2020-11-06T13:08:04-06:00 2019-12-31 BKD LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2019-01-01 751912147 United Regional Health Care System % STEPHEN P CALVERT UNIT 9407648299 1600 Eleventh Street Wichita Falls TX 76301 PHYLLIS COWLING PRESIDENT AND CEO 9727028262 2020-11-15 true Jeanette Verrelli P00742631 9727028262 167.68.126.162 76915820203115000000 2020-11-06 P EB976710118F518B8933A72D91D1D85239D99EDA EB976710118F518B8933A72D91D1D85239D99EDA 2019 2021-01-29 14:40:06Z PHYLLIS COWLING 1600 ELEVENTH STREET WICHITA FALLS TX 76301 424674202 false X WWW.UNITEDREGIONAL.ORG X 1983 TX ORGANIZED AND OPERATED FOR THE PURPOSE OF DEVELOPING AND OPERATING AN INTEGRATED HEALTH CARE SYSTEM. 17 12 2420 195 49714 43743 2564873 1375944 393063034 405054768 14013877 14053384 115318 49714 409757102 420533810 34242448 18255010 0 0 130988284 142851680 0 0 0 183676274 218290801 348907006 379397491 60850096 41136319 723461097 826178398 50422230 64661500 673038867 761516898 X TO OPERATE NONPROFIT HOSPITALS OR HOSPITAL FACILITIES, CLINICS, AND RELATED MEDICAL AND SURGICAL SERVICES BY PROVIDING SUCH SERVICES TO PERSONS THAT DO HAVE THE ABILITY TO PAY, AND TO THEREBY PROVIDE CHARITABLE MEDICAL, SURGICAL, AND HOSPITAL CARE FOR SICK, INJURED, AFFLICTED, INFIRM, DISABLED, OR DESTITUTE PERSONS THAT DO NOT HAVE THE ABILITY TO PAY. false false 313426775 18255010 405054768 UNITED REGIONAL HEALTH CARE SYSTEM, A 325-BED HOSPITAL, PROMOTES THE HEALTH OF THE COMMUNITY BY PROVIDING A VARIETY OF HEALTH CARE SERVICES. IN ADDITION TO INPATIENT BEDS, THERE ARE 14 NEWBORN BASSINETTES INCLUDING 14 INTERMEDIATE NURSERY BASSINETTES AND 42 ER BEDS. ADDITIONAL PROGRAMS WHICH BENEFIT THE COMMUNITY INCLUDE: STUDENTS IN NURSING, PHARMACY, LABORATORY TECHNOLOGY, RADIOLOGY, RESPIRATORY THERAPY AND OTHER ASSOCIATED HEALTH SCIENCES PROFESSIONS ALSO STUDY HERE. PREVENTIVE CARE A PRIORITY: UNITED REGIONAL HEALTH CARE SYSTEM HAS TAKEN STEPS TO ENHANCE PREVENTIVE CARE FOR PEOPLE OF ALL AGES THROUGH THE DEVELOPMENT OF LOW COST SCREENING PROGRAMS, VACCINATION CLINICS, AS WELL AS OTHER OUTREACH EDUCATION SERVICES. OTHER SERVICES ARE PROVIDED THROUGH THE UNITED REGIONAL REFERENCE LAB INCLUDE BOTH LOW COST FEE-FOR-SERVICE SCREENINGS AND FREE SCREENINGS AT COMMUNITY HEALTH FAIRS (CHOLESTEROL, PSA, TRIGLYCERIDES, ETC.) DESIGNATED TRAUMA CENTER: UNITED REGIONAL IS DESIGNATED LEVEL 2 TRAUMA CENTER FOR THE REGION BY THE HEALTH AND HUMAN SERVICES COMMISSION OF THE STATE OF TEXAS. UNITED REGIONAL HEALTH CARE SYSTEM'S EMERGENCY DEPARTMENT IS STAFFED 24 HOURS A DAY/7 DAYS A WEEK MEETING THE NEEDS OF THE COMMUNITY WITH AN AVERAGE OF 215 VISITS PER DAY. COMMUNITY CONNECTIONS: UNITED REGIONAL HEALTH CARE SYSTEM REACHES OUT TO PEOPLE AND COMMUNITIES THROUGHOUT ITS PRIMARY SERVICE AREA OF WICHITA COUNTY AND ITS SECONDARY SERVICE AREA OF 8 SURROUNDING COUNTIES CONSISTING OF ARCHER, BAYLOR, CLAY, HARDEMAN, JACK, MONTAGUE, WILBARGER AND YOUNG COUNTIES. THROUGH COOPERATIVE AGREEMENTS WITH LOCAL GOVERNMENTS AND HOSPITALS, UNITED REGIONAL PROVIDES FUNDING FOR A NUMBER OF HEALTHCARE SERVICES. COMMUNITY EDUCATION: UNITED REGIONAL HEALTH CARE SYSTEM PROVIDES THE FOLLOWING TYPES OF COMMUNITY EDUCATION: COMMUNITY EDUCATION SEMINARS WITH PRESENTATIONS BY PHYSICIANS ON HEALTH ISSUES AND TREATMENT OPTIONS; HEALTHY YOU NEWSLETTER, SENT TO APPROXIMATELY 50,000 HOUSEHOLDS, PROVIDING HEALTH PROMOTION AND DISEASE PREVENTION INFORMATION, AS WELL AS HOSPITAL SERVICES; 55-ADVANTAGE SENIOR PROGRAM, PROVIDING SPEAKERS ON A VARIETY OF HEALTH-RELATED TOPICS; AND PARTICIPATION IN A VARIETY OF COMMUNITY HEALTH FAIRS AND EVENTS PROMOTING GENERAL HEALTH AND PROVIDING HEALTH SCREENINGS. CHARITY CARE: UNITED REGIONAL HEALTH CARE SYSTEM PROVIDES MEDICAL CARE TO MEMBERS OF THE COMMUNITY REGARDLESS OF ABILITY TO PAY. ESTIMATED COST OF PROVIDING ADDITIONAL COMMUNITY BENEFITS DURING 2019 WAS $27,006,582 WHICH INCLUDED THE FOLLOWING: UNREIMBURSED COST OF EMERGENCY AND TRAUMA CARE $13,367,691 UNREIMBURSED COST OF FREE STANDING CLINICS $13,638,891 DONATIONS MADE BY THE HOSPITAL TO AREA CHARITABLE ORGANIZATIONS $26,019,829 TOTAL COSTS OF ADDITIONAL COMMUNITY BENEFITS $53,026,411 SOURCE: 2019 ANNUAL STATEMENT OF COMMUNITY BENEFIT STANDARDS (STATE OF TEXAS MANDATORY REPORT) 313426775 true true false true false false false false false true true false false true true false false true false false false false false false false false true true true false true false false false false false false true true false false false false false true true true false false true 252 0 2420 true true true false false false false false false false false false true false X 17 12 false false false false false true true true true false false false true true true true true true true true true X STEPHEN P CALVERT 9407648299 1600 ELEVENTH STREET WICHITA FALLS TX 76301 X PHYLLIS COWLING PRESIDENT & CEO 40.0 2.5 X X 1097476 0 110870 NANCY TOWNLEY SR VP OF OPERATIONS 40.0 2.5 X 696709 0 54939 ROBERT PERT CHIEF FINANCIAL OFFICER 40.0 2.5 X 521624 0 55520 JANE RITTER VP OF PATIENT CARE/CLINICAL SV 40.0 0.0 X 358847 0 53786 KRISTI FAULKNER VP OF HUMAN RESOURCES 40.0 0.0 X 357028 0 39320 STEPHANIE MCDONELL CHIEF INFORMATION OFFICER 40.0 0.0 X 352905 0 25410 JOHNNY ROBERTS VP UR PHYSICIAN GROUP 40.0 2.5 X 307973 0 45954 RICHARD CARPENTER VP OF FACILITIES, End: 04/19 40.0 0.0 X 247225 0 13862 DWAYNE MCKEE DIRECTOR OF CIBI 40.0 0.0 X 198538 0 29519 NATHAN WOOTEN DIRECTOR OF PHARMACY 40.0 0.0 X 178009 0 38295 SHELLEY MOSER SR DIRECTOR OF QUALITY & SAFET 40.0 0.0 X 176729 0 30065 JAMES BEASLEY CLINICAL PHARMACIST 40.0 0.0 X 173033 0 33181 LILA PEREZ CHARGE NURSE 51.0 0.0 X 169458 0 15862 LEE RODGERS VP MED AFFAIRS end: 06/18 40.0 0.0 X 161830 0 0 ANDRE DESIRE MD DIRECTOR 1.0 0.0 X 116828 0 0 ASHVINKUMAR PATEL MD DIRECTOR, End: 06/19 1.0 0.0 X 45169 0 0 BARRY HARDIN DIRECTOR 1.0 0.0 X 0 0 0 BLAKE ANDREWS DIRECTOR 1.0 0.0 X 0 0 0 KELLY FRISTOE DIRECTOR 1.0 0.0 X 0 0 0 ROBERT KINLEY HEGGLUND DIRECTOR 1.0 0.0 X 0 0 0 MICHAEL STANFORD CHAIRMAN 1.0 0.0 X X 0 0 0 MARGARET STEWART DIRECTOR 1.0 0.0 X 0 0 0 DEANDREA DAVIS DIRECTOR 1.0 0.0 X 0 0 0 KEITH WILLIAMSON MD DIRECTOR 1.0 0.0 X 0 0 0 TIM CORNELIUS DIRECTOR 1.0 0.0 X 0 0 0 LACEY MORGAN VICE CHAIR 1.0 0.0 X X 0 0 0 R KEN HINES DIRECTOR 1.0 0.0 X 0 0 0 RITA VOKES DIRECTOR, End: 06/19 1.0 0.0 X 0 0 0 YVONNE HEARN MD DIRECTOR 1.0 0.0 X 0 0 0 FRED LANGNER MD DIRECTOR 1.0 0.0 X 0 0 0 JOHN LUIG JR SECRETARY/TREASURER 1.0 0.0 X X 0 0 0 TERRY PATTON PAST CHAIR 1.0 0.0 X X 0 0 0 5159381 0 546583 171 true true false OXFORD GLOBAL RESOURCES LLC PO BOX 3256 BOSTON MA 02241 CONTRACT LABOR 6756242 LA MAGNA HEALTH PLLC 1631 11TH STREET WICHITA FALLS TX 76301 CLINICAL SERVICES 6539631 MEDEFIS CONSOLIDATED PO BOX 5068 NEW YORK NY 10087 CONTRACT LABOR 3714104 WICHITA FALLS ANESTHESIA PLLC 1600 11TH STREET WICHITA FALLS TX 76301 CLINICAL SERVICES 2863117 ACUTE CARE SURGERY TEXOMA PLLC 1600 BROOK AVE WICHITA FALLS TX 76301 CLINICAL SERVICES 2344285 55 1375944 0 1375944 Patient Service Revenue 621110 403269997 403269997 Supporting Revenue 900099 1374179 1374179 Related Rental Revenue 531120 410592 410592 405054768 10808448 10808448 0 0 0 0 0 7374628 10700 4140392 3234236 10700 3244936 3244936 0 0 0 0 0 0 0 0 0 PASS-THROUGH REVENUE 900099 49714 49714 49714 420533810 405054768 49714 14053384 X 18255010 18255010 0 0 0 4501445 3376564 1124881 310424 232836 77588 122628445 91971316 30657129 3430398 2572799 857599 2674793 2013431 661362 9306175 6979631 2326544 0 168650 168650 187240 187240 0 0 1499625 1499625 57328595 43143815 14184780 745174 558916 186258 7768127 6374854 1393273 7403102 5552327 1850775 0 3043601 2282701 760900 649106 486830 162276 0 184262 7597 176665 121385 121385 0 21801733 13294697 8507036 1280571 1280571 Bad Debt Expense 40832737 40832737 Medical Supplies 70529802 70529802 Equipment expenses 2330783 1748586 582197 Food Services expenses 570402 427801 142601 1845906 1382569 463337 379397491 313426775 65970716 0 250196 215102 53022001 49833386 0 0 34896091 39833456 0 0 0 0 0 0 7619532 7694090 7807035 7123202 415856706 209344610 188820379 206512096 347328165 422296527 0 0 0 0 0 0 83717698 92670539 723461097 826178398 39319798 53584440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11102432 11077060 50422230 64661500 X 673038867 761516898 0 0 673038867 761516898 723461097 826178398 X 41136319 48161601 -819889 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 150091 150091 false SCHEDULE C, PART II-B, LINE 1I LOBBYING ACTIVITIES: THE HOSPITAL PAID DUES TO ORGANIZATIONS, A PORTION OF WHICH IS DESIGNATED FOR LOBBYING EXPENSES. DUES %LOBBYING $LOBBYING TAVH $ 5,823 100.00% $ 5,823 THA $ 59,220 0% $ 0 AHA $ 49,573 22.73% $ 11,268 MCDERMOTT & CONSULTING $ 8,000 100.00% $ 8,000 DON GILBERT & ASSOC $125,000 100.00% $ 125,000 --------------------------------------------------------------------- TOTAL $247,616 $ 150,091 839392 345761 493631 839392 839392 839392 839392 1416349 1416349 1416349 1416349 0.59480 0.40520 false true true 15074757 15074757 220029874 98828815 121201059 178237019 108664350 69572669 2515056 1851445 663611 206512096 Due from Affiliates 77997727 Interest Receivable 171909 Est from 3rd Party Payors 14500903 92670539 0 Est due to third party payors 2335281 Self Insurance liabilities 8621000 DUE TO AFFILIATE 120779 11077060 SCHEDULE D, PART V, LINE 4 INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS: THE ENDOWMENT INCLUDES BOTH DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF DIRECTORS. FUNDS ARE USED TO ADVANCE AND PROMOTE THE HEALTH AND WELL-BEING OF PEOPLE AND ORGANIZATIONS IN THE COMMUNITY AND SURROUNDING AREAS. THE FUNDS DESIGNATED BY THE BOARD ARE NOT CURRENTLY BEING USED. 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. SCHEDULE D, PART V, COLUMNS B & C RESTATEMENT OF ENDOWMENT FUNDS: THE ENDOWMENT FUND BALANCES PER THE FINANCIAL STATEMENTS FOR 2017 AND 2018 WERE RESTATED DUE TO THE RECLASSIFICATION OF NET ASSETS. BOARD DESIGNATED ASSETS WERE RECLASSIFIED TO REMOVE THE DESIGNATION AND COMBINED WITH TEMPORARY RESTRICTED NET ASSETS IN MARCH OF 2019. true true X true X true X true true false true true 45131058 36604856 8526202 0.02520 35430387 42323448 2067837 707967 1359870 0.00400 82629282 79636271 9886072 0.02920 9682 9682 0.00010 47451115 24334671 23116444 0.06830 18255010 18255010 0.05390 65715807 24334671 41381136 0.12230 148345089 103970942 51267208 0.15150 9 6433 46857 9470 37387 0.00010 9 6433 46857 9470 37387 0.00010 false 40832737 4083274 112748398 114383418 -1635020 X true true united regional CARDIOVASCULAR SERVICES 0.5 0.5 health care system cardiology LLC united regional surgical management 0.5 0.5 health care system surgery llc 1 1 UNITED REGIONAL HEALTH CARE SYSTEM 1600 ELEVENTH STREET WICHITA FALLS TX 76301 WWW.UNITEDREGIONAL.ORG 000417 X X X X UNITED REGIONAL HEALTH CARE SYSTEM 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 200. 400. 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 true X false X X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 PERSONS WHO REPRESENT THE COMMUNITY: UNITED REGIONAL CONDUCTED 27 INTERVIEWS WITH THE TWO GROUPS OUTLINED IN IRS FINAL REGULATIONS RELEASED ON DECEMBER 29, 2014. DURING THESE INTERVIEWS, THE HOSPITAL DISCUSSED THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. BACKGROUND INFORMATION ON EACH INTERVIEWEE WAS ALSO GATHERED. THE INTERVIEWEES WERE INDIVIDUALS FROM VARIOUS NOT-FOR-PROFIT GROUPS, HEALTH CARE FACILITIES, GOVERNMENTAL AGENCIES AND OTHER AREAS OF THE COMMUNITY. THESE INDIVIDUALS WERE FROM THE FOLLOWING ORGANIZATIONS: -HELEN FARABEE CENTER -WICHITA FALLS AREA FOOD BANK -WICHITA FALLS CITY COUNCIL -GUFFEY'S PHARMACY -HOSPICE OF WICHITA FALLS -WICHITA COUNTY HEALTH DEPARTMENT -UNITED REGIONAL HEALTH CARE SYSTEM -FINANCIAL PARTNERS -WICHITA COUNTY -THE KITCHEN -UNITED REGIONAL FOUNDATION -ELECTRA MEMORIAL HOSPITAL -WICHITA FALLS ISD -PRESBYTERIAN MANOR -NORTH CENTRAL TEXAS COMMUNITY HEALTH CENTER -WICHITA FALLS FAITH MISSION -NORTH TEXAS AREA UNITED WAY -BOYS AND GIRLS CLUB OF WICHITA FALLS -WILSON SCHOOL OF NURSING -AMERICAN CANCER SOCIETY SCHEDULE H, PART V, SECTION B, LINE 7A & 10A CHNA & Implementation strategy website: The CHNA And implementation strategy can be found at WWW.UNITEDREGIONAL.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 20E EFFORTS TO NOTIFY INDIVIDUALS OF FINANCIAL ASSISTANCE POLICY: NEITHER THE UNITED REGIONAL HEALTH CARE SYSTEM, NOR THIRD PARTIES AUTHORIZED BY URHCS, 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 11 NEEDS ADDRESSED AND NOT ADDRESSED: UNITED REGIONAL IDENTIFIED AND PRIORITIZED 6 NEEDS USING A STRUCTURED MATRIX IN THE IMPLEMENTATION STRATEGY. THE NEEDS ARE: 1. ACCESS TO PRIMARY CARE SERVICES AND PROVIDERS: UNITED REGIONAL WILL CONTINUE TO RECRUIT AND EMPLOY ADDITIONAL PHYSICIANS TO THE COMMUNITY, AS WELL AS PHYSICIANS EMPLOYED BY THE UNITED REGIONAL PHYSICIAN GROUP. VIA ITS EMPLOYED PHYSICIAN GROUP, UNITED REGIONAL WILL CONTINUE TO OPERATE A PRIMARY CARE WALK-IN CLINIC, CAREPLUS, AS WELL AS ECARE, A VIRTUAL OPTION FOR RESIDENTS. 2. ACCESS TO SPECIALTY CARE SERVICES AND PROVIDERS: UNITED REGIONAL WILL CONTINUE TO EXPAND SPECIALTY CARE CAPACITY BY RECRUITING AND EMPLOYING ADDITIONAL SPECIALTY PHYSICIANS TO THE COMMUNITY. UNITED REGIONAL WILL CONTINUE TO OFFER PALLIATIVE CARE/SUPPORTIVE CARE SERVICES, DESIGNED TO ASSIST PATIENTS WHO HAVE CHRONIC DISEASES TO ACCESS THE MEDICAL AND EMOTIONAL SUPPORT NEEDED TO BEST MANAGE THEIR DISEASE PROCESSES WITH A FOCUS ON PRLIEF OF PAIN, STRESS AND OTHER DEBILITATING SYMPTOMS OF SERIOUS ILLNESS. 3. PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES: UNITED REGIONAL WILL CONTINUE TO INCREASE EDUCATIONAL OPPORTUNITIES FOR THE PUBLIC CONCERNING WELLNESS TOPICS AND HEALTH RISK CONCERNS, PREVENTIVE CARE AND HEALTHY LIFESTYLE CHOICES THROUGH MEDIA OUTLETS AND HOSTING AND/OR PARTICIPATING IN LOCAL HEALTH-RELATED EVENTS. CURRENT EXAMPLES INCLUDE: CPR, PREPARED CHILDBIRTH, SMOKING CESSATION, BREAST FEEDING, HEALTHY YOU TV SERIES, DIABETES EDUCATION, PRENATAL CLASSES, 55 ADVANTAGE, SENIOR FOCUS AND WOMENS EXPO. 4. ACCESS TO AFFORDABLE, HIGH NUTRITIONAL QUALITY FOOD OPTIONS: IN CONJUNCTION WITH THE WICHITA FALLS AREEA FOOD BANK, UNITED REGIONAL WORKS TO PROVIDE HEALTHY FOOD BOXES FOR PATIENTS PARTICIPATING IN DIABETES EDUCATION, HEART FAILURE CLINIC AND OUTPATIENT INFUSION AND POST-OPERATIVE PATIENTS WHO ARE FOOD INSECURE. ALSO, IN CONJUNCTION WITH THE WICHITA FALLS AREA FOOD BANK, UNITED REGIONAL OFFERS A MOBILE FOOD PANTRY AT SIX DIFFERENT LOCATIONS-ONCE EACH PER MONTH-IN AN EFFORT TO HAVE A HUNGER-FREE COMMUNITY. 5. ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS: UNITED REGIONAL WILL CONTINUE TO PROVIDE CASE MANAGEMENT SERVICES AND APPROPRIATE REFERRALS FOR PATIENTS WHO PRESENT TO THE HOSPITAL OR EMERGENCY DEPARTMENT WITH MENTAL OR BEHAVIORAL HEALTH CONDITIONS ON AN AS NEEDED BASIS. UNITED REGIONAL WILL CONTINUE TO PROVIDE PSYCHIATRIC TELEHEALTH SERVICES FOR APPLICABLE PATIENTS. 6. ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS: UNITED REGIONAL WILL CONTINUE TO PROVIDE MEDICAL CARE TO ALL PATIENTS IN NEED, REGARDLESS OF THEIR ABILITY TO PAY. UNITED REGIONAL WILL CONTINUE TO OPERATE ITS HEART FAILURE CLINIC. UNITED REGIONAL'S IMPLEMENTATION PLAN ADDRESSES ALL NEEDS IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. SEE THE SCHEDULE H, PART VI, LINE 5 DISCLOSURE FOR ADDITIONAL INFORMATION UPDATING UNITED REGIONAL'S PROGRESS ADDRESSING THESE NEEDS. SCHEDULE H, PART V, SECTION B, LINE 16A, 16B & 16C MEASURES TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUmmary are AVAILABLE AT THE FOLLOWING ADDRESS: https://www.unitedregional.org/patients-and-visitors/billing-questions-and -answers/financial-assistance/ SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT ADJUSTMENTS: THE ORGANIZATION'S BAD DEBT ADJUSTMENTS WERE CALCULATED USING THE ADJUSTMENT AMOUNT REPORTED AS REVENUE DEDUCTIONS ON THE INTERNAL FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS DETERMINED BY ESTIMATING THAT 10% OF THE BAD DEBT WOULD LIKELY BE CHARITY CARE. THIS IS THE APPROXIMATE PERCENTAGE OF PATIENTS NOT COMPLETING THE PAPER WORK TO APPLY FOR CHARITY CARE. BAD DEBT EXPENSE REPRESENTS GROSS CHARGES ADJUSTED FOR APPROPRIATE DISCOUNTS AND PAYMENTS ON ACCOUNTS. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT FOOTNOTE: SEE NOTE 2: CHANGE IN ACCOUNTING PRINCIPLE ON PAGE 14 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY: THE HOSPITAL USES MEDICARE COST REPORT METHODOLOGY TO DETERMINE MEDICARE ALLOWABLE COST, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) 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 $1,635,020. 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 COLLECTION PRACTICES: HOSPITAL PERSONNEL MAKE GOOD FAITH EFFORTS TO INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE, GOVERNMENTAL PROGRAMS AND ASSISTANCE IN APPLYING. SECTION 7.2 OF THE CHARITY AND BAD DEBT POLICY STATES: REQUIRED INFORMATION AND DOCUMENTATION AS NOTED IN THIS POLICY MUST BE PROVIDED BEFORE ELIGIBILITY FOR FINANCIAL ASSISTANCE WILL BE DETERMINED. ONCE THE REQUIREMENTS HAVE BEEN MET, A WRITTEN NOTICE WILL BE MAILED TO THE PATIENT INFORMING THEM OF THE DETERMINATION DECISION. NO COLLECTION EFFORTS WILL BE PURSUED ON A FINANCIAL ASSISTANCE APPLICATION FOR THE ELIGIBLE AMOUNT AFTER SUCH DETERMINATION IS MADE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: UNITED REGIONAL HEALTH CARE SYSTEM (URHCS) PROVIDES EMERGENCY, TRAUMA, OUTPATIENT AND SHORT TERM GENERAL ACUTE CARE INPATIENT CARE IN THE WICHITA FALLS AREA. IN CONJUNCTION WITH OTHER INTERESTED ORGANIZATIONS, IT UNDERTAKES PROJECTS TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES. FOR EXAMPLE, URHCS COLLABORATES WITH OTHER COMMUNITY HEALTH ORGANIZATIONS TO CREATE A HEALTHY WICHITA REPORT WHICH IS UPDATED PERIODICALLY. THIS REPORT ASSESSES THE HEALTHCARE SERVICES PROVIDED IN THE COMMUNITY TO COMPARE THE OUTCOMES TO STATE AND FEDERAL OUTCOMES AND DETERMINE IF THE COMMUNITY HEALTH NEEDS ARE BEING MET OR ADDITIONAL RESOURCES NEED TO BE DIRECTED TO PARTICULAR HEALTH AREAS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL INFORMS PATIENTS OF THE CHARITY CARE PROGRAM AND HOW TO APPLY FOR CHARITY CARE. THIS IS DONE BY POSTING NOTICES IN PATIENT REGISTRATION AREAS AND PROVIDING WRITTEN NOTICES TO PATIENTS. ALL PATIENT STATEMENTS HAVE AN ASSISTANCE APPLICATION ON THE REVERSE SIDE AND AN ALERT ON THE FRONT FOR THOSE ELIGIBLE OR INTERESTED IN APPLYING. THIS INCLUDES ALL STATEMENT NOTIFICATIONS AND NOT JUST PATIENT SHARE STATEMENTS. FURTHERMORE IT IS THE POLICY OF URHCS TO ASSIST PATIENTS WITH INFORMATION AND RESOURCES FOR POTENTIALLY QUALIFYING FOR GOVERNMENTAL OR OTHER FINANCIAL ASSISTANCE PROGRAMS. THE BUSINESS OFFICE WILL REFER THOSE PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE FROM A GOVERNMENTAL PROGRAM TO THE APPROPRIATE PROGRAM, SUCH AS MEDICAID, COUNTY INDIGENT, CRIME VICTIMS, OR OTHER PROGRAM, OR TO THE HOSPITAL'S CONTRACTED ELIGIBILITY VENDOR FOR SCREENING FOR GOVERNMENTAL PROGRAM COVERAGE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: URHCS PRIMARY SERVICE AREA IS MADE UP OF WICHITA COUNTY. WICHITA COUNTY CONTAINS THE CITY OF WICHITA FALLS WHERE URHCS IS LOCATED. ACCORDING TO THE HUMAN RESOURCES AND SERVICES ADMINISTRATION, US DEPARTMENT OF HEALTH AND HUMAN SERVICES, WICHITA FALLS HAS SEVERAL CENSUS TRACTS FEDERALLY DESIGNATED AS MEDICALLY UNDER-SERVED, INCLUDING CENSUS TRACT 102 WHERE URHCS IS LOCATED. CENSUS DATA FOR WICHITA FALLS IS AS FOLLOWS: MEDIAN HOUSEHOLD INCOME (2017 EST.): $ 44,285 PER CAPITA INCOME (2017 EST.): $ 22,843 UNDER AGE 18 CHILDREN BELOW POVERTY LEVEL (2017 EST.): 26.4% MEDIAN EARNINGS OF FULL-TIME WORKERS, FEMALE (2017 EST.): $39,254 PERSONS BELOW POVERTY LEVEL (2017 EST.): 20.9% EMPLOYED PERSON WITHOUT HEALTH INSURANCE COVERAGE 19 TO 64 YEARS (2017 EST.) : 21.1%. URHCS IS RECOGNIZED BY MEDICARE AS QUALIFYING FOR SOLE COMMUNITY HOSPITAL STATUS AND SERVES A DISPROPORTIONATE SHARE OF LOW-INCOME PATIENTS. UNITED REGIONAL QUALIFIES AS A DISPROPORTIONATE SHARE HOSPITAL FOR BOTH THE MEDICARE AND MEDICAID PROGRAMS. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: THE HOSPITAL IS GOVERNED BY A BOARD OF DIRECTORS THAT REPRESENTS THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. UNITED REGIONAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. UNITED REGIONAL OPERATES A LEVEL 2 TRAUMA UNIT FOR THE REGION. THE HOSPITAL PROVIDES TRAINING COURSES FOR NURSING AND ALLIED HEALTH PROFESSIONALS FOR THE COMMUNITIES IT SERVES. THE HOSPITAL PARTICIPATES IN MEDICAID AND IS THE MANDATED WICHITA COUNTY HEALTHCARE FACILITY. THE HOSPITAL ALSO PROVIDES NUMEROUS AVENUES TO EDUCATE THE COMMUNITY ON HEALTH INITIATIVES SUCH AS HEALTH FAIRS, NEWSLETTERS/EMAILS, SOCIAL MEDIA OUTREACH AND LECTURE SERIES ON CHRONIC AND ACUTE HEALTH ISSUES. UNITED REGIONAL REINVESTS SURPLUS FUNDS IN THE FACILITIES TO ENSURE PATIENTS ARE PROVIDED WITH STATE OF THE ART MEDICAL CARE. IN 2019 THE HOSPITAL CONDUCTED A COMPREHENSIVE SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT. SIX SIGNIFICANT COMMUNITY HEALTH NEEDS WERE IDENTIFIED AND AN IMPLEMENTATION PLAN WAS DEVELOPED TO DIRECTLY ADDRESS THE SIX IDENTIFIED PRIORITIES. DURING 2019, THE HOSPITAL CONTINUED TO ADDRESS ITEMS FROM THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. THE NEEDS AND PROGRAMS ADDRESSED IN 2019 ARE: -THE NEED FOR ADDITIONAL PRIMARY CARE AND SPECIALTY PROVIDERS: IN 2019 UNITED REGIONAL HAS RECRUITED OR ASSISTED WITH RECRUITMENT OF 23 PHYSICIANS IN THE FOLLOWING SPECIALTIES: - ANESTHESIA (1) - OBGYN (1) - FAMILY MEDICINE (2) - HOSPITALISTS (10) - NEUROLOGY (1) - PEDIATRICS (1) - CVT (1) - EMERGENCY (1) - UROLOGY (1) - ORTHO (1) OPHTHAMOLOGY (1) - INTERVENTIONAL CARDIOLOGIST (1) - ENT (1) -ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS: IN 2019, CAREPLUS SAW 24,451 PATIENTS, WHICH IS A 23% INCREASE OVER 2018. IN 2019, 434 NEW HEART FAILURE CLINIC PATIENTS WERE SEEN. THERE WERE 2,080 TOTAL VISITS. IN 2019 THE CALL-A-NURSE PHONE LINE REFERRAL SERVICE HAD 284 PHYSICIAN REFERRAL CALLS, 421 SERVICE REFERRAL CALLS, 1,670 CLASSES ENROLLED AND 3,270 NURSE TRIAGE CALLS. -PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESYTLES: IN 2019, UNITED REGIONAL SPONSORED COMMUNITY EDUCATION PROGRAMS, CLASSES, HEALTH FAIRS, SEMINARS AND OTHER EVENTS. THE EVENTS INCLUDED HEART RHYTHM DISORDERS, LOSE THE WEIGHT FOR LIFE, ACHY BREAKY JOINTS, LIVING WITH RHEUMATOID ARTHRITIS, BENEFITS OF CONTINUOUS GLUCOSE MONITORING IN DIABETES, REAL TALK FOR WOMEN, JOINT PAIN, PAIN GETTING OUT OF HAND AND NEUROSURGERY. TOTAL ATTENDANCE WAS OVER 1,000 COMMUNITY MEMBERS. IN ADDITION THERE WERE ALSO PRENATAL CLASSES HELD IN THE COMMUNITY WITH OVER 800 COMMUNITY MEMBERS. UNITED REGIONAL ALSO PARTICIPATED IN A VARIETY OF HEALTH FAIRS AND PRESENTATIONS PROVIDING FREE TESTING, SCREENING AND EDUCATIONAL PRESENTATIONS. UNITED REGIONAL PUBLISHED THREE EDITIONS OF A COMMUNITY MAGAZINE CALLED HEALTHY YOU. IT IS DISTRIBUTED TO APPROXIMATELY 37,000 RESIDENTS IN THE NINE-COUNTY PRIMARY AND SECONDARY SERVICE AREA. TOPICS INCLUDE: BLEEDING CONTROL, MENS HEALTH, PELVIC HEALTH, COMMON SPINE PROBLEMS, GLUTEN FREE RECIPES, MANAGING STRESS AND SURGERY FOR BACK PAIN. -ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE: IN 2019, 997 PATIENTS WERE IDENTIFIED FOR MENTAL/BEHAVIORAL HEALTH REFERRAL OR INTERNENTION. UNITED REGIONAL STAFFS A SANE (SEXUAL ASSAULT NURSE EXAMINER) THAT IS TRAINED TO TREAT SEXUALLY ASSAULTED PATIENTS. UNITED REGIONAL CONTINUES TO PROVIDE ADDITIONAL SERVICES THROUGH PSYCHIATRIC TELEHEALTH. -ACCESS TO AFFORDABLE, HIGH NUTRITIONAL QUALITY FOOD: UNITED REGIONAL HEALTH CARE SYSTEM PARTNERED WITH THE HEALTH DISTRICT TO PROMOTE PREVENTION SCREENINGS SUCH AS COLONOSCOPIES, MAMMOGRAMS, ETC. IN CONJUNCTION WITH THE WICHITA FALLS AREA FOOD BANK, UNITED REGIONAL PROVIDED 546 FOOD BOXES TO PATIENTS AND THEIR FAMILIES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: N/A SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: URHCS FILES AN ANNUAL STATEMENT OF COMMUNITY BENEFIT STANDARDS (ASCBS) WITH THE STATE OF TEXAS. THE CALCULATION OF COMMUNITY BENEFIT FOR THE ASCBS DIFFERS FROM THE CALCULATIONS REQUIRED FOR THE IRS SCHEDULE H REPORTING. THEREFORE, THE INFORMATION REPORTED IN THE TWO REPORTS IS INCONSISTENT. SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSES: BAD DEBT EXPENSE OF $40,832,737 WAS INCLUDED IN TOTAL EXPENSE ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSE IN COLUMN (F). SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL CONDUCTED ACTIVITIES TO PROMOTE AND SUPPORT THE HEALTH OF THE COMMUNITY THROUGH EDUCATION AND SUPPORT GROUPS. THESE ACTIVITIES INCLUDED THE FOLLOWING: -55 ADVANTAGE: A SENIOR AFFINITY PROGRAM HELD EVERY OTHER MONTH TO PROVIDE EDUCATION FOR SENIOR CITIZENS ON VARIOUS HEALTH TOPICS. -BREATHSAVERS: A PULMONARY SUPPORT GROUP THAT MEETS EVERY OTHER MONTH FOR ADULTS WITH PULMONARY DISEASES (COPD, ASTHMA, EMPHYSEMA, AND CHRONIC BRONCHITIS) AND IS DESIGNED TO ASSIST THOSE WITH THE DISEASES TO DEVELOP SELF-CARE SKILLS FOR A MORE ACTIVE LIFE. -CHILD PASSENGER SAFETY EDUCATION: A PROGRAM TO EDUCATE PARENTS ON CHILD PASSENGER SAFETY BY VIEWING A "SAFE RIDERS OF TEXAS" VIDEO, AND PROVIDE CAR SEAT CHECKS BY A CERTIFIED TECHNICIAN FOR PROPER INSTALLATION. THERE WERE 29 SEATS INSPECTED AND INSTALLED AND 26 SEATS WERE REPLACED. -DIABETES SUPPORT GROUP: A TYPE 2/TYPE 1 SUPPORT GROUP AND A PEDIATRIC DIABETES SUPPORT GROUP FOR THE COMMUNITY TO PROVIDE ONGOING SUPPORT AND EDUCATION TO DIABETES PATIENTS. -FAMILY HEALTH EDUCATION CLASS OFFERINGS: TO HELP NEW PARENTS MAKE AN EASIER TRANSITION TO PARENTHOOD, THE HOSPITAL OFFERS A VARIETY OF PRENATAL CLASSES. IN ADDITION, THE HOSPITAL ASSISTS SHEPPARD AIR FORCE BASE WITH THEIR MONTHLY PRENATAL ORIENTATION AS WELL AS INSTRUCTS STUDENTS AT A LOCAL ACCELERATED LEARNING CENTER FOR NONTRADITIONAL HIGH SCHOOL STUDENTS. A COMMUNITY HEALTH EDUCATION SPECIALIST PRESENTS INFORMATION ABOUT THE HOSPITAL'S MOTHER/BABY UNIT, WHAT TO EXPECT DURING THEIR STAY, AS WELL AS PROVIDES GENERAL PRENATAL EDUCATION. -COMMUNITY EDUCATION SEMINARS: PROVIDES LECTURES SERIES TO THE COMMUNITY ON A VARIETY OF HEALTH TOPICS INCLUDING HEART RHYTHM DISORDERS, JOINT REPLACEMENT SURGERY, NON-OPERATIVE TREATMENT FOR NECK AND BACK PAIN, BLADDER INCONTINENCE, HAND PAIN, DEMENTIA AND EAR, NOSE AND THROAT ISSUES. -SENIOR FOCUS: AN EDUCATION FAIR FOR SENIOR ADULTS THAT PROVIDES HEALTH INFORMATION, CHOLESTEROL SCREENINGS AND FLU SHOTS. -SMOKING CESSATION COURSE: A COURSE DESIGNED TO EDUCATE AND HELP INDIVIDUALS STOP SMOKING. -WOMEN'S EXPO/HEART OF A WOMAN: AN EDUCATIONAL FAIR FOR WOMEN THAT PROVIDES EDUCATION AND HEALTH SCREENINGS. SEE SCHEDULE H, PART VI, LINE 5 DISCLOSURE FOR MORE INFORMATION ON THESE ACTIVITIES. SCHEDULE H, PART I, LINE 6B COMMUNITY BENEFIT REPORT: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT CAN BE OBTAINED BY REQUEST FROM UNITED REGIONAL ADMINISTRATION OFFICES OR COMMUNITY BENEFITS OFFICES. THE COMMUNITY BENEFIT REPORT IS ALSO ON FILE WITH THE HEALTH AND HUMAN SERVICES COMMISSION OF THE STATE OF TEXAS. 