High Plains Baptist Health Foundation: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
High Plains Baptist Health Foundation (EIN 75-0800669)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201233189349303778
Schema version
2011v1.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-13T15:05:08-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1401 CONGRESS SUITE 1800AddressLine1
CityAUSTINCity
StateTXState
ZIP Code78701ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN750800669EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Baptist St Anthony's Hospital CorporationBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% JAMES TAYLORInCareOfName
Name ControlBAPTNameControl
Phone8062122000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13310 DANVERSAddressLine1
CityAMARILLOCity
StateTXState
ZIP Code79106ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBrian WaltonName
TitleCFOTitle
Date Signed2012-11-09DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone5124789881Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROBERT WILLIAMSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11600 WALLACE BLVDAddressLine1
CityAMARILLOCity
StateTXState
ZIP Code79106ZIPCode
FieldValueIRS element (for citing)
Gross Receipts333565730GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BSAHS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionPROVIDE QUALITY HEALTHCARE IN CHRISTIAN LOVE, SERVICE AND DIGNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees2798TotalNbrEmployees
Total Nbr Volunteers76TotalNbrVolunteers
Total Gross UBI1884524TotalGrossUBI
Net Unrelated Business Txbl Income-817505NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year39909ContributionsGrantsPriorYear
Contributions Grants Current Year323968ContributionsGrantsCurrentYear
Program Service Revenue Prior Year288719552ProgramServiceRevenuePriorYear
Program Service Revenue CY302294347ProgramServiceRevenueCY
Investment Income Prior Year15839698InvestmentIncomePriorYear
Investment Income Current Year17592609InvestmentIncomeCurrentYear
Other Revenue Prior Year773077OtherRevenuePriorYear
Other Revenue Current Year747048OtherRevenueCurrentYear
Total Revenue Prior Year305372236TotalRevenuePriorYear
Total Revenue Current Year320957972TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year131212GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY74467GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year108874228SalariesEtcPriorYear
Salaries Etc Current Year110936977SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year261675TotalFundrsngExpCurrentYear
Other Expense Prior Year150483494OtherExpensePriorYear
Other Expenses Current Year147300656OtherExpensesCurrentYear
Total Expenses Prior Year259488934TotalExpensesPriorYear
Total Expenses Current Year258312100TotalExpensesCurrentYear
Revenues Less Expenses Prior Year45883302RevenuesLessExpensesPriorYear
Revenues Less Expenses CY62645872RevenuesLessExpensesCY
Total Assets BOY476712976TotalAssetsBOY
Total Assets EOY532604489TotalAssetsEOY
Total Liabilities BOY137631216TotalLiabilitiesBOY
Total Liabilities EOY136109099TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY339081760NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY396495390NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPROVIDE QUALITY HEALTHCARE IN CHRISTIAN LOVE, SERVICE AND DIGNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense117511417Expense
Grants0Grants
Revenue183124553Revenue
DescriptionBSA PROVIDED INPATIENT SERVICES TO 20,954 PATIENTS. INPATIENT SERVICES INCLUDE, BUT ARE NOT LIMITED TO: CORONARY CARE, INPATIENT SURGICAL SERVICES, REHAB AND HOSPICE.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense51341766Expense
Grants0Grants
Revenue96292802Revenue
DescriptionBSA PROVIDED OUTPATIENT SERVICES TO 162,524 PATIENTS. OUTPATIENT SERVICES INCLUDE, BUT ARE NOT LIMITED TO: OPERATING ROOM, RECOVERY ROOM, ANESTHESIA, GASTROENTEROLOGY AND DAY SURGERY, HOSPICE HOME CARE AND PHYSICAL THERAPY.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense12207999Expense
Grants0Grants
Revenue11127500Revenue
DescriptionBSA EMERGENCY DEPARTMENT PROVIDED TREATMENT TO 56,782 PATIENTS. THE EMERGENCY DEPARTMENT IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK. PATIENTS ARE TREATED WITHOUT REGARD FOR ABILITY TO PAY. THE AVERAGE NUMBER OF PATIENTS SEEN EACH DAY IN THE EMERGENCY DEPARTMENT IS 156.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp21206906TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev10272676TotalOfOtherProgramServiceRev
Total Program Service Expense202268088TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvesttrueReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With1096258NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2798NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJAMES TAYLORNamePerson
Telephone Number8062126281TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13310 DANVERSAddressLine1
CityAMARILLOCity
