2015-09-29T11:00:37-05:00 2014-12-31 454084437 WARREN AVERETT LLC 2500 ACTON ROAD BIRMINGHAM AL 35243 990 2014-01-01 630312913 BAPTIST HEALTH SYSTEM INC BAPT 2057155716 PO BOX 830605 BIRMINGHAM AL 352830605 GREGORY D JOHNSTON SVP/CFO 2057155716 2015-09-02 1 JC ROUSE P00081132 2059794100 2014 2016-04-25 22:37:26Z KEITH PARROTT PO BOX 830605 BIRMINGHAM AL 352830605 800427719 0 X WWW.BAPTISTHEALTHALABAMA.ORG X 1922 AL "AS A WITNESS TO THE LOVE OF GOD, REVEALED THROUGH JESUS CHRIST, THE BAPTIST HEALTH SYSTEM IS COMMITTED TO MINISTRIES THAT ENHANCE THE HEALTH, DIGNITY, AND WHOLENESS OF THOSE WE SERVE, THROUGH INTEGRITY, COMPASSION, ADVOCACY, RESOURCEFULNESS, AND EXCELLENCE." 11 11 5144 306 -484753 -484753 3010129 4580178 475631694 481394570 11160465 23524292 14033725 11545471 503836013 521044511 0 0 0 0 228380898 231187139 0 0 0 264673702 265875889 493054600 497063028 10781413 23981483 770496637 767579002 527315332 559650610 243181305 207928392 X "AS A WITNESS TO THE LOVE OF GOD, REVEALED THROUGH JESUS CHRIST, THE BAPTIST HEALTH SYSTEM IS COMMITTED TO MINISTRIES THAT ENHANCE THE HEALTH, DIGNITY, AND WHOLENESS OF THOSE WE SERVE, THROUGH INTEGRITY, COMPASSION, ADVOCACY, RESOURCEFULNESS, AND EXCELLENCE." 0 0 320745454 407381784 PATIENT SERVICES -- BAPTIST HEALTH SYSTEM, INC. ("BHS"), CONTINUES IN ITS CHARITABLE MISSION, WHICH BEGAN IN 1922, OF PROVIDING MEDICAL AND EDUCATIONAL SERVICES TO THE COMMUNITY THROUGH ITS FOUR HOSPITALS AND OTHER PATIENT CARE FACILITIES. ONE OF THE HOSPITALS IS LOCATED WITHIN THE CITY LIMITS OF BIRMINGHAM, AL, WHICH ENABLES BHS TO PROVIDE SERVICES TO AREAS OF THE CITY WHICH MIGHT OTHERWISE BE UNDERSERVED. THE CORPORATION ALSO OWNS AND OPERATES HOSPITALS IN TALLADEGA, JASPER, AND ALABASTER, AL. SEVERAL OF THESE HOSPITALS SERVE RURAL COMMUNITIES WHICH, PRIOR TO BHS' INVOLVEMENT, WERE IN NEED OF STABLE HEALTH CARE FACILITIES. THESE RURAL HOSPITALS PROVIDE MUCH NEEDED SERVICES (SUCH AS OBSTETRICS), TO AREAS OF ALABAMA THAT WOULD OTHERWISE BE UNDERSERVED. BHS EXPERIENCES LOSSES FROM THE OPERATIONS OF SOME OF THESE HOSPITALS, WHICH FURTHER DEMONSTRATES ITS COMMITMENT TO SERVING THESE COMMUNITIES. EACH HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS. BHS EXPERIENCES LARGE CONTRACTUAL ADJUSTMENTS DUE TO THE LIMITED REIMBURSEMENT PROVIDED BY THE GOVERNMENTAL PROGRAMS. THE FOLLOWING CHART IS A BREAKDOWN OF TOTAL PATIENT DAYS INCLUDING THESE GOVERNMENTAL PROGRAMS:PROGRAM PATIENT DAYS PERCENTAGEMEDICARE 72,237 40.17%MEDICARE HMO 30,815 17.14%MEDICAID 22,798 12.68%TRICARE 534 0.30%OTHER 53,442 29.71%TOTAL 179,826 100.00%ADDITIONALLY, EACH HOSPITAL PARTICIPATES IN VARIOUS OTHER STATE AND LOCAL MEDICAL PROGRAMS. THIS PARTICIPATION IMPROVES ACCESS TO PATIENT CARE FOR THE COMMUNITIES SERVED BY BHS. 22286614 12385909 CHARITY CARE -- THE BHS HOSPITALS PROVIDE A SIGNIFICANT AMOUNT OF CHARITY CARE TO THEIR COMMUNITIES. NOTICES ARE POSTED IN EACH HOSPITAL TO INFORM PATIENTS THAT QUALITY HEALTH CARE SERVICES ARE AVAILABLE REGARDLESS OF A PERSON'S ABILITY TO PAY. CHARITY CARE REVENUE IS MADE UP OF AN ALLOCATION OF MEDICAID ACCESS AND DSH PAYMENTS. 79945131 68392310 GOVERNMENT SPONSORED HEALTHCARE -- GOVERNMENT SPONSORED HEALTHCARE INCLUDES UNPAID COSTS OF PUBLIC PROGRAMS, WHICH REPRESENTS THE SHORTFALL CREATED WHEN REIMBURSEMENTS ARE LESS THAN COSTS OF PROVIDING SERVICES. BHS RECORDS SERVICES PROVIDED TO MEDICAID RECIPIENTS AFTER ANNUAL MEDICAID BENEFITS ARE EXHAUSTED AS CHARITY CARE. 8926640 5086553 EDUCATION AND RESEARCH -- BHS IS ACTIVELY INVOLVED IN MEDICAL EDUCATION AND CLINICAL PASTORAL EDUCATION. BHS CURRENTLY HAS APPROXIMATELY 96 RESIDENCY POSITIONS IN TRANSITIONAL YEAR, INTERNAL MEDICINE, PATHOLOGY, RADIOLOGY, AND GENERAL SURGERY PROGRAMS. BHS'S MEDICAL EDUCATION PROGRAM ALSO PROVIDES CONTINUING EDUCATION TO LICENSED PHYSICIANS. THE CLINICAL PASTORAL EDUCATION PROVIDES TRAINING FOR 10 RESIDENTS AS WELL AS NUMEROUS PART-TIME STUDENTS. THIS TRAINING EQUIPS STUDENTS TO PROVIDE A BETTER LEVEL OF SPIRITUAL CARE TO PATIENTS. IN ADDITION, BHS, IN CONJUNCTION WITH SEVERAL COLLEGES AND UNIVERSITIES OF NURSING, PROVIDES TRAINING FOR NURSES THAT ARE HIRED THROUGHOUT THE SOUTHEASTERN UNITED STATES. 790029 0 BHS CONTINUALLY PROVIDES MANY SERVICES IN HEALTH PROMOTION AND SCREENING TO THE PUBLIC FREE OF CHARGE, OR AT A NOMINAL COST. SUCH SERVICES ARE PROVIDED THROUGH SCHOOLS, EMPLOYERS, AND FACILITIES THAT ARE EASILY ACCESSIBLE BY THE GENERAL PUBLIC. EMPLOYEES ARE ENCOURAGED TO DEVOTE SERVICES TO OTHER CHARITABLE ORGANIZATIONS IN THE COMMUNITY, AS WELL AS TO PROVIDE FINANCIAL SUPPORT. EMPLOYEES AND OTHER COMMUNITY MEMBERS HAVE ALSO PROVIDED SIGNIFICANT SUPPORT OF BHS' CHARITABLE ACTIVITIES--EVIDENCING THE COMMUNITIES' WILLINGNESS TO ACKNOWLEDGE AND SUPPORT THE MISSION OF BAPTIST HEALTH SYSTEM, INC. 9716669 5086553 432693868 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 1107 0 1 5144 1 1 1 1 BB CJ 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X GREGORY D JOHNSTON SVPCFO 2057155716 1130 22ND STREET S BIRMINGHAM AL 35205 KEITH PARROTT PRES. & CEO 40.00 X X 888907 0 37610 CLEMENT COTTER MD TRUSTEE 3.00 X 0 0 0 BILL DECKER MDIV TRUSTEE 3.00 X 0 0 0 JIM EMACK TRUSTEE 3.00 X 0 0 0 RICK FARRAR TRUSTEE 3.00 X 0 0 0 BRIAN HAMILTON TRUSTEE 3.00 X 0 0 0 JOHN HOLCOMB TRUSTEE 3.00 X 0 0 0 WAYNE PATE TRUSTEE 3.00 X 0 0 0 ANDY WESTMORELAND EDD TRUSTEE 3.00 X 0 0 0 DONTA WILSON TRUSTEE 3.00 X 0 0 0 CHRIS CRAIN MDIV EX-OFFICIO, VOTING 3.00 X 0 0 0 BILL STONE EX-OFFICIO, VOTING 3.00 X 0 0 0 MIKE MCLEMORE DD EX-OFFICIO, NON-VOTING 3.00 X 0 0 0 GREGORY D JOHNSTON SVP & CFO 40.00 X 563605 0 34055 DAVID COLEMAN WILSON ADMINISTRATOR 40.00 X 441642 0 19616 ELIZABETH POSTLETHWAIT ADMINISTRATOR 40.00 X 428342 0 25091 ROBERT PHILLIPS ADMINISTRATOR 40.00 X 295101 0 18760 JOEL TAYLOR ADMINISTRATOR 40.00 X 252323 0 18291 GEORGE SCOTT FENN CHIEF INTEGRATION OFFICER 40.00 X 522297 0 20732 ELIZABETH D ENNIS CHIEF MEDICAL OFFICER 40.00 X 526128 0 7800 DAVID ENNIS MEDICAL FACULTY 40.00 X 407137 0 20775 JOHN DAVIS CHIEF INFORMATION OFFICER 40.00 X 442921 0 16468 AMY S ALLEN VP & CAO 40.00 X 393143 0 18318 5161546 0 237516 152 0 1 0 GENERAL ELECTRIC HEALTHCARE PO BOX 402076 ATLANTA GA 30384 IT SERVICES 6488819 ABM HEALTHCARE SUPPORT SERVICES INC 22622 HARPER STREET ST CLAIR SHORES MI 48080 FACILITY SERVICES 5938075 ANESTHESIOLOGISTS ASSOCIATED PC 801 PRINCETON AVE BIRMINGHAM AL 35211 MEDICAL SERVICES 4523200 CERNER HEALTH SERVICES INC PO BOX 412702 KANSAS CITY MO 64141 IT SERVICES 3476212 MORRISON MANAGEMENT SPECIALISTS INC PO BOX 102289 ATLANTA GA 30368 DIETARY SERVICES 2605989 127 X 4580178 4580178 NET PATIENT SERVICE REVENUE 900099 481394570 481394570 481394570 6050787 6050787 3437806 27067 3303011 0 134795 27067 161862 -16376 178238 290801769 2277230 273787908 1817586 17013861 459644 17473505 17473505 419811 474703 -54892 -54892 MEDICAID MEANIGFUL USE INCENTIVE 900099 6732081 6732081 DIETARY/CAFETERIA 900099 1340884 1340884 REFERENCE LABORATORY 621500 -468377 0 -468377 3833913 3833913 11438501 521044511 493246556 -484753 23702530 2869921 2869921 190112432 158730051 31382381 38204786 29515349 8689437 20084007 16519357 3564650 14696317 12091794 2604523 30161781 22636627 7525154 SUPPLIES AND OTHER EXPE 190060361 184463370 5596991 LEASE EXPENSE 10873423 8737320 2136103 497063028 432693868 64369160 0 1697326 1738980 63254354 55730923 8375417 8207572 10816725 11224176 3609281 4466799 701365304 372193742 345043532 329171562 253249748 283823589 58299988 46328946 17902630 17754458 8247636 9131997 770496637 767579002 58794275 60812271 16153865 13214271 301281353 290354003 27982277 28960945 15783280 