2017-08-15T21:28:49-05:00 2016-09-30 BKD LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2015-10-01 751041154 The Good Shepherd Hospital Inc % NIKKI BENOIT GOOD 9033152000 700 E Marshall Ave Longview TX 75601 MICHAEL CHEEK CFO 9033152000 2017-08-15 true Jeanette Verrelli P00742631 9727028262 2015 2021-01-29 14:40:06Z Good Shepherd Medical Center MICHAEL CHEEK 700 E MARSHALL AVE LONGVIEW TX 75601 413935969 false X WWW.GSMC.ORG X 1959 TX GOOD SHEPHERD MEDICAL CENTER IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL DEDICATED TO CREATING A HEALTHIER FUTURE FOR THE RESIDENTS OF LONGVIEW AND NORTHEAST TEXAS. 13 11 2268 160 4397990 -61337 242766 742252 396033354 411320889 337057 -953755 2379236 2327397 398992413 413436783 949582 681199 0 0 113882193 108452109 0 0 0 287481662 318096173 402313437 427229481 -3321024 -13792698 160345805 123009390 188024148 181782797 -27678343 -58773407 X GOOD SHEPHERD MEDICAL CENTER PROVIDES SERVICES TO PATIENTS QUALIFYING UNDER THE CHARITY POLICY AND PROVIDES QUALITY TERTIARY HEALTH SERVICES TO THE RESIDENTS OF NORTHEAST TEXAS. false false 348404938 681199 406922899 GOOD SHEPHERD MEDICAL CENTER IS IMPACTED BY THE SIGNIFICANT CHANGES IN HEALTHCARE TODAY. TO ENSURE THAT GOOD SHEPHERD MEDICAL CENTER IS STRONGLY POSITIONED FOR THE FUTURE, THE FOLLOWING MAJOR STRATEGIES HAVE BEEN ADOPTED: - IMPROVE CLINICAL QUALITY OUTCOMES AND CUSTOMER SERVICE - IMPROVE OPERATING PERFORMANCE AND REDUCE COSTS - DEVELOP A HEALTH SYSTEM THAT PROVIDES A FULL CONTINUUM OF HOSPITAL, PHYSICIAN AND INSURANCE SERVICES - IMPROVE THE HEALTH STATUS OF THE SERVICE AREA - IMPROVE THE CAPABILITY AND ADAPTABILITY OF EMPLOYEES GOVERNED BY A VOLUNTARY BOARD OF DIRECTORS, GOOD SHEPHERD MEDICAL CENTER HAS A DIRECT LINK TO SOLICIT COMMUNITY INVOLVEMENT IN DECISION MAKING. THE BOARD OF DIRECTORS IS COMPOSED OF GOOD SHEPHERD MEDICAL CENTER'S PRESIDENT AND CHIEF EXECUTIVE OFFICER AND TWELVE MEMBERS OF THE COMMUNITY WHO SERVE ON A VOLUNTARY BASIS TO FURTHER THE MISSION OF GOOD SHEPHERD MEDICAL CENTER. THESE MEMBERS REPRESENT LOCAL BUSINESS, INDUSTRY, EDUCATION, MEDICAL SERVICES AND CONSUMERS-AT-LARGE. THE BOARD OF DIRECTORS PROVIDES PERPETUAL COMMUNICATION OF THE CONCERNS AND HEALTHCARE NEEDS OF THE GREATER LONGVIEW COMMUNITY. AS PART OF OUR ONGOING COMMITMENT TO THE UNDERSERVED POPULATION OF GOOD SHEPHERD'S SERVICE AREA, THE BOARD OF DIRECTORS ESTABLISHED CRITERIA FOR FINANCIAL ASSISTANCE CONSISTENT WITH THE ORGANIZATION'S MISSION AND FINANCIAL RESOURCES. FINANCIAL ASSISTANCE IS PROVIDED TO ALL PATIENTS, WITHOUT REGARD TO RACE, CREED, GENDER OR NATIONAL ORIGIN, WHO ARE CLASSIFIED AS FINANCIALLY INDIGENT ACCORDING TO GOOD SHEPHERD'S ELIGIBILITY GUIDELINES AND WHO PRESENT THEMSELVES FOR CARE AT GOOD SHEPHERD MEDICAL CENTER AND ITS REGIONAL SYSTEM OF SERVICES. MANY FACTORS SUCH AS ALL SOURCES OF INCOME, EMPLOYMENT STATUS, FAMILY SIZE, AMOUNT OF THE PATIENT'S ACCOUNT AND HEALTHCARE NEEDS ARE ALL TAKEN INTO CONSIDERATION WHEN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. GOOD SHEPHERD MEDICAL CENTER MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF FINANCIAL ASSISTANCE IT PROVIDES TO THE COMMUNITIES IT SERVES. - IN FISCAL YEAR 2016, CHARITY CARE BASED ON ESTABLISHED RATES WAS RENDERED IN THE AMOUNT OF $28,473,740. THIS AMOUNT ENCOMPASSES THE CARE OF MORE THAN 5,200 PATIENT VISITS AND REPRESENTS APPROXIMATELY 2.07 PERCENT OF GROSS PATIENT REVENUE. - GOOD SHEPHERD PROVIDED CHARITY CARE, GOVERNMENT-SPONSORED INDIGENT HEALTHCARE AND OTHER COMMUNITY BENEFITS COSTING $35,877,511 OR MORE THAN 12.8 PERCENT OF THE TOTAL OPERATING EXPENSES. GOOD SHEPHERD MEDICAL CENTER ALSO PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS, AS WELL AS OTHER FEDERAL, STATE AND LOCAL HEALTHCARE REIMBURSEMENT PROGRAMS FOR THOSE IN FINANCIAL NEED. THESE PROGRAMS ACCOUNT FOR MORE THAN 61 PERCENT OF THE MEDICAL CENTER'S GROSS PATIENT REVENUE. 348404938 true true false true false false false false false false true false false false true false false false false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true true false false true 141 0 2268 true true true false false false false false false false false false X 13 11 false false false false true true true true true false false false true true true true true true true false X NIKKI BENOIT 9033155177 700 E MARSHALL AVE LONGVIEW TX 75601 X STEVE ALTMILLER PRESIDENT - CEO 2.0 49.0 X X 0 650200 87557 KELLYN DRAYER CHAIR 2.0 0.0 X X 0 0 0 WILLIAM M HOLDA EDD TRUSTEE 2.0 0.0 X 0 0 0 MARK BOON TRUSTEE 2.0 0.0 X 0 0 0 CR MARTIN MD TRUSTEE 2.0 0.0 X 0 0 0 THOMAS P TIBILETTI TRUSTEE 2.0 0.0 X 0 0 0 STAN UPCHURCH MD