2011-08-11T11:37:36-07:00 2010-09-30 990 2009-10-01 590747311 SOUTHERN BAPTIST HOSPITAL OF FLORIDA INC SOUT 9042021797 3563 Philips Hwy Bldg A Ste 106 Attn Mike Lee Jacksonville FL 322075663 Michael Lukaszewski 9042022852 2011-08-11 2009 2016-02-24 21:20:13Z Baptist Medical Center & Baptist Medical Ctr South A Hugh Greene 800 Prudential Dr Jacksonville FL 32207 883076158 0 X e-baptisthealth.com X 1965 FL Continue the healing ministry of Christ by providing accessible, quality healthcare services at a reasonable cost in an atmosphere that fosters respect and compassion. 15 10 6936 335 530148 0 2018494 3129600 780873496 821586877 12275662 45220411 10137914 12461943 805305566 882398831 1317077 2568148 0 0 311570482 339343947 0 0 0 393384394 395195926 706271953 737108021 99033613 145290810 1165109357 1343254200 692696895 766731065 472412462 576523135 Continue the healing ministry of Christ by providing accessible, quality healthcare services at a reasonable cost in an atmosphere that fosters respect and compassion. 0 0 690946095 1614633 821507862 Health Care Delivery and Management: Southern Baptist Hospital of Florida, Inc. (SBHF) is comprised of Baptist Medical Center Downtown (BMC) and Baptist Medical Center South (BMCS), affiliated, licensed hospitals of Baptist Health System, Inc (BHS). BMC is a full-service hospital in downtown Jacksonville representing nearly all major specialties with 619 adult and children beds, and 43 nursery beds. This flagship campus is also home to Baptist Heart Hospital, offering comprehensive, high-quality cardiovascular care. Consistently rated Jacksonville's "Most Preferred Healthcare Provider" by consumers in the annual National Research Corporation survey, Baptist recently was named one of the 100 Best Places to Work in Healthcare in the U.S. by Modern Healthcare magazine. For 2009-10, BMC was named among U.S. News & World Reports "Best Hospitals 2009-10" and among the top 50 in the country for neurology and neurosurgery. BMC includes Wolfson Children's Hospital (WCH). WCH was named among the top three children's hospitals in Florida by Child magazine for 2007. WCH nurses and staff work collaboratively with pediatric physicians from Nemours Children's Clinic, the University of Florida College of Medicine at Jacksonville, Brooks Rehabilitation, Mayo Clinic and the Northeast Florida Pediatric Society. These partnerships provide our patients with access to physicians in every specialty of children's medicine. WCH also serves as the main teaching facility for the University of Florida/Jacksonville Pediatric Residency Training Program. BMCS is a full-service health care facility with 192 beds -- more than double its size when it opened in 2005 with 92 beds, including 22 maternity, 16 intensive care units (ICU) and an 18-bed Day Stay. BMCS offers vital services such as radiology, surgery, emergency, oncology, sleep lab and many more. The four licensed hospitals controlled by Baptist Health System, Inc., including Southern Baptist Hospital of Florida, Inc., were designated as a Magnet health system organization in December, 2007 for its excellence in nursing and patient care. For fiscal year 2010, SBHF had 38,023 admissions accounting for 200,943 patient days, 168,009 emergency room visits, 68,481 home health visits and 45,854 mental health visits. Uncompensated Care and Community Benefit: Southern Baptist Hospital of Florida, Inc. (SBHF) is an affiliate of Baptist Health System, Inc. (BHS). BHS is the region's only community-owned, faith-based health care system that is committed to improving the health of everyone in our community, regardless of their ability to pay. SBHF's primary focus is addressing unmet health needs, particularly among vulnerable populations who have limited health resources and access to health care. We envision a healthier community in which people have access to quality health care, health and wellness education, and resources to prevent disease and encourage healthy living. SBHF's community health efforts are guided by the Community Health Committee, which is comprised of selected BHS board members from across our health system. This committee provides strategic direction related to community health activities and ensures a focus on key community health priorities that align with SBHF's mission. A cornerstone of SBHF's commitment to the community is caring for the health of vulnerable, uninsured and underserved people among us. During the fiscal year ended September 30, 2010, SBHF provided the following uncompensated care and community benefit: (1) Charity care - $23.8 million, (2) Unreimbursed Medicaid Costs - $26.7 million, (3) Unreimbursed Medicare Costs - $19.6 million, (4) Specific Community Programs - $8.4 million, and (5) Unreimbursed Bad Debt Expenses, $2.1 million, for a total of $80.6 million of uncompensated care and community benefits. Many SBHF programs and services are operated at a financial loss (reimbursement from government payors is a fraction of the actual cost of providing care), but we continue to offer them because they address unmet, critical needs in the community. This is core to SBHF's mission and values. One