2012-11-13T15:39:35-06:00 2011-12-31 ERNST & YOUNG US LLP 55 IVAN ALLEN BOULEVARD SUITE 1000 ATLANTA GA 30308 990 2011-01-01 050615150 BayCare Alliant Hospital Inc % John Proni BAYC 7277346782 601 Main Street Dunedin FL 34698 JOHN PRONI 2012-10-31 4048748300 2011 2016-02-24 21:20:13Z Jacqueline Arocho 601 Main Street Dunedin FL 34698 17177386 false X www.baycare.org X 2004 FL BayCare Alliant Hospital will provide excellence in care for patients with prolonged illnesses recognizing that optimum healing requires a team approach to both medical and human values. 7 7 158 5 82 17691 0 14340652 17169973 0 0 10259 7413 14368602 17177386 1728 0 0 0 5482847 6645580 0 0 0 7655462 8774525 13140037 15420105 1228565 1757281 2207045 5285692 8629618 9950986 -6422573 -4665294 BAYCARE ALLIANT HOSPITAL WILL PROVIDE EXCELLENCE IN CARE FOR PATIENTS WITH PROLONGED ILLNESSES RECOGNIZING THAT OPTIMUM HEALING REQUIRES A TEAM APPROACH TO BOTH MEDICAL AND HUMAN VALUES. false false 13374696 17177386 BayCare Alliant Hospital, Inc. (BAH) is a 48 bed, long-term acute care hospital. During 2011, BAH provided inpatient care to 391 patients and the average length of stay was 29 days. Through efforts of the medical assistance program and the hospital's charity care program BAH saw a net community benefit expense of $904 thousand. The hospital also provided other community services totaling more than $4 thousand. Refer to Schedule H for additional information. 13374696 true false false true false false false false false false true false false false true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false false true 25 0 true 158 true false false false false false false false false false false X 7 7 false false false false true true true true true false false true true true true true true true true false X John Proni 7277346782 601 Main Street Dunedin FL 34698 BRUCE BOKOR 1.0 X 0 0 0 ROBERT EVANS 1.0 X 0 0 0 KEN HAMILTON 1.0 X X 0 0 0 ALAN HOLDERITH 1.0 X X 0 0 0 BRUCE FLAREAU 1.0 X 0 0 0 GLENN WATERS 1.0 X 0 0 0 CHARLES ROBINSON 1.0 X 0 0 0 JACQUELINE AROCHO 45.0 X 151892 0 3124 JOHN PRONI 45.0 X 83599 0 9870 KAREN DUFFY 45.0 X 115895 0 4350 351386 0 17344 2 false true false SUNBELT STAFFING SOLUTIONS PO BOX 1024640 ATLANTA GA 30368 STAFFING SERVICES 136039 BAYCARE HEALTH SYSTEM 16255 BAYVISTA DRIVE CLEARWATER FL 33760 MANAGEMENT FEES 982634 BAYCARE HOME CARE INC 8452 118TH AVE N LARGO FL 33773 HOME CARE SERVICES 265631 CROSS COUNTRY STAFFING PO BOX 404674 ATLANTA GA 30384 MEDICAL STAFFING 241366 BIO MEDICAL APPLICATIONS OF FL PO BOX 100002 ATLANTA GA 30348 MEDICAL SERVICES 159641 7 0 HOSPITAL PATIENT CARE 621999 2325092 2325092 MEDICARE/MEDICAID NET REVENUE 621999 14844881 14844881 17169973 0 0 0 0 0 0 0 MISCELLANEOUS 524298 7413 7331 82 7413 17177386 17177304 82 0 0 0 0 248485 248485 0 5106972 4765827 341145 123828 115556 8272 807088 753175 53913 359207 316959 42248 660070 660070 44473 44473 7669 7669 0 0 0 658191 611923 46268 20893 -528 21421 416921 356059 60862 12623 12623 0 1325251 1258992 66259 26011 13761 12250 0 0 79581 79581 0 14537 12447 2090 86752 53833 32919 PURCHASED SERVICES 2952290 2629990 322300 BAD DEBT EXPENSE 60891 60891 MISCELLANEOUS EXPENSES 268151 206745 61406 MEDICAL SUPPLIES 2140221 2139485 736 15420105 13374696 2045409 0 266740 2853588 0 0 0 0 1530387 1959220 0 0 0 0 100326 77154 0 0 167261 195709 167328 30868 76137 136460 0 0 0 0 10550 11191 55644 52370 0 0 2207045 5285692 599782 947558 0 0 6550 8013 0 0 0 0 0 0 7270000 8385678 0 0 753286 609737 8629618 9950986 X -6422573 -4665294 0 0 0 0 -6422573 -4665294 2207045 5285692 X 1757281 -2 X false true true X false X false false false false false false false false true 2900 2900 false Part II-B, Line 1i Dues were paid to the Acute Long Term Hospital Association, the association uses a portion of the dues to conduct lobbying activities. 112119 30868 81251 55209 55209 136460 0 ESTIMATED THIRD PARTY SETTLEMENTS 87634 DUE TO AFFILIATES 522103 609737 17177386 15420105 1757281 1757281 17177386 17177386 17177386 15420105 15420105 15420105 true true X true X 250. false true false false 1 47 2441736 2004238 437498 0.02850 1 28 1253764 786890 466874 0.03040 2 75 3695500 2791128 904372 0.05890 9 4114 4114 0.00030 9 4114 4114 0.00030 11 75 3699614 2791128 908486 0.05920 true 60891 10952799 10036055 916744 X true true 1 1 BAYCARE ALLIANT HOSPITAL INC

601 MAIN STREET DUNEDIN FL 34698

