2022-11-10T19:28:10-06:00 2021-12-31 990 2021-01-01 751438726 Texas Health Harris Methodist Hospital Hurst-Euless-Bedford % DAVID JACKSON TEXA 8178484000 1600 Hospital Parkway Bedford TX 76022 DAVID JACKSON Asst Secretary 6822367900 2022-11-10 DAVID JACKSON 999009999 2 2021 2022-09-23 18:48:47Z Jared Shelton 1600 Hospital Parkway Bedford TX 76022 286134505 false X www.texashealth.org X 1973 TX A FAITH-BASED ORGANIZATION WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES IT SERVES REGARDLESS OF THEIR ABILITY TO PAY. 15 14 1746 257 115194 0 11130284 1571061 239944051 279139852 2637752 -130800 2414240 988340 256126327 281568453 91418 109056 0 0 119751799 130798874 0 0 0 125684698 138361581 245527915 269269511 10598412 12298942 170104503 167766658 23023263 26249218 147081240 141517440 X A FAITH-BASED ORGANIZATION WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES IT SERVES REGARDLESS OF THEIR ABILITY TO PAY. false false 219476776 109056 279298844 Located in Bedford, Texas since 1973, Texas Health Harris Methodist Hospital Hurst-Euless-Bedford (THHEB) operates a 275 bed acute care facility serving Northeast Tarrant County. The city of Bedford is located between Dallas and Fort Worth. THHEB offers a broad range of inpatient and outpatient medical services to the communities in northeast Tarrant County with specialized capabilities in many areas, including women's services, cardiovascular services, orthopedic services, physical therapy, digestive diseases, oncology services, and behavioral health. The behavior health program consists of three inpatient units (Adult Psych, Adult Chemical Dependency, and Adolescent Psych). The program also offers an extensive partial hospitalization program, five outpatient satellite clinics, and provides crisis evaluation services to acute care facilities in Tarrant County. THHEB also holds a number of specialty accreditations and certifications. THHEB is accredited by The Joint Commission for the Hospital Program and the Behavioral Health Program. THHEB holds accreditation in ACR CT, MRI, and Nuclear Medicine. The Clinical, Anatomic, and Ancillary Testing Departments of the laboratory are accredited by the American Association of Blood Banks American College of Pathologist (CAP). THHEB was the first Laboratory in Northeast Tarrant County to be recognized by the International Organization for Standardization for quality and competence in medical laboratories. The hospital also earned a 3-year accreditation with commendation from American College of Surgeons Commission on Cancer. THHEB is a fully Accredited Cycle IV Chest Pain Center as well as an advance Level III trauma facility. THHEB earned chest pain & heart failure certification from the joint commission and is certified as a Primary Stroke Center. THHEB is designated as an advance Level III trauma facility. THHEB earned a Baby Friendly designation from the World Health Organization. THHEB is a Center of Excellence in Minimally Invasive Gynecology. More than 1,300 employees work at the hospital, and more than 670 physicians are practicing on its medical staff. THHEB provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. The hospital provides care to persons covered by governmental programs including Medicare and Medicaid for reimbursement that does not always cover the cost of providing the care. Recognizing its mission to the community, services are provided to both financially indigent and medically indigent patients. Community benefit is provided through many reduced-price services offered to the community. These services are essential to provide complete healthcare to the community served. Various health screenings are offered to the community for a nominal charge such as diabetes, chronic disease and balance. The faith based community nurse program offers free flu shots and blood pressure screenings. Education classes are offered at no charge for diabetes, water safety, sun safety, hand hygiene and CPR. The CASI program offers free car seat checks for the community. The NEAT program offers free exercise classes for breast cancer survivors. The H2OPE program offers aquatic fitness programs for special needs children. Twice a year, THHEB sponsors the Bluebonnet retreat for cancer patients. During the year, THHEB had 64,815 patient days, 14,583 discharges, 67,506 outpatient encounters, 55,458 emergency room visits and 2,265 births. 219476776 true true false true false false false false false false true false false false true false false true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false true X 0 0 1746 true true true false false false false false false false false false false false X 15 14 true false false false true true true true true false false true true true true true true false false true true X X DAVID JACKSON 6822367900 612 E LAMAR BLVD Arlington TX 76011 X Berdan Barclay E THR CEO/Trustee 0.64 49.36 X X 0 3299415 338211 McWhorter Ricky E Former Officer 0.0 50.0 X 0 1363156 161401 Kramer Kenneth J Assistant Secretary 0.5 49.5 X 0 1132375 136291 Jackson David W Assistant Secretary 0.5 40.0 X 0 535754 90372 Lloyd Scott D Chief Medical Officer THHEB 40.0 0.0 X 511730 0 87235 Asturi Elizabeth Former Officer 0.0 40.0 X 0 512663 50172 Hay Fraser Scott President THHEB 40.0 0.0 X 469509 0 85590 Schroeder Jennifer Ann Former Officer 0.0 40.0 X 0 459823 50701 Cantu Stacy G Corporate Secretary 0.5 40.0 X 0 383606 62821 Balluck Julie Patrice Chief Nursing Officer THHEB 40.0 0.0 X 370624 0 64276 James Jaime L Grp Finan Officer THHEB-THAL 36.0 4.0 X 333679 0 55526 Goertz Richard B VP Prof & Sprt Svcs Offr THHEB 40.0 0.0 X 289773 0 56914 NgoAnnie THi RN IV WE 40.0 0.0 X 225181 0 60114 James Jerry DIR PHARMACY 40.0 0.0 X 213263 0 51801 Emmanuel Christianna Aderonke Aduk RN IV 40.0 0.0 X 191507 0 56702 Mulvey Edward L term 11821 ENTITY HR OFFICER THHEB 40.0 0.0 X 219571 0 28212 Williams Lori L DIR NRSG EMERGENCY/CRITICAL CR 40.0 0.0 X 190342 0 35715 Wilder Jr Charles Chair 0.03 1.4 X 0 0 0 Vigness MD Richard Vice Chair 0.03 1.4 X 0 0 0 Stripling MD W Dennis Immediate past chair 0.03 1.4 X 0 0 0 Bernstein Kenneth Trustee 0.03 1.4 X 0 0 0 Guyton Michael Trustee 0.03 1.4 X 0 0 0 Haggar III Joseph Trustee 0.03 1.4 X 0 0 0 Hunt Hunter Trustee 0.03 1.4 X 0 0 0 Montgomery Lynn Trustee 0.03 1.4 X 0 0 0 Nunez MD Ignacio Trustee 0.03 1.4 X 0 0 0 Reeves Kenneth Trustee 0.03 1.4 X 0 0 0 