2016-07-26T10:18:50-05:00 2015-08-31 ERNST & YOUNG US LLP 1900 SCRIPPS CENTER 312 WALNUT ST CINCINNATI OH 43202 990 2014-09-01 610654587 Baptist Health Madisonville Inc % CARL G HERDE BAPT 2708255201 900 HOSPITAL DRIVE MADISONVILLE KY 42431 CARL HERDE TREASURER 5028965000 2016-07-26 true TRICIA M JOHNSON P00627205 5136121400 2014 2016-12-15 16:53:06Z CARL G HERDE 2701 EASTPOINT PARKWAY LOUISVILLE KY 40223 202861359 false X WWW.BAPTISTHEALTHMADISONVILLE.COM X 1956 KY TO OPERATE AN ACUTE CARE HOSPITAL SERVING RURAL COMMUNITIES IN Kentucky. OUR MISSION IS TO PROVIDE EXCELLENT CARE, EVERY TIME. 12 10 2258 83 79390 37390 1858859 1540068 137878944 131221966 1292945 1256255 41542131 55910901 182572879 189929190 1057428 220032 0 0 101411461 89297367 0 0 0 83906916 83428329 186375805 172945728 -3802926 16983462 175988754 175835186 45837091 47716040 130151663 128119146 X TO OPERATE AN ACUTE CARE HOSPITAL SERVING RURAL COMMUNITIES IN KENTUCKY. OUR MISSION IS TO PROVIDE EXCELLENT CARE, EVERY TIME. false false 158448828 220032 184431328 See Schedule O 158448828 true true false true false false false false false true true false false false true false false true false false false false false false false false true true true false true true false false false false false false false true true true false false false false false true true true true false true 156 0 true 2258 true true true false false false false false false false false false X 12 10 false false false false true true true true true false false true true true true true true true true true false KY X CARL G HERDE 5028965000 2701 EASTPOINT PARKWAY LOUISVILLE KY 40223 JANET BERRY DIRECTOR 1.0 0.0 X 0 1500 0 STEVE COX CHAIRMAN AND DIRECTOR 1.0 0.0 X X 0 1500 0 BARRY EVELAND DIRECTOR 1.0 0.0 X 0 1500 0 RON POOLE DIRECTOR 1.0 0.0 X 0 1500 0 LINDA THOMAS VICE CHAIRMAN AND DIRECTOR 1.0 0.0 X X 0 1500 0 STEPHEN C HANSON SYSTEM CEO 1.0 40.0 X X 0 1623391 361752 CHRIS HUTSON DIRECTOR (THROUGH 12/31/14) 1.0 0.0 X 0 3000 0 KENT MILLS DIRECTOR 1.0 0.0 X 0 1500 0 CHARLES ALLEN RUDD JR CHAIRMAN 1.0 0.0 X 0 3000 0 DARREN CHAPMAN DIRECTOR 1.0 40.0 X 0 378632 29632 MARK FITZMAURICE MD DIRECTOR (THROUGH 12/31/14) 40.0 0.0 X 331905 0 29717 JASON VINCENT DIRECTOR (EFFECTIVE 4/1/15) 1.0 0.0 X 0 0 0 AMY SANDERSON DIRECTOR (Effective 4/1/15) 1.0 0.0 X 0 0 0 LINDA ZELLICH DIRECTOR (Effective 4/1/15) 1.0 0.0 X 0 0 0 CARL HERDE VICE PRESIDENT AND TREASURER 1.0 40.0 X 0 812206 141469 JANET NORTON VICE PRESIDENT AND SECRETARY 1.0 40.0 X 0 575951 109170 MICHAEL BAUMGARTNER PRESIDENT (THROUGH 3/13/15) 40.0 0.0 X 468363 0 31184 ROBERT RAMEY PRESIDENT (effective 3/9/15) 40.0 0.0 X 188319 0 25035 ISAAC MYERS MD VICE PRESIDENT 1.0 40.0 X 0 544519 86340 URSULA DUGGER ASSISTANT SECRETARY 40.0 0.0 X 48374 0 2607 ALI KANBAR MD PHYSICIAN 40.0 0.0 X 742375 0 42572 BENJAMIN BURKETT MD PHYSICIAN 40.0 0.0 X 607682 0 20815 WAYNE LIPSON MD PHYSICIAN 40.0 0.0 X 594908 0 34450 JIM DONLEY MD PHYSICIAN 40.0 0.0 X 590796 0 13163 JOHN DACOSTA MD PHYSICIAN 40.0 0.0 X 810955 0 44101 ANDY SEARS VICE CHAIR (THROUGH 12/31/14) 0.0 40.0 X 0 557346 42549 C THOMAS MOORE FORMER CFO 0.0 0.0 X 173687 0 23329 TIMOTHY DUKES FORMER SENIOR VP AND COO 0.0 0.0 X 220566 0 27083 BERTON E WHITAKER FORMER PRESIDENT 0.0 0.0 X 512991 0 0 KIMBERLY ASHBY VP finance 40.0 0.0 X 216429 0 27759 5507350 4507045 1092727 122 true true false MCKESSON HBOC PO BOX 98347 CHICAGO IL 60693 COMPUTER SERVICES 2379496 ARAMARK CTS INC 12483 COLLECTIONS CENTER DR CHICAGO IL 60693 biomedical services 1895994 MDA HOLDINGS INC 145 TECHNOLOGY PARKWAY NW NORCROSS GA 30092 MEDICAL STAFFING 785520 INTERIM PHYSICIANS PO BOX 790379 ST LOUIS MO 63179 MEDICAL STAFFING 766267 LOUISVILLE RADIOLOGY 811 E PARRISH AVENUE OWENSBORO KY 42303 MEDICAL DIAGNOSTICS 739794 37 1467534 72534 1540068 PATIENT SERVICE REVENUE 621110 126614202 126534812 79390 HOME HEALTH AND HOSPICE 621610 3234740 3234740 FAMILY PRACTICE RESIDENCY 611600 944450 944450 ANESTHESIA PROGRAM 611600 258724 258724 OTHER 611600 169850 169850 131221966 880397 880397 0 0 637241 343902 293339 0 293339 293339 128287 247571 128287 247571 375858 375858 0 0 65208513 12588267 52620246 52620246 CAFETERIA SALES 722514 1536958 1536958 RESEARCH REVENUE 900099 598875 598875 GIFT SHOP 453220 133239 133239 728244 589116 139128 2997316 189929190 184351938 79390 3957794 220032 220032 0 0 0 1632901 1632901 40291 40291 74331954 72196197 2135757 2586905 2547176 39729 5662685 4621069 1041616 5042631 4286236 756395 0 255704 9678 246026 0 11775 11775 0 0 24726238 18182988 6543250 28844 28844 845005 784049 60956 0 0 3881437 3111150 770287 967655 290296 677359 0 5130 5130 561596 561596 0 13708769 12337892 1370877 628069 471052 157017 MEDICAL SUPPLIES 33568226 33568226 PROVIDER TAX EXPENSES 