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High Plains Baptist Health Foundation: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
High Plains Baptist Health Foundation (EIN 75-0800669)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201133189349304863
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-14T13:48:34-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1401 CONGRESS SUITE 1800AddressLine1
CityAUSTINCity
StateTXState
ZIP Code78701ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN750800669EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Baptist St Anthony's Hospital CorporationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBAPTNameControl
Phone8062122000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13310 DANVERSAddressLine1
CityAMARILLOCity
StateTXState
ZIP Code79106ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBrian PruittName
Titlevp/cfoTitle
Date Signed2011-11-04DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone5124789881Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROBERT WILLIAMSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11600 WALLACE BLVDAddressLine1
CityAMARILLOCity
StateTXState
ZIP Code79106ZIPCode
FieldValueIRS element (for citing)
Gross Receipts313188899GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BSAHS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionPROVIDE QUALITY HEALTHCARE IN CHRISTIAN LOVE, SERVICE AND DIGNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees2759TotalNbrEmployees
Total Nbr Volunteers85TotalNbrVolunteers
Total Gross UBI1415667TotalGrossUBI
Contributions Grants Prior Year920730ContributionsGrantsPriorYear
Contributions Grants Current Year39909ContributionsGrantsCurrentYear
Program Service Revenue Prior Year307040207ProgramServiceRevenuePriorYear
Program Service Revenue CY288719552ProgramServiceRevenueCY
Investment Income Prior Year-11178290InvestmentIncomePriorYear
Investment Income Current Year15839698InvestmentIncomeCurrentYear
Other Revenue Prior Year755055OtherRevenuePriorYear
Other Revenue Current Year773077OtherRevenueCurrentYear
Total Revenue Prior Year297537702TotalRevenuePriorYear
Total Revenue Current Year305372236TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year163211GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY131212GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year135234624SalariesEtcPriorYear
Salaries Etc Current Year108874228SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year280477TotalFundrsngExpCurrentYear
Other Expense Prior Year166832901OtherExpensePriorYear
Other Expenses Current Year150483494OtherExpensesCurrentYear
Total Expenses Prior Year302230736TotalExpensesPriorYear
Total Expenses Current Year259488934TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-4693034RevenuesLessExpensesPriorYear
Revenues Less Expenses CY45883302RevenuesLessExpensesCY
Total Assets BOY424905967TotalAssetsBOY
Total Assets EOY476712976TotalAssetsEOY
Total Liabilities BOY137973952TotalLiabilitiesBOY
Total Liabilities EOY137631216TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY286932015NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY339081760NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionProvide quality healthcare in Christian love, service and dignity.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense118410202Expense
Grants0Grants
Revenue175372652Revenue
DescriptionBSA provided inpatient services to 22,453 patients. Inpatient services include, but are not limited to: coronary care, inpatient surgical services, rehab and hospice.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense56767622Expense
Revenue93444967Revenue
DescriptionBSA provided outpatient services to 157,074 patients. Outpatient services include, but are not limited to: operating room, recovery room, anesthesia, gastroenterology and day surgery, hospice home care and physical therapy.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense11323479Expense
Revenue8957212Revenue
DescriptionBSA Emergency department provided treatment to 52,792 patients. The Emergency department is open 24 hours a day, 7 days a week. Patients are treated without regard for ability to pay. The average number of patients seen each day in the Emergency department is 149.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp15030365TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev10944721TotalOfOtherProgramServiceRev
Total Program Service Expense201531668TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvesttrueReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedfalseFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096208NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2759NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJAMES TAYLORNamePerson
Telephone Number8062126281TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13310 DANVERSAddressLine1
CityAMARILLOCity
StateTXState
ZIP Code79106ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
ROBERT WILLIAMS
CEO22.0XX084325521045
BELINDA GIBSON
VP PATIENT SERVICES38.0XX058888117910
BRIAN WALTON
VP FINANCE30.0XX0121792370
MICHAEL CRUZ
VP OPERATIONS II30.0XX056613313589
JOHN NEILSON
VP MEDICAL STAFF REL30.0XX037800724004
ELIZABETH PULLIAM
VP FINANCE thru 5/25/1030.0XX05158638239
LORI W HENKE