X ACUTE LTC HOSPITAL BAYCARE ALLIANT HOSPITAL INC 1 true true 250. false true X X X X X X X true true X X X X true X X true X X X X X X false X X false false Part I Line 3c Patients who are uninsured or underinsured and cannot pay for hospital services are eligible for charity consideration. These patients are screened by designated team members in our Financial Assistance Department. The Agency for Health Care Administration (AHCA) defines charity eligibility at 200 percent of the federal poverty guidelines, unless the total hospital bill is more than 25 percent of the patient's annual income. Medicaid recipients who have exceeded their coverage limits are also considered for charity care. BayCare Alliant Hospital goes above and beyond the AHCA requirements by providing additional "hardship" charity for patients who are at 250 percent of the federal poverty guidelines. In addition, an uninsured discount of 40% is given to any patient who does not have insurance coverage or benefits. There is no income or asset test required for the uninsured discount. Patients receive an additional 10% discount if the account is paid within 30 days. Part I Line 6a Part I Line 7 Financial assistance and means-tested government programs costs (lines A through D) are determined using our cost accounting system, which captures all inpatients and outpatients. The system also captures all patient pay types - private insurance, Medicare, Medicaid, uninsured and self pay. The costs have been offset by any payments received from Medicaid or any other uncompensated care program. Other benefits at cost (lines E through J, as well as amounts reported in Part II) were compiled by the community health department using the Catholic Health Association guide for planning and reporting community benefits. Part I Line 7 Column f Bad Debt expense of $60,891 was included on form 990, Part IX, Line 25, Column (a), but subtracted for purposes of calculating the percentage in this column. Part III Line 4 The organization's financial statements do not include a footnote directly on bad debt expense. Bad debt expense is reported as total bad debt for the facility. The amount of bad debt expense attributable to patients eligible for financial assistance is calculated as a charge ratio, derived from data sampling. The resulting charge ratio is then applied to total bad debt accounts of the organization, which calculates the bad debt attributable to finance assistance. The state of Florida requires the patient to provide certain documentation in order to qualify for financial assistance. In cases where the patient has not responded to hospital requests or billing statement alerts, those accounts are processed as bad debt, if unpaid. Part III Line 8 Cost reports were used to report Medicare allowable costs. Medicare defines allowable costs as those appropriate and helpful in developing and maintaining the operation of patient care facilities and activities. It specifically excludes certain costs that are not directly related to patient care. The hospital incurs additional expense related to the provision of care to Medicare patients that Medicare has deemed non-allowable. This additional expense includes costs of physician services (emergency on-call fees, hospitalist program, recruitment, etc.), advertising costs, cafeteria costs for meals sold to visitors, etc. The hospital attempts to collect coinsurance and deductibles from Medicare beneficiaries. To the extent collection efforts are unsuccessful, Medicare reimburses the hospital at 70% of unpaid amounts. The following table reconciles the surplus or shortfall from Line 7 to the actual surplus or shortfall. The additional costs were allocated to Medicare based upon Medicare's percentage of total allowable costs. The unpaid coinsurance/deductibles were estimated using historical collection results. Line 7 Surplus or (Shortfall)$916,744 Additional non-allowable costs and unpaid/non-reimbursed coinsurance/deductibles ($46,522) Total Surplus or (Shortfall) $870,222 Part III Line 9b Patients who are unable to pay are encouraged by BayCare Health System representatives, via personal interviews, signage, patient billing mailers, brochures or Customer Service phone calls, to submit financial information to the Financial Assistance Department to determine eligibility for programs, such as County, Medicaid, Disability, Victims of Crime, Charity, etc. For those patients who provide all the necessary documentation and qualify for charity according to the Financial Assistance policy, (defined in Part I, line 3c), patients' account would be written off completely to charity and not billed to the patients. Part V Section B Line 10 An uninsured discount of 40% is given to any patient who does not have insurance coverage or benefits. There is no income or asset test required for the uninsured discount. Patients receive an additional 10% discount if the account is paid within 30 days. Part V Section B Line 19d Patients who are uninsured or underinsured and cannot pay for hospital services are eligible for charity consideration. These patients are screened by designated team members in our Financial Assistance Department. The Agency for Health Care Administration (AHCA) defines charity eligibility at 200 percent of the federal poverty guidelines, unless the total hospital bill is more than 25 percent of the patient's annual income. Medicaid recipients who have exceeded their coverage limits are also considered for charity care. BayCare Alliant Hospital, Inc. goes above and beyond the AHCA requirements by providing additional "hardship" charity for patients who are at 250 percent of the federal poverty guidelines. Once a patient is identified as eligible for financial assistance their account balance is written off 100% to charity write-offs and are no longer billed for services provided. 