0 107320282 166309120 527315332 559650610 X 210447556 176807693 5900947 3809921 26832802 27310778 243181305 207928392 770496637 767579002 X 23981483 -17264594 -41969802 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 74055 74055 496988973 497063028 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 59662 70760 72255 74055 276732 250000 250000 250000 250000 1000000 1500000 36403590 36403590 329702017 140530590 189171427 2876733 2237660 639073 267376824 210257430 57119394 65006140 19168062 45838078 329171562 INVESTMENTS IN SUBSIDIARIES 46328946 C 46328946 MINIMUM PENSION LIABILITY 139706781 MALPRACTICE/WORKERS COMP LIABILITY 22005009 CAPITAL LEASES 759992 LEASE CONTINGENCY 1258899 EPIC LICENSING 1765595 OTHER 812844 166309120 X PART X, LINE 2: THE CORPORATION HAS ADOPTED GUIDANCE RELATING TO UNCERTAINTY IN INCOME TAXES WHICH REQUIRES ENTITIES TO ASSESS THEIR UNCERTAIN TAX POSITIONS FOR THE LIKELIHOOD THAT THEY WOULD BE OVERTURNED UPON INTERNAL REVENUE SERVICE (IRS) EXAMINATION OR UPON EXAMINATION BY STATE TAXING AUTHORITIES. IN ACCORDANCE WITH THIS GUIDANCE, THE CORPORATION HAS DETERMINED THAT IT DOES NOT HAVE ANY POSITIONS AS OF DECEMBER 31, 2014, THAT IT WOULD BE UNABLE TO SUBSTANTIATE. 1 1 X 1 X 1 X 1 1 0 1 1 22286614 10660712 11625902 0.02340 79945131 59923520 20021611 0.04030 102231745 70584232 31647513 0.06370 453001 453001 0.00090 8926640 5086553 3840087 0.00770 337028 337028 0.00070 9716669 5086553 4630116 0.00930 111948414 75670785 36277629 0.07300 0 12158 12158 0.00000 31477 31477 0.00010 0 2693 2693 0.00000 4666 4666 0.00000 2290 2290 0.00000 3015 3015 0.00000 56299 56299 0.00010 1 8412340 0 152387269 144802221 7585048 X 1 1 1 SSG REAL ESTATE OWNS LAND AND REAL ESTATE 0.30000 0.00000 0.70000 2 SHELBY BAPTIST AMBULATORY SURGERY CENTER LLC OPERATED AMBULATORY SURGERY CENTER 0.51000 0.00000 0.49000 4 1 PRINCETON BAPTIST MEDICAL CENTER 701 PRINCETON AVENUE SW BIRMINGHAM AL 35211 X X X X 2 SHELBY BAPTIST MEDICAL CENTER 1000 FIRST STREET NORTH ALABASTER AL 35007 X X X 3 WALKER BAPTIST MEDICAL CENTER 3400 US HIGHWAY 78 EAST JASPER AL 35501 X X X 4 CITIZENS BAPTIST MEDICAL CENTER 604 STONE AVENUE TALLADEGA AL 35161 X X X PRINCETON BAPTIST MEDICAL CENTER 1 0 0 1 X X X X X X X X X 13 1 1 0 1 X WWW.BAPTISTHEALTHALABAMA.COM/PRINCETON X 1 13 1 WWW.BAPTISTHEALTHALABAMA.COM/PRINCETON 0 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X 1 X X X X X 1 X 0 X X X X 1 X X 0 0 SHELBY BAPTIST MEDICAL CENTER 2 0 0 1 X X X X X X X X X 13 1 1 0 1 X WWW.BAPTISTHEALTHALABAMA.COM/SHELBY X 1 13 1 WWW.BAPTISTHEALTHALABAMA.COM/SHELBY 0 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X 1 X X X X X 1 X 0 X X X X 1 X X 0 0 WALKER BAPTIST MEDICAL CENTER 3 0 0 1 X X X X X X X X X 13 1 1 0 1 X WWW.BAPTISTHEALTHALABAMA.COM/WALKER X 1 13 1 WWW.BAPTISTHEALTHALABAMA.COM/WALKER 0 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X 1 X X X X X 1 X 0 X X X X 1 X X 0 0 CITZENS BAPTIST MEDICAL CENTER 4 0 0 1 X X X X X X X X X 13 1 1 0 1 X WWW.BAPTISTHEALTHALABAMA.COM/CITIZENS X 1 13 1 WWW.BAPTISTHEALTHALABAMA.COM/CITIZENS 0 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X 1 X X X X X 1 X 0 X X X X 1 X X 0 0 PRINCETON BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 5: THE HOSPITAL FACILITY GATHERED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVICED, AS WELL AS FROM INDIVIDUALS WHO HAVE SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. INTERVIEWS WERE CONDUCTED BY TELEPHONE AND INTERVIEWERS FOLLOWED THE SAME PROCESS FOR EACH INTERVIEW, WHICH INCLUDED DOCUMENTING THE INTERVIEWEE'S EXPERTISE AND EXPERIENCE RELATED TO THE COMMUNITY SERVED BY THE HOSPITAL FACILITY.AS THE BASIS FOR DISCUSSION, INTERVIEWERS USED QUESTIONS FOCUSED ON THE COMMUNITY'S HEALTHCARE STRENGTHS, CONCERNS, ASSETS AND AVAILABLE RESOURCES, CAPACITY UTILIZATION, BARRIERS TO SERVICE, POTENTIAL AREAS FOR IMPROVEMENT, AND COMMUNITY TRENDS IN HEALTHCARE.THE HOSPITAL FACILITY OBTAINED INPUT FROM THE FOLLOWING PERSONS:ROSEMARY BLACKMON, EXECUTIVE DIRECTOR, ALABAMA HOSPITAL ASSOCIATIONJOE ACKER, EXECUTIVE DIRECTOR, BIRMINGHAM EMERGENCY MEDICAL SERVICESNENA SANDERS, DEAN, IDA V. MOFFETT SCHOOL OF NURSING, SAMFORD UNIVERSITYAMA SHAMBULIA, DIRECTOR, WE COMMUNITY GARDENS URBAN MINISTRYRG LYONS, MINISTER, URBAN MINISTRIESJANICE TYSON, COUNSELOR, HEMPHILL ELEMENTARY SCHOOLMICHAEL WESLEY, PASTOR, GREATER SHILOH BAPTIST CHURCHNAOMI TRUMAN, EXECUTIVE DIRECTOR, HOUSING AUTHORITY OF BIRMINGHAMCEDRIC SPARKS, EXECUTIVE DIRECTOR, DIVISION OF YOUTH SERVICESSHAUNTICE ALLEN, ASSOCIATE, CLARUS CONSULTING GROUPGUS HEARD-HUGHES, DIRECTOR OF INITIATIVES, COMMUNITY FOUNDATION OF GREATER BIRMINGHAM SHELBY BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 5: THE HOSPITAL FACILITY GATHERED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVICED, AS WELL AS FROM INDIVIDUALS WHO HAVE SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. INTERVIEWS WERE CONDUCTED BY TELEPHONE AND INTERVIEWERS FOLLOWED THE SAME PROCESS FOR EACH INTERVIEW, WHICH INCLUDED DOCUMENTING THE INTERVIEWEE'S EXPERTISE AND EXPERIENCE RELATED TO THE COMMUNITY SERVED BY THE HOSPITAL FACILITY.AS THE BASIS FOR DISCUSSION, INTERVIEWERS USED QUESTIONS FOCUSED ON THE COMMUNITY'S HEALTHCARE STRENGTHS, CONCERNS, ASSETS AND AVAILABLE RESOURCES, CAPACITY UTILIZATION, BARRIERS TO SERVICE, POTENTIAL AREAS FOR IMPROVEMENT, AND COMMUNITY TRENDS IN HEALTHCARE.THE HOSPITAL FACILITY OBTAINED INPUT FROM THE FOLLOWING PERSONS:RICKY COLQUITT, COORDINATOR, SHELBY CO COOP EXTENSION SYSTEMMIMI WILLIAMS, SHELBY CO LEGISLATIVE DELEGATIONJACK GRAY, CHAIRMAN, CITY OF HELENA PLANNING BOARDDON MURPHY, MAYOR, CITY OF PELHAMJOEL BEARDEN, COMMISSIONER, SHELBY COSPRUCE MCREE, CHIEF, BRIERFIELD VOLUNTEER FIRE DEPTSTEVE MARTIN, BOARD MEMBER, SHELBY CO BOARD OF EDUCATIONLANE VINES, DIRECTOR, PELHAM YMCA WALKER BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 5: THE HOSPITAL FACILITY GATHERED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVICED, AS WELL AS FROM INDIVIDUALS WHO HAVE SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. INTERVIEWS WERE CONDUCTED BY TELEPHONE AND INTERVIEWERS FOLLOWED THE SAME PROCESS FOR EACH INTERVIEW, WHICH INCLUDED DOCUMENTING THE INTERVIEWEE'S EXPERTISE AND EXPERIENCE RELATED TO THE COMMUNITY SERVED BY THE HOSPITAL FACILITY.AS THE BASIS FOR DISCUSSION, INTERVIEWERS USED QUESTIONS FOCUSED ON THE COMMUNITY'S HEALTHCARE STRENGTHS, CONCERNS, ASSETS AND AVAILABLE RESOURCES, CAPACITY UTILIZATION, BARRIERS TO SERVICE, POTENTIAL AREAS FOR IMPROVEMENT, AND COMMUNITY TRENDS IN HEALTHCARE.THE HOSPITAL FACILITY OBTAINED INPUT FROM THE FOLLOWING PERSONS:GREG REED, SENATOR, STATE SENATE, DISTRICT 5HARRY ELLIS, MAYOR, CITY OF SUMITONPAUL KENNEDY, EXECUTIVE DIRECTOR, WALKER AREA COMMUNITY FOUNDATIONPENNE MOTT, DEAN, BEVILL STATE COMMUNITY COLLEGEDIANE BLACK, CLINIC SUPERVISOR, WALKER COUNTY HEALTH DEPTDANNY CAIN, COORDINATOR, WALKER COUNTY ALABAMA COOPERATIVE EXTENSION SYSTEM CITZENS BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 5: THE HOSPITAL FACILITY GATHERED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVICED, AS WELL AS FROM INDIVIDUALS WHO HAVE SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. INTERVIEWS WERE CONDUCTED BY TELEPHONE AND INTERVIEWERS FOLLOWED THE SAME PROCESS FOR EACH INTERVIEW, WHICH INCLUDED DOCUMENTING THE INTERVIEWEE'S EXPERTISE AND EXPERIENCE RELATED TO THE COMMUNITY SERVED BY THE HOSPITAL FACILITY.AS THE BASIS FOR DISCUSSION, INTERVIEWERS USED QUESTIONS FOCUSED ON THE COMMUNITY'S HEALTHCARE STRENGTHS, CONCERNS, ASSETS AND AVAILABLE RESOURCES, CAPACITY UTILIZATION, BARRIERS TO SERVICE, POTENTIAL AREAS FOR