Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 10-01-2022 , and ending 09-30-2023
BCheck if applicable:
CName of organization
BAPTIST MEMORIAL HOSPITAL-CALHOUN INC
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
350 N HUMPHREYS BLVD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MEMPHIS, TN38120
D Employer identification number

81-3257997
E Telephone number

G Gross receipts $ 14,891,498
F Name and address of principal officer:
JASON M LITTLE
350 N HUMPHREYS BLVD
MEMPHIS,TN38120
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.BAPTISTONLINE.ORG/LOCATIONS/CALHOUN
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 2016
M State of legal domicile: MS
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR AGE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 7
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 7
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 159
6 Total number of volunteers (estimate if necessary) ............. 6 7
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 163,712 583,077
9 Program service revenue (Part VIII, line 2g) ......... 13,412,874 14,244,715
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 0 0
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 59,019 63,706
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 13,635,605 14,891,498
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 291 200
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) 7,033,900 7,173,407
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 8,158,324 8,194,534
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 15,192,515 15,368,141
19 Revenue less expenses. Subtract line 18 from line 12....... -1,556,910 -476,643
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 8,652,572 8,472,614
21 Total liabilities (Part X, line 26)............. 14,405,028 14,701,713
22 Net assets or fund balances. Subtract line 21 from line 20..... -5,752,456 -6,229,099
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR AGE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 13,925,751 including grants of $ 200 ) (Revenue $ 14,244,715 )
BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, OR AGE. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC., IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES, AND FURTHER, THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. THEREFORE, IN KEEPING WITH ITS COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. PROVIDES THE FOLLOWING:- FREE CARE AND/OR SUBSIDIZED CARE WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST,- CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, AND- HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY.THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. IS A 25-BED ACUTE CARE HOSPITAL SERVING PATIENTS AND THEIR FAMILIES IN CALHOUN COUNTY AND THE SURROUNDING COUNTIES OF NORTH MISSISSIPPI, CENTRALLY LOCATED BETWEEN OXFORD, STARKVILLE AND GRENADA.BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. ALSO FEATURES A 120-BED NURSING HOME LOCATED ADJACENT TO THE HOSPITAL, A 24-HOUR EMERGENCY DEPARTMENT, OUTPATIENT CARE, REHABILITATION, DIAGNOSTIC IMAGING, AND RADIOLOGY.THE HOSPITAL BECAME AN AFFILIATE OF THE BAPTIST MEMORIAL HEALTH CARE SYSTEM ON 10/1/16. THIS AFFILATION HAS ENABLED BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. TO OFFER A WIDER RANGE OF MEDICAL SERVICES TO THE COMMUNITIES THAT IT SERVES. SOME OF OUR FACILITIES ALSO PROVIDE AN INTERDISCIPLINARY TEAM APPROACH TO SUB-ACUTE CARE FOR MEDICALLY COMPLEX PATIENTS NEEDING DIALYSIS, WOUND CARE, INTRAVENOUS ANTIBIOTICS AND REHABILITATIVE SERVICES, AMONG OTHERS.THE HOSPITAL ADMITTED 271 PATIENTS AND HAD 12,229 OUTPATIENT REGISTRATIONS DURING FY2023. THE LARGEST OUTPATIENT PROGRAM FOR THE FISCAL YEAR WAS PHYSICAL/OCCUPATIONAL/SPEECH THERAPY REHABILITATION SERVICES.
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 expensesMediumBullet13,925,751
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment
List of Attached Documents:
// Content
.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment
List of Attached Documents:
// Content
.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment
List of Attached Documents:
// Content
.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
List of Attached Documents:
// Content
....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment
List of Attached Documents:
// Content
..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment
List of Attached Documents:
// Content
..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment
List of Attached Documents:
// Content
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment
List of Attached Documents:
// Content
.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment
List of Attached Documents:
// Content
............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment
List of Attached Documents:
// Content
......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
List of Attached Documents:
// Content
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or 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? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
List of Attached Documents:
// Content
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
List of Attached Documents:
// Content
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
List of Attached Documents:
// Content
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
159
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
7
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
7
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletKAREN GOODRUM140 BURKE CALHOUN CITY RD   CALHOUN CITY,MS38916 (662) 628-2010
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) BRUCE LONGEST MD......................................................................
DIRECTOR
0.23
.................
0.23
X           0 0 0
(2) LEE PEDEN......................................................................
DIRECTOR/VICE CHAIR
0.23
.................
0.23
X           0 0 0
(3) RITA BOX......................................................................
CHAIRMAN
0.23
.................
0.23
X           0 0 0
(4) RITA TALFORD......................................................................
DIRECTOR
0.23
.................
0.23
X           0 0 0
(5) ROY MCDOWELL......................................................................
DIRECTOR
0.23
.................
0.23
X           0 0 0
(6) SHEILA FREELY......................................................................
DIRECTOR
0.23
.................
0.23
X           0 0 0
(7) TERRY MILLER......................................................................
DIRECTOR
0.23
.................
0.23
X           0 0 0
(8) JASON M LITTLE......................................................................
PRESIDENT
0.23
.................
39.77
    X       0 2,357,357 99,285
(9) PAUL D DEPRIEST MD......................................................................
VICE PRESIDENT (THRU 08/23)
0.23
.................
39.77
    X       0 1,407,602 87,814
(10) GREGORY M DUCKETT......................................................................
SECRETARY
0.23
.................
39.77
    X       0 1,120,752 82,097
(11) GARY C ANDERSON......................................................................
VICE PRESIDENT (AS OF 09/23)
0.23
.................
39.77
    X       0 1,062,887 83,871
(12) CHRISTOPHER THREADGILL......................................................................
CEO
28.00
.................
12.00
    X       0 167,972 52,814
(13) KAREN GOODRUM......................................................................
CONTROLLER
28.00
.................
12.00
    X       73,244 0 23,608
(14) DUSHARME PICKENS......................................................................
REGISTERED NURSE
39.43
.................
0.57
        X   133,624 1,651 18,749
(15) SAMUEL MYERS......................................................................
PHARMACIST
40.00
.................
0.00
        X   119,656 0 33,660
(16) ERIN H TEDDER......................................................................
NURSE MANAGER
40.00
.................
0.00
        X   121,308 0 21,351
(17) GAYLA M BUCHANAN......................................................................
REGISTERED NURSE
40.00
.................
0.00
        X   124,093 0 11
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) KAITLIN O RENFRO........................................................................
REGISTERED NURSE
40.00
.......................0.00
        X   122,563 0 11
























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 694,488 6,118,221 503,271
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet8
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
PROFESSIONAL THERAPY SERVICES INC

PO BOX 927
OXFORD,MS38655
PHYSICAL THERAPY SERVICES 1,849,485
DOBBS EMERGENCY GROUP

PO BOX 677979
DALLAS,TX752677979
PHYSICIAN SERVICES 1,236,117
STEPPING STONES HEALTHCARE CONSULTING

1821 LA CIMA DRIVE
MCKINNEY,TX75071
GEROPSYCHIATRIC CONSULTING SERVICES 335,760
SHIFTWISE INC

PO BOX 70870
ST PAUL,MN551709705
STAFFING AGENCY SERVICES 131,347
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet4
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e 583,077
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 583,077
 Program Service RevenueAmt Business Code
2a PATIENT SERVICE REV. 622110 13,693,496 13,693,496    
b OTHER OPERATING REV. 900099 551,219 551,219    
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 14,244,715
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet        
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   35,022 6a
b Less: rental expenses   0 6b
c Rental income or (loss)   35,022 6c
d Net rental income or (loss).......MediumBullet 35,022     35,022
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory     7a
b Less: cost or other basis and sales expenses     7b
c Gain or (loss)     7c
d Net gain or (loss).........MediumBullet        
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..MediumBullet      
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..MediumBullet        
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..MediumBullet        
Business Code Miscellaneous Revenue
11a CAFETERIA REVENUE 722514 28,684     28,684
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 28,684
12 Total revenue. See instructions.....MediumBullet 14,891,498 14,244,715 0 63,706
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 200 200
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 ........... 83,382 75,044 8,338  
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........ 5,890,802 5,301,722 589,080  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 132,430 119,187 13,243  
9 Other employee benefits ....... 625,872 563,285 62,587  
10 Payroll taxes ........... 440,921 396,829 44,092  
11 Fees for services (non-employees):        
a Management ......        
b Legal .........        
c Accounting ...........        
d Lobbying ........... 3,877   3,877  
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) 4,146,155 3,731,539 414,616  
12 Advertising and promotion .... 5,937 5,343 594  
13 Office expenses ....... 268,382 241,544 26,838  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 177,061 162,067 14,994  
17 Travel ............ 17,805 7,122 10,683  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 2,443 977 1,466  
20 Interest ........... 1,443 1,443    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 666,694 600,025 66,669  
23 Insurance ... 122,452 110,207 12,245  
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 CORPORATE MGMT FEE 1,231,224 1,108,102 123,122  
b MEDICAL SUPPLIES 1,131,684 1,131,684 0  
c REPAIRS AND MAINTENANCE 302,674 272,407 30,267  
d MEDICAID ASSESSMENT 58,746 58,746 0  
e All other expenses 57,957 38,278 19,679  
25 Total functional expenses. Add lines 1 through 24e 15,368,141 13,925,751 1,442,390 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 200 1 200
2 Savings and temporary cash investments ......... 324,524 2 548,757
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 2,537,859 4 2,835,036
5 Loans and other receivables from 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 .......
  5  
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  
7 Notes and loans receivable, net ........... 65,000 7 62,833
8 Inventories for sale or use ............ 184,400 8 169,630
9 Prepaid expenses and deferred charges ...... 204,034 9 279,224
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 7,904,163
b Less: accumulated depreciation 10b 3,455,974 4,498,885 10c 4,448,189
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 837,670 15 128,745
16 Total assets. Add lines 1 through 15 (must equal line 33)... 8,652,572 16 8,472,614
Liabilities 17 Accounts payable and accrued expenses ..... 686,377 17 706,157
18 Grants payable ...   18  
19 Deferred revenue ......... 583,077 19 0
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   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  
23 Secured mortgages and notes payable to unrelated third parties ..   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 13,135,574 25 13,995,556
26 Total liabilities. Add lines 17 through 25.. 14,405,028 26 14,701,713
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... -5,752,456 27 -6,229,099
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... -5,752,456 32 -6,229,099
33 Total liabilities and net assets/fund balances ........ 8,652,572 33 8,472,614
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
14,891,498
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
15,368,141
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-476,643
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
-5,752,456
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
-6,229,099
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

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
2022
Open to Public
Inspection
Name of the organization
BAPTIST MEMORIAL HOSPITAL-CALHOUN INC
 
Employer identification number

81-3257997
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
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) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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  
12
12
 
