2012-08-14T11:43:48-07:00 2011-09-30 990 2010-10-01 592980620 Baptist Medical Center of the Beaches Inc BAPT 9042021797 3563 Philips Hwy Bldg F Suite 608 Attn Mike Lee Jacksonville FL 32207 Mike Lukaszewski 9042022852 2012-08-14 2010 2016-02-24 21:20:13Z X BMC Beaches A Hugh Greene 800 Prudential Dr Jacksonville FL 32207 117906621 0 X e-baptisthealth.com X 1989 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. 12 7 895 190 18268 0 115422 72513 116349213 117012215 2641789 253836 587571 558841 119693995 117897405 23764 62523 0 0 48317287 48447229 0 0 0 60706167 61517636 109047218 110027388 10646777 7870017 132958071 133364772 32184340 25810976 100773731 107553796 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 99094892 62523 117012215 Baptist Medical Center of the Beaches, Inc. (BMCB) provides Jacksonville's thriving beach communities with a comprehensive range of high-tech health care services close to home. BMCB is a full-service medical center with (1) 146 private patient rooms, including 16 spacious maternity suites, (2) more than 450 physicians, representing 30-plus medical specialties, (3) 6 state-of-the-art operating suites and 3 new endoscopy suites for inpatient and outpatient procedures, (4) family-centered visiting areas with outdoor patios, kitchens and a health resource library, (5) the only 24-hour emergency service east of the Intracoastal Waterway, plus a 24-hour on-call surgical team, and (6) comprehensive diagnostic testing and interventional imaging services. BMCB is committed to improving the lives of everyone, regardless of their ability to pay. BMCB is one of 4 licensed hospitals of Baptist Health System, Inc. (BHS), the region's only community-owned, faith-based healthcare system. 0 0 0 99094892 1 1 0 0 0 0 0 0 0 1 1 0 0 1 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 0 0 0 0 0 0 0 1 0 0 0 0 1 63 0 1 895 1 1 1 0 0 0 0 0 0 0 0 0 X 12 7 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 Aetna Bldg Ste 1602 Jacksonville FL 32207 Ernest P Bono Sr 5 X X 0 0 0 Peter Ghiloni 5 X X 0 0 0 A Hugh Greene 0 X X 0 935923 406991 Sonny Bhikha 5 X X 0 0 0 John K Anderson Jr 5 X 0 0 0 Nancy Broner 5 X 0 0 0 Sam Christian MD 5 X 0 0 0 Nathaniel Herring 5 X 0 0 0 Marilyn McAfee 5 X 0 0 0 Howard C Serkin 5 X 0 0 0 Carol C Thompson 5 X 0 1391 0 William R Wainwright MD 5 X 0 0 0 Don Chao 5 X 0 0 0 John F Wilbanks 0 X 0 520205 182738 Edward H Sim 40 X 258436 0 50788 Harvey Granger 0 X 0 441702 171606 Michael Lukaszewski 0 X 0 504752 47190 Anna M Hollander 40 X 155875 0 29752 Elizabeth Blackwelder 40 X 144789 0 21841 Debra S Beighley 40 X 121048 0 20638 Robert N Classon 40 X 118427 0 22461 William Saelinger 40 X 109590 0 20528 908165 2403973 974533 20 0 1 0 Diversified Clinical Services 4500 Salisbury Rd Ste 300 Jacksonville FL 32216 Wound care mgt. fees & services 480177 North Florida Surgeons 11945 San Jose Blvd Bld 300 Jax FL 32223 Gen surgery/ER call coverage 425260 Sodexho Inc & Affiliates PO Box 536922 Atlanta GA 303536922 Restaurant/housekeeping 364610 Jacksonville Orthopedic Institute 1325 San Marco Blvd Ste 200 Jax FL 32207 Orthopedic ER on-call 361000 Jacksonville Anesthesia Association PA PO Box 160489 Miami FL 33116 CRN stipends/medical services 175601 8 0 0 0 72513 0 0 0 72513 Net patient service revenues 622000 117012215 117012215 0 0 0 0 0 0 117012215 253836 0 0 253836 0 0 0 0 0 0 0 0 68970 0 9216 0 59754 0 59754 0 0 59754 0 0 0 Hospital restaurant revenues 722100 381367 0 0 381367 Health/fitness revenues 812900 36343 0 0 36343 Reference lab 621500 18017 0 18268 -251 63360 0 0 63360 499087 117897405 117012215 18268 794409 62523 62523 0 0 0 0 0 0 309224 0 309224 0 0 0 0 0 33375862 32247758 1128104 0 3088400 2821254 267146 0 9146979 8871655 275324 0 2526764 2449192 77572 0 964776 916537 48239 0 98365 49183 49182 0 54680 27340 27340 0 0 0 0 0 0 0 0 0 0 0 5095093 4840338 254755 0 102496 51248 51248 0 21088571 20508635 579936 0 129716 125526 4190 0 0 0 0 0 2517305 2391440 125865 0 70813 45228 25585 0 0 0 0 0 59058 21792 37266 0 161165 155959 5206 0 0 0 0 0 6824156 6603736 220420 0 -1085487 -1029042 -56445 0 Provision for bad debts 16001449 16001449 0 0 System functions allocation 7419192 0 7419192 0 Indigent care/NICA/AHCA assessments 1310092 1310092 0 0 Bond interest rate swap 539901 539901 0 0 Dues & memberships 78694 39347 