2011-11-11T16:28:43-06:00 2010-12-31 ERNST & YOUNG US LLP 55 IVAN ALLEN BOULEVARD SUITE 1000 ATLANTA GA 30308 990 2010-01-01 050615150 BayCare Alliant Hospital Inc BAYC 7277346782 601 Main Street Dunedin FL 34698 Alan Holderith 9989809008 2011-11-11 4048748300 2010 2016-03-07 17:11:31Z Jacqueline Arocho 601 Main Street Dunedin FL 34698 14368602 false X www.baycare.org X 2004 FL BayCare Alliant Hospital will provide excellence in care for patients with prolonged illnesses recognizing that optimum healing requires a team approach to both medical and human values. 7 7 126 5 0 0 0 17691 10010784 14340652 405 0 3507 10259 10014696 14368602 0 1728 0 0 5477838 5482847 0 0 0 7452468 7655462 12930306 13140037 -2915610 1228565 2323904 2207045 9975042 8629618 -7651138 -6422573 BayCare Alliant Hospital will provide excellence in care for patients WITH PROLONGED ILLNESSES RECOGNIZING THAT OPTIMUM HEALING REQUIRES A TEAM APPROACH TO BOTH MEDICAL AND HUMAN VALUES. false false 11322571 1728 14350912 BayCare Alliant Hospital, Inc. (BAH) is a 48 bed, long-term acute care hospital. During 2010, BAH provided inpatient care to 356 patients and the average length of stay was 26 days. Through efforts of the medical assistance program and the hospital's charity care program BAH saw a net community benefit expense of $708 thousand. The hospital also provided other community services totaling more than $6 thousand. See Schedule H for additional information. 11322571 true true false false false false false false false true false false false true false true false false false false false false false false false true false false false true false false false false false false false false false false false false false false false false false false true 22 0 126 true false false false false false false false false false false X 7 7 false false false false true true true true true false false true true true true true true true true false X John Proni 7277346782 601 Main Street Dunedin FL 34698 X Bruce Bokor X X 0 0 0 Robert Evans X 0 0 0 Ken Hamilton X 0 0 0 Alan Holderith X X 0 0 0 Mary Labyak X 0 0 0 Bruce Flareau X 0 0 0 Glenn Waters X 0 0 0 John Proni 45.0 X 69948 0 2731 Anita Russell 45.0 X 173519 0 453 Karen Duffy 45.0 X 101963 0 6979 345430 0 10163 2 false true false EMCARE 7032 COLLECTION CENTER DR CHICAGO IL 60693 Medical Services 131400 LEONARD J DUNN MD 601 MAIN ST 5TH FLOOR DUNEDIN FL 34698 Medical Services 131739 CROSS COUNTRY STAFFING PO BOX 404674 ATLANTA GA 303844678 STAFFING SERVICES 292721 3 17691 5337 17691 HOSPITAL PATIENT CARE 621999 4386454 4386454 MEDICARE/MEDICAID NET REVENUE 621999 9954198 9954198 14340652 0 0 0 0 0 0 0 MISCELLANEOUS 524298 10259 10259 10259 14368602 14350911 0 1728 1728 0 0 0 246651 246651 0 4138332 3933288 205044 0 107036 101733 5303 707919 672844 35075 282909 250048 32861 629427 629427 51644 51644 7905 7905 0 0 0 584756 516661 68095 12675 12675 1515552 1473465 42087 515 382 133 0 1322835 1256698 66137 59818 43809 16009 0 0 88522 88522 0 12162 12162 81002 48746 32256 PURCHASED SERVICES 3017938 2668085 349853 BAD DEBT EXPENSE 174567 174567 MISCELLANEOUS EXPENSES 96144 79833 16311 13140037 11322571 1817466 0 684490 266740 0 0 1414548 1530387 100326 74812 167261 95741 19604 81028 76137 10109 10550 58917 55644 2323904 2207045 919545 599782 6550 8370000 7270000 685497 753286 9975042 8629618 X -7651138 -6422573 -7651138 -6422573 2323904 2207045 1228565 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 95741 19604 76137 76137 0 Estimated Third Party Settlements 55251 DUE TO AFFILIATES 698035 753286 14368602 13140037 1228565 1228565 14368602 14368602 14368602 13140037 13140037 13140037 true true X true X 250. false true true false false 1 33 1840419 1399930 440489 0.03400 1 14 542474 275255 267219 0.02060 2 47 2382893 1675185 707708 0.05460 7 5851 5851 0.00050 7 5851 5851 0.00050 9 47 2388744 1675185 713559 0.05510 true 42148 0 8754722 8160749 593973 X true true 1 1 BAYCARE ALLIANT HOSPITAL INC

601 MAIN STREET DUNEDIN FL 34698

