Attach to Form 990 or Form 990-EZ.
See separate instructions.| (i) Name of supported organization |
(ii) EIN |
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) |
(iv) Is the organization in col. (i) listed in your governing document? |
(v) Did you notify the organization in col. (i) of your support? |
(vi) Is the organization in col. (i) organized in the U.S.? |
(vii) Amount of support? |
|||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| (1)
BAPTIST HEALTH CARE FOUNDATION INC |
590192265 | 07 | Yes | Yes | Yes | 0 | |||
| (2)
BAPTIST HOSPITAL INC |
590657322 | 03 | Yes | Yes | Yes | 0 | |||
| (3)
ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS INC |
631143638 | 03 | Yes | Yes | Yes | 0 | |||
| (4)
JAY HOSPITAL INC |
592425149 | 03 | Yes | Yes | Yes | 0 | |||
| (5)
LAKEVIEW CENTER INC |
590737872 | 09 | Yes | Yes | Yes | 0 | |||
| (6)
THE BAPTIST MANOR INC |
592455515 | 09 | Yes | Yes | Yes | 0 | |||
| Total | 0 | ||||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public Support. Subtract line 5 from line 4. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public Support (Subtract line 7c from line 6.) | ||||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | ||||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | ||||||




| Facts And Circumstances Test |
|---|
| Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990 REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11 | AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. 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 PROVIDED ELECTRONICALLY TO 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. |
| MONITORING OF CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS AND OFFICERS RECEIVE CORRESPONDENCE EACH YEAR THAT MUST BE COMPLETED AND SIGNED. THE CORRESPONDENCE INCLUDES A CONFLICTS OF INTEREST QUESTIONNAIRE. 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. |
| COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION COMMITTEE OF THE ORGANIZATION'S BOARD UTILIZES INDEPENDENT COMPENSATION STUDIES THAT REFLECT THE CURRENT MARKET VALUE OF SPECIFIC KEY MANAGMENT POSITIONS AS BENCHMARK DATA. ALL COMPENSATION OF KEY INDIVIDUALS MUST BE APPROVED BY THE COMPENSATION COMMITTEE. |
| AVAILABILITY OF DOCUMENTS | FORM 990, PART VI, SECTION C, LINE 19 | 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. |
| CHANGES IN NET ASSETS | FORM 990, PART XI, LINE 5 | Change in minimum pension liability ($1,028,806) Unrealized losses on investments $ 74,259 Transfer of Assets $2,447,478 Book-to-tax differences - joint venture $ 156,322 Other ($ 114,175) ------------ $1,222,434 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:GARY LOUIS BEMBRY TITLE:SENIOR VP HOURS:40 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MARK FAULKNER TITLE:SENIOR VP HOURS:40 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ROBERT HARRIMAN TITLE:SENIOR VP HOURS:40 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:KENT SKOLROOD TITLE:SENIOR VP HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:AL STUBBLEFIELD TITLE:CEO HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:KERRY VERMILLION TITLE:CFO HOURS:30 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DAVID WILDERBRANDT TITLE:SENIOR VP HOURS:40 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:SHERRY HARTNETT TITLE:VICE PRESIDENT HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ROBERT JOHNSON TITLE:VICE PRESIDENT HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ELEANOR MCGEE TITLE:VICE PRESIDENT HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MICHAEL OLEKSYK, M.D. TITLE:VICE PRESIDENT HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JOHN PORTER TITLE:VICE PRESIDENT HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DAVID SJOBERG TITLE:VICE PRESIDENT HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ANDREW TERRY TITLE:VICE PRESIDENT HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:WANDA KAYE TILLERY TITLE:VICE PRESIDENT HOURS:10 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DENNIS WADE TITLE:VICE PRESIDENT HOURS:10 |