39347 0 87601 43801 43800 0 110027388 99094892 10932496 0 1400 1400 0 0 0 0 13544041 15257892 0 0 0 0 0 0 1589553 1590975 860652 799614 105431537 48942103 54949637 56489434 34324263 34578099 0 0 0 0 0 0 27688525 24647358 132958071 133364772 5874683 5782948 0 0 0 0 17634831 16573881 0 0 0 0 0 0 0 0 8674826 3454147 32184340 25810976 X 99404370 105850001 1369361 1703795 0 0 100773731 107553796 132958071 133364772 X 7870017 -1089952 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 123410 0 507 0 1480 0 122437 116531 0 11518 0 4639 0 123410 125265 0 -2472 0 6262 0 116531 1 0 0 0 1 1 0 2648060 2648060 0 57791266 21598047 36193219 0 0 0 0 0 39017890 26317241 12700649 0 5974321 1026815 4947506 56489434 Advances to Baptist Health System, Inc. 24704821 Interest in net assets of Baptist Health System Foundation, Inc. 1922229 Due (to) from affililiated organizations, net -2332135 Long-term physician guarantee receivable 312452 Prepaid bond cost of issuance 39991 24647358 0 Estimated third-party settlements 1104366 Bond swap market value 2349781 3454147 117897405 110027388 7870017 0 0 0 0 -35284 -35284 7834733 117862121 0 0 0 0 0 117862121 0 35284 35284 117897405 110027388 0 0 0 0 0 110027388 0 0 0 110027388 SchD_P05_S00_L04 Schedule D, Part V, Line 4 Baptist Medical Center of the Beaches, Inc. (BMCB) has one temporarily restricted quasi-endowment that is held by its related affiliate, Baptist Health System Foundation, Inc. Annually, 5% of the combined endowment corpus and accumulated earnings are available for spending on capital projects of BMCB. SchD_P10_S00_L02 Schedule D, Part X, Line 2 (in thousands) Deferred income taxes, which as of September 30, 2011 and 2010, 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, 2011 and 2010, Baptist Health System, Inc. (BHS), the parent affiliate of Baptist Medical Center of the Beaches, Inc. (BMCB, had deferred tax assets of $15,901 and $16, 536, 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 $15,901 and $16,536 allowance at September 30, 2011 and 2010, respectively, was necessary to reduce the deferred tax asset to the amount that would more likely than not be realized. The change in the valuation allowance for the current year is $635. At September 30, 2011, BHS has available net operating loss carryforwards of $42,255, of which $1,147 expires at the start of fiscal year 2012. SchD_P11_S00_L08 Schedule D, Part XI, Line 8 Net assets released from restrictions used for purchase of property, plant, and equipment recorded as an increase in unrestricted net assets per audited financial statements and as contribution revenue per Form 990. SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Net assets released from restrictions used for purchase of property, plant and equipment reported as an increase in unrestricted net assets per audited financial statements and as contribution revenue per Form 990. 1 1 X 1 X 1 X 1 1 1 0 1 1 4911927 0 4911927 0.0522 4452501 0 4452501 0.0474 0 0 0 0.00 0 0 9364428 0 9364428 0.0996 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 0 0 0 0.00 52100 0 52100 0.0007 0 0 52100 0 52100 0.0007 0 0 9416528 0 9416528 0.1003 0 1108748 0 32319164 40201140 -7881976 X 1 1 1 1 Baptist Medical Center of the Beaches Inc d/b/a BMCB

1350 13th Ave S Jacksonville Beach FL 32250

X X X Baptist Medical Center of the Beaches Inc d/b/a BMCB 1 0 1 1 200 1 400 1 X X X X X X X X 1 1 X 1 X X 1 X X X X 1 X 1 0 SchH_P01_S00_L06a Schedule H, Part I, Line 6a Baptist Health System, Inc. (BHS), the parent affiliate of Baptist Medical Center of the Beaches, Inc., prepares annually a Community Benefit report, available at BHS's website, that 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 $16, 001,449 was included in Form 990, Part IX, Line 25, and was excluded from Schedule H, Part I, Line 7, column (f), percent of total expense calculations. SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 The provision for bad debts is based upon management's assessments of historical and expected net collections considering business and economic conditions, trends in healthcare coverage and other collection techniques. Accounts receivable are written off after collection effort has been followed in accordance with the Medical Centers' 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. 