2014-08-11T10:44:05-05:00 2013-09-30 861065772 DELOITTE TAX LLP 424 CHURCH STREET SUITE 2400 NASHVILLE TN 37219 990 2012-10-01 630997281 BAPTIST MEMORIAL HOSPITAL- UNION COUNTY INC BAPT 6625382406 200 HIGHWAY 30 WEST NEW ALBANY MS 38652 JASON M LITTLE 9012275117 2014-08-11 1 FRANCIS J BEDARD P00752421 6152591811 2012 2016-02-25 16:41:14Z JASON M LITTLE 350 N HUMPHREYS BLVD MEMPHIS TN 38120 83315274 0 X BMHCC.ORG X 1991 MS SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEATHCARE EDUCATION. 3 3 506 28 367937 -277289 221732 51368 60201213 63615174 3939657 4065327 273082 463945 64635684 68195814 6000 5000 0 0 23940521 24180172 0 0 0 36599561 37202581 60546082 61387753 4089602 6808061 60019436 65307410 7129749 6035244 52889687 59272166 X BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PROVIDES QUALITY HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR AGE. ITS MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEATHCARE EDUCATION. 0 0 53653538 5000 63477595 BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR AGE. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES, AND FURTHER, THAT THE MISSION OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION.(SEE CONTINUATION AT SCHEDULE O, PAGE 51)THEREFORE, IN KEEPING WITH ITS COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PROVIDES THE FOLLOWING:--FREE CARE AND/OR SUBSIDIZED CARE WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST,--CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, AND--HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITYTHESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PROGRAM SERVICES INCLUDED AS OF SEPTEMBER 30, 2013 INCLUDED THE FOLLOWING:--THE SKILLED NURSING DEPARTMENT HAD 14,657 PATIENT DAYS AT A COST OF $10,162,854.--THE SURGERY DEPARTMENT PERFORMED 4,034 PROCEDURES AT A COST OF $5,152,188.--THE PHARMACY DEPARTMENT DISPENSED 337,058 UNIT DOSES OF MEDICATION Cost of $2,272,991.--THE RADIOLOGY DEPARTMENT PERFORMED 43,601 PROCEDURES AT A COST OF $2,265,268.--THE LAB DEPARTMENT PERFORMED 164,404 PROCEDURES AT A COST OF $2,174,213.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY SERVICED 3,774 INPATIENTS AND PROVIDED MORE THAN 46,651 OUTPATIENT VISITS DURING THE FISCAL YEAR 2013.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS FROM WHICH THE HOSPITAL RECEIVES AT LESS THAN MARKET VALUE REIMBURSEMENT. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO MEDICARE, MEDICAID AND UNINSURED PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, BAPTIST MEMORIAL HOSPITAL-UNION COUNTY RECOGNIZES THESE AMOUNTS AS CHARITY CARE IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. DURING THE YEAR ENDING SEPTEMBER 30, 2013, THE UN-REIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS $80,205,672. CHARITY CARE IS ALSO PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES WHICH BAPTIST MEMORIAL HOSPITAL-UNION COUNTY BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY HAS PROVIDED A NUMBER OF SERVICES IN THE COMMUNITY, SOME OF WHICH INCLUDE THE FOLLOWING: --HOSPITAL TOURS FOR VARIOUS COMMUNITY GROUPS AND SCHOOL ORGANIZATIONS --PROVIDED REPRESENTATIVES WHO SPOKE FREE OF CHARGE TO VARIOUS COMMUNITY GROUPS, CHURCHES, AND SCHOOLS THROUGHOUT THE YEAR --BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PRESENTED SEVERAL HEALTH FAIRS, BAPTIST HEALTHPLEX and HOSPITAL SPONSORED HEALTHY LIFESTYLE PROGRAMS AS WELL AS 5K RUNS THROUGHOUT THE YEAR FOR ADULTS AND CHILDREN. --BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PROVIDED SEVERAL HEALTH SCREENINGS AND VACCINATIONS THROUGHOUT THE YEAR FOR THE COMMUNITY AT NO-CHARGE OR REDUCED PRICES. --BAPTIST MEMORIAL HOSPITAL-UNION COUNTY CONDUCTED FREE LUNCHEONS ON VARIOUS HEALTH-RELATED TOPICS FOR THE COMMUNITY, SUCH AS BREAST CANCER AWARENESS, STROKE, AND HEART HEALTH. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PROVIDED VARIOUS FREE OR REDUCED PRICED CLASSES TO THE COMMUNITY THROUGHOUT THE YEAR, WHICH INCLUDED THE FOLLOWING:--CPR, FIRST AID, AED CLASSES --CHILDBIRTH CLASSES --BREASTFEEDING CLASSES --TOBACCO CESSATION CLASSES--DIABETIC CLASSES BAPTIST MEMORIAL HOSPITAL-UNION COUNTY OFFERS AN ANNUAL COMMUNITY HEALTH FAIR. FOR A REDUCED RATE, INDIVIDUALS WERE ABLE TO RECEIVE CHOLESTEROL, GLUCOSE, TRIGLYCERIDES AND PSA RESULTS AND RECEIVE FLU AND/OR PNEUMONIA VACCINES. OTHER SCREENINGS AVAILABLE FOR FREE ARE: HEIGHT, WEIGHT, BMI, BLOOD PRESSURE AND BONE DENSITY AND FREE EYE SCREENING FROM A LOCAL OPTOMETRIST. EDUCATIONAL INFORMATION WAS PROVIDED ON HEALTH ISSUES SUCH AS NUTRITION, MEN'S HEALTH, WOMEN'S HEALTH, CANCER, FITNESS, AND BMI. REPRESENTATIVES FROM THE RADIOLOGY DEPARTMENT WERE ALSO ON HAND TO PROMOTE BREAST CANCER AWARENESS AND EARLY DETECTION THROUGH SCREENINGS.IN ADDITION TO THE COMMUNITY HEALTH FAIR, SEVERAL HEALTH FAIRS WERE PROVIDED ON-SITE FOR EMPLOYEES INCLUDING BNA BANK, WORTHINGTON CYCLINDERS, NEW ALBANY