2019-08-15T13:16:30-05:00 2018-09-30 ERNST & YOUNG US LLP 425 HOUSTON STREET SUITE 600 FORT WORTH TX 76102 990 2017-10-01 750974351 CHRISTUS Good Shepherd Medical Center % KARLA BOUNDS CHRI 9033154000 700 E MARSHALL AVE LONGVIEW TX 75601 MICHAEL CHEEK CFO 2019-08-15 true KATHLEEN MOSELEY P00116760 8173351900 164.57.159.254 35057220192275000002 2019-08-15 P 3EE0EA4077A952E7D1F71D0CD73736AA8FC8EC2C 3EE0EA4077A952E7D1F71D0CD73736AA8FC8EC2C 2017 2019-02-21 02:37:17Z SEE SCHEDULE O MICHAEL CHEEK 700 E MARSHALL AVE LONGVIEW TX 75601 326999998 false X WWW.CHRISTUSHEALTH.ORG/GOOD-SHEPHERD/MARSHALL X 1954 TX TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION REGARDLESS OF RACE, SEX, CREED, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. 15 11 3100 180 2390524 -1283356 0 545512 92474396 323273533 -590635 182300 512003 2829028 92395764 326830373 4575830 583821 0 0 28288798 144002191 0 0 40618 63801879 134907822 96666507 279493834 -4270743 47336539 37546659 166740862 43190877 178728093 -5644218 -11987231 X TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION REGARDLESS OF RACE, SEX, CREED, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. false false 232352590 583821 323273533 DURING TAX YEAR 2016 GOOD SHEPHERD MEDICAL CENTER MARSHALL ENTERED INTO THREE YEAR TERM AFFILIATION AGREEMENTS WITH A LOCAL FEDERALLY QUALIFIED HEALTH CENTER (FQHC). THE PURPOSE OF THESE AGREEMENTS WAS TO PROVIDE ACCESSIBLE, HIGH QUALITY HEALTH CARE SERVICES, AS WELL AS UNCOMPENSATED CARE FOR PATIENTS WITH LITTLE OR NO INSURANCE, WHILE PROMOTING GENERAL PUBLIC HEALTH AND IMPROVING THE HEALTH STATUS OF CITIZENS LIVING IN MARSHALL, TEXAS. AS PART OF THESE AGREEMENTS, GSMC MARSHALL MADE GRANTS TO COVER OPERATING SHORTFALLS OF FAMILY PRACTICE AND PEDIATRIC CLINICS OF FQHC OPERATED CLINICS IN MARSHALL. CASH CONTRIBUTIONS TOTALLING $725,291 WERE MADE TO THE FQHC DURING THE CURRENT TAX YEAR TO COVER SUCH LOSSES. (THE AFFILIATION WITH THE FQHC HELPED TO ADDRESS COMMUNITY NEED #3 "AFFORDABLE PRIMARY AND PREVENTIVE CARE OPTIONSNEED #10 "UNINSURED/LIMITED INSURANCE DUE TO LACK OF MEDICAID EXPANSION OR HIGH DEDUCTIBLE PLANS".) HELPING PREPARE FUTURE HEALTHCARE PROFESSIONALS IS A DISTINGUISHING CHARACTERISTIC OF NONPROFIT HOSPITALS AND CONSTITUES A SIGNIFICANT COMMUNITY BENEFIT. CHRISTUS GOOD SHEPHERD MEDICAL CENTER - LONGVIEW ASSISTS IN THE EDUCATION OF HEALTHCARE PROFESSIONALS BY PROVIDING RESIDENCIES FOR PHYSICIANS. WE TRAINED 35 INTERNAL MEDICINE RESIDENT FTEs DURING THE FISCAL YEAR ENDED 09/30/18. TOTAL DIRECT COST (RESIDENT STIPENDS AND BENEFITS AND OTHER CHARGES FROM THE ACADEMIC PROGRAM SPONSOR) PLUS OVERHEAD ALLOCATIONS ON THE COST REPORT TOTALED $5,342,626 WITH OFFSETTING MEDICARE PAYMENTS OF $1,749,897. EACH YEAR CHRISTUS GOOD SHEPHERD MEDICAL CENTER - MARSHALL AND CHRISTUS GOOD SHEPHERD MEDICAL CENTER - LONGVIEW ASSIST IN THE EDUCATION OF NURSES AND ALLIED HEALTHCARE PROFESSIONALS BY PROVIDING CLINICAL SETTINGS AND INTERNSHIPS FOR NURSES, PHYSICAL THERAPISTS, SPEECH THERAPISTS, RESPIRATORY THERAPISTS, EMT, AND LAB. IN FYE 09/30/18, CHRISTUS GOOD SHEPHERD HELPED TRAIN 723 STUDENTS AT A COST OF $43,795. IN FYE 09/30/18, CHRISTUS GOOD SHEPHERD HELPED TRAIN 2,584 STUDENTS AT A COST OF $277,234. DURING THE TAX YEAR, CHRISTUS GOOD SHEPHERD MEDICAL CENTER - MARSHALL PROVIDED COMMUNITY HEALTH EDUCATION TO 3,314 PERSONS AT A COST OF $10,462. DURING THE CURRENT TAX YEAR, GOOD SHEPHERD MEDICAL CENTER - LONGVIEW ENTERED INTO A THREE YEAR COMMUNITY BENEFIT GRANT RELATED TO WOMEN AND CHILDREN'S SERVICES WITH WELLNESS POINTE, A LOCAL FEDERALLY QUALIFIED HEALTH CENTER (FQHC). GRANT PAYMENTS TOTALLING $116,250 WERE MADE TO WELLNESS POINTE THIS YEAR. 232352590 true true false true false false false false false false true true false true true true false true false false false false false false false false true true true false true true false false false false false false false false false false true false false false false true true true false false true 119 0 true 3100 true true true false false false false false false false false false X 15 11 true false false false true true true true true false false true true true true true true true true false X KARLA BOUNDS 9033154000 700 E MARSHALL AVE LONGVIEW TX 75601 R BLAIR ABNEY VICE CHAIRMAN 1.5 0.0 X X 0 0 0 VALERIE ALLMAN MD DIRECTOR 30.0 10.0 X X 0 251939 9877 RUSSELL J COLLIER PRESIDENT (THRU 1/18) 1.0 4.0 X X 0 380156 9723 KEN CUNNINGHAM SECRETARY 1.5 38.5 X X 0 751064 58662 KELLYN DRAYER BOARD CHAIRMAN 4.0 5.25 X X 0 0 0 GAYLE ENGLISH DIRECTOR 1.0 3.75 X 0 0 0 TODD HANCOCK GSHS PRESIDENT/CEO 1.0 39.0 X X 0 662266 114579 KEITH HONEY DIRECTOR 1.0 0.0 X 0 0 0 TED HUFFHINES VICE CHAIRMAN 1.0 1.0 X X 0 0 0 MITTIE HUTCHINS DIRECTOR 1.5 0.0 X 0 0 0 LESTER LUCY DIRECTOR (THRU 1/18) 3.5 0.0 X 0 0 0 GEORGE MEISENHEIMER DIRECTOR 1.5 0.0 X 0 0 0 TRUNG NGUYEN MD MEDICAL STAFF VICE PRESIDENT 1.5 38.5 X X 0 191031 8785 HOMER ROCKMORE DIRECTOR 3.5 0.0 X 0 0 0 JULIE SIMMONS DIRECTOR 1.5 0.0 X X 0 0 0 ALLEN STAGGERS DIRECTOR 1.5 0.0 X 0 0 0 THOMAS TIBILETTI DIRECTOR 3.75 3.75 X 0 0 0 MICHAEL CHEEK CHIEF FINANCIAL OFFICER 12.0 28.0 X 0 296387 50468 JASON ADAMS CHIEF OPERATING OFFICER 40.0 0.0 X 0 678273 97042 JOHN MCDONALD DO MEDICAL STAFF 30.0 10.0 X 0 267265 10571 RICKY A PAUL MD MEDICAL STAFF PRESIDENT 30.0 10.0 X 0 624351 22163 LARRY VERFURTH DO CMO(THRU 8/18) 5.0 35.0 X 0 603793 28513 DUSTIN MCDERMOTT CRNA 40.0 0.0 X 461512 0 12675 RICHARD L HOLLADAY CRNA 40.0 0.0 X 329369 0 4135 LEE A HOLLADAY CRNA 40.0 0.0 X 307422 0 13542 ZACKARY G LISTER CRNA 40.0 0.0 X 292362 0 10509 ROGER C BRYANT JR CRNA 40.0 0.0 X 279005 0 11933 STEVE ALTMILLER FORMER GSHS PRESIDENT/CEO 0.0 0.0 X 0 886253 9609 RAY DELK VP OPERATIONS 0.0 0.0 X 0 508499 9348 1669670 6101277 482134 24 true true false MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 303682289 CAFETERIA SERVICES 5657670 HOSPITAL HOUSEKEEPING SYSTEMS LTD PO BOX 826 SAN ANTONIO TX 782930826 JANITORIAL SERVICES 4961020 UNIVERSITY OF TEXAS HEALTH SCIENCE 11937 US HIGHWAY 271 TYLER TX 757083154 MEDICAL SERVICES 3984526 ACUTE CARE SPECIALIST LLC 2393 HG MOSLEY BLDG4 LONGVIEW TX 756043665 MEDICAL SERVICES 2103266 ALLIANT INSURANCE SERVICES INS 5847 SAN FELIPE STE 2750 HOUSTON TX 77057 INSURANCE SERVICES 2078304 34 350512 195000 288518 545512 NET PATIENT REVENUE 621990 288306799 288306799 LIFE WELLNESS CENTER 713940 3773643 3435156 338487 GOVERNMENT FUNDS - TRAUMA 624200 3180358 3180358 LAB OUTREACH REVENUE 621500 1990619 -4114 1994733 PHARMACY REVENUE 446110 62466 62466 25959648 25959648 323273533 165364 165364 0 0 1039080 14221 1024859 0 1024859 1024859 172340 155404 16936 16936 16936 0 0 0 0 0 0 0 0 0 FOOD SERVICE INCOME 722221 855545 855545 LAUNDRY SERVICES 722515 77876 77876 PARTNERSHIP INCOME 900099 57304 57304 813444 813444 1804169 326830373 320940313 2390524 2954024 X 583821 583821 0 0 0 0 0 119684184 97456418 22205822 21944 1327121 1080589 246277 255 15349525 12498396 2848232 2897 7641361 6221750 1418119 1492 1123989 909870 212843 1276 6481 5248 1226 7 7292 5903 1381 8 887 887 0 0 44242955 41088418 3152407 2130 1701 1382 319 34659635 28231234 6423758 4643 38756 31570 7181 5 0 9308897 7582499 1725180 1218 132402 107585 24747 70 0 78857 64273 14582 2 10720823 7348570 3372253 0 12365004 10062520 2299011 3473 3403850 2771509 631681 660 BAD DEBTS -49600991 -49600991 MEDICAL SUPPLIES 54821175 54821175 EQUIPMENT RENT 9874441 8048971 1825336 134 ASO SYSTEM 388606 315146 73132 328 3333062 2716734 616252 76 279493834 232352590 47100626 40618 X 9079 10262811 3924254 3769000 0 0 4429401 28513244 0 0 0 0 0 0 1627346 7189531 167171 415376 235376258 172541376 17618606 62834882 0 0 349578 8634154 0 0 945319 858059 8475905 44263805 37546659 166740862 3467640 17172177 0 0 0 0 31326919 123906282 0 0 0 0 0 0 0 0 8396318 37649634 43190877 178728093 X -6059423 -12645672 415205 658441 0 0 -5644218 -11987231 37546659 166740862 X 47336539 38 -350512 -53329078 X false true X true false X false