TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE (EIN 75-1748586)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-11
- IRS object ID
- 201603169349304655
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-11T15:56:00-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 751748586 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Texas Health Harris Methodist Hospital Azle | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DAVID JACKSON | InCareOfNm |
| Business Name Control | TEXA | BusinessNameControlTxt |
| Phone | 8174448600 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 108 Denver Trail | AddressLine1Txt |
| City | Azle | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76020 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RICK MCWHORTER | PersonNm |
| Person Title | Asst Secretary | PersonTitleTxt |
| Phone | 6822367900 | PhoneNum |
| Signature | 2016-11-11 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Texas Health Azle | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Bob Ellzey | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 108 Denver Trail | AddressLine1Txt |
| City | Azle | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76020 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $34,809,339 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.texashealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1954 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | A faith-based organization whose mission is to improve the health of the people in the communities it serves regardless of one's ability to pay. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 315 | TotalEmployeeCnt |
| Total Volunteers | 51 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $426,272 | PYContributionsGrantsAmt |
| CY Contributions Grants | $162,264 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $31,951,259 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $34,410,992 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$35,169 | PYInvestmentIncomeAmt |
| CY Investment Income | -$21,900 | CYInvestmentIncomeAmt |
| PY Other Revenue | $203,134 | PYOtherRevenueAmt |
| CY Other Revenue | $236,083 | CYOtherRevenueAmt |
| PY Total Revenue | $32,545,496 | PYTotalRevenueAmt |
| CY Total Revenue | $34,787,439 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $8,025 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $938,259 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,608,996 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,338,753 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,167,392 | PYOtherExpensesAmt |
| CY Other Expenses | $13,599,121 | CYOtherExpensesAmt |
| PY Total Expenses | $30,784,413 | PYTotalExpensesAmt |
| CY Total Expenses | $32,876,133 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,761,083 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,911,306 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,467,083 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,223,184 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,247,169 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,091,964 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$3,780,086 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,868,780 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | A FAITH-BASED ORGANIZATION WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES IT SERVES REGARDLESS OF ONE'S ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $27,433,198 | ExpenseAmt |
| Grant | $938,259 | GrantAmt |
| Revenue | $34,410,992 | RevenueAmt |
| Desc | Texas Health Harris Methodist Hospital Azle (THAZ) is a 31 bed community based hospital serving Azle, Lake Worth, Springtown and the surrounding areas. Since 1954, THAZ has provided quality health care services to the northwest Tarrant County community. Located in Azle, the hospital offers many services such as cardiovascular, imaging, inpatient/outpatient surgery, Outpatient Sports and Rehabilitation Center and an intensive care unit. During the year, THAZ had 4,879 patient days, 1,549 discharges, 31,554 outpatient encounters, 0 births and 23,385 emergency room visits. THAZ provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. The hospital provides care to persons covered by governmental programs including Medicare and Medicaid for reimbursement that does not always cover the cost of providing the care. Recognizing its mission to the community, services are provided to both financially indigent and medically indigent patients. Community benefit is provided through many reduced price services and free programs to the community. These services are essential to provide complete healthcare to the communities served. Some of these programs include: Various health screenings were offered to the community free of charge or for a nominal charge such as diabetes and breast cancer. THAZ participated in community education regarding good hand hygiene to promote awareness of proper hand washing in an effort to slow the spread of infection and disease. In the Better Living through Improved Fitness and Education (L.I.F.E.) program senior adults are encouraged to focus on improving their health with a range of physical activities, health education and screenings. THAZ provided healthy eating for children classes, smoking cessation classes and community health support groups. | Desc |
| Total Program Service Expenses | $27,433,198 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 39 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 315 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID JACKSON | PersonNm |
| Phone | 6822367900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 612 E LAMAR BLVD | AddressLine1Txt |
| City | Arlington | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76011 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (34 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Anderson Tanya Layne | |||||||||
| Vice Chairman | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Braudis Russell Paul | |||||||||
| Chairman | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Briggs Frank W | |||||||||
| Member | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Galindo Graciela | |||||||||
| Member | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Haas Anthony J | |||||||||
| Member | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Kuenstler MD Kristi M | |||||||||
| Ex Officio | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Miller DO Keegan | |||||||||
| Ex Officio | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Niles MD Richard | |||||||||
| Ex Officio | 2.0 | 0.0 | Yes (X) | $0 | $339,124 | $41,449 | |||
| Reger Kristie D | |||||||||
| Member | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Robbins Frankie | |||||||||
| Member | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Standefer Thomas Bishop | |||||||||
| Member | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Berenzweig MD Harold | |||||||||
| THR Corporate Officer | 0.5 | 40.0 | $0 | $758,494 | $124,731 | Yes (X) | |||
| Boes Charles W | |||||||||
| Assistant Secretary | 0.5 | 40.0 | $0 | $764,506 | $59,480 | Yes (X) | |||
| King Kirk | |||||||||
| THR Corporate Officer | 0.5 | 40.0 | $0 | $689,597 | $229,313 | Yes (X) | |||
| Kramer Kenneth | |||||||||
| Assistant Secretary | 0.5 | 40.0 | $0 | $669,825 | $109,536 | Yes (X) | |||
| Krejci Jacque | |||||||||
| Assistant Secretary | 0.5 | 40.0 | $0 | $124,885 | $26,330 | Yes (X) | |||
| McWhorter Rick E | |||||||||
| Assistant Secretary | 0.5 | 40.0 | $0 | $517,956 | $161,844 | Yes (X) | |||
| Stout Luanne R | |||||||||
| Corporate Secretary | 0.5 | 40.0 | $0 | $260,435 | $94,686 | Yes (X) | |||
| Wossum Marian | |||||||||
| Assistant Secretary | 0.5 | 40.0 | $0 | $113,155 | $22,024 | Yes (X) | |||
| EllzeyBob S | |||||||||
| PRESIDENT THAZ | 40.0 | 0.0 | $291,902 | $0 | $66,205 | Yes (X) | |||
| GilbertValarie G | |||||||||
