2013-08-14T10:08:40-07:00 2012-09-30 990 2011-10-01 590747311 Southern Baptist Hospital of Florida Inc SOUT 9042021797 3563 Philips Hwy Bldg F Ste 608 Attn Mike Lee Jacksonville FL 322075663 Michael Lukaszewski 9042022852 2013-08-14 2011 2016-02-24 21:20:13Z Baptist Medical Center & Baptist Medical Center South A Hugh Greene 841 Prudential Dr Aetna Bld Ste 1601 Jacksonville FL 32207 979695785 0 X e-baptisthealth.com X 1965 FL Continue the healing ministry of Christ by providing accessible, quality healthcare services at a reasonable cost in an atmosphere that fosters respect and compassion. 15 9 7067 258 504603 0 11476669 2112659 835083336 860904210 4523609 102982912 10840420 11807224 861924034 977807005 1783709 1578667 0 0 355223385 363828310 0 0 0 412520391 422846046 769527485 788253023 92396549 189553982 1434479806 1707369604 794582173 864980451 639897633 842389153 Continue the healing ministry of Christ by providing accessible, quality healthcare services at a reasonable cost in an atmosphere that fosters respect and compassion. 0 0 744668444 2112659 860904210 The program service accomplishments for the organization are numerous and expenses often overlap. Southern Baptist Hospital of Florida, Inc. (SBHF) is a subsidiary of Baptist Health System, Inc. (the Parent), a tax-exempt parent holding company located in Jacksonville, Florida. SBHF is a tax exempt organization that operates two acute care hospitals, Baptist Medical Center (BMC) and Baptist Medical Center South (BMCS). The primary program service accomplishments by expenses are the operation of the hospitals, and the following are some of the achievements accomplished for the organization's hospitals during the year. The two hospitals have 619 and 225 licensed beds, respectively. BMC is a full-service, Magnet-designated tertiary care hospital representing nearly all major specialties. A Magnet hospital is the highest honor a healthcare organization can receive for excellence in patient care. This flagship hospital is also home to Baptist Heart Hospital, offering comprehensive, high-quality cardiovascular care, and Wolfson Children's Hospital (WCH), the only full-service tertiary hospital for children in the region, serving North Florida, South Georgia and beyond. BMC is consistently rated Jacksonville's "Most Preferred Healthcare Provider" by consumers in the National Research Corporation survey. BMC and BMCS were ranked No. 1 among metro Jacksonville hospitals and No.5 in Florida during 2012 in U.S. News & World Report's 2012-2013 Best Hospitals rankings. WCH is recognized year after year as one of America's Best Children's Hospitals by U.S. News & World Report. WCH serves as the main teaching facility for the University of Florida College of Medicine's Pediatric Residency Training Program. For fiscal year 2012, SBHF had 39,754 admissions accounting for 198,727 patient days, 179,568 emergency room visits, and 68,326 home health visits. SBHF's primary focus is addressing unmet health needs, particularly among vulnerable populations who have limited health resources and access to health care. SBHF's community health efforts are guided by the Community Health Committee, which is comprised of selected BHS board members from across our health system. A cornerstone of SBHF's commitment to the community is caring for the health of vulnerable, uninsured and underserved people among us. During fiscal year 2012, SBHF provided the following uncompensated care and community benefit: (1) Charity care - $27.8 million, (2) Unreimbursed Medicaid Costs - $47.0 million, (3) Unreimbursed Medicare Costs - $31.6 million, (4) Specific Community Programs - $9.2 million, and (5) Unreimbursed Bad Debt Expenses - $4.9 million, for a total of $120 million of uncompensated care and community benefits. 0 0 0 744668444 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 1 400 0 1 7067 1 1 1 0 0 0 0 0 0 0 0 0 X 15 9 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X X Scott Finnegan 9042023270 841 Prudential Dr Suite 1602 Jacksonville FL 32207 M C Harden III 2 X X 0 0 0 Charles E Hughes Jr 2 X X 0 0 0 A Hugh Greene 40 X X 1013169 0 448925 Richard L Sisisky 2 X X 0 0 0 Charles C Baggs 2 X 0 0 0 Pam Chally 2 X 0 0 0 Richard D Glock MD 2 X 0 0 0 Jack R Groover MD 2 X 0 0 0 Robert E Hill Jr 2 X 0 0 0 Barbara G Jaffe 2 X 0 0 0 Eric Mann 2 X 0 0 0 William C Mason 2 X 15848 0 0 Christine R Milton 2 X 0 0 0 Ava Parker 2 X 0 0 0 David Robertson 2 X 0 0 0 Carol C Thompson 2 X 789 0 6197 John F Wilbanks 40 X 560658 0 201911 Harvey Granger 40 X 441898 0 189620 Michael Lukaszewski 40 X 632875 0 17412 Keith L Stein MD 40 X 542489 0 92694 Michael A Mayo 40 X 230231 0 35782 Michael Aubin 40 X 489424 0 38952 Ronald Robinson 40 X 262060 0 73568 Marianne Hillegass 40 X 439800 0 42690 Roland A Garcia 40 X 427288 0 84128 Serge Vilvar 40 X 358421 0 19413 Jerry A Bridgham 40 X 325936 0 27964 Diane Raines 40 X 295979 0 72128 Larry Freeman 40 X 1218049 0 9480 Marlene Spalten 40 X 273257 0 22012 7528171 0 1382876 172 1 1 0 Sodexho Inc & Affiliates PO Box 536922 Atlanta GA 303536922 Management fees - cafeteria & environmental services 7853771 Cerner Corporation PO Box 536922 Atlanta GA 30353 Software maintenance and IT support 7334192 Vitalize Consulting Solutions Inc 248 Main St Ste 101 Reading MA 01867 Software and IT consulting services 6073841 Baptist Primary Care Inc 3563 Philips Hwy Bldg A Ste 101 Jacksonville FL 32207 Hospitalist services provided to BMC & BMCS 5499200 University of Florida Jacksonville