TRUSTEE 2.0 0.0 X 0 0 0 KEITH HONEY TRUSTEE 2.0 0.0 X 0 0 0 LESTER LUCY TRUSTEE 2.0 0.0 X 0 0 0 GAYLE ENGLISH VICE CHAIR 2.0 0.0 X X 0 0 0 HOMER ROCKMORE TRUSTEE 2.0 0.0 X 0 0 0 SUSHAMA BRIMMER PHYSICIAN 2.0 40.0 X 0 427237 28190 MARK BOGLE FINANCE CHAIRMAN 2.0 0.0 X X 0 0 0 TIM PILEGGI INTERIM CFO 2.0 49.0 X 0 583683 0 DANIEL D SMITH CRNA 40.0 0.0 X 254222 0 25878 RICHARD LEE HOLLADAY CRNA 40.0 0.0 X 352622 0 12855 ROGER BRYANT JR CRNA 40.0 0.0 X 256719 0 25809 LEE ALLEN HOLLADAY CRNA 40.0 0.0 X 253393 0 21648 RICHARD HINSON CRNA 40.0 0.0 X 270023 0 23137 KEN CUNNINGHAM former EVP SECRETARY 0.0 40.0 X 0 383969 53690 1386979 2045089 278764 85 true true false LONGVIEW EMERGENCY MEDICINE 700 E MARSHALL AVE LONGVIEW TX 75601 PROFESSIONAL FEES 8427446 MORRIS AND DICKSON CO LLC PO BOX 51367 SHREVEPORT LA 71135 PHARMACY SERVICES 8177358 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 CAFETERIA SERVICES 5770275 LONGVIEW MEDICAL CENTER LP 2901 N 4TH ST LONGVIEW TX 75605 MEDICAL SERVICES 5075122 HOSPITAL HOUSEKEEPING SYSTEMS LTD PO BOX 826 SAN ANTONIO TX 78293 JANITORIAL SERVICE 4851034 71 165970 576282 0 742252 Net Patient Revenue 621110 340955055 340955055 Government and Trauma Funding 900099 3950658 3950658 Lab Outreach Revenue 621500 3878841 3878841 Wellness Center Revenue 624100 3646619 3127470 519149 Lease Revenue 532420 1497637 1497637 57392079 57392079 411320889 -881971 -881971 0 0 559609 427402 132207 0 132207 132207 71784 -71784 -71784 -71784 0 0 0 CAFETERIA REVENUE 722210 2145073 2145073 VENDING REVENUE 722210 50117 50117 2195190 413436783 406922899 4397990 1373642 681199 681199 0 0 0 0 0 87434621 71277027 16157594 1966947 1603462 363485 12548567 10229638 2318929 6501974 5300433 1201541 3437420 2802198 635222 325 265 60 0 0 0 0 36034038 29375081 6658957 0 1548007 1261941 286066 677101 551975 125126 0 9801097 7989891 1811206 125752 102513 23239 0 282204 230054 52150 6250059 5095071 1154988 0 4377988 3568952 809036 1042762 850063 192699 BAD DEBTS 157493007 128388883 29104124 Medical Supplies 40830141 33284882 7545259 Equipment Rental 3208076 2615235 592841 ASO SYSTEM 51015368 41587918 9427450 1972828 1608257 364571 427229481 348404938 78824543 0 3982292 0 0 0 0 0 60325472 28081152 0 0 0 0 0 0 9875299 5360223 560165 8497989 158298684 103255910 53353307 55042774 18874725 16698158 9084299 5326194 0 0 2644639 2276627 1645607 1726273 160345805 123009390 28553890 29852155 0 0 207618 48857 116375286 114165000 0 0 0 0 666250 471250 0 0 42221104 37245535 188024148 181782797 X -35095675 -59020037 7417332 246630 0 0 -27678343 -58773407 160345805 123009390 X -13792698 -1908937 -28176800 12783371 X X false false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 15867 15867 false PART II-B, LINE 1 LOBBYING ACTIVITIES: THE AMOUNT REPRESENTS THE PERCENTAGE OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION THAT THE AHA DETERMINED WAS FOR LOBBYING EXPENSES. 614744 614744 96896642 55667416 41229226 5048713 3813804 1234909 49181636 43774690 5406946 6556949 6556949 55042774 0 DUE TO AFFILIATES 8998581 INTEREST PAYABLE 24442672 MALPRACTICE RESERVES 3804282 37245535 true true X true X true X 500. true true false true true 5342824 2348871 2942803 0.01050 46565714 35219076 11346638 0.04050 322127 121622 200505 0.00070 52230665 37689569 14489946 0.05170 419244 12405 406839 0.00150 7285411 1721062 5564349 0.01990 681199 681199 0.00240 8385854 1733467 6652387 0.02380 60616519 39423036 21142333 0.07550 true 146552247 81371732 68803981 12567751 X true true 1 1 GOOD SHEPHERD MEDICAL CENTER 700 EAST MARSHALL AVE LONGVIEW TX 75601 WWW.GSMC.ORG 000029 X X X X THE GOOD SHEPHERD HOSPITAL INC 1 false false true X X X X X X X X X 15 true false false true X SEE PART V, SECTION C X true 15 true SEE PART V, SECTION C false true X 100 500. X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X true X false X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 REPRESENTATIVES FROM THE COMMUNITY: GSMC RECEIVED INPUT FROM REPRESENTATIVES OF THE COMMUNITY WHICH INCLUDES THE FOLLOWING INDIVIDUALS WITH; A) SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH B) AFFILIATION WITH LOCAL GOVERNMENT, SCHOOLS AND INDUSTRY C) INVOLVEMENT WITH UNDERSERVED AND MINORITY POPULATIONS. ALL INTERVIEWS WERE CONDUCTED USING A STANDARD QUESTIONNAIRE DEVELOPED BY BKD, LLP, A NATIONAL CPA FIRM THAT PROVIDES TAX AND OTHER ADVISORY SERVICES. THE FOLLOWING INDIVIDUALS PARTICIPATED IN OUR KEY INFORMANT INTERVIEW PROCESS: GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR OF EMERGENCY SERVICES - LONGVIEW GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR GOOD SHEPHERD MEDICAL