TY 2017 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) A Hugh Greene President	0.5 ................. 39.5	X	X	1,626,899	55,811
(2) Christina H Bryan Chairman	0.5 ................. 0	X	X	0	0
(3) James McManemon Secretary/Treasurer	0.5 ................. 0	X	X	0	0
(4) Jon C Lasserre Vice Chairman	0.5 ................. 0	X	X	0	0
(5) Michael M Bell Vice Chairman	0.5 ................. 0	X	X	0	0
(6) Brandy B Carvalho Director	0.1 ................. 0	X		0	0
(7) Donna L VanPuymbrouck Director	0.1 ................. 0	X		0	0
(8) Gerald R Burford MD Director	0.1 ................. 0	X		0	0
(9) Gregory N Smith MD Director	0.1 ................. 0	X		0	0
(10) Janice Ancrum Director	0.1 ................. 0	X		0	0
(11) Jodi H Henson Director	0.1 ................. 0	X		0	0
(12) Karen Hackett Director	0.1 ................. 0	X		0	0
(13) Robert Ferreira Director	0.1 ................. 0	X		0	0
(14) William H Gower Director	0.1 ................. 0	X		0	0
(15) Willie J Scott Director	0.1 ................. 0	X		0	0
(16) John F Wilbanks Executive Vice President	0.5 ................. 39.5		X	9,172,754	127,484
(17) Scott Wooten SVP/CFO	0.5 ................. 39.5		X	830,219	193,318

(A) Name and business address	(B) Description of services	(C) Compensation
Alcon Surgical 6201 South Freeway Ft Worth,TX761342001	Medical Supply Distributor	10,534,979
Brasfield & Gorrie LLC 4601 Touchton Rd Bldg 300 Suite 3190 Jacksonville,FL32246	Construction	7,664,350
Owens & Minor Inc 8489 Westside Industrial Dr Jacksonville,FL32219	Medical Supply Distributor	2,382,039
McKesson Corporation 4345 Southpoint Blvd 110 Jacksonville,FL32216	Medical Supply Distributor	1,621,533
Zimmer US Inc 1520 Tradeport Dr Jacksonville,FL32218	Medical Supply Distributor	1,304,283
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 61

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

Baptist Medical Center of Nassau Inc

Employer identification number

59-3234721

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Baptist Medical Center of Nassau Inc

Employer identification number

59-3234721

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	2,584,655	1,476,134	1,253,224	636,768	212,505
b	Contributions ...	514,000	935,480	136,103	666,301	401,162
c	Net investment earnings, gains, and losses	105,374	176,358	88,832	-33,972	23,860
d	Grants or scholarships ...		0	0	0	0
e	Other expenditures for facilities and programs ...	52,584	3,317	2,025	15,873	759
f	Administrative expenses ....		0	0	0	0
g	End of year balance ......	3,151,445	2,584,655	1,476,134	1,253,224	636,768

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

1.66 %

Permanent endowment SchDMd Bullet

89.09 %

Term endowment SchDMd Bullet

9.25 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	477,107		477,107
b	Buildings ....	60,472,074	19,044,769	41,427,305
c	Leasehold improvements	422,185	107,046	315,139
d	Equipment ....	36,502,011	27,078,535	9,423,476
e	Other .....	3,934,026	1,242,292	2,691,734
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				54,334,761

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)Advances to affiliated organizations				55,309,203
(2)Interest in Net Assets of Baptist Health System Foundation, Inc.				3,390,372
(3)Prepaid bonds cost of issuance				0
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				58,699,575

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	4,660,629
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Schedule D, Part V, Line 4 Intended uses of endowment funds	Baptist Medical Center of Nassau Inc. (BMCN) has temporary restricted quasi-endowment funds and permanently restricted endowment funds that are held and administered by its related fundraising affiliated organization, Baptist Health System Foundation, Inc. Annually, 5% of the combined endowment corpus and accumulated investment earnings are available for capital projects of BMCN.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	With few exceptions, Baptist Medical Center of Nassau, Inc. is no longer subject to examinations by major tax jurisdictions for years ended September 30, 2015 and prior. Management does not believe there are any material uncertain positions.

Schedule D (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Baptist Medical Center of Nassau Inc

Employer identification number

59-3234721

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

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) . . .	0	0	3,229,265	0	3,229,265	5.09 %
b	Medicaid (from Worksheet 3, column a) . . . . .	0	0	6,884,128	7,843,620	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	0	0	0	0	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	10,113,393	7,843,620	3,229,265	5.09 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	0	0	90,253	0	90,253	0.14 %
f	Health professions education (from Worksheet 5) . . .	0	0	0	0	0	0 %
g	Subsidized health services (from Worksheet 6) . . . .	0	0	0	0	0	0 %
h	Research (from Worksheet 7) .	0	0	0	0	0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	0	0	266,220	0	266,220	0.42 %
j	Total. Other Benefits . .	0	0	356,473	0	356,473	0.56 %
k	Total. Add lines 7d and 7j .	0	0	10,469,866	7,843,620	3,585,738	5.65 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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
1	Physical improvements and housing
2	Economic development	1
3	Community support	2
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	5
7	Community health improvement advocacy	8
8	Workforce development	2
9	Other	2
10	Total	20	0	0	0

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

2,790,735

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

26,286,073

Enter Medicare allowable costs of care relating to payments on line 5.....

34,466,344

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-8,180,271

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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) 2019

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?1Name, 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)
1	Baptist Medical Center of Nassau Inc 1250 S 18th St Fernandina Beach,FL32034 www.baptistjax.com 4355	X	X	X

Schedule H (Form 990) 2019

Page 4

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)

	Baptist Medical Center of Nassau Inc
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

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

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 .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

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. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): https://www.baptistjax.com/about-us/social-responsibility/assessing-community-health-needs

Other website (list url): http://www.hpcnef.org/jacksonville-nonprofit-hospital-partnership-community-health-needs-assessment/

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): https://www.baptistjax.com/about-us/social-responsibility/assessing-community-health-needs

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on 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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Baptist Medical Center of Nassau Inc
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0%
and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

https://www.baptistjax.com/patient-info/financial-assistance

The FAP application form was widely available on a website (list url):

https://www.baptistjax.com/patient-info/financial-assistance

A plain language summary of the FAP was widely available on a website (list url):
https://www.baptistjax.com/patient-info/financial-assistance

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	Baptist Medical Center of Nassau Inc
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Baptist Medical Center of Nassau Inc
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