GAZETTE, NEWALBANY SCHOOLS, AND UNION COUNTY SCHOOLS. CHILDREN, AGES NEWBORN TO 12 YEARS OLD, WERE INVITED TO ATTEND OUR ANNUAL BACK TO SCHOOL HEALTH FAIR. THIS EVENT WAS EXPANDED TO NEWBORNS AND TODDLERS TO PROMOTE LEARNING IN EARLY CHILDHOOL AS PART OF THE EXCEL BY 5 COMMUNITY INIATITVE. SCREENINGS OFFERED WERE BLOOD PRESSURE, HEIGHT AND WEIGHT, BMI, AND VISION. EDUCATIONAL DISPLAYS FROM VARIOUS COMMUNITY GROUPS AND HOSPITAL REPRESENTATIVES WERE AVAILABLE, SUCH AS, NUTRITION, DENTAL, FINGERPRINTING, HANDWASHING, TOBACCO PREVENTION, ATV SAFETY, CHILDREN'S ASHTMA, AND CAR SEAT SAFETY TO NAME A FEW. THE ANNUAL EVENT ALWAYS DRAWS A CROWD OF 500 OR MORE CHILDREN PLUS ADULTS. PARTICIPANTS ENJOY FREE GAMES AND REFRESHMENTS ALONG WITH MANY GIVEAWAYS AND SCHOOL SUPPLIES.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY HOSTS AN ANNUAL BABY CARE FAIR FOR EXPECTANT MOTHERS. INFORMATION INCLUDES CARSEAT SAFETY, NUTRITION, WELLNESS, BABY CARE, PREADMISSIONS, LACTATION SPECIALIST, AND WIC. THE EVENT ATTRACTS ABOUT 120 MOTHERS ON AVERAGE.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY RECOGNIZES THAT ITS PEOPLE ARE ITS MOST VALUABLE ASSET. TO SHARE THIS ASSET WITH THE COMMUNITY AT LARGE, ALL PERSONNEL ARE ENCOURAGED TO GET INVOLVED BY VOLUNTEERING. BELOW IS A PARTIAL LISTING OF ORGANIZATIONS AND ACTIVITIES BAPTIST MEMORIAL HOSPITAL-UNION COUNTY SUPPORTED THROUGH ITS VOLUNTEER'S EFFORTS: --NEW HAVEN CENTER FOR SPECIAL NEEDS ADULTS--BOYS AND GIRLS CLUBS--AMERICAN HEART ASSOCIATION HEART EDUCATION IN SCHOOLS--AMERICAN CANCER SOCIETY'S RELAY FOR LIFE--TANGLEFOOT TRAILS--BNA PARK AND SPORTSPLEX--AMERICAN RED CROSS--NORTHEAST UNION FIRE DEPARTMENT FIRE SAFETY HOUSE--DIABETIC SUPPORT--BREAST CANCER AWARENESS--TALLAHATCHIE 5K RIVER RUN--SPONSORSHIP OF SCHOOL SAFETY--FOOD DRIVE FOR THE GOOD SAMARITIAN CENTER--UNION COUNTY FAIR ASSOCIATION CHILDREN'S DAY AT THE FAIR--UNION COUNTY FAIR SENIOR ADULT HEALTH FAIR--CAMP BLUEBIRD--NEW ALBANY MAIN STREET ASSOCIATION--MAGNOLIA CIVIC CENTER--LIGHTHOUSE CENTER--FIRST CHOICE FOR WOMEN--NEW ALBANY KIWANIS--NEW ALBANY ROTARY--UNION COUNTY DEVELOPMENT ASSOCIATION--SANCTUARY HOSPICE HOUSE--JUNIOR AUXILIARY--KOMEN FOUNDATION--MINORITY PUL ALLIANCE--EXCEL BY 5 COALITION--UNION COUNTY SCHOOLS--NEW ALBANY CITY SCHOOLS 53653538 1 1 0 1 0 0 0 0 0 0 1 1 1 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 X 0 0 1 506 1 1 1 0 0 0 0 0 0 0 0 0 X 3 3 0 1 0 0 1 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 X KIM HIGH 6625382406 HIGHWAY 30 WEST NEW ALBANY MS 38652 REV TOM SUMRALL 0.20 0.00 X 0 0 0 JOHN STANFORD DDS 0.20 0.00 X 0 0 0 LUDWRICK E BROWN 0.20 0.00 X 0 0 0 KIMBERLY D HIGH 40.00 0.00 X 105847 0 37337 STEPHEN C REYNOLDS 0.20 39.80 X 0 2474610 68968 JASON M LITTLE 0.20 39.80 X 0 1140766 51370 GREGORY M DUCKETT 0.20 39.80 X 0 807335 64462 WALTER J GRACE 40.00 0.00 X 0 210375 44865 LARRY RAMSEY 40.00 0.00 X 110481 0 37337 ANGELA BROWNING 40.00 0.00 X 102681 0 37322 319009 4633086 341661 3 0 1 0 MIDSOUTH ANESTHESIA CONSULTANTS PLLC PO BOX 1572 SOUTHAVEN MS 38671 ANESTHESIA SERVICES 1290365 1 12535 38833 51368 HOSPITAL REVENUES 713940 63615174 63298480 316694 63615174 1321704 1321704 55686 44324 11362 11362 11362 17729084 89675 14945882 129254 2783202 -39579 2743623 2743623 CAFETERIA REVENUE 722210 250424 51243 199181 INSURANCE RECOVERIES 900099 178356 178356 PAT./EMP. CONVENIENCES 900099 23044 23044 759 759 452583 68195814 63477595 367937 4298914 5000 5000 137736 114321 23415 18076723 15003680 3073043 783263 650108 133155 3874942 3216202 658740 1307508 1085232 222276 6857 6857 3861604 3205132 656472 84189 69877 14312 1336586 1109366 227220 1205752 1000774 204978 67944 56394 11550 31738 26343 5395 227023 188429 38594 5318526 4414377 904149 1777543 1475361 302182 68990 57262 11728 BAD DEBT, NET OF RECOVE 13321216 13321216 0 MEDICAL SUPPLIES 5304551 4402777 901774 MEDICAID ASSESSMENT 2545877 2545877 0 REPAIRS & MAINTENANCE 1573873 1306315 267558 470312 392638 77674 61387753 53653538 7734215 0 1566 1564 1819170 2307136 5771475 5813711 1455062 1494950 119602 126301 43495099 32471640 11640058 11023459 38614187 43698953 598316 841336 60019436 65307410 2345176 2565572 4784573 3469672 7129749 6035244 X 52838533 59221012 51154 51154 52889687 59272166 60019436 65307410 X 6808061 977154 -1402736 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6857 6857 0 Explanation of Lobbying Activities: Part II-B, Line 1: BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PAYS MEMBERSHIP DUES TO THE MISSISSIPPI HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION FOR WHICH A PERCENTAGE OF THE DUES IS RELATED TO LOBBYING EXPENDITURES. THE SOLE MEMBER, BAPTIST MEMORIAL HEALTH CARE CORPORATION, PAYS MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION, THE ARKANSAS HOSPITAL ASSOCIATION, THE MISSISSIPPI HOSPITAL ASSOCIATION, AND THE TENNESSEE HOSPITAL ASSOCIATION. A PORTION OF THOSE DUES ARE FOR CONSULTANTS WHO ADVISE AND CONSULT WITH THE ORGANIZATION ON LEGISLATIVE AND REGULATORY MATTERS THAT MAY AFFECT THE ORGANIZATION AND ITS AFFILIATES. THESE CONSULTANTS MAY ADVOCATE POSITIONS WITH THE LEGISLATIVE AND REGULATORY BODIES OF GOVERNMENT AT LOCAL, STATE, AND FEDERAL LEVELS. 