13
First 5 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
14
14
 
15
15
 
16a
33 1/3% support test—2022. 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
b
33 1/3% support test—2021. 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—2022. 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
b
10%-facts-and-circumstances test—2021. 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
18
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) 2022

Schedule A (Form 990) 2022
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) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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) right arrow (a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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 on 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.)..            
14
First 5 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
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2022. 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
b
33 1/3% support tests—2021. 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
20
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) 2022

Schedule A (Form 990) 2022
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c 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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
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.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on 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.
9c
 
 
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
 
 
b
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) 2022

Schedule A (Form 990) 2022
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, 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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
By reason of the relationship described in line 2 above, 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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
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.
2a
 
 
b
Did the activities described on line 2a, above 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.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
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?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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 0.015 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 0.035 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  
7
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2022 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2022
(iii)
Distributable
Amount for 2022
1 Distributable amount for 2022 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2022:
a From 2017.......  
b From 2018.......  
c From 2019.......  
d From 2020.......  
e From 2021.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2022 distributable amount  
i Carryover from 2017 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2022 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2022 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2022, 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 2022. 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 2023. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2018.....  
b Excess from 2019.....  
c Excess from 2020.....  
d Excess from 2021.....  
e Excess from 2022.....  
Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022
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) 2022


Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
BAPTIST MEMORIAL HOSPITAL-CALHOUN INC
 
Employer identification number

81-3257997
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2018 (b) 2019 (c) 2020 (d) 2021 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990) 2021


Schedule C (Form 990) 2021
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
3,877
j
Total. Add lines 1c through 1i ....................................................................................................
3,877
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: BAPTIST MEMORIAL HEALTH CARE CORPORATION PAYS MEMBERSHIP DUES TO VARIOUS HOSPITAL ASSOCIATIONS SUCH AS THE TENNESSEE HOSPITAL ASSOCIATION, MISSISSIPPI HOSPITAL ASSOCIATION, AND ARKANSAS HOSPITAL ASSOCIATION. A PORTION OF THE MEMBERSHIP DUES IS DESIGNATED AS LOBBYING FEES BY THE HOSPITAL ASSOCIATIONS. EACH HOSPITAL ASSOCIATION ALLOCATES A DIFFERENT PERCENTAGE, AND THE PERCENTAGE MAY VARY ANNUALLY. THE HOSPITAL ASSOCIATIONS PAY CONSULTANTS WHO MONITOR AND ADVISE THE ORGANIZATIONS ON LEGISLATIVE AND REGULATORY MATTERS THAT MAY AFFECT THE MEMBER ORGANIZATIONS AND THE MEMBERS' AFFILIATES. THESE CONSULTANTS MAY ADVOCATE POSITIONS WITH LEGISLATIVE AND REGULATORY BODIES OF GOVERNMENT AT LOCAL, STATE AND FEDERAL LEVELS. BAPTIST MEMORIAL HEALTH CARE CORPORATION ALLOCATES A PORTION OF THESE FEES AMONG ITS HOSPITALS.
Schedule C (Form 990) 2021


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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
2021
Open to Public Inspection
Name of the organization
BAPTIST MEMORIAL HOSPITAL-CALHOUN INC
 
Employer identification number

81-3257997
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
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.
b
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 $  
2
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:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 .....   44,800 44,800
b Buildings ....   4,795,694 1,879,433 2,916,261
c Leasehold improvements        
d Equipment ....   2,218,752 1,188,424 1,030,328
e Other .....   844,917 388,117 456,800
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 4,448,189
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
Page 3
Part VII
Investments - Other 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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program 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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
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.)Small Bullet 13,995,556
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) 2021

Schedule D (Form 990) 2021
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
PART X, LINE 2: FROM THE COMBINED AUDITED FINANCIAL STATEMENTS OF BAPTIST MEMORIAL HEALTH CARE CORPORATION AND AFFILIATES: AS OF SEPTEMBER 30, 2023, BAPTIST MEMORIAL HEALTH CARE CORPORATION (BMHCC) HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS UNDER FASB ASC TOPIC 740, INCOME TAXES, REQUIRING ADJUSTMENTS TO ITS COMBINED FINANCIAL STATEMENTS. IN THE EVENT BMHCC WERE TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AS INTEREST EXPENSE. GENERALLY, BMHCC IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR TAX YEARS PRIOR TO 2019 (FISCAL YEAR ENDED SEPTEMBER 30, 2020).
Schedule D (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
BAPTIST MEMORIAL HOSPITAL-CALHOUN INC
 