StateTXState
ZIP Code79106ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
ROBERT WILLIAMS
CEO22.0XX068748225445
BELINDA GIBSON
VP PATIENT SERVICES38.0XX031397120503
BRIAN WALTON
CFO/VP FINANCE30.0XX039866718181
MICHAEL CRUZ
VP OPERATIONS30.0XX038759320672
JOHN WILLIAM NEILSON MD
VP MEDICAL AFFAIRS30.0XX040441726366
PAUL HANCOCK MD
VICE PRESIDENT6.0XX021227715146
LORI W HENKE
DIRECTOR PHARMACY40.017170111271X
N M KENDRICK
PHARMACIST40.015291716472X
JAMES G MARTIN
PHARMACIST40.0153069015813X
KHALED BARAKAT
PHARMACIST40.014920812421X
STEPHANIE NOGGLER
MANAGER PHARMACY40.0146247014473X
CATHY COCHRAN
MANAGER PHARMACY40.0145556010541X
ELIZABETH PULLIAM
VP FINANCE THRU 5/25/100.001350025899X
FieldValueIRS element (for citing)
Total Reportable Comp From Org918698TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2539409TotalReportableCompFrmRltdOrgs
Total Other Compensation213203TotalOtherCompensation
Number Individuals GT100 K46NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
AMARILLO ANESTHESIA CONSULTANTS
PO BOX 50667AMARILLOTX79159consulting services3374705
AMARILLO EMERGENCY PHYSICIANS
PO BOX 50405AMARILLOTX79159ER Physicians1792196
HIGH PLAINS RADIOLOGICAL ASSOCIATES
PO BOX 3780AMARILLOTX79116radiology services724337
PANHANDLE OBSTETRICS GYN PA
7620 WALLACE BLVDAMARILLOTX79124Women's Healthcare720000
AMARILLO PATHOLOGY ASSOCIATES
PO BOX 50117AMARILLOTX79159Pathology Consultant617970
FieldValueIRS element (for citing)
Number Of Contractors GT100 K24NumberOfContractorsGT100K
Related Organizations323968RelatedOrganizations
Total Contributions323968TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
INPATIENT REVENUE621990187106119187106119
OUTPATIENT REVENUE621990103438736103438736
MEDICARE COST RECOVERY/3RD PARTY STLMNT62199036682193668219
MGT FEES FROM PANHANDLE SURGICAL621990923838459912463926
All other program service revenue621990715743561445451012890
FieldValueIRS element (for citing)
Total Program Service Revenue302294347TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column16330698TotalRevenueColumn
Exclusion$16,330,698ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities13556569Securities
Other4200Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities12240766Securities
Other58092Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1315803Securities
Other-53892Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1261911TotalRevenueColumn
Exclusion$1,261,911ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory607143GrossSalesOfInventory
Cost Of Goods Sold308900CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column298243TotalRevenueColumn
Exclusion$298,243ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
TELECOMMUNICATION517000113725113725
HOUSEKEEPING/LINEN561499198109157012$41,097
PRINT SHOP561439101299101299

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column35672TotalRevenueColumn
Unrelated Business Revenue35672UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue448805TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column320957972TotalRevenueColumn
Related Or Exempt Function Income300817531RelatedOrExemptFunctionIncome
Unrelated Business Revenue1884524UnrelatedBusinessRevenue
Exclusion$17,931,949ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total74467Total
Program Services74467ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total182972Total
Management And General182972ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total92268154Total
Program Services73245003ProgramServices
Management And General18852813ManagementAndGeneral
Fundraising170338Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3685675Total
Program Services2929287ProgramServices
Management And General749576ManagementAndGeneral
Fundraising6812Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8087769Total
Program Services5879844ProgramServices
Management And General2194907ManagementAndGeneral
Fundraising13018Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6712407Total
Program Services5315656ProgramServices
Management And General1384070ManagementAndGeneral
Fundraising12681Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total30175072Total
Program Services21284747ProgramServices
Management And General8882314ManagementAndGeneral
Fundraising8011Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total4971Total
Program Services1264ProgramServices
Management And General3565ManagementAndGeneral
Fundraising142Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total7250933Total
Program Services1921604ProgramServices
Management And General5291385ManagementAndGeneral
Fundraising37944Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total13463684Total
Program Services10292166ProgramServices
Management And General3162950ManagementAndGeneral
Fundraising8568Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2978556Total
Program Services1267702ProgramServices
Management And General1710854ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total501024Total