false false false false false true 887 false false 887 false PART II-B, LINE 1D AT THE STATE LEVEL, HAD DIRECT CONTACT WITH MEMBERS OF THE TEXAS LEGISLATURE AND THEIR RESPECTIVE STAFF THROUGH EMAILS, LETTERS, TELEPHONE CALLS AND MEETINGS ON ISSUES RELATED TO MEDICAID REIMBURSEMENT, ACCESS TO HEALTHCARE AND STATE FUNDING FOR SAFETY NET PROVIDERS, GRADUATE MEDICAL EDUCATION, TRAUMA NETWORK AND SERVICES, AND THE 1115 WAIVER PROGRAM. AT THE FEDERAL LEVEL, HAD DIRECT CONTACT WITH MEMBERS AND STAFF THROUGH EMAILS, LETTERS, TELEPHONE CALLS AND MEETINGS TO DISCUSS ISSUES RELATED TO SAFETY-NET PROVIDERS, ACCESS TO CARE, HEALTHCARE REFORM PROPOSALS, QUALITY PROGRAM IMPLEMENTATION, RURAL HOSPITALS, REMOTE MEDICAL TECHNOLOGY, 340B DRUG PROGRAM, CHILDRENS HEALTH ISSUES, CHIP REAUTHORIZATION, RURAL HEALTH PROGRAM REAUTHORIZATION, AND HEALTHCARE FOR VETERANS. EXECUTIVE HOURS 4 601681 601681 149415194 95814061 53601133 5730345 4103307 1627038 75826362 69285272 6541090 3802676 3338736 463940 62834882 0 INTERCOMPANY RECEIVABLE 21379001 OTHER RECEIVABLES 22495604 MALPRACTICE REINSURANCE 389200 44263805 0 INTERCOMPANY PAYABLES 32733807 LIABILITY RESERVE 3386663 INTEREST PAYABLE 1529164 37649634 X FORM 990, SCHEDULE D, PART X UNCERTAIN TAX POSITIONS UNDER ASC 740 PER FOOTNOTE 3 IN THE CONSOLIDATED FINANCIAL STATEMENTS, THERE ARE NO MATERIAL UNRECORDED TAX LIABILITIES AS OF SEPTEMBER 30, 2018 AND 2017. true true X true X true X true true true false true true 38953122 38953122 0.14380 44399182 55848239 1306081 616049 690032 0.00250 84658385 56464288 39643154 0.14630 5663655 1762442 3901213 0.01440 903324 903324 0.00330 6566979 1762442 4804537 0.01770 91225364 58226730 44447691 0.16400 true -49600991 99553996 98033481 1520515 X true true 2 1 CHRISTUS GOOD SHEPHERD MEDICAL CENTER 811 SOUTH WASHINGTON AVE MARSHALL TX 75670 www.christushealth.org/good-shepherd 000020 X X X A 2 THE GOOD SHEPHERD HOSPITAL INC 700 E MARSHALL AVE LONGVIEW TX 75601 www.christushealth.org/good-shepherd 000020 X X X X A A 12 false false true X X X X X X X X X 16 true false false true X SEE PART V, SECTION C X true 16 true SEE PART V, SECTION C false true X 200. 400. X X X X true true X 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 X true X false false FORM 990, SCHEDULE H, PART V, SECTION B, LINE 3E ADDRESSING SIGNIFICANT COMMUNITY NEEDS IN RESPONSE TO THE RESULTS OF THE 2017 CHNA, THE HOSPITALS BOARD OF DIRECTORS AND MANAGEMENT TEAM DEVELOPED A CHNA IMPLEMENTATION PLAN IN ORDER TO PRIORITIZE AND ADDRESS THE MAJOR COMMUNITY NEEDS. IN REGARDS TO THE #1 COMMUNITY NEED IDENTIFIED IN THE CHNA (LACK OF MENTAL HEALTH PROVIDERS/SERVICES), WE TOOK SEVERAL ACTIONS DURING THE TAX YEAR AND PLAN TO CONTINUE BUILDING UPON THESE STEPS IN THE FUTURE. THESE ACTIONS ARE PRIMARILY TO ADDRESS THE ONGOING ISSUE OF TREATING BEHAVIORAL HEALTH PATIENTS IN OUR EMERGENCY DEPARTMENT AND REFERRING THESE PATIENTS TO OTHER PSYCHIATRIC PROVIDERS. OUR GOAL IS TO BOTH IMPROVE CARE AND PROVIDE SERVICES IN A MORE APPROPRIATE TREATMENT SETTING. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 5 CHRISTUS GOOD SHEPHERD MEDICAL CENTER RECEIVED INPUT FROM REPRESENTATIVES OF THE COMMUNITY WHICH INCLUDED THE FOLLOWING INDIVIDUALS WITH; A.) SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH B.) AFFILIATION WITH LOCAL GOVERNMENT, SCHOOLS AND INDUSTRY C.) INVOLVEMENT WITH UNDERSERVED AND MINORITY POPULATIONS. ALL INTERVIEWS WERE CONDUCTED USING A STANDARD QUESTIONNAIRE DEVELOPED BY BKD, LLP, A NATIONAL CPA FIRM THAT PROVIDES TAX AND OTHER ADVISORY SERVICES. THE FOLLOWING INDIVIDUALS PARTICIPATED IN OUR KEY INFORMANT INTERVIEW PROCESS: GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR OF EMERGENCY SERVICES - LONGVIEW GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR GOOD SHEPHERD MEDICAL ASSOCIATES, GASTROENTEROLOGIST GOOD SHEPHERD MEDICAL CENTER, PHARMACY DIRECTOR GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF REIMBURSEMENT GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR MEDICAL/SURGICAL GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR OF PATIENT ACCESS GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR OF INFECTION CONTROL GOOD SHEPHERD HEALTH SYSTEM, CHIEF INFORMATION OFFICER GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF EMERGENCY SERVICES (KILGORE) GOOD SHEPHERD HEALTH SYSTEM, EDUCATIONAL SERVICES DIRECTOR GOOD SHEPHERD HEALTH SYSTEM, EMPLOYEE HEALTH DIRECTOR LONGVIEW CITY COUNCILMAN, DISTRICT 5 GOOD SHEPHERD MEDICAL ASSOCIATES, FAMILY NURSE PRACTIONER GOOD SHEPHERD HEALTH SYSTEM, PHYSICIAN SERVICES DIRECTOR GOOD SHEPHERD MEDICAL CENTER, INTERNAL MEDICINE RESIDENCY PROGRAM DIRECTOR GREGG COUNTY HEALTH DEPARTMENT AIR LIFETEAM AIRE RESCUE GOOD SHEPHERD HEALTH SYSTEM, VICE PRESIDENT OF HUMAN RESOURCES COMMUNITY HEALTHCORE, EXECUTIVE DIRECTOR CITY OF LONGVIEW, FIRE CHIEF GOOD SHEPHERD MEDICAL CENTER, IMAGING SERVICES DIRECTOR GOOD SHEPHERD MEDICAL CENTER, LAB SUPERVISOR GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR OF MARKETING COMMUNITY HEALTHCORE, EMPLOYEE RUSK COUNTY HEALTH DISTRICT GOOD SHEPHERD MEDICAL CENTER, PHYSICIAN DIRECTOR OF EMERGENCY SERVICES GOOD SHEPHERD MEDICAL CENTER, INPATIENT REHAB SERVICES DIRECTOR GOOD SHEPHERD MEDICAL ASSOCIATES, PHYSICIAN DIRECTOR INTERNAL MEDICINE CLINIC GOOD SHEPHERD MEDICAL ASSOCIATES, NURSE PRACTIONER LONGVIEW CITY COUNCILWOMAN, DISTRICT 3 GOOD SHEPHERD MEDICAL CENTER, VICE PRESIDENT ANCILLARY SERVICES (MARSHALL) GOOD SHEPHERD MEDICAL CENTER, CHIEF NURSING OFFICER (MARSHALL) LONGVIEW CHAMBER OF COMMERCE, CHIEF EXECUTIVE OFFICER MARSHALL/HARRISON COUNTY HEALTH DISTRICT, EMPLOYEE GOOD SHEPHERD MEDICAL ASSOCIATES, PHYSICIAN LONGVIEW CITY COUNCILWOMAN, DISTRICT 4 GOOD SHEPHERD MEDICAL ASSOCIATES, EXECUTIVE VICE PRESIDENT/COO GOOD SHEPERD MEDICAL CENTER, COMPLIANCE SPECIALIST - QUALITY GOOD SHEPHERD HEALTH SYSTEM, EXECUTIVE DIRECTOR HEALTH & PREVENTION COMMUNITY HEALTHCORE, EMPLOYEE GOOD SHEPHERD MEDICAL CENTER, CHIEF NURSING OFFICER (LONGVIEW) GOOD SHEPHERD MEDICAL CENTER, MEDICAL DIRECTOR SURGICAL SERVICES COMMUNITY HEALTHCORE, EMPLOYEE GOOD SHEPHERD HEALTH SYSTEM, PATIENT EXPERIENCE DIRECTOR GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR ORTHO/NEURO UNIT GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR ONCOLOGY UNIT GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR ANTEPARTUM/MOTHER-BABY UNIT HARRISON COUNTY UNITED WAY GOOD SHEPHERD HEALTH SYSTEM, SENIOR VICE PRESIDENT INTEGRATION & BUSINESS DEVELOPMENT CUMBERLAND PRESBYTERIAN CHURCH OF MARSHALL, REVEREND COMMUNITY HEALTHCORE, EMPLOYEE GOOD SHEPHERD MEDICAL ASSOCIATES, PEDIATRICIAN GOOD SHEPHERD MEDICAL ASSOCIATES, CLINIC DIRECTOR OF OPERATIONS (PRIMARY CARE) GOOD SHEPHERD MEDICAL ASSOCIATES, GASTROENTEROLOGIST GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF EMERGENCY SERVICES (NORTHPARK) GOOD SHEPHERD MEDICAL CENTER, EMERGENCY MEDICINE PHYSICIAN GOOD SHEPHERD MEDICAL ASSOCIATES, CLINIC DIRECTOR OF OPERATIONS (SPECIALTY CARE) GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR LABOR & DELIVERY PINE TREE SCHOOL DISTRICT, SUPERINTENDENT GOOD SHEPHERD HEALTH SYSTEM, CHIEF FINANCIAL OFFICER GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR GOVERNMENT & COMMUNITY RELATIONS GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF EMERGENCY SERVICES (LONGVIEW) RUSK COUNTY UNITED WAY GOOD SHEPHERD MEDICAL ASSOCIATES, PEDIATRICIAN THE FOLLOWING PRIORITIZED COMMUNITY NEEDS WERE IDENTIFIED THROUGH THE CHNA 1. LACK OF MENTAL HEALTH PROVIDERS/SERVICES 2. OBESITY, DIABETES, HEART DISEASE AND OTHER CHRONIC DISEASES 3. AFFORDABLE PRIMARY AND PREVENTATIVE CARE OPTIONS 4. UNEMPLOYEMENT AND DECREASE IN INCOME IN THE COMMUNITY DUE TO ECONOMIC DOWNTURN 5. HEALTHY BEHAVIORS/LIFESTYLE CHOICES 6. SUBSTANCE ABUSE 7. LACK OF HEALTH KNOWLEDGE/EDUCATION 8. LACK OF COMMUNITY RESOURCES TO PROMOTE HEALTH (FACILITIES, OUTDOOR SPACES) 9. POOR NUTRITION/LIMITED ACCESS TO HEALTHY FOOD OPTIONS 10. UNINSURED/LIMITED INSURANCE DUE TO LACK OF MEDICAID EXPANSION OR HIGH DEDUCTIBLE PLANS 11. ADULT SMOKING/TOBACCO USE 12. CRIME AND VIOLENCE SCHEDULE H, PART V, SECTION B, LINE 6A CHNA CONDUCTED WITH OTHER FACILITIES GOOD SHEPHERD HEALTH SYSTEM OPERATES HOSPITALS IN LONGVIEW AND MARSHALL. THE CHNA WAS CONDUCTED TO INCLUDE BOTH OF THE FOLLOWING SYSTEM HOSPITAL FACILITIES: THE GOOD SHEPHERD HOSPITAL, INC. (D/B/A GOOD SHEPHERD MEDICAL CENTER) HARRISON COUNTY HOSPITAL ASSOCIATION (D/B/A GOOD SHEPHERD MEDICAL CENTER MARSHALL) SCHEDULE H, PART V, SECTION B, LINE 7A THE URLS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENTS ARE: MARSHALL: https://www.christushealth.org/-/media/files/chip/christus-good-shepherd-m arshall-chna-2016 LONGVIEW: https://www.christushealth.org/-/media/files/chip/christus-good-shepherd-l ongview-chna-2016 SCHEDULE H, PART V, SECTION B, LINE 10A THE URLS FOR THE ORGANIZATION'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGIES ARE: MARSHALL: https://www.christushealth.org/-/media/files/chip/christus-good-shepherd-m arshall-chip-2017 LONGVIEW: https://www.christushealth.org/-/media/files/chip/christus-good-shepherd-l ongview-chip-2017 FORM 990, SCHEDULE H, PART V, SECTION B, LINE 11 IN RESPONSE TO THE RESULTS OF THE 2017 CHNA, THE HOSPITALS BOARD OF DIRECTORS AND MANAGEMENT TEAM DEVELOPED A CHNA IMPLEMENTATION PLAN IN ORDER TO PRIORITIZE AND ADDRESS THE MAJOR COMMUNITY NEEDS. IN REGARDS TO THE #1 COMMUNITY NEED IDENTIFIED IN THE CHNA (LACK OF MENTAL HEALTH PROVIDERS/SERVICES), WE TOOK SEVERAL ACTIONS DURING THE TAX YEAR AND PLAN TO CONTINUE BUILDING UPON THESE STEPS IN THE FUTURE. THESE ACTIONS ARE PRIMARILY TO ADDRESS THE ONGOING ISSUE OF TREATING BEHAVIORAL HEALTH PATIENTS IN OUR EMERGENCY DEPARTMENT AND REFERRING THESE PATIENTS TO OTHER PSYCHIATRIC PROVIDERS. OUR GOAL IS TO BOTH IMPROVE CARE AND PROVIDE SERVICES IN A MORE APPROPRIATE TREATMENT SETTING. ACTIONS TAKEN TOWARDS ADDRESSING THE #1 NEED INCLUDED: - HIRED A FULL TIME PSYCHIATRIST AND BEHAVIORAL HEALTH TECHNICIANS. - CREATED A NEW CLINICAL DIRECTOR OF BEHAVIORAL HEALTH POSITION THAT IS STAFFED BY A BOARD-CERTIFIED PSYCHIATRIC NURSE. - REMODELED SIX EMERGENCY ROOMS AND SIX INPATIENT ROOMS SPECIFICALLY FOR USE AS A PSYCH-SAFE DELIVERY SPACES. - ENGAGED A TELE-PSYCHIATRY SERVICE PROVIDER TO HELP EXPEDITE PSYCH PATIENT EVALUATIONS - HOSTED THE FIRST ANNUAL BEHAVIORAL HEALTH COLLABORATION CONFERENCE WITH LAW ENFORCEMENT, LOCAL MENTAL HEALTH PROVIDERS AND COUNTY JUDGES. ALSO, CONTINUE TO HOST QUARTERLY COMMUNITY-WIDE BEHAVIORAL HEALTH MEETINGS. - PROVIDED SAME DE-ESCALATION TRAINING TO HELP PREVENT PSYCHIATRIC PATIENT AGGRESSION FROM BEING PHYSICALLY HARMFUL. - PROVIDED 800 PSYCHIATRIC PATIENT TRANSPORTS TO SHORT-TERM REGIONAL CRISIS STABILIZATION CENTERS, LOCAL INPATIENT FACILITIES AND STATE OPERATED PSYCHIATRIC HOSPITALS. - CONTINUED A SPECIAL PROJECT FUNDED THROUGH THE TEXAS MEDICAID WAIVER WITH CMS TO INTEGRATE PSYCHIATRIC PATIENTS INTO OUR PATIENT CENTER MEDICAL HOME WITHIN AN INTERNAL MEDICINE CLINIC. WE ALSO CONTINUE TO EMPLOY PATIENT CARE NAVIGATORS (PCNS) WHO EVALUATE AND REFER PATIENTS TO COMMUNITY HEALTHCORE (THE REGIONAL MENTAL HEALTH AUTHORITY), AND OTHER OUTPATIENT PSYCHIATRIC SERVICE PROVIDERS. - HOSPITAL MANAGERS HAVE ALSO BEGAN PARTICIPATING IN A SPECIAL CITY OF LONGVIEW TASK FORCE DEVELOPED BY THE MAYOR TO ADDRESS ISSUES (INCLUDING PSYCHIATRIC AND SUBSTANCE ABUSE NEEDS) INVOLVING THE CITYS HOMELESS POPULATION. THE AFOREMENTIONED ACTIONS WILL ALSO ADDRESS COMMUNITY NEED #6 (SUBSTANCE ABUSE) AND INDIRECTLY CONTRIBUTE TO A REDUCTION IN NEED #12 (CRIME AND VIOLENCE) DUE TO HIGH CRIME AND VIOLENCE RECIDIVISM OF UNTREATED PSYCHIATRIC AND SUBSTANCE ABUSE PATIENTS. IN REGARDS TO THE REMAINING COMMUNITY NEEDS, THE HOSPITAL WILL CONTINUE TO OFFER A WIDE RANGE OF SERVICES, PROGRAMS, EDUCATION AND TRAINING TO ADDRESS NEED #S 2, 5, 7, AND 11. ISSUE #8 IS PARTIALLY ADDRESSED BY STATE-OF-THE-ART FITNESS CENTER, INCLUDING FITNESS SCHOLARSHIPS OFFERED TO LOW INCOME PATIENTS WITH SIGNIFICANT HEALTH PROBLEM, NEED #S 3 AND 10 ARE ADDRESSED BY SPECIAL IN-HOUSE PROGRAMS TO ASSIST THE UNINSURED, INCLUDING PAYMENT DISCOUNT PROGRAMS, CERTIFIED APPLICATION COUNSELORS TO ASSIST PATIENTS WITH ACCESS TO THE FEDERAL HEALTH INSURANCE MARKETPLACE, CHARITY POLICIES AND REFERRALS TO LOCAL FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS). MORE DETAILS REGARDING OUR CHNA IMPLEMENTATION STRATEGY MAY BE FOUND AT https://www.christushealth.org/about/donate/community-health/community-hea lth-needs-assessment-and-implementation-plan. COMMUNITY NEEDS NOT ADDRESSED: AREAS OF NEED NOT SPECIFICALLY ADDRESSED BY THE HOSPITAL INCLUDE NEED #4 (UNEMPLOYMENT AND DECREASE IN INCOME DUE TO ECONOMIC DOWNTURN), #9 (POOR NUTRITION/LIMITED ACCESS TO HEALTHY FOODS) AND DIRECT ACTION TO MEET #12 (CRIME AND VIOLENCE). WHILE MEMBERS OF HOSPITAL MANAGEMENT PARTICIPATE IN LOCAL GROUPS AND COMMITTEES FORMED TO PROMOTE ECONOMIC GROWTH AND JOBS, THE HOSPITAL DOES NOT CHOOSE TO DIRECTLY ADDRESS ECONOMIC MATTERS OF THE COMMUNITY DUE TO OUR FINANCIAL LIMITATIONS. ALSO, WHILE THE HOSPITAL PROVIDES SOME EDUCATION TO PATIENTS REGARDING PROPER DIET, WE DO NOT HAVE THE RESOURCES OR ABILITY TO ENSURE THAT IMPOVERISHED POPULATIONS ENJOY NUTRITIONAL AND VARIED FOOD OPTIONS DELIVERED TO FOOD DESERTS. FINALLY, IT IS NOT CONSIDERED A HOSPITAL ROLE TO CONFRONT RISING CRIME AND VIOLENCE THROUGH DIRECT ENFORCEMENT ACTIONS. SCHEDULE H, PART V, SECTION B, LINE 16A THE FAP AND PLAIN LANGUAGE SUMMARY WERE WIDELY AVAILABLE AT THE FOLLOWING URL: https://www.christushealth.org/-/media/patient-resources/good-shepherd/lon gview-financial-assistance/plsgoodshepherd_english.ashx?la=en SCHEDULE H, PART V, SECTION B, LINE 16B THE FAP APPLICATION WAS WIDELY AVAILABLE AT THE FOLLOWING URL: https://www.christushealth.org/-/media/Files/Finance-Files/Application-Eng lish SCHEDULE H, PART V, SECTION B, LINE 16C THE PLAIN LANGUAGE SUMMARY WAS WIDELY AVAILABLE AT THE FOLLOWING URL: https://www.christushealth.org/-/media/patient-resources/good-shepherd/lon gview-financial-assistance/plsgoodshepherd_english.ashx?la=en FORM 990, SCHEDULE H, PART V, SECTION B, LINE 16J A NOTIFICATION WAS PLACED IN THE NEWSPAPERS WITHIN THE TWO LARGEST CITIES IN THE HOSPITAL SERVICE AREA (LONGVIEW AND MARSHALL) WHICH EXPLAINED THE AVAILABLILITY OF A FINANCIAL ASSISTANCE POLICY AND INCLUDED AN INVITATION TO SPEAK WITH A FINANCIAL COUNSELOR AND ALSO REFERENCED THE WEB-SITE WHICH PROVIDES ADDITIONAL FINANCIAL ASSISTANCE DETAILS. IN ADDITION, IN AN EFFORT TO MORE WIDELY PUBLICIZE OUR FINANCIAL ASSISTANCE WITHIN OUR COMMUNITY, INCLUDING PERSONS MORE LIKELY TO REQUIRE FINANCIAL ASSISTANCE, WE SUBMITTED A COPY OF OUR PLAIN LANGUAGE FINANCIAL ASSISTANCE POLICY TO A NUMBER OF ORGANIZATIONS THAT INTERACT WITH POOR POPULATION GROUPS. THESE ORGANIZATIONS INCLUDE COUNTY HEALTH DEPARTMENTS, FQHCS, VARIOUS NON-PROFITS AND MINISTRIES SUPPORTED BY THE UNITED WAY AND OTHER AGENCIES SERVING THE POOR. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 20E EFFORTS TO INITATE EFFORTS FROM LINE 19 CHRISTUS HEALTH USES AN OUTSIDE VENDOR, PARO DECISION SUPPORT, LLC, WHICH UTILIZES PUBLIC RECORDS TO MODEL PRESUMPTIVE CHARITY. THE VENDORS SOCIO-ECONOMIC MODEL IS DESIGNED TO ELIMINATE BARRIERS MANY PATIENTS FACE TO TRADITIONAL APPLICATION PROCESSES WHICH MIGHT INCLUDE LITERACY AND UNDERSTANDING OF FORMS, DOCUMENTATION, OR CULTURAL BARRIERS THAT PRECLUDE THEM FROM SEEKING ASSISTANCE. THE MODEL PROJECTS FAMILY SIZE AND INCOME LEVELS WHICH IS USED TO PRESUMPTIVELY DETERMINE QUALIFICATION UNDER THE HOSPITAL FINANCIAL ASSISTANCE POLICY; THEREBY, EXTENDING OUR OUTREACH FOR FINANCIAL ASSISTANCE WITHIN OUR COMMUNITIES. FORM 990, SCHEDULE H, PART V, SECTION B, LINE 22D DETERMINATION OF AMOUNTS BILLED THE FINANCIAL ASSISTANCE ELIGIBILITY DISCOUNT GUIDELINES IN PLACE DURING TAX YEAR 2015 STATED, 'ALL UNINSURED PATIENTS WHO QUALIFY FOR LESS THAN 68% FINANCIAL ASSISTANCE AND COMPLETE THE NECESSARY APPLICATION PROCESS, WILL RECEIVED THE DISCOUNT UNDER THE UNINSURED ADJUSTMENT. THIS AMOUNT IS BASED ON AN AVERAGE OF GSHS MANAGED CARE CONTRACTS DEEPEST DISCOUNTS.' IN THE YEAR 2016, THE HOSPITAL CHANGED TO USING MEDICARE RATES TO CALCULATE MAXIMUM AMOUNTS THAT CAN BE CHARGED. 