Employer identification number

81-3257997
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    773,456 366,046 407,410 2.650 %
b Medicaid (from Worksheet 3, column a) . . . . .     1,947,948 1,447,896 500,052 3.250 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     45,891 3,226 42,665 0.280 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     2,767,295 1,817,168 950,127 6.180 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).            
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .     4,946,280 3,884,913 1,061,367 6.910 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .     4,946,280 3,884,913 1,061,367 6.910 %
k Total. Add lines 7d and 7j .     7,713,575 5,702,081 2,011,494 13.090 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development     142   142 0 %
9 Other            
10 Total     142   142 0 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
42,831
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
3,872
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
4,928,505
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
4,467,232
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
461,273
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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)
Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 BAPTIST MEMORIAL HOSPITAL-CALHOUN
140 BURKE CALHOUN CITY RD
CALHOUN CITY,MS38916
WWW.BAPTISTONLINE.ORG/CALHOUN
11-259
X X     X   X      
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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 MEMORIAL HOSPITAL-CALHOUN
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):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
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.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://WWW.BAPTISTONLINE.ORG/ABOUT/CHNA
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2022
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
BAPTIST MEMORIAL HOSPITAL-CALHOUN
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
BAPTIST MEMORIAL HOSPITAL-CALHOUN
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
BAPTIST MEMORIAL HOSPITAL-CALHOUN
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 8
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
BAPTIST MEMORIAL HOSPITAL-CALHOUN PART V, SECTION B, LINE 5: THE FY2022 CHNA FOR BAPTIST'S NORTH MISSISSIPPI SERVICE AREA WAS CONDUCTED FROM JULY 2021 TO AUGUST 2022 AND INCLUDED QUANTITATIVE AND QUALITATIVE RESEARCH METHODS TO DETERMINE HEALTH TRENDS AND DISPARITIES AFFECTING SERVICE AREA RESIDENTS. THROUGH A COMPREHENSIVE VIEW OF STATISTICAL HEALTH INDICATORS AND COMMUNITY STAKEHOLDER FEEDBACK, A PROFILE OF PRIORITY AREAS WAS DETERMINED. THE FINDINGS WILL GUIDE HEALTH CARE SERVICES AND HEALTH IMPROVEMENT EFFORTS, AS WELL AS SERVE AS A COMMUNITY RESOURCE FOR GRANT MAKING AND ADVOCACY, AND SUPPORT THE MANY PROGRAMS PROVIDED BY HEALTH AND SOCIAL SERVICE PARTNERS.COMMUNITY ENGAGEMENT WAS AN INTEGRAL PART OF THE FY2022 CHNA. IN ASSESSING COMMUNITY HEALTH NEEDS, INPUT WAS SOLICITED AND RECEIVED FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, AS WELL AS UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. THESE INDIVIDUALS PROVIDED WIDE PERSPECTIVES ON HEALTH TRENDS, EXPERTISE ABOUT EXISTING COMMUNITY RESOURCES AVAILABLE TO MEET THOSE NEEDS AND INSIGHTS INTO SERVICE DELIVERY GAPS THAT CONTRIBUTE TO HEALTH DISPARITIES AND INEQUITIES.BAPTIST SOUGHT TO ENGAGE INDIVIDUALS AND COMMUNITIES HISTORICALLY UNDERREPRESENTED AND UNDERSERVED BY HEALTH CARE SERVICES TO ILLUMINATE DIVERSE PERSPECTIVES ON COMMUNITY NEEDS AND INFORM COMMUNITY HEALTH IMPROVEMENT STRATEGY. CONSUMER INTERVIEWS AND FOCUS GROUPS WERE HOSTED ACROSS THE BAPTIST SERVICE AREAS WITH THE GOAL OF GARNERING STAKEHOLDER FEEDBACK AND RECOMMENDATIONS TO IMPROVE HEALTH AND THE HEALTH CARE EXPERIENCE BY ADDRESSING ACCESS TO CARE CHALLENGES AND UNDERLYING SOCIAL DETERMINANTS OF HEALTH AND INEQUITIES. THIS FEEDBACK IS REFLECTED IN BAPTIST'S APPROACH TO DEFINING THE FY2022 - FY2025 PRIORITY AREAS AND DEVELOPING EACH HOSPITAL COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP).THE FOLLOWING RESEARCH METHODS WERE USED TO DETERMINE COMMUNITY HEALTH NEEDS:- ANALYSIS OF EXISTING SECONDARY DATA SOURCES, INCLUDING PUBLIC HEALTH STATISTICS, DEMOGRAPHIC AND SOCIAL MEASURES AND HEALTH CARE UTILIZATION.- KEY INFORMANT SURVEYS TO ASSESS PERCEIVED HEALTH PRIORITIES, PERSPECTIVES ON EMERGING HEALTH TRENDS AND RECOMMENDATIONS TO ADVANCE COMMUNITY HEALTH IMPROVEMENT.- PATIENT ACCESS TO CARE AND SERVICES SURVEY TO UNDERSTAND HEALTH CARE PROVIDERS' PERSPECTIVES ON BARRIERS TO CARE, THE IMPACT OF SOCIAL DETERMINANTS OF HEALTH, CULTURAL COMPETENCIES AND OTHER FACTORS THAT IMPEDE OPTIMAL OUTCOMES FOR PATIENTS.- CONSUMER INTERVIEWS AND FOCUS GROUPS WITH INDIVIDUALS REPRESENTING BLACK, INDIGENOUS AND PEOPLE OF COLOR (BIPOC) AND OTHER POPULATIONS HISTORICALLY UNDERSERVED BY HEALTH CARE SERVICES TO INFORM COMMUNITY HEALTH IMPROVEMENT STRATEGY.CHNA LEADERSHIP:A BAPTIST MEMORIAL HEALTH CARE STEERING COMMITTEE, ALONG WITH COMMUNITY REPRESENTATIVES AND PARTNERS, OVERSAW THE FY2022 CHNA. THESE INDIVIDUALS SERVED AS LIAISONS TO THEIR ORGANIZATIONS AND THE COMMUNITIES SERVED BY THEIR ENTITIES.THE FOLLOWING CONTRIBUTED TO THE CHNA PROCESS AS COMMUNITY PARTNERS:AGAPE HEALTH SERVICESAMERICAN CANCER SOCIETYBANCORPSOUTHCALHOUN COUNTY SCHOOL DISTRICTCALHOUN ECONOMIC DEVELOPMENT ASSOCIATION, INC.CHILDREN'S ADVOCACY CENTERS OF MISSISSIPPICITY OF COLUMBUSCITY OF YAZOO CITYCOLUMBUS POLICE DEPARTMENTCOMMUNICARECREEKMORE CLINICFIRST BAPTIST CHURCHFIRST CHOICE CENTER FOR WOMEN, INC.FIRST UNITED METHODIST CHURCHGOLDEN TRIANGLE CONTACT TELEMINISTRY, INC.HEALTH PROMOTION & WELLNESSHELPING HANDS OF COLUMBUSHOPE HOUSE OF HOSPITALITY, INC.HOUSE OF GRACE, DOMESTIC VIOLENCE CENTERINTERNATIONAL PAPERLOWNDES COUNTY COUNCIL ON AGINGMISSISSIPPI FOOD NETWORKMISSISSIPPI STATE DEPARTMENT OF HEALTHMISSISSIPPI UNIVERSITY FOR WOMENMSDH/MCCCPNEONFROG, INC.NEW ALBANY MAIN STREETNEW ALBANY SCHOOL DISTRICTOXFORD MEDICAL MINISTRIES CLINICST. JUDE CHILDREN'S RESEARCH HOSPITALST. MARY'S CATHOLIC CHURCHST. PAUL BAPTIST CHURCH, MINISTERSTANFORD DENTAL CLINICSUSAN G. KOMEN MEMPHIS - MIDSOUTH MISSISSIPPITHE COMMERCIAL DISPATCH NEWSPAPERTK ELEVATOR NORTH AMERICA SUPPLY CHAIN AND MANUFACTURINGUCDAUNION COUNTY EXTENSION OFFICEUNITED WAY OF LOWNDES & NOXUBEEUNIVERSITY OF MISSISSIPPI, UNIVERSITY HEALTH SERVICESVIBRANT CHURCHWEST POINT MINISTERIAL ALLIANCE
BAPTIST MEMORIAL HOSPITAL-CALHOUN PART V, SECTION B, LINE 6A: BAPTIST MEMORIAL HOSPITAL-CALHOUN CONDUCTED ITS CHNA WITH THE FOLLOWING OTHER HOSPITAL FACILITIES: BAPTIST MEMORIAL HOSPITAL-BOONEVILLE BAPTIST MEMORIAL HOSPITAL-GOLDEN TRIANGLE BAPTIST MEMORIAL HOSPITAL-NORTH MISSISSIPPI BAPTIST MEMORIAL HOSPITAL-UNION COUNTY
BAPTIST MEMORIAL HOSPITAL-CALHOUN PART V, SECTION B, LINE 11: BAPTIST MEMORIAL HEALTH CARE (BAPTIST) IS DEDICATED TO THE HEALTH AND WELL-BEING OF THE MANY COMMUNITIES WE SERVE ACROSS THE MID-SOUTH. WE BELIEVE STRONGLY IN CORPORATE CITIZENSHIP AND THE IMPORTANCE OF COLLABORATION WITH LOCAL ORGANIZATIONS TO BUILD STRONGER AND HEALTHIER COMMUNITIES.TO HELP US TRACK COMMUNITY HEALTH AND RESPOND TO THE NEEDS OF RESIDENTS, EVERY THREE YEARS WE CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND DEVELOP COMMUNITY HEALTH IMPROVEMENT PLANS (CHIP) FOR EACH COMMUNITY HOSPITAL. THESE ENDEAVORS HELP TO ENSURE OUR INITIATIVES, ACTIVITIES AND PARTNERSHIPS ALIGN WITH OUR COMMUNITIES' MOST PRESSING CONCERNS, AND GUIDE OUR COMMUNITY BENEFIT INVESTMENTS. THEY ARE VITAL TOOLS TO GUIDE COMMUNITY HEALTH IMPROVEMENT ACTIVITIES AS WELL AS ENHANCE CARE DELIVERY, IMPROVE PATIENT ENGAGEMENT STRATEGIES AND DIRECT POPULATION HEALTH MANAGEMENT.IT IS IMPERATIVE TO PRIORITIZE RESOURCES AND ACTIVITIES TOWARD THE MOST PRESSING AND CROSS-CUTTING HEALTH NEEDS WITHIN OUR COMMUNITY. IN DETERMINING THE ISSUES ON WHICH TO FOCUS EFFORTS OVER THE NEXT THREE-YEAR CYCLE, BAPTIST COLLECTED FEEDBACK FROM COMMUNITY PARTNERS AND SOUGHT TO ALIGN WITH COMMUNITY PROGRAMS, POPULATION HEALTH MANAGEMENT STRATEGIES AND DIVERSITY, EQUITY AND INCLUSION INITIATIVES. BAPTIST WILL FOCUS EFFORTS ON THE FOLLOWING COMMUNITY HEALTH PRIORITIES OVER THE NEXT THREE-YEAR CYCLE:1. BEHAVIORAL HEALTH2. CHRONIC DISEASES3. MATERNAL AND CHILD HEALTHBEHAVIORAL HEALTHTHE GOAL IS TO STRENGTHEN EQUITY AND QUALITY IN BEHAVIORAL HEALTH CARE AND IMPROVE ACCESS TO PREVENTION, TREATMENT AND RECOVERY SERVICES.BAPTIST MEMORIAL HOSPITAL-CALHOUN HAS OUTLINED THE FOLLOWING OBJECTIVES:1. INCREASE THE NUMBER OF PEOPLE WHO ARE SCREENED FOR BEHAVIORAL HEALTH CONDITIONS.2. INCREASE THE NUMBER OF PEOPLE RECEIVING BEHAVIORAL HEALTH CARE AND SUPPORT.BAPTIST MEMORIAL HOSPITAL-CALHOUN WILL IMPLEMENT THE FOLLOWING STRATEGIES:1. INITIATE UNIVERSAL BEHAVIORAL HEALTH SCREENINGS ACROSS ALL CARE SETTINGS.2. EDUCATE PEOPLE TO RECOGNIZE SIGNS AND SYMPTOMS OF MENTAL HEALTH CONDITIONS AND SUBSTANCE ABUSE AND WHERE TO GET HELP.3. SUPPORT, PROMOTE AND PARTICIPATE IN COMMUNITY BEHAVIORAL HEALTH AWARENESS EFFORTS.4. EXPAND WORKFORCE TRAINING AND CAPABILITY IN THE DETECTION, DIAGNOSIS AND MANAGEMENT OF BEHAVIORAL HEALTH CONDITIONS.5. PROVIDE INFORMATION ON THE MEDICAID AND CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) AND COVERAGE OF ESSENTIAL BEHAVIORAL HEALTH SERVICES FOR CHILDREN