efile Public Visual Render
ObjectId: 202311989349302721 - Submission: 2023-07-17
TIN: 61-0444707
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
21
Open to Public Inspection
Name of the organization
Baptist Healthcare System Inc
Employer identification number
61-0444707
Part I
Identification of Disregarded Entities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
(1)
Baptist Health Network Partners LLC
2501 Kentucky Avenue
Paducah
,
KY
42001
45-4290974
Physician Network
KY
6,383,963
0
BHSI
(2)
Baptist Health Care Partners LLC
1901 Campus Place
Louisville
,
KY
40299
47-4067700
ACO
KY
0
0
BHSI
(3)
Baptist Health Surgery Center Eastpoint
2400 Eastpoint Parkway
Louisville
,
KY
40223
26-0834852
Ambulatory Surgery Center
KY
1,067,099
0
BHSI
(4)
Hardin Professional Services LLC
1901 Campus Place
Louisville
,
KY
40299
20-4435701
Professional Physician Practice
KY
0
0
BHSI
(5)
CareFirst Urgent Care Center LLC
1901 Campus Place
Louisville
,
KY
40299
61-1345615
Urgent Care Center
KY
0
0
BHSI
Part II
Identification of Related Tax-Exempt Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
Baptist Health Medical Group Inc
1901 Campus Place
Louisville
,
KY
40299
20-5497203
Physician Services
KY
501(c)(3)
Line 3
BHSI
Yes
(2)
Mercy Regional Emergency Medical Systems
126 Lone Oak Road
Paducah
,
KY
42001
61-1310466
Ambulance Service
KY
501(c)(3)
Line 12a, I
BHSI
Yes
(3)
Baptist Health Foundation Richmond Inc
1901 Campus Place
Louisville
,
KY
40299
31-1506378
Fundraising
KY
501(c)(3)
Line 12a, I
BHSI
Yes
(4)
Baptist Health Foundation Corbin Inc
1901 Campus Place
Louisville
,
KY
40299
47-3033550
Fundraising
KY
501(c)(3)
Line 12a, I
BHSI
Yes
(5)
Baptist Health Foundation Lexington Inc
1901 Campus Place
Lexington
,
KY
40299
61-1480774
Fundraising
KY
501(c)(3)
Line 12a, I
BHSI
Yes
(6)
Baptist Health Foundation Paducah Inc
1901 Campus Place
Paducah
,
KY
40299
26-4057759
Fundraising
KY
501(c)(3)
Line 12a, I
BHSI
Yes
(7)
Baptist Health Foundation Greater Louisville Inc
1901 Campus Place
Louisville
,
KY
40299
20-0292291
Fundraising
KY
501(c)(3)
Line 12a, I
BHSI
Yes
(8)
Baptist Healthcare Foundation Inc
1901 Campus Place
Louisville
,
KY
40299
31-1122867
Fundraising
KY
501(c)(3)
Line 12a, I
BHSI
Yes
(9)
Pattie A Clay Hospital Auxiliary
PO Box 1600
Richmond
,
KY
40476
51-0172717
Hospital Support
KY
501(c)(3)
Line 12a, I
BHSI
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Page 2
Schedule R (Form 990) 2021
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
Baptist East Milestone LLC
750 Cypress Station Road
Louisville
,
KY
40207
61-1355065
Fitness Center
KY
BHSI
Excluded
522,083
3,287,473
No
No
50.230 %
(2)
Baptist Physicicans Surgery Center
1720 Nicholasville Road
Lexington
,
KY
40503
04-3665929
Ambulatory Surgery Center
KY
BHSI
Related
1,324,988
2,617,985
No
No
56.680 %
(3)
Medical Associates of Middletown
1901 Campus Place
Louisville
,
KY
40299
20-0399400
Medical Office Building
KY
BHSI
Related
37,911
711,272
No
No
35.000 %
(4)
Cumberland Valley Surgical Center LLC
PO Box 1620
Corbin
,
KY
40701
61-1348280
Ambulatory Surgery Center
IN
BHSI
Related
375,393
3,778,855
No
No
51.000 %
(5)
1931 West Street
1901 Campus Place
