2025-08-15T06:48:32-05:00 2024-08-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-09-01 472893430 Baptist Health Deaconess Madisonville Fo BAPT 2703266133 900 Hospital Drive Madisonville KY 42431 Alisa Coleman President 2703266133 2025-08-14 1 0 Kim Hunwardsen CPA P00484560 6122536500 2025-08-14 2023 2025-03-06 01:10:19Z Alisa Coleman 900 Hospital Drive Madisonville KY 42431 305767 0 X www.baptisthealthdeaconess.com X 2014 KY To assist, advance, strengthen and support Baptist Health Deaconess Madisonville, Inc. 17 16 0 18 0 0 681285 240515 0 0 37020 65252 0 0 718305 305767 416477 309371 0 0 201929 143861 0 0 35965 81392 55265 699798 508497 18507 -202730 3880461 4457653 1129239 1649197 2751222 2808456 Rooted in a tradition of Christian service, Baptist Health Deaconess Madisonville expands access to high quality healthcare delivered with a compassionate and nurturing spirit to all. 0 0 371886 309371 Baptist Health Deaconess Maidsonville Foundation, Inc. operates to assist, advance, strengthen & support Baptist Health Deaconess Madisonville, Inc. in its mission and ministry of continuing the Christian heritage of service by enhancing the health of the people and communities served. The Foundation operates to encourage, solicit and receive donations, bequests, gifts and benefactions made to or for the benefit of Baptist Health Deaconess Madisonville, Inc. Baptist Health Deaconess Madisonville Foundation is operated exclusively for the benefit of, to perform the functions of, and to carry out the purpose of Baptist Health Deaconess Madisonville, Inc. 371886 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 17 16 1 1 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 KY X Valarie Howard 2703266133 900 Hospital Drive Madisonville KY 42431 Alisa Coleman President 1.00 42.00 X X 0 0 0 Terry Douglass Chair 1.00 0.00 X X 0 0 0 Jason Vincent Vice Chair 1.00 0.00 X X 0 0 0 Mary Rhea Ashby Director 1.00 0.00 X 0 0 0 Devi Thorp Director 1.00 0.00 X 0 0 0 Cheri McNary Director 1.00 0.00 X 0 0 0 Nan Nance Director 1.00 0.00 X 0 0 0 David Lamb Director 1.00 0.00 X 0 0 0 Elizabeth Oldham Director 1.00 0.00 X 0 0 0 Rev Ken Hundley Director 1.00 0.00 X 0 0 0 Chuck Shockley Director 1.00 0.00 X 0 0 0 Ron Sanders Sr Director 1.00 0.00 X 0 0 0 Patrick Falvey Director 1.00 3.00 X 0 0 0 Kara Foster Director 1.00 0.00 X 0 0 0 Megan Chaney Director 1.00 0.00 X 0 0 0 James Fellows MD Director 1.00 0.00 X 0 0 0 Penelope Metcalfe Director 1.00 0.00 X 0 0 0 Daniel Mercer Director until 2/12/24 1.00 0.00 X 0 0 0 Molly Deahl Director until 5/7/24 1.00 0.00 X 0 0 0 Kim Ashby VP of Finance 1.00 42.00 X 0 294342 11469 Richard Carrico Treasurer 1.00 3.00 X 0 0 0 Janet Norton Secretary 1.00 1.00 X 0 0 0 Ashley Galvan Assistant Secretary 40.00 0.00 X 0 68179 1115 Valarie Howard Assistant Treasurer 1.00 40.00 X 0 136068 5144 0 498589 17728 0 0 1 1 0 33794 206721 240515 59084 59084 6168 0 6168 6168 6168 305767 0 0 65252 309371 309371 114227 42835 42835 28557 3573 1340 1340 893 17512 6567 6567 4378 8549 3206 3206 2137 13472 13472 16500 16500 4468 808 3660 8226 2225 6001 386 386 Administrative Expenses 4846 4846 Dues and Subscriptions 833 833 Purchased services 800 800 Bank Fees 200 200 5534 5534 508497 371886 100646 35965 1542962 2108861 424241 185982 12460 1899773 2161785 1025 1025 3880461 4457653 26204 1129239 1622993 1129239 1649197 X 1327593 1414440 1423629 1394016 2751222 2808456 3880461 4457653 -202730 259964 0 X 0 1 X 1 0 X X X 1 Baptist Health Deaconess Madisonville 610654587 3 1 309371 0 1 309371 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 Due to Affiliate 1622993 1622993 X 552259 259964 259964 292295 13472 13472 305767 495025 0 495025 13472 13472 508497 Part X, Line 2: Baptist Health Deaconess Madisonville Foundation, Inc. evaluates its uncertain tax positions on an annual basis. A tax benefit from an uncertain position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolution of any related appeals or litigation processes, based on the technical merit of the position. The Foundation has determined that it has no uncertain tax positions that are required to be recorded as of August 31, 2024 or 2023. 