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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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
Schedule H, Part V, Section B, Line 3E	The significant health needs of the community are identified on our CHNA. The methodology to determine the significance of the community health needs and prioritization of the health needs are also described in our CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Baptist Medical Center of Nassau, Inc.. Community health needs were identified by collecting and analyzing data and information from multiple quantitative and qualitative sources. Considering information from a variety of sources is important when assessing community health needs, to ensure the assessment captures a wide range of facts and perspectives and to assist in identifying the highest-priority health needs. Statistics for numerous health status, health care access, and related indicators were analyzed, including from local, state, and federal public agencies, local community service organizations, and hospital members of The Partnership. Comparisons to benchmarks were made where possible. Details from the quantitative data are presented in the CHNA Data and Analysis section of this report, followed by a review of the principal findings of health assessments and reports conducted by other organizations in the community in recent years. Input from 195 persons representing the broad interests of the community was taken into account via 12 key informant interview sessions, nine focus groups, and four town hall meetings. Interviews included: individuals with special knowledge of or expertise in public health; the local public health department; agencies with current data or information about the health needs of the community; and leaders, representatives, and members of medically underserved, lowincome, and minority populations, and populations with chronic disease needs. Duval County Department of Health staff, working under subcontract with Verite, conducted and summarized results from the key informant interviews and community meetings.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - Baptist Medical Center of Nassau, Inc.. 11 hospitals: (Baptist Medical Center Jacksonville, Baptist Medical Center South, Wolfson Children's Hospital, Baptist Medical Center of the Beaches, Inc., Baptist Medical Center of Nassau, Inc., Brooks Rehabilitation Hospital, Mayo Clinic Florida, St. Vincent's Medical Center Riverside, St. Vincent's Medical Center South, St. Vincent's Medical Center Clay and UF Health Jacksonville)
Schedule H, Part V, Section B, Line 7 Facility , 1	Facility , 1 - Baptist Medical Center of Nassau, Inc.. Public release was held April 28, 2016 with all health system CEOs presenting the assessment methodology, the needs identified in the assessment and the needs prioritized by each hospital. The public release was attended by approximately 75 people including media representatives. Newspaper articles and radio and television stories reported on the assessment and informed community members where they could find each hospital's assessment and implementation plans. Link to story in the Florida Times-Union - http://jacksonville.com/news/metro/2016-04-28/story/what-are-jacksonvilles-biggest-health-needs-these-hospitals-have-some.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Baptist Medical Center of Nassau, Inc.. Access: To address this need, Baptist Medical Center Nassau will undertake the following program initiatives: Assure that the hospital's financial assistance programs comply fully with state and federal requirements, Partner with Barnabas to provide access to care for diabetes and mental illness for people with low incomes, Partner with Nassau County Council on Aging to provide transportation for low-income and indigent individuals to reach medical appointments, Provide health screenings in low income, African American and Hispanic communities and follow-up on abnormal results with action items including connection to a medical home. Planned Collaborations: In implementing the above initiatives, Baptist Medical Center Nassau anticipates collaborating with the following organizations: Barnabas Center, Inc., Nassau County Council on Aging, Faith-based and community organizations, and Others. Anticipated Impacts: Improved awareness of and access to health care to the under/uninsured population in Nassau County which has a low supply of primary care physicians, dentists, and mental health providers and Reduced transportation barriers to medical appointments. Evaluation Plan: Baptist Medical Center Nassau will assess the impact of the above initiatives as part of the community health needs assessment it will conduct in 2018. Track the number of patients served through funding provided to Barnabas and patients' health outcomes, Track the number of individuals transported to medical appointments by the Council on Aging of Nassau County, Track the number of individuals screened at community events and the number requiring follow up, and the number of patients requiring follow up who are connected to care through Barnabas Center. BMCN staff participates in Nassau NCHIC meetings and Inter-Faith Health Ministry. Participated in the Nassau Council on Aging on September 14, 2018. 200 screenings completed on participants to include blood pressure, body mass index, blood glucose, cholesterol, and bone density. In partnership with Barnabas, established and implemented procedures to refer uninsured patients who need primary care services Strategic Investments: Barnabas provides primary, specialty and dental care to adults without insurance in Nassau County. 785 unduplicated patients received primary care for a total of 2,576 visits. 24 patients received mental health and/or substance abuse counseling (53 in FY17). 663 patients received dental care (768 in FY17) for a total of 1,962 visits (2,484 in FY17). 267 patients were provided gynecological exams or mammograms (367 in FY17). Provided funding to Vision Is Priceless, which provided vision screenings to 1,195 children and 54 adults in Nassau County. 83 adults in Nassau County received comprehensive eye exams, and 76 received glasses. Provided funding to Nassau County Council on Aging to provide transportation to indigent residents. 477 trips to medical appointments were provided. Cancer: To address this need, Baptist Medical Center Nassau will undertake the following program initiatives: Provide education and screenings in low income, African American and Hispanic communities and follow-up on abnormal results with action items including connection to a medical home. Offer prostate specific antigen (PSA) screenings at community events. Follow up phone calls will be made to patients with abnormal results to encourage patients to visit their primary care physician or connect them to a free or low cost clinic, Increase the amount of inpatient and outpatient referrals to Northeast Florida AHEC for smoking cessation by educating Baptist Primary Care physicians about the referral process, Train Baptist Health Social Responsibility PRN registered nurses in motivational interviewing to identify and refer people who are interested in quitting smoking to AHEC for classes. Work with NACDAC to educate teens on the importance of HPV vaccine in preventing cervical cancer, Facilitate classes on the dangers of tobacco products and smoking cessation resources in middle and high schools, Provide information at health fairs and other community events about the health risks associated with smoking and resources for smoking cessation, Register eligible women at community events for mammograms from the Florida Breast and Cervical Cancer Early Detection Program offered through the Florida Department of Health, Offer community education sessions on various forms of cancer. Planned Collaborations: In implementing the above initiatives, Baptist Medical Center Nassau anticipates collaborating with community organizations, including: Council on Aging of Nassau County, NACDAC , Northeast Florida AHEC, Florida Department of Health in Nassau County, Baptist MD Anderson Cancer Center, Baptist Primary Care, Faith based and community organizations, and Others. Anticipated Impacts: Increased number of cancer screenings in the community from the baseline of being the leading cause of death in Nassau County at a rate of 187, compared to Florida which is at a rate of 159.6, Increased awareness regarding lifestyle and other risks associated with developing cancer, Increased participation in smoking cessation programs, More young adults will be educated on the HPV vaccine, More middle and high school students will be educated on the dangers of smoking and smokeless tobacco. Evaluation Plan: Baptist Medical Center Nassau will assess the impact of the above initiatives as part of the community health needs assessment it will conduct in 2018. Track the number of men that have PSA screenings and the number of abnormal tests requiring follow up, Track the number of youth who participate in tobacco prevention classes, Track the number of women referred to the Florida Breast and Cervical Cancer Early Detection Program and the number who receive mammography screenings at Baptist Medical Center Nassau, Analyze survey results from participants at health education sessions to measure knowledge gains and planned lifestyle changes, Utilize AHEC's state-wide database to track by referral source the number of referrals received, the number of people who attend classes, the number of people who complete classes and the number of people who quit smoking. Program Results: Active representation at NCHIC, CHIP and Interfaith Health Ministry meetings. Strategic Investments: Barnabas provides primary, specialty and dental care to adults without insurance in Nassau County. 785 unduplicated patients received primary care for a total of 2,576 visits. 267 patients were provided gynecological exams or mammograms (367 in FY17). 249 patients participated in smoking cessation classes and 30 stopped smoking.
