2017-10-23T08:44:14-05:00 2016-12-31 BKD LLP 14241 DALLAS PKWY STE 1100 DALLAS TX 75254 990 2016-01-01 751912147 United Regional Health Care System % STEPHEN P CALVERT UNIT 9407648299 1600 Eleventh Street Wichita Falls TX 76301 PHYLLIS COWLING PRESIDENT AND CEO 9727028262 2017-11-15 true Jeanette Verrelli P00742631 9727028262 167.68.126.162 76915820172965000009 2017-10-23 P ACBA2431EF37DEF71821A9057AFD5F2E9C389335 ACBA2431EF37DEF71821A9057AFD5F2E9C389335 2016 2021-01-29 14:40:06Z PHYLLIS COWLING 1600 ELEVENTH STREET WICHITA FALLS TX 76301 362354309 false X WWW.UNITEDREGIONAL.ORG X 1983 TX ORGANIZED AND OPERATED FOR THE PURPOSE OF DEVELOPING AND OPERATING AN INTEGRATED HEALTH CARE SYSTEM. 16 12 2121 250 94973 84476 4603418 1964521 329863782 349175764 13021424 4424042 0 0 347488624 355564327 14332010 18576722 0 0 119679708 122469211 0 0 0 158298397 173708846 292310115 314754779 55178509 40809548 642429467 713553807 127044082 134634802 515385385 578919005 X TO OPERATE NONPROFIT HOSPITALS OR HOSPITAL FACILITIES, CLINICS, AND RELATED MEDICAL AND SURGICAL SERVICES BY PROVIDING SUCH SERVICES TO PERSONS THAT DO HAVE THE ABILITY TO PAY, AND TO THEREBY PROVIDE CHARITABLE MEDICAL, SURGICAL, AND HOSPITAL CARE FOR SICK, INJURED, AFFLICTED, INFIRM, DISABLED, OR DESTITUTE PERSONS THAT DO NOT HAVE THE ABILITY TO PAY. false false 268654876 18576722 349175764 UNITED REGIONAL HEALTH CARE SYSTEM, A 325-BED HOSPITAL, PROMOTES THE HEALTH OF THE COMMUNITY BY PROVIDING A VARIETY OF HEALTH CARE SERVICES. IN ADDITION TO INPATIENT BEDS, THERE ARE 20 NEWBORN BASSINETTES INCLUDING 6 INTERMEDIATE NURSERY BASSINETTES AND 30 ER BEDS. ADDITIONAL PROGRAMS WHICH BENEFIT THE COMMUNITY INCLUDE: RESIDENCY/HEALTH PROFESSIONS TRAINING: AT ANY ONE TIME, THERE MAY BE UP TO 24 RESIDENTS IN TRAINING AT UNITED REGIONAL HEALTH CARE SYSTEM. THE RESIDENTS ARE PART OF THE UNITED REGIONAL HEALTH CARE SYSTEM PROGRAM IN PARTNERSHIP WITH THE WICHITA FALLS FAMILY PRACTICE RESIDENCY PROGRAM (THROUGH AN AFFILIATION WITH THE SOUTHWESTERN SCHOOL OF MEDICINE). IN SEPTEMBER 2016, THE HOSPITAL ENTERED INTO AGREEMENTS WITH NORTH CENTRAL TEXAS COMMUNITY HEALTH CARE CENTER, INC., NORTH CENTRAL TEXAS MEDICAL FOUNDATION AND THE UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH TO STRENGTHEN AND CONTINUE RESIDENCY TRAINING AT UNITED REGIONAL HEALTH CARE SYSTEM. STUDENTS IN NURSING, PHARMACY, LABORATORY TECHNOLOGY, RADIOLOGY, RESPIRATORY THERAPY AND OTHER ASSOCIATED HEALTH SCIENCES PROFESSIONS ALSO STUDY HERE. PREVENTIVE CARE A PRIORITY: UNITED REGIONAL HEALTH CARE SYSTEM HAS TAKEN STEPS TO ENHANCE PREVENTIVE CARE FOR PEOPLE OF ALL AGES THROUGH THE DEVELOPMENT OF LOW COST SCREENING PROGRAMS, VACCINATION CLINICS, AS WELL AS OTHER OUTREACH EDUCATION SERVICES. OTHER SERVICES ARE PROVIDED THROUGH THE UNITED REGIONAL REFERENCE LAB BOTH LOW COST FEE-FOR-SERVICE SCREENINGS AND FREE SCREENINGS AT COMMUNITY HEALTH FAIRS (CHOLESTEROL, PSA, TRIGLYCERIDES, ETC.) DESIGNATED TRAUMA CENTER: UNITED REGIONAL IS DESIGNATED LEVEL 2 TRAUMA CENTER FOR THE REGION BY THE HEALTH AND HUMAN SERVICES COMMISSION OF THE STATE OF TEXAS. UNITED REGIONAL HEALTH CARE SYSTEM'S EMERGENCY DEPARTMENT IS STAFFED 24 HOURS A DAY/7 DAYS A WEEK MEETING THE NEEDS OF THE COMMUNITY WITH AN AVERAGE OF 206 VISITS PER DAY. COMMUNITY CONNECTIONS: UNITED REGIONAL HEALTH CARE SYSTEM REACHES OUT TO PEOPLE AND COMMUNITIES THROUGHOUT ITS PRIMARY SERVICE AREA OF WICHITA COUNTY AND ITS SECONDARY SERVICE AREA OF 8 SURROUNDING COUNTIES CONSISTING OF ARCHER, BAYLOR, CLAY, HARDEMAN, JACK, MONTAGUE, WILBARGER AND YOUNG COUNTIES. THROUGH COOPERATIVE AGREEMENTS WITH LOCAL GOVERNMENTS AND HOSPITALS, UNITED REGIONAL PROVIDES FUNDING FOR A NUMBER OF HEALTHCARE SERVICES. COMMUNITY EDUCATION: UNITED REGIONAL HEALTH CARE SYSTEM PROVIDES THE FOLLOWING TYPES OF COMMUNITY EDUCATION: COMMUNITY EDUCATION SEMINARS WITH PRESENTATIONS BY PHYSICIANS ON HEALTH ISSUES AND TREATMENT OPTIONS; HEALTHY YOU NEWSLETTER, SENT TO APPROXIMATELY 50,000 HOUSEHOLDS, PROVIDING HEALTH PROMOTION AND DISEASE PREVENTION INFORMATION, AS WELL AS HOSPITAL SERVICES; 55-ADVANTAGE SENIOR PROGRAM, PROVIDING SPEAKERS ON A VARIETY OF HEALTH-RELATED TOPICS; AND PARTICIPATION IN A VARIETY OF COMMUNITY HEALTH FAIRS AND EVENTS PROMOTING GENERAL HEALTH AND PROVIDING HEALTH SCREENINGS. CHARITY CARE: UNITED REGIONAL HEALTH CARE SYSTEM PROVIDES MEDICAL CARE TO MEMBERS OF THE COMMUNITY REGARDLESS OF ABILITY TO PAY. ESTIMATED COST OF PROVIDING ADDITIONAL COMMUNITY BENEFITS DURING 2016 WAS $17,463,895 WHICH INCLUDED THE FOLLOWING: UNREIMBURSED COST OF EMERGENCY AND TRAUMA CARE $5,436,099 UNREIMBURSED COST OF FREE STANDING CLINICS $12,027,796 DONATIONS MADE BY THE HOSPITAL TO AREA CHARITABLE ORGANIZATIONS $17,854,183 TOTAL COSTS OF ADDITIONAL COMMUNITY BENEFITS $35,318,078 SOURCE: 2016 ANNUAL STATEMENT OF COMMUNITY BENEFIT STANDARDS (STATE OF TEXAS MANDATORY