Physicians Inc PO Box 44008 Jacksonville FL 322314008 Physician specialty services for children's hospital 5445232 71 0 0 0 2087412 0 25247 0 2112659 Net patient service revenues 622000 860878206 860878206 0 0 Partnership income - Premier 541900 26004 0 26004 0 0 0 0 0 860904210 102308708 0 0 102308708 0 0 0 0 0 0 0 0 2496775 0 813115 0 1683660 0 1683660 0 0 1683660 0 1749869 0 1075665 0 674204 674204 674204 0 0 0 Restaurant revenue 722100 5292464 0 0 5292464 Reference lab revenues 621500 1015710 0 478599 537111 Vending machine revenues 722210 300867 0 0 300867 3514523 0 0 3514523 10123564 977807005 861552410 504603 113637333 1578667 1578667 0 0 0 0 0 0 8749935 0 8749935 0 0 0 0 0 244792021 231782945 13009076 0 23209711 21196893 2012818 0 68192495 64145038 4047457 0 18884148 17349864 1534284 0 4890028 2445014 2445014 0 584374 292187 292187 0 232101 232101 0 0 42605 0 42605 0 0 0 0 0 0 0 39098927 37695276 1403651 0 2649212 1324606 1324606 0 161090725 157138546 3952179 0 8050575 7847700 202875 0 110297 110297 0 0 36686399 35369357 1317042 0 1016965 844691 172274 0 0 0 0 0 1241612 1026689 214923 0 7157142 6900201 256941 0 0 0 0 0 49480642 47763664 1716978 0 4932737 4761571 171166 0 Provision for bad debts 75894556 75894556 0 0 Purchased services 13528442 13059005 469437 0 Indigent care/other state assessments 9930444 9930444 0 0 Bond swap market changes 4363673 4189126 174547 0 1864590 1790006 74584 0 788253023 744668444 43584579 0 23916 24166 5139131 4292430 0 0 134099355 148022886 0 0 0 0 0 0 12828597 12374101 10911632 10230156 1231189087 607002705 545340255 624186382 654475246 822581525 0 0 78756 93590 3304175 3454175 68278743 82110193 1434479806 1707369604 82583233 84584707 0 0 0 0 477321578 546393284 0 0 0 0 0 0 0 0 234677362 234002460 794582173 864980451 X 618916006 817864059 12794613 13746875 8187014 10778219 639897633 842389153 1434479806 1707369604 X 189553982 12937538 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 42605 0 0 42605 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 During the fiscal year, the organization paid $42,605 to an unrelated firm, BH & Associates, Inc., for State of Florida legislative and executive branch representation concerning hospital-related issues. 13206971 2593958 2482752 0 565803 0 17717878 13652478 229666 31982 0 707155 0 13206971 12440512 133141 1230016 0 151191 0 13652478 13034648 187203 -241049 0 540290 0 12440512 0.2416 0.6083 0.1501 0 1 1 0 17049780 17049780 0 570104972 241974952 328130020 0 0 0 0 0 466174281 359885547 106288734 0 177860054 5142206 172717848 624186382 Stock - Principal Financial 93590 F 93590 0 Pension & SERP liability 176361069 Bond swap market valuation 23787005 Hospital self-insurance trust 22349298 Estimated third-party settlements 5038383 Worker's comp. sel-insurance trust 4499438 Lease incentive obligation 1224868 SunTrust signing bonus 288895 Other liabilities 453504 234002460 977807005 788253023 189553982 0 0 0 0 0 0 189553982 978620120 0 0 0 0 0 978620120 0 -813115 -813115 977807005 789066138 0 0 0 0 0 789066138 0 -813115 -813115 788253023 SchD_P05_S00_L04 Schedule D, Part V, Line 4 Southern Baptist Hospital of Florida, Inc. (SBHF) endowment funds are held by its related affiliate, Baptist Health System Foundation, Inc. (BHF). BHF's endowment policy allows annually that 5% of the combined endowment corpus and accumulated earnings become available for spending on capital projects of SBHF. SchD_P10_S00_L02 Schedule D, Part X, Line 2 The following is Note 10, Income Taxes, included in the consolidated financial statements of the organization (all numbers in thousands): Deferred income taxes, which as of September 30, 2012 and 2011, have no net carrying value, reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting and the amounts used for income tax purposes. As of September 30, 2012 and 2011, BHS had deferred tax assets of $21,411and $15,901, respectively, relating principally to net operating loss carryovers. ASC 740-10-50-3, Income Taxes: Disclosure, requires a valuation allowance to reduce the deferred tax assets reported if, based on the weight of the evidence, it is more likely than not that some portion or all of the deferred tax assets will not be realized. After consideration of all the evidence, both positive and negative, management determined that a $21,411 and $15,901 allowance at September 30, 2012 and 2011, respectively, was necessary to reduce the deferred tax assets to the amount that would more likely than not be realized. The change in the valuation allowance for the current year is $5,510. At September 30, 3012, BHS has available net operating loss carryforwards of $56,900, of which $466 expires at the start of fiscal year 2013. SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Rental expenses of $813,115 are included on Form 990, Part VIII, Line 6b, Statement of Revenues, but are reported as expenses on the audited financial statements. SchD_P13_S00_L04b Schedule D, Part XIII, Line 4b Form 990, Part VIII, Line 6b, Statement of Revenues, includes rental expenses of $813,115 that are reported as expenses on the audited financial statements. 1 1 X 1 X 1 X 1 1 1 0 1 1 27716946 0 27716946 0.0389 47054156 0 47054156 0.066 0 0 0 0 0 0 74771102 0 74771102 0.1049 1488625 0 1488625 0.0021 3499051 0 3499051 0.0049 8434063 6323489 2110574 0.003 0 0 0 0 1538874 0 1538874 0.0022 0 0 14960613 6323489 8637124 0.0122 0 0 89731715 6323489 83408226 0.1171 0 4938990 0 186501797 218021508 -31519711 X 1 1 2 1 Baptist Medical Center