6 CHRISTUS Good Shepherd LifeCenter 612 S Grove St Marshall TX 75670 HEALTH CLINIC CHRISTUS Good Shepherd Home Care 401 S Bolivar St Marshall TX 75670 HEALTH CLINIC Marshall Health Clinic 805 Lindsey Drive Marshall TX 75670 Health Clinic East Texas Pediatrics 618 S Grove Street Ste 100 Marshall TX 75670 Health Clinic Marshall Pediatric Clinic 707 S Grove Street Marshall TX 75670 Health Clinic First In Pediatrics 304 University Ste 105 Marshall TX 75670 Health Clinic SCHEDULE H, PART I, LINE 3C CRITERIA FOR DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE THE HOSPITAL FOLLOWS FINANCIAL ASSISTANCE POLICIES OF CHRISTUS HEALTH. THE QUALIFICATION THRESHOLD FOR FINANCIAL ASSISTANCE IS 400% OF FPG. ELIGIBILITY FOR FREE CARE (100% DISCOUNTS) IS AT OR BELOW 200% FPG. SCHEDULE H, PART I, LINE 6A ANNUAL COMMUNITY BENEFIT REPORT A COMMUNITY BENEFIT REPORT IS PREPEARED FOR THE HOSPITAL EACH YEAR AND IS SUBMITTED ALONG WITH AN AHA SURVEY TO THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES WITH A COPY PROVIDED TO HARRISON COUNTY AND GREGG COUNTY. FORM 990, SCHEDULE H, PART I RETROACTIVE APPLICATION OF PRESUMPTIVE CHARITY DURING THE CURRENT TAX YEAR, CHRISTUS GOOD SHEPHERD HOSPITALS IN LONGVIEW AND MARSHALL FULLY IMPLEMENTED CHRISTUS HEALTH PRACTICES REGARDING USE OF PRESUMPTIVE CHARITY ELIGIBILITY TO DETERMINE QUALIFICATION FOR FINANCIAL ASSISTANCE. THIS CHANGE NOT ONLY IMPACTED ACTIVE ACCOUNTS IN FISCAL YEAR 2018, BUT ALSO INCLUDED A LOOK BACK OF DATES OF SERVICE STARTING IN JULY 2016 TO DETERMINE PAST ACCOUNTS THAT MAY HAVE BEEN MISCLASSIFIED BETWEEN CHARITY AND BAD DEBT. AS A RESULT A NUMBER OF ACCOUNTS WERE RETROACTIVELY QUALIFIED FOR CHARITY. THIS CHANGE IN CLASSIFICATION RESULTED IN AN INCREASE IN CHARITY DEDUCTIONS FROM $22,462,422 IN FISCAL YEAR 2017 TO $273,083,131 IN FISCAL YEAR 2018 AND A DECREASE IN BAD DEBT PROVISIONS FROM $177,232,621 IN FISCAL YEAR 2017 TO A CREDIT OF $(49,600,991) IN FISCAL YEAR 2018. FORM 990, SCHEDULE H, PART I, LINES 7A & 7B ALLOCATION OF MEDICAID SUPPLEMENTAL PAYMENTS DURING THE CURRENT REPORTING PERIOD, THE STATE OF TEXAS PARTICIPATED IN A SPECIAL 1115 MEDICAID WAIVER WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). VARIOUS SUPPLEMENTAL PAYMENTS UNDER THE WAIVER ARE INTENDED TO HELP HOSPITALS OFFSET MEDICAID AND UNINSURED LOSSES AND/OR CREATE NEW PROGRAMS DESIGNED TO IMPROVE THE PATIENT CARE EXPERIENCE, ENHANCE HEALTH OUTCOMES AND REDUCE COSTS FOR THESE SAME PATIENT POPULATIONS. SUPPLEMENTAL PAYMENTS ARE CAPPED BY MEDICAID AND UNINSURED LOSSES DETERMINED FROM A SPECIAL UNCOMPENSATED CARE (UC) TOOL DESIGNED BY THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION (HHSC). IN FISCAL YEAR 2018, THE HOSPITAL RECOGNIZED $26,775,022 OF SUPPLEMENTAL PAYMENT INCOME UNDER THE MEDICAID WAIVER. FOR PURPOSES OF IRS FORM 990 SCHEDULE H REPORTING, CONSISTENT WITH CHRISTUS HEALTH POLICY, 100% OF NET MEDICAID SUPPLEMENTAL PAYMENTS ARE REPORTED AS MEDICAID DIRECT OFFSETING REVENUE. CASH CONTRIBUTIONS- DURING TAX YEAR 2016 GOOD SHEPHERD MEDICAL CENTER MARSHALL ENTERED INTO THREE YEAR AFFILIATION AGREEMENTS WITH A LOCAL FEDERALLY QUALIFIED HEALTH CENTER (FQHC). THE PURPOSE OF THESE AGREEMENTS WAS TO PROVIDE ACCESSIBLE, HIGH QUALITY HEALTH CARE SERVICES, AS WELL AS UNCOMPENSATED CARE FOR PATIENTS WITH LITTLE OR NO INSURANCE, WHILE PROMOTING GENERAL PUBLIC HEALTH AND IMPROVING THE HEALTH STATUS OF CITIZENS LIVING IN MARSHALL, TEXAS. AS PART OF THESE AGREEMENTS, GSMC MARSHALL MADE GRANTS TO COVER OPERATING SHORTFALLS OF FAMILY PRACTICE AND PEDIATRIC CLINICS OF FQHC OPERATED CLINICS IN MARSHALL. CASH CONTRIBUTIONS TOTALLING $725,291 WERE MADE TO THE FQHC DURING THE CURRENT YEAR TO COVER SUCH LOSSES. DURING THE CURRENT TAX YEAR, GOOD SHEPHERD MEDICAL CENTER - LONGVIEW ENTERED INTO A THREE YEAR COMMUNITY BENEFIT GRANT RELATED TO WOMEN AND CHILDREN'S SERVICES WITH WELLNESS POINTE, A LOCAL FEDERALLY QUALIFIED HEALTH CENTER (FQHC). GRANT PAYMENTS TOTALLING $116,250 WERE MADE TO WELLNESS POINTE THIS YEAR. FORM 990, SCHEDULE H, PART I, LINE 7, COL (F) BAD DEBT EXPENSE BAD DEBT IN THE AMOUNT OF -$49,600,991, WAS NOT INCLUDED IN TOTAL EXPENSE USED TO COMPUTE THE PERCENTAGE REPORTED IN PART I, LINE 7 COL (F). SCHEDULE H, PART I, LINE 7 LINE 7A: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7B: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7E: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7F: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7I: ACTUAL EXPENSE OF THE CONTRIBUTIONS SCHEDULE H, PART III, SECTION A, LINE 1 BAD DEBT REPORTING IN ACCORDANCE WITH HFMA STATEMENT 15 CHRISTUS HEALTH FOLLOWS IN PRINCIPLE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. THE SYSTEM HAS ADOPTED AN UNCOMPENSATED CARE POLICY WHERE REVENUE FROM SERVICES PROVIDED TO THE UNINSURED IS RECOGNIZED AT THE TIME OF PAYMENT, RATHER THAN AT THE TIME OF SERVICE. THIS POLICY IS THE RESULT OF A LACK OF REASONABLE ASSURANCE OF COLLECTION FOR SERVICES PROVIDED TO THE UNINSURED DUE TO THE SYSTEM'S HISTORICALLY LOW COLLECTION RATE. MANAGEMENT HAS ESTIMATED THAT THE DIFFERENCE BETWEEN RECORDING REVENUE FROM THE UNINSURED ON A CASH BASIS, RATHER THAN THE ACCRUAL BASIS, IS IMMATERIAL. ACCORDINGLY, ALL ACCOUNTS RECEIVABLE FROM THE UNINSURED HAVE BEEN FULLY RESERVED IN THE ALLOWANCE FOR UNCOMPENSATED CARE. SCHEDULE H, PART III, SECTION A, LINE 2 METHODOLOGY USED IN DETERMINING BAD DEBT THE ORGANIZATION'S TOTAL BAD DEBT EXPENSE (TOTAL OF ALL HOSPITAL FACILITIES) IS IN ACCORDANCE WITH THE ORGANIZATION'S FINANCIAL STATEMENTS, WHICH IS COMPUTED AS BAD DEBT NET OF CONTRACTUAL ALLOWANCE, PAYMENTS RECEIVED AND RECOVERIES OF BAD DEBT PREVIOUSLY WRITTEN OFF. SCHEDULE H, PART III, SECTION A, LINE 3 ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ORGANIZATION'S CHARITY CARE POLICY THE FILING ORGANIZATION RECOGNIZES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO SEEK FINANCIAL ASSISTANCE DUE TO BARRIERS SUCH AS EDUCATIONAL LEVEL, LITERACY, DOCUMENTATION REQUIREMENTS, OR BEING INTIMIDATED BY THE APPLICATION PROCESS. IN ORDER TO ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT SUBMITTED AN APPLICATION, THE ORGANIZATION ENGAGED PARO DECISION SUPPORT, LLC. PARO CHARITY SCORE IS DESIGNED TO IDENTIFY PATIENTS THAT LIKELY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON A PREDICTIVE MODEL AND OTHER FINANCIAL AND ASSET ESTIMATES FOR THE PATIENT DERIVED FROM PUBLIC RECORD SOURCES. IN ORDER TO ASSESS THE BAD DEBT ACCOUNTS THAT WOULD LIKELY QUALIFY FOR CHARITY CARE, THE FOLLOWING CRITERIA WERE ESTABLISHED BASED ON AN ANALYSIS OF HISTORICAL DATA OF CHRISTUS HEALTH AND ITS RELATED ORGANIZATIONS: 1. PARO SCORE OF LESS THAN OR EQUAL TO 586, WHICH IS A PREDICTOR DEFINING THE LIKELY SOCIOECONOMIC CONDITIONS FOR THE PATIENT; 2. ESTIMATED FEDERAL POVERTY LEVEL OF LESS THAN OR EQUAL TO 226%, WHICH IS BASED ON ESTIMATED HOUSEHOLD SIZE AND HOUSEHOLD ESTIMATED INCOME; AND 3. THIRD PARTY DATA AVAILABLE ON PATIENT ACCOUNTS WHICH INDICATE THAT THE PATIENT IS NOT A HOMEOWNER OR A PROBABLE HOMEOWNER. FOR THE FISCAL YEAR ENDING JUNE 30, 2011, THE ORGANIZATION REPORTED THAT 30% OF BAD DEBT EXPENSES WERE ATTRIBUTABLE TO PATIENTS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE BUT WERE NOT RESPONSIVE TO THE APPLICATION PROCESS EXISTING AT THAT TIME. THIS FIGURE WAS BASED ON THE PARO ANALYSIS AND ESTIMATES OF PATIENTS' FINANCIAL NEEDS THAT EXAMINED WHETHER PATIENTS WERE CHARACTERISTIC OF OTHERS WHO HISTORICALLY QUALIFIED FOR ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. THE PRESUMPTIVE CHARITY CARE ANALYSIS PERFORMED FOR THE PRIOR FISCAL YEAR DETERMINED A BENCHMARK OF BAD DEBT ACCOUNTS IN THE CHRISTUS HEALTH SYSTEM THAT LACKED THE INFORMATION TO QUALIFY FOR