Louisville
,
KY
40299
83-1709486
Real Estate
KY
BHSI
Related
No
No
100.000 %
(6)
Northgate Medical Imaging LLC
1214 Spring Street
Jeffersonville
,
IN
47130
20-2246378
Outpatient Care Facility
IN
BHSI
Related
588,371
870,860
No
No
50.000 %
(7)
Baptist Health Intuitive of Kentucky & Southern Indiana
1901 Campus Place
Louisville
,
KY
40299
85-4150917
Management
KY
BHSI
Related
-55,447
No
No
51.000 %
(8)
Baptist Health Surgery Center LLC
240 Fountain Court
Lexington
,
KY
40509
84-3280181
Ambulatory Surgery Center
KY
BHSI
Related
-93,035
3,437,343
No
No
(9)
Baptist Health Deaconess LLC
1901 Campus Place
Louisville
,
KY
40299
87-2361058
Management
KY
BHSI
Related
No
No
50.000 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
Baptist Health Assurance Group LTD
1901 Campus Place
Louisville
,
KY
40299
98-1681017
Captive Insurance Company
KY
BHSI
T
100.000 %
Yes
Schedule R (Form 990) 2021
Page 3
Schedule R (Form 990) 2021
Page
3
Part V
Transactions With Related Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
Yes
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
No
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
Yes
s
Other transfer of cash or property from related organization(s)
............................
1s
Yes
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
Baptist Health Care Partners Inc
Q
203,559
Cost
(2)
Baptist Health Care Partners Inc
S
3,009,710
Cost
(3)
Baptist Health Foundation Corbin Inc
B
167,239
Cost
(4)
Baptist Health Foundation Corbin Inc
C
1,076,434
Cost
(5)
Baptist Health Foundation Corbin Inc
R
135,939
Cost
(6)
Baptist Health Foundation Lexington Inc
B
611,127
Cost
(7)
Baptist Health Foundation Lexington Inc
C
233,628
Cost
(8)
Baptist Health Foundation Lexington Inc
S
209,918
Cost
(9)
Baptist Health Foundation Greater Louisville Inc
B
659,179
Cost
(10)
Baptist Health Foundation Greater Louisville Inc
C
576,541
Cost
(11)
Baptist Health Foundation Paducah Inc
B
301,435
Cost
(12)
Baptist Health Foundation Paducah Inc
C
188,236
Cost
(13)
Baptist Health Foundation Paducah Inc
S
72,344
Cost
(14)
Baptist Health Foundation Richmond Inc
B
201,670
Cost
(15)
Baptist Health Intuitive of KY & Southern IN
R
760,418
Cost
(16)
Baptist Health Medical Group Inc
J
12,886,020
Cost
(17)
Baptist Health Medical Group Inc
O
303,296
Cost
(18)
Baptist Health Medical Group Inc
P
64,560,075
Cost
(19)
Baptist Health Medical Group Inc
Q
37,080,617
Cost
(20)
Baptist Health Medical Group Inc
R
52,910,417
Cost
(21)
Baptist Health Surgery Center LLC
J
775,600
Cost
(22)
Baptist Health Surgery Center LLC
O
213,668
Cost
(23)
Baptist Healthcare Foundation Inc
B
2,795,734
Cost
(24)
Baptist Healthcare Foundation Inc
C
257,812
Cost
(25)
Baptist Physicians Surgery Center LLC
J
1,237,415
Cost
(26)
Baptist Physicians Surgery Center LLC
O
145,069
Cost
(27)
Baptist Physicians Surgery Center LLC
Q
203,896
Cost
Schedule R (Form 990) 2021
Page 4
Schedule R (Form 990) 2021
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2021
Page 5
Schedule R (Form 990) 2021
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference
Explanation
Schedule R (Form 990) 2021
Additional Data
Software ID:
Software Version: