2021-11-12T16:07:30-06:00 2020-12-31 BKD LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2020-01-01 746083124 Hill Country Memorial Hospital % JANICE MENKING HILL 8309974353 PO Box 835 Fredericksburg TX 78624 Susan Neves CFO 9727028262 2021-11-15 true Susan Neves 999009999 Jeanette Verrelli P00742631 9727028262 2 2020 2022-09-23 18:48:47Z JAYNE POPE PO BOX 835 FREDERICKSBURG TX 78624 117148624 false X WWW.HILLCOUNTRYMEMORIAL.ORG X 1966 TX MISSION IS REMARKABLE ALWAYS - TO PROVIDE REMARKABLE HEALTH CARE SERVICES TO THE HILL COUNTRY AREA THROUGH THE OPERATION AND MAINTENANCE OF A COMMUNITY HOSPITAL. 12 12 748 117 0 0 2286700 7758654 98588981 83100139 369742 -8009 -306818 118189 100938605 90968973 47091 0 0 0 31862934 32933880 0 0 0 52822530 52939461 84732555 85873341 16206050 5095632 201063998 229903609 12127528 26115122 188936470 203788487 X HILL COUNTRY MEMORIAL HOSPITAL'S VISION IS EMPOWER OTHERS, CREATE HEALTHY. THE HOSPITAL'S VALUES ARE: COMPASSION, OWNERSHIP, INNOVATION, EXCELLENCE false false 69139829 79001485 MEDICAL CARE SERVICES - PROVIDED HEALTH CARE SERVICES TO LOCAL RESIDENTS. DAYS OF CARE INCLUDED: ROUTINE AND OB - 4,708; INTENSIVE AND CRITICAL CARE UNITS - 1,313; NURSERY - 676; EMERGENCY ROOM CARE WAS PROVIDED FOR 10,105 VISITS; 209,409 LABORATORY TESTS WERE PERFORMED; 60,126 IMAGING PROCEDURES (ALL MODALITIES) WERE PERFORMED; 44,425 PHYSICAL/OCCUPATIONAL/SPEECH THERAPY VISITS WERE PROVIDED; 4,007 OPERATIONS AND 3,679 OUTPATIENT PROCEDURES WERE PERFORMED AND 406 BABIES WERE DELIVERED. 3207899 2812278 HOME CARE SERVICES - PROVIDE NURSES AND THERAPISTS TO ASSIST PATIENTS IN THEIR HOMES WITH EDUCATION, ASSESSMENT AND OBSERVATION OF WOUNDS, RESPIRATORY STATUS, CARDIAC STATUS AND OTHER BODY SYSTEMS. NURSES ALSO ADMINISTER IVS, WOUND CARE, COLOSTOMY CARE, AND CATHETER CARE. A TOTAL OF 13,697 HOME CARE VISITS WERE MADE. 1102499 696864 WELLNESS CENTER - PROMOTES HEALTH AND WELLNESS BY PROVIDING FITNESS EQUIPMENT AND CLASSES; CONDUCTING HEALTH SEMINARS AND CPR/FIRST AID CLASSES; PROVIDING NUTRITION INFORMATION THROUGH EDUCATION CLASSES AND DIETARY CONSULTATIONS; CONDUCTING HEALTH AND FITNESS SCREENINGS, FREE BLOOD PRESSURE CHECKS AND COUNSELING SEMINARS; AND OFFERING BREAST FEEDING SUPPLIES AND BREAST PUMP RENTALS, CHILDCARE AND YOUTH DAY CAMPS AS WELL AS MASSAGE THERAPY. DURING 2020 THERE WERE 86,905 VISITS IN WELLNESS CENTER PROGRAMS. 315508 376128 WIC PROGRAM 111545 279746 CLINIC RENT INCOME 50761 Surgery Center Income 427053 706635 73877280 true true false true false false false false false true true true false true true false false true false false false false false false false false true true false false true false false false false false false false true false false false false true true true true false false true 126 0 748 true false false false false false false false false false false false false X 12 12 false true false false false false false true true false false true true true true false true true true true true X JANICE MENKING 8309974353 822 REUBEN ST FREDERICKSBURG TX 78624 X Jayne Pope CEO 39.0 1.0 X 420525 0 24431 Clinton Kotal Chief Integration Officer 15.75 24.25 X 309558 0 44808 Mike Reno COO, End: 10/20 40.0 0.0 X 253625 0 24047 James Partin CMO 40.0 0.0 X 192308 0 42331 Maureen Polivka CNO 40.0 0.0 X 225249 0 8542 Amanda Stevens CSO/Fdn Exec. Director 20.0 20.0 X 95399 95399 37926 Kevin Shane Dickinson IT Director 25.0 15.0 X 189627 0 28172 Le Ann Myers Pharmacy Director 40.0 0.0 X 187315 0 20068 Nikki Rivers Chief Clinical Officer 40.0 0.0 X 195199 0 125 Elizabeth Hawronsky Director of Revenue 35.0 5.0 X 171430 0 14662 Timothy Boyd Roberts Facility Director 25.0 15.0 X 150679 0 27998 Melissa Jasso Admin Dir. Inpatient Services 40.0 0.0 X 142237 0 19031 Penny McBride Chairman 0.85 1.0 X X 0 0 0 Jenny Wieser VICE-CHAIRMAN 0.56 1.0 X X 0 0 0 Joel Junker Secretary 0.5 1.0 X X 0 0 0 Kevin Gallagher DO DIRECTOR 0.5 1.0 X 0 0 0 Dale Crenwelge Director 0.5 1.0 X 0 0 0 Anne Pluenneke MD Director 0.5 1.0 X 0 0 0 Michael Johnson MD DIRECTOR 0.5 1.0 X 0 0 0 John Willome Director 0.5 1.0 X 0 0 0 Dutch Bouwman Director 0.5 1.0 X 0 0 0 Drake McLean Director 0.5 1.0 X 0 0 0 Dan Sechrist Director 0.5 1.0 X 0 0 0 Jane Morgan Director 0.5 1.0 X 0 0 0 Susan Neves CFO 39.0 1.0 X 0 0 0 2533151 95399 292141 44 false true false ENDEAVOR REVENUE CYCLE SERVICES LLC 28 HUNTERS POINT NEW BRAUNFELS TX 78132 REVENUE CYCLE SVCS 537088 ETTAIN GROUP P O BOX 60070 CHARLOTTE NC 28260 IT STAFF SUPPORT 480669 TEXAS SELECT STAFFING LLC P O BOX 577 WEST BEND WI 53095 AGENCY STAFFING 416701 C2XSEVEN LLC 25 HIGHLAND PARK VILLAGE DALLAS TX 75205 MANAGEMENT SERVICES 374696 BKD LLP 510 N Valley Mills Drive Ste 200 WACO TX 76710 