2024-08-15T10:10:14+00:00 2023-09-30 440160260 Forvis Mazars LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2022-10-01 592425149 Jay Hospital Inc JAYH 4482278478 POST OFFICE BOX 17500 PENSACOLA FL 32522 Leonard A Terry CFO 4482278478 2024-08-15 true true April Arnold P01559426 8162216300 2022 2024-08-08 14:25:15Z Keith Strickling 125 BAPTIST WAY SUITE 6A PENSACOLA FL 32503 13314558 false X www.ebaptisthealthcare.org/jayhospital X 1983 FL JAY HOSPITAL'S PRIMARY MISSION IS DEDICATED TO MEETING THE HEALTHCARE NEEDS IN THE JAY, CENTURY, FLOMATON AND SURROUNDING COMMUNITITES IN THE NORTHWEST FLORIDA-SOUTH ALABAMA AREA. 18 18 159 29 42487 3585 0 13481234 13256724 1442 -203 36843 23982 13519519 13280503 13220 13107 0 8723465 9219144 0 0 9319228 9144904 18055913 18377155 -4536394 -5096652 4766031 5351314 2605475 3448682 2160556 1902632 HELPING PEOPLE THROUGHOUT LIFE'S JOURNEY: JAY HOSPITAL'S PRIMARY MISSION IS DEDICATED TO MEETING THE HEALTHCARE NEEDS IN THE JAY, CENTURY, FLOMATON AND SURROUNDING COMMUNITITES IN THE NORTHWEST FLORIDA-SOUTH ALABAMA AREA. JAY HOSPITAL IS A 49-BED ACUTE CARE FACILITY AND PART OF AN INTEGRATED NETWORK OF AFFILIATED ORGANIZATIONS. JAY HOSPITAL AND ITS AFFILIATED ORGANIZATIONS ARE COMMITTED TO PROVIDING A BROAD RANGE OF GENERAL AND SPECIALIZED HEALTH CARE SERVICES INCLUDING INPAITIENT, PRIMARY CARE, LONG TERM AND OUTPATIENT HEALTHCARE SERVICES. QUALITY MEDICAL CARE IS PROVIDED TO ALL PERSONS REQUIRING IMMEDIATE TREATMENT REGARDLESS OF THEIR ABILITY TO PAY. false false 14029038 13214237 GENERAL AND SPECIALIZED HEALTH CARE SERVICES INCLUDING INPATIENT, PRIMARY CARE, LONG TERM AND OUTPATIENT HEALTHCARE SERVICES. 13107 13107 0 COMMUNITY BENEFIT OUTREACH ACTIVITIES CONDUCTED BY THE ORGANIZATION INCLUDING HEALTH EDUCATION SEMINARS, HEALTH FAIRS, AND DONATIONS TO OTHER NON-PROFIT ENTITIES. 14042145 true false false true false false false false false true false false false true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true X 1 0 true 159 true true true false false false false false false false false false false false X 18 18 true false true false true true true true true false false true true true true true true true true false X Keith Strickling 8506758024 14114 Alabama Street Jay FL 32565 DAVE CLEVELAND MEMBER/TREASURER 1.0 1.0 X X 0 0 0 KARA CARDONA MEMBER/VICE CHAIR 1.0 1.0 X X 0 0 0 MARGARET T STOPP MEMBER/VICE CHAIRMAN 1.0 2.0 X X 0 0 0 RICKY W SMITH MEMBER/SECRETARY 1.0 1.0 X X 0 0 0 RONALD E JACKSON MEMBER/CHAIRMAN 1.0 1.0 X X 0 0 0 BRIAN WYER MEMBER 1.0 1.0 X 0 0 0 DAVID HAWKINS MEMBER 1.0 1.0 X 0 0 0 JARL (JT) YOUNG MEMBER 1.0 1.0 X 0 0 0 JOHN HEER MEMBER 1.0 1.0 X 0 0 0 JOHN HOSMAN MEMBER 1.0 1.0 X 0 0 0 JOHN M KIZZIAH MEMBER 1.0 1.0 X 0 0 0 MARCUS PAUL DMD MEMBER 1.0 1.0 X 0 0 0 MARJORIE MOORE MEMBER 1.0 1.0 X 0 0 0 MARTHA SAUNDERS PHD MEMBER 1.0 1.0 X 0 0 0 MICHAEL J MAZENKO MEMBER 1.0 1.0 X 0 0 0 SHIRLEY HENDERSON MEMBER 1.0 1.0 X 0 0 0 STEVEN SHELL MEMBER 1.0 1.0 X 0 0 0 THOMAS F OWENS MEMBER 1.0 1.0 X 0 0 0 ANDREW TERRY SENIOR VP/CFO-INCOMING 10.0 40.0 X 0 425152 26118 BRETT ALDRIDGE COO & EVP 10.0 40.0 X 0 438882 43709 MICHAEL GLEASON SENIOR VP/CFO-OUTGOING 10.0 40.0 X 0 784097 25421 MICHAEL HUTCHINS VP/ADMINISTRATOR 40.0 0 X 261944 0 20714 DANIEL D SHEPPARD MANAGER PHARMACY 40.0 0 X 129289 0 29779 DEBRA JENKINS ASST. ADMINISTRATOR 40.0 0 X 140775 0 30333 GREG W PETTY REHAB MANAGER 40.0 0 X 109075 0 12381 KARIN PARDUE PHYSICIAN 40.0 0 X 301781 0 28381 KATHRYN R HUNT PHYSICIAN 40.0 0 X 138763 0 0 1081626 1648131 216837 11 false true false MARK ELDER DO 2946 GREYSTONE DR PACE FL 32571 PHYSICIAN SERVICES 331587 1 0 NET PATIENT SERVICE REVENUE 621990 12843219 12800732 42487 COVID-19 RECOVERIES 621990 100000 100000 MEDICAID DHS 621990 313505 313505 0 0 0 0 13256724 196 196 23804 33656 -9852 0 -9852 -9852 399 