2024-07-15T16:49:57-05:00 2023-08-31 346565596 Ernst & Young US LLP 221 E 4th Street Suite 2900 Cincinnati OH 45202 990 2022-09-01 863269008 Baptist Health Deaconess Medical Group Inc BAPT 2708255857 900 Hospital Drive Madisonville KY 42431 Cheryl Wathen Treasurer 2708255201 2024-07-15 1 Cheryl Wathen 999009999 0 Julie L Sparks P01268401 5136121400 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X Alisa Coleman 900 Hospital Drive Madisonville KY 42431 42077589 0 X www.baptisthealthdeaconess.com X 2021 KY To provide medical services that promote the health and wellness of our community. 8 8 449 6 0 0 60719 0 32985507 40891292 2695 0 947397 1186297 33996318 42077589 0 0 0 0 47555711 50094166 0 0 0 12063777 11734990 59619488 61829156 -25623170 -19751567 27602147 6859699 6367528 6912636 21234619 -52937 X See Schedule O. 0 0 57269438 42077589 Baptist Health Deaconess Medical Group, Inc. ("BHDMG") is a professional medical services company organized and operated to benefit Baptist Health Deaconess Madisonville, Inc. ("BHDM") hospital and the surrounding community. BHDMG is a comprehensive network of primary and specialty care physician practices in Madisonville, Kentucky that includes more than 80 primary care physicians, specialist physicians and advance practice clinicians. Providers represent more than 50 specialties, including primary care and family medicine, internal medicine, osteopathic medicine, emergency medicine, general surgery and a wide range of surgical specialties offering advanced treatments and care. During fiscal year 2023, BHDMG had over 340,000 patient visits at more than 40 locations. BHDMG also operates urgent care centers, rural health clinics and occupational medicine facilities. BHDMG's primary and specialty care physicians, urgent care centers, occupational medicine facilities and rural health centers offer more convenient and less costly quality care services to patients and help to maintain sufficient physician expertise and capacity to deliver efficient, appropriate and compassionate patient care in the communities BHDMG serves. Our physicians play key leadership roles in determining the direction and development of patient services, they spearhead innovation by leading clinical research and they help to bring advanced treatments and technology to our facilities.In order to meet the health and wellness needs of our communities throughout the Madisonville service area, Baptist Health Deaconess Madisonville, Inc., (BHDM), (a nonprofit Section 501(c)(3) related entity), has historically provided grants to Baptist Health Deaconess Medical Group, Inc. (BHDMG). These grants have allowed BHDMG to continue to provide care and support for Medicaid and charity care patients through primary care centers, rural health centers, urgent care centers and specialty health centers that meet a demonstrated community need. BHDM made these grants on the condition that BHDMG use the grant funds only for the following activities:1. To provide care for patients participating in Medicaid and other means-tested government health programs, including but not limited to the Kentucky Children's Health Insurance (KCHIP) program.2. To provide care, for free or at discounted rates, to low-income patients who cannot afford the cost of care.3. To fund the operations of rural health clinics that provide care for the patients described above.4. To engage in community activities and programs in response to demonstrated community needs to improve community health, including but not limited to health screenings; COVID testing; vaccinations and community health education. Baptist Health Deaconess Madisonville, Inc. reported the grants related to the above activities on its respective IRS Form 990, Schedule H, Part I, Line 7. 57269438 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 449 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 KY X X Cheryl Wathen 8124503296 4011 Gateway Blvd Newburgh IN 47630 Gerard Colman Chair (Through 8/1/23) & Dir 1.00 0.00 X X 0 0 0 Shawn McCoy Chair (Effective 8/2/23) & Dir 1.00 0.00 X X 0 0 0 Isaac J Meyers MD Director 1.00 0.00 X 0 0 0 James Porter MD Director 1.00 0.00 X 0 0 0 Jared Florence Director 1.00 0.00 X 0 0 0 Jody Prather MD Director 1.00 0.00 X 0 0 0 Lynn Lingafelter Director 1.00 0.00 X 0 0 0 Patrick Falvey Director 1.00 0.00 X 0 0 0 Alisa Coleman President (Effective 1/1/23) 1.00 0.00 X 0 0 0 Cheryl Wathen Treasurer (Effective 8/2/23) 1.00 0.00 X 0 0 0 Doug Welp Secretary 1.00 0.00 X 0 0 0 Stephen R Oglesby VP & Treasurer (Through 1/6/23) 1.00 0.00 X 0 0 0 Robert Ramey President (Through 12/16/22) 2.00 40.00 X 0 592760 23526 John Dacosta MD Physician 40.00 0.00 X 826254 0 41933 James Dodds MD Physician 40.00 0.00 X 945691 0 43505 Sumalatha Satoor MD Physician 40.00 0.00 X 801452 0 22885 Tejas Modi MD Physician 40.00 0.00 X 837871 0 42373 Thomas Stanfield MD Physician 40.00 0.00 X 862435 0 45123 4273703 592760 219345 89 0 1 0 0 Ins & Patient Payments 621111 39079582 39079582 Other Patient Service 621999 