800 Prudential Dr Jacksonville FL 32207

X X X X X X 2 Baptist Medical Center South

14550 Old St Augustine Rd Jacksonville FL 32258

X X X Baptist Medical Center 1 0 1 1 200 1 400 1 X X X X X X X X 1 1 X 1 X 1 X X X X X 1 X 0 0 Baptist Medical Center South 2 0 1 1 200 1 400 1 X X X X X X X X 1 1 X 1 X 1 X X X X X 1 X 0 0 6 Baptist Behavioral Health

4160 University Blvd S Jacksonville FL 32216

Comprehensive mental health services. Baptist Behavioral Health

87010 Professional Way Yulee FL 32097

Comprehensive mental health services in Nassau County. Baptist Behavioral Health

900 Beach Blvd Ste 930 Jacksonville Beach FL 32250

Comprehensive mental health services in the beaches' communities. Baptist Behavioral Health

13241 Bartram park Blvd Ste 1901 Jacksonville FL 32258

Comprehensive mental health services in the Mandarin community. Baptist Behavioral Health

1325 San Marco Blvd Ste 500 Jacksonville FL 32207

Comprehensive mental health services in the San Marco community. Baptist Behavioral Health

800 Prudential Dr Ste 510/512 Jacksonville FL 32207

Comprehensive mental health services at Baptist Medical Center Jacksonville's hospital campus. SchH_P01_S00_L06a Schedule H, Part I, Line 6a Baptist Health System, Inc. (BHS), the parent affiliate of Southern Baptist Hospital of Florida, Inc., prepares annually a Community Benefit report, available at BHS's website, which includes consolidated information for all of the hospital affiliates of BHS. SchH_P01_S00_L07 Schedule H, Part I, Line 7 The organization uses a cost-to-charge ratio based on its cost accounting system. SchH_P01_S00_L072f Schedule H, Part I, Line 7, Column f Bad debt expense of $75,894,556 was included in Form 990, Part IX, Line 24, column (A), but was not included in the percentage calculations for Schedule H, Part I, Line 7, column (f), per the Form 990, Schedule H instructions. SchH_P01_S00_L07g Schedule H, Part I, Line 7g Southern Baptist Hospital of Florida, Inc. (SBHF) is one of only two Medical-Surgical hospitals in Duval County that are Baker Act receiving facilities, and the only hospital that offers a continuum of Behavioral Health Services. SBHF's children's hospital, Wolfson Children's Hospital, is the only hospital with a Pediatric Psychiatric unit and a Behavioral day-stay program in the region. SBHF believes that Behavioral Health is an essential service to its community even though these programs are operated at a financial loss. SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 The provision for bad debts is based on management's assessments of historical and expected net collections considering business and economic conditions, trends in healthcare coverage and other collection indicators. Accounts receivable are written off after collection effort has been followed in accordance with the organization's policies. Accounts written off as uncollectible are deducted from the allowance for uncollectible patient accounts, and subsequent recoveries are added. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category. Bad debt expense at cost is determined by the organization's cost accounting system and cost-to-charge ratio. None of the bad debt expense at cost is included in Schedule H, Part I. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 Medicare allowable costs of care based on the organization's cost-to-charge ratio and cost accounting system are used to determine the amount reported on Line 6. None of the shortfall reported on Line 7 is included in Schedule H, Part I. SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b Yes, the organization does have a written debt collection policy. The policy does not specifically address those patients who are known to qualify or have applied for charity care as the organization does not bill these patients. The organization's cost accounting system identifies all patients who have a pending or approved charity application. The organization would only bill the patient if, after multiple attempts to obtain any needed documentation from the patient to complete the charity approval process, the patient was noncompliant. SchH_P05_S0B_L11 Schedule H, Part V, Section B, Line 11 Credit scores and existing credit delinquencies are also factors that are used. SchH_P05_S0B_L17 Schedule H, Part V, Section B, Line 17 At every patient access point, "Guidelines for Charity Care Eligibility" cards are provided that contains financial discount and charity care information. This includes a general chart of eligible income levels and encourages patients to speak with our patient financial advocates to arrange a financial evaluation. If seen by one of the organization's patient financial advocates, the patient is advised prior to discharge. All statements to patients provide a number to call if they need financial assistance. All applications for financial assistance are maintained whether or not the patient qualifies. SchH_P05_S0B_L19 Schedule H, Part V, Section B, Line 19 The organization has an automatic 40% discount for all uninsured patients. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 Baptist Health System, Inc. (BHS), the parent affiliate of Southern Baptist Hospital of Florida, Inc., uses a variety of resources to assess the health care needs of the communities it serves. BHS works closely with the Health Planning Council of NE Florida which regularly collects data on the most pressing health needs in our area. We contract with the Health Planning Council to develop a "dashboard" which highlights health needs and tracks our progress in meeting those needs. BHS considers our local health departments to be important partners and we also use their needs assessment information in making decisions. BHS has a Social Responsibility and Community Health Committee that is made up of board members from across the health system (two of whom serve on the Southern Baptist Hospital of Florida Board of Directors) that regularly review the community benefit work of our hospitals and provides direction regarding specific areas of need. BHS has been working in collaboration with the other nonprofit health systems in Northeast Florida to complete a comprehensive community health needs assessment and implementation plan and that work will be reported on the 2012 Form 990. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 At every patient access point, "Guidelines for Charity Care Eligibility" cards are provided that contains financial discount and charity care information. This includes a general chart of eligible income levels and encourages patients to speak with one of our patient financial advocates to arrange a financial evaluation. The organization sends statements to patients who have applied for charity care but have not provided all the documentation that is required to make a determination; letters are sent by the organization requesting the information to complete their application. SchH_P06_S00_L04 Schedule H, Part VI, Line 4 The Southern Baptist Hospital of Florida license covers the downtown hospital (Baptist Medical Center and Wolfson Children's Hospital) which serves a large part of Duval County and our newest hospital serving southern Duval County and Northern St. Johns County (Baptist Medical Center South). For purposes of community benefit, we target neighborhoods and populations with a high rate of poverty and unemployment. We work with nonprofit partners to provide access to care to vulnerable populations and work in conjunction with our faith based partners to provide screenings and education. The demographic information for Southern Baptist Hospital of Florida is as follows: a) Service Area Population - 959,831; b) Estimated Average Household Income - $60,472; c) Families Below Poverty - 10.5%; d) Medicaid Discharges - 18.9%; e) Self Pay/NonPayment Discharges - 9.9%. There are six other hospitals located in this service area. There are federally designated medically underserved areas and populations in this community. SchH_P06_S00_L05 Schedule H, Part VI, Line 5 Baptist Health System, Inc. (BHS) directly donates over one million dollars a year to nonprofit organizations that are helping meet identified community health needs. Our doctors and nurses regularly volunteer their time at organizations that provide access to care to vulnerable populations across our community. Health Zone One is an area of extreme need that is located close to Baptist Medical Center and Wolfson Children's Hospital. We focus a tremendous amount of effort in that community from funding school nurses, to helping build community gardens, to our award winning asthma program, and working with Edward Waters College to provide health education to their students in need. Baptist Medical Center South works with Mandarin High School to provide medical education and works with assisted living centers for the elderly to provide services for those in need. The Players Center for Child Health provides a multitude of programming for children and families in need from bicycle safety to drowning prevention programs and from vaccinations to education on nutrition and preventing childhood obesity. BHS participates in over one hundred health fairs each year and works closely with our faith based partners to reach individuals in need. Some of the improvements using surplus funds included installation of EMR (electronic medical records) for BHS hospitals to improve operating efficiency and patient care, $6.4 million, purchase of Davinci Surical Robot Si and Ortho Mako Robot to improve patient outcomes, opening of WCH Children's Specialty Center in Lake City, Florida, and redesignation as a Magnet Health System by the American Nurses Credentialing Center. Magnet is considered the gold standard among healthcare organizations for quality patient care and innovations in professional nursing practice. A majority of Southern Baptist Hospital of Florida's (SBHF's) Board of Directors reside in the primary