REPORT) 268654876 true true false true false false false false false true true false false true true false false true false false false false false false false false true true true false true true false false false false false false false false true true false false false false false true true true false false true 248 0 2121 true true true false false false false false false false false false X 16 12 false false false false false true true true true false false false true true true true true true true true true X STEPHEN P CALVERT 9407648299 1600 ELEVENTH STREET WICHITA FALLS TX 76301 X KELLY FRISTOE DIRECTOR 1.0 0.0 X 0 0 0 LINDA YEAGER DIRECTOR 1.0 0.0 X 0 0 0 PHYLLIS COWLING PRESIDENT & CEO 40.0 2.5 X X 947847 0 99461 ANDRE DESIRE MD DIRECTOR 1.0 0.0 X 115886 0 0 ASHWINKUMAR PATEL MD DIRECTOR 1.0 0.0 X 46112 0 0 BARRY HARDIN DIRECTOR 1.0 0.0 X 0 0 0 BLAKE ANDREWS CHAIRMAN 1.0 0.0 X X 0 0 0 DON HAMLIN DIRECTOR 1.0 0.0 X 0 0 0 MICHAEL STANFORD DIRECTOR 1.0 0.0 X 0 0 0 LARRY COOK PAST CHAIRMAN 1.0 0.0 X X 0 0 0 PAUL FOLEY DIRECTOR 1.0 0.0 X 0 0 0 R KEN HINES DIRECTOR 1.0 0.0 X 0 0 0 RITA VOKES DIRECTOR 1.0 0.0 X 0 0 0 YVONNE HEARN MD DIRECTOR 1.0 1.0 X 0 0 0 FRED LANGNER MD DIRECTOR 1.0 0.0 X 0 0 0 JOHN LUIG JR DIRECTOR 1.0 0.0 X 0 0 0 TERRY PATTON SECRETARY/TREASURER 1.0 0.0 X X 0 0 0 NANCY TOWNLEY SR VP OF OPERATIONS 40.0 2.5 X 554663 0 38800 ROBERT PERT CHIEF FINANCIAL OFFICER 40.0 2.5 X 461975 0 47002 STEPHANIE JO BROWN VP OF MARKETING 40.0 0.0 X 248078 0 29139 RICHARD CARPENTER VP OF FACILITIES 40.0 0.0 X 232325 0 39495 KRISTI FAULKNER VP OF HUMAN RESOURCES 40.0 0.0 X 261072 0 35040 JOHNNY ROBERTS VP OF UR PHYSICIAN GROUP 40.0 2.5 X 271138 0 37665 LEE RODGERS VP OF MEDICAL AFFAIRS 40.0 0.0 X 323785 0 13744 JANE RITTER VP PATIENT CARE/CLINICAL SVS 40.0 0.0 X 257592 0 26238 MATTHEW BAKER DIRECTOR OF PHARMACY 40.0 0.0 X 171076 0 30002 JAMES BEASLEY CLINICAL PHARMACIST 40.0 0.0 X 155884 0 25983 RODNEY BRUMBELOW CLINICAL PHARMACIST 40.0 0.0 X 157009 0 29218 DWAYNE MCKEE DIRECTOR OF CIBI 40.0 0.0 X 156423 0 23629 LILA PEREZ NURSE SPECIALIST (PT CARE) 40.0 0.0 X 155902 0 7332 4516767 0 482748 94 false true false CLINICAL PARTNERS WICHITA FALLS 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 CLINICAL SERVICES 3012757 HURON CONSULTING SERVICES LLC 3005 MOMENTUM PLACE CHICAGO IL 60689 PROFESSIONAL SERVICE 2379535 ACUTE CARE SURGERY TEXOMA PLLC 1600 BROOK AVENUE WICHITA FALLS TX 76301 CLINICAL SERVICES 2010595 CRITICAL CARE SPECIALISTS OF NORTH 1208 BROOK STREET WICHITA FALLS TX 76301 CLINICAL SERVICES 1771283 TITANIUM EMERGENCY GROUP LLP PO BOX 206676 DALLAS TX 75320 CLINICAL SERVICES 1758877 52 1964521 1964521 PATIENT SERVICE REVENUE 621110 346919846 346919846 SUPPORTING REVENUE 900099 1007487 1007487 RELATED RENTAL REVENUE 531120 540921 540921 EHR Incentive Revenue 900099 707510 707510 349175764 7455045 94973 7360072 0 0 0 0 0 3758979 0 6151371 638611 -2392392 -638611 -3031003 -3031003 0 0 0 0 0 0 0 0 0 0 355564327 349175764 94973 4329069 X 18576722 18576722 0 0 0 4133564 3102537 1031027 53731 40329 13402 104229012 78171731 26057281 3303145 2477359 825786 3057292 2356071 701221 7692467 5769350 1923117 0 132325 132325 187799 187799 0 0 1332231 1332231 38907934 29321800 9586134 601701 451276 150425 5408475 4540563 867912 4745087 3558815 1186272 0 2728553 2046415 682138 574481 430861 143620 0 387944 9634 378310 3340287 3340287 0 19828828 19828828 7689623 7689623 BAD DEBT EXPENSE 31638760 31638760 0 MEDICAL SUPPLIES 52548981 52548981 0 EQUIPMENT RENTAL & MAINT. 1734285 1300714 433571 FOOD SERVICE EXPENSE 362992 272244 90748 1558560 1181976 376584 314754779 268654876 46099903 0 180097 213655 32075120 21004851 0 0 28078568 32909952 0 0 0 0 0 0 6499008 7146945 3567870 5108338 424831385 255443632 163953648 169387753 360189415 416633448 0 0 0 0 0 0 47885741 61148865 642429467 713553807 26069904 28210953 0 0 0 0 88255975 84561742 0 0 0 0 0 0 0 0 12718203 21862107 127044082 134634802 X 515385385 578919005 0 0 0 0 515385385 578919005 642429467 713553807 X 40809548 22481160 242912 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 34302 34302 false SCHEDULE C, PART II-B, LINE 1I LOBBYING ACTIVITIES: THE HOSPITAL PAID DUES TO ORGANIZATIONS, A PORTION OF WHICH IS DESIGNATED FOR LOBBYING EXPENSES. DUES %LOBBYING $LOBBYING TAVH $ 7,874 100% $ 7,874 THA $ 73,088 22% $ 16,079 AHA $ 45,811 22.59% $ 10,349 ------------------------------------------------- TOTAL $ 126,773 $ 34,302 1416349 1416349 1416349 0 0 0 0 0 1416349 1413719 2630 0 0 0 0 1416349 1580533 0 0 166814 0 0 1413719 1580533 0 0 0 0 0 1580533 0.79270 0.20730 false true true 11184025 11184025 172999688 87647247 85352441 210612817 166207430 44405387 30034855 1588955 28445900 169387753 INTERCOMPANY RECEIVABLE 51554517 DUE FROM PHYSICIANS 93633 INTEREST RECEIVABLE 521647 EST DUE FROM 3RD PARTY PAYERS 4979068 REINSURANCE RECEIVABLE 4000000 