Program Services283167ProgramServices
Management And General214063ManagementAndGeneral
Fundraising3794Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1662Total
Program Services1335ProgramServices
Management And General327ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total4640101Total
Program Services4454485ProgramServices
Management And General185616ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total18593617Total
Program Services13592735ProgramServices
Management And General5000882ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1085289Total
Management And General1085289ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES63846944605564113290533
Repairs and Maintenance23572169385711418645
Collection Agency893585893585
All other expenses15080022296441277991367

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total258312100Total
Program Services202268088ProgramServices
Management And General55782337ManagementAndGeneral
Fundraising261675Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY12746BOY
EOY5218EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY30043248BOY
EOY36299090EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY29278053BOY
EOY33692381EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3937463BOY
EOY4806515EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4890656BOY
EOY4334397EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis441055547LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec281135859LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY164383525BOY
EOY159919688EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY109701366BOY
EOY130249350EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1000BOY
EOY34975EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY27185938BOY
EOY29307323EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY107278981BOY
EOY133955552EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY476712976BOY
EOY532604489EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY34392150BOY
EOY36105947EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY90460000BOY
EOY86490000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1099835BOY
EOY597515EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY11679231BOY
EOY12915637EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY137631216BOY
EOY136109099EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY339074507BOY
EOY396495390EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7253BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY339081760BOY
EOY396495390EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY476712976BOY
EOY532604489EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses62645872ReconcilationRevenueExpenses
Reconcilation Other Changes-5232242ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance7253BeginningOfYearBalance
Other Expenditures7253OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance0EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance7253BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses0InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance7253EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance-9450BeginningOfYearBalance
Contributions33407Contributions
Investment Earnings Or Losses0InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures16704OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance7253EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance13568BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses0InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses23018AdministrativeExpenses
End Of Year Balance-9450EndOfYearBalance
FieldValueIRS element (for citing)
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3366769OtherCostOrOtherBasis
Book Value3366769BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis208422916OtherCostOrOtherBasis
Depreciation90767269Depreciation
Book Value117655647BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis3394546OtherCostOrOtherBasis
Depreciation3147050Depreciation
Book Value247496BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis217269435OtherCostOrOtherBasis
Depreciation187221540Depreciation
Book Value30047895BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8601881OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value8601881BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings159919688TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionINV. IN PANHANDLE SURG HOSPDescription
Book Value29307323BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related29307323TotalOfBookValueProgramRelated

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
Other accounts receivable1976027
DUE FROM AFFILIATES131979525
FieldValueIRS element (for citing)
Total Book Value Other Assets133955552TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Asbestos retirement obligation$2,174,044
EST PAYABLE FOR SELF INS CLAIMS$10,440,713
DEF CONTRIBUTION SERP LIABILITY$300,880
FieldValueIRS element (for citing)