Washington Bernice Trustee 0.03 1.4 X 0 0 0 Weeks Susan Trustee 0.03 1.4 X 0 0 0 Wynne James Trustee 0.03 1.4 X 0 0 0 Siripurapu MD Ravi Trustee 0.03 1.4 X 0 0 0 3015179 7686792 1472054 272 true true false Texas Health Resources 612 E Lamar Blvd ARLINGTON TX 76011 Management Fee 39570989 Texas Health Physicians Group 9250 Amberton Pkwy DALLAS TX 75243 Physician Services 2759782 Vanguard Resources 6500 Highway 281 North SPRING BRANCH TX 78070 Housekeeping 2115574 Crothall Healthcare Inc 1301 Pennsylvania Ave FORT WORTH TX 76104 Environmental Svcs 1910031 OBHG Texas Holdings 777 Lowndes Hill Rd Bldg 1 GREENVLLE SC 29607 Physician Services 1524000 44 191713 1379348 8433 1571061 PATIENT SERVICE REVENUE 622110 276554032 276554032 DSRIP REVENUE 622110 1476657 1476657 COST REPORT ADJUSTMENTS 622110 836718 836718 INTERCOMPANY AFFILIATE FEES 622110 272430 272430 EDUCATION 624190 15 15 279139852 2235 2235 0 0 22744 9737 0 0 22744 9737 32481 9737 22744 4433017 4566052 -133035 -133035 -133035 0 0 0 0 0 0 0 0 0 CAFETERIA 722514 619917 619917 LABS 621511 120157 4963 115194 MEDICAL STAFF CREDENTIALING 622110 99550 99550 116235 44742 71493 955859 281568453 279298844 115194 583354 109056 109056 0 0 0 2324857 2324857 0 103610084 103388447 221637 0 4331433 4331433 13340588 13340588 7191912 7100612 91300 39570989 39570989 0 0 0 0 0 20983988 14870604 6113384 83128 3171 79957 530843 493439 37404 1253790 1245089 8701 0 5331545 5296056 35489 51120 50188 932 0 80383 63103 17280 4233578 4233578 0 13967455 13236287 731168 2348853 2348853 MEDICAL SUPPLIES 39040164 39040127 37 REPAIR AND MAINTENANCE 2164790 1991627 173163 NON CAPITAL EQUIPMENT 2064246 1886158 178088 LPPF 1942072 1942072 4714637 4506288 208349 269269511 219476776 49792735 0 -2010 -100649 0 0 0 0 36243532 39271008 0 0 0 0 47869 21156 4727201 4474491 379268 296633 270634222 147877500 128170359 122756722 0 0 0 0 0 0 503974 503974 34310 543323 170104503 167766658 17771877 19349729 0 0 5042437 5073269 0 0 0 0 0 0 0 0 0 0 208949 1826220 23023263 26249218 X 147081240 141517440 0 0 147081240 141517440 170104503 167766658 X 12298942 -17862742 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false true false false false false false false Schedule C, Part II-B - Additional Information Officers and/or Board Members of the corporation may, to an insubstantial degree, make comments or statements concerning legislation that may affect either the healthcare industry or the health status of the communities the Corporation serves. In pursuing this activity, Officers and/or Board Members may engage in conversations and/or write letters to various federal, state, and local officials regarding such matters on a personal level, and not as a representative of the organization. The amount of time and money involved in these activities is negligible. In no case has either the Corporation, or any person acting on behalf of the Corporation, intervened in any political campaign. 5101347 5101347 71618697 44486845 27131852 89140116 40799162 48340954 101953170 62591493 39361677 2820892 2820892 122756722 0 ASSET RETIREMENT OBLIGATIONS 518568 EST. 3RD PARTY PAYOR SETTLEMEN 803792 OPERATING LEASE LIABILITIES 515329 LEASE ACCOUNTING ADJUSTMENT -11469 1826220 true true X true X true X 500. true true true false true true 15139532 153759 14985773 0.05570 25212815 16199171 9013644 0.03350 1891 1891 40354238 16352930 24001308 0.08920 2841765 2841765 0.01060 1618831 1618831 0.00600 125218 125218 0.00050 4585814 4585814 0.01710 44940052 16352930 28587122 0.10630 18881 18881 0.00010 3576 3576 7624 7624 33147 33147 0.00010 63228 63228 0.00020 false 34599609 0 44098622 45734471 -1635849 X true true 1 1 Texas Health H-E-B 1600 Hospital Parkway Bedford TX 76022 www.texashealth.org TDH #000182 X X X Texas Health H-E-B 1 false false true X X X X X X X X X 19 true true false true X See Section C X true 20 true See Section C false true X 200. 500. X X X X true true X X X true X See Section C X See Section C X See Section C X X X X X X true X false X X X X true X false false Part V, Section B Texas Health Harris Methodist Hurst-Euless-Bedford (THHEB) Part V. Section B, Line 3e The significant health needs of the community are in line with the significant health needs that have been prioritized and identified in the current CHNA. Part V. Section B, Line 5 Texas Health Hurst-Euless-Bedford's (THHEB) 2019 CHNA was a collaborative process utilizing qualitative and quantitative methods to assess the health needs of persons within the service areas in the Tarrant/Parker Counties region. The 2019 CHNA was conducted at the Tarrant/Parker Counties regional level to generate community-driven solutions for better integration in addressing the clinical and social needs of individuals living in North Texas. Between April 2018 and August 2018, the communities' health needs were assessed through key informant interviews, secondary data analysis, a windshield survey serving to assist asset-mapping through community observation and focus groups. Key informants and focus group participants included, but were not limited to faith community representatives, public health officials, lay community members, school officials and city administration. The organization engaged 159 community members with interests specific to the health of individuals in the Tarrant/Parker Counties region in the CHNA development process. One hundred forty-nine of these community members were engaged across eleven separate focus groups held in zip-codes that were identified as underserved areas. Ten served as key informants, and the windshield survey was conducted by two Texas Health graduate fellows and five community health managers. To gain a comprehensive understanding of the health needs and priorities of individuals in this region, Texas Health used focus group sessions and key informant interviews to engage the medically underserved, low-income or minority populations along with representatives from the following community organizations: Azle ISD; Broadie's Aircraft; City of Bedford; Emergency Medicine Consultant Ltd.; Ft Worth South, Inc.; Higginbotham Insurance Agency; Higher Praise Family Church; KPMG; Private Wealth Solutions Inc.; Parker County Hospital District; Tarrant County College; Tarrant Transit Alliance; The Abbey Church; Thos.S. Byrne, Inc.; United Way of Tarrant County; Urban Theory; and Z's Cafe & Catering. Findings