0 -399 -399 -399 OTHER REVENUE 900099 33834 33834 0 0 0 0 33834 13280503 13214237 42487 23779 X 13107 13107 180253 144202 36051 7471497 6799062 672435 154330 140440 13890 871292 792876 78416 541772 493013 48759 2888325 110525 2777800 37947 37947 2082335 2057333 25002 0 15673 15673 115382 106889 8493 54680 39370 15310 323195 287644 35551 78158 7777 70381 351587 298849 52738 462237 462237 BAD DEBT EXPENSE 1600565 1600565 MEDICAL SUPPLIES 958482 958482 INDIGENT ASSESSMENT 122157 122157 DUES & SUBSCRIPTIONS 23794 23794 30387 30387 0 0 18377155 14042145 4335010 0 85070 52487 2298654 2507343 0 0 0 0 176756 177351 86711 58610 12056977 9501454 2118840 2555523 0 0 0 0 4766031 5351314 1114857 1498244 0 0 261358 799234 1229260 1151204 2605475 3448682 2160556 1902632 2160556 1902632 4766031 5351314 X -5096652 4838728 X false true X true true true X X 0 2837 218263 2837 218263 18354991 842283071 18357828 842501334 1000000 1000000 250000 250000 0 0 0 0 1000000 996917 1000000 1000000 3996917 5995376 190875 2008 128467 218263 539613 25000 249229 250000 250000 774229 1161344 0 0 0 62193 62193 5744989 4142028 1602961 6073414 5359426 713988 176381 176381 2555523 DUE TO THIRD PARTIES 670924 ASSET RETIREMENT OBLIGATION 146875 LEASE OBLIGATION 333405 1151204 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES, PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC TOPIC 740 PROVIDES GUIDANCE FOR RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2022 AND 2023. true true X true X 300 false true true true false true true 620717 620717 0.0370 2672061 2099019 573042 0.0342 0 0.0 0 0 3292778 2099019 1193759 0.0712 0 0.0 0 0.0 0 0.0 0 0.0 13108 13108 0.0008 0 0 13108 0 13108 0.0008 0 0 3305886 2099019 1206867 0.0719 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 1600565 357086 4704786 7820399 -3115613 X true true 1 1 JAY HOSPITAL 14114 ALABAMA STREET JAY FL 32565 WWW.EBAPTISTHEALTHCARE.ORG/JAYHOSPITAL 100048 X X X JAY HOSPITAL 1 false false true X X X X X X X X X 21 true true true true X https://ebaptisthealthcare.org/community/chna X true 21 true https://ebaptisthealthcare.org/community/chna false true X 300.0 X X X X X X true true X X X true X https://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES X https://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES X https://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - JAY HOSPITAL, INC.. The CHNA process was conducted through Achieve Healthy EscaRosa (AHER), our community's collective impact collaboration focused on improving the health of the community so that everyone can live well and thrive. AHER has replaced the former The Live Well Partnership for the roles of conducting the community health needs assessment for Escambia and Santa Rosa Counties in Florida and to support and promote collaborative initiatives that address identified health priorities. This collective effort resulted in 2,937 viable surveys, the largest number of community survey responses to date. An effort was made to involve individuals from many different sectors of the local economy in developing this CHNA. The CHNA Planning Team, comprised of the Florida Department of Health in Escambia and Santa Rosa counties, area hospitals and health providers, educational institutions, area health coalitions, nonprofit organizations and others, was established to provide guidance and input throughout data gathering, analysis, and production of the CHNA. The CHNA Planning Team provided input on their perceptions of health and health services, reviewed health outcomes, narrowed the focus to the top health priorities across both counties, and approved this report. Below is a roster of the CHNA Planning Team. CHNA Planning Committee - responsible for planning, data collection/analysis, communication and report writing * Adrienne