2586897 2586897 MINOR EQUIPMENT 1123710 1123710 DUES AND SUBSCRIPTIONS 529274 433858 95416 172945728 158448828 14496900 0 12847 13647 6377360 14442962 0 0 30849422 28666684 0 0 0 0 732054 98575 2780399 2913966 3788847 2732291 283403999 207317184 76927225 76086815 50191203 50599595 0 0 0 0 3926500 0 402897 280651 175988754 175835186 15100081 19070556 0 0 0 0 21147500 19197000 0 0 0 0 2327362 1427173 0 0 7262148 8021311 45837091 47716040 X 129986194 127953677 165469 165469 0 0 130151663 128119146 175988754 175835186 X 16983462 -640893 -18375086 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false false false true 11775 11775 false SCHEDULE C, PART II-B, LINE 1i OTHER ACTIVITIES THE ORGANIZATION AND CERTAIN EMPLOYEES ARE MEMBERS OF VARIOUS ASSOCIATIONS that ATTRIBUTE A PORTION OF DUES TO LOBBYING EXPENSE. THE ORGANIZATION HAS DISCLOSED A LOBBYING ALLOCATION OF $11,775 PER FORM 990. THESE ASSOCIATIONS INCLUDE THE AMERICAN MEDICAL ASSOCIATION, KENTUCKY HOSPITAL ASSOCIATION, KENTUCKY MEDICAL ASSOCIATION, AS WELL AS VARIOUS OTHERS. 164488 5625 -981 171094 164559 4023 4094 164488 159404 9552 4397 164559 153560 197043 191199 159404 153226 12778 12444 153560 1.00000 false false 9902460 9902460 93134492 50197765 42936727 174055583 152861264 21194319 6311464 4258155 2053309 76086815 0 ROA WORKERS COMP LIABILITY 1254684 MCC BUILDING PLEDGE 600000 THIRD PARTY PAYABLES 6166627 8021311 Schedule D, Part V, Line 4 Intended use of endowment funds: PATIENT CARE, HOSPICE BEREAVEMENT CAMP, MAHR CANCER CENTER, AND OTHER PATIENT CARE INITIATIVES. true true true X true X true true true false true true 3273371 3273371 0.01890 32008457 37659151 -5650694 0.03270 35281828 37659151 -2377323 0.01380 475691 475691 0.00280 6307212 796611 5510601 0.03190 4886817 6958692 -2071875 0.01200 12163 12163 0.00010 2500281 2500281 0.01450 14182164 7755303 6426861 0.03730 49463992 45414454 4049538 0.02350 1306 1306 20402 20402 21708 21708 true 2815369 47429775 51537164 -4107389 X true true 1 1 BAPTIST HEALTH MADISONVILLE 900 HOSPITAL DRIVE MADISONVILLE KY 42431 www.baptisthealthmadisonville.com 100184 X X X baptist health madisonville 1 false false true X X X X X X X X 14 true false false true X WWW.BAPTISTHEALTHMADISONVILLE.COM X X true 14 true WWW.BAPTISTHEALTHMADISONVILLE.COM false false true X 200. 400. X X X X true true X X X true X WWW.BAPTISTHEALTHMADISONVILLE.COM X WWW.BAPTISTHEALTHMADISONVILLE.COM X WWW.BAPTISTHEATLHMADISONVILL X X X X X true X false X X X X true X false false SCHEDULE H, PART V, LINE 5 Input From Community Representatives Interviews with 25 key informants were conducted over a three day period. Interviewees were determined based on their a) specialized knowledge or expertise in public health b) their affiliation with local government, schools, or industry or c) their involvement with underserved and minority populations. All interviews were conducted using a standard questionnaire. A summary of their opinions is reported without judging the truthfulness or accuracy of their remarks. Community leaders provided comments on the following issues: health and quality of life for residents of the primary community, barriers to improving health and quality of life for residents of the primary community, opinions regarding the important health issues that affect Hopkins, Webster and Muhlenberg county residents and the types of services that are important for addressing these issues, and delineation of the most important healthcare issues discussed and actions necessary for addressing these issues. Name and organizational affiliations were not connected to the information presented in the report. Key informants from the community worked for the following types of organizations and agencies: social service agencies, local school system and community college, local city and county government, public health agencies, industry, faith community, and medical providers. Schedule H, Part V, Section B, Line 7 Availability of CHNA Report Copies of the CHNA were also distributed internally and externally to those who participated in the needs assessment (individuals and organizations). Schedule H, Part V, Section B, Line 11 Needs not Addressed The hospital has entered into a services agreement with horizon health to assist in opening a 20 bed inpatient adult behavioral health unit at the hospital. The unit opened in the fall of 2015. 