250000 250000 12686613 7556033 5130580 24651364 20121245 4530119 5907122 4794362 1112760 11023459 INVESTMENT IN GROUP ASSET FUNDS 43687654 F PENSION FUND INVESTMENTS 11299 F 43698953 CAPITAL LEASE OBLIGATIONS 3064806 ESTIMATED SETTLEMENTS WITH THIRD PARTIES 58026 DUE TO AFFILIATES 346840 3469672 X 54780145 0 54780145 13415669 13415669 68195814 47972084 0 47972084 13415669 13415669 61387753 Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: AS OF SEPTEMBER 30, 2013 AND 2012, THE HOSPITAL HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS UNDER FASB ASC TOPIC 740, INCOME TAXES, REQUIRING ADJUSTMENTS TO ITS FINANCIAL STATEMENTS. IN THE EVENT THE HOSPITAL WERE TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE RECOGNIZED IN THE FINANCIAL STATEMENTS AS INTEREST EXPENSE. GENERALLY, TAX YEARS 2010 THROUGH 2013 ARE OPEN TO EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES. THERE ARE NO INCOME TAX EXAMINATIONS CURRENTLY IN PROCESS. Part XI, Line 4b - Other Adjustments: LOSS ON DISPOSAL OF ASSETS -39,579. INSURANCE RECOVERIES 178,356. BAD DEBTS, NET OF RECOVERIES 13,321,216. RENT EXPENSE -44,324. Part XII, Line 4b - Other Adjustments: LOSS ON DISPOSAL OF ASSETS -39,579. INSURANCE RECOVERIES 178,356. RENTAL EXPENSES -44,324. BAD DEBTS, NET OF RECOVERIES 13,321,216. 1 1 X 1 X 1 X 1 1 0 1 1 2809445 0 2809445 0.05840 16250766 15853267 397499 0.00830 560227 710438 -150211 0.00000 19620438 16563705 3056733 0.06670 20 11242 116027 15369 100658 0.00210 2 193 42631 0 42631 0.00090 16316281 13042358 3273923 0.06810 5 744 21390 0 21390 0.00040 27 12179 16496329 13057727 3438602 0.07150 27 12179 36116767 29621432 6495335 0.13820 1 0 3897 0 3897 0.00000 3 535 10543 0 10543 0.00020 1 176 6239 0 6239 0.00010 1 350 26222 220 26002 0.00050 6 1061 46901 220 46681 0.00080 1 4808915 3013316 6195878 5703645 492233 X 1 1 1 1 BAPTIST MEMORIAL HOSPITAL-UNION COUNTY

200 HWY 30 WEST NEW ALBANY MS 38652

WWW.BAPTISTONLINE.ORG/UNION-COUNTY/ X X X BAPTIST MEMORIAL HOSPITAL-UNION COUNTY 1 1 X X X X X X X X 12 1 0 1 X X X X X X X X 1 0 1 1 100.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X X X 1 0 1 X 0 0 Part I, Line 7: OUR COST ACCOUNTING PROCESS REFLECTS FULLY LOADED COST FOR ALL OF OUR PATIENT POPULATIONS. FULLY LOADED COST INCLUDES DIRECT, CAPITAL, AND INDIRECT COST. AFTER WORKING WITH OUR DEPARTMENT DIRECTORS AND CFOS TO MAKE SURE THE DOLLARS IN THE GENERAL LEDGER ARE IN THE CORRECT PLACE TO REFLECT OUR TIME AND EFFORTS SPENT THROUGHOUT THE YEAR, WE DEVELOP RELATIVE VALUE UNITS TO ALLOCATE THE ACTUAL GENERAL LEDGER COST DOWN TO THE PROCEDURE CHARGE CODES FROM OUR PATIENT ACCOUNTING SYSTEM. ALL OVERHEAD IS ALLOCATED DOWN TO THE REVENUE PRODUCING DEPARTMENTS BASED ON VARIOUS STATISTICS. ONCE EVERY CHARGE CODE HAS GONE THROUGH THE COST AND AUDIT PROCESS, WE CAN RUN THE PATIENT LEVEL REPORTS USED FOR THE FORM 990 TO GET TO THE COST INFORMATION NEEDED. Part I, Line 7g: SUBSIDIZED HEALTH SERVICES DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. Part I, L7 Col(f): PART I, LINE 7, COLUMN (F):PER IRS INSTRUCTIONS, BAD DEBT EXPENSE WAS NOT INCLUDED IN THE CALCULATION OF THE PERCENTAGE OF TOTAL CHARITY CARE AND COMMUNITY BENEFITS COST ON SCHEDULE H, LINE 7, COLUMN (F).PART I, LINE 7c, COLUMN (F):DUE TO SOFTWARE LIMITATIONS, THE PERCENT OF TOTAL EXPENSES FOR LINE 7C COLUMN (F) UNREIMBURSED COSTS-OTHER MEANS TESTED GOVERNMENT PROGRAMS IS REPORTED AS ZERO, BUT THE ACTUAL AMOUNT OF LINE 7C IS -.31%. PART I, LINE 6a:THE COMMUNITY BENEFIT REPORT IS PREPARED BY THE HOSPITAL'S SOLE MEMBER, BAPTIST MEMORIAL HEALTH CARE CORPORATION. THE COMMUNITY BENEFIT REPORT IS MADE AVAILABLE TO THE PUBLIC BY MAIL AND AVAILABLE AT EACH AFFILIATE OF BAPTIST MEMORIAL HEALTH CARE CORPORATION. Part II: BAPTIST MEMORIAL HOSPITAL CONDUCTS SEVERAL HEALTH FAIRS, SEMINARS AND CLASSES THROUGHOUT THE YEAR FOR THE COMMUNITIES IT SERVES. BAPTIST ALSO IS INVOLVED IN LOCAL COMMUNITY AND NON-PROFIT ORGANIZATIONS SUCH AS THE AMERICAN CANCER SOCIETY RACE FOR THE CURE, WALK AMERICA, ST. JUDE, AND MANY OTHERS. NOT ONLY DO WE PROVIDE MONETARY DONATIONS, BUT OUR EMPLOYEES ARE ACTIVE VOLUNTEERS IN THESE WORTHY CAUSES. Part III, Line 4: FROM THE AUDITED FINANCIAL STATEMENTS OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND SEPTEMBER 30, 2012:ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ACCOUNTS RECEIVABLE BY PAYOR CATEGORY IN DETERMINING THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ADDITIONALLY, THE HOSPITAL ALSO CONSIDERS PAST HISTORY, COLLECTION TRENDS, THE AGE OF THE ACCOUNTS RECEIVABLE, AND RECOVERIES OF AMOUNTS PREVIOUSLY