DIRECTOR - PHARMACY40.016877508227X
KIMBERLY R GALLOP
NURSE PRACTIONER40.0133935016141X
CATHY L COCHRAN
MGR, PHARMACY40.013816208999X
BRIGITTE A GRISSOM
NURSE PRACTIONER40.014487509917X
JAMES G MARTIN
PHARMACIST40.0137535013801X
STEPHANIE A NOGGLER
MANAGER PHARMACY40.013583611332X
JOHN D HICKS
FORMER CEO97500000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1834118TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3013931TotalReportableCompFrmRltdOrgs
Total Other Compensation153574TotalOtherCompensation
Number Individuals GT100 K44NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SIEMENS HEALTH SERVICES
PO BOX 12001 DEPT 0733DALLASTX753120733IT Services5373192
AMARILLO ANESTHESIA CONSULTANTS
PO BOX 50667AMARILLOTX79159Consulting Services3314248
TEXAS TECH UNIVERSITY HS
1400 WALLACE BLVDAMARILLOTX79106Residency Program1502341
AMARILLO EMERGENCY PHYSICIANS
PO BOX 50405AMARILLOTX79159ER Physicians1490192
XEROX CORPORATION
PO BOX 7405PASADENACA91109Document Services1829002
FieldValueIRS element (for citing)
Number Of Contractors GT100 K48NumberOfContractorsGT100K
Related Organizations36559RelatedOrganizations
All Other Contributions3350AllOtherContributions
Total Contributions39909TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
INPATIENT REVENUE621990178139598178139598
OUTPATIENT REVENUE6219909963518499635184
MEDICARE COST RECOVERY/3RD PARTY STLMNT62199034456153445615
MGT FEES FROM PANHANDLE SURGICAL561000850448850448
All other program service revenue62199066487075679413969294
FieldValueIRS element (for citing)
Total Program Service Revenue288719552TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column13450594TotalRevenueColumn
Exclusion$13,450,594ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities8573871Securities
Other1306400Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities7384541Securities
Other106626Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1189330Securities
Other1199774Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2389104TotalRevenueColumn
Exclusion$2,389,104ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory634429GrossSalesOfInventory
Cost Of Goods Sold325496CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column308933TotalRevenueColumn
Exclusion$308,933ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Telecommunication517000115349115349
Housekeeping/Linen561499187181169410$17,771
Print Shop5614399459394593

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column67021TotalRevenueColumn
Unrelated Business Revenue67021UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue464144TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column305372236TotalRevenueColumn
Related Or Exempt Function Income287750258RelatedOrExemptFunctionIncome
Unrelated Business Revenue1415667UnrelatedBusinessRevenue
Exclusion$16,166,402ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total131212Total
Program Services131212ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total177002Total
Management And General177002ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total90965705Total
Program Services71353657ProgramServices
Management And General19386958ManagementAndGeneral
Fundraising225090Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3051279Total
Program Services2395437ProgramServices
Management And General648285ManagementAndGeneral
Fundraising7557Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7683414Total
Program Services5440581ProgramServices
Management And General2232086ManagementAndGeneral
Fundraising10747Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6996828Total
Program Services5412632ProgramServices
Management And General1568494ManagementAndGeneral
Fundraising15702Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total28575080Total
Program Services20093230ProgramServices
Management And General8479109ManagementAndGeneral
Fundraising2741Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total4807Total
Program Services1754ProgramServices
Management And General3053ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total73095516Total
Program Services61807340ProgramServices
Management And General11271070ManagementAndGeneral
Fundraising17106Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total12137590Total
Program Services9274167ProgramServices
Management And General2863423ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2775577Total
Program Services1201387ProgramServices
Management And General1574190ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total310258Total
Program Services226156ProgramServices
Management And General83709ManagementAndGeneral
Fundraising393Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total4738276Total
Program Services4548745ProgramServices
Management And General189531ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total19559488Total
Program Services14690165ProgramServices
Management And General4869323ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1185585Total
Management And General1185585ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBT45507114550711
REPAIRS & MAINTENANCE18842153900711494144
COLLECTION AGENCY13117161311716
ALL OTHER EXPENSES354675144233391111141

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total259488934Total
Program Services201531668ProgramServices