1811710 1811710 40891292 Call Coverage 900099 1174957 1174957 Other Revenue 900099 11340 11340 1186297 42077589 42077589 0 0 43172957 40425851 2747106 1025498 977156 48342 3751643 3610527 141116 2144068 2038025 106043 3079566 2542001 537565 123029 80322 42707 105186 6369 98817 26260 26260 521894 501636 20258 3084645 2384645 700000 180105 146331 33774 61622 52700 8922 754404 754404 Medical Supplies 3001404 3001404 Purchased Services 538789 538789 Dues, Sub & Licenses 106736 85889 20847 Health Educ & Training 79343 78193 1150 72007 45196 26811 61829156 57269438 4559718 0 854665 350 5380154 4921200 636141 93432 533918 542709 20833410 1395440 27602147 6859699 5186285 5137447 1181243 1775189 6367528 6912636 X 21234619 -52937 21234619 -52937 27602147 6859699 X -19751567 -1535989 X 0 1 X 1 0 X Part I: Reason for Public Charity Status Baptist Health Deaconess Medical Group's public charity status is a hospital; however, Baptist Health Deaconess Medical Group does not have a hospital license or operate hospital facilities for purposes of Schedule H reporting. 636141 93432 542709 542709 Other Current Assets 151517 Third Party Settlements 1066295 Due From Affiliate 177628 1395440 Due To Affiliate 1775189 1775189 X Part X, Line 2: Baptist Health Deaconess LLC evaluates its uncertain tax positions on an annual basis. A tax benefit from an uncertain position may be recognized when it is more likely than not that the position will be sustained upon examination, including the resolution of any related appeals or litigation processes, based on the technical merit of the position. Baptist Health Deaconess LLC has determined that it has no uncertain tax positions that are required to be recorded as of August 31, 2023. As BHD, LLC started operations September 1, 2021, 2022 and 2023 are the only tax years that are open. 0 0 0 0 0 1 1 0 0 James Dodds MD Physician 589917 0 353842 0 1932 0 12200 0 31305 0 989196 0 0 0 Thomas Stanfield MD Physician 801623 0 56000 0 4812 0 12200 0 32923 0 907558 0 0 0 Tejas Modi MD Physician 491224 0 344607 0 2040 0 12200 0 30173 0 880244 0 0 0 John Dacosta MD Physician 641889 0 179553 0 4812 0 12200 0 29733 0 868187 0 0 0 Sumalatha Satoor MD Physician 520458 0 277862 0 3132 0 12200 0 10685 0 824337 0 0 0 Robert Ramey President (Through 12/16/22) 0 447984 0 133154 0 11622 0 12200 0 11326 0 616286 0 0 Part I, Line 6 Compensation Contingent Upon Net Earnings: Incentive compensation payments made by the organization and/or a related organization are based upon the successful achievement of established inpatient satisfaction measures, outpatient satisfaction measures, compliance with publicly reported quality indicators, operating margin as well as other technical and personal functional goals of both the organization and related organizations. The incentive compensation programs are formulated to reward behavior that balances patient needs and the efficient delivery of patient care to ensure the best outcomes are achieved. Part I, Line 3 Baptist Health Deaconess Madisonville, Inc. and Baptist Health Deaconess LLC., related organizations of Baptist Health Deaconess Medical Group, Inc., used the following to establish the compensation of the organization's President/CEO who held the position through 12/16/2022: - Comparability data - Independent compensation consultant - Form 990 of other organizations - Written employment contract - Compensation survey or study - Approval by the Board or Compensation Committee. Part III Mission Statement The mission of Baptist Health Deaconess Medical Group, Inc. is to promote health and wellness in the Madisonville, Kentucky service area by working together through a regional health care delivery network; to facilitate the sharing of clinical expertise and resources to provide an enhanced patient care model; to improve quality, patient safety and care coordination, and to improve the overall health of the populations served. Through a collaboration with Baptist Healthcare System, Inc. and Deaconess Health System, Inc., BHDMG will work to improve efficiencies and capture economies of scale to reduce costs for patients and third party payors; to help ensure that the BHD Madisonville Hospital remains a viable provider of healthcare for patients in the Madisonville service area; to better position providers to successfully participate in population health management; to recruit and retain physicians and other providers to the Madisonville service area, and to engage in other activities that further the non-profit missions of Baptist Healthcare System, Inc. and Deaconess Health System, Inc. in the Madisonville service area. Part V, Line 1 Form 1096 is filed by Baptist Health Deaconess Madisonville, Inc., FEIN 61-0654587. Form 990, Part VI, Section A, line 2 The Baptist Health Deaconess Medical Group Inc. president through 12/16/2022, Robert Ramey, had a business relationship with a related organization as an officer of the related organization. The Baptist Health Deaconess Medical Group Inc. president effective 