WRITTEN OFF IN DETERMINING AND EVALUATING THE AMOUNT OF THE ALLOWANCE. HISTORICALLY, THE HOSPITAL HAS NOT HAD SIGNIFICANT BAD DEBTS ON ACCOUNTS RECEIVABLE FROM THIRD-PARTY PAYORS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF OFFERED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS INCREASED FROM 38.62% OF ACCOUNTS RECEIVABLE (NET OF CONTRACTUALS) AS OF SPETEMBER 30, 2012, TO 42.48% AS OF SEPTEMBER 30, 2013. THIS INCREASE IS PRIMARILY THE RESULT OF DECREASES IN COLLECTION RATES EXPERIENCED IN 2012.PART II, LINES 2 AND 3:THE COSTING METHODOLGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3: A BAD DEBT REPORT IS RUN TO PULL ALL PATIENTS THAT HAVE BEEN MOVED TO A BAD DEBT ACCOUNT LOCATION. WE TAKE THE TOTAL ACCOUNT BALANCE OF ALL THE PATIENTS IN THE BAD DEBT LOCATION AND DIVIDE IT BY THE TOTAL CHARGES OF THE SAME PATIENT POPULATION. WE MULTIPLY THE RESULTING RATIO BY THE TOTAL COST OF THE SAME PATIENT POPULATION. THIS GIVES US THE COST ASSOCIATED WITH THE TOTAL AMOUNT OF THE ACCOUNT BALANCE MOVED TO THE BAD DEBT STATUS.WE RUN A QUERY OUT OF OUR INTERNAL DATA WAREHOUSE SYSTEM THAT IDENTIFIES THIS PATIENT POPULATION. THIS INFORMATION IS ENTERED INTO THE STANDARD NOTE SECTION OF EACH PATIENT RECORD. WE QUALIFY OUR PATIENT QUERY BY THE STANDARD NOTES THAT REPRESENT WHEN A PATIENT REFUSES TO COMPLETE THE PAPERWORK, IF THE INFORMATION PROVIDED BY THE PATIENT IS INCOMPLETE, OR WHEN A SELF-PAY MINIMUM DISCOUNT NOTE IS ENTERED ON THE PATIENT RECORD. WE THEN TAKE THIS PATIENT POPULATION AND RUN A REPORT THAT GIVES US THE TOTAL COST OF THE PATIENT POPULATION. Part III, Line 8: WE CAN'T GET THE PAYMENT AND MEDICARE ALLOWABLE COST INFORMATION FROM THE COST REPORT IN THE FORMAT THAT WE NEED, SO WE DO THE FOLLOWING. FOR LINE 5, WE TAKE THE TOTAL PAYMENTS FOR MEDICARE PATIENTS FROM SCHEDULE 6 PATIENT POPULATION AND DIVIDE THAT BY THE TOTAL HOSPITAL MEDICARE PAYMENTS. WE MULTIPLY THE RESULTING RATIO BY THE REVENUE NUMBERS THAT COME FROM THE COST REPORT. FOR LINE 6, WE USE THE SAME CONCEPT TO GET THE COST INFORMATION. WE GET THE TOTAL COST OF MEDICARE PATIENTS FROM SCHEDULE 6 AND DIVIDE THAT NUMBER BY THE TOTAL COST OF THE TOTAL MEDICARE PATIENT POPULATION OF THE HOSPITAL. WE THEN MULTIPLY THIS RATIO BY THE COST INFORMATION FROM THE COST REPORT. Part III, Line 9b: THE HOSPITAL'S COLLECTION AGENCY, WILL DETERMINE IF THE PATIENT HAS A CHARITY APPLICATION ON FILE AND WAS DEEMED TO BE A CHARITY CASE BY THE HOSPITAL. IF IT WAS DETERMINED THAT THE PATIENT IS A CHARITY CASE, THEN THE COLLECTION AGENCY WILL REVIEW THE REMAINING UNPAID BALANCE AFTER THE APPLICATION OF THE CHARITY DISCOUNT, AND PURSUE APPROPRIATE COLLECTION EFFORTS. DEPENDING UPON THE CIRCUMSTANCES AT THE TIME, THE ENTIRE AMOUNT OWED MAY BE WRITTEN OFF.OTHER PATIENTS, WHO ARE NOT CHARITY PATIENTS, GENERALLY ARE NOT OFFERED A DISCOUNT ON THE AMOUNT OWED IF THE ACCOUNT IS 0-6 MONTHS OLD. THE HOSPITAL'S COLLECTION AGENCY WILL TRY TO SET UP A PAYMENT PLAN. IF THE PATIENT HAS INSURANCE AND THE BILL WAS FILED WITH THEIR INSURANCE COMPANY, THE PRIOR PPO ADJUSTMENT IS GIVEN. THE AMOUNT OF DISCOUNT INCREASES AS THE AGE OF THE DEBT INCREASES. AS THE AGE OF THE DEBT INCREASES, DETERMINING FACTORS ARE ALSO CONSIDERED SUCH AS THE ABILITY OF THE PATIENT TO PAY, THE AGE AND HEALTH OF THE PATIENT, FAMILY CIRCUMSTANCES, CREDIT SCORE, ETC.RISK FACTORS ARE ALSO CONSIDERED WHEN DETERMINING WHETHER TO SETTLE AN ACCOUNT. RISK FACTORS INCLUDE HARDSHIP AND CATASTROPHE, OTHER DEBTS, AND FUTURE EXPECTANCIES. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY Part V, Section B, Line 3: SURVEYS:A STATISTICAL HOUSEHOLD SURVEY WAS COMPLETED WITH 528 ADULTS FROM THE BAPTIST MEMORIAL HOSPITAL-UNION COUNTY SERVICE AREA. THE SURVEY THAT WAS UTILIZED ALIGNS WITH THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) QUESTIONNAIRE THAT IS ANNUALLY CONDUCTED NATIONWIDE BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND STATE HEALTH DEPARTMENTS. THE SURVEY ASSESSED INDICATORS SUCH AS GENERAL HEALTH STATUS, PREVENTION ACTIVITIES (SCREENINGS, EXERCISE, ETC.), AND RISKY BEHAVIORS (ALCOHOL USE, ETC.). THE RESULTS WERE ALSO EXAMINED BY A VARIETY OF DEMOGRAPHIC INDICATORS SUCH AS AGE, RACE, ETHNICITY, AND GENDER.KEY INFORMANT INTERVIEWS:KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH 75 PROFESSIONALS AND KEY CONTACTS IN THE AREAS SURROUNDING THE 14-HOSPITAL SERVICE AREAS. WORKING WITH LEADERSHIP FROM EACH OF THE SYSTEM HOSPITALS, BAPTIST IDENTIFIED SPECIFIC INDIVIDUALS TO BE INTERVIEWED AND INVITED THEM TO PARTICIPATE IN THE STUDY. THE SURVEY INCLUDED A RANGE OF INDIVIDUALS, INCLUDING ELECTED OFFICIALS, PRIVATE PHYSICIANS, HEALTH AND HUMAN SERVICES EXPERTS, LONG-TERM CARE PROVIDERS, REPRESENTATIVES FROM THE FAITH COMMUNITY, AND EDUCATORS. THE CONTENT OF THE QUESTIONNAIRE FOCUSED ON PERCEPTIONS OF COMMUNITY NEEDS AND STRENGTHS ACROSS THREE KEY DOMAINS: PERCEIVED