IMPROVEMENT, AND COMMUNITY TRENDS IN HEALTHCARE.THE HOSPITAL FACILITY OBTAINED INPUT FROM THE FOLLOWING PERSONS:MARK FERGUSON, CTZ-HACAVERY EMBRY, SCHOOL CFO, TALLADEGA CO BOARD OF EDUCATIONMARY TUBERVILLE, ADMINISTRATOR, TALLADEGA HEALTH CARE CENTERCLAY SPENCER, COMFORT CARE HOSPICE OF TALLADEGALLOYD GIBBS, PASTOR, LINCOLN UNITED METHODIST CHURCHLAURA DALTON, EXECUTIVE DIRECTOR, FIRST FAMILY SERVICES OF TALLADEGAWANDA JURIAANS, COORDINATOR, TALLADEGA CO ALABAMA COOP EXTENSION SYSTEMMARGARET MORTON, EXECUTIVE DIRECTOR, SAFE FAMILY SERVICES CENTER PRINCETON BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 6A: SHELBY BAPTIST MEDICAL CENTERWALKER BAPTIST MEDICAL CENTERCITIZENS BAPTIST MEDICAL CENTER SHELBY BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 6A: PRINCETON BAPTIST MEDICAL CENTERWALKER BAPTIST MEDICAL CENTERCITIZENS BAPTIST MEDICAL CENTER WALKER BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 6A: PRINCETON BAPTIST MEDICAL CENTERSHELBY BAPTIST MEDICAL CENTERCITIZENS BAPTIST MEDICAL CENTER CITZENS BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 6A: PRINCETON BAPTIST MEDICAL CENTERSHELBY BAPTIST MEDICAL CENTERWALKER BAPTIST MEDICAL CENTER PRINCETON BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 11: FOLLOWING A COMPREHENSIVE REVIEW OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE PRINCETON BAPTIST MEDICAL CENTER LEADERSHIP TEAM DEVELOPED AN IMPLEMENTATION STRATEGY TO ADDRESS THE IDENTIFIED HEALTH PRIORITIES. THE RESULTING IMPLEMENTATION STRATEGY LINKS SPECIFIC ACTIVITIES TO ACHIEVING TARGETED OUTCOMES FOR EACH PRIORITY'S SPECIFIED GOALS AND OBJECTIVES. THESE ACTIVITIES INCLUDE EXISTING PROGRAMS AND PARTNERSHIPS AS WELL AS NEW ACTIVITIES AIMED AT ENHANCING THE BENEFITS PRINCETON BAPTIST MEDICAL CENTER PROVIDES TO THE COMMUNITY. ADDITIONALLY, THE IMPLEMENTATION STRATEGY PROVIDES RATIONALE FOR ANY HEALTH PRIORITIES NOT ADDRESSED (IF APPLICABLE). THE COMPLETE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY FOR PRINCETON BAPTIST MEDICAL CENTER ARE AVAILABLE ON THE FACILITY WEB SITE AT WWW.BAPTISTHEALTHALABAMA.ORG/PRINCETON. SHELBY BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 11: FOLLOWING A COMPREHENSIVE REVIEW OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE SHELBY BAPTIST MEDICAL CENTER LEADERSHIP TEAM DEVELOPED AN IMPLEMENTATION STRATEGY TO ADDRESS THE IDENTIFIED HEALTH PRIORITIES. THE RESULTING IMPLEMENTATION STRATEGY LINKS SPECIFIC ACTIVITIES TO ACHIEVING TARGETED OUTCOMES FOR EACH PRIORITY'S SPECIFIED GOALS AND OBJECTIVES. THESE ACTIVITIES INCLUDE EXISTING PROGRAMS AND PARTNERSHIPS AS WELL AS NEW ACTIVITIES AIMED AT ENHANCING THE BENEFITS SHELBY BAPTIST MEDICAL CENTER PROVIDES TO THE COMMUNITY. ADDITIONALLY, THE IMPLEMENTATION STRATEGY PROVIDES RATIONALE FOR ANY HEALTH PRIORITIES NOT ADDRESSED (IF APPLICABLE). THE COMPLETE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY FOR SHELBY BAPTIST MEDICAL CENTER ARE AVAILABLE ON THE FACILITY WEB SITE AT WWW.BAPTISTHEALTHALABAMA.ORG/SHELBY. WALKER BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 11: FOLLOWING A COMPREHENSIVE REVIEW OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE WALKER BAPTIST MEDICAL CENTER LEADERSHIP TEAM DEVELOPED AN IMPLEMENTATION STRATEGY TO ADDRESS THE IDENTIFIED HEALTH PRIORITIES. THE RESULTING IMPLEMENTATION STRATEGY LINKS SPECIFIC ACTIVITIES TO ACHIEVING TARGETED OUTCOMES FOR EACH PRIORITY'S SPECIFIED GOALS AND OBJECTIVES. THESE ACTIVITIES INCLUDE EXISTING PROGRAMS AND PARTNERSHIPS AS WELL AS NEW ACTIVITIES AIMED AT ENHANCING THE BENEFITS WALKER BAPTIST MEDICAL CENTER PROVIDES TO THE COMMUNITY. ADDITIONALLY, THE IMPLEMENTATION STRATEGY PROVIDES RATIONALE FOR ANY HEALTH PRIORITIES NOT ADDRESSED (IF APPLICABLE). THE COMPLETE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY FOR WALKER BAPTIST MEDICAL CENTER ARE AVAILABLE ON THE FACILITY WEB SITE AT WWW.BAPTISTHEALTHALABAMA.ORG/WALKER. CITZENS BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 11: FOLLOWING A COMPREHENSIVE REVIEW OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE CITIZENS BAPTIST MEDICAL CENTER LEADERSHIP TEAM DEVELOPED AN IMPLEMENTATION STRATEGY TO ADDRESS THE IDENTIFIED HEALTH PRIORITIES. THE RESULTING IMPLEMENTATION STRATEGY LINKS SPECIFIC ACTIVITIES TO ACHIEVING TARGETED OUTCOMES FOR EACH PRIORITY'S SPECIFIED GOALS AND OBJECTIVES. THESE ACTIVITIES INCLUDE EXISTING PROGRAMS AND PARTNERSHIPS AS WELL AS NEW ACTIVITIES AIMED AT ENHANCING THE BENEFITS CITIZENS BAPTIST MEDICAL CENTER PROVIDES TO THE COMMUNITY. ADDITIONALLY, THE IMPLEMENTATION STRATEGY PROVIDES RATIONALE FOR ANY HEALTH PRIORITIES NOT ADDRESSED (IF APPLICABLE). THE COMPLETE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY FOR CITIZENS BAPTIST MEDICAL CENTER ARE AVAILABLE ON THE FACILITY WEB SITE AT WWW.BAPTISTHEALTHALABAMA.ORG/CITIZENS. PRINCETON BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 13H: IN 2014, IN ORDER TO COMPLY WITH THE ACA 501R REGULATIONS, THE HOSPITAL ADJUSTS PRIVATE PAY ACCOUNTS AT TIME OF BILL USING THE MEDICARE LOOKBACK METHODOLOGY. SHELBY BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 13H: IN 2014, IN ORDER TO COMPLY WITH THE ACA 501R REGULATIONS, THE HOSPITAL ADJUSTS PRIVATE PAY ACCOUNTS AT TIME OF BILL USING THE MEDICARE LOOKBACK METHODOLOGY. WALKER BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 13H: IN 2014, IN ORDER TO COMPLY WITH THE ACA 501R REGULATIONS, THE HOSPITAL ADJUSTS PRIVATE PAY ACCOUNTS AT TIME OF BILL USING THE MEDICARE LOOKBACK METHODOLOGY. CITZENS BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 13H: IN 2014, IN ORDER TO COMPLY WITH THE ACA 501R REGULATIONS, THE HOSPITAL ADJUSTS PRIVATE PAY ACCOUNTS AT TIME OF BILL USING THE MEDICARE LOOKBACK METHODOLOGY. PRINCETON BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 22D: BHS USES MEDICARE DRG RATES FOR INPATIENTS AND ESTIMATES MEDICARE APC RATES USING 13% OF CHARGES FOR OUTPATIENTS. ALL PRIVATE PAY ACCOUNTS ARE ADJUSTED TO MEDICARE LOOKBACK DISCOUNT RATES. IN ADDITION, FAMILIES WITH INCOME BETWEEN 200 - 300 FPL ARE ADDITIONALLY ADJUSTED ON A SLIDING SCALE FROM 25% - 75% ON TOP OF THE MEDICARE LOOKBACK DISCOUNT. WE ALSO SCREEN FOR MEDICAL INDIGENCY ON PRIVATE PAY AND RESIDUAL SELF PAY (I.E. PATIENT BALANCE AFTER INSURANCE) ACCOUNTS. MEDICAL INDIGENCY IS DETERMINED BY LIMITING THE PATIENT PAYMENT OBLIGATION TO A MAXIMUM OF 20% OF THE HOUSEHOLD INCOME. SHELBY BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 22D: BHS USES MEDICARE DRG RATES FOR INPATIENTS AND ESTIMATES MEDICARE APC RATES USING 13% OF CHARGES FOR OUTPATIENTS. ALL PRIVATE PAY ACCOUNTS ARE ADJUSTED TO MEDICARE LOOKBACK DISCOUNT RATES. IN ADDITION, FAMILIES WITH INCOME BETWEEN 200 - 300 FPL ARE ADDITIONALLY ADJUSTED ON A SLIDING SCALE FROM 25% - 75% ON TOP OF THE MEDICARE LOOKBACK DISCOUNT. WE ALSO SCREEN FOR MEDICAL INDIGENCY ON PRIVATE PAY AND RESIDUAL SELF PAY (I.E. PATIENT BALANCE AFTER INSURANCE) ACCOUNTS. MEDICAL INDIGENCY IS DETERMINED BY LIMITING THE PATIENT PAYMENT OBLIGATION TO A MAXIMUM OF 20% OF THE HOUSEHOLD INCOME. WALKER BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 22D: BHS USES MEDICARE DRG RATES FOR INPATIENTS AND ESTIMATES MEDICARE APC RATES USING 13% OF CHARGES FOR OUTPATIENTS. ALL PRIVATE PAY ACCOUNTS ARE ADJUSTED TO MEDICARE LOOKBACK DISCOUNT RATES. IN ADDITION, FAMILIES WITH INCOME BETWEEN 200 - 300 FPL ARE ADDITIONALLY ADJUSTED ON A SLIDING SCALE FROM 25% - 75% ON TOP OF THE MEDICARE LOOKBACK DISCOUNT. WE ALSO SCREEN FOR MEDICAL INDIGENCY ON PRIVATE PAY AND RESIDUAL SELF PAY (I.E. PATIENT BALANCE AFTER INSURANCE) ACCOUNTS. MEDICAL INDIGENCY IS DETERMINED BY LIMITING THE PATIENT PAYMENT OBLIGATION TO A MAXIMUM OF 20% OF THE HOUSEHOLD INCOME. CITZENS BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 22D: BHS USES MEDICARE DRG RATES FOR INPATIENTS AND ESTIMATES MEDICARE APC RATES USING 13% OF CHARGES FOR OUTPATIENTS. ALL PRIVATE PAY ACCOUNTS ARE ADJUSTED TO MEDICARE LOOKBACK DISCOUNT RATES. IN ADDITION, FAMILIES WITH INCOME BETWEEN 200 - 300 FPL ARE ADDITIONALLY ADJUSTED ON A SLIDING SCALE FROM 25% - 75% ON TOP OF THE MEDICARE LOOKBACK DISCOUNT. WE ALSO SCREEN FOR MEDICAL INDIGENCY ON PRIVATE PAY AND RESIDUAL SELF PAY (I.E. PATIENT BALANCE AFTER INSURANCE) ACCOUNTS. MEDICAL INDIGENCY IS DETERMINED BY LIMITING THE PATIENT PAYMENT OBLIGATION TO A MAXIMUM OF 20% OF THE HOUSEHOLD INCOME. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY PRINCETON BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16A WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/PRINCETON PRINCETON BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16B WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/PRINCETON PRINCETON BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16C WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/PRINCETON SHELBY BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16A WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/SHELBY SHELBY BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16B WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/SHELBY SHELBY BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16C WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/SHELBY WALKER BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16A WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/WALKER WALKER BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16B WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/WALKER WALKER BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16C WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/WALKER CITZENS BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16A WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/CITIZENS CITZENS BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16B WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/CITIZENS CITZENS BAPTIST MEDICAL CENTER PART V, SECTION B, LINE 16C WEBSITE: WWW.BAPTISTHEALTHALABAMA.COM/CITIZENS 1 PRISON HEALTHCARE LLC 1000 FIRST STREET NORTH ALABASTER AL 35007 PROVIDES INPATIENT, OUTPATIENT, ER, SPECIALTY CARE TO DETAINEES PART I, LN 7 COL(F): A COST TO CHARGE RATIO WAS DERIVED USING THE WORKSHEETS PROVIDED IN THE SCHEDULE H INSTRUCTIONS TO CALCULATE THE NET COMMUNITY BENEFIT EXPENSE OF CHARITY CARE. THE UNREIMBURSED MEDICAID CALCULATION WAS DETERMINED BY USING A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS, INCLUDING BUT NOT LIMITED TO INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, AND SELF PAY. AMOUNTS FOR OTHER COMMUNITY BENEFITS WERE COMPILED USING THE CBISA PROGRAM AT A FACILITY LEVEL. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES ADDRESS THE CAUSES OF COMMUNITY HEALTH PROBLEMS BY OFFERING THE SYSTEM'S HEALTH CARE EXPERTISE AND RESOURCES. EXAMPLES OF SUCH ACTIVITIES INCLUDE:LN 2. ECONOMIC DEVELOPMENT - VARIOUS CHAMBERS OF COMMERCE, BLUEPRINT BIRMINGHAM, SPEAKING AT AREA CHURCHES, REGIONAL CARE ORGANIZATION STEERING COMMITTEELN 3. COMMUNITY SUPPORT - LOCAL EMERGENCY PLANNING COMMITTEE, EXPLORERS MEETINGS, ROTARY CLUB MEETINGS, GIDEONS, KIWANIS, INFECTION CONTROL, HAM RADIO TRAINING/CERTIFICATIONLN 5. LEADERSHIP DEVELOPMENT AND LEADERSHIP TRAINING - LEADERSHIP SHELBY BOARD PARTICIPATION, WALKER COUNTY ADULT LEADERSHIP PROGRAM LN 6. COALITION BUILDING - WALKER COUNTY UNITED WAY ACTIVITIES, WATCH 2020 BOARDLN 7. ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS - JASPER AREA MINISTERIAL EMERGENCY SERVICES BOARDLN 8. WORKFORCE DEVELOPMENT - EXPLORERS HEALTH CAREERS PROGRAM, JOB SHADOW DAY PART III, LINE 2: BAD DEBT EXPENSE IS DERIVED BY APPLYING THE PATIENT COST TO CHARGE RATIO TO GROSS CHARGES OF BAD DEBTS ATTRIBUTABLE TO PATIENT ACCOUNTS. THIS AMOUNT IS REDUCED BY ANY OFFSETTING REVENUES ALLOCATED TO BAD DEBTS. PART III, LINE 3: BHS HAS IMPLEMENTED A TOOL KNOWN AS THE "PAYMENT ASSISTANCE RANK ORDER" (PARO) WITH THE PURPOSE OF IDENTIFYING PATIENTS WHO HAVE FAILED TO APPLY FOR CHARITY CARE THAT MAY BE ELIGIBLE TO RECEIVE FINANCIAL ASSISTANCE. AS A RESULT OF THIS IMPLEMENTATION, A PORTION OF PATIENT CARE REVENUE THAT WOULD OTHERWISE BE REPORTED AS BAD DEBT IS NOW BEING REPORTED AS CHARITY CARE. WE HAVE ALSO IMPLEMENTED PARO SCORING ON RESIDUAL SELF PAY (I.E. PATIENT BALANCE AFTER INSURANCE.) PART III, LINE 4: THE CORPORATION RECORDS BAD DEBT EXPENSE AS ITS ESTIMATE OF THE AMOUNT OF GROSS CHARGES DUE FROM PATIENTS THAT WILL NOT ULTIMATELY BE COLLECTED. BAD DEBT EXPENSE AS A PERCENTAGE OF GROSS PATIENT CHARGES WAS 1.0% AND 3.6% FOR THE YEARS ENDED DECEMBER 31, 2014 AND 2013, RESPECTIVELY. PLEASE REFER TO PAGE 8 OF THE ATTACHED AUDIT REPORT FOR THE CHANGE IN POLICY.THE ALLOWANCE FOR BAD DEBTS IS ESTABLISHED FOR ACCOUNTS DEEMED POTENTIALLY UNCOLLECTIBLE BY MANAGEMENT BASED ON CONTRACT TERMS AND HISTORICAL COLLECTION EXPERIENCE. ACCOUNTS ARE WRITTEN OFF ONCE COLLECTION EFFORTS HAVE BEEN EXHAUSTED. PART III, LINE 8: THIS DATA IS A COMPILATION OF MEDICARE COST REPORTS FILED FOR THE YEAR ENDED DECEMBER 31, 2014. THE MEDICARE COST REPORT USES THE WORKING TRIAL BALANCE AS A STARTING POINT AND APPLIES MEDICARE COST REPORTING PRINCIPALS TO DETERMINE TOTAL ALLOWABLE COSTS ON A COST CENTER BASIS. MEDICARE COST REPORTING PRINCIPALS ARE ALSO USED TO DETERMINE TOTAL PATIENT REVENUE ON A COST CENTER BASIS IN ORDER TO COMPUTE A RATIO OF COST TO CHARGES. PART III, LINE 9B: THE FOLLOWING IS FOUND IN THE CHARITY CARE POLICY REGARDING BILLING AND COLLECTIONS:1. BHS ENSURES THAT ALL PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY 2. BHS HAS IMPLEMENTED WRITTEN POLICIES FOR DEFINING AND DELINEATING THE CIRCUMSTANCES UNDER WHICH AND UNDER WHOSE AUTHORITY A PATIENT ACCOUNT IS ADVANCED FOR COLLECTION TO A THIRD-PARTY COLLECTION AGENCY. 3. BHS DEFINES THE STANDARDS AND SCOPE OF PRACTICES TO BE USED BY THIRD-PARTY COLLECTION AGENTS ACTING ON ITS BEHALF SUCH THAT ANY STANDARDS AND SCOPE OF PRACTICES, AT A MINIMUM, ARE CONSISTENT WITH THE BHS MISSIONS AND VALUES. BHS OBTAINS WRITTEN AGREEMENTS FROM EACH THIRD-PARTY COLLECTION AGENT TO ENSURE ADHERENCE TO SUCH MISSION AND VALUES.4. AT THE TIME OF BILLING BHS PROVIDES TO ALL LOW-INCOME UNINSURED PATIENTS THE SAME INFORMATION CONCERNING SERVICES AND CHARGES PROVIDED TO ALL OTHER PATIENTS WHO RECEIVE CARE AT BHS. 5. WHEN SENDING A BILL TO A PATIENT, BHS INCLUDES A) A STATEMENT THAT INDICATES IF THE PATIENT MEETS CERTAIN INCOME REQUIREMENTS, THE PATIENT MAY BE ELIGIBLE FOR A GOVERNMENT-SPONSORED PROGRAM (I.E. MEDICAID) OR FOR FINANCIAL ASSISTANCE FROM BHS; AND B) A STATEMENT THAT PROVIDES THE PATIENT WITH THE NAME AND TELEPHONE NUMBER OF A BHS FINANCIAL COUNSELOR OR THE CENTRAL BUSINESS OFFICE FROM WHOM OR WHERE THE PATIENT MAY OBTAIN INFORMATION ABOUT BHS'S FINANCIAL ASSISTANCE POLICIES FOR PATIENTS AND HOW TO APPLY FOR SUCH ASSISTANCE. 6. ANY PATIENT OR PATIENT'S LEGAL REPRESENTATIVE SEEKING FINANCIAL ASSISTANCE FROM BHS WILL COMPLETE A FINANCIAL NEEDS ASSESSMENT (FNA). A COMPLETED FNA PROVIDES BHS INFORMATION CONCERNING A PATIENT'S INSURANCE COVERAGE, FINANCIAL STATUS AND ANY OTHER INFORMATION THAT IS NECESSARY FOR BHS TO MAKE A DETERMINATION REGARDING THE PATIENT'S STATUS RELATIVE TO BHS'S CHARITY CARE POLICY, DISCOUNTED PAYMENT POLICY OR ELIGIBILITY FOR GOVERNMENT-SPONSORED PROGRAMS (I.E. MEDICAID). 