| CHIEF NURSING OFFICER THAZ | 40.0 | 0.0 | $198,602 | $0 | $57,670 | Yes (X) | |||
| LavioletteJudy D | |||||||||
| CHIEF MEDICAL OFFR THAZ & THC | 8.0 | 32.0 | $81,977 | $327,908 | $37,120 | Yes (X) | |||
| MilandStephanie | |||||||||
| GRP FIN OFF THFW-THC-THAZ-THSH | 0.5 | 40.0 | $0 | $301,896 | $59,885 | Yes (X) | |||
| WardVanessa | |||||||||
| PHARMACIST | 40.0 | 0.0 | $151,902 | $0 | $25,232 | Yes (X) | |||
| FonvilleMary V | |||||||||
| DIR SR QUAL/PT SF/RSK/SPRT SVC | 40.0 | 0.0 | $134,486 | $0 | $46,869 | Yes (X) | |||
| EdwardsConnie Beck | |||||||||
| DIR REHAB SVC | 40.0 | 0.0 | $126,506 | $0 | $24,969 | Yes (X) | |||
| OwensRobyn L | |||||||||
| DIR QUALITY/PT SAFETY/RISK | 40.0 | 0.0 | $121,711 | $0 | $27,095 | Yes (X) | |||
| SosebeeTonya A | |||||||||
| ASSOC CNO THAZ | 40.0 | 0.0 | $120,349 | $0 | $24,791 | Yes (X) | |||
| BerdanBarclay E | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $1,690,376 | $220,980 | Yes (X) | |||
| MitchellJohn D | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $417,466 | $90,554 | Yes (X) | |||
| CanoseJeffrey L | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $1,018,371 | $363,705 | Yes (X) | |||
| HumphreyRichard I | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $475,895 | $91,806 | Yes (X) | |||
| MiaoWinjie Tang | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $354,318 | $66,718 | Yes (X) | |||
| DeSioTerri Alice | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $217,031 | $33,193 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,227,435 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $9,041,238 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,106,185 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 22 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Texas Health Resources | |||||
| 612 E Lamar Blvd Ste 900 | ARLINGTON | TX | 76011 | Management Fee | $3,818,554 |
| TEXAS HEALTH PHYSICIANS GROUP | |||||
| 9229 LBJ FREEWAY | DALLAS | TX | 75243 | PHYSICIAN SERVICES | $971,788 |
| Northstar Anesthesia PA | |||||
| 6225 North State Hwy 161 200 | IRVING | TX | 75038 | Anesthesia Coverage | $159,932 |
| Hutcherson Construction INC | |||||
| PO Box 650638 | DALLAS | TX | 75265 | Construction Service | $121,459 |
| North Texas Healthcare Laundry Coop | |||||
| PO Box 535849 | GRAND PRAIRIE | TX | 75050 | Laundry Services | $104,542 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $60,938 | RelatedOrganizationsAmt |
| All Other Contributions | $101,326 | AllOtherContributionsAmt |
| Total Contributions | $162,264 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $31,423,300 | $31,423,300 |
| DSRP REVENUE | 622110 | $2,133,425 | $2,133,425 |
| MEDICARE/MEDICAID ADJUSTMENT | 622110 | $839,037 | $839,037 |
| EDUCATION | 611430 | $15,230 | $15,230 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $34,410,992 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $75,285 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $75,285 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $75,285 | TotalRevenueColumnAmt |
| Exclusion | $75,285 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $21,900 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$21,900 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$21,900 | TotalRevenueColumnAmt |
| Exclusion | -$21,900 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 722212 | $125,896 | $125,896 |
| REBATES & INCENTIVES | 454210 | $16,521 | $16,521 |
| VENDING | 454210 | $7,914 | $7,914 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,467 | TotalRevenueColumnAmt |
| Exclusion | $10,467 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $160,798 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,787,439 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,410,992 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $214,183 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $938,259 | TotalAmt |
| Program Services | $938,259 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $696,824 | TotalAmt |
| Management And General | $696,824 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,022,175 | TotalAmt |
| Program Services | $13,683,293 | ProgramServicesAmt |
| Management And General | $338,882 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $647,635 | TotalAmt |
| Program Services | $647,635 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,987,551 | TotalAmt |
| Program Services | $1,964,413 | ProgramServicesAmt |
| Management And General | $23,138 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $984,568 | TotalAmt |
| Program Services | $984,568 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,818,554 | TotalAmt |
| Management And General | $3,818,554 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,384 | TotalAmt |
| Program Services | $1,384 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,514,949 | TotalAmt |
| Program Services | $2,466,368 | ProgramServicesAmt |
| Management And General | $48,581 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,136 | TotalAmt |
| Program Services | $168,136 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $269,203 | TotalAmt |
| Program Services | $222,140 | ProgramServicesAmt |
| Management And General | $47,063 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $334,942 | TotalAmt |
| Program Services | $334,942 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $419,094 | TotalAmt |
| Program Services | $266,670 | ProgramServicesAmt |
| Management And General | $152,424 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,286 | TotalAmt |
| Program Services | $32,209 | ProgramServicesAmt |
| Management And General | $3,077 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,129 | TotalAmt |
| Program Services | $13,230 | ProgramServicesAmt |
| Management And General | $1,899 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,244 | TotalAmt |
| Program Services | $5,688 | ProgramServicesAmt |
| Management And General | $256,556 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,129,001 | TotalAmt |
| Program Services | $1,129,001 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,794 | TotalAmt |
| Program Services | $66,794 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $3,099,445 | $3,083,007 | $16,438 |
| PATIENT SERVICES | $726,779 | $726,779 | |
| FURNITURE & EQUIPMENT | $364,770 | $346,919 | $17,851 |
| REPAIRS & MAINTENANCE | $207,294 | $207,294 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,117 | TotalAmt |
| Program Services | $144,469 | ProgramServicesAmt |
| Management And General | $21,648 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,876,133 | TotalAmt |
| Program Services | $27,433,198 | ProgramServicesAmt |
| Management And General | $5,442,935 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$8,856 | BOYAmt |
| EOY | $57,327 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,356,079 | BOYAmt |
| EOY | $4,338,318 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $455,157 | BOYAmt |
| EOY | $543,684 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,258 | BOYAmt |
| EOY | $37,696 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $20,830,667 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,584,508 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,609,445 | BOYAmt |
| EOY | $8,246,159 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,467,083 | BOYAmt |
| EOY | $13,223,184 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,878,245 | BOYAmt |
| EOY | $2,750,457 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,368,924 | BOYAmt |
| EOY | $12,341,507 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,247,169 | BOYAmt |
| EOY | $15,091,964 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,780,086 | BOYAmt |
| EOY | -$1,868,780 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,780,086 | BOYAmt |
| EOY | -$1,868,780 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,467,083 | BOYAmt |