2 - Needs Assessment BayCare Alliant Hospital, Inc. is committed to meeting the needs of the community it serves. Our quality philosophy is modeled around understanding our customers' needs in the communities it serves. BayCare Alliant Hospital, Inc. addresses community health status assessments by accessing existing third party databases profiling health status information for geographies it serves. The assessments provide a profile of health status indicators in comparison to state averages and, if available, national benchmarks. In addition, BayCare Alliant Hospital, Inc. conducts physician community need studies that outline physician deficits by specialty for the geographic area served. Studies are also conducted to identify gaps in geographic access to services such as primary care, outpatient services and inpatient services. All of the above processes occur on an ongoing basis to assist BayCare Alliant Hospital, Inc. in developing initiatives and programs/services to address identified health care needs in the communities it serves. 3 - Patient education of eligibility for assistance BayCare Alliant Hospital, Inc. Financial Assistance team members are dedicated to assisting patients in obtaining assistance through federal, state and local government programs or through the BayCare Alliant Hospital, Inc. financial assistance policy. Signage and brochures are available, as well as team members whose full responsibility is to assist patients on inpatient units. The Financial Assistance team interviews patients for all available programs, assists the patients in completing applications to government agencies and for hospital charity care, advises patients regarding available community resources for health care, reviews and approves patient requests for charity care, and provides education and support to the patient throughout the assistance process. In addition to the aforementioned comprehensive process, BayCare Alliant Hospital, Inc. also informs and educates patients who may be billed for patient care, but may be eligible for charity or other programs, via patient billing mailers and customer service representative calls. The goal in using these various means is to effectively communicate with the entire patient population so they are informed and educated about their eligibility for assistance. 4 - Community information BayCare Alliant Hospital, Inc. is in a suburban setting serving parts of Pasco and Pinellas counties. The average income is lower than both the state and national averages. The population served is predominantly Caucasian and high-school or higher educated. Hispanics are the second largest ethnic group representing 10% of the population and 13% of households are poverty level. BayCare Alliant Hospital, Inc. is part of BayCare Health System that serves west central Florida. The area served by BayCare Alliant Hospital has 14 hospitals with 7 being Not-for Profit. There are 6 federally designated medically underserved areas in BayCare Alliant Hospital's service area. With the service area expanding and the over 65 population expected to grow 12% in the next five years, the health care needs of our service area are expanding and changing. The population served by BayCare Alliant Hospital, Inc. is expected to grow 2% in the next 5 years. This expected growth is lower than the expected growth rate for the United States. However, the population Age 55+ is expected to grow 20% in the next 5 years. In 2011, this age group represented 79% of BayCare Alliant Hospital, Inc's patient population. The community experiences higher incidence rates compared to the state of Florida in the following areas: adults with asthma, HIV cases, AIDs cases, adults with high blood cholesterol, melanoma, asthma hospitalization, adult smokers, domestic violence, fully immunized kindergarteners and sexually transmitted diseases. Based on Florida inpatient discharge data for the period of 07/01/10-06/30/11, the payor mix for the geographic area consists of 53.4% Medicare/Medicare HMO, 13.7% Medicaid/Medicaid HMO, 22.1% Commercial Insurance, 7.2% Self-pay, and 3.6% Other. 