2017-11-02T14:34:49-05:00 2016-12-31 ERNST & YOUNG US LLP 425 HOUSTON STREET SUITE 600 FORT WORTH TX 76102 990 2016-01-01 741287016 Methodist Healthcare Ministries Texas Inc % KEVIN C MORIARTY PRES/CEO METH 2106920234 4507 Medical Drive San Antonio TX 782294401 Tony LoBasso CFO 2106920234 2017-11-02 true MELVA SCOTT P01207335 8173351900 72.182.5.195 75303520173065000000 2017-11-02 P 86CB424AE1FAFE4696ABA155B4C5EF7FBA72D4DC 86CB424AE1FAFE4696ABA155B4C5EF7FBA72D4DC 2016 2021-01-29 14:40:06Z Kevin C Moriarty 4507 Medical Drive San Antonio TX 782294401 334286927 false X www.mhm.org X 1955 TX "Serving Humanity to Honor God" by improving the physical, mental and spiritual health of those least served in the rio texas conference area of the United Methodist Church 28 28 408 242 27957 26957 375402 3474669 140379587 144938188 32921509 17083400 1301597 1270156 174978095 166766413 25964889 26848863 0 0 26175905 30151140 0 0 0 24569504 24519321 76710298 81519324 98267797 85247089 977474981 1038588554 32461037 32484541 945013944 1006104013 X IN FURTHERANCE OF THE FOUNDERS' VISION OF "SERVING HUMANITY TO HONOR GOD," METHODIST HEALTHCARE MINISTRIES OF SOUTH TEXAS, INC. (MHM) HAS A TWO-FOLD MISSION, BOTH EQUALLY IMPORTANT: TO IMPROVE THE PHYSICAL, MENTAL, AND SPIRITUAL HEALTH OF THOSE LEAST SERVED IN THE RIO TEXAS CONFERENCE AREA OF THE UNITED METHODIST CHURCH, WHICH CONSISTS OF 74 COUNTIES ACROSS SOUTH TEXAS; AND AS THE LOCAL HALF-OWNER OF THE, METHODIST HEALTHCARE SYSTEM (MHS)- THE LARGEST HEALTHCARE SYSTEM IN SOUTH TEXAS - MHM IS COMMITTED TO ENSURING MHS CONTINUES TO BE A BENEFIT TO THE COMMUNITY BY PROVIDING QUALITY CARE TO ALL AND CHARITABLE CARE WHEN NEEDED. false false 26682911 26682911 0 SINCE 1996, MHM HAS PROVIDED COMMUNITY GRANTS TO PARTNERS THAT SHARE IN ITS MISSION OF SERVING THE LEAST SERVED: LOW-INCOME FAMILIES AND THE UNINSURED, AND THAT ARE SUCCESSFULLY DELIVERING HEALTHCARE AND SOCIAL SERVICES TO THIS POPULATION IN THEIR RESPECTIVE COMMUNITIES THROUGHOUT SOUTH TEXAS. SHORT-TERM GRANTS INCLUDE DIRECT SERVICES TO PATIENTS AS WELL AS CAPITAL FUNDING FOR CONSTRUCTION OF NEW AND/OR RENOVATIONS TO EXISTING FACILITIES USED FOR THE DELIVERY OF SERVICES. In addition to providing grants, MHM was awarded a federal grant by the Social Innovation Fund (SIF), a program of the Corporation for National and Community Service (CNCS) that combines public and private resources to grow the impact of innovative, community-based solutions that have compelling evidence of improving the lives of people in low-income communities throughout the United States. Through this grant MHM developed the S Texas: Social Innovation for a Healthy South Texas project, focusing on integrated behavioral health models that are effectively improving health outcomes in South Texas communities with high rates of poverty, depression, diabetes, obesity, and associated risk factors. 14811304 165952 102998 MHM OWNS AND OPERATES TWO PRIMARY CARE CLINICS AT TWO LOCATIONS - WESLEY HEALTH & WELLNESS CENTER AND THE BISHOP ERNEST T. DIXON, JR. CLINIC - IN SAN ANTONIO WHERE MEDICAL, DENTAL, AND BEHAVIORAL HEALTH SERVICES ARE OFFERED TO UNINSURED INDIVIDUALS AND FAMILIES WHO DO NOT QUALIFY FOR ANY TYPE OF BENEFITS SUCH AS MEDICAID OR MEDICARE. SERVICES ARE BASED ON A SLIDING-SCALE FEE, HOUSEHOLD INCOME AND FAMILY SIZE. HOWEVER, NO ONE IS DENIED BASED ON THEIR ABILITY TO PAY. MHM ALSO OPERATES SCHOOL BASED HEALTH CENTERS WHICH PROVIDE PRIMARY MEDICAL CARE, DENTAL CARE AND COUNSELING TO SCHOOL-AGE CHILDREN AND THEIR SIBLINGS UP TO THE AGE OF 21 IN TWO SCHOOL DISTRICTS. 10264570 0 0 THE WESLEY NURSE PROGRAM SPANS 83 SITES THROUGHOUT SOUTH TEXAS, AND IS MHM'S LARGEST GEOGRAPHIC OUTREACH PROGRAM. A KEY COMPONENT WESLEY NURSES UNDERTAKE IN THEIR COMMUNITIES IS PROVIDING HEALTH EDUCATION, HEALTH PROMOTION AND FACILITATION OF RESOURCES. WHILE THE WESLEY NURSE PROGRAM IS A COMPONENT OF MHM'S ECUMENICAL OUTREACH, AND LOCATED WITHIN CHURCHES, IT DOES NOT TEACH A PARTICULAR SET OF DENOMINATIONAL BELIEFS. ALL WESLEY NURSE PROGRAMS ARE FREE AND ALL MEMBERS OF THE COMMUNITY ARE WELCOME. PROGRAMS ARE OFFERED TO GROUPS OR ON AN INDIVIDUAL BASIS. 19565217 144835190 71324002 true true false true false false false false false true true true true false false false false true false false false false false false false false true true true true true false false false false false false false false false false false false false true true true false false true 253 0 true 408 true true true false false false false false false false false false X 28 28 true false false false false false false true true false false true true true true true true true true true true X X KEVIN C MORIARTY PRESCEO 2106920234 4507 MEDICAL DRIVE SAN ANTONIO TX 78229 Scott D Bryan Director 2.0 0.0 X 0 0 0 Mindi Alterman Director 2.0 0.0 X 0 0 0 Jorge Alvarez MD Director 2.0 0.0 X 0 0 0 Polin C Barraza Director 2.0 0.0 X 0 0 0 Bonnie K Berry Director 2.0 0.0 X 0 0 0 Blas S Catalani II Director 2.0 0.0 X 0 0 0 Rinaldo J Gonzalez Director 2.0 0.0 X 0 0 0 Susan W Holmes Director 2.0 0.0 X 0 0 0 R Dan Johnson Director 2.0 0.0 X 0 0 0 Paula Larson MD Director 2.0 0.0 X 0 0 0 Rev Javier Leyva Director 2.0 0.0 X 0 0 0 Sam O'Krent Director 2.0 0.0 X 0 0 0 Kerwin L Overby Director 2.0 0.0 X 0 0 0 Michael F Porter Jr Director 2.0 0.0 X 0 0 0 Rev Carl W Rohlfs Director 2.0 0.0 X 0 0 0 Rev Charles Stephens Director 2.0 0.0 X 0 0 0 John F Stoll MD Director (non-voting) 2.0 0.0 X 0 0 0 Rev Virgilio Vazquez-Garza Director 2.0 0.0 X 0 0 0 Pendelton Wickersham MD Director 2.0 0.0 X 0 0 0 Bishop Joel Martinez DIRECTOR (Term 8/24/16) 2.0 0.0 X 0 0 0 Lott McIlhenny Director 2.0 0.0 X 0 0 0 Darrell Frank Smith Past Chair (non-voting) 2.0 0.0 X 0 0 0 Shirley S Watkins Director 2.0 0.0 X 0 0 0 Rev Taylor S Boone DIRECTOR (non-voting) 2.0 0.0 X 0 0 0 Dudley Harral DIRECTOR (non-voting) 2.0 0.0 X 0 0 0 Bishop Robert Schnase Director 2.0 0.0 X 0 0 0 WM D Balthrope Director (non-voting) 2.0 0.0 X 0 0 0 James A Garcia Chair Elect 4.0 0.0 X X 0 0 0 Lavonne Garrison Treasurer 4.0 0.0 X X 0 0 0 Nancy May Director 2.0 0.0 X X 0 0 0 Joe E Johnston MD Secretary 4.0 0.0 X X 0 0 0 Alice H Gannon Vice Chair 4.0 0.0 X X 0 0 0 Michael J Lane MD Vice Chair 4.0 0.0 X X 0 0 0 George N Ricks Chair 6.0 0.0 X X 0 0 0 Kevin Moriarty Chief Executive Officer 40.0 0.0 X 472200 0 44382 Tony Lobasso Chief Financial Officer 40.0 0.0 X 240722 0 37675 George Thomas Chief Operating Officer 40.0 0.0 X 237971 0 44756 Peggy Cary VP of Finance & Audit Services 40.0 0.0 X 203146 0 40876 Rebecca Brune SR VP of Strategic Pln & grwth 40.0 0.0 X 190813 0 35267 Oanh Maroney-omitade VP of Clinical Operations 40.0 0.0 X 157442 0 47640 Jennifer Correa-knoulton VP of Regional Operations 40.0 0.0 X 153669 0 40233 Cynthia McCloy VP of Accounting & Controller 40.0 0.0 X 156619 0 33293 1812582 0 324122 32 false true false Carlson Capital 2100 McKinney Avenue Dallas TX 75201 Investment Manager 1702510 Eagle Capital 499 Park Avenue 17th Floor New York NY 10022 Investment Manager 443145 VHS San Antonio Imaging Partners L PO Box 849553 Dallas TX 752849553 Radiology Services 425741 Brown Investment Advisory Trust C 901 South Bond Street Suite 400 Baltimore MD 212313340 Investment Manager 317261 Southwest Diagnostic Center PO Box 241000 San Antonio TX 78224 Radiology Services 279080 23 0 3434677 39992 0 3474669 Ordinary Income from MHS 622110 144784448 144142814 641634 0 CLINIC REVENUE - DIRECT MHM 621498 102998 102998 0 0 WESLEY KITCHEN - DIRECT MHM 900099 50742 50742 0 0 144938188 10524836 -613677 11138507 0 0 7051079 5813487 1237592 0 1237592 1237592 168265591 161707027 6558564 6558564 6558564 0 0 0 0 0 0 0 0 0 All other Revenue 900099 32564 0 32564 32564 166766413 144296554 27957 18967227 26682911 26682911 165952 165952 0 0 0 0 942212 942212 0 0 0 0 0 22227715 19328527 2899188 0 1321632 1081001 240631 0 4034975 3114468 920507 0 1624606 1392162 232444 0 0 0 0 0 74615 2272 72343 0 49000 0 49000 0 271389 271389 0 0 0 0 1843867 0 1843867 0 8004198 7351280 652918 0 34569 0 34569 0 1086856 926152 160704 0 924153 398128 526025 0 0 0 0 0 789986 563806 226180 0 828187 719015 109172 0 0 0 0 0 271966 220628 51338 0 0 0 0 0 0 0 0 0 1810464 1484385 326079 0 290316 209552 80764 0 K-1 EXPENSES 2464331 2464331 0 0 PHARMACY CHRGS & DELIVERY 2415274 2415274 0 0 Dental Supplies 396730 396730 0 0 Community Outreach 386130 386130 0 0 2577290 1749909 827381 81519324 71324002 10195322 0 877727 950533 42319111 59911192 0 0 149594 439875 0 0 0 0 0 0 0 0 648314 576922 43342163 14625654 30053328 28716509 338570459 344687362 143225028 161000145 421087702 441720516 0 0 543718 585500 977474981 1038588554 3184704 3600092 29276333 28884449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32461037 32484541 X 944913944 1006004013 0 0 100000 100000 945013944 1006104013 977474981 1038588554 X 85247089 19775162 0 0 -43932182 X false true X true true true X Schedule A, Part I, Line 3 Methodist Healthcare Ministries of South Texas, Inc. has a dual public charity status as a section 509(a)(1) and a section 509(a)(3) supporting organization. Methodist Healthcare Ministries of South Texas, Inc. is a hospital and supports the Rio Texas Conference of the United Methodist Church. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false 0 false 0 false 0 true 155778 true 6179 true 7820 true 2606 172383 false SCHEDULE C, PART II-B: LOBBYING ACTIVITIES: FUNDING FOR PARTNERS TO FORMALLY COORDINATE A COALITION THAT WILL FOCUS ON MOBILIZING INTERESTED STAKEHOLDERS TO WORK WITH STATE LEADERS TO IMPROVE POLICIES AND INCREASE FUNDING FOR HEALTH SERVICES AND ACCESS TO CARE IN TEXAS; EXPLORE AND DISCUSS STRATEGIES FOR LEGISLATIVE SESSIONS; REGISTRATION FEES AND MEMBERSHIP DUES. 201733 7419 3010 206142 208344 -451 6160 201733 208539 5965 6160 208344 100000 100000 10172 1633 208539 100000 1488 1488 100000 0.51500 0.48500 true false 0 2534558 2534558 0 34488384 9693173 24795211 0 38327 17702 20625 0 6280894 4914779 1366115 0 28716509 OVERSEAS CAP PARTNERS, INC. 1630217 F BLACK DIAMOND, LTD. 26436383 F DOUBLE BLACK DIAMOND, LTD. 14871104 F BLACK DIAMOND THEMATIC, LTD. 4451559 F BLACK DIAMOND ENERGY L/S LTD. 24022828 F EAGLE INCOME APPRECIATION II 16390777 F BALYASNY ATLAS GLOBAL INVSTMTS 25059940 F TEXAS METHODIST FOUNDATION 2799349 F EVANSTON WEATHERLOW OFFSHORE 24851401 F ACL ALTERNATIVE FUND SAC LMTD 18262996 F INCUBE VENTURES II, LP 709832 C TARGETED TECH. FUND I, LP 313759 C TARGETED TECH. FUND II, LP 400000 C BIO2 MEDICAL 300000 C AZAYA THERAPEUTICS 500000 C 161000145 Equity Ownership in Methodist 441720516 C 441720516 Schedule D, Part V, Line 4: INTENDED USE OF ENDOWMENT FUNDS MHM'S ENDOWMENT CONSISTS OF TWO INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ENDOWMENT INCLUDES BOTH DONOR-RESTRICTED FUNDS AND FUNDS DESIGNATED BY THE BOARD TO FUNCTION AS ENDOWMENTS. true true X true X true X 500. true true true false true true 43124200 1052185 42077731 0.05020 63027265 114578958 0 0.00000 1148558 1117345 31213 0.00000 107300023 116748488 42108944 0.05020 45057849 482487 44575362 0.05320 1389792 59422 1330370 0.00160 26682911 26682911 0.03180 73130552 541909 72588643 0.08660 180430575 117290397 114697587 0.13680 false 6469041 610643 196168585 195209775 958810 X true true METH AMB SUR CTR MC Freestanding ASC 0.299 0.201 METH AMB SUR CTR NC Freestanding ASC 0.377 0.123 CTR SPECIAL SURGERY Freestanding ASC 0.255 0.245 COMP RAD MGMT SVCS Imaging Services 0.25 0.25 8 1 Methodist Hospital 7700 Floyd Curl Drive San Antonio TX 78229 www.SAHealth.com 000154 X X X A 2 Methodist Children's Hospital 7700 FLOYD CURL DRIVE San Antonio TX 78229 www.SAHealth.com 000154 X X X A 3 Metropolitan Methodist Hospital 1310 McCullough Avenue San Antonio TX 78212 www.SAHealth.com 000154 X X X A 4 Methodist Specialty & Transplant 8026 Floyd Curl Drive San Antonio TX 78229 www.SAHealth.com 000154 X X X A 5 Methodist Stone Oak Hospital 1139 E Sonterra Blvd San Antonio TX 78258 www.SAHealth.com 008741 X X X A 6 Northeast Methodist Hospital 12412 Judson Road San Antonio TX 78223 www.SAHealth.com 000154 X X X A 7 Methodist Texsan Hospital 6700 IH 10 West San Antonio TX 78201 www.SAHealth.com 000154 X X X A 8 Methodist Ambulatory Surgery Hospital 9150 Huebner Rd Suite 100 San Antonio TX 78240 www.SAHealth.com 000681 X X X A A 18 false false true X X X X X X X X X X 16 true true true true X SEE PART V, SECTION C X WWW.HEALTHCOLLABORATIVE.NET/REPORTS/ X true 14 true See Part V, Section C false true X 200. 