7. FOR PATIENTS WHO HAVE AN FNA PENDING FOR EITHER GOVERNMENT-SPONSORED COVERAGE OR FOR BHS'S OWN CHARITY CARE AND FINANCIAL ASSISTANCE PROGRAM, BHS DOES NOT SEND THAT PATIENT'S ACCOUNT TO A COLLECTION AGENCY PRIOR TO 120 DAYS FROM THE TIME OF INITIAL BILLING. 8. IF A PATIENT QUALIFIES FOR ASSISTANCE UNDER BHS'S FINANCIAL ASSISTANCE POLICY AND IS REASONABLY COOPERATING WITH BHS IN AN EFFORT TO SETTLE AN OUTSTANDING ACCOUNT, BHS DOES NOT SEND THE ACCOUNT TO ANY OUTSIDE COLLECTION AGENCY.9. BHS OR OUTSIDE COLLECTION AGENCIES OPERATING ON BEHALF OF BHS DO NOT, IN DEALING WITH LOW-INCOME UNINSURED PATIENTS, USE LIENS ON PRIMARY RESIDENCES AS MEANS OF COLLECTING AN UNPAID PATIENT ACCOUNT. BHS INSTRUCTS BOTH ITS ASSOCIATES AND OUTSIDE COLLECTION AGENCIES THAT TACTICS SUCH AS CHARGING INTEREST, REQUIRING PATIENTS OR PATIENT GUARANTORS TO INCUR DEBT OR LOANS WITH RECOURSE TO THE PATIENT'S PERSONAL OR REAL PROPERTY ASSETS (RECOURSE INDEBTEDNESS) OR SO CALLED "BODY ATTACHMENTS" (I.E. THE ARREST OR JAILING OF PATIENTS IN DEFAULT ON THEIR ACCOUNTS, SUCH AS FOR MISSED COURT APPEARANCES) ARE STRICTLY PROHIBITED. 10. ELIGIBILITY FOR CHARITY CARE AND DISCOUNT PAYMENTS MAY BE DETERMINED AT ANY TIME BHS IS IN RECEIPT OF ALL INFORMATION (I.E. COMPLETED FNA) NEEDED TO DETERMINE THE PATIENT'S ELIGIBILITY FOR ITS FINANCIAL ASSISTANCE PROGRAMS. ALL UNINSURED PATIENTS, PRIOR TO PLACEMENT WITH A BAD DEBT COLLECTION AGENCY, ARE SCREENED FOR CHARITY QUALIFICATION USING THE "PAYMENT ASSISTANCE RANK ORDER" (PARO), REFERENCED ABOVE.11. PATIENT PAYMENTS MADE PRIOR TO FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION FOR QUALIFYING ACCOUNTS WILL BE REFUNDED TO THE PATIENT IF THE PATIENT QUALIFIES FOR THE BHS FREE CARE FINANCIAL ASSISTANCE PROGRAM. PART VI, LINE 2: AS A NOT-FOR-PROFIT HEALTH CARE PROVIDER, BAPTIST HEALTH SYSTEM (BHS) IS COMMITTED TO MINISTERING QUALITY HEALTH CARE - PHYSICALLY, MENTALLY, AND SPIRITUALLY - WHILE SERVING AS A WITNESS TO THE LOVE OF GOD AS REVEALED THROUGH CHRIST JESUS. IN ORDER TO ACHIEVE THIS COMMITMENT, IT IS IMPORTANT TO IDENTIFY THE NEEDS OF THE COMMUNITY TO WHICH WE ARE MINISTERING. DURING VARIOUS PLANNING MEETINGS, BHS MANAGEMENT CONSULTS A VARIETY OF MARKET EXPERTS, PHYSICIANS, LOCAL HEALTH OFFICIALS, AS WELL AS HISTORICAL DATA TRENDS BASED ON INTERNAL/EXTERNAL DATA IN ORDER TO DETERMINE EMERGING NEEDS IN THE COMMUNITY. INFORMATION REGARDING THE COMMUNITY IS COMPILED THROUGH HEALTH SCREENINGS, QUESTIONNAIRES, AND PATIENT INTERVIEWS OFFERED TO THE PUBLIC. PART VI, LINE 3: COMMUNICATION OF BHS FINANCIAL ASSISTANCE POLICIES WITH PATIENTS AND THE PUBLIC: ALL NOTIFICATIONS OF OUR FINANCIAL ASSISTANCE POLICIES ARE IN BOTH ENGLISH AND SPANISH, INCLUDING SIGNAGE, STATEMENTS, WEB SITES, AND ETC. BHS POSTS NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME UNINSURED PATIENTS. THESE NOTICES ARE POSTED IN VISIBLE LOCATIONS THROUGHOUT THE FACILITY INCLUDING PATIENT ACCESS/REGISTRATION, THE CASHIER/BILLING OFFICE, THE EMERGENCY DEPARTMENT AND OTHER APPROPRIATE SETTINGS. EVERY POSTED NOTICE REGARDING FINANCIAL ASSISTANCE CONTAINS A STATEMENT INDICATING THAT THE FACILITY HAS A FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME PATIENTS WHO MAY NOT BE ABLE TO PAY THEIR BILL AND BRIEF INSTRUCTIONS REGARDING HOW TO APPLY FOR CHARITY CARE OR A DISCOUNTED BILL. THE NOTICES INCLUDE A CONTACT NAME AND TELEPHONE NUMBER THAT CAN BE USED BY A PATIENT OR FAMILY MEMBER WHO IS REQUESTING ADDITIONAL INFORMATION. BHS ENSURES THAT STAFF MEMBERS IN THE PATIENT ACCESS/REGISTRATION AREAS AND IN THE CENTRAL BUSINESS OFFICE ARE KNOWLEDGEABLE ABOUT THE EXISTENCE OF FINANCIAL ASSISTANCE POLICIES. TRAINING IS PROVIDED TO STAFF MEMBERS WHO DIRECTLY INTERACT WITH PATIENTS REGARDING THEIR BILLS FOR HEALTH CARE SERVICES. IN COMMUNICATION WITH PATIENTS AND FAMILIES REGARDING FINANCIAL ASSISTANCE POLICIES, BHS ATTEMPTS TO COMMUNICATE IN THE PRIMARY LANGUAGE OF THE PATIENT, OR HIS/HER FAMILY, IF REASONABLY POSSIBLE. THIS IS DONE IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. A WRITTEN NOTICE ON THE BILLING STATEMENT INFORMS THE PATIENT THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE EITHER FROM A GOVERNMENT PROGRAM OR THROUGH THE BHS FINANCIAL ASSISTANCE POLICY.AT THE TIME OF BILLING, BHS WILL PROVIDE TO ALL UNINSURED PATIENTS THE SAME INFORMATION ON SERVICES AND CHARGES THAT IS PROVIDED TO ALL OTHER PATIENTS RECEIVING CARE AT A BHS ENTITY. WHEN SENDING A BILL TO AN UNINSURED PATIENT, THE FOLLOWING INFORMATION IS INCLUDED WITH THE BILL: * A STATEMENT THAT INDICATES THAT IF THE PATIENT MEETS CERTAIN INCOME REQUIREMENTS, THE PATIENT MAY BE ELIGIBLE FOR A GOVERNMENT-SPONSORED PROGRAM OR FOR FINANCIAL ASSISTANCE FOR HELP IN PAYING FOR THE SERVICES THAT WERE PROVIDED; AND*A STATEMENT THAT PROVIDES THE PATIENT WITH A CONTACT RESOURCE ABOUT THE BHS FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS AND HOW TO APPLY FOR SUCH ASSISTANCE FOR THE PAYMENT OF SERVICES THAT WERE PROVIDED. BHS WILL PROVIDE INFORMATION TO ALL PATIENTS INFORMING THEM OF THEIR RESPONSIBILITY TO PROVIDE DOCUMENTATION FOR VERIFICATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: BAPTIST HEALTH SYSTEM OWNS AND OPERATES FOUR ACUTE CARE HOSPITALS LOCATED IN JEFFERSON, SHELBY, TALLADEGA, AND WALKER COUNTIES. THESE COUNTIES ACCOUNT FOR APPROXIMATELY 77% OF INPATIENT ADMISSIONS. ADDITIONALLY, OTHER COUNTIES WHICH PROVIDE A SIGNIFICANT AMOUNT OF ADMISSIONS BUT ARE NOT CONSIDERED TO BE PART OF THE PRIMARY SERVICE AREA INCLUDE CHILTON, WINSTON, BIBB, CULLMAN AND MARION COUNTIES. ADMISSIONS FROM JEFFERSON (PRINCETON BAPTIST MEDICAL CENTER) AND SHELBY (SHELBY BAPTIST MEDICAL CENTER) COUNTIES ACCOUNTED FOR 48.29% OF TOTAL ADMISSIONS IN FY 2014. THE MAJOR COMPETITORS IN THE MARKET INCLUDE UAB HOSPITAL (UNIVERSITY OF ALABAMA SYSTEM), TRINITY HOSPITAL (COMMUNITY HEALTH), BROOKWOOD HOSPITAL (TENET HEALTHCARE), AND ST. VINCENTS HOSPITAL (ASCENSION HEALTHCARE).EACH HOSPITAL IS LOCATED IN AN AREA THAT HAS BEEN DESIGNATED AS A MEDICALLY UNDERSERVED AREA/POPULATION BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA). THIS IS PRIMARILY DUE TO LOW INCOME DESIGNATIONS GIVEN TO THE SURROUNDING POPULATIONS. FURTHERMORE, ALL FACILITIES EXCEPT SHELBY BAPTIST MEDICAL CENTER RESIDE IN AN AREA DESIGNATED BY THE HRSA AS A "PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA" AND A "MENTAL HEALTH PROFESSIONAL SHORTAGE AREA".BASED ON PAYOR DATA FROM FY 2014, MEDICARE/MEDICARE HMO WAS THE CORPORATION'S LARGEST SOURCE OF PATIENT REVENUE AT 54% OF GROSS CHARGES. OTHER SIGNIFICANT SOURCES OF PATIENT REVENUE INCLUDED BLUE CROSS AT 21% AND MEDICAID AT 11% OF GROSS CHARGES. PART VI, LINE 5: THE BOARD OF DIRECTORS FOR BAPTIST HEALTH SYSTEM IS COMPRISED OF INDEPENDENT COMMUNITY LEADERS WHO RESIDE IN THE SYSTEM'S PRIMARY SERVICE AREA. IN ADDITION, BHS OPERATES AN OPEN MEDICAL STAFF AND ACTIVELY RECRUITS PHYSICIAN SPECIALTIES BASED ON THE NEEDS OF THE COMMUNITY. ALL SURPLUS FUNDS ARE USED TO IMPROVE PATIENT CARE THROUGH IMPROVEMENTS IN FACILITIES, SERVICE OFFERINGS, AND TRAINING MEDICAL STAFF. EACH HOSPITAL OPERATES A FULL-TIME EMERGENCY ROOM OPEN TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ACTIVE INVOLVEMENT IN COMMUNITY SERVICE IS ONE OF THE MANY WAYS BHS LIVES TRUE TO ITS MISSION OF BEING COMMITTED TO MINISTRIES THAT ENHANCE THE HEALTH, DIGNITY, AND WHOLENESS OF THOSE WE SERVE. EXAMPLES OF THIS INCLUDE OPPORTUNITIES FOR STUDENTS TO SPEND TIME SHADOWING CLINICIANS AT BHS FACILITIES, INTERNSHIP PROGRAMS, FREE HEALTH SCREENINGS, PARTNERING WITH LOCAL CHURCHES TO PROVIDE MEDICAL CARE TO THOSE EXPERIENCING DIFFICULT CIRCUMSTANCES, AND