4 BAPTIST HEALTH HOME CARE 200 CLINIC DRIVE MADISONVILLE KY 42431 HOME HEALTH AGENCY BAPTIST HEALTH SPORTS MEDICINE AND REHAB 500 CLINIC DRIVE MADISONVILLE KY 42431 REHAB SERVICES BAPTIST HEALTH HOSPICE 418 NORTH SCOTT STREET MADISONVILLE KY 42431 HOSPICE BAPTIST HEALTH TRANSITIONAL CARE 900 HOSPITAL DRIVE MADISONVILLE KY 42431 SKILLED NURSING FACILITY Schedule H, Part I, Line 7 COSTING METHODOLOGY: A COST-TO-CHARGE RATIO BASED ON THE MOST RECENT AS FILED MEDICAID COST REPORT WAS USED TO CALCULATE THE AMOUNTS REPORTED IN EACH LINE OF THE TABLE. SCHEDULE H, PART II, LINE 10 COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY THROUGH OPEN MEDICAL STAFF, SERVICE ON COMMUNITY BOARDS, 24 HOUR EMERGENCY DEPARTMENT, OCCUPATIONAL MEDICINE PROGRAM, FREE ATHLETIC PHYSICALS, HEALTH FAIRS AND SCREENINGS, a COURTESY MEMBERSHIP TO FITNESS centers FOR ATHLETES, POLICE OFFICERS AND FIRE DEPARTMENT, EDUCATIONAL PROGRAMS, ATHLETIC TRAINERS AT SCHOOL EVENTS, AND A CENTERING PREGNANCY PROGRAM. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE FOOTNOTE PER THE FINANCIAL STATEMENTS OF BAPTIST HEALTHCARE SYSTEM (WHICH INCLUDE THE ACTIVITY OF BAPTIST HEALTH MADISONVILLE) THERE IS NO BAD DEBT FOOTNOTE FOR THE CURRENT YEAR. THE AMOUNT ON LINE 2 WAS CALCULATED USING A COST-TO-CHARGE RATIO. SCHEDULE H, PART III, LINE 8 TREATMENT OF MEDICARE SHORTFALL AS COMMUNITY BENEFIT DUE TO THE FACT THAT MEDICARE RATES ARE NON-NEGOTIABLE AND ARE ESTABLISHED BY THE GOVERNMENT, ALL OF THE SHORTFALL FOR MEDICARE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. SCHEDULE H, PART III, LINE 8 MEDICARE COSTING METHODOLOGY: MEDICARE REVENUES AND ALLOWABLE COSTS WERE TAKEN FROM THE AS FILED MEDICARE COST REPORT. MUCH CARE IS TAKEN TO ENSURE THAT ALL ADJUSTMENTS TO REMOVE NON-ALLOWABLE COSTS ARE TAKEN. SCHEDULE H, PART III, LINE 9B COLLECTION PRACTICES: ONCE A PATIENT HAS BEEN DETERMINED TO QUALIFY FOR CHARITY CARE, THE PATIENT IS CLASSIFIED AS SUCH FOR THREE MONTHS. IF THE PATIENT RETURNS FOR SERVICES WITHIN THREE MONTHS, THEY ARE AUTOMATICALLY QUALIFIED FOR CHARITY CARE, WHICH IMPROVES THEIR ACCESS TO HEALTHCARE SERVICES. SCHEDULE H, PART VI NEEDS ASSESSMENT: THE COMMUNITY SERVED BY THE HOSPITAL WAS DEFINED BY UTILIZING INPATIENT AND OUTPATIENT DATA REGARDING PATIENT ORIGIN. POPULATION DEMOGRAPHICS AND SOCIOECONOMIC CHARACTERISTICS OF THE COMMUNITY WERE GATHERED AND REPORTED UTILIZING VARIOUS THIRD PARTIES. THE HEALTH STATUS OF THE COMMUNITY WAS THEN REVIEWED. INFORMATION ON THE LEADING CAUSES OF DEATH AND MORBIDITY INFORMATION WAS ANALYZED IN CONJUNCTION WITH HEALTH OUTCOMES AND FACTORS REPORTED FOR THE COMMUNITY BY COUNTYHEALTHRANKINGS.ORG. HEALTH FACTORS WITH SIGNIFICANT OPPORTUNITY FOR IMPROVEMENT WERE NOTED. AN INVENTORY OF HEALTH CARE FACILITIES AND RESOURCES WERE PREPARED AND THE ESTIMATED DEMAND FOR PHYSICIAN AND HOSPITAL SERVICES WERE EVALUATED. COMMUNITY INPUT WAS PROVIDED THROUGH KEY INFORMATION INTERVIEWS AND SURVEYS. INFORMATION GATHERED WAS ANALYZED AND REVIEWED TO IDENTIFY HEALTH ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS, MINORITY GROUPS AND THE COMMUNITY AS A WHOLE. HEALTH NEEDS WERE RANKED UTILIZING A WEIGHTING METHOD AND THEN PRIORITIZED TAKING INTO ACCOUNT THE PERCEIVED DEGREE OF INFLUENCE THE HOSPITAL HAS TO IMPACT THE NEED. INFORMATION GAPS WERE IDENTIFIED DURING THE PRIORITIZATION PROCESS AND WERE REPORTED. SCHEDULE H, PART VI PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE ORGANIZATION IDENTIFIES UNINSURED PATIENTS BY REQUESTING INSURANCE INFORMATION AT THE TIME OF THE APPOINTMENT REQUEST. IF THE PATIENT HAS NO INSURANCE BENEFITS, APPOINTMENT SCHEDULING STAFF WILL INFORM THE PATIENT OF THE SELF-PAY POLICY. EXCEPT FOR EMERGENCY ROOM VISITS, NEW PATIENTS WHO ARE UNABLE TO PAY AT THE TIME OF SERVICE ARE PROVIDED SERVICES BY FINANCIAL COUNSELORS FOR EDUCATION AND ASSISTANCE. EMERGENCY ROOM PATIENTS ARE NOT ASKED FOR PAYMENT OR INSURANCE UPON REGISTRATION OR ADMISSION. DURING FINANCIAL COUNSELING, PATIENTS WILL BE INFORMED OF THE KENTUCKY PHYSICIANS CARE PROGRAM (KPC) IN COORDINATION WITH THE DISPROPORTIONATE SHARE HOSPITAL (DSH) PROGRAM. THEY WILL ALSO BE COUNSELED ON POTENTIAL ELIGIBILITY FOR MEDICAID AND DISABILITY PROGRAMS. PATIENTS WILL ALSO BE ADVISED OF THE FINANCIAL ASSISTANCE POLICY AND APPLICATIONS WILL BE PROVIDED. SCHEDULE H, PART VI COMMUNITY INFORMATION: THE ORGANIZATION IS BASED IN MADISONVILLE, KENTUCKY (HOPKINS COUNTY) NEAR INTERSTATE 69, APPROXIMATELY 50 MILES SOUTH OF EVANSVILLE, IN. THE BULK OF THE COMMUNITY'S POPULATION IS CONCENTRATED IN AND AROUND THE CITY OF MADISONVILLE, WITH PORTIONS OF THE NEARBY COUNTIES OF WEBSTER AND MUHLENBERG ALSO HAVING SIGNIFICANT DISCHARGE NUMBERS. APPROXIMATELY 23% OF THE COMMUNITY'S POPULATION FALLS IN THE Under 18 AGE RANGE AND 17% IN THE Over 65 AGE RANGE. APPROXIMATELY 51% ARE FEMALE AND 49% ARE MALE BASED ON 2015 DATA. SCHEDULE H, PART VI PROMOTION OF COMMUNITY HEALTH: THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY THROUGH OPEN MEDICAL STAFF, SERVICE ON COMMUNITY BOARDS, 24 HOUR EMERGENCY DEPARTMENT, OCCUPATIONAL MEDICINE PROGRAM, FREE ATHLETIC PHYSICALS, HEALTH