2017-08-15T15:15:26-05:00 2016-09-30 BKD LLP 14241 DALLAS PARKWAY STE 1100 DALLAS TX 75254 990 2015-10-01 263091251 Dimmit Regional Hospital % ALMA MELENDEZ DIMM 8308762424 PO Box 1016 Carrizo Springs TX 78834 ERNEST FLORES JR CEO 8308762424 2017-08-15 true Jeanette Verrelli P00742631 9727028262 2015 2021-01-29 14:40:06Z ERNEST FLORES JR PO Box 1016 Carrizo Springs TX 78834 20567772 false X WWW.DIMMITREGIONALHOSPITAL.COM X 2008 TX TO OPERATE AND MANAGE DIMMIT COUNTY MEMORIAL HOSPITAL; TO RAISE FUNDS ON BEHALF OF THE HOSPITAL; AND TO PROMOTE THE HEALTH OF RESIDENTS OF DIMMIT COUNTY. 7 7 270 8 0 0 9227 542625 21596944 19633585 0 -8041 135937 341044 21742108 20509213 0 0 0 0 9276107 11511743 0 0 0 12442298 11956964 21718405 23468707 23703 -2959494 6420853 5228660 1813389 3580690 4607464 1647970 X TO OPERATE AND MANAGE DIMMIT COUNTY MEMORIAL HOSPITAL; TO RAISE FUNDS ON BEHALF OF, AND CONTRIBUTE FINANCIAL SUPPORT TO, THE HOSPITAL; TO SUPPORT OTHER HEALTH-CARE DELIVERY ORGANIZATIONS THAT ARE CLOSELY RELATED TO THE HOSPITAL; AND TO PROMOTE THE HEALTH OF THE RESIDENTS OF DIMMIT COUNTY AND SURROUNDING COMMUNITIES. false false 18739087 19974629 PROVIDED MEDICAL CARE TO RESIDENTS IN THE DIMMIT COUNTY AREA, INCLUDING 571 OPERATIONS; 9,300 EMERGENCY ROOM VISITS; 1,034 OBSERVATIONS VISITS; 2,133 HOME HEALTH VISITS AND 3,307 PATIENT DAYS. 18739087 true true false true false false false false false false true false false true true true true false false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 36 0 true 270 true false false false false false false false false false false X 7 7 false false true false false false false true true false false false true true true false true true true false X ALMA MELENDEZ 8308762424 704 HOSPITAL DRIVE CARRIZO SPRINGS TX 78834 X ALFREDO CASTANEDA DIRECTOR 0.25 0.0 X 235 0 0 BRUCE E LEONARD CHAIRMAN 0.25 0.0 X X 287 0 0 CLEO BUSTAMANTE JR VICE-CHAIRMAN 0.25 0.0 X X 260 0 0 MARY ALICE VALDEZ DIRECTOR 0.25 0.0 X 227 0 0 AUGUST LINNARTZ JR DIRECTOR 0.25 0.0 X 104 0 0 MIGUEL URIEGAS DIRECTOR 0.25 0.0 X 287 0 0 SAMUEL ALLEN JR SECRETARY 0.25 0.0 X X 235 0 0 ALMA MELENDEZ CFO 40.0 0.0 X 87430 0 5800 CARMEN P ESQUIVEL CNO 40.0 0.0 X 108164 0 12727 JIM BUCKNER CEO 40.0 0.0 X 180719 0 13293 ENRIQUE ITURBE ASSISTANT ADMINISTRATOR 40.0 0.0 X 110284 0 7443 JOCELYN VALENCIA MED TECH 40.0 0.0 X 116506 0 2074 JOSE LUNA HOME HEALTH SUPVR/DRG CODER 40.0 0.0 X 110854 0 7471 715592 0 48808 5 false true false PHYSICAL THERAPY SYSTEMS 302 S 5TH STREET CARRIZO SPRINGS TX 78834 PHYSICAL THERAPY 389238 TAB ANESTHESIA 20 LOU STROUP UVALDE TX 78801 HOSPITALIST SERVICE 336000 EMCARE 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 24 HR E.R. COVERAGE 428314 TRUSTAFF TRAVEL NURSE PO BOX 63-8231 CINCINNATI OH 45263 E.R. & L.D. RN COVER 613429 KHCR DBA ENDEAVOR 28 HUNTERS POINT