61148865 0 EST 3RD-PARTY PAYOR SETTLEMENT 4004123 SELF-INSURANCE LIABILITY 17335000 INTERCOMPANY PAYABLE 522984 21862107 SCHEDULE D, PART V, LINE 4 INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS: THE ENDOWMENT INCLUDES BOTH DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF DIRECTORS. FUNDS ARE USED TO ADVANCE AND PROMOTE THE HEALTH AND WELL-BEING OF PEOPLE AND ORGANIZATIONS IN THE COMMUNITY AND SURROUNDING AREAS. SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X 175. true X true true false true true 37635500 35745067 1890433 0.00670 30022122 36254676 1639057 737242 901815 0.00320 69296679 72736985 2792248 0.00990 977843 768696 209147 0.00070 32423843 14959948 17463895 0.06170 18576722 18576722 0.06560 51978408 15728644 36249764 0.12800 121275087 88465629 39042012 0.13790 9 6878 57456 3300 54156 0.00020 9 6878 57456 3300 54156 0.00020 false 31638760 3163876 104420949 97974787 6446162 X true true UNITED REGIONAL CARDIOVASCULAR SERVICES 0.5 0.5 HEALTH CARE SYSTEM CARDIOLOGY LLC UNITED REGIONAL SURGICAL MANAGEMENT 0.5 0.5 HEALTH CARE SYSTEM SURGERY LLC 1 1 UNITED REGIONAL HEALTH CARE SYSTEM 1600 ELEVENTH STREET WICHITA FALLS TX 76301 WWW.UNITEDREGIONAL.ORG 000417 X X X X UNITED REGIONAL HEALTH CARE SYSTEM false false true X X X X X X X X X 16 true false false true X SEE PART V, SECTION C X true 16 true SEE PART V, SECTION C false true X 175. 400. X X X X true true 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 true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 PERSONS WHO REPRESENT THE COMMUNITY: UNITED REGIONAL CONDUCTED 23 INTERVIEWS WITH THE THREE GROUPS ORIGINALLY OUTLINED IN IRS NOTICE 2011-52. DURING THESE INTERVIEWS, THE HOSPITAL DISCUSSED THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. THE INTERVIEWEES WERE INDIVIDUALS FROM VARIOUS NOT-FOR-PROFIT GROUPS, HEALTH CARE FACILITIES, GOVERNMENTAL AGENCIES AND OTHER AREAS OF THE COMMUNITY. THESE INDIVIDUALS WERE FROM THE FOLLOWING ORGANIZATIONS: -HELEN FARABEE CENTER -WICHITA FALLS AREA FOOD BANK -AUXILLARY BOARD -WICHITA CITY COUNCIL -WALGREENS PHARMACY -HOSPICE OF WICHITA FALLS -WICHITA COUNTY HEALTH DEPARTMENT -UNITED REGIONAL HEALTH CARE SYSTEM -FINANCIAL PARTNERS -WICHITA COUNTY -THE KITCHEN -LOOKIN GOOD SPA -UNITED REGIONAL FOUNDATION -ELECTRA MEMORIAL HOSPITAL -WICHITA FALLS ISD -AMBULATORY AND CLIENT DISEASE MANAGEMENT -WEST CENTRAL DISTRICT HEALTH DEPARTMENT -PRESBYTERIAN MANOR -NORTH CENTRAL TEXAS COMMUNITY HEALTH CENTER -MIDWESTERN STATE UNIVERSITY -WICHITA FALLS FAITH MISSION -NORTH TEXAS AREA UNITED WAY SCHEDULE H, PART V, SECTION B, LINE 20E EFFORTS TO NOTIFY INDIVIDUALS OF FINANCIAL ASSISTANCE POLICY: NEITHER THE UNITED REGIONAL HEALTH CARE SYSTEM, NOR THIRD PARTIES AUTHORIZED BY URHCS, TAKE ANY ACTIONS UPON NON-PAYMENT FROM A PATIENT BEFORE MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR THE FACILITY'S FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART V, SECTION B, LINE 11 Needs addressed and not addressed: United Regional identified and prioritized 5 needs using a structured matrix in the implementation strategy. The needs are: 1. Need for additional Primary Care and Specialty providers: United Regional will continue to recruit and employ additional physicians to the community, as well as physicians employed by the United Regional Physician Group. United Regional will continue to expand specialty care capacity by recruiting physicians in the following specialties: -Orthopedics -Urology -Trauma surgery -Dermatology 2. Prevention, Education and Services to Address High Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy Lifestyles: United Regional will continue to offer health education classes within the community on a variety of topics, such as CPR, prepared childbirth, smoking cessation, and breast feeding. United Regional will continue to participate in a variety of health fairs and presentations focused on education and prevention in the community. United Regional will continue to publish "Healthy You", a community magazine which is distributed three times per year to approximately 50,000 residents in the nine county primary service and secondary service area. Each edition contains content relevant to a variety of health concerns as well as promotes hospital services including support groups and community education offerings. Example health topics have included stroke, cardiac health, emergency care, diabetes, healthy eating, influenza, seasonal allergies, hospitalist program, summer safety, athletic injuries, concussions, joint replacement, and other specialty services and surgical interventions. 