2020-11-12T14:12:59-06:00 2019-12-31 990 2019-01-01 752890358 Texas Health Presbyterian Hospital Allen % DAVID JACKSON TEXA 9727471000 1105 Central Expressway North Allen TX 75013 DAVID JACKSON Assistant Secretary 6822367900 2020-11-12 12.50.9.252 80738820203175000015 2020-11-12 P 0D33BBB54333E46932C7CF539F0981FD51E56782 C6207B00799800B6519E6B6D36727100FAAB12D3 2019 2021-01-29 14:40:06Z Jared Shelton 1105 Central Expressway North Allen TX 75013 90722546 false X texashealth.org X 2000 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 14 458 109 0 154053 30146 91658508 90150950 8136 28364 961418 488106 92782115 90697566 163933 118187 0 0 39462239 37726206 0 0 0 46843731 48452871 86469903 86297264 6312212 4400302 67778674 102331493 13115408 17841790 54663266 84489703 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 71165060 118187 90194531 Texas Health Presbyterian Hospital Allen ("THA") is a 76-bed acute care hospital serving the northern Collin County area since 2000. The hospital's services include emergency services, orthopedic care, back and spine, cardiac rehab, digestive health, wound care and women's services. The hospital recently completed a $68.0 million expansion that increased bed, Cath lab and operating room capacity and opened in June 2020. THA was designated a "Texas Ten-Step" hospital for maternal and newborn care by the Texas Department of State and Health Services and an Accredited Chest Pain Center and Stroke Ready hospital by the Joint Commission. More than 380 employees work at this hospital, and more than 500 physicians are practicing on its medical staff. THA had 8,096 patient days, 2,617 discharges, 210 births, 43,266 outpatient encounters, and 22,598 emergency room visits during the year. THA provides quality medical healthcare services regardless of the patient's race, creed, sex, national origin, handicap, age or ability to pay. THA 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. THA also provides charity care to patients who are unable to pay for the services they receive 71165060 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 59 0 true 458 true false 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 false X X DAVID JACKSON 6822367900 612 E LAMAR BLVD Arlington TX 76011 X BerdanBarclay E Trustee/CEO 0.32 44.68 X X 0 2638211 312692 RansomElizabeth Former Officer 0.0 40.0 X 0 1285275 45344 McWhorterRicky E Former Officer 0.0 40.0 X 0 920489 115378 KramerKenneth J Assistant Secretary 0.5 40.0 X 0 875091 121588 SchwabRobert Adams Chief Medical Officer THA 40.0 0.0 X 539679 0 67210 McClungBrett S Former Officer 0.0 40.0 X 0 501260 34623 ReecerJeffrey P Former Officer 0.0 40.0 X 0 405329 77336 EscandonChristy Anne Former Officer 0.0 40.0 X 0 442479 38047 JacksonDavid W Assistant Secretary 0.5 40.0 X 0 407550 56852 AsturiElizabeth Chief Nursing Officer THD 0.0 40.0 X 0 352084 33114 SheltonJared Christop President THA 40.0 0.0 X 310960 0 62816 GildonLisa Grp Finan Officer THP-THA 16.0 24.0 X 0 306569 34021 CantuStacy G Corporate Secretary 0.5 40.0 X 0 306015 33643 BraxtonKenneth W Former Officer 0.0 40.0 X 0 232502 22516 SummersJohn Blue Chief Nursing Officer THA 40.0 0.0 X 214609 0 36574 KrejciJacque D Former Officer 0.0 40.0 X 0 193325 22482 KOLBETSHARON Assistant Secretary 0.5 40.0 X 0 187464 17299 AmayaChristopher Jule DIR PHARMACY 40.0 0.0 X 168559 0 27345 PecenkaMichelle Leann DIR NRSG MED SURG/ICU/ED 40.0 0.0 X 158372 0 24530 HornKin-Lai Y RN V 40.0 0.0 X 144567 0 30903 HughesRex Wayne SPL NUCLEAR MED 40.0 0.0 X 137227 0 30290 VargheseJainamma RN V 40.0 0.0 X 140430 0 26500 Bloemendal MD Lee C Trustee 0.02 1.41 X 0 0 0 Haggar III Joseph Trustee 0.02 1.41 X 0 0 0 Hunt Hunter Trustee 0.02 1.41 X 0 0 0 Montgomery Lynn Trustee 0.02 1.41 