AND YOUTH.6. EXPAND ACCESS TO COMMUNITY-BASED SERVICES AND RESOURCES SUCH AS PEER SUPPORT, COMMUNITY HEALTH WORKERS, HOME AND COMMUNITY-BASED SERVICES AND SOCIAL SUPPORTS.7. STRENGTHEN AND SUPPORT COMMUNITY ORGANIZATIONS PROVIDING YOUTH MENTAL HEALTH SUPPORT, INCLUDING MENTORSHIP, CAREER DEVELOPMENT AND SOCIAL EMOTIONAL LEARNING OPPORTUNITIES.8. PROVIDE EDUCATION AND SUPPORT ABOUT BEHAVIORAL HEALTH FOR HEALTH CARE PROVIDERS AND PROFESSIONALS.CHRONIC DISEASESTHE GOAL IS TO ENSURE ALL RESIDENTS HAVE KNOWLEDGE OF, AND EQUITABLE ACCESS TO, THE RESOURCES THEY NEED TO MAINTAIN AND IMPROVE THEIR HEALTH.BAPTIST MEMORIAL HOSPITAL-CALHOUN HAS OUTLINED THE FOLLOWING OBJECTIVES:1. INCREASE ACCESS TO TRADITIONAL AND ALTERNATIVE PLACES PEOPLE CAN ACCESS HEALTH CARE.2. REDUCE DISPARITIES IN CHRONIC DISEASE PREVALENCE AND DEATH RATES.BAPTIST MEMORIAL HOSPITAL-CALHOUN WILL IMPLEMENT THE FOLLOWING STRATEGIES:1. PROVIDE INFORMATION ON THE MEDICAID AND CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) AND COVERAGE OF ESSENTIAL BEHAVIORAL HEALTH SERVICES FOR CHILDREN AND YOUTH.2. CONTINUE TO ASSESS COMMUNITY NEED FOR SPECIALTY CARE SERVICES AND OPPORTUNITIES TO EXPAND AVAILABLE CLINICS.3. EXPAND EQUITABLE ACCESS TO TELEHEALTH VISITS BY INCREASING TECHNOLOGY KNOW-HOW AND USE OF TELEHEALTH AMONG PRIORITY POPULATIONS.4. SUPPORT, PROMOTE, AND PARTICIPATE IN EVENTS OFFERING AFFORDABLE PREVENTIVE SCREENINGS AND OTHER MOBILE HEALTH SERVICES, BRINGING CARE TO THE COMMUNITY.5. OPTIMIZE DATA COLLECTION, STANDARDIZATION AND TRANSPARENCY TO IDENTIFY DISPARITIES AND TRACK IMPROVEMENT.6. INCREASE CHRONIC DISEASE SCREENING RATES AMONG UNDERSERVED POPULATIONS.7. PROVIDE EDUCATION AND SUPPORT PROGRAMS THAT ADDRESS PHYSICAL, MENTAL, SPIRITUAL AND FINANCIAL CONCERNS.MATERNAL AND CHILD HEALTHTHE GOAL IS TO ACHIEVE EQUITABLE OUTCOMES FOR MOTHERS AND BABIES BY STRENGTHENING COMMUNITIES AND ADDRESSING UNDERLYING BARRIERS TO CARE.BAPTIST MEMORIAL HOSPITAL-CALHOUN HAS OUTLINED THE FOLLOWING OBJECTIVES:1. REDUCE HEALTH DISPARITIES IN BIRTH OUTCOMES FOR BLACK/AFRICAN AMERICAN WOMEN AND BABIES.2. INCREASE ACCESS TO COMPREHENSIVE PRE- AND POST-NATAL CARE SERVICES.BAPTIST MEMORIAL HOSPITAL-CALHOUN WILL IMPLEMENT THE FOLLOWING STRATEGIES:1. OPTIMIZE DATA COLLECTION, STANDARDIZATION AND TRANSPARENCY TO IDENTIFY DISPARITIES AND TRACK IMPROVEMENT.2. EXPAND AND DIVERSIFY THE PERINATAL WORKFORCE.3. STRENGTHEN ECONOMIC AND SOCIAL SUPPORT FOR PEOPLE BEFORE, DURING AND AFTER PREGNANCY.4. CREATE INCLUSIVE AND WELCOMING CARE SETTINGS THAT HONOR DIVERSITY AND REFLECT THE COMMUNITY.5. PARTNER WITH COMMUNITY-BASED ORGANIZATIONS INCLUDING FAITH-BASED INSTITUTIONS TO PROVIDE EDUCATION AND CARE IN COMMUNITIES.6. PROVIDE MOBILE, IN-HOME, AND TELEHEALTH CARE TO INCREASE ACCESS FOR UNDERSERVED POPULATIONS.WE RECOGNIZE THAT OUR HOSPITALS ARE VITAL ORGANIZATIONS WITHIN THE COMMUNITIES WE SERVE. AND WE KNOW THAT WE CANNOT ADDRESS EVERY COMMUNITY NEED BY OURSELVES. TO PROMOTE HEALTH AND QUALITY OF LIFE, WE COLLABORATE WITH COMMUNITY PARTNERS WHO HAVE EXPERTISE IN SOCIAL NEEDS, SPECIALTY SERVICES, FAITH LEADERSHIP, ADVOCACY AND ESSENTIAL RESOURCES. WE FOSTER ONGOING RELATIONSHIPS WITH THESE PARTNERS AND PROVIDE FINANCIAL AND IN-KIND GIFTS TO SUPPORT THEIR WORK.BUILDING UPON THE CURRENT CHNA AND IMPLEMENTATION STRATEGY, THE HOSPITAL DID THE FOLLOWING DURING FY'23 TO ADDRESS THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY:- PROVIDED CPR CLASSES TO LOCAL SCHOOLS AND DAYCARE CENTERS.- PROVIDED COMMUNITY EDUCATION ON DEMENTIA AWARENESS.- PROVIDED TELE-ADDICTION SERVICES.- PARTICIPATED IN HEALTH FAIRS AND INFORMATIONAL BOOTHS TO PROVIDE HEALTH INFORMATION AND PROMOTE HEALTHY LIFESTYLES.- ASSISTED THE VULNERABLE POPULATION BY PROVIDING A COMPUTER STATION TO REGISTER FOR COVID-19 VACCINATIONS.
BAPTIST MEMORIAL HOSPITAL-CALHOUN PART V, SECTION B, LINE 13B: 1. MONEY INCOME INCLUDING: EARNINGS, UNEMPLOYMENT COMPENSATION, WORKERS' COMPENSATION, SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, DISABILITY PAYMENTS, PUBLIC ASSISTANCE, VETERANS' PAYMENTS, SURVIVOR BENEFITS, PENSION OR RETIREMENT INCOME, INTEREST, DIVIDENDS, RENTS, ROYALTIES, INCOME FROM ESTATES AND/OR TRUSTS, EDUCATIONAL ASSISTANCE, ALIMONY, CHILD SUPPORT, ASSISTANCE FROM OUTSIDE THE HOUSEHOLD, AND OTHER MISCELLANEOUS SOURCES OF INCOME. THE GROSS AMOUNT IS USED WHEN CALCULATING INCOME FROM ANY OF THE PRECEDING SOURCES. 2. NON-CASH BENEFITS, SUCH AS FOOD STAMPS AND HOUSING SUBSIDIES, DO NOT COUNT AS INCOME.3. IF A PERSON LIVES WITH A FAMILY, THE TOTAL GROSS INCOME OF ALL FAMILY MEMBERS IS CALCULATED WHEN DETERMINING INCOME. PLEASE NOTE: (A) NON-RELATIVES, INCLUDING HOUSEMATES, DO NOT COUNT; (B) A CHILD WHO IS A FULL-TIME STUDENT AWAY FROM HOME AT AN ACCREDITED COLLEGE MAY BE COUNTED; (C) MINOR CHILDRENS' EARNED WAGES ARE NOT INCLUDED IN DETERMINING INCOME; AND (D) COURT-ORDERED OR STATE/FEDERAL ISSUED ASSISTANCE RELATED TO A MINOR SHOULD BE INCLUDED IN DETERMINING INCOME.4. PRIMARY RESIDENCE OF INDIVIDUALS CLAIMED IN A FAMILY UNIT SHOULD BE VERIFIED USING TAX RETURNS OR FEDERAL, STATE OR GOVERNMENTAL COURT DOCUMENTS INDICATING RESIDENCY.
BAPTIST MEMORIAL HOSPITAL-CALHOUN: PART V, SECTION B, LINE 16A: THE FAP FOR BAPTIST MEMORIAL HOSPITAL-CALHOUN CAN BE FOUND AT THE FOLLOWING LINK: HTTPS://WWW.BAPTISTONLINE.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE BAPTIST MEMORIAL HOSPITAL-CALHOUN:PART V, SECTION B, LINE 16B: THE FAP APPLICATION FOR BAPTIST MEMORIAL HOSPITAL-CALHOUN CAN BE FOUND AT THE FOLLOWING LINK: HTTPS://WWW.BAPTISTONLINE.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE BAPTIST MEMORIAL HOSPITAL-CALHOUN:PART V, SECTION B, LINE 16C: THE PLAIN LANGUAGE SUMMARY OF THE FAP FOR BAPTIST MEMORIAL HOSPITAL-CALHOUN CAN BE FOUND AT THE FOLLOWING LINK: HTTPS://WWW.BAPTISTONLINE.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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?1
Name and address Type of Facility (describe)
1 1 - BAPTIST CALHOUN RURAL HEALTH CLINIC
112 MEDICAL ARTS DRIVE
CALHOUN CITY,MS38916
RURAL HEALTH CLINIC
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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
PART I, LINE 3C: BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. USES FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE ELIGIBILITY FOR FREE OR REDUCED CARE FOR LOW INCOME AND MEDICALLY INDIGENT INDIVIDUALS. IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. USES MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS PREPARED BY BAPTIST MEMORIAL HEALTH CARE CORPORATION (EIN: 58-1521475), THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. THE COMMUNITY BENEFIT REPORT IS MADE AVAILABLE TO THE PUBLIC BY MAIL AND AVAILABLE AT EACH AFFILIATE OF BAPTIST MEMORIAL HEALTH CARE CORPORATION.
PART I, LINE 7: OUR COST ACCOUNTING PROCESS REFLECTS FULLY LOADED COST FOR ALL OF OUR PATIENT POPULATIONS. FULLY LOADED COST INCLUDES DIRECT, CAPITAL, AND INDIRECT COST. AFTER WORKING WITH OUR DEPARTMENT DIRECTORS AND CFOS TO MAKE SURE THE DOLLARS IN THE GENERAL LEDGER ARE IN THE CORRECT PLACE TO REFLECT OUR TIME AND EFFORT SPENT THROUGHOUT THE YEAR, WE DEVELOP RELATIVE VALUE UNITS TO ALLOCATE THE ACTUAL GENERAL LEDGER COST DOWN TO THE PROCEDURE CHARGE CODES FROM OUR PATIENT ACCOUNTING SYSTEM. ALL OVERHEAD IS ALLOCATED DOWN TO THE REVENUE PRODUCING DEPARTMENTS BASED ON VARIOUS STATISTICS. ONCE EVERY CHARGE CODE HAS GONE THROUGH THE COST AND AUDIT PROCESS, WE CAN RUN THE PATIENT LEVEL REPORTS USED FOR THE FORM 990 TO GET TO THE COST INFORMATION NEEDED.
PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES DO NOT INCLUDE ANY COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. PART II, COMMUNITY BUILDING ACTIVITES: BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. CONDUCTS SEVERAL HEALTH FAIRS, SEMINARS AND CLASSES THROUGHOUT THE YEAR FOR THE COMMUNITIES IT SERVES.BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. ALSO IS INVOLVED IN LOCAL COMMUNITY AND NON-PROFIT ORGANIZATIONS SUCH AS THE AMERICAN CANCER SOCIETY, RACE FOR THE CURE, WALK AMERICA, ST. JUDE CHILDREN'S RESEARCH HOSPITAL, AND MANY OTHERS. NOT ONLY DO WE PROVIDE MONETARY DONATIONS, BUT OUR EMPLOYEES ARE ACTIVE VOLUNTEERS IN THESE WORTHY CAUSES.
PART III, LINE 2: BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC.'S BAD DEBT EXPENSE WAS DETERMINED AS FOLLOWS:A BAD DEBT REPORT IS RUN TO PULL ALL PATIENTS THAT HAVE BEEN MOVED TO A BAD DEBT ACCOUNT LOCATION. WE THEN TAKE THE TOTAL ACCOUNT BALANCE OF ALL THE PATIENTS IN THE BAD DEBT LOCATION AND DIVIDE IT BY THE TOTAL CHARGES OF THE SAME PATIENT LOCATION. WE MULTIPLY THE RESULTING RATIO BY THE TOTAL COST OF THE SAME PATIENT POPULATION WHICH PROVIDES US WITH THE COST ASSOCIATED WITH THE TOTAL AMOUNT OF THE ACCOUNT BALANCE MOVED TO BAD DEBT STATUS.
PART III, LINE 3: BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC.'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE BAPTIST MEMORIAL HEALTH CARE CORPORATION'S FINANCIAL ASSISTANCE POLICY WAS DETERMINED AS FOLLOWS:WE IDENTIFY THE PATIENTS ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER BAPTIST MEMORIAL HEALTH CARE CORPORATION'S FINANCIAL ASSISTANCE POLICY. THIS INFORMATION IS INCLUDED IN THE PATIENT'S RECORD. WE ALSO INCLUDE PATIENTS WHO REFUSE TO COMPLETE THE FINANCIAL ASSISTANCE PAPERWORK. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, IF INFORMATION PROVIDED BY THE PATIENT IS INCOMPLETE, OR WHEN A SELF-PAY MINIMUM DISCOUNT NOTE IS ENTERED IN THE PATIENT RECORD, WE RUN A REPORT WHICH PROVIDES US THE COST ASSOCIATED WITH THE TOTAL AMOUNT OF BAD DEBT ATTRIBUTABLE TO THOSE PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE.
