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        <MethodOfValuation>C</MethodOfValuation>
      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>Investment in BMA</Description>
        <BookValue>33278485</BookValue>
        <MethodOfValuation>C</MethodOfValuation>
      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>Investment in WBMV</Description>
        <BookValue>13209958</BookValue>
        <MethodOfValuation>C</MethodOfValuation>
      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>Investment in BPL</Description>
        <BookValue>39284817</BookValue>
        <MethodOfValuation>C</MethodOfValuation>
      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>Investment in AEIX</Description>
        <BookValue>9850892</BookValue>
        <MethodOfValuation>C</MethodOfValuation>
      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>Investment in BPS</Description>
        <BookValue>5245437</BookValue>
        <MethodOfValuation>C</MethodOfValuation>
      </InvestmentsProgramRelated>
      <InvestmentsProgramRelated>
        <Description>Other</Description>
        <BookValue>9019203</BookValue>
        <MethodOfValuation>C</MethodOfValuation>
      </InvestmentsProgramRelated>
      <TotalOfBookValueProgramRelated>133572539</TotalOfBookValueProgramRelated>
      <OtherAssets>
        <Description>Other Current Assets</Description>
        <BookValue>14953918</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Due from Affiliates</Description>
        <BookValue>59235676</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Trustee Funds - Malpractice Agrmts.</Description>
        <BookValue>43964824</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Trustee Funds - Work Comp Agrmts.</Description>
        <BookValue>12579933</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Investments in Joint Ventures</Description>
        <BookValue>1993783</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Unamortized Issue Costs</Description>
        <BookValue>3218181</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>135946315</TotalBookValueOtherAssets>
      <OtherLiabilities>
        <Description>Estimated Third Party Settlements</Description>
        <Amount>15004419</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Malpractice Liability</Description>
        <Amount>59069515</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Workers Comp. Liability</Description>
        <Amount>13294753</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Accrued Post Retirement/Misc.</Description>
        <Amount>23873047</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>111241734</TotalOfAmounts>
      <Form990ScheduleDPartXIV>
        <Identifier>Description of Intended Use of Endowment Funds:</Identifier>
        <ReturnReference>Part V, Line 4:</ReturnReference>
        <Explanation>The endowment funds are used to support &amp; enhance patient care at the hospitals, finance capital improvements and provide educational &amp; financial assistance to hospital employees.</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="RetDoc1041500001">
      <CharityCarePolicy>1</CharityCarePolicy>
      <WrittenPolicy>1</WrittenPolicy>
      <PolicyAppliedToAllHospitals>X</PolicyAppliedToAllHospitals>
      <FPGReferenceFreeCare>1</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>1</FPGReferenceDiscountedCare>
      <Pcent400>X</Pcent400>
      <FreeDiscCareMedicallyIndigent>1</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>1</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>0</ExpensesExceededBudget>
      <AnnualCommunityBenefitReport>1</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>1</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <PersonsServed>40540</PersonsServed>
        <TotalCommunityBenefitExpense>42310397</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>9249740</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>33060657</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02880</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <PersonsServed>79569</PersonsServed>
        <TotalCommunityBenefitExpense>103358155</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>79229242</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>24128913</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02100</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <TotalCharityCare>
        <PersonsServed>120109</PersonsServed>
        <TotalCommunityBenefitExpense>145668552</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>88478982</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>57189570</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.04980</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <PersonsServed>100195</PersonsServed>
        <TotalCommunityBenefitExpense>3142142</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>442334</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>2699808</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00240</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>387047</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>387047</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00030</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <SubsidizedHealthServices>
        <PersonsServed>43974</PersonsServed>
        <TotalCommunityBenefitExpense>79703274</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>68785239</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>10918035</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00950</PercentOfTotalExpense>
      </SubsidizedHealthServices>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>779690</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>779690</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00070</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <PersonsServed>144169</PersonsServed>
        <TotalCommunityBenefitExpense>84012153</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>69227573</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>14784580</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01290</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <PersonsServed>264278</PersonsServed>
        <TotalCommunityBenefitExpense>229680705</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>157706555</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>71974150</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.06270</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <BadDebtExpenseReported>0</BadDebtExpenseReported>
      <BadDebtExpenseAmount>19261891</BadDebtExpenseAmount>
      <AmountAttributableTo>7289000</AmountAttributableTo>
      <AmountReimbursedByMedicare>370836690</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>415706766</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-44870076</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>1</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>1</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>4</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>Baptist Hospital East</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>4000 Kresge Way</AddressLine1>