Total Of Amounts12915637TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierIntended Use of Endowment FundsIdentifier
Return ReferenceFORM 990, SCHEDULE D, PART VReturnReference
ExplanationFunds are used to provide assistance to employees desiring to complete a GED program. FIN 48 FOOTNOTE FORM 990, SCHEDULE D, PART X, LINE 2 In July 2006, the FASB issued guidance regarding accounting for uncertainty in income taxes, which requires that the taxable subsidiaries of the System recognize in their financial statements the effect of a tax position if that tax position is more likely than not of being sustained on audit, based upon the technical merits of the tax position. The System has adopted ASC 740-10 as of the required effective date. The System currently does not have any positions reserved.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense15148882TotalCommunityBenefitExpense
Direct Offsetting Revenue1719976DirectOffsettingRevenue
Net Community Benefit Expense13428906NetCommunityBenefitExpense
Percent Of Total Expense0.04810PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense15291857TotalCommunityBenefitExpense
Direct Offsetting Revenue13308698DirectOffsettingRevenue
Net Community Benefit Expense1983159NetCommunityBenefitExpense
Percent Of Total Expense0.00710PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense227528TotalCommunityBenefitExpense
Direct Offsetting Revenue339984DirectOffsettingRevenue
Net Community Benefit Expense-112456NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense30668267TotalCommunityBenefitExpense
Direct Offsetting Revenue15368658DirectOffsettingRevenue
Net Community Benefit Expense15299609NetCommunityBenefitExpense
Percent Of Total Expense0.05480PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense184098TotalCommunityBenefitExpense
Net Community Benefit Expense184098NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense1604000TotalCommunityBenefitExpense
Direct Offsetting Revenue424519DirectOffsettingRevenue
Net Community Benefit Expense1179781NetCommunityBenefitExpense
Percent Of Total Expense0.00420PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense73278856TotalCommunityBenefitExpense
Direct Offsetting Revenue47214631DirectOffsettingRevenue
Net Community Benefit Expense26064225NetCommunityBenefitExpense
Percent Of Total Expense0.09330PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense57624TotalCommunityBenefitExpense
Net Community Benefit Expense57624NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense75124578TotalCommunityBenefitExpense
Direct Offsetting Revenue47639150DirectOffsettingRevenue
Net Community Benefit Expense27485728NetCommunityBenefitExpense
Percent Of Total Expense0.09840PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense105792845TotalCommunityBenefitExpense
Direct Offsetting Revenue63007808DirectOffsettingRevenue
Net Community Benefit Expense42785337NetCommunityBenefitExpense
Percent Of Total Expense0.15320PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense800TotalCommunityBuildingExpense
Net Community Building Expense800NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense800TotalCommunityBuildingExpense
Net Community Building Expense800NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$8,497,036BadDebtExpenseAmount
Amount Reimbursed By Medicare96331003AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare111348187CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-15017184MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1Phy Surg Hosp LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary Activityambulatory surgical hospitalDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.51000OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0.00000OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.49000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities3NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (3 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursEr OtherErOther
BAPTIST-ST ANTHONY'S HOSPITAL
11600 WALLACE BOULEVARDAMARILLOTX79106XXXX
Physician's Surgical Hospital-Panhandle
27100 W 9th AvenueAmarilloTX79106XXX
Physician's Surgical Hospital-Quail Crk
36819 Plum Creek DriveAmarilloTX79124XXXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (3 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareState RegulationStateRegulationExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAvailable On RequestAvailableOnRequestOther PublicityOtherPublicityActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
BAPTIST-ST ANTHONY'S HOSPITAL
1truetrue200.true400.trueXXXXXXXtruetrueXXXtruefalsetrueXfalsefalse
Physician's Surgical Hospital-Panhandle
2truetrue200.true400.trueXXXXXXXtruetrueXXXtruefalsetrueXfalsefalse
Physician's Surgical Hospital-Quail Crk
3truetrue200.true400.trueXXXXXXXtruetrueXXXtruefalsetrueXfalsefalse

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
IdentifierSchedule H Supplemental InformationIdentifier