FAIRS AND SCREENINGS, COURTESY MEMBERSHIP TO FITNESS A Center FOR ATHLETES, POLICE OFFICERS AND FIRE DEPARTMENT, EDUCATIONAL PROGRAMS, ATHLETIC TRAINERS AT SCHOOL EVENTS, AND A CENTERING PREGNANCY PROGRAM. SCHEDULE H, PART VI AFFILIATED HEALTH CARE SYSTEM ON NOVEMBER 1, 2012, TROVER HEALTH SYSTEM SIGNED A MEMBERSHIP SUBSTITUTION AGREEMENT WITH BAPTIST HEALTH SYSTEM BASED IN LOUISVILLE, KY AND EFFECTIVELY BECAME BAPTIST HEALTH MADISONVILLE. BAPTIST HEALTH SYSTEM, ALSO A NON-PROFIT ORGANIZATION, SHARES A SIMILAR MISSION AND SUPPORTS THE PROMOTION OF HEALTH IN THE LOCAL COMMUNITIES SERVICED BY THE ORGANIZATION AS A WHOLE. SCHEDULE H, PART VI STATE FILING OF COMMUNITY BENEFIT REPORT KENTUCKY true CITY OF MADISONVILLE PO BOX 705 MADISONVILLE KY 42431 616001864 gov't 10000 GENERAL SUPPORT COMMUNITY IMPROVEMENT FOUNDATION PO BOX 413 MADISONVILLE KY 42431 611304905 501(c)(3) 32000 GENERAL SUPPORT HAPPY FEET EQUALS LEARNING FEET INC 1020 STATE ROUTE 56 EAST MORGANFIELD KY 42437 455231361 501(c)(3) 8000 GENERAL SUPPORT MADISONVILLE CHAMBER OF COMMERCE 15 EAST CENTER STREET MADISONVILLE KY 42431 610561820 501(c)(6) 12362 GENERAL SUPPORT MADISONVILLE TRADEWATER PIRATES LLC 145 EAST CENTER STREET SUITE 1B MADISONVILLE KY 42431 454217401 501(c)(3) 8448 GENERAL SUPPORT MUHLENBERG COUNTY BOARD OF EDUCATION 501 ROBERT L DRAPER WAY GREENVILLE KY 42345 616001286 gov't 20334 GENERAL SUPPORT PROJECT FIT AMERICA PO BOX 308 BOYES HOT SPRINGS CA 95416 363730823 501(c)(3) 49050 GENERAL SUPPORT SUPPLIES OVER SEAS 1500 ARLINGTON AVENUE LOUISVILLE KY 40206 272624272 501(c)(3) 15600 GENERAL SUPPORT UNITED WAY PO BOX 366 MADISONVILLE KY 42431 610732633 501(c)(3) 26200 GENERAL SUPPORT 8 1 Schedule I, Part I, Line 2 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS: THERE IS A COMMITTEE THAT IS RESPONSIBLE FOR APPROVING ALL DONATIONS. THE COMMITTEE SELECTS THE ORGANIZATION BASED ON NONPROFIT CRITERIA. AN ANNUAL BUDGET IS ESTABLISHED TO DETERMINE THE TOTAL AMOUNT OF FUNDS TO BE DISTRIBUTED EACH YEAR. X true true X X X X X true true false false false false false true false CARL HERDE VICE PRESIDENT AND TREASURER 0 604265 0 196630 0 11311 0 111756 0 29713 0 953675 0 0 JANET NORTON VICE PRESIDENT AND SECRETARY 0 417981 0 142725 0 15245 0 76530 0 32640 0 685121 0 0 MICHAEL BAUMGARTNER PRESIDENT (THROUGH 3/13/15) 360297 0 87840 0 20226 0 13000 0 18184 0 499547 0 0 0 ALI KANBAR MD PHYSICIAN 742375 0 0 0 0 0 13000 0 29572 0 784947 0 0 0 BENJAMIN BURKETT MD PHYSICIAN 607682 0 0 0 0 0 0 0 20815 0 628497 0 0 0 WAYNE LIPSON MD PHYSICIAN 594908 0 0 0 0 0 13000 0 21450 0 629358 0 0 0 JIM DONLEY MD PHYSICIAN 590796 0 0 0 0 0 0 0 13163 0 603959 0 0 0 JOHN DACOSTA MD PHYSICIAN 810955 0 0 0 0 0 13000 0 31101 0 855056 0 0 0 STEPHEN C HANSON SYSTEM CEO 0 940038 0 654800 0 28553 0 318782 0 42970 0 1985143 0 0 ANDY SEARS VICE CHAIR (THROUGH 12/31/14) 0 335704 0 112746 0 108896 0 18200 0 24349 0 599895 0 0 KIMBERLY ASHBY VP finance 193980 0 22449 0 0 0 15161 0 12598 0 244188 0 0 0 C THOMAS MOORE FORMER CFO 173687 0 0 0 0 0 11347 0 11982 0 197016 0 0 0 DARREN CHAPMAN DIRECTOR 0 378632 0 0 0 0 0 13000 0 16632 0 408264 0 0 TIMOTHY DUKES FORMER SENIOR VP AND COO 195024 0 25542 0 0 0 13973 0 13110 0 247649 0 0 0 ROBERT RAMEY PRESIDENT (effective 3/9/15) 163971 0 22688 0 1660 0 12325 0 12710 0 213354 0 0 0 ISAAC MYERS MD VICE PRESIDENT 0 411573 0 119313 0 13633 0 57069 0 29271 0 630859 0 0 MARK FITZMAURICE MD DIRECTOR (THROUGH 12/31/14) 242448 0 89457 0 0 0 16120 0 13597 0 361622 0 0 0 BERTON E WHITAKER FORMER PRESIDENT 512991 0 0 0 0 0 0 0 15942 0 528933 0 0 Schedule J, Part I, Line 1a SUPPLEMENTAL COMPENSATION INFORMATION: THE ORGANIZATION PAYS COUNTRY CLUB MEMBERSHIP DUES FOR THE CHIEF OPERATING OFFICER AND ROTARY CLUB DUES FOR THE PRESIDENT. USE OF THE COUNTRY CLUB MEMBERSHIP IS EXCLUSIVELY FOR BUSINESS PURPOSE. Schedule J, Part I, Line 4a DURING THE YEAR, THE FORMER PRESIDENT (BERTON WHITAKER) AND FORMER CFO (C. THOMAS MOORE) RECEIVED SEVERANCE PAYMENTS IN ACCORDANCE WITH THEIR CONTRACTS. Schedule J, Part I, Line 4b Six officers and executives of Baptist Healthcare System, Inc., (BHS), (four of whom are Directors and/or officers of Baptist Health Madisonville), who participated in the Supplemental Executive Retirement Plan accrued amounts for 2014 which is a portion of the amount reported as deferred compensation in Schedule J, Column C. Other retirement and deferred compensation reported in Schedule J, Column C include amounts for the Retirement Accumulation Plan and Thrift Plan. The following individuals participate in and accrued amounts from the Supplemental Executive Retirement Plan: Carl Herde $93,556 Janet Norton $60,410 Isaac Myers, MD $57,069 Stephen Hanson $308,829 The following individual received a