NEW BRAUNFELS TX 78132 HOSPITAL BILLING 390434 8 350000 9054 183571 542625 Net Patient Revenue 621110 19513353 19513353 Clinic Rent 531390 120232 120232 19633585 3819 3819 0 0 0 0 0 46699 58559 -11860 -11860 -11860 0 0 0 Miscellaneous Revenue 900099 292529 292529 Dietary Meals 721210 39213 39213 Medical Transcripts 561000 9302 9302 341044 20509213 19974629 -8041 0 0 0 0 410501 309286 101215 0 8655023 6523543 2131480 252831 189623 63208 1512340 1134255 378085 681048 520383 160665 0 22758 22758 152836 152836 0 0 0 2037813 1450453 587360 367974 11098 356876 338964 94458 244506 166875 166875 0 455052 233192 221860 98027 53529 44498 0 2058 2058 41831 41831 0 580550 580550 82406 82406 Medical Supplies 1847298 1847298 Dues and Subscriptions 104536 58410 46126 Bad Debt Expense 5650603 5650603 . 0 7383 7383 23468707 18739087 4729620 0 771995 476062 882255 223115 0 100000 1523700 1211629 0 0 0 0 0 0 67822 61741 29636 55318 4802916 2253437 1608373 2549479 0 0 0 0 0 0 0 0 1537072 551316 6420853 5228660 1187454 1687671 0 0 0 0 0 0 0 0 0 0 625935 0 0 280924 0 1612095 1813389 3580690 X 4607464 1547970 0 100000 0 0 4607464 1647970 6420853 5228660 -2959494 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1550 1550 false SCHEDULE C, PART II-B, LINE 1I OTHER ACTIVITIES: HOSPITAL PAID DUES TO ORGANIZATIONS, A PORTION OF WHICH IS DESIGNATED FOR LOBBYING EXPENSES. 474274 58570 415704 4276509 2194867 2081642 52133 52133 2549479 Other Assets 192830 Est amounts from 3rd party 179079 Due from District 179407 551316 0 EST AMOUNTS DUE TO 3RD PARTY 421354 EST SELF-INSURANCE COSTS 151824 CAPITAL LEASE OBLIGATION 1038917 1612095 X 16794165 1977386 -5692434 -3715048 20509213 20509213 19753659 1977386 1977386 17776273 5692434 5692434 23468707 SCHEDULE D, PART X, LINE 2 LIABILITY FOR UNCERTAIN TAX POSITIONS: AS AN ESSENTIAL GOVERNMENT FUNCTION, THE DISTRICT IS GENERALLY EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 115 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE DISTRICT IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. IN 2012, THE HOSPITAL RECEIVED NOTICE FROM THE IRS THAT ITS TAX-EXEMPT STATUS HAD BEEN AUTOMATICALLY REVOKED, EFFECTIVE FEBRUARY 15, 2011. THE HOSPITAL BELIEVES THE REVOCATION TO BE AN ERROR AND FILED AN APPLICATION FOR RETROACTIVE REINSTATEMENT OF ITS TAX-EXEMPT STATUS WITH REASONABLE CAUSE. THE HOSPITAL RECEIVED A DETERMINATION OF EXEMPT STATUS EFFECTIVE NOVEMBER 5, 2012, THE DATE OF FILING OF THE NEW APPLICATION. THE HOSPITAL MAY BE ASSESSED PENALTIES, INTEREST AND TAX FOR THE TIME PERIOD BETWEEN FEBRUARY 15, 2011 AND NOVEMBER 4, 2012 IF THE REQUEST FOR RETROACTIVE REINSTATEMENT WITH REASONABLE CAUSE IS NOT APPROVED. HOWEVER, THE HOSPITAL BELIEVES IT IS PROBABLE THAT THE PENALTIES, INTEREST AND TAX WILL BE ABATED WITH THE RETROACTIVE REINSTATEMENT, WHICH IS CURRENTLY