PROVIDING AID TO BHS EMPLOYEES WHO ARE INVOLVED IN MISSION RELATED VOLUNTEER ACTIVITIES. PART VI, LINE 6: BHS, AS REPORTED IN SCHEDULE H, FURTHERS ITS FAITH-BASED MISSION THROUGH ITS AFFILIATION WITH THE BAPTIST HEALTH CENTERS (BHC) AND THE BAPTIST HEALTH FOUNDATION (BHF).BAPTIST HEALTH CENTERS, INC. IS A WHOLLY OWNED SUBSIDIARY OF BAPTIST HEALTH SYSTEM, INC. THAT SPECIALIZES IN PHYSICIAN PRACTICE MANAGEMENT. BHC WAS FORMED AND OPERATES TO EXPAND ACCESS TO QUALITY HEALTHCARE ACROSS ALABAMA.THE BAPTIST HEALTH FOUNDATION EXISTS TO SUPPORT THE FAITH-BASED MISSION OF BHS BY WORKING TO PROVIDE THE CHARITABLE AND COMMUNITY RESOURCES NECESSARY FOR ITS OPERATION. THE FOUNDATION SUPPORTS A WIDE ARRAY OF HEALTH RELATED ACTIVITIES INCLUDING PASTORAL CARE MINISTRIES, MEDICAL EDUCATION, MEDICAL RESEARCH AND CHARITY CARE AS WELL AS CLINICAL PROGRAMS SUCH AS HEART AND CANCER CARE, OBSTETRICS, WOMEN'S SERVICES AND ORTHOPEDIC REHABILITATION. X 1 1 X X X X X 0 1 0 0 0 1 0 0 0 KEITH PARROTT PRES. & CEO 669447 0 217699 0 1761 0 25300 0 13754 0 927961 0 0 0 GREGORY D JOHNSTON SVP & CFO 390071 0 169704 0 3830 0 25300 0 9966 0 598871 0 0 0 DAVID COLEMAN WILSON ADMINISTRATOR 320453 0 117713 0 3476 0 7800 0 12823 0 462265 0 0 0 ELIZABETH POSTLETHWAIT ADMINISTRATOR 310811 0 111568 0 5963 0 25091 0 961 0 454394 0 0 0 ROBERT PHILLIPS ADMINISTRATOR 221245 0 71555 0 2301 0 6312 0 13152 0 314565 0 0 0 JOEL TAYLOR ADMINISTRATOR 192468 0 59162 0 693 0 5876 0 13929 0 272128 0 0 0 GEORGE SCOTT FENN CHIEF INTEGRATION OFFICER 379138 0 140191 0 2968 0 7800 0 14122 0 544219 0 0 0 ELIZABETH D ENNIS CHIEF MEDICAL OFFICER 357165 0 114085 0 54878 0 7800 0 1107 0 535035 0 50435 0 DAVID ENNIS MEDICAL FACULTY 405040 0 0 0 2097 0 5279 0 15912 0 428328 0 0 0 JOHN DAVIS CHIEF INFORMATION OFFICER 345981 0 94478 0 2462 0 7650 0 9898 0 460469 0 0 0 AMY S ALLEN VP & CAO 278903 0 112146 0 2094 0 7800 0 11396 0 412339 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS: THE BHS TRAVEL POLICY DOES NOT ALLOW FOR REIMBURSEMENT OF TRAVEL EXPENSES FOR COMPANIONS. HOWEVER, THE CORPORATION WILL MAKE EXCEPTIONS FOR INSTANCES IN WHICH EXECUTIVE SPOUSES ARE REQUIRED TO ATTEND SEMINARS/TRAINING ON A VERY LIMITED BASIS. IN ACCORDANCE WITH IRS REGULATION SECTION 1.162(C), BHS PAYS REASONABLE TRAVEL EXPENSES IF THE ATTENDANCE OF THE SPOUSES IS REQUIRED IN ORDER TO PERFORM THE SUBSTANTIVE DUTIES OF THE EMPLOYEE'S BUSINESS. PART I, LINE 4B KEITH PARROTT - $25,300 GREGORY D. JOHNSTON - $25,300 DAVID COLEMAN WILSON - $7,800 ELIZABETH POSTLETHWAIT - $25,091 ROBERT PHILLIPS - $6,312 JOEL TAYLOR - $5,876 GEORGE SCOTT FENN - $7,800 ELIZABETH ENNIS - $7,800 DAVID ENNIS - $5,279 JOHN DAVIS - $7,650 AMY S. ALLEN - $7,800 PART I, LINE 6 BHS OFFERS AN ANNUAL INCENTIVE PLAN TO MEMBERS OF THE MANAGEMENT TEAM. PAYOUT UNDER THE INCENTIVE PLAN IS APPROVED BY THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES USING THE FOLLOWING CRITERIA: 1.) OVERALL SYSTEM AND FACILITY SPECIFIC TARGETS. 2.) CRITICAL SUCCESS FACTORS INCLUDING FINANCIAL TARGETS, QUALITY METRICS, PATIENT SATISFACTION, OPERATIONAL GROWTH, COST EFFICIENCIES, AS WELL AS INDIVIDUAL GOALS AND OBJECTIVES. TO ENSURE THERE ARE FUNDS AVAILABLE FOR DISTRIBUTION, THE PLAN IS TRIGGERED BY THE ACHIEVEMENT OF A THRESHOLD FINANCIAL PERFORMANCE. THE ACTUAL DISTRIBUTIONS ARE CALCULATED BY THE ACHIEVEMENT OF TARGETS RELATED TO EXPANDING OUR SERVICES TO ADDITIONAL PATIENTS, ACHIEVING PATIENT SATISFACTION GOALS, ACHIEVING HIGH LEVELS OF CLINICAL QUALITY AND MAINTAINING A COMPETITIVE COST STRUCTURE. A SEE PART VI 630847033 091104GG8 2005-11-29 248260262 SEE PART VI 0 0 0 B SEE PART VI 630847033 NOTAPPLIC 2012-05-18 29965000 SEE PART VI 0 0 0 C SEE PART VI 630847033 NOTAPPLIC 2012-12-20 36408272 SEE PART VI 0 0 0 D SEE PART VI 630847033 NOTAPPLIC 2013-12-06 30000000 SEE PART VI 0 0 0 A 59380000 259641679 18546651 2995749 59839233 5283961 2009 1 1 1 1 B 7300000 26965000 1 0 1 1 C 36408272 36372 1 0 1 1 D 30000000 12852193 2013 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0 0 0 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 NA 0 0 1 SEE PART VI 2.800000000000 1 1 1 B 0 0 1 0 0 0 NA 0 0 0 NA 0 0 1 C 0 0 1 0 1 0 NA 0 0 0 NA 0 0 1 D 0 0 1 0 0 0 NA 0 0 0 NA 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, PART I, LINE A ISSUER NAME: THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM-BAPTIST MEDICAL CENTERS ISSUER EIN: THE EMPLOYER IDENTIFICATION NUMBER ("EIN") OF THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS ("THE ISSUER") IS 63-0847033. THE ISSUER RECEIVED CORRESPONDENCE (LETTER NO. LTR3875C/LETTER DATE: 03/08/2013) FROM THE INTERNAL REVENUE SERVICE (THE "IRS") STATING THAT ITS RECORDS INDICATED THAT THE ISSUER'S EIN IS 52-1734355. BECAUSE THIS MATTER HAS NOT BEEN RESOLVED WITH THE IRS, EIN 63-0847033 IS USED HEREIN SINCE THAT IS THE NUMBER THE ISSUER TRADITIONALLY HAS USED WITH RESPECT TO FILINGS WITH THE IRS. DESCRIPTION OF PURPOSE: TO REFUND PRIOR ISSUED BONDS AND CAPITAL IMPROVEMENTS FOR HEALTHCARE FACILITIES. THE REFUNDED BONDS WERE ISSUED ON THE FOLLOWING DATES: HOSPITAL REVENUE BONDS (WALKER REGIONAL MAY 25, 1993 MEDICAL CENTER, INC. PROJECT), SERIES 1993, ISSUED BY THE MEDICAL CLINIC BOARD OF THE CITY OF JASPER TAX-EXEMPT REVENUE BONDS (THE BAPTIST MEDICAL MAY 12, 1993 CENTERS), SERIES 1993-A, ISSUED BY THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS REVENUE BONDS, SERIES 1995-B (BAPTIST HEALTH MAY 2, 1995 SYSTEM, INC.), ISSUED BY THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS REVENUE BONDS, SERIES 1996-A (BAPTIST HEALTH OCTOBER 1, 1996 SYSTEM,INC.), ISSUED BY THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS REVENUE BONDS, SERIES 2000A-2 (BAPTIST MARCH 30, 2000 HEALTH SYSTEM, INC.), ISSUED BY THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS REVENUE BONDS, SERIES 2000-C (BAPTIST HEALTH MAY 31, 2000 SYSTEM, INC.), ISSUED BY THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS TO CONSTRUCT & EQUIP A HOSPITAL BED TOWER TO CONSTRUCT & EQUIP A HOSPITAL ENERGY PLANT TO RELOCATE A HOSPITAL EMERGENCY ROOM TO CONSTRUCT A HOSPITAL PARKING DECK SCHEDULE K, PART I, LINE B ISSUER NAME: THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM-BAPTIST MEDICAL CENTERS ISSUER EIN: THE EMPLOYER IDENTIFICATION NUMBER ("EIN") OF THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS ("THE ISSUER") IS 63-0847033. THE ISSUER RECEIVED CORRESPONDENCE (LETTER NO. LTR3875C/LETTER DATE: 03/08/2013) FROM THE INTERNAL REVENUE SERVICE (THE "IRS") STATING THAT ITS RECORDS INDICATED THAT THE ISSUER'S EIN IS 52-1734355. BECAUSE THIS MATTER HAS NOT BEEN RESOLVED WITH THE IRS, EIN 63-0847033 IS USED HEREIN SINCE THAT IS THE NUMBER THE ISSUER TRADITIONALLY HAS USED WITH RESPECT TO FILINGS WITH THE IRS. DESCRIPTION OF PURPOSE: TO REFUND PRIOR ISSUED BOND THE REFUNDED BOND WAS ISSUED ON THE FOLLOWING DATE: REVENUE BOND, SERIES 2001-A (BAPTIST HEALTH JUNE 27, 2001 SYSTEM, INC.),ISSUED BY THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM-BAPTIST MEDICAL CENTERS SCHEDULE K, PART I, LINE C ISSUER NAME: THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM-BAPTIST MEDICAL CENTERS ISSUER EIN: THE EMPLOYER IDENTIFICATION NUMBER ("EIN") OF THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS ("THE ISSUER") IS 63-0847033. THE ISSUER RECEIVED CORRESPONDENCE (LETTER NO. LTR3875C/LETTER DATE: 03/08/2013) FROM THE INTERNAL REVENUE SERVICE (THE "IRS") STATING THAT ITS RECORDS INDICATED THAT THE ISSUER'S EIN IS 52-1734355. BECAUSE THIS MATTER HAS NOT BEEN RESOLVED WITH THE IRS, EIN 63-0847033 IS USED HEREIN SINCE THAT IS THE NUMBER THE ISSUER TRADITIONALLY