from all data sources (secondary data, interviews and focus groups, and the windshield survey/observational asset mapping) were compared. Recurring themes were pulled and analyzed to stratify the top medical and social determinant of health needs. The outlined needs/barriers will inform the development of the 2020 CHNA implementation plan, which will leverage integrated strategies across THR's internal and external stakeholders to enhance its service and program delivery in the target communities. Part V. Section B, Line 6a The 2019 CHNA for the Tarrant/Parker Counties Region was conducted in collaboration with Texas Health Alliance (THAL), Texas Health Arlington Memorial (THAM), Texas Health Fort Worth (THFW), Texas Health Specialty Hospital (THSH), Texas Health Southwest Fort Worth (THSW), Texas Health HEB (THHEB), Texas Health Azle (THAZ), AMH Cath Labs (AMHH), Texas Health Southlake (THSL), USMD at Arlington (USMD-Arl), USMD at Fort Worth (USMD-FW), and Texas Health Huguley. Part V. Section B, Lines 7a and 10a The most recently adopted implementation strategy and the CHNA is widely available on the following website at: https://www.texashealth.org/Community-Health/Community-Health-Needs-Assess ment Part V. Section B, Line 11 The 2020 - 2022 implementation strategy focused on reforming the delivery of our services in the target communities. The hospital is part of the Texas Health Resources (THR) healthcare system, which developed a system-wide community benefit strategy to increase its hospitals' ability to impact the community health needs of the target areas with a higher focus on three health priorities. Through the prioritization process these three health priorities from the 2019 CHNA were determined to be ongoing issues that THR hospitals needed to address: 1. Behavioral Health 2. Chronic Disease Prevention & Management 3. Access to Health Services and Healthcare Navigation & Literacy In 2021, Texas Health HEB (THHEB) addressed significant health needs with the following approaches: 1. Behavioral Health 1a. Through an RFP process by Texas Health Resources through its Texas Health Community Impact (THCI) Initiative, three agencies in Tarrant and Parker Counties were awarded grants to address depression, anxiety, and food insecurity among underserved individuals in specific zip-codes in the hospital's region. The collaborating organizations in this effort include the Railroad, the Center for Hope, and the United Way of Tarrant County. 2. Chronic Disease Prevention & Management 2a. Faith Community Nursing 2a1. THHEB Faith Community Nurses partnered with five covenant faith communities representing Methodist, Lutheran, Presbyterian, Church of Christ, Catholic, non-denominational and Islamic faith communities to provide flu vaccination clinic and programs focused on chronic disease management such as diabetes management, blood pressure checks, and Walk to Bethlehem (a program encouraging increased physical activity). 3. Access, Literacy, and Navigation (ALN) 3a. Health Workshops 3a1. Child Automobile Safety Initiative (CASI) is a program focused on protecting children from injury in motor vehicle collisions by providing free car seat safety checks and community-based education. All the priority health needs identified are being addressed by the hospital in the category listed above. Part V. Section B, Line 13 h Although a patient may have been notified of the Financial Assistance Policy, there are times when the patient chooses not to complete the Financial Assistance Application. Texas Health routinely screens uninsured patients using an independent third party for financial assistance eligibility. Part V. Section B, Lines 16 a, b & c The FAP, FAP Application and the Plain Language Summary of the FAP were widely available at this website: https://www.texashealth.org/Costs-and-Billing/Financial-Assistance Texas Health H-E-B Part I, Line 3c - Patient Eligibility Patients with family income at or below 200% of applicable Federal Poverty Guidelines (FPG) may be eligible for free care if the patient lacks sufficient funds and assets to pay the out-of-pocket portion of their hospital bill. Patients with a family income above 200% of applicable FPG who have unpaid medical bills exceeding a specified percentage of the patient's annual gross income, as determined on a sliding scale based on FPG, may be deemed medically indigent and eligible for charity care. The patient may be eligible for a charity adjustment up to 100% of the unpaid balance of their hospital bill in excess of a specified patient responsible amount if the patient has insufficient funds/assets to pay his hospital bill without incurring an undue financial hardship. The patient responsible amount is based on a percentage of the patient's annual income in relation to FPG. A determination as to whether or not a patient has insufficient funds and/or assets to pay for purposes of determining both financial and medical indigence is made at the time a patient's financial assistance application is reviewed. Assets considered when determining eligibility include cash, stocks, bonds and other financial assets that can be readily converted to cash. An additional process to screen for charity patients using publicly available financial information is also in place for patients not submitting a financial assistance application. Part I, Line 7 - Cost-to-Charge Ratio A cost-to-charge ratio is used to compute the amounts reported on Lines 7a-7c. The cost-to-charge ratio is derived from Worksheet 2 - Ratio of Patient Care Cost-to-Charges, as found in the Schedule H Instructions. The amounts reported on Lines 7e-7i were computed using direct costs, as determined by a cash outlay. Part II - Community Building The organization participates in community building activities that aim to address the disparities in the social determinants of health factors that influence the overall health and wellbeing of individuals in the communities Texas Health serves. As identified in the community health needs assessment, there are areas of need that are not aligned with the traditional operations of a hospital system. Our volunteerism, collaborations and partnership opportunities with various community-based organizations and coalitions foster our ability to address the social and environmental needs for the purpose of providing for the whole person