Audit/Tax Services 233373 10 6766357 992297 7758654 Net Patient Hospital Revenue 621110 78884362 78884362 Home Health Care Revenue 621610 2812278 2812278 Wellness Center Service Revenue 624100 696864 696864 WIC Program Revenue 624100 376128 376128 Clinic Rent Revenue 531120 279746 279746 50761 50761 83100139 721807 721807 0 0 0 0 0 25170001 25899817 -729816 -729816 -729816 0 0 0 0 0 0 349780 279834 69946 69946 Auxiliary Revenue 900099 43625 43625 MEDICAL RECORDS REVENUE 561000 3552 3552 All Other Misc Revenue 900099 1066 1066 1066 1066 48243 90968973 83217262 -6943 X 0 0 0 0 1855110 1855110 0 25998023 22441621 3556402 578356 533164 45192 2570255 2178690 391565 1932136 1616639 315497 374696 374696 99926 99926 179245 179245 0 0 0 12852540 11206781 1645759 330940 46928 284012 1137307 651594 485713 279371 279371 0 8415885 6757869 1658016 92177 87529 4648 0 58082 46102 11980 87072 81234 5838 0 4763594 3953783 809811 542743 450477 92266 Medical Supplies 18506645 18506645 Bad Debt Expense 4660888 4660888 Dues & Subscriptions 149865 35574 114291 Recruitment & Recognition 138464 36908 101556 270021 305483 -35462 85873341 73877280 11996061 0 32768706 33585269 32209339 45382889 1025040 1050040 10753042 8143479 0 0 0 0 0 0 1953313 2453361 10528698 11554555 117273033 72740405 45343304 44532628 0 0 25702916 33862063 0 0 0 0 40779640 49339325 201063998 229903609 7565206 10989087 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4562322 15126035 12127528 26115122 X 163233554 169926424 25702916 33862063 188936470 203788487 201063998 229903609 X 5095632 1612403 8143982 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4499 4499 false Schedule C, Part II-B, Line 1i LOBBYING EXPENSES: HILL COUNTRY MEMORIAL HOSPITAL PAID DUES TO ORGANIZATIONS, A PORTION OF WHICH IS DESIGNATED FOR LOBBYING EXPENSES. DUES LOBBYING % LOBBYING $ THA $28,372 14.50% $4,114 TORCH 3,850 10.00% 385 ----------------------------------------------------------- TOTAL $32,222 $4,499 18879729 7535 2307819 182514 21012569 15042722 113054 3679370 -44583 18879729 17720826 24451 -1760145 942311 99 15042722 17744630 52370 2483208 2559382 17720826 16977030 21784 1033609 287793 17744630 0.20140 0.42980 0.36880 false true true 8786007 8786007 52863256 31403078 21460178 1174293 1174293 53467376 41337327 12130049 982101 982101 44532628 INTEREST IN FOUNDATION 33862063 F 33862063 DEFERRED COMP PLAN INVESTMENT 1136408 DUE FROM AFFILIATES 48185158 Refund 17759 49339325 0 HCM Refundable Advance 300000 HCM Financing 1847674 Estimated Self Insurance COsts 234000 EST DUE TO 3RD PARTY PAYERS 12744361 15126035 SCHEDULE D, PART V, LINE 4 INTENDED USE OF ENDOWMENT FUNDS: HILL COUNTRY MEMORIAL FOUNDATION HOLDS AND MAINTAINS THE ENDOWMENT FUNDS FOR THE BENEFIT OF THE HOSPITAL. THERE ARE ENDOWMENTS DESIGNATED FOR THE FOLLOWING: EQUIPMENT AND TECHNOLOGY AT HCM; HCM NURSE STIPENDS, SCHOLARSHIPS, AND CERTIFICATIONS; AND STROKE EDUCATION AND AWARENESS. ADDITIONALLY, THERE ARE SEVERAL ENDOWMENT FUNDS ESTABLISHED AT THE FOUNDATION FOR HCM WHICH ARE UNRESTRICTED FOR PURPOSE. schedule d, part x, line 2 ASC 740 footnote: Management has evaluated their income tax positions under the guidance included in asc 740. based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. true true X true X 300. true X 500. true true true false true true 4626191 4626191 0.05700 2792243 5315314 0.00000 44426 44667 0.00000 7462860 5359981 4626191 0.05700 1039677 46072 993605 0.01220 24230098 19709426 4520672 0.05560 25269775 19755498 5514277 0.06780 32732635 25115479 10140468 0.12480 false 4660888 27525134 31433766 -3908632 X true true HILL COUNTRY SURGERY CENTER 0.51 0.1225 Memorial Surgery CTR 1 1 HILL COUNTRY MEMORIAL HOSPITAL 1020 KERRVILLE HWY FREDERICKSBURG TX 78624 WWW.HILLCOUNTRYMEMORIAL.ORG 00219 X X X HILL COUNTRY MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 19 true false false true X See Part V, Section C X true 19 true SEE PART V, SECTION C false true X 300. 500. X X X X X true true X X X true X see part v, section c X see part v, section c X see part v, section c X X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM PERSONS WHO RESPRESENT THE COMMUNITY: GILLESPIE, BLANCO AND KENDALL COUNTIES WERE THE PRIMARY FOCUS OF THE CHNA DUE TO THE SERVICE AREA OF HILL COUNTRY MEMORIAL HOSPITAL. USED AS THE STUDY AREA, GILLESPIE, BLANCO AND KENDALL COUNTIES PROVIDED 63% OF INPATIENT DISCHARGES. THE COMMUNITY INCLUDES MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS WHO LIVE IN THE GEOGRAPHIC AREAS FROM WHICH HILL COUNTRY MEMORIAL HOSPITAL DRAWS THEIR PATIENTS. ALL PATIENTS WERE USED TO DETERMINE THE SERVICE AREA WITHOUT REGARD TO INSURANCE COVERAGE OR ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER HILL COUNTRY MEMORIAL HOSPITAL'S FINANCIAL ASSISTANCE POLICY. IN MAY 2019, HILL COUNTRY MEMORIAL HOSPITAL BEGAN A COMMUNITY HEALTH NEEDS ASSESSMENT FOR GILLESPIE, BLANCO AND KENDALL COUNTIES, AND SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY USING SEVERAL METHODS: - INFORMATION GATHERING, USING SECONDARY PUBLIC HEALTH SOURCES, OCCURRED IN JUNE 2019. - 38 COMMUNITY MEMBERS, NOT-FOR-PROFIT ORGANIZATIONS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS, THE ELDERLY, HEALTH PROVIDERS, EDUCATION PROVIDERS, AND THE HEALTH DEPARTMENT PARTICIPATED IN EIGHT FOCUS GROUPS FOR THEIR PERSPECTIVES ON COMMUNITY HEALTH NEEDS AND ISSUES ON AUGUST 1 THROUGH AUGUST 19, 2019. - 410 COMMUNITY MEMBERS PARTICIPATED IN A RANDOM COMMUNITY SURVEY CONDUCTED FROM JULY 1, 2019 THROUGH AUGUST 19, 2019. - A COMMUNITY HEALTH SUMMIT WAS CONDUCTED ON AUGUST 28, 2019 WITH 91 COMMUNITY STAKEHOLDERS. THE AUDIENCE CONSISTED OF HEALTHCARE PROVIDERS, GOVERNMENT REPRESENTATIVES, SCHOOLS, NOT-FOR-PROFIT ORGANIZATIONS, STATE AND LOCAL HEALTH DEPARTMENTS, EMPLOYERS AND OTHER COMMUNITY MEMBERS. - INPUT OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS WAS RECEIVED DURING THE FOCUS GROUPS, INTERVIEWS, SURVEYS, AND THE COMMUNITY HEALTH SUMMIT. AGENCIES REPRESENTING THESE POPULATION GROUPS WERE INTENTIONALLY INVITED TO THE FOCUS GROUPS AND SUMMIT. ADDITIONALLY, THE COMMUNITY SURVEY WAS RANDOM AND REPRESENTED SOME LOW-INCOME, MEDICALLY UNDERSERVED AND MINORITY POPULATIONS. THE COMMUNITY SURVEY WAS REPRESENTATIVE OF THE WHOLE COMMUNITY. - THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES AND THE GILLESPIE COUNTY HEALTH DIVISION PARTICIPATED IN THE FOCUS GROUPS AND THE SUMMIT. FIVE HUNDRED AND TWENTY-EIGHT INDIVIDUALS FROM THIRTY-SIX COMMUNITY AND HEALTHCARE ORGANIZATIONS COLLABORATED TO IMPLEMENT A COMPREHENSIVE CHNA PROCESS FOCUSED ON IDENTIFYING AND DEFINING SIGNIFICANT HEALTH NEEDS, ISSUES, AND CONCERNS OF GILLESPIE, BLANCO AND KENDALL COUNTIES. THE THREE-MONTH PROCESS CENTERED ON GATHERING AND ANALYZING DATA AS WELL AS RECEIVING INPUT FROM PERSONS WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY TO PROVIDE DIRECTION FOR THE COMMUNITY AND HOSPITAL TO CREATE A PLAN TO IMPROVE THE HEALTH OF THE COMMUNITIES. BELOW IS A LIST OF ALL OF THE ORGANIZATIONS THAT GAVE INPUT INTO THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN: ORGANIZATION POPULATION REPRESENTED (KIDS, LOW INCOME, MINORITIES, THOSE W/O ACCESS) PARTICIPATION AREA AGENCY ON AGING/AACOGLOW INCOME SENIORS FOCUS GROUP, BETHANY LUTHERAN CHURCH FAITH COMMUNITY SUMMIT, BETHANY PRESCHOOL COMMUNITY CHILDREN FOCUS GROUP, BLANCO INDEPENDENT SCHOOL DISTRICT KIDS SUMMIT, BOYS AND GIRLS CLUB - FREDERICKSBURG COMMUNITY CHILDREN FOCUS GROUP, BVK SUMMIT, CHAMBER BUSINESSES SUMMIT, CHRISTIAN JOB CORPS OF GILLESPIE COUNTYLOW SKILLED/INCOME FOCUS GROUP, CITY HEALTH DEPARTMENT COMMUNITY SUMMIT, CITY OF FREDERICKSBURG SUMMIT, CITY/COUNTY EMERGENCY MANAGEMENT ALL FOCUS GROUP, COMFORT GOLDEN AGE CENTER SENIOR COMMUNITY FOCUS GROUP, COMFORT PUBLIC LIBRARY FOCUS GROUP, COMMUNITY VISIONING SUMMIT, CORNERSTONE CLINIC PRIMARY CARE SUMMIT, COUNCIL WOMAN, MASON CANCER BENEFIT BOARD FOCUS GROUP, DOGOLOGIE SUMMIT, FCUB SUMMIT, FELLOWSHIP OF CHRISTIAN ATHLETICS KIDS SUMMIT, FIRST UNITED METHODIST CHURCH ALL FOCUS GROUP, FISCHER AND WIESER SPECIALISTS FOUNDATION, LOW INCOME, MINORITIES, LACK OF ACCESS SUMMIT, FISD COMMUNITY EDUCATION, HILL COUNTRY COMMUNITY FOCUS GROUP FREDERICKSBURG CLINIC HEALTHCARE, KIDS, LOW INCOME SUMMIT, FREDERICKSBURG FIRE MarShALL FOCUS GROUP, FREDERICKSBURG INDEPENDENT SCHOOL DISTRICT FISD FAMILIES, EVERYONE FOCUS GROUP, SUMMIT FREDERICKSBURG POLICE DEPARTMENT YOUTH, ALL SUMMIT FRONTERA HEALTHCARE NETWORK MASON COUNTY FOCUS GROUP, SUMMIT GABLE S CORP. COMMUNITY SUMMIT, GILLESPIE COUNTY ATTORNEY GILLESPIE COUNTY/STATE OF TEXAS SUMMIT, GILLESPIE COUNTY HEALTH DIVISIONAL FOCUS GROUP, SUMMIT GILLESPIE COUNTY VETERANS SERVICE OFFICE VETERANS - 2,800 FOCUS GROUP, SUMMIT HARPER VOLUNTEER FIRE DEPARTMENT FOCUS GROUP, SUMMIT HCC NEEDS COUNCIL LOW INCOME, MINORITIES SUMMIT, HEB COMMUNITY SUMMIT, HILL COUNTRY MEMORIAL ALL FOCUS GROUP SUMMIT, HILL COUNTRY MEMORIAL FOUNDATION COMMUNITY SUMMIT, HILL COUNTRY MEMORIAL HOME CARE HOME BOUND SENIORS FOCUS GROUP SUMMIT, HILL COUNTRY MEMORIAL HOSPICE END OF LIFE- PRIMARILY SENIORS FOCUS GROUP SUMMIT, HILL COUNTRY MEMORIAL MEDICAL GROUP HOSPITAL SUMMIT, HILL COUNTRY UNIVERSITY CENTER of HIGHER EDUCATION, HEALTHCARE SUMMIT, HILL COUNTRY WELLNESS CENTER SUMMIT, HOLY CHRIST CHURCH PRESCHOOL AND ELDERLY SUMMIT, JP/COURT & HARPER VOLUNTEER FIRE DEPARTMENT ALL FOCUS GROUP SUMMIT, JUNCTION/KIMBLE CO EMS FOCUS GROUP, KIMBLE COUNTY SCHOOL DISTRICT FOCUS GROUP SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS ADDRESSED AND NOT ADDRESSED: TO SUCCESSFULLY MAKE OUR COMMUNITY HEALTHIER, IT IS NECESSARY TO HAVE A COLLABORATIVE VENTURE WHICH BRINGS TOGETHER ALL OF THE CARE PROVIDERS, CITIZENS, GOVERNMENT, SCHOOLS, CHURCHES, NOT-FOR-PROFIT ORGANIZATIONS AND BUSINESS AND INDUSTRY AROUND AN EFFECTIVE PLAN OF ACTION. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED PREVIOUSLY AND POSTED ON HCM'S WEBSITE. BASED ON THE RESULTS OF THE CHNA, HCM HAS SELECTED THREE OF THE IDENTIFIED SIGNIFICANT HEALTH NEEDS TO ADDRESS. 1. BEHAVIORAL HEALTH A) MENTAL HEALTH SERVICES 1. IDENTIFY AND IMPLEMENT OPPORTUNITIES TO EXPAND MENTAL HEALTH SERVICES AS APPROPRIATE. SUPPORT EXISTING RESOURCES E.G. FIND VOLUNTEERS WITH EXPERIENCE TO TRAIN OTHERS AND ENHANCE SUPPORT GROUPS LIKE AA, AL ANON AND NAMI. 2. EVALUATE TELEMEDICINE, MEDICAL SCHOOLS, PRIMARY CARE INTEGRATED BEHAVIORAL HEALTH, GERIATRIC PSYCHIATRY, AND ALLIED MENTAL HEALTH PROFESSIONALS AS POTENTIAL COMMUNITY RESOURCES. B) SUBSTANCE ABUSE 1. IDENTIFY AND IMPLEMENT OPPORTUNITIES TO EXPAND BEHAVIOR AND MENTAL HEALTH SERVICES AS APPROPRIATE. SUPPORT EXISTING RESOURCES E.G. FIND VOLUNTEERS WITH EXPERIENCE TO TRAIN OTHERS AND ENHANCE SUPPORT GROUPS LIKE AA, AL ANON AND NAMI. 2. EVALUATE TELEMEDICINE, MEDICAL SCHOOLS, PRIMARY CARE INTEGRATED BEHAVIORAL HEALTH, GERIATRIC PSYCHIATRY, AND ALLIED MENTAL HEALTH PROFESSIONALS AS POTENTIAL COMMUNITY RESOURCES. DUE TO THE LIMITING FACTORS OF THE COVID 19 PANDEMIC, THIS AREA WAS NOT ADDRESSED IN 2020. 2.HEALTHY EATING/ACTIVE LIVING A) CHILDREN HEALTH AND WELLNESS 1. CREATE A HEALTHY COMMUNITY COUNCIL (CAHC) WILL EVALUATE BEST PRACTICE PHYSICAL ACTIVITY PROGRAMS/IDEAS WITH A FOCUS ON CHILDREN'S (<18 YEARS) HEALTH AND WELLNESS. CAHC WILL SELECT A PLAN TO MOTIVATE HEALTHY BEHAVIORS, E.G. EDUCATE ON WAYS TO GET EXERCISE AND EXISTING RESOURCES, MEDIA CAMPAIGNS, SCHOOL-BASED HEALTH CENTERS, TEXT MESSAGE-BASED HEALTH INTERVENTIONS, WALKS/RUNS, A RESOURCE DESCRIBING LOCAL OPPORTUNITIES FOR FITNESS ACTIVITIES, ETC. IN THE FIRST QUARTER OF 2020, A HEALTHY COMMUNITY COUNCIL WAS FORMED WITH MEMBERS FROM THE GILLESPIE COUNTY AGRICUTLTURAL EXTENSION AGENCY (FAMILY & COMMUNITY HEALTH AGENT), METHODIST HEALTH CARE, GREATER HILL COUNTRY HOSPICE, HILL COUNTRY MEMORIAL MARKETING OUTREACH, GILLESPIE COUNTY HEALTH DIVISION (DIRECTOR OF HEALTH SERVICES), AND OTHERS. DURING THE FIRST QUARTER HEALTHY EATING PRESENTATIONS WERE MADE AT SCHOOLS IN GILLESPIE AND MASON COUNTY TOUCHING 517 STUDENTS. WHILE THE COUNCIL CONTINUED TO MEET DURING 2020 BY TELECONFERENCE, ALL IN PERSON EFFORTS WERE SUSPENDED FOR THE REMAINDER OF THE YEAR DUE TO THE COVID 19 PANDEMIC. B) SENIOR HEALTH AND WELLNESS 1. CREATE A HEALTHY COMMUNITY COUNCIL (CAHC), IN COLLABORATION WITH HCM HOME CARE AND HCM HOSPICE SERVICES, WILL EVALUATE BEST PRACTICE PHYSICAL ACTIVITY PROGRAMS/IDEAS WITH A FOCUS ON SENIOR'S (GREATER THAN 65 YEARS) HEALTH AND WELLNESS. CAHC/HCM HOME CARE/HCM HOSPICE WILL SELECT A PLAN TO MOTIVATE HEALTHY BEHAVIORS, E.G. EDUCATE ON WAYS TO GET EXERCISE AND EXISTING RESOURCES, MEDIA CAMPAIGNS, ACTIVITY PROGRAMS FOR OLDER ADULTS, COMMUNITY-BASED SOCIAL SUPPORT FOR PHYSICAL ACTIVITY, WALKS/RUNS, TELEMEDICINE SERVICES FOR REMOTE TREATMENT SERVICES, TEXT MESSAGE BASED HEALTH INTERVENTIONS, ETC. DURING THE FIRST QUARTER COOKING SCHOOLS TARGETING CARDIAC RISK SENIORS WERE HELD AND ATTENDED BY 318 PERSONS. ACTIVITIES WERE SUSPENDED FOR THE REMAINDER OF THE YEAR DUE TO THE COVID 19 PANDEMIC. 3. HEALTH LITERACY A) ACCESS TO CARE IN RURAL AREA 1. IDENTIFY AND IMPLEMENT BEST PRACTICES FOR INDIVIDUALS TO HAVE THE OPPORTUNITY TO OBTAIN, PROCESS, AND UNDERSTAND BASIC HEALTH INFORMATION AND SERVICES NEEDED TO MAKE APPROPRIATE HEALTH DECISIONS IN HCM'S RURAL SERVICE AREAS OR GILLESPIE COUNTY, BLANCO COUNTY, AND KENDAL COUNTY. SUPPORT EXISTING RESOURCES E.G. FIND VOLUNTEERS WITH EXPERIENCE TO TRAIN OTHERS AND ENHANCE SUPPORT GROUPS AND ANTICIPATED HEALTHCARE SERVICES PARTNERS INCLUDING LOCAL SOCIAL SERVICE PROVIDERS, THE GOOD SAMARITAN CENTER, MHDD, TELEMEDICINE, SCHOOLS, LAW ENFORCEMENT, EMERGENCY MEDICAL SERVICES, AND LOCAL FQHCS. EVALUATE TELEMEDICINE, MEDICAL SCHOOLS, PRIMARY CARE INTEGRATED BEHAVIORAL HEALTH, GERIATRIC PSYCHIATRY, AND ALLIED MENTAL HEALTH PROFESSIONALS AS POTENTIAL COMMUNITY RESOURCES. INCREASE CONVENIENT PRIMARY CARE OPPORTUNITIES (E.G. CLINICS, FQHCS) IN SURROUNDING COUNTIES AFTER CONDUCTING A FEASIBILITY STUDY AND DETERMINING COMMUNITY SUPPORT. B) CHRONIC DISEASE MANAGEMENT 1. RECRUIT NEW PRIMARY CARE PROVIDERS TO SERVE OUR COMMUNITIES THROUGH CHRONIC CARE MANAGEMENT. IDENTIFY AND ACT UPON ADDITIONAL SCREENING OPPORTUNITIES FOR CHRONIC