ASSOCIATES, GASTROENTEROLOGIST GOOD SHEPHERD MEDICAL CENTER, PHARMACY DIRECTOR GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF REIMBURSEMENT GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR - MEDICAL/SURGICAL GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR OF PATIENT ACCESS GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR OF INFECTION CONTROL GOOD SHEPHERD HEALTH SYSTEM, CHIEF INFORMATION OFFICER GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF EMERGENCY SERVICES (KILGORE) GOOD SHEPHERD HEALTH SYSTEM, EDUCATIONAL SERVICES DIRECTOR GOOD SHEPHERD HEALTH SYSTEM, EMPLOYEE HEALTH DIRECTOR LONGVIEW CITY COUNCILMAN, DISTRICT 5 GOOD SHEPHERD MEDICAL ASSOCIATES, FAMILY NURSE PRACTITIONER GOOD SHPEHERD HEALTH SYSTEM, PHYSICIAN SERVICES DIRECTOR GOOD SHEPHERD MEDICAL CENTER, INTERNAL MEDICINE RESIDENCY PROGRAM DIRECTOR GREGG COUNTY HEALTH DEPARTMENT AIR LIFETEAM AIR RESCUE GOOD SHEPHERD HEALTH SYSTEM, VICE PRESIDENT OF HUMAN RESOURCES COMMUNITY HEALTHCORE, EXECUTIVE DIRECTOR CITY OF LONGVIEW, FIRE CHIEF GOOD SHEPHERD MEDICAL CENTER, IMAGING SERVICES DIRECTOR GOOD SHEPHERD MEDICAL CENTER, LAB SUPERVISOR GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR OF MARKETING COMMUNITY HEALTHCORE, EMPLOYEE RUSK COUNTY HEALTH DISTRICT GOOD SHEPHERD MEDICAL CENTER, PHYSICIAN DIRECTOR OF EMERGENCY SERVICES GOOD SHEPHERD MEDICAL CENTER, INPATIENT REHAB SERVICES DIRECTOR GOOD SHEPHERD MEDICAL ASSOCIATES, PHYSICIAN DIRECTOR - INTERNAL MEDICINE CLINIC GOOD SHEPHERD MEDICAL ASSOCIATES, NURSE PRACTITIONER LONGVIEW CITY COUNCILWOMAN, DISTRICT 3 GOOD SHEPHERD MEDICAL CENTER, VICE PRESIDENT - ANCILLIARY SERVICES (MARSHALL) GOOD SHEPHERD MEDICAL CENTER, CHIEF NURSING OFFICER (MARSHALL) LONGVIEW CHAMBER OF COMMERCE, CHIEF EXECUTIVE OFFICER MARSHALL/HARRISON COUNTY HEALTH DISTRICT, EMPLOYEE GOOD SHEPHERD MEDICAL ASSOCIATES, PHYSICIAN LONGVIEW CITY COUNCILWOMAN, DISTRICT 4 GOOD SHEPHERD MEDICAL ASSOCIATES, EXECUTIVE VICE PRESIDENT/COO GOOD SHEPHERD MEDICAL CENTER, COMPLIANCE SPECIALIST - QUALITY GOOD SHEPHERD HEALTH SYSTEM, EXECUTIVE DIRECTOR - HEALTH & PREVENTION COMMUNITY HEALTHCORE, EMPLOYEE GOOD SHEPHERD MEDICAL CENTER, CHIEF NURSING OFFICER (LONGVIEW) GOOD SHEPHERD MEDICAL CENTER, MEDICAL DIRECTOR - SURGICAL SERVICES COMMUNITY HEALTHCORE, EMPLOYEE GOOD SHEPHERD HEALTH SYSTEM, PATIENT EXPERIENCE DIRECTOR GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR - ORTHO/NEURO UNIT GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR - ONCOLOGY UNIT GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR - ANTEPARTUM/MOTHER BABY UNIT HARRISON COUNTY UNITED WAY GOOD SHEPHERD HEALTH SYSTEM, SENIOR VICE PRESIDENT - INTEGRATION & BUSINESS DEVELOPMENT CUMBERLAND PRESBYTERIAN CHURCH OF MARSHALL, REVEREND COMMUNITY HEALTHCORE, EMPLOYEE GOOD SHEPHERD MEDICAL ASSOCIATES, PEDIATRICIAN GOOD SHEPHERD MEDICAL ASSOCIATES, CLINIC DIRECTOR OF OPERATIONS (PRIMARY CARE) GOOD SHEPHERD MEDICAL ASSOCIATES, GASTROENTEROLOGIST GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF EMERGENCY SERVICES (NORTHPARK) GOOD SHEPHERD MEDICAL CENTER, EMERGENCY MEDICINE PHYSICIAN GOOD SHEPHERD MEDICAL ASSOCIATES, CLINIC DIRECTOR OF OPERATIONS (SPECIALTY CARE) GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR - LABOR & DELIVERY PINE TREE SCHOOL DISTRICT, SUPERINTENDENT GOOD SHEPHERD HEALTH SYSTEM, CHIEF FINANCIAL OFFICER GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR - GOVERNMENT & COMMUNITY RELATIONS GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF EMERGENCY SERVICES (LONGVIEW) RUSK COUNTY UNITED WAY GOOD SHEPHERD MEDICAL ASSOCIATES, PEDIATRICIAN THE FOLLOWING PRIORITIZED COMMUNITY NEEDS WERE IDENTIFIED THROUGH CHNA 1. LACK OF MENTAL HEALTH PROVIDERS/SERVICES 2. OBESITY, DIABETES, HEART DISEASE AND OTHER CHRONIC DISEASES 3. AFFORDABLE PRIMARY AND PREVENTATIVE CARE OPTIONS 4. UNEMPLOYMENT AND DECREASE IN INCOME IN THE COMMUNITY DUE TO ECONOMIC DOWNTURN 5. HEALTHY BEHAVIORS/LIFESTYLE CHOICES 6. SUBSTANCE ABUSE 7. LACK OF HEALTH KNOWLEDGE/EDUCATION 8. LACK OF COMMUNITY RESOURCES TO PROMOTE HEALTH (FACILITIES, OUTDOOR SPACES) 9. POOR NUTRITION/LIMITED ACCESS TO HEALTHY FOOD OPTIONS 10. UNINSURED/LIMITED INSURANCE DUE TO LACK OF MEDICAID EXPANSION OR HIGH DEDUCTIBLE PLANS 11. ADULT SMOKING/TOBACCO USE 12. CRIME AND VIOLENCE SCHEDULE H, PART V, SECTION B, LINE 11 IDENTIFIED NEEDS ADDRESSED AND NOT ADDRESSED: IN RESPONSE TO THE RESULTS OF THE 2016 CHNA, THE HOSPITAL'S BOARD OF DIRECTORS AND MANAGEMENT TEAM DEVELOPED A CHNA IMPLEMENTATION PLAN IN ORDER TO PRIORITIZE AND ADDRESS THE MAJOR COMMUNITY NEEDS. IN REGARDS TO THE #1 COMMUNITY NEED IDENTIFIED IN THE CHNA (LACK OF MENTAL HEALTH PROVIDERS/SERVICES), WE TOOK SEVERAL ACTIONS DURING THE TAX YEAR AND PLAN TO CONTINUE BUILDING UPON THESE STEPS IN THE FUTURE. THESE ACTIONS ARE PRIMARILY TO ADDRESS THE ONGOING ISSUE OF TREATING BEHAVIORAL HEALTH PATIENTS IN OUR EMERGENCY DEPARTMENT AND REFERRING THESE PATIENTS TO OTHER PSYCHIATRIC PROVIDERS. OUR GOAL IS TO BOTH IMPROVE CARE AND PROVIDE SERVICES IN A MORE APPROPRIATE TREATMENT SETTING. ACTIONS TAKEN TOWARDS ADDRESSING THE #1 NEED INCLUDED: - HIRED A FULL TIME PSYCHIATRIST AND BEHAVIORAL HEALTH TECHNICIANS. - CREATED A NEW CLINICAL DIRECTOR OF BEHAVIORAL HEALTH POSITION THAT IS STAFFED BY A BOARD-CERTIFIED PSYCHIATRIC NURSE. - REMODELED SIX EMERGENCY ROOMS AND SIX INPATIENT ROOMS SPECIFICALLY FOR USE AS A PSYCH-SAFE CARE DELIVERY SPACES. - ENGAGED A TELE-PSYCHIATRY SERVICE PROVIDER TO HELP EXPEDITE PSYCH PATIENT EVALUATIONS - HOSTED THE FIRST ANNUAL BEHAVIORAL HEALTH COLLABORATION CONFERENCE WITH LAW ENFORCEMENT, LOCAL MENTAL HEALTH PROVIDERS AND COUNTY JUDGES. ALSO, CONTINUE TO HOST QUARTERLY COMMUNITY-WIDE BEHAVIORAL HEALTH MEETINGS. - PROVIDED SAMA DE-ESCALATION TRAINING TO HELP PREVENT PSYCHIATRIC PATIENT AGGRESSION FROM BEING PHYSICALLY HARMFUL. - PROVIDED 800 PSYCHIATRIC PATIENT TRANSPORTS TO SHORT-TERM REGIONAL CRISIS STABILIZATION CENTERS, LOCAL INPATIENT FACILITIES AND STATE OPERATED PSYCHIATRIC HOSPITALS. - CONTINUED A SPECIAL PROJECT FUNDED THROUGH THE TEXAS MEDICAID WAIVER WITH CMS TO INTEGRATE PSYCHIATRIC PATIENTS INTO OUR PATIENT CENTERED MEDICAL HOME WITHIN AN INTERNAL MEDICINE CLINIC. WE ALSO CONTINUE TO EMPLOY PATIENT CARE NAVIGATORS (PCNS) WHO EVALUATE AND REFER PATIENTS TO COMMUNITY HEALTHCORE (THE REGIONAL MENTAL HEALTH AUTHORITY), AND OTHER OUTPATIENT PSYCHIATRIC SERVICE PROVIDERS. - HOSPITAL MANAGERS HAVE ALSO BEGAN PARTICIPATING IN A SPECIAL CITY OF LONGVIEW TASK FORCE DEVELOPED BY THE MAYOR TO ADDRESS ISSUES (INCLUDING PSYCHIATRIC AND SUBSTANCE ABUSE NEEDS) INVOLVING THE CITY'S HOMELESS POPULATION. THE AFOREMENTIONED ACTIONS WILL ALSO ADDRESS COMMUNITY NEED #6 (SUBSTANCE ABUSE) AND INDIRECTLY CONTRIBUTE TO A REDUCTION IN NEED #12 (CRIME AND VIOLENCE) DUE TO HIGH CRIME AND VIOLENCE RECIDIVISM OF UNTREATED PSYCHIATRIC AND SUBSTANCE ABUSE PATIENTS. IN REGARDS TO THE REMAINING COMMUNITY NEEDS, THE HOSPITAL WILL CONTINUE TO OFFER A WIDE RANGE OF SERVICES, PROGRAMS, EDUCATION AND TRAINING TO ADDRESS NEED #'S 2, 5, 7, AND 11. ISSUE #8 IS PARTIALLY ADDRESSED BY STATE-OF-THE-ART FITNESS CENTER, INCLUDING FITNESS SCHOLARSHIPS OFFERED TO LOW INCOME PATIENTS WITH SIGNIFICANT HEALTH PROBLEMS, NEED #'S 3 AND 10 ARE ADDRESSED BY SPECIAL IN-HOUSE PROGRAMS TO ASSIST THE UNINSURED, INCLUDING PAYMENT DISCOUNT PROGRAMS, CERTIFIED APPLICATION COUNSELORS TO ASSIST PATIENTS WITH ACCESS TO THE FEDERAL HEALTH INSURANCE MARKETPLACE, CHARITY POLICIES AND REFERRALS TO LOCAL FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS). MORE DETAILS REGARDING OUR CHNA IMPLEMENTATION STRATEGY MAY BE FOUND AT WWW.GSMC.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. COMMUNITY NEEDS NOT ADDRESSED: AREAS OF NEED NOT SPECIFICALLY ADDRESSED BY THE HOSPITAL INCLUDE NEED #4 (UNEMPLOYMENT AND DECREASE IN INCOME DUE TO ECONOMIC DOWNTURN), #9 (POOR NUTRITION/LIMITED ACCESS TO HEALTHY FOODS) AND DIRECT ACTION TO MEET #12 (CRIME AND VIOLENCE). WHILE MEMBERS OF HOSPITAL MANAGEMENT PARTICIPATE IN LOCAL GROUPS AND COMMITTEES FORMED TO PROMOTE ECONOMIC GROWTH AND JOBS, THE HOSPITAL DOES NOT CHOOSE TO DIRECTLY ADDRESS ECONOMIC MATTERS OF THE COMMUNITY DUE TO OUR FINANCIAL LIMITATIONS. ALSO, WHILE THE HOSPITAL PROVIDES SOME EDUCATION TO PATIENTS REGARDING PROPER DIET, WE DO NOT HAVE THE RESOURCES OR ABILITY TO ENSURE THAT IMPOVERISHED POPULATIONS ENJOY NUTRITIONAL AND VARIED FOOD OPTIONS DELIVERED TO FOOD DESERTS. FINALLY, IT IS NOT CONSIDERED A HOSPITAL ROLE TO CONFRONT RISING CRIME AND VIOLENCE THROUGH DIRECT ENFORCEMENT ACTIONS. SCHEDULE H, PART V, SECTION B, LINE 22D DETERMINATION OF AMOUNTS BILLED: THE FINANCIAL ASSISTANCE ELIGIBILITY DISCOUNT GUIDELINES IN PLACE DURING TAX YEAR 2015 STATED, "ALL UNINSURED PATIENTS WHO QUALIFY FOR LESS THAN 68% FINANCIAL ASSISTANCE AND COMPLETE THE NECESSARY APPLICATION PROCESS, WILL RECEIVE THE DISCOUNT UNDER THE UNINSURED ADJUSTMENT. THIS AMOUNT IS BASED ON AN AVERAGE OF GSHS MANAGED CARE CONTRACTS DEEPEST DISCOUNTS." (BEGINNING IN TAX YEAR 2016, THE HOSPITAL CHANGED TO USING MEDICARE RATES TO CALCULATE MAXIMUM AMOUNTS THAT CAN BE CHARGED.) SCHEDULE H, PART V, SECTION B, LINES 7 & 10A CHNA & IMPLEMENTATION STRATEGY: THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: WWW.GSMC.ORG/LONGVIEW/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 16A, 16B & 16C FAP DOCUMENTS AVAILABLE TO THE PUBLIC: THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: WWW.gsmc.org/patients-visitors/financial-assistance-1 5 INSTITUTE FOR HEALTHY LIVING 3133 GOOD SHEPHERD WAY LONGVIEW TX 75605 PHYSICAL THERAPY, SPEECH PATHOLOGY, OCCUPATIONAL THERAPY, CARDIAC REHAB CENTER PERFORMANCE REHAB 2220 H G MOSLEY PARKWAY LONGVIEW TX 75604 PHYSICAL THERAPY KILGORE EMERGENCY DEPARTMENT 1612 S HENDERSON BLVD KILGORE TX 75662 EMERGENCY SERVICES NORTHPARK EMERGENCY DEPARTMENT 323 E HAWKINS PARKWAY LONGVIEW TX 75605 EMERGENCY SERVICES NEUROLOGICAL CLINIC 701 E MARSHALL AVE STE 400 LONGVIEW TX 75601 PAIN MANAGEMENT CLINIC SCHEDULE H, PART III, SECTION A, LINE 2 & 3 BAD DEBT EXPENSE: THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24(A) OF $157,493,007, HAS BEEN REDUCED BY ALLOCATED MEDICAID SUPPLEMENTAL PAYMENTS OF $10,940,760. WE DID NOT INCLUDE ANY BAD DEBT AMOUNTS IN COMMUNITY BENEFITS. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY: SOURCE OF INFORMATION ON LINE 6 IS THE FYE 09/30/16 MEDICARE COST REPORT. THE SUM OF MEDICARE PART A ALLOWABLE COSTS REPORTED ON WORKSHEET D-1, PART II (FOR BOTH INPATIENT ACUTE PPS AND INPATIENT REHAB FACILITY) AND WORKSHEET DV, COLUMN 9.01 FOR MEDICARE OUTPATIENT PPS SERVICES. SINCE ALLOWABLE COSTS ARE NOT DETERMINED FOR SERVICES RENDERED TO MEDICARE PATIENTS ENROLLED IN MEDICARE ADVANTAGE (MEDICARE PART C) OR FOR PHYSICIAN SERVICES BILLED UNDER MEDICARE PART B, NEITHER THE REVENUES OR COSTS RELATED TO THESE SERVICES HAVE BEEN INCLUDED ON LINES 5 OR 6. MEDICARE ALLOWABLE COSTS WERE DERIVED FROM THE FYE 09/30/16 MEDICARE COST REPORT. THE COST REPORT USES FINANCIAL AND STATISTICAL DATA TO DEVELOP PER DIEMS AND COST TO CHARGE RATIOS THAT ULTIMATELY DETERMINE ALLOWABLE MEDICARE INPATIENT AND OUTPATIENT COSTS. SCHEDULE H, PART III, SECTION C, LINE 9B PROVISIONS ON COLLECTION PRACTICES: ALL PATIENTS WHO ARE UNDERINSURED OR UNINSURED WILL BE EVALUATED FOR GOVERNMENT PROGRAMS, PAYMENT PLANS AND FINANCIAL ASSISTANCE. IF ALL ATTEMPTS FAIL, WE WILL CONSIDER EACH ACCOUNT MEETING CERTAIN CRITERIA FOR FINANCIAL ASSITANCE. ANY ACCOUNT THAT HAS A BALANCE GREATER THAN $10,000 AND HAS NOT QUALIFIED FOR MEDICAID OR COUNTY CHARITY PROGRAMS WILL BE REVIEWED ON A CASE BY CASE BASIS FOR CHARITY CONSIDERATION. CREDIT REPORTS MAY BE RUN AND SUBMITTED FOR REVIEW. WRITE OFFS WILL BE MONITORED THROUGH A SPECIFIC CODE, TO MONITOR AND EVALUATE, AS NEEDED, FOR CHANGES OR UPDATES. IF AT ANYTIME RECOVERIES ARE OBTAINED AFTER WRITE-OFF, THE CHARITY ADJUSTMENT WILL BE REVERSED AND ADDITIONAL REVIEW OF THE ACCOUNT WILL BE REQUIRED. GOOD SHEPHERD MEDICAL CENTER DOES NOT CONDUCT, OR PERMIT COLLECTION AGENCIES TO CONDUCT ON ITS BEHALF, EXTRAORDINARY COLLECTION ACTIONS, AGAINST INDIVIDUALS BEFORE REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR THE FINANCIAL ASSISTANCE PROGRAM. IF AT ANY TIME IT IS DETERMINED THAT AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE, ALL COLLECTION ATTEMPTS ARE STOPPED. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: THE UNITED WAY CONDUCTS A NEEDS ASSESSMENT SURVEY EVERY TWO YEARS TO DETERMINE THE HEALTH NEEDS OF THE COMMUNITY. GOOD SHEPHERD USES THIS DATA TO AUGMENT INFORMATION GATHERED IN OUR INTERNAL CHNA. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: AS PATIENTS ENTER OUR FACILITY, SIGNAGE IS POSTED IN DESIGNATED AREAS WHICH STATE OUR POLICY TO PROVIDE CHARITY CARE TO THOSE PATIENTS WHO MEET ELIGIBILITY REQUIREMENTS. BUSINESS OFFICE AND REGISTRATION STAFF DISCUSS PAYMENT OPTIONS AND FINANCIAL ASSISTANCE AVAILABLE TO PATIENTS USING VERBAL AND WRITTEN COMMUNICATION. PATIENTS ARE CONTACTED PRIOR TO SERVICES WITH AN ESTIMATED COST AND OUT OF POCKET EXPENSES. CASH PRICES AND PAYMENT OPTIONS ARE DISCUSSED AND FINANCIAL ASSISTANCE SCREENING IS AVAILABLE UPON REQUEST. GOOD SHEPHERD MEDICAL CENTER EVALUATES PATIENT APPLICATIONS AND UTILIZES A SLIDING SCALE TO QUALIFY PATIENTS BASED ON GOVERNMENT POVERTY GUIDELINES. ADDITIONALLY, OUR ELIGIBILITY VENDOR SCREENS FOR GOVERNMENT AGENCY PROGRAMS AND OFFERS FINANCIAL ASSISTANCE APPLICATIONS TO THOSE WHO DO NOT QUALIFY FOR GOVERNMENT PROGRAMS. BUSINESS OFFICE AND REGISTRATION PERSONNEL ARE AVAILABLE TO ANSWER ANY FINANCIAL QUESTIONS AND ASSIST THE PUBLIC WITH THEIR FINANCIAL OBLIGATIONS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: GOOD SHEPHERD MEDICAL CENTER SERVES AN 11-COUNTY REGION INCLUDING THE FOLLOWING COUNTIES: GREGG, HARRISON, MARION, MORRIS, PANOLA, RUSK, UPSHUR, CAMP, CASS, WOOD AND TITUS. GOOD