500. X X X X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X X true X false false Schedule H, Part V, Sec B, Line 3J: IN 2016, EACH METHODIST HOSPITAL, AS WELL AS THE SYSTEM, ADOPTED THE HEALTH PRIORITY AREAS BASED UPON THE BEXAR COUNTY COMMUNITY HEALTH ASSESSMENT (UNDERTAKEN BY THE HEALTH COLLABORATIVE), THE BEXAR COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND THE SA 2020 GOALS. ADDITIONAL INFORMATION ABOUT THE HEALTH COLLABORATIVE'S ASSESSMENT PROCESS IS NOTED BELOW. IT IS IMPORTANT TO NOTE THAT THE FIVE PRIORITY AREAS IDENTIFIED IN THE PRIOR CHNA HAVE NOT CHANGED IN THE 2016 PLAN. IN 2016, MHS' IMPLEMENTATION STRATEGY, INCLUDING AN EXECUTION PLAN AND PRIORITIZATION OF HEALTH NEEDS, SERVICES AND METRICS FOR EACH HOSPITAL WERE PRESENTED TO AND APPROVED BY THE MHS COMMUNITY BENEFITS COMMITTEE, THE MHS COMMUNITY BOARD, THE MHS BOARD OF GOVERNORS, AND THE METHODIST HEALTHCARE MINISTRIES BOARD OF DIRECTORS APPROVED THE IMPLEMENTATION STRATEGY FOR 2017 2019. IN ORDER TO ASSESS THE RURAL AREAS METHODIST HEALTHCARE SERVES, MHS UTILIZED ASSESSMENT INFORMATION FROM THE REGIONAL HEALTHCARE PARTNERSHIP 6 PLAN SUBMITTED TO THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION AS PART OF THE MEDICAID 1115 WAIVER PROGRAM. UNIVERSITY HEALTHCARE SYSTEM (RHP6 ANCHOR) LED THIS PROCESS WHICH INCLUDED MULTIPLE MEETINGS, CONFERENCE CALLS AND PUBLIC FORUMS FROM FEBRUARY - MAY OF 2012. PARTICIPANTS IN THIS PROCESS INCLUDED HOSPITAL CEOS, COUNTY JUDGES, COUNTY COMMISSIONERS, PHYSICIANS FROM THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO, UNIVERSITY HEALTH SYSTEM AND CHRISTUS SANTA ROSA. INPUT WAS ALSO OBTAINED FROM FEDERALLY QUALIFIED HEALTH CENTERS, HOME HEALTH AGENCIES, CITY GOVERNMENT OFFICIALS, INDIGENT CARE COORDINATORS, ADVOCACY GROUPS AND HEALTHCARE ACCESS SAN ANTONIO. MHM AND MHS ARE MEMBERS OF THE HEALTH COLLABORATIVE (THC) WHICH CONSISTS OF THE FOLLOWING MEMBERS: APPDDICTION STUDIOS, BAPTIST HEALTH SYSTEM, CHRISTUS SANTA ROSA HEALTH SYSTEM, BEXAR COUNTY DEPARTMENT OF COMMUNITY RESOURCES, COMMUNITY FIRST HEALTH PLANS, SAN ANTONIO METROPOLITAN HEALTH DISTRICT (METRO HEALTH), INTERLEX COMMUNICATIONS, OUR LADY OF THE LAKE UNIVERSITY, UNIVERSITY OF THE INCARNATE WORD, THE UT HEALTH SCIENCE CENTER AT SAN ANTONIO DEPT. OF FAMILY AND COMMUNITY MEDICINE, THE YMCA OF GREATER SAN ANTONIO, UNIVERSITY HEALTH SYSTEM, AND COMMUNITY MEMBERS AT LARGE. FUNDERS OF THE THC COMMUNITY HEALTH ASSESSMENT ARE: BAPTIST HEALTH FOUNDATION, BEXAR COUNTY, THE KRONKOSKY CHARITY FOUNDATION, UNITED WAY OF SAN ANTONIO, SAN ANTONIO METROPOLITAN HEALTH DEPARTMENT, AND METHODIST HEALTH MINISTRIES. AS NOTED ABOVE, METHODIST HEALTHCARE SYSTEM IS A PARTNER OF THE HEALTH COLLABORATIVE. THE COLLABORATIVE UNDERTAKES A COUNTY-WIDE COMMUNITY ASSESSMENT STUDY EVERY THREE YEARS TO GUIDE THE COMMUNITY HEALTH STRATEGIC PLANNING PROCESS. FOR THE CURRENT STUDY, THE HEALTH COLLABORATIVE ENGAGED HEALTH RESOURCES IN ACTION AND COMMUNITY INFORMATION NOW (CI:NOW) TO COLLABORATE ON THE PROCESS. THC BASES ITS COMMUNITY HEALTH ASSESSMENT ON THE SOCIAL DETERMINANT MODEL WHICH VIEWS OUTCOMES AS A PRODUCT OF HEALTH-RELATED BEHAVIORS AND THE BEHAVIORS THEMSELVES AS A LIKELY PRODUCT OF SOCIAL DYNAMICS AT THE LEVEL OF THE SOCIAL CONTEXT OF THE NEIGHBORHOOD. THE BCCHNA USES DATA FROM THE SAN ANTONIO METROPOLITAN HEALTH DISTRICT'S ANNUAL HEALTH PROFILES, A REPORT WHICH LOOKS AT HEALTH TRENDS, AREA DEMOGRAPHICS, INFORMATION ON PREVALENCE OF DISEASE, AND OTHER FINDINGS. HEALTH PROFILES LOOKS AT THE POPULATION BY AGE, BY GENDER AND BY RACE/ETHNICITY AS IT RELATES TO CURRENT POPULATION, PROJECTED POPULATION, BIRTH, EDUCATION, ZIP CODE AND CENSUS TRACT. IT ALSO PROVIDES AN IN-DEPTH LOOK AT BIRTH TRENDS, INCLUDING FERTILITY RATES, MATERNAL HEALTH, MATERNAL AGE AND ETHNICITY, TEEN BIRTHS, LOW BIRTH WEIGHT AND PREMATURE TRENDS AND MOTHER'S BMI AND WEIGHT GAIN. YOUTH INDICATORS EXAMINED INCLUDE JUVENILE PROBATION, FAMILY VIOLENCE, IMMUNIZATION RATES, AND CHILD ABUSE. DEATHS ARE EXAMINED BY INFANT MORTALITY RATE AND CAUSES, LIFE EXPECTANCY BY RACE/ETHNICITY AND GENDER, ALL CAUSES OF DEATH, AND YEARS OF POTENTIAL LIFE LOST. THE BCHNA ALSO DRAWS FROM THE FOLLOWING DATA SOURCES: POPULATION AND HOUSING DATA FROM THE U.S. CENSUS BUREAU; POPULATION ESTIMATES AND PROJECTIONS FROM THE TEXAS STATE DEMOGRAPHIC CENTER AT THE UNIVERSITY OF TEXAS SAN ANTONIO; SOCIAL AND ECONOMIC CONDITIONS DATA FROM THE U.S. CENSUS BUREAU AMERICAN COMMUNITY SURVEY; CRIME DATA FROM THE U.S. DEPARTMENT OF JUSTICE UNIFORM CRIME REPORT; VITAL STATISTICS, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), INJURY, HOSPITAL DISCHARGE, HOSPITAL BED, AND HEALTH PROFESSIONS DATA FROM THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES; MEDICAID AND PUBLIC BENEFITS FROM THE TEXAS HEALTH AND HUMAN SERVICE COMMISSION; AND COMMUNICABLE DISEASE AND VITAL STATISTIC DATA FROM THE SAN ANTONIO METROPOLITAN HEALTH DISTRICT. FINALLY, DATA IS COLLECTED AT THE NEIGHBORHOOD LEVEL WITH THE INTENT OF DESCRIBING THE SOCIAL CONTEXTS THAT POSSIBLY GIVE RISE TO HEALTH-RELATED BEHAVIORS DESCRIBED IN THE HEALTH PROFILES AND BRFSS SURVEY DATA. DISCUSSION GROUPS AND INTERVIEWS WERE CONDUCTED CITY-WIDE WITH OVER 160 PARTICIPANTS, RANGING FROM COMMUNITY RESIDENTS, SERVICE PROVIDERS, GOVERNMENT STAFF AND OFFICIALS, AND ADVOCATES FOR THE HEALTH OF BEXAR COUNTY'S LOW-INCOME, MEDICALLY-UNDERSERVED AND MINORITY POPULATIONS. THESE INTERVIEWS AND MEETINGS TOOK PLACE DURING MARCH AND APRIL OF 2016. THE HEALTH COLLABORATIVE CONTRACTED WITH CI:NOW, A LOCAL DATA INTERMEDIARY SERVING SOUTH CENTRAL TEXAS, FOR QUANTITATIVE DATA COLLECTION AND ANALYSIS FOR DEVELOPMENT OF THE ASSESSMENT NARRATIVE. USING INFORMATION FROM THE COLLABORATIVE'S COMMUNITY HEALTH NEEDS ASSESSMENT, AS WELL AS OTHER DATA, METHODIST HEALTHCARE SYSTEM DEVELOPED INDIVIDUAL PLANS FOR EACH CAMPUS, WHICH INCLUDED A 3-YEAR PLAN FOR 2014-2016. THE IMPLEMENTATION STRATEGY INCLUDES THE FOLLOWING: COMMUNICATION PLAN, PRIORITY INITIATIVE WORK PLAN, ROLE AND RESPONSIBILITY ASSIGNMENTS, AND MEASURES/INDICATORS FOR SUCCESS ALONG WITH BASELINE DATA. ADDITIONAL MONITORING OF THE PLAN WILL OCCUR THROUGH THE QUARTERLY COMMUNITY BENEFITS REPORTS TO THE MHS COMMUNITY BENEFITS COMMITTEE AND THE ANNUAL CHARITY CARE REPORT. METHODIST HAS ALSO USED INFORMATION FROM THE 2016 CHNA TO DEVELOP A 3 YEAR PLAN FOR 2017 2019. THE 2017 2019 PLAN HAS BEEN APPROVED BY THE MHS COMMUNITY BENEFITS COMMITTEE, MHS COMMUNITY BOARD, MHS BOARD OF GOVERNORS, AND THE METHODIST HEALTHCARE MINISTRIES BOARD OF DIRECTORS. Schedule H, Part V, Sec B, Line 5: AS NOTED IN PART V, SECTION B, LINE 3J, Discussions and interviews were held with multiple stakeholders in the community during March and April 2016. Key regional groups and city officials included the following: Haven for Hope (representing homeless population), University Health System (representing low-income and medically underserved), National Alliance on Mental Health Illness (representing mental illness population) , San Antonio Food Bank (representing low-income population), Bexar County Economic Development (representing low-income population), San Antonio Housing Authority (representing low-income population), CommuniCare (representing low-income and medically underserved population), San Antonio Metropolitan Health District (with special knowledge of and expertise in public health), Healthy Futures of Texas (focuses on the prevention of teen and unplanned pregnancies), The Rivard Report (keeping the community informed of public health issues) , Roy Maas Youth Alternatives (representing homeless population), Nelson Wolff, J.D. - Bexar County Judge (with special knowledge of and expertise in public health) , and Northside Independent School District (representing children and their families). Other discussion groups included individuals representing faith organizations, social service providers, hospitals, public health leaders, academic researchers, community planning agencies, community focused organizations, individual community members, and business leaders. Schedule H, Part V, Sec B, Line 6A: THE COMMUNITY NEEDS ASSESSMENT WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES: METHODIST HEALTHCARE SYSTEM (METHODIST HOSPITAL, METHODIST CHILDREN'S HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, METHODIST SPECIALTY AND TRANSPLANT HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, METROPOLITAN METHODIST HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, NORTHEAST METHODIST HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, METHODIST TEXSAN HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, METHODIST STONE OAK HOSPITAL, METHODIST AMBULATORY SURGERY HOSPITAL - (NORTHWEST); BAPTIST HEALTH SYSTEM (BAPTIST MEDICAL CENTER, NORTH CENTRAL BAPTIST HOSPITAL, MISSION TRAILS BAPTIST HOSPITAL, ST. LUKE'S BAPTIST HOSPITAL, NORTHEAST BAPTIST HOSPITAL); CHRISTUS SANTA ROSA HEALTH SYSTEM (CHRISTUS SANTA ROSA MEDICAL CENTER, CHRISTUS SANTA ROSA WESTOVER HILLS, CHILDREN'S HOSPITAL OF SAN ANTONIO) AND UNIVERSITY HOSPITAL. Schedule H, Part V, Sec B, Line 6B: IN ADDITION TO THE HOSPITAL FACILITIES LISTED ABOVE, THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN CONJUNCTION WITH THE FOLLOWING NON-HOSPITAL ORGANIZATIONS: APPDDICTION STUDIO, BEXAR COUNTY DEPARTMENT OF COMMUNITY RESOURCES, COMMUNITY FIRST HEALTH PLANS, INTERLEX COMMUNICATIONS, METHODIST HEALTHCARE MINISTRIES OF SOUTH TEXAS, INC., OUR LADY OF THE LAKE UNIVERSITY, THE CITY OF SAN ANTONIO METROPOLITAN HEALTH DISTRICT, SAN ANTONIO CLUBHOUSE, UNIVERSITY OF INCARNATE WORD, UT HEALTH SCIENCE CENTER AT SAN ANTONIO DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE, THE YMCA OF GREATER SAN ANTONIO, AND COMMUNITY MEMBERS AT LARGE. Schedule H, Part V, Sec B, Line 7A: HTTPS://SAHEALTH.COM/ABOUT/COMMUNITY/INDEX.DOT Schedule H, Part V, Sec B, Line 10A: HTTPS://SAHEALTH.COM/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS-PLAN.DOT Schedule H, Part V, Sec B, Line 11: AS NOTED ABOVE, METHODIST HEALTHCARE SYSTEM HAS DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS PLAN ADDRESSED ALL ITEMS IDENTIFIED BY THE HEALTH COLLABORATIVE. PRIORITIES AND SPECIFIC TACTICS INCLUDE THE FOLLOWING, WITH IMPLEMENTATION IN 2014, AND WITH YEARLY UPDATES THROUGH 2019: COMMUNITY HEALTH PRIORITY NO. 1: HEALTHY EATING AND ACTIVE LIVING - COMMUNITY GOAL - TO FOSTER SOCIAL CHANGE AND STRENGTHEN POSITIVE BEHAVIORS AROUND HEALTHY EATING AND ACTIVE LIVING TO ENSURE ACCESS TO NUTRITIOUS FOODS AND BUILD ENVIRONMENTS THAT ENABLE ALL RESIDENTS TO MAKE HEALTHY CHOICES AND LEAD HEALTHY LIVES. TACTICS - COMMUNITY HEALTH PRIORITY NO. 1: - HOST TWO HEARTCHECK HEALTH FAIRS. THESE HEALTH FAIRS WILL BE HELD IN LOWER SOCIOECONOMIC NEIGHBORHOODS PROVIDING THE COMMUNITY GLUCOSE, BLOOD PRESSURE, FULL LIPID PANEL CHOLESTEROL AND BMI CHECKS, AS WELL AS LITERATURE. METHODIST HEALTHCARE SYSTEM ANTICIPATED SCREENING 400 PARTICIPANTS IN 2016. TWO HEALTH FAIRS WERE HELD, WITH A TOTAL OF 215 ATTENDEES. - HOST TWO CARDIAC CONNECTIONS SERIES WITH FOCUS ON HYPERTENSION, DIABETES AND HYPERLIPIDEMIA. EACH EVENT IS LED BY PHYSICIANS AND MEDICAL PROFESSIONALS. METHODIST HEALTHCARE SYSTEM ANTICIPATED 150 ATTENDEES THROUGHOUT 2016. A TOTAL OF Fifteen EVENTS OCCURRED, WITH A TOTAL OF 1,603 ATTENDEES. - PROVIDE HEARTMATTERS/STROKEMATTERS, A FREE RESOURCE TO THE COMMUNITY. METHODIST HEALTHCARE SYSTEM ANTICIPATED THAT 20,000 MEMBERS OF THE COMMUNITY WOULD RECEIVE THIS MAGAZINE IN 2016. IN 2016, 22,880 MEMBERS OF THE COMMUNITY RECEIVED THIS PUBLICATION. - METHODIST HEALTHCARE SYSTEM WILL EMAIL E-NEWSLETTERS TO OVER 12,000 SUBSCRIBERS ON HEART, WOMEN'S SERVICES AND CHILDREN'S SERVICES EACH MONTH IN 2016. IN 2016 A TOTAL OF Fifteen E-NEWSLETTERS WERE MAILED. - PRODUCE "KEEPING WELL", A COMMUNITY HEALTH AND WELLNESS MAGAZINE PUBLISHED THREE TIMES PER YEAR AND AVAILABLE IN ELECTRONIC AND HARD COPY FORMAT. METHODIST HEALTHCARE SYSTEM ANTICIPATED A READERSHIP OF 250,000 IN 2016. THREE EDITIONS OF THIS MAGAZINE WERE PUBLISHED IN 2016. - METHODIST HEALTHCARE SYSTEM'S EMPLOYER SOLUTIONS PROGRAM, HEALTHPOWER, WILL PARTNER WITH 195 LOCAL BUSINESSES WHICH PARTICIPATE IN METHODIST HEALTHCARE-SPONSORED WELLNESS ACTIVITIES, INCLUDING CHALLENGE WEIGH-INS, GLUCOSE AND BLOOD PRESSURE CHECKS. IN 2016, METHODIST HEALTHCARE SYSTEM ANTICIPATED 118,000 EMPLOYEES WILL BE REACHED THROUGH HEALTHPOWER, REPRESENTING MORE THAN 330,000 COVERED LIVES. METHODIST HEALTHCARE SYSTEM HELD 91 HEALTHPOWER EVENTS IN 2016. - OFFER MORE THAN 600 55PLUS SPONSORED LINE DANCING CLASSES WITH AN ANTICIPATED ATTENDANCE TOTAL OF GREATER THAN 7,000 IN 2016. METHODIST HEALTHCARE SYSTEM SPONSORED 2,900 EVENTS--LINE DANCING, WALKER WELLNESS, AND SILVER SNEAKERS (IN CONJUNCTION WITH THE YMCA)--DURING 2016. 