UNDER REVIEW BY THE INTERNAL REVENUE SERVICE. MANAGEMENT CURRENTLY ESTIMATES THE AMOUNT OF TAX OWED FOR THE TIME PERIOD BETWEEN FEBRUARY 15, 2011 AND NOVEMBER 4, 2012 TO BE $95,000 TO $237,000, HOWEVER, THE HOSPITAL BELIEVES IT IS MORE-LIKELY-THAN-NOT THAT ITS TAX-EXEMPT STATUS WILL BE RETROACTIVELY REINSTATED AND NO PROVISION IS MADE IN THESE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT EXPENSE $(5,650,603) INTEREST EXPENSE (41,831) ------------ TOTAL $(5,692,434) SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT EXPENSE $5,650,603 INTEREST EXPENSE 41,831 ----------- TOTAL $5,692,434 true true X true X true X true true true false true true 1653667 1653667 0.09280 5048844 8324636 0.00000 6702511 8324636 1653667 0.09280 62581 62581 0.00350 62581 62581 0.00350 6765092 8324636 1716248 0.09630 false 5650603 2677225 3335072 -657847 X true false 1 1 DIMMIT REGIONAL HOSPITAL 704 HOSPITAL DRIVE CARRIZO SPRINGS TX 78834 WWW.DIMMITREGIONALHOSPITAL.COM 100175 X X X DIMMIT REGIONAL HOSPITAL 1 false false true X X X X X X X X 13 true false false true X SEE PART V, SECTION C X true 13 true SEE PART V, SECTION C false true X 100 200. X true true 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 X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM THE COMMUNITY: THE ORGANIZATION CONDUCTED INTERVIEWS AND FOCUS GROUPS WITH BUSINESS LEADERS, MEMBERS OF THE HISPANIC COMMUNITY, ELECTED OFFICIALS, SENIOR CITIZENS, THE HOSPITAL AUXILIARY, THE CHAMBER OF COMMERCE, AND MINISTERS. SCHEDULE H, PART V, SECTION B, LINE 11 IDENTIFIED NEEDS ADDRESSED AND NOT ADDRESSED: THE IMPLEMENTATION STRATEGY ADDRESSED THE FOLLOWING NEEDS IDENTIFIED IN THE CHNA: 1. HOSPITAL OPERATION ISSUES - THERE IS A LACK OF CUSTOMER SERVICE TRAINING, AND THE LENGTH OF TIME TO FILE A PATIENT'S CLAIMS IS TOO LONG. THE HOSPITAL ALSO WANTS TO ENFORCE THE PERCEPTION THAT PERSONAL HEALTH INFORMATION IS NOT SHARED IN THE COMMUNITY. THE HOSPITAL PLANS TO ENFORCE HIPAA REQUIREMENTS AND FOLLOW THE PRINCIPLES SET FORTH IN "HARDWIRING EXCELLENCE: PURPOSE, WORTHWHILE WORK, MAKING A DIFFERENCE." THE HOSPITAL HAS ALSO INTENSIFIED STAFF TRAINING AROUND SERVICE EXCELLENCE. 2. COMMUNITY OUTREACH - THE HOSPITAL WANTS TO INCREASE VISIBILITY IN THE COMMUNITY AND INCREASE ACCESS TO SPECIALTY PHYSICIAN SERVICES. THE HOSPITAL HAS WORKED ON MEETING THIS NEED DURING THE 2016 FISCAL YEAR THROUGH THE FOLLOWING ACTIONS: - NEW ECHOCARDIOGRAPHY EQUIPMENT HAS BEEN PURCHASED TO HELP MANAGE PATIENTS IN HEART FAILURE. - THE HOSPITAL HAS A CAPITAL CAMPAIGN FOR MAMMOGRAPHY SERVICES IN PROGRESS. THE FUNDS FROM THIS CAMPAIGN HAS HELPED CREATE THE WOMAN'S IMAGING CENTER WHICH IS SET TO OPEN OCTOBER OF 2017. - THE FQHC IN CRYSTAL CITY AND THE HOSPITAL HAVE WORKED TOGETHER IN PRIMARY CARE RECRUITMENT. - STAFF TRAINED AS EDUCATORS IN BASIC LIFE SUPPORT