PART III, LINE 4: BAPTIST MEMORIAL HEALTH CARE CORPORATION, THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC., HAS ADOPTED HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15, VALUATION AND FINANCIAL STATEMENT PRESENTATION OF CHARITY CARE AND BAD DEBTS BY INSTITUTIONAL PROVIDERS.THERE IS NOT A SEPARATE BAD DEBT EXPENSE FOOTNOTE IN BAPTIST MEMORIAL HEALTH CARE CORPORATION'S COMBINED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8: THE SHORTFALL, IF ANY, IS NOT TREATED AS COMMUNITY BENEFIT.WE CANNOT GET THE PAYMENT AND MEDICARE ALLOWABLE COST INFORMATION FROM THE COST REPORT IN THE FORMAT WE NEED. THEREFORE, WE TAKE THE FOLLOWING STEPS. FOR LINE 5, WE TAKE THE TOTAL PAYMENTS FOR MEDICARE PATIENTS FROM SCHEDULE 6, PATIENT POPULATION, AND DIVIDE THAT BY THE TOTAL HOSPITAL MEDICARE PAYMENTS. WE MULTIPLY THE RESULTING RATIO BY THE REVENUE NUMBERS THAT COME FROM THE COST REPORT. FOR LINE 6, WE USE THE SAME CONCEPT TO GET THE COST INFORMATION. WE GET THE TOTAL COST OF MEDICARE PATIENTS FROM SCHEDULE 6 AND DIVIDE THAT NUMBER BY THE TOTAL COST OF THE TOTAL MEDICARE PATIENT POPULATION OF THE HOSPITAL. WE THEN MULTIPLY THIS RATIO BY THE COST INFORMATION FROM THE COST REPORT.
PART III, LINE 9B: THE HOSPITAL'S COLLECTION AGENCY WILL DETERMINE IF THE PATIENT HAS A FINANCIAL ASSISTANCE APPLICATION ON FILE AND WAS DEEMED TO QUALIFY FOR FINANCIAL ASSISTANCE BY THE HOSPITAL. IF IT WAS DETERMINED THAT THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THEN THE COLLECTION AGENCY WILL REVIEW THE REMAINING UNPAID BALANCE AFTER THE APPLICATION OF THE FINANCIAL ASSISTANCE DISCOUNT, AND PURSUE APPROPRIATE COLLECTION EFFORTS. DEPENDING UPON THE CIRCUMSTANCES AT THE TIME, THE ENTIRE AMOUNT OWED MAY BE WRITTEN OFF.
PART VI, LINE 2: BAPTIST MEMORIAL HEALTH CARE CORPORATION (BMHCC), AS SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC., PROVIDES NEEDS ASSESSMENTS THROUGH THE HEALTH SERVICES RESEARCH DEPARTMENT. IN ADDITION, LOCAL ADVISORY BOARDS PROVIDE FEEDBACK TO THE LOCAL HOSPITAL ADMINISTRATORS.REPUTATION.COM IS CONTRACTED TO ANALYZE AND GARNER ADDITIONAL FEEDBACK FROM ONLINE REVIEWS POSTED ON SOCIAL MEDIA AS WELL AS TO SOLICIT REVIEWS FROM BAPTIST PATIENTS. THESE EFFORTS ARE GEARED TOWARDS RAPID RESPONSE AND CORRECTION OF SUBOPTIMAL PERFORMANCE AS WELL AS TO BETTER UNDERSTAND THE CUSTOMER SERVICE NEEDS OF BMHCC'S PATIENT CONSTITUENCY. THIS APPLIES TO BOTH HOSPITALS AND PHYSICIAN PRACTICES.PROVIDER ENGAGEMENT SURVEYS ARE CONDUCTED YEARLY TO DETERMINE LEVELS OF ENGAGEMENT AND ALIGNMENT OF PHYSICIANS AND ADVANCE PRACTICE PROVIDERS. ENGAGEMENT ASSESSES PRIDE IN THE ORGANIZATION, INTENT TO STAY, WILLINGNESS TO RECOMMEND, AND OVERALL WORKPLACE SATISFACTION. ALIGNMENT ASSESSES THE EXTENT TO WHICH PHYSICIANS FEEL A STRONG PARTNERSHIP AND CONNECTION WITH LEADERSHIP, INCLUDING A SHARED VISION OF HOW TO EXECUTE THE ORGANIZATIONAL MISSION. AN IMPORTANT FACET OF ALIGNMENT IS THE PHYSICIANS' SENSE THAT THEIR INPUT AND FEEDBACK ARE VALUED AND HAVE AN IMPACT ON GOAL SETTING AND DIRECTION. QUESTIONS SEEK INPUT ON THEIR PATIENTS' EXPERIENCES, STAFF INTERACTIONS AND SERVICES PROVIDED, QUALITY STATUS AND IMPROVEMENT INITIATIVES, NEEDED EQUIPMENT AND SERVICES, RESOURCES AVAILABLE TO PATIENTS AND PROVIDERS, CONTINUING MEDICAL EDUCATION OPPORTUNITIES AND OUR COMMITMENT TO DIVERSITY. SURVEY INVITATIONS ARE EMAILED TO BOTH SYSTEM AFFILIATED PROVIDERS AND COMMUNITY PROVIDERS BY PRESS GANEY ASSOCIATES, LLC.COMMUNITY NEEDS ASSESSMENTS (CNA) FOR ADDITIONAL PHYSICIANS IN THE COMMUNITY ARE ALSO CONDUCTED. POPULATION-BASED DEMAND ESTIMATES ARE OBTAINED FROM THE MILLIMAN DATA DRIVEN MODELS CREATED IN COLLABORATION WITH BMHCC'S CNA VENDOR, 3DHEALTH. THEY TAKE INTO ACCOUNT THE AGE AND GENDER OF THE POPULATION. THIS IS THEN COMPARED TO THE SUPPLY OF PHYSICIANS AS DETERMINED THROUGH AN IQVIA NATIONAL PHYSICIAN DATABASE. 3DHEALTH ALSO CALLS PHYSICIAN OFFICES IN EACH SERVICE AREA TO DETERMINE THE FULL TIME EQUIVALENT OF PHYSICIANS AVAILABLE IN THE SPECIALTY OF INTEREST FOR EACH ASSESSMENT. THE DEMAND MINUS THE SUPPLY GIVES THE "NET NEED" CURRENTLY, AND IN YEARS TO COME. THE REQUEST FOR THESE ANALYSES ARE MADE BY THE HOSPITAL'S CHIEF EXECUTIVE OFFICER BASED ON THE PRIORITIES GIVEN BY THE MEDICAL STAFF AND ACCORDING TO KNOWLEDGE OF PHYSICIANS THAT ARE LIKELY TO LEAVE THE AREA IN THE NEXT YEAR OR TWO. GENERALLY, THE DEMAND AND SUPPLY ESTIMATES ARE FOR A GEOGRAPHIC AREA DEFINED BY THE PRIMARY SERVICE AREA OF THE HOSPITAL AS DEFINED BY THE STARK ACT.BMHCC ALSO CONSULTS WITH MULTIPLE OUTSIDE VENDORS IN THE REAL ESTATE AND HEALTH CARE FACILITY PLANNING BUSINESS TO ASSESS FACILITY NEED AND OPTIMAL LOCATION TO BEST SERVE THE PUBLIC. MULTIPLE SOFTWARE PACKAGES WITH PROPRIETARY ALGORITHMS TO ASSESS BEST LOCATION FOR PROSPECTIVE NEW FACILITIES ARE USED. NATIONAL CLAIMS DATABASES OF HEALTH CARE VISITS, AS WELL AS DATA SETS GATHERED FROM SOCIAL MEDIA AND CELL COMPANIES THAT ASSESS POPULATION TRAFFIC MOVEMENTS, PROVIDE CUTTING EDGE DATA TO ULTIMATELY PROVIDE OPTIMAL LOCATIONS FOR THE MARKETS BAPTIST SERVES.PATIENT EXPERIENCE SURVEYS ARE USED TO ASSESS COMMUNITY NEED AND TO SOLICIT FEEDBACK ON OUR SERVICES. THROUGH PRESS GANEY ASSOCIATES, LLC, BMHCC UTILIZES MAIL, E-MAIL AND TEXT TO SEEK FEEDBACK FROM OVER 1.2 MILLION PATIENT VISITS PER YEAR. SERVICES FOR THESE VISITS MAY BE PROVIDED IN ONE OF SEVEN SETTINGS: INPATIENT, OUTPATIENT TEST AND TREATMENT, ONCOLOGY CENTER, EMERGENCY DEPARTMENT, AMBULATORY SURGERY, URGENT CARE CENTER, AND PHYSICIAN PRACTICE CLINIC. THE SURVEY MEASURES THE PATIENT'S PERCEPTION OF KEY COMPONENTS OF THEIR JOURNEY WITH OUR HEALTH CARE ORGANIZATION. THESE COMPONENTS INCLUDE ADMISSION, REGISTRATION, COMMUNICATION WITH NURSES, COMMUNICATION WITH DOCTORS, WAIT TIME, RESPONSE TO NEEDS, HOSPITAL ENVIRONMENT, DISCHARGE, CARE TRANSITION, ETC. THE RATINGS ON EACH QUESTION ARE USED, ALONG WITH COMMENTS, TO IDENTIFY THE CONTINUATION OF BEST PRACTICES ALONG WITH ANY CHANGES IN PROCESSES OR BEHAVIORS THAT ARE NECESSARY TO MEET THE NEEDS OF THE COMMUNITIES WE SERVE.
PART VI, LINE 3: PATIENTS ARE INFORMED OF THEIR ELIGIBILITY FOR ASSISTANCE IN PERSON UPON ENTERING THE HOSPITAL FACILITY. EACH PATIENT IS ASSIGNED AN ADMISSIONS PERSON WHO PROVIDES WRITTEN INFORMATION AS WELL AS VERBAL INFORMATION. IN ADDITION, THE PATIENT MAY OBTAIN INFORMATION AS FOLLOWS:(A) A COPY IS GIVEN TO THE PATIENT DURING THE ADMISSIONS AND/OR DISCHARGE PROCESS FOR EACH VISIT FOR MEDICAL TREATMENT.(B) A COPY IS SENT WITH THE FIRST POST-DISCHARGE BILLING STATEMENT.(C) COPIES ARE POSTED AND AVAILABLE UPON REQUEST AT ALL ADMISSIONS, EMERGENCY AND BUSINESS OFFICE DEPARTMENT AREAS AT ALL BAPTIST MEMORIAL HEALTH CARE CORPORATION FACILITIES.(D) COPIES ARE ALSO AVAILABLE FOR DOWNLOAD AND PRINTING ONLINE ON THE BAPTIST MEMORIAL HEALTH CARE CORPORATION WEBSITE UNDER "FINANCIAL ASSISTANCE OR BY CONTACTING THE FACILITY WHERE SERVICES WERE RECEIVED AND REQUESTING A COPY BY MAIL OR EMAIL AT FAP@BMHCC.ORG.(E) COPIES OF ALL FINANCIAL ASSISTANCE POLICY DOCUMENTS WILL BE PROVIDED ELECTRONICALLY TO ANY INDIVIDUAL WHO INDICATES THAT IS THEIR PREFERENCE.
PART VI, LINE 4: BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. SERVICES THE CALHOUN COUNTY, MISSISSIPPI AREA. THE AFRICAN AMERICAN COMMUNITY COMPRISES ABOUT 26.2% OF OUR PRIMARY SERVICE AREA. HISPANICS MAKE UP ABOUT 6.0%, AND CAUCASIANS ARE ABOUT 65.2%.DEMOGRAPHIC SNAPSHOTS ARE PROVIDED BY THE INDEPENDENT OUTSIDE FIRM OF CLARITAS, INC. OUR OWN HEALTH SERVICES RESEARCH DEPARTMENT AT BAPTIST MEMORIAL HEALTH CARE CORPORATION (OUR PARENT) CALCULATES THE DISTRIBUTION OF INPATIENT DISCHARGES (EXCLUDING NEWBORNS) BY COUNTY. THIS IS SORTED IN DESCENDING NUMBER PER COUNTY AND DETERMINES THOSE COUNTIES WITH UP TO 75-77% OF THE DISCHARGES AND THESE CONTIGUOUS COUNTIES COMPRISE THE PRIMARY MARKET AREA. COUNTIES COMPRISING 78-95% OF THE DISCHARGES ARE DESIGNATED THE SECONDARY MARKET, WHILE THE REMAINING 5% IS THE TERTIARY MARKET.BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC.'S PRIMARY MARKET SERVICE AREA HAS 12,529 PERSONS WITH THE COMBINED PRIMARY AND SECONDARY AREA HAVING 50,896 PERSONS. OTHER ITEMS SUCH AS AGE, HOUSEHOLD INCOME, AND RACE/ETHNICITY PERCENTAGES, AS COMPARED TO THE NATION AS A WHOLE, ARE ALSO USED IN THE MIX.DUN AND BRADSTREET DATA IS ALSO USED TO DETERMINE THE COMMUNITIES' LARGEST EMPLOYERS.
PART VI, LINE 5: THE HOSPITALS HAVE OPEN MEDICAL STAFFS, COMMUNITY BOARD INVOLVEMENT, SUPPORT SERVICES, FREE AND/OR REDUCED MAMMOGRAMS, HEALTH FAIRS, DONATION OF SUPPLIES AND MONEY, AND MANY OTHER THINGS.
PART VI, LINE 6: BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. IS AN AFFILIATE OF BAPTIST MEMORIAL HEALTH CARE CORPORATION. BAPTIST MEMORIAL HEALTH CARE CORPORATION IS THE SOLE MEMBER OF A NUMBER OF HOSPITALS, MINOR MEDICAL CENTERS, HOME CARE AND HOSPICE SERVICES, AND PHYSICIAN SERVICES IN WEST TENNESSEE, NORTH AND CENTRAL MISSISSIPPI, AND EAST ARKANSAS. EACH FACILITY PROVIDES HEALTH CARE SERVICES TO MEET THE NEEDS OF THE COMMUNITIES SERVED.
Schedule H (Form 990) 2022
Additional Data