Management And General57676789ManagementAndGeneral
Fundraising280477Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5827BOY
EOY12746EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY21931160BOY
EOY30043248EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY32481421BOY
EOY29278053EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4045595BOY
EOY3937463EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4446193BOY
EOY4890656EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis428344436LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec263960911LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY172706216BOY
EOY164383525EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY83638376BOY
EOY109701366EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY1000EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY24971445BOY
EOY27185938EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY80679734BOY
EOY107278981EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY424905967BOY
EOY476712976EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY28410024BOY
EOY34392150EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY94285000BOY
EOY90460000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1029177BOY
EOY1099835EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY14249751BOY
EOY11679231EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY137973952BOY
EOY137631216EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY286924762BOY
EOY339074507EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7253BOY
EOY7253EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY286932015BOY
EOY339081760EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY424905967BOY
EOY476712976EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses45883302ReconcilationRevenueExpenses
Reconcilation Other Changes6266443ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance7253BeginningOfYearBalance
End Of Year Balance7253EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance-9450BeginningOfYearBalance
Contributions33407Contributions
Other Expenditures16704OtherExpenditures
End Of Year Balance7253EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance13568BeginningOfYearBalance
Administrative Expenses23018AdministrativeExpenses
End Of Year Balance-9450EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3366769OtherCostOrOtherBasis
Book Value3366769BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis202906024OtherCostOrOtherBasis
Depreciation82079345Depreciation
Book Value120826680BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis3256465OtherCostOrOtherBasis
Depreciation3124852Depreciation
Book Value131612BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis212536399OtherCostOrOtherBasis
Depreciation178756714Depreciation
Book Value33779685BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6278779OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value6278779BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings164383525TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionINV. IN PANHANDLE SURG HOSPDescription
Book Value27185938BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related27185938TotalOfBookValueProgramRelated

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
Other accounts receivable692366
DUE TO/FROM AFFILIATES106586615
FieldValueIRS element (for citing)
Total Book Value Other Assets107278981TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Reserve-retirement liability$150,000
Asbestos retirement obligation$2,070,518
EST PAYABLE FOR SELF INS CLAIMS$9,458,713
FieldValueIRS element (for citing)
Total Of Amounts11679231TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierIntended Use of Endowment FundsIdentifier
Return ReferenceFORM 990, SCHEDULE D, PART VReturnReference
ExplanationFunds are used to provide assistance to employees desiring to complete a GED program. FIN 48 FOOTNOTE FORM 990, SCHEDULE D, PART X, LINE 2 BAPTIST ST. ANTHONY'S HEALTH SYSTEM AND AFFILIATES HAS BEEN AUDITED ON A CONSOLIDATED BASIS IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES FOR THE YEAR ENDED DECEMBER 31, 2010. IN JULY 2006, THE FASB ISSUED GUIDANCE REGARDING ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH REQUIRES THAT THE TAXABLE SUBSIDIARIES OF THE SYSTEM RECOGNIZE IN THEIR FINANCIAL STATEMENTS THE EFFECT OF A TAX POSITION IF THAT TAX POSITION IS MORE LIKELY THAN NOT OF BEING SUSTAINED ON AUDIT, BASED UPON THE TECHNICAL MERITS OF THE TAX POSITION. THE SYSTEM HAS ADOPTED ASC 740-10 AS OF THE REQUIRED EFFECTIVE DATE, BUT THE ADOPTION OF THIS GUIDANCE DID NOT HAVE A SIGNIFICANT IMPACT ON THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS, NOR DOES THE SYSTEM CURRENTLY HAVE ANY POSITIONS RESERVED.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense23903057TotalCommunityBenefitExpense
Direct Offsetting Revenue2210252DirectOffsettingRevenue
Net Community Benefit Expense21692805NetCommunityBenefitExpense
Percent Of Total Expense0.07850PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense15171933TotalCommunityBenefitExpense
Direct Offsetting Revenue14013206DirectOffsettingRevenue
Net Community Benefit Expense1158727NetCommunityBenefitExpense
Percent Of Total Expense0.00420PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense252218TotalCommunityBenefitExpense