SHEPHERD MEDICAL CENTERS IN LONGVIEW AND MARSHALL OFFER A TRUE SYSTEM OF HEALTHCARE THAT ENCOMPASSES THE REACH OF OUR REGION. TO MEET THE EVERYDAY HEALTHCARE NEEDS OF THE RESIDENTS IN OUR REGION, GOOD SHEPHERD HEALTH SYSTEM OPERATES FAMILY HEALTH CENTERS IN THE COMMUNITIES OF LONGVIEW, GLADEWATER, HENDERSON AND KILGORE. THE PROJECTED 2016 PRIMARY 6 COUNTIES POPULATIONS ARE GREGG 130,315, HARRISON 69,524, MARION 11,151, UPSHUR 42,803, RUSK 59,148 AND PANOLA 25,122 AND TOTAL 338,063. (SOURCE: HTTPS://WWW.DSHS.TEXAS.GOV/CHS/POPDAT/ST2016P.SHTM.) SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: GOVERNED BY A VOLUNTARY BOARD OF DIRECTORS, GOOD SHEPHERD MEDICAL CENTER HAS A DIRECT LINK TO SOLICIT COMMUNITY INVOLVEMENT IN DECISION MAKING. THE BOARD OF DIRECTORS IS COMPOSED OF GOOD SHEPHERD MEDICAL CENTER'S PRESIDENT AND CHIEF EXECUTIVE OFFICER, AND TWELVE MEMBERS OF THE COMMUNITY WHO SERVE ON A VOLUNTARY BASIS TO FURTHER THE MISSION OF GOOD SHEPHERD MEDICAL CENTER. THESE MEMBERS REPRESENT LOCAL BUSINESS, INDUSTRY, EDUCATION, MEDICAL SERVICES, AND CONSUMERS-AT-LARGE. THE BOARD OF DIRECTORS PROVIDES PERPETUAL COMMUNICATION OF THE CONCERNS AND HEALTHCARE NEEDS OF THE GREATER LONGVIEW COMMUNITY. GOOD SHEPHERD MEDICAL CENTER MAINTAINS A PRESENCE TO PROVIDE HEALTHCARE INFORMATION TO COMMUNITIES THROUGHOUT THE REGION. IN ADDITION, THE ORGANIZATION HOSTS AN ANNUAL HEALTH FAIR OFFERING FREE HEALTH SCREENINGS. GOOD SHEPHERD ALSO OFFERS DISCOUNTED MAMMOGRAMS EACH MONTH, FREE PROSTATE SCREENING ANNUALLY, AND WAS INEGRALLY INVOLVED IN ESTABLISHING THE MAYOR'S FITNESS COUNCIL. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: GOOD SHEPHERD HEALTH SYSTEM OPERATES HOSPITALS IN LONGVIEW AND MARSHALL. IN EACH OF THE COMMUNITIES, THE HOSPITAL OFFERS FREE SCREENINGS TO IDENTIFY EARLY DISEASE, EDUCATIONAL OFFERINGS FEATURING PHYSICIAN SPEAKERS AND CONTINOUSLY PARTICIPATES IN COMMUNITY ACTIVITIES WHERE PREVENTION AND WELLNESS INFORMATION CAN BE SHARED. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: TEXAS SCHEDULE H, PART I, LINES 7A & 7B ALLOCATION OF MEDICAID SUPPLEMENTAL PAYMENTS: DURING THE CURRENT REPORTING PERIOD, THE STATE OF TEXAS PARTICIPATED IN A SPECIAL 1115 MEDICAID WAIVER WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). VARIOUS SUPPLEMENTAL PAYMENTS UNDER THE WAIVER ARE INTENDED TO HELP HOSPITALS OFFSET MEDICAID AND UNINSURED LOSSES AND/OR CREATE NEW PROGRAMS DESIGNED TO IMPROVE THE PATIENT CARE EXPERIENCE, ENHANCE HEALTH OUTCOMES AND REDUCE COSTS FOR THESE SAME PATIENT POPULATIONS. SUPPLEMENTAL PAYMENTS ARE CAPPED BY MEDICAID AND UNINSURED LOSSES DETERMINED FROM A SPECIAL UNCOMPENSATED CARE (UC) TOOL DESIGNED BY THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION (HHSC) IN FISCAL YEAR 2016, THE HOSPITAL RECOGNIZED $25,748,097 OF SUPPLEMENTAL PAYMENT INCOME UNDER THE MEDICAID WAIVER. THE PAYMENTS WERE PARTIALLY FUNDED THROUGH INTER-GOVERNMENT TRANSFER (IGT) PAYMENTS FROM A LOCAL PROVIDER PARTICIPATION FUND ENABLED BY A LAW PASSED IN THE 84TH TEXAS LEGISLATURE. THE LPPF IS FUNDED BY HOSPITAL TAX ASSESSMENTS TOTALING $17,061 IN FISCAL YEAR 2016. FOR PURPOSES OF IRS FORM 990 SCHEDULE H REPORTING, THE MEDICAID SUPPLEMENTAL PAYMENTS AND TAX ASSESSMENTS HAVE BEEN ALLOCATED BETWEEN FINANCIAL ASSISTANCE (CHARITY), MEDICAID AND BAD DEBT USING RATIOS DERIVED FROM THE UC TOOL AND OTHER INTERNAL DOCUMENTS USED FOR PURPOSES OF PREPARING MEDICARE COST REPORT WORKSHEET S-10 "HOSPITAL UNCOMPENSATED AND INDIGENT CARE DATA". MORE INFORMATION ON THE MEDICAID WAIVER MAY BE FOUND AT HTTP://WWW.HHSC.STATE.TX.US/1115WAIVER-SHTML. SCHEDULE H, PART III, LINE 4 BAD DEBT FOOTNOTE: THE INFORMATION IS PROVIDED IN THE ATTACHED AUDITED FINANCIAL STATEMENT ON PAGES 10 AND 11 TITLED "PATIENT ACCOUNTS RECEIVABLE". SCHEDULE H, PART I, LINE 3B PROCESS FOR DETERMINING ELIGIBILITY FOR DISCOUNTED CARE: POLICY IN TAX YEAR 2015 ALLOWED FOR FINANCIAL ASSISTANCE FOR PERSONS UP TO 500% OF FEDERAL POVERTY GUIDELINES (FPG). BEGINNING IN TAX YEAR 2016, THE QUALIFICATION THRESHOLD WAS LOWERED TO 400% OF FPG. SCHEDULE H, PART I, LINE 3C FACTORS TO DETERMINE FREE OR DISCOUNTED CARE: TO QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY THE FOLLOWING MUST BE MET: (1) A RATIO IS DEVELOPED BY DIVIDING THE PATIENT'S INCOME BY THE FEDERAL POVERTY GUIDELINES. (2) THIS RATIO IS MATCHED TO THE FOLLOWING CHART TO DETERMINE AMOUNT ELIGIBLE FOR FINANCIAL ASSISTANCE. RATIO ASSISTANCE 0% - 100% 100% 101% - 200% 80% 201% - 300% 60% 301% - 400% 40% 401% - 500% 20% 501% - 1000% 0% FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: - ASSET LEVEL - MEDICAL INDIGENCY - INSURANCE