HAS USED WITH RESPECT TO FILINGS WITH THE IRS. DESCRIPTION OF PURPOSE: TO REFUND PRIOR ISSUED BONDS AND TO PAY COST OF ISSUANCE THE REFUNDED BONDS WERE ISSUED ON THE FOLLOWING DATES: REVENUE BOND, SERIES 2009-A1 (BAPTIST DECEMBER 15, 2009 HEALTH SYSTEM, INC.),ISSUED BY THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS REVENUE BOND, SERIES 2009-A2 (BAPTIST MAY 6, 2010 HEALTH SYSTEM, INC.),ISSUED BY THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS REVENUE BOND, SERIES 2009-B (BAPTIST DECEMBER 31, 2009 HEALTH SYSTEM, INC.),ISSUED BY THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS SCHEDULE K, PART I, LINE D ISSUER NAME: THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM-BAPTIST MEDICAL CENTERS ISSUER EIN: THE EMPLOYER IDENTIFICATION NUMBER ("EIN") OF THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM - BAPTIST MEDICAL CENTERS ("THE ISSUER") IS 63-0847033. THE ISSUER RECEIVED CORRESPONDENCE (LETTER NO. LTR3875C/LETTER DATE: 03/08/2013) FROM THE INTERNAL REVENUE SERVICE (THE "IRS") STATING THAT ITS RECORDS INDICATED THAT THE ISSUER'S EIN IS 52-1734355. BECAUSE THIS MATTER HAS NOT BEEN RESOLVED WITH THE IRS, EIN 63-0847033 IS USED HEREIN SINCE THAT IS THE NUMBER THE ISSUER TRADITIONALLY HAS USED WITH RESPECT TO FILINGS WITH THE IRS. DESCRIPTION OF PURPOSE: TO REFUND AND RETIRE OBLIGATIONS PURSUANT TO MASTER LOAN AND SECURITY AGREEMENTS DATED 02/29/2012 AND 02/28/2013 BETWEEN BAPTIST HEALTH SYSTEM, INC. AND PEOPLE'S CAPITAL AND LEASING CORP. TO REIMBURSE THE CORPORATION FOR THE ACQUISITION AND CONSTRUCTION OF CERTAIN HEALTH CARE FACILITIES THE REFUNDED OBLIGATIONS WERE ISSUED ON THE FOLLOWING DATES: MASTER LOAN SECURITY AGREEMENT DATED FEBRUARY 29, 2012 FEBRUARY 29, 2012 BETWEEN BAPTIST HEALTH SYSTEM, INC. AND PEOPLE'S CAPITAL LEASING CORP. AND THAT CERTAIN SCHEDULE NO. 2 TO MASTERLOAN AND SECURITY AGREEMENT DATED FEBRUARY 29, 2012 MASTER LOAN SECURITY AGREEMENT DATED FEBRUARY 28, 2013 FEBRUARY 29, 2012 BETWEEN BAPTIST HEALTH SYSTEM, INC. AND PEOPLE'S CAPITAL LEASING CORP. AND THAT CERTAIN SCHEDULE NO. 3 TO MASTERLOAN AND SECURITY AGREEMENT DATED FEBRUARY 28, 2013 MASTER LOAN SECURITY AGREEMENT DATED FEBRUARY 28, 2013 FEBRUARY 28, 2013 BETWEEN BAPTIST HEALTH SYSTEM, INC. AND PEOPLE'S CAPITAL LEASING CORP. AND THAT CERTAIN SCHEDULE NO. 4 TO MASTERLOAN AND SECURITY AGREEMENT DATED FEBRUARY 28, 2013 SCHEDULE K, PART II, COLUMN A, LINE 1 ON JUNE 25, 2009, THE CORPORATION CONSUMMATED A TENDER OFFER TRANSACTION, IN CONNECTON WITH WHICH THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF BIRMINGHAM-BAPTIST MEDICAL CENTERS (THE "AUTHORITY") ISSUED ITS $ 4,858,500 REVENUE BOND (BAPTIST HEALTH SYSTEM, INC.) SERIES 2009-A1 (THE "SERIES 2009-A1 BOND") AND ITS $6,371,900 REVENUE BOND (BAPTIST HEALTH SYSTEM, INC.), SERIES 2009-A2 (THE "SERIES 2009-A2 BOND"). PROCEEDS FROM THE SERIES 2009-A1 BONDS AND THE SERIES 2009-A2 BONDS WERE USED TO PURCHASE $ 14,580,000 OF THE AUTHORITY'S REVENUE BONDS (BAPTIST HEALTH SYSTEM, INC.), SERIES 2005-A (THE "SERIES 2005-A BONDS") AT A DISCOUNT TO THEIR PRINCIPAL AMOUNT. BOND TENDER TRANSACTION $14,580,000.00 PRINCIPAL PAYMENT 11/15/09 6,565,000.00 PRINCIPAL PAYMENT 11/15/10 6,900,000.00 PRINCIPAL PAYMENT 11/15/11 7,255,000.00 PRINCIPAL PAYMENT 11/15/12 7,630,000.00 PRINCIPAL PAYMENT 11/15/13 8,020,000.00 PRINCIPAL PAYMENT 11/15/14 8,430,000.00 TOTAL BONDS RETIRED $59,380,000.00 SCHEDULE K, PART II, COLUMN A, LINE 3 TOTAL PROCEEDS INCLUDE THE FOLLOWING: PROCEEDS FROM ISSUE: PROCEEDS USED FOR BOND ISSUANCE COSTS $2,995,065 PROCEEDS ALLOCATED TO RESERVE FUND 18,996,125 PROCEEDS USED TO CURRENTLY REFUND PRIOR ISSUES 113,860,398 PROCEEDS USED TO ADVANCE REFUND PRIOR ISSUES 58,666,214 TOTAL PROCEEDS FROM ISSUE: $194,517,802 NONREFUNDING PROCEEDS OF THE ISSUE (ACQUISITION FUND) $53,742,460 ACQUISITION FUND EARNINGS: $6,096,773 COST OF ISSUANCE FUND EARNINGS: $683 RESERVE FUND EARNINGS: $5,283,961 TOTAL PROCEEDS $259,641,679 EARNINGS ON INVESTMENTS IN THE ACQUISITION FUND AND THE COSTS OF ISSUANCE FUND WERE ALLOCATED TO CAPITAL PROJECTS AND COSTS OF ISSUE IN ACCORDANCE WITH SECTION 148 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND SECTION 1.148-6(D)(1)(I) OF THE TREASURY REGULATIONS PROMULGATED THEREUNDER. EARNINGS ON INVESTMENTS IN THE RESERVE FUND AND EXCESS SALE AND INVESTMENT PROCEEDS IN THE RESERVE FUND WERE ALLOCATED TO THE PAYMENT OF PRINCIPAL OR INTEREST ON THE SERIES 2005-A BONDS IN ACCORDANCE WITH SECTION 148 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND EITHER SECTION 1.148-6(D)(3)(II)(A)(6) OR SECTION 1.148-6(D)(3)(II)(A)(7) OF THE TREASURY REGULATIONS PROMULGATED THEREUNDER. TOTAL PROCEEDS EXCLUDE EARNINGS ON INVESTMENTS IN THE DEFEASANCE ESCROW FUNDS ESTABLISHED IN CONNECTION WITH THE SERIES 2005-A BONDS. THESE INVESTMENTS WERE STRUCTURED SO THAT THE YIELD ON INVESTMENTS ALLOCABLE TO THE SERIES 2005-A BOND PROCEEDS DID NOT EXCEED THE YIELD ON THE SERIES 2005-A BOND. SCHEDULE K, PART II, COLUMN A, LINE 11 RESERVE FUND EARNINGS $5,283,961 EARNINGS ON INVESTMENTS IN THE RESERVE FUND AND EXCESS SALE AND INVESTMENT PROCEEDS IN THE RESERVE FUND WERE ALLOCATED TO THE PAYMENT OF PRINCIPAL OR INTEREST ON THE SERIES 2005-A BONDS IN ACCORDANCE WITH SECTION 148 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND EITHER SECTION 1.148-6(D)(3)(II)(A)(6) OR SECTION 1.148-6(D)(3)(II)(A)(7) OF THE TREASURY REGULATIONS PROMULGATED THEREUNDER. SCHEDULE K, PART II, COLUMN B, LINE 13 THE SERIES 2012-A BOND ISSUE WAS A REFUNDING ONLY SCHEDULE K, PART II, COLUMN C, LINE 13 THE SERIES 2012-B BOND ISSUE WAS A REFUNDING ONLY SCHEDULE K, PART II, COLUMN D, LINE 13 THE SERIES 2013-B BOND ISSUE WAS A REFUNDING OF TAXABLE OBLIGATIONS OF BAPTIST HEALTH SYSTEM, INC. NONREFUNDING PROCEEDS WERE USED TO REIMBURSE BAPTIST HEALTH SYSTEM FOR CAPITAL PURCHASES MADE IN 2013. SCHEDULE K, PART III, COLUMN A, LINE 7 THE SERIES 2005-A BONDS WERE ISSUED AS QUALIFIED 501(C)(3) BONDS IN ACCORDANCE WITH SECTION 145 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED (THE "INTERNAL REVENUE CODE"), AND THE REGULATIONS PROMULGATED THEREUNDER, AND THE SERIES 2005-A BONDS DO NOT MEET EITHER THE PRIVATE BUSINESS USE TEST OR THE PRIVATE SECURITY OR PAYMENT TEST UNDER SECTION 141 OF THE INTERNAL REVENUE CODE (AS MODIFIED BY SECTION 145 OF THE INTERNAL REVENUE CODE). HENCE, WITH RESPECT TO THE SERIES 2005-A BONDS,THE ANSWER TO THE QUESTION "DOES THE BOND ISSUE MEET THE PRIVATE SECURITY OR PAYMENT TEST?" IS "NO". SCHEDULE K, PART III, COLUMN A, LINE 8A CAPITAL EXPENDITURES FROM NONREFUNDING PROCEEDS WERE $ 59,839,232.88. THERE HAS NOT BEEN A SALE OR DISPOSITION OF THE PROPERTY PURCHASED WITH THE NONREFUNDING PROCEEDS. ALL REFUNDING PROCEEDS REFUNDED BONDS ISSUED PRIOR TO 12/31/2002. SCHEDULE K, PART III, COLUMN B PART III NOT COMPLETED SINCE 2012-A ISSUE WAS A REFUNDING ONLY OF BONDS ISSUED PRIOR TO 12/31/2002. SCHEDULE K, PART III, COLUMN C, LINE 7 THE SERIES 2012-B BONDS WERE ISSUED AS QUALIFIED 501(C)(3) BONDS IN ACCORDANCE WITH SECTION 145 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED (THE "INTERNAL REVENUE CODE"), AND THE REGULATIONS PROMULGATED THEREUNDER, AND THE SERIES 2012-B BONDS DO NOT MEET EITHER THE PRIVATE BUSINESS USE TEST OR THE PRIVATE SECURITY OR PAYMENT TEST UNDER SECTION 141 OF THE INTERNAL REVENUE CODE (AS MODIFIED BY SECTION 145 OF THE INTERNAL REVENUE CODE). HENCE, WITH RESPECT TO THE SERIES 2012-B BONDS, THE ANSWER TO THE QUESTION "DOES THE BOND ISSUE MEET THE PRIVATE SECURITY OR PAYMENT TEST?" IS "NO". SCHEDULE K, PART III, COLUMN D, LINE 7 THE SERIES 2013-A BONDS WERE ISSUED AS QUALIFIED 501(C)(3) BONDS