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_L19 Schedule H, Part V, Section B, Line 19 The organization has an automatic 40% discount for all uninsured patients. SchH_P05_S0B_L20 Schedule H, Part V, Section B, Line 20 The hospital has a minimum 40% discount, including those eligible for charity assistance, in addition to further discounts for patients qualified under our Charity Care Policy. On occasion, the net amount billed to such uninsured patients may exceed the net amount billed to insured patients. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 Baptist Health System, Inc. (BHS) is the parent affiliate of Baptist Medical Center of the Beaches, Inc. (BMCB). BHS uses a variety of sources to develop its assessment of community health needs. The organization has partnered with the Duval County Health Department in its regional health assessment (MAPP). BHS also performed, in conjunction with the Health Planning Council, a "porch-to-porch" assessment in the New Town subdivision of Health Zone 1. This zone represents the greatest number of health disparities for the region and the lowest socio-economic indicators. The organization also relies on a number of statistical reports provided by the Duval County Health Department on a variety of health care needs in the community. BHS has a dedicated community health board that focuses solely on the health needs of the community. BHS is an organizing member of a committee comprised of several non-profit hospitals and other health care agencies that focus on health care needs. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 At every patient access point, "Guidelines for Charity Care Eligibility" cards are provided that contain 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 Baptist Health System, Inc. (BHS), the parent affiliate of Baptist Medical Center of the Beaches, Inc., includes four licensed hospitals as part of its health system that covers both urban and rural areas. BHS covers a five-county area of Northeast Florida including downtown Jacksonville. BHS focuses its community health initiatives on lower income areas that also have high health needs. Much of this is provided through the churches in the area as well as the school systems. There is a heightened emphasis on cardiovascular diseases and asthma. The focus is one the uninsured and underserved groups consisting primarily of African-Americans with a smaller percentage of Caucasian, Hispanic and Asian populations. SchH_P06_S00_L05 Schedule H, Part VI, Line 5 All Baptist Health System, Inc. (BHS) affiliates, including Baptist Medical Center of the Beaches, Inc. (BMCB), maintain an open medical staff. BHS has a Community Health Board Committee that focuses on community health needs in the five-county area. BHS directly donates over a million dollars annually to several organizations that provide health services to low income adults and families. BHS is actively working to improve the health of our community, especially in our most vulnerable neighborhoods. Chief among these is Health Aone 1, the urban area of northwest Jacksonville noted as having the area's highest mortality rate for heart disease and diabetes-related conditions. BHS is actively collaborating with other community organizations and hospitals toward achievement of measurable improvements in the health and well-being of residents in this area, as well as others with a concentration of disproportionate unmet health needs. SchH_P06_S00_L06 Schedule H, Part VI, Line 6 Southern Baptist Hospital of Florida, Inc., d/b/a Baptist Medical Center, is the largest hospital in Baptist Health System, Inc. (BHS), the parent affiliate, and coordinates the majority of community health initiatives for the hospital system, including Baptist Medical Center of the Beaches, Inc. However, each affiliate hospital is involved in health initiatives in their immediate community. These initiatives consist primarily of direct health care services to low income adults and families. SchH_P06_S00_L07 Schedule H, Part VI, Line 7 Baptist Health System, Inc. (BHS), parent affiliate of Baptist Medical Center of the Beaches, Inc. and its related affiliates, are all located within the Northeast Florida quadrant. An annual Community Benefit Report is published and available on the e-baptisthealth.com website. 