SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Baptist Healthcare System Inc
 
Employer identification number

61-0444707
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		  58,173 33,841,995 9,600,001 24,241,994 1.760 %
b Medicaid (from Worksheet 3, column a) . . . . .   158,047 180,755,665 170,865,572 9,890,093 0.720 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .   216,220 214,597,660 180,465,573 34,132,087 2.480 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).   69,363 2,202,449 15,130 2,187,319 0.160 %
f Health professions education (from Worksheet 5) . . .     78,946   78,946 0.010 %
g Subsidized health services (from Worksheet 6) . . . .   117,303 48,805,328 39,652,403 9,152,925 0.660 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     1,189,153   1,189,153 0.090 %
j Total. Other Benefits . .   186,666 52,275,876 39,667,533 12,608,343 0.920 %
k Total. Add lines 7d and 7j .   402,886 266,873,536 220,133,106 46,740,430 3.400 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
13,438,395
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
3,738,225
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
383,817,790
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
421,682,603
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-37,864,813
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?5
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Baptist Health Louisville
4000 Kresge Way
Louisville,KY40207
www.baptisthealth.com
100451 		X X         X     A
2 Baptist Health Lexington
1740 Nicholasville Rd
Lexington,KY40503
www.baptisthealth.com
100101 		X X         X     A
3 Baptist Health Paducah
2501 Kentucky Avenue
Paducah,KY42003
www.baptisthealth.com
100313 		X X         X     A
4 Baptist Health Corbin
1 Trillium Way
Corbin,KY40701
www.baptisthealth.com
100417 		X X         X     A
5 Baptist Health LaGrange
1025 New Moody Lane
LaGrange,KY40031
www.baptisthealth.com
100575 		X X         X     A
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?.......................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................. 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.baptisthealth.com
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

A
Name of hospital facility or letter of facility reporting group  
Financial Assistance Policy (FAP) Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

A
Name of hospital facility or letter of facility reporting group  
Financial Assistance Policy (FAP) Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Part V Section B, Line 5 Schedule H, Part V, Section B, Line 5 A-1 Baptist Health Louisville (BHLOU) Contact was made with the health departments responsible for the counties in the service area. There are four health departments responsible for the counties BHLOU serves: Louisville Metro Public Health & Wellness (Jefferson County); the Bullitt County Health Department; the Oldham County Public Health Department; and the North Central District Health Department, which serves both Shelby and Spencer Counties. Through these contacts, the public meetings that were held, and public surveys conducted in Jefferson and Oldham counties, BHLOU solicited primary feedback on the health issues confronting its service area. Schedule H, Part V, Section B, Line 5 A-2 Baptist Health Lexington (BHLEX) To assess the needs of the greater community of the Lexington-Fayette County area in which Baptist Health Lexington resides, the hospital partnered with the Lexington-Fayette County Health Department as a participant in the MAPP process (Mobilizing for Action through Planning and Partnerships). The MAPP framework is a process designed to assess the community health status and needs, prioritize health issues and identify resources to address them. This is a community-driven process which engages the community and develops partnerships. Schedule H, Part V, Section B, Line 5 A-3 Baptist Health Paducah (BHPAD) The Purchase District Coalition for Health is a group comprised of representatives from the Purchase District Health Department, which Serves Ballard, Carlisle, Fulton, Hickman, and McCracken counties in the Purchase Area Development District; the City of Paducah; UK County Extension Offices; United Way of Paducah-McCracken County; Lourdes Hospital and Baptist Health Paducah. Bringing these groups together helps avoid duplication of efforts in data collection and resource allocation. Through these contacts and public surveys, BHPAD collected primary data and feedback on the health issues confronting its service area. Secondary data from demographic and socioeconomic sources, Kentucky vital statistics, disease prevalence and health indicators and statistics were collected from national, state and local sources. Schedule H, Part V, Section B, Line 5 A-4 Baptist Health Corbin (BHCOR) Primary data was obtained by Baptist Health Corbin through electronic surveys targeting the community considered in the assessment. The survey data was obtained over a two month time period. Surveys were also conducted through the Whitley County Health Department and Laurel County Health Department/St. Joseph Hospital of London. The broad surveys were intended to gather information regarding overall health of the community. Schedule H, Part V, Section B, Line 5 A-5 Baptist Health LaGrange (BHLAG) There are three health departments responsible for the counties BHLAG serves: the Oldham County Public Health Department; the North Central District Health Department, which serves both Henry and Trimble Counties and the Three Rivers District Health Department, which serves Carroll County. Public feedback via Surveymonkey, used to assess what the public views as their top three (3) health related issues for 2015 and forward were reviewed. Public surveys by the other health departments were also used to collect relevant data.