beyond the clinical services. Part III, Lines 2, 3 & 4 - Bad Debts Bad debt expense is not included for purposes of reporting community benefits. Each patient qualifying for charity care is treated as a charity patient and no charges related to that patient are included in bad debt expense. The hospital is part of a consolidated system of hospitals which operate under the name Texas Health Resources (THR). THR's annual audit is conducted on a system-wide basis with a single consolidated audit report issued for THR and its affiliates. The audited financial statements of THR, which includes the activity of the organization, contain a footnote regarding Accounts Receivable and Net Patient Service Revenue (Dollars in Thousands) that reads as follows: Patient service revenue is reported at the amount that reflects the consideration to which the System expects to be entitled in exchange for providing patient care. Healthcare services promised in the contract with a patient represent a bundle of goods and (or) services that is distinct and accounted for as a single performance obligation. The transaction price for the bundled goods and (or) services provided is estimated by reducing the total standard charges by variable price concessions, including contractual adjustments based on the terms provided by (in the case of Medicare and Medicaid) or negotiated with (in the case of managed care and commercial insurance companies) third-party payors, the System's discount policies, and other implicit price concessions based on historical collections experience for uninsured and under-insured patients who do not qualify for financial assistance. A portfolio approach by major payor categories and types of service is used to estimate the historical collections experience. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to patient service revenue in the period of the change. Portfolio collection estimates are updated at least quarterly based on actual collections experience. The System believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach was used. Under Texas Health's financial assistance policy, the Tax-Exempt Hospitals, THRW, and THPG provide care to patients without charge or at amounts less than their established rates if the patient meets certain established criteria. The consolidated joint venture hospitals and healthcare entities have similar financial assistance policies, or have adopted the Texas Health financial assistance policy. As the System does not pursue collection of amounts determined to qualify as financial assistance, those amounts are not reported as patient service revenue or patient accounts receivable. Revenue related to providing care to patients is recognized as the performance obligation is satisfied over the period of time the patient is receiving treatment, as the patient is simultaneously receiving and consuming the benefits provided by the System. The performance obligation is generally satisfied over an average period of less than five days for inpatient services and one day for outpatient services. Generally, patients and third-party payors are billed within days after the services are performed and (or) the patient is discharged. The transaction price related to unsatisfied or partially unsatisfied performance obligations at the end of the reporting period primarily relate to inpatient acute care services for patients who remain admitted at that time (in-house patients). As of December 31, 2021 and 2020, contract assets of $50,827 and $49,827, respectively, were recorded in patient accounts receivable on the consolidated balance sheets. Patient accounts receivable is reported at the amount that reflects the consideration to which the System expects to be entitled in exchange for providing patient care. The primary collection risks relate to uninsured patient accounts, including patient accounts for which the primary insurance company has paid the amounts covered by the applicable agreement, but patient responsibility amounts remain outstanding. Implicit price concessions relate primarily to amounts due directly from patients based upon management's assessment of historical write-offs and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Patient accounts are monitored and, if necessary, past due accounts are placed with collection agencies in accordance with guidelines established by management. Accounts are written off when all reasonable internal and external collection efforts have been performed. Estimated implicit price concessions of $463,241 and $366,511 were recorded as reductions to patient accounts receivable at December 31, 2021 and 2020, respectively, on the consolidated balance sheets. Part III, Line 8 - Medicare Shortfall The state of Texas treats any Medicare shortfall as a community benefit for meeting the state statutory requirements for charity care & community benefit. For state purposes, the shortfall is computed by comparing actual Medicare reimbursements with the estimated cost the hospital incurs in providing these services to Medicare patients. Cost is determined by applying a cost-to-charge ratio (with costs determined in accordance with generally accepted accounting principles) to billed charges. The shortfall amount reported to the state of Texas for 2021 is $49,055,547. Sch H requires a different method to calculate the Medicare shortfall shown on Part III, Lines 5-7. Part III, Line 9b - Debt Collection During the year, standard collection procedures were in place and uniformly applicable to all patient accounts. Except to the extent a patient receives a recovery from any third party or other source, no attempts are made to collect unpaid charges from patient accounts approved for adjustment under the Financial Assistance Policy. Part VI, Line 2 - Needs Assessment In 2019, Texas Health Resources (Texas Health) completed a community health needs assessment (CHNA) for 25 facilities across 5 regions using the following steps: - Demographic analysis by region - Secondary data analysis of health indicators to identify zip codes of highest-needs within each region and prioritize zip codes for the community impact initiative - Primary data collection via key informant interviews, focus groups, and a wind true Tarrant Safety Net Support Corporation 612 E Lamar Blvd Arlington TX 76011 823171862 501(c)(3) 85666 Cash Indigent Health