Return ReferencePart I, Line 3cReturnReference
ExplanationBaptist St. Anthony's Hospital uses income-based criteria for determining eligibility for free or discounted care under its financial assistance policy. Financially indigent patients whose gross annual income is 200% of the Federal Poverty Income Guidelines or less are eligible for free care while those with gross annual income between 200% and 400% of the Federal Poverty Income Guidelines are eligible for discounted care under the organization's financial assistance policy. The Hospital also uses an assets test to determine eligibility for charity care. Part I, Line 6a N/A Part I, Line 7 The Hospital used a cost-to-charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges, to calculate the amounts reported in the table in Part I, line 7. Part II The culture at BSA is to focus all of our creativity and efforts toward the well-being of our patients. At the same time, we also appreciate our position in our community as the community hospital. Our staff members are encouraged to serve on various boards that make our community grow and flourish. We also encourage and accommodate those employees who may not want to serve on an actual board, but who want to actively participate in the many functions that raise funds and awareness about these organizations. An example is one of our employees who serves as a mentor for local high school students throughout the school year. This is done during regular work hours at the expense of BSA. We receive numerous requests each year for financial support of these organizations and try to be wise stewards of our funds and donate to organizations that will make a great impact on our community. An example of this is the donation that we make to the Cancer Symposium each year. We also provide volunteers to work on specific projects that will make that same impact by the manpower provided by BSA. An example is the Loaned Executive to the United Way. We select an employee who would like to work in this capacity and we pay the $750 fee for them to serve in that role. We are proud that BSA is considered a leader in this community and we are especially proud of the efforts made by our employees who want to make a difference. Part III, Line 4 Audited Financial Statement Footnote 7. Patient Accounts Receivable Patient accounts receivable consist of the following at December 31 (in thousands): 2011 2010 Patient accounts, net of contractual allowances $ 57,246 $ 47,187 Less allowance for bad debts (6,128) (4,719) $ 51,118 $ 42,468 The System maintains allowances for uncollectible accounts for estimated losses resulting from a payer's inability to make payments on accounts. The System uses an income statement approach to value the allowance account based on historical write-offs, cash collections, and the aging of the accounts. Accounts are written off when collection efforts have been exhausted. Management continually monitors and adjusts its allowances associated with its receivables. Costing Methodology for Bad Debts The organization has used 2011 audited financial statements and the cost-to-charge ratio methodology provided for in optional Worksheet A - Estimated Bad Debt Expense (at Cost). At the end of 2011, the organization estimated the amount of bad debt expense that could reasonably be attributable to patients who likely would qualify for financial assistance under the hospital's charity care policy. As a result, a reclassifying entry was made from bad debt expense to recognize this amount appropriately as charity. Consequently, a zero amount is being reported in Part III, Section A, Line 3. Part III, Line 8 Methodology used to determine medicare allowable cost The costing methodology is the structure built into the CMS 2552-96, transmittals 23-25. Costs are grouped from the general ledger and classified in the appropriate cost center as allowable or non-reimbursable. Then adjustments are made on w/s A8 for reductions to allowable costs due to income offsetting revenues or costs identified as non reimbursable per CMS regulations. Additionally, costs are reclassified on W/S A6 for proper matching of costs and revenues or nature of the expense incurred. Next, the overhead costs are allocated to the direct and non-reimbursable expenses based on appropriate CMS allocation techniques and statistical bases. The total cost related to the Medicare revenue is taken from the following areas. The accommodation or routine portion of costs is taken from CMS 2552-96 D-1 line 37 for the appropriate Title XVIII provider or sub-provider. Cost for I/P ancillary service are taken from D-4 line 102, column 3. Costs for O/P ancillary services are taken from DV line 102, column 9. Subsidized care services are claimed as a community benefit for the following reason. These services exclude Medicaid and charity services already reported separately. These services are regarded as a community benefits because they are vital to the