QUALITY OF CARE, KEY HEALTH ISSUES PROMINENT IN THE COMMUNITY, AND QUALITY OF LIFE ISSUES. FOCUS GROUPS:IN NOVEMBER 2012, HEALTH CARE CONSUMERS FROM THE HOSPITALS' SERVICE AREAS PARTICIPATED IN FOCUS GROUPS. THE FOCUS GROUPS ADDRESSED DIABETES AND PRE-DIABETES BASED ON FINDINGS FROM THE SURVEYS. DISCUSSION TOPICS INCLUDED HEALTH KNOWLEDGE, SELF-CARE BEHAVIORS, HEALTH CARE ACCESS, COMMUNICATION PREFERENCES, AND DESIRED SUPPORT SERVICES. A DISCUSSION GUIDE, DEVELOPED IN CONSULTATION WITH BAPTIST MEMORIAL HEALTH CARE, WAS USED TO PROMPT DISCUSSION AND GUIDE THE FACILITATION. PARTICIPANTS WERE RECRUITED THROUGH TELEPHONE CALLS TO HOUSEHOLDS WITHIN THE SERVICE AREA AND THROUGH LOCAL HEALTH AND HUMAN SERVICE ORGANIZATIONS. PARTICIPANTS WERE PRE-SCREENED TO ENSURE THAT THEY WERE EITHER DIABETIC OR PRE-DIABETIC. EACH SESSION LASTED APPROXIMATELY TWO HOURS AND WAS FACILITATED BY TRAINED HOLLERAN STAFF. IN EXCHANGE FOR THEIR PARTICIPATION, ATTENDEES WERE GIVEN A $50 CASH INCENTIVE AT THE COMPLETION OF THE FOCUS GROUP; DINNER WAS ALSO PROVIDED. IT IS IMPORTANT TO NOTE THAT THE FOCUS GROUP RESULTS REFLECT THE PERCEPTIONS OF A SMALL SAMPLE OF COMMUNITY MEMBERS AND MAY NOT NECESSARILY REPRESENT ALL COMMUNITY MEMBERS IN THE HOSPITAL'S SERVICE AREA. COMMUNITY REPRESENTATION:COMMUNITY ENGAGEMENT AND FEEDBACK WERE AN INTEGRAL PART OF THE CHNA PROCESS. A STATISTICALLY VALID SAMPLING STRATEGY ENSURED COMMUNITY REPRESENTATION IN THE HOUSEHOLD SURVEY. PUBLIC HEALTH EXPERTS, HEALTH CARE PROFESSIONALS, AND REPRESENTATIVES OF UNDERSERVED POPULATIONS SHARED KNOWLEDGE AND EXPERTISE ABOUT COMMUNITY HEALTH ISSUES AS PART OF THE KEY INFORMANT INTERVIEWS. HEALTH CARE CONSUMERS, INCLUDING MEDICALLY UNDERSERVED INDIVIDUALS AND CHRONICALLY-ILL PATIENTS, WERE INCLUDED IN THE FOCUS GROUPS.LINE 5a:THE CHNA IS AVAILABLE ON THE HOSPITAL'S WEBSITE AT WWW.BAPTISTONLINE.ORG/UNION-COUNTY. BAPTIST MEMORIAL HOSPITAL-UNION COUNTY Part V, Section B, Line 20d: PATIENTS RECEIVING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE WHO DO NOT HAVE INSURANCE ARE BILLED IN ACCORDANCE WITH THE TERMS OF THE HOSPITAL'S "CHARITY, UNINSURED AND INDIGENT POLICY." THIS POLICY OFFERS PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE A VARIETY OF PAYMENT OPTIONS OR TERMS FOR PAYMENT. THE HOSPITAL UTILIZES PAYMENT PROCEDURES FOR UNINSURED OR MEDICALLY UNDERINSURED, WHICH TAKE INTO CONSIDERATION OTHER PAYMENT ARRANGEMENTS WITH INSURANCE COMPANIES, MANAGED CARE NETWORKS, AND GOVERNMENT-SPONSORED PROGRAMS. Part VI, Line 2: BAPTIST MEMORIAL HEALTH CARE CORPORATION, THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC., PROVIDES NEEDS ASSESSMENTS THROUGH THE HEALTH SERVICES RESEARCH DEPARTMENT. IN ADDITION, LOCAL ADVISORY BOARDS PROVIDE FEEDBACK TO THE LOCAL HOSPITAL ADMINISTRATORS. THE HEALTH SERVICES RESEARCH DEPARTMENT USES VARIOUS TOOLS TO ASSIST THEM IN THE ASSESSMENTS.ONE OF THESE TOOLS USED BY HEALTH SERVICES RESEARCH DEPARTMENT IS YACOUBIAN RESEARCH, INC. COMMUNITY OPINION SURVEY. THIS IS A QUARTERLY RANDOM-DIGIT DIALING TELEPHONE SURVEY. SURVEYS INCLUDE QUESTIONS ASKING RESPONENTS TO GRADE THE QUALITY OF HEALTH CARE SERVICES IN THEIR COMMUNITY. THE SERVICES ARE GRADED FROM A-F. IF A SERVICE IS GIVEN A RATING OF C OR BELOW, THE RESPONDENTS ARE ASKED FOR IDEAS FOR IMPROVEMENT. THESE CAN BE REVIEWED BY AREA, COUNTY, TOWN, ZIP CODE, AGE, GENDER, AND RACE. THE IMPROVEMENTS REQUESTED GENERALLY INVOLVE REQUESTS FOR MORE AND BETTER DOCTORS AND STAFF, AND LESS WAIT TIME. MEDICAL STAFF SURVEYS ARE ALSO USED TO ASSESS NEEDS. THESE ARE CONDUCTED BY MAIL OR INTERNET (WHICH EVER IS PREFERRED BY THE RESPONDENT) BY PRESS-GANEY, A NATIONALLY KNOWN RESEARCH COMPANY FOR BOTH PATIENT SATISFACTION AND PHYSICIAN SATISFACTION. IN THIS SURVEY, CONDUCTED EVERY OTHER YEAR, RESPONDENTS ARE QUESTIONED ABOUT THE NEED FOR NEW SERVICES OR PHYSICIAN SPECIALTIES IN THE HOSPITAL OR COMMUNITY. THERE ARE USUALLY MULTI-PHYSICIAN RECOMMENDATIONS FOR ADDITIONAL EQUIPMENT AND CERTAIN TYPES OF PHYSICIAN SPECIALISTS. THIS IS USED AS A STARTING POINT FOR DETERMINING POTENTIAL PRIORITIES FOR PHYSICIAN RECRUITING.COMMUNITY NEEDS ASSESSMENT FOR ADDITIONAL PHYSICIANS IN THE COMMUNITY IS ALSO CONDUCTED. POPULATION-BASED DEMAND ESTIMATES ARE OBTAINED FROM THE MEDSTAT INFORUM MEDI-EDGE SOFTWARE, AND TAKES INTO ACCOUNT THE AGE AND GENDER OF THE POPULATION. THIS IS THEN COMPARED TO THE SUPPLY OF PHYSICIANS AS DETERMINED THROUGH SEVERAL DIFFERENT SOURCES-INCLUDING OUR OWN CALLING OF OFFICES TO DETERMINE THE FULL TIME EQUIVALENT OF PHYSCIANS AVAILABLE IN THE SPECIALTY OF INTEREST. THE DEMAND MINUS THE SUPPLY GIVES THE "NET NEED" CURRENTLY, AND IN 5 YEARS. THE REQUEST FOR THESE ANALYSES ARE MADE BY THE HOSPITAL'S CHIEF EXECUTIVE OFFICERS' BASED ON THE PRIORITIES GIVEN BY THE MEDICAL STAFF AND ACCORDING TO KNOWLEDGE OF CERTAIN PHYSICIANS THAT ARE LIKELY TO BE LEAVING THE AREA IN THE NEXT YEAR OR