68,919 INDIVIDUALS ATTENDED THESE EVENTS. - UTILIZE SOCIAL MEDIA TO PUSH HEALTH AND WELLNESS TOPICS, INCLUDING TOPICS RELATED TO HEALTHY EATING AND ACTIVE LIVING TO THE COMMUNITY VIA FACEBOOK AND TWITTER AT LEAST TWO TIMES PER WEEK. - Methodist Healthcare SYSTEM anticipated an increase in Twitter followers of 4,100 and Facebook to 18,300 in 2016. Actual results for 2016: 4,012 Twitter followers and 18,260 Facebook Fans. - DONATE/SPONSOR TO THE FOLLOWING NONPROFITS: AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, LEUKEMIA AND LYMPHOMA SOCIETY, MULTIPLE SCLEROSIS SOCIETY, AMERICAN HEART ASSOCIATION, WOMEN AND GIRLS' DEVELOPMENT, HARPER'S EMBRACE, WINGS, SHARED BEAT, AMERICAN DIABETES ASSOCIATION EXPO, AS WELL AS OTHER MEDICALLY RELATED NON-PROFITS. METHODIST HEALTHCARE SYSTEM EXPECTS TO DONATE $180,000 IN 2016. ACTUAL DONATIONS IN 2016 TOTALED $222,816. THE AMERICAN DIABETES ASSOCIATION EXPO IS NO LONGER BEING OFFERED IN SAN ANTONIO. Methodist HEALTHCARE SYSTEM sponsored the Tour De Cure to benefit the American Diabetes Association in 2016. - CONTINUE INVOLVEMENT WITH Healthy Me (formerly PROJECT MEASURE UP) IN PARTNERSHIP WITH THE HEALTH COLLABORATIVE (THC). METHODIST HEALTHCARE SYSTEM PARTICIPATES IN THIS SURVEILLANCE AND SERVICE PROGRAM AIMED AT DECREASING THE PREVALENCE OF YOUTH OVERWEIGHT AND OBESITY IN BEXAR COUNTY THROUGH PROGRAMS IN AREA SCHOOL DISTRICTS. Healthy Me IS IMPLEMENTED IN NINE SAN ANTONIO SCHOOL DISTRICTS. METHODIST HEALTHCARE SYSTEM ANTICIPATED REACHING OVER 10,000 LIVES IN 2016. IN 2016, THERE WERE 14,683 PARTICIPANTS. - CONTINUE ITS INVOLVEMENT IN THE FAMILY FITNESS PROGRAM IN PARTNERSHIP WITH THC, METHODIST HEALTHCARE SYSTEM SUPPORTS FAMILY FITNESS EVENTS WITH CERTIFIED TRAINERS AND DISTRIBUTION OF HEALTH INFORMATION THROUGH SEVERAL AREA SCHOOL DISTRICTS. METHODIST HEALTHCARE SYSTEM ANTICIPATED REACHING MORE THAN 6,000 LIVES IN 2016. TOTALS FOR THESE EVENTS HAVE BEEN INCLUDED IN THE 2,900 EVENTS NOTED ABOVE. - Methodist HEALTHCARE SYSTEM will create five new brochures based on healthy eating and active living. These brochures will be handed out with The Health Collaborative at their various events. Methodist Healthcare SYSTEM anticipated 30,000 brochures will be distributed in 2016. The five new brochures produced in 2016 included: "Fruits and Vegetables", "Rethink Your Drink", "Eat More Weigh Less", "Portion Control", and "Physical Activity". - DONATE IN KIND PRINTING TO VARIOUS NON-PROFITS INCLUDING THE LEUKEMIA AND LYMPHOMA SOCIETY, MULTIPLE SCLEROSIS SOCIETY AND OTHERS. THE MONETARY VALUE FOR THE PRINTING WAS $25,000 IN 2016. THE MONETARY VALUE OF ACTUAL PRINTED MATERIALS WAS $43,400 FOR 2016. - HOLD A FOOD DRIVE TO BENEFIT THE SAN ANTONIO FOOD BANK. IN 2016, ONE FOOD DRIVE SPANNING FIVE LOCATIONS WAS HELD. COMMUNITY HEALTH PRIORITY NO 2: HEALTHY CHILD AND FAMILY DEVELOPMENT - COMMUNITY GOAL - TO MAKE PREGNANCY AND EARLY CHILDHOOD THE FOCUS OF SYSTEM LEVEL CHANGES THAT SUPPORT HEALTHY CHILD AND FAMILY DEVELOPMENT. TACTICS - COMMUNITY HEALTH PRIORITY NO. 2: - OFFER COMPLIMENTARY PREGNANCY TESTING THROUGH ITS FIVE FAMILY HEALTH CENTERS. METHODIST HEALTHCARE SYSTEM ANTICIPATED PROVIDING 15,000 PREGNANCY TESTS IN 2016. METHODIST HEALTHCARE SYSTEM PROVIDED 8,639 TESTS IN 2016, AND REFERRED 2,250 INDIVIDUALS. There has been a city-wide decline in overall OB volume. This can be attributed to the Zika virus and concerns about it as it relates to pregnancy. There were also more facilities offering these services in 2016. - Offer assistance to those in the community filling out CHIP applications through its five Family Health Centers. CHIP is Childrens Health Insurance Program. In Texas, children without health insurance are eligible to receive low cost or free health coverage through CHIP. Methodist Healthcare SYSTEM anticipates assisting with 15 applications in 2016. The Family Health Centers did not track this information in 2016. - CONTINUE TO OFFER CALL-A-NURSE FOR CHILDREN - A TELEPHONE SERVICE OFFERING FREE MEDICAL ADVICE BY TRAINED EMERGENCY CARE PEDIATRIC NURSES TO PARENTS OF SICK/INJURED CHILDREN. THE CALL-A-NURSE FOR CHILDREN SERVICE IS AVAILABLE FROM 5 P.M. TO 8 A.M. MONDAY THROUGH FRIDAY AND AROUND THE CLOCK ON WEEKENDS AND HOLIDAYS. METHODIST HEALTHCARE SYSTEM ANTICIPATED RECEIVING 92,000 CALLS DURING 2016. THE CALL-A-NURSE LINE RECEIVED 57,987 CALLS IN 2016. MHS MARKETING IS REVIEWING THE DECLINE FROM 2015. AN "AD" WAS PLACED IN THE FALL 2016 ISSUE OF "KEEPING WELL,MARKETING IS ALSO REVIEWING OTHER METHODS FOR PROMOTING THIS SERVICE. - CONTINUE TO OPERATE A COMMUNITY PHONE-IN HEALTH RESOURCE CALLED HEALTHLINE DURING NORMAL BUSINESS HOURS. THE HEALTHLINE OFFERS PHYSICIAN REFERRALS, INCLUDING PRIMARY CARE PHYSICIANS, FAMILY MEDICINE, OBSTETRICIANS AND GYNECOLOGISTS THROUGH THE DOCTORSOURCE PROGRAM. METHODIST HEALTHCARE SYSTEM ANTICIPATED 8,600 PHYSICIAN REFERRALS IN 2016. REFERRALS TO THE PHYSICIAN SPECIALTIES NOTED ABOVE WERE 5,761 IN 2016. - CONTINUE TO TEACH PROPER CAR SEAT INSTALLATION TO THE COMMUNITY THROUGH OUR BUCKLE UP BABY CLASSES. METHODIST HEALTHCARE SYSTEM ANTICIPATED TEACHING THE INSTALLATION OF A COMBINED TOTAL 230 CAR SEATS IN 2016 AT METHODIST HOSPITAL, METROPOLITAN METHODIST HOSPITAL, METHODIST STONE OAK HOSPITAL AND VARIOUS COMMUNITY EVENTS. Two HUNDRED Forty-Seven CAR SEATS WERE DISTRIBUTED IN 2016. - OFFER THE COMMUNITY PARENTING CLASSES INCLUDING DADDY BOOT CAMP, BREASTFEEDING, GETTING READY FOR CHILDBIRTH AND TOUR, PETS AND YOUR BABY, CPR, NICU (NEONATAL INTENSIVE CARE UNIT) CPR, BEYOND BABY BLUES CLASS (POSTPARTUM DEPRESSION) AND CHILDBIRTH EDUCATION CLASSES OFFERED IN SPANISH TO BE HELD AT METHODIST HOSPITAL, METROPOLITAN METHODIST HOSPITAL AND METHODIST STONE OAK HOSPITAL. METHODIST HEALTHCARE SYSTEM ANTICIPATED A COMBINED TOTAL OF 995 CLASSES WITH 16,530 ATTENDEES AT THE THREE HOSPITALS. 11,397 INDIVIDUALS ATTENDED THESE CLASSES IN 2016. - CONTINUE PROVIDING THE COMMUNITY WITH FREE LACTATION CONSULTATIONS (IN PERSON AND BY PHONE). METHODIST HEALTHCARE SYSTEM ANTICIPATED A COMBINED TOTAL OF 47,875 CONSULTATIONS (INCLUDING IN PERSON AND BY PHONE) IN 2016 AT METHODIST HOSPITAL, METROPOLITAN METHOD A-4 METHODIST SPECIALTY AND TRANSPLANT HOSPITAL ("MSTH") COMMUNITY HEALTH PRIORITY NO. 1: HEALTHY EATING AND ACTIVE LIVING - PROVIDE DIABETES EDUCATION TO PATIENTS. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL WILL MONITOR AND REPORT THE NUMBER OF CLASSES AND INDIVIDUAL INSTRUCTION PROVIDED TO PATIENTS. IN 2016, METHODIST SPECIALTY AND TRANSPLANT DIABETES EDUCATORS HAD 2,114 VISITS. - METHODIST HELD 74 DIABETES EDUCATION SEMINARS IN 2016. TOTAL ATTENDANCE WAS 28,241 (SYSTEM TOTAL). - PROVIDE SAN ANTONIO FOOD BANK COLLECTION AND SUPPORT. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL ANTICIPATED AT LEAST ONE MAJOR FOOD DRIVE FOR ALL EMPLOYEES TO SUPPORT THE SAN ANTONIO FOOD BANK IN 2016. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL HELD ONE FOOD DRIVE TO SUPPORT THE SAN ANTONIO FOOD BANK IN 2016. COMMUNITY HEALTH PRIORITY NO 2: HEALTHY CHILD AND FAMILY DEVELOPMENT - THROUGH PRINTING OF COURSE MATERIALS AND OFFERING CLASSROOM SPACE, METHODIST SPECIALTY AND TRANSPLANT HOSPITAL WILL CONTINUE TO SUPPORT THE NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI). SEMINAR TOPICS INCLUDE BASIC CLASSES (6 SESSIONS) AND FAMILY TO FAMILY CLASSES (12 SESSIONS). THESE PROGRAMS ARE FREE AND DESIGNED TO ALLOW FAMILIES TO CONNECT WITH OTHERS WHILE LEARNING ABOUT MENTAL ILLNESS, PARENTING, AND EMPOWERING THEMSELVES AS THEY NAVIGATE THROUGH THE HEALTH CARE ENVIRONMENT. SIX BASICS CLASSES WERE HELD IN 2016 and Methodist specialty and transplant hospital held 39 support group sessions. - DISTRIBUTE THE "YOUNG HEROES CLUB HERALD" PUBLICATION. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL DISTRIBUTED 540 PUBLICATIONS. COMMUNITY HEALTH PRIORITY NO. 3: SAFE COMMUNITIES - CONTINUE FUNDING THE SEXUAL ASSAULT RESPONSE TEAM (SART) AT METHODIST SPECIALTY AND TRANSPLANT HOSPITAL, WHICH PROVIDES A COMPASSIONATE ENVIRONMENT FOR SEXUAL ASSAULT SURVIVORS AND AN INTEGRATED COMMUNITY EFFORT TO TREAT SEXUAL ASSAULT SURVIVORS WITH SPECIALLY TRAINED SEXUAL ASSAULT NURSE EXAMINERS (SANE). METHODIST SPECIALTY AND TRANSPLANT HOSPITAL WILL ASSIST WITH MORE THAN 500 CASES IN 2016. THE TEAM ASSISTED WITH 888 CASES IN 2016. - MONTHLY, PROVIDE TWO COMMUNITY EDUCATION TRAINING CLASSES ON THE PREVENTION OF SEXUAL VIOLENCE TO DIFFERENT GROUPS. 35 EVENTS WITH 864 ATTENDEES WERE HELD IN 2016. - Host informational meetings on domestic violence. Two meetings were held in 2016, and 57 individuals attended. COMMUNITY HEALTH PRIORITY NO. 4: BEHAVIORAL HEALTH AND MENTAL WELL-BEING - PARTICIPATE IN NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) EVENTS IN 2016. SEE INFORMATION ABOVE REGARDING NAMI BASICS CLASSES. METHODIST specialty and transplant hospital ALSO PROVIDED THE FOLLOWING SUPPORT IN 2016: SPONSORED NAMI WALK FOR $1,000. - HOST COMMUNITY SUPPORT GROUPS AT METHODIST SPECIALTY AND TRANSPLANT HOSPITAL. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL HOSTED NAMI CONNECTIONS MEETINGS, AND 48 SUPPORT GROUP MEETINGS FOR ALCOHOLICS ANONYMOUS, COCAINE ANONYMOUS, NARCOTICS ANONYMOUS AND DEPRESSIVE BIPOLAR SUPPORT GROUP. - EDUCATE LAW ENFORCEMENT ON MENTAL HEALTH BY: PROVIDING ON A QUARTERLY BASIS PRINT MATERIALS FOR CRISIS INTERVENTION TRAINING (CIT), AN INITIATIVE TO IMPROVE THE WAY LAW ENFORCEMENT AND THE COMMUNITY RESPONDS TO PEOPLE EXPERIENCING MENTAL HEALTH CRISES. IT IS A COLLABORATIVE CLASS FOR EMS/FIRE, SAPD AND BEXAR COUNTY MENTAL HEALTH CONSORTIUM. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL ANTICIPATED PRINTING MATERIALS FOUR TIMES PER YEAR. MSTH PROVIDED 5 TRAINING SESSIONS FOR 270 ATTENDEES IN 2016. The educator position was vacant for half of 2016, but was filled in January of 2017. - HOST/PARTICIPATE IN COMMUNITY EVENTS EMPHASIZING BEHAVIORAL HEALTH AND MENTAL WELL-BEING. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL PARTICIPATED IN 10 EVENTS IN 2016. 275 INDIVIDUALS ATTENDED THESE EVENTS. COMMUNITY HEALTH PRIORITY NO 5: SEXUAL HEALTH - METHODIST HEALTHCARE SYSTEM DEVELOPED TWO EDUCATIONAL BROCHURES REGARDING SYPHILIS AND SEXUALLY TRANSMITTED DISEASES IN 2015. 190 were DISTRIBUTED IN 2016. - SPONSOR THE ZERO PROSTATE RUN. METHODIST specialty and transplant hospital CONTRIBUTED $3,000 TO THIS EVENT IN 2016. - PROVIDE LITERATURE ON TEEN PREGNANCY AND PREGNANCY TESTING AT FAMILY HEALTH CENTERS. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL WILL PROVIDE 100 PIECES OF LITERATURE PER MONTH. IN 2016, MSTH PROVIDED 220 PIECES OF LITERATURE. A-5 METHODIST STONE OAK HOSPITAL ("MSOH") COMMUNITY HEALTH PRIORITY NO. 1: HEALTHY EATING AND ACTIVE LIVING - PROVIDE DIABETES EDUCATION TO PATIENTS. METHODIST STONE OAK HOSPITAL WILL MONITOR AND REPORT THE NUMBER OF CLASSES AND INDIVIDUAL INSTRUCTION PROVIDED TO PATIENTS. IN 2016, METHODIST STONE OAK HOSPITAL DIABETES EDUCATORS HAD 200 VISITS. METHODIST HEALTHCARE SYSTEM ALSO HOSTED 74 DIABETES-RELATED EVENTS, WITH 28,241 IN ATTENDANCE. - CONTINUE TO SUPPORT HEART DISEASE EDUCATION AND PREVENTION. METHODIST STONE OAK HOSPITAL ANTICIPATED OVER 500 PARTICIPANTS FOR THESE EVENTS IN 2016: RED DRESS FUN RUN, CARDIAC CONNECTIONS, AND SUPPORT OF THE AMERICAN HEART ASSOCIATION THROUGH THE HEART WALK (MSOH raised $5,000 in 2016). IN 2016, 997 ATTENDED THE RED DRESS FUN RUN, METHODIST STONE OAK HOSPITAL HELD TWO CARDIAC CONNECTIONS EVENTS WITH TOTAL ATTENDANCE OF 27, AND CONTRIBUTED $5,000 TO THE AMERICAN HEART ASSOCIATION. - PROVIDE SAN ANTONIO FOOD BANK COLLECTION AND SUPPORT. METHODIST STONE OAK HOSPITAL ANTICIPATED AT LEAST ONE MAJOR FOOD DRIVE FOR ALL EMPLOYEES TO SUPPORT THE SAN ANTONIO FOOD BANK IN 2016. METHODIST STONE OAK HOSPITAL HELD ONE FOOD DRIVE TO SUPPORT THE SAN ANTONIO FOOD BANK IN 2016. - POST NUTRITIONAL VALUE OF FOODS OFFERED IN METHODIST STONE OAK HOSPITAL CAFETERIA AND OFFER A MENU OF OFFERINGS OF UNDER 500 CALORIES AND WORK WITH FOOD & NUTRITION SERVICES TO OFFER HEALTHIER FOOD OPTIONS. ENCOURAGE STAFF TO PROVIDE HEALTHIER OPTIONS FOR CEREMONIES FOR STAFF RECOGNITION, BIRTHDAYS, EMPLOYMENT ANNIVERSARIES, AND OTHER MILESTONES. IN 2016, METHODIST STONE OAK HOSPITAL CONTINUED TO DESIGNATE HEALTHY FOOD OPTIONS IN THE CAF, AND ALSO PROVIDED NUTRITIONAL INFORMATION FOR ITEMS SERVED. - DISTRIBUTION OF PUBLIC AWARENESS MATERIALS, INCLUDING INFORMATION ON DIABETES, CARDIAC DISEASE AND OTHER HEALTHY EATING AND ACTIVE LIVING ISSUES. METHODIST STONE OAK HOSPITAL WILL DISTRIBUTE OVER 100 PIECES PER MONTH IN 2016. METHODIST STONE OAK HOSPITAL DISTRIBUTED 1,900 PIECES OF HEALTH LITERATURE IN 2016. COMMUNITY HEALTH PRIORITY NO 2: HEALTHY CHILD AND FAMILY DEVELOPMENT - PROVIDE Three SCHOLARSHIPS ($1,500 EACH) TO HIGH SCHOOL STUDENTS SEEKING HEALTH CARE DEGREES IN 2016. METHODIST STONE OAK HOSPITAL PROVIDED $4,500 IN SCHOLARSHIPS IN 2016. - OFFER THE COMMUNITY PARENTING CLASSES INCLUDING BUCKLE UP BABY, DADDY BOOT CAMP, BREASTFEEDING, GETTING READY FOR CHILDBIRTH AND TOUR, PETS AND YOUR BABY, CPR, NICU (NEONATAL INTENSIVE CARE UNIT) CPR, BEYOND BABY BLUES CLASS (POSTPARTUM DEPRESSION) AND CHILDBIRTH EDUCATION CLASSES OFFERED IN SPANISH. METHODIST STONE OAK HOSPITAL WILL HOLD CLASSES AS NEEDED. IN 2016, METHODIST STONE OAK HELD 198 CLASSES WITH 2,191 ATTENDEES. - CONTINUE PROVIDING THE COMMUNITY WITH FREE LACTATION CONSULTATIONS (IN PERSON AND BY PHONE). MHS ANTICIPATED A COMBINED TOTAL OF 17,625 CONSULTATIONS (INCLUDING IN PERSON AND BY PHONE) IN 2016. 