| EOY | $13,223,184 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,911,306 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | Yes (true) | VolunteersInd |
| Paid Staff Or Management | Yes (true) | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | Yes (true) | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Lobbying Activities | FormAndLineReferenceDesc |
| Explanation | Officers and/or Board Members of the corporation may, to an insubstantial degree, make comments or statements concerning legislation that may affect either the healthcare industry or the health status of the communities the Corporation serves. In pursuing this activity, Officers and/or Board Members may engage in conversations and/or write letters to various federal, state, and local officials regarding such matters. The amount of time and money involved in these activities is negligible. In no case has either the Corporation, or any person acting on behalf of the Corporation, intervened in any political campaign. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $145,334 | OtherCostOrOtherBasisAmt |
| Book Value | $145,334 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,999,331 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,066,557 | DepreciationAmt |
| Book Value | $4,932,775 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $229,289 | OtherCostOrOtherBasisAmt |
| Depreciation | $133,888 | DepreciationAmt |
| Book Value | $95,401 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,353,718 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,384,063 | DepreciationAmt |
| Book Value | $2,969,654 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $102,995 | OtherCostOrOtherBasisAmt |
| Book Value | $102,995 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,246,159 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY PAYABLE | $12,072,678 |
| ASSET RETIREMENT OBLIGATIONS | $268,829 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $12,341,507 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 900. | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,647,376 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $78,357 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,569,019 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13900 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,939,093 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,720,677 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $218,416 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00660 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,923 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,836 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,087 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,597,392 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,802,870 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,794,522 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14580 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $551,951 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $91,671 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $460,280 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01400 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $927,709 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $927,709 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02820 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,479,660 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $91,671 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,387,989 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04220 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,077,052 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,894,541 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,182,511 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18800 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $56,663 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $28,262 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $28,401 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $56,663 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $28,262 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $28,401 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,650,933 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $6,704,968 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,115,961 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$410,993 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Texas Health Azle | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 108 Denver Trail | AddressLine1Txt |
| City | Azle | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76020 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.texashealth.org | WebsiteAddressTxt |
| State License | TDH #469 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Texas Health Azle | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www/texashealth.org/chna | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.texashealth.org/chna | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 900. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Section C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Section C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Section C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Texas Health Azle | FormAndLineReferenceDesc |
| Explanation | Part V. Section B, Line 5 Texas Health Azles (THAZ) CHNA was a six-month collaborative process which utilized vast amounts of qualitative and quantitative data to assess the health needs of the persons in the communities served by the hospital. As a means to further understand the needs from those engaged in the community, THAZ conducted a series of community feedback sessions through surveys, interviews, and a community stakeholder meeting. Multiple interviews were conducted between December 2012 and January 2013. Participants of the community feedback interviews included, but were not limited to: political leaders, faith community representatives, public health officials, lay community members, school officials, and city administration. Nine persons with interests specific to the health of THAZs community completed a survey, and sixteen individuals participated in an in-person discussion. These methods for gathering community feedback were aimed at soliciting input from participants for community health resources, as well as the health needs of the community. Responses were divided into four sections (acknowledged strengths, gaps in services/care, community concerns, suggestions and opportunities), analyzed against secondary data, and assessed using criteria designed to rank or prioritize the issues. Participants of the stakeholder meeting represented both hospital staff and persons who represent the broad interests of the community, including members of medically underserved, low-income, and minority populations. Organizations represented in the in-person community stakeholder meeting included: Tarrant County Public Health, Tarrant County Safe Kids Coalition, City of Azle, and Azle Independent School District. Part V. Section B, Line 7d The hospital produced executive summaries of the completed CHNA along with other information that is of benefit to community members as well as a comparison between the health needs of the community and the state of Texas statistics. This information is widely available throughout the facility and given out at various community coalition and partnership meetings in an effort to disseminate the information through various community-based outlets. Part V. Section B, Line 11 CHNA 2013 revealed a vast number of community health issues that require collective action to improve the health of the community. In order to assist the organization in determining which health needs should be addressed, Texas Health Azle (THAZ) categorized the community needs in alignment with the national objectives of Healthy People 2020 categories. By using a strategic prioritization method to determine the top needs within the community aligned with the ability to address the issues, two areas were chosen and are being addressed through the 2014-2016 implementation plans. 