Care Community Enrichment Center 6250 NE Loop 820 North Richland Hills TX 76180 756004020 501(c)(3) 10000 Cash General Support 2 0 Monitoring Grants Texas Health HEB (THHEB) is a member of the Texas Health Resources (THR) healthCare system. The majority of the grants distributed by the system are to related tax exempt organizations. The hospital does not specifically monitor the use of grants paid to related organizations since THR administration monitors the use of these grants on a system basis for all members of the THR healthcare system. Grants to non-related tax exempt organizations are generally given to entities that are in the hospital's community and/or service area or to certain organizations which will specifically impact the hospital's community. These grants are typically monitored by hospital personnel who are working closely with the non-related nonprofit organization. X true true true true false false false false false false false Berdan Barclay E THR CEO/Trustee 0 1675202 0 1247300 0 376913 0 289437 0 48774 0 3637626 0 268618 Kramer Kenneth J Assistant Secretary 0 629563 0 297194 0 205618 0 98557 0 37734 0 1268666 0 46912 Jackson David W Assistant Secretary 0 325186 0 111884 0 98684 0 53076 0 37296 0 626126 0 11705 Cantu Stacy G Corporate Secretary 0 260900 0 68801 0 53905 0 12656 0 50165 0 446427 0 696 Lloyd Scott D Chief Medical Officer THHEB 307602 0 96842 0 107286 0 39229 0 48006 0 598965 0 8587 0 Hay Fraser Scott President THHEB 270602 0 94342 0 104565 0 45156 0 40434 0 555099 0 8243 0 Balluck Julie Patrice Chief Nursing Officer THHEB 237172 0 58458 0 74994 0 30447 0 33829 0 434900 0 1940 0 James Jaime L Grp Finan Officer THHEB-THAL 211999 0 57135 0 64545 0 13506 0 42020 0 389205 0 0 0 Goertz Richard B VP Prof & Sprt Svcs Offr THHEB 176384 0 51530 0 61859 0 9740 0 47174 0 346687 0 0 0 McWhorter Ricky E Former Officer 0 785374 0 332535 0 245247 0 114232 0 47169 0 1524557 0 39816 Asturi Elizabeth Former Officer 0 297245 0 107903 0 107515 0 46410 0 3762 0 562835 0 10867 Schroeder Jennifer Ann Former Officer 0 281886 0 80550 0 97387 0 21750 0 28951 0 510524 0 0 NgoAnnie THi RN IV WE 208574 0 11915 0 4692 0 14737 0 45377 0 285295 0 0 0 Mulvey Edward L term 11821 ENTITY HR OFFICER THHEB 124747 0 16298 0 78526 0 0 0 28212 0 247783 0 0 0 James Jerry DIR PHARMACY 191662 0 21081 0 520 0 11497 0 40304 0 265064 0 0 0 Emmanuel Christianna Aderonke Ad RN IV 177260 0 9858 0 4389 0 12731 0 43971 0 248209 0 0 0 Williams Lori L DIR NRSG EMERGENCY/CRITICAL CR 163015 0 19589 0 7738 0 11205 0 24510 0 226057 0 0 0 Schedule J, Part I, Line 1a - Discretionary Spending Account Each executive at the vice president level and above receives a perk allowance which is include in the taxable compensation of the employee. This allowance covers costs such as business use of their personal vehicles in lieu of reimbursement for auto mileage. It also allows access to certain executive benefits including individual Long Term Disability, Long Term Care, and Individual Life insurance. Schedule J, Part I, Line 3 - CEO Compensation The organization relied on Texas Health Resources (THR), a related 501(c)(3) organization with centralized compensation professionals to use the following methods to establish the compensation of the organization's President. * The Governance committee (which includes independent persons) performs reviews and makes recommendations to the THR Board to approve the overall payment philosophy. * An Independent compensation consultant may be hired. * Compensation surveys or studies are utilized. * Board or Governance committee approves the executive compensation parameters within the executive compensation philosophy Schedule J, Part I, Line 4a - Severance Settlement The settlement payment was paid out as part of a mutually agreed upon employment transition agreement that resulted in a separation of employment from THR. Edward L Mulvey $ 72,110 Schedule J, Part I, LIne 4B - Nonqualified Retirement Plan Participation in the THR plans is made available to a select group of management and highly compensated employees who are providing services in key positions of management and/or responsibility and who are determined by the THR Board of Trustees. SERP: For the active restoration account (Account balances after 12/31/2009) SERP benefits vest while the participant is employed if the participant: * Reaches age 65 * Becomes disabled or dies, * Reaches the following years of service: 2 Years - 25%; 3 Years - 50%; 4 Years - 75% and 5 or more years - 100% Participants must be employed on Dec 1 to qualify for the current year's SERP Benefit unless separation is due to death, disability, retirement (Age 65) or early retirement (separation from service at or after age 55 with 75 years of combined age and service with the system.) SERP benefits are calculated each Dec 1. Vested balances are taxed to the employee and the net balances begin accruing earnings. Vested balances are paid in a cash lump sum within a 90-day period commencing on the earlier of death, disability, or separation from service. The deferred portion is included in Schedule J, Part II, column C. In frozen restoration accounts (account balances prior to 1/1/2010), the participant or beneficiary shall be taxed on his or her vested SERP benefits upon the earliest of: * Continued employment in THR until age 68 * Termination of employment for disability or death * Involuntary termination of employment without reasonable cause; or * Satisfying a 24 month non-compete period following his/her termination of employment. Payment follows the before mentioned events, except in the case of involuntary separation when the participant must wait 24 months to receive the previously taxed benefit. LTIP: The Long Term Incentive Plan covers 2, 3 or 4 years. Payouts are made over 2, 3, or 4 years after key performance goals are met. Benefits vest if they are employed at the end of the year the payout is made. Payments can also be made if separation is due to death, disability, retirement (Age 65) or early retirement (separation from service at or after age 55 with 75 years of combined age and service with the system.) In the case of retirement and early retirement, CEO approval must be obtained and a non-compete must be satisfied prior to the end of year payout. Retention: A retention agreement may be offered to an executive in a key position