CHARITY CARE UNDER THE FILING ORGANIZATION'S CUSTOMARY PROCESS BUT WOULD HAVE LIKELY QUALIFIED FOR ASSISTANCE. DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2018, THE ORGANIZATION UTILIZED THE PARO SCORE TO IDENTIFY THE ACCOUNTS OF INDIVIDUAL PATIENTS THAT WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE DESPITE HAVING NOT COMPLETED AN APPLICATION, AND SUCH ANALYSIS DETERMINED THAT 28.75% OF SUCH ACCOUNTS WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE. THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY FOR THESE ACCOUNTS AND THEY WERE RECLASSIFIED UNDER OUR FINANCIAL ASSISTANCE POLICY. THE AMOUNTS WERE NOT REPORTED AS BAD DEBT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3 IS THE DIFFERENCE BETWEEN THE PRESUMPTIVE CHARITY CARE BENCHMARK ESTABLISHED IN THE FISCAL YEAR ENDING JUNE 30, 2011 AND THE AGGREGATE OF INDIVIDUAL ACCOUNTS FOR WHICH THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY IN THE FISCAL YEAR ENDING SEPTEMBER 30, 2018. THUS, THE ORGANIZATION ESTIMATES THAT ONLY 3.73% OF THE BAD DEBT EXPENSES IN FISCAL YEAR ENDING SEPTEMBER 30, 2018 ARE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. IT IS IMPORTANT TO NOTE THAT THE FIGURE CALCULATED FOR FISCAL YEAR ENDING JUNE 30, 2011 WAS ESTIMATED AND NOT EXACT, AND THEREFORE THE DIFFERENCE BETWEEN THE AMOUNTS QUALIFIED AS PRESUMPTIVE CHARITY CARE IN ANY FISCAL YEAR MAY VARY FROM THE BENCHMARK ESTABLISHED IN FISCAL YEAR ENDING JUNE 30, 2011. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE THE FOOTNOTE TO THE CHRISTUS HEALTH CONSOLIDATED FINANCIAL STATEMENTS SAYS, "THE PREPARATION OF THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES (US GAAP) REQUIRES MANAGEMENT OF THE SYSTEM TO MAKE ASSUMPTIONS, ESTIMATES, AND JUDGMENTS THAT AFFECT THE AMOUNTS REPORTED IN THE FINANCIAL STATEMENTS, INCLUDING THE NOTES THERETO, AND RELATED DISCLOSURES OF COMMITMENTS AND CONTINGENCIES, IF ANY. THE SYSTEM CONSIDERS CRITICAL ACCOUNTING POLICIES TO BE THOSE THAT REQUIRE MORE SIGNIFICANT JUDGMENTS AND ESTIMATES IN THE PREPARATION OF ITS FINANCIAL STATEMENTS, INCLUDING THE FOLLOWING: RECOGNITION OF NET PATIENT SERVICE REVENUES, WHICH INCLUDE CONTRACTUAL ALLOWANCES AND THE PROVISION FOR BAD DEBT; ESTIMATES FOR REIMBURSEMENT UNDER THE UPPER PAYMENT LIMIT, DISPROPORTIONATE SHARE AND MEDICAID 1115 WAIVER PROGRAMS; RESERVES FOR LOSSES AND EXPENSES RELATED TO HEALTH CARE PROFESSIONAL AND GENERAL LIABILITIES; ACCRUAL FOR CLAIMS INCURRED BUT NOT YET REPORTED RELATED TO THE SYSTEM'S HEALTH PLAN; DETERMINATION OF FAIR VALUES OF CERTAIN FINANCIAL INSTRUMENTS; DETERMINATION OF FAIR VALUE OF CERTAIN GOODWILL AND LONG-LIVED ASSETS, INCLUDING ASSETS ACQUIRED; AND RISKS AND ASSUMPTIONS FOR MEASUREMENT OF PENSION AND RETIREE MEDICAL LIABILITIES. MANAGEMENT RELIES ON HISTORICAL EXPERIENCE AND ON OTHER ASSUMPTIONS BELIEVED TO BE REASONABLE UNDER THE CIRCUMSTANCES IN MAKING ITS JUDGMENTS AND ESTIMATES. ACTUAL RESULTS COULD DIFFER MATERIALLY FROM THESE 'ESTIMATES.'" FORM 990, SCHEDULE H, PART III, LINE 8 COSTING METHODOLOGY THE SOURCE OF INFORMATION ON LINES 5 AND 6 IS THE FISCAL PERIOD ENDED SEPTEMBER 30, 2018 MEDICARE COST REPORT. THE REVENUES WERE DERIVED FROM COST REPORT WORKSHEETS E PART A, E PART B AND E-3, PART III. COST INFORMATION WAS OBTAINED BY SUMMING OF MEDICARE PART A ALLOWABLE COSTS REPORTED ON WORKSHEET D-1, PART II (FOR BOTH INPATIENT ACUTE PPS AND INPATIENT REHAB FACILITY) AND WORKSHEET DV, COLUMNS 5.00 THROUGH 7.00 FOR MEDICARE OUTPATIENT PPS SERVICES. SINCE ALLOWABLE COSTS ARE NOT DETERMINED FOR SERVICES RENDERED TO MEDICARE PATIENTS ENROLLED IN MEDICARE ADVANTAGE (MEDICARE PART C) OR FOR PHYSICIAN SERVICES BILLED UNDER MEDICARE PART B, NEITHER THE REVENUES OR COSTS RELATED TO THESE SERVICES HAVE BEEN INCLUDED ON LINES 5 OR 6. THE COST REPORT USES FINANCIAL AND STATISTICAL DATA TO DEVELOP PER DIEMS AND COST TO CHARGE RATIOS THAT ULTIMATELY DETERMINE ALLOWABLE MEDICARE INPATIENT AND OUTPATIENT COSTS. (NOTE: EFFECTIVE AUGUST 1, 2017, THE LICENSE AND MEDICARE PROVIDER NUMBER OF GOOD SHEPHERD MEDICAL CENTER - LONGVIEW AND GOOD SHEPHERD MEDICAL CENTER - MARSHALL WERE COMBINED. THIS MERGER RESULTED IN ONE COST REPORT FOR THE COMBINED HOSPITALS.) FORM 990, SCHEDULE H, PART III, LINE 9B PROVISIONS ON COLLECTION PRACTICES THE HOSPITAL UTILIZES THE CHRISTUS REVENUE CYCLE BILLING AND COLLECTION POLICY. THIS POLICY IS DESIGNED TO COMPLY WITH IRS 501(r ) GUIDELINES AND INCLUDES THE FOLLOWING STATEMENTS: - "CHRISTUS WILL USE REASONABLE COLLECTION PROCEDURES IN A FAIR AND CONSISTENT MANNER TO COLLECT PATIENT SELF-PAY BALANCES, MAINTAINING CONFIDENTIALITY AND PATIENT DIGNITY. FINANCIAL ASSISTANCE WILL BE OFFERED TO THOSE PATIENTS WHOSE INCOME AND ASSETS WILL NOT ALLOW FULL PAYMENT OF SERVICES WITHIN A REASONABLE TIME FRAME. - PATIENTS ENROLLED IN A CHRISTUS PAYMENT PLAN WHO ARE MAKING THE MONTHLY SCHEDULED PAYMENTS WILL NOT BE ASSIGNED TO COLLECTIONS UNLESS THE PAYMENT PLAN BECOMES DELINQUENT. - CHRISTUS DOES NOT CURRENTLY ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS (ECAs). UNDER NO CIRCUMSTANCE WILL CHRISTUS ENGAGE IN AN ECA BEFORE 120 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT." FORM 990, SCHEDULE H, PART VI, LINE 2 NEED ASSESSMENT GOOD SHEPHERD MEDICAL CENTER ENGAGED BKD, LLP TO CONDUCT A FORMAL CHNA. BKD, LLP IS ONE OF THE LARGEST CPA AND ADVISORY FIRMS IN THE UNITED STATES, WITH APPROXIMATELY 2,000 PARTNERS AND EMPLOYEES IN 34 OFFICES. BKD SERVES MORE THAN 900 HOSPITALS AND HEALTH CARE SYSTEMS ACROSS THE COUNTRY. THE CHNA WAS CONDUCTED DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2016. BASED ON CURRENT LITERATURE AND OTHER GUIDANCE FROM THE TREASURY AND THE IRS, THE FOLLOWING STEPS WERE CONDUCTED AS PART OF GOOD SHEPHERDS CHNA: - AN EVALUATION OF THE IMPACT OF ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE TAX YEAR 2013 CHNA WAS COMPLETED AND AN IMPLEMENTATION STRATEGY SCORECARD WAS PREPARED TO UNDERSTAND THE EFFECTIVENESS OF GOOD SHEPHERDS CURRENT STRATEGIES AND PROGRAMS. - THE "COMMUNITY" SERVED BY GOOD SHEPHERD WAS DEFINED BY UTILIZING INPATIENT DATA REGARDING PATIENT ORIGIN. THIS PROCESS IS FURTHER DESCRIBED IN COMMUNITY SERVED BY THE HOSPITAL. - POPULATION DEMOGRAPHICS AND SOCIOECONOMIC CHARACTERISTICS OF THE COMMUNITY WERE GATHERED AND REPORTED UTILIZING VARIOUS THIRD PARTIES (SEE REFERENCES IN APPENDICES). THE HEALTH STATUS OF THE COMMUNITY WAS THEN REVIEWED. INFORMATION ON THE LEADING CAUSES OF DEATH AND MORBIDITY INFORMATION WAS ANALYZED IN CONJUNCTION WITH HEALTH OUTCOMES AND FACTORS REPORTED FOR THE COMMUNITY BY COUNTYHEALTHRANKINGS.ORG. HEALTH FACTORS WITH SIGNIFICANT OPPORTUNITY FOR IMPROVEMENT WERE NOTED. - COMMUNITY INPUT WAS PROVIDED THROUGH KEY STAKEHOLDER SURVEYS. RESULTS AND FINDINGS ARE DESCRIBED IN THE KEY STAKEHOLDER SURVEY RESULTS SECTION OF THIS REPORT. - INFORMATION GATHERED IN THE ABOVE STEPS WAS ANALYZED AND REVIEWED TO IDENTIFY HEALTH ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS AND MINORITY GROUPS AND THE COMMUNITY AS A WHOLE. HEALTH NEEDS WERE RANKED UTILIZING A WEIGHTING METHOD THAT WEIGHS 1) THE SIZE OF THE PROBLEM, 2) THE SERIOUSNESS OF THE PROBLEM, 3) THE IMPACT OF THE ISSUES ON VULNERABLE POPULATIONS, 4) THE PREVALENCE OF COMMON THEMES AND 5) HOW IMPORTANT THE ISSUE IS TO THE COMMUNITY. - AN INVENTORY OF HEALTH CARE FACILITIES AND OTHER COMMUNITY RESOURCES POTENTIALLY AVAILABLE TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA WAS PREPARED AND COLLABORATIVE EFFORTS WERE IDENTIFIED. HEALTH NEEDS WERE THEN PRIORITIZED TAKING INTO ACCOUNT THE PERCEIVED DEGREE OF INFLUENCE GOOD SHEPHERD HAS TO IMPACT THE NEED AND THE HEALTH NEEDS IMPACT ON OVERALL HEALTH FOR THE COMMUNITY. INFORMATION GAPS IDENTIFIED DURING THE PRIORITIZATION PROCESS HAVE BEEN REPORTED. FORM 990, SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE AS PATIENTS ENTER OUR FACILITY, SIGNAGE IS POSTED IN DESIGNATED AREAS WHICH STATE OUR POLICY TO PROVIDE CHARITY CARE TO THOSE PATIENTS WHO