community in the case of Neonatal, and Obstetrical services furnished at a negative margin by Baptist St Anthony's. Also other health services are provided to older patients with complications and complex health problems. These services are also necessary for public health and could not be fully provided by other resources available in the community if they were not provided by Baptist St Anthony's. Part III, Line 9b The following is an excerpt from the Bad Debt Policy. It refers collectors to the Charity Policy once it is identified that a patient may qualify. The charity policy/procedure is followed from there. When reviewing accounts as potential bad debt, the collection and reviewing personnel should always look for signs that the account might qualify for charity. Such signs may include prior charity, a large dollar amount owed to BSA, employment status, marital status, and any combination of these or other factors that may become evident while working the account. In cases where a patient cannot or will not provide sufficient information to fully document eligibility for Charity Care, a presumption of eligibility may be made based on statistical data and other reliable assumptions so long as those assumptions are properly documented. Presumptive Charity and/or Financial Aid will be applied after all normal collection activities have been exhausted and before accounts are sent to an external collection agency. This may include one or more of the following situations: o Collections and Payment Prediction and Charity Eligibility based on MedeAnalytics o Insurance coverage is no longer in effect. o Patient cannot be located through collection attempts, is unemployed and uninsured. o Patient is unresponsive to collection attempts, is unemployed, uninsured, no credit information available. o Patient resided in a shelter or indicates they are homeless with no income or assets to validate. o Patient is not able to provide income information. o Patient is deceased and there is no estate. o Patient residence is in an area of high poverty. Once a determination of eligibility for Charity Care under Financial or Medical Indigence is made, no further collection efforts shall be pursued for the amount applied toward Charity Care. All patients approved will either be classified as financially indigent, medically indigent, or qualified for financial discount. Part V, Sec B, Line 1J N/A Part V, Sec B, Line 3 N/A Part V, Sec B, Line 4 N/A Part V, Sec B, Line 5c N/A Part V, Sec B, Line 6i N/A Part V, Sec B, Line 7 N/A Part V, Sec B, Line 9 N/A Part V, Sec B, Line 10 N/A Part V, Sec B, Line 11h N/A Part V, Sec B, Line 13g The financial assistance and charity care policy is available upon request; however, patients are notified of the policy as follows: o Patients who have a high deductible or are uninsured are informed of the charity care policy at the time of pre-registration, and patients are then directed to a financial counselor if they wish to pursue financial assistance. o If prior arrangements for financial assistance were not made prior to admission, patients are directed to a financial counselor for screening. o Patients admitted through the emergency department who indicate an inability to pay or are uninsured are screened by financial counselors to determine eligibility for financial assistance. o Patients are notified of the availability of financial assistance at the time of billing. Part V, Sec B, Line 15e N/A Part V, Sec B, Line 16e N/A Part V, Sec B, Line 17e N/A Part V, Sec B, Line 18d N/A Part V, Sec B, Line 19d In keeping with the mission and philosophy of the Baptist St. Anthony's Health System, BSA will apply a discount of 25% on all services provided to uninsured patients, who do not qualify for a 100% discount. In addition, BSA will provide charity care services, within the resources available, to financially or medically indigent patients. These services will be discounted up to 100% depending on patient's need. For those uninsured or underinsured patients who do not qualifExplanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantAcademic ScholarshipTypeOfGrant
Number Of Recipients77NumberOfRecipients
Amount Of Cash Grant74467AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule IIdentifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationBaptist St. Anthony's Health System (BSA) offers academic and/or scholarship assistance to employees through the BSA Education Assistance Program. The program provides scholarship assistance for the achievement of higher education and is designed to encourage development through education for positions within the hospital system. This benefit is subject to the availability of funds each year. Participation in the scholarship program requires a minimum of 3 months employment in good standing and recommendation by his/her director. In addition, scholarship recipients will provide proof of enrollment at an accredited college or university, maintain a 2.75 cumulative GPA, and commit to work at BSA for a designated amount of time upon completion of the degree. Scholarships are available for degree plans, approved by the executive team, to fill necessary vacancies and are subject to change. The number of credit hours enrolled determines scholarship amount awarded. The funds may not completely cover all expenses. The recipient is responsible for paying his/her incurred expenses at the educational institution. Scholarship assistance may be subject to federal taxes and withholding based upon the operative internal revenue regulations in place at the time of payment. Any applicable taxes are the student's/employee's responsibility.