or based on succession planning needs of the system. The length of the retention period will be dependent upon the needs of the organization to retain the key executive. Payments are made within 2 months following the end of the retention period. Payouts to the following employees were made during the year for all the plans listed above. The amounts below are included in the amount reported on Sch J, Part II, Column B(iii) and Column (F). Elizabeth Asturi $ 10,867 Julie Balluck $ 1,940 Barclay Berdan $268,618 Fraser Scott Hay $ 8,243 David Jackson $ 11,705 Kenneth Kramer $ 46,912 Scott Lloyd $ 8,587 Ricky E McWhorter $ 39,816 990, Part V, Line 1a - Number reported in Box 3 of Form 1096 The taxpayer is a part of a healthcare system who recently adopted a new accounting system. As part of the change to the new accounting system, all Form 1099 filings were centralized under the parent, Texas Health Resources (THR). This is part of the system's efforts toward overall centralization of vendor relations and other shared services. THR bills its subsidiaries for management services. In some instances, the new accounting system was implemented at some point during the year. In these cases, the payments made to vendors captured under the old accounting system were processed by the entity under their own, individual FEIN. As a result, the number of Form 1099 filings reportable by the entity are significantly lower than in prior years since they are reporting for only a portion of the year. This does not reflect a change in operations, but merely a change in how the entity captures and pays its contractors/vendors. 990, Part VI, Section A, Line 2 - Business Relationship Texas Health Resources (THR) and its related organizations included in the THR healthcare system encourage employees to become involved in philanthropic endeavors in their communities. As a result, THR healthcare system employees who are serving as officers, board members, or key employees may, from time to time, also serve on the boards of various community organizations such as church boards, United Way, etc. There may be a business relationship as a result of multiple THR employees serving on the same community boards. THR employees serve as the corporate officers of each subsidiary organization. As THR system employees, all officers have a business relationship within the organizations of the THR healthcare system. THR also appoints system officers to the boards of various controlled joint ventures. As THR system employees, various officers of the organization may have a business relationship through serving on THR controlled joint venture boards. 990, Part VI, Section A, Lines 6&7a - Members Texas Health Resources (THR) is the sole member of the organization. 990, Part VI, Section A, Line 7b - Governance Decisions Reserved The following actions require the approval of Texas Health Resources (THR): (a) Amendment, restatement or repeal of the Certificate of Formation or these Bylaws. (b) Sale, exchange, lease or other transfer of all or substantially all of the assets of the Corporation. (c) Merger or consolidation of the Corporation. (d) Dissolution of the Corporation. (e) Election of members of the Board of Trustees (f) Removal of a member of the Board of Trustees (g) Creation of affiliates or subsidiaries and approval of the initial governing documents. (h) Incurrence of debt not included in the budgets. (i) Discontinuing the operations of a licensed health care facility controlled by the corporation. (j) Activities involving winding up, distribution, conversion or exchange under Chapter 11 990, Part VI, Section B, Line 11b - Form 990 Filing The Texas Health Resources (THR) tax department staff prepares the Forms 990 for THR and all of its wholly controlled affiliates. In order to accurately prepare the returns, the tax staff works closely with various other departments to gather and review the information needed to complete the return. The departments involved in this process include, but are not limited to accounting, finance, treasury, human resources, payroll, legal, governance, and corporate compliance. The returns are then reviewed twice within the tax department before being given to the Financial Reporting department to review and to ensure that the financial information is accurate and up to date. All THR System Forms 990 are provided to members of the Audit and Compliance Committee of the THR Board, giving them an opportunity to review, comment and ask questions regarding the Forms 990. The tax department Vice President provides an overview presentation to the committee highlighting various areas of the Form 990. A resolution to approve all of the returns is voted upon at this meeting. Once the Audit and Compliance Committee has approved the returns, each return is then reviewed and signed by the Chief Accounting Officer/Assistant Secretary. The members of the governing Boards are provided a copy of the Form 990 for their respective entity before the Form 990 is filed. 990, Part VI, Section B, Line 12c - Conflict of Interest Texas Health Resources (THR) has adopted a Conflict of Interest Policy that applies to THR and all of its wholly owned or wholly controlled affiliates. During the first quarter of each fiscal year, a Duality and Conflict of Interest Statement Form is distributed by the THR Chief Compliance Officer to all board members, officers, contracted medical directors, employees with a title of manager or above, employed physicians, and certain committee members and other employees based upon function. All disclosed conflicts are reviewed by the THR Chief Compliance Officer. A report, listing each reported Duality of Interest or Conflict of Interest is given to both the Chair of the Governing body and the President of the Corporation with which the reporting person is affiliated. The THR Board of Trustees receives a report when the Annual Disclosure process is complete. Progressive corrective action is taken for any identified noncompliance which may include removal from a board or committee or physician/employee counseling if the person fails to provide the disclosure. In addition, THR monitors physician payments through a public database implemented by CMS. Management plans are executed as needed based upon disclosures. THR also educates the Boards and workforce annually through either a web based or live compliance training. 