MEET ELIGIBILITY REQUIREMENTS. BUSINESS OFFICE AND REGISTRATION STAFF DISCUSS PAYMENT OPTIONS AND FINANCIAL ASSISTANCE AVAILABLE TO PATIENTS USING VERBAL AND WRITTEN COMMUNICATION. PATIENTS ARE CONTACTED PRIOR TO SERVICES WITH AN ESTIMATED COST AND OUT OF POCKET EXPENSES. CASH PRICES AND PAYMENT OPTIONS ARE DISCUSSED AND FINANCIAL ASSISTANCE SCREENING IS AVAILABLE UPON REQUEST. CHRISTUS GOOD SHEPHERD MEDICAL CENTER EVALUATES PATIENT APPLICATIONS AND UTILIZES A SLIDING SCALE TO QUALIFY PATIENTS BASED ON GOVERNMENT POVERTY GUIDELINES. ADDITIONALLY, OUR ELIGIBILITY VENDOR SCREENS FOR GOVERNMENT AGENCY PROGRAMS AND OFFERS FINANCIAL ASSISTANCE APPLICATIONS TO THOSE WHO DO NOT QUALIFY FOR GOVERNMENT PROGRAMS. BUSINESS OFFICE AND REGISTRATION PERSONNEL ARE AVAILABLE TO ANSWER ANY FINANCIAL QUESTIONS AND ASSIST THE PUBLIC WITH THEIR FINANCIAL OBLIGATIONS. FORM 990, SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION CHRISTUS GOOD SHEPHERD MEDICAL CENTER IS LOCATED IN THE PINEY WOOD OF EAST TEXAS AND SERVICES A RURAL COMMUNITY WHICH INCLUDES HARRISON, NORTHERN PANALO AND SOUTHERN MARION COUNTIES. THE POPULATION IN EACH OF THESE COUNTIES IS DIVERSE IN INCOME AND ETHNICITY. HARRISON COUNTY, ESTABLISHED IN 1839, IS LOCATED IN NORTHEASTERN TEXAS ALONG THE LOUISIANA BORDER AND COMPRISES 984 SQUARE MILES. MARSHALL, THE COUNTY SEAT IS LOCATED 152 MILES EAST OF DALLAS AND 39 MILES WEST OF SHREVEPORT. ACCORDING TO THE 2018 CENSUS ESTIMATES, 17.3% OF HARRISON COUNTY POPULATION LIVES IN POVERTY. 16.9% OF HARRISON COUNTY RESIDENTS ARE AGE 65 OR OLDER. THE CENSUS BUREAU REPORTS THAT ONLY 18.8% OF ADULTS HOLD A COLLEGE DEGREE OR HIGHER LEVEL OF EDUCATION. EDUCATION LEVEL IMPACTS THE TYPES OF AVAILABLE JOBS AND BENEFIT LEVELS, INCLUDING HEALTHCARE COVERAGE. IN OTHER SERVICE LOCATIONS, MARION COUNTY HAS A MEDIAN ANNUAL INCOME OF $36,938 AND 22.8% OF ITS RESIDENTS LIVE IN POVERTY. PANOLA COUNTY HAS A MEDIAN ANNUAL HOUSEHOLD INCOME OF $49,704 AND 15.0% OF ITS RESIDENTS LIVE IN POVERTY. UNEMPLOYMENT IN HARRISON, PANOLA AND MARION COUNTIES IS CURRENTLY BETWEEN 3.8% TO 4.2%. IT IS CLEAR THAT WITHIN THE AREA SERVED THERE ARE MANY OBSTACLES TO OVERCOME REGARDING HEALTH CARE COVERAGE. MANY FIND IT DIFFICULT TO AFFORD THE COST OF HEALTHCARE BOTH IN BASIC PREVENTION AND IN TREATMENT OF EXISTING CONDITIONS. (SOURCE: U.S. CENSUS BUREAU & FEDERAL RESERVE BANK OF ST. LOUISTEXAS COUNTIES: UNEMPLOYMENT RATE) GOOD SHEPHERD HOSPITAL SERVES AN 11-COUNTY REGION INCLUDING THE FOLLOWING COUNTIES: GREGG, HARRISON, MARION, MORRIS, PANOLA, RUSK, UPSHUR, CAMP, CASS, WOOD AND TITUS. CHRISTUS GOOD SHEPHERD MEDICAL CENTERS IN LONGVIEW AND MARSHALL OFFER A TRUE SYSTEM OF HEALTHCARE THAT ENCOMPASSES THE REACH OF OUR REGION. TO MEET THE EVERYDAY HEALTHCARE NEEDS OF THE RESIDENTS IN OUR REGION, GOOD SHEPHERD HEALTH SYSTEM OPERATES FAMILY HEALTH CENTERS IN THE COMMUNITIES OF LONGVIEW, GLADEWATER, HENDERSON AND KILGORE. THE PROJECTED 2017 PRIMARY 6 COUNTIES POPULATIONS ARE GREGG 131,827, HARRISON 70,179, MARION 11,220, UPSHUR 43,368, RUSK 60,164 AND PANOLA 25,325 AND TOTAL 342,083. (SOURCE: HTTPS://WWW.DSHS.TEXAS.GOV/CHS/POPDAT/ST2017.SHTM.) FORM 990, SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH THE COMMUNITY BUILDING ACTIVITIES INCLUDE OUR WELLNESS CENTER AND THE PROGRAMS WE OFFER IN AN ATTEMPT TO KEEP OUR COMMUNITY HEALTHY. THE WELLNESS CENTER IS THE HUB OF OUR PROGRAM OFFERING FITNESS AND WELLNESS PROGRAMS FOR INDIVIDUALS, FAMILIES AND BUSINESSES IN OUR COMMUNITY, INCLUDING HOSPITAL EMPLOYEES AND THEIR FAMILIES. WE ALSO OFFER A VARIETY OF WATER AEROBICS, ADULT AEROBIC CLASSES, SENIOR EXERCISE CLASSES, SPECIALTY CLASSES SUCH AS ZUMBA, CARDIAC REHAB, ETC. WE ALSO OFFER ACUTE, CHRONIC AND PREVENTATIVE EDUCATIONAL PROGRAMS TO OUR COMMUNITY. WE ARE INVOLVED IN THE SCHOOLS WITH PRENATAL CLASSES FOR PREGNANT TEENS AND ALSO WORK WITH THE SCHOOLS ON OBESITY PROGRAMS. IN ADDITION, WE PROVIDE COMMUNITY EDUCATIONAL SERVICES AND PROGRAMS, SUCH AS CPR, CERTIFIED DIABETIC EDUCATION PROGRAMS, WOULD CARE EDUCATION AND PREVENTION, SEATBELT AWARENESS, HARD HATS FOR LITTLE HEADS BICYCLE RODEO AND SHOPPING CLASSES FOR PERSONS TRYING TO MODIFY DIET FOR CARDIAC REASONS OR WEIGHT LOSS. FURTHERMORE, WE OFFER HEALTH FAIRS PROVIDE BASIC SCREENING EXAMS AT NO COST TO OUR COMMUNITY. OUR CASE MANAGEMENT AND SOCIAL SERVICES PROGRAM OFFERS THE AVAILABILITY OF EXTERNAL SOURCES AND PROGRAMS TO ASSIST PATIENTS AND THEIR FAMILIES, SUCH AS WIC AND OTHER GOVERNMENT AND PRIVATE PROGRAMS. FORM 990, SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM GOOD SHEPHERD HEALTH SYSTEM IS PART OF CHRISTUS HEALTH, AN INTERNATIONAL, CATHOLIC, FAITH BASED, NONPROFIT HEALTH SYSTEM COMPRISED OF ALMOST 350 SERVICES AND FACILITIES INCLUDING MORE THAN 60 HOSPITALS AND LONG TERM CARE FACILITIES, 175 CLINICS AND OUTPATIENT CENTERS, AND OTHER COMMUNITY HEALTH MINISTRIES AND COMMUNITY DEVELOPMENT VENTURES. CHRISTUS SERVICES CAN BE FOUND IN: ARKANSAS, GEORGIA, IOWA, LOUISIANA, NEW MEXICO, TEXAS, IN SIX PROVINCES OF MEXICO, AND IN SANTIAGO, CHILE. A COMMON MISSION, CORE VALUES, AND VISION UNITE THE HEALTH SYSTEM. EACH REGION, INCLUDING GOOD SHEPHERD HEALTH SYSTEM, DEVELOPS FIVE-YEAR AND TEN-YEAR STRATEGIC PLANS THAT HELP SET THE YEARLY OPERATIONAL PLANS AND BUDGETS. REGIONAL STRATEGIC GOALS ARE SET IN COLLABORATION WITH CHRISTUS HEALTH AND INCLUDE METRICS THAT WILL BE USED TO MEASURE COMMUNITY BENEFIT, CLINICAL OUTCOMES, PATIENT SATISFACTION, AND ASSOCIATE ENGAGEMENT. CHRISTUS HEALTH PROVIDES UPDATED MARKET, DEMOGRAPHICS, AND HEALTH INDICATOR DATA ON AN ANNUAL BASIS. THE DATA SUPPLIED FROM CHRISTUS HEALTH ALONG WITH THE SYSTEM WIDE STRATEGIC INITIATIVES ARE CONSISTENT WITH THE COMMUNITY NEEDS ASSESSMENT OF THE REGION. GOOD SHEPHERD HEALTH SYSTEM, IN TURN, PARTNERS WITH OTHER NONPROFIT GROUPS (CHURCHES, HEALTH CARE PROVIDERS, AND GOVERNMENT AGENCIES) TO CREATE COLLABORATIONS WHERE HEALTH NEEDS CAN BE ADDRESSED AND THE GENERAL HEALTH OF INDIVIDUALS AND THE COMMUNITY IS IMPROVED. GOOD SHEPHERD HEALTH SYSTEM OPERATES HOSPITALS IN LONGVIEW AND MARSHALL. IN EACH OF THE COMMUNITIES, THE HOSPITAL OFFERS FREE SCREENINGS TO IDENTIFY EARLY DISEASE, EDUCATIONAL OFFERINGS FEATURING PHYSICIAN SPEAKERS AND CONTINOUSLY PARTICIPATES IN COMMUNITY ACTIVITIES WHERE PREVENTION AND WELLNESS INFORMATION CAN BE SHARED. EFFECTIVE FEBRUARY 1, 2017, CHRISTUS HEALTH ACQUIRED GOOD SHEPHERD HEALTH SYSTEM INC. CHRISTUS HEALTH BECAME THE SOLE CORPORATE MEMBER OF GOOD SHEPHERD HOSPITAL, INC. D/B/A GOOD SHEPHERD MEDICAL CENTER. FORM 990, SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT A COMMUNITY BENEFIT REPORT IS PREPEARED FOR THE HOSPITAL EACH YEAR AND IS SUBMITTED ALONG WITH AN AHA SURVEY TO THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES WITH A COPY PROVIDED TO HARRISON COUNTY AND GREGG COUNTY. true EAST TEXAS BORDER HEALTH CLINIC POBOX 1326 MARSHALL TX 75671 030538912 501(c)(3) 545071 HEALTHCARE SERVICES LONGVIEW WELLNESS CENTER INC 1107 E MARSHALL AVE LONGVIEW TX 75601 752723993 501(C)(3) 38750 HEALTHCARE SERVICES 2 0 SCHEDULE I, PART I, LINE 2 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS AFTER A NEED IS DETERMINED FOR ASSISTANCE, A REQUEST FROM THE SERVICE ORGANIZATION OF GOOD SHEPHERD IS SUBMITTED, IDENTIFYING THE FUNDS NEEDED FOR THE PROGRAM AND/OR PATIENT. THE REQUEST IS REVIEWED AND APPROVED BY THE CFO BEFORE FUNDS ARE TRANSFERRED. A SERVICE LOG IS SUBMITTED TO THE CFO TO DOCUMENT HOURS INCURRED ON PROJECTS AND SUPPORT USE OF FUNDS. true true false false false false false false false VALERIE ALLMAN MD DIRECTOR 0 155386 0 95316 0 1237 0 0 0 9877 0 261816 0 0 STEVE ALTMILLER FORMER GSHS PRESIDENT/CEO 0 71251 0 160000 0 655002 0 2769 0 6840 0 895862 0 171973 RUSSELL J COLLIER PRESIDENT (THRU 1/18) 0 317149 0 0 0 63007 0 8100 0 1623 0 389879 0 47920 KEN CUNNINGHAM SECRETARY 0 332954 0 340000 0 78110 0 35522 0 23140 0 809726 0 51084 TODD HANCOCK GSHS PRESIDENT/CEO 0 402471 0 259095 0 700 0 94801 0 19778 0 776845 