1 Baptist Health Deaconess Madisonville Inc 900 Hospital Drive Madisonville KY 42431 610654587 501(c)(3) 309371 0 Purchase of supplies and funding of patient care and assistance programs 1 0 Part I, Line 2: Baptist Health Deaconess Madisonville Foundation provides only direct contributions and other general support to Baptist Heatlh Deaconess Madisonville, Inc. Since the organizations have officer and board member overlap, the funds are used for their intended purpose. 0 0 0 0 0 0 1 0 0 Kim Ashby VP of Finance 0 250925 0 42992 0 425 0 9951 0 1518 0 305811 0 0 Part I, Line 3 Alisa Coleman, President, is compensated by Deaconess Health System, an unrelated organization for services to the Foundation and related entities. Deaconess Health System uses some of the processes described in Part I, Question 3 to help determine appropriate compensation for the President. Compensation approval is done by the Board of Directors or Compensation Committee of Deaconess Health System. Part I, Line 6 Incentive compensation is based on operating margin performance which is affected by the net earnings. If the operating margin is low there is no payout. The incentive payment is also based on the successful achievement of established inpatient satisfaction measures, outpatient satisfaction measures, and compliance with publicly reported quality indicators, as well as other technical and personal functional goals of the related organizations. The incentive compensation programs are formulated to reward behavior that balances patient needs and the efficient delivery of patient care to ensure the best outcomes are achieved. Form 990, Part V, Lines 1 and 2: Form W-2 and Form 1096 are filed under Baptist Health Deaconess Madisonville, Inc., FEIN 61-0654587. Form 990, Part VI, Section A, line 2 Alisa Coleman, Kim Ashby, Ashely Galvan, Valarie Howard, Richard Carrico, Janet Norton, and Patrick Falvey have a business relationship. Form 990, Part VI, Section A, line 3 Alisa Coleman, President, is employed by Deaconess Health System, an unrelated organization. Compensation for the President is provided by Deaconess Health System through a management agreement for services to Baptist Health Deaconess Madisonville, Baptist Health Deaconess Medical Group, and Baptist Health Deaconess of Madisonville Foundation. All three are related entities. This position has the responsibility of supervising the management, administration and operation of the Foundation, Baptist Health Deaconess Medical Group, and Baptist Health Deaconess Madisonville. Below is the calendar year 2023 compensation for the President. Compensation $451,153 Retirement 22,914 Benefits 22,722 Form 990, Part VI, Section A, line 6 The organization's sole member is Baptist Health Deaconess Madisonville, Inc. Form 990, Part VI, Section A, line 7a Baptist Health Deaconess Madisonville, Inc., the sole member, has the authority to appoint the Board members for Baptist Health Deaconess Madisonville Foundation, Inc. Form 990, Part VI, Section A, line 7b Approval of the sole member, Baptist Health Deaconess Madisonville, Inc., is required for the Foundation to take any of the following actions, which may be via approval of a recommendation of the Board of the Foundation or via a direct action by the Member. (a) sell or agree to sell or otherwise dispose of all or a substantial part of the assets of the Foundation or any investment or interest in any business enterprise; (b) amend, repeal or alter the Articles of Incorporation or these bylaws of the Foundation; (c) merge or consolidate or agree to merge or consolidate the Foundation with or into any other organization; (d) liquidate, dissolve, reorganize, or recapitalize the Foundation, or take any actions relating to bankruptcy or receivership; (e) create or incur any indebtedness to Baptist Healthcare System, Inc. ("BHSI"), Deaconess Health Kentucky, Inc. ("DHKY") or otherwise exceeding $100,000; (f) make any capital expenditure requiring the payment of more than $100,000; (g) authorize the execution of any contract, agreement, or similar instrument by which the Foundation may be obligated to pay more than $100,000; (h) acquire any stock of any corporation or invest in or acquire any interest in any business enterprise, other than accepting and liquidating gifts of marketable securities; (i) approve the annual operating budget and capital expenditures