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgstrueCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ROBERT WILLIAMS
05402320146389086101746407981071292700
BELINDA GIBSON
02669660459000110501746403039033447400
BRIAN WALTON
02949230001037440980008381041684800
MICHAEL CRUZ
03102710758570146501746403208040826500
JOHN WILLIAM NEILSON MD
03231340796500163301746408902043078300
PAUL HANCOCK MD
01981210001415601363901507022742300
LORI W HENKE
170057164401127101829720
N M KENDRICK
149982293501031561571693890
JAMES G MARTIN
1475560285602657010258055550168882000
KHALED BARAKAT
13833826428228972726941616290
STEPHANIE NOGGLER
14257002772090509679047940160720000
CATHY COCHRAN
142848027080009312012290156097000
ELIZABETH PULLIAM
013500200000005899014090100

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental Compensation InformationIdentifier
Return ReferenceSchedule J, Part 1, Question 3ReturnReference
ExplanationCEO/EXECUTIVE DIRECTORS' COMPENSATION IS DETERMINED BY A RELATED ORGANIZATION, BSA HEALTH SYSTEM. THEREFORE, THE METHODS USED TO DETERMINE THE CEO/EXECUTIVE DIRECTOR'S COMPENSATION ARE IDENTIFIED ON THE BSA HEALTH SYSTEM 990. SCHEDULE J, PART I, LINE 4A ELIZABETH PULLIAM (FORMER VP FINANCE) RECEIVED $140,901 OF SEVERANCE COMPENSATION. THIS AMOUNT IS INCLUDED IN REPORTABLE COMPENSATION. Schedule J, Part 1, Question 4b Effective January 1, 2011, a new Supplemental Executive Retirement Plan was adopted. The new SERP was designed to comply with the requirements of Section 457(F) of the IRC to provide deferred compensation for a select group of management or highly compensated employees. The individuals listed below were eligible for the plan. However, no contributions were funded during the tax year. ROBERT WILLIAMS MICHAEL CRUZ BELINDA GIBSON JOHN NEILSON, MD BRIAN WALTON PAUL HANCOCK, MD Schedule J, Part I, Question 6a & 6b BSAHS paid an Employee Bonus. All employee, excluding the Executive Team, were eligible for the distribution. The compensation was contingent upon two criteria. 1) Net operating income in excess of budget for the consolidated organization 2) Patient satisfactionExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Supplemental InformationForm 990, Part III, Line 4dDESCRIPTION OF OTHER PROGRAM SERVICES OTHER PROGRAM REVENUE IS FROM THE PROVISION OF OUTPATIENT ANCILLARY SERVICES INCLUDING, BUT NOT LIMITED TO, LAB, DIAGNOSTIC IMAGING AND CATHETERIZATIONS. IN ADDITION SUPPORTING SERVICES PROVIDED THROUGH A CAFETERIA, PRINT SHOP, LAUNDRY AND OTHERS GENERATE ADDITIONAL REVENUES AND INCUR ADDITIONAL EXPENSES. FORM 990, PART VI, QUESTIONS 6, 7A, & 7B BAPTIST ST. ANTHONY'S HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF BAPTIST ST. ANTHONY'S HOSPITAL CORPORATION. THE BOARD OF TRUSTEES OF BAPTIST ST. ANTHONY HEALTH SYSTEM APPOINTS THE OFFICERS OF THE HOSPITAL AND THE BOARD OF TRUSTEES HAS CERTAIN AUTHORIZATION POWERS, WHICH INCLUDE THE FOLLOWING: (A) AMENDMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (B) ANY DEVIATION FROM OR AMENDMENT TO THE BROAD OBJECTIVES OF THE CORPORATION; (C) INCURRENCE OR ASSUMPTION OF ANY CAPITAL INDEBTEDNESS; (D) AUTHORIZING ANY PUBLIC FUND RAISING CAMPAIGN; (E) AUTHORIZING CAPITAL IMPROVEMENTS OR EXPANSION IN EXCESS OF $50,000; (F) DISPOSITION OF ANY PART OF THE CORPORATION'S PHYSICAL PLANT (REAL PROPERTY) HAVING A FAIR MARKET VALUE IN EXCESS OF $50,000; (G) AUTHORIZING THE INCURRENCE OF OPERATING EXPENSES IN EXCESS OF INCOME FOR OPERATIONS, FOR WHICH PURPOSE INCOME AVAILABLE FOR OPERATIONS SHALL INCLUDE DIRECT REVENUES, ENDOWMENT, OR INVESTMENT INCOME, CONTRIBUTIONS, FUNDS PROPERLY TRANSFERABLE FROM SPECIAL PURPOSE FUNDS, AND CONTINGENCY RESERVE FUNDS; (H) DISSOLUTION OF THE CORPORATION; (I) CESSATION OF OPERATIONS OF ANY LICENSED HOSPITAL; (J) SALE, LEASE, MORTGAGE, OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (K) APPROVAL OF THE ANNUAL STRATEGIC / OPERATING PLAN, IF ANY, THE ANNUAL BUDGET AND THE ANNUAL COMMUNITY BENEFIT PLAN, IF ANY, OF THE CORPORATION FORM 990, PART VI, QUESTION 11B THE FORM 990 IS PRESENTED TO EACH BOARD MEMBER AND REVIEWED PRIOR TO FILING. FORM 990, PART VI, QUESTION 12C THE CODE OF COMPLIANCE POLICY REQUIRES EMPLOYEES TO DISCLOSE CONFLICTS OF INTEREST. A "STATEMENT OF UNDERSTANDING" ACKNOWLEDGES THAT THE EMPLOYEE