DISEASES AND PROVIDING ACTIONABLE INFORMATION. DURING THE FIRST QUARTER, CARDIAC RISK AND CALCIUM ASSESSMENT CREENINGS WERE HELD WITH 308 PARTICIPANTS. ACTIVITIES WERE SUSPENDED OR THE REMAINDER OF THE YEAR DUE TO THE COVID 19 PANDEMIC. HILL COUNTRY MEMORIAL IS CONTINUING RECRUITING EFFORTS FOR PRIMARY CARE PROVIDERS. HCM DOES NOT INTEND TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS DUE TO LACK OF EXPERTISE AND RESOURCES: 1. ACCESS TO CARE AND INSURANCE IS A HEALTH NEED THAT HCM CANNOT DIRECTLY IMPACT AT THIS TIME. HCM WILL CONTINUE TO PROVIDE MORE ACCESS TO AFFORDABLE HEALTHCARE BY RECRUITING PRIMARY CARE DOCTORS TO EXPAND ACCESS AND CONTINUING TO OFFER ITS FINANCIAL ASSISTANCE PROGRAM. 2. SUBSTANCE USE: DUE TO RESOURCE LIMITATIONS, HCM IS NOT DIRECTLY ADDRESSING SUBSTANCE ABUSE/ADDICTION HEALTH NEEDS AT THIS TIME. HCM WILL CONTINUE TO PARTNER WITH LOCAL REHABILITATION CENTERS AND SOCIAL SERVICES BETTER POSITIONED TO DIRECTLY ADDRESS THIS HEALTH NEED. 3. AFFORDABLE HOUSING: WHILE THIS IS IMPORTANT TO OUR COMMUNITY IT IS A DIFFICULT ITEM FOR HCM TO DIRECTLY ADDRESS. HCM WILL CONTINUE TO PARTNER WITH LOCAL GOVERNMENT AND COMMUNITY LEADERS SEEKING SOLUTIONS TO MAKE AFFORDABLE HOUSING AVAILABLE IN THE COMMUNITY. 4. CHILD CARE: WHILE WE AGREE THAT THIS IS A NEED IN OUR COMMUNITY, WE SEE OTHERS IN OUR COMMUNITY BETTER-POSITIONED TO FILL THE GAP AT THIS TIME. HCM WILL CONTINUE TO OFFER CHILDREN'S PROGRAMMING DURING CERTAIN SCHOOL HOLIDAYS AT OUR WELLNESS CENTER AND CONTINUE TO COLLABORATE WITH SOCIAL SERVICES FOCUSING ON CHILDREN. 5. SENIOR CARE: DUE TO RESOURCE LIMITATIONS, WE ARE NOT ADDRESSING GERIATRIC HEALTHCARE SERVICES AT THIS TIME. HCM WILL CONTINUE TO PARTNER WITH LOCAL SENIOR SERVICES AND COMMUNITY LEADERS SEEKING SOLUTIONS TO MAKE GERIATRIC HEALTHCARE SERVICES AVAILABLE IN THE COMMUNITY. SCHEDULE H, PART V, SECTION B, LINE 13H OTHER FACTORS USED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE: THE NUMBER OF MEMBERS OF A HOUSEHOLD ARE ALSO CONSIDERED IN CALCULATING THE ELIGIBILITY FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 16 MEANS BY WHICH HOSPITAL PUBLICIZED POLICY: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY, AND APPLICATION CAN BE FOUND AT THIS WEBSITE: https://hillcountrymemorial.org/page/patient-information/financial-assista nce-forms/ THE FINANCIAL ASSISTANCE POLICY IS ALSO PUBLICIZED THROUGH AREA PHYSICIAN PRACTICES. SCHEDULE H, PART V, SECTION B, LINES 18 & 19 BILLING AND COLLECTIONS UNDER FACILITY'S FAP: NEITHER HILL COUNTRY MEMORIAL HOSPITAL, NOR THIRD PARTIES AUTHORIZED BY HILL COUNTRY MEMORIAL HOSPITAL, TAKE ANY ACTIONS UPON NON-PAYMENT FROM A PATIENT BEFORE MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR THE FACILITY'S FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART V, SECTION B, LINE 7 & 10 AVAILABILITY TO THE PUBLIC: THE CHNA AND IMPLEMENTATION STRATEGY ARE AVAILABLE ON THE HOSPITAL'S WEBSITE AND ARE MADE AVAILABLE TO THE FREDERICKSBURG STANDARD TO PUBLISH. IN ADDITION, WE HAVE MADE COPIES AVAILABLE BY CALLING OR EMAILING THE HOSPITAL. THE WEBSITE IS https://www.hillcountrymemorial.org/about/who-we-are/community-needs/commu nity-needs-health-assessment/ 1 HCM HOME CARE 808 REUBEN STREET FREDERICKSBURG TX 78624 HOME HEALTH SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT: FOR GENERAL LEDGER PURPOSES, HCM ESTIMATES THE BAD DEBTS EXPENSE BASED ON HISTORY. A MONTHLY REPORT DETERMINES THE PERCENTAGE OF COLLECTIONS ON EVERY PAYOR FOR THE LAST SIX MONTHS. THIS HISTORY OF THE PERCENTAGE OF UNCOLLECTIBLE CHARGES IS USED TO ESTIMATE THE BAD DEBT EXPENSE. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE POLICY: THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT FOOTNOTE: NOT APPLICABLE DUE TO ADOPTION OF ASU 606 REVENUE FROM CONTRACTS WITH CUSTOMERS. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY: THE HOSPITAL USES COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. THE ORGANIZATION HAD A MEDICARE SHORTFALL IN THE AMOUNT OF $3,908,632. THE STATE OF TEXAS TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT FOR MEETING STATUTORY REQUIREMENTS FOR CHARITY CARE AND COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION C, LINE 9B PROVISIONS ON COLLECTION PRACTICES FOR QUALIFIED PATIENTS: HILL COUNTRY MEMORIAL HOSPITAL'S COLLECTION POLICY EXCLUDES PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. OTHER FACTORS ARE USED IN DETERMINING AMOUNTS CHARGED TO PATIENTS. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: HILL COUNTRY MEMORIAL ASSESSES THE NEEDS OF THE COMMUNITIES IT SERVES THROUGH A TRIENNIAL COMPREHENSIVE COMMUNITY NEEDS ASSESSMENT, CONDUCTED BY A THIRD PARTY IN COLLABORATION WITH INTERNAL STAKEHOLDERS. ADDITIONALLY, HCM ACCESSES AND REVIEWS THE COMMUNITY HEALTH NEEDS ASSESSMENTS PUBLICALLY POSTED BY HEALTH ENTITIES IN OUR MORE DISTANT SERVICE AREAS. THESE ITEMS ARE INCORPORATED INTO OUR STRATEGIC PLAN. FINALLY, HCM CONDUCTS ANNUAL SWOT ASSESSMENTS WITH MORE THAN 100 KEY STAKEHOLDERS TO DETERMINE HEALTHCARE NEEDS BEFORE SETTING ITS ANNUAL STRATEGY. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: HILL COUNTRY MEMORIAL PATIENTS SPEAK WITH A HILL COUNTRY MEMORIAL BUSINESS OFFICE REPRESENTATIVE BEFORE CARE TO DETERMINE IF THEY ARE ELIGIBLE FOR ASSISTANCE UNDER THE FEDERAL, STATE AND LOCAL GOVERNMENT PROGRAMS OR THE ORGANIZATION'S CHARITY CARE POLICY. THE PATIENT'S ELIGIBILITY IS ASSESSED AND CAREFULLY MANAGED, SO THAT IF HE/SHE OVERPAYS, HE/SHE IS REIMBURSED THE RECONCILING AMOUNT. UPON DISCHARGE, PATIENTS ARE GIVEN THE INFORMATION, AND IT IS THEIR DECISION WHETHER OR NOT TO CONTACT THE HOSPITAL. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: THE ORGANIZATION SERVES EIGHT COUNTIES IN THE HILL COUNTRY: GILLESPIE, BLANCO, BURNET, KENDALL, KERR, KIMBLE, MASON, AND LLANO. THE PRIMARY SERVICE AREA OF GILLESPIE COUNTY (POP. 26,646) ACCOUNTS FOR ABOUT 50% OF HILL COUNTRY MEMORIAL PATIENTS. THE TOTAL SERVICE AREA POPULATION IS 215,600, AND THE AVERAGE PATIENT AGE IS 69 YEARS OLD. SCHEDULE H, PART VI, LINE 5 Promotion of Community Health: HILL COUNTRY MEMORIAL HOSPITAL'S VISION IS TO EMPOWER OTHERS, CREATE HEALTHY. ENCOURAGING WELLNESS IS AN INVESTMENT IN OUR COMMUNITIES' HEALTH. WE EMPOWER OTHERS BY HOLDING EDUCATIONAL/COMMUNITY EVENTS. 2020 WAS A CHALLENGING YEAR FOR CREATING HEALTHY WITH THE OUTBREAK OF COVID 19 IN OUR WORLD. BUT HCM WAS UP TO THE CHALLENGE. PUBLIC HEALTH EVENTS WERE STILL HEALD AS VIDEO CONVERENCES AND WERE WELL ATTENDED. SOME OF THE EVENTS AND SCREENINGS OFFERED WERE VIDEO CONFERENCES WITH OUR CHIEF MEDICAL OFFICER CONERNING COVID IN OUR COUMMUNITY. HCM WELLNESS CENTER POSTED, FOR THE COMMUNITY, GROUP EXERCISE CLASSES FOR AT HOME WELLNESS EXERCISES. IN ADDITION, HCM PROVIDED TELECONFERECES WITH AT-RISK +65 AGE GROUPS IN OUR RURAL COMMUNITY. CREATE A HEALTHY COMMUNITY COUNCIL PROVIDED FIVE COMMUNITY FIT TRAILS WITH TEN EXERCISE STATIONS ON A ONE MILE LOOP THROUGH LOCAL NEIGHBORHOODS. THE HEALTHYU PROGRAM, HYPERTENSION MANAGEMENT THROUGH BEHAVIORAL CHANGES, CONTINUED WITH 150 PARTICIPANTS WITH REMOTE WEBINARS, NUTRITIONAL CONSULTATIONS, OFF SITE FITNESS ACTIVITIES. HCM WELLNESS CENTER COMPLIED WITH PANDEMIC SAFETY PROTOCALS TO PROVIDE A RESOURCE FOR WELLNESS ACTIVITIES; OUTDOOR GROUP EXERCISE CLASSES, SMALLER AQUA CLASSES, FITNESS EQUIPEMENT SANITATION PROTOCOLS, AND TWO HOUR RESERVATION BLOCKS TO REDUCE THE USER INTERACTION. Embracing its value of ownership, HCM proactively initiated the Hill Country community response to COVID-19 by organizing regular stakeholder meetings with key community leaders; disseminating transparent, research based education; implementing innovative and expanded approaches to access care; and sharing best practices at the local, state, and national level. HCM's leadership remains committed to the overarching response of delivering coordinated care to improve population. In February 2020, HCM began identifying and organizing community leaders to engage in frequent conversations around the emerging spread of COVID-19. With greater than 30% of the local population older than 65, HCM knew it would need community partnerships to help bolster the medical community and protect the vulnerable population. The Community Stakeholder Committee was comprised of representatives from local city and county government, Chamber of Commerce, Visitor's Bureau, Economic Development, faith based organizations, independent school district, media, emergency/first-responders, and medical community representatives. The group met weekly and in times of emerging information and increasing cases, met as frequently as daily. HCM engaged a comprehensive approach to outreach by including research-based education on the spread of COVID, safety measures, and prevention methods. Information was released on frequent (daily and weekly) bases through multifaceted channels including Conversation on COVID with the Chief Medical Officer including radio interviews, newspaper interviews, and Facebook Live. Educational and awareness information was shared through a dedicated COVID website (HCMCOVID19.org), print media, and digital outlets. From February 6, 2020 to August 15, 2021, HCM reached 672,504 individuals through Social Media. This number illustrates HCM's commitment to providing COVID education and awareness in efforts to keep our residents safe. HCM team members rapidly developed a COVID response plan that included drive-through COVID testing, conversion of patient rooms into negative pressure suites, and access of healthcare through technology. HCM's drive-through COVID testing became one of the first offered in the state of Texas. HCM was the first rural hospital in Texas to construct a self-containing, ventilated COVID Unit equipped with a Tru-D ultraviolet light machine. HCM clinical team members use it after terminal cleaning in all isolation rooms, no matter the hospitalization or procedure circumstance. Implementation of the light technology provides increased safety by eliminating pathogenic growth in niche point areas. THE ORGANIZATION HAS THE LARGEST VOLUNTEER BASE IN FREDERICKSBURG. EMPLOYEES SERVED IN LEADERSHIP ROLES FOR MANY COMMUNITY ORGANIZATIONS. HCM ALSO COLLABORATES WITH CITY AND COUNTY OFFICIALS TO PREPARE FOR EMERGENCY SCENARIOS. HCM INVITES CITY AND COUNTY EMERGENCY OFFICIALS TO PARTICIPATE IN MOCK EMERGENCY SITUATIONS TO PREPARE FOR AN ACTUAL, LIKELY EMERGENCY BASED ON THE GEOGRAPHIC PROXIMITY OF THE HOSPITAL, SUCH AS A TORNADO OR MAJOR CHEMICAL SPILL. HCM'S PURPOSE IS TO SERVE AND PARTNER WITH OTHERS TO CREATE HEALTHY COMMUNITIES FOR GENERATIONS TO COME. THE ORGANIZATION DOES THIS BY HAVING AN OPEN MEDICAL STAFF AND A COMMUNITY BOARD. HCM ALSO PROVIDES MILLIONS OF DOLLARS OF CHARITY CARE EACH YEAR. AS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION, OUR EARNINGS ARE INVESTED BACK INTO THE ORGANIZATION FOR IMPROVEMENTS IN THE FACILITIES, TECHNOLOGY AND THOSE WHO DELIVER CARE. IN 2020, HCM INVESTED IN NEW EQUIPMENT FOR COVID RESPONSE, NEW TELEMETRY SYSTEM, AND UPGRADING IT SYSTEMS. FOR ADDITIONAL INFORMATION ABOUT ACTIVITIES THE HOSPITAL CONDUCTED TO PROMOTE COMMUNITY HEALTH, SEE THE SCHEDULE H, PART V, SECTION B, LINE 11 DISCLOSURE. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE HOSPITAL IS PART OF A SYSTEM WHICH INCLUDES TEN ORGANIZATIONS. HILL COUNTRY MEMORIAL HOSPITAL PROVIDES HEALTHCARE; HILL COUNTRY MEMORIAL FOUNDATION PROVIDES FUNDRAISING; HILL COUNTRY PHYSICIAN ASSOCIATES PROVIDES HEALTHCARE; HILL COUNTRY PRIMARY CARE PHYSICIANS PROVIDES HEALTHCARE; AND GREATER HILL COUNTRY HOSPICE PROVIDES HOSPICE SERVICE. IN ADDITION, THE AFFILIATED HEALTH CARE SYSTEM INCLUDES THE FOLLOWING INACTIVE ENTITIES: HILL COUNTRY MEMORIAL HEALTH SYSTEM, HILL COUNTRY MEMORIAL COMMUNITY SERVICES, HILL COUNTRY MEMORIAL MEDICAL OFFICE BUILDING, AND HILL COUNTRY WELLNESS CENTER. HC HEALTH, LLC, AN ACO, WAS CREATED IN 2019 AND IS FULLY OWNED BY THE HOSPITAL. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: TEXAS SCHEDULE H, PART I, LINE 7 COLUMN F FINANCIAL ASSISTANCE & CERTAIN OTHER COMMUNITY BENEFITS AT COST: THE AMOUNT OF BAD DEBT EXPENSES REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT PERCENTAGE WAS $4,660,888. SCHEDULE H, PART I, LINE 3C FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING OTHER CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: -ASSET LEVEL -MEDICAL INDIGENCY -INSURANCE STATUS -UNDERINSURANCE STATUS -NUMBER OF HOUSEHOLD MEMBERS SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. THE COST COMPUTED ON IRS WORKSHEET 4 FROM THE GOOD SAMARITAN CENTER IS BASED ON CHARGES WRITTEN OFF. ALL OTHER ACTIVITY IS ACTUAL CASH COSTS. WORKSHEET 6 PULLED THE DATA FROM THE COST ACCOUNTING SYSTEM CONSISTING OF ACTUAL CHARGES AND RECEIPTS, ACTUAL COSTS AND OVERHEAD COSTS. X X X true false false false false false false false false Jayne Pope CEO 360525 0 60000 0 0 0 11200 0 13231 0 444956 0 0 0 Clinton Kotal Chief Integration Officer 274788 0 34770 0 0 0 11001 0 33807 0 354366 0 0 0 Mike Reno COO, End: 10/20 211317 0 0 0 42308 0 11000 0 13047 0 277672 0 0 0 Maureen Polivka CNO 214691 0 10558 0 0 0 8542 0 0 0 233791 0 0 0 Nikki Rivers Chief Clinical Officer 195199 0 0 0 0 0 0 0 125 0 195324 0 0 0 James Partin CMO 179908 0 12400 0 0 0 11200 0 31131 0 234639 0 0 0 Amanda Stevens CSO/Fdn Exec. Director 84529 84529 10870 10870 0 0 3254 3254 15709 15709 114362 114362 0 0 Kevin Shane Dickinson IT Director 182422 0 761 0 6444 0 6926 0 21246 0 217799 0 0 0 Le Ann Myers Pharmacy Director 180466 0 0 0 6849 0 6817 0 13251 0 207383 0 0 0 Elizabeth Hawronsky Director of Revenue 168065 0 0 0 3365 0 0 0 14662 0 186092 0 0 0 Timothy Boyd Roberts Facility Director 149306 0 761 0 612 0 5059 0 22939 0 178677 0 0 0 Melissa Jasso Admin Dir. Inpatient Services 141517 0 0 0 720 0 3800 0 15231 0 161268 0 0 0 Schedule J, Part I, Line 4a SEVERANCE PAYMENT: SEVERANCE IS A VOLUNTARY AGREEMENT THAT SET FORTH THE AGREED UPON SEPARATION DATE FOR EMPLOYMENT AND BENEFITS COVERAGE, THE AMOUNT OF PAYMENT, A CONFIDENTIALITY AGREEMENT CONCERNING COMPANY INFORMATION AND MATERIALS, RETURN OF COMPANY MATERIALS, AND COOPERATION