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - Baptist Medical Center of Nassau, Inc.. Health Disparities: To address this need, Baptist Medical Center Nassau will undertake the following program initiatives: Provide education and screenings in low income, African American and Hispanic communities and follow-up on abnormal results with action items including connection to a medical home, Partner with Barnabas to provide access to care for diabetes and mental illness for people with low incomes, Offer 8 Weeks to Healthy Living program through faith-based and community organizations, Train Baptist Health Social Responsibility PRN team members in motivational interviewing to identify and refer people who are interested in quitting smoking to AHEC for classes and support, Partner with Northeast Florida AHEC to provide smoking cessation classes in the community in low-income neighborhoods, Facilitate classes on the dangers of tobacco products and smoking cessation resources in middle and high schools, Partner with Barnabas to provide mammograms for women without insurance, Register eligible women at community events for mammograms from the Florida Breast and Cervical Cancer Early Detection Program offered through the Florida Department of Health, Implement training for community members in low-income areas on the warning signs of mental illness in adults and children and how to intervene when necessary. Planned Collaborations: In implementing the above initiatives, Baptist Medical Center Nassau anticipates collaborating with community organizations, including: Council on Aging of Nassau County, Barnabas Center, Inc., Boys and Girls Clubs of Nassau County, NACDAC Teens for Change and other youth organizations, Starting Point Behavioral Healthcare, Mental Health America, Florida Department of Health - Nassau County, Faith-based and community organizations, and Others. Anticipated Impacts: Improved awareness of and access to healthcare professionals to the under/uninsured population from the baseline of 12 percent of the community living in poverty, Improved awareness and increased number of people participating in tobacco cessation programs in the community, Increased number of mammography screenings in the community, Increased awareness of mental illness and decrease stigma associated with it. Evaluation Plan: Baptist Medical Center Nassau will assess the impact of the above initiatives as part of the community health needs assessment it will conduct in 2018. Track the number of individuals screened at community events and the number requiring follow up, Track the number of patients served through financial support of local healthcare clinics for low-income individuals, Track the participants in the 8 Weeks to Healthy Living Program and record outcomes and improvements in health screening categories, Utilize AHEC's state-wide database to track by referral source the number of referrals received, the number of people who attend classes, the number of people who complete classes and the number of people who quit smoking, Measure knowledge gains in health education sessions, Track the number of mammography screenings and the number of people requiring follow up at Barnabas, Track the number of women referred to the Florida Breast and Cervical Cancer Early Detection Program and the number that receive mammography screenings at Baptist Medical Center Nassau, Measure participants' knowledge gains after attending Adult and Youth Mental Health First Aid trainings. Program Results: Provided a class on the dangers of tobacco products and smoking cessation resources for high school students at the Boys and Girls Clubs, Provided a class on Sexually Transmitted Infections for high school students at the Boys and Girls Clubs. Strategic Investments: Barnabas provides primary, specialty and dental care to adults without insurance in Nassau County. 785 unduplicated patients received primary care (1,242 in FY 17) for a total of 2,576 visits (4,074 in FY17). 24 patients received mental health and/or substance abuse counseling. 663 patients received dental care for a total of 1,962 visits. 267 patients were provided gynecological exams or mammograms, Provided funding to Nassau County Council on Aging to provide transportation to indigent residents. 477 trips to medical appointments were provided. 52% were senior citizens, Provided funding to the Boys and Girls Club to educate young ppl about health promotion through Tipping the Scale program, Provided funding to Vision Is Priceless, which provided vision screenings to 1,195 children and 54 adults in Nassau County. 83 adults in Nassau County received comprehensive eye exams, and 76 received glasses. Mental Health: To address this need, Baptist Medical Center Nassau will undertake the following program initiatives: Partner with United Way of Northeast Florida to develop and implement a community-wide effort to reduce stigma associated with mental illness and increase access to care. Baptist Health has trained facilitators who will implement training for community members on the warning signs of mental illness and what to do to help young people, including the Youth Mental Health First Aid training, Baptist Health trained facilitators will implement training for community members on the warning signs or mental illness and what to do to help adults, including the Adult Mental Health First Aid training, Partner with faith-based organizations to offer Faith and Mental Health education, Train adults in the community on recognizing the warning signs of mental illness and suicide among youth, Collaborate with other community providers to develop integrated pediatric care clinic that will provide additional mental health resources in the community. Planned Collaborations: In implementing the above initiatives, Baptist Medical Center Nassau anticipates collaborating with community organizations, including: Starting Point Behavioral Healthcare, Mental Health America, United Way of Northeast Florida, and Others Anticipated Impacts: Increased access to mental health services from the baseline of Nassau County having the highest age- adjusted rate of mortality from suicide in Northeast Florida. At 20.6 the rate is well above the Florida average of 13.8, Reduction in stigma associated with mental illness by training 10,000 people in the community Mental Health First Aid classes. Evaluation Plan: Baptist Health Medical Center Nassau will assess the impact of the above initiatives as part of the community health needs assessment it will conduct in 2018, An evaluation of mental health awareness, attitudes and access will be included in the United Way effort. The number of participants in the Youth Mental Health First Aid eight-hour training will be tracked and knowledge gains measured through surveys, Track the number of participants at the Faith and Mental Health Conference, Track the number of uninsured/underinsured children receiving services at the integrated care clinic, Survey participants in training on youth mental illness and suicide and measure knowledge gains. Monitor admissions in emergency department related to mental health, Monitor rates of suicide in the community. Program Results: 117 people were trained in Adult Mental Health First Aid by Starting Point Behavioral Health (200 in FY17). Strategic Investments: Barnabas provides primary, specialty and dental care to adults without insurance in Nassau County. 785 unduplicated patients received primary care for a total of 2,576 visits. 24 patients received mental health and/or substance abuse counseling (77 in FY17), Provided funding to Starting Point Behavioral Health to train residents in Nassau and Duval County in Mental Health First Aid. 429 people received training and were certified as Mental Health First Aiders (262 in FY17), Funded Starting Point Care Coordinator at B-Nassau Emergency Department. 176 patients were referred of which 65 received care coordination services and 10 received substance abuse and/or mental health treatment, Provided funding to Mental Health America of Northeast Florida to increase awareness of and advocacy for additional mental health services in our community resulting in increased funding and legislation that expands the capacity of mental health services in northeast Florida, Provided funding to the Health Planning Council to coordinate Mental Health First Aid trainings in Northeast Florida. 2,476 people were trained in 2018, Provided funding to The Partnership: For Mental Health to reduce stigma and increase access to mental health care in Northeast Florida.
Schedule H, Part V, Section B, Line 11 Facility , 3	Facility , 3 - Baptist Medical Center of Nassau, Inc.. No entity can address all of the health needs present in its community. Baptist Medical Center Nassau is committed to serving the community by adhering to its mission, using its skills and capabilities, and remaining a strong organization so that it can continue to provide a wide range of community benefits. This implementation strategy does not include specific plans to address the following health priorities that were identified in the 2015 Community Health Needs Assessment: Alcohol/Substance Abuse. Baptist Medical Center Nassau does not anticipate implementing additional initiatives to address identified alcohol and substance abuse needs. The hospital does not have sufficient resources to effectuate a significant change in this area and will focus on other significant community health needs. Dental Care. Baptist Medical Center Nassau supports Barnabas Center which provides dental care. Due to resource constraints and the availability of other resources in the community, the hospital will focus on other significant community health needs. Maternal and Child Health. Baptist Medical Center Nassau does not anticipate implementing additional initiatives to address identified maternal and child health needs. Baptist Health is comprised of THE PLAYERS Center for Child Health which addresses maternal and child health across the five-county region. Baptist Nassau will continue offering many free classes for expecting mothers that are open to community members. Due to resource constraints and the availability of other resources in the community the hospital will focus on other significant community health needs. Nutrition, Physical Activity, and Obesity. Baptist Medical Center Nassau supports the Nassau County Council on Aging to provide transportation to seniors for healthy meals and activities provided through the senior center. The hospital does not have sufficient resources to effectuate a significant change in this area and will focus on other significant community health needs. Transportation. Baptist Medical Center Nassau supports the Nassau County Council on Aging to provide transportation for seniors to attend doctor appointments and other errands. The hospital does not have expertise in this area nor sufficient resources to effectuate a significant change. Accordingly, the hospital will focus on other significant community health needs.
Schedule H, Part V, Section B, Line 20 Facility , 1	Facility , 1 - Baptist Medical Center of Nassau, Inc.. Charity or Discounted Care posters are located in the Emergency Rooms and Patient Admission areas to inform patients of financial assistance and who to contact regarding financial assistance. AT PATIENT ACCESS POINTS, "GUIDELINES FOR CHARITY CARE ELIGIBILITY" CARDS ARE PROVIDED THAT CONTAIN FINANCIAL DISCOUNT AND CHARITY CARE INFORMATION. THIS INCLUDES A GENERAL CHART OF ELIGIBLE INCOME LEVELS AND ENCOURAGES PATIENTS TO SPEAK WITH OUR PATIENT FINANCIAL ADVOCATES TO ARRANGE A FINANCIAL EVALUATION. All billing statements conspicuously display the phone number, address, and website which directs patients to our financial assistance advocates and contains all financial assistance information. ALL APPLICANTS FOR FINANCIAL ASSISTANCE ARE MAINTAINED WHETHER OR NOT THE PATIENT QUALIFIES. All attempts to contact the patient are exhausted before sending to collections. All patients are sent through a system that analyses the financial position of the individual. All patients who are scored a certain number in accordance with our policy and who have not already applied for financial assistance are automatically deemed eligible for financial assistance.