5 - Promotion of community health BayCare Alliant Hospital, Inc. is a 48-bed, long-term acute care hospital (LTCH) affiliated with BayCare. It is the only facility of its kind located within a 26 mile radius of Dunedin, Florida. The 25,000-square-foot facility provides diagnostic, medical treatment and rehabilitation for patients experiencing complex medical conditions due to chronic disease or injuries. The hospital takes a multi-disciplinary, family-centered approach with physicians, nursing and other health care specialists working together toward the goal of the best possible recovery for patients. BayCare Alliant is located inside Mease Dunedin Hospital. This proximity enables BayCare Alliant to provide the community with access to high quality patient care and minimizes patient transportation. Long-term hospitals located within general acute care hospitals are often referred to as "hospitals within a hospital" or "HIH's". A typical stay at a long-term acute care hospital is 25 days. The board is made up of community members who want to provide the community with access to compassionate patient care of superior quality. The Hospital has provided educational sessions to the physician and clinical community. In addition, the Hospital has lectured to local organizations and sponsored charitable events. There is a critical need for the Hospital given that it is the only LTCH within the vicinity, and given that it serves the most highly acute and chronically ill segment of the community. 6 - Affiliated health care system BayCare Alliant Hospital is part of BayCare Health System, a leading, community-based health system in the Tampa Bay area with 19,600 employees, 10 not-for-profit hospitals, 17 outpatient centers, and a complete range of services, such as imaging, lab, behavioral health, and home care. BayCare's hospitals are Mease Countryside, Mease Dunedin, Morton Plant, Morton Plant North Bay, St. Anthony's, South Florida Baptist, St. Joseph's, St. Joseph's Women's, St. Joseph's Children's, and St. Joseph's Hospital-North. St. Joseph's hospitals operate as one entity and file one Form 990. BayCare was founded in 1997 when the area's top not-for-profit hospitals came together united by a common mission to improve the health of their communities and continue caring for all patients regardless of their ability to pay. In 2011, BayCare provided $167 million in community benefits, which included $77.9 million in traditional charity care, $77.6 million in Medicaid and other means-tested programs, and $11.8 million in unbilled community services. In addition to charity care, BayCare's financial stability and centralization of shared services in finance, information technology, and human resources strengthens each hospital's ability to allocate resources to help meet the needs of their communities. BayCare's hospitals are located in three geographic regions, each with their own Boards of local leadership focused on their community's specific needs. Recognizing the need for mental health services, BayCare continues to be the largest, not-for-profit provider of behavioral health services in west central Florida. BayCare Behavioral Health offers inpatient, outpatient, in-home treatment, support group and case management services. BayCare's designated Baker Act-receiving facilities in Hillsborough, Pinellas, and Pasco counties provide inpatient crisis stabilization and partial hospitalization programs as part of the continuum of mental health care. BayCare is the only organization in the Tampa Bay area that operates dedicated psychiatric emergency rooms at each of its hospital-based, Baker Act facilities. In Hillsborough County, St. Joseph's prepared in 2011 to open a 45,000-square-foot behavioral health facility as the only private, freestanding, inpatient psychiatric Baker Act receiving hospital in the county. Earlier that year, the Tampa Bay Partnership, a regional research and education foundation, published a report that noted the area's suicide rate was statistically higher than state and national rates. St. Joseph's also began admitting mothers and babies to a new 125,000-square-foot, five-story tower with 64 neonatal intensive care unit suites, one floor exclusively for new mothers and one floor for medical/surgical patients. The Tampa Bay region has a high infant mortality rate, according to the partnership's report. In north Pinellas County, Morton Plant opened a new, four-story pavilion that expanded cancer, imaging and patient support services. The report noted that the region's mortality rate due to cancer was higher than Florida's rate. In south Pinellas County, St. Anthony's identified a growing need for emergency services in its local community. As a result, the hospital