Direct Offsetting Revenue139651DirectOffsettingRevenue
Net Community Benefit Expense112567NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense39327208TotalCommunityBenefitExpense
Direct Offsetting Revenue16363109DirectOffsettingRevenue
Net Community Benefit Expense22964099NetCommunityBenefitExpense
Percent Of Total Expense0.08310PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense81447TotalCommunityBenefitExpense
Net Community Benefit Expense81447NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense1709148TotalCommunityBenefitExpense
Direct Offsetting Revenue386025DirectOffsettingRevenue
Net Community Benefit Expense1323123NetCommunityBenefitExpense
Percent Of Total Expense0.00480PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense126062943TotalCommunityBenefitExpense
Direct Offsetting Revenue87512978DirectOffsettingRevenue
Net Community Benefit Expense38549965NetCommunityBenefitExpense
Percent Of Total Expense0.13950PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense236169TotalCommunityBenefitExpense
Net Community Benefit Expense236169NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense128089707TotalCommunityBenefitExpense
Direct Offsetting Revenue87899003DirectOffsettingRevenue
Net Community Benefit Expense40190704NetCommunityBenefitExpense
Percent Of Total Expense0.14550PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense167416915TotalCommunityBenefitExpense
Direct Offsetting Revenue104262112DirectOffsettingRevenue
Net Community Benefit Expense63154803NetCommunityBenefitExpense
Percent Of Total Expense0.22860PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served343PersonsServed
Total Community Building Expense45900TotalCommunityBuildingExpense
Net Community Building Expense45900NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served2PersonsServed
Total Community Building Expense7200TotalCommunityBuildingExpense
Net Community Building Expense7200NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served6700PersonsServed
Total Community Building Expense18894TotalCommunityBuildingExpense
Net Community Building Expense18894NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served7045PersonsServed
Total Community Building Expense71994TotalCommunityBuildingExpense
Net Community Building Expense71994NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$4,550,711BadDebtExpenseAmount
Amount Reimbursed By Medicare97119358AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare111199605CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-14080247MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (4 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
Phy Surg Hosp LLC
ambulatory surgical hospital0.510000.49000
Amarillo Surg & End
GI surgery/endoscopy center0.510000.49000
Adv Img Ctr Amarillo
diagnostic imaging center0.510000.49000
panhandle nuclear rx
wholesale nuclear phar prodts0.666700.33300
FieldValueIRS element (for citing)
Number Of Hospital Facilities4NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (4 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursEr OtherErOtherOtherOther
BAPTIST-ST ANTHONY'S HOSPITAL
11600 WALLACE BOULEVARDAMARILLOTX79106XXXX
Physician's Surgical Hospital-Panhandle
27100 W 9th AvenueAmarilloTX79106XXX
Physician's Surgical Hospital-Quail Crk
36819 Plum Creek DriveAmarilloTX79124XXX
ADC Endoscopy Specialist
41 Care CircleAmarilloTX79124Ambulatory Surgical Center

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (4 entries)

Hospital Facility NumberHospitalFacilityNumber
BAPTIST-ST ANTHONY'S HOSPITAL
1
Physician's Surgical Hospital-Panhandle
2
Physician's Surgical Hospital-Quail Crk
3
ADC Endoscopy Specialist
4

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
IdentifierCosting Methodology for Bad DebtsIdentifier
Return ReferencePart I, Line 7ReturnReference
ExplanationThe organization has used 2010 audited financial statements and the cost-to-charge ratio methodology provided for in optional Worksheet A - Estimated Bad Debt Expense (at Cost). At the end of 2010, the organization estimated the amount of bad debt expense that could reasonably be attributable to patients who likely would qualify for financial assistance under the hospital's charity care policy. As a result, a reclassifying entry was made from bad debt expense to recognize this amount appropriately as charity. Consequently, a zero amount is being reported in Part III, Section A, Line 3. BAD DEBT EXPENSE Schedule H, Part I, Line 7(f) The bad debt expense included on Form 990, Part IX, line 25 but subtracted for purposes of calculating the percentages in Sch H, Part I, Line 7(f) was $4,550,711. Audited Financial Statement Footnote Part III, Line 4 Patient Accounts Receivable Patient accounts receivable consist of the following at December 31 (in thousands): 2010 Patient accounts, net of contractual allowances - $47,187 Less allowance for bad debts - $(4,719) Total - $42,468 2009 Patient accounts, net of contractual allowances - $68,387 Less allowance for bad debts - $(11,819) Total - $42,922 The System maintains allowances for uncollectible accounts for estimated losses resulting from a payor's inability to make payments on accounts. The System uses an income statement approach to value the allowance account