Maygarden, Ascension Sacred Heart * Dr. Debra Vinci, University of West Florida * Dr. Patricia Barrington, University of West Florida * Jen Grove, Baptist Health Care * Joy Sharp, Baptist Health Care * Kimberly Pace, Florida Department of Health- Escambia * Laura Gilliam, United Way of West Florida * Matt Dobson, Chair, Florida Department of Health - Santa Rosa * Nicole Gislason, University of West Florida Haas Center * Nicholas Billings, University of West Florida * Sandra Donaldson, Community Health Northwest Florida Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - JAY HOSPITAL, INC.. The CHNA process was facilitated by AHER, a nonprofit organization whose mission is to unite and align resources to improve the health and well-being of Escambia and Santa Rosa Counties. The CHNA Planning Committee included representation from Baptist Health Care and Ascension Sacred Heart. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - JAY HOSPITAL, INC.. Non-hospital stakeholder members of the CHNA Planning Committee included representatives from the Florida Departments of Health in Escambia and Santa Rosa Counties, Community Health Northwest Florida (a federally qualified health center), the University of West Florida, and the United Way of West Florida. The input process to prioritize focus areas also included input from representatives from over 35 not-for-profit and community-based organizations. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - JAY HOSPITAL, INC.. Baptist Health Care recognized that sustained community health improvement happens when organizations from all sectors of the community landscape take ownership of the community's health and work together for improvement. As such, AHER hosted a community convening in February of 2022, during which community members were introduced to the priority focus areas and other health metrics through a review of the CHNA. The convening also served as an action planning workshop, in which participants were encouraged to provide input to one of the six priority health focus areas. The AHER Executive Committee has taken the inputs provided and is in the process of developing a draft action plan to share with participants and the broader community. The CHNA results and subsequent planning discussions determined the prioritized focus areas are: Overweight and Obesity Substance abuse Mental health Child abuse Access to healthcare Food insecurity Baptist Health Care serves as a leader and convener of these efforts and is actively engaged in multiple ways in this enhanced approach to health and wellness in the communities we serve. Jennifer Grove, VP External Relations of Baptist Health Care, serves as the Chair of Achieve Healthy EscaRosa, and various other team members participate in the Data, Communications, and CHNA Committees of AHER. In addition, Baptist leaders and team members are actively engaged in the Community Health Improvement Planning process, through which AHER will convene workgroups to build action plans in each of these prioritized focus areas for the community. Baptist already engages in collaborations and direct service in many of these prioritized focus areas, and looks forward to continued collaboration with other community partners to impact the outcomes in these prioritized focus areas. Baptist Health Care Actions in 2023: In the area of Access to Healthcare, Baptist Health Care achieved the following in 2023: * Began operations a new hospital campus to offer an advanced state-of-the-art healthcare experience to those in the communities we serve. Achieved September 23, 2023. * Partner with Escambia County Area Transit to ensure reliable and prompt transportation for all in the community to access quality care at the new Baptist Hospital campus. Achieved September 23, 2023. * Provided $.5M in support for our local FQHC, Community Health Northwest Florida, to ensure access for uninsured and underinsured. Achieved * Began work to expand offerings at Baptist Medical Park - Nine Mile to include a Hybrid Free Standing Emergency Department & Urgent Care facility that replicates the Navarre model. Scheduled to open in 2024. In the area of Mental Health, Baptist Health Care achieved the following in 2023: * Began operations at our new Baptist Hospital behavioral health unit to offer state-of-the-art facilities that allow our team to provide the most advanced, quality care in the region. Achieved * Collaborated with the Share Your Heart Program to provide social and spiritual support to our community using volunteer chaplains. - Baptist Faith Health Network: Goal to train and onboard 26 (one per zip code) - achieved 115 volunteer chaplains. - Goal of 50 families per year served - achieved 165 - 50 closed loop (full continuum of care) referrals per year given by Baptist team members - achieved 165. * Goal to meet immediate behavioral health needs for children and adolescents in Escambia and Santa Rosa counties in crisis through serving as the central and sole Baker Act Receiving Facility in Circuit 1 and continue to collaborate in establishing an adult Baker Act Receiving Facility elsewhere in our community completing the vision of a fully functioning Baker Act receiving system in Circuit 1. Achieved * Provide support services and spiritual care to patients, family members, team members and community through support services and Baptist Health Care's RISE Program . In 2023, BHC achieved 5,775. In the area of Food Insecurity, Baptist Health Care achieved the following in 2023: * Baptist supports target patient populations through community Food Prescription Program for those experiencing food insecurities. Goal of 25 families enrolled in the food prescriptions per year. In 2023, BHC achieved 100. * Baptist's Faith Health Network offers Church to Church Food Pantry Program. Goal of 1,000 households served per year. In 2023, BHC achieved 4,800. * 20 churches take part in the Church-to-Church Program each year. In 2023, BHC achieved 145. In the area of Overweight and Obesity, Baptist Health Care achieved the following in 2023: * Conduct outreach and provide education to community through the Wellness Connection Series at multiple Baptist Health Care locations including Baptist Medical Park - Nine Mile, Baptist Towers, Andrews Institute and at locations throughout the community. In 2023, BHC achieved 33 classes with over 1,513 participants. In the area of Substance Abuse, Baptist Health Care achieved the following in 2023: Goal for Baptist to work with community partners to create and support an updated database of programs and support groups for addiction recovery or intervention in Escambia or Santa Rosa Counties to supply a trusted continuum of care. Achieved through work done as members of the Northwest Florida Mental Health Task Force led by Representative Salzman. In the area of Child Abuse, Baptist Health Care achieved the following in 2023: Baptist Health Care raised awareness for and supported team members to engage in local child abuse training "KNOW" Child Abuse through Gulf Coast Kids House and engaged in Child Safety Matters through Achieve Healthy EscaRosa. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - JAY HOSPITAL, INC.. IN ADDITION TO THE FPG THE ORGANIZATION USES AN ASSET TEST, MEDICAL INDIGENCY AND INSURANCE STATUS IN DETERMINING FREE OR DISCOUNTED CARE. 1 CENTURY MEDICAL CENTER 8401 N CENTURY BLVD CENTURY FL 32535 PRIMARY CARE PRACTICE Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care IN ADDITION TO THE FPG THE ORGANIZATION USES AN ASSET TEST, MEDICAL INDINGENCY AND INSURANCE STATUS IN DETERMINING FREE OR DISCOUNTED CARE. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 1600565 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The costing methodology used in determining the amount reported on Line 7 is the cost to charge ratio calculated pursuant to the IRS schedule H worksheet 2 instructions. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORT HAS BEEN FOLLOWED IN ACCORDANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS, AND SUBSEQUENT RECOVERIES ARE ADDED. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. THE HOSPITAL PROVIDES SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, SUCH SERVICES ARE NOT REPORTED AS NET REVENUE. THE HOSPITAL'S CHARITY CARE POLICY UTILIZES THE GENERALLY RECOGNIZED FEDERAL POVERTY INCOME LEVELS. FOR PATIENTS WHO DO NOT APPLY OR DO NOT QUALIFY, THE UNCOLLECTED AMOUNTS ARE RECOGNIZED AS BAD DEBT EXPENSE. ESTIMATED COST OF BAD DEBT IS BASED ON THE RATIO OF COST TO CHARGES AS DETERMINED BY HOSPITAL SPECIFIC DATA. Schedule H, Part III, Line 3 Bad Debt Expense Methodology BAD DEBT IS NOT INCLUDED AS PART OF JAY HOSPITAL'S COMMUNITY BENEFIT. APPROXIMATELY 22.31% OF JAY HOSPITAL'S PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE. THIS MEANS THAT APPROXIMATELY $357,086, OR 22.31%, OF JAY'S HOSPITAL'S BAD DEBT EXPENSE COULD BE INCLUDED AS COMMUNITY BENEFIT HAD THOSE INDIVIDUALS GONE THROUGH THE FINANCIAL ASSISTANCE PROCESS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE MEDICARE SHORTFALL WAS NOT INCLUDED IN THE COMMUNITY BENEFIT COST, AND THE COSTING METHODOLOGY CONSISTED OF INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE ENTIRE COST OF PROVIDING CARE TO MEDICARE PATIENTS CAUSING THE ORGANIZATION TO USE OTHER SURPLUS FUNDS TO COVER THE SHORTFALL. HOWEVER, THE ORGANIZATION PROVIDES CARE TO MEDICARE PATIENTS REGARDLESS OF THIS SHORTFALL, WHICH RELIEVES THE STATE AND FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR THE CARE OF MEDICARE BENEFICIARIES. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance PATIENTS ARE DEEMED FINANCIALLY INDIGENT IF (A) THEY ARE UNINSURSED OR UNDERINSURED AND (B) THEIR INCOME IS BELOW 300% OF FPL (BASED UPON THE PATIENT'S HOUSEHOLD INCOME AS DEFINED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES IN THE FEDERAL REGISTER AS THE FEDERAL POVERTY LEVEL (FPL) GUIDELINES). IF A PATIENT IS FOUND TO BE FINANCIALLY INDIGENT OR MEDICALLY INDIGENT, APPROPRITE FINANCIAL ASSISTANCE DISCOUNTS ARE APPLIED TO THE PATIENT'S ACCOUNT. FOR ANY PATIENT THAT QUALIFIES UNDER THE ORGANIZATION'S CHARITY CARE POLICY, THE PATIENT ACCOUNT IS WRITTEN OFF AS CHARITY CARE AND THE ORGANIZATION DOES NOT PURSUE ANY COLLECTIONS. Schedule H, Part V, Section B, Line 16a FAP website - JAY HOSPITAL: Line 16a URL: https://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES; Schedule H, Part V, Section B, Line 16b FAP Application website - JAY HOSPITAL: Line 16b URL: https://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - JAY HOSPITAL: Line 16c URL: https://ebaptisthealthcare.org/PATIENTFINANCIALRESOURCES/FINANCIAL-ASSISTANCE-POLICIES; Schedule H, Part VI, Line 2 Needs assessment The organization's mission is helping people throughout life's journey. In response to this mission, the organization helps ensure that all citizens are afforded access to health care by investing in community health, and by participating in and leading collaborative, community-wide partnerships. Free health screenings, support groups, education seminars, and other programs that are offered focus on areas that have been identified through internal studies and external sources as critical health concerns in the surrounding communities. A full copy of the hospital's Community Health Needs Assessment can be accessed using the following website: HTTP://EBAPTISTHEALTHCARE.ORG/COMMUNITY/CHNA Schedule