X ACUTE LTC HOSPITAL BAYCARE ALLIANT HOSPITAL INC 1 true true 250. false true X X X X X X X true true X X X X true X X true X X X X X true X false false Part I Line 3c Patients who are uninsured or underinsured and cannot pay for hospital services are eligible for charity consideration. These patients are screened by designated team members in our Medical Assistance Department. The Agency for Health Care Administration (AHCA) defines charity eligibility at 200 percent of the federal poverty guidelines, unless the total hospital bill is more than 25 percent of the patient's annual income. Medicaid recipients who have exceeded their coverage limits are also considered for charity care. BayCare Alliant Hospital, Inc. goes above and beyond the AHCA requirements by providing additional "hardship" charity for patients who are at 250 percent of the federal poverty guidelines. In addition, an uninsured discount of 40% is given to any patient who does not have insurance coverage or benefits. There is no income or asset test required for the uninsured discount. Patients receive an additional 10% discount if the account is paid within 30 days. Part I Line 6a No Community Benefit Report Part I Line 7 Financial assistance and means-tested government programs costs (lines A through D) are determined using our cost accounting system, which captures all inpatients and outpatients, including emergency room patients. The system also captures all patient pay types - private insurance, Medicare, Medicaid, uninsured and self pay. The costs have been offset by any payments received from Medicaid or any other uncompensated care program. Other benefits at cost (lines E through J, as well as amounts reported in Part II) were compiled by the community health department using the Catholic Health Association guide for planning and reporting community benefits. Part I Line 7 Column f Bad Debt expense of $174,567 was included on form 990, Part IX, Line 25, Column (a), but subtracted for purposes of calculating the percentage in this column. Part III Line 4 The organization's financial statements do not include a footnote directly on bad debt expense. Bad debt expense at cost was calculated by the ratio of cost to charge method, using data from Schedule H. Total expense of the organization is reduced by the community benefit expenses reported on Part I, Line 7 (column C), and gross patient revenue is reduced by the direct offsetting revenue reported on Part I, Line 7 (column D). The resulting ratio of cost to charges is then applied to total bad debt expense of the organization, which calculates the bad debt expense at cost. We believe the method described above understates the true cost of bad debt. In many instances, bad debt results from non-payment of co-pays and deductibles, which would not be at charges but at a lesser amount. The state of Florida requires the patient to provide certain documentation in order to qualify for financial assistance. In cases where the patient has not responded to hospital requests or billing statement alerts, those accounts are processed as bad debt, if unpaid. Part III Line 8 Cost reports were used to report Medicare allowable costs. Medicare defines allowable costs as those appropriate and helpful in developing and maintaining the operation of patient care facilities and activities. It specifically excludes certain costs that are not directly related to patient care. The hospital incurs additional expense related to the provision of care to Medicare patients that Medicare has deemed non-allowable. This additional expense includes costs of physician services (emergency on-call fees, hospitalist program, recruitment, etc.), advertising costs, cafeteria costs for meals sold to visitors, etc. The hospital attempts to collect coinsurance and deductibles from Medicare beneficiaries. To the extent collection efforts are unsuccessful, Medicare reimburses the hospital at 70% of unpaid amounts. The following table reconciles the surplus or shortfall from Line 7 to the actual surplus or shortfall. The additional costs were allocated to Medicare based upon Medicare's percentage of total allowable costs. The unpaid coinsurance/deductibles were estimated using historical collection results. Line 7 Surplus or (Shortfall)$593,973 Additional non-allowable costs and unpaid/non-reimbursed coninsurance/deductibles $226,301 Total Surplus or (Shortfall) $367,672 Part III Line 9b Patients who are unable to pay are encouraged by BayCare Health System representatives, via personal interviews, signage, patient billing mailers, brochures or Customer Service phone calls, to submit financial information to the Medical Assistance Department to determine eligibility for programs, such as County, Medicaid, Disability, Victims of Crime, Charity, etc. For those patients who provide all the necessary documentation and qualify for charity according to the charity care policy, (defined in Part I, line 3c), patients' account would be written off completely to charity and not billed to the patients. Part V Section B Line 19d BayCare Alliant Hospital, Inc. applies a discount of 40% and offers up to a 50% discount of charges for individuals who do not have insurance covering emergency or other medically necessary care. This discount or allowance is consistent with