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 - UNDERINSURANCE STATUS - RESIDENCY 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. COST COMPUTED ON IRS WORKSHEETS 5 and 6 WERE COMPUTED FROM THE MEDICARE COST REPORT, INCLUDING DIRECT COSTS PLUS OVERHEAD ALLOCATIONS COMPUTED IN THE COST REPORT. The cost computed on worksheet 8 were from the hospital's income statement and grant schedule. true UNITED REGIONAL HEALTH CARE FOUNDATION 1600 11TH STREET WICHITA FALLS TX 76301 752761467 501(C)(3) 608010 General support SERVICE ORGANIZATION OF NORTH TEXAS 2950 50TH STREET LUBBOCK TX 79413 800368789 501(C)(3) 17647000 emergency care & physician support 2 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: UNITED REGIONAL HEALTH CARE SYSTEM PROVIDES GENERAL CONTRIBUTIONS TO THE COMMUNITY, NATIONAL CHARITIES AND OTHER COMPANIES FOR THE FURTHERANCE OF THEIR MISSION OR PURPOSE. THE ORGANIZATIONS MAKE THEIR REQUESTS IN WRITING. THESE CONTRIBUTIONS ARE REVIEWED AND APPROVED BY APPROPRIATELY AUTHORIZED BOARD ACTION; OR OFFICERS; OR EMPLOYEES AS APPROPRIATE IN THE CIRCUMSTANCE IN EACH INSTANCE OF SUCH CONTRIBUTION BEING MADE. UNITED REGIONAL FOLLOWS UP WITH EACH ORGANIZATION TO MAKE SURE EACH CONTRIBUTION WAS USED FOR ITS INTENDED PURPOSE. X X X true true false false false true true false false PHYLLIS COWLING PRESIDENT & CEO 702411 0 290927 0 104138 0 98700 0 12170 0 1208346 0 70985 0 NANCY TOWNLEY SR VP OF OPERATIONS 518656 0 167523 0 10530 0 24700 0 30239 0 751648 0 0 0 ROBERT PERT CHIEF FINANCIAL OFFICER 377264 0 136284 0 8076 0 24700 0 30820 0 577144 0 0 0 STEPHANIE MCDONELL CHIEF INFORMATION OFFICER 304786 0 46377 0 1742 0 10500 0 14910 0 378315 0 0 0 RICHARD CARPENTER VP OF FACILITIES, End: 04/19 82989 0 32486 0 131750 0 6113 0 7749 0 261087 0 0 0 KRISTI FAULKNER VP OF HUMAN RESOURCES 266585 0 89845 0 598 0 20587 0 18733 0 396348 0 0 0 JOHNNY ROBERTS VP UR PHYSICIAN GROUP 241177 0 43170 0 23626 0 20146 0 25808 0 353927 0 0 0 LEE RODGERS VP MED AFFAIRS end: 06/18 0 0 0 0 161830 0 0 0 0 0 161830 0 0 0 JANE RITTER VP OF PATIENT CARE/CLINICAL SV 266181 0 85377 0 7289 0 18945 0 34841 0 412633 0 0 0 JAMES BEASLEY CLINICAL PHARMACIST 163041 0 1166 0 8826 0 7365 0 25816 0 206214 0 0 0 LILA PEREZ CHARGE NURSE 168235 0 1166 0 57 0 5682 0 10180 0 185320 0 0 0 NATHAN WOOTEN DIRECTOR OF PHARMACY 170776 0 7076 0 157 0 7648 0 30647 0 216304 0 0 0 DWAYNE MCKEE DIRECTOR OF CIBI 173191 0 23582 0 1765 0 6299 0 23220 0 228057 0 0 0 SHELLEY MOSER SR DIRECTOR OF QUALITY & SAFET 172256 0 2665 0 1808 0 7357 0 22708 0 206794 0 0 0 SCHEDULE J, PART I, LINE 6 EXPLANATION OF COMPENSATION CONTINGENT ON NET EARNINGS: A RANGE BETWEEN 20% AND 25% OF ANNUAL BONUS IS BASED ON CONSOLIDATED NET OPERATING INCOME. OTHER BONUS CRITERIA INVOLVE QUALITY SCORES, SERVICE SCORES AND INDIVIDUAL GOALS. 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. SEVERANCE WAS PAID TO THE FOLLOWING INDIVIDUALs: Lee Rodgers, MD $ 161,830 Richard Carpenter $ 131,363 Schedule J, Part I, Line 4B DEFERRED COMPENSATION PLAN: UNITED REGIONAL HEALTH CARE SYSTEM OFFERS A DEFERRED COMPENSATION PLAN. CERTAIN MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES MAY ELECT TO PARTICIPATE, IF ELIGIBLE, IN A DEFERRED COMPENSATION PLAN WHICH IS IN COMPLIANCE WITH THE IRC SECTION 457(F), ELIGIBLE DEFERRED COMPENSATION PLAN SPONSORED BY A TAX EXEMPT ORGANIZATION. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE PLAN DURING THE 2019 TAX YEAR: NAME AMOUNT IN W-2 AMOUNT DEFERRED ------------------------------------------------------------- PHYLLIS COWLING $70,985 $68,500 WICHITA FALLS DIALYSIS SEE PART V 770174 PROFESSIONAL FEES false JANA FRISTOE SPOUSE OF DIRECTOR 73974 SALARY false NATALIE STARY DAUGHTER OF OFFICER 74620 sALARY false LA MAGNA HEALTH PLLC SEE PART V 6539631 HOSPITALIST FEES false SCHEDULE L, PART IV, COLUMN(B) ADDITIONAL INFORMATION ON TRANSACTIONS WITH INTERESTED PERSONS: ASHWINKUMAR PATEL, DIRECTOR, IS A MORE THAN 35% OWNER OF WICHITA FALLS DIALYSIS, AN ORGANIZATION DOING BUSINESS WITH THE HOSPITAL. Andre Desire, MD, Director, is a more than 35% owner of La Magna Health PLLC, an organization doing business with the hospital. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS OF THE GOVERNING BODY: THE WICHITA COUNTY-CITY OF WICHITA FALLS, TEXAS HOSPITAL BOARD (WHB) APPOINTS ONE INDIVIDUAL TO SERVE EX OFFICIO AS A VOTING DIRECTOR. THE INDIVIDUAL APPOINTED BY THE WHB DOES NOT HAVE TO BE A MEMBER OF THE WHB BUT MUST MEET THE QUALIFICATIONS FOR DIRECTORS SET FORTH BY THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL: THE JOINT CITY-COUNTY BOARD HAS APPROVAL REGARDING BOND FINANCING AND APPROVAL OF THE BUDGET. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: THE EXECUTIVE COMMITTEE CHARTER, AS APPROVED BY THE UNITED REGIONAL HEALTH CARE SYSTEM BOARD, DELEGATES THE REVIEW OF 990S TO THE EXECUTIVE COMMITTEE AND THE FINANCE/AUDIT COMMITTEE. ALL MEMBERS OF THE COMMITTEE ARE PROVIDED A COPY OF THE FORM 990 PRIOR TO FILING WITH THE IRS. THE 990 IS REVIEWED BY MANAGEMENT OFFICIALS OF THE HOSPITAL AND THE EXECUTIVE COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ALL OFFICERS, DIRECTORS, AND CERTAIN EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. THE FORMS ARE REVIEWED INITIALLY BY THE CHIEF COMPLIANCE OFFICER AND THE CEO FOR POTENTIAL CONFLICTS. ANY ACTUAL CONFLICTS ARE REVIEWED BY THE BOARD OF DIRECTORS. A PERSON WITH A CONFLICT IS RESTRICTED FROM VOTING ON RELATED MATTERS. FORM 990, PART VI, SECTION B, LINE 15A & 15B PROCESS USED TO DETERMINE COMPENSATION OF MANAGEMENT AND OTHER OFFICERS: THE EXECUTIVE COMMITTEE PERFORMS AN ANNUAL REVIEW OF COMPENSATION OF THE CEO AND REVIEWS ALL CORPORATE OFFICERS COMPENSATION EVERY OTHER YEAR. THE EXECUTIVE COMMITTEE MAKES FINAL RECOMMENDATIONS REGARDING COMPENSATION OF THE CEO ANNUALLY AND ALL OFFICERS EVERY OTHER YEAR. A COMPENSATION CONSULTANT PROVIDES MARKET COMPARISONS ON AN EVERY OTHER YEAR BASIS. THIS WAS LAST COMPLETED IN 2019. AN ANNUAL COMPENSATION REVIEW IS PERFORMED BY THE CEO FOR ALL OTHER OFFICERS OF THE ORGANIZATION WITHIN THE PARAMETERS SET BY THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE REVIEWS ALL OTHER CORPORATE OFFICERS OTHER THAN THE CEO EVERY OTHER YEAR. ALL COMPENSATION REVIEWS ARE DOCUMENTED IN THE EXECUTIVE COMMITTEE'S MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE TO THE PUBLIC: AN AD IS RUN IN THE LOCAL PAPER ON AN ANNUAL BASIS INFORMING THE COMMUNITY THE FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE OTHER DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION A, LINE 1A DELEGATION OF AUTHORITY: THE EXECUTIVE COMMITTEE HAS AUTHORITY TO TRANSACT ALL BUSINESS OF THE BOARD IN THE GOVERNANCE OF THE CORPORATION DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD, SUBJECT TO THE LIMITATIONS SET FORTH IN THE BYLAWS AND ANY LIMITATIONS OTHERWISE IMPOSED BY THE BOARD. FORM 990, PART VII, SECTION A Compensation of Officers and Directors: Directors reported on part vii, section a are compensated for professional services as physicians and not as directors. Directors receiving 1099 income from united regional is compensation related to administrative and general services rendered to clinical areas of the organization, other professional services and for trauma or other off-hour availability. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: INTERCOMPANY TRANSFERS ($819,889) FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:33170791 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:8342021 FORM 990 PART IX LINE 11G DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:7793234 FORM 990 PART IX LINE 11G DESCRIPTION:TEMPORARY LABOR TOTAL FEES:5834675 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:1937982 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSPORT TOTAL FEES:125395 FORM 990 PART IX LINE 11G DESCRIPTION:CATERING EXPENSE TOTAL FEES:124497 UNITED REGIONAL HEALTH CARE FOUNDATION 1600 ELEVENTH STREET WICHITA FALLS TX 76301 752761467 SUPPORT TX 501(C)(3) 12, TYPE I URHCS true CITY OF WICHITA FALLS-WC HOSPITAL BOARD 1300 SEVENTH STREET WICHITA FALLS TX 76301 756002771 OVERSIGHT TX GOVT N/A NA false RATHGEBER HOSPITALITY HOUSE 1615 TWELFTH STREET WICHITA FALLS TX 76301 752811394 LODGING TX 501(C)(3) 7 URHC FDN true UNITED REGIONAL HEALTH CARE SYSTEM AUXIL 1600 ELEVENTH STREET WICHITA FALLS TX 76301 756004656 BENEVOL SVCS TX 501(C)(3) 12, TYPE I URHCS true UNITED REGIONAL PHYSICIAN GROUP 1600 ELEVENTH STREET WICHITA FALLS TX 76301 752925491 HEALTH CARE TX 501(C)(3) 10 URHCS true TEXOMA HIE 1600 ELEVENTH STREET WICHITA FALLS TX 76301 463617299 HTH INFO EXCH TX 501(C)(3) 10 URHCS true UNITED REGIONAL PROFESSIONAL SERVICES 1600 ELEVENTH STREET WICHITA FALLS TX 76301 752549298 MGMT SERVICES TX URHCS C-CORPORATION 4319159 16204331 1.00000 true TEXOMA INSURANCE AGENCY 1600 ELEVENTH STREET WICHITA FALLS TX 76301 422683761 INSURANCE TX NA C-CORPORATION 0 0 1.00000 true true true true true true false false false false false false false true false true false true true true UNITED REGIONAL PHYSICIAN GROUP a 279245 FMV UNITED REGIONAL HEALTH CARE FOUNDATION B 608010 Cash Value UNITED REGIONAL HEALTH CARE FOUNDATION C 1317298 Cash Value United Regional Physician Group Q 8475570 Cash Value Rathgeber Hospitality House R 75164 Cash Value united regional auxiliary c 58646 cash value SCHEDULE R, PART V, LINE 2, COLUMN (D) METHOD OF DETERMINING AMOUNTS FOR TRANSACTIONS DESCRIBED IN LINES 1B, 1C, 1Q, 1R: AMOUNTS REPORTED IN LINE 2, COLUMN (C) FOR THESE TRANSACTION TYPES ARE STATED AT CASH VALUE. METHOD OF DETERMINING AMOUNTS FOR TRANSACTIONS DESCRIBED IN LINE 1A: AMOUNTS REPORTED ON LINE 2, COLUMN (C) FOR THESE TRANSACTION TYPES ARE AT FAIR MARKET VALUE AND ARE COMPARABLE TO TRANSACTIONS BETWEEN TWO OR MORE UNRELATED PARTIES DEALING AT ARM'S LENGTH.