STATUS - UNDERINSURANCE STATUS SCHEDULE H, PART I, LINE 7, COL(F) BAD DEBT EXPENSE: BAD DEBT IN THE AMOUNT OF $157,493,007, WAS NOT INCLUDED IN TOTAL EXPENSE USED TO COMPUTE THE PERCENTAGE REPORTED IN PART I, LINE 7 COL(F). true SERVICE ORGANIZATION OF GOOD SHEPHERD 2950 50TH STREET LUBBOCK TX 79413 383914883 501(C)(3) 681199 HEALTHCARE SERVICES 1 SCHEDULE I, PART I, LINE 2 AFTER A NEED IS DETERMINED FOR ASSISTANCE, A REQUEST FROM THE SERVICE ORGANIZATION OF GOOD SHEPHERD IS SUBMITTED, IDENTIFYING THE FUNDS NEEDED FOR THE PROGRAM AND/OR PATIENT. THE REQUEST IS REVIEWED AND APPROVED BY THE CFO BEFORE FUNDS ARE TRANSFERRED. A SERVICE LOG IS SUBMITTED TO THE CFO TO DOCUMENT HOURS INCURRED ON PROJECTS AND SUPPORT USE OF FUNDS. false true false false false false false false false STEVE ALTMILLER PRESIDENT - CEO 0 650200 0 0 0 0 0 75600 0 11957 0 737757 SUSHAMA BRIMMER PHYSICIAN 0 331519 0 95718 0 0 0 10600 0 17590 0 455427 TIM PILEGGI INTERIM CFO 0 583683 0 0 0 0 0 0 0 0 0 583683 DANIEL D SMITH CRNA 254222 0 0 0 0 0 10443 0 15435 0 280100 0 RICHARD LEE HOLLADAY CRNA 352622 0 0 0 0 0 10600 0 2255 0 365477 0 ROGER BRYANT JR CRNA 256719 0 0 0 0 0 10468 0 15341 0 282528 0 LEE ALLEN HOLLADAY CRNA 253393 0 0 0 0 0 10448 0 11200 0 275041 0 RICHARD HINSON CRNA 270023 0 0 0 0 0 10600 0 12537 0 293160 0 KEN CUNNINGHAM former EVP SECRETARY 0 353969 0 30000 0 0 0 36100 0 17590 0 437659 PART I, LINE 3 GSMC DOES NOT HAVE A CEO THAT IT EMPLOYS WHO IS PAID DIRECTLY OR INDIRECTLY BY THE FILING ORGANIZATION OR A RELATED ORGANIZATION. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DESCRIBED IN 457(F): INDIVIDUALS: PAYMENT IN W-2: DEFERRED COMPENSATION: STEVE ALTMILLER NONE $ 65,000 KEN CUNNINGHAM NONE $ 25,500 A GREGG COUNTY HEALTH FACILITIES DEVELOPMENT 751865828 39753MFFO 2012-09-05 33033015 CAPITAL IMPROVEMENTS false false false B GREGG COUNTY HEALTH FACILITIES DEVELOPMENT 751865828 39753MDT2 2015-02-01 88000000 REFINANCING false false false C GREGG COUNTY HEALTH FACILITIES DEVELOPMENT 751865828 39753MDU9 2006-11-08 99276418 ADVANCE REFUNDING OF BONDS false false false A 315000 0 33033015 2176874 0 8338548 660660 0 14045280 0 0 7811653 2014 false true false true B 77682622 0 87286972 8800000 0 0 804350 0 0 0 0 0 2015 false true false true C 1335000 0 99276418 0 0 96480044 636501 2159873 0 0 0 0 2012 false true true true A false false false false 0 false false false false B false false false false 0 false false false false C false false false false 0 false false false false A false true false false false true 0 false false false 0 false false B false true false false true false 0 false 0 false false C false false false true false false 0 false 0 false false A false B false C false SCHEDULE K, PART II, LINE 3: $87,286,972 IS THE $88,000,000 LESS $713,028 UNDERWRITERS DISCOUNT. SCHEDULE K, PART IV, ARBITRAGE, LINE 2C: (A) ISSUER NAME: GREGG COUNTY HEALTH FACILITIES DEVELOPMENT CORPORATION DATE THE REBATE COMPUTATION WAS PERFORMED: 11/07/2011 FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE ORGANIZATION: GSHS INC IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINES 7A & 7B GOVERNING DECISIONS OF THE ORGANIZATION: A NUMBER OF DECISIONS OF THE ORGANIZATION ARE SUBJECT TO APPROVAL OF THE MEMBER OF THE ORGANIZATION. THESE RESERVED POWERS ARE STATED BELOW: A) BEGINNING JANUARY 1, 2007, APPROVE THE MEMBERS OF THE BOARD; B) BEGINNING JANUARY 1, 2007, REMOVE MEMBERS FROM THE BOARD AND SET SIZE OF BOARD; C) APPROVE THE ELECTION AND REMOVAL OF OFFICERS OF THE CORPORATION AND ESTABLISH, TERMINATE AND/OR REVISE ALL EMPLOYMENT CONTRACTS, COMPENSATION, AND BENEFIT PACKAGES OF THE OFFICERS OF THE CORPORATION; D) DESIGNATE THE FISCAL YEAR; E) APPROVE THE SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, OUTSIDE GENERAL LEGAL COUNSEL, AND OUTSIDE INVESTMENT ADVISORS; F) AMEND THE ARTICLES OF INCORPORATION; G) AMEND OR REPEAL THE BYLAWS; H) APPROVAL OF ALL MERGERS, ACQUISITIONS, CONSOLIDATIONS, OR AFFILIATIONS WITH OTHER ENTITIES, THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE SALE, MORTGAGE, OR ENCUMBRANCE OF ANY REAL PROPERTY OWNED BY THE CORPORATION; I) APPROVE THE DISSOLUTION OR LIQUIDATION OF THE CORPORATION; J) APPROVE CAPITAL PLANS, STRATEGIC PLANS, AND ANNUAL OPERATING AND CAPITAL BUDGETS; K) APPROVE ANY EXCEPTION TO THE CAPITAL BUDGET FOR A SINGLE ITEM OR RELATED ITEM THAT IS $500,000 OR MORE, AND APPROVE ANY OPERATING EXPENSE THAT EXCEEDS THE BUDGET BY $500,000 OR MORE; L) SELECT OFFICIAL DEPOSITORIES FOR THE CORPORATION'S FUNDS; M) CREATING OR INVESTING IN ANY SUBSIDIARY ENTITY OR ENTERING ANY PARTNERSHIP OR JOINT VENTURE; N) AUTHORIZATION