0 0 TRUNG NGUYEN MD MEDICAL STAFF VICE PRESIDENT 0 153511 0 25208 0 12312 0 0 0 8785 0 199816 0 0 MICHAEL CHEEK CHIEF FINANCIAL OFFICER 0 280236 0 0 0 16151 0 29202 0 21266 0 346855 0 0 JASON ADAMS CHIEF OPERATING OFFICER 0 418001 0 221213 0 39059 0 73010 0 24032 0 775315 0 0 RAY DELK VP OPERATIONS 0 23531 0 230000 0 254968 0 0 0 9348 0 517847 0 40180 JOHN MCDONALD DO MEDICAL STAFF 0 232864 0 0 0 34401 0 3822 0 6749 0 277836 0 0 RICKY A PAUL MD MEDICAL STAFF PRESIDENT 0 560736 0 57830 0 5785 0 0 0 22163 0 646514 0 0 LARRY VERFURTH DO CMO(THRU 8/18) 0 240647 0 345100 0 18046 0 0 0 28513 0 632306 0 40344 DUSTIN MCDERMOTT CRNA 65462 0 264050 0 132000 0 0 0 12675 0 474187 0 0 0 RICHARD L HOLLADAY CRNA 276050 0 0 0 53319 0 0 0 4135 0 333504 0 0 0 LEE A HOLLADAY CRNA 269178 0 0 0 38244 0 0 0 13542 0 320964 0 0 0 ZACKARY G LISTER CRNA 262566 0 0 0 29796 0 470 0 10039 0 302871 0 0 0 ROGER C BRYANT JR CRNA 259186 0 0 0 19819 0 4189 0 7744 0 290938 0 0 0 Schedule J, Part I, Line 3 EXPLANATION OF RELATED ORGANIZATION DETERMINING EXECUTIVE DIRECTOR COMPENSATION THE FILING ORGANIZATION'S PRESIDENT/CEO IS AN EMPLOYEE OF CHRISTUS HEALTH, A RELATED ORGANIZATION. AS A RESULT, COMPENSATION IS ESTABLISHED AT THE CHRISTUS HEALTH LEVEL AND THE FILING ORGANIZATION DOES NOT HAVE A ROLE IN IMPLEMENTING THE METHODS USED TO ESTABLISH COMPENSATION OR IN DETERMINING THE PRESIDENT/CEO COMPENSATION. CHRISTUS HEALTH USES AN EXECUTIVE COMPENSATION COMMITTEE TO ESTABLISH AND APPROVE THE COMPENSATION OF THE FILING ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. THIS COMMITTEE USES AN INDEPENDENT COMPENSATION CONSULTANT WHO PERFORMS BI-ANNUAL COMPENSATION SURVEY. FORM 990, SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS: STEVE ALTMILLER $325,000 RAY DELK $ 92,885 Schedule J, Part I, Line 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN DESCRIBED IN 457(F): INDIVIDUALS: PAYMENT IN W-2: DEFERRED COMPENSATION: STEVE ALTMILLER $171,973 $ 2,769 KEN CUNNINGHAM $ 51,084 $35,522 JASON ADAMS NONE $73,010 MICHAEL CHEEK NONE $29,202 RUSSELL J. COLLIER $ 47,920 $ 8,100 RAY DELK $ 40,180 NONE TODD HANCOCK NONE $94,801 JOHN MCDONALD NONE $ 3,822 LARRY VERFURTH $ 40,344 NONE COMPENSATION REPORTED AS DEFERRED IN A PRIOR FORM 990 DEFERRED COMPENSATION INCLUDES EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, AND PENSION RESTORATION PLAN. ESTIMATED PENSION BENEFITS WERE CALCULATED BASED ON THE PROVISIONS OF THE CURRENT PENSION RESTORATION PLAN AT 6% OF PENSIONABLE EARNINGS WHICH ARE OVER THE IRS LEGISLATIVE COMPENSATION LIMIT. SOME ASSOCIATES ARE GRANDFATHERED UNDER AN EARLIER LEGACY PENSION PLAN. IF A PARTICIPANT HAS PROTECTED PENSION BENEFITS UNDER SUCH LEGACY PLANS, HIS/HER PERCENTAGE IS ZERO UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, AS THE PROTECTED BENEFIT IS ALREADY EQUAL TO OR BETTER THAN CURRENT MARKET. SUPPLEMENTAL COMPENSATION INFORMATION FORM 990, SCHEDULE J, PART II W-2 COMPENSATION MAY INCLUDE PAYMENTS RELATED TO COMPENSATION DEFERRED IN PRIOR YEARS. DEFERRED COMPENSATION MAY INCLUDE DEFERRALS OF CURRENT YEAR COMPENSATION UNDER EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN AND PENSION RESTORATION PLAN. SUPPLEMENTAL COMPENSATION INFORMATION FORM 990, SCHEDULE J, PART II, COLUMN B (II) BONUS AND INCENTIVE COMPENSATION MAY INCLUDE AMOUNTS THAT WERE DEFERRED IN A PRIOR YEAR BUT PAID OUT IN CALENDAR YEAR 2017. DEFERRED COMPENSATION FORM 990, SCHEDULE J, PART II, COLUMN C DEFERRED COMPENSATION INCLUDES EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, EMPLOYER CONTRIBUTION TO 403(B) MATCHED SAVINGS PLAN, PENSION RESTORATION PLAN AND ESTIMATED PENSION BENEFITS UNDER CHRISTUS HEALTH CASH BALANCE PLAN. ESTIMATED PENSION BENEFITS WERE CALCULATED BASED ON THE PROVISIONS OF THE CURRENT CASH BALANCE PLAN AT 6% OF PENSIONABLE EARNINGS. SOME ASSOCIATES ARE GRANDFATHERED UNDER AN EARLIER PENSION PLAN. THESE GRANDFATHERED PARTICIPANTS, BASED ON COMPUTATION AT THE TIME OF THEIR RETIREMENT, WILL RECEIVE THE LARGER OF THE RETIREMENT BENEFIT COMPUTED UNDER THE CASH BALANCE PLAN COMPARED TO THE PREVIOUS PENSION PLAN. DUE TO THE COMPLEXITY OF CALCULATING AN ACCURATE BENEFIT COST FOR GRANDFATHERED PARTICIPANTS, THE FORM 990 REPORTS AS PENSION BENEFITS THEIR ANNUAL ESTIMATED CASH BALANCE PLAN ACCRUAL. A HARRISON COUNTY HEALTH FACILITIES DEVELOPMENT 752740093 415221AW0 2010-09-22 43980049 REFUND ESCROWS & CAPITAL PROJECTS false false false B GREGG COUNTY HEALTH FACILITIES DEVELOPMENT 751865828 39753MFFO 2012-09-05 33033015 CAPITAL IMPROVEMENTS false false false C GREGG COUNTY HEALTH FACILITIES DEVELOPMENT 751865828 39753MDT2 2015-02-01 88000000 REFINANCING false false false D GREGG COUNTY HEALTH FACILITIES DEVELOPMENT 751865828 39753MDU9 2006-11-08 99276418 ADVANCE REFUNDING OF BONDS false false false A 2005000 0 43980049 3077293 0 31331629 879600 0 0 8691527 0 0 2013 true false false true B 315000 0 33033015 2176874 0 8338548 660660 0 14045280 0 0 7811653 2014 false true false true C 77682622 0 87286972 8800000 0 804350 0 0 0 0 0 0 2015 false true false true D 1335000 0 99276418 0 0 96480044 636501 2159873 0 0 0 0 2012 false true true true A false false false false 0 false false false false B false false false false 0 false false false false C false false false false 0 false false false false D false false false false 0 false false false false A false false false true false false 0 false 0 false false B false true false false false false 0 false 0 false false C false true false false false false 0 false 0 false false D false false false true false false 0 false 0 false false A false B true C true D true SCHEDULE K, PART I, BOND ISSUES (A) THE ISSUER NAME: HARRISON COUNTY HEALTH FACILITIES DEVELOPMENT CORPORATION (F) DESCRIPTION OF PURPOSE: REFUND ESCROWS, CAPITAL PROJECTS AND IMPROVEMENTS SCHEDULE K, PART IV, ARBITRAGE, LINE 2C: (A) ISSUER NAME: HARRISON COUNTY HEALTH FACILITIES DEVELOPMENT CORPORATION DATE THE REBATE COMPUTATION WAS PERFORMED: 08/01/2015 X VITAL MONITORS 48 288518 FAIR VALUE false true false SCHEDULE M, PART I, COLUMN (B) THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN COLUMN (B). FORM 990, PART I, ITEM C DOING BUSINESS AS CHRISTUS GOOD SHEPHERD MEDICAL CENTER OPERATES UNDER THE FOLLOWING NAMES: ACUITY DIAGNOSTICS CARE DIRECT CENTER FOR INNOVATIVE LEARNING CHAMPION EMS-GOOD SHEPHERD MEDICAL CENTER CHRISTUS GOOD SHEPHERD BREAST CENTER GOOD SHEPHERD FRESH EXPRESS CHRISTUS GOOD SHEPHERD HEALTHY LIVING SPA GOOD SHEPHERD INSTITUTE FOR HEALTHY LIVING GOOD SHEPHERD MEDICAL CENTER CHRISTUS GOOD SHEPHERD MEDICAL CENTER LONGVIEW CHRISTUS GOOD SHEPHERD MEDICAL CENTER MARSHALL CHRISTUS GOOD SHEPHERD SURGERY CENTER GOOD SHEPHERD NORTH PARK BREAST SCREENING GOOD SHEPHERD NORTH PARK EMERGENCY DEPARTMENT GOOD SHEPHERD OCCUPATIONAL MEDICINE GOOD SHEPHERD PERFORMANCE REHABILITATION JOINT WORKS MARSHALL LIFE CENTER MEDICAL SIMULATION CENTER OF EAST TEXAS TAYLOER MEDICAL CENTER THE NEUROLOGICAL INSTITUTE AT GOOD SHEPHERD FORM 990, PART VI, SECTION A, LINE 1A DELEGATION OF AUTHORITY THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION BETWEEN MEETINGS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 2 RICHARD HOLLADAY AND LEE ALLEN HOLLADAY HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS THE SOLE MEMBER OF THE ORGANIZATION IS GOOD SHEPHERD HEALTH SYSTEM,INC. FORM 990, PART VI, SECTION A, LINE 7A GOOD SHEPHERD HEALTH SYSTEM, INC., THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION, HAS THE POWER TO APPOINT ALL MEMBERS OF THE FILING ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, LINE 7B DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS A NUMBER OF DECISIONS OF THE ORGANIZATION ARE SUBJECT TO APPROVAL OF THE MEMBER OF THE ORGANIZATION. THESE RESERVED POWERS ARE STATED BELOW: A. THE APPOINTMENT OF ONE MEMBER OF THE ORGANIZATIONS BOARD OF DIRECTORS, AND THE APPROVAL OF THE REMAINING DIRECTORS FOLLOWING THE NOMINATION PROCESS AND SUBJECT TO THE PROVISIONS GOVERNING STAFF DIRECTOR; B. THE