2015 was the second year of implementation, and the focus was to deploy the systems, structures, and interventions that were chosen in 2014. The two priority areas from the 2013 CHNA were Awareness, Literacy, and Navigation and Chronic Disease. In addition, in 2015 THAZ worked to align and coordinate services and interventions with community partners for a collective impact to meet the two priority areas defined. Below are some ways in which the priority areas were addressed by THAZ. 1. Awareness, Literacy, and Navigation (ALN) 1a. Community Health Improvement strategies include collaboration to develop an area resource guide of key services available to the local community, individuals, and non-profit partners that address the social determinants of health. In 2015, Community Connect, a website database of free and reduced-cost social services that is available to both external and internal audiences, was launched as a result of this collaboration. 1b. The Texas Health Grant and Sponsorship Program provides community benefit grants, sponsorships, and other in-kind resources to improve the health status of the communities served. Grants are limited to the specific areas of health disparities, disease management, wellness, disease prevention and health promotion programs, clinics, charitable care, and community health collaborations. 1c. Sponsorship and partnering with area collaborations working to address ALN continued. Texas Health Azle has maintained and supported relationships with key partners, such as the Long Live Parker County Collaboration and Cook Childrens Community Coalition. 1d. For the past 15 years, THAZ has partnered with the Azle Independent School District to improve the health of the students. Over the years, many health issues have been addressed, such as hand hygiene, texting and drive, and childhood obesity. 1e. The Child Automobile Safety Initiative (CASI) strives to educate and raise community awareness about child passenger safety and the risk of unintentional injury from motor vehicle collisions. CASI's program model, based on the ecological perspective, includes four main components: child passenger restraint checks, community-based education, school-based education, and training. In 2015, Texas Health Azle held two car seat fitting stations. 2. Chronic Disease 2a. Community Health Improvement strategies include implementing new evidence-based programs and maintaining existing chronic disease programs provided at the hospital with a focus on self-management programs. Active partnerships and sponsorships aligned with the strategic efforts to address chronic diseases remains a top priority. 2b. The Chronic Disease Self-Management Program (CDSMP) is a program offered by the hospital and local community partners with the goal of enabling individuals to build the self-confidence and motivation they need to manage the challenges of living with a chronic health condition. Participants are adults experiencing chronic health conditions such as hypertension, arthritis, heart disease, stroke, lung disease, and diabetes. Their family members, friends, and caregivers also participate. The program provides information and teaches practical skills on managing chronic health problems through the use of lay leaders. 2c. Recognizing the need to engage older adults in the community, THAZ developed a fitness program called the Better Living through Improved Fitness and Education Program (Better L.I.F.E.) in 1997. The program is designed to improve the health and quality of life in older Americans. Healthy lifestyles and injury prevention are included with free exercise classes ranging from chair exercise for beginners to line dancing for the more active. Currently, there are four yoga classes, two line dancing sessions, a walking club, and senior mixers, a chair-based exercise program. Free screenings, flu vaccines, and classes stress the importance of early detection and self-management. 2d. In 2015 alone, 1,040 hospital staff hours were devoted to provide medically supervised exercise for patients with heart and/or lung problems who do not qualify for pulmonary or physical therapy through the Better Breathers Club. 2e. Texas Health Azles HELP Clinic provides access to routine healthcare and education for patients with chronic conditions who do not have access to primary care and are forced to utilize the hospitals emergency department as a way to manage their conditions. Patients are connected to local resources such as prescription assistance and eye exams. HELP care plans are assigned based on the individuals health care needs and include non-physician health professionals; nurses providing care outside of the clinic setting via phone, email, and other electronic support; health coaches offering culturally and linguistically appropriate education; and social workers helping patients to navigate the health care system. 2f. In 2011, Texas Health Azle reached out to several community partners and created the Healthy Eating Initiative, a strategic approach to address the issue of the lack of accessible and affordable produce as an obstacle to healthy eating in the community. The goal of the Healthy Eating Initiative is to increase the amount of fruits and vegetables consumed by improving the availability and affordability of healthy food options with a multi-pronged approach including community gardens, a farmers market, and food hubs. In the 2012 baseline survey, the number of servings of fruit was reported as just under 4 servings per week. By 2015, this number had doubled to 8 servings per week. The average number of servings of all fruit and vegetables increased 27 percent over the baseline survey. Texas Health Azle will not adopt new strategies for the following identified needs in the community for the reasons listed. 1. Access: Provider Supply Resource constraints and lack of effective intervention. The facility will continue to address the need at its current level of support. 2. Cancer - This need is currently being addressed by multiple outside organizations in the community. The facility will continue to address the need at its curren | ExplanationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Texas Health Azle | FormAndLineReferenceDesc |
| Explanation | Part I, Line 3c - Patient Eligibility Patients with family income at or below 200% of applicable FPG may be eligible for free care if the patient lacks sufficient funds and assets to pay the out-of-pocket portion of their hospital bill. Patients with family income above 200% of applicable FPG who have unpaid medical bills exceeding a specified percentage of the patient's annual gross income, as determined on a sliding scale based on FPG, may be deemed medically indigent and eligible for charity care. The patient may be eligible for a charity adjustment up to 100% of the unpaid balance of their hospital bill in excess of a specified patient responsible amount if the patient has insufficient funds/assets to pay his hospital bill without incurring an undue financial hardship. The patient responsible amount is based on a percentage of the patient's annual income in relation to FPG. A determination as to whether or not a patient has insufficient funds and/or assets to pay for purposes of determining both financial and medical indigence is made at the time a patient's financial assistance application is reviewed. Assets considered when determining eligibility include cash, stocks, bonds and other financial assets that can be readily converted to cash. An additional process to screen for charity patients using publicly available financial