IN ACCORDANCE WITH SECTION 145 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED (THE "INTERNAL REVENUE CODE"), AND THE REGULATIONS PROMULGATED THEREUNDER, AND THE SERIES 2013-A BONDS DO NOT MEET EITHER THE PRIVATE BUSINESS USE TEST OR THE PRIVATE SECURITY OR PAYMENT TEST UNDER SECTION 141 OF THE INTERNAL REVENUE CODE (AS MODIFIED BY SECTION 145 OF THE INTERNAL REVENUE CODE). HENCE, WITH RESPECT TO THE SERIES 2013-B BONDS, THE ANSWER TO THE QUESTION "DOES THE BOND ISSUE MEET THE PRIVATE SECURITY OR PAYMENT TEST?" IS "NO". SCHEDULE K, PART IV, COLUMN A, LINE 2(C) DATE OF LAST REBATE COMPUTATION WAS DECEMBER 31, 2014. SCHEDULE K, PART IV, COLUMN A, LINE 5(B), 5(C), AND 5(D) PROCEEDS OF THE SERIES 2005-A BONDS (ACQUISITION FUND PROCEEDS) WERE INVESTED IN TWO (2) GICS AS LISTED BELOW: FIRST GIC: (B) NAME OF PROVIDER: TRANSAMERICA LIFE INSURANCE COMPANY (C) TERM OF GIC: DECEMBER 15,2005 TO MARCH 1, 2007 (D) WAS THE REGULATORY SAFE HARBOR FOR ESTABLISHING THE FAIR MARKET VALUE OF THE GIC SATISFIED? -YES SECOND GIC: (B) NAME OF PROVIDER: HYPO PUBLIC FINANCE BANK (C) TERM OF GIC: MARCH 23, 2007 TO NOVEMBER 28, 2008 ELECTED TO TERMINATE THE GIC ON OCTOBER 20, 2008 (D) WAS THE REGULATORY SAFE HARBOR FOR ESTABLISHING THE FAIR MARKET VALUE OF THE GIC SATISFIED? -YES TERM OF GICS IN YEARS 441 TOTAL DAYS - FIRST GIC 578 TOTAL DAYS - SECOND GIC 1019 TOTAL DAYS - TOTAL OF GIC TERMS 2.8 TOTAL TERM IN YEARS TO THE NEAREST 10TH SCHEDULE K, PART IV, COLUMN A, LINE 6 A PORTION OF THE PROCEEDS OF THE SERIES 2005-A BONDS WAS DEPOSITED IN AN ACQUISITION FUND FOR EXPENDITURE ON NEW BHS CAPITAL PROJECTS. AT THE TIME OF ISSUANCE OF THE 2005-A BONDS, BHS EXPECTED TO MEET THE GENERAL 3-YEAR TEMPORARY PERIOD FOR CAPITAL PROJECTS CONTEMPLATED BY SECTION 148(C) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND SECTION 1.148-2(E) (2) OF THE TREASURY REGULATIONS PROMULGATED THEREUNDER. IN OTHER WORDS, BHS EXPECTED TO SPEND ALL PROCEEDS IN THE ACQUISITION FUND BY NOVEMBER 29, 2008 AND OTHERWISE COMPLY WITH THE REQUIREMENTS OF THE GENERAL 3-YEAR TEMPORARY PERIOD. AFTER ISSUANCE OF THE SERIES 2005-A BONDS, BHS DETERMINED THAT IT WAS IN ITS BEST INTEREST AND BEST SERVED ITS HEALTHCARE MISSION TO REDIRECT A LARGER PORTION OF THE PROCEEDS OF THE 2005-A BONDS TO CAPITAL PROJECTS AT BHS'S SHELBY BAPTIST MEDICAL CENTER. THE PROCESS OF REDIRECTING PROCEEDS TO SHELBY BAPTIST MEDICAL CENTER CAUSED DELAYS THAT CAUSED BHS TO INVEST PROCEEDS IN THE ACQUISITION FUND BEYOND THE TEMPORARY PERIOD EXCEPTION CONTEMPLATED BY SECTION 148(C) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND SECTION 1.148-2(E) (2) OF THE TREASURY REGULATIONS PROMULGATED THEREUNDER. ALL PROCEEDS IN THE ACQUISITION FUND WERE EXPENDED BY JUNE 2, 2009. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO THE RESTATED ARTICLES OF INCORPORATION OF BAPTIST HEALTH SYSTEM, INC., THE BIRMINGHAM BAPTIST ASSOCIATION, AN ALABAMA NONPROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, ELECTS THE BOARD OF TRUSTEES OF BAPTIST HEALTH SYSTEM, INC. FROM A SLATE PRESENTED BY BAPTIST HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7B ANY AMENDMENT TO THE BAPTIST HEALTH SYSTEM, INC. ARTICLES OF INCORPORATION MUST BE APPROVED BY THE BIRMINGHAM BAPTIST ASSOCIATION AND ANY MORTGAGE PLACED ON ANY PART OR PORTION OF REAL PROPERTY OWNED BY BAPTIST HEALTH SYSTEM, INC. MUST BE APPROVED BY THE BIRMINGHAM BAPTIST ASSOCIATION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO THE BOARD FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATION, DEDICATED TO ITS FAITH BASED HEALTH CARE MINISTRY, HAS DEMONSTRATED THE VALUE OF INTEGRITY BY SETTING FORTH A POLICY PROHIBITING CONFLICT OF INTEREST AND PROVIDING A MECHANISM FOR REPORTING POTENTIAL CONFLICT OF INTEREST SITUATIONS. THE PURPOSE OF THIS CONFLICT OF INTEREST POLICY IS TO PROTECT THE CORPORATION'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF A TRUSTEE, BOARD COMMITTEE MEMBER, HOSPITAL ADVISORY COUNCIL MEMBER, OFFICER, DIRECTOR, OR MANAGER OF BHS. THIS POLICY IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY APPLICABLE FEDERAL OR ALABAMA LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO NONPROFIT AND CHARITABLE ORGANIZATIONS. THE CORPORATION CONDUCTS AN ANNUAL CONFLICT OF INTEREST SURVEY FOR ALL OF ITS BOARD MEMBERS, OFFICERS, DIRECTORS, AND MANAGERS TO ENSURE THAT ALL POTENTIAL CONFLICTS ARE REPORTED AND ADDRESSED. THE CORPORATION ALSO HAS A TRAVEL POLICY IN PLACE THAT ALLOWS FOR THE REIMBURSEMENT OF TRAVEL EXPENSES THAT ARE REASONABLE IN AMOUNT AND ARE CONSIDERED ORDINARY, NECESSARY, AND APPROPRIATE TO THE CONDUCT OF THE CORPORATION'S BUSINESS. THE REIMBURSEMENT GUIDELINES ARE IN ACCORDANCE WITH INTERNAL REVENUE SERVICE REGULATIONS. THE AMOUNT OF FUNDS EXPENDED EACH YEAR RELATED TO TRAVEL IS BUDGETED. EMPLOYEES AND TRUSTEES OF THE CORPORATION ARE NOT COMPENSATED THROUGH EXPENSE ALLOWANCES. TO BE REIMBURSED FOR TRAVEL, EMPLOYEES AND TRUSTEES MUST SUBMIT A SIGNED EXPENSE REPORT FORM AND PROVIDE DOCUMENTATION IN THE FORM OF RECEIPTS FOR ANY EXPENSE OF $20 OR MORE. FORM 990, PART VI, SECTION B, LINE 15 THE ANNUAL PROCESS OF REVIEWING COMPENSATION FOR EXECUTIVES CLASSIFIED AS DISQUALIFIED PERSONS UNDER IRS INTERMEDIATE SANCTIONS GUIDELINES INCLUDES THE FOLLOWING STEPS: THE GOVERNANCE COMMITTEE (A SUB COMMITTEE OF THE BOARD OF DIRECTORS) REVIEWS AND APPROVES BASE SALARY, INCENTIVES, FRINGE AND OTHER BENEFITS, AND RETIREMENT AND/OR DEFERRED COMPENSATION BENEFITS. THE GOVERNANCE COMMITTEE EMPLOYS A THIRD PARTY CONSULTANT TO PROVIDE THE INDEPENDENT MARKET DATA AND UTILIZES A DOCUMENTED TOTAL COMPENSATION PHILOSOPHY TO GUIDE IN THE DECISION MAKING. PEER GROUP MARKET DATA AND ANALYSIS IS UTILIZED FOR COMPARISON OF THE TOTAL COMPENSATION PACKAGE. MEETING MINUTES ARE MAINTAINED WHICH REFLECT THE CONSIDERATION OF PHILOSOPHY, PERFORMANCE, AND MARKET DATA. THE ANNUAL PROCESS FOR EXECUTIVES NOT CLASSIFIED AS DISQUALIFIED PERSONS UNDER IRS INTERMEDIATE SANCTIONS GUIDELINES INCLUDE THE FOLLOWING: THE BHS PRESIDENT AND CEO REVIEWS AND APPROVES ALL COMPENSATION DECISIONS. THIRD PARTY CONSULTANTS AND TOTAL COMPENSATION SURVEYS ARE UTILIZED TO PROVIDE INDEPENDENT MARKET DATA. A DOCUMENTED TOTAL COMPENSATION PHILOSOPHY IS UTILIZED TO GUIDE IN THE DECISION MAKING. PEER GROUP MARKET DATA AND ANALYSIS IS UTILIZED FOR COMPARISON OF THE TOTAL COMPENSATION PACKAGE. THE GOVERNANCE COMMITTEE REVIEWS AND APPROVES INCENTIVES, FRINGE BENEFITS, AND RETIREMENT AND/OR DEFERRED COMPENSATION BENEFITS. FORM 990, PART VI, SECTION C, LINE 19 AS A GENERAL RULE, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. ANY WRITTEN REQUEST BY THE PUBLIC WOULD BE REVIEWED AND ACTED UPON BY THE BOARD. HOWEVER, BHS FILES ITS ANNUAL FINANCIAL STATEMENTS WITH DAC AS REQUIRED BY THE CONTINUING DISCLOSURE AGREEMENT OF THE MASTER TRUST INDENTURE. FORM 990, PART VIII, LINE 2A: EFFECTIVE JANUARY 1, 2012, THE CORPORATION ADOPTED ACCOUNTING STANDARDS REGARDING THE PROVISION FOR BAD DEBTS RELATED TO PATIENT SERVICE REVENUE. AS A RESULT, THE PROVISION FOR BAD DEBTS IS DISPLAYED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN UNRESTRICTED NET ASSETS. FORM 990, PART XI, LINE 9: DECREASE IN MINIMUM PENSION LIABILITY -42,310,768. INCREASE IN INVESTMENT IN AFFILIATE-TEMPORARILY RESTRICTED -2,091,079. INCREASE IN INVESTMENT IN AFFILIATE-PERMANENTLY RESTRICTED 477,778. OTHER CHANGES 573,320. RECLASSIFICATION OF CONTRIBUTIONS AND SUBSIDIARY INCOME/LOSS 1,380,947. FORM 990, PART XII, LINE 2C: THE ORGANIZATION MADE NO CHANGES TO ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. 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