION PARTICIPATES IN MANY FREE HEALTH SCREENINGS, SUPPORT GROUPS, EDUCATION SEMINARS, AND HEALTH FAIRS THAT BENEFIT ALL COMMUNITIES WITHIN THE SYSTEM AND ARE NOT LIMITED TO THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. AFFILIATED ENTITIES INCLUDE: - 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. true Santa Rosa Community Clinic 5520 Stewart Street Milton FL 32570 311746599 501(c)(3) 12500 Healthcare Assistance 1 Schedule I, Part I, Line 2 Within one year, the organization requests documentation from the recipient regarding proper use of funds provided for indigent patients. X X X X X false true false false false false false false false MIKE HUTCHINS VP/ADMINISTRATOR 148325 0 43072 0 34468 0 4140 0 21268 0 251273 0 0 0 KERRY VERMILLION SENIOR VP/CFO 0 317547 0 127920 0 21419 0 72578 0 17336 0 556801 0 0 Part I, Line 4b Kerry Vermillion $66,636 PART II THE 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. FORM 990, PART III, LINE 1 JAY HOSPITAL'S PRIMARY MISSION IS DEDICATED TO MEETING THE HEALTHCARE NEEDS IN THE JAY, CENTURY, FLOMATON, AND SURROUNDING COMMUNITIES IN THE NORTHWEST FLORIDA-SOUTH ALABAMA AREA. JAY HOSPITAL IS A 55-BED ACUTE CARE FACILITY AND PART OF AN INTEGRATED NETWORK OF AFFILIATED ORGANIZATIONS. JAY HOSPITAL AND ITS AFFILIATED ORGANIZATIONS ARE COMMITTED TO PROVIDING A BROAD RANGE OF GENERAL AND SPECIALIZED HEALTH CARE SERVICES INCLUDING INPATIENT, PRIMARY CARE, LONG TERM AND OUTPATIENT HEALTHCARE SERVICES. QUALITY MEDICAL CARE IS PROVIDED TO ALL PERSONS REQUIRING IMMEDIATE TREATMENT REGARDLESS OF THEIR ABILITY TO PAY. FORM 990, PART VI, SECTION A, LINE 6 BAPTIST HEALTH CARE CORPORATION, A FLORIDA CORPORATION NOT-FOR-PROFIT, IS THE SOLE MEMBER OF JAY HOSPITAL, INC. BAPTIST HEALTH CARE CORPORATION HAS THE RIGHT TO ELECT THE BOARD OF DIRECTORS OF JAY HOSPITAL, INC. FORM 990, PART VI SECTION A, LINE 7A BAPTIST HEALTH CARE CORPORATION, BEING THE SOLE MEMBER OF JAY HOSPITAL, INC., HAS THE RIGHT TO ELECT THE GOVERNING BODY OF JAY HOSPITAL, INC. FORM 990, PART VI SECTION A, LINE 7B THE FOLLOWING SHALL REQUIRE APPROVAL BY THE BAPTIST HEALTH CARE CORPORATION, THE SOLE MEMBER, BOARD OF DIRECTORS: A. Election of the directors of the corporation at the annual meeting of the 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 11 AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S MANAGEMENT PERSONNEL. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S MANAGEMENT PERSONNEL HAS ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN 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 12C BOARD 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 15 THE 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 19 THE ORGANIZATION HAS ALL GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE ANNUAL FINANCIAL STATEMENTS ON FILE IN THE ACCOUNTING AND ADMINISTRATION DEPARTMENTS. ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. BAPTIST HEALTH CARE CORPORATION 1717 N E STREET PENSACOLA FL 32501 592425151 HEALTHCARE FL 501(c)(3) 11c NA false BAPTIST HEALTH CARE FOUNDATION 1717 N E STREET PENSACOLA FL 32501 590192265 FUNDRAISING FL 501(c)(3) 7 BHC true BAPTIST HOSPITAL INC 1000 WEST MORENO STREET PENSACOLA FL 32501 590657322 HEALTHCARE FL 501(c)(3) 3 BHC true CMHC HERNANDEZ HOUSE INC 1221 WEST LAKEVIEW AVE PENSACOLA FL 32501 592041794 LOW COST HOUS FL 501(c)(3) 9 LCI true ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPIT 401 MEDICAL PARK DRIVE ATMORE AL 36502 631143638 HEALTHCARE AL 501(c)(3) 3 