TWO. GENERALLY THE DEMAND AND SUPPLY ESTIMATES ARE FOR A GEOGRAPHIC AREA DEFINED BY THE HALF-WAY MARK BETWEEN OUR FACILITY AND THE COMMUNITY HAVING A SIMILAR SIZED MEDICAL FACILITY OF A COMPETITOR. IN LARGER MARKET AREAS, THE PHYSICIAN NEEDS ARE GENERALLY CONCENTRATED AROUND HIGHLY SPECIALIZED PHYSICIANS WHO MAY BE LEAVING OR RETIRING. THE SOFTWARE PACKAGE HAS MODULES THAT ARE USED TO DETERMINE THE NEED FOR NEW FACILITIES, SUCH AS HOSPITALS, URGENT CARE CENTERS, EXPANDED EMERGENCY ROOMS, ETC. THIS IS REVIEWED IF THERE IS AN INCREASE IN POPULATION GROWTH.PATIENT SATISFACTION SURVEYS ARE ANOTHER TOOL USED TO ASSESS NEED. PRESS GANEY MAILS SURVEYS EVERY TWO WEEKS TO A RANDOM SAMPLE OF DISCHARGED PATIENTS. THE GOAL IS TO GET APPROXIMATELY 350 COMPLETED SURVEYS PER YEAR IN EACH OF THE VARIOUS CARE SETTINGS PER FACILITY. THESE CARE SETTINGS INCLUDE INPATIENT, OUTPATIENT, EMERGENCY ROOMS, OUTPATIENT SURGERY, OUTPATIENT DIAGNOSTICS, HOME HEALTH CARE, URGENT CARE CENTERS, ETC. BASED ON THESE SURVEYS, THE NEED FOR SPECIFIC CHANGES IN PROCESSES OR TYPES OF PERSONNEL ARE ASSESSED TO MEET THE NEEDS OF THE COMMUNITIES WE SERVE.NATIONAL RESEARCH CORPORATION IS A RESEARCH COMPANY THAT INTERVIEWS 600 PEOPLE IN OUR COMMUNITY SERVICE AREA EACH YEAR VIA THE INTERNET. THESE PEOPLE ARE A PART OF A PANEL SELECTED TO REPRESENT THE CHARACTERISTICS OF THE COMMUNITY. THIS SURVEY PROVIDES AN ON-LINE TOOL FOR DETERMINING SELF-REPORTED PERCENTAGES WITH CHRONIC CONDITIONS AND USE OF PREVENTIVE SERVICES IN AREAS OF SIMILAR SIZE AND CHARACTERISTICS AROUND THE COUNTRY. Part VI, Line 3: PATIENTS ARE INFORMED OF THEIR ELIGIBILTY FOR ASSISTANCE IN PERSON UPON ENTERING THE HOSPITAL FACILITY. EACH PATIENT IS ASSIGNED AN ADMISSION'S PERSON WHO PROVIDES WRITTEN INFORMATION AS WELL AS VERBAL INFORMATION. Part VI, Line 4: BAPTIST MEMORIAL HOSPITAL-UNION COUNTY SERVICES THE UNION COUNTY, MISSISSIPPI AREA. SOME PATIENTS COME FROM OTHER MISSISSIPPI COUNTIES SURROUNDING THE UNION COUNTY AREA. THE AFRICAN-AMERICAN COMMUNITY COMPRISES ABOUT 17.4% OF OUR PRIMARY SERVICE AREA. HISPANICS MAKE UP ABOUT 3.2%, AND CAUCASIONS ARE ABOUT 78.4%.DEMOGRAPHIC SNAPSHOTS ARE PROVIDED BY THE INDEPENDENT OUTSIDE FIRM OF CLARITAS, INC. OUR OWN HEALTH SERVICES RESEARCH DEPARTMENT AT BAPTIST MEMORIAL HEALTH CARE CORPORATION (OUR PARENT) CALCULATES THE DISTRIBUTION OF INPATIENT DISCHARGES (EXCLUDING NEWBORNS) BY COUNTY. THIS IS SORTED IN DESCENDING NUMBER PER COUNTY AND DETERMINES THOSE COUNTIES WITH UP TO 75-77% OF THE DISCHARGES AND THESE CONTIGUOUS COUNTIES COMPRISE THE PRIMARY MARKET AREA. COUNTIES COMPRISING 78-95% OF THE DISCHARGES ARE DESIGNATED THE SECONDARY MARKET, WHILE THE REMAINING 5% IS THE TERTIARY MARKET.BAPTIST MEMORIAL HOSPITAL-UNION COUNTY'S PRIMARY MARKET SERVICE AREA HAS 85,324 PERSONS WITH THE COMBINED PRIMARY AND SECONDARY AREA HAVING 264,178 PERSONS. OTHER ITEMS SUCH AS AGE, HOUSEHOLD INCOME, AND RACE/ETHNICITY PERCENTAGES, AS COMPARED TO THE NATION AS A WHOLE, ARE ALSO USED IN THE MIX.DUNN AND BRADSTREET DATA IS ALSO USED TO DETERMINE THE COMMUNITIES LARGEST EMPLOYERS. Part VI, Line 5: THE HOSPITALS HAVE OPEN MEDICAL STAFFS, COMMUNITY BOARD INVOLVMENT, SUPPORT SERVICES, FREE AND/OR REDUCED MAMMOGRAMS, HEALTH FAIRS, DONATION OF SUPPLIES AND MONEY, AND MANY OTHER THINGS. Part VI, Line 6: BAPTIST MEMORIAL HOSPITAL IS AN AFFILIATE OF BAPTIST MEMORIAL HEALTH CARE CORPORATION. BAPTIST MEMORIAL HEALTH CARE CORPORATION IS THE PARENT ORGANIZATION OF A NUMBER OF HOSPITALS, MINOR MEDICAL CENTERS, HOME CARE AND HOSPICE SERVICES, AND PHYSICIAN SERVICES IN WEST TENNESSEE, NORTH MISSISSIPPI, AND EAST ARKANSAS. Reports Filed With States Part VI, Line 7 AR,MS,TN X 0 0 0 0 0 0 0 0 0 0 0 STEPHEN C REYNOLDS 0 1154210 0 1182630 0 137770 0 47500 0 21468 0 2543578 0 0 JASON M LITTLE 0 582009 0 515627 0 43130 0 29500 0 21870 0 1192136 0 0 GREGORY M DUCKETT 0 375226 0 406217 0 25892 0 37500 0 26962 0 871797 0 0 WALTER J GRACE 0 157131 0 32702 0 20542 0 23577 0 21288 0 255240 0 0 Part I, Line 1a THE OFFICERS RECEIVE A PERQUISITE ALLOWANCE WHICH IS INCLUDED IN THEIR SALARIES. Part I, Line 1b THE PRESIDENT, VICE PRESIDENTS, AND ADMINISTRATORS RECEIVE A PERQUISITE ALLOWANCE. THE ALLOWANCE IS INCLUDED IN THEIR SALARIES AND IS TAXABLE TO THEM AS ADDITIONAL INCOME. THE ORGANIZATION ALSO HAS AN ACCOUNTABLE PLAN, BUT A DISCRETIONARY SPENDING ACCOUNT IS NOT PART OF AN ACCOUNTABLE PLAN. IF ANY OF THE OTHER ITEMS LISTED ON SCHEDULE J, PART I, LINE 1a WERE APPLICABLE, THE RECIPIENTS WOULD BE REQUIRED TO FOLLOW THE ORGANIZATION'S WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT. Supplemental Information Part III PART I, LINE 3: BAPTIST MEMORIAL HEALTH CARE CORPORATION'S HUMAN RESOURCE DEPARTMENT, THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS, AND AN INDEPENDENT COMPENSATION CONSULTING FIRM PERFORM ANNUAL REVIEWS EACH DECEMBER AND APPROVE COMPENSATION OF THE