Software ID:  
Software Version:  
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
2022
Open to Public Inspection
Name of the organization
BAPTIST MEMORIAL HOSPITAL-CALHOUN INC
 
Employer identification number

81-3257997
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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 .....
1b
 
 
2
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? ....
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
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, 1099-MISC compensation, and/or 1099-NEC (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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1JASON M LITTLE
PRESIDENT
(i)

(ii)
0
-------------
1,300,107
0
-------------
571,150
0
-------------
486,100
0
-------------
63,875
0
-------------
35,410
0
-------------
2,456,642
0
-------------
0
2PAUL D DEPRIEST MD
VICE PRESIDENT (THRU 08/23)
(i)

(ii)
0
-------------
802,180
0
-------------
343,970
0
-------------
261,452
0
-------------
58,938
0
-------------
28,876
0
-------------
1,495,416
0
-------------
0
3GREGORY M DUCKETT
SECRETARY
(i)

(ii)
0
-------------
487,324
0
-------------
191,182
0
-------------
442,246
0
-------------
48,172
0
-------------
33,925
0
-------------
1,202,849
0
-------------
0
4GARY C ANDERSON
VICE PRESIDENT (AS OF 09/23)
(i)

(ii)
0
-------------
531,848
0
-------------
213,044
0
-------------
317,995
0
-------------
58,938
0
-------------
24,933
0
-------------
1,146,758
0
-------------
0
5CHRISTOPHER THREADGILL
CEO
(i)

(ii)
0
-------------
133,645
0
-------------
28,549
0
-------------
5,778
0
-------------
23,985
0
-------------
28,829
0
-------------
220,786
0
-------------
0
6DUSHARME PICKENS
REGISTERED NURSE
(i)

(ii)
127,599
-------------
1,651
6,000
-------------
0
25
-------------
0
16,919
-------------
165
849
-------------
816
151,392
-------------
2,632
0
-------------
0
7SAMUEL MYERS
PHARMACIST
(i)

(ii)
119,583
-------------
0
0
-------------
0
73
-------------
0
11,433
-------------
0
22,227
-------------
0
153,316
-------------
0
0
-------------
0
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
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
PART I, LINE 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION, A RELATED ORGANIZATION OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B ELIGIBLE EXECUTIVES PARTICIPATE IN VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. THE FOLLOWING INDIVIDUAL(S) LISTED ON PART VII RECEIVED SUPPLEMENTAL NON-QUALIFIED PLAN PAYMENTS DURING THE CALENDAR YEAR: JASON M. LITTLE - $351,138 GREGORY M. DUCKETT - $344,125 PAUL D. DEPRIEST, MD - $84,690 GARY C. ANDERSON - $216,372
PART I, LINE 7: THE BAPTIST MEMORIAL HEALTH CARE SYSTEM HAS ESTABLISHED A MANAGEMENT ACCOUNTABILITY AND FINANCIAL INCENTIVE PLAN THAT ENCOURAGES MANAGEMENT PARTICIPATION IN THE SIGNIFICANT IMPROVEMENTS OF THE QUALITY, FINANCIAL, GROWTH, AND HUMAN RESOURCE RELATED OPERATIONS OF THE ORGANIZATION. AN INCENTIVE BONUS MAY BE PAID TO APPROVED MEMBERS OF MANAGEMENT BASED ON ATTAINMENT OF GOALS IN THE AREAS OF 1) PATIENT SATISFACTION; 2) EMPLOYEE SATISFACTION; 3) PHYSICIAN SATISFACTION; 4) QUALITY AND SAFETY; 5) OPERATIONAL PERFORMANCE METRICS; AND 6) OPERATING INCOME MARGIN. PARTICIPANTS RECEIVE POINTS UNDER A PLAN SCORING SYSTEM FOR MEETING THEIR PREDETERMINED GOALS. THE POINTS ARE THEN ENTERED INTO THE PLAN FORMULA TO DETERMINE THE INCENTIVE COMPENSATION.
Schedule J (Form 990) 2022

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
BAPTIST MEMORIAL HOSPITAL-CALHOUN INC
 
Employer identification number

81-3257997
Return Reference Explanation
FORM 990, PART V, LINE 1A: ALL FORMS 1099 ARE PREPARED BY THE ACCOUNTS PAYABLE DEPARTMENT OF BAPTIST MEMORIAL HEALTH CARE CORPORATION, THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. ALL FORMS 1099 ARE ISSUED USING THE FEDERAL TAX IDENTIFICATION NUMBER OF BAPTIST MEMORIAL HEALTH CARE CORPORATION. FORMS 1099 ARE NOT PROCESSED BY ENTITY, BUT BY VENDOR GROUP. MANY VENDORS PERFORM SERVICES FOR MULTIPLE BAPTIST MEMORIAL HEALTH CARE CORPORATION ENTITIES, SO ONLY ONE 1099 IS ISSUED PER VENDOR WITH THE TOTAL AMOUNT PAID FOR SERVICES. THIS NUMBER IS REPORTED ON BAPTIST MEMORIAL HEALTH CARE CORPORATION'S FORM 990, PART V, LINE 1A.
FORM 990, PART V, LINE 2A: THE PAYROLL FUNCTION IS CENTRALIZED AT THE CORPORATE PAYROLL DEPARTMENT OF BAPTIST MEMORIAL HEALTH CARE CORPORATION, THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. THE CORPORATE PAYROLL DEPARTMENT IS RESPONSIBLE FOR ALL SALARIES AND WAGES OF EMPLOYEES FOR THE ENTIRE BAPTIST MEMORIAL HEALTH CARE CORPORATION SYSTEM. FORMS W-2 AND W-3 ARE SUBMITTED ELECTRONICALLY TO THE INTERNAL REVENUE SERVICE USING BAPTIST MEMORIAL HEALTH CARE CORPORATION'S FEDERAL TAX IDENTIFICATION NUMBER, ACCORDING TO THE GUIDELINES ASSOCIATED WITH COMMON PAYMASTER. HOWEVER, THE EMPLOYEE INFORMATION IS ALLOCATED TO ITS RESPECTIVE FACILITY FOR FINANCIAL REPORTING PURPOSES AND THEY ARE REPORTED TO THE STATE BY EACH FACILITY. THUS, THE AMOUNT REPORTED ON FORM 990, PART V, LINE 2A REFLECTS THE NUMBER OF EMPLOYEES AT THIS FACILITY WHO RECEIVED A W-2. THE TOTAL NUMBER OF FORMS W-2 FOR ALL BAPTIST MEMORIAL HEALTH CARE CORPORATION ENTITIES IS REPORTED ON THE BAPTIST MEMORIAL HEALTH CARE CORPORATION W-3.
FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUALS HAVE A BUSINESS RELATIONSHIP BECAUSE THEY ARE BOARD MEMBERS OR SHARED OFFICERS OF A TAXABLE ENTITY WITHIN BAPTIST MEMORIAL HEALTH CARE CORPORATION: JASON M. LITTLE GREGORY M. DUCKETT GARY C. ANDERSON
FORM 990, PART VI, SECTION A, LINE 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION, AS SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC., PROVIDES CERTAIN LEGAL, FINANCE, QUALITY, AND PERSONNEL SERVICES PURSUANT TO A SHARED SERVICES AGREEMENT.
FORM 990, PART VI, SECTION A, LINE 6 BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. IS A NON-PROFIT, NON-STOCK CORPORATION WHOSE SOLE MEMBER IS BAPTIST MEMORIAL HEALTH CARE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7A BAPTIST MEMORIAL HEALTH CARE CORPORATION, AS THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC., APPOINTS ITS BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B BAPTIST MEMORIAL HEALTH CARE CORPORATION, AS THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC., APPROVES THE BOARD OF DIRECTORS' ACTIONS.
FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY BAPTIST MEMORIAL HEALTH CARE CORPORATION'S EXECUTIVE VICE-PRESIDENT/CFO, THE ENTITY'S TOP FINANCIAL OFFICIAL, AND AN OUTSIDE INDEPENDENT ACCOUNTING AND TAX FIRM PRIOR TO SUBMITTING THE FORM 990 TO THE IRS. THE FORM 990 WAS NOT REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS BEFORE SUBMITTING IT TO THE IRS. BAPTIST MEMORIAL HEALTH CARE CORPORATION, AS THE SOLE MEMBER OF THE ORGANIZATION, HAS A FINANCE, AUDIT AND COMPLIANCE COMMITTEE THAT IS APPOINTED BY ITS BOARD OF DIRECTORS. THE FINANCE, AUDIT AND COMPLIANCE COMMITTEE WILL REVIEW THE FORM 990 AFTER SUBMITTING IT TO THE IRS. THE COMMITTEE REPORTS THE COMPLETION OF THE REVIEW TO THE CORPORATE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C BAPTIST MEMORIAL HEALTH CARE CORPORATION, THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC., REQUIRES THAT ALL EMPLOYEES, INCLUDING OFFICERS AND KEY EMPLOYEES, PERIODICALLY COMPLETE A CERTIFICATION AND ACKNOWLEDGEMENT OF THE BAPTIST MEMORIAL HEALTH CARE CORPORATION STANDARDS OF CONDUCT, WHICH INCORPORATES THE CONFLICT OF INTEREST POLICY. BOARD MEMBERS DISCLOSE AND SIGN A CONFLICT OF INTEREST STATEMENT EACH DECEMBER. IN THE EVENT THAT AN EMPLOYEE OR BOARD MEMBER BECOMES AWARE OF A POTENTIAL CONFLICT OF INTEREST, HE/SHE IS REQUIRED TO REPORT IT TO THEIR CHIEF EXECUTIVE OFFICER BEFORE TAKING ANY ACTION. IF HE/SHE IS THE CHIEF EXECUTIVE OFFICER, THEN HE/SHE IS TO REPORT TO THE CHAIRMAN OF THE BOARD OF DIRECTORS. THE SIGNED CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE SENIOR VICE PRESIDENT AND CORPORATE COUNSEL AND ARE MAINTAINED IN THE BAPTIST MEMORIAL HEALTH CARE CORPORATION LEGAL DEPARTMENT. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, IT WILL BE THE RESPONSIBILITY OF THE CHIEF EXECUTIVE OFFICER, WITH THE INVOLVEMENT OF THE BAPTIST MEMORIAL HEALTH CARE CORPORATION LEGAL DEPARTMENT TO RESOLVE THE ISSUE.
FORM 990, PART VI, SECTION B, LINE 15 AS SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC., BAPTIST MEMORIAL HEALTH CARE CORPORATION'S HUMAN RESOURCE DEPARTMENT, THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS, AND AN INDEPENDENT COMPENSATION CONSULTING FIRM PERFORM ANNUAL REVIEWS EACH DECEMBER AND APPROVE COMPENSATION OF THE CEO AND OTHER TOP MANAGEMENT PERSONNEL. THEY USE COMPARABILITY DATA AND OTHER SOURCES AS NEEDED. THE CEO AND OTHER TOP MANAGEMENT USE THE SAME TYPE OF INFORMATION TO APPROVE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. ON DECEMBER 6, 2021, THE COMPENSATION WAS REVIEWED AND APPROVED FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2022 FOR THE PRESIDENT, THE VICE PRESIDENTS, AND THE CEO/ADMINISTRATOR.
FORM 990, PART VI, SECTION C, LINE 18 BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. MAKES COPIES OF ITS FORM 1023 AND FORM 990 AVAILABLE FOR PUBLIC INSPECTION TO ANYONE WHO REQUESTS THEM AS REQUIRED BY THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION C, LINE 19 BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,230,691. MANAGEMENT AND GENERAL EXPENSES 247,855. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,478,546. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 1,282,298. MANAGEMENT AND GENERAL EXPENSES 142,478. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,424,776. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 218,550. MANAGEMENT AND GENERAL EXPENSES 24,283. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 242,833.
FORM 990, PART XII, LINE 2C: BAPTIST MEMORIAL HEALTH CARE CORPORATION, AS THE SOLE MEMBER OF BAPTIST MEMORIAL HOSPITAL-CALHOUN, INC., HAS AN AUDIT COMMITTEE THAT CHOOSES THE AUDIT FIRM, OVERSEES AND REVIEWS THE AUDIT REPORTS, AND THEN FOLLOWS UP ON ANY NECESSARY CHANGES AND RECOMMENDATIONS. THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
BAPTIST MEMORIAL HOSPITAL-CALHOUN INC
 