the average blended inpatient/outpatient rate of BayCare's commercial payer's contractual allowance rate. 2- Needs Assessment BayCare Alliant Hospital, Inc is committed to meeting the needs of the community it serves. Our quality philosophy is modeled around understanding our customers' needs in the communities it serves. BayCare Alliant Hospital, Inc develops community health status assessments by accessing existing third party databases profiling health status information for geographies it serves. The assessments provide a profile of health status indicators in comparison to state averages and, if available, national benchmarks. In addition, BayCare Alliant Hospital, Inc conducts physician community need studies that outline physician deficits by specialty for the geographic area served. All of the above processes occur on an ongoing basis to assist BayCare Alliant Hospital, Inc in developing initiatives and programs/services to address identified health care need in the communities it serves. 3 - Patient education of eligibility for assistance BayCare Alliant Hospital, Inc. Medical Assistance team members are dedicated to assisting patients in obtaining assistance through federal, state and local government programs or through the BayCare Alliant Hospital, Inc. charity care policy. Signage and brochures are available, as well as team members whose full responsibility is to assist patients in the emergency room and on inpatient units. The Medical Assistance team interviews patients for all available programs, assists the patients in completing applications to government agencies and for hospital charity care, advises patients regarding available community resources for health care, reviews and approves patient requests for charity care, and provides education and support to the patient throughout the assistance process. In addition to the aforementioned comprehensive process, BayCare Alliant Hospital, Inc. also informs and educates patients who may be billed for patient care, but may be eligible for charity or other programs, via patient billing mailers and customer service representative calls. The goal in using these various means is to effectively communicate with the entire patient population so they are informed and educated about their eligibility for assistance. 4 - Community information BayCare Alliant Hospital is in a suburban setting serving parts of Pasco and Pinellas counties. The average income is lower than both the state and national averages. The population served is predominantly Caucasian and high-school or higher educated. Hispanics are the second largest ethnic group representing 8% of the population and 12% of households are poverty level. BayCare Alliant Hospital is part of BayCare Health System that serves west central Florida. The area served by BayCare Alliant Hospital has 14 hospitals with 7 being Not-for Profit. There are 6 federally designated medically underserved areas in BayCare Alliant Hospital's service area. With the service area expanding and the over 55 population expected to grow 10% in the next five years, the health care needs of our service area are expanding and changing. Further, BayCare Alliant Hospital is the only Long Term Acute Hospital within its 26 mile radius. The population served by BayCare Alliant Hospital is expected to grow 3.5% in the next 5 years. This expected growth is slightly lower than the expected growth rate for the United States. However, the population Age 55+ is expected to grow 10% in the next 5 years. The community experiences higher incidence rates compared to the state of Florida in the following areas: adults with asthma, HIV cases, AIDs cases, adults with high blood cholesterol, melanoma, asthma hospitalization, adult smokers, domestic violence, fully immunized kindergarteners and sexually transmitted diseases. Based on Florida inpatient discharge data for the period of 07/01/09-06/30/10, the payor mix for the geographic area consists of 56.1% Medicare/Medicare HMO, 12.4% Medicaid/Medicaid HMO, 11.5% Commercial Insurance, 10.0% HMO/PPO, 5.5% Self-Pay, and 4.5% Other. 