1 IM Sulzbacher Clinic Beaches 850 Sixth Ave S Jacksonville Beach FL 32250 593229898 501(c)(3) 20000 0 book Donation to organization that provides shelter and food for the homeless in the Jacksonville Beaches community. Mission House 800 Shetter Ave Jacksonville Beach FL 32250 593376704 501(c)(3) 15000 0 book Donation to organization to help fund the Mission House Clinic, which provides medical assistance to uninsured, disadvantaged individuals in the Jacksonville Beach community. The clinic also provides meals, clothing, and help in securing stable employment, stable medical care and stable housing. 2 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 0 635023 0 270900 0 30000 0 392827 0 14164 0 1342914 0 0 John F Wilbanks 0 367392 0 137813 0 15000 0 169216 0 13522 0 702943 0 0 Harvey Granger 0 327477 0 99225 0 15000 0 153278 0 18328 0 613308 0 0 Michael Lukaszewski 0 345772 0 143980 0 15000 0 33730 0 13460 0 551942 0 0 Edward H Sim 204436 0 44000 0 10000 0 33468 0 17320 0 309224 0 0 0 Anna M Hollander 140875 0 15000 0 0 0 18120 0 11632 0 185627 0 0 0 Elizabeth Blackwelder 132789 0 12000 0 0 0 14745 0 7096 0 166630 0 0 0 SchJ_P01_S00_L04 Schedule J, Part I, Line 4 Baptist Health System, Inc. (BHS), parent affiliate of Baptist Medical Center of the Beaches, Inc., 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 2011: A. Hugh Greene, $362,706, John F. Wilbanks, $140,879, Harvey Granger, $124,136, and Edward Sim, $23,668. These amounts were included in Schedule J, Part II, Column (c) for each of the listed individuals. Jacksonville Health Facilities Authority Var Rate Hospital Rev Refunding Bonds Series 2007 CDE 469404UN5 2007-05-17 11451000 Refund Series 1997A bonds 0 0 0 1848369 0 0 0 0 9602631 29846 0 0 0 0 0 2007 1 0 1 1 0 0 0 0 1 0 0 0 1 0 1 1 UBS and Wells Fargo 11.8 0 0 0 0 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 Executive Committee of the Board of Directors of Baptist Health System, Inc., the sole corporate member of the organization, reviewed the organization's Form 990 prior to its filing. The Executive Committee of the Board of Baptist Health System, Inc. consists of seven (7) members of its Board of Directors and is authorized by its Bylaws to act on behalf of its Board of Directors. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The Board of the organization's sole corporate member, Baptist Health System, Inc., has 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 corporate 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 paramaters 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's 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 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 minutes 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. Copies of the organization's Audited Financial Statements are on file with Florida's Agency for Health Care Administration. F990_P11_S00_L05 Form 990, Part XI, Line 5 (1) Unrestricted net assets: transfers to affiliates, ($1,464,900), contributions for the purchase of purchase of property, plant, and equipment, $40,514; (2) Restricted net assets: contributions, $376,550, net assets released from restrictions, ($42,116). Southern Baptist Hospital of Florida Inc 800 Prudential Dr Jacksonville FL 32207 590747311 501(c)(3) charitable hospital FL 501(c)(3) 3 Baptist Health System Inc 0 Baptist Health System Inc 800 Prudential Dr Jacksonville FL 32207 592487136 Management assistance FL 501(c)(3) 11a N/A 0 Baptist Medical Center of Nassau Inc 1250 S 18th St Fernandina Beach FL 32034 593234721 501(c)(3) charitable hospital FL 501(c)(3) 3 Baptist Health System Inc 0 Baptist Health System Foundation Inc 841 Prudential Drive Aetna Bldg - 13th floor Jacksonville FL 32207 592487135 Fundraising activities to support hospital operations. FL 501(c)(3) 7 Baptist Health System Inc 0 Baptist Health Properties Inc 800 Prudential Dr Jacksonville FL 32207 592487133 Real estate and property management for hospital. FL 501(c)(3) 11a Baptist Health System Inc 0 Baptist Health Ambulatory Services Inc 800 Prudential Dr Jacksonville FL 32207 593410739 Cancer research and education FL 501(c)(3) 11a Baptist Health System Inc 0 Pavilion Health Services Inc 800 Prudential Dr Jacksonville FL 32207 592059710 Physician practices/retail pharmacies FL N/A C 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1