3. Access to Affordable Care and Reducing Health Disparities Among Specific Populations: United Regional will continue to operate its Heart Failure Clinic. All heart failure patients are scheduled to follow-up at the Heart Failure Clinic within one (1) week of hospital discharge to assess post-discharge health, address lifestyle changes to help stay healthy, and avoid readmission. The clinic takes all payer sources and those without insurance. Physician referral, class registration, and nurse triage services will continue to be offered at no charge to the community through the United Regional's "Call-A-Nurse" phone line. Referrals are provided for local physicians as well as other community health care services. United Regional will continue to host Senior Focus, which provides health information for seniors with approximately 1,500 in attendance. Educational topics include diabetes, mammography, cardiac disease, senior safe driving, fall prevention, and stroke education. Screenings are provided free of charge and include blood pressure, peripheral artery disease, blood sugar, and pulmonary function testing. A wellness panel screening (cholesterol and full lipid panel) is provided at no cost and PSAs are also provided. In addition, flu shots are provided free of charge to those in attendance. 4. Access to Affordable, High Nutritional Quality Food Options: United Regional will collaborate as appropriate with the Health Coalition of Wichita County in the following activities identified by the Coalition: -Develop and implement a communications campaign to encourage healthy lifestyle choices. -Increase Wichita County community members intake of healthy food choices. -Increase community levels of physical activity. 5. Access to Mental and Behavioral Health: United Regional will participate, as appropriate, in the Health Coalition of Wichita Countys initiatives to increase early identification and treatment of individuals with behavioral and mental health conditions. United Regional will continue to provide case management services and appropriate referrals for patients who present to the hospital or emergency department with mental or behavioral health conditions on an as needed basis. United Regional's implementation plan addresses all needs identified in the most recent community health needs assessment. SCHEDULE H, PART V, SECTION B, LINE 16A, 16B & 16C MEASURES TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT THE FOLLOWING ADDRESS: HTTP://WWW.UNITEDREGIONAL.ORG/FINANCIAL-ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINES 7 & 10 CHNA & IMPLEMENTATION STRATEGY WEBSITE: THE CHNA AND IMPLEMENTATION STRATEGY CAN BE FOUND AT HTTP://WWW.UNITEDREGIONAL.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. 1 Wichita Falls Endoscopy Center 1500 tenth street wichita falls TX 76301 AMBULATORY SURGERY CENTER SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT ADJUSTMENTS: THE ORGANIZATION'S BAD DEBT ADJUSTMENTS WERE CALCULATED USING THE ADJUSTMENT AMOUNT REPORTED AS REVENUE DEDUCTIONS ON THE INTERNAL FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS DETERMINED BY ESTIMATING THAT 10% OF THE BAD DEBT WOULD LIKELY BE CHARITY CARE. THIS IS THE APPROXIMATE PERCENTAGE OF PATIENTS NOT COMPLETING THE PAPER WORK TO APPLY FOR CHARITY CARE. BAD DEBT EXPENSE REPRESENTS GROSS CHARGES ADJUSTED FOR APPROPRIATE DISCOUNTS AND PAYMENTS ON ACCOUNTS. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT FOOTNOTE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, URHCS ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, URHCS ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, URHCS RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. URHCS' ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS APPROXIMATELY 98% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2016 AND 2015. URHCS' WRITE-OFFS INCREASED APPROXIMATELY $684,000 FROM APPROXIMATELY $31,803,000 FOR THE YEAR ENDED DECEMBER 31, 2015, TO APPROXIMATELY $32,487,000 FOR THE YEAR ENDED DECEMBER 31, 2016. THIS INCREASE WAS PRIMARILY DUE TO SLIGHT SHIFTS IN PAYER MIX. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY: THE HOSPITAL USES MEDICARE COST REPORT METHODOLOGY TO DETERMINE MEDICARE ALLOWABLE COST, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION PRACTICES: HOSPITAL PERSONNEL MAKE GOOD FAITH EFFORTS TO INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE, GOVERNMENTAL PROGRAMS AND ASSISTANCE IN APPLYING. SECTION 7.2 OF THE CHARITY AND BAD DEBT POLICY STATES: REQUIRED INFORMATION AND DOCUMENTATION AS NOTED IN THIS POLICY MUST BE PROVIDED BEFORE ELIGIBILITY FOR FINANCIAL ASSISTANCE WILL BE DETERMINED. ONCE THE REQUIREMENTS HAVE BEEN MET, A WRITTEN NOTICE WILL BE MAILED TO THE PATIENT INFORMING THEM OF THE DETERMINATION DECISION. NO COLLECTION EFFORTS WILL BE PURSUED ON A FINANCIAL ASSISTANCE APPLICATION FOR THE ELIGIBLE AMOUNT AFTER SUCH DETERMINATION IS MADE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: UNITED REGIONAL HEALTH CARE SYSTEM (URHCS) PROVIDES EMERGENCY, TRAUMA, OUTPATIENT AND SHORT TERM GENERAL ACUTE CARE INPATIENT CARE IN THE WICHITA