          <City>Louisville</City>
          <State>KY</State>
          <ZIPCode>402074604</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>2</FacilityNumber>
        <Name>
          <BusinessNameLine1>Baptist Regional Medical Center</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>1 Trillium Way</AddressLine1>
          <City>Corbin</City>
          <State>KY</State>
          <ZIPCode>407018420</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>3</FacilityNumber>
        <Name>
          <BusinessNameLine1>Central Baptist Hospital</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>1740 Nicolasville Rd</AddressLine1>
          <City>Lexington</City>
          <State>KY</State>
          <ZIPCode>405031431</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>4</FacilityNumber>
        <Name>
          <BusinessNameLine1>Western Baptist Hospital</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>2501 Kentucky Ave</AddressLine1>
          <City>Paducah</City>
          <State>KY</State>
          <ZIPCode>420033813</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, Line 6a: Each hospital within Baptist Healthcare System (61-0444707) prepares a community benefit report. In addition, a summary community benefit report is prepared on a consolidated basis for all entities within Baptist Healthcare System, Inc.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, Line 7: Baptist Healthcare System utilizes a sophisticated cost accounting system that identifies the cost of delivering care at the individual procedure and item (supply) level for direct costs and a detailed step-down methodology to allocate overhead costs as accurately as possible. Costs are determined for each patient based upon the specific procedures performed and items used for each patient. Patients are also categorized by:- Patient type (inpatient and outpatient),- Payer plan (42 unique categories of payer plans. Charity, State-sponsored charity and the Uninsured are among the uniquely identified payer plans), and- Clinical service (53 unique clinical services). The cost of care for uninsured patients who qualify for "full" charity care (under a State-sponsored or BHS sponsored charity program) is determined by calculating the cost of each uninsured charity patient (at the procedure and item level) and accumulating the cost of each patient.For insured patients who also qualify for partial charity under the Baptist Healthcare System sponsored charity program, costs are allocated to each portion (insurance, partial charity, patient payments and bad debt) using the patient's payer plan cost-to-charge ratio (CCR). For example, this CCR is multiplied by the charges covered by insurance to determine the cost of insurance, multiplied by charges covered by partial charity to determine the cost of partial charity, multiplied by patient payments to determine the cost of paid services and multiplied by unpaid charges to determine the cost of bad debt.The cost of care for uninsured patients who do NOT qualify for charity care (full or partial bad debt accounts) are allocated to each portion (patient paid portion and unpaid portion) using the patient's uninsured payer plan CCR. For example, this CCR is multiplied by patient payments to determine the cost of paid services and multiplied by unpaid charges to determine the cost of bad debt.Much care is taken to ensure that costs used for community benefit reporting are directly related to exempt-purpose patient care (excluding physician-related costs) and that costs are reported accurately. For example, the cost of charity and Medicaid are removed from the calculation of the loss on subsidized services.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, Line 7g: No physician clinic costs are included in the costs of subsidized health services.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part I, L7 Col(f): The organization included bad debt expense of $73,394,618 on Form 990, Part IX, Line 25 but subtracted this amount for purposes of calculating the amount reported on Line 7f.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 4: A separate footnote for bad debt expense is not included in the audited financial statements.Costing methodology of bad debt is outlined in Schedule H, Part VI, Line 1.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 8: 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. 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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part III, Line 9b: Patients and guarantors who qualify for a "full" charity discount will not be billed once the charity determination is made. Patients and guarantors who qualify for a "partial" charity discount will be billed only for the non-discounted portion of their account.Guarantors who have an ability to pay for services will be billed based on the following guidelines.- Patients or guarantors may be asked to pay an estimated patient liability at point of service.- BHS facilities will accept and file claims for all insurances assigned to the organization with adequate proof of coverage. This assignment does not relieve the guarantor of responsibility for payment if the insurer fails to pay as prescribed by regulation, statute or patient-insurance contract. Deductibles, co-payments and non-covered services will be the responsibility of guarantors.- Statements will be sent to guarantors once patient liability is determined for insured or uninsured patients and necessary billing follow-up calls will be made by BHS Patient Financial Services and/or a designated external early out vendor over a period of time averaging from 90 to 120 days. All statements will contain information regarding the availability of financial assistance. If applicable, effort will be made to assist uninsured patients to secure coverage through any governmental or other assistance programs.- Patients requesting detailed charge information will be provided with an itemized bill.- BHS Patient Financial Services will provide all patients the same information concerning services and charges.- Patient accounts not resolved at the end of this cycle will be considered for placement with external collection agencies. Collection agencies will continue to pursue patient balances while maintaining compliance with the Fair Debt Collection Practices Act and the ACA International's Code of Ethics and Professional Responsibility.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 2: Baptist Healthcare System (BHS) conducts a tri-annual planning process that is driven by the strategic vision to be the health care leader in Kentucky. Key industry and community issues (such as prominent health conditions present within each community, underserved areas and underprovided clinical services) are considered and analyzed for their impact on BHS and the four hospitals. Frequently, outside experts reaffirm the assessment and assist in the development of plans to address the community need. A course of action, including key strategies and goals, are shared with and approved by the BHS Board and the Hospital's administrative Boards.