budget of the Foundation, as well as any capital expenditures over $100,000; (j) approve the mission, vision, and values of the Foundation and amendments thereto; (k) approve strategic plans of the Foundation; (l) establish appropriate reserves (consistent with operational needs and strategic initiatives for the community); (m) take action on any issue identified at any time as a key decision for Member action by a BHSI Director or a DHKY Director (as each are defined herein); (n) accept any gift that requires the Foundation, the Member, Baptist Health Deaconess, LLC, Baptist Health Deaconess Medical Group, Inc., BHSI, or DHKY to match funds, to carry out substantial new activities in connection with the gift, or that is made subject to restrictions that are not clearly consistent with the Foundation's charitable purposes or with the mission of the Member, Baptist Health Deaconess Medical Group, Inc., BHSI, or DHKY, respectively; (o) accept any gift of real property; (p) accept any gift that requires the Foundation or the Member to assume indebtedness; (q) make any gift or contribution to any organization other than the Member or Baptist Health Deaconess Medical Group, Inc., unless such gift or contribution is consistent with guidelines established by the Member; and (r) adopt investment guidelines. Form 990, Part VI, Section A, line 8b The Foundation does not have committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 will be provided to each voting member of the Board of Directors prior to filing with the IRS. The CFO reviews the Form 990 before it is filed with the IRS. Form 990, Part VI, Section B, line 12c Annually the Secretary of Baptist Health Deaconess LLC. sends out a Conflict of Interest questionnaire to each of the officers and directors serving on the Board of Baptist Health Deaconess Madisonville Foundation. After completion, they are returned to the secretary and reviewed by the Board or the Governance Effectiveness Committee for any potential conflicts. A conflict of interest is any circumstance, relationship (financial or otherwise), activity or decision (made in the course of governance, management or professional responsibilities or otherwise) that adversely influences or appears to adversely influence the ability of a covered person to: 1) make objective decisions on behalf of Baptist Health Deaconess Madisonville Foundation and/or 2) act in the best interests of Baptist Health Deaconess Madisonville Foundation in a manner consistent with the tax-exempt purposes of Baptist Health Deaconess Madisonville Foundation. The Board or Committee will determine by a majority vote of disinterested directors whether the disclosed financial or special interest may result in a conflict of interest. Form 990, Part VI, Section B, line 15 Compensation for the President is provided by Deaconess Health System, an unrelated organization for services to the Foundation and the related entities. Deaconess Health System, an unrelated organization, and Baptist Health Deaconess Madisonville, a related organization, have a management agreement in place for services provided. Deaconess Health System uses comparability data, independent compensation committee, and substantiation to determine the compensation of the President. This is completed on an annual basis. Compensation for the VP of Finance is provided by Baptist Health Deaconess Madisonville, a related organization. Baptist Health Deaconess Madisonville uses comparability data, independent compensation committee, and substantiation to determine the compensation of the VP of Finance. This is completed on an annual basis. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. Baptist Health Deaconess of Madisonville Inc 900 Hospital Drive Madisonville KY 42431 610654587 Health Care Services KY 501(c)(3) Line 3 0 Baptist Health Deaconess Medical Group Inc 900 Hospital Drive Madisonville KY 42431 863269008 Physician Services KY 501(c)(3) Line 3 Baptist Health Deaconess LLC 0 Baptist Health Deaconess LLC 900 Hospital Drive Madisonville KY 42431 872361058 Management KY N/A 0 0 Baptist Health Deaconess Home Care LLC 200 Clinic Drive Suite 210 Madisonville KY 42431 933197463 Home Care Services OH N/A 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 1 0