FALLS AREA. IN CONJUNCTION WITH OTHER INTERESTED ORGANIZATIONS, IT UNDERTAKES PROJECTS TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES. FOR EXAMPLE, URHCS COLLABORATES WITH OTHER COMMUNITY HEALTH ORGANIZATIONS TO CREATE A HEALTHY WICHITA REPORT WHICH IS UPDATED PERIODICALLY. THIS REPORT ASSESSES THE HEALTHCARE SERVICES PROVIDED IN THE COMMUNITY TO COMPARE THE OUTCOMES TO STATE AND FEDERAL OUTCOMES AND DETERMINE IF THE COMMUNITY HEALTH NEEDS ARE BEING MET OR ADDITIONAL RESOURCES NEED TO BE DIRECTED TO PARTICULAR HEALTH AREAS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL INFORMS PATIENTS OF THE CHARITY CARE PROGRAM AND HOW TO APPLY FOR CHARITY CARE. THIS IS DONE BY POSTING NOTICES IN PATIENT REGISTRATION AREAS AND PROVIDING WRITTEN NOTICES TO PATIENTS. ALL PATIENT STATEMENTS HAVE AN ASSISTANCE APPLICATION ON THE REVERSE SIDE AND AN ALERT ON THE FRONT FOR THOSE ELIGIBLE OR INTERESTED IN APPLYING. THIS INCLUDES ALL STATEMENT NOTIFICATIONS AND NOT JUST PATIENT SHARE STATEMENTS. FURTHERMORE IT IS THE POLICY OF URHCS TO ASSIST PATIENTS WITH INFORMATION AND RESOURCES FOR POTENTIALLY QUALIFYING FOR GOVERNMENTAL OR OTHER FINANCIAL ASSISTANCE PROGRAMS. THE BUSINESS OFFICE WILL REFER THOSE PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE FROM A GOVERNMENTAL PROGRAM TO THE APPROPRIATE PROGRAM, SUCH AS MEDICAID, COUNTY INDIGENT, CRIME VICTIMS, OR OTHER PROGRAM, OR TO THE HOSPITAL'S CONTRACTED ELIGIBILITY VENDOR FOR SCREENING FOR GOVERNMENTAL PROGRAM COVERAGE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: URHCS PRIMARY SERVICE AREA IS MADE UP OF WICHITA COUNTY. WICHITA COUNTY CONTAINS THE CITY OF WICHITA FALLS WHERE URHCS IS LOCATED. ACCORDING TO THE HUMAN RESOURCES AND SERVICES ADMINISTRATION, US DEPARTMENT OF HEALTH AND HUMAN SERVICES, WICHITA FALLS HAS SEVERAL CENSUS TRACTS FEDERALLY DESIGNATED AS MEDICALLY UNDER-SERVED, INCLUDING CENSUS TRACT 102 WHERE URHCS IS LOCATED. CENSUS DATA FOR WICHITA FALLS IS AS FOLLOWS: MEDIAN HOUSEHOLD INCOME (2015 EST.): $ 45,543 PER CAPITA INCOME (2015 EST.): $ 22,861 UNDER AGE 18 CHILDREN BELOW POVERTY LEVEL (2015 EST.): 25.6% MEDIAN EARNINGS OF FULL-TIME WORKERS, FEMALE (2015 EST.): $29,121 PERSONS BELOW POVERTY LEVEL (2015 EST.): 17.6% EMPLOYED PERSON WITHOUT HEALTH INSURANCE COVERAGE 18 TO 64 YEARS (2015 EST.) : 21.8%. URHCS IS RECOGNIZED BY MEDICARE AS QUALIFYING FOR SOLE COMMUNITY HOSPITAL STATUS AND SERVES A DISPROPORTIONATE SHARE OF LOW-INCOME PATIENTS. UNITED REGIONAL QUALIFIES AS A DISPROPORTIONATE SHARE HOSPITAL FOR BOTH THE MEDICARE AND MEDICAID PROGRAMS. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: THE HOSPITAL IS GOVERNED BY A BOARD OF DIRECTORS THAT REPRESENTS THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. UNITED REGIONAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. UNITED REGIONAL OPERATES A LEVEL 2 TRAUMA UNIT FOR THE REGION. THE HOSPITAL CONTRACTS WITH A FAMILY RESIDENCY PROGRAM TO ASSIST IN TRAINING PRIMARY CARE PHYSICIANS AS WELL AS TRAINING COURSES FOR NURSING AND ALLIED HEALTH PROFESSIONALS FOR THE COMMUNITIES IT SERVES. THE HOSPITAL PARTICIPATES IN MEDICAID AND IS THE MANDATED WICHITA COUNTY HEALTHCARE FACILITY. THE HOSPITAL ALSO PROVIDES NUMEROUS AVENUES TO EDUCATE THE COMMUNITY ON HEALTH INITIATIVES SUCH AS HEALTH FAIRS, NEWSLETTERS/EMAILS, SOCIAL MEDIA OUTREACH AND LECTURE SERIES ON CHRONIC AND ACUTE HEALTH ISSUES. UNITED REGIONAL REINVESTS SURPLUS FUNDS IN THE FACILITIES TO ENSURE PATIENTS ARE PROVIDED WITH STATE OF THE ART MEDICAL CARE. DURING 2016, THE HOSPITAL CONTINUED TO ADDRESS ITEMS FROM THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. THE NEEDS AND PROGRAMS ADDRESSED IN 2016 ARE: -ADDITIONAL HEALTHCARE PROVIDERS: Between 2011-August 2016 United Regional has recruited or assisted with recruitment of 27 physicians in the following specialties: - Anesthesia (3) - Primary care (6) - Hospitalists (5) - Pathology (1) - OB/Gyn (4) - Podiatry (1) - Pulmonary/CC (4) - General Surgery (1) - Rheumatology (2) -ACCESS TO AFFORDABLE PRIMARY CARE AND AFTER-HOURS NON-URGENT CARE: United Regional provided assistance in the expansion of an affiliates urgent care services. In 2016, CarePlus saw 13,620 patients, which is a 20% increase over 2015. -FRAGMENTED CONTINUUM OF CARE: In 2016, 246 new Heart Failure Clinic patients were seen. There were 1,243 total visits (246 new & 997 f/u visits). In 2016 the Call-A-Nurse phone line referral service had 403 physician referral calls, 416 service referral calls, 829 classes enrolled and 3,702 nurse triage calls. -PATIENT EDUCATION AND PREVENTIVE CARE: In 2016, United Regional sponsored community education programs, classes, health fairs, seminars and other events. The events included Lecture Series, Joint Replacement Seminars and Breathsavers. Total attendance was over 400 community members. In addition there were also prenatal classes held in