AND ADVANCED CARDIAC LIFE SUPPORT AND ARE MAKING EDUCATION AVAILABLE TO THE CITY, COUNTY AND AREA EMPLOYERS AND THE COMMUNITY. - A NEW BREASTFEEDING CAMPAIGN IS UNDERWAY. - TWO NEW FAMILY PRACTICE PHYSICIANS STARTED IN 2015 BY RECRUITMENT EFFORT OF THE HOSPITAL. IN 2016, THE PHYSICIANS LEFT, AND WE ARE LOOKING TO RECRUIT A FAMILY PRACTICE PHYSICIAN BY OCTOBER 2017. - A NEW CARDIOLOGIST NOW PRACTICES PART-TIME IN CARRIZO SPRINGS. - THE HOSPITAL IS LOOKING INTO PROVIDING INTERVENTIONAL RADIOLOGY SERVICES BY 2017 AND MORE SPECIALTY SERVICES FOR ENT, ONCOLOGY AND MENTAL HEALTH. THE ORGANIZATION'S CHNA IDENTIFIED SOME NEEDS THAT ARE BEYOND THEIR RESOURCES OR CAPABILITIES. SOME NEEDS ARE BEING ADDRESSED BY OTHER AGENCIES, PROVIDERS, OR ORGANIZATIONS. THESE NEEDS INCLUDE CHRONIC DISEASES (SUCH AS RENAL, CANCER, RESPIRATORY, AND SUBSTANCE ABUSE), TEEN PREGNANCY, INDUSTRIAL ACCIDENTS, HIGHWAY TRAUMA AND SPECIALTY PHYSICIAN ACCESS. SCHEDULE H, PART V, SECTION B, LINE 7 AVAILABILITY OF CHNA: THE CHNA IS AVAILABLE UPON REQUEST OR AT THE FOLLOWING ADDRESS: http://www.dimmitregionalhospital.com/getpage.php?name=Community_Health_Ne eds_Assessment&sub=Community+Health+Needs+Assessment SCHEDULE H, PART V, section b, LINES 16A, 16B, & 16C AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAM POLICY: THE FAP, FAP APPLICATION, AND FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY ARE AVAILABLE UPON REQUEST OR AT THE FOLLOWING ADDRESS: http://www.dimmitregionalhospital.com/getpage.php?name=Patient_Financial_S ervices&sub=Patient+Financial+Services Schedule H, Part V, Section B, Line 10a AVAILABILITY OF IMPLEMENTATION STRATEGY: THE HOSPITAL'S IMPLEMENTATION STRATEGY IS AVAILABLE AT THE FOLLOWING ADDRESS: http://www.dimmitregionalhospital.com/getpage.php?name=Implementation_Plan &sub=Implementation+Plan SCHEDULE H, PART V, SECTION B, LINES 18, 19, & 20 BILLING AND COLLECTIONS: NEITHER DIMMIT REGIONAL HOSPITAL, NOR THIRD PARTIES AUTHORIZED BY DIMMIT REGIONAL HOSPITAL, TAKE ANY ACTIONS UPON NON-PAYMENT FROM A PATIENT BEFORE MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR THE FACILITY'S FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART V, SECTION B, LINE 22 DETERMINATION OF AMOUNTS BILLED: BEGINNING IN TAX YEAR 2016, THE HOSPITAL ADOPTED THE LOOK-BACK METHOD TO ESTABLISH THE AMOUNTS GENERALLY BILLED (AGB) TO INDIVIDUALS WHO HAD INSURANCE COVERING SUCH CARE. THE HOSPITAL WILL LIMIT THE AMOUNT CHARGED FOR CARE IT PROVIDES TO ANY INDIVIDUAL WHO IS ELIGIBLE FOR ASSISTANCE TO NOT MORE THAN AGB. 1 SURECARE CLINIC 404 SOUTH 8TH STREET CARRIZO SPRINGS TX 78834 FAMILY MEDICINE SCHEDULE H, PART III, SECTION A, LINE 2 METHODOLOGY TO ESTIMATE BAD DEBT EXPENSE: THE AMOUNT ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT AS A COMMUNITY BENEFIT: THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT FOOTNOTE: The Hospital reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The Hospital provides an allowance for uncollectible accounts based upon a review of outstanding receivables, historical collection information, and existing economic conditions. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY: THE MEDICAL CENTER USES COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. IN ADDITION, THE STATE OF TEXAS TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT FOR MEETING STATUTORY REQUIREMENTS FOR CHARITY CARE AND COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION PRACTICES: THE COLLECTION POLICY CURRENTLY DOES NOT CONTAIN EXPLICIT PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. THE HOSPITAL IS IN THE PROCESS OF AMENDING ITS COLLECTIONS POLICY TO INCLUDE THE PRACTICES TO BE FOLLOWED FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: COMMUNITY ASSESSMENT IS CONDUCTED THROUGH TELEPHONE AND PERSONAL MEETINGS. COMMUNITY LEADERS, BUSINESS LEADERS AND COMMUNITY MEMBERS ARE INTERVIEWED CONCERNING THE NEEDS OF THE COMMUNITY. THE RESULTS ARE THEN PRESENTED TO THE BOARD OF MANAGERS AND A PLAN IS DEVELOPED TO ADDRESS THOSE NEEDS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS GIVEN TO ALL PATIENTS. CHARITY CARE APPLICATIONS ARE GIVEN TO E.R. PATIENTS THAT WILL BE SELF PAYING. A LETTER IS MAILED WITH A CHARITY CARE APPLICATION TO THESE PATIENTS. FOLLOW-UP CALLS ARE THEN MADE TO THE PATIENTS THAT WERE SENT APPLICATIONS TO EXPLAIN AND ASK IF THEY NEED HELP IN COMPLETING THESE FORMS. AT REGISTRATION OR ADMISSION, CHARITY CARE APPLICATIONS ARE GIVEN TO INPATIENTS AND OUTPATIENTS THAT WILL BE SELF PAYING. WE ALSO HAVE AVAILABLE AN INDIGENT COORDINATOR, MONDAY THRU FRIDAY, 8AM TO 5PM, THAT WILL TALK TO THESE PATIENTS AND EXPLAIN WHAT ASSISTANCE WE HAVE AVAILABLE. IF AN APPLICATION IS REQUESTED LATER, IT IS SENT TO THE PATIENT. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: DIMMIT COUNTY'S ESTIMATED POPULATION IS 10,794 WITH A TOTAL SERVICE AREA OF 24,100 PEOPLE. THE GENDER COMPOSITION IS 49.2% MALE AND 50.80% FEMALE. THE POVERTY RATE IS 24.45% AND THE MEDIAN INCOME PER HOUSEHOLD IS $36,825. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: A SPECIALTY CLINIC WAS STARTED AND CURRENTLY SERVICES PODIATRY, ONCOLOGY, DENTAL AND ENT SERVICES. DIMMIT REGIONAL HOSPITAL (DRH) IS CURRENTY RECRUITING FOR ORTHOPEDIC AND DERMATOLOGY. THIS WILL HELP ALLEVIATE FINANCIAL STRAIN FOR PATIENTS WHO NEED SPECIALTY CARE AND HAVE TO TRAVEL TO OBTAIN IT. EDUCATION PROGRAMS ARE ALSO PROVIDED TO PROMOTE HEALTHCARE HABITS. ADDITIONALLY, TRAINING IS PROVIDED TO NEW PARENTS ON CAR SAFETY SEATS. SEATS ARE PROVIDED TO THOSE WHO CANNOT AFFORD THEM. HEALTH FAIRS ARE ALSO HELD AND SCHOLARSHIPS ARE AWARDED TO STUDENTS THAT ARE INTERESTED IN NURSING CAREERS. THE HOSPITAL HAS ALSO STARTED A TELEMEDICINE PROJECT WITH METHODIST HOSPITAL IN SAN ANTONIO TO PROVIDE STROKE ALERT SERVICES IN THE EMERGENCY ROOM. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: N/A SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: TEXAS SCHEDULE H, PART I, LINE 3C FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: - MEDICAL INDIGENCY SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE, TOTALING $5,650,603. X X false false false false false false false false false JIM BUCKNER CEO 168891 0 11828 0 0 0 8445 0 4848 0 194012 0 FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990: THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM FOLLOWING THE COMPLETION OF AN AUDIT OF THE FINANCIAL STATEMENTS. AN OFFICER REVIEWS THE RETURN PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: EACH DIRECTOR, PRINCIPAL OFFICER AND BOARD COMMITTEE MEMBER ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS THAT THEY AGREE TO COMPLY WITH THE CONFLICT OF INTEREST POLICY. WHEN A POSSIBLE CONFLICT OF INTEREST ARISES, THE DIRECTOR OR OFFICER MUST DISCLOSE THE INTEREST AND RELATED FACTS. THE PERSON MUST LEAVE THE MEETING AND THE REST OF THE BOARD MUST DECIDE IF A CONFLICT OF INTEREST EXISTS. IF IT IS DECIDED THAT A CONFLICT OF INTEREST EXISTS, THE INTERESTED PERSON IS NOT ALLOWED TO PARTICIPATE IN DISCUSSION OR VOTE ON THE TRANSACTION OR ARRANGEMENT INVOLVED. FORM 990, PART VI, SECTION B, LINE 15A REVIEW OF CEO OR TOP MGMT OFFICIAL COMPENSATION: THE COMPENSATION OF THE CEO INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DECISION. THE MOST RECENT REVIEW WAS CONDUCTED IN JANUARY OF 2016 BY THE BOARD OF DIRECTORS. THE REVIEW WAS DOCUMENTED IN THE HUMAN RESOURCE FILES. FORM 990, PART VI, SECTION B, LINE 15B REVIEW OF COMPENSATION OF OTHER OFFICERS: THE CEO COMPLETES AN EVALUATION FORM FOR ALL OTHER OFFICERS AND MEETS WITH EACH INDIVIDUAL TO DISCUSS. THE SCORE OR POINTS ON THE EVALUATION DETERMINES THE PERCENTAGE OF ANY COMPENSATION ADJUSTMENTS. THE MOST RECENT REVIEW WAS CONDUCTED IN NOVEMBER 2015 AND DOCUMENTED IN THE HUMAN RESOURCE FILES. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: THE BYLAWS WERE RESTATED ON AUGUST 3, 2016. THE MOST SIGNIFICANT CHANGE INDICATES THAT "IN NO EVENT SHALL A MAJORITY OF THE BOARD OF DIRECTORS OF DIMMIT REGIONAL HOSPITAL BE MEMBERS OF THE BOARD OF DIRECTORS OF DIMMIT REGIONAL HOSPITAL DISTRICT." THE RESTATED BYLAWS WERE ALSO AMENDED TO READ THAT IF THE BOARD OF DIRECTORS CONSISTS OF LESS THAN NINE MEMBERS, THE BOARD WILL NOT HAVE STANDING COMMITTEES UNLESS A MAJORITY OF THE DIRECTORS RESOLVE TO DO SO. DIMMIT REGIONAL HOSPITAL DISTRICT PO BOX 1016 CARRIZO SPRINGS TX 78834 271613078 LEASING TX GOVT N/A NA false false false true true true false false false false false false false false true true false false false false