service area and are not employees, independent contractors or family members thereof. SBHF extends medical privileges to all qualified physicians in the community. SchH_P06_S00_L06 Schedule H, Part VI, Line 6 Baptist Health System, Inc. (BHS) is the parent affiliate of Southern Baptist Hospital of Florida, Inc. (SBHF). The Social Responsibility and Community Health team at BHS coordinates the funding of nonprofit partners for SBHF and works with our employees in facilitating volunteer opportunities across our community. Two members of the SBHF Board of Directors serve on the Social Responsibility and Community Health Committee. SBHF works closely with a number of nonprofit partners to meet the health needs in our community. SchH_P06_S00_L07 Schedule H, Part VI, Line 7 Baptist Health System, Inc. (BHS), parent affiliate of Southern Baptist Hospital of Florida, Inc. and its related affiliates, are located within the Northeast Florida quadrant. An annual Community Benefit Report is published and available on the e-baptisthealth.com website. 1 Community Hospice of NE FL 4266 Sunbeam Rd Jacksonville FL 32257 591940256 501(c)(3) 205900 0 book Pediatric hospice medical leadership. I M Sulzbacher Center for the Homeless Inc 611 E Adams St Jacksonville FL 32202 593229898 501(c)(3) 107500 0 book Provide support to organization providing food, clothing and shelter for two community clinics: Downtown, $27,500 and Beaches clinic, $80,000. Art With a Heart in Healthcare 841 Prudential Dr Ste 204 Jacksonville FL 32207 261313805 501(c)(3) 100200 0 book Pediatric patient assistance for children. United Way of Northeast Florida 1301 Riverplace Blvd Ste 400 Jacksonville FL 32207 590637825 501(c)(3) 100000 0 book Support charitable functions of local branch of national fundraising organization. Jacksonville Jaguars Foundation One Stadium Place Jacksonville FL 32202 593249687 501(c)(3) 80277 0 book Provide support for charitable foundation with programs emphazing teen fitness in the local community. We Care Jax 900 University Blvd N Jacksonville FL 32211 593431724 501(c)(3) 75000 0 book Provide support to local charitable organization providing indigent healthcare. Volunteers in Medicine 41 E Duval St Jacksonville FL 32202 753002172 501(c)(3) 75000 0 book Provides support for charitable downtown health clinic for indigent families. Health Planning Council of NE FL Inc 100 N Laura St Ste 801 Jacksonville FL 32202 592247189 501(c)(3) 57000 0 book Coalition council of hospital members and other planning officials involved in preparation of community-wide health needs assessment. Jacksonville University 2800 University Blvd N Jacksonville FL 32211 590624412 501(c)(3) 45000 0 book Support for development of sports medicine program for student-athletes. The Tom Coughlin Jay Fund Foundation Inc PO Box 50798 Jacksonville Beach FL 32240 593426937 501(c)(3) 44700 0 book Provide support to charitable foundation providing assistance to children with cancer. American Heart Association 5851 St Augustine Rd Jacksonville FL 32207 135613797 501(c)(3) 40000 0 book Provide support for local branch of national charitable organization for programs related to study and research of cardiology diseases. Ronald McDonald House 824 Childrens Way Jacksonville FL 32207 592625008 501(c)(3) 35000 0 book Provides support to organization with a mission to improve the health and well being of children. University of North Florida One UNF Dr Jacksonville FL 32224 237167701 501(c)(3) 30000 0 book Support for cooperate development of medical sciences laboratory to educate students preparing to be laboratory medical technologists. American Lung Association of Florida 6852 Belfort Oaks Pl Jacksonville FL 32216 590662271 501(c)(3) 25000 0 book Provide support to organization for health research and education of cardiopulmonary diseases. DLC Nurse and Learn 4101-1 College St Jacksonville FL 32205 593618761 501(c)(3) 20000 0 book Provide support to organization dedicated to meeting the needs of special needs children through various educational programs. Edward Waters College 1658 Kings Rd Jacksonville FL 32209 900750130 501(c)(3) 20000 0 book Provide support for renovation of chemistry lab for local college. UNF - Brooks College of Health One UNF Drive Jacksonville FL 32224 237167701 501(c)(3) 20000 0 book Support for training of nursing students by funding purchase of mother and birthing baby simulators. The Jacksonville Speech and Hearing Center Inc 1128 N Laura St Jacksonville FL 32206 590970718 501(c)(3) 19800 0 book Support programs providing assistance to persons with speech and hearing disabilities in the community. Coalition to Protect America's Health Care 4600 East-West Highway Ste 900 Bethesda MD 20814 522253225 501(c)(4) 15000 0 book Support for national organization providing education and research for health care issues. Youth Crisis Center 3015 Parental Home Rd Jacksonville FL 32216 592176287 501(c) 15000 0 book Support for nursing assistance