2022-01-11T14:51:52-06:00 2021-09-30 990 2020-10-01 463047378 Limesone Hillcrest Healthcare Partnership LIME 2148204135 301 N Washington Avenue Dallas TX 75246 Shellie Mach Treasurer 2148204135 2022-01-11 Shellie Mach 999009999 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z X Matthew Rohrer 301 N Washington Avenue Dallas TX 75246 0 0 X N/A X 2013 TX To alleviate the burden of financing indigent health care in the community. X 4 4 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16669 0 0 0 16669 0 X To alleviate the burden of financing indigent health care in the community. 0 1 0 0 0 See Schedule OLimestone Hillcrest Healthcare Partnership (the Organization") is composed of members who are public and private hospitals in the State of Texas and desire to participate in the State of Texas Healthcare Transformation and Quality Improvement Program 1115 Waiver (the "1115 Waiver") in order to assist with the provision of indigent care in the community. The present members of the Organization are Hillcrest Baptist Medical Center dba Baylor Scott & White Medical Center-Hillcrest (BSWMC-Hillcrest) and South Limestone Hospital District (SLHD) (collectively the "Members"). BSWMC-Hillcrest is a Texas non-profit corporation and recognized as a tax-exempt organization by the Internal Revenue Service pursuant to Section 501(c)(3). SLHD is a political subdivision of the State of Texas and an entity described under Internal Revenue Code Sections 115 and l70(c). 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 4 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 X Shellie Mach 2542029450 100 Hillcrest Medical Blvd Waco TX 76712 X Matthew Rohrer Director/President (eff 09/22/21) 1.00 X X 0 0 0 Larry Price Director 1.00 X 0 0 0 Michael Williams Director/Secretary 1.00 X X 0 0 0 Shellie N Mach Director/VP/Treasurer 1.00 X X 0 0 0 James Morrison MD Director/President (thru 09/22/21) 1.00 X X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16669 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16669 0 0 0 X 16669 0 16669 0 16669 0 X 0 -16669 X 0 0 0 X 1027617 757671 1785288 1027617 757671 1785288 1785288 1785288 1.00000 1.00000 X Cash 2021-09-30 16669 Cash 741161944 Hillcrest Baptist Medical Center 301 N Washington Avenue Dallas TX 75246 501(c)(3) 0 1 0 0 1 1 1 1 0 Part I, Line 2e: Person(s) Involved: Matthew Rohrer is VP Clinic Operations and Shellie Mach is the CFO at Hillcrest Baptist Medical Center dba Baylor Scott & White Medical Center-Hillcrest (BSWMC-Hillcrest), a Texas nonprofit corporation exempt under IRC Section 501(c)(3). BSWMC-Hillcrest is one of the two member organizations of LHHP. Both of these individuals were employees of BSWMC-Hillcrest before the distribution was made and remained employees of BSWMC-Hillcrest after LHHP was dissolved. Neither individual recieved any compensation or benefits as part of this dissolution. Form 990, Part III, line 3 Limestone Hillcrest Healthcare Partnership (LHHP) has ceased operations. A final distribution of all assets was made to Baylor Scott & White Medical Center-Hillcrest (BSWMC-Hillcrest), one of the two member organizations and a 501(c)(3) tax exempt organization. The distribution was approved by the board of directors and made in accordance with the bylaws of LHHP. Form 990, Part VI, Section A, line 2 Business relationship: Matthew Rohrer, Shellie Mach and James Morrison M.D. are officers of and or employed by BSWMC-Hillcrest. Larry Price and Michael Williams are officers and or employees of SLHD. BSWMC-Hillcrest and SLHD are the two members of LHHP. Form 990, Part VI, Section A, line 6 Members or stockholders: The organization is a Texas nonprofit membership organization in which BSWMC-Hillcrest, a tax exempt, Texas nonprofit corporation and SLHD, a political subdivision of the State of Texas, are members. Form 990, Part VI, Section A, line 7a Election of members of governing body by members, stockholders, or other persons: BSWMC-Hillcrest and SLHD have control and substantial reserved powers over the organization, including those to elect and remove the governing body of the organization. Form 990, Part VI, Section A, line 7b Governing body decisions subject to approval: Certain rights and powers were reserved to the organization's members, BSWMC-Hillcrest and SLHD, including: Approval of annual operating and capital budgets, financial expenditures deviating more than $5,000 from the annual budget, sale, lease or transfer of property, merger, acquisitions or consolidations, borrowing or lending money, giving or seeking grants, settlement of litigation, appointment and removal of directors, confirmation and removal of officers, appointment and removal of administrator, creation, ownership, acquisition or affiliation, approval of strategic plan and aleration, amendment or repeal of Bylaws. Form 990, Part VI, Section B, line 11b Process used to review the Form 990: The Form 990 is prepared and reviewed by the Baylor Scott & White Health tax department. Upon completion, the Form 990 is reviewed by the organization's Treasurer. A complete final copy of the return is provided to the organization's board of directors prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Process used to monitor and enforce compliance with the organization's conflict of interest policy: Persons with an actual or perceived ability to influence the organization have the duty to disclose annually and otherwise promptly as potential conflicts are identified, any familial, professional or financial relationships with entities or individuals that do, or seek to do business with the organization or that compete with the organization. These individuals include the organization's officers, governing body, management, physicians with administrative services agreements and other key personnel who interact with outside organizations or businesses on behalf of the organization. The LHHP Board of Directors reviews all relevant disclosures submitted by these individuals to determine whether a conflict of interest exists and to determine an appropriate resolution, if necessary. Any individual with a perceived or potential conflict is prohibited from voting or participating in the decision making process regarding such transaction with that individual. Form 990, Part VI, Section C, line 19 Process for making governing documents, conflict of interest policy, & financial statements available to the public: The organization's certificate of formation and amendments thereto are made available to the public by the filing of those documents with the Texas Secretary of State. The organization's other governing documents, conflicts of interest policy, and financial statements are not made available to the public. Form 990, Part XI, line 9: Dissolution distribution -16,669.