| Software ID: | |
| Software Version: |
|
Affiliated Group Business Name:
LAKEVIEW CENTER INC
Address. Either US or Foreign Type:
1221 W LAKEVIEW AVENUE
PENSACOLA, FL325011836 EIN:
59-0737872
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
1,472
Total Lobbying Expenditures:
1,472
Other Exempt Purpose Expenditures:
146,112,387
Total Exempt Purpose Expenditures:
146,113,859
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
ANDREWS-PAULOS RESEARCH & ED
Address. Either US or Foreign Type:
1040 GULF BREEZE PARKWAY
GULF BREEZE, FL32561 EIN:
26-3263612
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
1,522,547
Total Exempt Purpose Expenditures:
1,522,547
Lobbying Nontaxable Amount:
226,127
Grassroots Nontaxable Amount:
56,532
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
BAPTIST HEALTH CARE CORPORAT
Address. Either US or Foreign Type:
PO BOX 17500
PENSACOLA, FL325227500 EIN:
59-2425151
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
193,298
Total Lobbying Expenditures:
193,298
Other Exempt Purpose Expenditures:
36,553,091
Total Exempt Purpose Expenditures:
36,746,389
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
BAPTIST HEALTH CARE FOUNDATI
Address. Either US or Foreign Type:
PO BOX 17500
PENSACOLA, FL325227500 EIN:
59-0192265
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
2,051,812
Total Exempt Purpose Expenditures:
2,051,812
Lobbying Nontaxable Amount:
252,591
Grassroots Nontaxable Amount:
63,148
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
BAPTIST HOSPITAL INC
Address. Either US or Foreign Type:
PO BOX 17500
PENSACOLA, FL325227500 EIN:
59-0657322
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
14,320
Total Lobbying Expenditures:
14,320
Other Exempt Purpose Expenditures:
393,775,723
Total Exempt Purpose Expenditures:
393,790,043
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
CMHC HERNANDEZ HOUSE INC
Address. Either US or Foreign Type:
1221 W LAKEVIEW AVENUE
PENSACOLA, FL325011836 EIN:
59-2041794
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
52,211
Total Exempt Purpose Expenditures:
52,211
Lobbying Nontaxable Amount:
10,442
Grassroots Nontaxable Amount:
2,611
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
ESCAMBIA COUNTY ALABAMA COMM
Address. Either US or Foreign Type:
PO BOX 17500
PENSACOLA, FL325227500 EIN:
63-1143638
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
7,608
Total Lobbying Expenditures:
7,608
Other Exempt Purpose Expenditures:
21,357,086
Total Exempt Purpose Expenditures:
21,364,694
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
JAY HOSPITAL INC
Address. Either US or Foreign Type:
PO BOX 17500
PENSACOLA, FL325227500 EIN:
59-2425149
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
16,924,421
Total Exempt Purpose Expenditures:
16,924,421
Lobbying Nontaxable Amount:
996,221
Grassroots Nontaxable Amount:
249,055
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
LAKEVIEW PLACE INC
Address. Either US or Foreign Type:
1221 W LAKEVIEW AVENUE
PENSACOLA, FL325011836 EIN:
59-2804577
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
79,956
Total Exempt Purpose Expenditures:
79,956
Lobbying Nontaxable Amount:
15,991
Grassroots Nontaxable Amount:
3,998
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
LAKEVIEW VILLA INC
Address. Either US or Foreign Type:
1221 W LAKEVIEW AVENUE
PENSACOLA, FL325011836 EIN:
59-2842486
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
151,576
Total Exempt Purpose Expenditures:
151,576
Lobbying Nontaxable Amount:
30,315
Grassroots Nontaxable Amount:
7,579
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
THE BAPTIST MANOR INC
Address. Either US or Foreign Type:
PO BOX 17500
PENSACOLA, FL325227500 EIN:
59-2455515
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
14,370,634
Total Exempt Purpose Expenditures:
14,370,634
Lobbying Nontaxable Amount:
868,532
Grassroots Nontaxable Amount:
217,133
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|