information is also in place for patients not submitting a Financial Assistance application. Part I, Line 7 - Cost to Charge Ratio A cost to charge ratio is used in computing the amounts reported in Lines 7a-7c. The amounts reported on Lines 7e-7i were obtained using direct costs, as determined by a cash outlay or, in the case of reporting employee volunteer hours, by using an average national volunteer wage rate. Part II - Community Building The organization participates in community building activities that aim to address the socio-economic factors that influence the overall health of individuals in the communities served. As identified in the community health needs assessment, there are areas of need that are not in alignment with the operations of a hospital system. Our volunteerism, collaborations and partnerships with various aid organizations and various area coalitions aid in addressing the socio-economic factors that are the backbone for many underlying health concerns. Part III, Lines 2, 3 & 4 - Bad Debts Bad debt expense is not included as a community benefit for purposes of reporting community benefits. We treat each patient qualifying for charity care as a charity patient and no charges related to that patient are included in bad debt expense. The hospital is part of a consolidated system of hospitals which operate under the name Texas Health Resources (THR). THR's annual audit is conducted on a system-wide basis with a single consolidated audit report issued for THR and its affiliates. The audited financial statements of THR, which includes the activity of the organization, contain a footnote regarding Accounts Receivable and Allowance for Doubtful Accounts that reads as follows: Patient accounts receivable are reported net of estimated allowances for doubtful accounts and contractual adjustments in the balance sheets. The allowance and resulting provision for bad debts is based upon a combination of the aging of receivables and managements assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage and other collection indicators for each of its major payor sources of revenue. Management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience and payment trends by payor category. Patient accounts are also monitored and, if necessary, past due accounts are placed with collection agencies in accordance with guidelines established by management. For receivables associated with services provided to patients who have third-party coverage, the System analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the System records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the billed rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Systems allowance for doubtful accounts for self-pay patients (including allowances for charity care) remained constant at 96.1% of self-pay accounts receivable at December 31, 2015 and 2014. In addition, the Systems self-pay write-offs for bad debts decreased from approximately $310,000,000 for fiscal year 2014 to approximately $250,000,000 for fiscal year 2015. The decrease in write offs was the result of a decrease in uninsured patients in fiscal year 2015, as well as a financial assistance policy change. The System does not maintain a material allowance for doubtful accounts from third-party payors, nor did it have significant write-offs from third-party payors. Pt III, Line 8 - Medicare Shortfall The state of Texas treats any Medicare shortfall as a community benefit for meeting the state statutory requirements for charity care & community benefit. For state purposes, the shortfall is computed by comparing actual Medicare reimbursements with the estimated cost the hospital incurs in providing these services to Medicare patients. Cost is determined by applying a cost-to-charge ratio (with costs determined in accordance with generally accepted accounting principles) to billed charges. The shortfall amount reported to the state of Texas for 2015 is $3,933,090. Sch H requires a different method of calculating the Medicare shortfall shown on Part III, Lines 5-7. Part III, Line 9b - Debt Collection During the year, standard collection procedures were in place and uniformly applicable to all patient accounts. Except to the extent a patient receives a recovery from any third party or other source, no attempts are made to collect unpaid charges from patient accounts approved for adjustment under the Financial Assistance Policy. Part VI, Line 2 - Needs Assessment The organization is part of the Texas Health Resources (THR) Healthcare System. In addition to the organizations Community Health Needs Assessment (CHNA), THR developed and implemented, as a healthcare system, a Community Benefit Framework (CBF), based on the Public Health Institutes Best Practices ASACB Program. The CBF systematically integrates internal practices into the community to improve the efficiency and effectiveness of THRs Community Health Improvement (CHI) Strategy, to address disproportionate unmet health needs (DUHN), to address primary prevention, and to improve community capacity. The CBF provides a quantitative approach to parallel the CHNA in identifying key communities within THRs service area and the means to align them with a THR entity. The CBF contains five phases: assessment/profile, infrastructure, community health council, programmatic review, and strategy development. THR works with each entitys Community Health Advocate to examine the entitys structure and programs for gaps, needs, strengths, and alignment with the CBF, CHNA, and ASACB standards. Part VI, Line 3 - Patient Education A description of the Financial Assistance Policy (FAP), the Plain Language Summary of the FAP (PLS) and the FAP application are available on the THR website at www.TexasHealth.org in English and other languages. The PLS is included in the patients admission packets. Signs alerting patients of financial assistance and related contact information are posted in various areas of the hospital including admissions & registration and the emergency room. Additionally, financial assistance information is provided verbally and in writing to self-pay patients by financial counselors. As part of the financial counseling meeting, patients are screened for potential eligibility in other governmental assistance programs. If it is determined that the patient is potentially eligible for governmental assistance, the counselor will assist the patient in completing forms necessary to apply for the assistance. At the same time, patients are provided with a financial assistance application. The patient is informed that the hospital is a non-profit organization offering financial assistance to patients deemed medically or financia | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tarrant County Indigent Care Corporation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 612 E LAMAR BLVD | AddressLine1Txt |
| City | Arlington | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76011 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 260648532 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $926,806 | CashGrantAmt |
| Purpose Of Grant | Indigent Health Care | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Monitor Grants | FormAndLineReferenceDesc |
| Explanation | Texas Health Azle (THAZ) is a member of the Texas Health Resources (THR) healthcare system. The majority of the grants distributed by the system are to related tax exempt organizations. The hospital does not specifically monitor the use of grants paid to related organizations since THR administration monitors the use of these grants on a system basis for all members of the THR healthcare system. Grants to non-related tax exempt organizations are generally given to entities that are in the hospitals community and/or service area or to certain organizations which will specifically impact the hospitals community. These grants are typically monitored by hospital personnel who are working closely with the non-related nonprofit organization. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (21 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Niles MD Richard | ||||||||||||||