payout from the Supplemental Executive Retirement Plan, a Nonqualified deferred compensation plan, as they are fully vested in the plan: Andrew Sears, MD $91,673 Schedule J, Part I, Line 7 SEVERAL PHYSICIANS ARE COMPENSATED BASED UPON AN INCENTIVE COMPENSATION PLAN. THE INCENTIVE COMPENSATION PAYMENTS ARE NOT CONTINGENT UPON GROSS REVENUES OR NET EARNINGS OF THE ORGANIZATION, BUT ARE BASED UPON THE PHYSICIANS'S INDIVIDUAL PRODUCTIVITY AND QUALITY MEASURES. Schedule J, Part I, Line 3 Baptist Healthcare System, a related organization of Baptist Health madisonville, Inc., uses the following to establish the compensation of the organization's CEO: - Compensation committee - Independent compensation consultant - Form 990 of other organizations - Written employment contract - Compensation survey or study - Approval by the Board or Compensation committee. A CITY OF MADISONVILLE KENTUCKY 616001864 2010-12-21 25780000 SEE PART VI false false false A 6583000 0 25780000 0 0 0 234600 0 0 0 25545000 0 2011 true false false true A false true true false false 0.02190 0.00000 0.02190 false false false false A false true false false true false 0 false 0 false false A false schedule k, part I, LINE A DESCRIPTION OF PURPOSE THE PURPOSE OF THE BOND ISSUE WAS TO REFUND CERTAIN SERIES 2006 BONDS. A PORTION OF THE PROCEEDS WERE ALSO USED TO finance the construction, rehabilitation and equipping of certain Facilities. schedule k, part vi procedures to undertake corrective action The organization is in the process of establishing FORMAL WRITTEN PROCEDURES; HOWEVER, IN THE EVENT REMEDIATION ISSUES ARISE, THE ORGANIZATION SEEKS THE ADVICE OF LEGAL COUNSEL. ELIZABETH EVELAND FAMILY MEMBER OF DIRECTOR 34573 COMPENSATION false GAIL EVELAND FAMILY MEMBER OF DIRECTOR 5718 COMPENSATION false Form 990, Part III Statement of Program Services Accomplishments a. Baptist Health Madisonville is an acute care hospital serving numerous rural communities and offering a broad range of inpatient and outpatient services. Baptist Health Madisonville provides a substantial amount of charity care as detailed below in the Community Service section. Baptist Health Madisonville provided care for 7,998 inpatient adult, pediatric, and nursery admissions during fiscal year 2015. Patient days totaled 43,169. There were 884 live births, of which over 58% were Medicaid births. Surgery visits totaled 5,963 for fiscal year 2015. Baptist Health Madisonville's Mahr Cancer Center is approved by the American College of Surgeons' Commission on Cancer, receiving the No. 1 overall rating. The Mahr Center provided services to approximately 40,000 patients during fiscal year 2015, and is affiliated with the James Graham Brown Cancer Center at the University of Louisville. b. The Trover Foundation Residency Program is an educational program in which Foundation physicians instruct and work with Residents. The Residency Program is affiliated with the University Of Louisville School Of Medicine. Twenty-four residents were involved in the Residency Program during 2015. c. The Dr. Loman C. Trover Medical Education and Research Center (Trover Education and Research Center) provides numerous educational programs that benefit the communities of Western Kentucky. In addition to the Family Practice Residency Program, the Trover Education and Research Center collaborates with Murray State University to offer a graduate degree in nurse anesthesia. The program is dedicated to graduating nurse anesthetists of the highest professional competence who are committed to returning to rural areas to practice. Baptist Health Madisonville serves as the primary clinical site. The Trover Education and Research Center also coordinates the West Area Health Education Center (AHEC) program, connecting the academic health centers at the University of Kentucky and University of Louisville with medically underserved communities throughout the state, in an effort to address Kentucky health care access problems. The Foundation is a regional campus for the University Of Louisville School Of Medicine through the Foundation's Off-Campus Teaching Center. The Center provides individualized clinical training in a small-town environment, with a goal towards increasing the number of physicians in rural areas. The Trover Education and Research Center is a location for the University of Kentucky's Center for Rural Health, created to improve the health status of the rural population of the state. The Trover Education and Research Center sponsors the Delta Project for 20 counties in the state of Kentucky. The goal of the Delta Project is to improve the health status and health care system in each county served. During the 2015 fiscal year 31,520 students were contacted in