example is our behavioral health program, which provides the area's only hospital-based continuum of mental health services for children and adults. In fiscal year 2010, there were 45,854 mental health visits to our outpatient, inpatient, and partial hospitalization programs. One of our guiding principles of community health is to partner with other local organizations to leverage our collective expertise and strengths for the benefit of the community's health. This collaborative approach helps ensure efficiency and avoids duplication of effort as we work together to improve the lives of area residents at every life stage and income level. Our community health priorities currently include: (1) increasing access to care for medically underserved people, (2) preventing and managing chronic diseases, especially in children, (3) mentoring disadvantaged adolescents and teens, and (4) helping seniors transition from the hospital to the home, and (5) enhancing the continuum of care and transition. Keeping these priorities in mind, during 2010 SBHF invested $8.443 million in specific community benefit programs. SBHF provides care, financial support, and volunteerism for the homeless, working poor and uninsured in the community. A few of the community programs highlights during 2010 included: (1) Eldercare Advocacy, through a partnership with United Way of Northeast Florida, reached nearly 700 seniors with 1,970 services, (2) New Town Health Project, a first-ever porch-to-porch health assessment in an urban area of Jacksonville, FL noted as having the area's highest mortality rate for heart disease and diabetes-related conditions, funded in partnership with Jessie Ball duPont Fund and the Health Planning Council of Northeast Florida, (3) Second Annual Autism Symposium, in partnership with the University of Florida/Jacksonville and Nemours Children's Clinic, Jacksonville, (4) Fuel Up to Play 60, a program designed to help curb and prevent childhood obesity by encouraging youth to be more physically active and eat nutritious foods, in partnership with the Jaguars Foundation and local schools, (5) Community Asthma Partnership at Wolfson Children's Hospital, a program that provided a free community asthma workshop, in partnership with the Duval County Health Department, (6) Student Vision Initiative, a program that partners with the local school system to provide free glasses to more than 100 students, and (7) Faith-Based Partnership Program works collaboratively with faith-based organizations located in communities of greatest need that desire to improve the health of their members, neighbors and community. Behaivoral Health Programs: Southern Baptist Hospital of Florida, Inc. (SBHF) is one of only two medical-surgical hospitals in Duval County that are Baker-Act receiving facilities and the only hospital that offers a continuum of behavioral health services. SBHF has a 34 bed adult impatient unit, adult intensive outpatient and emergency E.D. services, and a 24-hour crisis call center. SBHF's children's hospital, Wofson Children's Hospital, is the only hospital with a pediatric psychiatric unit and a behavioral day-stay program in the region. SBHF believes this is an essential service to our community even though these programs are operated at a financial loss. 0 0 0 n/a 0 0 0 n/a 0 0 0 690946095 1 1 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 1 326 0 6936 1 1 1 0 0 0 0 0 0 0 0 15 10 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X Scott Finnegan 9042023270 3563 Philips Hwy Bld A Ste 608 Jacksonville FL 32207 Robert E Hill Jr 2 X X 0 0 0 Charles E Hughes Jr 2 X X 0 0 0 A Hugh Greene 40 X X 1061640 0 312797 M C Harden III 2 X X 0 0 0 Charles C Baggs 2 X 0 0 0 Joe Louis Barrow Jr 2 X 0 0 0 Richard D Glock MD 2 X 0 0 0 Jack R Groover MD 2 X 0 0 0 Preston H Haskell 2 X 0 0 0 Barbara G Jaffe 2 X 0 0 0 William C Mason 2 X 8758 0 0 Christine R Milton 2 X 0 0 0 Richard L Sisisky 2 X 0 0 0 Carol C Thompson 2 X 1778 0 8964 John H Williams Jr 2 X 0 0 0 John F Wilbanks 40 X 597690 0 132026 Harvey Granger 40 X 479343 0 129232 Michael Lukaszewski 40 X 3798767 0 39987 Keith L Stein MD 40 X 587266 0 64929 Larry Freeman 40 X 265618 0 87006 Joseph M Mitrick 40 X 334236 0 60437 Ronald Robinson 40 X 280434 0 50760 Roland A Garcia 40 X 442010 0 59222 Jerry A Bridgham MD 40 X 330799 0 26346 Diane S Raines 40 X 277436 0 56800 Melanie J Husk 40 X 272037 0 38459 Donald D Pollock MD 40 X 249069 0 27097 8986881 0 1094062 154 0 1 0 University of Florida Jacksonville Physicians Inc PO Box 44008 Jacksonville FL 322314008 Physician specialty services for children's hospital 4935390 Nemours Children's Clinic 10140 Centurion Parkway N Jacksonville FL 32256 Physician and medical services for children's hospital 4162711 Haskell Company 111 Riverside Ave Jacksonville FL 32231 Construction services 3974158 University of Florida 580 W 8th St 5th Floor Jacksonville FL 32209 Pediatric physician residency program serving children's hospital 2695377 Sodexho Inc & Affiliates PO Box 536922 Atlanta GA 303536922 Management fees - cafeteria & environ services 2026969 26 0 0 0 2858759 0 270841 0 3129600 Net patient service revenues 622000 