Employer identification number

81-3257997
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?
Yes No
(1)BAPTIST BESTHEALTH INC
350 N HUMPHREYS BLVD

MEMPHIS,TN381202177
83-1651534
HEALTH CARE SERVICE PROVIDER TN 501(C)(3) 12 TYPE I BAPTIST MEMORIAL HEALTH SERVICES INC
 
Yes
 
(2)BAPTIST CANCER CENTER PHYSICIANS FOUNDATION INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
45-2842963
HEALTH CARE SERVICE PROVIDER TN 501(C)(3) 3 BAPTIST MEMORIAL MEDICAL GROUP INC
 
Yes
 
(3)BAPTIST CLINICAL RESEARCH INSTITUTE INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
45-3032246
FACILITATE MEDICAL & SCIENTIFIC RESEARCH TN 501(C)(3) 4 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(4)BAPTIST HEALTH FOUNDATION INC
1225 NORTH STATE STREET

JACKSON,MS39202
47-3403762
SOLICIT, RAISE, MANAGE, APPLY & INVEST FUNDS IN SUPPORT OF BAPTIST ENTITIES MS 501(C)(3) 12 TYPE I MISSISSIPPI BAPTIST HEALTH SYSTEMS INC
 
Yes
 
(5)BAPTIST MEDICAL CENTER - LEAKE INC
1225 NORTH STATE STREET

JACKSON,MS39202
45-2896080
HEALTH CARE FACILITY/HOSPITAL MS 501(C)(3) 3 MISSISSIPPI BAPTIST HEALTH SYSTEMS INC
 
Yes
 
(6)BAPTIST MEDICAL CENTER - YAZOO INC
823 GRAND AVENUE

YAZOO CITY,MS39194
64-0844470
HEALTH CARE FACILITY/HOSPITAL MS 501(C)(3) 3 MISSISSIPPI BAPTIST HEALTH SYSTEMS INC
 
Yes
 
(7)BAPTIST MEMORIAL COLLEGE OF HEALTH SCIENCES INC
1003 MONROE AVE

MEMPHIS,TN38104
62-1599670
EDUCATION OF HEALTH CARE PROFESSIONALS TN 501(C)(3) 2 BAPTIST MEMORIAL HOSPITAL
 
Yes
 
(8)BAPTIST MEMORIAL HEALTH CARE CORPORATION
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
58-1521475
MANAGEMENT, ADMINISTRATIVE & FINANCIAL SERVICES TN 501(C)(3) 12 TYPE III-FI N/A
 
No
(9)BAPTIST MEMORIAL HEALTH CARE FOUNDATION INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
58-1544781
SOLICIT, RAISE, MANAGE, APPLY & INVEST FUNDS IN SUPPORT OF BAPTIST ENTITIES TN 501(C)(3) 12 TYPE I BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(10)BAPTIST MEMORIAL HEALTH CARE SYSTEM INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
58-1456556
CARRY OUT THE HEALTH CARE MISSIONS OF THE BAPTIST CONVENTIONS OF AR, MS, TN TN 501(C)(3) 12 TYPE I N/A
 
No
(11)BAPTIST MEMORIAL HEALTH SERVICES INC
350 N HUMPHREYS BLVD

MEMPHIS,TN381202177
62-1509127
PROVISIONS OF HEALTH CARE PROVIDERS & HOME MEDICAL EQUIPMENT/SERVICES TN 501(C)(3) 12 TYPE I BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(12)BAPTIST MEMORIAL HOME CARE INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
58-1562973
HOME HEALTH CARE & HOSPICE SERVICES TN 501(C)(3) 10 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(13)BAPTIST MEMORIAL HOSPITAL
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
62-0123940
HEALTH CARE FACILITY/HOSPITAL TN 501(C)(3) 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(14)BAPTIST MEMORIAL HOSPITAL-BOONEVILLE INC
100 HOSPITAL STREET

BOONEVILLE,MS38829
64-0663760
HEALTH CARE FACILITY/HOSPITAL MS 501(C)(3) 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(15)BAPTIST MEMORIAL HOSPITAL-CRITTENDEN INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
82-3844150
HEALTH CARE FACILITY/HOSPITAL AR 501(C)(3) 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(16)BAPTIST MEMORIAL HOSPITAL-DESOTO INC
7601 SOUTHCREST PARKWAY

SOUTHAVEN,MS38671
64-0682111
HEALTH CARE FACILITY/HOSPITAL MS 501(C)(3) 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(17)BAPTIST MEMORIAL HOSPITAL-GOLDEN TRIANGLE INC
2520 5TH STREET NORTH

COLUMBUS,MS39705
62-1519754
HEALTH CARE FACILITY/HOSPITAL MS 501(C)(3) 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(18)BAPTIST MEMORIAL HOSPITAL-HUNTINGDON INC
631 RB WILSON DRIVE

HUNTINGDON,TN38344
62-1166050
HEALTH CARE FACILITY/HOSPITAL TN 501(C)(3) 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(19)BAPTIST MEMORIAL HOSPITAL-JONESBORO INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
26-1214372
HEALTH CARE FACILITY/HOSPITAL AR 501(C)(3) 3 NEA BAPTIST HEALTH SYSTEM INC
 
Yes
 
(20)BAPTIST MEMORIAL HOSPITAL-NORTH MISSISSIPPI INC
1100 BELK BOULEVARD

OXFORD,MS38655
64-0772726
HEALTH CARE FACILITY/HOSPITAL MS 501(C)(3) 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(21)BAPTIST MEMORIAL HOSPITAL-TIPTON INC
1995 HIGHWAY 51 SOUTH

COVINGTON,TN38019
62-1113167
HEALTH CARE FACILITY/HOSPITAL TN 501(C)(3) 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(22)BAPTIST MEMORIAL HOSPITAL-UNION CITY INC
1201 BISHOP ST

UNION CITY,TN38261
62-1138045
HEALTH CARE FACILITY/HOSPITAL TN 501(C)(3) 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(23)BAPTIST MEMORIAL HOSPITAL-UNION COUNTY INC
200 HWY 30 W

NEW ALBANY,MS38652
63-0997281
HEALTH CARE FACILITY/HOSPITAL MS 501(C)(3) 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(24)BAPTIST MEMORIAL MEDICAL GROUP INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
62-1545731
PROVISION OF HEALTH CARE PROVIDERS FOR BAPTIST ENTITIES TN 501(C)(3) 12 TYPE I BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(25)BAPTIST MEMORIAL MEDICAL MINISTRIES EMPLOYEE HEALTH AND WELFARE TRUST
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
62-1407946
BAPTIST EMPLOYEE HEALTH PLAN TN 501(C)(9)   BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(26)BAPTIST MEMORIAL REGIONAL REHABILITATION SERVICES INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
58-1645396
HEALTH CARE FACILITY/HOSPITAL TN 501(C)(3) 3 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(27)BAPTIST MINOR MEDICAL CENTERS INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
62-1538114
NON-EMERGENCY CLINICS TN 501(C)(3) 3 BAPTIST MEMORIAL MEDICAL GROUP INC
 