Schedule H (Form 990) 2019

Page 9

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?0
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

Page 10

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 VI, Line 7 State Filing of the Community Benefit Report	Baptist Health System, Inc. (BHS), parent company of the filing organization, is located within the northeast Florida quadrant. There are no requirements for state filing in Florida of the annual community benefit report. However, BHS does publish the report and it is available upon request or at the www.baptistjax.com website.
Schedule H, Part II, Line 2 Economic Development	Economic Development-New employment opportunities were provided to 3 teenagers 16 - 18 years old after successful completion of an eight-week job readiness training program (4 in FY17). Teens are provided exposure to the scope of practice for one of their top three areas of career interest at our flagship hospital system. The teens come from low-income neighborhoods and attend school with very low graduation rates. The summer employment opportunity provides teens exposure to real-life careers which motivates them to prepare appropriately for life after high school.
Schedule H, Part II, Line 3 Community Support	Community Support- 13 employees volunteered their time to provide one-to-one mentoring for high school students each week. The students who participate in the program are from our most vulnerable communities and low income families. They also attend local schools with low graduation rates. In this career guidance mentoring program, mentors introduce students to various careers in healthcare. In addition, they serve as supporters and encouragers for teens as they navigate the challenges of adolescence. Summer Youth Volunteer Program - Baptist Health offers opportunities for approximately 24 young people ages 16-17 to volunteer during the summer to assist in the selection of a career and as an opportunity to serve others (17 in FY17). Baptist employees supervise the volunteers giving them direction and support during their service.
Schedule H, Part II, Line 6 Coalition Building	Coalition Building - Jacksonville Nonprofit Hospital Partnership came together to develop a multi-hospital system collaborative community health needs assessment. The Partnership is a network of five health systems that are a shared voice to improve population health by eliminating the gaps that prevent quality, integrated health care and to improve access to resources that support a healthier lifestyle. During FY 2016, the Partnership initiated a collaboration to reduce stigma and crises related to mental illness through a community implementation of Mental Health First Aid, a program recognized by the Substance Abuse and Mental Health Services Administration. Nassau Community Health Improvement Coalition - BAPTIST NASSAU IS A MEMBER OF THE NASSAU COMMUNITY HEALTH IMPROVEMENT COALITION (NCHIC). NCHIC is a coalition of LOCAL AGENCIES, ORGANIZATIONS, COMMUNITY GROUPS, AND COMMUNITY MEMBERS WITH THE COMMON GOAL OF IMPROVING THE OVERALL HEALTH OF THE NASSAU COUNTY COMMUNITY. THE COALITION WORKS TO IMPROVE THE LEVEL OF HEALTH IN NASSAU COUNTY THROUGH AWARENESS, EDUCATION, PARTNERSHIP, PREVENTION, SERVICE DELIVERY, AND POLICY DEVELOPMENT SO THAT INDIVIDUALS ACHIEVE THEIR POTENTIAL TO LIVE HEALTHY, ACTIVE LIFESTYLES. Nassau County School Health Advisory Council - Wolfson Children's Hospital participates inThe Nassau County School District's advisory council that meets to implement a coordinated school health program. The advisory council advises and supports the schools' efforts to assess their needs and to design programs to help children develop the knowledge, skills, and attitudes they need to become healthy, productive citizens. Uninsured Working Group is a consortium of organizations working together to improve access to care through enrollment in health insurance programs or increased provider availability. Wolfson Children's Hospital and Baptist Health are active members of the Uninsured Working Group. Nassau Interfaith Health Ministry (IHM) brings healthcare professionals and the faith community together to: Strengthen each church's efforts to minister to the health needs of their members and the greater community. Address health and health care in a holistic way, attending to body, mind, and spirit. Create a bridge between Medicine and Religion on a community-wide basis.
Schedule H, Part II, Line 7 Community Health Improvement Advocacy	Community Health Improvement Advocacy- CHNA Priorities Access to Care and Health Disparities - Baptist Medical Center Nassau partners WITH BARNABAS CENTER located in Nassau CountyTO PROVIDE ACCESS TO PRIMARY HEALTH CARE FOR people who are UNINSURED AND UNDERINSURED. In addition to providing funding for Barnabas Center operations, Baptist Medical Center Nassau employs the physician serving as medical director for Barnabas Center and provides lab and other medical services in-kind for Barnabas Center. In addition, Baptist Nassau PARTNERS WITH THE NASSAU COUNTY COUNCIL ON AGING TO SUPPORT THE PROVISION OF TRANSPORTATION PROGRAM FOR THE ELDERLY IN A COMMUNITY WHERE NO PUBLIC TRANSPORTATION IS AVAILABLE. Baptist Nassau also partners with the Boys and Girls Club of Nassau County to provide positive youth development activities the goals of which are to help students be successful in school and life including on-time graduation from high school addressing economic and educational determinants that result in health disparities. Baptist Nassau partners with Vision is Priceless to provide screenings and exams to under-insured adults and children living in Nassau county. CHNA Priority Mental Health - BAPTIST MEDICAL CENTER Nassau partners with Starting Point Behavioral Health and the Northeast Florida Health Planning Council to provide MENTAL HEALTH FIRST AID training. Mental Health First Aid TEACHES PARTICIPANTS A FIVE-STEP ACTION PLAN TO ASSESS A SITUATION, SELECT AND IMPLEMENT INTERVENTIONS AND SECURE APPROPRIATE CARE FOR THE INDIVIDUAL. BMCN also partners with Starting Point to provide access to treatment for uninsured and underinsured people in Nassau County who are addicted to and abusing substances. BMCN provides funding and referrals for ED patients to receive services with appropriate permission. CHNA Priority Cancer - In addition to providing access to care through a partnership with Barnabas Center, BAPTIST Medical Center NASSAU PARTNERS WITH AHEC to offer smoking cessation classes in the hospital and community. Baptist Medical Center Nassau also partners with the Museum of Science and History to educate adult and youth visitors about health systems and how to be healthy.
Schedule H, Part II, Line 8 Workforce Development	Workforce Development - Workforce Development opportunities were provided to 3 teenagers 16 - 18 years old after successful completion of an eight-week job readiness training program (4 in FY17). Teens are provided exposure to the scope of practice for one of their top three areas of career interest at our flagship hospital system. The teens come from low-income neighborhoods and attend school with very low graduation rates. The summer employment opportunity provides teens exposure to real-life careers which motivates them to prepare appropriately for life after high school. Baptist Medical Center Nassau provided Clinical Education and Training to undergraduate and graduate student interns procuring degrees in nursing, IT, pharmacy, physical therapy and other health care professional provided by Baptist Health clinicians. In FY 18, Baptist Medical Center Nassau provided 182 students (139 in FY17) with 6,103 hours of clinical education supervision (13,292 in FY17).
Schedule H, Part II, Line 9 Other	Other Mental Health First Aid - Baptist Health provided 8-hour certification training in Mental Health First Aid, Youth and Adult, to 191 community members. The AgeWell Institute provided education on various topics to 1,110 people during fiscal year 2018 (550 in FY17).
Schedule H, Part I, Line 6a Community benefit report prepared by related organization	Baptist Health System, Inc.
Schedule H, Part I, Line 7g Subsidized Health Services	There were no physician clinic costs included in the subsidized health services cost.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	0
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	We obtained our cost using our CCA cost accounting system to develop payor-level RCC's which were applied to payor charges to calculate cost.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Patient service revenues are reported at estimated net realizable amounts for services rendered. BHS recognizes patient service revenues associated with patients who have third-party payor coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for charity care, revenue is recognized on the basis of discounted rates in accordance with BHS' policy. Patient service revenues are reduced by the provision for bad debts and accounts receivable are reduced by an allowance for uncollectible accounts. These amounts are based on management's assessment of historical and expected net collections for each major payor source, considering business and economic conditions, trends in health care coverage and other collection indicators. Management regularly reviews collections data by major payor sources in evaluating the sufficiency of the allowance for uncollectible accounts. On the basis of historical experience, a significant portion of BHS' self-pay patients will be unable or unwilling to pay for the services provided. Thus, BHS records a significant provision for bad debts in the period services are provided related to self-pay patients. For receivables associated with patients who have third-party coverage, BHS analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts, if necessary. Accounts receivable are written off after collection efforts have been followed in accordance with BHS' policies.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	The entire provision for bad debts is recorded as a deduction from patient service revenues. None of the provision is included in the expenses of the Form 990 including Schedule H and the calculation of community benefit.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Baptist Health System, Inc. and Subsidiaries Notes to Consolidated Financial Statements 2. Significant Accounting Policies Net Patient Service Revenues, Accounts Receivable, and Provision for Bad Debts Patient service revenues are reported at estimated net realizable amounts for services rendered. The organization recognizes patient service revenues associated with patients who have third-party payor coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for charity care, revenue is recognized on the basis of discounted rates in accordance with the organization's policy. PATIENT SERVICE REVENUES ARE REDUCED BY THE PROVISION FOR BAD DEBTS AND ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THESE AMOUNTS ARE BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS FOR EACH MAJOR PAYOR SOURCE, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT REGULARLY REVIEWS COLLECTIONS DATA BY MAJOR PAYOR SOURCES IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE ORGANIZATION'S SELF-PAY PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD SERVICES ARE PROVIDED RELATED TO SELF-PAY PATIENTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYSES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORT HAS BEEN FOLLOWED IN ACCORDANCE WITH THE ORGANIZATION'S POLICIES.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Medicare allowable costs of care based on the organization's cost accounting system which is used to determine the amount reported on Line 6. None of the shortfall reported on Line 7 is included in Schedule H, Part I.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	Yes, the organization does have a written debt collection policy. The policy does not specifically address those patients who are known to qualify or have applied for charity care as the organization does not bill these patients. The organization's cost accounting system identifies all patients who have a pending or approved charity application. The organization would only bill the patient if, after multiple attempts to obtain any needed documentation from the patient to complete the charity approval process, the patient was noncompliant.
Schedule H, Part V, Section B, Line 16a FAP website	- Baptist Medical Center of Nassau, Inc.: Line 16a URL: https://www.baptistjax.com/patient-info/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Baptist Medical Center of Nassau, Inc.: Line 16b URL: https://www.baptistjax.com/patient-info/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- Baptist Medical Center of Nassau, Inc.: Line 16c URL: https://www.baptistjax.com/patient-info/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessment	Baptist Health System Inc. (BHS), parent company of the filing organization, is a member of the Jacksonville Community Benefit Partnership that is a collaborative of 5 hospitals who work together to access and address important community health needs. Baptist Health has partnered with 6 faith-based organizations located in vulnerable low-income neighborhoods in Nassau County where a health needs survey is conducted annually. The survey of the members of our faith-based partners is anonymous. In addition, data is gathered from the Northeast Florida Counts website which serves as a source of population data and information about the health status of the community. It gathers information for Baker, Clay, Duval, Flagler, Nassau, St. Johns, and Volusia Counties.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	At patient access points, "Guidelines for Charity Care Eligibility" cards are provided that contains financial discount and charity care information. This includes a general chart of eligible income levels and encourages patients to speak with one of our patient financial advocates to arrange a financial evaluation. The organization sends statements to patients who have applied for charity care but have not provided all the documentation that is required to make a determination; letters are sent by the organization requesting the information to complete their application.
Schedule H, Part VI, Line 4 Community information	Baptist Medical Center of Nassau: Nassau County Nassau County has a total area of 725.86 square miles, of which 651.55 square miles (or 89.76%) is land and 74.30 square miles (or 10.24%) is water, much of it in the Atlantic Ocean. Fernandina Beach is located on Amelia Island, the county's one inhabited island. There are 75,710 people residing in Nassau the county. The racial makeup of the county is 90.02% White, 7.74% Black or African American, 0.43% Native American, 0.46% Asian, 0.03% Pacific Islander, 0.32% from other races, and 1.00% from two or more races. 1.51% of the population are Hispanic or Latino of any race. In the county the population is spread out with 25.00% under the age of 18, 7.20% from 18 to 24, 28.80% from 25 to 44, 26.30% from 45 to 64, and 12.60% who are 65 years of age or older. The median age is 38 years. The median income for a household in the county is $46,022, and the median income for a family was $52,477. Males had a median income of $37,027 versus $25,443 for females. The per capita income for the county is $22,836. About 6.40% of families and 9.10% of the population is below the poverty line, including 10.90% of those under age 18 and 8.90% of those age 65 or over.
Schedule H, Part VI, Line 5 Promotion of community health	Baptist Health System Inc. (BHS), parent company of the filing organization, continues to maintain an open medical staff. A designated Social Responsibility Community Health Board Committee consisting of Northeast Florida residents who also serve on Baptist hospital boards of directors provides direction to the community health work based on the community need within the four county area served by Baptist Health. Baptist Health continues to donate more than $1.9 million to support nonprofit organizations that provide health services to the underserved and low income community. Some of the nonprofit organizations provide primary care for the uninsured and the underinsured. Some provide behavioral health services to families who would not otherwise have access while others provide health services and transportation for the frail elderly.
Schedule H, Part VI, Line 6 Affiliated health care system	Baptist Health System, Inc. (BHS) is the parent affiliate of Baptist Medical Center of Nassau, Inc. (BMCN). The Social Responsibility and Community Health team at BHS coordinates the funding of nonprofit partners for BMCN and works with our employees in facilitating volunteer opportunities across our community. Members of the BMCN Board of Directors also serve on the Social Responsibility and Community Health committee. BMCN works closely with a number of nonprofit partners to meet the community health needs of Nassau County, Florida.

Schedule H (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
Baptist Medical Center of Nassau Inc

Employer identification number
59-3234721

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) BARNABAS CENTER 1303 JASMINE ST STE 101 FERNANDINA BEACH,FL32034	59-2920275	501(c)(3)	91,000	TO SUPPORT COMPREHENSIVE SERVICE CENTER ADDRESSING HUNGER, AFFORDABLE HEALTHCARE, AND PREVENTION OF HOMELESSNESS IN NASSAU COUNTY.
(2) BOYS AND GIRLS CLUB OF NASSAU COUNTY FOUNDATION INC PO BOX 16003 FERNANDINA BEACH,FL32035	59-3672345	501(c)(3)	41,000	TO SUPPORT YOUTH IN NASSAU COUNTY TO IMPROVE THEIR LIVES THROUGH VARIOUS PROGRAMS.
(3) STARTING POINT BEHAVIORAL HEALTHCARE 463142 SR 200 YULEE,FL32097	59-3029469	501(c)(3)	79,300	TO SUPPORT PROGRAMS THAT OFFER AID TO THOSE IN NEED OF MENTAL HEALTH TREATMENT AND SUBSTANCE ABUSE RECOVERY ALTERNATIVES FOR PEOPLE OF ALL AGES.
(4) NASSAU COUNTY ECONOMIC DEVELOPMENT BOARD INC 76346 WILLIAM BURGESS BLVD B101 YULEE,FL32097	59-3293246	501(c)(3)	15,000	TO SUPPORT COMMUNITY ECONOMIC DEVELOPMENT IN NASSAU COUNTY.

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	Annual budgets for community donations are prepared by the hospital organization and approved by Baptist Health System, Inc., parent affiliate of the organization.

Schedule I (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Baptist Medical Center of Nassau Inc

Employer identification number

59-3234721

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1A Hugh Greene President	(i) (ii)	0 ------------- 1,061,599	0 ------------- 535,300	0 ------------- 30,000	0 ------------- 44,450	0 ------------- 11,361	0 ------------- 1,682,710	0 ------------- 0
2John F Wilbanks Executive Vice President	(i) (ii)	0 ------------- 591,945	0 ------------- 196,000	0 ------------- 8,384,809	0 ------------- 116,607	0 ------------- 10,877	0 ------------- 9,300,238	0 ------------- 8,369,809
3Scott Wooten SVP/CFO	(i) (ii)	0 ------------- 602,049	0 ------------- 213,170	0 ------------- 15,000	0 ------------- 183,770	0 ------------- 9,548	0 ------------- 1,023,537	0 ------------- 0
4Harvey Granger Assistant Secretary	(i) (ii)	0 ------------- 453,057	0 ------------- 134,840	0 ------------- 15,000	0 ------------- 46,325	0 ------------- 18,482	0 ------------- 667,704	0 ------------- 0
5Ed Hubel Vice President	(i) (ii)	236,504 ------------- 0	40,000 ------------- 0	0 ------------- 0	33,082 ------------- 0	10,614 ------------- 0	320,200 ------------- 0	0 ------------- 0
6G Scott Baity Assistant Secretary	(i) (ii)	0 ------------- 256,072	0 ------------- 25,180	0 ------------- 0	0 ------------- 34,454	0 ------------- 10,996	0 ------------- 326,702	0 ------------- 0
7Kellene Sauls MSNRN Nurse Executive	(i) (ii)	142,185 ------------- 0	15,870 ------------- 0	0 ------------- 0	20,735 ------------- 0	10,053 ------------- 0	188,843 ------------- 0	0 ------------- 0
8Stephen Bean Pharmacist	(i) (ii)	141,284 ------------- 0	0 ------------- 0	0 ------------- 0	23,346 ------------- 0	17,607 ------------- 0	182,237 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation

In accordance with the Executive Compensation policy of Baptist Health System, Inc. (BHS), the organization's sole member, BHS's Compensation Committee (made up of independent Directors of BHS) engages annually a third party compensation consultant who provides a database composed of current data regarding compensation paid for each executive position by similarly situated tax exempt health systems in the country. These health systems are generally the same size as BHS, considering revenue and other appropriate indicators. The group of comparator companies that is derived based on the above stated parameters comprise the "Market". When the Committee meets with such consultant, the consultant provides to Committee members compensation target levels that are competitive with the Market. Generally, the median of the Market is targeted. The actual amount that health system executives receive as compensation may be higher or lower than the median, depending on the health system and the individual's performance. The objective is to have a strong link between health system and individual performance and executive compensation such that if the health system and the individual perform at an optimal level, his or her compensation is in the higher range of the Market. Conversely, if either the health system or individual performance is below expectation, compensation may be in the lower range of the Market. The minutes of the annual Compensation Committee are recorded by the Committee's compensation consultant and are approved promptly by the Chair of such Committee.

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan

Baptist Health System, Inc. (BHS) parent affiliate of Baptist Medical Center of Nassau, Inc., has two active supplemental nonqualified retirement plans (SERPS). One is for certain executives (supplemental executive retirement plan) and the other is for certain vice presidents (vice-president supplemental executive retirement plan). These SERPs are plans described in IRS Section 457(f). The benefits under these plans accrue during each executive's term of employment. These benefits are unvested and subject to forfeiture until the covered employee reaches retirement age. After over 32 years of service, John F. Wilbanks reached retirement age under the executive SERP during 2017, causing his SERP benefit to vest. Accordingly, the total amount of Mr. Wilbanks' SERP taxable benefit included in his W-2, Box 5 was $8,369,809 in addition to his current year income. Like other participants in the executive SERP, Mr. Wilbanks' SERP compensation is payable over his lifetime with a 15-year period certain. This SERP Amount is Reported on Schedule J, Part II, Column (B)(III) "Other Reportable Compensation" in addition to other reportable compensation, Column (F) "Compensation in Column (B) Reported as Deferred in Prior Form 990", and Form 990, Part VII. The following individuals accrued unvested benefits under these plans during calendar year 2017: John F. Wilbanks, $71,598 and Scott Wooten $172,970. These accrued benefits are unvested and subject to forfeiture unless the named employee remains employed with Baptist Medical Center of Nassau, Inc. until the covered employee reaches retirement age. This amount is included on Schedule J, part II, column (c).

Schedule J (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
Baptist Medical Center of Nassau Inc

Employer identification number
59-3234721

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Jacksonville Health Facilities Authority Series 2007CDE	59-2263061		12-01-2011	2,737,800	Revenue Refunding Bonds to Refund prior issue 05/17/2007.		X		X		X
B	Jacksonville Health Facilities Authority Series 2001	59-2263061	469404TR8	12-01-2011	2,776,664	Hospital Revenue Bonds to refund a prior issue 09/06/2001.		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	895,800		1,836,965
2 Amount of bonds legally defeased ..............	0		0
3 Total proceeds of issue ..................	2,737,800		2,776,664
4 Gross proceeds in reserve funds .............	0		0
5 Capitalized interest from proceeds .............	0		0
6 Proceeds in refunding escrows ...............	0		0
7 Issuance costs from proceeds ...............	0		0
8 Credit enhancement from proceeds .............	0		0
9 Working capital expenditures from proceeds .............	0		0
10 Capital expenditures from proceeds .............	0		0
11 Other spent proceeds .............	0		0
12 Other unspent proceeds .............	0		0
13 Year of substantial completion .............	2007
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.01 %		0.01 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %
6 Total of lines 4 and 5 .............	0.01 %		0.01 %
7 Does the bond issue meet the private security or payment test? ...	X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X
b Exception to rebate? ........		X		X
c No rebate due? .........		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X		X
b Name of provider ..........	UBS and Wells Fargo		UBS & Wells Fargo
c Term of hedge .........	1610 %		1610 %
d Was the hedge superintegrated? ......		X		X
e Was the hedge terminated? ........		X		X