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 3: Following is a list of various methods/processes used to inform/educate patients on the availability of financial assistance: - Financial counselors advise and/or screen uninsured patients before or during hospital services,- A third party vendor advises and/or screens uninsured patients during hospital services,- Financial counselors provide follow-up contact for patients missed during services,- The State-sponsored DSH form is provided to all ER uninsured patients,- Telephone calls and in-person visits are handled by staff trained to discuss financial assistance,- Information regarding financial assistance is included in patient statements.- The BHS sponsored charity care program policy is posted in key areas of each hospital.- The BHS sponsored charity care program policy is posted on the website of each hospital and the System.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 4: Baptist Healthcare System is comprised of four regional hospitals. Each one serves a unique and separate geographic area within Kentucky. Baptist Hospital East (BHE) opened in 1975 and is located in St. Matthews, approximately five miles east of downtown Louisville area. BHE is strategically located near Interstate 64, a main access to downtown, and Interstate 264, a main beltway around Louisville. The primary geographic service area for BHE consists of Jefferson, Oldham and Bullitt Kentucky counties. BHE serves as a general acute care facility, specializing in services such as cardiovascular services, cancer care and comprehensive rehabilitation services that are much needed in the area. In addition, BHE operates one of the busiest emergency rooms in the State of Kentucky.Approximately 13.4% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 10.3%, as compared to the national average of 9.3%. Approximately 4% of the patients seeking care at BHE are Medicaid and approximately 4% are uninsured.Baptist Regional Medical Center (BRMC) opened in 1986 in Corbin, Kentucky. It is located one-half mile off of Interstate 75, approximately three miles from downtown Corbin and near U.S. Highway 25, which is a main access to several of the surrounding communities.The primary geographic service area for BRMC consists of the counties of Knox, Laurel and Whitley in Kentucky. BRMC serves as a general acute care facility, specializing in services such as psychiatric, substance abuse, comprehensive rehabilitation and emergency care services. The psychiatric program at BRMC has grown over the past several years and BRMC has plans to continue its growth. Approximately 48% of the psychiatric program serves the Medicaid and uninsured populations. Overall, approximately 28% and 11% of the patients seeking care at BRMC are Medicaid and uninsured, respectively.Approximately 13.5% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 11.0%, as compared to the national average of 9.3%. Central Baptist Hospital (CBH) opened in 1954 in Lexington, the second largest city in Kentucky. It is located approximately five miles from Interstate 75 and Interstate 64 which provide access for the immediate Lexington metro area patients as well as patients from other areas of central and eastern Kentucky which the hospital serves. The primary geographic service area for CBH consists of the Kentucky counties of Bourbon, Clark, Fayette, Franklin, Jessamine, Madison, Scott and Woodford. In addition, Central serves as a regional referral center with approximately 38% of its discharges coming from Kentucky counties outside of the primary service area. As such, CBH provides tertiary care services not offered by many hospitals in the surrounding areas including specialty cardiovascular, orthopedic and intensive care services. Approximately 9% and 4% of the patients seeking care at CBH are Medicaid and uninsured, respectively.Approximately 10.8% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 7.8%, as compared to the national average of 9.3%. Western Baptist Hospital (WBH) was opened in 1953 in Paducah, Kentucky, the largest city in Western's service area. The hospital is located approximately one and one-half miles from Interstate 24. Western is one of only two hospitals located in Paducah.The primary geographic service area for Western consists of Ballard, Carlisle, Graves, Livingston, Lyon, Marshall and McCracken counties in Kentucky and Massac County in Illinois. WBH draws nearly 83% of its discharges from the primary service area. WBH serves as a general acute care facility, specializing in services such as cardiovascular services, cancer care and skilled nursing that are much needed in the area. Approximately 13% and 7% of the patients seeking care at CBH are Medicaid and uninsured, respectively.Approximately 16.6% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 8.9%, as compared to the national average of 9.3%.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 6: The BHS Board of Directors is comprised of local representatives who, along with the hospital's management and employees, understand that they are responsible to provide high quality health care services to the communities they serve. Operating healthcare facilities in today's environment requires a delicate balance between producing a sufficient margin to allow for adequate staffing and investment in new technologies, while also providing enough resources to absorb the cost of care for those patients who do not have the ability to pay for the services. In 2011, because of its ability to produce a modest operating margin, BHS was able to re-invest nearly $89 million into the communities in new technology, construction, renovation and systems improvement. BHS hospitals reach out to the community in many ways through:- Conducting health fairs for local schools, businesses and churches.- Participating in fund-raising and other events to help local agencies such as the American Heart Association, Metro United Way, American Cancer Society, Big Brothers and Big Sisters and the American Red Cross.- Donating hospital space for community group meetings.- Participating on community health assessment teams that are dedicated to identifying and addressing local health needs in each of the counties we serve.- Hosting educational programs, including our pre-natal classes, and Safe Sitter program. - Maintaining necessary, but unprofitable services that meet community needs.- Helping to recruit physicians to underserved areas.- Helping patients coordinate services with other healthcare providers.- Providing resources for support groups, such as cancer recovery groups.- Promoting and providing preventive care services.- Monitoring clinical outcomes in order to ensure quality care.- Committing resources to improving safety and processes of care.