REMOVAL OF A MEMBER OF THE ORGANIZATIONS BOARD AND ALSO THE APPROVAL OF REMOVAL AND APPOINTMENTS TO FILL VACANCIES ON THE BOARD AND SET THE SIZE OF THE BOARD; C. APPROVE THE ELECTION AND REMOVAL OF OFFICERS OF THE ORGANIZATION AND ESTABLISH, TERMINATE, AND/OR REVISE ALL EMPLOYMENT CONTRACTS, COMPENSATION, AND BENEFIT PACKAGES OF THE OFFICERS OF THE ORGANIZATION REGARDLESS OF WHICH ENTITY ACTUALLY PAYS SUCH COMPENSATION OR BENEFITS; D. DESIGNATE THE FISCAL YEAR; E. APPROVE THE SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, OUTSIDE GENERAL LEGAL COUNSEL, AND OUTSIDE INVESTMENT ADVISORS; F. AMEND THE ARTICLES OF INCORPORATION; G. APPROVE ALL MERGERS, ACQUISITIONS, CONSOLIDATIONS, OR AFFILIATIONS WITH OTHER ENTITIES, THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE SALE, MORTGAGE, OR ENCUMBRANCE OF ANY REAL PROPERTY OWNED BY THE CORPORATION; H. APPROVE THE DISSOLUTION OR LIQUIDATION OF THE ORGANIZATION; I. APPROVE CAPITAL PLANS, STRATEGIC PLANS, AND ANNUAL OPERATING AND CAPITAL BUDGETS; J. APPROVE ANY EXCEPTION TO THE CAPITAL BUDGET FOR A SINGLE ITEM OR RELATED ITEM THAT EXCEEDS $100,000 AND/OR APPROVE ANY AGGREGATE ANNUAL EXPENDITURES THAT EXCEEDS THE BUDGET BY $50,000; K. SELECT OFFICIAL DEPOSITORIES FOR THE ORGANIZATIONS FUNDS; L. CREATE OR INVEST IN ANY SUBSIDIARY ENTITY OR ENTER INTO ANY PARTNERSHIP OR JOINT VENTURE; M. AUTHORIZE ANY LOANS, GUARANTEES, OR INCURRENCE OF DEBT; N. AUTHORIZE THE COMMENCEMENT OF ANY LITIGATION OR OTHER LEGAL PROCEEDING, OR THE SETTLEMENT, DISPOSITION, OR TERMINATION OF ANY SUCH LITIGATION OR OTHER LEGAL PROCEEDING OR OF ANY CLAIM OR THREAT OF LITIGATION OR OTHER LEGAL PROCEEDING NOT FULLY COVERED BY INSURANCE; AND O. APPROVE THE ADMISSION OF ADDITIONAL MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990 THE FORM 990 IS PREPARED AND REVIEWED BY THE ORGANIZATIONS EXTERNAL INDEPENDENT ACCOUNTANTS. THE CHRISTUS HEALTH ACCOUNTING DEPARTMENT WORKS WITH AN EXTERNAL ACCOUNTING FIRM IN PREPARATION AND REVIEW OF THE FORM 990. THE FILING ORGANIZATIONS CFO, OR OTHER DESIGNEE, REVIEWS THE FORM 990. THE FINAL FORM 990 THAT WILL BE FILED WITH THE IRS IS POSTED TO A SECURE INTERNET PORTAL FOR ALL MEMBERS OF THE BOARD OF DIRECTORS TO VIEW. REVIEW OF THE FINAL FORM 990 OCCURS PRIOR TO FILING WITH THE IRS IN THE SUMMER 2019 VIA EITHER MEETING, CONFERENCE CALL OR WEB PORTAL POLLING TOOL BY THE RESPECTIVE CHRISTUS ORGANIZATIONS BOARD, BASED ON A SET OF SUGGESTED REVIEW PROCESSES DEVELOPED BY CHRISTUS HEALTH. FORM 990, PART VI, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST AT THE END OF EACH CALENDAR YEAR, THE CHRISTUS HEALTH CORPORATE SECRETARY DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE TO ALL OF THE ORGANIZATION'S BOARD AND COMMITTEE MEMBERS FOR COMPLETION PRIOR TO THE 1ST OF JANUARY IN THE NEXT YEAR. THE CORPORATE SECRETARY THOROUGHLY REVIEWS ALL COMPLETED AND EXECUTED CONFLICT OF INTEREST QUESTIONNAIRE FORMS TO ENSURE ACCURACY AND THAT NO POTENTIAL OR IDENTIFIED CONFLICT IS DISCLOSED OR EXISTS. THE ORGANIZATION'S BOARD OF DIRECTORS IS RESPONSIBLE FOR ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY OF THE ORGANIZATION. FORM 990, PART VI, LINE 15A COMPENSATION DETERMINATION PROCESS THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION IS PAID BY A RELATED ORGANIZATION; THEREFORE, THE FILING ORGANIZATION WAS NOT INVOLVED IN THE PROCESS OF DETERMINING COMPENSATION FOR THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION. THE RELATED ORGANIZATION DETERMINES THE COMPENSATION OF THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION BY USE OF AN INDEPENDENT AND EXTERNAL CONSULTANT. THE CONSULTANT HELPS DETERMINE PAY RATES FOR THE ASSOCIATES OF THE RELATED ORGANIZATION, TAKING INTO ACCOUNT MARKET DATA AND SHIFT DIFFERENTIAL. THE COMPENSATION RATES ARE APPROVED BY THE RELATED ORGANIZATION. BASED ON THE AFOREMENTIONED PROCEDURE, THE EXECUTIVE DIRECTOR'S COMPENSATION IS NOT REVIEWED BY A COMPENSATION COMMITTEE. THE EXECUTIVE DIRECTOR'S SALARY IS SPLIT BETWEEN THE FILING ORGANIZATION AND THE RELATED ORGANIZATION. FORM 990, PART VI, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CHRISTUS HEALTH ARE MADE AVAILABLE TO THE PUBLIC VIA THE CHRISTUS HEALTH WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART X THE GOOD SHEPHERD HOSPITAL, INC., ALSO DOING BUSINESS AS CHRISTUS GOOD SHEPHERD MEDICAL CENTER LONGVIEW (CGSMC - LONGVIEW), IS ONE OF TWO CAMPUSES DELIVERING QUALITY HEALTHCARE SERVICES TO THE PEOPLE OF NORTHEAST TEXAS. CHRISTUS GOOD SHEPHERD MEDICAL CENTER - MARSHALL (CGSMC MARSHALL) IS THE OTHER CAMPUS. EFFECTIVE SEPTEMBER 1, 2017 AND THROUGHOUT THE FISCAL YEAR ENDED 09/30/18, THE COMBINED CAMPUSES OPERATED UNDER A SINGLE STATE HOSPITAL LICENSE #000020 HELD BY CGSMC MARSHALL. AS A RESULT OF THE CHANGE OF STATE LICENSURE, THE ACTIVITIES FOR CGSMC LONGVIEW ARE NOW BEING REPORTED UNDER CGSMC MARSHALL'S FEDERAL EMPLOYER IDENTIFICATION NUMBER (EIN) 75-0974351 FOR TAX FILING PURPOSES. THEREFORE ALL REVENUE, EXPENSES AND BALANCE SHEET AMOUNTS INCLUDING SCHEDULE H REPORTING ARE REPORTED ON CGSMC MARSHALL'S 2017 FORM 990. THE CGSMC LONGVIEW FEDERAL EIN 75-1041154 IS STILL OPEN, BUT NO ACTIVITY WILL BE REPORTED UNDER THIS FEDERAL EIN. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS CONTRIBUTED CAPITAL $17,031,507 PURCHASE PRICE ADJUSTMENT $ 614,740 INVESTMENT IN FOUNDATION (UNRESTRICTED) $ 387,799 TEMPORARY RESTRICTED CONTRIBUTIONS $ 18,937 INVESTMENT IN FOUNDATION (RESTRICTED) ($ 1,920) K-1 INCOME ($ 57,304) TRANSFER OF ASSETS FROM THE GOOD SHEPHERD HOSPITAL, INC. ($71,322,837) ---------- TOTAL -$53,329,078 FORM 990 PART IX LINE 11G DESCRIPTION:PHYISICIAN FEES TOTAL FEES:25491190 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:3758582 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE SERVICES TOTAL FEES:1428198 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER TOTAL FEES:13564985 MARSHALL HEALTH SERVICES INC 700 E MARSHALL AVE LONGVIEW TX 75601 752580686 HEALTHCARE TX 501(c)(3) 3 GSMC MARSH true MARSHALL HOSPITAL FOUNDATION 811 S WASHINGTON AVE MARSHALL TX 75670 752605699 SUPPORT TX 501(c)(3) 7 GSMC MARSH true THE GOOD SHEPHERD HOSPITAL INC 700 E MARSHALL AVE LONGVIEW TX 75601 751041154 HEALTHCARE TX 501(c)(3) 3 GSHS INC true GSHS ADMINISTRATIVE SERVICES ORG INC 700 E MARSHALL AVE LONGVIEW TX 75601 861132471 ADMIN SUPPORT TX 501(c)(3) 12A GSHS INC true GOOD SHEPHERD MEDICAL CENTER - LINDEN I 404 N KAUFMAN STREET LINDEN TX 75563 010829282 HEALTHCARE TX 501(c)(3) 3 GSHS INC true GSMC - LINDEN FOUNDATION INC 404 N KAUFMAN STREET LINDEN TX 75563 200845127 SUPPORT TX 501(c)(3) 12a GSMC LINDE true CHRISTUS HEALTH 919 HIDDEN RIDGE DRIVE IRVING TX 75038 760590551 SUPT HLTH SVC TX 501(c)(3) 10 NA false GOOD SHEPHERD FOUNDATION 700 E MARSHALL AVE LONGVIEW TX 75601 752056700 SUPPORT TX 501(c)(3) 12A GSMC true GOOD SHEPHERD HEALTH SYSTEM INC 700 E MARSHALL AVE LONGVIEW TX 75601 752027157 SUPPORT GSMC TX 501(c)(3) 12B CH false GSHS CUSTOMER SERVICE BUILDING I LTD 700 E MARSHALL AVE LONGVIEW TX 75601 020636726 CUSTOMER SERVICE TX GSHS INC false GSHS ENTERPRISES INC 700 E MARSHALL AVE LONGVIEW TX 75601 752027162 HEALTHCARE TX GSHS INC C Corp true GS PHYSICIAN SERVICES INC 700 E MARSHALL AVE LONGVIEW TX 75601 752762417 MEDICAL SERVICES TX GSHS ENTERPRISE C Corp true MARSHALL PHYSICIAN HOSPITAL ORGANIZATION 700 E MARSHALL AVE LONGVIEW TX 75601 752580689 INACTIVE TX GSMC MARSHALL C Corp 0 11630 1.00000 true GSHS CUSTOMER SERVICE BUILDING LLC 700 E MARSHALL AVE LONGVIEW TX 75601 710896055 CUSTOMER SERVICES DE GSHS INC LLC true false false true false false false false false false false false true false false true true true false false CHRISTUS TRINITY MOTHER FRANCIS L 11377165 ACTUAL CHRISTUS TRINITY MOTHER FRANCIS O 574265 ACTUAL CHRISTUS TRINITY MOTHER FRANCIS Q 84026 ACTUAL GOOD SHEPHERD FOUNDATION C 61994 ACTUAL SCHEDULE R, PART III GSHS CUSTOMER SERVICE BUILDING I, LTD. EIN: 02-0636726 ADDRESS: 700 E. MARSHALL AVE., LONGVIEW, TX 75601