based on historical write-offs, cash collections, and the aging of the accounts. Accounts are written off when collection efforts have been exhausted. Management continually monitors and adjusts its allowances associated with its receivables. PART III, LINE 8 METHODOLOGY USED TO DETERMINE MEDICARE ALLOWABLE COSTS The costing methodology is the structure built into the CMS 2552-96, transmittals 23-25. Costs are grouped from the general ledger and classified in the appropriate cost center as allowable or non-reimbursable. Then adjustments are made on w/s A8 for reductions to allowable costs due to income offsetting revenues or costs identified as non reimbursable per CMS regulations. Additionally, costs are reclassified on W/S A6 for proper matching of costs and revenues or nature of the expense incurred. Next, the overhead costs are allocated to the direct and non-reimbursable expenses based on appropriate CMS allocation techniques and statistical bases. The total cost related to the Medicare revenue is taken from the following areas. The accommodation or routine portion of costs is taken from CMS 2552-96 D-1 line 37 for the appropriate Title XVIII provider or sub-provider. Cost for I/P ancillary service are taken from D-4 line 102, column 3. Costs for O/P ancillary services are taken from DV line 102, column 9. Subsidized care services are claimed as a community benefit for the following reason. These services exclude Medicaid and charity services already reported separately. These services are regarded as a community benefits because they are vital to the community in the case of Neonatal, and Obstetrical services furnished at a negative margin by Baptist St Anthonys. Also other health services are provided to older patients with complications and complex health problems. These services are also necessary for public health and could not be fully provided by other resources available in the community if they were not providers by Baptist St Anthonys. Part III, line 9B The following is an excerpt from the Bad Debt Policy. It refers collectors to the Charity Policy once it is identified that a patient may qualify. The charity policy/procedure is followed from there. When reviewing accounts as potential bad debt, the collection and reviewing personnel should always look for signs that the account might qualify for charity. Such signs may include prior charity, a large dollar amount owed to BSA, employment status, marital status, and any combination of these or other factors that may become evident while working the account. In cases where a patient cannot or will not provide sufficient information to fully document eligibility for Charity Care, a presumption of eligibility may be made based on statistical data and other reliable assumptions so long as those assumptions are properly documented. Presumptive Charity and/or Financial Aid will be applied after all normal collection activities have been exhausted and before accounts are sent to an external collection agency. This may include one or more of the following situations: *Collections and Payment Prediction and Charity Eligibility based on MedeAnalytics *Insurance coverage is no longer in effect.3) Patient cannot be located through collection attempts, is unemployed and uninsured. *Patient is unresponsive to collection attempts, is unemployed, uninsured, no credit information available. *Patient resided in a shelter or indicates they are homeless with no income or assets to validate. *Patient is not able to provide income information. *Patient is deceased and there is no estate. *Patient residence is in an area of high poverty. Once a determination of eligibility for Charity Care under Financial or Medical Indigence is made, no further collection efforts shall be pursued for the amount applied toward Charity Care. All patients approved will either be classified as financially indigent, medically indigent, or qualified for financial discount. Patient Education of Eligibility For Assistance: BSA employs the services of Medical Advocacy Services for Healthcare, Inc. (MASH) to screen patients for assistance under federal and state programs, including Medicaid, SSI Medicaid and RSDI Medicare Disability, and Victims of Violent Crime Assistance. MASH screens all uninsured inpatients and outpatient and ER accounts over $500. Inpatients are contacted by personal visit while they are in the hospital. The MASH advocate works with the patient and/or family members to gather the required information and begin the application process. For outpatients and ER patients, MASH contacts them via telephone and/or locating letters with number of attempts varying based on the total charges on the account. In addition, BSA offers Charity Care and Financial Assistance. Patients are made aware of the assistance availability in multiple ways: *At the point of pre-registration for scheduled services when the patient indicates an inability to pay *At the point of registration for unscheduled services, *By Business Office staff post discharge *BSA employs 2 FTE who serve as Financial Counselors who work with patients in person, telephonically and by written correspondence. *BSAs patient statements indicate that Financial Assistance is available and provide a phone number to call if the