X 0 0 0 Reeves Kenneth Trustee 0.02 1.41 X 0 0 0 Tatum Stephen Trustee 0.02 1.41 X 0 0 0 Vigness MD Richard Trustee 0.02 1.41 X 0 0 0 Washington Bernice Trustee 0.02 1.41 X 0 0 0 Weeks DNP RN Susan Trustee 0.02 1.41 X 0 0 0 Wynne James Trustee 0.02 1.41 X 0 0 0 Stripling MD W Dennis Chairman 0.02 1.41 X 0 0 0 Turner Wesley Immediate Past Chair 0.02 1.41 X 0 0 0 Wilder Jr Charles Joh Vice Chair 0.02 1.41 X 0 0 0 Hum MD Lawrence Trustee 0.02 1.41 X 0 0 0 1814403 9053643 1271103 61 true true false Texas Health Resources 612 E Lamar Blvd ARLINGTON TX 76011 Mgmt Services 12328567 AUSTIN COMMERICIAL INC 3535 TRAVIS ST STE 300 DALLAS TX 75204 Construction Service 4962487 TEXAS HEALTH PHYSICIANS GROUP 9229 LBJ Freeway DALLAS TX 75243 Physician Services 1407630 MICHAEL D DECK MD PA 550 LAKESIDE PWY STE 200 LEWISVILLE TX 75028 PHYSICIAN SERVICES 242006 VANGUARD RESOURCES INC 6500 Hwy 281 North SPRING BRANCH TX 78070 HOUSEKEEPING 228439 17 30146 30146 PATIENT REVENUE 622110 89838045 89838045 COST REPORT ADJ 622110 288751 288751 MANAGEMENT FEES 622110 14400 14400 EDUCATION 624190 9754 9754 90150950 24381 24381 0 0 70962 70962 0 70962 70962 28962 24980 3982 3983 3983 0 0 0 0 0 0 0 0 0 CAFETERIA 722514 186579 186579 WOMEN'S HEALTH CENTER 713940 101365 101365 RETAIL SALES 453220 45190 45190 84010 43581 40429 417144 90697566 90194531 472889 118187 118187 0 0 0 1231850 1231850 0 29097200 28683696 413504 0 1329547 1316556 12991 3963947 3963947 0 2103662 2037095 66567 12328568 12328568 0 0 0 0 0 8461155 8389511 71644 19720 15755 3965 264175 143941 120234 332744 315300 17444 0 1782591 1405875 376716 21024 10615 10409 0 32512 25132 7380 628715 628715 0 5733249 5417949 315300 1365094 1365094 MEDICAL SUPPLIES 13194751 13194751 0 LPPF IGT 1286727 1286727 0 NON CAPITAL EQUIPMENT 847780 847780 0 REPAIR & MAINTENANCE 463861 458836 5025 1690205 1539598 150607 86297264 71165060 15132204 0 108076 -6796 0 0 0 0 11199737 12339505 0 0 0 0 618402 417710 1255411 1476819 257650 120938 147259444 59276664 54339398 87982780 0 0 0 0 0 0 0 0 0 537 67778674 102331493 13115408 13984844 0 0 0 1064842 0 0 0 0 0 0 0 0 0 0 0 2792104 13115408 17841790 X 54663266 84489703 0 0 54663266 84489703 67778674 102331493 X 4400302 25426135 X X false true X true false 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. 8903474 8903474 26115706 21652167 4463539 23215293 13571577 9643716 38680815 24052920 14627895 50344156 50344156 87982780 0 EST THIRD PARTY PAYOR SETTLEMENT 2792104 2792104 true true X true X true X 500. true true false true true 5100730 80314 5020416 0.05820 5083530 4892511 191019 0.00220 10184260 4972825 5211435 0.06040 621514 0 621514 0.00720 267654 0 267654 0.00310 56698 0 56698 0.00070 945866 0 945866 0.01100 11130126 4972825 6157301 0.07140 22071 0 22071 0.00030 72637 0 72637 0.00080 26879 0 26879 0.00030 121587 0 121587 0.00140 false 10303369 0 13966434 16573729 -2607295 X true true 1 1 Texas Health Allen 1105 Central Expressway North Allen TX 75013 www.texashealth.org THD #7242 X X X Texas Health Allen 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 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 Texas Health Allen 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 Allens (THA) 2019 CHNA was a collaborative process utilizing qualitative and quantitative methods to assess the health needs of persons within the service areas in the Collin County region. The 2019 CHNA was conducted at the Collin County 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 22 community members with interests specific to the health of individuals in the Collin County region in the CHNA development process. Seventeen of these community members were engaged across two separate focus groups held in zip-codes that were identified as underserved areas. Five served as key informants, and the windshield survey was conducted by two Texas Health graduate fellows and three 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: Allen Community Outreach; ARTA Travel; Cigna; City of Plano; Frisco Chamber of Commerce; Iconic Consulting Group, Inc.; Northbridge Church; Plano ISD; Professional Office Services of Dallas; Texas Department of State Health Services; and Toyota Motor North America. 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 THRs 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 Collin County Region was done in collaboration with Texas Health Frisco (THF), Texas Health Plano (THP), Texas Health Allen (THA) and Physicians Medical Center (PMC). 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 8 While a CHNA was conducted in 2019, the implementation strategy tied to the assessment was not adopted until 2020. In 2019, the hospital completed the three year cycle of the hospitals previous CHNAs implementation strategy (2017-2019). Part V. Section B, Ln 11 The 2017 - 2019 implementation strategy was utilized throughout 2019 to develop the programs and activities outlined below. The hospital is a part of the Texas Health Resources healthcare system, which developed a system-wide community benefit strategy to leverage internal and external resources to increase its ability to impact the community health needs of the target areas with a higher focus on these three health priorities which were carried over from the 2016 CHNA: 1. Behavioral Health 2. Chronic Disease Prevention & Management 3. Access to Health Services and Healthcare Navigation & Literacy (ALN) In 2019, Texas Health Allen addressed significant health needs identified with the following approaches: 1. Behavioral Health 1a. In 2019, The Texas Health initiative known as Texas Health Community Impact (THCI) awarded grants to deliver behavioral health services to underserved communities. The initiative pinpoints specific ZIP codes to address social determinants of health as it relates to behavioral health, with the aim of preventing comorbid problems that may surface in the form of chronic diseases or premature death. The Community Impact initiative calls on agencies from different sectors - education, health care, government, grassroots organizations and others - to unite against identified issues. Through LifePath System, Beyond Blue collaboration is designed to improve services to the over 55 population in McKinney who are at risk of, or diagnosed with, depression. Through Plano Education Foundation, PlanoUp! collaboration will centralize services to address depression and social determinants of health on school campuses in East Plano. 2. Chronic Disease Prevention & Management 2a. Historically, Texas Health has funded the work of local community health clinics in our mission to improve the health of the people in the communities we serve. In 2016, Texas Health launched Clinic Connect, a streamlined process for receiving and evaluating funding requests from clinics that reach vulnerable populations and serve as outpatient resources for our acute care hospitals. The goal of Clinic Connect is to create a collaborative relationship with local non-profit community-based clinics by providing financial support, educational opportunities, information sharing, and expanded services to improve healthcare access and quality for underserved, vulnerable populations. 