TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE (EIN 75-1748586)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-12
- IRS object ID
- 201813169349302651
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-12T09:15:57-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 751748586 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Texas Health Harris Methodist Hospital Azle | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DAVID JACKSON | InCareOfNm |
| Business Name Control | TEXA | BusinessNameControlTxt |
| Phone | 8174448600 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 108 Denver Trail | AddressLine1Txt |
| City | Azle | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76020 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID JACKSON | PersonNm |
| Person Title | Assistant Secretary | PersonTitleTxt |
| Phone | 6822367900 | PhoneNum |
| Signature | 2018-11-12 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 12.50.9.252 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 80738820183165000002 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2018-11-12 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 55E137C1C0FE766D765F7634C8846E5029CDF457 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 631EFFC3DBC3CC1ECF1FA4DC9E140E0EB9698683 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Bob Ellzey | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 108 Denver Trail | AddressLine1Txt |
| City | Azle | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76020 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $34,286,411 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.texashealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1954 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | A faith-based organization whose mission is to improve the health of the people in the communities it serves regardless of one's ability to pay. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 309 | TotalEmployeeCnt |
| Total Volunteers | 70 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $242,501 | PYContributionsGrantsAmt |
| CY Contributions Grants | $84,300 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $33,901,291 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $33,945,280 | CYProgramServiceRevenueAmt |
| PY Investment Income | $159 | PYInvestmentIncomeAmt |
| CY Investment Income | $7,647 | CYInvestmentIncomeAmt |
| PY Other Revenue | $236,973 | PYOtherRevenueAmt |
| CY Other Revenue | $209,829 | CYOtherRevenueAmt |
| PY Total Revenue | $34,380,924 | PYTotalRevenueAmt |
| CY Total Revenue | $34,247,056 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,271,052 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,288,430 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $19,233,357 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $19,473,494 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,830,097 | PYOtherExpensesAmt |
| CY Other Expenses | $16,744,520 | CYOtherExpensesAmt |
| PY Total Expenses | $36,334,506 | PYTotalExpensesAmt |
| CY Total Expenses | $37,506,444 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,953,582 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,259,388 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,441,103 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,683,494 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,263,465 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,151,676 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$3,822,362 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,531,818 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | A FAITH-BASED ORGANIZATION WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES IT SERVES REGARDLESS OF ONE'S ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $29,608,131 | ExpenseAmt |
| Grant | $1,288,430 | GrantAmt |
| Revenue | $33,945,280 | RevenueAmt |
| Desc | Texas Health Harris Methodist Hospital Azle (THAZ) is 36 licensed bed community based hospital serving Azle, Lake Worth, Springtown and the surrounding areas. Since 1954, THAZ has provided quality health care services to the northwest Tarrant County community. Located in Azle, the hospital offers many services such as cardiovascular, imaging, inpatient/outpatient surgery, Outpatient Sports and Rehabilitation Center and an intensive care unit.During the year, THAZ had 4,636 patient days, 1,468 discharges, 31,940 outpatient encounters and 23,681 emergency room visits. THAZ provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. The hospital provides care to persons covered by governmental programs including Medicare and Medicaid for reimbursement that does not always cover the cost of providing the care. Recognizing its mission to the community, services are provided to both financially indigent and medically indigent patients. Community benefit is provided through many reduced price services and free programs to the community. These services are essential to provide complete healthcare to the communities served. Some of these programs include: Various health screenings were offered to the community free of charge or for a nominal charge such as diabetes and breast cancer. THAZ participated in community education regarding good hand hygiene to promote awareness of proper hand washing in an effort to slow the spread of infection and disease. In the Better Living through Improved Fitness and Education (L.I.F.E.) program senior adults are encouraged to focus on improving their health with a range of physical activities, health education and screenings. THAZ provided healthy eating for children classes, smoking cessation classes and community health support groups. | Desc |
| Total Program Service Expenses | $29,608,131 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 39 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 309 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID JACKSON | PersonNm |
| Phone | 6822367900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 612 E LAMAR BLVD | AddressLine1Txt |
| City | Arlington | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76011 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Anderson Tanya Layne | |||||||||
| Vice Chair | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Braudis Russell Paul | |||||||||
| Chair | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Brownback Paul | |||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Buckel Robert W | |||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Cullen Robert J | |||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Cusano Gregory | |||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Dunn Leah | |||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Haas Anthony J | |||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Miller Keegan | |||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Niles Richard K | |||||||||
| Trustee | 2.0 | 40.0 | Yes (X) | $0 | $362,673 | $44,955 | |||
| Standefer Thomas Bishop | |||||||||
| Trustee | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Berenzweig Harold K | |||||||||
| THR Corporate Officer | 0.5 | 40.0 | $0 | $884,585 | $150,380 | Yes (X) | |||
| Cantu Stacy G | |||||||||
| Corporate Secretary | 0.5 | 40.0 | $0 | $246,920 | $42,204 | Yes (X) | |||
| King James Kirk | |||||||||
| THR Corporate Officer | 0.5 | 40.0 | $0 | $905,686 | $157,562 | Yes (X) | |||
| Kramer Kenneth J | |||||||||
| Assistant Secretary | 0.5 | 40.0 | $0 | $866,539 | $162,826 | Yes (X) | |||
| Krejci Jacque D | |||||||||
| Assistant Secretary | 0.5 | 40.0 | $0 | $182,509 | $35,222 | Yes (X) | |||
| McWhorter Ricky E | |||||||||
| Assistant Secretary | 0.5 | 40.0 | $0 | $662,520 | $192,700 | Yes (X) | |||
| Ellzey Bob S | |||||||||
| President THAZ | 40.0 | 0.0 | $317,389 | $0 | $77,865 | Yes (X) | |||
| Gilbert Valarie G | |||||||||