approximately 85 different schools. d. Green River Hospice is a program assisting terminally ill patients and their families through the death and bereavement process. The Hospice provided service for approximately 10,000 hospice days during the fiscal year. 2015 COMMUNITY SERVICE Community Service Detail Hours No. of Events Contacts Educational & Health Improvement Events 10,030 868 79,912 Community Events 1,240 49 5,188 Donations/Support 4,824 2,465 6,394 Total 16,100 3,382 91,494 CHARITY AND COMMUNITY BENEFIT CARE Baptist Health Madisonville provides care to patients who meet guidelines established in the organization's charity care policy at no charge or at charges less than established rates. Other uncompensated care relates principally to contractual allowances for government payors, discounts taken by commercial payors and bad debts. The following summary quantifies additional community benefit expense in terms of uncompensated care, services to the indigent and benefits to the broader community during 2015: Uncompensated care: Bad debt expense (at cost) $ 2,815,000 Benefits for the poor: Traditional charity care $ 3,273,000 Unpaid costs of Medicare 4,107,000 Total quantifiable benefits for the poor 7,380,000 Benefits for the broader community: Educational and Health Improvement Events $ 6,783,000 Donations/Support 2,500,000 Research 12,000 Total quantifiable benefits for the broader community 9,295,000 Total quantifiable community benefits 19,490,000 Community benefits expense represents approximately 11% of the total organization's expense for the period ended August 31, 2015. In addition to the above, Baptist Health Madisonville provides a wide range of community benefits including coordination of charitable activities by organization's staff. EDUCATIONAL EVENTS Baptist Health Madisonville's mission is excellent care every time. In order to support this mission, the organization strives to be involved in numerous educational programs. The Certified Registered Nurse Anesthesia Program has trained more than 250 nurses to become CRNAs since the program's inception. The University of Louisville/Trover Education and Research Center's Medical Campus provided training for 24 medical students. It provided educational activities for high school students interested in a medical career, including shadowing and enhancement classes. Centering Pregnancy Smiles is a partnership between UK, Trover Education and Research Center, the Hopkins County Health Department, the national Centering Pregnancy initiative and other federal, state, and local leaders. The alliance, established to end the cycle of preterm births, low birth weight, and poor oral health in Kentucky, has already saved Kentucky more than $2.0 million in medical procedures needed by those babies at birth. In over 900 different events, the Foundation offered everything from tours to seminars to participation in community educational events. Thousands of students in western Kentucky benefited in some way from the Foundation's efforts. Over 11,000 hours were dedicated to educational events involving over 85,000 individuals throughout the service area. Baptist Health Madisonville physicians also participated in a Women's Health Forum sponsored in part by the organization. Physicians gave presentations on women's health issues. There were also exhibits about women's health. This event attracted approximately 50 participants. Baptist Health Madisonville also participates in the World's Greatest Baby Showers throughout the service area, with over 360 participants. These events are held to help educate expectant mothers about their pregnancy and about taking care of their babies. An OB/GYN, a Family Practice physician or a pediatrician typically participate. Baptist Health Madisonville maintains a website for consumer health education topics in both English and Spanish. The website includes daily consumer health news, and interactive consumer health tools such as quizzes and calculators. The fees for maintaining this website were $12,000 in 2015. Other educational events sponsored or supported by the organization include the first Step Nursing Program, Rural Health Scholar Program, shadowing opportunities for students, and Breast Cancer Awareness Bingo in Muhlenberg County. Baptist Health Madisonville served over 3,500 individuals through health fairs and screenings in 2015. The Foundation provided blood sugar and blood pressure screenings regularly at satellite locations. Working with the Kentucky Cancer Program, The Mahr Cancer Center provided prostate cancer screenings and colorectal screenings for several hundred people. Additionally the organization participated in a health fair for local businesses providing screenings