2b. Hosted COPD/Lung Disease and Smoking Cessation support groups for the community. The Better Breathers Club support group is for individuals and their families who are affected by chronic lung problems such as COPD, asthma, pulmonary fibrosis and lung cancer, and their caregivers. Participants learn better ways to cope with their condition while getting support from others who share similar conditions. The Freedom from Smoking support group is for individuals who are trying to quit smoking. The goal for both support groups is to give participants the tools they need to live the best quality of life. 3. Access, Literacy, and Navigation (ALN) 3a. A Matter of Balance (AMOB), an evidence-based fall prevention program for older adults. 3b. Chronic Disease Self-Management Program (CDSMP), a nationally recognized program designed to enable individuals to build the self-confidence and motivation they need to manage the challenges of living with a chronic disease. 3c. Child Automobile Safety Initiative (CASI), a program focused on protecting children from injury in motor vehicle collisions by providing free car seat safety checks and community based education. 3d. Diabetes Self-Management Program (DSMP), a workshop offering information and skill building exercises specific to diabetes self-management. 3e. Faith Community Nursing (FCN) administered flu shots in the community. All significant health needs identified are being addressed by the hospital in one of the categories listed above. 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/About-Texas-Health/Insurance-and-Costs/Financi al-Assistance Texas Health Allen 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 socio-economic factors that influence the overall health of individuals in the communities served. As identified in the community health needs assessment, there are areas of need that are not in alignment with the operations of a hospital system. Our volunteerism, collaborations and partnerships with various help organizations and various area coalitions help in addressing the socio-economic factors that are the backbone for many underlying health concerns. 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 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 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 THRs financial assistance policy, the Tax-Exempt Hospitals, THRW, and Texas Health Physicians Group (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 THR 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, 2019 and 2018, contract assets of $33,617,000 and $38,520,000, 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 managements 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 $437,785,000 and $379,437,000 were recorded as reductions to patient accounts receivable at December 31, 2019 and 2018, 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 2019 is $13,577,155. 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 through the following steps: - Demographic analysis by region - Secondary data analysis of health indicators to identify zip codes of highest-needs within each region - Community input data collection and assessment via key informant interviews, focus groups, and a windshield survey - Synthesis of secondary data and community input data to identify most pressing health needs by region - Prioritization of zip codes with imme true DALLAS SAFETY NET SUPPORT CORPORATION 1441 N BECKLEY AVE DALLAS TX 75203 823131059 501(c)(3) 20238 INDIGENT Health CARE ALLEN COMMUNITY OUTREACH 801 E MAIN STREET ALLEN TX 75002 751986190 501(c)(3) 20000 General Purpose CITY OF ALLEN 305 CENTURY PARKWAY ALLEN TX 75013 756004912 City of Allen 20000 General Purpose ALLEN CHAMBER OF COMMERCE 210 W MCDERMOTT DR ALLEN TX 75013 751876471 501(c)(6) 8200 GENERAL PURPOSE Allen Sports Association 108 Tiburon Court Allen TX 75013 752253580 501(c)(3) 10000 General Purpose Allen ISD 612 E BETHANY DRIVE ALLEN TX 75002 756000023 ALLEN ISD 25000 SPONSORSHIP FOUNDATION FOR ALLEN SCHOOLS 612 E BETHANY