Yes
 
(28)BAPTIST NURSING HOME - CALHOUN INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
81-3655778
HEALTH CARE FACILITY/HOSPITAL MS 501(C)(3) 12 TYPE I BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(29)BAPTIST PATIENT SAFETY SYSTEM INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
45-3032372
ESTABLISH, MAINTAIN & MANAGE A PATIENT SAFETY ORGANIZATION TN 501(C)(3) 11 BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(30)BMG FAMILY PHYSICIANS GROUP FOUNDATION INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
46-1953140
HEALTH CARE SERVICE PROVIDER TN 501(C)(3) 3 BAPTIST MEMORIAL MEDICAL GROUP INC
 
Yes
 
(31)GASTROINTESTINAL SPECIALISTS FOUNDATION INC
80 HUMPHREYS CENTER

MEMPHIS,TN38120
35-2461541
HEALTH CARE SERVICE PROVIDER TN 501(C)(3) 3 BAPTIST MEMORIAL MEDICAL GROUP INC
 
Yes
 
(32)INTEGRITY ONCOLOGY FOUNDATION INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
45-3303687
HEALTH CARE SERVICE PROVIDER TN 501(C)(3) 3 BAPTIST MEMORIAL MEDICAL GROUP INC
 
Yes
 
(33)MEDICAL FINANCIAL SERVICES INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
62-1112364
COLLECTION AGENCY FOR BAPTIST ENTITIES TN 501(C)(3) 12 TYPE II BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(34)MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI INC
1225 NORTH STATE STREET

JACKSON,MS39202
75-3068151
CLINICS MS 501(C)(3) 3 MISSISSIPPI BAPTIST HEALTH SYSTEMS INC
 
Yes
 
(35)MEMPHIS LUNG PHYSICIANS FOUNDATION INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
45-2832975
HEALTH CARE SERVICE PROVIDER TN 501(C)(3) 3 BAPTIST MEMORIAL MEDICAL GROUP INC
 
Yes
 
(36)MISSISSIPPI BAPTIST HEALTH SYSTEMS INC
1225 NORTH STATE STREET

JACKSON,MS39202
64-0306253
HOLDING COMPANY MS 501(C)(3) 12 TYPE II BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(37)MISSISSIPPI BAPTIST MEDICAL CENTER INC
1225 NORTH STATE STREET

JACKSON,MS39202
64-0881013
HEALTH CARE FACILITY/HOSPITAL MS 501(C)(3) 3 MISSISSIPPI BAPTIST HEALTH SYSTEMS INC
 
Yes
 
(38)MISSISSIPPI HOSPITAL FOR RESTORATIVE CARE INC
1225 NORTH STATE STREET

JACKSON,MS39202
64-0833383
HEALTH CARE FACILITY/HOSPITAL MS 501(C)(3) 3 MISSISSIPPI BAPTIST HEALTH SYSTEMS INC
 
Yes
 
(39)MJMH IMPROVEMENT CORPORATION
1225 NORTH STATE STREET

JACKSON,MS39202
80-0812322
HOLDING COMPANY MS 501(C)(3) 12 TYPE I MISSISSIPPI BAPTIST HEALTH SYSTEMS INC
 
Yes
 
(40)NEA BAPTIST HEALTH SYSTEM INC
350 N HUMPHREYS BLVD

MEMPHIS,TN38120
27-1799652
HEALTH CARE SERVICE PROVIDER AR 501(C)(3) 12 TYPE II BAPTIST MEMORIAL HEALTH CARE CORPORATION
 
Yes
 
(41)NORTHEAST ARKANSAS CLINIC CHARITABLE FOUNDATION INC
4802 EAST JOHNSON AVE

JONESBORO,AR72401
71-0850123
HEALTH CARE SERVICE PROVIDER AR 501(C)(3) 3 NEA BAPTIST HEALTH SYSTEM INC
 
Yes
 
(42)THE BAPTIST HEALTHPLEX INC
102 CLINTON PARKWAY

CLINTON,MS39056
64-0900902
PROMOTION OF HEALTH & FITNESS MS 501(C)(3) 10 MISSISSIPPI BAPTIST HEALTH SYSTEMS INC
 
Yes
 
(43)THE STERN CARDIOVASCULAR FOUNDATION INC
8060 WOLF RIVER BLVD

GERMANTOWN,TN38138
27-4396698
HEALTH CARE SERVICE PROVIDER TN 501(C)(3) 3 BAPTIST MEMORIAL MEDICAL GROUP INC
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) BAPTIST - DESOTO SURGERY CENTER LP

340 SEVEN SPRINGS WAY SUITE 600
BRENTWOOD,TN37027
20-0804946
AMBULATORY SURGERY MS N/A
        No   Yes    
(2) BAPTIST - EMSC LP

80 HUMPHREYS CENTER SUITE 101
MEMPHIS,TN38120
62-1846584
AMBULATORY SURGERY TN N/A
        No   Yes    
(3) BAPTIST - UT INSTITUTE FOR ACADEMIC EXCELLENCE LLC

350 N HUMPHREYS BLVD
MEMPHIS,TN38120
87-1722903
MEDICAL MANAGEMENT TN N/A
        No   Yes    
(4) BAPTIST-GERMANTOWN SURGERY CENTER LLC

6077 PRIMACY PKWY SUITE 140
MEMPHIS,TN38119
62-1829424
AMBULATORY SURGERY TN N/A
        No   Yes    
(5) BAPTIST MEMORIAL REHABILITATION HOSPITAL GP

330 SEVEN SPRINGS WAY
BRENTWOOD,TN37027
46-1613457
REHABILITATION SERVICES TN N/A
        No   Yes    
(6) BAPTIST MEMORIAL REHABILITATION HOSPITAL - MADISON LLC

330 SEVEN SPRINGS WAY
BRENTWOOD,TN37027
92-4010592
REHABILITATION SERVICES MS N/A
        No   Yes    
(7) BMH NORTH MISSISSIPPI IMAGING SERVICES LLC

504 AZALEA DRIVE
OXFORD,MS38655
26-2641267
DIAGNOSTIC SERVICES MS N/A
        No     No  
(8) BAPTIST AND PHYSICIANS' OUTPATIENT SURGERY CENTER OF N MISSISSIPPI LP

340 SEVEN SPRINGS WAY SUITE 600
BRENTWOOD,TN37027
64-0925692
AMBULATORY SURGERY MS N/A
        No     No  
(9) BAPTIST STERN CARDIOVASCULAR CO-MANAGEMENT LLC

350 N HUMPHREYS BLVD
MEMPHIS,TN38120
82-0605766
MEDICAL MANAGEMENT TN N/A
        No   Yes    
(10) BMHSIAEL MICROBIOLOGY LABORATORY GP

12357-A RIATA TRACE PARKWAY SUITE 2
AUSTIN,TX78727
81-4211152
LABORATORY SERVICES TX N/A
        No   Yes    
(11) BRAIN AND SPINE NETWORK BAPTIST SEMMES-MURPHEY LLC

350 N HUMPHREYS BLVD
MEMPHIS,TN38120
47-5240436
MEDICAL MANAGEMENT TN N/A
        No   Yes    
(12) DOWNTOWN FITNESS LLC

100 EAST CAPITOL STREET SUITE 107
JACKSON,MS39201
61-1852202
FITNESS CENTER MS N/A
        No     No  
(13) EAST MEMPHIS UROLOGY CENTER LP

340 SEVEN SPRINGS WAY SUITE 600
BRENTWOOD,TN37027
62-1810940
AMBULATORY UROLOGICAL SERVICES TN N/A
        No   Yes    
(14) MADISON HEALTHPLEX PERFORMANCE TRAINING CENTER LLC

1600 N STATE STREET SUITE 400
JACKSON,MS39202
46-1218603
FITNESS CENTER MS N/A
        No   Yes    
(15) MAIN STREET FAMILY MEDICAL LLC

1225 NORTH STATE STREET
JACKSON,MS39202
45-2778113
MEDICAL SERVICES MS N/A
        No   Yes    
(16) MAYS & SCHNAPP PAIN CLINIC

55 HUMPHREYS CENTER DRIVE SUITE 200
MEMPHIS,TN38120
62-1512849
PAIN MANAGEMENT SERVICES TN N/A
        No   Yes    
(17) MEDICAL ALTERNATIVES

6949 APPLING FARMS PKWY STE 109
MEMPHIS,TN38133
62-1488427
PROVIDE HOME INFUSION PRODUCTS AND SERVICES TO PATIENTS TN N/A
        No   Yes    
(18) MID-SOUTH IMAGING CENTER LLC

350 N HUMPHREYS BLVD
MEMPHIS,TN38120
87-2098257
DIAGNOSTIC SERVICES MS N/A
        No   Yes    
(19) WEST TENNESSEE IMAGING LLC

800 CRESCENT CENTRE DR SUITE 400
FRANKLIN,TN37067
90-1022012
MEDICAL SERVICES TN N/A
        No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) BAPTIST HEALTH SERVICES GROUP OF THE MID-SOUTH INC

350 N HUMPHREYS BLVD
MEMPHIS,TN38120
62-1534210
HEALTH INSURANCE CONTRACTING TN N/A
C       Yes  
(2) GERMANTOWN BUSINESS PARK OWNERS ASSOCIATION

350 N HUMPHREYS BLVD
MEMPHIS,TN38120
20-1158216
BOOKKEEPING & DATA PROCESSING GERMANTOWN BUS. PARK TN N/A
C       Yes  
(3) HEALTH TECH AFFILIATES INC

350 N HUMPHREYS BLVD
MEMPHIS,TN381202177
62-1278576
BUYING & LEASING REAL & PERSONAL PROPERTY TN N/A
C       Yes  
(4) MISSISSIPPI BAPTIST MEDICAL ENTERPRISES INC AND SUBS

1225 NORTH STATE STREET
JACKSON,MS39202
64-0776164
INVESTMENTS MS N/A
C       Yes  
(5) SOUTHCREST PROPERTY OWNERS ASSOCIATION INC

350 N HUMPHREYS BLVD
MEMPHIS,TN38120
64-0768703
BOOKKEEPING & DATA PROCESSING FOR THE SOUTHCREST DEVELOPMENT MS N/A
C       Yes  




Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) BAPTIST MEMORIAL HEALTH CARE CORPORATION

E 108,054 CASH
(2) BAPTIST MEMORIAL HEALTH CARE CORPORATION

M 1,231,224 CASH
(3) BAPTIST MEMORIAL MEDICAL MINISTRIES EMPLOYEE HEALTH AND WELFARE TRUST

R 595,629 CASH



Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
Schedule R (Form 990) 2021

Additional Data


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