- Providing services conveniently accessible by patients.In addition, BHS employees volunteer thousands of hours in community services and leadership. BHS's support for community activities underscores its commitment to improving the lives of those served. Because BHS and its employees contribute so much of their time, talents and resources to serve others, communities served by BHS are better places to live and work.Quantification of many of the community benefits is detailed elsewhere in this schedule. However, what the quantifiable amount doesn't measure is the economic benefit derived by the community from BHS being one of the major employers in the area. The economic impact of the wages paid to BHS employees is significant considering the dollars they spend on food, housing, services, and other products.The Internal Revenue Service Revenue Ruling 69-545 provides that a hospital can demonstrate it has met the community benefit standard by having a full-time emergency room open to the public regardless of ability to pay for services received. BHS hospitals operate an Emergency Department that is open 24 hours a day, 365 days a year and treated over 165,336 emergency patients during fiscal year 2011. BHS and its emergency department posts policies stating that patients will be treated regardless of their ability to pay. Depending on the severity of a patient's condition, as a service to the patient BHS may verify insurance prior to rendering services in the emergency department. Under no circumstances is emergency care delayed by discussions regarding insurance coverage or ability to pay for services. In addition, BHS does not convey or intimate in any way to any emergency medical transportation service an unwillingness to treat any particular patient in need of medical attention.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Explanation>Part VI, Line 7: Baptist Healthcare System, Inc. is a nonprofit, tax-exempt organization that owns and operates four hospitals. Baptist Healthcare Affiliates, Inc. is a nonprofit, tax-exempt affiliate that owns and operates an additional hospital.Baptist Community Health Services, Inc. is a nonprofit, tax-exempt affiliate that owns and operates urgent care centers, and occupational and physical therapy clinics within the regions surrounding the hospitals.Baptist Medical Associates, Inc., Baptist Physicians Lexington, Inc., Baptist Physicians Southeast, Inc. and Western Baptist Medical Ventures, Inc. are nonprofit, tax-exempt affiliates that own and operate physician practices. Baptist Healthcare Foundation, Inc., Baptist Hospital Foundation of Greater Louisville, Inc., Central Baptist Hospital Foundation, Inc., Lexington Cardiac Research Foundation, Inc., and Western Baptist Hospital Foundation, Inc. are nonprofit, tax-exempt affiliate corporations. Bluegrass Family Health, Inc. (BFH) is a nonprofit, tax-exempt affiliate health maintenance organization. Baptist Ventures, Inc. is a for-profit, affiliate corporation. Baptist Physicians' Surgery Center is a for-profit limited liability corporation, of which Baptist Community Health Services, Inc. owns 51%. PET/CT Management, LLC is a for-profit limited liability corporation, of which Baptist Healthcare System, Inc. owns 76%. Corbin Long Term Acute Care, LLC is a limited liability corporation of which Baptist Community Health Services, Inc. is the sole member. Baptist Eastpoint Surgery Center, LLC is a limited liability company which as of August 31, 2010 Baptist Community Health Services, Inc. owns 77%. All entities are located in the Commonwealth of Kentucky. All entities described in Schedule H, Part VI, Line 7 contributed a combined community benefit amount as follows:Charity care at cost = $36,224,000Unreimbursed Medicaid = $30,223,000Community health improvement = $2,776,000Health professions education = $387,000Subsidized health services = $12,794,000Cash and in-kind contributions = $849,000Total community benefit = $83,253,000Other items that also contribute to the benefit of the community:Bad debt at cost = $24,079,000Unreimbursed Medicare = $67,535,000</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <RecordsMaintained>0</RecordsMaintained>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Baptist Hospital Foundation of Greater Louisville</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>4000 Kresge Way</AddressLine1>
          <City>Louisville</City>
          <State>KY</State>
          <ZIPCode>40207</ZIPCode>
        </AddressUS>
        <EINOfRecipient>200292291</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>268034</AmountOfCashGrant>
        <PurposeOfGrant>General Support</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Paducah Junior College</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 7380</AddressLine1>
          <City>Paducah</City>
          <State>KY</State>
          <ZIPCode>42002</ZIPCode>
        </AddressUS>
        <EINOfRecipient>616001156</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>100320</AmountOfCashGrant>
        <PurposeOfGrant>General Support</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Western Baptist Hospital Foundation</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>2501 Kentucky Ave</AddressLine1>
          <City>Paducah</City>
          <State>KY</State>
          <ZIPCode>42003</ZIPCode>
        </AddressUS>
        <EINOfRecipient>264057759</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>98297</AmountOfCashGrant>
        <PurposeOfGrant>General Support</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>University of Kentucky Hospital</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 119</AddressLine1>
          <City>Lexington</City>
          <State>KY</State>
          <ZIPCode>405010119</ZIPCode>
        </AddressUS>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>68667</AmountOfCashGrant>
        <PurposeOfGrant>General Support</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Children's Charity Fund of the Bluegrass Inc</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>2724 Martinique Ln</AddressLine1>
          <City>Lexington</City>
          <State>KY</State>
          <ZIPCode>40509</ZIPCode>
        </AddressUS>
        <EINOfRecipient>311078176</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>65753</AmountOfCashGrant>
        <PurposeOfGrant>General Support</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Hope Center</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO Box 6</AddressLine1>
          <City>Lexington</City>
          <State>KY</State>
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        <IRCSection>501(c)(3)</IRCSection>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>John Henson</NamePerson>
        <BaseCompensationFilingOrg>331995</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>59659</BonusFilingOrg>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>Carl G Herde Sch O</NamePerson>
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        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>92076</BonusFilingOrg>