DR ALLEN TX 75002 752750519 501(c)(3) 5250 SPONSORSHIP 6 1 Schedule I, Part II - Monitoring Grants Texas Health Allen (THA) 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 BerdanBarclay E Trustee/CEO 0 1491037 0 840553 0 306621 0 291002 0 21690 0 2950903 0 207003 CantuStacy G Corporate Secretary 0 230366 0 46600 0 29049 0 11015 0 22628 0 339658 0 131 JacksonDavid W Assistant Secretary 0 291525 0 68192 0 47833 0 46678 0 10174 0 464402 0 0 KOLBETSHARON Assistant Secretary 0 175895 0 11569 0 0 0 7980 0 9319 0 204763 0 0 KramerKenneth J Assistant Secretary 0 520443 0 226454 0 128194 0 94909 0 26679 0 996679 0 50254 SchwabRobert Adams Chief Medical Officer THA 345200 0 135223 0 59256 0 39605 0 27605 0 606889 0 25508 0 SheltonJared Christopher President THA 200853 0 69877 0 40230 0 32874 0 29942 0 373776 0 7136 0 SummersJohn Blue Chief Nursing Officer THA 167589 0 22820 0 24200 0 14483 0 22091 0 251183 0 0 0 GildonLisa Grp Finan Officer THP-THA 0 225625 0 51096 0 29848 0 14445 0 19576 0 340590 0 0 EscandonChristy Anne Former Officer 0 207662 0 64938 0 169879 0 14262 0 23785 0 480526 0 0 BraxtonKenneth W Former Officer 0 210039 0 13768 0 8695 0 13175 0 9341 0 255018 0 0 ReecerJeffrey P Former Officer 0 268458 0 84706 0 52165 0 46236 0 31100 0 482665 0 26108 KrejciJacque D Former Officer 0 180925 0 11880 0 520 0 13128 0 9354 0 215807 0 0 McClungBrett S Former Officer 0 205335 0 163912 0 132013 0 21000 0 13623 0 535883 0 0 RansomElizabeth Former Officer 0 433213 0 157435 0 694627 0 21000 0 24344 0 1330619 0 0 AsturiElizabeth Chief Nursing Officer THD 0 245079 0 76205 0 30800 0 32648 0 466 0 385198 0 7374 McWhorterRicky E Former Officer 0 641092 0 172412 0 106985 0 105378 0 10000 0 1035867 0 39522 AmayaChristopher Jules DIR PHARMACY 155209 0 6623 0 6727 0 12338 0 15007 0 195904 0 0 0 PecenkaMichelle Leann DIR NRSG MED SURG/ICU/ED 143171 0 10175 0 5026 0 0 0 24530 0 182902 0 0 0 HornKin-Lai Y RN V 138959 0 1081 0 4527 0 11095 0 19808 0 175470 0 0 0 VargheseJainamma RN V 136810 0 574 0 3046 0 10712 0 15788 0 166930 0 0 0 HughesRex Wayne SPL NUCLEAR MED 132215 0 576 0 4436 0 10722 0 19568 0 167517 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 and flexible benefit allowance which is included in the taxable compensation of the employee. The perk allowance covers costs such as business use of their personal vehicles in lieu of reimbursement for auto mileage. The flexible benefit allowance can be used to purchase executive benefits on an after-tax basis. Schedule J, Part I, Line3 - 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 - Position Elimination THR'S separation pay plan provides payments to employees whose positions were eliminated by the organization. The separation pay is based on the employee's years of service and the level of the affected position. The employee listed qualified for severance based on an involuntary separation from service without a comparable position being open and available at the time of separation. Elizabeth Ransom $540,630 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. Christy Escandon $146,394 Sch J, Part I, Line 4b Nonqualified Retirement Plan Participation in the plan is made available to a select group of management and highly compensated employees as determined by the THR Board of Trustees, who are providing services in a key position of management and responsibility. 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. Payouts to the following employee were made during the year. The amounts below are included in the amount reported on Sch J, Part II, Column B(iii) and Column (F). Elizabeth Asturi $ 7,374 Barclay Berdan $207,003 Christy Escandon $ 4,309 Kenneth Kramer $ 50,254 Brett McClung $198,381 Ricky McWhorter $ 39,522 Elizabeth Ransom $154,337 Jeffrey Reecer $ 26,108 Robert Schwab $ 25,508 Jared Shelton $ 7,136 990, 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. Several THPG board members are also employees of THPG. As employees of THPG and the THR system, they will have a business relationship with each other and other officers and board members that are employees of the THR system. 990, Part VI, Section A, Line 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 after the Audit and Compliance Committee approval process and 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 15a&b - Compensation Determination The organization relied on Texas Health Resources (THR) with centralized compensation professionals to review and establish the compensation of the organization's officers. The THR Board approves the compensation philosophy of officers of the organization. The Governance committee approves the elements of the officer's compensation, and the entity management or THR management pay an employee/officer within the approved parameters. Any officer whose compensation falls outside the approved compensation philosophy must be reviewed and approved by the THR Governance committee. See 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 $25,426,135 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 Johnson County Community Care Corp 612 E Lamar Blvd Arlington TX 76011 452793120 Indigent Care TX 501(c)(3) 12a TH Cleburne 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 9229 LBJ Freeway Dallas TX 75243 474724257 Phys. Clinic TX 501(c)(3) 10 TH Phys Grou false TX Health Behav Health Hospital Bedford 2717 Tibbets Dr Bedford TX 76022 812798838 Inactive TX 501(c)(3) 3 TH Resources false TX Health Behav Health Hospital Plano 6110 W Parker Road Plano TX 75093 812792484 Inactive TX 501(c)(3) 3 TH Resources 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 false 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 612 E Lamar Blvd Arlington TX 76011 831954982 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Mansfield 612 E Lamar Blvd Arlington TX 76011 831869297 Hospital TX 501(c)(3) 3 TH Resources 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 TX Health Outpatient Surg Ctr Alliance 10840 Texas Health Trail Fort Worth TX 76244 800800294 Inactive TX 501(c)(3) 3 TH Alliance false Texas Health Physicians Group 9229 LBJ Freeway 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 612 E Lamar Blvd Arlington TX 76011 814317635 Urgent Care C 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 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 false 0 true Arlington Surgery Center LLC 918 N Davis Dr Arlington TX 76012 752055800 Amb Surg Ctr TX NA N/A false 0 true Cleburne Surgical Center LLC 2010 W Katherine P Raines Blvd St Cleburne TX 76033 203742012 Amb Surg Ctr TX NA N/A false 0 true Denton Surgery Center LLC 207 North Bonnie Brea Denton TX 76201 470926556 Amb Surg Ctr TX NA N/A false 0 true Flower Mound Hospital Partners LLC 4400 Long Prairie Rd Flower Mound TX 75028 260684968 Hospital TX NA N/A false 0 true Fort Worth Endoscopy Centers LLC 900 W Magnolia Ave 101 Fort Worth TX 76104 770368346 Endoscopy Center TX NA N/A false 0 true Greenville Surgery Center LLC 7150 Greenville Ave Ste 200 Dallas TX 75231 742411643 Amb Surg Ctr TX NA N/A false 0 true Health Imaging Partners LLC 8610 Explorer Drive Ste 300 Colorado Springs CO 80920 271385885 Medical Imaging TX NA N/A false 0 false North Dallas Surgical Center LLC 17980 Dallas Pkw Ste 100 Dallas TX 75287 272248103 Amb Surg Ctr TX NA N/A false 0 true Opthalmology Surgery Center of Dallas LL 10740 N Central Expy Dallas TX 75231 261914835 Amb Surg Ctr TX NA N/A false 0 true Park Hill Surgery Center LLC 3455 Locke Ave Fort Worth TX 