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Schedule K, Part I, Column (c) Series 2007 CDE	CUSIP #'s: 2007C: N/A 2007D: 469404UP0 2007E: 469404UM7

Schedule K (Form 990) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

Baptist Medical Center of Nassau Inc

Employer identification number

59-3234721

Return Reference	Explanation
Form 990, Part VI, Line 6 Classes of members or stockholders	The organization has a sole corporate member, Baptist Health System, Inc.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	The Board of Directors of Baptist Health System, Inc., the sole corporate member of the organization, elects the members of the governing body of the organization.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	The Board of Directors of Baptist Health System, Inc., the sole corporate member of the organization, has the right to remove Directors of the Organization and must approve any amendments to the governing documents of the Organization.
Form 990, Part VI, Line 11b Review of form 990 by governing body	Form 990 and accompanying schedules are prepared internally and then provided to Baptist Health System, Inc. who is the sole corporate member of Baptist Medical Center of Nassau, Inc. The board of directors of Baptist Health System, Inc. are provided a copy of the form 990 and all accompanying schedules prior to filing with the internal revenue service center.
Form 990, Part VI, Line 12c Conflict of interest policy	The Board of Directors of the organization's sole member, Baptist Health System, Inc., has appointed a Conflicts of Interest Committee which regularly reviews the required disclosures of potential conflicts of interest by the Directors and Officers of the organization and its affiliates and recommends any action to be taken with regard to such disclosures. In accordance with the Conflicts of Interest Policy, during meetings of the organization's governing body, a Director who may have a conflict of interest is excused from discussion by the governing body about any transaction or matter that may have given rise to the Director's actual or potential conflict of interest.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	In accordance with the Executive Compensation policy of Baptist Health System, Inc. (BHS), the organization's sole member, BHS's Compensation Committee (made up of independent Directors of BHS) engages annually a third party compensation consultant who provides a database composed of current data regarding compensation paid for each executive position by similarly situated tax exempt health systems in the country. These health systems are generally the same size as BHS, considering revenue and other appropriate indicators. The group of comparator companies that is derived based on the above stated parameters comprise the "Market". When the Committee meets with such consultant, the consultant provides to Committee members compensation target levels that are competitive with the Market. Generally, the median of the Market is targeted. The actual amount that health system executives receive as compensation may be higher or lower than the median, depending on the health system's and the individual's performance. The objective is to have a strong link between health system and individual performance and executive compensation such that if the health system and the individual perform at an optimal level, his or her compensation is in the higher range of the Market. Conversely, if either the health system or individual performance is below expectation, compensation may be in the lower range of the Market. The minutes of the annual Compensation Committee are recorded by the Committee's compensation consultant and are approved promptly by the Chair of such Committee.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	All officers and key employees of the organization were included in the Executive Compensation policy described on Form 990, Part VI, Line 15a. This process is used to establish compensation for these individuals for each calendar year.
Form 990, Part VI, Line 19 Required documents available to the public	The organization makes its governing documents, conflict of interest policy, financial statements, and three most recent forms 990 available to the public upon request.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Transfer to Affiliated Organization - -8625323;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

- TIN:

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.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Baptist Medical Center of Nassau Inc

Employer identification number

59-3234721

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

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?
(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	Yes	No
(1)SOUTHERN BAPTIST HOSPITAL OF FLORIDA INC 800 PRUDENTIAL DR JACKSONVILLE,FL32207 59-0747311	HOSPITAL	FL	501(c)(3)	3	BAPTIST HEALTH SYSTEM INC		No
(2)BAPTIST HEALTH SYSTEM INC 841 PRUDENTIAL DR STE 1602 JACKSONVILLE,FL32207 59-2487136	Financial/management assistance for healthcare system	FL	501(c)(3)	Type II	Coastal Community Health Inc		No
(3)BAPTIST MEDICAL CENTER OF THE BEACHES INC 1350 13TH AVE S JACKSONVILLE BEACH,FL32250 59-2980620	HOSPITAL	FL	501(c)(3)	3	BAPTIST HEALTH SYSTEM INC		No
(4)BAPTIST HEALTH SYSTEM FOUNDATION INC 841 PRUDENTIAL DR 13TH FLOOR JACKSONVILLE,FL32207 59-2487135	Fundraising activities to support tax-exempts entities of healthcare system	FL	501(c)(3)	7	BAPTIST HEALTH SYSTEM INC		No
(5)BAPTIST HEALTH PROPERTIES INC 1660 Prudential Dr Ste 101 JACKSONVILLE,FL32207 59-2487133	Owns/manages real estate properties for healthcare system	FL	501(c)(3)	Type I	BAPTIST HEALTH SYSTEM INC		No
(6)BAPTIST HEALTH AMBULATORY SERVICES INC 1660 Prudential Dr Ste 203 JACKSONVILLE,FL32207 59-3410739	Medical Research and Education	FL	501(c)(3)	Type I	BAPTIST HEALTH SYSTEM INC		No
(7)Coastal Community Health Inc 841 Prudential Dr Ste 1450 Jacksonville,FL32207 47-1322041	Regional affiliation of BHS with 2 other 501(c)(3) healthcare systems	FL	501(c)(3)	Type I	na		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) PAVILION ASSOCIATES LTD 1660 Prudential Drive Ste 101 JACKSONVILLE,FL32207 59-2505491	NON-RESIDENTIAL PROPERTY MGT.	FL	SOUTHERN BAPTIST HOSPITAL OF FLORIDA INC	Excluded	0	0					No	0 %
(2) Corporate Health LLC 841 Prudential Dr Ste 1802 Jacksonville,FL32207	Development/operation of a medically-based wellness program for the northeast Florida community	FL	Baptist Health Ambulatory Services Inc	Related	0	0					No	0 %

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?
(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		Yes	No
(1) PAVILION HEALTH SERVICES INC 3563 PHILIPS HWY BLD F STE 608 JACKSONVILLE,FL32207 59-2059710	PHYSICIAN PRACTICES/RETAIL PHARMACIES	FL	BAPTIST HEALTH SYSTEM INC	C Corporation	0	0	0 %		No
(2) IT4CIN Inc 841 Prudential Dr Ste 1802 Jacksonville,FL32207 47-3954500	Contracts for health information technology products and services for its members.	FL	na	C Corporation	0	0	0 %		No

Schedule R (Form 990) 2019

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

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

Schedule R (Form 990) 2019

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

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) 2019

Additional Data

Software ID:	17005876
Software Version:	2017v2.2

1	Briefly describe the organization’s mission or most significant activities: Continue the healing ministry of Christ by providing accessible, quality healthcare services at a reasonable cost in an atmosphere that fosters respect and compassion.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	524
6	Total number of volunteers (estimate if necessary) .............	6	217
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	10,093
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	-1,078

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	29,900	4,050
9	Program service revenue (Part VIII, line 2g) .........	72,740,981	79,540,421
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	777,766	739,836
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	158,645	111,969
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	73,707,292	80,396,276
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	353,428	239,695
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	32,335,394	33,593,793
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	29,256,077	29,653,206
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	61,944,899	63,486,694
19	Revenue less expenses. Subtract line 18 from line 12.......	11,762,393	16,909,582
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	130,250,412	136,613,469
21	Total liabilities (Part X, line 26).............	14,273,145	12,358,709
22	Net assets or fund balances. Subtract line 21 from line 20.....	115,977,267	124,254,760