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        <NamePerson>Janet M Norton Sch O</NamePerson>
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      <Form990ScheduleJPartII>
        <NamePerson>Mary Lou Tipgos</NamePerson>
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        <BonusFilingOrg>25000</BonusFilingOrg>
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      <Form990ScheduleJPartII>
        <NamePerson>David Gray</NamePerson>
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        <NontaxableBenefitsRelatedOrgs>29887</NontaxableBenefitsRelatedOrgs>
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        <TotalCompensationRelatedOrgs>480770</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>John R Barton</NamePerson>
        <BaseCompensationFilingOrg>541402</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>John M O'Brien</NamePerson>
        <BaseCompensationFilingOrg>531293</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Douglas A Milligan</NamePerson>
        <BaseCompensationFilingOrg>518723</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
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        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>20052</DeferredCompFilingOrg>
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        <TotalCompensationFilingOrg>568199</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>David Rhodes</NamePerson>
        <BaseCompensationFilingOrg>318477</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>59283</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>25042</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>24462</DeferredCompFilingOrg>
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        <NontaxableBenefitsFilingOrg>28811</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>456075</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Bernard Tamme</NamePerson>
        <BaseCompensationFilingOrg>308803</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>75930</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>15441</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>18582</DeferredCompFilingOrg>
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        <NontaxableBenefitsFilingOrg>18116</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>436872</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <ReturnReference>Part I, Line 1a</ReturnReference>
        <Explanation>Five officers received gross-up payments which were included in taxable compensation.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <ReturnReference>Part I, Line 4b</ReturnReference>
        <Explanation>During calendar year 2010, four officers of BHS received a payout from a Supplemental Executive Retirement Plan, a nonqualified deferred compensation plan. The Plan is offered to a select group of management as determined by the BHS Executive Benefits Committee. The amounts paid during 2010 were previously reported as compensation on the 990 and were included in W-2 wages in 2010, reported in Schedule J, Part II, Column(F) and is a portion of the amount reported in Column B(iii). The following individuals received a payout from a Supplemental Executive Retirement Plan, a nonqualified deferred compensation plan: - Larry Barton - $554,435 - William Sisson - $35,138 - Susan Stout Tamme - $28,662 - John Henson - $242,776 In addition, all six officers who participate in the Supplemental Executive Retirement Plan accrued amounts for 2010 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 participated in and accrued amounts from the Supplemental Executive Retirement Plan: - Tommy Smith - $3,602 - William Sisson - $33,320 - Susan Stout Tamme - $30,058 - Larry Barton - $29,260 - John Henson - $15,421 - Carl Herde - $34,988</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>Ky Economic Development Finance Authority</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>610600439</IssuerEIN>
        <CUSIPNumber>49126KFM8</CUSIPNumber>
        <DateIssued>2009-02-19</DateIssued>
        <IssuePrice>502227848</IssuePrice>
        <DescriptionOfPurpose>Redeem 1/99, 1/05 &amp; 12/05 issues; acquire, construct &amp; equipt a hospital</DescriptionOfPurpose>
        <Defeased>0</Defeased>
        <OnBehalfOfIssuer>0</OnBehalfOfIssuer>
        <PoolFinancing>0</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <AmountRetired>17195000</AmountRetired>
        <TotalProceeds>502247678</TotalProceeds>
        <IssuanceCostsFromProceeds>4716995</IssuanceCostsFromProceeds>
        <CreditEnhancement>697784</CreditEnhancement>
        <CapitalExpenditures>99994925</CapitalExpenditures>
        <OtherSpentProceeds>396837974</OtherSpentProceeds>
        <YearOfSubstCompletion>2010</YearOfSubstCompletion>
        <CurrentRefunding>1</CurrentRefunding>
        <AdvanceRefunding>0</AdvanceRefunding>
        <FinalAllocationMade>1</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>1</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>0</OwningBondFinancedProperty>
        <AnyLeaseArrangements>0</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>1</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>0</AnyResearchAgreements>
        <BondCounselRoutinelyEngaged>1</BondCounselRoutinelyEngaged>
        <PrcntgePrvtBusinessUseByOthers>0.00100</PrcntgePrvtBusinessUseByOthers>
        <TotalPrivateBusinessUse>0.00100</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>1</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>0</Form8038TFiled>
        <VariableRateIssue>1</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>0</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>0</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>0</GrossProceedsInvested>
        <ExceptionToRebate>1</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartV>
        <Identifier>Schedule K, Part I:</Identifier>
        <ReturnReference>Explanation of Difference Between Issue Price:</ReturnReference>
        <Explanation>Differences between the issue price shown in Part I and total proceeds shown in Part II is due to investment earnings.</Explanation>
      </Form990ScheduleKPartV>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Juanita Baker</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>A Director of BHS has a family member employed by BHS (Bob Baker)</Relationship>
        <AmountOfTransaction>10389</AmountOfTransaction>
        <DescriptionOfTransaction>Wages</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Nicole Jackson-Gary</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>A Director of BHS has a family member employed by BHS (Frances Hamilton)</Relationship>
        <AmountOfTransaction>37926</AmountOfTransaction>
        <DescriptionOfTransaction>Wages</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Family Practice Properties</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>A Director of BHS is an owner of Family Practice Properties (Jeffrey Foxx)</Relationship>