990, Part VI, Section B, Lines 15 a&b - Compensation Determination The organization relied on Texas Health Resources (THR) with centralized compensation professionals to review and establish the compensation of the organizations officers. A more in-depth discussion of executive compensation review can be found on Schedule J, Part III. 990, Part VI, Section C, Line 19 - Public Disclosure The organization does not make its governing documents or conflict of interest policy available to the public. The consolidated financial statements of Texas Health Resources (THR) are made available to the public on the website www.dacbond.com. Consolidated financial statements are posted to this website quarterly and the audited financial statements are posted annually. The financial statements of the wholly controlled affiliates of THR are not posted to the website nor are they generally made available to the public in any other manner. 990, Part XI, Line 9 - Other Changes in Net Assets Adjustment for Intercompany Transactions of a Controlled Group ($17,862,742) The intercompany adjustment eliminated the receivable/payable balance as of the end of the year between Texas Health Resources (THR) and all wholly controlled tax-exempt entities included in the THR Healthcare System. The adjustment represents current year activity. The THR Healthcare System records all related transactions through the intercompany Receivable/Payable accounts for each entity. The types of transactions recorded in the Intercompany accounts include management fees charged by the parent organization, services purchased between related organizations, supplies purchased by a centralized purchasing department, daily cash sweeps and similar transactions. 990, Part XII, Line 2c - Consolidated Financial Statements Texas Health Resources (THR) prepares consolidated financial statements with its related entities. The THR Board appoints an audit and compliance sub-committee that assumes responsibility for oversight of the consolidated audit for all related entities. The related entities do not have a separate audit committee, but abide by the THR committee's oversight. There has been no change during the year in the organizations oversight selection process. Huguley Medical Assoc Inc 11801 South Freeway Burleson TX 76028 752547668 Phys Clinic TX 501(c)(3) 3 TH Huguley false North Texas Healthy Communities 612 E Lamar Blvd Arlington TX 76011 464513182 Comm Support TX 501(c)(3) 7 TH Resources false Southwestern Health Resources JOC 5323 Harry Hines Blvd Dallas TX 75390 811575989 Mgmt Org TX 501(c)(3) 12b TH Resources false Texas Health Arlington Memorial Hospital 800 West Randol Mill Rd Arlington TX 76012 750972805 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Back Care 9250 Amberton Pkwy Dallas TX 75243 474724257 Phys. Clinic TX 501(c)(3) 10 TH Phys Grou false Texas Health Alliance 10864 Texas Health Trail Fort Worth TX 76244 451502252 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Azle 108 Denver Trail Azle TX 76020 751748586 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Cleburne 201 Walls Dr Cleburne TX 76033 751977850 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Fort Worth 1301 Pennsylvania Ave Fort Worth TX 76104 756001743 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Hurst-Euless-Bedford 1600 Hospital Parkway Bedford TX 76022 751438726 Hospital TX 501(c)(3) 3 TH Resources Texas Health Southwest Fort Worth 6100 Harris Parkway Fort Worth TX 76132 752678857 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Stephenville 411 Belknap Stephenville TX 76401 751752253 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Frisco 12400 Dallas Parkway Frisco TX 75033 831954982 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Mansfield 2300 Lone Star Rd Mansfield TX 76063 831869297 Hospital TX 501(c)(3) 3 TH Huguley false Texas Health Huguley Inc 11801 S Freeway Burleson TX 76028 452694620 Hospital FL 501(c)(3) 3 TH Resources false Texas Health Medical Support 612 E Lamar Blvd Arlington TX 76011 812833150 Spec Drugs TX 501(c)(3) 10 TH Resources false Texas Health Physicians Group 9250 Amberton Pkwy Dallas TX 75243 752613493 Phys. Clinic TX 501(c)(3) 10 TH Resources false Texas Health Allen 1105 Central Expressway N Allen TX 75013 752890358 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Dallas 8200 Walnut Hill Ln Dallas TX 75231 751047527 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Denton 3000 North Interstate 35 Denton TX 76201 432008974 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Kaufman 850 Ed Hall Drive Kaufman TX 75142 752771437 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Plano 6200 W Parker Rd Plano TX 75093 752770738 Hospital TX 501(c)(3) 3 TH Resources false TH Recovery and Wellness Center 240 Miller Road Mansfield TX 76063 812813227 Resd Trmt Ctr TX 501(c)(3) 3 TH Resources false TX Health Research & Education Institute 612 E Lamar Blvd Arlington TX 76011 752562191 Edu& Research TX 501(c)(3) 4 TH Resources false Texas Health Resources 612 E Lamar Blvd Arlington TX 76011 752702388 System Mgmt TX 501(c)(3) 12c NA false Texas Health Resources Foundation 612 E Lamar Blvd Arlington TX 76011 752022128 Fundraising TX 501(c)(3) 7 TH Resources false TH Specialty Hospital Fort Worth 1301 Pennsylvania Ave Fort Worth TX 76104 751648589 LT Hospital TX 501(c)(3) 3 TH Resources false TX Health Urgent Care 3805 W University Park 100 McKinney TX 75071 814317635 Urgent Care TX 501(c)(3) 3 TH Resources false TX Health Virtual Care 612 E Lamar Blvd Arlington TX 76011 873611585 Virtual Care TX 501(c)(3) 3 TH Resources false WW Ward Endowment Fund Trust 612 E Lamar Blvd Arlington TX 76011 756196065 Nursing Grant TX 501(c)(3) 12a TH Foundatio false Healthy Tarrant County Collaboration PO Box 8040 Fort Worth TX 76124 432087946 Support Org TX 501(c)(3) 12a na false Texas Health Huguley Surgery Center LLC 12001 S Freeway Burleson TX 76028 821289045 Amb Surg Ctr TX 501(c)(3) 3 TH Huguley false AMH Cath Labs LLC 811 Wright St Arlington TX 76012 203003947 Hospital TX NA N/A Arlington Surgery Center LLC 918 N Davis Dr Arlington TX 76012 752055800 Amb Surg Ctr TX NA N/A Cleburne Surgical Center LLC 2010 W Katherine P Raines Blvd St Cleburne TX 76033 203742012 Amb Surg Ctr TX NA N/A Cross Timbers Surgery Center LLC 1001 N Waldrop Dr Ste 705 Arlington TX 76102 