Part V, Section B, Line 11 A-1 Baptist Health Louisville Based on the data analyzed through this assessment, three main issues were identified that the hospital will focus on over the next three years. They are: health literacy, cancer and cardiovascular disease. The other five areas of focus are the aging population, mental health, substance abuse, obesity and diabetes. The consensus of the team conducting the assessment is that many of these issues are related and efforts to combat one will result in improvements in one or more of the others. Health literacy was defined as an increased awareness of the public to their overall healthcare environment, including knowledge of how and when to access care, understanding their personal health status, and the necessity of compliance to medicine and lifestyle regimens assigned by their physicians. Only through the combined efforts of medical professionals, schools, churches and government agencies will we be successful in educating and engaging individuals in caring for themselves. Kentucky has some of the highest rates in the nation for preventable health conditions and for behaviors that have been identified as unhealthy. The committee felt that continued focus on health literacy and personal responsibility would improve the general health of the population more than any other activity. As cancer continues to be a leading cause of death in this service area, the committee ranked it as their second priority in terms of public health issues. Although Jefferson county mortality levels are better than the state average they are still higher than the national average. The committee acknowledged the continued need for board certified oncologists and easy access to cancer related services such as chemotherapy and radiation therapy. Cardiovascular disease ranked as the committee's third priority and encompasses coronary artery disease, heart attack, arrhythmias, heart failure, cardiomyopathy and vascular disease. The discussion focused on education, prevention and treatment. The goal is to expand public awareness of disease root causes and common associated conditions to increase compliance with standard of care protocols. It is not within the scope of Baptist Health Louisville's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. But it is through networking and partnerships with other community stakeholder organizations and agencies that these issues are being addressed. Baptist Health Louisville works collaboratively with other community resources to provide support and serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment and uninsured populations are being dealt with by economic development groups, the Kentucky Chamber of Commerce, city and county governments, and county health departments. Schedule H, Part V, Section B, Line 11 A-2 Baptist Health Lexington After compiling and analyzing all of the data in this assessment, BHL will pursue benchmarking, identifying targets and ideas and implementing strategies. Some of the strategies will address multiple needs. These lists are not intended to be exhaustive and do not imply there is only one way to address the identified health needs. Obesity, cardiovascular disease and cancer, including breast, colorectal and lung were the health needs of the community with the highest priority. Obesity issues will be addressed through education, prevention and community-based initiatives to decrease the no exercise rate in Fayette County as measured by the BRFSS, (Behavioral Risk Factor Surveillance System), which collects data through the CDC, (the Centers for Disease Control and Prevention)), by 2018. Efforts will continue to expand the program directory for physical activity venues and identify mechanisms of assistance for participation in programs. The identification of, and increase in the number of organizations in Fayette County that offer worksite wellness programs should produce measurable results and a healthier lifestyle. Baptist Health Lexington works collaboratively with other community resources to provide support and to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. It is not within the scope of Baptist Health Lexington's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. But it is through networking and partnerships with other community stakeholder organizations and agencies that these issues are being addressed. Impact issues such as unemployment and uninsured populations are being dealt with by economic development groups, the Kentucky Chamber of Commerce, city and county governments, and county health departments. Schedule H, Part V, Section B, Line 11 A-3 Baptist Health Paducah The committee identified and prioritized community needs for the service area that Baptist Health Paducah can address and affect by implementing programs, education and preventive screenings. Obesity prevention and illnesses related to obesity are a primary concern. Plans are being implemented to increase the awareness of obesity as a health threat to our service area residents and to encourage healthier living through diet, exercise and other means. The hospital is providing additional support to meet this need through its new bariatric surgery and metabolic disease management program; Project Fit America fitness programs in area elementary schools and internal programs to improve employees' health. The ability of individuals in a community to access health care resources to preserve or improve health is essential. Access to health care has an impact on overall health status, the prevention of disease