CEO AND OTHER TOP MANAGEMENT PERSONNEL. THEY USE COMPARABILITY DATA AND OTHER SOURCES AS NEEDED. THE CEO AND OTHER TOP MANAGEMENT USE THE SAME TYPE OF INFORMATION TO APPROVE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. PART IV, LINE 20B: AUDITED FINANCIAL STATEMENTS: ATTACHED ARE THE FINANCIAL STATEMENTS AS OF AND FOR THE YEARS ENDED SEPTEMBER 30, 2013 AND SEPTEMBER 30, 2012, AND INDEPENDENT AUDITOR'S REPORT FOR BAPTIST MEMORIAL HOSPITAL-UNION COUNTY, INC. PART V: STATEMENTS REGARDING OTHER IRS FILINGS & TAX COMPLIANCE: LINE 1a: ALL FORMS 1099 ARE PREPARED BY THE ACCOUNTS PAYABLE DEPARTMENT OF THE SOLE MEMBER, BAPTIST MEMORIAL HEALTH CARE CORPORATION. ALL FORMS 1099 ARE ISSUED USING THE FEDERAL TAX IDENTIFICATION NUMBER OF BAPTIST MEMORIAL HEALTH CARE CORPORATION. THE 1099S ARE NOT PROCESSED BY ENTITY, BUT BY VENDOR GROUP. MANY VENDORS PERFORM SERVICES FOR MULTIPLE BAPTIST ENTITIES, SO ONLY ONE 1099 IS ISSUED PER VENDOR WITH THE TOTAL AMOUNT PAID FOR SERVICES. THIS NUMBER IS REPORTED ON BAPTIST MEMORIAL HEALTH CARE CORPORATION'S FORM 990, PART V, LINE 1a. LINE 2a: THE PAYROLL FUNCTION IS CENTRALIZED AT THE PAYROLL DEPARTMENT OF THE SOLE MEMBER, BAPTIST MEMORIAL HEALTH CARE CORPORATION. THE CORPORATE PAYROLL DEPARTMENT IS RESPONSIBLE FOR ALL SALARIES AND WAGES OF THE EMPLOYEES FOR ENTIRE THE BAPTIST SYSTEM. THE W-3s AND W-2s ARE SUBMITTED ELECTRONICALLY TO THE IRS USING BAPTIST MEMORIAL HEALTH CARE CORPORATION'S FEDERAL TAX IDENTIFICATION NUMBER, ACCORDING TO THE GUIDELINES ASSOCIATED WITH COMMON PAYMASTER. HOWEVER, THE EMPLOYEE INFORMATION IS ALLOCATED TO ITS RESPECTIVE FACILITY FOR FINANCIAL REPORTING PURPOSES AND THEY ARE REPORTED TO THE STATE BY EACH FACILITY. THUS, THE AMOUNT REPORTED ON PART V, LINE 2a REFLECTS THE NUMBER OF EMPLOYEES AT THIS FACILITY WHO RECEIVED A W-2. THE TOTAL NUMBER OF W-2S FOR ALL BAPTIST ENTITIES IS REPORTED ON THE BAPTIST MEMORIAL HEALTH CARE CORPORATION W-3. LINE 7g: THE ORGANIZATION DID NOT RECEIVE ANY CONTRIBUTIONS OF QUALIFIED INTELLECTUAL PROPERTY REQUIRING IT TO FILE A FORM 8899. Line 7h: THE ORGANIZATION DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES, OR OTHER VEHICLES REQUIRING IT TO FILE A FORM 1098-C. Form 990, Part VI, Section A, line 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION AS SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY PROVIDES CERTAIN LEGAL, FINANCE, QUALITY, AND PERSONNEL SERVICES PURSUANT TO A SHARED SERVICES AGREEMENT. Form 990, Part VI, Section A, line 6 BAPTIST MEMORIAL HOSPITAL-UNION COUNTY IS A NON-STOCK CORPORATION WHOSE SOLE MEMBER IS BAPTIST MEMORIAL HEALTH CARE CORPORATION. Form 990, Part VI, Section A, line 7a BAPTIST MEMORIAL HEALTH CARE CORPORATION AS THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY ELECTS ITS BOARD OF DIRECTORS. Form 990, Part VI, Section A, line 7b BAPTIST MEMORIAL HEALTH CARE CORPORATION AS THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-UNION COUNTY APPROVES THE BOARD OF DIRECTORS ACTIONS. Form 990, Part VI, Section B, line 11 THE FORM 990 IS REVIEWED BY BAPTIST MEMORIAL HEALTH CARE CORPORATION'S PRESIDENT/CEO, SR. V.P./CFO, THE V.P. OF CORPORATE FINANCE, AND THE HOSPITAL CFO. IN ADDITION, THE FORM 990 IS REVIEWED ON A ROTATING BASIS OF EVERY THREE YEARS BY AN OUTSIDE INDEPENDENT ACCOUNTING AND TAX FIRM. THE FORM 990 HAS NOT BEEN REVIEWED BY THE BOARD OF DIRECTORS. HOWEVER, BAPTIST MEMORIAL HEALTH CARE CORPORATION, AS SOLE MEMBER, HAS A GOVERNANCE COMMITTEE THAT IS APPOINTED BY ITS BOARD OF DIRECTORS. THE BAPTIST MEMORIAL HEALTH CARE CORPORATION GOVERNANCE COMMITTEE CONSISTS OF THREE OR MORE MEMBERS ALL OF WHICH MAY OR MAY NOT BE MEMBERS OF THE BOARD OF DIRECTORS. THE BAPTIST MEMORIAL HEALTH CARE CORPORATION GOVERNANCE COMMITTEE WILL REVIEW THE FORM 990 AFTER SUBMITTING IT TO THE IRS. Form 990, Part VI, Section B, line 12c BAPTIST MEMORIAL HOSPITAL-UNION COUNTY REQUIRES THAT ALL EMPLOYEES, INCLUDING OFFICERS AND KEY EMPLOYEES, PERIODICALLY COMPLETE A CERTIFICATION AND ACKNOWLEDGEMENT OF THE BAPTIST MEMORIAL HEALTH CARE CORPORATION STANDARDS OF CONDUCT, WHICH INCORPORATES THE CONFLICT OF INTEREST POLICY. BOARD MEMBERS DISCLOSE AND SIGN A CONFLICT OF INTEREST STATEMENT EACH DECEMBER. IN THE EVENT THAT AN EMPLOYEE OR BOARD MEMBER BECOMES AWARE OF A POTENTIAL CONFLICT OF INTEREST, HE/SHE IS REQUIRED TO REPORT IT TO THEIR CHIEF EXECUTIVE OFFICER BEFORE TAKING ANY ACTION. IF HE/SHE IS THE CHIEF EXECUTIVE OFFICER, THEN HE/SHE IS TO REPORT TO THE CHAIRMAN OF THE BOARD OF DIRECTORS. THE SIGNED CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE SENIOR V.P. AND CORPORATE COUNSEL, AND ARE MAINTAINED IN THE BAPTIST MEMORIAL HEALTH CARE CORPORATION LEGAL DEPARTMENT. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, IT WILL BE THE RESPONSIBILITY OF THE CEO, WITH THE INVOLVEMENT OF THE BAPTIST MEMORIAL HEALTH CARE CORPOATION LEGAL DEPARTMENT, TO RESOLVE THE ISSUE. Form 990, Part VI, Section B, line 15 BAPTIST MEMORIAL HEALTH CARE CORPORATION'S HUMAN RESOURCE DEPARTMENT, THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS, AND AN INDEPENDENT COMPENSATION CONSULTING FIRM PERFORM ANNUAL REVIEWS EACH DECEMBER AND APPROVE COMPENSATION OF THE CEO AND OTHER TOP MANAGEMENT PERSONNEL. THEY USE COMPARABILITY DATA AND OTHER SOURCES AS NEEDED. THE CEO AND OTHER TOP MANAGEMENT USE THE SAME TYPE OF INFORMATION TO APPROVE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. ON DECEMBER 12, 2011 THE COMPENSATION WAS REVIEWED AND APPROVED FOR THE CALENDAR YEAR ENDING DECEMBER 31, 2012 FOR THE PRESIDENT, THE VICE PRESIDENTS, AND THE CEO/ADMINISTRATOR. Form 990, Part VI, Section C, line 18 BAPTIST MEMORIAL HOSPITAL-UNION COUNTY MAKES COPIES OF ITS FORMS 1023, 990, AND 990T AVAILABLE FOR PUBLIC INSPECTION TO ANYONE WHO REQUESTS THEM AS REQUIRED BY THE IRS. Form 990, Part VI, Section C, line 19 BAPTIST MEMORIAL HOSPITAL-UNION COUNTY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Contact Addresses for Officers, Directors, Etc Form 990, Part VII STEPHEN C. REYNOLDS - 350 N. HUMPHREYS BLVD, MEMPHIS, TN 38120-2177. JASON M. LITTLE - 350 N. HUMPHREYS BLVD, MEMPHIS, TN 38120-2177. GREGORY M. DUCKETT - 350 N. HUMPHREYS BLVD, MEMPHIS, TN 38120-2177. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: EQUITY TRANSFER TO/FROM BAPTIST MEMORIAL MEDICAL GROUP, INC. -1,402,736. PART XII, LINE 2c: FINANCIAL STATEMENTS AND REPORTING: BAPTIST MEMORIAL HEALTH CARE CORPORATION, AS SOLE MEMBER, HAS AN AUDIT COMMITTEE THAT CHOOSES THE AUDIT FIRM, OVERSEES AND REVIEWS THE AUDIT REPORTS, AND THEN FOLLOWS UP ON ANY NECESSARY CHANGES AND RECOMMENDATIONS. THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS. NORTHEAST ARKANSAS BAPTIST MEMORIAL HEALTH CARE LLC 4800 E JOHNSON AVE JONESBORO AR 72401 810572898 OPERATION OF BAPTIST MEMORIAL HOSPTIAL-JONESBORO, INC. AR N/A NORTHEAST ARKANSAS BAPTIST HEALTH SERVICES GROUP LLC 4800 E JOHNSON AVE JONESBORO AR 72401 271471186 OPERATE A PREFERRED PROVIDER ORGANIZATION AR N/A BAPTIST MEMORIAL HEALTH CARE CORPORATION 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 581521475 MANAGEMENT, ADMINISTRATIVE & FINANCIAL SERVICES FOR AFFILIATES TN 501(c)(3) 509(a)(3) N/A 0 BAPTIST MEMORIAL HEALTH CARE SYSTEM INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 581456556 CARRY OUT THE HEALTH CARE MISSIONS OF THE BAPTIST CONVENTIONS OF AR, MS, TN TN 501(c)(3) 509(a)(3) N/A 0 BAPTIST MEMORIAL COLLEGE OF HEALTH SCIENCES INC 1003 MONROE MEMPHIS TN 38104 621599670 EDUCATION OF HEALTH CARE PROFESSIONALS TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HOSPITAL INC 0 BAPTIST MEMORIAL HEALTH SERVICES INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 621509127 PROVISION OF HEALTH CARE PROVIDERS & HOME MEDICAL EQUIPMENT/SERVICES TN 501(c)(3) 509(a)(2) BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 BAPTIST MEMORIAL HOSPITAL INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 620123940 HEALTH CARE FACILITY/HOSPITAL TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 MEDICAL FINANCIAL SERVICES INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 621112364 COLLECTION AGENCY FOR BAPTIST ENTITIES TN 501(c)(3) 509(a)(3) BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 BAPTIST MEMORIAL HOSPITAL-BOONEVILLE INC 100 HOSPITAL ST BOONEVILLE MS 38829 640663760 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 BAPTIST MEMORIAL HOSPITAL-DESOTO INC 7601 SOUTHCREST PKWY SOUTHAVEN MS 38671 640682111 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 BAPTIST MEMORIAL HOSPITAL-GOLDEN TRIANGLE INC 2520 FIFTH ST COLUMBUS MS 39703 621519754 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 BAPTIST MEMORIAL HOSPITAL-HUNTINGDON INC 631 RB WILSON DR HUNTINGDON TN 38344 621166050 HEALTH CARE FACILITY/HOSPITAL TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 BAPTIST CLINICAL RESEARCH INSTITUTE INC 350 N HUMPHREYS BLVD MEMPHIS TN 381202177 453032246 FACILITATE MEDICAL & SCIENTIFIC RESEARCH TN 501(c)(3)PENDING BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 BAPTIST MEMORIAL HOSPITAL-NORTH MISSISSIPPI INC 2301 S LAMAR OXFORD MS 38655 640772726 HEALTH CARE FACILITY/HOSPITAL MS 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 BAPTIST MEMORIAL HOSPITAL-TIPTON INC 1995 HWY 51 SOUTH COVINGTON TN 38019 621113167 HEALTH CARE FACILITY/HOSPITAL TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 BAPTIST MEMORIAL HOSPITAL-UNION CITY INC 1201 BISHOP ST UNION ICTY TN 38261 621138045 HEALTH CARE FACILITY/HOSPITAL TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 BAPTIST MEMORIAL REGIONAL REHABILITATION SERVICES INC 2100 EXETER RD GERMANTOWN TN 38138 581645396 HEALTH CARE FACILITY/HOSPITAL TN 501(c)(3) 509(a)(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION 0 BAPTIST 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