        <AmountOfTransaction>626679</AmountOfTransaction>
        <DescriptionOfTransaction>Lease Agreement</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>BB&amp;T Insurance Services</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>A Director of BHS is an officer of BB&amp;T Insurance Services (Danny McMahan)</Relationship>
        <AmountOfTransaction>254407</AmountOfTransaction>
        <DescriptionOfTransaction>Insurance Brokering Services</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Baptist Physicians Surgery Center</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>An Officer of BHS is a board member of Baptist Phys Surg Ctr (W Sisson)</Relationship>
        <AmountOfTransaction>1007598</AmountOfTransaction>
        <DescriptionOfTransaction>Lease Agreement</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>PETCT Management</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>An Officer of BHS is a board member of PET/CT Management (S Tamme)</Relationship>
        <AmountOfTransaction>1169103</AmountOfTransaction>
        <DescriptionOfTransaction>Equipment Services</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Baptist Eastpoint Surgery Center LLC</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>An Officer of BHS is a board member of Baptist Eastpoint Surg Ctr (S Tamme)</Relationship>
        <AmountOfTransaction>954892</AmountOfTransaction>
        <DescriptionOfTransaction>Management Fees &amp; Lease Agreement</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>Susan D White Consulting</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>A Director of BHS has a family member who is a vendor of BHS (V Buster)</Relationship>
        <AmountOfTransaction>127583</AmountOfTransaction>
        <DescriptionOfTransaction>Consulting Services</DescriptionOfTransaction>
        <SharingOfRevenues>0</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartV>
        <Identifier>Schedule L, Part IV:</Identifier>
        <ReturnReference>Business Transactions Involving Interested Persons:</ReturnReference>
        <Explanation>All transactions reported on Part IV are reported as arms-length for fair market value.</Explanation>
      </Form990ScheduleLPartV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 2</Identifier>
        <Explanation>The Board of Directors is made up of executives from related organizations. The following individuals have a business relationship in that they serve on the Board of Directors of the organization and are officers and/or directors of a related organization: Tommy Smith, Larry Barton, John Henson, William Sisson, Susan Stout Tamme, Carl Herde, Janet Norton, David Gray, Robert Baker, Tom Davis, Robert Hook Jr, Lindsey Ingram Jr, Danny McMahan, Frank Purdy III, Eugene Siler Jr, Victoria Buster, John Logan, Chris Hutson, and Jeff Holland.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 11</Identifier>
        <Explanation>A copy of the 990 is provided to the board of directors prior to the filing of the return. Any questions or comments are addressed by explanation or a change to the form.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section B, line 12c</ReturnReference>
        <Explanation>Annually the secretary of Baptist Healthcare System, Inc. (BHS) sends out a conflict of interest questionnaire to each of the directors serving on the board of BHS. After completion, they are returned to the secretary and reviewed by her and the Board or a Board committee for any potential conflicts.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section B, line 15</ReturnReference>
        <Explanation>Annually, the Baptist Healthcare System, Inc. Compensation Committee reviews the compensation, including base compensation and incentive compensation for the CEO and all officers and key employees of Baptist Healthcare System, Inc. except for the Secretary and Assistant Secretary. Compensation for these employees is reviewed and approved by the CEO of Baptist Healthcare System, Inc. The Baptist Healthcare System, Inc. Compensation Committee is comprised of independent Board Members. The Committee retains a Compensation Consultant to advise the Committee and who provides data as to comparable compensation for similarly qualified persons in functionally comparable positions at similarly situated healthcare organizations. The Committee reviews this information in approving annual base and incentive compensation and other items of reportable compensation described on Schedule J of the IRS Form 990. The decisions of the Committee regarding compensation are contemporaneously documented in the minutes of the Committee. Annually, the Committee Chairperson and the Compensation Consultant provide a report on executive compensation to the full Board of Directors of Baptist Healthcare System, Inc.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>Form 990, Part VI, Section C, line 19</ReturnReference>
        <Explanation>In adherence to the Master Trust Indenture among Baptist Healthcare System, Inc., Baptist Healthcare Affiliates, Inc. and U.S. Bank National Association, as Master Trustee, Dated as of February 1, 2009, Baptist Healthcare System, Inc. reports its financial results on a quarterly basis to the Master Trustee who in turn makes them available through Electronic Municipal Market Access. Additionally, the organization will provide any documents open to public inspection upon request.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Explanation of Hours for Officers:</Identifier>
        <ReturnReference>Form 990, Part VII:</ReturnReference>
        <Explanation>Officers for Baptist Healthcare System, Inc. provide services to Baptist Healthcare System, Inc. and its subsidiaries. Hours worked are not tracked on an entity by entity basis. Therefore, all officers hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week for all entities.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Changes in Net Assets or Fund Balances:</Identifier>
        <ReturnReference>Form 990, Part XI, line 5:</ReturnReference>
        <Explanation>Net unrealized gains on investments: 29,886,988. Capital Distribution - Baptist Community Health Services 700,000. Capital Distribution - PET/CT Management, LLC 351,985. Capital Distribution - Paducah MRI 50,000. Funding for Strategic and Capital Needs -231,271. Post Retirement Change -52,704. Total to Form 990, Part XI, Line 5: 30,704,998.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Community Benefit Report:</Identifier>
        <ReturnReference>Form 990, Part III:</ReturnReference>