and the quality of life. Efforts are underway through education and the availability of additional resources to remove the potential barriers to receiving necessary health care services. It is not within the scope of Baptist Health Paducah's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. But it is through networking and partnerships with other community stakeholder organizations and agencies that these issues are being addressed. Impact issues such as unemployment and uninsured populations are being dealt with by economic development groups, the Kentucky Chamber of Commerce, city and county governments, and county health departments. The use of illicit drugs or the abuse of prescription or over-the-counter medications for purposes other than those for which they are indicated or in a manner or in quantities other than directed is a growing problem in McCracken County. This particular issue presents a need that cannot be met by Baptist Health Paducah, but is better met by services already in the community including those at Four Rivers Behavioral Health. Schedule H, Part V, Section B, Line 11 A-4 Baptist Health Corbin Baptist Health Corbin will work to increase the awareness of the importance of early detection and prevention of cardiovascular diseases including Stroke, Hypertension and CHF through screening and educational programs for residents of Whitley, Knox and Laurel County. The development of community partnerships to educate local residents on healthy lifestyles and ways to manage cardiovascular diseases, diabetes and cancer are primary objectives. Increased availability to preventive screenings will provide benefits for these and additional health issues. It is not within the scope of Baptist Health Corbin's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. But it is through networking and partnerships with other community stakeholder organizations and agencies that these issues are being addressed. Impact issues such as unemployment and uninsured populations are being dealt with by economic development groups, the Kentucky Chamber of Commerce, city and county governments, and county health departments. Schedule H, Part V, Section B, Line 11 A-5 Baptist Health LaGrange Based on the data analyzed through this assessment, three main issues were identified that the hospital will focus on over the next three years. They are: health literacy, cancer and cardiovascular disease. The other five areas of focus are the aging population, mental health, substance abuse, obesity and diabetes. The consensus of the team conducting the assessment is that many of these issues are related and efforts to combat one will result in improvements in one or more of the others. Health literacy was defined as an increased awareness of the public to their overall healthcar
Part V, Section B, Line 19 Billing and Collections Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Schedule H, Part I, Line 6a COMMUNITY BENEFIT REPORT Each hospital within Baptist Healthcare System ("BHS") (61-0444707) prepares a community benefits report. In addition, a summary community benefits report is prepared on a consolidated basis for all entities within BHS.
Schedule H, Part I, Line 7g No physician clinic costs are included in the costs of subsidized health services.
Schedule H, Part I, Line 7 COSTING METHODOLOGY BHS utilizes a sophisticated cost accounting system that identifies the cost of delivering care at the individual procedure and item (supply) level for direct costs and a detailed step-down methodology to allocate overhead costs as accurately as possible. Costs are determined for each patient based upon the specific procedures performed and items used for each patient. Patients are also categorized by: 1.patient type (inpatient and outpatient), 2.payer plan (42 unique categories of payer plans. Charity, State-sponsored charity and the Uninsured are among the uniquely identified payer plans), and 3.clinical service (53 unique clinical services). The cost of care for uninsured patients who qualify for "full" charity care (under a State-sponsored or BHS sponsored charity program) is determined by calculating the cost of each uninsured charity patient (at the procedure and item level) and accumulating the cost of each patient. For insured patients who also qualify for partial charity under the BHS sponsored charity program, costs are allocated to each portion (insurance, partial charity, patient payments and bad debt) using the patient's payer plan cost-to-charge ratio (CCR). For example, this CCR is multiplied by the charges covered by insurance to determine the cost of insurance, multiplied by charges covered by partial charity to determine the cost of partial charity, multiplied by patient payments to determine the cost of paid services and multiplied by unpaid charges to determine the cost of bad debt. The cost of care for uninsured patients who do NOT qualify for charity care (full or partial bad debt accounts) are allocated to each portion (patient paid portion and unpaid portion) using the patient's uninsured payer plan CCR. For example, this CCR is multiplied by patient payments to determine the cost of paid services and multiplied by unpaid charges to determine the cost of bad debt. Much care is taken to ensure that costs used for community benefit reporting are directly related to exempt-purpose patient care (excluding physician-related costs) and that costs are reported accurately. For example, the cost of charity and Medicaid are removed from the calculation of the loss on subsidized services.