5 - Promotion of community health BayCare Alliant Hospital is a 48-bed, long-term acute care hospital (LTCH) affiliated with BayCare. It is the only facility of its kind located within a 26 mile radius of Dunedin, Florida. The 25,000-square-foot facility provides diagnostic, medical treatment and rehabilitation for patients experiencing complex medical conditions due to chronic disease or injuries. The hospital takes a multi-disciplinary, family-centered approach with physicians, nursing and other health care specialists working together toward the goal of the best possible recovery for patients. BayCare Alliant is located inside Mease Dunedin Hospital. This proximity enables BayCare Alliant to provide the community with access to high quality patient care and minimizes patient transportation. Long-term hospitals located within general acute care hospitals are often referred to as "hospitals within a hospital" or "HIH's". A typical stay at a long-term acute care hospital is 25 days. The board is made up of community members who want to provide the community with access to compassionate patient care of superior quality. The Hospital has provided educational sessions to the physician and clinical community. In addition, the Hospital has lectured to local organizations and sponsored charitable events. There is a critical need for the Hospital given that it is the only LTCH within the vicinity, and given that it serves the most highly acute and chronically ill segment of the community. 6 - Affiliated health care system BayCare Alliant Hospital, Inc. is part of BayCare Health System, a leading community-based health care system in the Tampa Bay area with 10 not-for-profit hospitals, 70 outpatient facilities, more than 200 access sites and 18,500 employees. Together, BayCare organizations provide a lifetime of expert medical care by connecting patients to a complete range of services, such as primary care, imaging, lab, behavioral health and home health care. BayCare's hospitals are Mease Countryside, Mease Dunedin, Morton Plant, Morton Plant North Bay, St. Anthony's, South Florida Baptist and St. Joseph's Hospitals. St. Joseph's Hospitals operate as one entity and files one Form 990, however it includes several distinct hospitals: St. Joseph's, St. Joseph's Children's, St. Joseph's Women's and St. Joseph's Hospital-North. BayCare was founded in 1997 when several of the area's not-for-profit hospitals came together united by a common Mission to improve the health of their communities through high-quality, community-based health care. With BayCare, these hospitals created a unique model for a successful organization. Since those ingrained in the community can best determine their population's needs, BayCare's hospitals are in three geographic regions with their own local boards. BayCare provides organizational and financial strength for the hospitals and has centralized certain services regionally such as finance, human resources, home care and behavioral health. This enables each hospital to remain focused on their shared Mission of serving the health care needs of the entire community, regardless of their ability to pay. Each BayCare hospital provides charity care and unbilled community benefit services too. This is an essential expression of BayCare's shared Mission. In 2010, BayCare provided $184.5 million in community benefits, which includes $80 million in traditional charity care, $11 million in unbilled community services and $93 million in unreimbursed costs of Medicaid and county welfare programs. As one of the largest employers in the Tampa Bay area, BayCare has also played a significant role in the creation of jobs in the Tampa Bay community. Even though unemployment has increased, BayCare has brought on more than 1,650 employees since the end of 2006. BayCare's comprehensive network provides patients with increased access to services, such as emergency care, inpatient, outpatient and home health. For example, BayCare HomeCare helps patients leave the hospital sooner and recover at home where they are more comfortable. In 2010, HomeCare provided approximately 599,000 home health visits to more than 50,000 patients through 11 offices located throughout Florida. Recognizing the need for mental health services, BayCare is the largest, not-for-profit provider of behavioral health services in west central Florida. BayCare Behavioral Health offers inpatient, outpatient, in-home, residential treatment, support group and case management services. BayCare's designated Baker Act-receiving facilities in Hillsborough, Pinellas and Pasco counties provide inpatient crisis stabilization and partial hospitalization programs as part of the continuum of mental health care. BayCare also is the only organization in the Tampa Bay area that operates dedicated psychiatric emergency rooms at each of its hospital-based, Baker Act facilities. In 2010, BayCare Behavioral Health opened the Morton Plant North Bay Recovery Center, a 72-bed acute care, behavioral health facility to treat adults, children and adolescents. It is the only hospital-based children's mental health facility in Pasco County. BayCare hospitals also benefit from faster