        <Explanation>Since its inception in 1924, Baptist Healthcare System, Inc. ("Baptist") is dedicated to providing accessible, quality healthcare to all patients regardless of their ability to pay. The hospitals owned and operated by Baptist under tax identification number 61-0444707 include: Baptist Hospital East, Louisville, Kentucky Baptist Regional Medical Center, Corbin, Kentucky Central Baptist Hospital, Lexington, Kentucky Western Baptist Hospital, Paducah, Kentucky Vision: The vision of Baptist is to be the healthcare leader in Kentucky. Having earned a reputation of providing high quality patient care and utilizing the latest in medical technology, patients seek out Baptist facilities for their care. According to state statistics in 2010, Baptist is one of the largest healthcare providers in the state. Kentucky 2010 Hospital Statistics: Licensed Beds - 1,548 Beds - Second largest number of beds of any health system in Kentucky Employees - 11,037 Employees - One of the top employers in Kentucky Inpatient Care - 73,607 Admissions/347,566 Days - Largest number of admissions in Kentucky at a system-owned or managed hospital - One out of every eight inpatients receiving care in Kentucky received care at a system-owned or managed hospital Obstetric (Deliveries) - 9,059 Babies - Largest number of babies delivered in Kentucky at a system-owned or managed hospital - One in six babies in Kentucky was delivered at Baptist hospitals at a system-owned or managed hospital Cardiology (Open heart surgeries) - 842 Cases - Second largest number of open-heart surgeries performed by any system-owned or managed hospital in Kentucky - One in six open-heart surgeries in Kentucky was performed at a system-owned or managed hospital Emergency Visits - 165,336 Registrations - The largest number of emergency visits in Kentucky at a system-owned or managed hospital - One in thirteen ER patients was treated at a system-owned or managed hospital Outpatient Visits - 704,535 Hospital Visits - One in twelve outpatients in Kentucky receiving care in an acute-care setting was seen at a system-owned or managed hospital Mission: As indicated by its mission statement, Baptist strives to continue its "Christian heritage of service and to enhance the health of the people and the communities we serve." Baptist is organized and operated exclusively for the benefit of each community and each hospital is considered a valuable community asset. The Baptist Boards of Directors are comprised of local representatives who, along with the hospitals' management and employees, understand that they are responsible to the communities for providing high quality health care services. Over the years, Baptist has gained a reputation for providing compassionate, high quality, cost efficient, patient friendly care. Responsive to Community Need: Operating healthcare facilities in today's environment requires a delicate balance between producing a sufficient margin to allow for adequate staffing and investment in new technologies, while also providing enough resources to absorb the cost of care for those patients who do not have the ability to pay for the services. In 2011, because of its ability to produce a modest operating margin, Baptist was able to re-invest over $89 million into the communities in new technology, construction, renovation and systems improvement. Because of the need to generate a modest margin while caring for all patients, Baptist strives to fulfill its community responsibility of collecting appropriate reimbursement from all patients who have the necessary resources while providing a generous, yet accountable charity care policy to assist those patients who do not have the means to pay for the services rendered. (See "Charity Care Policy on the next page for further discussion). From a broad perspective, Baptist hospitals consistently provide a high level of quality care to every patient and enhance the health of the people it serves through health promotions, health screenings, medical research, and training of health professionals. Other community benefits include: - Maintaining necessary, but unprofitable services that meet community needs - Helping to recruit physicians to underserved areas - Helping patients coordinate services with other healthcare providers - Providing resources for support groups - Promoting and providing preventive care services - Monitoring clinical outcomes in order to ensure quality care - Committing resources to improving safety and processes of care - Providing services conveniently accessible by patients In addition, Baptist employees volunteer thousands of hours in community services and leadership. Baptist's support for community activities underscores its commitment to improving the lives of those served. Because Baptist and its employees contribute so much of their time, talents and resources to serve others, communities served by Baptist are better places to live and work. Quantification of many of the community benefits is detailed further in "Statement 8: Part III - Statement of Program Service Accomplishments". However, what the Statement of Program Service Accomplishments doesn't measure is the economic benefit derived by each community from Baptist being one of the largest employers in the state. The economic impact of the wages paid to Baptist employees is significant considering the dollars they spend on food, housing, services, and other products. Charity Care Policy: To further the mission of enhancing the health of the people and communities it serves, Baptist provides medically necessary inpatient and outpatient care to patients regardless of race, religion, sex, national origin, disability, age or their ability to pay. Recognizing that not all patients have the ability to pay, Baptist has a charity care policy to accurately evaluate a patient's ability to pay for services received. Baptist relies solely on the physician order to determine whether treatment is medically necessary and whether the patient is treated on an inpatient or outpatient basis. Neither the patient's financial condition nor their ability to pay for services has any bearing upon whether, or how, the patient is treated in a Baptist facility. Patients are transferred only when Baptist does not provide the specialized service that is required, or by specific request of the patient. Baptist has notices posted throughout the hospital that clearly communicate Baptist's charity care policy. Baptist employees are instructed in the application of the charity care policy and are trained to recognize situations that indicate the financial resources of a patient may be inadequate. These employees freely and willingly volunteer information regarding the charity care policy to any patient who may express a concern regarding the ability to pay for services. The policy provides that: 1. Patients/guarantors with resources of less than 200% of the Poverty Guideline for their family size will receive full charity. 2. Patients/guarantors with resources of 200% but less than 400% of the Poverty Guideline for their family size will qualify for partial charity. The ratio of resources up to 400% of the Poverty Guideline determines the percentage of the bill that will be the responsibility of the applicant. However, the liability is capped at 10% of the resources. 