Schedule H, Part III, Line 4 BAD DEBT EXPENSE FOOTNOTE A separate footnote for bad debt expense is not included in the audited financial statements. However, beginning in 2012 BHS reported the provision for uncollectible accounts related to patient service revenue as a deduction from patient service revenue. Costing methodology of bad debt is outlined in Schedule H, Part VI, line 1. The estimated amount of bad debt expense attributable to patients eligible under the organization's FAP was determined using a historical percent to total of net amounts written off as bad debt for those patients with a low propensity to pay or low income to total net amounts written off as bad debt.
Schedule H, Part III, Line 8 MEDICARE COSTING METHODOLOGY Medicare revenues and allowable costs were taken from the "as filed" Medicare cost report. Much care is taken to ensure that all adjustments to remove non-allowable costs are taken. Due to the fact that Medicare rates are non-negotiable and are established by the government, all of the shortfall for Medicare should be included as a community benefit.
Schedule H, Part III, line 9b COLLECTION PRACTICES Patients and guarantors who qualify for a "full" charity discount will not be billed once the charity determination is made. Patients and guarantors who qualify for a "partial" charity discount will be billed only for the non-discounted portion of their account. Guarantors who have an ability to pay for services will be billed based on the following guidelines: - Patients or guarantors may be asked to pay an estimated patient liability at point of service. - BHS facilities will accept and file claims for all insurances assigned to the organization with adequate proof of coverage. This assignment does not relieve the guarantor of responsibility for payment if the insurer fails to pay as prescribed by regulation, statute or patient-insurance contract. Deductibles, co-payments and non-covered services will be the responsibility of guarantors. - Statements will be sent to guarantors once patient liability is determined for insured or uninsured patients and necessary billing follow-up calls will be made by BHS Patient Financial Services and/or a designated external early out vendor over a period of time averaging from 90 to 120 days. All statements will contain information regarding the availability of financial assistance. If applicable, effort will be made to assist uninsured patients to secure coverage through any governmental or other assistance programs. - Patients requesting detailed charge information will be provided with an itemized bill. - BHS Patient Financial Services will provide all patients the same information concerning services and charges. - Patient accounts not resolved at the end of this cycle will be considered for placement with external collection agencies. Collection agencies will continue to pursue patient balances while maintaining compliance with the Fair Debt Collection Practices Act and the ACA International's Code of Ethics and Professional Responsibility.
Schedule H, Part VI, line 2 NEEDS ASSESSMENT BHS conducts a tri-annual planning process that is driven by the strategic vision to be the health care leader in Kentucky. Key industry and community issues (such as prominent health conditions present within each community, underserved areas and underprovided clinical services) are considered and analyzed for their impact on BHS and the five hospitals. Frequently, outside experts reaffirm the assessment and assist in the development of plans to address the community need. A course of action, including key strategies and goals, are shared with and approved by the BHS Board and the Hospital's administrative Boards.
Schedule H, Part VI, line 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE Following is a list of various methods/processes used to inform/educate patients on the availability of financial assistance: - financial counselors advise and/or screen uninsured patients before or during hospital services, - a third party vendor advises and/or screens uninsured patients during hospital services, - financial counselors provide follow-up contact for patients missed during services, - the State-sponsored DSH form is provided to all ER uninsured patients, - telephone calls and in-person visits are handled by staff trained to discuss financial assistance, - information regarding financial assistance is included in patient statements. - The BHS sponsored charity care program policy is posted in key areas of each hospital. - The BHS sponsored charity care program policy is posted on the website of each hospital and the System.