H, Part VI, Line 3 Patient education of eligibility for assistance JAY EMPLOYEES WORKING IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS AREAS HAVE BEEN TRAINED TO BE FULLY VERSED IN ALL FINANCIAL ASSISTANCE-RELATED POLICIES, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND BE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE REPRESENTATIVES. FOR NON-EMERGENCY PURPOSES, EVERY FILE FOR A PATIENT THAT HAS PRE-SCHEDULED AN OFFICE VISIT OR PROCEDURE IS REVIEWED BEFORE THE PATIENT ARRIVES AT THE HOSPITAL. A FINANCIAL COUNSELOR IS ASSIGNED TO THAT PATIENT IF IT IS DETERMINED THAT THE INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ETC. ALSO, WHEN A PATIENT RECEIVES A BILL, THE ORGANIZATION INCLUDES PAPERWORK EXPLAINING THAT FINANCIAL ASSISTANCE IS AVAILABLE. JAY HOSPITAL HAS POSTED MULTILINGUAL NOTICES OF FINANCIAL ASSISTANCE POLICIES IN THE EMERGENCY DEPARTMENT. SAID NOTICES HAVE BEEN PUBLISHED IN ENGLISH AND SPANISH, AND HAVE BEEN MADE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. JAY HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM, PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS FOR APPLYING FOR ASSISTANCE. ALSO, JAY HOSPITAL HAS POSTED A SUMMARY OF ITS CURRENT CHARITY CARE POLICY ON ITS INTERNET WEBSITE. Schedule H, Part VI, Line 4 Community information JAY HOSPITAL, INC. OPERATES IN SANTA ROSA COUNTY, FLORIDA. APPROXIMATELY 203,000 INDIVIDUALS RESIDE IN THIS COUNTY, 9.4% OF WHICH LIVE BELOW POVERTY LEVEL. WHEN CONSIDERING THESE FACTORS, MORE THAN 19,000 RESIDENTS COULD BE ELIGIBLE TO QUALIFY FOR CHARITY CARE. APPROXIMATELY 22.31% OF JAY HOSPITAL'S PATIENTS DURING FY2023 WERE UNINSURED OR WERE MEDICAID RECIPIENTS. THREE HOSPITALS, INCLUDING JAY HOSPITAL, ARE LOCATED IN SANTA ROSA COUNTY. Schedule H, Part VI, Line 5 Promotion of community health THE ORGANIZATION DOES NOT LIMIT MEDICAL STAFF PRIVILEGES TO THE ORGANIZATION'S EMPLOYED PHYSICIANS BUT EXTENDS THOSE PRIVILEGES TO QUALIFIED PHYSICIANS FOR MOST AREAS OF SERVICE.THE ORGANIZATION'S BOARD OF DIRECTORS PRIMARILY CONSISTS OF COMMUNITY LEADERS AND RESIDENTS WHO ARE INDEPENDENT OF THE ORGANIZATION. THE ORGANIZATION STRIVES TO EDUCATE ALL BOARD MEMBERS REGARDING THE HEALTH NEEDS OF THE COMMUNITY AND HOW THESE NEEDS RELATE TO THE ORGANIZATION'S MISSION AND VALUES.THE ORGANIZATION SEEKS TO STRATEGICALLY ALLOCATE AVAILABLE FUNDS TO BENEFIT THE SURROUNDING COMMUNITIES. FOCUS AREAS INCLUDE INCREASING THE TYPES OF CARE TO BE PROVIDED TO THE COMMUNITY, IMPROVING THE QUALITY OF PATIENT CARE, AND FURTHERING MEDICAL EDUCATION AND RESEARCH. Schedule H, Part VI, Line 6 Affiliated health care system ALTHOUGH THE ORGANIZATION MAY OPERATE IN DIFFERENT SERVICE AREAS WHEN COMPARED TO ITS AFFILIATES, ALL AFFILIATES WORK COLLABORATIVELY TO ENSURE THAT THE NEEDS OF THE COMMUNITIES ARE BEING ADDRESSED. THE ORGANIZATION PARTICIPATES IN MANY FREE HEALTH SCREENINGS, SUPPORT GROUPS, EDUCATION SEMINARS, AND HEALTH FAIRS THAT BENEFIT ALL COMMUNITIES WITHIN THE SYSTEM AND ARE NOT LIMITED TO THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. AFFILIATED ENTITIES INCLUDE: - BAPTIST HEALTH CARE, INC. - OPERATES BAPTIST HOSPITAL, GULF BREEZE HOSPITAL, AS WELL AS A FREE-STANDING EMERGENCY DEPARTMENT/URGENT CARE. - BAPTIST HEALTH CARE FOUNDATION, INC. - PROVIDES FINANCIAL AND FUNDRAISING ASSISTANCE FOR ALL AFFILIATES - BAPTIST URGENT CARE, LLC - DELIVER AMBULATORY CARE IN A DEDICATED MEDICAL FACILITY OUTSIDE OF A TRADITIONAL EMERGENCY ROOM. true SANTA ROSA COMMUNITY CLINIC 5520 STEWART ST MILTON FL 32570 311746599 501(C)(3) 11458 HEALTHCARE 1 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. WITHIN ONE YEAR, THE ORGANIZATION REQUESTS DOCUMENTATION FROM THE RECIPIENT REGARDING PROPER USE OF FUNDS PROVIDED FOR INDIGENT PATIENTS X true true X X X X X false true false false