| Chief Nursing Officer THAZ | 40.0 | 0.0 | $227,560 | $0 | $37,777 | Yes (X) | |||
| Dollahite Harry Anderson | |||||||||
| CMO THAZ | 0.0 | 40.0 | $0 | $352,106 | $48,780 | Yes (X) | |||
| Miland Stephanie | |||||||||
| Grp Fin Off THFW-THC-THAZ-THSH | 4.6 | 35.4 | $0 | $351,460 | $60,912 | Yes (X) | |||
| Ward Vanessa | |||||||||
| PHARMACIST | 40.0 | 0.0 | $154,052 | $0 | $27,731 | Yes (X) | |||
| Shuffield Elizabeth Suzanne | |||||||||
| DIR PHARMACY | 40.0 | 0.0 | $152,818 | $0 | $7,726 | Yes (X) | |||
| Blessing Brian Bradley | |||||||||
| DIR SR QUAL/PT SF/RSK/SPRT SVC | 40.0 | 0.0 | $141,140 | $0 | $61,420 | Yes (X) | |||
| Fonville Mary V | |||||||||
| PROFESSIONAL SVCS OFFICER THAZ | 40.0 | 0.0 | $140,239 | $0 | $52,859 | Yes (X) | |||
| Edwards Connie Beck | |||||||||
| DIR REHAB SVC | 40.0 | 0.0 | $132,552 | $0 | $26,798 | Yes (X) | |||
| Berdan Barclay E | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $2,297,506 | $326,466 | Yes (X) | |||
| Mitchell John D | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $557,585 | $101,281 | Yes (X) | |||
| Canose Jeffrey L | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $1,483,682 | $206,035 | Yes (X) | |||
| Humphrey Richard I | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $428,323 | $52,979 | Yes (X) | |||
| DeSio Terri Alice | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $233,022 | $45,894 | Yes (X) | |||
| Laviolette Judy D | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $489,382 | $48,986 | Yes (X) | |||
| Stout Luanne R | |||||||||
| Assistant Secretary | 0.0 | 0.0 | $0 | $104,371 | $8,709 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,265,750 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $10,408,869 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,978,067 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Texas Health Resources | |||||
| 612 E Lamar Blvd | ARLINGTON | TX | 76011 | Management Fees | $6,626,515 |
| Texas Health Physicians Group | |||||
| 9229 LBJ Freeway | DALLAS | TX | 75243 | Physician Services | $1,130,567 |
| Northstar Anesthesia PA | |||||
| 6225 North State Hwy 161 200 | IRVING | TX | 75038 | anesthesia coverage | $501,789 |
| Careflite | |||||
| 3110 S Great Southwest Parkwary | GRAND PRAIRIE | TX | 75052 | ambulance services | $180,818 |
| Shared Imaging LLC | |||||
| 801 Phoenix Lake Ave | STREAMWOOD | IL | 60107 | imaging services | $114,432 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $84,300 | RelatedOrganizationsAmt |
| Total Contributions | $84,300 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $32,246,815 | $32,246,815 | $0 |
| DSRP REVENUE | 622110 | $1,497,968 | $1,497,968 | $0 |
| MEDICARE/MEDICAID ADJUSTMENT | 622110 | $127,017 | $127,017 | |
| EDUCATION | 624190 | $73,480 | $73,480 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $33,945,280 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $79,564 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $79,564 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $79,564 | TotalRevenueColumnAmt |
| Exclusion | $79,564 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $47,002 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $39,355 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,647 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,647 | TotalRevenueColumnAmt |
| Exclusion | $7,647 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 722514 | $122,016 | $122,016 |
| VENDING | 454210 | $7,985 | $7,985 |
| MEDICAL RECORDS | 622110 | $264 | $264 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $130,265 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,247,056 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,945,280 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $217,476 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,288,430 | TotalAmt |
| Program Services | $1,288,430 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $626,022 | TotalAmt |
| Management And General | $626,022 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,975,953 | TotalAmt |
| Program Services | $14,605,007 | ProgramServicesAmt |
| Management And General | $370,946 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $613,441 | TotalAmt |
| Program Services | $613,441 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,196,393 | TotalAmt |
| Program Services | $2,196,393 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,061,685 | TotalAmt |
| Program Services | $1,036,404 | ProgramServicesAmt |
| Management And General | $25,281 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,626,515 | TotalAmt |
| Management And General | $6,626,515 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,616 | TotalAmt |
| Program Services | $3,616 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,666,200 | TotalAmt |
| Program Services | $2,607,046 | ProgramServicesAmt |
| Management And General | $59,154 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,930 | TotalAmt |
| Program Services | $14,411 | ProgramServicesAmt |
| Management And General | $519 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,034 | TotalAmt |
| Program Services | $210,779 | ProgramServicesAmt |
| Management And General | $39,255 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,037 | TotalAmt |
| Program Services | $193,577 | ProgramServicesAmt |
| Management And General | $4,460 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $541,835 | TotalAmt |
| Program Services | $413,342 | ProgramServicesAmt |
| Management And General | $128,493 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,567 | TotalAmt |
| Program Services | $20,588 | ProgramServicesAmt |
| Management And General | $979 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,277 | TotalAmt |
| Program Services | $22,404 | ProgramServicesAmt |
| Management And General | $2,873 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,228 | TotalAmt |
| Program Services | $290,228 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,490,065 | TotalAmt |
| Program Services | $1,483,677 | ProgramServicesAmt |
| Management And General | $6,388 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,820 | TotalAmt |
| Program Services | $258,820 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $3,029,612 | $3,029,612 | $0 |
| PATIENT SERVICES | $696,648 | $696,648 | |
| REPAIRS & MAINTENANCE | $353,396 | $353,396 | |
| FURNITURE & EQUIPMENT | $106,739 | $104,554 | $2,185 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,001 | TotalAmt |
| Program Services | $165,758 | ProgramServicesAmt |
| Management And General | $5,243 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,506,444 | TotalAmt |
| Program Services | $29,608,131 | ProgramServicesAmt |
| Management And General | $7,898,313 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$55,742 | BOYAmt |
| EOY | $89,361 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,286,079 | BOYAmt |
| EOY | $4,934,449 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $549,006 | BOYAmt |
| EOY | $619,770 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,183 | BOYAmt |
| EOY | $29,907 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $22,478,579 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,248,384 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,609,577 | BOYAmt |
| EOY | $8,230,195 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $779,812 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,441,103 | BOYAmt |
| EOY | $14,683,494 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,856,394 | BOYAmt |
| EOY | $3,075,070 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $789,076 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,407,071 | BOYAmt |
| EOY | $287,530 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,263,465 | BOYAmt |
| EOY | $4,151,676 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,822,362 | BOYAmt |