expanded its current facilities with a new, 105,000-square-foot Emergency Center and Patient Care Tower. BayCare also meets the needs of the community by being one of the largest employers in the Tampa Bay region. In 2011, BayCare added 1,000 new employees during a tough economy when unemployment rates in other areas remained high. The community also benefits from BayCare's comprehensive network, which provides increased access to services, such as emergency care, outpatient and home care. In 2011, BayCare HomeCare provided 625,000 home health visits, helping patients leave the hospital sooner and recover at home where they are more comfortable. BayCare also meets the needs of the community by helping its hospitals continue evolving to keep pace with changes in the health care industry and new technologies. In 2011, BayCare continued developing a clinically integrated network in the Tampa Bay area. This new, physician-led organization puts more emphasis on prevention, early detection and disease management by creating a flexible model of care that better aligns physicians with BayCare's resources. In addition, BayCare successfully completed the second phase of its system-wide implementation of an electronic medical record (EMR). With the completion of this phase in 2011, every hospital in BayCare now documents clinical information in a system-wide EMR, providing the entire health team with real-time, electronic access to patient information. In 2011, BayCare hosted its sixth annual and largest Quality Sharing Day event, with more than 500 employees taking part in a full day of learning about best practices from Six Sigma and performance improvement projects. In 2011, BayCare had 193 Six Sigma and performance improvement projects championed by employees throughout the health system. BayCare currently has 31 certified Six Sigma Black Belts and 57 certified Green Belts. Since BayCare began its Six Sigma program in 2004, more than 5,400 employees have participated in performance improvement projects that have helped drive process efficiency and cost savings throughout its hospitals and facilities. As part of its commitment to the community, BayCare collaborates with Hillsborough Community College, University of Tampa, St. Petersburg College, Pasco Hernando Community College and the Pinellas Technical Education Center to help educate future nurses and health care professionals. BayCare also continues to support other organizations committed to improving the health of the community. These organizations include the American Heart Association (Greater Southeast Affiliate), Susan G. Komen for the Cure (Florida Suncoast Affiliate), and the Tampa Bay Partnership: ONE BAY Healthy Communities. 7 - State Filing N/A false false false false false false false true false JACQUELINE AROCHO 151778 0 0 0 114 0 3124 0 0 0 155016 0 0 0 Supplemental Compensation Information Part I, Line 3 The filing organization does not use any of the options listed in Schedule J, Line 3 to establish the compensation of the CEO/Executive Director. The organization follows the compensation policy of BayCare Health System Inc, uses Compensation committee, Independent compensation consultant, Written employment contract, Compensation survey or study and Approval by the board or compensation committee as a means to establish the CEO's compensation of the filing organization. Part I, Line 4a Severance payment was made during the year to Anita Russell, $60,382.40 Part I, Line 7 80 percent of the incentive compensation for which an individual is eligible would be considered fixed based on the instructions. 20 percent would be considered non-fixed and is based on the discretion of the employee's immediate supervisor. Part VI Part VI, Line 6 - Description of Classes of Members or Stockholders The sole member of BayCare Alliant Hospital, Inc. is BayCare Health System, Inc. Part VI, Line 7a - Members of the Board of Directors A. The Board of Directors shall be composed of seven (7) directors. The directors shall be designated as "Number 1", "Number 2", Number 3, "Number 4", "Number 5, "Number 6" and "Number 7" respectively. B. Director Numbers 1,2,3,4 and 5 (collectively, the "Self-Perpetuating Directors" shall be initially appointed by BayCare. Thereafter, at the end of a term of office or to otherwise fill the vacancy of any Self-Perpetuating Director, all the then Self- Perpetuating Directors by majority vote shall appoint a successor Self-Perpetuating Director. No Self-Perpetuating Director may also serve as a director, officer or employee of BayCare or any other participants in the BayCare Joint Operating Agreement. Furthermore, no Self-Perpetuating Director may be a member of the medical staff of a hospital owned, leased, managed or other wise operated