821056729 821056729 0 0 Partnership income related to program services 541900 79015 0 79015 0 Reference lab revenues 621500 451133 0 451133 0 0 0 0 0 821586877 45209016 0 0 45209016 0 0 0 0 0 0 0 0 2666998 0 677327 0 1989671 0 1989671 0 0 1989671 0 11395 0 0 0 11395 11395 0 0 11395 0 Restaurant revenues 722100 4327026 0 0 4327026 Reference lab 621500 1486568 0 0 1486568 Vending machines 722210 364237 0 0 364237 4294441 0 0 4294441 10472272 882398831 821056729 530148 57682354 2568148 2568148 0 0 0 0 0 0 10361093 0 10361093 0 0 0 0 0 226608330 216639526 9968804 0 18083625 16448551 1635074 0 65814213 62536665 3277548 0 18476686 16859976 1616710 0 10544817 5364148 5180669 0 608937 304469 304468 0 267065 267065 0 0 38138 0 38138 0 0 0 0 0 0 0 34509083 33270207 1238876 0 2171450 1085725 1085725 0 172107571 166135438 5972133 0 12957923 12508283 449640 0 1955 1955 0 0 18213627 17559758 653869 0 1459156 1211975 247181 0 0 0 0 0 603846 499320 104526 0 5613848 5419047 194801 0 0 0 0 0 46445820 44834150 1611670 0 6715508 6482480 233028 0 Provision for bad debts 58462243 58462243 0 0 Cost containment fees 11020756 11020756 0 0 Losses on bond interest rate swaps 11246198 10796350 449848 0 Dues and memberships 868265 0 868265 0 1339720 669860 669860 0 737108021 690946095 46161926 0 4083333 23416 0 4661359 0 0 119598588 128272063 0 0 0 0 0 0 10216833 12053607 7633402 12004718 1013062477 509885698 489314191 503176779 450964817 584382982 0 3108726 90046 0 0 80189467 98589230 1165109357 1343254200 90183232 77124274 0 0 0 0 428200237 470527416 0 0 0 0 0 0 0 0 174313426 219079375 692696895 766731065 X 451745307 551762519 12491679 16483038 8175476 8277578 472412462 576523135 1165109357 1343254200 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 51728 0 0 51728 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 During the fiscal year, Southern Baptist Hospital of Florida, Inc. (SBHF) paid $38,138 to an unrelated firm, BH & Associates, for State of Florida legislative and executive branch representation concerning hospital-related issues. SBHF also paid $13,590 to an unrelated firm, MWW Group, for legislative and advocacy representation concerning hospital-related services at the federal level. 12440512 133141 1230016 0 151191 0 13652478 13034648 187203 -241049 0 540290 0 12440512 0.226 0.606 0.168 0 1 1 0 17584054 17584054 0 524292294 201719963 322572331 0 0 0 0 0 404567269 303623368 100943901 0 66618860 4542367 62076493 503176779 Long-term investments 90046 F 90046 Interest in net assets of Baptist Health System Foundation, Inc. 25954216 Advances to affiliated organizations 55020951 All other assets 17614063 98589230 0 Pension liability 149705915 SERP liability 17845599 Bond swap market valuation 19844125 Hospital professional liability self-insurance trust 20847446 Estimated third-party settlements 7654400 Worker's compensation self-insurance trust 2655647 All other liabilities 526243 219079375 882398831 737108021 145290810 1231164 0 0 13533339 -55944640 -41180137 104110673 878426754 0 0 0 0 0 878426754 0 3972077 3972077 882398831 737785348 0 0 0 677327 677327 737108021 0 0 0 737108021 SchD_P05_S00_L04 Schedule D, Part V, Line 4 Southern Baptist Hospital of Florida, Inc. (SBHF) endowment funds are held by its related affiliate, Baptist Health System Foundation, Inc. (BHF). BHF's endowment policy allows annually that 5% of the combined endowment corpus and accumulated earnings become available for spending on capital projects of SBHF. SchD_P10_S00_L00 Schedule D, Part X In July 2006, ASC 740-10-50-15, Income Taxes: Unrecognized Tax Benefit Related Disclosures was issued. ASC 740-10-50-15 creates a single model to address uncertain income tax positions and clarifies the accounting for income taxes by prescribing a "more likely than not" minimum recognition threshold that a tax position is required to meet before being recognized in the financial statements. Under the requirements of ASC 740-10, tax-exempt organizations may be required to record an obligation as the result of a tax position they have historically taken on various tax exposure items. Prior to ASC 740-10, the determination of when to record a liability for a tax exposure was based on whether a liability was considered probable and reasonably estimable in accordance with ASC 450, Contingencies. On January 1, 2008, Southern Baptist Hospital of Florida, Inc. adopted ASC 740-10. The impact of the adoption of ASC 740-10 on these financial statements was not significant. SchD_P11_S00_L08 Schedule D, Part XI, Line 8 Unrestricted net assets: (1) Changes related to pension and executive compensation other than period costs, ($31,612,080) (2) Transfers to affiliated organizations, ($24,596,463), (3) Contributions for the purchase of property, plant & equipment, $1,044,115, (4) Net assets released from restriction used for purchase of property, plant & equipment, $1,063,428, (5) Contributions of ($4,378,563) from Baptist Health System Foundation, Inc., (6) Other changes ($56,533). Temporary restricted net assets: (1) Contributions, $4,438,594 (2) Releases from restrictions, ($1,949,240). Permanently restricted net assets: (1) Contributions, $102,102. SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Part VIII, Line 6b, Rental expenses of ($677,327) are reported as expenses, not a deduction from revenues, per the organization's audited financial statements. Contribution of $270,841 reported on Form 990, Part VIII, 1(f), but included in temporary restricted net assets and not revenue per audited financial statements. Contributions of $4,378,563 from Baptist Health System Foundation, Inc. reported on Form 990, Part VIII, Line 1(d), but included as a change in net assets on the audited financial statements. SchD_P13_S00_L02d Schedule D, Part XIII, Line 2d Part VIII, Line 6b, rental expenses, are included in expenses, not as a deduction from revenues, in the organization's audited financial statements. 