AGREES TO COMPLY WITH THE POLICY AND FAILURE TO COMPLY MAY BE GROUNDS FOR TERMINATION. THIS STATEMENT SHALL BE SIGNED BY EVERY NEW EMPLOYEE AND SHALL BE SIGNED ANNUALLY BY DEPARTMENT DIRECTORS, SUPERVISORS AND SELECTED EMPLOYEES. SELECTED EMPLOYEES SHALL COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. THE DIRECTOR OF CORPORATE COMPLIANCE REVIEWS ALL DISCLOSURES AND DETERMINES IF A CONFLICT EXISTS, AND REPORTS TO THE CHIEF COMPLIANCE OFFICER (CFO). IN MATTERS RELATED TO A DEPARTMENT DIRECTOR, SUPERVISOR OR SELECTED EMPLOYEE, THE CONFLICT OF INTEREST SHOULD BE RESOLVED BY DIRECTING THE EMPLOYEE TO DISCONTINUE OUTSIDE RELATIONSHIP/ACTIVITY, ABSTAIN FROM PARTICIPATING IN DECISION WHERE A CONFLICT EXISTS, OR DISCONTINUING BSA'S RELATIONSHIP WITH OUTSIDE ORGANIZATION. A MANAGEMENT PLAN SHALL BE ESTABLISHED TO MONITOR RELATIONSHIP/ACTIVITY SO AS TO ELIMINATE RISK. DIRECTORS, OFFICERS, AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS SHALL SIGN AN ANNUAL STATEMENT THAT THE PERSON RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, UNDERSTANDS THE POLICY AND AGREES TO COMPLY, AND UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS. TO DETERMINE WHETHER A POTENTIAL CONFLICT EXISTS, ALL EXISTENCES OF FINANCIAL INTEREST AND ALL MATERIAL FACTS MUST BE DISCLOSED TO THE BOARD OF DIRECTORS OR COMMITTEE FOR INVESTIGATION. AFTER INVESTIGATION, THE BOARD OF DIRECTORS MUST TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION, WHICH COULD INCLUDE LEGAL REMEDIES AND POSSIBLE SANCTIONS AGAINST THE INTERESTED PERSON. RECORDS WILL BE INCLUDED IN THE MINUTES OF THE BOARD MEETINGS AND ALL COMMITTEES WITH BOARD DELEGATED POWER. PERIODIC REVIEWS SHALL BE CONDUCTED BY THE DIRECTORS AND OFFICERS TO ENSURE THAT BSA AND TAX EXEMPT ENTITIES OPERATE IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX. THIS POLICY IS ADMINISTERED AND ENFORCED BY THE BOARD OF DIRECTORS OF EACH TAX EXEMPT ENTITY. FORM 990, PART VI, QUESTIONS 15B BAPTIST ST. ANTHONY'S HOSPITAL CORPORATION OFFICERS AND KEY EMPLOYEE COMPENSATION IS DIRECTED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES, THE CORPORATION CONTRACTS WITH SULLIVAN, COTTER, AND ASSOCIATES OF MINNEAPOLIS, MINNESOTA TO REVIEW THE DUTIES AND COMPENSATION. SULLIVAN COTTER CONFIRMS THAT COMPENSATION IS REASONABLE. SULLIVAN COTTER COMMUNICATES DIRECTLY WITH THE EXECUTIVE COMMITTEE ON MATTERS OF EXECUTIVE COMPENSATION. THE MOST RECENT REVIEW WAS COMPLETED IN 2012. FORM 990, PART VI, QUESTION 19 OUR 990'S ARE AVAILABLE ON GUIDESTAR AND UPON REQUEST. GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, QUESTION 5 CHANGE IN UNREALIZED GAINS/LOSSES $5,232,242
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ROBERT WILLIAMS TITLE:CEO HOURS:18
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:BELINDA GIBSON TITLE:VP PATIENT SERVICES HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:BRIAN WALTON TITLE:CFO/VP FINANCE HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MICHAEL CRUZ TITLE:VP OPERATIONS HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JOHN WILLIAM NEILSON, MD TITLE:VP MEDICAL AFFAIRS HOURS:10
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:PAUL HANCOCK, MD TITLE:VICE PRESIDENT HOURS:34

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Baptist St Anthony's Foundation
3310 DanversAmarilloTX79106752122630FundraisingTX501(c)(3)7BSAHStrue
Baptist St Anthony's Medical Group
3310 DanversAmarilloTX79106752565440StaffingTX501(c)(3)9BSAHStrue
Second Chance Foundation
3310 DanversAmarilloTX79106752160474FundraisingTX501(c)(3)11 TYPE IBSAHCtrue
Baptist St Anthony's Health System
3310 DanversAmarilloTX79106751858993Parent CorpTX501(c)(3)11,III,FINAfalse
The Don & Sybil Harrington Cancer Center
1500 WALLACE BLVDAmarilloTX79106751578415Cancer CenterTX501(c)(3)9BSAHStrue
Harrington Physicians Inc
1500 Wallace BlvdAmarilloTX78106752312574MEDICAL CARETX501(c)(3)9HCCtrue

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
Physicians Surgical Hospitals LLC
1600 Wallace BlvdAmarilloTX79106731620274Stand-alone HospTXNARelated1083139631680877false$0false0.51000
Physicians Surgical Real Estate LLC
1600 Wallace BlvdAmarilloTX79106202894224Holding CompanyTXNARelated8471237356140false$0false0.51000

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1BSA Holdings IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13310 DanversAddressLine1
CityAmarilloCity
StateTXState
ZIP Code79106ZIPCode
FieldValueIRS element (for citing)
EIN752058579EIN
Primary ActivityHolding CompanyPrimaryActivity
Legal Domicile StateTXLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CorpTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Baptist St Anthony's Foundation
C323968cost
The Don & Sybil Harrington Cancer Center Inc
L409317cost
Baptist St Anthony's Medical Group
O3583884cost
Physicians Surgical Hospitals LLC
P1390723cost
BSA Holdings Inc
P1168554cost
Baptist St Anthony's Health System
Q26120441cost

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