and health education. Baptist Health Madisonville provided free sports physicals to over 1,350 high school students in Hopkins, Christian, Crittenden, Caldwell, McLean, Webster, Union, Muhlenburg, Ohio, Trigg, Todd and Lyon Counties. The organization also operates a full-time dedicated research center, established to ensure that the community has early access to promising new medicine and medical treatment. The Loman C. Trover Medical Education and Research Center for Clinical Studies has participated in projects sponsored by Aventis, Merck, GlaxoSmithKline, Duke University, University of Louisville School of Medicine and others. The support groups offered at no cost by the organization served over 540 patients and families with over 120 hours of employee time. These groups discuss such topics as Alzheimer's disease, cancer, diabetes, Fibromyalgia, Multiple Sclerosis, asthma, and several others. To enhance access, some support groups are held at satellite locations. Most groups meet once or twice a month, typically at night for optimum patient convenience. This also requires staff to work additional hours above their normal workloads. The organization employs a full-time chaplain for our employees, patients, and guests, as well as a full-time chaplain for the Hospice program. Th FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS BAPTIST HEALTHCARE SYSTEM IS THE SOLE CORPORATE MEMBER OF BAPTIST HEALTH MADISONVILLE. FORM 990, PART VI, LINE 7A POWER TO ELECT OR APPOINT MEMBERS THE BOARD OF DIRECTORS IS TO BE APPOINTED BY BAPTIST HEALTHCARE SYSTEM. POWER TO ELECT OR APPOINT MEMBERS To THE BOARD OF DIRECTORS IS TO BE APPOINTED BY BAPTIST HEALTHCARE SYSTEM. FORM 990, PART VI, LINE 7B DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS THE CONSENT & APPROVAL OF THE SOLE MEMBER SHALL BE REQUIRED FOR ALL MAJOR CORPORATE ACTIONS, AND ANY ACT THE RESULT OF WHICH WOULD BE TO: A. APPROVE THE MISSION, VISION, AND VALUE OF THE CORPORATION AND AMENDMENTS THERETO; B. APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION AND THE BYLAWS OF THE CORPORATION; C. APPROVE THE STRATEGIC PLAN OF THE CORPORATION; D. APPROVE THE TRANSFER OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS OR INVESTMENT OR INTEREST IN ANY BUSINESS ENTERPRISE; ANY MERGER, COMBINATION, OR REORGANIZATION OF THE CORPORATION; ANY LIQUIDATION, REORGANIZATION, OR RECAPITALIZATION OF THE CORPORATION; OR ANY AGREEMENT TO DO THE FOREGOING; E. APPROVE THE CAPITAL EXPENDITURE AND OPERATING BUDGETS OF THE CORPORATION, AND ANY UNBUDGETED EXPENDITURES OVER $500,000; F. SELECTION OF THE CORPORATION'S AUDITOR; G. APPROVE THE INCURRENCE OF DEBT OF THE CORPORATION ABOVE $500,000 OR OTHER AMOUNT ESTABLISHED BY BHS AND THE MAKING OF ANY CAPITAL EXPENDITURE ABOVE $500,000 OR OTHER AMOUNT ESTABLISHED BY BHS; H. APPROVE THE APPOINTMENT, REMOVAL, AND EVALUATION OF THE PRESIDENT OR CHIEF EXECUTIVE OFFICER OF THE CORPORATION ACTING THROUGH THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF BHS; I. APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION. APPOINTMENT AND REMOVAL SHALL NOT REQUIRE A RECOMMENDATION OF THE CORPORATION'S BOARD; J. APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE CHAIR OF THE BOARD OF THE CORPORATION. APPOINTMENT AND REMOVAL SHALL NOT REQUIRE A RECOMMENDATION OF THE CORPORATION'S BOARD; K. AUTHORIZE EXECUTION OF ANY CONTRACT, AGREEMENT, OR SIMILAR INSTRUMENT BY WHICH THE CORPORATION MAY BE OBLIGATED TO PAY MORE THAN AN AMOUNT ESTABLISHED BY BHS; L. ACQUIRE ANY STOCK OF ANY CORPORATION OR ANY EQUITY IN ANOTHER CORPORATE FORM, OR INVEST IN OR ACQUIRE ANY INTEREST IN ANY BUSINESS ENTERPRISE. FORM 990, PART VI, LINE 11B PROCESS USED TO REVIEW THE FORM 990 THE INTERNALLY PREPARED FORM 990 IS REVIEWED AND APPROVED BY TAX CONSULTANTS. COPIES ARE GIVEN TO EACH VOTING MEMBER OF THE BOARD PRIOR TO FILING FOR THEIR REVIEW. THE FORM 990 IS THEN PRESENTED AT A MONTHLY MEETING OF THE HOSPITAL'S BOARD OF DIRECTORS. FORM 990, PART VI, LINE 12C MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY CONFLICT OF INTEREST STATEMENTS ARE COMPLETED FOR EACH BOARD MEMBER, PRINCIPAL OFFICER, AND COMMITTEE MEMBER WITH BOARD DELEGATED POWERS. THE CHAIRMAN OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR BEING FAMILIAR WITH THE STATEMENTS AND IDENTIFYING EXISTING OR CONTEMPLATED TRANSACTIONS OR RELATIONSHIPS WHICH MAY GIVE RISE TO A CONFLICT OF INTEREST. AFFECTED BOARD MEMBERS, OFFICERS, AND COMMITTEE MEMBERS ARE ALSO RESPONSIBLE FOR BRINGING CONFLICTS WHICH THEY MAY BE A PART OF TO THE ATTENTION OF THE BOARD. SUCH AFFECTED PARTIES ARE REQUIRED TO WITHDRAW FROM THE MEETINGS FOR THE TIME IN WHICH THE MATTER CONTINUES UNDER DISCUSSION. IF THE MATTER IS BROUGHT TO A VOTE, THE AFFECTED PARTY WILL