by BayCare. C. Director Numbers 6 and 7 (collectively, the "BayCare Appointees") shall be appointed by BayCare. At lease sixty (60) days before the expiration of the term of any BayCare Appointee, the Board of Directors shall notify BayCare of (i) its obligation to appoint a successor to such BayCare Appointee and (ii) the date upon which term of such BayCare appointee shall expire. D. Each Director shall serve for a term of three (3) years, except that in order to provide for staggered tenures of the initial Board of Directors, Director Numbers 1, 2, 5 and 6 shall serve an initial term of three (3) years, and Director Numbers 3,4, and 7 shall serve an initial term of two (2) years. Each director thereafter appointed to fill an expired term shall be appointed for and shall serve the full term of three (3) years. E. Each director shall serve until his or her successor is appointed as described in this Article. Part VI, Line 7b - Descr Classes of Persons, Decisions Requiring Appr & Type of Voting Rights The following actions of the Board are subject to the member BayCare Health System's approval: 1) Changing the name of the corporation. 2) Changes to Bylaws. 3) The sale or merger of the assets of the corporation. Part VI, Line 11b - Describe the Process used by Management &/or Governing Body to Review 990 The Form 990 is prepared by the organization and reviewed by the CFO, as well as the organization's paid preparer. A final copy of the Form 990 was reviewed by a subcommittee of the Board of Directors. Prior to filing with the IRS, a final copy of the Form 990 was made available to the entire Board. Part VI, Line 12c - Description of Process to Monitor Transactions for Conflicts of Interest BayCare Alliant Hospital, Inc. has an affirmative policy which requires that all actual or apparent conflicts be disclosed promptly and fully to all necessary parties and which prohibits specified involvement in the affairs of the corporation by persons having such conflicts. The policy applies to all members of the Board of Directors and corporate officers, agents and employees of the Corporation, including independent contractor providers of services and materials. The Corporation's management has the affirmative obligation to publicize periodically this policy to all parties. All persons whom the policy applies must promptly disclose all real and apparent conflicts which they discover or have brought to their attention to the appropriate persons in the form of a written description of the facts comprising the real and apparent conflict. An annual disclosure statement must be circulated to all persons to whom this policy applies to assist them in considering such disclosures, but disclosure is appropriate whenever conflicts arise. The written disclosure notices of conflicts must be filed annually with the President of the Corporation or any other persons designated by her from time to time to receive such notifications. All disclosure notices received will be noted for record in the minutes of the meeting of the Board of Directors. When an individual Director, officer, agent or employee believes that he or a member of his immediate family might have or does have a real or apparent conflict, he should in addition to filing the disclosure notice, abstain from making motions, voting, executing agreements, or taking any other similar direct action on behalf of the Corporation where the conflict might pertain. When any person requests in writing, or upon its own initiative, the Board at any time may establish further guidelines consistent with the interests of the Corporation for the resolution of any real or apparent conflicts. Part VI Part VI, Lines 15a & 15b - Offices & Positions for Which Process was Used, & Year Process was Begun BayCare Alliant Hospital, Inc. uses nationally recognized compensation consultants every two years to assist in the review of compensation of employees in leadership positions. Compensation consultants provide a review of the leadership positions at Alliant Hospital to determine if compensation is reasonable when compared against market standards. The hospital utilizes a compensation committee to further examine the results provided by the compensation consultants. The hospital also utilizes an annual manager marker study and a semi-annual non-management market study to determine if all other positions are congruous with market standards. The review was completed in 2011. Part VI, Line 19 - Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public BayCare Alliant Hospital, Inc. publishes its financial statements with the Agency for Health Care Administration. Governing documents and policies are not available for public inspection. Part XI, Line 5 Other Changes in Net Assets Other ($1) Total ($1)