3. Patients/guarantors with resources of 400% of the Poverty Guideline for their family size but no more than 1200% of the Poverty Guideline for their family of one will qualify for partial charity if the liability exceeds 20% of their resources. In these situations, the patient/guarantor will be responsible for an amount not to exceed 20% of their resources. 4. If eligible for a charity discount, a patient will receive the discount regardless of whether they pay the balance on the bill. If necessary, payment arrangements may be made on the balance of the patient's bill in accordance with hospital procedures. If charity care eligibility cannot be determined, good stewardship requires that the hospital initially begin the collection process. However, immediately upon determining that the guarantor is eligible for charity care, collection efforts on the balance eligible for charity will cease and the appropriate balance will be designated as charity. Tax-Exempt Status Requirements: The Internal Revenue Service Revenue Ruling 69-545 provides that a hospital can demonstrate it has met the community benefit standard by having a full-time emergency room open to the public regardless of ability to pay for services received.</Explanation>
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      <GeneralExplanation>
        <Explanation>Baptist operates Emergency Departments that are open 24 hours a day, 365 days a year and treated 165,336 emergency patients during fiscal year 2011. Baptist facilities and emergency departments post policies stating that patients will be treated regardless of their ability to pay. Depending on the severity of a patient's condition, as a service to the patient Baptist may verify insurance prior to rendering services in the emergency department. Under no circumstances is emergency care delayed by discussions regarding insurance coverage or ability to pay for services. In addition, Baptist does not convey or intimate in any way to any emergency medical transportation service an unwillingness to treat any particular patient in need of medical attention. Accountability to the Broader Community: As previously noted, the Baptist Board of Directors embraces its responsibility to represent the broader community in guiding Baptist in its provision of healthcare services. The Board meets periodically to provide oversight as to how best to continue to serve each community. Regularly scheduled meetings of the full Board and its Committees are described below: Board of Directors - Quarterly Audit Committee - Quarterly Executive Committee - Monthly Executive Compensation Sub-Committee - As needed Finance Committee - Monthly Governance Effectiveness Committee - Quarterly Hospital Administrative Boards - Monthly Legal Affairs Committee - Quarterly Quality and Mission Effectiveness Committee - Quarterly Physician Transaction Review Committee - As needed One of the key functions of the Board is to ensure Baptist not only utilizes sound financial management, but also embraces a culture of compliance that permeates throughout the healthcare system. This is best demonstrated by Baptist's commitment of resources for compliance activities including the designation of a Compliance Officer. The compliance function reports to the Audit Committee (established in 1994) which is comprised of three independent members of the Board who are not members of either the Executive or Finance Committees. Additionally, at least one member has the expertise to be considered a financial expert in the public sector. Another key function of the Board is to ensure that compensation paid to executives is reasonable and meets the guidelines set forth by the Internal Revenue Service. Through the Executive Compensation Sub-committee (ECS), the Board ensures that: 1. Members of the ECS do not have any conflicts of interest, i.e., they are not employed or receive compensation subject to approval by the executives 2. The compensation is approved in advance by the ECS 3. The ECS obtains and relies upon appropriate comparability data in making decisions 4. Every form of compensation and benefit is included in the comparisons 5. The ECS documents the basis for its decision concurrently with making the decision 6. Based upon the data, the compensation is reasonable. The following is a summary of Baptist's community service for the year ended August 31, 2011, in terms of services to the poor and indigent and the benefits provided to the communities it serves. Quantifiable Community Benefit: Baptist is fully committed to its responsibility as a charitable organization and commits extensive resources to fulfill that obligation to the community. To the extent possible, Baptist has quantified the benefits provided to the communities it serves: - Benefits for the Poor and Indigent: Unreimbursed Cost of Charity Care = $33,061,000 Unreimbursed Cost of Medicaid = $24,129,000 Total Benefits for the Poor and Indigent = $57,190,000 - Benefits for the Broader Community: Net Loss on Subsidized Health Services = $10,918,000 Community Health Improvement Services = $2,700,000 Health Professions Education = $387,000 Financial &amp; In-Kind Contributions = $779,000 Total Benefits for the Community = $14,784,000 Total Quantifiable Community Benefit = $71,974,000 Glossary of Community Benefit Terms: - Benefits for the Poor and Indigent: Describes services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured. This includes those patients that qualify for Charity, Medicaid, Kentucky's Children Health Insurance Program (KCHIP), Kentucky Hospital Care Program (KHCP) and other citizens whose income is inadequate (based on each patient's individual circumstances). 1. Unreimbursed cost of charity care describes the services provided to persons who cannot afford to pay. It also includes the Health Care Provider Tax (Kentucky Revised Statutes 142.303) that is assessed on all hospital patient revenues received for the purpose of funding state Medicaid, KHCP and KCHIP programs. The amounts reflect the net cost of these services after reducing the costs for contributions and other revenues received by Baptist as direct assistance for the provision of care. 2. Unreimbursed cost of Medicaid reflects costs of treating Medicaid beneficiaries not reimbursed by government programs. - Benefits for the Broader Community: Describes services provided to other needy populations that may not qualify as indigent but that need special services and support. The benefits include the cost of health promotion and education, health clinics and screenings, and medical research that benefits the community. 1. Net loss on subsidized health services reflects the loss from services that would be discontinued if the decision were based on profit motives only. 2. Other community benefit includes costs incurred by Baptist in providing support and coordination of health education and awareness events as well as the cost of employees paid time to attend, staff, and coordinate these activities. 3. Baptist makes cash and in-kind donations on behalf of the poor and needy to community agencies and to special funds used for charitable purposes.</Explanation>
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