| EOY | $10,531,818 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,822,362 | BOYAmt |
| EOY | $10,531,818 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,441,103 | BOYAmt |
| EOY | $14,683,494 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,259,388 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $17,613,568 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | Yes (true) | VolunteersInd |
| Paid Staff Or Management | Yes (true) | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | Yes (true) | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B - Additional Information | FormAndLineReferenceDesc |
| Explanation | Officers and/or Board Members of the corporation may, to an insubstantial degree, make comments or statements concerning legislation that may affect either the healthcare industry or the health status of the communities the Corporation serves. In pursuing this activity, Officers and/or Board Members may engage in conversations and/or write letters to various federal, state, and local officials regarding such matters on a personal level, and not as a representative of the organization. The amount of time and money involved in these activities is negligible. In no case has either the Corporation, or any person acting on behalf of the Corporation, intervened in any political campaign. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $145,333 | OtherCostOrOtherBasisAmt |
| Book Value | $145,333 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,041,089 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,078,020 | DepreciationAmt |
| Book Value | $3,963,069 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $460,955 | OtherCostOrOtherBasisAmt |
| Depreciation | $287,237 | DepreciationAmt |
| Book Value | $173,718 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,629,827 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,883,126 | DepreciationAmt |
| Book Value | $3,746,701 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $201,374 | OtherCostOrOtherBasisAmt |
| Book Value | $201,374 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,230,195 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | GOVERNMENT PROGRAM FUNDS | Desc |
| Book Value | $779,812 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $779,812 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ASSET RETIREMENT OBLIGATIONS | Desc |
| Amt | $287,530 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $287,530 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 500. | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,646,282 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $315,356 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,330,926 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16880 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,737,004 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,333,510 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $403,494 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01080 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $40,920 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,427 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,493 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,424,206 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,663,293 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,760,913 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18030 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $536,741 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $61,863 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $474,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01270 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,305,316 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,305,316 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03480 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,842,057 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $61,863 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,780,194 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04750 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,266,263 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,725,156 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,541,107 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.22780 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,970 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,970 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,970 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,970 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,803,409 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $5,704,879 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,611,269 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,906,390 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Texas Health Azle | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 108 Denver Trail | AddressLine1Txt |
| City | Azle | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76020 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.texashealth.org | WebsiteAddressTxt |
| State License | TDH #469 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Texas Health Azle | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www/texashealth.org/chna | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.texashealth.org/chna | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 500. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Section C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Texas Health Azle | FormAndLineReferenceDesc |
| Explanation | Part V. Section B, Line 3e The CHNA contains a prioritized description of the significant health needs of the community as identified through the CHNA. Part V. Section B, Line 5 Texas Health Azle's (THAZ) Community Health Needs Assessment (CHNA) was a one-year collaborative process which utilized qualitative and quantitative data to assess the health needs of persons in the communities served by the hospital. As a means to further understand the needs of the community, THAZ gathered feedback through key informant interviews conducted between 12/18/2015 and 1/29/2016, focus group discussions and an online community survey. Key informants and focus group participants included, but were not limited to: faith community representatives, public health officials, lay community members, school officials and city administration. Thirteen persons with interests specific to the health of THAZ's community participated in a focus group, five served as key informants and 63 individuals responded to the online survey. The online survey was conducted only in English. While the online survey may not have reached the medically underserved, low-income or minority populations directly, organizations serving those populations were present at the focus group and served as key informants; these organizations included: Azle Dental Care; Azle Independent School District; Parker County Center of Hope, a nonprofit dedicated to helping others break the cycle of poverty; the City of Azle Fire Department; Community Caring Center of Azle; Eagle Mountain Family Dentistry; Laura's Pharmacy; and Tarrant County Public Health. In order to gain a comprehensive understanding of the significant health needs for THAZ's service area, the findings from all three data sets (secondary data, interviews and focus groups, and the online community survey) were compared and studied together. The top five to seven health needs identified by each data source were analyzed for areas of overlap with the other two data sources. Health needs were determined to be significant if they were cited as a top need in at least two of the three data sources. Part V. Section B, Line 11 Following a CHNA conducted in 2016, THAZ adopted an implementation strategy in May 2017. THAZ is part of the Texas Health healthcare system (Texas Health), which developed a system-wide community benefit strategy to leverage internal and external resources and increase its ability to impact community health needs. The significant health needs across the Texas Health system were: 1. Mental Health & Substance Abuse 2. Exercise, Nutrition, & Weight 3. Access to Health Services and Healthcare Navigation & Literacy From 2017-2019, THAZ has committed to implement strategies and activities aimed at addressing these areas. Mental Health & Substance Abuse is categorized as Behavioral Health; Exercise, Nutrition, & Weight is grouped under Chronic Disease, which has been a strategic area of focus for Community Health Improvement since the 2013 CHNA; and Access to Health Services and Healthcare Navigation & Literacy is jointly titled Awareness, Health Literacy, & Navigation. In 2017, Texas Health Azle addressed significant health needs with the following approaches: 1. Behavioral Health 1a. Explored opportunities for new system-wide behavioral health community program. 