false false false false false BRETT ALDRIDGE COO & EVP 0 353535 0 58471 0 26876 0 7625 0 36084 0 482591 0 0 MICHAEL GLEASON SENIOR VP/CFO-OUTGOING 0 626582 0 116627 0 40889 0 7625 0 17796 0 809518 0 0 MICHAEL HUTCHINS VP/ADMINISTRATOR 192655 0 25114 0 44174 0 5863 0 14851 0 282658 0 0 0 ANDREW TERRY SENIOR VP/CFO-INCOMING 0 333001 0 67461 0 24689 0 7625 0 18493 0 451270 0 0 DEBRA JENKINS ASST. ADMINISTRATOR 139590 0 0 0 1186 0 3662 0 26671 0 171109 0 0 0 KARIN PARDUE PHYSICIAN 289208 0 12030 0 543 0 0 0 28381 0 330162 0 0 0 DANIEL D SHEPPARD MANAGER PHARMACY 129289 0 0 0 0 0 3389 0 26391 0 159068 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments THE FOLLOWING OFFICERS/KEY EMPLOYEES RECEIVED TAX GROSS-UP PAYMENTS THAT WERE INCLUDED IN THEIR W-2 TAXABLE WAGES: --MICHAEL HUTCHINS Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: BRETT ALDRIDGE MICHAEL GLEASON MICHAEL HUTCHINS THERE WERE NO CONTRIBUTIONS TO THE PLAN DURING THE TAX YEAR. Schedule J, Part II THE RELATED COMPENSATION REPORTED ON FORM 990, PART VII, SECTION A & SCHEDULE J, PART II WAS PAID BY THE FOLLOWING RELATED ORGANIZATIONS: --BAPTIST HEALTH CARE, INC. Form 990, Part V, Line 1a MOST 1099'S ARE ISSUED ON THE ORGANIZATION'S BEHALF BY BAPTIST HEALTH CARE, INC. (EIN: 59-0657322), A RELATED TAX EXEMPT ORGANIZATION. Form 990, Part VI, Line 2 PART VI, LINE 2 MICHAEL GLEASON, ANDREW TERRY, BRETT ALDRIDGE, AND MICHAEL HUTCHINS, HAVE A BUSINESS RELATIONSHIP. THE BUSINESS RELATIONSHIP IS AN EMPLOYER/EMPLOYEE RELATIONSHIP AT RELATED TAX-EXEMPT ORGANIZATIONS. ALL BOARD MEMBERS OF JAY HOSPITAL, INC. HAVE A BUSINESS RELATIONSHIP WITH MICHAEL GLEASON, ANDREW TERRY, AND BRETT ALDRIDGE. ALL MEMBERS ALSO SERVE ON THE BOARD OF BAPTIST HEALTH CARE, INC. AND MICHAEL GLEASON, ANDREW TERRY, AND BRETT ALDRIDGE ARE EMPLOYED OFFICERS OF BAPTIST HEALTH CARE, INC. Form 990, Part VI, Line 15a & 15b PROCESS TO ESTABLISH COMPENSATION EACH YEAR, THE COMPENSATION COMMITTEE OF THE BAPTIST HEALTH CARE, INC. BOARD UTILIZES INDEPENDENT COMPENSATION STUDIES THAT REFLECT THE CURRENT MARKET VALUE OF SPECIFIC KEY MANAGEMENT POSITIONS AS BENCHMARK DATA. ALL COMPENSATION OF KEY INDIVIDUALS MUST BE APPROVED BY THE BAPTIST HEALTH CARE COMPENSATION COMMITTEE. Form 990, Part VI, Line 4 Significant changes to organizational documents Effective October 1, 2022, Baptist Health Care, Inc. (f/k/a Baptist Hospital, Inc.), became the sole member of Jay Hospital, Inc. Form 990, Part VI, Line 6 Classes of members or stockholders BAPTIST HEALTH CARE, INC., A FLORIDA CORPORATION NOT-FOR-PROFIT, IS THE SOLE MEMBER OF JAY HOSPITAL, INC. BAPTIST HEALTH CARE, INC. HAS THE RIGHT TO ELECT THE BOARD OF DIRECTORS OF JAY HOSPITAL, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body BAPTIST HEALTH CARE, INC., BEING THE SOLE MEMBER OF JAY HOSPITAL, INC. HAS THE RIGHT TO ELECT THE GOVERNING BODY OF JAY HOSPITAL, INC. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE FOLLOWING SHALL REQUIRE APPROVAL BY THE BAPTIST HEALTH CARE INC., THE SOLE MEMBER, BOARD OF DIRECTORS: A. ELECTION OF THE DIRECTORS OF THE CORPORATION AT THE ANNUAL MEETING OF THE MEMBERS FROM AMONG THOSE PERSONS NOMINATED BY THE BAPTIST HEALTH CARE, INC. NOMINATING COMMITTEE. B. REMOVAL OF A DIRECTOR OF THE CORPORATION WITH OR WITHOUT CAUSE WHENEVER SUCH ACTION WOULD BE IN THE BEST INTEREST OF THE CORPORATION C. ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE. D. APPOINTMENT OF THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION E. ANY CONTRACT OR PURCHASE ORDER IN EXCESS OF $1,000,000 IN ADVANCE F. THE INCURRENCE BY THE CORPORATION OF ANY INDEBTEDNESS IN EXCESS OF $1,000,000 BEFORE SUCH INDEBTEDNESS IS CONTRACTED AND BEFORE EVIDENCE OF SUCH INDEBTEDNESS IS ISSUED G. ANNUAL CAPITAL AND OPERATING BUDGETS OF THE CORPORATION H. TRANSFER ASSETS BY THE CORPORATION DURING ANY FISCAL YEAR OF ASSETS EXCEEDING $100,000 IN NET VALUE Form 990, Part VI, Line 11b Review of form 990 by governing body FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S MANAGEMENT PERSONNEL. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S MANAGEMENT PERSONNEL HAS ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN MADE AVAILABLE TO THE EXECUTIVE COMPENSATION COMMITTEE AND ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990 WITH THE IRS. ALL BOARD MEMBERS ARE INFORMED THAT A PAPER COPY OF THE FORM 990 IS AVAILABLE AT THE ORGANIZATION'S PRINCIPAL OFFICE. Form 990, Part VI, Line 12c Conflict of interest policy BOARD MEMBERS AND OFFICERS RECEIVE CORRESPONDENCE EACH YEAR THAT MUST BE COMPLETED AND SIGNED. THE CORRESPONDENCE INCLUDES A CONFLICTS OF INTEREST QUESTIONAIRE. OFFICERS AND KEY STAFF ALSO RECEIVE AN ATTESTATION FORM THAT MUST BE SIGNED CONFIRMING THAT THEY WILL DISCLOSE ANY CONFLICTS THAT VIOLATE THE ORGANIZATION'S POLICY. THE BOARD REVIEWS ALL CONFLICTS AND DETERMINES IF FURTHER ACTIONS NEED TO BE TAKEN. WHEN A CONFLICT DOES EXIST, THE INTERESTED PERSON MUST SUBMIT A DISCLOSURE NOTICE TO THE BOARD AND ABSTAIN FROM MAKING MOTIONS, VOTING, NEGOTIATING, EXECUTING AGREEMENTS, OR TAKING ANY OTHER DIRECT ACTION ON BEHALF OF THE ORGANIZATION WHERE THE CONFLICT MIGHT PERTAIN. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION HAS ALL GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE ANNUAL FINANCIAL STATEMENTS ON FILE IN THE ACCOUNTING AND ADMINISTRATION DEPARTMENTS. ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees PROFESSIONAL FEES - Total Expense: 509332, Program Service Expense: 509332, Management and General Expenses: , Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 1508103, Program Service Expense: 1508103, Management and General Expenses: , Fundraising Expenses: ; OTHER PROFESSIONAL FEES - Total Expense: 64900, Program Service Expense: 39898, Management and General Expenses: 25002, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFER FROM AFFILIATE - 4838728; BAPTIST HEALTH CARE FOUNDATION 125 BAPTIST WAY SUITE 6A PENSACOLA FL 32503 590192265 FUNDRAISING FL 501(c)(3) 7 BHCI true BAPTIST HEALTH CARE INC 125 BAPTIST WAY SUITE 6A PENSACOLA FL 32503 590657322 HEALTHCARE FL 501(c)(3) 3 NA false BAPTIST MEDICAL PARK SURGERY CENTER LLC 9400 UNIVERSITY PKWY PENSACOLA FL 32541 593535262 AMBULATORY SURGERY FL NA N/A ANDREWS INSTITUTE ASC LLC 1040 GULF BREEZE PKWY GULF BREEZE FL 32561 352274952 AMBULATORY SURGERY FL NA N/A LIGHTHOUSE HEALTH PLAN LLC 1717 NORTH E STREET STE 320 PENSACOLA FL 32501 823182832 HEALTH INSURANCE FL NA N/A BHI-INTUITIVE HEALTH OF ESCAMBIA COUNTY LLC 5700 GRANITE PARKWAY STE 456 PLANO TX 75024 843637126 FREESTANDING ED FL NA N/A BAPTIST HEALTH VENTURES INC 1717 NORTH E ST PENSACOLA FL 32501 592667929 ADMINISTRATIVE FL NA C Corporation true THE TOWERS PHARMACY INC 1717 NORTH E ST PENSACOLA FL 32501 592667929 RETAIL SALES FL NA C Corporation true LCC HOLDING COMPANY INC 1717 NORTH E ST PENSACOLA FL 32501 592874324 MEDICAL SERVICES FL NA C Corporation true LAKEVIEW ASSOCIATED ENTERPRISES-PHASE I 21 W LAKEVIEW AVE PENSACOLA FL 32501 611711170 FRANCHISING FL NA C Corporation true PARCEL 27 LAND CONDOMINIUM ASSOC INC 1221 W LAKEVIEW AVE PENSACOLA FL 32501 821313799 CONDO ASSOCIATION FL NA C Corporation true false false false false false false false false false false false false true false true true false false false Jay Hospital Inc POST OFFICE BOX 17500 PENSACOLA FL 32522 592425149 X 0 2837 2837 18354991 18357828 1000000 250000 0 0 0 BAPTIST HEALTH CARE INC PO BOX 17500 PENSACOLA FL 325227500 590657322 X 0 215426 215426 819854477 820069903 1000000 250000 0 0 0 BAPTIST HEALTH CARE FOUNDATION PO BOX 17500 PENSACOLA FL 325227500 590192265 X 0 0 0 4073603 4073603 353680 88420 0 0 0