| Ex Officio | $0 | $224,203 | $0 | $114,921 | $0 | $0 | $9,480 | $0 | $31,969 | $0 | $380,573 | $0 | $0 | |
| Berenzweig MD Harold | ||||||||||||||
| THR Corporate Officer | $0 | $511,183 | $0 | $164,509 | $0 | $0 | $84,227 | $0 | $40,504 | $0 | $883,225 | $0 | $24,136 | $82,802 |
| Boes Charles W | ||||||||||||||
| Assistant Secretary | $0 | $493,855 | $0 | $157,708 | $0 | $0 | $19,875 | $0 | $39,605 | $0 | $823,986 | $0 | $25,860 | $112,943 |
| King Kirk | ||||||||||||||
| THR Corporate Officer | $0 | $461,755 | $0 | $122,904 | $0 | $0 | $181,515 | $0 | $47,798 | $0 | $918,910 | $0 | $25,734 | $104,938 |
| Kramer Kenneth | ||||||||||||||
| Assistant Secretary | $0 | $306,934 | $0 | $288,282 | $0 | $0 | $59,034 | $0 | $50,502 | $0 | $779,361 | $0 | $213,851 | $74,609 |
| Krejci Jacque | ||||||||||||||
| Assistant Secretary | $0 | $123,495 | $0 | $540 | $0 | $0 | $7,484 | $0 | $18,846 | $0 | $151,215 | $0 | $0 | $850 |
| McWhorter Rick E | ||||||||||||||
| Assistant Secretary | $0 | $361,032 | $0 | $94,454 | $0 | $0 | $129,475 | $0 | $32,369 | $0 | $679,800 | $0 | $11,875 | $62,470 |
| Stout Luanne R | ||||||||||||||
| Corporate Secretary | $0 | $190,958 | $0 | $41,692 | $0 | $0 | $65,856 | $0 | $28,830 | $0 | $355,121 | $0 | $0 | $27,785 |
| EllzeyBob S | ||||||||||||||
| PRESIDENT THAZ | $196,801 | $0 | $61,949 | $0 | $33,152 | $27,115 | $0 | $39,090 | $0 | $358,107 | $0 | $5,355 | $0 | $0 |
| GilbertValarie G | ||||||||||||||
| CHIEF NURSING OFFICER THAZ | $162,560 | $0 | $26,620 | $0 | $9,422 | $22,483 | $0 | $35,187 | $0 | $256,272 | $0 | $1,496 | $0 | $0 |
| LavioletteJudy D | ||||||||||||||
| CHIEF MEDICAL OFFR THAZ & THC | $61,596 | $246,383 | $13,516 | $54,063 | $6,865 | $5,703 | $22,810 | $1,721 | $6,886 | $89,401 | $357,604 | $56 | $225 | $27,462 |
| MilandStephanie | ||||||||||||||
| GRP FIN OFF THFW-THC-THAZ-THSH | $0 | $211,976 | $0 | $42,395 | $0 | $0 | $18,555 | $0 | $41,330 | $0 | $361,781 | $0 | $0 | $47,525 |
| BerdanBarclay E | ||||||||||||||
| Former Officer | $0 | $1,073,202 | $0 | $417,182 | $0 | $0 | $181,176 | $0 | $39,804 | $0 | $1,911,356 | $0 | $49,442 | $199,992 |
| MitchellJohn D | ||||||||||||||
| Former Officer | $0 | $274,141 | $0 | $79,766 | $0 | $0 | $44,435 | $0 | $46,119 | $0 | $508,020 | $0 | $10,605 | $63,559 |
| CanoseJeffrey L | ||||||||||||||
| Former Officer | $0 | $687,287 | $0 | $220,259 | $0 | $0 | $322,467 | $0 | $41,238 | $0 | $1,382,076 | $0 | $29,378 | $110,825 |
| HumphreyRichard I | ||||||||||||||
| Former Officer | $0 | $333,384 | $0 | $74,205 | $0 | $0 | $43,414 | $0 | $48,392 | $0 | $567,701 | $0 | $0 | $68,306 |
| MiaoWinjie Tang | ||||||||||||||
| Former Officer | $0 | $240,920 | $0 | $67,293 | $0 | $0 | $40,880 | $0 | $25,838 | $0 | $421,036 | $0 | $8,373 | $46,105 |
| DeSioTerri Alice | ||||||||||||||
| Former Officer | $0 | $195,058 | $0 | $14,091 | $0 | $0 | $12,264 | $0 | $20,929 | $0 | $250,224 | $0 | $0 | $7,882 |
| WardVanessa | ||||||||||||||
| PHARMACIST | $148,226 | $0 | $2,360 | $0 | $1,316 | $9,013 | $0 | $16,219 | $0 | $177,134 | $0 | $0 | $0 | $0 |
| FonvilleMary V | ||||||||||||||
| DIR SR QUAL/PT SF/RSK/SPRT SVC | $121,470 | $0 | $10,002 | $0 | $3,014 | $9,856 | $0 | $37,013 | $0 | $181,355 | $0 | $0 | $0 | $0 |
| EdwardsConnie Beck | ||||||||||||||
| DIR REHAB SVC | $119,944 | $0 | $5,584 | $0 | $978 | $9,173 | $0 | $15,796 | $0 | $151,475 | $0 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1A - Gross-Up Payments | Certain imputed income is grossed-up to include employment taxes paid on the listed persons behalf. All tax indemnification payments provided to employees are included in the taxable compensation of the employee. |
| Schedule J, Part I, Line 1a - Discretionary Spending Account | EACH EXECUTIVE AT THE VICE PRESIDENT LEVEL AND ABOVE RECEIVES A PERK ALLOWANCE WHICH IS INCLUDED IN THE TAXABLE COMPENSATION OF THE EMPLOYEE. This allowance covers costs such as business use of their personal vehicles in lieu of reimbursement for auto mileage. |
| Schedule J, Part I, Line 3 - CEO Compensation | THE ORGANIZATIONS RELIED ON TEXAS HEALTH RESOURCES (THR), A RELATED 501(C)(3) ORGANIZATION WITH CENTRALIZED COMPENSATION PROFESSIONALS TO USE THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT. * THR HAS A Governance Committee COMPRISED OF EXTERNAL BOARD MEMBERS THAT REVIEW COMPENSATION PHILOSOPHY AND DESIGN. One function of the governance committee is to serve as a compensation committee for the THR system. * THR BOARD HIRED INDEPENDENT COMPENSATION CONSULTANTS. * THR & THE INDEPENDENT COMPENSATION CONSULTANTS UTILIZE PUBLISHED THIRD-PARTY COMPENSATION SURVEYS. AN INDEPENDENT THIRD PARTY COMPENSATION CONSULTANT IS HIRED BY THE THR BOARD OF TRUSTEES (BOARD) TO REVIEW BASE PAY ANNUALLY AS COMPARED TO A PEER GROUP OF EMPLOYERS SIMILAR IN SIZE AND SCOPE TO THR. EVERY THREE YEARS THE INDEPENDENT COMPENSATION CONSULTANT REVIEWS ALL ASPECTS OF EXECUTIVE COMPENSATION (BASE, INCENTIVES, BENEFITS, ETC.) WHICH INCLUDES: * REVIEW AND CONFIRMATION OF THE EXECUTIVE COMPENSATION PHILOSOPHY. * MARKET REVIEW OF BASE AND INCENTIVE PAY FOR ALL POSITIONS. NATIONAL, REGIONAL, AND LOCAL DATA IS REVIEWED WHEN AVAILABLE. * MARKET REVIEW OF BENEFITS AND PERQUISITES, * INTERVIEW OF SELECTED OFFICERS AND MEMBERS OF THE GOVERNANCE COMMITTEE (COMPENSATION COMMITTEE) OF THE THR BOARD OF TRUSTEES, AND * REVIEW OF FINANCIAL REPORTS, JOB DESCRIPTIONS, ORGANIZATIONAL CHARTS, CURRENT SALARIES, INCENTIVE OPPORTUNITIES, INCENTIVE PAYMENTS, BENEFITS, PERQUISITES AND PLAN DOCUMENTS. THE INDEPENDENT COMPENSATION CONSULTANT MEETS DIRECTLY WITH THE GOVERNANCE COMMITTEE TO REPORT THE RESULTS OF THE TOTAL COMPENSATION STUDY. AT THE BEGINNING OF EACH YEAR, THE GOVERNANCE COMMITTEE REVIEWs A DETAILED REPORT CONTAINING THE BELOW INFORMATION. THE BOARD REVIEWS AN EXECUTIVE SUMMARY OF THE DETAILED REPORT. * MARKET ANALYSIS BASED ON THE RESULTS OF THE OUTSIDE CONSULTANT'S REVIEW * OFFICER BASE SALARY ADJUSTMENTS INCLUDING MERIT AND MARKET/EQUITY ADJUSTMENTS * PRIOR YEAR EXECUTIVE ANNUAL INCENTIVE AWARDS * CURRENT YEAR EXECUTIVE ANNUAL INCENTIVE PLAN TARGETS, KEY PERFORMANCE INDICATORS AND POTENTIAL PAYOUT AMOUNTS. |
| Schedule J, Part I, Line 4b - Nonqualified Retirement Plan | PARTICIPATION IN THE PLAN IS MADE AVAILABLE TO A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES, AS DETERMINED BY THE THR BOARD OF TRUSTEES, WHO ARE PROVIDING SERVICES IN KEY POSITIONS OF MANAGEMENT AND RESPONSIBILITY. FOR THE ACTIVE RESTORATION ACCOUNT (ACCOUNT BALANCES AFTER 12/31/2009), SERP BENEFITS VEST WHILE THE PARTICIPANT IS EMPLOYED IF THE PARTICIPANT: * REACHES AGE 65, * BECOMES DISABLED or DIES, * REACHES THE FOLLOWING YEARS OF SERVICE: 2 YEARS - 25%; 3 YEARS -50%; 4 YEARS - 75%; AND 5 OR MORE - 100%. PARTICIPANTS MUST BE EMPLOYED ON DEC 1 TO QUALIFY FOR THE CURRENT YEAR'S SERP benefit UNLESS SEPARATION IS DUE TO DEATH, DISABILITY, RETIREMENT (AGE 65) OR EARLY RETIREMENT (SEPARATION FROM SERVICE AT OR AFTER AGE 55 WITH 75 YEARS OF COMBINED AGE AND CONTINUOUS SERVICE WITH THE SYSTEM). SERP benefits ARE CALCULATED EACH DEC 1. VESTED BALANCES ARE TAXED to the employee AND THE NET BALANCES BEGIN ACCRUING EARNINGS. VESTED BALANCES ARE PAID IN a CASH LUMP SUM WITHIN a 90 DAY PERIOD COMMENCING ON THE EARLIER OF DEATH, DISABILITY, OR SEPARATION FROM SERVICE. The deferred portion is included in Schedule J, Part II, column c. In FROZEN RESTORATION ACCOUNTS (ACCOUNT BALANCES PRIOR TO 1/1/2010), THE PARTICIPANT OR BENEFICIARY SHALL BE TAXED ON HIS OR HER VESTED SERP BENEFITS UPON THE EARLIEST OF: * Continued employment in THR until AGE 68 * TERMINATION OF EMPLOYMENT FOR DISABILITY OR DEATH * INVOLUNTARY TERMINATION OF EMPLOYMENT WITHOUT REASONABLE CAUSE; OR * SATISFYING A 24 MONTH