the community with over 1,000 community members. United Regional also participated in a variety of health fairs and presentations providing free testing, screening and educational presentations. United Regional published three editions of a community magazine called "Healthy You". It is distributed to approximately 50,000 residents in the nine-county primary and secondary service area. Topics include: Save Your Flip-Flops for the Beach, maintaining foot health; Physicians Office vs. Walk-in Clinic vs. Hospital Based ER; Lowering Womens Stroke Risks; Summer Safety; Tips to Avoid Skin Cancer; Needed Adult Vaccines; Common Non-operative Ortho Conditions; Secondhand Smoke: Affecting Fertility and Menopause; Chronic Fatigue Syndrome; the Benefits of Stretching; Whats Your Fitness Personality; New Ways to Eat Falls Healthiest Five Foods; How to Help your Aching Back; How to Tell if your Child is Too Sick for School; and Six Common Digestive Disorders. -HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS: United Regional Held programs such as 55 Advantage and Senior Focus to provide education for senior citizens on various health topics. In 2016 attendance was over 1,400 for these programs. Senior Focus provides health information for seniors. In 2016 there were approximately 2,200 in attendance 261 cholesterol tests/89 PSA/400 flu shots. Diabetes education was provided to 2,210 inpatients, 1,842 outpatients and 718 diabetes outpatient calls were made by the Hospital. United Regional Health Care System Palliative Care/Supportive Care services were provided to 3,378 patients. -UNHEALTHY LIFESTYLES AND BEHAVIORS IN THE COMMUNITY: United Regional Health Care System continues to operate and support a Heart Failure Clinic. A communication campaign to encourage preventive care and healthy lifestyle choices was launched in January 2014 and continued through the end of 2016 and included TV spots, direct mail infographics, web site pages and community education events. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: N/A SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: URHCS FILES AN ANNUAL STATEMENT OF COMMUNITY BENEFIT STANDARDS (ASCBS) WITH THE STATE OF TEXAS. THE CALCULATION OF COMMUNITY BENEFIT FOR THE ASCBS DIFFERS FROM THE CALCULATIONS REQUIRED FOR THE IRS SCHEDULE H REPORTING. THEREFORE, THE INFORMATION REPORTED IN THE TWO REPORTS IS INCONSISTENT. SCHEDULE H, PART I, LINE 6B COMMUNITY BENEFIT REPORT: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT CAN BE OBTAINED BY REQUEST FROM UNITED REGIONAL ADMINISTRATION OFFICES OR COMMUNITY BENEFITS OFFICES. THE COMMUNITY BENEFIT REPORT IS ALSO ON FILE WITH THE HEALTH AND HUMAN SERVICES COMMISSION OF THE STATE OF TEXAS. SCHEDULE H, PART I, LINE 3C FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING OTHER CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: - ASSET LEVEL - MEDICAL INDIGENCY - UNDERINSURANCE STATUS - RESIDENCY SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSES: BAD DEBT EXPENSE OF $31,638,760 WAS INCLUDED IN TOTAL EXPENSE ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSE IN COLUMN (F). SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL CONDUCTED 9 ACTIVITIES TO PROMOTE AND SUPPORT THE HEALTH OF THE COMMUNITY THROUGH EDUCATION AND SUPPORT GROUPS. THESE ACTIVITIES INCLUDED THE FOLLOWING: -55 ADVANTAGE: A SENIOR AFFINITY PROGRAM HELD EVERY OTHER MONTH TO PROVIDE EDUCATION FOR SENIOR CITIZENS ON VARIOUS HEALTH TOPICS. -BREATHSAVERS: A PULMONARY SUPPORT GROUP THAT MEETS EVERY OTHER MONTH FOR ADULTS WITH PULMONARY DISEASES (COPD, ASTHMA, EMPHYSEMA, AND CHRONIC BRONCHITIS) AND IS DESIGNED TO ASSIST THOSE WITH THE DISEASES TO DEVELOP SELF-CARE SKILLS FOR A MORE ACTIVE LIFE. -CHILD PASSENGER SAFETY EDUCATION: A PROGRAM TO EDUCATE PARENTS ON CHILD PASSENGER SAFETY BY VIEWING A "SAFE RIDERS OF TEXAS" VIDEO, AND PROVIDE CAR SEAT CHECKS BY A CERTIFIED TECHNICIAN FOR PROPER INSTALLATION. THERE WERE 92 SEATS INSPECTED AND INSTALLED. -DIABETES SUPPORT GROUP: A TYPE 2/TYPE 1 SUPPORT GROUP AND A PEDIATRIC DIABETES SUPPORT GROUP FOR THE COMMUNITY TO PROVIDE ONGOING SUPPORT AND EDUCATION TO DIABETES PATIENTS. -FAMILY HEALTH EDUCATION CLASS OFFERINGS: TO HELP NEW PARENTS MAKE AN EASIER TRANSITION TO PARENTHOOD, THE HOSPITAL OFFERS A VARIETY OF PRENATAL CLASSES. IN ADDITION, THE HOSPITAL ASSISTS SHEPPARD AIR FORCE BASE WITH THEIR MONTHLY PRENATAL ORIENTATION AS WELL AS INSTRUCTS STUDENTS AT A LOCAL ACCELERATED LEARNING CENTER FOR NONTRADITIONAL HIGH SCHOOL STUDENTS. A COMMUNITY HEALTH EDUCATION SPECIALIST PRESENTS INFORMATION ABOUT THE HOSPITAL'S MOTHER/BABY UNIT, WHAT TO EXPECT DURING THEIR STAY, AS WELL AS PROVIDES GENERAL PRENATAL EDUCATION. -HEART SAVERS SUPPORT GROUP: A SUPPORT GROUP DESIGNED FOR HEART PATIENTS AND THEIR CAREGIVERS DEDICATED TO IMPROVING THE QUALITY OF LIFE THROUGH EDUCATION AND ONGOING