patient is in need. *BSAs Financial Assistance Policy is published on the BSA website *All accounts with a patient balance that is not paid by the time the scheduled statements have been sent receive up to two automated phone calls. The automated message notifies patients at that time that financial assistance is available and gives the patient/guarantor the option of indicating that they would like for someone to contact them to discuss this option. Community Information: The community served by Baptist-Saint Anthonys Hospital includes the City of Amarillo as well as the Texas Panhandle and surrounding states. Amarillo is located near the middle of the Texas Panhandle comprised of the upper 26 counties of the State of Texas. The hospitals service area extends to the bordering states of Oklahoma and New Mexico as well as Kansas and Colorado which are also within close proximity. The population of the City of Amarillo is approximately 200,000, and the scope of the Texas Panhandle increases that population to over 400,000. Approximately 11% of Amarillos population reports income below the poverty line, with approximately 89% reporting above that line. Occupation classification reports indicate that 24% are Blue Collar, 57.9% are White Collar and 18.1% are employed in Service or Farm industries. Community Building Activities: The culture at BSA is to focus all of our creativity and efforts toward the well-being of our patients. At the same time, we also appreciate our position in our community as the community hospital. Our staff members are encouraged to serve on various boards that make our community grow and flourish. We also encourage and accommodate those employees who may not want to serve on an actual board, but who want to actively participate in the many functions that raise funds and awareness about these organizations. An example is one of our employees who serves as a mentor for local high school students throughout the school year. This is done during regular work hours at the expense of BSA. We receive numerous requests each year for financial support of these organizations and try to be wise stewards of our funds and donate to organizations that will make a great impact on our community. An example of this is theExplanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantAcademic ScholarshipTypeOfGrant
Number Of Recipients113NumberOfRecipients
Amount Of Cash Grant131212AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule IIdentifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationBaptist St. Anthony's Health System (BSA) offers academic and/or scholarship assistance to employees through the BSA Spirit Award Scholarship Program. The program provides Scholarship Assistance for the achievement of higher education and is designed to encourage development through education for positions within the hospital system. This benefit is subject to the availability of funds each year. Participation in the scholarship program requires a minimum of 3 months employment in good standing and recommendation by his/her director. In addition, scholarship recipients will provide proof of enrollment at an accredited college or university, maintain a 2.75 cumulative GPA, and commit to work at BSA for a designated amount of time upon completion of the degree. Scholarships are available for degree plans, approved by the Executive Team, to fill necessary vacancies and are subject to change. The number of credit hours enrolled determines scholarship amount awarded. The funds may not completely cover all expenses. The recipient is responsible for paying his/her incurred expenses at the educational institution. Scholarship assistance may be subject to federal taxes and withholding based upon the operative internal revenue regulations in place at the time of payment. Any applicable taxes are the student's/employee's responsibility.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ROBERT WILLIAMS
05029740340281000136320741308643000178659
BELINDA GIBSON
03176510266557046730136320427806067910154027
MICHAEL CRUZ
02887700277363000121550143405797220160808
JOHN NEILSON
0293426070750013831013468010536040201100
KIMBERLY R GALLOP
127700012910494407002091390150076000
LORI W HENKE
167107016680008227000177002000
BRIGITTE A GRISSOM
14457802970006451034660154792000
JAMES G MARTIN
134619014060151007007067940151336000
ELIZABETH PULLIAM
017702200033884107369087005241020146293
JOHN D HICKS
000097500000000975000000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental Compensation InformationIdentifier
Return ReferenceSCHEDULE J, PART I, QUESTION 3ReturnReference
ExplanationCEO/Executive Directors compensation is determined by a related organization, BSA Health System. Therefore, the methods used to determine the CEO/Executive Directors compensation are identified on the BSA Health System 990. SCHEDULE J, PART I, Question 4A ELIZABETH PULLIAM (FORMER VP FINANCE) RECEIVED $332,498 OF SEVERANCE COMPENSATION. THIS AMOUNT IS INCLUDED IN REPORTABLE COMPENSATION. JOHN HICKS (FORMER CEO) RECEIVED $975,000 OF SEVERANCE COMPENSATION. THIS AMOUNT IS INCLUDED IN REPORTABLE COMPENSATION. SCHEDULE J, PART I, Question 4B IN ACCORDANCE WITH BSA'S RETIREMENT REPLACEMENT PLAN, WHICH WAS DESIGNED TO COMPLY WITH THE REQUIREMENTS OF SECTION 457(F) OF THE IRC TO PROVIDE DEFERRED COMPENSATION FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES, THE INDIVIDUALS LISTED BELOW RECEIVED THE FOLLOWING DURING THE TAX YEAR: *MICHAEL CRUZ 2010 CONTRIBUTION - $34,217 TOTAL DISTRIBUTION - $251,308 *Robert Williams 2010 Contribution - $54,590 Total Distribution - $295,781 *Belinda Gibson 2010 Contribution - $32,567 Total Distribution - $240,502 *John Neilson, MD 2010 Contribution - $38,000 Total Distribution - $38,000 *Elizabeth Pulliam Total Distribution - $197,496 The plan was closed in 2010.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