CONCERNING BUSINESS MATTERS. DUE TO THE NATURE OF THE CONFIDENTIALITY CLAUSE OF THE AGREEMENT, THE HOSPITAL CAN NOT REPORT THE NAME OF THE RECIPIENT OR THE AMOUNT OF SEVERANCE PAID ON A PUBLIC DOCUMENT. C2XSEVEN LLC OWNED BY OFFICER 374696 MANAGEMENT CONTRACT false FORM 990, PART VI, SECTION A, LINE 3 DELEGATION OF MANAGEMENT DUTIES: DURING THE 2020 TAX YEAR, THE HOSPITAL ENTERED INTO A MANAGEMENT AGREEMENT WITH C2XSEVEN, LLC TO CONTRACT AN INDIVIDUAL TO ACT AS THE INTERIM CHIEF FINANCIAL OFFICER OF THE HOSPITAL. PER IRS GUIDANCE, NO COMPENSATION IS SHOWN ON FORM 990, PART VII, FOR THIS INDIVIDUAL: SUSAN NEVES $374,696 FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: THE HOSPITAL BOARD HAS GIVEN THE AUDIT COMMITTEE THE RESPONSIBILITY TO REVIEW THE FORM 990. ALL BOARD MEMBERS ARE ALSO PROVIDED A LINK TO ACCESS THE 990 FOR REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: CONFLICT OF INTEREST FORMS ARE COMPLETED BY BOARD MEMBERS, OFFICERS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES, AND ALL DEPARTMENT DIRECTORS ON AN ANNUAL BASIS. ALL DISCLOSURES ARE REVIEWED BY THE BOARD GOVERNANCE COMMITTEE AND REPORTED TO THE HOSPITAL BOARD. BOARD MEMBERS MUST RECUSE THEMSELVES FROM VOTING ON ISSUES RELATED TO THEIR CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION REVIEW AND APPROVAL PROCESS FOR CEO: THE CEO COMPENSATION AND EVALUATION COMMITTEE OF THE BOARD REVIEWS RELEVANT WAGE SURVEY AND DATA TO DETERMINE CEO COMPENSATION. DATA AND SURVEYS ARE SUPPLIED BY THE HUMAN RESOURCE DIRECTOR AND REPORTED TO THE HOSPITAL BOARD. THE REVIEW IS CONDUCTED ANNUALLY AND DOCUMENTED IN THE MINUTES. FORM 990, PART VI, SECTION B, LINE 15B COMPENSATION REVIEW AND APPROVAL PROCESS FOR OTHER OFFICERS AND KEY EMPLOYEES: THE CEO REVIEWS WAGE DATA AND SURVEYS SUPPLIED BY THE HUMAN RESOURCE DIRECTOR. THE REVIEWS ARE CONDUCTED ANNUALLY AND DOCUMENTED IN THE HR FILES. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION A, LINE 1 DELEGATION OF AUTHORITY: THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN, VICE-CHAIRMAN, SECRETARY AND ONE AT-LARGE TRUSTEE. THE CEO AND CHIEF OF THE HOSPITAL'S MEDICAL STAFF SHALL BE EX-OFFICIO, NON-VOTING MEMBERS OF THE EXECUTIVE COMMITTEE. THE COMMITTEE SHALL HAVE THE POWER TO TRANSACT BUSINESS OF THE CORPORATION AND THE HOSPITAL SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD. THE EXECUTIVE COMMITTEE SHALL HAVE SUCH ADDITIONAL DUTIES AND RESPONSIBILITIES AS MAY BE SET FORTH IN THE BYLAWS. ACTIONS OF THE EXECUTIVE COMMITTEE SHALL BE BROUGHT TO THE BOARD AT THE NEXT REGULAR MEETING FOR RATIFICATION. FORM 990, PART III, LINE 4D DESCRIPTION OF OTHER PROGRAM SERVICES: WIC PROGRAM - PROVIDE NUTRITIONAL EDUCATION, BREAST FEEDING SUPPORT, WIC FOODS AND SOCIAL SERVICe REFERRALS FOR WOMEN AND CHILDREN MEETING WIC ELIGIBILITY REQUIREMENTS; AND COMMUNITY HEALTH PROGRAMS SUCH AS IMMUNIZATIONS FOR Children. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: UNDISTRIBUTED PORTION OF CHANGE IN INTEREST IN NET ASSETS OF HCMH FOUNDATION $ 8,159,147 NET ASSET TRANSFER TO FOUNDATION (15,165) ---------------- TOTAL $ 8,143,982 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:12852540 HC HEALTH LLC 1020 S HIGHWAY 16 FREDERICKSBURG TX 78624 833115572 ACO TX 0 7493 HCMH HILL COUNTRY MEMORIAL HEALTHCARE SYSTEM 1020 KERRVILLE HWY FREDERICKSBURG TX 78624 742858904 SUPPORT TX 501(C)(3) 12, TYPE I HCMH true HILL COUNTRY MEMORIAL COMMUNITY SERVICES 1020 KERRVILLE HWY FREDERICKSBURG TX 78624 742858907 HOME CARE SRV TX 501(C)(3) 12 TYPE III HCMH true HILL COUNTRY WELLNESS CENTER 1020 KERRVILLE HWY FREDERICKSBURG TX 78624 742858905 HEALTH ED TX 501(C)(3) 12 TYPE III HCMH true HILL COUNTRY MEMORIAL FOUNDATION INC 1020 KERRVILLE HWY FREDERICKSBURG TX 78624 742557105 FUNDRAISING TX 501(C)(3) 12 TYPE III NA false HILL COUNTRY MEM MEDICAL OFFICE BLDG 1020 KERRVILLE HWY FREDERICKSBURG TX 78624 742858909 OFFICE BLDG TX 501(C)(3) 12 TYPE III HCMH true GREATER HILL COUNTRY HOSPICE 1020 KERRVILLE HWY FREDERICKSBURG TX 78624 742912643 HOSPICE TX 501(C)(3) 3 HCMH true HILL COUNTRY PHYSICIAN ASSOCIATES 1020 KERRVILLE HWY FREDERICKSBURG TX 78624 262553196 HEALTHCARE TX 501(C)(3) 12, TYPE I HCMH true HILL COUNTRY PRIMARY CARE PHYSICIANS 1020 KERRVILLE HWY FREDERICKSBURG TX 78624 272860109 HEALTHCARE TX 501(C)(3) 3 HCMH true HILL COUNTRY MEMORIAL SURGERY CENTER PO BOX 835 FREDERICKSBURG TX 79624 331039828 SURGERY CENTER TX HCMH RELATED -199188 373023 false 0 false 0.51000 false false false true false false false false false true false false true true true false true true true Hill Country Primary Care Physicians R 6870447 FMV Hill Country Memorial Surgery Center R 669730 FMV Greater Hill Country Hospice Q 4759453 FMV