NON-COMPETE PERIOD FOLLOWING HIS/HER TERMINATION OF EMPLOYMENT. PAYMENT follow THE BEFORE MENTIONED EVENTS, EXCEPT IN THE CASE OF INVOLUNTARY SEPARATIONS FOR WHICH THE PARTICIPANT MUST WAIT 24 MONTHS TO RECEIVE THE PREVIOUSLY TAXED BENEFIT. Payouts TO THE FOLLOWING EMPLOYEES WERE MADE DURING THE YEAR. THE AMOUNTS BELOW ARE INCLUDED IN THE AMOUNT REPORTED ON SCH J, PART II, COLUMN B(III) AND COLUMN (F). Berdan, Barclay $9,819 Laviolette, Judy $ 281 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Business Relationship-Part VI, Section A, Line 2 | Texas Health Resources (THR) and its related organizations included in the THR healthcare system encourage employees to become involved in philanthropic endeavors in their communities. As a result, THR healthcare system employees who are serving as officers, board members, or key employees may, from time to time, also serve on the boards of various community organizations such as church boards, United Way, etc. There may be a business relationship as a result of multiple THR employees serving on the same community boards. THR employees serve as the corporate officers of each subsidiary organization. As THR system employees, all officers have a business relationship within the organizations of the THR healthcare system. THR also appoints system officers to the boards of various controlled joint ventures. As THR system employees, various officers of the organization may have a business relationship through serving on THR controlled joint venture boards. |
| Governing Documents Part VI, Section A, Line 4 | The governing documents were amended with an effective date of 1/1/15 with the following significant changes: *The reserved powers were transferred from the Founding Members to Texas Health Resources (THR). All authority pertaining to governance of the organization now resides entirely with the THR Board. *The definition of Community Representative changed in order to allow one primary care or specialty physician employed by Texas Health Physicians Group (THPG) to fill one Community Representative position on the board, provided the percentage of physicians on the board does not exceed 40%. *The requirement to state the purpose of a specially called meeting in the notice has been removed. *The medical staff leader positions on the board were changed. The Chief/President of the medical staff will continue to serve ex officio with vote; however, the other two positions may continue to be the Vice Chief/President-Elect and/or Immediate Past Chief/President. These positions may also be other medical staff leaders selected by the board. The terms for the latter two positions will be one year, eligible for re-election for up to a total of nine years. *The board officer position of Secretary was changed to a corporate officer position. |
| Members-Part VI, Section A, Lines 6&7a | Texas Health Resources (THR) is the sole member of the organization. |
| Governance Decisions Reserved-Part VI, Section A, Line 7b | The following actions require the approval of Texas Health Resources (THR): (a) Amendment, restatement or repeal of the Certificate of Formation or these Bylaws. (b) Any action that would adversely affect the religious or church practices or religious affiliation of the Corporation. (c) Sale, exchange, lease or other transfer of all or substantially all of the assets of the Corporation. (d) Merger or consolidation of the Corporation. (e) Dissolution of the Corporation. (f) Election of members of the Board of Trustees (g) Removal of a member of the Board of Trustees (h) Creation of affiliates or subsidiaries and approval of the initial governing documents. (i) Incurrence of debt not included in the budgets. (j) Discontinuing the operations of a licensed health care facility controlled by the corporation. (k) Activities involving winding up, distribution, conversion or exchange under Chapter 11 |
| Form 990 Filing-Part VI, Section B, Line 11b | A full copy of the Form 990 is provided to members of the governing board before filing. In addition, the Audit & Compliance Committee of the Texas Health Resources (THR) Board of trustees is given the opportunity to review, comment, and ask questions regarding the Form 990s filed for THR and each of its wholly controlled affiliates. |
| Conflict of Interest- Part VI, Section B, Line 12c | Texas Health Resources (THR) has adopted a Conflict of Interest Policy that applies to THR and all of its wholly owned or wholly controlled affiliates. During the first quarter of each fiscal year, a Duality and Conflict Statement Form is distributed by the THR Chief Compliance Officer to all board members, officers, contracted medical directors, employees with a title of manager or above, employed physicians, and certain committee members and other employees based upon function. All disclosed conflicts are reviewed by the THR Chief Compliance Officer. A report, listing each reported Duality of Interest or Conflict of Interest is given to both the Chair of the Governing body and the President of the Corporation with which the reporting person is affiliated. The THR Board of Trustees receives a report when the Annual Disclosure process is complete. Progressive corrective action is taken for any identified noncompliance which may include removal from a board or committee or physician/employee counseling if the person fails to provide the disclosure. In addition, THR monitors through a public database recently implemented by CMS. Management plans are executed as needed based upon disclosures. THR also educates the Boards and workforce annually through either a web based or live compliance training. |
| Compensation Determination-Part VI, Section B, Line 15 a&b | The organization relied on Texas Health Resources (THR) with centralized compensation professionals to review and establish the compensation of the organizations officers. A more in depth discussion of executive compensation review can be found on Schedule J, Part III. |
| Public Disclosure-Part VI, Section C, Line 19 | The organization does not make its governing documents or conflict of interest policy available to the public. The consolidated financial statements of Texas Health Resources (THR) are made available to the public on the website www.dacbond.com. Consolidated financial statements are posted to this website quarterly and the audited financial statements are posted annually. The financial statements of the wholly controlled affiliates of THR are not posted to the website nor are they generally made available to the public in any other manner. |
| Consolidated Financial Statements-Part XII, Line 2c | Texas Health Resources (THR) prepares consolidated financial statements with its related entities. The THR Board appoints an audit and compliance sub-committee that assumes responsibility for oversight of the consolidated audit for all related entities. The related entities do not have a separate audit committee, but abide by the THR committee's oversight. There has been no change during the year in the organizations oversight selection process. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Johnson County Community Care Corp | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 452793120 | Support Org. | TX | 501(c)(3) | 11a | TH Cleburne | false |
| North Texas Healthy Communities | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 464513182 | Comm Support | TX | 501(c)(3) | 7 | TH Resources | false |
| Texas Health Arlington Memorial Hospital | ||||||||||
| 800 West Randol Mill Rd | Arlington | TX | 76011 | 750972805 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Back Care | ||||||||||
| 9229 LBJ Freeway | Dallas | TX | 75243 | 474724257 | Phys. Clinic | TX | 501(c)(3) | 9 | TH Phys Grou | false |
| Texas Health Alliance | ||||||||||
| 10864 Texas Health Trail | Fort Worth | TX | 76244 | 451502252 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Azle | ||||||||||