39,963 CONSULTATIONS WERE PROVIDED IN 2016 (SYSTEM TOTAL). - DISTRIBUTE CALL-A-NURSE MAGNETS. THE CALL-A-NURSE PROGRAM IS A TELEPHONE SERVICE OFFERING FREE MEDICAL ADVICE BY TRAINED EMERGENCY CARE PEDIATRIC NURSES TO PARENTS OF SICK/INJURED CHILDREN. THE CALL-A-NURSE FOR CHILDREN SERVICE IS AVAILABLE FROM 5 P.M. TO 8 A.M. MONDAY THROUGH FRIDAY AND AROUND THE CLOCK ON WEEKENDS AND HOLIDAYS. METHODIST STONE OAK HOSPITAL ANTICIPATED DISTRIBUTING 500 MAGNETS IN 2016. METHODIST STONE OAK DISTRIBUTED 850 MAGNETS IN 2016. - CONTINUE TO TEACH PROPER CAR SEAT INSTALLATION TO THE COMMUNITY THROUGH OUR BUCKLE UP BABY CLASSES. METHODIST STONE OAK HOSPITAL ANTICIPATED TEACHING THE INSTALLATION OF 140 CAR SEATS IN 2016. METHODIST STONE OAK PROVIDED TEACHING FOR 112 CAR SEAT INSTALLATIONS IN 2016. COMMUNITY HEALTH PRIORITY NO. 3: SAFE COMMUNITIES - CONTROLLING STRAY ANIMALS-DISTRIBUTING RESPONSIBLE PET OWNERSHIP MATERIALS TO PUBLIC. METHODIST STONE OAK HOSPITAL WILL DISTRIBUTE OVER 1,000 COPIES TO THE COMMUNITY IN 2016. METHODIST STONE OAK DISTRIBUTED 1,000 PIECES OF LITERATURE ON THIS SUBJECT IN 2016. - PROVIDE INFORMATION ON HELMET SAFETY, POISON CONTROL AND DOMESTIC VIOLENCE. 335 PIECES OF LITERATURE WERE DISTRIBUTED IN 2016. COMMUNITY HEALTH PRIORITY NO. 4: BEHAVIORAL HEALTH AND MENTAL WELL-BEING - THIS COMMUNITY HEALTH PRIORITY IS PART OF THE OVERALL METHODIST HEALTHCARE SYSTEM PLAN, AND IS ADDRESSED AT THE SYSTEM LEVEL. COMMUNITY HEALTH PRIORITY NO 5: SEXUAL HEALTH - Provide information to teens on STDs. 315 brochures were distributed in 2016. - Promote teen pregnancy awareness - Provide literature on teen pregnancy. Methodist Stone Oak Hospital will stock literature in waiting rooms and lobbies throughout the hospital. Distribute 100 pieces per month in 2016. METHODIST STONE OAK HOSPITAL distr Schedule H, Part V, Sec B, Lines 13B, 13H, AND 15E: METHODIST HEALTHCARE SYSTEM USES FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY. THE FOLLOWING IS A SUMMARY OF THE CHARITY CARE POLICY ADOPTED BY MHS: CHARITY CARE ELIGIBILITY SYSTEM - METHODIST REQUIRES THE COMPLETION OF AN APPLICATION, WHICH ALLOWS FOR THE COLLECTION OF APPROPRIATE INFORMATION. - VERIFICATION OF FAMILY MEMBERS IN THE HOUSEHOLD - ADULTS: PATIENT, PATIENT'S SPOUSE AND ANY DEPENDENTS. MINORS: PATIENT, PATIENT'S MOTHER AND FATHER, AND DEPENDENTS OF BOTH. - INCOME CALCULATION - ADULTS: SUM OF THE TOTAL YEARLY GROSS INCOME OF THE PATIENT AND THE PATIENT'S SPOUSE. MINORS: TOTAL YEARLY GROSS INCOME OF THE PATIENT, AND THE PATIENT'S MOTHER AND FATHER. - DOCUMENTATION - VARIOUS OFFICIAL INCOME REPORTING DOCUMENTATION IS REQUIRED (E.G. W-2, WAGE AND TAX STATEMENT, PAY CHECK REMITTANCE AND OTHERS). DOCUMENTATION ASSOCIATED WITH THE PARTICIPATION IN A PUBLIC BENEFIT PROGRAM CAN BE PROVIDED IN LIEU OF INCOME DOCUMENTATION (PROOF OF PARTICIPATION INDICATES THE PATIENT HAS BEEN DEEMED FINANCIALLY INDIGENT AND THEREFORE IS NOT REQUIRED TO PROVIDE INCOME INFORMATION). THERE IS ALSO A VERIFICATION PROCESS IN PLACE FOR PATIENTS THAT DO NOT HAVE APPROPRIATE DOCUMENTATION. - ZIP CODE WRITE-OFF ELIGIBILITY - METHODIST WILL ACCEPT UNINSURED RESIDENTIAL INDIGENT PATIENTS AS ELIGIBLE FOR CHARITY WRITE-OFF UPON EXHAUSTION OF INSURANCE ELIGIBILITY DETERMINATION (I.E. MEDICAID) AND EFFORTS TO OBTAIN A COMPLETED CHARITY APPLICATION WITH SUPPORTING PROOF OF INCOME. THE WRITE-OFF WILL APPLY TO ALL PATIENT TYPES. A RESIDENTIAL INDIGENT PATIENT IS AN UNINSURED PERSON WHO IS ACCEPTED FOR CARE WITH NO OBLIGATION OR WITH A DISCOUNTED OBLIGATION TO PAY FOR THE SERVICES RENDERED, AND LIVES IN SPECIFICALLY DEFINED ZIP CODES--THOSE WITH HIGH POVERTY POPULATIONS. FOR THE YEAR ENDED DECEMBER 31, 2016, THE CHARITY CARE WRITE OFF RELATED TO THIS ELIGIBILITY PROCESS WAS $174.4 MILLION ($100.3 MILLION IN 2015). CHARITY ELIGIBILITY CLASSIFICATIONS - FINANCIALLY INDIGENT - YEARLY INCOME IS LESS THAN OR EQUAL TO 200% OF THE FEDERAL POVERTY GUIDELINES. - MEDICALLY INDIGENT - THE AMOUNT OWED BY THE PATIENT AFTER PAYMENT BY ALL THIRD-PARTY PAYORS MUST EXCEED TEN PERCENT OF THE PATIENT'S YEARLY INCOME AND THE PATIENT MUST BE UNABLE TO PAY THE REMAINING BILL. ACCEPTANCE BY MHS IS BASED ON MEETING EITHER OF TWO CRITERIA: YEARLY INCOME MUST BE GREATER THAN 200%, BUT LESS THAN OR EQUAL TO 500% OF THE FEDERAL POVERTY GUIDELINES. ALTERNATIVELY, PATIENTS WITH ABNORMALLY LARGE ACCOUNTS MAY QUALIFY AS CATASTROPHICALLY ELIGIBLE WHEN THEIR REMAINING BALANCE EXCEEDS A SPECIFIC PERCENTAGE OF THEIR INCOME. IT IS IMPORTANT TO NOTE THAT THE GUIDELINES APPLIED FOR CATASTROPHIC ELIGIBILITY RANGE FROM 201% OF THE FEDERAL POVERTY GUIDELINES TO OVER 1000% OF THE FEDERAL POVERTY GUIDELINES. Schedule H, Part V, Sec B, Lines 16A-C: HTTPS://SAHEALTH.COM/ABOUT/MISSION-VALUES/CHARITY-CARE.DOT Schedule H, Part V, Sec B, Lines 16J AND 20E: MHS HAS TAKEN STEPS OVER THE PAST SEVERAL YEARS TO HEIGHTEN COMMUNITY AWARENESS REGARDING MHS' CHARITABLE MISSION. SIGNS THAT PROMINENTLY PRESENT INFORMATION ABOUT THE CHARITY MISSION AND GUIDELINES ARE PRESENT AT ALL POINTS OF ADMISSION. MHS ALSO PUBLISHES A NOTICE OF ITS CHARITY POLICY ANNUALLY IN THE SAN ANTONIO EXPRESS-NEWS. A PATIENT BROCHURE, ENTITLED "A GUIDE TO YOUR HOSPITAL BILL", EXPLAINS THE HOSPITAL BILLING PROCESS AND INFORMS PATIENTS OF THE CHARITY POLICY IN THE EVENT THEY NEED FINANCIAL ASSISTANCE. INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY IS ALSO AVAILABLE IN ENGLISH AND SPANISH ON MHS' WEBSITE WWW.SAHEALTH.COM. ALL SHARED SERVICE CENTER PERSONNEL RECEIVE TRAINING AND AN ANNUAL REFRESHER COURSE ON THE POLICY, AND UNDERSTAND THE CRUCIAL ROLE THEY PLAY IN INFORMING PATIENTS ABOUT THE POLICY. FINANCIAL COUNSELORS AND HOSPITAL CASE MANAGEMENT STAFF EDUCATE PATIENTS AND ARE AVAILABLE TO ASSIST THEM WITH THE CHARITY CARE APPLICATION PROCESS. IN ADDITION TO PROVIDING INFORMATION DURING THE ADMITTING PROCESS, MHS CONTINUES TO PROVIDE INFORMATION ABOUT THE AVAILABILITY OF CHARITY CARE ASSISTANCE DURING THE COLLECTION PROCESS FOR THOSE PATIENTS WHO HAVE BEEN BILLED, BUT HAVE NOT PAID. 16 Methodist Ambulatory Surgery Center 4411 Medical Drive Suite 200 San Antonio TX 78229 Freestanding Ambulatory Surgery Center Ctr for Special Surgery TX Ctr Athlete 21 Spurs Lane SL-100 San Antonio TX 78240 Freestanding Ambulatory Surgery Center Methodist Ambulatory Surg Ctr-N Central 19010 Stone Oak Parkway San Antonio TX 78258 Freestanding Ambulatory Surgery Center Methodist Boerne Emergency Center 134 Menger Springs Boerne TX 78006 Emergency Department Metropolitan Methodist Emergency Center 250 East Basse Road 101 San Antonio TX 78209 Emergency Department Methodist Cardiology Physicians 8109 Fredericksburg Road San Antonio TX 78229 Texas Certified Nonprofit Healthcare Corporation Texas Institute of Medicine and Surgery 8109 Fredericksburg Road San Antonio TX 78229 Texas Certified Nonprofit Healthcare Corporation Methodist Physician Practice Svcs LLC 8109 Fredericksburg Road San Antonio TX 78229 Medical Services Organization Methodist Physician Practices PLLC 8109 Fredericksburg Road San Antonio TX 78229 Physician Practice Cardiology Clinic of San Antonio PLLC 8109 Fredericksburg Road San Antonio TX 78229 Physician Practice Pediatric Anesthesia Consultants of SA 8109 Fredericksburg Road San Antonio TX 78229 Physician Practice Methodist Family Health CTR-Austin HWY 1533 Austin Highway Suite 105 San Antonio TX 78218 Family Health Center Methodist Family Health CTR-E Southcross 2388 E Southcross San Antonio TX 78223 Family Health Center Methodist Family Health CTR-Las Palmas 803 Castroville Rd Suite 131 San Antonio TX 78237 Family Health Center Methodist Family Health CTR-SW Military 137 SW Military Drive San Antonio TX 78221 Family Health Center Methodist Community Health Center 507 St James San Antonio TX 78202 Primary Care Clinic Schedule H, Part I, Line 6A: METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., LLP ("MHS") FILES ANNUAL STATEMENTS OF COMMUNITY BENEFITS AS REQUIRED BY THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES, PER PROVISIONS OF THE TEXAS HEALTH AND SAFETY CODE, CHAPTER 311, SUBCHAPTERS C AND D. METHODIST HEALTHCARE MINISTRIES OF SOUTH TEXAS, INC. ("MHM") OWNS A 50% INTEREST OF MHS SO ONLY 50% OF MHS' FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS ARE REPORTED ON MHM'S 990 SCHEDULE H. SCHEDULE H, PART I, LINE 7: COSTING METHODOLOGY - COST TO CHARGE RATIOS FROM WORKSHEET 2 USED. PART I, LINE 7A EXPLANATION - THE PARTNERSHIP IS A MEMBER OF THE BEXAR COUNTY CLINICAL SERVICES (BCCS), AS PART OF AN INDIGENT CARE AFFILIATION AGREEMENT ENTERED INTO WITH OTHER HEALTHCARE SYSTEMS IN SAN ANTONIO. THE AFFILIATED HOSPITALS COLLABORATE TO ENSURE THE AVAILABILITY OF, AND TO MORE COST EFFECTIVELY PROVIDE, QUALITY HEALTHCARE SERVICES TO LOW INCOME AND NEEDY RESIDENTS IN THE BEXAR COUNTY COMMUNITY. BCCS HAS CONTRACTED WITH VARIOUS PROVIDERS TO DELIVER PHYSICIAN AND OTHER HEALTHCARE SERVICES TO THE COMMUNITY'S LOW INCOME AND NEEDY RESIDENTS. EACH HOSPITAL CONTRIBUTES FUNDS TO BCCS, WHICH ARE THEN USED TO SUPPORT THE PROVISION OF HOSPITAL AND CLINICAL PHYSICIAN SERVICES, PHYSICIAN IN-TRAINING SERVICES, PHYSICIAN ASSISTANT/NURSE PRACTITIONER SERVICES, SPECIALTY PHYSICIAN SERVICES AND OTHER HEALTHCARE SERVICES THROUGH BCCS. SCHEDULE H, PART III, LINES 2 & 3: COSTING METHODOLOGY - COST TO CHARGE RATIOS FROM WORKSHEET 2 USED. MHM AND MHS JOINTLY ANALYZED ZIP CODES WHERE, BASED ON FINANCIAL DEMOGRAPHICS, IT APPEARED THAT THE PATIENTS IN THOSE ZIP CODES WOULD LIKELY QUALIFY FOR CHARITY CARE. AN ANALYSIS OF PAST COLLECTIONS IN THE ZIP CODE AREAS AND SEVERAL FEDERAL POVERTY GUIDELINE SURVEYS USING THE ZIP CODES RESULTED IN MHM'S CONCLUSION THAT ALL PATIENTS IN THE IDENTIFIED ZIP CODES ARE PATIENTS THAT, UNDER MHS CHARITY CARE POLICIES, WOULD LIKELY QUALIFY FOR CHARITY CARE. THE ESTIMATED AMOUNT OF MHS' BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS CALCULATED USING ZIP CODE DATA. SCHEDULE H, PART III, LINE 4: METHODIST HEALTHCARE SYSTEM BAD DEBT FOOTNOTE: ADDITIONS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR DOUBTFUL ACCOUNTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED. THE AMOUNT OF THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL AND PRIVATE EMPLOYER HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THE PROVISION FOR DOUBTFUL ACCOUNTS AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS RELATE PRIMARILY TO "UNINSURED" AMOUNTS (INCLUDING CO-PAYMENT AND DEDUCTIBLE AMOUNTS FROM PATIENTS WHO HAVE HEALTHCARE COVERAGE) DUE DIRECTLY FROM PATIENTS. ACCOUNTS ARE WRITTEN OFF WHEN ALL REASONABLE INTERNAL AND EXTERNAL COLLECTION EFFORTS HAVE BEEN PERFORMED. THE RETURN OF AN ACCOUNT FROM THE SECONDARY EXTERNAL COLLECTION AGENCY IS CONSIDERED TO BE THE CULMINATION OF REASONABLE COLLECTION EFFORTS AND THE TIMING BASIS FOR WRITING OFF THE ACCOUNT BALANCE. WRITE-OFFS ARE BASED UPON SPECIFIC IDENTIFICATION, AND THE WRITE-OFF PROCESS REQUIRES A WRITE-OFF ADJUSTMENT ENTRY TO THE PATIENT ACCOUNTING SYSTEM. MANAGEMENT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND RECOVERIES AT FACILITIES THAT REPRESENT