BCBS TX
John Hicks - see Part V45101475insurance carrierfalse
VHA TX
John Hicks - see Part V30000paid in membership duesfalse
VHA TX
John Hicks - see Part V490141paid in program expensesfalse
VHA TX
John Hicks - see Part V541153received program distributionfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierSchedule L, Part IVIdentifier
ExplanationJohn Hicks (Former CEO) also served on the boards of BCBS, TX and VHA, TX.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Supplemental InformationForm 990, Part III, Line 4dDescription of Other Program Services Other program revenue is from the provision of outpatient ancillary services including, but not limited to, lab, diagnostic imaging and catheterizations. In addition supporting services provided through a cafeteria, print shop, laundry and others generate additional revenues and incur additional expenses. Form 990, Part VI, Questions 6, 7a, & 7b Baptist St. Anthony's Health System IS THE SOLE CORPORATE MEMBER OF Baptist St. Anthony's Hospital Corporation. THE BOARD OF TRUSTEES OF Baptist St. Anthony Health System APPOINTS THE OFFICERS OF THE HOSPITAL AND THE BOARD OF TRUSTEES HAS CERTAIN AUTHORIZATION POWERS, which include the following: (A) AMENDMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (B) ANY DEVIATION FROM OR AMENDMENT TO THE BROAD OBJECTIVES OF THE CORPORATION; (C) INCURRENCE OR ASSUMPTION OF ANY CAPITAL INDEBTEDNESS; (D) AUTHORIZING ANY PUBLIC FUND RAISING CAMPAIGN; (E) AUTHORIZING CAPITAL IMPROVEMENTS OR EXPANSION IN EXCESS OF $50,000; (F) DISPOSITION OF ANY PART OF THE CORPORATION'S PHYSICAL PLANT (REAL PROPERTY) HAVING A FAIR MARKET VALUE IN EXCESS OF $50,000; (G) AUTHORIZING THE INCURRENCE OF OPERATING EXPENSES IN EXCESS OF INCOME FOR OPERATIONS, FOR WHICH PURPOSE INCOME AVAILABLE FOR OPERATIONS SHALL INCLUDE DIRECT REVENUES, ENDOWMENT, OR INVESTMENT INCOME, CONTRIBUTIONS, FUNDS PROPERLY TRANSFERABLE FROM SPECIAL PURPOSE FUNDS, AND CONTINGENCY RESERVE FUNDS; (H) DISSOLUTION OF THE CORPORATION; (I) CESSATION OF OPERATIONS OF ANY LICENSED HOSPITAL; (J) SALE, LEASE, MORTGAGE, OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (K) APPROVAL OF THE ANNUAL STRATEGIC / OPERATING PLAN, IF ANY, THE ANNUAL BUDGET AND THE ANNUAL COMMUNITY BENEFIT PLAN, IF ANY, OF THE CORPORATION Form 990, Part VI, Question 11b THE FORM 990 IS PRESENTED TO EACH BOARD MEMBER AND REVIEWED PRIOR TO FILING. Form 990, Part VI, Question 12c Each new employee shall sign a "Statement of Understanding" upon employment, and Department Directors, Supervisor and selected employees of interest shall annually sign a "Statement of Understanding" which affirms that such a person: *Has received a copy of the Code of Compliance policy, which requires employees to disclose conflict of interest to their managers *Understands that selected employees will be required to complete a conflict of interest disclosure form *Has read and understands the policy *Has agreed to comply with the policy *Understands that failure to comply with BSA's Code of Compliance may be grounds for disciplinary action, including termination. *Understands that BSA is a charitable organization and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes -All employees who have a direct or indirect financial interest (as described in the Conflict of Interest Policy) in the BSA Health Care System and/or its entities are considered an "interested person". -All interested persons shall submit the "Statement of Understanding" mentioned immediately above. -The Director of Corporate Compliance reviews all statements and determines if a conflict exists, and reports the results of all determinations to the Chief Compliance Officer (CFO). In matters related to a Department Director, Supervisor or selected employee, the conflict of interest should be resolved with the employee's direct manager by: *Directing employee to discontinue outside relationship/activity *Directing employee to abstain from participating in decision where a conflict of interest exists *Discontinuing BSA's relationship with outside organization *Establishing management plan to monitor relationship/activity so as to eliminate risk. Violations of the Conflicts of Interest Policy -If there is reasonable cause to believe that an interested person has failed to disclose actual or possible conflicts of interest, the interested person shall be informed of the basis for such belief and afforded an opportunity to explain the alleged failure to disclose. -If, after hearing the response of the interested person and making such further investigation as may be warranted in the circumstances, it is determined that the interested person has in fact failed to disclose