76107 451484375 Amb Surg Ctr TX NA N/A false 0 true Physicians Medical Center LLC 6020 W Parker Rd Plano TX 75093 481281376 Hospital TX NA N/A false 0 true Presbyterian Cancer Ctr-Dallas LLC PO Box 819067 Dallas TX 75381 260422749 Cancer Ctr TX NA N/A false 0 false Rockwall Regional Hospital LLC 3150 Horizon Rd Rockwall TX 75032 202848116 Hospital TX NA N/A false 0 true South Arlington Surgical Providers LLC 350 E Interstate 20 Ste 200 Arlington TX 76018 752723958 Amb Surg Ctr TX NA N/A false 0 true Southlake Specialty Hospital LLC 1545 E Southlake Blvd Southlake TX 76092 020555370 Hospital TX NA N/A false 0 true Surgical Caregivers of Fort Worth LLC 2001 W Rosedale St Fort Worth TX 76104 751925497 Amb Surg Ctr TX NA N/A false 0 true Texas Health Craig Ranch Surgery Center 8080 State Hwy 121 Ste 100 McKinney TX 75070 383897811 Amb Surg Ctr TX NA N/A false 0 true Texas Health Flower Mound Orthopedic Sur 5000 Long Prairie Rd Flower Mound TX 75028 800866449 Amb Surg Ctr TX NA N/A false 0 true Texas Health Orthopedic Surgery Center A 9848 N Beach St Fort Worth TX 76244 814977249 Amb Surg Ctr TX NA N/A false 0 true Texas Health Spine Surgery Center Allen 1120 Raintree Cir Ste 100 Allen TX 75013 300957868 Amb Surg Ctr TX NA N/A false 0 true Texas Health Spine Surgery Center Allian 1545 E Southlake Blvd Ste 100 Southlake TX 76092 320571301 Amb Surg Ctr TX NA N/A false 0 true Texas Health Supply Chain Services LLC 612 E Lamar Blvd Ste 600 Arlington TX 76011 841833532 Purchasing Co TX NA N/A false -18594 true Texas Health Surgery Center Alliance LLC 10840 Texas Health Trail Ste 100 Fort Worth TX 76244 822296081 Amb Surg Ctr TX NA N/A false 0 true Texas Health Surgery Center Bedford LLC 1605 Airport Freeway Ste 100 Bedford TX 76021 821307876 Amb Surg Ctr TX NA N/A false 0 true Texas Health Surgery Center Irving LLC 2120 N MacArthur Blvd Ste 200 Irving TX 75061 831085415 Amb Surg Ctr TX NA N/A false 0 true Texas Health Surgery Center Preston Plaz 17950 Preston Road Ste 75 Dallas TX 75252 203991622 Amb Surg Ctr TX NA N/A false 0 true Texas Health Surgery Center Rockwall LLC 3144 Horizon Rd Ste 120 Rockwall TX 75032 474425996 Amb Surg Ctr TX NA N/A false 0 true Texas Health Surgery Center Waxahachie 1434 US Hwy 287 Bypass Ste 100 Waxahachie TX 75165 831464243 Inactive TX NA N/A false 0 true Texas Institute for Surgery LLP 7115 Greenville Ave Ste 100 Dallas TX 75231 770628004 Hospital TX NA N/A false 0 true THR-STT Rockwall ASC LLC 1545 E Southlake Blvd Southlake TX 76092 262429878 Amb Surg Ctr TX NA N/A false 0 true THR-STT Southlake ASC LLC 1545 E Southlake Blvd Southlake TX 76092 201728912 Amb Surg Ctr TX NA N/A false 0 true USMD Hospital at Arlington LP 801 I -20 West Arlington TX 76017 731662763 Hospital TX NA N/A false 0 false USMD Hospital at Fort Worth LP 5900 Altamesa Blvd Fort Worth TX 76132 203571243 Hospital TX NA N/A false 0 false Walnut Hill Surgery Center LLC 5494 Glen Lakes Dr Dallas TX 75231 364499777 Amb Surg Ctr TX NA N/A false 0 true Wilson Creek Surigcal Center LLC 8855 Synergy Drive McKinney TX 75070 274816583 Amb Surg Ctr TX NA N/A false 0 true Women's Specialty Surgery Center of Dall 8230 Walnut Hill Ln Ste 101 Dallas TX 75231 262310072 Amb Surg Ctr TX NA N/A false 0 true Grace Indemnity Company SPC Ltd 1159 Carribean 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 THR Primary Care Ext Physcian Network 612 E Lamar Blvd Arlington TX 76011 465365421 Inactive TX NA C Corp false false false true false false false false false false true true false true false false true true true true See Part VII for Explanation Schedule R, Part V, Line 2 - Related Transactions Texas Health Resources (THR) is the parent organization of 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.