1 1 X 1 X 1 X 1 1 1 0 1 1 23763405 0 23763405 0.035 26723752 0 26723752 0.0394 0 0 0 0.00 0 0 50487157 0 50487157 0.0744 0 0 1344498 0 1344498 0.002 2727888 2727888 0.004 8883924 7027534 1856390 0.0027 0 0 0.00 1614633 1614633 0.0024 0 0 14570943 7027534 7543409 0.0111 0 0 65058100 7027534 58030566 0.0855 0 2079607 0 177486020 197041795 -19555775 X 1 1 Baptist Medical Center

800 Prudential Dr Jacksonville FL 32207

X X X X X X Baptist Medical Center South

14550 Old St Augustine Rd Jacksonville FL 32258

X X X The organization uses a cost-to-charge ratio based on its cost accounting system. Southern Baptist Hospital of Florida, Inc. (SBHF) is one of only two Medical-Surgical hospitals in Duval County that are Baker Act receiving facilities and the only hospital that offers a continuum of Behavioral Health services. SBHF has a 34 bed adult inpatient unit, adult intensive outpatient and emergency E.D. services, and a 24-hour crisis call center. SBHF's children's hospital, Wolfson Children's Hospital, is the only hospital with a Pediatric Psychiatric unit and a Behavioral day-stay program in the region. SBHF believes that Behavioral Health is an essential service to its community even though these programs are operated at a financial loss. $58,462,243 was included in Form 990, Part IX, Line 25, column (A), but was not included in the percentage calculations for Schedule H, Part I, Line 7, column (f) per the Form 990, Schedule H instructions. The provision for bad debts is based upon management's assessments of historical and expected net collections considering business and economic conditions, trends in healthcare coverage and other collection indicators. Accounts receivable are written off after collection effort has been followed in accordance with the organization's policies. Accounts written off as uncollectible are deducted from the allowance for uncollectible patient accounts, and subsequent recoveries are added. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category. Bad debt expense at cost is determined by the organization's cost accounting system and cost-to-charge ratio. None of the bad debt expense at cost is included in Schedule H, Part I. Medicare allowable costs of care based on cost to charge ratio and cost accounting system of the organization. None of the shortfall reported in Line 7 is included in Schedule H, Part I. Yes, the organization does have a written debt collection policy. The policy does not specifically address those patients who are known to qualify for charity, or have applied for charity, as the organization does not bill these patients. The organization's cost accounting system identifies all patients who have a pending or approved charity application. The organization would only bill the patient if, after multiple attempts to obtain any needed documentation from the patient to complete the charity approval process, the patient was non-compliant. Part VI-Line 8 - Baptist Health System, Inc. (BHS), parent affiliate of Southern Baptist Hospital of Florida, Inc., and its related affiliates are all located within the Northeast Florida quadrant. An annual Community Benefit Report is published and available on the e-baptisthealth.com website. Baptist Health System, Inc. (BHS) is the parent affiliate of Southern Baptist Hospital of Florida, Inc. BHS uses a variety of sources to develop its assessment of community health needs. The organization has partnered with the Duval County Health Department in its regional health assessment (MAPP). BHS also performed, in conjunction with the Health Planning Council, a "porch-to-porch" assessment in the New Town subdivision of Health Zone 1. This zone represents the greatest number of health disparities for the region and the lowest social-economic indicators. The organization also relies on a number of statistical reports provided by the Duval County Health Department on a variety of health care needs in the community. BHS has a dedicated community health board that focuses solely on the health needs of the community. BHS is an organizing member of a committee comprised of several non-profit hospitals and other health care agencies that focus on health care needs. At every patient access point, "Guidelines for Charity Care Eligibility" cards are provided that contain financial discount and charity care information. This includes a general chart of eligible income levels