for children in the local community. Susan G Komen for the Cure 2950 Halcyon Ln 501 Jacksonville FL 32223 751835298 501(c) 15000 0 book Support for branch affiliate in NE Fla of national organization providing cancer research and education on women's breast health. Mission House Inc 800 Shetter Ave Jacksonville Beach FL 32250 593376704 501(c)(3) 15000 0 book Support organization providing food, medical care, and clothing to indigent persons in our Beaches communities. Barnabas Center Inc 11 S 11th St Fernandina Beach FL 32034 592920275 501(c)(3) 15000 0 book Support organization providing financial assistance to families in crisis, medical and dental care for the indigent, and food and housing assistance to persons in Nassau County. Pine Castle Inc 4911 Spring Park Rd Jacksonville FL 32207 590704733 501(c)(3) 15000 0 book Provide support for organization providing care for developmentally disabled adults in the community. One Jax Inc One UNF Drive Bld 53 Ste 2100 Jacksonville FL 32224 202719059 501(c)(3) 14000 0 book Provide support for community organization providing various charitable programs to the local communities. American Cancer Society Inc 1430-B Prudential Dr Jacksonville FL 32207 131788491 501(c) 11500 0 book Provide support to organization providing education and research on cancer. Jacksonville Chamber of Commerce Foundation 3 Independent Dr Jacksonville FL 32202 591867407 501(c)(3) 10000 0 book Support for downtown Jacksonville econcomic development programs. Camp Boggy Creek 30500 Brantley Branch Rd Eustis FL 32736 590000000 501(c) 10000 0 book Provide support for organization dedicated to assisting youths through various group outings to improve mental and physical well-being. Boys & Girls Club of Nassau County Foundation PO Box 16003 Fernandina Beach FL 32035 593672345 501(c)(3) 10000 0 book Support for children's programs in Nassau County. Clay County Chamber of Commerce Foundation Inc 1734 Kingsley Ave Orange Park FL 32073 030601285 501(c) 8000 0 book Support for county economic development investment. Cystic Fibrosis Foundation 12620-3 Beach Blvd Ste 339 Jacksonville FL 32246 131930701 501(c)(3) 7200 0 book Support for programs to benefit those persons in the local community who suffer from cystic fibrosis. The Arc of NE Florida 1050 N Davis St Jacksonville FL 32209 593385683 501(c)(3) 6000 0 book Support for organization that provides assistance to persons in the community with intellectual and/or development disabilities. Micah's Place Inc PO Box 16287 Fernandina Beach FL 32035 593675485 501(c)(3) 6000 0 book Support organization that provides services to survivors of domestic violence in Nassau County. Childrens Miracle Network 580 W 8th St Tower 1 3rd Floor Jacksonville FL 32209 870387205 501(c)(3) 5100 0 book Support organization providing medical/financial assistance to children and their families. 35 0 SchI_P01_S00_L02 Schedule I, Part I, Line 2 Our community health efforts are guided by the organization's Community Health Committee, comprised of selected Baptist Health System, Inc. (BHS) board members (BHS is the parent affiliate of the organization). The committee provides strategic direction related to our community health activities and ensures we focus on key priorities that align with our mission. X X X X 0 1 0 0 0 0 0 0 0 A Hugh Greene 738913 0 244256 0 30000 0 434970 0 13955 0 1462094 0 0 0 John F Wilbanks 419938 0 125720 0 15000 0 189487 0 12424 0 762569 0 0 0 Michael Lukaszewski 414541 0 101025 0 117309 0 4287 0 13125 0 650287 0 102309 0 Keith L Stein MD 428116 0 102373 0 12000 0 81541 0 11153 0 635183 0 0 0 Harvey Granger 337996 0 88902 0 15000 0 170655 0 18965 0 631518 0 0 0 Michael Aubin 335424 0 144000 0 10000 0 22816 0 16136 0 528376 0 0 0 Ronald Robinson 220060 0 42000 0 0 0 55765 0 17803 0 335628 0 0 0 Michael A Mayo 185231 0 40000 0 5000 0 27645 0 8137 0 266013 0 0 0 Marianne Hillegass 202150 0 35221 0 202429 0 36072 0 6618 0 482490 0 192429 0 Roland A Garcia 332427 0 84861 0 10000 0 72141 0 11987 0 511416 0 0 0 Serge Vilvar 358421 0 0 0 0 0 8287 0 11126 0 377834 0 0 0 Diane Raines 244979 0 41000 0 10000 0 53885 0 18243 0 368107 0 0 0 Jerry A Bridgham 271545 0 44391 0 10000 0 9800 0 18164 0 353900 0 0 0 Larry Freeman 24493 0 0 0 1193556 0 0 0 9480 0 1227529 0 1192787 0 Marlene Spalten 188356 0 34395 0 50506 0 10593 0 11419 0 295269 0 38506 0 SchJ_P01_S00_L03 Schedule J, Part I, Line 3 See explanation in Schedule O for Form 990, Part VI, Section B, Line 15. SchJ_P01_S00_L04 Schedule J, Part I, Line 4 Baptist Health System, Inc. (BHS), parent affiliate of Southern Baptist Hospital of Florida, Inc. (SBHF), has two active Supplemental Nonqualified Retirement Plans (SERPS). One is for certain executives (Supplemental Executive Retirement Plan) and the other is for certain vice presidents (Vice-President Supplemental Executive Retirement Plan). These SERPS are plans described in IRS Section 457(f). The benefits under these plans accrue during each executive's