Schedule H, Part VI, Line 4 Community Information BHS is comprised of five regional hospitals. each one serves a unique and separate geographic area within Kentucky. Baptist Health Louisville (BHLOU) opened in 1975 and is located in St. Matthews, approximately five miles east of downtown Louisville area. BHLOU is strategically located near interstate 64, a main access to downtown, and interstate 264, a main beltway around Louisville. The primary geographic service area for BHLOU consists of Jefferson, Oldham, Shelby, Spencer and Bullitt Kentucky counties. BHLOU serves as a general acute care facility, specializing in services such as cardiovascular services, cancer care and comprehensive rehabilitation services that are much needed in the area. in addition, BHLOU operates one of the busiest emergency rooms in the state of Kentucky. Approximately 14.6% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 5.9%, as compared to the national average of 6.2%. Baptist Health Corbin (BHCOR) opened in 1986 in Corbin, Kentucky. it is located one-half mile off of interstate 75, approximately three miles from downtown Corbin and near U.S. highway 25, which is a main access to several of the surrounding communities. The primary geographic service area for BHCOR consists of the counties of Knox, Laurel and Whitley in Kentucky. BHCOR serves as a general acute care facility, specializing in services such as psychiatric, substance abuse, comprehensive rehabilitation and emergency care services. The psychiatric program at BHCOR has grown over the past several years and BHCOR has plans to continue its growth. Approximately 15.2% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 8.8%, as compared to the national average of 6.2%. Baptist Health Lexington (BHLEX) opened in 1954 in Lexington, the second largest city in Kentucky. It is located approximately five miles from Interstate 75 and Interstate 64 which provide access for the immediate Lexington metro area patients as well as patients from other areas of central and eastern Kentucky which the hospital serves. The primary geographic service area for BHLEX consists of the Kentucky counties of Bourbon, Clark, Fayette, Franklin, Jessamine, Madison, Scott and Woodford. In addition, BHLEX serves as a regional referral center with approximately 42% of its discharges coming from Kentucky counties outside of the primary service area. As such, BHLEX provides tertiary care services not offered by many hospitals in the surrounding areas including specialty cardiovascular, orthopedic and intensive care services. Approximately 13.4% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 5.2%, as compared to the national average of 6.2%. Baptist Health Paducah (BHPAD) was opened in 1953 in Paducah, Kentucky, the largest city in BHPAD's service area. the hospital is located approximately one and one-half miles from Interstate 64. BHPAD is one of only two hospitals located in Paducah. The primary geographic service area for BHPAD consists of Ballard, Carlisle, Graves, Livingston, Lyon, Marshall and McCracken counties in Kentucky and Massac county in Illinois. BHPAD draws nearly 80% of its discharges from the primary service area. BHPAD serves as a general acute care facility, specializing in services such as cardiovascular services, cancer care and skilled nursing that are much needed in the area. Approximately 19.1% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 7.19%, as compared to the national average of 6.2%. Baptist Health LaGrange, (BHLAG) became part of the BHS system in 1992. Baptist Health LaGrange can serve all of the primary healthcare needs of its service area. BHLAG defines its service area by looking at where the majority of its inpatients reside. Approximately 85% of BHLAG's inpatients come from Oldham, Henry, Trimble, and Carroll Counties. Oldham County is a shared service area between Baptist Health Louisville and BHLAG. Approximately 13.1% of the population of the local area surrounding the hospital is over 65 and the unemployment rate is 6.2%, as compared to the national average of 6.2%.
Schedule H, Part VI, Line 5 Promotion of Community Health The BHS board of directors is comprised of local representatives who, along with the hospital's management and employees, understand that they are responsible for providing high quality health care services to the communities they serve. Operating healthcare facilities in today's environment requires a delicate balance between producing a sufficient margin to allow for adequate staffing and investment in new technologies, while also providing enough resources to absorb the cost of care for those patients who do not have the ability to pay for the services. In 2015, Baptist was able to re-invest over $81 million into the communities in new technology, construction, renovation and systems improvement. BHS hospitals reach out to the community in many ways through: - Conducting health fairs for local schools, businesses and churches. - Participating in fund-raising and other events to help local agencies such as the American Heart Association, Metro United Way, American Cancer Society, Big Brothers and Big Sisters and the American Red Cross. - Donating hospital space for community group meetings. - Participating on community health assessment teams that are dedicated to identifying and addressing local health needs in each of the counties we serve. - Hosting educational programs, including our pre-natal classes, and safe sitter program. - Maintaining necessary, but unprofitable services that meet community needs. - Helping to recruit physicians to underserved areas. - Helping patients coordinate services with other healthcare providers. - Providing resources for support groups, such as cancer recovery groups. - Promoting and providing preventive care services. - Monitoring clinical outcomes in order to ensure quality care. - Committing resources to improving safety and processes of care. - Providing services conveniently accessible by patients. In addition, BHS employees volunteer thousands of hours in community services and leadership. BHS's support for community activities underscores its commitment to improving the lives of those served. because BHS and its employees contribute so much of their time, talents and resources to serve others, communities served by BHS are better places to live and work. Quantification of many of the community benefits is detailed elsewhere in this schedule. However, what the quantifiable amount doesn't measure is the economic benefit derived by the community from BHS being one of the major employers in the area. The economic impact of the wages paid to BHS employees is significant considering the dollars they spend on food, housing, services, and other products. The Internal Revenue Service revenue ruling 69-545 provides that a hospital can demonstrate it has met the community benefit standard by having a full-time emergency room open to the public regardless of ability to pay for services received. BHS hospitals operate emergency departments that are open 24 hours a day, 365 days a year and treated over 191,541 emergency patients during fiscal year 2015. BHS and its emergency departments post policies stating that patients will be treated regardless of their ability to pay. Depending on the severity of a patient's condition, as a service to the patient BHS may verify insurance prior to rendering services in the emergency department. Under no circumstances is emergency care delayed by discussions regarding insurance coverage or ability to pay for services. In addition, BHS does not convey or intimate in any way to any emergency medical transportation service an unwillingness to treat any particular patient in need of medical attention.