1/1/2023, Alisa Coleman, has a business relationship with a related organization as an officer of the related organization. Form 990, Part VI, Section A, line 6 Baptist Health Deaconess LLC (FEIN 87-2361058) is the sole member of the corporation. Form 990, Part VI, Section A, line 7a Baptist Healthcare System, Inc. and Deaconess Health Kentucky, Inc. each appoint 50% of the governing board of Baptist Health Deaconess, LLC, the sole member of Baptist Health Deaconess Medical Group Inc. The same individuals also serve as the board of directors of Baptist Health Deaconess Medical Group Inc. The directors may be removed at any time, with or without cause, by the System that appointed them. Through the power to appoint and remove the directors of Baptist Health Deaconess Medical Group Inc., the Systems will exert ultimate control over Baptist Health Deaconess Medical Group Inc. Form 990, Part VI, Section A, line 7b The consent & approval of the sole member shall be required for all major corporate actions, and any act the result of which would be to: (a) amend, repeal or alter the Articles of Incorporation or Bylaws; (b) merge or consolidate or agree to merge or consolidate the corporation with or into any other organization; (c) liquidate, reorganize or recapitalize the corporation; (d) adopt the corporation's annual operating budget & capital expenditures budget; (e) create or incur any unbudgeted indebtedness which exceeds $100,000; (f) make any unbudgeted capital expenditure which exceeds $100,000; (g) other than acquiring marketable securities held for investment purposes, acquire the stock of any corporation or invest in or acquire an interest in any business enterprise; (h) sell or agree to sell or otherwise dispose of all or a substantial part of the assets of the corporation or any investment or interest in any business enterprise, other than marketable securities disposed of in the ordinary course of the corporation's activities. Form 990, Part VI, Section B, line 11b The internally prepared IRS Form 990 is reviewed and approved by an outside accounting firm. A copy of the Form 990 is provided to the Board of Directors prior to the filing of the return. Any questions or comments are addressed by explanation or a change to the form. Form 990, Part VI, Section B, line 12c Annually, the Secretary of Baptist Health Deaconess LLC. (BHD) sends out a Conflict of Interest questionnaire to each of the officers and directors serving on the Board of Baptist Health Deaconess Medical Group, Inc. (BHDMG). After completion, they are returned to the Secretary and reviewed by the Board or the Governance Effectiveness Committee for any potential conflicts. A conflict of interest is any circumstance, relationship (financial or otherwise), activity or decision (made in the course of governance, management or professional responsibilities or otherwise) that adversely influences or appears to adversely influence the ability of a Covered Person to: 1) make objective decisions on behalf of BHDMG and/or 2) act in the best interests of BHDMG in a manner consistent with the tax-exempt purposes of BHDMG. The Board or Committee will determine by a majority vote of disinterested directors whether the disclosed financial or special interest may result in a conflict of interest. Form 990, Part VI, Section B, line 15 The President of Baptist Health Deaconess Medical Group Inc. through 12/16/2022 was not an employee of and was not compensated by Baptist Health Deaconess Medical Group, Inc., but was an employee of and was compensated by Baptist Health Deaconess Madisonville, Inc., an affiliated tax-exempt 501(c)(3) organization. No other officers of the corporation were compensated by a related entity. The Baptist Health Deaconess Medical Group Inc. physician compensation model is designed to comply with applicable laws and regulations and includes terms which are commercially reasonable and which do not exceed fair market value as determined by independent compensation valuators. The organization makes every effort to ensure that the compensation of all employees is reasonable and appropriate for the value of the services received by the organization. Form 990, Part VI, Section C, line 19 The organization will provide any requested documents open to public inspection upon request. Form 990, Part XI, line 9: Physician Entity Funding -1,535,989. Baptist Health Deaconess Madisonville Inc 900 Hospital Drive Madisonville KY 42431 610654587 Hospital KY 501(c)(3) Line 3 Baptist Health Deaconess LLC 1 Baptist Health Deaconess Madisonville Foundation Inc 900 Hospital Drive Madisonville KY 42431 472893430 Fundraising KY 501(c)(3) Line 12a Baptist Health Deaconess LLC 1 Baptist Health Deaconess LLC 900 Hospital Drive Madisonville KY 42431 872361058 Management KY N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 Baptist Health Deaconess Madisonville Inc K 2879954 Cost Baptist Health Deaconess Madisonville Inc R 19933710 Cost Baptist Health Deaconess Madisonville Inc Q 2396603 Cost