term of employment. These benefits are unvested and subject to forfeiture until the covered employee reaches retirement age. The following individuals accrued unvested benefits under these plans during fiscal year 2012: A. Hugh Greene, $401,716, John F. Wilbanks, $158,534, Harvey Granger, $139,082, Keith Stein, $52,779, Roland Garcia, $41,183, Diane Raines, $31,843, Ronald Robinson, $27,826, Michael Mayo, $24,850, and Michael Aubin, $22,816. These amounts are included in Schedule J, Part II, Column (c) for each of the listed individuals. Jacksonville Health Facilities Authority Var Rate Hospital Revenue Extendable Notes Series 2003A 2011-12-01 70000000 Hospital capital improvements 0 0 0 Jacksonville Health Facilities Authority Var Rate Hospital Revenue Extendable Notes - Series 2004 2011-12-01 50000000 Hospital capital improvements 0 0 0 Jacksonville Health Facilities Authority Hospital Revenue Bonds Series 2007A 469404TW7 2007-02-01 65000000 Hospital capital improvements 0 0 0 Jacksonville Health Facilities Authority Variable Rate Hospital Revenue Bonds Series 2007B 2012-09-04 25750000 Hospital capital improvements 0 0 0 0 0 70000000 0 0 0 182810 0 0 69817190 0 0 2003 0 0 1 1 0 0 50000000 0 0 0 169514 0 0 49830486 0 0 2004 0 0 1 1 0 0 65000000 0 0 0 270168 1310772 0 64729832 0 0 2007 0 0 1 1 0 0 25750000 0 0 0 82022 0 0 25667978 0 0 2007 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 Wells Fargo 10.9 1 0 0 0 0 Jacksonville Health Facilities Authority Var Rate Hospital Revenue Refunding Notes Series 2007CDE 2011-12-01 110935000 Refund Series 1997A bonds 0 0 0 Jacksonville Health Facilities Authority Var Rate Hospital Revenue Notes Series 2009 469404UM7 2009-09-01 30000000 Hospital capital improvements 0 0 0 Jacksonville Health Facilities Authority Var Rate Hospital Revenue Extendable Notes Series 2010A 2010-06-01 25000000 Hospital capital improvements 0 0 0 Jacksonville Health Facilities Authority Var Rate Hospital Revenue Extendable Notes Series 2010B 2010-11-01 25000000 Hospital capital improvements 0 0 0 22873000 0 110935000 0 0 0 237615 0 0 110697385 0 0 2007 0 1 1 1 11852003 0 30000000 0 0 0 123500 0 0 29876500 0 0 2009 0 0 1 1 1225000 0 25000000 0 0 0 25000 0 0 24975000 0 0 2010 0 0 1 1 1225000 0 25000000 0 0 0 0 0 0 25000000 0 0 2010 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 UBS and Wells Fargo Banks 16.1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 Jacksonville Health Facilities Authority Var Rate Hospital Revenue Extendable Notes Series 2010C 2010-12-01 25000000 Hospital capital improvements 0 0 0 Jacksonville Health Facilities Authority Var Rate Hospital Revenue Extendable Notes Series 2003B 2012-09-04 35000000 Hospital capital improvements 0 0 0 Jacksonville Health Facilities Authority Fixed Rate Hospital Revenue Extendable Notes - Series 2003C 2012-07-01 20000000 Hospital capital improvements 0 0 0 Jacksonville Health Facilities Authority Var Rate Hospital Revenue Extendable Notes Series 2012A 2012-03-01 25000000 Hospital capital expenditures 0 0 0 1225000 0 25000000 0 0 0 25000 0 0 24975000 0 0 2010 0 0 1 1 0 0 35000000 0 0 0 82022 0 0 34917978 0 0 2003 0 0 1 1 0 0 20000000 0 0 0 52231 0 0 19947769 0 0 2003 0 0 1 1 650000 0 25000000 0 0 0 0 0 0 25000000 0 0 2012 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 BBVA Compass 10.0 1 0 0 0 0 Jacksonville Health Facilities Authority Var Rate Hospital Revenue Extendable Notes Series 2012B 2012-03-01 20000000 Hospital capital expenditures 0 0 0 Jacksonville Health Facilities Authority Var Rate Hospital Revenue Extendable Notes Series 2012C 2012-03-01 15000000 Hospital capital expenditures 0 0 0 Jacksonville Health Facilities Authority Var Rate Hospitable Revenue Extendable Notes Series 2012D 2012-05-01 26000000 Hospitable capital expenditures 0 0 1 550000 0 20000000 0 0 0 0 0 0 20000000 0 0 2012 0 0 1 1 1024282 0 15000000 0 0 0 0 0 0 15000000 0 0 2012 0 0 1 1 0 0 26000000 0 0 0 0 0 0 26000000 0 0 2012 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 SunTrust 7.0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 Harden & Associates Inc Director 834000 Employee benefits insurance commissions 0 Harden & Associates Inc Director 174300 Insurance consulting fees 0 Blair Sherman Employee 46295 Family member of director 0 F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 The organization has a sole corporate member, Baptist Health System, Inc., whose Board of Directors elects the members of the organization's governing body. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a The Board of Directors of Baptist Health System, Inc., the sole corporate member of the organization, elects the members of the governing body of the organization. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b While the organization's governing body did not review the Form 990, the Board of Directors of Baptist Health System, Inc., the sole corporate member of the organization, was provided the organization's entire Form 990 prior to its filing via a link to a password-protected website. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The Board of Directors of the organization's sole member, Baptist Health System, Inc., has appointed a Conflicts of Interest Committee which regularly reviews the required disclosures of potential conflicts of interest by the Directors and Officers of the organization and its affiliates and recommends any action to be taken with regard to such disclosures. In accordance with the Conflicts of Interest Policy, during meetings of the organization's governing body, a Director who may have a conflict of interest is excused from discussion by the governing body about any transaction or matter that may have given rise to the Director's actual or potential conflict of interest. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 In accordance with the Executive Compensation policy of Baptist Health System, Inc. (BHS), the organization's sole member, BHS's Compensation Committee (made up of independent Directors of BHS) engages annually a third party compensation consultant who provides a database composed of current data regarding compensation paid for each executive position by similarly situated tax exempt health systems in the country. These health systems are generally the same size as BHS, considering revenue and other appropriate indicators. The group of comparator companies that is derived based on the above stated parameters comprise the "Market". When the Committee meets with such consultant, the consultant provides to Committee members compensation target levels that are competitive with the Market. Generally, the median of the Market is targeted. The actual amount that health system executives receive as compensation may be higher or lower than the median, depending on the health system and the individual's performance. The objective is to have a strong link between health system and individual performance and executive compensation such that if the health system and the individual perform at an optimal level, his or her compensation is in the higher range of the Market. Conversely, if either the health system or individual performance is below expectation, compensation may be in the lower range of the Market. The minutes of the annual Compensation Committee are recorded by the Committee's compensation consultant and are approved promptly by the Chair of such Committee. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Upon receiving a request from anyone, the organization will supply a copy of its governing documents, Conflicts of Interest Policy, financial statements and its most recently filed Form 990. The organization also makes its Form 990 available at the website guidestar.org. F990_P11_S00_L05 Form 990, Part XI, Line 5 Unrestricted net assets: (1) changes related to pension and executive compensation other than period costs, $5,047,826, (2) transfers to affiliated organizations, ($392,996), (3) contributions for the purchase of property, plant, and equipment, $99,410, (4) net assets released from restrictions used for purchase of property, plant, and equipment, $6,377,099, (5) unrealized loss on interest rate swap agreements, ($1,737,268); Temporarily restricted net assets: (1) restricted contributions, $5,877,065, (2) investment gains, $708,232, (3) transfers of investment gains from permanently restricted net assets, $1,775,308, (4) net assets released from restrictions, ($7,408,343); Permanently restricted net assets: (1) contributions, $2,591,205, (2) investment gain, $1,775,308, (3) Transfers of investment gains to temporarily restricted net assets, ($1,775,308). Baptist Medical Center of the Beaches Inc 1350 13th Ave S Jacksonville Beach FL 32250 592980620 Hospital FL 501(c)(3) 3 Baptist Health System Inc 0 Baptist Medical Center of Nassau Inc 1250 S 18th St Fernandina Beach FL 32034 593234721 Hospital FL 501(c)(3) 3 Baptist Health System Inc 0 Baptist Health System Inc 800 Prudential Dr Jacksonville FL 32207 592487136 Management assistance to health system FL 501(c)(3) 11a N/A 0 Baptist Health System Foundation Inc 841 Prudential Dr Aetna Bld 13th Flr Jacksonville FL 32207 592487135 Fundraising for health system FL 501(c)(3) 7 Baptist Health System Inc 0 Baptist Health Properties Inc 3563 Philips Hwy Bld A Ste 106 Jacksonville FL 32207 592487133 Manage property for health system FL 501(c)(3) 11a Baptist Health System Inc 0 Baptist Health Ambulatory Services Inc 3563 Philips Hwy Bld A Ste 106 Jacksonville FL 32207 593410739 Cancer education & research for health system FL 501(c)(3) 11a Baptist Health System Inc 0 Pavilion Associates Ltd 3563 Philips Hwy Bld A Ste 106 Jacksonville FL 32207 592505491 Property management FL Southern Baptist Hospital of Florida Inc Related 1324604 10069002 0 0 0 0.985 Pavilion Health Services Inc 3563 Philips Hwy Bld A Ste 106 Jacksonville FL 32207 592059710 Physician practices/retail pharmacies FL N/A C 0 1 1 0 1 0 0 0 1 1 0 1 1 1 1 1 0 0