Schedule H, Part VI, line 6 Affiliated Health Care System BHS is a nonprofit, tax-exempt organization that owns and operates five hospitals. Baptist Health Richmond, INC. is a nonprofit, tax-exempt affiliate that owns and operates a hospital in Richmond, KY. Baptist Health Madisonville, INC. is a nonprofit, tax-exempt affiliate that owns and operates a hospital in Madisonville, KY. Baptist Community Health Services, INC. is a nonprofit, tax-exempt affiliate that owns and operates rehabilitation centers, urgent care centers, and occupational and physical therapy clinics within the regions surrounding the hospitals. Baptist Health Medical Group, Inc. is a nonprofit, tax-exempt affiliate that owns and operates physician practices. Baptist Healthcare Foundation, INC., Baptist Health Foundation of Greater Louisville, INC., Baptist Health Foundation Corbin, INC., Baptist Health foundation Richmond, Inc., Baptist Health Foundation Madisonville, Inc., Lexington Cardiac Research Foundation, INC., Baptist Health Foundation Lexington, INC., and Baptist Health Foundation Paducah, Inc. are nonprofit, tax-exempt affiliate corporations. Baptist Health Plan, INC. (BHP) is a nonprofit, taxable affiliate health maintenance organization. Baptist Ventures, INC. is an affiliate corporation. Baptist Physicians' Surgery Center is a limited liability corporation, of which Baptist Community Health Services, INC. owns 55%. Pet/Ct Management, LLC is a limited liability corporation, of which Baptist Healthcare System, INC. owns 83%. Baptist Eastpoint Surgery Center, LLC is a limited liability company of which Baptist Community Health Services, INC. owns 80%. Baptist Health Employer Solutions, INC. (BHES), formed in 2010, is a non-profit corporation in which BHS is the sole member. BHES is a network of healthcare providers, hospitals and physicians. BHES's activities and purposes serve to support the charitable activities and operations of BHS. Purchase Health Quality Collaborative, LLC ("PHQC"), formed in 2011, is a non-profit limited liability company whose sole member is BHS. PHQC was formed to support a physician/hospital network established by PHP, working with BHPAD to engage in clinical integration activities. Mercy Regional Emergency Medical System, LLC ("MREMS"), formed in 1996, is a non-profit taxable corporation, which owns and operates an ambulance service in McCracken county, Kentucky in the service area of BH Paducah. BHS owns a 50% interest in MREMS and the remaining 50% interest is owned by Mercy Health System, INC. D.B.A. Lourdes Hospital. All entities are located in the Commonwealth of Kentucky. All entities described in Schedule H, Part VI, Line 6 contributed a combined community benefit amount as follows: Charity Care at Cost $24,242,000 Unreimbursed Medicaid 9,890,000 Community Health Improvement 2,187,000 Health Professions Education 79,000 Subsidized Health Services 9,153,000 Cash and In-Kind Contributions 1,189,000 ----------- Total Community Benefit $46,740,000
Schedule H (Form 990) 2014
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