A MAJORITY OF REVENUES AND ACCOUNTS RECEIVABLE (THE HINDSIGHT ANALYSIS) AS A PRIMARY SOURCE OF INFORMATION TO UTILIZE IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. THE HINDSIGHT ANALYSIS IS PERFORMED QUARTERLY, UTILIZING ROLLING 12-MONTH ACCOUNTS RECEIVABLE COLLECTION AND WRITE-OFF DATA. THE RESULTS OF THE DETAILED REVIEW OF HISTORICAL COLLECTION AND WRITE-OFF EXPERIENCE, ADJUSTED FOR CHANGES IN TRENDS AND CONDITIONS, ARE USED TO EVALUATE THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AMOUNT FOR THE CURRENT PERIOD. AT DECEMBER 31, 2016 AND 2015, RESPECTIVELY, THE PARTNERSHIP'S COMBINED ALLOWANCE FOR DOUBTFUL ACCOUNTS AND SELF-PAY DISCOUNTS, WHICH ARE RECORDED AS A REDUCTION TO PATIENT ACCOUNTS RECEIVABLE, REPRESENTED APPROXIMATELY 93% OF THE $417.6 MILLION AND 94% OF THE $409.6 MILLION, RESPECTIVELY, TOTAL PATIENT ACCOUNTS RECEIVABLE DUE BALANCE, INCLUDING ACCOUNTS, NET OF ESTIMATED CONTRACTUAL DISCOUNTS, RELATED TO PATIENTS FOR WHICH ELIGIBILITY FOR MEDICAID COVERAGE WAS BEING EVALUATED (PENDING MEDICAID ACCOUNTS). ADVERSE CHANGES IN GENERAL ECONOMIC CONDITIONS, BUSINESS OFFICE OPERATIONS, PAYOR MIX, OR TRENDS IN FEDERAL OR STATE GOVERNMENTAL HEALTHCARE COVERAGE COULD AFFECT THE PARTNERSHIP'S COLLECTION OF ACCOUNTS RECEIVABLE, RESULTS OF OPERATIONS, AND CASH FLOWS. AS OF DECEMBER 31, 2016, THE BAD DEBT AMOUNT WAS $107,710,000. THIS AMOUNT IS NOT REFLECTED ON MHM'S 990 PART IX EXPENSES DUE TO THE BAD DEBT AMOUNT BEING REPORTED IN THE METHODIST HEALTHCARE SYSTEM'S FINANCIALS. SCHEDULE H, PART III, LINE 8: THE AMOUNTS REPORTED ON PART III, LINES 5-7 HAVE BEEN DETERMINED BY AGGREGATING THE INFORMATION FROM THE INDIVIDUAL FACILITY COST REPORT(S) FOR EACH OF THE HOSPITALS OPERATED BY MHS. THE HOSPITALS OPERATED BY MHS MAY HAVE COST REPORT YEAR ENDS OTHER THAN DECEMBER 31, 2016. ACCORDINGLY, FOR A FACILITY WITH A NON-CALENDAR COST REPORT YEAR END, THE COST REPORT THAT WAS FILED FOR THE COST REPORT YEAR END THAT ENDED DURING 2016 WAS UTILIZED. IT IS IMPORTANT TO NOTE THAT AMOUNTS INCLUDED IN LINES 5-7 DO NOT INCLUDE MEDICARE REVENUE AND RELATED COST FOR FREESTANDING AMBULATORY SURGERY SERVICES AND FOR PHYSICIAN SERVICES. SCHEDULE H, PART III, LINE 9B: MHS HAS A POLICY TO PROVIDE DISCOUNTS TO THOSE INDIVIDUALS WHO DO NOT HAVE INSURANCE OR ONE NOT COVERED BY A GOVERNMENTAL REIMBURSEMENT PROGRAM. IF A PATIENT QUALIFIES FOR MEDICAID, THEN HE OR SHE IS ONLY RESPONSIBLE FOR ANY NON-COVERED CHARGES. IF THE PATIENT DOES NOT QUALIFY FOR MEDICAID, HE OR SHE MAY COMPLETE THE MHS FINANCIAL ASSISTANCE APPLICATION TO HAVE THE ENCOUNTER REVIEWED FOR A POTENTIAL CHARITY DISCOUNT. IF THE PATIENT'S YEARLY INCOME IS LESS THAN OR EQUAL TO 200% OF THE POVERTY GUIDELINES UPDATED ANNUALLY IN THE FEDERAL REGISTER BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ("FEDERAL POVERTY GUIDELINES"), THE PATIENT WILL BE GRANTED CLASSIFICATION AS FINANCIALLY INDIGENT, AND THE ACCOUNT WILL BE WRITTEN OFF TO CHARITY. LETTERS ARE THEN SENT TO THE PATIENT NOTIFYING THAT THE ACCOUNT HAS QUALIFIED FOR THE CHARITY DISCOUNT AND IS CONSIDERED CLOSED. IN ADDITION, A SLIDING SCALE DISCOUNT IS APPLIED TO ACCOUNTS FOR PATIENTS WHOSE INCOME IS BETWEEN 200% AND 500% OF THE FEDERAL POVERTY GUIDELINES, AND WHOSE REMAINING ACCOUNT BALANCE, AFTER ANY THIRD-PARTY PAYMENTS, EXCEEDS A PERCENTAGE OF THEIR INCOME ("MEDICALLY INDIGENT"). IN ADDITION, PATIENTS WITH ABNORMALLY LARGE ACCOUNTS MAY QUALIFY AS CATASTROPHICALLY ELIGIBLE WHEN THEIR REMAINING BALANCE EXCEEDS A SPECIFIC PERCENTAGE OF THEIR INCOME. IF A PATIENT DOES NOT QUALIFY FOR A CHARITY DISCOUNT, AN UNINSURED DISCOUNT IS APPLIED TO TOTAL CHARGES. IF A PATIENT IS UNABLE TO PAY THE REMAINING BALANCE IN FULL, AFTER APPLYING ANY CHARITY OR UNINSURED DISCOUNTS, MHS WILL WORK WITH THE PATIENT TO SET UP A MONTHLY PAYMENT ARRANGEMENT. THROUGHOUT THE DEBT COLLECTION PROCESS, MHS CONTINUES TO INFORM PATIENTS ABOUT THE AVAILABILITY OF CHARITY CARE ASSISTANCE. SCHEDULE H, PART VI, QUESTION 2: IN ADDITION TO THE ITEMS SPECIFICALLY NOTED TO ADDRESS THE COMMUNITY HEALTH PRIORITIES, OTHER HIGHLIGHTS FROM 2016 INCLUDE THE FOLLOWING: IN LATE 2011, THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION FILED AN APPLICATION FOR A WAIVER OF CERTAIN FEDERAL MEDICAID REQUIREMENTS UNDER SECTION 1115 OF THE SOCIAL SECURITY ACT. AS A RESULT OF THE GRANTING OF THIS APPLICATION THE TEXAS HEALTH CARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM WAS DEVELOPED TO PROVIDE PAYMENTS (DELIVERY REFORM INCENTIVE PAYMENTS, OR DSRIP) TO HOSPITAL AND OTHER PROVIDERS UPON THEIR ACHIEVING CERTAIN GOALS THAT ARE INTENDED TO IMPROVE THE QUALITY AND LOWER THE COST OF CARE. THIS INITIATIVE DIVIDES THE STATE INTO TWENTY DIFFERENT REGIONS, EACH REGION DEVELOPED A COMMUNITY NEEDS ASSESSMENT, AND PROVIDERS IN THE REGION WILL SUBMIT PROJECTS FOR FUNDING CONSIDERATION TO ADDRESS THOSE NEEDS. METHODIST HEALTHCARE SYSTEM RECEIVED APPROVAL FOR THE FOLLOWING PROJECTS: INTRODUCE EXPAND OR ENHANCE TELEMEDICINE/TELEHEALTH - METHODIST WILL IMPLEMENT A TELEHEALTH PROGRAM THAT WILL PROVIDE TELEHEALTH CONSULTATIONS WITH TRAINED SPECIALISTS IN SELECTED SERVICES. BY THE END OF 2016, THE TELE-STROKE PROGRAM EXPANDED TO INCLUDE TWELVE LOCATIONS, WITH ADDITIONAL LOCATIONS PLANNED IN 2016. THROUGH THIS PROGRAM, PHYSICIANS CAN DRAMATICALLY INCREASE RESPONSE TIME, TRANSFERS CAN BE MINIMIZED, AND PATIENTS CAN OFTEN RECEIVE LIFESAVING CARE MORE RAPIDLY, OFTEN TIMES AT THEIR HOME HOSPITAL. THE BEHAVIORAL HEALTH TELEMEDICINE PROGRAM'S OPERATIONS STARTED IN JANUARY, 2014. THE GOAL OF THIS PROGRAM IS TO PROVIDE TIMELY CONSULTATIONS, DIAGNOSIS AND TREATMENT RECOMMENDATIONS FOR BEHAVIORAL HEALTH/SUBSTANCE ABUSE PATIENTS IN EVERY METHODIST EMERGENCY DEPARTMENT OR IN MEDICAL ACUTE UNITS THROUGHOUT METHODIST. 4,285 BEHAVIORAL HEALTH AND 209 TELE-STROKE CONSULTATIONS WERE PROVIDED FOR THE DSRIP REPORTING PERIOD ENDED SEPTEMBER 30, 2016. 56% OF THE CONSULTATIONS PROVIDED WERE TO MEDICAID OR LOW INCOME UNINSURED PATIENTS. ESTABLISH MORE PRIMARY CARE CLINICS - METHODIST OPENED THE METHODIST COMMUNITY HEALTH CENTER IN 2014. THE CENTER IS AN URGENT CARE CENTER LOCATED IN EAST SAN ANTONIO. THE METHODIST COMMUNITY HEALTH CENTER PROVIDES SERVICES TO ALL PATIENTS AT NO COST. THE CENTER PROVIDED 2,377 ENCOUNTERS FOR THE DSRIP REPORTING PERIOD ENDING SEPTEMBER 30, 2016. OF THESE ENCOUNTERS, 78.1% WERE PROVIDED TO MEDICAID OR LOW INCOME UNINSURED PATIENTS. REDESIGN TO IMPROVE THE PATIENT EXPERIENCE - THE FOCUS FOR THIS PROJECT IS TO IMPROVE HOW PATIENTS EXPERIENCE CLINICAL CARE AS WELL AS THE PATIENT'S SATISFACTION WITH THEIR CARE. IN 2015, METHODIST STARTED A PATIENT FAMILY ADVISORY COUNCIL, AND HAS IMPLEMENTED AN ONLINE PATIENT PORTAL TO FURTHER IMPROVE COMMUNICATION EFFORTS WITH PATIENTS. METHODIST HAS ALSO DEVELOPED AN ELECTRONIC DASHBOARD WHICH SUMMARIZES HCAHPS AND OUTPATIENT SURVEY DATA BY FACILITY AND BY NURSING UNIT. METHODISTS' MANAGERS AND ABOVE RECEIVE WEEKLY NOTIFICATIONS REGARDING DASHBOARD UPDATES. APPLY PROCESS IMPROVEMENT METHODOLOGY TO IMPROVE QUALITY/EFFICIENCIES SPECIFIC TO SEPSIS - IMPROVEMENT OF SEPSIS MANAGEMENT IS A KEY INITIATIVE IN METHODIST'S CLINICAL EXCELLENCE PLAN. METHODIST HAS DEVELOPED AND CONTINUES TO REFINE THE SEPSIS EARLY RECOGNITION SCREENING TOOL WHICH WILL ALLOW CLINICAL STAFF TO BETTER IDENTIFY PATIENTS IN EARLY SEPSIS AND TO PROVIDE RAPID INTERVENTION AND REDUCTION OF PATIENTS DEVELOPING SEVERE SEPSIS AND/OR SEPTIC SHOCK. SEPSIS BUNDLE ELEMENTS ARE NOT INCLUDED IN THE ELECTRONIC TRIAGE SCREENING FOR ED, ICU, IN-HOSPITAL NURSING, AND RAPID RESPONSE TEAMS. THE METROPOLITAN METHODIST HOSPITAL CAMPUS IS CURRENTLY THE ONLY SEPSIS CERTIFIED FACILITY IN TEXAS. METHODIST NOW HAS FULL TIME SEPSIS COORDINATORS AT THREE CAMPUSES, AND PART-TIME COORDINATORS AT THE OTHER CAMPUSES. IN 2016, METROPOLITAN METHODIST HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, COMPLETED RENOVATION OF THEIR LABORATORY. THEY ALSO BEGAN RENOVATION ON THE 7TH FLOOR. A NEW RETAINING WALL AND SIDEWALK ALONG MCCULLOUGH AND BROOKLYN WAS COMPLETED TO ENSURE SAFETY OF VISITORS AND STAFF. CONSTRUCTION ON ED OVERFLOW, AS WELL AS A HELIPAD ARE ALSO UNDERWAY. THE PATIENT RESTROOMS WERE RENOVATED AT METHODIST SPECIALTY AND TRANSPLANT, A CAMPUS OF METHODIST HOSPITAL. CAREFUL CONSIDERATION WAS TAKEN TO REDUCE PATIENT FALLS AS A RESULT OF WATER FROM THE SHOWERS. A NEW CLINICAL TRANSITION UNIT (CTU) OPENED IN MARCH, 2016. A SECOND CT SCANNER WAS ADDED TO ACCOMMODATE THE HOSPITAL'S GROWING DEMAND. IN ADDITION, THIS PARTICULAR MACHINE HAS UNIQUE CAPABILITIES THAT WILL HELP IDENTIFY VERY SMALL LIVER TUMORS WHICH HAD PREVIOUSLY GONE UNDETECTED. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL ALSO PURCHASED NEW OPERATING ROOM EQUIPMENT TO SUPPORT GROWTH AND QUALITY IN SURGICAL SERVICES. THIS INCLUDES NEW HIGH DEFINITION MONITOR SYSTEMS AND ELECTROSURGICAL CUTTING SYSTEMS FOR MINIMALLY INVASIVE AND LAPAROSCOPIC PROCEDURES IN ALL MAIN OPERATING ROOMS, NEW ANESTHESIA MACHINES FOR MAIN OPERATING ROOMS AND CARDIOVASCULAR ROOMS, AN OLYMPUS VISERA TOWER SYSTEM WITH IMPROVED HIGH-DEFINITION MONITORING FOR UROLOGY AND GENERAL SURGERY CASES, AND TWO NEW NEPTUNE WASTE MANAGEMENT SYSTEMS FOR FLUID REMOVAL THAT WILL IMPROVE PHYSICIAN AND STAFF EFFICIENCY. IN NOVEMBER, CONSTRUCTION FOR THREE NEW REGISTRATION BOOTHS FOR THE KIDNEY TRANSPLANT CLINIC WAS COMPLETED. THIS MADE A SIGNIFICANT IMPROVEMENT ON THE REGISTRATION EXPERIENCE AND DECREASED WAIT TIME. METHODIST TEXSAN HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, PURCHASED THE MAKO ROBOT FOR HIP AND KNEE REPLACEMENTS. A NEW ELECTRONIC MESSAGING SIGN WAS CONSTRUCTED IN FRONT OF THE HOSPITAL ALONG IH-10. IN 2016, NORTHEAST METHODIST HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, BEGAN EXPANSION ON THEIR EMERGENCY DEPARTMENT, AS WELL AS ON THE TELEMEDICINE UNIT. THE HOSPITAL ALSO BEGAN RENOVATIONS ON A DISCHARGE LOUNGE, REHAB/ONCOLOGY AND OP CARDIAC IMAGING CLINIC. METHODIST STONE OAK HOSPITAL BEGAN CONSTRUCTION OF THE BED TOWER EXPANSION (81 BEDS). CONSTRUCTION ALSO BEGAN ON THE NEW PARKING GARAGE. A NEW GYM FOR EMPLOYEES, AS WELL AS BROWN COFFEE ALSO OPENED IN 2016. CONSTRUCTION AT METHODIST HOSPITAL AND METHODIST CHILDREN'S HOSPITAL CONTINUED. THE NEWLY EXPANDED NICU OPENED (94 BEDS TOTAL), AND THE EXPANSION OF THE EMERGENCY ROOM ADDED 15 ADDITIONAL ROOMS, BRINGING THE TOTAL TO 40 ALL-PRIVATE ROOMS. CLINICAL SERVICE ENHANCEMENTS INCLUDE METHODIST HEALTHCARE FURTHER INVESTING IN BUILDING ITS TEAM OF ONCOLOGY PATIENT NURSE NAVIGATORS. METHODIST HEALTHCARE HAS FOUR BREAST CANCER NAVIGATORS, TWO COMPLEX GI NAVIGATORS, ONE BLOOD CANCER NAVIGATOR AND ONE LUNG CANCER NAVIGATOR FOR A TOTAL OF EIGHT PATIENT NURSE NAVIGATORS. TOGETHER, THEY HAVE NAVIGATED 997 TOTAL CANCER PATIENTS IN 2016, UP FROM 828 CANCER PATIENTS IN 2015. TO ADDRESS A GROWING NEED FOR PSYCHIATRIC ASSESSMENTS, A "TELE-PSYCH" PROGRAM WAS ESTABLISHED TO EXPEDITE THE EVALUATION AND TREATMENT OF PATIENTS IN THE EMERGENCY DEPARTMENTS OF METHODIST HOSPITALS. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL, METROPOLITAN METHODIST HOSPITAL, NORTHEAST METHODIST HOSPITAL, ALL CAMPUSES OF METHODIST HOSPITAL, AND METHODIST STONE OAK HOSPITAL HAVE ALL GONE LIVE WITH THIS SERVICE IN THEIR EMERGENCY DEPARTMENTS. BY UTILIZING VIDEO CONFERENCING TECHNOLOGY, BOARD-CERTIFIED PSYCHIATRISTS IN OTHER PARTS OF TEXAS AND THE U.S. ARE AVAILABLE AROUND THE CLOCK TO PROVIDE EVALUATIONS AND RECOMMEND TREATMENT OPTIONS FOR PATIENTS. IN 2016, METHODIST HEALTHCARE PROVIDED OVER 10,000 TELE-PSYCH CONSULTS. PATIENTS REQUIRING PSYCHIATRIC SERVICES ARE OFTEN ONE OF THE MOST UNDERSERVED POPULATIONS IN THE COMMUNITY, AND METHODIST STRIVES TO ENSURE THESE PATIENTS HAVE ACCESS TO APPROPRIATE CARE. UPWARDS OF 30% OF THE BEHAVIORAL HEALTH SERVICES OFFERED BY METHODIST SPECIALTY AND TRANSPLANT HOSPITAL ARE PROVIDED TO CHARITY AND SELF-PAY PATIENTS. FURTHERMORE, METHODIST HEALTHCARE SUPPORTS A CLINICALLY ALIGNED NON-PROFIT HEALTHCARE ORGANIZATION (NPHO) WHICH EMPLOYS A NUMBER OF HOSPITALISTS TO SUPPORT THIS PROGRAM, AS SAN ANTONIO PSYCHIATRISTS IN PRIVATE PRACTICE TYPICALLY WILL NOT TREAT HOSPITALIZED PATIENTS. METHODIST MANAGEMENT ALSO CONTINUES TO MONITOR AND WORK WITH PARALLON, AN HCA SUBSIDIARY, TO IMPROVE THE PROCESSES FOR IDENTIFYING AND PROCESSING CHARITY CASES IN THE MOST EFFICIENT AND TIMELY MANNER POSSIBLE. ALL PARALLON PERSONNEL RECEIVE TRAINING, INCLUDING AN ANNUAL REFRESHER COURSE, TO INCLUDE INSTRUCTION ON THE METHODIST CHARITY POLICY AND OUR CHARITABLE MISSION IN CONJUNCTION WITH METHODIST HEALTHCARE MINISTRIES. IN ADDITION, THEY HAVE A FORMAL PROCESS FOR MHM'S PATIENTS TO DIRECTLY ACCESS CHARITABLE MEDICAL SERVICES AT METHODIST FACILITIES. AS PART OF METHODIST HEALTHCARE'S CONTINUED COMMITMENT TO THE HEALTH OF THE COMMUNITY, METHODIST HEALTHCARE SENIOR LEADERS CHAIRED THE AMERICAN CANCER SOCIETY'S CATTLE BARON'S GALA, NETTING OVER $1.1 MILLION DOLLARS. RELATED TO CONSUMER PERCEPTION OF EXCELLENCE, READERS OF THE SAN ANTONIO EXPRESS NEWS SELECTED METHODIST FOR THE EIGHT SCHEDULE H, PART VI, QUESTION 3: MHS HAS TAKEN STEPS OVER THE PAST SEVERAL YEARS TO HEIGHTEN COMMUNITY AWARENESS REGARDING MHS' CHARITABLE MISSION. SIGNS THAT PROMINENTLY PRESENT INFORMATION ABOUT THE CHARITY MISSION AND GUIDELINES ARE PRESENT AT ALL POINTS OF ADMISSION. MHS ALSO PUBLISHES A NOTICE OF ITS CHARITY POLICY ANNUALLY IN THE SAN ANTONIO EXPRESS-NEWS. A PATIENT BROCHURE, ENTITLED "A GUIDE TO YOUR HOSPITAL BILL", EXPLAINS THE HOSPITAL BILLING PROCESS AND INFORMS PATIENTS OF THE CHARITY POLICY IN THE EVENT THEY NEED FINANCIAL ASSISTANCE. INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY IS ALSO AVAILABLE IN ENGLISH AND SPANISH ON MHS' WEBSITE WWW.SAHEALTH.COM. ALL SHARED SERVICE CENTER PERSONNEL RECEIVE TRAINING AND AN ANNUAL REFRESHER COURSE ON THE POLICY, AND UNDERSTAND THE CRUCIAL ROLE THEY PLAY IN INFORMING PATIENTS ABOUT THE POLICY. FINANCIAL COUNSELORS AND HOSPITAL CASE MANAGEMENT STAFF EDUCATE PATIENTS AND ARE AVAILABLE TO ASSIST THEM WITH THE CHARITY CARE APPLICATION PROCESS. IN ADDITION TO PROVIDING INFORMATION DURING THE ADMITTING PROCESS, MHS CONTINUES TO PROVIDE INFORMATION ABOUT THE AVAILABILITY OF CHARITY CARE ASSISTANCE DURING THE COLLECTION PROCESS FOR THOSE PATIENTS WHO HAVE BEEN BILLED, BUT HAVE NOT PAID. AS NOTED ABOVE, MHS USES MULTIPLE METHODS TO COMMUNICATE AND PUBLICIZE FINANCIAL ASSISTANCE POLICIES. INFORMATION SYSTEMS PROGRAMMING CHANGES ARE CURRENTLY IN DEVELOPMENT. THESE CHANGES WILL ALLOW A MESSAGE ABOUT THE POLICIES TO PRINT ON PATIENT BILLING STATEMENTS. SCHEDULE H, PART VI, QUESTION 4: THE SAN ANTONIO METROPOLITAN STATISTICAL AREA (MSA) OF 2.13 MILLION PEOPLE INCLUDES THE SEVENTH LARGEST PERCENTAGE OF HISPANICS IN THE UNITED STATES. 59% OF THE LOCAL POPULATION IS HISPANIC, 29% IS WHITE NON-HISPANIC, 7% IS BLACK, 3% IS ASIAN AND 2% IS OTHER. TEXAS AND SAN ANTONIO CONTINUE TO LEAD THE NATION IN THE NUMBER OF UNINSURED ADULTS AND CHILDREN (TEXAS IS RANKED NO. 1 WITH 24.3% UNINSURED AND THE U.S. IS 17%). A LITTLE OVER SIXTEEN PERCENT OF CHILDREN IN TEXAS ARE WITHOUT HEALTH INSURANCE COMPARED TO THE U.S. AT 8.6%. IN SAN ANTONIO, ONE OUT OF FOUR ADULTS AND CLOSE TO ONE OUT OF THREE CHILDREN DO NOT HAVE HEALTH INSURANCE. THE MEDIAN HOUSEHOLD INCOME IN SAN ANTONIO IS $42,731, COMPARED TO $45,792 FOR TEXAS AND $50,221 FOR THE NATION. SAN ANTONIO HAS A LARGE POPULATION LIVING IN POVERTY WHEN COMPARED TO OTHER PARTS OF TEXAS. 14.5% OF SAN ANTONIO RESIDENTS LIVE AT OR BELOW THE POVERTY LEVEL, AND BEXAR COUNTY IS AT 13%, COMPARED TO 12.8% FOR TEXAS, AND 14.3% FOR THE U.S. SAN ANTONIO'S PERCENT OF HOUSEHOLDS RECEIVING FOOD STAMPS IS 17%, WITH TEXAS AT 15.3%, AND THE U.S. AT 13.8%. METHODIST HEALTHCARE SERVES AN ESTIMATED POPULATION OF NEARLY 2.9 MILLION IN BEXAR AND 26 SOUTH AND CENTRAL TEXAS COUNTIES: ATASCOSA, BANDERA, CALDWELL, COMAL, DEWITT, DIMMIT, EDWARDS, FRIO, GILLESPIE, GONZALES, GUADALUPE, KARNES, KENDALL, KERR, KINNEY, LA SALLE, LAVACA, MAVERICK, MCMULLEN, MEDINA, REAL, UVALDE, VAL VERDE, WEBB, WILSON AND ZAVALA. SINCE THIS GEOGRAPHIC AREA IS MAJORITY HISPANIC, MHS SEES THIS REFLECTED IN OUR PATIENT POPULATION. SCHEDULE H, PART VI, QUESTION 5: IN ADDITION TO THE ITEMS SPECIFICALLY NOTED TO ADDRESS THE COMMUNITY HEALTH PRIORITIES, OTHER HIGHLIGHTS FROM 2016 INCLUDE THE FOLLOWING: IN LATE 2011, THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION FILED AN APPLICATION FOR A WAIVER OF CERTAIN FEDERAL MEDICAID REQUIREMENTS UNDER SECTION 1115 OF THE SOCIAL SECURITY ACT. AS A RESULT OF THE GRANTING OF THIS APPLICATION THE TEXAS HEALTH CARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM WAS DEVELOPED TO PROVIDE PAYMENTS (DELIVERY REFORM INCENTIVE PAYMENTS, OR DSRIP) TO HOSPITAL AND OTHER PROVIDERS UPON THEIR ACHIEVING CERTAIN GOALS THAT ARE INTENDED TO IMPROVE THE QUALITY AND LOWER THE COST OF CARE. THIS INITIATIVE DIVIDES THE STATE INTO TWENTY DIFFERENT REGIONS, EACH REGION DEVELOPED A COMMUNITY NEEDS ASSESSMENT, AND PROVIDERS IN THE REGION WILL SUBMIT PROJECTS FOR FUNDING CONSIDERATION TO ADDRESS THOSE NEEDS. METHODIST HEALTHCARE SYSTEM RECEIVED APPROVAL FOR THE FOLLOWING PROJECTS: INTRODUCE EXPAND OR ENHANCE TELEMEDICINE/TELEHEALTH - METHODIST WILL IMPLEMENT A TELEHEALTH PROGRAM THAT WILL PROVIDE TELEHEALTH CONSULTATIONS WITH TRAINED SPECIALISTS IN SELECTED SERVICES. BY THE END OF 2016, THE TELE-STROKE PROGRAM EXPANDED TO INCLUDE TWELVE LOCATIONS, WITH ADDITIONAL LOCATIONS PLANNED IN 2016. THROUGH THIS PROGRAM, PHYSICIANS CAN DRAMATICALLY INCREASE RESPONSE TIME, TRANSFERS CAN BE MINIMIZED, AND PATIENTS CAN OFTEN RECEIVE LIFESAVING CARE MORE RAPIDLY, OFTEN TIMES AT THEIR HOME HOSPITAL. THE BEHAVIORAL HEALTH TELEMEDICINE PROGRAM'S OPERATIONS STARTED IN JANUARY, 2014. THE GOAL OF THIS PROGRAM IS TO PROVIDE TIMELY CONSULTATIONS, DIAGNOSIS AND TREATMENT RECOMMENDATIONS FOR BEHAVIORAL HEALTH/SUBSTANCE ABUSE PATIENTS IN EVERY METHODIST EMERGENCY DEPARTMENT OR IN MEDICAL ACUTE UNITS THROUGHOUT METHODIST. 4,285 BEHAVIORAL HEALTH AND 209 TELE-STROKE CONSULTATIONS WERE PROVIDED FOR THE DSRIP REPORTING PERIOD ENDED SEPTEMBER 30, 2016. 56% OF THE CONSULTATIONS PROVIDED WERE TO MEDICAID OR LOW INCOME UNINSURED PATIENTS. ESTABLISH MORE PRIMARY CARE CLINICS - METHODIST OPENED THE METHODIST COMMUNITY HEALTH CENTER IN 2014. THE CENTER IS AN URGENT CARE CENTER LOCATED IN EAST SAN ANTONIO. THE METHODIST COMMUNITY HEALTH CENTER PROVIDES SERVICES TO ALL PATIENTS AT NO COST. THE CENTER PROVIDED 2,377 ENCOUNTERS FOR THE DSRIP REPORTING PERIOD ENDING SEPTEMBER 30, 2016. OF THESE ENCOUNTERS, 78.1% WERE PROVIDED TO MEDICAID OR LOW INCOME UNINSURED PATIENTS. REDESIGN TO IMPROVE THE PATIENT EXPERIENCE - THE FOCUS FOR THIS PROJECT IS TO IMPROVE HOW PATIENTS EXPERIENCE CLINICAL CARE AS WELL AS THE PATIENT'S SATISFACTION WITH THEIR CARE. IN 2015, METHODIST STARTED A PATIENT FAMILY ADVISORY COUNCIL, AND HAS IMPLEMENTED AN ONLINE PATIENT PORTAL TO FURTHER IMPROVE COMMUNICATION EFFORTS WITH PATIENTS. METHODIST HAS ALSO DEVELOPED AN ELECTRONIC DASHBOARD WHICH SUMMARIZES HCAHPS AND OUTPATIENT SURVEY DATA BY FACILITY AND BY NURSING UNIT. METHODISTS' MANAGERS AND ABOVE RECEIVE WEEKLY NOTIFICATIONS REGARDING DASHBOARD UPDATES. APPLY PROCESS IMPROVEMENT METHODOLOGY TO IMPROVE QUALITY/EFFICIENCIES SPECIFIC TO SEPSIS - IMPROVEMENT OF SEPSIS MANAGEMENT IS A KEY INITIATIVE IN METHODIST'S CLINICAL EXCELLENCE PLAN. METHODIST HAS DEVELOPED AND CONTINUES TO REFINE THE SEPSIS EARLY RECOGNITION SCREENING TOOL WHICH WILL ALLOW CLINICAL STAFF TO BETTER IDENTIFY PATIENTS IN EARLY SEPSIS AND TO PROVIDE RAPID INTERVENTION AND REDUCTION OF PATIENTS DEVELOPING SEVERE SEPSIS AND/OR SEPTIC SHOCK. SEPSIS BUNDLE ELEMENTS ARE NOT INCLUDED IN THE ELECTRONIC TRIAGE SCREENING FOR ED, ICU, IN-HOSPITAL NURSING, AND RAPID RESPONSE TEAMS. THE METROPOLITAN METHODIST HOSPITAL CAMPUS IS CURRENTLY THE ONLY SEPSIS CERTIFIED FACILITY IN TEXAS. METHODIST NOW HAS FULL TIME SEPSIS COORDINATORS AT THREE CAMPUSES, AND PART-TIME COORDINATORS AT THE OTHER CAMPUSES. IN 2016, METROPOLITAN METHODIST HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, COMPLETED RENOVATION OF THEIR LABORATORY. THEY ALSO BEGAN RENOVATION ON THE 7TH FLOOR. A NEW RETAINING WALL AND SIDEWALK ALONG MCCULLOUGH AND BROOKLYN WAS COMPLETED TO ENSURE SAFETY OF VISITORS AND STAFF. CONSTRUCTION ON ED OVERFLOW, AS WELL AS A HELIPAD ARE ALSO UNDERWAY. THE PATIENT RESTROOMS WERE RENOVATED AT METHODIST SPECIALTY AND TRANSPLANT, A CAMPUS OF METHODIST HOSPITAL. CAREFUL CONSIDERATION WAS TAKEN TO REDUCE PATIENT FALLS AS A RESULT OF WATER FROM THE SHOWERS. A NEW CLINICAL TRANSITION UNIT (CTU) OPENED IN MARCH, 2016. A SECOND CT SCANNER WAS ADDED TO ACCOMMODATE THE HOSPITAL'S GROWING DEMAND. IN ADDITION, THIS PARTICULAR MACHINE HAS UNIQUE CAPABILITIES THAT WILL HELP IDENTIFY VERY SMALL LIVER TUMORS WHICH HAD PREVIOUSLY GONE UNDETECTED. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL ALSO PURCHASED NEW OPERATING ROOM EQUIPMENT TO SUPPORT GROWTH AND QUALITY IN SURGICAL SERVICES. THIS INCLUDES NEW HIGH DEFINITION MONITOR SYSTEMS AND ELECTROSURGICAL CUTTING SYSTEMS FOR MINIMALLY INVASIVE AND LAPAROSCOPIC PROCEDURES IN ALL MAIN OPERATING ROOMS, NEW ANESTHESIA MACHINES FOR MAIN OPERATING ROOMS AND CARDIOVASCULAR ROOMS, AN OLYMPUS VISERA TOWER SYSTEM WITH IMPROVED HIGH-DEFINITION MONITORING FOR UROLOGY AND GENERAL SURGERY CASES, AND TWO NEW NEPTUNE WASTE MANAGEMENT SYSTEMS FOR FLUID REMOVAL THAT WILL IMPROVE PHYSICIAN AND STAFF EFFICIENCY. IN NOVEMBER, CONSTRUCTION FOR THREE NEW REGISTRATION BOOTHS FOR THE KIDNEY TRANSPLANT CLINIC WAS COMPLETED. THIS MADE A SIGNIFICANT IMPROVEMENT ON THE REGISTRATION EXPERIENCE AND DECREASED WAIT TIME. METHODIST TEXSAN HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, PURCHASED THE MAKO ROBOT FOR HIP AND KNEE REPLACEMENTS. A NEW ELECTRONIC MESSAGING SIGN WAS CONSTRUCTED IN FRONT OF THE HOSPITAL ALONG IH-10. IN 2016, NORTHEAST METHODIST HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, BEGAN EXPANSION ON THEIR EMERGENCY DEPARTMENT, AS WELL AS ON THE TELEMEDICINE UNIT. THE HOSPITAL ALSO BEGAN RENOVATIONS ON A DISCHARGE LOUNGE, REHAB/ONCOLOGY AND OP CARDIAC IMAGING CLINIC. METHODIST STONE OAK HOSPITAL BEGAN CONSTRUCTION OF THE BED TOWER EXPANSION (81 BEDS). CONSTRUCTION ALSO BEGAN ON THE NEW PARKING GARAGE. A NEW GYM FOR EMPLOYEES, AS WELL AS BROWN COFFEE ALSO OPENED IN 2016. CONSTRUCTION AT METHODIST HOSPITAL AND METHODIST CHILDREN'S HOSPITAL CONTINUED. THE NEWLY EXPANDED NICU OPENED (94 BEDS TOTAL), AND THE EXPANSION OF THE EMERGENCY ROOM ADDED 15 ADDITIONAL ROOMS, BRINGING THE TOTAL TO 40 ALL-PRIVATE ROOMS. CLINICAL SERVICE ENHANCEMENTS INCLUDE METHODIST HEALTHCARE FURTHER INVESTING IN BUILDING ITS TEAM OF ONCOLOGY PATIENT NURSE NAVIGATORS. METHODIST HEALTHCARE HAS FOUR BREAST CANCER NAVIGATORS, TWO COMPLEX GI NAVIGATORS, ONE BLOOD CANCER NAVIGATOR AND ONE LUNG CANCER NAVIGATOR FOR A TOTAL OF EIGHT PATIENT NURSE NAVIGATORS. TOGETHER, THEY HAVE NAVIGATED 997 TOTAL CANCER PATIENTS IN 2016, UP FROM 828 CANCER PATIENTS IN 2015. TO ADDRESS A GROWING NEED FOR PSYCHIATRIC ASSESSMENTS, A "TELE-PSYCH" PROGRAM WAS ESTABLISHED TO EXPEDITE THE EVALUATION AND TREATMENT OF PATIENTS IN THE EMERGENCY DEPARTMENTS OF METHODIST HOSPITALS. METHODIST SPECIALTY AND TRANSPLANT HOSPITAL, METROPOLITAN METHODIST HOSPITAL, NORTHEAST METHODIST HOSPITAL, ALL CAMPUSES OF METHODIST HOSPITAL, AND METHODIST STONE OAK HOSPITAL HAVE ALL GONE LIVE WITH THIS SERVICE IN THEIR EMERGENCY DEPARTMENTS. BY UTILIZING VIDEO CONFERENCING TECHNOLOGY, BOARD-CERTIFIED PSYCHIATRISTS IN OTHER PARTS OF TEXAS AND THE U.S. ARE AVAILABLE AROUND THE CLOCK TO PROVIDE EVALUATIONS AND RECOMMEND TREATMENT OPTIONS FOR PATIENTS. IN 2016, METHODIST HEALTHCARE PROVIDED OVER 10,000 TELE-PSYCH CONSULTS. PATIENTS REQUIRING PSYCHIATRIC SERVICES ARE OFTEN ONE OF THE MOST UNDERSERVED POPULATIONS IN THE COMMUNITY, AND METHODIST STRIVES TO ENSURE THESE PATIENTS HAVE ACCESS TO APPROPRIATE CARE. UPWARDS OF 30% OF THE BEHAVIORAL HEALTH SERVICES OFFERED BY METHODIST SPECIALTY AND TRANSPLANT HOSPITAL ARE PROVIDED TO CHARITY AND SELF-PAY PATIENTS. FURTHERMORE, METHODIST HEALTHCARE SUPPORTS A CLINICALLY ALIGNED NON-PROFIT HEALTHCARE ORGANIZATION (NPHO) WHICH EMPLOYS A NUMBER OF HOSPITALISTS TO SUPPORT THIS PROGRAM, AS SAN ANTONIO PSYCHIATRISTS IN PRIVATE PRACTICE TYPICALLY WILL NOT TREAT HOSPITALIZED PATIENTS. METHODIST MANAGEMENT ALSO CONTINUES TO MONITOR AND WORK WITH PARALLON, AN HCA SUBSIDIARY, TO IMPROVE THE PROCESSES FOR IDENTIFYING AND PROCESSING CHARITY CASES IN THE MOST EFFICIENT AND TIMELY MANNER POSSIBLE. ALL PARALLON PERSONNEL RECEIVE TRAINING, INCLUDING AN ANNUAL REFRESHER COURSE, TO INCLUDE INSTRUCTION ON THE METHODIST CHARITY POLICY AND OUR CHARITABLE MISSION IN CONJUNCTION WITH METHODIST HEALTHCARE MINISTRIES. IN ADDITION, THEY HAVE A FORMAL PROCESS FOR MHM'S PATIENTS TO DIRECTLY ACCESS CHARITABLE MEDICAL SERVICES AT METHODIST FACILITIES. AS