1b. Managed and strengthened Delivery System Reform Incentive Payment (DSRIP) programs under the Medicaid 1115 Waiver to continue partnership with counseling center to address depression in HELP clinic patients. 2. Chronic Disease Prevention & Management 2a. Continued implementation of evidence-based chronic disease self-management programs in partnership with the Community Council of Greater Dallas/Area Agency on Aging of Dallas County, North Central Texas Council of Governments Area Agency on Aging, Sixty and Better, Tarrant County Public Health, and the United Way of Tarrant County/Area Agency on Aging of Tarrant County. 2b. Improved the availability and affordability of healthy food options through the implementation of community gardens, a farmer's market, and food hubs, known as the Eat Healthy Initiative. 2c. Managed and strengthened DSRIP programs under the Medicaid 1115 Waiver to continue implementation of HELP clinic for underserved populations. 3. Awareness, Literacy, & Navigation (ALN) 3a. Continued investment in Community Connect Online Resource Guide, a database of free and reduced-cost social services. 3b. Continued the implementation of A Matter of Balance Fall Prevention Program in partnership with the Community Council of Greater Dallas/Area Agency on Aging of Dallas County, North Central Texas Council of Governments Area Agency on Aging, Sixty and Better, Tarrant County Public Health, and the United Way of Tarrant County/Area Agency on Aging of Tarrant County. 3c. Managed and strengthened DSRIP programs under the Medicaid 1115 Waiver to provide Emergency Department (ED) navigation program and the Azle Minor Care Clinic to underserved populations. All significant health needs identified are being addressed by the hospital in one of the categories listed above. Part V. Section B, Lines 16 a, b & c The FAP, FAP Application and the Plain Language Summary of the FAP were widely available at this website: www.texashealth.org/patient-and-visitor-information/billing-and-payment-in formation/financial-help-for-those-in-need | ExplanationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Texas Health Azle | FormAndLineReferenceDesc |
| Explanation | Part I, Line 3c - Patient Eligibility Patients with a family income at or below 200% of applicable FPG may be eligible for free care if the patient lacks sufficient funds and assets to pay the out-of-pocket portion of their hospital bill. Patients with a family income above 200% of applicable FPG who have unpaid medical bills exceeding a specified percentage of the patient's annual gross income, as determined on a sliding scale based on FPG, may be deemed medically indigent and eligible for charity care. The patient may be eligible for a charity adjustment up to 100% of the unpaid balance of their hospital bill in excess of a specified patient responsible amount if the patient has insufficient funds/assets to pay his hospital bill without incurring an undue financial hardship. The patient responsible amount is based on a percentage of the patient's annual income in relation to FPG. A determination as to whether or not a patient has insufficient funds and/or assets to pay for purposes of determining both financial and medical indigence is made at the time a patient's financial assistance application is reviewed. Assets considered when determining eligibility include cash, stocks, bonds and other financial assets that can be readily converted to cash. An additional process to screen for charity patients using publicly available financial information is also in place for patients not submitting a financial assistance application. Part I, Line 7 - Cost-to-Charge Ratio A cost-to-charge ratio is used in computing the amounts reported in Lines 7a-7c. The cost-to-charge ratio is derived from Worksheet 2 - Ratio of Patient Care Cost-to-Charges, as found in Schedule H Instructions. The amounts reported on Lines 7e-7i were obtained using direct costs, as determined by a cash outlay. Part II - Community Building The organization participates in community building activities that aim to address the socio-economic factors that influence the overall health of individuals in the communities served. As identified in the community health needs assessment, there are areas of need that are not in alignment with the operations of a hospital system. Our volunteerism, collaborations and partnerships with various aid organizations and various area coalitions aid in addressing the socio-economic factors that are the backbone for many underlying health concerns. Part III, Lines 2, 3 & 4 - Bad Debts Bad debt expense is not included as a community benefit for purposes of reporting community benefits. Each patient qualifying for charity care is treated as a charity patient and no charges related to that patient are included in bad debt expense. The hospital is part of a consolidated system of hospitals which operate under the name Texas Health Resources (THR). THR's annual audit is conducted on a system-wide basis with a single consolidated audit report issued for THR and its affiliates. The audited financial statements of THR, which includes the activity of the organization, contain a footnote regarding Accounts Receivable and Allowance for Doubtful Accounts that reads as follows: Patient accounts receivable are reported net of estimated allowances for doubtful accounts and contractual adjustments in the consolidated balance sheets. The allowance and resulting provision for bad debts is based upon a combination of the aging of receivables and management's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage and other collection indicators for each of its major payor sources of revenue. Management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience and payment trends by payor category. Patient accounts are also monitored and, if necessary, past due accounts are placed with collection agencies in accordance with guidelines established by management. For receivables associated with services provided to patients who have third-party coverage, the System analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the System records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the billed rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The System's allowance for doubtful accounts for self-pay patients (including allowances for charity care) was 97.5% and 97.7% of self-pay accounts receivable at December 31, 2017 and 2016, respectively. In addition, the System's self-pay write-offs for bad debts was approximately $368,000,000 and $306,000,000 for the year ended December 31, 2017 and 2016, respectively. The System does not maintain a material allowance for doubtful accounts from third-party payors, nor did it have significant write-offs from third-party payors. Part III, Line 8 - Medicare Shortfall The state of Texas treats any Medicare shortfall as a community benefit for meeting the state statutory requirements for charity care & community benefit. For state purposes, the shortfall is computed by comparing actual Medicare reimbursements with the estimated cost the hospital incurs in providing these services to Medicare patients. Cost is determined by applying a cost-to-charge ratio (with costs determined in accordance with generally accepted accounting principles) to billed charges. The shortfall amount reported to the state of Texas for 2017 is $5,849,866. Sch H requires a different method to calculate the Medicare shortfall shown on Part III, Lines 5-7. Part III, Line 9b - Debt Collection During the year, standard collection procedures were in place and uniformly applicable to all patient accounts. Except to the extent a patient receives a recovery from any third party or other source, no attempts are made to collect unpaid charges from patient accounts approved for adjustment under the Financial Assistance Policy. Part VI, Line 2 - Needs Assessment In 2016, Texas Health Resources (Texas Health) completed a community health needs assessment (CHNA) for 23 facilities through the following steps: - Demographic analysis by zip code tabulation area - Secondary data analysis of health indicators - Community input data collection and analysis via key informant interviews, focus groups, and a community survey - Synthesis of secondary data and community input data to identify most pressing health needs - Prioritization of health needs using standard criteria elected by Texas Health To objectively prioritize the health needs identified by the data analysis and synthesis, each Texas Health facility used the following criteria: alignment with national, state, or local initiatives; magnitude; economic burden on the community; severity; and opportunity to intervene at a prevention level. The top priority health needs across the Texas Health system were Mental Health & Substance Abuse; Exercise, Nutrition, & Weight; and Access to Health Services and Healthcare Navigation & Literacy. Texas Health developed a system-wide community benefit strategy to leverage internal and external resources to increase its ability to impact community health needs. From 2017-2019, Texas Health has committed to implement strategies and activities aimed at addressing these areas. Mental Health & Substance Abuse is categorized as Behavioral Health; Exercise, Nutrition, & Weight is grouped under Chronic Disease, which has been a strategic area of focus for Community Health Improvement since the 2013 CHNA; and Access to Health Services and Healthcare Navigation & Literacy is jointly titled Awareness, Health Literacy, & Navigation. Part VI, Line 3 - Patient Education A description of the Financial Assistance Policy (FAP), the Plain Language Summary of the FAP (PLS) and the FAP application are available on the THR website at www.TexasHealth.org in English and other languages. The PLS is included in the patient's admission packets. Signs alerting patients of financial assistance and related contact information are posted in various areas of the hospital including admissions & registration and the emergency room. Additionally, financial assistance information is provided verbally and in writing to self-pay patients by financial counselors. As part of the financial counseling meeting, patients are s | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Tarrant County Indigent Care Corporation | |||||||
| 612 E LAMAR BLVD | Arlington | TX | 76011 | 260648532 | 501(c)(3) | $994,955 | Indigent Health Care |
| Tarrant County Hospital District-JPS | |||||||
| 1500 South Main Street | Fort Worth | TX | 76104 | 756000439 | Tarrant County | $286,785 | Indigent Health Care |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Monitor Grants | FormAndLineReferenceDesc |
| Explanation | Texas Health Azle (THAZ) is a member of the Texas Health Resources (THR) healthcare system. The majority of the grants distributed by the system are to related tax exempt organizations. The hospital does not specifically monitor the use of grants paid to related organizations since THR administration monitors the use of these grants on a system basis for all members of the THR healthcare system. Grants to non-related tax exempt organizations are generally given to entities that are in the hospitals community and/or service area or to certain organizations which will specifically impact the hospitals community. These grants are typically monitored by hospital personnel who are working closely with the non-related nonprofit organization. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (23 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Niles Richard K | ||||||||||||||
| Trustee | $0 | $262,118 | $0 | $100,555 | $0 | $0 | $0 | $10,948 | $0 | $34,007 | $0 | $407,628 | $0 | $0 |
| Berenzweig Harold K | ||||||||||||||
| THR Corporate Officer | $0 | $491,933 | $0 | $306,379 | $0 | $86,273 | $0 | $108,856 | $0 | $41,524 | $0 | $1,034,965 | $0 | $82,585 |
| Cantu Stacy G | ||||||||||||||
| Corporate Secretary | $0 | $217,919 | $0 | $0 | $0 | $29,001 | $0 | $545 | $0 | $41,659 | $0 | $289,124 | $0 | $0 |
| King James Kirk | ||||||||||||||
| THR Corporate Officer | $0 | $472,529 | $0 | $307,068 | $0 | $126,089 | $0 | $107,566 | $0 | $49,996 | $0 | $1,063,248 | $0 | $75,344 |
| Kramer Kenneth J | ||||||||||||||
| Assistant Secretary | $0 | $481,919 | $0 | $251,279 | $0 | $133,341 | $0 | $109,968 | $0 | $52,858 | $0 | $1,029,365 | $0 | $50,254 |
| Krejci Jacque D | ||||||||||||||
| Assistant Secretary | $0 | $166,353 | $0 | $14,711 | $0 | $1,445 | $0 | $9,897 | $0 | $25,325 | $0 | $217,731 | $0 | $0 |
| McWhorter Ricky E | ||||||||||||||
| Assistant Secretary | $0 | $383,835 | $0 | $194,085 | $0 | $84,600 | $0 | $159,374 | $0 | $33,326 | $0 | $855,220 | $0 | $39,522 |
| Ellzey Bob S | ||||||||||||||
| President THAZ | $197,993 | $0 | $81,318 | $0 | $38,078 | $0 | $37,026 | $0 | $40,839 | $0 | $395,254 | $0 | $22,384 | $0 |
| Gilbert Valarie G | ||||||||||||||
| Chief Nursing Officer THAZ | $165,485 | $0 | $39,328 | $0 | $22,747 | $0 | $26,860 | $0 | $10,917 | $0 | $265,337 | $0 | $12,050 | $0 |
| Dollahite Harry Anderson | ||||||||||||||
| CMO THAZ | $0 | $318,458 | $0 | $22,560 | $0 | $11,088 | $0 | $6,534 | $0 | $42,246 | $0 | $400,886 | $0 | $0 |
| Miland Stephanie | ||||||||||||||
| Grp Fin Off THFW-THC-THAZ-THSH | $0 | $223,879 | $0 | $66,500 | $0 | $61,081 | $0 | $20,243 | $0 | $40,669 | $0 | $412,372 | $0 | $0 |
| Berdan Barclay E | ||||||||||||||
| Former Officer | $0 | $1,115,192 | $0 | $905,490 | $0 | $276,824 | $0 | $285,581 | $0 | $40,885 | $0 | $2,623,972 | $0 | $207,003 |
| Mitchell John D | ||||||||||||||
| Former Officer | $0 | $307,987 | $0 | $152,794 | $0 | $96,804 | $0 | $58,920 | $0 | $42,361 | $0 | $658,866 | $0 | $31,519 |
| Canose Jeffrey L | ||||||||||||||
| Former Officer | $0 | $814,967 | $0 | $442,558 | $0 | $226,157 | $0 | $166,371 | $0 | $39,664 | $0 | $1,689,717 | $0 | $112,689 |
| Humphrey Richard I | ||||||||||||||
| Former Officer | $0 | $217,466 | $0 | $111,784 | $0 | $99,073 | $0 | $16,200 | $0 | $36,779 | $0 | $481,302 | $0 | $0 |
| DeSio Terri Alice | ||||||||||||||
| Former Officer | $0 | $201,316 | $0 | $18,492 | $0 | $13,214 | $0 | $16,445 | $0 | $29,449 | $0 | $278,916 | $0 | $0 |
| Laviolette Judy D | ||||||||||||||
| Former Officer | $0 | $318,641 | $0 | $129,039 | $0 | $41,702 | $0 | $39,107 | $0 | $9,879 | $0 | $538,368 | $0 | $25,617 |
| Stout Luanne R | ||||||||||||||
| Assistant Secretary | $0 | $7,874 | $0 | $57,726 | $0 | $38,771 | $0 | $3,497 | $0 | $5,212 | $0 | $113,080 | $0 | $0 |
| Ward Vanessa | ||||||||||||||
| PHARMACIST | $145,352 | $0 | $479 | $0 | $8,221 | $0 | $9,335 | $0 | $18,396 | $0 | $181,783 | $0 | $0 | $0 |
| Shuffield Elizabeth Suzanne | ||||||||||||||
| DIR PHARMACY | $147,024 | $0 | $5,234 | $0 | $560 | $0 | $0 | $0 | $7,726 | $0 | $160,544 | $0 | $0 | $0 |
| Blessing Brian Bradley | ||||||||||||||
| DIR SR QUAL/PT SF/RSK/SPRT SVC | $124,695 | $0 | $10,894 | $0 | $5,551 | $0 | $10,533 | $0 | $50,887 | $0 | $202,560 | $0 | $0 | $0 |
| Fonville Mary V | ||||||||||||||
| PROFESSIONAL SVCS OFFICER THAZ | $125,038 | $0 | $10,612 | $0 | $4,589 | $0 | $10,383 | $0 | $42,476 | $0 | $193,098 | $0 | $0 | $0 |
| Edwards Connie Beck | ||||||||||||||
| DIR REHAB SVC | $121,105 | $0 | $4,387 | $0 | $7,060 | $0 | $9,766 | $0 | $17,032 | $0 | $159,350 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1A - TRAVEL FOR COMPANIONS | IN ACCORDANCE WITH THE THR TRAVEL POLICY, THE ORGANIZATION ALLOWS SPOUSES/GUESTS TO ACCOMPANY ELIGIBLE EMPLOYEES, OFFICERS OR BOARD MEMBERS OF THE ORGANIZATION ON BUSINESS RELATED TRAVEL. THE VALUE OF THE SPOUSE/GUEST TRAVEL IS INCLUDED IN THE TAXABLE COMPENSATION OF THE EMPLOYEE. |
| SCHEDULE J, PART I, LINE 1A - DISCRETIONARY SPENDING ACCOUNT | EACH EXECUTIVE AT THE VICE PRESIDENT LEVEL AND ABOVE RECEIVES A PERK ALLOWANCE WHICH IS INCLUDED IN THE TAXABLE COMPENSATION OF THE EMPLOYEE. THIS ALLOWANCE COVERS COSTS SUCH AS BUSINESS USE OF THEIR PERSONAL VEHICLES IN LIEU OF REIMBURSEMENT FOR AUTO MILEAGE. |
| SCHEDULE J, PART I, LINE 3 - CEO COMPENSATION | The organization relied on Texas Health Resources (THR), a related 501(c)(3) organization with centralized compensation professionals to use the following methods to establish the compensation of the organizations President. *The Compensation committee (which includes independent persons) performs reviews and makes recommendations to the THR Board. *An Independent compensation consultant may be hired. *Compensation surveys or studies are utilized. *Approval by the Board or Compensation committee is required. |
| SCHEDULE J, PART I, LINE 4B - NONQUALIFIED RETIREMENT PLAN | PARTICIPATION IN THE PLAN IS MADE AVAILABLE TO A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES, AS DETERMINED BY THE THR BOARD OF TRUSTEES, WHO ARE PROVIDING SERVICES IN KEY POSITIONS OF MANAGEMENT AND RESPONSIBILITY. FOR THE ACTIVE RESTORATION ACCOUNT (ACCOUNT BALANCES AFTER 12/31/2009), SERP BENEFITS VEST WHILE THE PARTICIPANT IS EMPLOYED IF THE PARTICIPANT: * REACHES AGE 65, * BECOMES DISABLED OR DIES, * REACHES THE FOLLOWING YEARS OF SERVICE: 2 YEARS - 25%; 3 YEARS -50%; 4 YEARS - 75%; AND 5 OR MORE - 100%. PARTICIPANTS MUST BE EMPLOYED ON DEC 1 TO QUALIFY FOR THE CURRENT YEAR'S SERP BENEFIT UNLESS SEPARATION IS DUE TO DEATH, DISABILITY, RETIREMENT (AGE 65) OR EARLY RETIREMENT (SEPARATION FROM SERVICE AT OR AFTER AGE 55 WITH 75 YEARS OF COMBINED AGE AND CONTINUOUS SERVICE WITH THE SYSTEM). SERP BENEFITS ARE CALCULATED EACH DEC 1. VESTED BALANCES ARE TAXED TO THE EMPLOYEE AND THE NET BALANCES BEGIN ACCRUING EARNINGS. VESTED BALANCES ARE PAID IN A CASH LUMP SUM WITHIN A 90 DAY PERIOD COMMENCING ON THE EARLIER OF DEATH, DISABILITY, OR SEPARATION FROM SERVICE. THE DEFERRED PORTION IS INCLUDED IN SCHEDULE J, PART II, COLUMN C. IN FROZEN RESTORATION ACCOUNTS (ACCOUNT BALANCES PRIOR TO 1/1/2010), THE PARTICIPANT OR BENEFICIARY SHALL BE TAXED ON HIS OR HER VESTED SERP BENEFITS UPON THE EARLIEST OF: * CONTINUED EMPLOYMENT IN THR UNTIL AGE 68 * TERMINATION OF EMPLOYMENT FOR DISABILITY OR DEATH * INVOLUNTARY TERMINATION OF EMPLOYMENT WITHOUT REASONABLE CAUSE; OR * SATISFYING A 24 MONTH NON-COMPETE PERIOD FOLLOWING HIS/HER TERMINATION OF EMPLOYMENT. PAYMENT FOLLOWS THE BEFORE MENTIONED EVENTS, EXCEPT IN THE CASE OF INVOLUNTARY SEPARATION WHEN THE PARTICIPANT MUST WAIT 24 MONTHS TO RECEIVE THE PREVIOUSLY TAXED BENEFIT. PAYOUTS TO THE FOLLOWING EMPLOYEES WERE MADE DURING THE YEAR. THE AMOUNTS BELOW ARE INCLUDED IN THE AMOUNT REPORTED ON SCH J, PART II, COLUMN B(III) AND COLUMN (F). Berdan,Barclay E. $ 207,002.95 Berenzweig,Harold K $ 82,584.90 Canose,Jeffrey L $ 112,689.38 Ellzey,Bob S $ 22,383.96 Gilbert,Valarie G. $ 12,049.93 Humphrey,Richard I $ 21,934.41 King,James Kirk $ 75,343.55 Kramer,Kenneth J. $ 50,254.15 Laviolette,Judy D $ 22,909.82 McWhorter,Ricky E. $ 39,521.88 Mitchell,John D. $ 31,518.69 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 990, Part VI, Section A, Line 2 - Business Relationship | Texas Health Resources (THR) and its related organizations included in the THR healthcare system encourage employees to become involved in philanthropic endeavors in their communities. As a result, THR healthcare system employees who are serving as officers, board members, or key employees may, from time to time, also serve on the boards of various community organizations such as church boards, United Way, etc. There may be a business relationship as a result of multiple THR employees serving on the same community boards. THR employees serve as the corporate officers of each subsidiary organization. As THR system employees, all officers have a business relationship within the organizations of the THR healthcare system. THR also appoints system officers to the boards of various controlled joint ventures. As THR system employees, various officers of the organization may have a business relationship through serving on THR controlled joint venture boards. |
| 990, Part VI, Section A, Lines 6&7a - Members | Texas Health Resources (THR) is the sole member of the organization. |
| 990, Part VI, Section A, Line 7b - Governance Decisions Reserved | The following actions require the approval of Texas Health Resources (THR): (a) Amendment, restatement or repeal of the Certificate of Formation or these Bylaws. (b) Sale, exchange, lease or other transfer of all or substantially all of the assets of the Corporation. (c) Merger or consolidation of the Corporation. (d) Dissolution of the Corporation. (e) Election of members of the Board of Trustees (f) Removal of a member of the Board of Trustees (g) Creation of affiliates or subsidiaries and approval of the initial governing documents. (h) Incurrence of debt not included in the budgets. (i) Discontinuing the operations of a licensed health care facility controlled by the corporation. (j) Activities involving winding up, distribution, conversion or exchange under Chapter 11 |
| 990, Part VI, Section B, Line 11b - Form 990 Filing | The Texas Health Resources (THR) tax department staff prepares the Forms 990 for THR and all of its wholly controlled affiliates. In order to accurately prepare the returns, the tax staff works closely with various other departments to gather and review the information needed to complete the return. The departments involved in this process include, but are not limited to accounting, finance, treasury, human resources, payroll, legal, governance, and corporate compliance. The returns are then reviewed twice within the tax department before being given to the Financial Reporting department to review and to ensure that the financial information is accurate and up to date. All THR System Forms 990 are provided to members of the Audit and Compliance Committee of the THR Board, giving them an opportunity to review, comment and ask questions regarding the Forms 990. The tax department Sr. Director provides an overview presentation to the committee highlighting various areas of the Form 990. A resolution to approve all of the returns is voted upon at this meeting. Once the Audit and Compliance Committee has approved the returns, each return is then reviewed and signed by the Chief Accounting Officer and Assistant Secretary. The members of the governing Boards are provided a copy of the Form 990 for their respective entity after the Audit and Compliance Committee approval process and before the Form 990 is filed. |