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 60,165,202 including grants of $ 239,695 ) (Revenue $ 79,540,421 )
	Baptist Medical Center of Nassau, Inc. (BMCN) is a highly advanced, extremely well-equipped community hospital located on Amelia Island, serving Nassau County and its surrounding area. The hospital provides a full spectrum of inpatient and outpatient services and 24-hour emergency care. The medical staff includes highly trained physicians in 26 different specialties along with a 24/7 hospitalist program. BMCN is an accredited chest pain center, has earned magnet recognition for excellence in patient care, and offers many advanced services and technologies not typically seen in a community hospital including a 30,000 square foot surgery/procedural center, 64-slice ct, digital 3D mammography, cardiac rehab center and sleep center. Inpatients are cared for in ultra-modernized building, which offers 48 private patient suites including intensive care. Other programs include maternity department, delivering 514 babies during the past fiscal year. BMCN was one of the first community hospitals in the nation to convert to an electronic medical record system. Baptist Medical Center of Nassau is fully integrated within a five hospital system of Baptist Health System, Inc. (BHS). Inpatient pediatric care is provided by Wolfson Children's Hospital in Jacksonville. During the fiscal year, there were 426 employees, 62 beds, 3,608 admissions accounting for 11,819 patient days, and 23,567 emergency room visits. As part of BHS, the region's only community-owned, faith-based healthcare system, BMCN is committed to improving the health of everyone in its community, regardless of their ability to pay. BMCN provided the following uncompensated care and community benefit for the fiscal year ended September 30, 2018: (1) charity care, $3.2 million, (2) unreimbursed Medicare costs, $8.2 million, and (3) specific community programs, $356 thousand, for a total of $11.8 million of uncompensated care and community benefit. BMCN's primary focus is addressing unmet health needs, particularly among vulnerable populations who have limited resources and access to health care. BMCN has gone beyond the delivery of essential health care to improve the lives of individuals and the overall quality of life in our region. Baptist health's community health committee guides the community health efforts. This committee provides strategic direction related to community health activities and ensures focus on key priorities that align with Baptist health's mission. A cornerstone of our commitment to the community is caring for the health of vulnerable, uninsured and underserved people among us. One of BMCN's guiding principles of community health is to collaborate with other local organizations to leverage our collective expertise and strength for the health benefits of the community. This collaborative approach helps ensure efficiency and avoids duplication of effort, resulting in enhancement of the lives of area residents at every life stage and income level. BMCN community health priorities currently include: (1) increasing access to care for medically underserved people, (2) preventing and managing chronic diseases, (3) assisting victims of domestic violence, and (4) helping our children and youth.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses60,165,202

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) Harvey Granger Assistant Secretary	0.3 .......................39.7	X		0	602,897	64,807
(19) Ed Hubel Vice President	40.0 .......................0	X		276,504	0	43,696
(20) G Scott Baity Assistant Secretary	0.3 .......................39.7	X		0	281,252	45,450
(21) David Toncray Director, Pharmacy	40.0 .......................0		X	123,103	0	11,271
(22) Kellene Sauls MSNRN Nurse Executive	40.0 .......................0		X	158,055	0	30,788
(23) Pamela Bolden Asssociate Director, Surgical Services	40.0 .......................0		X	112,133	0	24,990
(24) Patricia Hausauer Director, Finance	40.0 .......................0		X	121,369	0	19,470
(25) Stephen Bean Pharmacist	40.0 .......................0		X	141,284	0	40,953

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	932,448	12,514,021	658,038

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	4,050
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		4,050

		Business Code
2a	Patient service revenues, Net	621990	78,805,727	78,805,727	0	0
b	EHR revenue medicare	621990	122,351	122,351	0	0
c	Hospital Cafeteria	722514	332,956	332,956	0	0
d	Rental Revenue	531120	232,134	232,134	0	0
e	Other Revenue	621990	47,253	47,253
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		79,540,421

3 Investment income (including dividends, interest, and othersimilar amounts) ......			737,669	0	0	737,669
4 Income from investment of tax-exempt bond proceeds			0	0	0	0
5 Royalties...........			0	0	0	0
		(ii) Personal	(i) Real
6a	Gross rents	0	141,313	6a
b	Less: rental expenses		39,437	6b
c	Rental income or (loss)	0	101,876	6c
d	Net rental income or (loss).......			101,876			101,876
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	2,167	0	7a
b	Less: cost or other basis and sales expenses		0	7b
c	Gain or (loss)	2,167	0	7c
d	Net gain or (loss).........			2,167			2,167
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	Reference Lab Revenue		621500	10,093	0	10,093	0
b
c
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			10,093
12	Total revenue. See instructions.....			80,396,276	79,540,421	10,093	841,712

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	239,695	239,695
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	278,534	139,267	139,267
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	24,292,491	23,186,848	1,105,643
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,389,397	1,346,904	42,493
9	Other employee benefits .......	5,792,077	5,528,883	263,194
10	Payroll taxes ...........	1,841,294	1,786,288	55,006
11	Fees for services (non-employees):
a	Management ......	277,654	220,080	57,574
b	Legal .........	0	0	0
c	Accounting ...........	30,481	23,824	6,657
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	4,887,521	3,812,266	1,075,255	0
12	Advertising and promotion ....	28,164	25,348	2,816
13	Office expenses .......	4,266,462	4,175,758	90,704
14	Information technology ......	86,430	84,589	1,841
15	Royalties ..
16	Occupancy ...........	2,276,510	2,146,977	129,533
17	Travel ............	20,400	10,200	10,200
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	68,170	34,085	34,085
20	Interest ...........	150,418	150,418
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	4,658,653	4,425,720	232,933
23	Insurance ...	252,505	239,880	12,625
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Hospital/Medical Supplies	11,427,948	11,427,948
b	AHCA & NICA Assessments	936,518	936,518
c	Patient Transportation	162,039	162,039
d	Dues & Memberships	82,636	41,318	41,318
e	All other expenses	40,697	20,349	20,348	0
25	Total functional expenses. Add lines 1 through 24e	63,486,694	60,165,202	3,321,492	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			600	1	625
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			8,593,885	4	9,143,882
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			1,207,743	8	1,434,102
9	Prepaid expenses and deferred charges ......			376,990	9	627,904
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	101,807,403
b	Less: accumulated depreciation	10b	47,472,642	43,748,618	10c	54,334,761
11	Investments—publicly traded securities .			11,759,900	11	12,372,620
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............			0	14
15	Other assets. See Part IV, line 11 ...........			64,562,676	15	58,699,575
16	Total assets. Add lines 1 through 15 (must equal line 33)...			130,250,412	16	136,613,469

17	Accounts payable and accrued expenses .....	6,418,119	17	5,435,908
18	Grants payable ...	0	18
19	Deferred revenue .........	0	19
20	Tax-exempt bond liabilities .........	3,279,405	20	2,262,172
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	4,575,621	25	4,660,629
26	Total liabilities. Add lines 17 through 25..	14,273,145	26	12,358,709

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....	0	29	0
30	Paid-in or capital surplus, or land, building or equipment fund ...	0	30	0
31	Retained earnings, endowment, accumulated income, or other funds	0	31	0
32	Total net assets or fund balances ...........	115,977,267	32	124,254,760
33	Total liabilities and net assets/fund balances ........	130,250,412	33	136,613,469