technological advancements like the system-wide introduction of an electronic medical record (EMR) and a biometric patient identity program that uses cutting-edge, palm scanning technology. Both of these projects provide more comprehensive access to patient records with the goal of improving patient safety. BayCare has registered more than 1.5 million patients through its biometric, palm-scanning registration and added more than 2 million patient charts to its EMR repository. Because of these two systems, a patient's medical record is now available at any BayCare hospital or facility. With the scan of a palm, BayCare's facilities will be able access the patient's data and avoid duplicate information requests at different times in the care process. An EMR also provides real-time communication and care-team coordination that can lead to a more complete picture of the patient's needs and better outcomes. In an effort to offer greater communications, increased patient safety and continuous care, BayCare is also working to electronically connect our hospitals with physicians' offices through an electronic medical record. In addition, each facility can gain knowledge from best practices shared by other BayCare hospitals through a system-wide Quality program that helps drive higher performance to improve patient care, processes and technology. In 2010, every BayCare hospital participated in the Fifth Annual Quality Sharing Day, an event designed to help employees share and learn best practices that were implemented elsewhere in the health system. As part of the organization's commitment to the community, BayCare partners with Hillsborough Community College, University of Tampa, University of South Florida, Erwin Technical Center and St. Petersburg College to help educate future nurses and health care professions. In addition, BayCare is an organizational sponsor for the United Way of Tampa Bay's Hands on Tampa Bay. The program provides volunteer support in a variety of service areas such as homelessness and hunger; education and literacy; children, youth, and family; seniors; animals and environment; and persons with disabilities. BayCare also supports organizations that work to foster economic development in the Tampa Bay area. These organizations include the Tampa Bay Partnership and the Pasco Economic Development Council. 7 - State filing of community benefit report N/A: only provided benefit in the State of Florida. true false false false false false false true false Anita Russell 99855 0 13127 0 60537 0 453 0 0 0 173972 0 0 0 Supplemental Information Schedule J Part I, Line 3 The filing organization does not use any of the options listed in Schedule J, Line 3 to establish the compensation of the CEO/Executive Director. The organization follows the compensation policy of BayCare Health System Inc, uses Compensation committee, Independent compensation consultant, Written employment contract, Compensation survey or study and Approval by the board or compensation committee as a means to establish the CEO's compensation of the filing organization. Part I, Line 4a Severance payment was made during the year to Anita Russell, $60,382.40 Part I, Line 7 80 percent of the incentive compensation for which an individual is eligible would be considered fixed based on the instructions. 20 percent would be considered non-fixed and is based on the discretion of the employee's immediate supervisor. Part VI Form 990, Part VI, Question 6 - Description of Classes of Members or Stockholders The sole member of BayCare Alliant Hospital, Inc. is BayCare Health System, Inc. Form 990, Part VI, Section A, Question 7a - Members of the Board of Directors A. The Board of Directors shall be composed of seven (7) directors. The directors shall be designated as "Number 1", "Number 2", Number 3, "Number 4", "Number 5, "Number 6" and "Number 7" respectively. B. Director Numbers 1,2,3,4 and 5 (collectively, the "Self-Perpetuating Directors" shall be initially appointed by BayCare. Thereafter, at the end of a term of office or to otherwise fill the vacancy of any Self-Perpetuating Director, all the then Self- Perpetuating Directors by majority vote shall appoint a successor Self-Perpetuating Director. No Self-Perpetuating Director may also serve as a director, officer or employee of BayCare or any other participants in the BayCare Joint Operating Agreement. Furthermore, no Self-Perpetuating Director may be a member of the medical staff of a hospital owned, leased, managed or other wise operated by BayCare. C. Director Numbers 6 and 7 (collectively, the "BayCare Appointees") shall be appointed by BayCare. At lease sixty (60) days