| 990, Part VI, Section B, Line 12c - Conflict of Interest | Texas Health Resources (THR) has adopted a Conflict of Interest Policy that applies to THR and all of its wholly owned or wholly controlled affiliates. During the first quarter of each fiscal year, a Duality and Conflict of Interest Statement Form is distributed by the THR Chief Compliance Officer to all board members, officers, contracted medical directors, employees with a title of manager or above, employed physicians, and certain committee members and other employees based upon function. All disclosed conflicts are reviewed by the THR Chief Compliance Officer. A report, listing each reported Duality of Interest or Conflict of Interest is given to both the Chair of the Governing body and the President of the Corporation with which the reporting person is affiliated. The THR Board of Trustees receives a report when the Annual Disclosure process is complete. Progressive corrective action is taken for any identified noncompliance which may include removal from a board or committee or physician/employee counseling if the person fails to provide the disclosure. In addition, THR monitors physician payments through a public database implemented by CMS. Management plans are executed as needed based upon disclosures. THR also educates the Boards and workforce annually through either a web based or live compliance training. |
| 990, Part VI, Section B, Lines 15 a&b - Compensation Determination | The organization relied on Texas Health Resources (THR) with centralized compensation professionals to review and establish the compensation of the organizations officers. The THR Board approves the compensation of certain officer of this organization. See Schedule J, Part III. |
| 990, Part VI, Section C, Line 19 - Public Disclosure | The organization does not make its governing documents or conflict of interest policy available to the public. The consolidated financial statements of Texas Health Resources (THR) are made available to the public on the website www.dacbond.com. Consolidated financial statements are posted to this website quarterly and the audited financial statements are posted annually. The financial statements of the wholly controlled affiliates of THR are not posted to the website nor are they generally made available to the public in any other manner. |
| 990, Part XI, Line 9 Other Changes in Net Assets | Adjustment for Intercompany Transactions of a Controlled Group $17,613,568 The intercompany adjustment eliminated the receivable/payable balance as of 12/31/2017 between Texas Health Resources (THR) and all wholly controlled tax exempt entities included in the THR Healthcare System. The adjustment includes 2017 activity as well as prior year accumulated activity. The THR Healthcare System records all related transactions through the intercompany Receivable/Payable accounts for each entity. The types of transactions recorded in the Intercompany accounts include management fees charged by the parent organization, services purchased between related organizations, supplies purchased by a centralized purchasing department, daily cash sweeps and similar transactions. |
| 990, Part XII, Line 2c - Consolidated Financial Statements | Texas Health Resources (THR) prepares consolidated financial statements with its related entities. The THR Board appoints an audit and compliance sub-committee that assumes responsibility for oversight of the consolidated audit for all related entities. The related entities do not have a separate audit committee, but abide by the THR committee's oversight. There has been no change during the year in the organizations oversight selection process. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (32 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Johnson County Community Care Corp | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 452793120 | Support Org. | TX | 501(c)(3) | 12a | TH Cleburne | false |
| Huguley Medical Associates Inc | ||||||||||
| 11801 South Freeway | Burleson | TX | 76028 | 752547668 | Phys Clinic | TX | 501(c)(3) | 3 | TH Huguley | false |
| North Texas Healthy Communities | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 464513182 | Comm Support | TX | 501(c)(3) | 7 | TH Resources | false |
| Southwestern Health Resources JOC | ||||||||||
| 5323 Harry Hines Blvd | Dallas | TX | 75390 | 811575989 | Support Org. | TX | 501(c)(3) | 12b | TH Resources | false |
| Texas Health Arlington Memorial Hospital | ||||||||||
| 800 West Randol Mill Rd | Arlington | TX | 76012 | 750972805 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Back Care | ||||||||||
| 9229 LBJ Freeway | Dallas | TX | 75243 | 474724257 | Phys. Clinic | TX | 501(c)(3) | 10 | TH Phys Grp | false |
| TH Behavioral Health Hospital Corinth | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 814317635 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Medical Support | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 812833150 | Spec Drugs | TX | 501(c)(3) | 10 | TH Resources | false |
| Texas Health Alliance | ||||||||||
| 10864 Texas Health Trail | Fort Worth | TX | 76244 | 451502252 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Azle | ||||||||||
| 108 Denver Trail | Azle | TX | 76020 | 751748586 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Cleburne | ||||||||||
| 201 Walls Dr | Cleburne | TX | 76033 | 751977850 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Fort Worth | ||||||||||
| 1301 Pennsylvania Ave | Fort Worth | TX | 76104 | 756001743 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Hurst-Euless-Bedford | ||||||||||
| 1600 Hospital Parkway | Bedford | TX | 76022 | 751438726 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Southwest Fort Worth | ||||||||||
| 6100 Harris Parkway | Fort Worth | TX | 76132 | 752678857 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Stephenville | ||||||||||
| 411 Belknap | Stephenville | TX | 76401 | 751752253 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Huguley Inc | ||||||||||
| 11801 S Freeway | Burleson | TX | 76028 | 452694620 | Hospital | FL | 501(c)(3) | 3 | TH Resources | false |
| TX Health Outpatient Surg Ctr Alliance | ||||||||||
| 10840 Texas Health Trail | Fort Worth | TX | 76244 | 800800294 | Hospital | TX | 501(c)(3) | 3 | TH Alliance | false |
| Texas Health Physicians Group | ||||||||||
| 9229 LBJ Freeway | Dallas | TX | 75243 | 752613493 | Phys. Clinic | TX | 501(c)(3) | 10 | TH Resources | false |
| TH Recovery and Wellness Center | ||||||||||
| 240 Miller Road | Mansfield | TX | 76063 | 812813227 | Resd Trmt Ctr | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Resources Foundation | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 752022128 | Fundraising | TX | 501(c)(3) | 7 | TH Resources | false |
| Texas Health Allen | ||||||||||
| 1105 Central Expressway N | Allen | TX | 75013 | 752890358 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Dallas | ||||||||||
| 8200 Walnut Hill Ln | Dallas | TX | 75231 | 751047527 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Denton | ||||||||||
| 3000 North Interstate 35 | Denton | TX | 76201 | 432008974 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Kaufman | ||||||||||
| 850 Ed Hall Drive | Kaufman | TX | 75142 | 752771437 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Plano | ||||||||||
| 6200 W Parker Rd | Plano | TX | 75093 | 752770738 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| TX Health Research & Education Institute | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 752562191 | Edu& Research | TX | 501(c)(3) | 4 | TH Resources | false |
| Texas Health Resources | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 752702388 | Mgmt Supp Org | TX | 501(c)(3) | 12c | NA | false |
| TH Seay Behavioral Health Hospital | ||||||||||
| 6110 W Parker Rd | Plano | TX | 75093 | 812792484 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| TH Springwood Behavioral Health Hospital | ||||||||||
| 2717 Tibbets Dr | Bedford | TX | 76022 | 812798838 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| TH Specialty Hospital Fort Worth | ||||||||||