NOT VOTE ON IT. IF THE MATTER REQUIRES A SPECIAL CALLED MEETING, THE AFFECTED PARTY WILL NOT BE COUNTED IN ESTABLISHING A QUORUM. THE BOARD WILL ALSO APPOINT A NON-INTERESTED PERSON TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION. FORM 990, PART VI, SECTion B, LINE 15A & 15B COMPENSATION DETERMINATION PROCESS EXECUTIVE COMPENSATION FOR BHM IS REVIEWED ANNUALLY IN SEPTEMBER. THIS REVIEW WAS ALSO INCLUDED IN THE REVIEW PERFORMED AT THE SYSTEM LEVEL. COMPENSATION PACKAGES FOR ORGANIZATION EXECUTIVES AND OTHER OFFICERS ARE COMPARED WITH INDEPENDENT SURVEYS AND RECOMMENDATIONS OF CONSULTANTS. COMPENSATION IS ULTIMATELY APPROVED BY THE COMPENSATION COMMITTEE AND DOCUMENTED IN A WRITTEN EMPLOYMENT CONTRACT. FORM 990, PART VI, LINE 19 PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST IN THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: INTERCOMPANY FUNDING ($18,375,086) MEDICAL CENTER AMBULANCE SERVICES INC 629 LAFOON STREET MADISONVILLE KY 42431 610946210 ambulance svc KY 501(c)(3) line 9 na true BAPTIST COMMUNITY HEALTH SERVICES INC 2701 EASTPOINT PARKWAY LOUISVILLE KY 40223 611141242 MEDICAL svcs KY 501(c)(3) line 11a bhs true Baptist Health Medical Group Inc 2701 EASTPOINT PARKWAY LOUISVILLE KY 40223 205497203 PHYSICIAN svc KY 501(c)(3) line 3 bhs true BAPTIST HEALTHCARE FOUNDATION INC 2701 EASTPOINT PARKWAY LOUISVILLE KY 40223 311122867 FUNDRAISING KY 501(c)(3) line 11a bhs true BH FOUNDATION GREATER LOUISVILLE INC 4000 KRESEGE WAY LOUISVILLE KY 40207 200292291 FUNDRAISING KY 501(c)(3) line 11a bhs true BAPTIST HEALTH FOUNDATION LEXINGTON INC 1740 NICHOLASVILLE ROAD LEXINGTON KY 40503 611480774 FUNDRAISING KY 501(c)(3) line 11a bhs true LEXINGTON CARDIAC RESEARCH Fnd Inc 1740 NICHOLASVILLE ROAD LEXINGTON KY 40503 204242792 MEDICAL RSrch KY 501(c)(3) line 11a bhs true BAPTIST HEALTH FOUNDATION PADUCAH INC 2501 KENTUCKY AVENUE PADUCAH KY 42003 264057759 FUNDRAISING KY 501(c)(3) line 11a bhs true MERCY REGIONAL EMERGENCY MEDICAL SYSTEMS 126 LONE OAK ROAD PADUCAH KY 42001 611310466 AMBULANCE Svc KY 501(c)(3) line 11a bhs true BAPTIST HEALTHCARE SYSTEM INC 2701 EASTPOINT PARKWAY LOUISVILLE KY 40223 610444707 HOSPITAL KY 501(c)(3) line 3 NA false BAPTIST HEALTH RICHMOND INC PO Box 1600 RICHMOND KY 40476 610461940 HOSPITAL KY 501(c)(3) line 3 bhs true BAPTIST HEALTH FOUNDATION RICHMOND INC PO Box 1600 RICHMOND KY 40476 311506378 FUNDRAISING KY 501(c)(3) line 11a bhs true PATTIE A CLAY HOSPITAL AUXILIARY PO BOX 1600 RICHMOND KY 40476 510172717 SUPPORT HOSP KY 501(c)(3) line 11a bhs true Baptist Health Foundation Corbin Inc 2701 Eastpoint Parkway Louisville KY 40223 473033550 Fundraising KY 501(c)(3) line 11a bhs true Baptist Health Foundation Madisonville 2701 Eastpoint Parkway Louisville KY 40223 472893430 Fundraising KY 501(C)(3) Line 11a bhs true MUHLENBERG MEDICAL CENTER 200 CLINIC DR MADISONVILLE KY 42431 200108053 RENTAL KY bmms unrelated BAPTIST EASTMILESTONE LLC 750 CYPRESS STATION DR LOUISVILLE KY 40207 611355065 FITNESS CENTER KY BVI EXCLUDED BAPTIST PHYSICIANS' SURGERY CENTER LLC 1720 NICHOLASVILLE Rd 101 LEXINGTON KY 405031490 043665929 AMBULATORY SR KY bchs RELATED BAPTIST EASTPOINT SURGERY CENTER LLC 2400 EASTPOINT PARKWAY LOUISVILLE KY 40223 260834852 AMBULATORY SR KY bchs RELATED MEDICAL ASSOCS OF MIDDLETOWN LLC 4000 KRESEGE WAY LOUISVILLE KY 40207 200399400 MOB KY BHS RELATED PETCT MANAGEMENT LLC 7807 SHELBYVILLE RD STE 201 LOUISVILLE KY 40222 200154982 MGMT AND EQUIP KY BHS RELATED D-1 SPORTS TRAINING OF LOUISVILLE INC 2701 EASTPOINT PARKWAY LOUISVILLE KY 40223 SPORTS TRAINING KY BCHS RELATED ST MATTHEW'S SURGERY CENTER LLC 4130 dutchmans lane suite 200 Louisville KY 40207 453714318 amb surg center KY BCHS RELATED BAPTIST VENTURES INC 2701 EASTPOINT PARKWAY LOUISVILLE KY 40223 611217018 MANAGEMENT KY BHS C Corp true BAPTIST HEALTH PLAN INC 651 PERIMETER PARK STE 300 LEXINGTON KY 40223 611241101 INSURANCE KY BHS C Corp true BAPTIST HEALTH EMPLOYER SOLUTIONS INC 2701 EASTPOINT PARKWAY LOUISVILLE KY 40223 272939694 ACO KY BHS C Corp true MUTUAL CREDIT SERVICES INC PO BOX 149 MADISONVILLE KY 42431 610660705 COLLECTION KY BHS C CORP true BAPTIST MEDICAL MANAGEMENT SERVICES INC 900 hospital drive madisonville KY 42431 371519513 hc mso KY BHS c corp true MS COMMUNITY HEALTH INC 2701 EASTPOINT PARKWAY LOUISVILLE KY 40223 611303514 HEALTH CLINIC KY BHMG C CORP true false false false false false false false false false true false false false false true true false true BAPTIST HEALTH MEDICAL GROUP INC k 119854 Cost BAPTIST HEALTHCARE SYSTEM INC P 754052 Cost BAPTIST HEALTHCARE SYSTEM INC Q 24229704 Cost BAPTIST HEALTHCARE SYSTEM INC S 1731573 Cost BAPTIST HEALTH MEDICAL GROUP INC S 1797593 Cost BAPTIST COMMUNITY HEALTH SERVICES INC S 106874 Cost