752862780 Amb Surg Ctr TX NA N/A Denton Surgery Center LLC 207 North Bonnie Brea Denton TX 76201 470926556 Amb Surg Ctr TX NA N/A Flower Mound Hospital Partners LLC 4400 Long Prairie Rd Flower Mound TX 75028 260684968 Hospital TX NA N/A Fort Worth Endoscopy Centers LLC 900 W Magnolia Ave 101 Fort Worth TX 76104 770368346 Endoscopy Center TX NA N/A Greenville Surgery Center LLC 7150 Greenville Ave Ste 200 Dallas TX 75231 742411643 Amb Surg Ctr TX NA N/A Health Imaging Partners LLC 8610 Explorer Drive Ste 300 Colorado Springs CO 80920 271385885 Medical Imaging TX NA N/A Mansfield Endoscopy Center LLC 647 N Miller Rd Mansfield TX 76063 861354607 Endoscopy TX NA N/A North Dallas Surgical Center LLC 17980 Dallas Pkw Ste 100 Dallas TX 75287 272248103 Amb Surg Ctr TX NA N/A Opthalmology Surgery Center of Dallas LL 10740 N Central Expy Dallas TX 75231 261914835 Amb Surg Ctr TX NA N/A Park Hill Surgery Center LLC 3455 Locke Ave Fort Worth TX 76107 451484375 Amb Surg Ctr TX NA N/A Physicians Medical Center LLC 6020 W Parker Rd Plano TX 75093 481281376 Hospital TX NA N/A Presbyterian Cancer Ctr-Dallas LLC PO Box 819067 Dallas TX 75381 260422749 Cancer Ctr TX NA N/A Rockwall Regional Hospital LLC 3150 Horizon Rd Rockwall TX 75032 202848116 Hospital TX NA N/A South Arlington Surgical Providers LLC 350 E Interstate 20 Ste 200 Arlington TX 76018 752723958 Amb Surg Ctr TX NA N/A Southlake Specialty Hospital LLC 1545 E Southlake Blvd Southlake TX 76092 020555370 Hospital TX NA N/A Surgical Caregivers of Fort Worth LLC 2001 W Rosedale St Fort Worth TX 76104 751925497 Amb Surg Ctr TX NA N/A Texas Health Craig Ranch Surgery Center 8080 State Hwy 121 Ste 100 McKinney TX 75070 383897811 Amb Surg Ctr TX NA N/A Texas Health Flower Mound Orthopedic Sur 5000 Long Prairie Rd Flower Mound TX 75028 800866449 Amb Surg Ctr TX NA N/A Texas Health Huguley Surgery Center LLC 12001 S Freeway Burleson TX 76028 821289045 Amb Surg Ctr TX NA N/A Texas Health Orthopedic Surgery Center A 9848 N Beach St Fort Worth TX 76244 814977249 Amb Surg Ctr TX NA N/A Texas Health Spine Surgery Center Allen 1120 Raintree Cir Ste 100 Allen TX 75013 300957868 Amb Surg Ctr TX NA N/A Texas Health Spine Surgery Center Allian 1545 E Southlake Blvd Ste 100 Southlake TX 76092 320571301 Amb Surg Ctr TX NA N/A Texas Health Supply Chain Services LLC 612 E Lamar Blvd Ste 600 Arlington TX 76011 841833532 Purchasing Co TX NA N/A Texas Health Surgery Center Alliance LLC 10840 Texas Health Trail Ste 100 Fort Worth TX 76244 822296081 Amb Surg Ctr TX NA N/A Texas Health Surgery Center Bedford LLC 1605 Airport Freeway Ste 100 Bedford TX 76021 821307876 Amb Surg Ctr TX NA N/A Texas Health Surgery Center Chisholm Tra 5900 Altamesa Blvd Fort Worth TX 76132 851225852 Amb Surg Ctr TX NA N/A Texas Health Surgery Center Irving LLC 2120 N MacArthur Blvd Ste 200 Irving TX 75061 831085415 Amb Surg Ctr TX NA N/A Texas Health Surgery Center Preston Plaz 17950 Preston Road Ste 75 Dallas TX 75252 203991622 Amb Surg Ctr TX NA N/A Texas Health Surgery Center Rockwall LLC 3144 Horizon Rd Ste 120 Rockwall TX 75032 474425996 Amb Surg Ctr TX NA N/A Texas Health Surgery Center Southwest Fo 6317 Harris Parkway Ste 200 Fort Worth TX 76132 843814490 Amb Surg Ctr TX NA N/A Texas Health Surgery Center Waxahachie 1434 US Hwy 287 Bypass Ste 100 Waxahachie TX 75165 831464243 Amb Surg Ctr TX NA N/A Texas Health Surgery Center Willow Park 612 E Lamar Blvd Ste 600 Arlington TX 76011 841953918 Inactive TX NA N/A Texas Institute for Surgery LLP 7115 Greenville Ave Ste 100 Dallas TX 75231 770628004 Hospital TX NA N/A THR-STT Rockwall ASC LLC 1545 E Southlake Blvd Southlake TX 76092 262429878 Amb Surg Ctr TX NA N/A THR-STT Southlake ASC LLC 1545 E Southlake Blvd Southlake TX 76092 201728912 Amb Surg Ctr TX NA N/A USMD Hospital at Arlington LP 801 I -20 West Arlington TX 76017 731662763 Hospital TX NA N/A USMD Hospital at Fort Worth LP 5900 Altamesa Blvd Fort Worth TX 76132 203571243 Hospital Closed TX NA N/A Walnut Hill Surgery Center LLC 5494 Glen Lakes Dr Dallas TX 75231 364499777 Amb Surg Ctr TX NA N/A Wilson Creek Surigcal Center LLC 8855 Synergy Drive McKinney TX 75070 274816583 Amb Surg Ctr TX NA N/A Women's Specialty Surgery Center of Dall 8230 Walnut Hill Ln Ste 101 Dallas TX 75231 262310072 Amb Surg Ctr TX NA N/A Grace Indemnity Company SPC Ltd 1159 Caribbean Plaza Grand Cayman CJ KY 1-1102 981209573 Captive Insur CJ NA C Corp false Texas Health Biomedical Advancement Cent 612 E Lamar Blvd Arlington TX 76011 752636884 Research TX NA C Corp false false false true false false false false false false false true false true false false true true true true See Part V for Explanation Schedule R, Part V, Line 2 - Related Transactions Texas Health Resources (THR) is the parent organization in a large healthcare system made up of both wholly owned entities as well as related controlled joint ventures as listed on Schedule R. THR's role is to plan, manage and coordinate the activities of the affiliated healthcare system in order to maximize opportunities to deliver cost effective quality medical care to residents of north central Texas. THR provides direction and oversight to its wholly owned affiliates through centralized services. They also provide oversight for the controlled joint ventures. As an integral part of providing centralized services to the affiliates, THR maintains intercompany receivable/payable accounts, most of which do not fall within the scope of IRC Section 512(b)(13). The range of centralized services provided by THR include information services, managed care contracting, Human resources, revenue cycle, billing and collections, patient access/admissions, legal, tax, compliance, supply chain, quality, business development, insurance, treasury, marketing, general accounting, real estate services, coding, transcription, and strategic planning. In addition, THR does daily cash sweeps of all controlled tax-exempt entity cash accounts. As a result, THR has numerous daily transactions with controlled tax-exempt entities, none of which fall within the scope of IRC Section 512(b)(13). A management fee is charged for the centralized services and reported on Form 990, Part VII, Section B as a professional services fee. Transactions with related tax-exempt organizations falling within the meaning of centralized services as described above, are not listed on Schedule R, Part V, Line 2.