| 1301 Pennsylvania Ave | Fort Worth | TX | 76104 | 751648589 | LT Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| WW Ward Endowment Fund Trust | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 756196065 | Support Org. | TX | 501(c)(3) | 12a | TH Foundatio | false |
| Health Tarrant County Collaboration | ||||||||||
| PO Box 8040 | Fort Worth | TX | 76124 | 432087946 | Support Org | TX | 501(c)(3) | 12a | NA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (34 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|
| AMH Cath Labs LLC | |||||||
| 811 Wright St | Arlington | TX | 76012 | 203003947 | Hospital | TX | na |
| Arlington Surgery Center LLC | |||||||
| 918 N Davis Dr | Arlington | TX | 76012 | 752055800 | Amb Surg Ctr | TX | na |
| Cleburne Imaging LLC | |||||||
| PO Box 820519 | Dallas | TX | 75382 | 460767278 | Medical Imaging | TX | na |
| Cleburne Surgical Center LLC | |||||||
| 2010 W Katherine P Raines Blvd St | Cleburne | TX | 76033 | 203742012 | Amb Surg Ctr | TX | na |
| Denton Surgery Center LLC | |||||||
| 207 North Bonnie Brea | Denton | TX | 76201 | 470926556 | Amb Surg Ctr | TX | na |
| Flower Mound Hospital Partners LLC | |||||||
| 4400 Long Prairie Rd | Flower Mound | TX | 75028 | 260684968 | Hospital | TX | na |
| Fort Worth Endoscopy Centers LLC | |||||||
| 900 W Magnolia Ave 101 | Fort Worth | TX | 76104 | 770368346 | Endoscopy Ctr | TX | na |
| FTH DFW Partners LLC | |||||||
| 1401 E Trinity Mills Rd | Carrollton | TX | 75006 | 473426036 | Hospital/ER | TX | na |
| Greenville Surgery Center LLC | |||||||
| 7150 Greenville Ave Ste 200 | Dallas | TX | 75231 | 742411643 | Amb Surg Ctr | TX | na |
| Health Imaging Partners LLC | |||||||
| 8610 Explorer Drive Ste 300 | Colorado Springs | CO | 80920 | 271385885 | Medical Imaging | TX | na |
| North Dallas Surgical Center LLC | |||||||
| 17980 Dallas Parkway Ste 100 | Dallas | TX | 75287 | 272248103 | Amb Surg Ctr | TX | na |
| Opthalmology Surgery Center of Dallas LL | |||||||
| 10740 N Central Expy | Dallas | TX | 75231 | 261914835 | Amb Surg Ctr | TX | na |
| Park Hill Surgery Center LLC | |||||||
| 3455 Locke Ave | Fort Worth | TX | 76107 | 451484375 | Amb Surg Ctr | TX | na |
| Physician Medical Center LLC | |||||||
| 6020 W Parker Rd | Plano | TX | 75093 | 481281376 | Hospital | TX | na |
| Presbyterian Cancer Center-Dallas LLC | |||||||
| PO Box 819067 | Dallas | TX | 75381 | 260422749 | Cancer Ctr | TX | na |
| Rockwall Regional Hospital LLC | |||||||
| 3150 Horizon Rd | Rockwall | TX | 75032 | 202848116 | Hospital | TX | na |
| Southlake Specialty Hospital LLC | |||||||
| 1545 E Southlake Blvd | Southlake | TX | 76092 | 020555370 | Hospital | TX | na |
| Surgical Caregivers of Fort Worth LLC | |||||||
| 2001 W Rosedale Street | Fort Worth | TX | 76104 | 751925497 | Amb Surg Ctr | TX | na |
| Texas Health Craig Ranch Surgery Center | |||||||
| 8080 State Hwy 121 Ste 100 | McKinney | TX | 75070 | 383897811 | Amb Surg Ctr | TX | na |
| Texas Health Spine Surgery Center Allen | |||||||
| 1545 E Southlake Blvd Ste 100 | Southlake | TX | 76092 | 300957868 | Amb Surg Ctr | TX | na |
| Texas Health Orthopedic Surgery Center A | |||||||
| 9848 North Beach St | Fort Worth | TX | 76244 | 814977249 | Inactive | TX | na |
| Texas Health Surgery Center Alliance LL | |||||||
| 800 5th Ave Ste 200 | Fort Worth | TX | 76104 | 822296081 | Amb Surg Ctr | TX | na |
| Texas Health Surgery Center Bedford LLC | |||||||
| 1605 Airport Freeway Suite 100 | Bedford | TX | 76021 | 821307876 | Amb Surg Ctr | TX | na |
| Texas Health Flower Mound Orthopedic Sur | |||||||
| 5000 Long Prairie Road | Flower Mound | TX | 75028 | 800866449 | Amb Surg Ctr | TX | na |
| Texas Health Surgery Center Preston Plaz | |||||||
| 17950 Preston Road Ste 75 | Dallas | TX | 75252 | 203991622 | Amb Surg Ctr | TX | na |
| Texas Health Surgery Center Rockwall LL | |||||||
| 569 Brookwood Village Ste 901 | Birmingham | AL | 35209 | 474425996 | Inactive | TX | na |
| Texas Health Surgery Center South Arling | |||||||
| 569 Brookwood Village ste 901 | Birmingham | AL | 35209 | 731662763 | Inactive | TX | na |
| Texas Institute for Surgery LLP | |||||||
| 7715 Greenville Ave Ste 100 | Dallas | TX | 75231 | 203571243 | Hospital | TX | na |
| THR-STT Rockwall ASC LLC | |||||||
| 1545 E Southlake Blvd | Southlake | TX | 76092 | 770628004 | Amb Surg Ctr | TX | na |
| THR-STT Southlake ASC LLC | |||||||
| 1545 E Southlake Blvd | Southlake | TX | 76092 | 262429878 | Amb Surg Ctr | TX | na |
| USMD Hospital at Arlington LP | |||||||
| 801 I -20 West | Arlington | TX | 76017 | 201728912 | Hospital | TX | na |
| USMD Hospital at Fort Worth LP | |||||||
| 6333 North State Hwy 161 Ste 200 | Irving | TX | 75038 | 731662763 | Hospital | TX | na |
| Wilson Creek Surgical Center LLC | |||||||
| 8855 synergy Dr | McKinney | TX | 75070 | 203571243 | Amb Surg Ctr | TX | na |
| Women's Specialty Surgery Center | |||||||
| 8230 Walnut Hill Ln Ste 101 | Dallas | TX | 75231 | 274816583 | Amb Surg Ctr | TX | na |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Grace Indemnity Company Ltd | ||||||||||||||
| 1159 Caribbean Plaza | Grand Cayman | CJ | KY 1-1102 | 981209573 | Captive Insurance | CJ | NA | C Corp | false | |||||
| Texas Health Biomedical Advancement Cent | ||||||||||||||
| 752636884 | Research | NA | C Corp | false | 612 E Lamar Blvd | Arlington | TX | 76011 | TX | |||||
| SWHR Specialty Programs Group | ||||||||||||||
| 465588632 | Inactive | NA | C Corp | false | 612 E Lamar Blvd | Arlington | TX | 76011 | TX | |||||
| THR Primary Care Ext Physcian Network | ||||||||||||||
| 465365421 | Inactive | NA | C Corp | false | 612 E Lamar Blvd | Arlington | TX | 76011 | TX | |||||
| Charitable Remainder Trusts (4) | ||||||||||||||
| CR Trust | NA | Trust | false | 612 E Lamar Blvd | Arlington | TX | 76011 | TX | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R, Part V, Line 2 - Related Transactions | FormAndLineReferenceDesc |
| Explanation | Texas Health Resources (THR) is the parent organization in a large healthcare system made up of both wholly owned entities as well as related controlled joint ventures as listed on Schedule R. THR's role is to plan, manage and coordinate the activities of the affiliated healthcare system in order to maximize opportunities to deliver cost effective quality medical care to residents of north central Texas. THR provides direction and oversight to its wholly owned affiliates through centralized services. They also provide oversight for the controlled joint ventures. As an integral part of providing centralized services to the affiliates, THR maintains intercompany receivable/payable accounts, most of which do not fall within the scope of IRC Section 512(b)(13). During 2017, the intercompany receivable/payable balances between THR and its wholly owned tax exempt controlled entities were written off. The range of centralized services provided by THR include information services, managed care contracting, Human resources, revenue cycle, billing and collections, patient access/admissions, legal, tax, compliance, supply chain, quality, business development, insurance, treasury, marketing, general accounting, real estate services, coding, transcription and strategic planning. In addition, THR does daily cash sweeps of all controlled tax exempt entity cash accounts. As a result, THR has numerous daily transactions with controlled tax exempt entities, none of which fall within the scope of IRC Section 512(b)(13). A management fee is charged for the centralized services and reported on Form 990, Part VII, Section B as a professional services fee. Transactions with related tax exempt organizations falling within the meaning of centralized services as described above, are not listed on Schedule R, Part V, Line 2. | ExplanationTxt |
Comments