and encourages patients to speak with one of our patient financial advocates to arrange a financial evaluation. Baptist Health System, Inc. (BHS), the parent affiliate of Southern Baptist Hospital of Florida, Inc., has four licensed hospitals that cover both urban and rural areas. BHS covers a five-county area of Northeast Florida including downtown Jacksonville. BHS focuses its community health initiatives on lower income areas that also have high health needs. Much of this is provided through the churches in the area as well as the school systems. There is a heightened emphasis on cardiovascular diseases and asthma. The focus is on the uninsured and underserved groups consisting primarily of African-Americans with a smaller percentage of Caucasian, Hispanic and Asian populations. All Baptist Health System, Inc. (BHS) affiliates, including Southern Baptist Hospital of Florida, Inc., maintain an open medical staff. BHS has a Community Health Board Committee that focuses on community health needs in the five-county area. BHS directly donates over a million dollars annually to several organizations that provide health care services to low income adults and families. Baptist is actively working to improve the health of our community, especially in our most vulnerable neighborhoods. Chief among these is Health Zone 1, the urban area of northwest Jacksonville noted as having the area's highest mortality rate for heart disease and diabetes-related conditions. We are actively collaborating with other community stakeholders and hospitals toward achievement of measurable improvements in the health and well-being of residents in this area, as well as others with a concentration of disproportionate unmet health needs. Southern Baptist Hospital of Florida, Inc., d/b/a Baptist Medical Center, is the largest hospital in the Baptist Health System and coordinates the majority of community health initiatives for the hospital system. However, each affiliate hospital is involved in health initiatives in their immediate community. These initiatives consist primarily of direct health care services to low income adults and families. 1 Nemours Children's Clinic Jacksonville 807 Childrens Way Jacksonville FL 32207 590634433 501(c)(3) 246000 0 Cash Donation to the Nemours pediatric services program for the benefit of the pediatric patients in the Jacksonville area community. Community Hospice of Northeast Florida Inc 4266 Sunbeam Rd Jacksonville FL 32257 591940256 501(c)(3) 138875 0 Cash Donation to support organization's pediatric palliative program. Baptist Health System Foundation Inc 841 Prudential Dr Ste 1300 Jacksonville FL 32207 592487135 501(c)(3) 120000 0 Cash Donation is to sponsor the "Tipping the Scale Adolescent Advocacy and Intervention Mentoring" program. The program was developed to help students stay in school through a holistic model that addresses academics, health, social enrichment, mentoring, job skills training and employment. We Care Jacksonville Inc 900 University Blvd N Ste 200-E Jacksonville FL 32211 593431724 501(c)(3) 105000 0 Cash Donation to support organization providing medical care to the non-insured, the homeless, and medically underserved people of Jacksonville. United Way of Northeast Florida Inc 1301 Riverplace Blvd Ste 400 Jacksonville FL 32207 590637825 501(c)(3) 100000 0 Cash Annual community donation to support organization's programs such as childhood success, helping students achieve, and programs for the elderly. Wolfson Children's Hospital 800 Prudential Dr Jacksonville FL 32207 590747311 501(c)(3) 76000 0 Cash Women's Board Children's Presenter sponsorship for 2009-2010 & 2010-2011 Florida Forum fundraiser and Autism symposium sponsorship. IM Sulzbacher Center for the Homeless Inc 611 E Adams St Jacksonville FL 32202 593229898 501(c)(3) 75000 0 Cash Donation to organization that provides shelter and food for the homeless of our community. Jax Jaguars Foundation One Stadium Place Jacksonville FL 32202 593249687 501(c)(3) 75000 0 Cash Youth Anti-obesity Partnership Jacksonville Sports Medicine Program Inc 1325 San Marco Blvd Ste 300 Jacksonville FL 32207 592997510 501(c)(3) 59000 0 Cash Donation to support the volunteer-based organization that is dedicated to the improvement and maintenance of the physical and mental well being of student athletes in Northeast Florida. Museum of Science & History 1025 Museum Circle Jacksonville FL 32207 590651090 501(c)(3) 50000 0 Cash Sponsorship of "The Human Body Exhibit". Duval County Health Dept 515 W Sixth St Jacksonville FL 32206 000000000 government organiz. 