SUPPORT FROM CLINIC STAFF AND OTHER PEERS. -SENIOR FOCUS: AN EDUCATION FAIR FOR SENIOR ADULTS THAT PROVIDES HEALTH INFORMATION, CHOLESTEROL SCREENINGS AND FLU SHOTS. -SMOKING CESSATION COURSE: A COURSE DESIGNED TO EDUCATE AND HELP INDIVIDUALS STOP SMOKING. -WOMEN'S EXPO/HEART OF A WOMAN: AN EDUCATIONAL FAIR FOR WOMEN THAT PROVIDES EDUCATION AND HEALTH SCREENINGS. SEE SCHEDULE H, PART VI, LINE 5 DISCLOSURE FOR MORE INFORMATION ON THESE ACTIVITIES. true SERVICE ORGANIZATION OF NORTH TEXAS 2950 50TH STREET LUBBOCK TX 79413 800368789 501(C)(3) 17700000 CONTRIBUTION UNITED REGIONAL HEALTH CARE FOUNDATION 1600 ELEVENTH STREET WICHITA FALLS TX 76301 751579910 501(C)(3) 859229 General Support MIDWESTERN STATE UNIVERSITY 3410 TAFT BLVD WICHITA FALLS TX 76308 756001738 501(C)(3) 17493 FUNDING FOR SIMULATION CENTER 3 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: UNITED REGIONAL HEALTH CARE SYSTEM PROVIDES GENERAL CONTRIBUTIONS TO THE COMMUNITY AND NATIONAL CHARITIES FOR THE FURTHERANCE OF THEIR MISSION. THE ORGANIZATIONS MAKE THEIR REQUESTS IN WRITING. THESE CONTRIBUTIONS ARE REVIEWED AND APPROVED BY APPROPRIATELY AUTHORIZED BOARD ACTION; OR OFFICERS; OR EMPLOYEES AS APPROPRIATE IN THE CIRCUMSTANCE IN EACH INSTANCE OF SUCH CONTRIBUTION BEING MADE. UNITED REGIONAL FOLLOWS UP WITH EACH ORGANIZATION TO MAKE SURE EACH CONTRIBUTION WAS USED FOR ITS INTENDED PURPOSE. X X X false true false false false true true false false PHYLLIS COWLING PRESIDENT & CEO 598826 0 236680 0 112341 0 89680 0 9781 0 1047308 0 74319 NANCY TOWNLEY SR VP OF OPERATIONS 415747 0 130740 0 8176 0 25380 0 13420 0 593463 0 ROBERT PERT CHIEF FINANCIAL OFFICER 336270 0 98747 0 26958 0 25380 0 21622 0 508977 0 STEPHANIE JO BROWN VP OF MARKETING 206266 0 31097 0 10715 0 20963 0 8176 0 277217 0 RICHARD CARPENTER VP OF FACILITIES 197168 0 28172 0 6985 0 20428 0 19067 0 271820 0 KRISTI FAULKNER VP OF HUMAN RESOURCES 218492 0 35858 0 6722 0 22002 0 13038 0 296112 0 JOHNNY ROBERTS VP OF UR PHYSICIAN GROUP 210994 0 36013 0 24131 0 22668 0 14997 0 308803 0 LEE RODGERS VP OF MEDICAL AFFAIRS 315730 0 0 0 8055 0 12500 0 1244 0 337529 0 JANE RITTER VP PATIENT CARE/CLINICAL SVS 236262 0 16939 0 4391 0 13053 0 13185 0 283830 0 MATTHEW BAKER DIRECTOR OF PHARMACY 164231 0 1255 0 5590 0 9016 0 20986 0 201078 0 JAMES BEASLEY CLINICAL PHARMACIST 147770 0 1255 0 6859 0 8410 0 17573 0 181867 0 RODNEY BRUMBELOW CLINICAL PHARMACIST 145948 0 1255 0 9806 0 8320 0 20898 0 186227 0 DWAYNE MCKEE DIRECTOR OF CIBI 154316 0 1255 0 852 0 8092 0 15537 0 180052 0 LILA PEREZ NURSE SPECIALIST (PT CARE) 154603 0 1255 0 44 0 0 0 7332 0 163234 0 SCHEDULE J, PART I, LINE 4C DEFERRED COMPENSATION PLAN: UNITED REGIONAL HEALTH CARE SYSTEM OFFERS A DEFERRED COMPENSATION PLAN. CERTAIN MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES MAY ELECT TO PARTICIPATE, IF ELIGIBLE, IN A DEFERRED COMPENSATION PLAN WHICH IS IN COMPLIANCE WITH THE IRC SECTION 457(F), ELIGIBLE DEFERRED COMPENSATION PLAN SPONSORED BY A TAX EXEMPT ORGANIZATION. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE PLAN DURING THE 2016 TAX YEAR: NAME AMOUNT IN W-2 AMOUNT DEFERRED ---------------------------------------------------------- PHYLLIS COWLING $74,319 $58,800 SCHEDULE J, PART I, LINE 6 EXPLANATION OF COMPENSATION CONTINGENT ON NET EARNINGS: A RANGE BETWEEN 20% AND 25% OF ANNUAL BONUS IS BASED ON CONSOLIDATED NET OPERATING INCOME. OTHER BONUS CRITERIA INVOLVE QUALITY SCORES, SERVICE SCORES AND INDIVIDUAL GOALS. A NORTH TEXAS HEALTHCARE FACILITIES DEVELOPMENT 900049824 662823CG6 2007-07-12 93891074 CONSTRUCTION OF BRIDWELL TOWER false false false A 9131074 0 93891074 4384937 0 26749095 849712 1907330 0 60000000 0 0 2010 false true true true A false false true false false 0 false false false true A false false false true false false 0 false 0 false true A true SCHEDULE K, PART IV, LINE 2C ARBITRAGE: SERIES 2007 BONDS - REBATE COMPUTATION PERFORMED 8/19/2016 WICHITA FALLS DIALYSIS SEE PART V 939923 PROFESSIONAL FEES false JANA FRISTOE SPOUSE OF DIRECTOR 53731 SALARY false SCHEDULE L, PART IV, COLUMN(B) ADDITIONAL INFORMATION ON TRANSACTIONS WITH INTERESTED PERSONS: ASHWINKUMAR PATEL, DIRECTOR, IS A MORE THAN 35% OWNER OF WICHITA FALLS DIALYSIS, AN ORGANIZATION DOING BUSINESS WITH THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS OF THE GOVERNING BODY: THE WICHITA COUNTY-CITY OF WICHITA FALLS, TEXAS HOSPITAL BOARD (WHB) APPOINTS ONE INDIVIDUAL TO SERVE EX OFFICIO AS A VOTING DIRECTOR. THE INDIVIDUAL APPOINTED BY THE WHB DOES NOT HAVE TO BE A MEMBER OF THE WHB BUT MUST MEET THE QUALIFICATIONS FOR DIRECTORS SET FORTH BY THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL: THE JOINT CITY-COUNTY BOARD HAS APPROVAL REGARDING BOND FINANCING AND APPROVAL OF THE BUDGET. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: THE EXECUTIVE COMMITTEE CHARTER, AS APPROVED BY THE UNITED REGIONAL HEALTH CARE SYSTEM BOARD, DELEGATES THE REVIEW OF 990S TO THE EXECUTIVE COMMITTEE. ALL MEMBERS OF THE COMMITTEE ARE PROVIDED A COPY OF THE FORM 990 PRIOR TO FILING WITH THE IRS. THE 990 IS REVIEWED BY MANAGEMENT OFFICIALS OF THE HOSPITAL AND THE EXECUTIVE COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ALL OFFICERS, DIRECTORS, AND CERTAIN EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. THE FORMS ARE REVIEWED INITIALLY BY THE CHIEF COMPLIANCE OFFICER AND THE CEO FOR POTENTIAL CONFLICTS. ANY ACTUAL CONFLICTS ARE REVIEWED BY THE BOARD OF DIRECTORS. A PERSON WITH A CONFLICT IS RESTRICTED FROM VOTING ON RELATED MATTERS. FORM 990, PART VI, SECTION B, LINE 15A & 15B PROCESS USED TO DETERMINE COMPENSATION OF MANAGEMENT AND HIGHEST COMPENSATED EMPLOYEES: THE EXECUTIVE COMMITTEE PERFORMS AN ANNUAL REVIEW OF COMPENSATION OF THE CEO AND REVIEWS ALL CORPORATE OFFICERS COMPENSATION EVERY OTHER YEAR. THE EXECUTIVE COMMITTEE MAKES FINAL RECOMMENDATIONS REGARDING COMPENSATION OF THE CEO ANNUALLY AND ALL OFFICERS EVERY OTHER YEAR. A COMPENSATION CONSULTANT PROVIDES MARKET COMPARISONS ON AN EVERY OTHER YEAR BASIS. THIS WAS COMPLETED IN 2009, 2011, 2013 AND 2015. AN ANNUAL COMPENSATION REVIEW IS PERFORMED BY THE CEO FOR ALL OTHER OFFICERS OF THE ORGANIZATION WITHIN THE PARAMETERS SET BY THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE REVIEWS ALL OTHER CORPORATE OFFICERS OTHER THAN THE CEO EVERY OTHER YEAR. ALL COMPENSATION REVIEWS ARE DOCUMENTED IN THE EXECUTIVE COMMITTEE'S MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE TO THE PUBLIC: AN AD IS RUN IN THE LOCAL PAPER ON AN ANNUAL BASIS INFORMING THE COMMUNITY THE FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE OTHER DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION A, LINE 1A Delegation of Authority: THE EXECUTIVE COMMITTEE HAS AUTHORITY TO TRANSACT ALL BUSINESS OF THE BOARD IN THE GOVERNANCE OF THE CORPORATION DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD, SUBJECT TO THE LIMITATIONS SET FORTH IN THE BYLAWS AND ANY LIMITATIONS OTHERWISE IMPOSED BY THE BOARD. FORM 990, PART VII, SECTION A Compensation of Officers and Directors: Directors reported on part vii, section a are compensated for professional services as physicians and not as directors. Directors receiving 1099 income from united regional is compensation related to administrative and general services rendered to clinical areas of the organization, other professional services and for trauma or other off-hour availability. FORM 990, PART XI, LINE 9 OTHER CHANGES TO NET ASSETS: CHANGE IN INTERCOMPANY TRANSFERS $242,912 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:6544568 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:22425731 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:1203342 FORM 990 PART IX LINE 11G DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:5804452 FORM 990 PART IX LINE 11G DESCRIPTION:TEMPORARY LABOR TOTAL FEES:2790308 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSPORT TRANSFER SERVICES TOTAL FEES:139533 UNITED REGIONAL HEALTH CARE FOUNDATION 1600 ELEVENTH STREET WICHITA FALLS TX 76301 752761467 SUPPORT TX 501(C)(3) 12, TYPE I URHCS true RATHGEBER HOSPITALITY HOUSE 1615 TWELFTH STREET WICHITA FALLS TX 76301 752811394 LODGING TX 501(C)(3) 7 URHC FDN true UNITED REGIONAL PHYSICIAN GROUP 1600 ELEVENTH STREET WICHITA FALLS TX 76301 752925491 HEALTH CARE TX 501(C)(3) 10 URHCS true UNITED REGIONAL HEALTH CARE SYSTEM AUXIL 1600 ELEVENTH STREET WICHITA FALLS TX 76301 756004656 BENEVOL SVCS TX 501(C)(3) 12, TYPE I URHCS true CITY OF WICHITA FALLS-WC HOSPITAL BOARD 1300 SEVENTH STREET WICHITA FALLS TX 76301 756002771 OVERSIGHT TX 115 N/A NA false TEXOMA HIE 1600 ELEVENTH STREET WICHITA FALLS TX 76301 463617299 INACTIVE TX 501(C)(3) 10 URHCS true UNITED REGIONAL PROFESSIONAL SERVICES 1600 ELEVENTH STREET WICHITA FALLS TX 76301 752549298 MGMT SERVICES TX URHCS C-CORPORATION 3264117 8177418 1.00000 true TEXOMA INSURANCE AGENCY 1600 ELEVENTH STREET WICHITA FALLS TX 76301 422683761 INSURANCE TX NA C-CORPORATION 1.00000 true true true true true false false false false false false false false true true true false true true true UNITED REGIONAL PHYSICIAN GROUP A 229411 FMV UNITED REGIONAL HEALTH CARE FOUNDATION C 1960408 CASH VALUE UNITED REGIONAL PHYSICIAN GROUP Q 8440000 CASH VALUE UNITED REGIONAL HEALTH CARE FOUNDATION B 859229 CASH VALUE SCHEDULE R, PART V, LINE 2, COLUMN (D) METHOD OF DETERMINING AMOUNTS FOR TRANSACTIONS DESCRIBED IN LINES 1B, 1C AND 1Q: AMOUNTS REPORTED IN LINE 2, COLUMN (C) FOR THESE TRANSACTION TYPES ARE STATED AT CASH VALUE. METHOD OF DETERMINING AMOUNTS FOR TRANSACTIONS DESCRIBED IN LINE 1A: AMOUNTS REPORTED ON LINE 2, COLUMN (C) FOR THESE TRANSACTION TYPES ARE AT FAIR MARKET VALUE AND ARE COMPARABLE TO TRANSACTIONS BETWEEN TWO OR MORE UNRELATED PARTIES DEALING AT ARM'S LENGTH.