before the expiration of the term of any BayCare Appointee, the Board of Directors shall notify BayCare of (i) its obligation to appoint a successor to such BayCare Appointee and (ii) the date upon which term of such BayCare appointee shall expire. D. Each Director shall serve for a term of three (3) years, except that in order to provide for staggered tenures of the initial Board of Directors, Director Numbers 1, 2, 5 and 6 shall serve an initial term of three (3) years, and Director Numbers 3,4, and 7 shall serve an initial term of two (2) years. Each director thereafter appointed to fill an expired term shall be appointed for and shall serve the full term of three (3) years. E. Each director shall serve until his or her successor is appointed as described in this Article. Form 990, Part VI, Question 7b - Descr Classes of Persons, Decisions Requiring Appr & Type of Voting Rights The following actions of the Board are subject to the member BayCare Health System's approval: 1) Changing the name of the corporation. 2) Changes to Bylaws. 3) The sale or merger of the assets of the corporation. Form 990, Part VI, Question 11b - Describe the Process used by Management &/or Governing Body to Review 990 The Form 990 is prepared by the organization and reviewed by the CFO, as well as the organization's paid preparer. A final copy of the Form 990 was reviewed by a subcommittee of the Board of Directors. Prior to filing with the IRS, a final copy of the Form 990 was made available to the entire Board. Form 990, Part VI, Question 12c - Description of Process to Monitor Transactions for Conflicts of Interest BayCare Alliant Hospital, Inc. has an affirmative policy which requires that all actual or apparent conflicts be disclosed promptly and fully to all necessary parties and which prohibits specified involvement in the affairs of the corporation by persons having such conflicts. The policy applies to all members of the Board of Directors and corporate officers, agents and employees of the Corporation, including independent contractor providers of services and materials. The Corporation's management has the affirmative obligation to publicize periodically this policy to all parties. All persons whom the policy applies must promptly disclose all real and apparent conflicts which they discover or have brought to their attention to the appropriate persons in the form of a written description of the facts comprising the real and apparent conflict. An annual disclosure statement must be circulated to all persons to whom this policy applies to assist them in considering such disclosures, but disclosure is appropriate whenever conflicts arise. The written disclosure notices of conflicts must be filed annually with the President of the Corporation or any other persons designated by her from time to time to receive such notifications. All disclosure notices received will be noted for record in the minutes of the meeting of the Board of Directors. When an individual Director, officer, agent or employee believes that he or a member of his immediate family might have or does have a real or apparent conflict, he should in addition to filing the disclosure notice, abstain from making motions, voting, executing agreements, or taking any other similar direct action on behalf of the Corporation where the conflict might pertain. When any person requests in writing, or upon its own initiative, the Board at any time may establish further guidelines consistent with the interests of the Corporation for the resolution of any real or apparent conflicts. Part VI Form 990, Part VI, Question 15a & 15b - Offices & Positions for Which Process was Used, & Year Process was Begun BayCare Alliant Hospital, Inc. uses nationally recognized compensation consultants every two years to assist in the review of compensation of employees in leadership positions. Compensation consultants provide a review of the leadership positions at Alliant Hospital to determine if compensation is reasonable when compared against market standards. The hospital utilizes a compensation committee to further examine the results provided by the compensation consultants. The hospital also utilizes an annual manager marker study and a semi-annual non-management market study to determine if all other positions are congruous with market standards. The review was completed in 2009. Form 990, Part VI, Question 19 - Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public BayCare Alliant Hospital, Inc. publishes its financial statements with the Agency for Health Care Administration. Governing documents and policies are not available for public inspection.