45102 0 Cash Fund nursing for New Town Project in medically underserved community of Jacksonville. Ronald McDonald House Charities of Jacksonville Inc 824 Childrens Way Jacksonville FL 32207 592625008 501(c)(3) 36000 0 Cash Annual contribution to support an organization whose mission is to create, find and support programs that directly improve the health and well being of children. Volunteers in Medicine Jax Inc 41 E Duval St Jacksonville FL 32202 753002172 501(c)(3) 30000 0 Cash Annual donation to support organization's volunteer-run medical clinic that provides free primary care medical services to the working uninsured. UNF Foundation Inc One UNF Drive Jacksonville FL 32224 237167701 501(c)(3) education 30000 0 Cash Annual donation to the university's "Health Leadership Institute" program. St Boniface Haiti Foundation 800 Prudential Dr Jacksonville FL 32207 000000000 25000 0 Cash Donation for Haitian families victimized by earthquake. American Heart Association Inc 1101 Northchase Pkwy Ste 1 Atlanta GA 30067 135613797 501(c)(3) 25000 0 Cash Donation to organization to support heart disease awareness and education. American Red Cross of Northeast Florida 751 Riverside Ave Jacksonville FL 32203 000000000 25000 0 Cash Haitian Relief Fund Managed Access to Child Health Inc 910 N Jefferson St Jacksonville FL 32209 593192240 501(c)(3) 25000 0 Cash Donation to support continuation of the "Medical Home for Homeless Children Project". The Bridge of NE Florida Inc 1824 Pearl St Jacksonville FL 32209 591406016 501(c)(3) 25000 0 Cash Donation to support organization's programs that provide counseling, mentoring and other services to adolescents in the community who are disadvantaged, with the goal of preparing them for a better way of life. Jacksonville Speech & Hearing Center Inc 1128 N Laura St Jacksonville FL 32206 590970718 501(c)(3) 20000 0 Cash Donation to community organization that provides speech evaluation and therapy and with hearing evaluation and therapy to people of all ages regardless of their ability to pay. ONEJAX Inc 1022 Park St Ste 302 Jacksonville FL 32204 202719059 501(c)(3) 17000 0 Cash Donation to organization that promotes respect and understanding among people of different religions, races, cultures and beliefs within our community. Youth Crisis Center Inc 3015 Parental Home Rd Jacksonville FL 32216 592176287 501(c)(3) 15000 0 Cash Donation to support the organization's mission of providing housing and skill training to foster children living in our community. Barnabus Center Inc 11 S 11th St Fernandina Beach FL 32034 592920275 501(c)(3) 15000 0 Cash Donation to support organization's programs in Nassau County that provides families in distress and in need with shelter, food and basic necessities. Mission House Inc 800 Shetter Ave Jacksonville Beach FL 32250 593376704 501(c)(3) 15000 0 Cash Donation to help fund the Mission House Clinic, which provides medical assistance to uninsured, disadvantaged individuals in the Jacksonville Beach, FL community and meals, clothing and help in securing stable employment, stable medical care and stable housing. The Brunell Family Foundation Inc 402 N 4th St Jacksonville Beach FL 32250 593484251 501(c)(3) 10000 0 Cash Donation to an organization that strives to improve the quality of life for children and families during a time of life-changing trauma through emotional, physical and financial support that improves the overall wellness and strength of the family or individual. World Affairs Council of Jacksonville Inc 3948 3rd St S Jacksonville Beach FL 32250 592522757 501(c)(3) 10000 0 Cash Donation to support organization whose mission is to promote understanding of the world and its people and to engage citizens of Northeast Florida in becoming better informed participants in the global community. Great 100 Nurses of Northeast Florida Inc 3832 10 Baymeadows Rd 336 Jacksonville FL 32217 542076888 501(c)(3) 10000 0 Cash Donation to sponsor organization's Celebration and Nursing Scholarship Program. Health Planning Council of NE Florida Inc 644 Cesery Blvd Ste 210 Jacksonville FL 32211 592247189 501(c)(3) 10000 0 Cash Donation to organization that provides four core services: health planning and research, community organizing, health promotion and non-profit and coalition support. Interchurch Coalition for Action Reconciliation and Empowerment Inc 2650 Park St Jacksonville FL 32204 593332540 501(c)(3) 8000 0 Cash Donation to support organization's mission to address neighborhood and city-wide justice issues with programs such as drug rehabilitation and crime. Clay County Chamber of Commerce Inc 1734 Kingsley Ave Orange Park FL 32073 590549602 501(c)(3) 8000 0 Cash Donation to support economic development initiatives within Clay County, Florida. Paraguay Baptist Medical Center Foundation Inc 4101 W Green Oaks Blvd Ste 305 Arlington TX 76016 752816127 501(c)(3) 7500 0 Cash Donation to support organization whose mission includes supporting medical clinics in Paraguay. San Marco Preservation Society Inc 1468 Hendricks Ave Jacksonville FL 32207 591674207 501(c)(3) 7500 0 Cash Support organization in its promotion of appropriate future development that will be economically viable while preserving the historic character and quality of life in the San Marco community of Jacksonville. Micah's Place Inc PO Box 16287 Fernandina Beach FL 32035 593675485 501(c)(3) 6000 0 Cash Donation to support organization whose mission is to provide prevention and intervention services to victims of domestic violence and to provide education to the community to effect change in behavior and attitudes relating to domestic violence. Cystic Fibrosis Foundation Inc 8382 Baymeadows Rd Ste 9 Jacksonville FL 32256 131930701 501(c) medical 6000 0 Cash Support research and education of cystic fibrosis. 