OF ANY LOANS, GUARANTEES, OR INCURRENCE OF DEBT; O) THE COMMENCEMENT OF ANY LITIGATION OR OTHER LEGAL PROCEEDINGS, OR THE SETTLEMENT, DISPOSITION, OR TERMINATION OF ANY SUCH LITIGATION OR OTHER LEGAL PROCEEDING OR OF ANY CLAIM OR THREAT OF LITIGATION OR OTHER LEGAL PROCEEDING NOT FULLY COVERED BY INSURANCE; AND P) APPROVAL OF THE ADMISSION OF ADDITIONAL MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS OF REVIEWING FORM 990: THE ORGANIZATION HAS AN EXTERNAL ACCOUNTING FIRM AUDIT ON A CONSOLIDATED BASIS. THE 990 IS PREPARED BY AN EXTERNAL ACCOUNTING FIRM. THE RETURN IS THEN REVIEWED BY INTERNAL ACCOUNTANTS AND EXECUTIVES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY: DISCLOSURES ARE OBTAINED ANNUALLY. THE BOARD REVIEWS AND APPROVES THE BOARD MEMBERS' DISCLOSURES, AND THE CEO REVIEWS AND APPROVES THE EMPLOYEES' DISCLOSURES. BOARD MINUTES REFLECT WHEN A BOARD MEMBER DECLARES A CONFLICT AND DOES NOT VOTE. FORM 990, PART VI, SECTION B, LINE 15 PROCESS OF DETERMINING COMPENSATION: A COMPENSATION SUBCOMMITTEE OF THE BOARD NEGOTIATES CONTRACTS WITH EXECUTIVES THROUGH LONGNECKER & ASSOCIATES. THIS SUBCOMMITTEE OF THE BOARD REVIEWS AND APPROVES COMPENSATION AND BONUSES ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: GOOD SHEPHERD MEDICAL CENTER DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IV, LINE 12 & PART XII, LINE 2 AUDITED FINANCIAL STATEMENTS: THE ORGANIZATION HAS ANSWERED "NO" TO THE QUESTIONS REGARDING AN AUDIT IN PART IV, LINE 12 AND PART XII. THE ORGANIZATION ONLY RECEIVED AN AUDIT OF ITS BALANCE SHEET FOR THE YEAR ENDED SEPTEMBER 30, 2016. THEREFORE, SINCE THE ORGANIZATION DID NOT HAVE AN AUDITED INCOME STATEMENT FOR THE PERIOD COVERED BY THIS RETURN, THE ORGANIZATION DOES NOT HAVE AUDITED FINANCIAL STATEMENTS ACCORDING TO THE IRS INSTRUCTIONS. THE ORGANIZATION HAS ATTACHED A COPY OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2015 AND SEPTEMBER 30, 2014 TO THE FORM 990 AND ANSWERED "YES" TO PART IV, LINE 20B. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: FORGIVENESS OF DEBT WITH FOUNDATION $ 6,425,256 CHANGE IN BOND SWAP AGREEMENT 12,980,328 OTHER RECLASSIFICATIONS (6,622,213) ------------------------ TOTAL $12,783,371 GSHS INC 700 E MARSHALL AVE LONGVIEW TX 75601 752027157 SUPPORT GSMC TX 501(C)(3) 11, TYPE II NA false GOOD SHEPHERD HOSPITAL AUXILIARY 700 E MARSHALL AVE LONGVIEW TX 75601 237203364 SUPPORT TX 501(C)(3) 9 GSMC true GOOD SHEPHERD FOUNDATION 700 E MARSHALL AVE LONGVIEW TX 75601 752056700 SUPPORT TX 501(C)(3) 11, TYPE I GSMC true GSHS ADMINISTRATIVE SERVICES ORG 700 E MARSHALL AVE LONGVIEW TX 75601 861132471 ADMIN SUPPORT TX 501(C)(3) 11, TYPE I GSHS true HARRISON COUNTY HOSPITAL ASSOCIATION 811 SOUTH WASHINGTON AVE MARSHALL TX 75670 750974351 HEALTHCARE TX 501(C)(3) 3 GSHS true GOOD SHEPHERD MEDICAL CENTER - LINDEN 404 N KAUFMAN STREET LINDEN TX 75563 010829282 HEALTHCARE TX 501(C)(3) 3 GSHS true GSMC - LINDEN FOUNDATION 404 N KAUFMAN STREET LINDEN TX 75563 200845127 SUPPORT TX 501(C)(3) 11, TYPE I GSMC LINDEN true MARSHALL HOSPITAL FOUNDATION 811 SOUTH WASHINGTON AVE MARSHALL TX 75670 752605699 SUPPORT TX 501(C)(3) 7 GSMC MARSH true MARSHALL HEALTH SERVICES 811 SOUTH WASHINGTON AVE MARSHALL TX 75670 752580686 HEALTHCARE TX 501(C)(3) 3 GSMC MARSH true MEMORIAL HOSPITAL AUXILARY 811 S WASHINGTON AVE MARSHALL TX 75670 510151805 SUPPORT TX 501(C)(3) 3 GSMC Marsh true GS AMBULATORY SURGICAL CENTER 700 E MARSHALL AVE LONGVIEW TX 75601 900259782 SURGERY TX NA N/A GSHS ENTERPRISES 700 E MARSHALL AVE LONGVIEW TX 75601 752027162 HEALTHCARE TX GSHS C CORP true GOOD SHEPHERD HEALTH NETWORK 700 E MARSHALL AVE LONGVIEW TX 75601 752554695 INACTIVE TX GSMC C CORP 0 0 1.00000 true NORTHEAST TEXAS PHYSICIAN SERVICES 700 E MARSHALL AVE LONGVIEW TX 75601 752712245 MGMT SERVICES TX GSHS ENTERPRISE C CORP true GS PHYSICIAN SERVICES 700 E MARSHALL AVE LONGVIEW TX 75601 752762417 MEDICAL SERVICES TX GSHS ENTERPRISE C CORP true GSHS ENTERPRISES HOLDING 700 E MARSHALL AVE LONGVIEW TX 75601 510412465 HOLDING COMPANY DE GSHS ENTERPRISE C CORP true GSHS ENTERPRISES OPERATING 1 700 E MARSHALL AVE LONGVIEW TX 75601 752954772 HEALTHCARE DE GSHS ENTERPRISE C CORP true GSHS ENTERPRISES OPERATING 2 700 E MARSHALL AVE LONGVIEW TX 75601 752954777 HEALTHCARE DE GSHS ENTERPRISE C CORP true MARSHALL PHYSICIAN HOSPITAL ORGANIZATION 700 E MARSHALL AVE LONGVIEW TX 75601 752580689 INACTIVE TX GSMC MARSHALL C CORP true false false true false true false false false false true true true true true true true true true true GOOD SHEPHERD FOUNDATION E 471250 CASH PAID GOOD SHEPHERD HOSPITAL AUXILIARY C 116291 CASH PAID