an actual or possible conflict of interest, appropriate disciplinary and correct action shall be taken in accordance with the Disciplinary Action Policy HR-440. -Records of proceedings will be maintained on file in the Corporate Compliance Office. -Key employees are covered by the conflict of interest policy described above. -Officers, directors, and trustees are covered by the policy described immediately below. -For the purposes of the "Conflicts of Interest Policy - Directors and Officers", director means a member of the Board of Directors, and officer means an individual holding an office provided for by the Bylaws. -All directors, officers, and members of committees with board delegated powers are required to sign an annual statement that the person: *Has received a copy of the conflict of interest policy *Has read and understands the policy *Has agreed to comply with the policy *Understands that the policy applies to all committees and subcommittees having board-delegated powers *Understands that BSA System, BSA Hospital, HCC, and HPI are charitable organizations and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. In order to determine whether a potential conflict exists, all existences of financial interest and all material facts must be disclosed to the board of directors or committee for investigation. After investigation, the Board of Directors must take appropriate disciplinary and corrective action with respect to an interested person who violates the "Conflict of Interest" policy, which could include: *Legal remedies *Possible sanctions against the interested person, but shall not be limited to, oral admonishment, written reprimand, reassignment, demotion, suspension, removal, separation or resignation. *Records will be included in the minutes of the board meetings and all committees with board delegated power. Periodic reviews shall be conducted by the directors and officers to ensure that BSA and tax exempt entities operate in a manner consistent with its charitable purposes and that it does not engage in activities that could jeopardize its status as an organization exempt from federal income tax. This policy is administered and enforced by the Board of Directors of each tax exempt entity. Form 990, Part VI, Questions 15b Baptist St. Anthony's Hospital Corporation officers and key employee compensation is directed by the Executive Committee of the Board of Trustees. The Corporation contracts with Sullivan, Cotter, and Associates of Minneapolis, Minnesota to review the duties and compensation. Sullivan Cotter confirms that compensation is reasonable. Sullivan Cotter communicates directly with the Executive Committee on matters of executive compensation. Form 990, Part VI, Question 19 Our 990's are available on Guidestar and upon request. Governing documents, conflict of interest policy, and financial statements are available upon request. Form 990, Part XI, Question 5 Other changes in net assets or fund balances Change in Unrealized Gains/Losses - $6,269,286 Other immaterial changes to fund balance - ($2,843)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ROBERT WILLIAMS TITLE:CEO HOURS:18
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:BELINDA GIBSON TITLE:VP PATIENT SERVICES HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:BRIAN WALTON TITLE:VP FINANCE HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MICHAEL CRUZ TITLE:VP OPERATIONS II HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN NEILSON TITLE:VP MEDICAL STAFF REL HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ELIZABETH PULLIAM TITLE:VP FINANCE thru 5/25/10 HOURS:10

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Baptist St Anthony's Foundation
3310 DanversAmarilloTX79106752122630FundraisingTX501(c)(3)7BSAHS
Baptist St Anthony's Health Network
3310 DanversAmarilloTX79106752565440StaffingTX501(c)(3)9BSAHS
Second Chance Foundation
3310 DanversAmarilloTX79106752160474FundraisingTX501(c)(3)11 TYPE IBSAHC
Baptist St Anthony's Health System
3310 DanversAmarilloTX79106751858993Parent CorpTX501(c)(3)11,iii,fiNA
Don & Sybil Harrington Cancer Center
1500 WALLACE BLVDAmarilloTX79106751578415Cancer CenterTX501(c)(3)9BSAHS
Harrington Physicians Inc
1500 Wallace BlvdAmarilloTX78106752312574MEDICAL CARETX501(c)(3)9HCC

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
Physicians Surgical Hospitals LLC
1600 Wallace BlvdAmarilloTX79106731620274Stand-alone HospTXnaRelated1072697529654397falsefalse0.51000
Physicians Surgical Real Estate LLC
1600 Wallace BlvdAmarilloTX79106202894224Holding CompanyTXnaRelated3876817056483falsefalse0.51000

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1BSA Holdings IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13310 DanversAddressLine1
CityAmarilloCity
StateTXState
ZIP Code79106ZIPCode
FieldValueIRS element (for citing)
EIN752058579EIN
Primary ActivityHolding CompanyPrimaryActivity
Legal Domicile StateTXLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1naBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CorpTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Baptist St Anthony's Foundation
C36409
Baptist St Anthony's Health Network
o3616902
Don & Sybil Harrington Cancer Center
L495033
Physicians Surgical Hospitals LLC
P1842567
BSA Holdings Inc
P618946