PART OF METHODIST HEALTHCARE'S CONTINUED COMMITMENT TO THE HEALTH OF THE COMMUNITY, METHODIST HEALTHCARE SENIOR LEADERS CHAIRED THE AMERICAN CANCER SOCIETY'S CATTLE BARON'S GALA, NETTING OVER $1.1 MILLION DOLLARS. RELATED TO CONSUMER PERCEPTION OF EXCELLENCE, READERS OF THE SAN ANTONIO EXPRESS NEWS SELECTED METHODIST FOR THE EIGHT SCHEDULE H, PART VI, QUESTION 6: SEE RESPONSES FOR QUESTION 2 ABOVE REGARDING EXPANSION OF SERVICES IN 2016. ALL SHARED SERVICE CENTER PERSONNEL RECEIVE TRAINING AND AN ANNUAL REFRESHER COURSE ON THE POLICY, AND UNDERSTAND THE CRUCIAL ROLE THEY PLAY IN INFORMING PATIENTS ABOUT THE POLICY. FINANCIAL COUNSELORS AND HOSPITAL CASE MANAGEMENT STAFF EDUCATE PATIENTS AND ARE AVAILABLE TO ASSIST THEM WITH THE CHARITY CARE APPLICATION PROCESS. IN ADDITION TO PROVIDING INFORMATION DURING THE ADMITTING PROCESS, MHS CONTINUES TO PROVIDE INFORMATION ABOUT THE AVAILABILITY OF CHARITY CARE ASSISTANCE DURING THE COLLECTION PROCESS FOR THOSE PATIENTS WHO HAVE BEEN BILLED, BUT HAVE NOT PAID. AS NOTED ABOVE, MHS USES MULTIPLE METHODS TO COMMUNICATE AND PUBLICIZE FINANCIAL ASSISTANCE POLICIES. INFORMATION SYSTEMS PROGRAMMING CHANGES HAVE BEEN IMPLEMENTED. THESE CHANGES WILL ALLOW A MESSAGE ABOUT THE POLICIES TO PRINT ON PATIENT BILLING STATEMENTS. LATE IN 2009 MHS CONSOLIDATED ALL BED PLACEMENT SERVICES, INCLUDING RURAL ED TRANSFER ASSISTANCE, INTO A SYSTEM-WIDE PATIENT PLACEMENT CENTER. RURAL TRANSFERS THROUGH THE CENTER CONTINUE TO INCREASE (2.5% OVER 2015). THE ACCEPTANCE RATE IN 2016 WAS 95.5% COMPARED TO 96.5% IN 2015. SELF-PAY PATIENTS ACCOUNTED FOR 17.6% OF ALL TRANSFERS AS COMPARED TO 14.9% IN 2015. PEDIATRIC AND HIGH-RISK MATERNAL TRANSFERS ARE ALSO NOW HANDLED THROUGH THESE CONSOLIDATED PLACEMENT SERVICES. THE ACCEPTANCE RATE FOR THESE TRANSFERS WAS 99.1% IN 2016 (99.6% IN 2015), WITH SELF-PAY PATIENTS ACCOUNTING FOR 12.4% OF ALL PEDIATRIC TRANSFERS AS COMPARED TO 13.5% IN 2015. MHS AIRCARE, IN PARTNERSHIP WITH REACH AIR MEDICAL SERVICES HAS THREE RURAL HELICOPTERS IN THE REGION. SPECIALIZED SERVICES AVAILABLE AT MHS FACILITIES INCLUDE THE FOLLOWING: NEONATOLOGY SERVICES, PEDIATRIC SUBSPECIALTY SERVICES, BONE MARROW TRANSPLANT, KIDNEY TRANSPLANTS, HEART TRANSPLANTS, LIVER TRANSPLANTS, PANCREAS TRANSPLANTS, HYPERBARIC OXYGEN TREATMENT, STROKE CARE, MEDICAL AIR TRANSPORT, GAMMA KNIFE RADIOSURGERY, AND BARIATRIC SURGERY. THE MAJORITY OF CHARITY CARE PROVIDED BY THE HOSPITALS IS FROM PATIENTS RECEIVING EMERGENCY SERVICES. EMERGENCY DEPARTMENT (ED) VISITS TO MHS FACILITIES TOTALED 315,899 IN 2016 (321,789 IN 2015). SEVENTEEN PERCENT OF TOTAL ED VISITS RESULTED IN INPATIENT ADMISSIONS WITH A 0.55% INCREASE IN ED ADMISSIONS OVER 2015. IN ADDITION, 22.9% OF ALL VISITS TO METHODIST EMERGENCY DEPARTMENTS IN 2016 WERE MADE BY CHARITY OR SELF-PAY PATIENTS. MHS CONTINUES TO FOCUS ON IMPROVING ACCESS TO CARE FOR THE COMMUNITY BY IMPROVING EMERGENCY DEPARTMENT ACCESS. WHEN COMPARING 2016 TO 2015, MHS SAW A 36.4% DECLINE IN THE PATIENT-ARRIVAL-TO-BED (ATB) METRIC AND A 32.8% IMPROVEMENT IN ARRIVAL-TO-GREET (ATG) METRIC. THE AVERAGE LENGTH OF STAY FOR ALL PATIENTS DECREASED FROM 224 MINUTES TO 223 MINUTES. TEXAS TRANSPLANT INSTITUTE (TTI), AT METHODIST SPECIALTY & TRANSPLANT HOSPITAL, A CAMPUS OF METHODIST HOSPITAL, CONTINUES TO PROVIDE INCREASED ACCESS FOR PATIENTS REQUIRING KIDNEY TRANSPLANTS. TTI IS THE HOME OF THE BUSIEST PAIRED EXCHANGE KIDNEY TRANSPLANT PROGRAM IN THE NATION, AND THE NATION'S NO. 1 LIVING DONOR KIDNEY TRANSPLANT PROGRAM. MHS ALSO OPERATES THREE HEALTH BUSES ON THE EAST, SOUTH AND WEST SIDE OF SAN ANTONIO OFFERING COMPLIMENTARY TRANSPORTATION TO VARIOUS HEALTH CARE FACILITIES. THERE WERE 12,168 TRANSPORTS IN 2016, WHICH IS ABOVE THE MANDATED BENCHMARK, AS WELL AS A 3.4% INCREASE FROM 2015. METROPOLITAN METHODIST HOSPITAL IN CONJUNCTION WITH METHODIST HOSPITAL WOMEN'S SERVICES, OPERATES FIVE FAMILY HEALTH CENTERS THAT PROVIDE COMPLIMENTARY PREGNANCY TESTING, PHYSICIAN REFERRALS (2,250 IN 2016), COUNSELING, HEALTH EDUCATION AND SCREENING PROGRAMS. MHS ALSO OPERATES CALL-A-NURSE FOR CHILDREN, A TELEPHONE SERVICE OFFERING FREE MEDICAL ADVICE BY TRAINED EMERGENCY CARE PEDIATRIC NURSES TO PARENTS OF SICK/INJURED CHILDREN. THE SERVICE OPERATES FROM 5:00 P.M. TO 8:00 A.M. MONDAY THROUGH FRIDAY AND AROUND THE CLOCK ON WEEKENDS AND HOLIDAYS (WHEN PHYSICIANS' OFFICES ARE CLOSED). CALL VOLUMES IN 2016 WERE 57,987. IN 2015, THE MHS CONTACT CENTER WAS SOLD TO HCA WITH THE AGREEMENT TO CONTINUE OPERATING A COMMUNITY PHONE-IN HEALTH RESOURCE CALLED HEALTHLINE DURING NORMAL BUSINESS HOURS. HEALTHLINE CALLERS SCHEDULE ATTENDANCE TO HEALTH AND WELLNESS EVENTS, PARENTING CLASSES, AND RECEIVE PHYSICIAN REFERRALS THROUGH THE MHS DOCTORSOURCE PROGRAM. IN 2016, MHS REFERRED PHYSICIANS TO 5,761 DOCTORSOURCE CALLERS (UP TO THREE PHYSICIANS MAY BE REFERRED TO EACH CALLER). IN ONE OTHER COMMUNITY BENEFITS CATEGORY, MHS PROVIDED DIRECT SUPPORT TO 49 NON-PROFIT HEALTH AND HUMAN SERVICE AGENCIES SERVING THE COMMUNITY. MHS PLAYS A LEADING ROLE IN THE SUPPORT OF THE HEALTH COLLABORATIVE, INCLUDING THE UTILIZATION OF THEIR COMMUNITY HEALTH ASSESSMENT TO ASSIST IN THE DETERMINATION OF WHERE MHS SHOULD CONCENTRATE COMMUNITY ACTIVITIES (SEE ADDITIONAL INFORMATION IN QUESTION 3, SECTION V). MHS HAS AN OPEN ADMISSIONS POLICY WHICH ALLOWS MEDICAL STAFF TO ADMIT PATIENTS DIRECTLY TO ANY MHS FACILITY REGARDLESS OF THE PATIENT'S ABILITY TO PAY. MHS FUNDS AND PROVIDES TRAINING AND CONTINUING EDUCATION TO PHYSICIANS, NURSES, EMS PROFESSIONALS AND OTHER ALLIED HEALTH PROFESSIONALS. MHS PARTICIPATES IN ALL QUALITY MEASURES (CMS, JCAHO, ETC). MHS USES THE CMS CORE MEASURES AS THE PRIMARY QUALITY INDICATORS FOR CLINICAL CARE. SCHEDULE H, PART VI, QUESTION 7: MHS FILES AN ANNUAL STATEMENT OF COMMUNITY BENEFITS WITH THE STATE OF TEXAS. true 911 Park Place 911 Park Avenue Corpus Christi TX 78401 742996340 501(c)(3) 40300 Operational Support Alamo Colleges 201 W Sheridan San Antonio TX 78204 746002173 501(c)(3) 122162 Nursing Student Training American Heart Association 8415 Wurzbach San Antonio TX 78229 135613797 501(c)(3) 64500 DONATION American Diabetes Association 1100 Northeast Lp 410 San Antonio TX 78209 131623888 501(c)(3) 5880 DONATION Amistad Community Health Center 1533 Brownlee Blvd Corpus Christi TX 78404 203008507 501(c)(3) 559595 HEALTHCARE SERVICES Arthur Nagel Community Clinic 1116 12th Street Bandera TX 78003 770697361 501(c)(3) 91819 PRIMARY CARE Srvcs & Women's Health Atascosa Health Center 310 W Oaklawn Rd Pleasanton TX 78064 742089103 501(c)(3) 155483 Medical, dental and health services Barrio Comprehensive Family Health Care CTR 3066 E Commerce St San Antonio TX 78220 741724391 501(c)(3) 1997055 Medical, dental and counseling services Behavioral Health Solutions of South Texas 5510 N Cage Blvd Suite C Pharr TX 78577 742648885 501(c)(3) 112808 Residency training and behavioral health Bexar County Health Collaborative 1002 N Flores San Antonio TX 78212 742953076 501(c)(3) 57135 Childhood screening for mental health Boys and Girls Club of Pharr 1026 S Fir Street Pharr TX 78577 752258513 501(c)(3) 99833 YOUTH DEVELOPMENT SERVICES Children's Bereavement CTR of South Texas 205 W Olmos Drive San Antonio TX 78212 742828178 501(c)(3) 139875 Healing programs for grieving youth ChildSafe 7130 US Hwy 90 San Antonio TX 78227 742633697 501(c)(3) 80000 COUNSELING SERVICES Cimarron Praise United Methodist Church 10155 Old Cimarron Trl Converse TX 78109 472006289 501(c)(3) 5200 DONATION Clarity Child Guidance Center 8535 Tom Slick Dr San Antonio TX 78229 741153067 501(c)(3) 407500 Behavioral health SVCS for children Coastal Plains Community Center 200 Marriot Portland TX 78374 742919178 Local Governmt 254163 Integrated health- care program Communities in Schools of San Antonio Inc 1616 E Commerce St San Antonio TX 78205 742393714 501(c)(3) 104984 Mental Health Svcs for At-Risk Youth Community Health CTRs of South Central TX 228 St George Street Gonzalez TX 78629 741548089 501(c)(3) 674352 Dental Salary Supplement Community Health Development 908 S Evans Bldg A Uvalde TX 78801 742269739 501(c)(3) 262500 Oral health services Community Hope Projects Inc 2332 W Jordan Road McAllen TX 78503 742742024 501(c)(3) 326944 Counseling svcs and diabetes prevention Concho Valley CTR for Human Advancement 1501 West Beauregard San Angelo TX 76901 751251523 501(c)(3) 52600 OPERATIONAL SUPPORT Corpus Christi Metro Ministries 1919 Leopard St Corpus Christi TX 78408 742247261 501(c)(3) 137613 Medical services at health clinic Daughters of Charity Services 7607 Somerset Road San Antonio TX 78211 746106876 501(c)(3) 585956 mental health svcs Ecumenical Center for Religion and Health 8310 Ewing Halsell Dr San Antonio TX 78229 741587388 501(c)(3) 761825 Medical ethics, pastoral care,seminars El Centro del Barrio (DBA CentroMed) 3750 Commercial Ave San Antonio TX 78221 741787031 501(c)(3) 1843447 Capital, medical, & dental svcs Family Counseling Service 3833 S Staples Corpus Christi TX 78411 741321308 501(c)(3) 109975 COUNSELING SERVICES Family Service Assoc of San Antonio Inc 702 San Pedro San Antonio TX 78212 741117341 501(c)(3) 631241 Child abuse prev and mental health svcs Family Violence Prevention Services Inc 7911 Broadway San Antonio TX 78209 741994151 501(c)(3) 18419 Counseling Services Gateway Community Health Center Inc 1515 Pappas St Laredo TX 78041 742553409 501(c)(3) 810456 Diabetes mgmt and behavioral health Good Samaritan Community Services 1600 Saltillo San Antonio TX 78207 741117340 501(c)(3) 63689 YOUTH DEVELOPMENT SERVICES Gulf Bend Mental HealthRetardation CTR 6502 Nursery Drive Victoria TX 77904 741659064 Local Governmt 150000 Integrated health- care program Healthcare Access San Antonio 5535 Fredericksburg San Antonio TX 78229 203752122 501(c)(3) 620500 OPERATIONAL SUPPORT Healy-Murphy Center 618 Live Oak San Antonio TX 78202 741667875 501(c)(3) 64118 Behavioral health services Hill Country Christian Counseling CTR 1127 East Main St Kerville TX 78028 742897680 501(c)(3) 120000 Integrated behavioral health Hill Country Daily Bread Ministries 234 West Bandera Rd Boerne TX 78006 300148195 501(c)(3) 82491 FAMILY MENTORING Hill Country Mission Health 122 Commerce Avenue Boerne TX 78006 481262832 501(c)(3) 101500 MEDICAL SERVICES Horses Helping the Handicapped Inc 791 Backhaus Road Pipe Creek TX 78063 742746369 501(c)(3) 219548 children's mental health program I Care San Antonio 1 Haven for Hope Way San Antonio TX 78207 742690192 501(c)(3) 23625 VISION CARE Infant & Family Nutrition Agency 1225 Boca Chica Blvd BROWNSVILLE TX 78520 743005860 501(c)(3) 20000 OPERATIONAL SUPPORT Jewish Family Service of San Antonio Inc 12500 NW Military Hwy San Antonio TX 78231 741759254 501(c)(3) 230321 Youth counseling and outpatient psychiatry Laurel Heights United Methodist Church 227 W Woodlawn Ave San Antonio TX 78212 741272395 501(c)(3) 10000 DONATION Lower Rio Grande Valley Comm Health Mgmt 901 E Vermont Ave McAllen TX 78503 742784427 501(c)(3) 469000 Wellness center and medical services La Union del Pueblo Entero 1601 US 83 Business San Juan TX 78589 931029197 501(c)(3) 234059 Healthcare svcs and patient education Life Choices Medical Clinic 3234 Northwestern Dr San Antonio TX 78238 742809910 501(c)(3) 100000 Women's healthcare Magdalena House 6257 Babcock Road San Antonio TX 78240 800251526 501(c)(3) 180000 CAPITAL Matagorda Episcopal Health Outreach Prgm 101 Ave F North Bay City TX 77414 200537948 501(c)(3) 280048 MEDICAL AND DENTAL SERVICES Medina Healthcare System 3100 Avenue E Hondo TX 78861 270492434 Hospital 250000 CAPITAL Mercy Ministries of Laredo 2500 Zacatecas Street Laredo TX 78046 200198462 501(c)(3) 342991 Dental services and women's health scvs Mission of Mercy Inc 719 S Shoreline Corpus Christi TX 78401 860704883 501(c)(3) 20999 Mobile Medical svcs Morningside Ministries Foundation Inc 700 Babcock Road San Antonio TX 78201 742927605 501(c)(3) 105000 Web-based training caring for adults National CTR for Behavioral Health Solutions 3031 IH 10 West San Antonio TX 78201 470857847 501(c)(3) 102500 Behavioral health services New Braunfels Christian Ministries 1659 State Hwy 46W New Braunfels TX 78132 262221231 501(c)(3) 257650 Medical, dental, and equipment Nuestra Clinica del Valle 801 W 1st Street San Juan TX 78589 741721807 501(c)(3) 162000 Dental salary supplement People's Community Clinic 1101 Camino La Costa Austin TX 78752 237087608 501(c)(3) 107127 