34 0 SchI_P01_S00_L02 Schedule I, Part I, Line 2 Our community health efforts are guided by the organization's Community Health Committee, comprised of selected Baptist Health System board members. The committee provides strategic direction related to our community health activities and ensures we focus on key priorities that align with our mission. X X X X 0 1 0 0 0 0 0 0 0 A Hugh Greene 705486 0 325000 0 31154 0 294876 0 17921 0 1374437 0 0 0 John F Wilbanks 416149 0 165964 0 15577 0 119121 0 12905 0 729716 0 0 0 Michael Lukaszewski 396129 0 133520 0 3269118 0 27154 0 12833 0 3838754 0 3151623 0 Harvey Granger 343476 0 120290 0 15577 0 111912 0 17320 0 608575 0 0 0 Keith L Stein MD 435615 0 139190 0 12461 0 52093 0 12836 0 652195 0 0 0 Larry Freeman 217233 0 38000 0 10385 0 75224 0 11782 0 352624 0 0 0 Joseph M Mitrick 273851 0 50000 0 10385 0 43231 0 17206 0 394673 0 0 0 Ronald Robinson 230434 0 40000 0 10000 0 34323 0 16437 0 331194 0 0 0 Roland A Garcia 316396 0 115230 0 10384 0 46546 0 12676 0 501232 0 0 0 Jerry A Bridgham MD 268415 0 52000 0 10384 0 9800 0 16546 0 357145 0 0 0 Diane S Raines 217051 0 50000 0 10385 0 40293 0 16507 0 334236 0 0 0 Melanie J Husk 220912 0 40740 0 10385 0 27228 0 11231 0 310496 0 0 0 Donald D Pollock MD 249069 0 0 0 0 0 20000 0 7097 0 276166 0 0 0 SchJ_P01_S00_L04 Schedule J, Part I, Line 4 Southern Baptist Hospital of Florida, Inc. has two active Supplemental Nonqualified Retirement Plans (SERPs). One is for certain executives (Supplemental Executive Retirement Plan) and the other is for certain vice-presidents (Supplemental Vice-President Executive Retirement Plan). These Serps are plans described in IRS Section 457(f). The benefits under these plans accrue during each executive's term of employment. These benefits are unvested and subject to forfeiture until the covered employee reaches retirement age. The following individuals accrued unvested benefits under these plans during 2009: A. Hugh Greene, $272,142, John F. Wilbanks, $100,597, Harvey Granger, $90,141, Keith L. Stein, $33,127, Larry Freeman, $48,997, Joseph M. Mitrick, $23,254 and Ronald G. Robinson, $16,616. These amounts were included in Schedule J, Part II, Column (c) for each of the listed individuals. During 2009, Michael Lukaszewski reached retirement age under the plan and his benefit of $2,856,831 (an amount accrued over his 22 years of service) vested. Because this vested amount became taxable upon Mr. Lukaszewski reaching retirement age, the plan distributed $1,033,344 to the IRS for associated income taxes and payroll taxes. The remainder wil be distributed on a monthly basis over Mr. Lukaszewski's life expectancy. In addition to the SERP plans, Southern Baptist Hospital of Florida, Inc. had an inactive 457(f) nonqualified elective deferred compensation plan that was terminated on January 30, 2009. As a result of this termination, the accumulated value of the previously deferred employee contributions became vested and were distibuted to participants. Amounts distributed included $396,711 to Michael Lukaszewski and $181 to Harvey Granger. These amounts were included on Schedule J, Part II, Line (B)(iii) for each individual. Jacksonville Health Facilities Authority Variable Rate Hospital Revenue Bonds Series 2003A 2003B 469404TS6 2003-06-01 125000000 Hospital capital improvements 0 0 Jacksonville Health Facilities Authority Variable Rate Hospital Revenue Bonds Series 2004 469404tv9 2004-11-01 50000000 Hospital capital improvements 0 0 Jacksonville Health Facilities Authority Hospital Revenue Bonds Series 2007A 469404TW7 2007-02-01 65000000 Hospital capital improvements 0 0 Jacksonville Health Facilities Authority Variable Rate Hospital Revenue Bonds Series 2007B 469404UL9 2007-02-01 35000000 Hospital capital improvements 0 0 Jacksonville Health Facilities Authority Variable Rate Hospital Refunding Bonds Series 2007CDE 469404UN5 2007-05-01 110935000 Refund Series 1997A bonds 0 0 125000000 0 0 0 320233 0 124679767 2003 0 0 1 1 50000000 0 0 0 181632 0 49818368 2004 0 0 1 1 65000000 0 0 0 298776 0 64701224 2007 0 0 1 1 35000000 0 0 0 80352 0 34919648 2007 0 0 1 1 110935000 0 0 0 234528 110700472 0 2007 0 1 1 1 0 0 0 0 1 0.00 0.00 0.00 1 0 0 0 0 1 0.00 0.00 0.00 1 0 0 0 0 1 0.00 0.00 0.00 1 0 0 0 0 1 0.00 0.00 0.00 1 0 0 0 0 1 0.00 0.00 0.00 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 UBS and Wells Fargo 16.1 0 0 0 Jacksonville Health Facilities Authority Variable Rate Hospital Revenue Notes Series 2009 469404UM7 2009-09-01 30000000 Hospital capital improvements 0 0 Jacksonville Health Facilities Authority Hospital Revenue Extendable Notes Series 2010ABC 2010-06-01 54000000 Hospital capital improvements 0 0 30000000 0 0 0 92060 0 29907940 2009 0 0 1 1 54000000 0 0 0 223952 0 53776048 2010 0 0 1 1 0 0 0 0 1 0.00 0.00 0.00 1 0 0 0 0 1 0.00 0.00 0.00 1 0 1 0 0 0 0 0 1 0 0 0 0 Haskell Company Director 3974158 Construction services 0 Harden & Associates Inc EBD Director 726287 Employee benefit insurance 0 Harden & Associates Inc Director 129700 Insurance consulting fees 0 Cheryl J Million Employee 65889 Family member of director 0 Phillip G Cottrell Employee 50948 Family member of director 0 Blair Sherman Employee 43756 Family member of director 0 F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 The organization has a sole corporate member, Baptist Health System, Inc., whose Board of Directors elects the members of the organization's governing body. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a The Board of Directors of Baptist Health System, Inc., the sole corporate member of the organization, elects the members of the governing body of the organization. F990_P06_S0B_L11 Form 990, Part VI, Section B, Line 11 11a. While the organization's governing body did not review the Form 990, the Executive Committee of the Board of Directors of Baptist Health System, Inc., the sole corporate member of the organization, reviewed the organization's Form 990 prior to its filing. The Executive Committee of the Board of Baptist Health System, Inc., consists of seven (7) members of its Board of Directors and is authorized by its Bylaws to act on behalf of its Board of Directors. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The Board of the organization's sole member, Baptist Health System, Inc., has a Conflicts of Interest Committee which regularly reviews the required disclosures of potential conflicts of interest by the Directors and Officers of the organization and its affiliates and recommends any action to be taken with regard to such disclosures. In accordance with Conflicts of Interest Policy, during meetings of the organization's governing body, a Director who may have a conflict of interest is excused from discussion by the governing body about any transaction or matter that may have given rise to the Director's actual or potential conflict of interest. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 15a & 15b. In accordance with the Executive Compensation policy of Baptist Health System, Inc. (BHS), the organization's sole member, BHS's Compensation Committee (made up of independent Directors of BHS) engages annually a third party compensation consultant who provides a database composed of current data regarding compensation paid for each executive position by similarly situated tax exempt health systems in the country. These health systems are generally the same size as BHS, considering revenue and other appropriate indicators. The group of comparator companies that is derived on the above stated paramaters comprise the "Market". When the Committee meets with such consultant, the consultant provides to Committee members compensation target levels that are competitive with the Market. Generally, the median of the Market is targeted. The actual amount that health system executives receive as compensation may be higher or lower than the median, depending on the health system and the individual's performance. The objective is to have a strong link between the health system and individual's performance and executive compensation such that if the health system and the individual perform at an optimal level, his or her compensation is in the higher range of the Market. Conversely, if either health system or individual performance is below expectation, compensation may be in the lower range of the Market. The minutes of the annual Compensation Committee minutes are recorded by the Committee's compensation consultant and are approved promptly by the Chair of such Committee. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Upon receiving a request from anyone, the organization will supply a copy of its governing documents, Conflicts of Interest Policy, financial statements and its most recently filed Form 990. Copies of the organization's Audited Financial Statements are on file with Florida's Agency for Health Care Administration. Baptist Medical Center of the Beaches Inc 1350 13th Ave S Jacksonville Beach FL 32250 592980620 Hospital FL 501(c)(3) 3 Baptist Health System Inc Baptist Medical Center of Nassau Inc 1250 S 18th St Fernandina Beach FL 32034 593234721 Hospital FL 501(c)(3) 3 Baptist Health System Inc Baptist Health System Inc 800 Prudential Dr Jacksonville FL 32207 592487136 Management assistance to health system FL 501(c)(3) 11a N/A Baptist Health System Foundation Inc 841 Prudential Dr Aetna Bld 13th Flr Jacksonville FL 32207 592487135 Fundraising for health system FL 501(c)(3) 7 Baptist Health System Inc Baptist Health Properties Inc 3563 Philips Hwy Bld A Ste 106 Jacksonville FL 32207 592487133 Manage property for health system FL 501(c)(3) 11a Baptist Health System Inc Baptist Health Ambulatory Services Inc 3563 Philips Hwy Bld A Ste 106 Jacksonville FL 32207 593410739 Cancer education & research for health system FL 501(c)(30 11a Baptist Health System Inc Pav Assoc Ltd 3563 Philips Hwy Bld A Ste 106 Jacksonville FL 32207 592505491 Property management FL Southern Baptist Hospital of Florida Inc Related 966167 8935521 0 0 0 Pavilion Health Services Inc 3563 Philips Hwy Bld A Ste 106 Jacksonville FL 32207 592059710 Physician practices/retail pharmacies FL N/A C 0 1 1 0 0 0 0 0 1 1 0 1 1 1 1 1 0 0 Baptist Health System Foundation Inc c 2858759 Baptist Health System Foundation Inc b 120000