BHC true LAKEVIEW CENTER INC 1221 WEST LAKEVIEW AVENUE PENSACOLA FL 32501 590737872 HEALTHCARE FL 501(c)(3) 7 BHC true LAKEVIEW PLACE INC 1221 WEST LAKEVIEW AVE PENSACOLA FL 32501 592804577 LOW COST HOUS FL 501(c)(3) 9 LCI true LAKEVIEW VILLA INC 1221 WEST LAKEVIEW AVE PENSACOLA FL 32501 592842486 LOW COST HOUS FL 501(c)(3) 9 LCI true THE BAPTIST MANOR INC 10095 HILLVIEW RD PENSACOLA FL 32514 592455515 HEALTHCARE FL 501(c)(3) 9 BHC true ANDREWS RESEARCH & EDUCATION INSTITUTE 1040 GULF BREEZE PARKWAY GULF BREEZE FL 32561 263263612 RESEARCH FL 501(c)(3) 9 BHC true BAPTIST MEDICAL PARK SURGERY CENTER LLC 9400 UNIVERSITY PKWY PENSACOLA FL 32514 593535262 AMBULATORY SU FL NA NONE 0 0 false 0 false ENDOSCOPY CENTER OF GULF BREEZE LLC 1116 GULF BREEZE PKWY GULF BREEZE FL 32561 432086670 AMBULATORY SU FL BHI NONE 0 0 false 0 false PHYSICIANS LABORATORIES 14 WEST JORDAN STREET STE A PENSACOLA FL 32501 590879739 LABORATORY SV FL NA NONE 0 0 false 0 false ANDREWS INSTITUTE ASC LLC 1040 GULF BREEZE PKWY GULF BREEZE FL 32561 352274952 AMBULATORY SU FL BHI NONE 0 0 false 0 false BAPTIST HEALTH VENTURES INC 1717 NORTH E ST PENSACOLA FL 32501 592415910 ADMINISTRATIV FL BHV C CORP 0 0 true PENSACOLA POB INC 1717 NORTH E ST PENSACOLA FL 32501 592462399 LEASING AGENT FL BHV C CORP 0 0 true MOBILE DIAGNOSTICS INC 1717 NORTH E ST PENSACOLA FL 32501 592864191 MEDICAL SERVI FL BHV C CORP 0 0 true MEDICAL PROFESSIONAL AGENCY INC 1717 NORTH E ST PENSACOLA FL 32501 592555835 MEDICAL SERVI FL BHV C CORP 0 0 true THE TOWERS PHARMACY INC 1717 NORTH E ST PENSACOLA FL 32501 592667929 RETAIL SALES FL BHV C CORP 0 0 true LANGHORNE CARDIOLOGY CONSULTANTS INC 1717 NORTH E ST PENSACOLA FL 32501 592874324 MEDICAL SERVI FL BHI C CORP 0 0 true LAKEVIEW ASSOCIATED ENTERPRISES-PHASE I 1221 W LAKEVIEW AVE PENSACOLA FL 32501 611711170 FRANCHISING FL BHV C CORP 0 0 true LAKEVIEW ASSOCIATED ENTERPRISES-PHASE II 1221 W LAKEVIEW AVE PENSACOLA FL 32501 465458197 FRANCHISING FL BHV C CORP 0 0 true false true true true false false false false false false false false true false false true false true false Baptist Hospital Inc D 2918233 FMV Baptist Hospital Inc M 135276 FMV Baptist Hospital Inc R 52298 FMV ANDREWS RESEARCH & EDUCATION 1040 GULF BREEZE PARKWAY GULF BREEZE FL 32561 263263612 0 0 0 2138117 2138117 256906 64227 0 0 0 BAPTIST HEALTH CARE CORPORAT PO BOX 17500 PENSACOLA FL 325227500 592425151 X 0 44973 44973 48282189 48327162 1000000 250000 0 0 0 BAPTIST HEALTH CARE FOUNDATI PO BOX 17500 PENSACOLA FL 325227500 590192265 X 0 0 0 1775206 1775206 238760 59690 0 0 0 BAPTIST HOSPITAL INC PO BOX 17500 PENSACOLA FL 325227500 590657322 0 55879 55879 435052493 435108372 1000000 250000 0 0 0 CMHC HERNANDEZ HOUSE INC 1221 W LAKEVIEW AVENUE PENSACOLA FL 325011836 592041794 0 0 0 43778 43778 8756 2189 0 0 0 ESCAMBIA COUNTY ALABAMA COMM PO BOX 17500 PENSACOLA FL 325227500 631143638 0 7283 7283 24060630 24067913 1000000 250000 0 0 0 JAY HOSPITAL INC PO BOX 17500 PENSACOLA FL 325227500 592425149 0 3692 3692 15035927 15039619 901981 225495 0 0 0 LAKEVIEW PLACE INC 1221 W LAKEVIEW AVENUE PENSACOLA FL 325011836 592804577 0 0 0 80277 80277 16055 4014 0 0 0 LAKEVIEW VILLA INC 1221 W LAKEVIEW AVENUE PENSACOLA FL 325011836 592842486 0 0 0 723665 723665 133550 33388 0 0 0 THE BAPTIST MANOR INC PO BOX 17500 PENSACOLA FL 325227500 592455515 0 0 0 2367404 2367404 268370 67093 0 0 0 LAKEVIEW CENTER INC 1221 W LAKEVIEW AVENUE PENSACOLA FL 325011836 590737872 0 0 0 201049841 201049841 1000000 250000 0 0 0