Integrated behavioral health Planned Living Asst Network of Central Tx 4110 Guadalupe Blvd 410 Austin TX 78751 742861614 501(c)(3) 39857 Behavioral health services Planned Parenthood of San Antonio 2140 Babcock Road San Antonio TX 78229 741297211 501(c)(3) 445300 Diagnostic women's healthcare scvs Proyecto Desarrollo Humano Inc 17617 Sabal Palm Drive Penitas TX 78576 205709276 501(c)(3) 18425 WELLNESS PROGRAM Proyecto Juan Diego Inc 2216 Eduardo Ave Brownsville TX 78526 810606967 501(c)(3) 222900 Diabetes programs & collective impact Raphael Community Free Clinic Inc 1807 Water Street Kerrville TX 78028 742819628 501(c)(3) 229400 MEDICAL SERVICES Respite Care of San Antonio 605 Belknap Place San Antonio TX 78212 742467770 501(c)(3) 7500 DONATION Rio TX Conf of the United Methodist Church 16400 Huebner Road San Antonio TX 78248 741326672 501(c)(3) 472291 Pastoral health and wellness education Roy Maas Youth Alternatives Inc 3103 West Ave San Antonio TX 78213 741914638 501(c)(3) 65054 Emergency shelter & psychiatric services San Antonio Christian Dental Clinic 1 Haven for Hope Way San Antonio TX 78207 742428161 501(c)(3) 87500 Dental svcs & dental salary supplement San Antonio Clubhouse Inc 6851 Citizens Parkway San Antonio TX 78229 820559940 501(c)(3) 185682 Mental health services San Antonio Food Bank 5200 Enrique Barrera Pkwy San Antonio TX 78227 742122979 501(c)(3) 332707 Social svcs outreach and food pantry San Antonio Metropolitan Ministry 5254 Blanco Road San Antonio TX 78216 742285793 501(c)(3) 101674 Integrated health and wellness prgm Schreiner University 2100 Memorial Blvd Kerrville TX 78013 741193459 School 248132 Nursing program SLEW Inc 12521 Nacogdoches Rd San Antonio TX 78217 421580967 501(c)(3) 55034 Mental health scvs for women w cancer South Texas Rural Health Service 611 Thornton Cotulla TX 78014 741905196 501(c)(3) 739947 Dental salary,mental- health, medical svcs Su Clinica Familiar 1706 Treasure Hills Harlingen TX 78550 742357970 501(c)(3) 120000 Diabetic retinopathy screening program Tejas Health Care 753 East Travis Street La Grange TX 78945 753260266 501(c)(3) 282952 Diabetes outreach & dental services; behavioral health svcs Texas A&M Health Science Center 209 N Water St Corpus Christi TX 78401 742907553 School 299672 Diabetes prevention programs Texas A&M International University 5201 University Boulevard Laredo TX 78041 741761398 School 465467 NURSING PROGRAM Texas A&M University 400 Harvey Mitchell Pkwy College Station TX 77845 746000531 501(c)(3) 24828 Community health worker program Texas Diaper Bank 5415 Bandera Road San Antonio TX 78238 742886380 501(c)(3) 200000 Assistance for low income families Texas Impact 200 East 30th St Austin TX 78705 741902234 501(c)(4) 20000 DONATION Texas Lutheran University 1000 West Court Street Seguin TX 78155 741109748 501(c)(3) 345061 NURSING PROGRAM The Arc of San Antonio Inc 13430 West Avenue San Antonio TX 78216 741200110 501(c)(3) 129481 Nursing services The Children's Shelter 2939 W Woodlawn Ave San Antonio TX 78228 741109660 501(c)(3) 133087 Behavioral health services Univ of TX Health Science CTr at HOUSTON 7000 Fannin Street Houston TX 77030 741761309 School 192985 Wellness promotion & collective impact ThriveWell Cancer Foundation 4383 Medical Dr San Antonio TX 78229 260371270 501(c)(3) 44204 Patient transportation Timons Ministries 10501 S Padre Isl Corpus Christi TX 78418 311638327 501(c)(3) 111275 Operational Support and capital United Medical Centers 2525 N Veterans Blvd Eagle Pass TX 78852 741993570 501(c)(3) 217200 Diabetes and hypertension management program University of Texas Rio Grande Valley 1201 W University Dr Edinburg TX 78539 465292740 School 561690 Collaborative med- care program Univ of Tx Health Science Ctr San Antonio 7703 Floyd Curl Dr San Antonio TX 78229 741586031 School 1540422 Medical & dental Svcs Med Student training Vida Y Salud Health Systems Inc 308 Cesar Chavez Ave Crystal City TX 78839 741715419 501(c)(3) 80031 Dental salary and behavioral health svcs Wesley Community Center 4015 MacArthur Corpus Christi TX 78416 741185657 501(c)(3) 172500 Homeless Children's Program West Texas Counseling & Guidance Inc 242 N Magdalen San Angelo TX 76903 751561599 501(c)(3) 429000 Counseling services Women Involved in NurturingGivingSharing 7500 US Hwy 90 W San Antonio TX 78227 742920912 501(c)(3) 267409 Breast cancer treatment support 89 1 Electricity assistance 413 81726 Water assistance 111 20068 Rent/Mortgage assistance 180 63074 Healthcare Program assistance 4 1084 SCHEDULE I, PART I, LINE 2: DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS THE GRANTEE IS GIVEN A DISBURSEMENT REQUEST FORM IN THE BEGINNING OF THE FISCAL YEAR TO USE IN REQUESTING FUNDS. WHEN A REQUEST IS SUBMITTED FOR PAYMENT (YEARLY, QUARTERLY, OR MONTHLY) THE ACCOUNTANT REVIEWS AND VERIFIES EXPENSES BASED ON ACTUAL INVOICES AND/OR THE ORGANIZATION'S GENERAL LEDGER. THE ORGANIZATION'S EXPENSE INFORMATION IS VERIFIED TO THE APPROVED BUDGET SUBMITTED WITH THE GRANTEE APPLICATION. THE EXPENSE INFORMATION IS THEN ENTERED INTO THE GRANT TRACKING SOFTWARE (GIFTS). AFTER THE EXPENSES HAVE BEEN VERIFIED AND DOCUMENTED, IT IS SUBMITTED TO THE VP OF ACCOUNTING & CONTROLLER FOR APPROVAL AND SIGNATURE. IF PAYMENT REQUEST IS GREATER OR EQUAL TO $10,000, THE REQUEST REQUIRES CFO APPROVAL. THE GRANTS ASSOCIATE ALSO REVIEWS EACH GRANT REQUEST FOR COMPLIANCE WITH BUDGETED GOALS AND OUTCOMES. IT IS THEN FORWARDED TO THE ACCOUNTS PAYABLE DEPARTMENT FOR PAYMENT. A CHECK IS PROCESSED AND MAILED TO THE GRANTEE. THE BACKUP OF THE CHECK REQUEST IS RETURNED TO THE ACCOUNTANT TO FILE IN A GRANT FOLDER. IN ADDITION TO THESE PROCEDURES, THE ACCOUNTANTS DO SITE VISITS TO REVIEW PATIENT FILES OR INVOICES TO ENSURE THAT FUNDS ARE BEING USED APPROPRIATELY. EACH GRANTEE IS AUDITED EVERY OTHER YEAR (SOME ARE VISITED ANNUALLY BASED ON THE TYPE OF GRANT) TO ENSURE COMPLIANCE WITH GRANT CONTRACTS. X X X X false false false false false false false false false Kevin Moriarty Chief Executive Officer 421028 0 25000 0 26172 0 15154 0 29228 0 516582 0 0 Tony Lobasso Chief Financial Officer 239522 0 0 1200 0 17037 0 20638 0 278397 0 0 George Thomas Chief Operating Officer 235571 0 0 2400 0 17020 0 27736 0 282727 0 0 Peggy Cary VP of Finance & Audit Services 199549 0 0 3597 0 18801 0 22075 0 244022 0 0 Rebecca Brune SR VP of Strategic Pln & grwth 190813 0 0 0 13427 0 21840 0 226080 0 0 Oanh Maroney-omitade VP of Clinical Operations 157442 0 0 0 15374 0 32266 0 205082 0 0 Jennifer Correa-knoulton VP of Regional Operations 146966 0 0 6703 0 14566 0 25667 0 193902 0 0 Cynthia McCloy VP of Accounting & Controller 153606 0 0 3013 0 12494 0 20799 0 189912 0 0 Form 990, Part III, Line 4D: DESCRIPTION OF OTHER PROGRAM SERVICES OTHER PROGRAM SERVICES OWNED AND OPERATED BY MHM FOR LOW-INCOME AND UNINSURED PATIENTS/CLIENTS INCLUDE: COMMUNITY COUNSELING SERVICES: COMMUNITY COUNSELORS HELP PEOPLE WHO ARE UNINSURED, WHOSE EXISTING COVERAGE DOES NOT PROVIDE MENTAL HEALTH SERVICES BENEFITS, ARE LOW-INCOME AND LACK THE MONEY TO PAY FOR COUNSELING SERVICES, OR WHO WOULD NOT RECEIVE TREATMENT ANY OTHER WAY. COUNSELING SERVICES ARE PROVIDED BY TRAINED, LICENSED PROFESSIONAL COUNSELORS AND SOCIAL WORKERS IN LOCAL CHURCHES ACROSS THE RIO GRANDE VALLEY, LAREDO AND THE COASTAL BEND. COMMUNITY HEALTH WORKERS OR PROMOTORES DE SALUD: COMMUNITY HEALTH WORKERS HAVE THE DISTINCT ABILITY TO REACH VULNERABLE, LOW-INCOME AND UNDERSERVED MEMBERS OF THE COMMUNITY THROUGH THEIR SPECIALIZED KNOWLEDGE OF THE COMMUNITIES MHM SERVES AND THEIR UNIQUE ABILITY TO ENGAGE COMMUNITY MEMBERS AT A HANDS-ON LEVEL. COMMUNITY HEALTH WORKERS SUPPORT HEALTH EDUCATION AND PREVENTION EFFORTS AND BRIDGE ACCESS TO COMMUNITY-BASED HEALTH PROGRAMS AND ADVOCATES. THE GET FIT (FAMILIES IN TRAINING) PROGRAM IS A PREVENTIVE PROGRAM AIMED AT AVERTING TYPE II DIABETES, OBESITY AND SEDENTARY LIFESTYLES, FOCUSING ON CHILDREN AND FAMILIES IN RURAL COMMUNITIES. PARENTING PROGRAMS: DESIGNED TO HELP PARENTS AND GUARDIANS LEARN PARENTING SKILLS SO THEY WILL BE MORE CONFIDENT AND MORE COMPETENT LEADERS WITHIN THEIR FAMILIES. PROGRAMS INCLUDE: MELD; PARENTS HELPING PARENTS; PARENTS AS TEACHERS; AND THE NURTURING PARENTING PROGRAMS. IN ADDITION TO THE MEDICAL, DENTAL, AND BEHAVIORAL HEALTH SERVICES IDENTIFIED UNDER PROGRAM SERVICE ACTIVITY #2, THE FOLLOWING PROGRAMS ARE ALSO OFFERED AT MHM OWNED FACILITIES: RECREATION & ENRICHMENT PROGRAMS: AVAILABLE AT MHM'S WESLEY HEALTH & WELLNESS CENTER OFFERS YOUTH, ADULTS AND SENIORS FREE, SAFE AND FUN ACTIVITIES THAT PROMOTE HEALTH, WELLNESS AND LEARNING SKILLS. PROGRAMS CONSIST OF YOUTH DEVELOPMENT PROGRAMS SUCH AS CAMP WESLEY, A FREE 8-WEEK SUMMER CAMP FOR YOUTH AGES 6-18 AND 'LOS MARIACHITOS DE WESLEY,' A FREE CULTURAL ARTS PROGRAM FOR YOUTH AGES 6-18. THE YOUTH DEVELOPMENT PROGRAM AT WESLEY HEALTH & WELLNESS CENTER IS A NEIGHBORHOOD RECREATION PROGRAM AND IS NOT REGULATED BY STATE CHILDCARE LICENSING, AND IS NOT A DAY CARE FACILITY. ADULT PROGRAMMING INCLUDES EXERCISE CLASSES, PARENT AND FAMILY TRAININGS AND COMMUNITY-BASED SUPPORT GROUPS SUCH AS ALCOHOLICS ANONYMOUS AND THE COMMUNITY JUSTICE PROGRAM. HEALTH EDUCATION & NUTRITION: OFFERED AT THE WESLEY HEALTH & WELLNESS CENTER (WHWC) AND THE BISHOP ERNEST T. DIXON, JR. CLINIC ARE DESIGNED TO TEACH AND MODEL HEALTH AND WELLNESS THROUGH HEALTHY COOKING, DIRECT HEALTH EDUCATION WITH CLIENTS AND THROUGH THE PROVISION OF HEALTHY AND NUTRITIOUS MEALS PREPARED BY PROFESSIONAL CULINARY ARTISTS AT MHM'S WESLEY CAF LOCATED AT WHWC. HEALTH EDUCATION IS OFFERED UNDER THE DIRECTION OF REGISTERED NURSES AND DIETICIANS AND IS PRIMARILY DESIGNED FOR DIABETIC CLIENTS IN ONE-ON-ONE AND GROUP SETTINGS, AND INCLUDES DISTRIBUTION OF GLUCOMETER STRIPS TO HELP MANAGE THEIR DISEASE. THE WESLEY CAF PREPARES HEALTHY AND NUTRITIOUS MEALS FOR THE CHILDREN AND GUESTS OF THE WHWC, AND SERVES AS AN EMERGENCY FOOD PANTRY AND BREAD LINE TO THOSE IN NEED. Form 990, Part VI, Line 2: FAMILY OR BUSINESS RELATIONSHIPS JOE JOHNSTON (10% OWNERSHIP) AND PENDLETON WICKERSHAM (51% OWNERSHIP) ARE PARTNERS IN A MEDICAL DEVICE COMPANY. FORM 990, PART VI, LINE 11B: PROCESS TO REVIEW THE FORM 990 THE FINANCE COMMITTEE REVIEWS A DRAFT OF THE FORM 990 TAX RETURN AND MAKES RECOMMENDATION TO THE FULL BOARD. AFTER THIS REVIEW, THE TAX RETURN IS FORWARDED TO THE FULL BOARD FOR REVIEW AND ACCEPTANCE PRIOR TO FILING. FORM 990, PART VI, LINE 12C: MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY ARTICLE 7 OF THE BOARD'S BYLAWS REQUIRE A CONFLICTS OF INTEREST POLICY. THE BOARD ADOPTED A POLICY ON DECEMBER 10, 1997, ARTICLE VI OF WHICH REQUIRES ANNUAL STATEMENTS. THE POLICY IS ENFORCED AND THE RESULTS ARE REPORTED ANNUALLY TO THE FINANCE COMMITTEE AND TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, LINES 15A AND 15B: PROCESS FOR DETERMINING COMPENSATION LINE 15A: PRESIDENT & CEO - PEARL MEYER & PARTNERS, LLC WAS RETAINED TO CONDUCT A TOTAL COMPENSATION STUDY IN OCTOBER 2016. THE COMPLETE STUDY WAS RECEIVED BY THE PERSONNEL COMMITTEE OF THE MHM BOARD. LINE 15B: OFFICERS AND KEY EMPLOYEES - PEARL MEYER & PARTNERS, LLC WAS RETAINED TO CONDUCT A TOTAL COMPENSATION STUDY IN OCTOBER 2016. THE COMPLETE STUDY WAS RECEIVED BY THE PERSONNEL COMMITTEE OF THE MHM BOARD. FORM 990, PART VI, LINE 19 PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC DOCUMENTS ARE CURRENTLY PROVIDED UPON REQUEST. THE FINANCIAL STATEMENTS AND TAX RETURNS ARE ALSO AVAILABLE THROUGH METHODIST HEALTHCARE MINISTRIES WEBSITE AT: MHM.ORG>LIBRARY>FINANCIAL STATEMENTS AND TAX RETURNS. Form 990, Part XI, Question 9: WPCC REVENUE $165,160 WPCC EXPENSES ($3,298,563) TAX PARTNERSHIP ON FORM 1065 ($149,940,653) PARTNERSHIP EARNINGS ON THE BOOKS $109,132,814 OTHER $9,060 TOTAL ($43,932,182) Wesley Primary Care Clinic 4507 Medical Drive San Antonio TX 78229 742784284 Medical SVCS TX 501(c)(3) 12A-TYPE I MHM true Rio Texas Conference of the UMC 16400 Huebner Road San Antonio TX 78248 741326672 CHURCH TX 501(c)(3) 1 NA false Methodist Healthcare System SA 8109 Fredericksburg Rd SA TX 78229 742730328 Hospital System TX NA Related 152587053 599470487 false 0 true 0.50000 false true false false false false false false false true false false false false false false false true true Wesley Primary Care Clinic r 3124343 Cash Rio Texas Conference of the UMC b 472291 Cash Methodist Healthcare System of San Antonio s 88500000 Cash Methodist Healthcare System of San Antonio j 84400 Cash