| 108 Denver Trail | Azle | TX | 76020 | 751748586 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Cleburne | ||||||||||
| 201 Walls Dr | Cleburne | TX | 76033 | 751977850 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Fort Worth | ||||||||||
| 1301 Pennsylvania Ave | Fort Worth | TX | 76104 | 756001743 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Hurst-Euless-Bedford | ||||||||||
| 1600 Hospital Parkway | Bedford | TX | 76022 | 751438726 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Southwest Fort Worth | ||||||||||
| 6100 Harris Parkway | Fort Worth | TX | 76132 | 752678857 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Stephenville | ||||||||||
| 411 Belknap | Stephenville | TX | 76401 | 751752253 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Huguley Inc | ||||||||||
| 11801 S Freeway | Burleson | TX | 76028 | 452694620 | Hospital | FL | 501(c)(3) | 3 | TH Resources | false |
| TX Health Outpatient Surg Ctr Alliance | ||||||||||
| 10840 Texas Health Trail | Fort Worth | TX | 76244 | 800800294 | Hospital | TX | 501(c)(3) | 3 | TH Alliance | false |
| Texas Health Physicians Group | ||||||||||
| 9229 LBJ Freeway | Dallas | TX | 75243 | 752613493 | Phys. Clinic | TX | 501(c)(3) | 9 | TH Resources | false |
| Texas Health Resources Foundation | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 752022128 | Fundraising | TX | 501(c)(3) | 7 | TH Resources | false |
| Texas Health Allen | ||||||||||
| 1105 Central Expressway N | Allen | TX | 75013 | 752890358 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Dallas | ||||||||||
| 8200 Walnut Hill Ln | Dallas | TX | 75231 | 751047527 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Denton | ||||||||||
| 3000 North Interstate 35 | Denton | TX | 76201 | 432008974 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Kaufman | ||||||||||
| 850 Ed Hall Drive | Kaufman | TX | 75142 | 752771437 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| Texas Health Plano | ||||||||||
| 6200 W Parker Rd | Plano | TX | 75093 | 752770738 | Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| TX Health Research & Education Institute | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 752562191 | Edu& Research | TX | 501(c)(3) | 4 | TH Resources | false |
| Texas Health Resources | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 752702388 | Mgmt Supp Org | TX | 501(c)(3) | 11c | NA | false |
| TX Health Resources Self-Insurance Trust | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 756335902 | Insur Trust | TX | 501(c)(3) | 11c | TH Resources | false |
| TH Specialty Hospital Fort Worth | ||||||||||
| 1301 Pennsylvania Ave | Fort Worth | TX | 76104 | 751648589 | LT Hospital | TX | 501(c)(3) | 3 | TH Resources | false |
| WW Ward Endowment Fund Trust | ||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 756196065 | Support Org. | TX | 501(c)(3) | 11a | TH Foundatio | false |
| Healthy Tarrant County Collaboration | ||||||||||
| PO Box 8040 | Fort Worth | TX | 76124 | 432087946 | Support Org | TX | 501(c)(3) | 11a | TH Resources | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (27 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|---|
| AMH Cath Labs LLC | ||||||||
| 811 Wright St | Arlington | TX | 76012 | 203003947 | Hospital | TX | NA | N/A |
| Cleburne Imaging LLC | ||||||||
| PO Box 820519 | Dallas | TX | 75382 | 460767278 | Outpatient Diagno | TX | NA | N/A |
| Cleburne Surgical Center LLC | ||||||||
| 2010 W Katherine P Raines Blvd St | Cleburne | TX | 76033 | 203742012 | Amb Surg Ctr | TX | NA | N/A |
| Denton Surgery Center LLC | ||||||||
| 207 North Bonnie Brea | Denton | TX | 76201 | 470926556 | Amb Surg Ctr | TX | NA | N/A |
| Flower Mound Hospital Partners LLC | ||||||||
| 612 E Lamar Blvd Ste 600 | Arlington | TX | 76011 | 260684968 | Hospital | TX | NA | N/A |
| Fort Worth Endoscopy Centers LLC | ||||||||
| 900 W Magnolia Ave 101 | Fort Worth | TX | 76104 | 770368346 | Endoscopy Center | TX | NA | N/A |
| Greenville Surgery Center LLC | ||||||||
| 7150 Greenville Ave Ste 200 | Dallas | TX | 75231 | 742411643 | Amb Surg Ctr | TX | NA | N/A |
| Health Imaging Partners LLC | ||||||||
| 8610 Explorer Drive Ste 300 | Colorado Springs | CO | 80920 | 271385885 | Outpatient Diagno | TX | NA | N/A |
| North Dallas Surgical Center LLC | ||||||||
| 17980 Dallas Parkway Ste 100 | Dallas | TX | 75287 | 272248103 | Amb Surg Ctr | TX | NA | N/A |
| Physician Medical Center LLC | ||||||||
| 612 E Lamar Blvd 6th Flr | Arlington | TX | 76011 | 481281376 | Hospital | TX | NA | N/A |
| Presbyterian Cancer Center-Dallas LLC | ||||||||
| 1220 Senlac Drive 2nd Flr | Carrollton | TX | 75006 | 260422749 | Cancer Treatment | TX | NA | N/A |
| Rockwall Regional Hospital LLC | ||||||||
| 612 E Lamar Blvd 6th Flr | Arlington | TX | 76011 | 202848116 | Hospital | TX | NA | N/A |
| Southlake Specialty Hospital LLC | ||||||||
| 612 E Lamar Blvd 6th Flr | Arlington | TX | 76011 | 020555370 | Hospital | TX | NA | N/A |
| Surgical Caregivers of Fort Worth LLC | ||||||||
| 2001 W Rosedale Street | Fort Worth | TX | 76104 | 751925497 | Amb Surg Ctr | TX | NA | N/A |
| Texas Health Craig Ranch Surgery Center | ||||||||
| 8080 State Hwy 121 Ste 100 | McKinney | TX | 75070 | 383897811 | Amb Surg Ctr | TX | NA | N/A |
| Texas Health Flower Mound Orthopedic Sur | ||||||||
| 5000 Long Prairie Road | Flower Mound | TX | 75028 | 800866449 | Amb Surg Ctr | TX | NA | N/A |
| Texas Health MedSynergies LLC | ||||||||
| 909 Hidden Ridge Ste 300 | Irving | TX | 75038 | 800272951 | Mgmt Services | TX | NA | N/A |
| Texas Health Spine Center Arlington | ||||||||
| 1545 E Southlake Blvd Ste 100 | Southlake | TX | 76092 | 464143686 | Inactive | TX | NA | N/A |
| Texas Health Surgery Center Preston Plaz | ||||||||
| 17950 Preston Road Ste 75 | Dallas | TX | 75252 | 203991622 | Amb Surg Ctr | TX | NA | N/A |
| Texas Health Surgery Center Rockwall LL | ||||||||
| 569 Brookwood Village Ste 901 | Birmingham | AL | 35209 | 474425996 | Inactive | TX | NA | N/A |
| Texas Institute for Surgery LLP | ||||||||
| 7715 Greenville Ave Ste 100 | Dallas | TX | 75231 | 770628004 | Hospital | TX | NA | N/A |
| THR-STT Rockwall ASC LLC | ||||||||
| 1545 E Southlake Blvd | Southlake | TX | 76092 | 262429878 | Amb Surg Ctr | TX | NA | N/A |
| THR-STT Southlake ASC LLC | ||||||||
| 1545 E Southlake Blvd | Southlake | TX | 76092 | 201728912 | Amb Surg Ctr | TX | NA | N/A |
| USMD Hospital at Arlington LP | ||||||||
| 801 I -20 West | Arlington | TX | 76017 | 731662763 | Hospital | TX | NA | N/A |
| USMD Hospital at Fort Worth LP | ||||||||
| 6333 North State Hwy 161 Ste 200 | Irving | TX | 75038 | 203571243 | Hospital | TX | NA | N/A |
| Wilson Creek Surigcal Center LLC | ||||||||
| 569 Brookwood Village Ste 901 | Birmingham | AL | 35209 | 274816583 | Amb Surg Ctr | TX | NA | N/A |
| Women's Specialty Surgery Center | ||||||||
| 8230 Walnut Hill Ln Ste 101 | Dallas | TX | 75231 | 262310072 | Amb Surg Ctr | TX | NA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Grace Indemnity Company Ltd | ||||||||||||||
| 1159 Caribean Plaza | Grand Cayman | CJ | KY 1-1102 | 981209573 | Captive Insurance | CJ | NA | C Corp | false | |||||
| Huguley Medical Associates Inc | ||||||||||||||
| 752547668 | Phys Clinics | NA | C Corp | false | 11801 South Freeway | Burleson | TX | 76028 | TX | |||||
| Magnum Health Holdings Inc | ||||||||||||||
| 475486814 | Inactive | NA | C Corp | false | 612 E Lamar Blvd Ste 600 | Arlington | TX | 76011 | TX | |||||
| Magnum Health Plan Inc | ||||||||||||||
| 475548221 | Inactive | NA | C Corp | false | 612 E Lamar Blvd Ste 600 | Arlington | TX | 76011 | TX | |||||
| Texas Health Biomedical Advancement Cent | ||||||||||||||
| 752636884 | Research | NA | C Corp | false | 612 E Lamar Blvd | Arlington | TX | 76011 | TX | |||||
| Texas Health Resources Casualty Company | ||||||||||||||
| 030310676 | Insurance | NA | C Corp | false | 612 E Lamar Blvd | Arlington | TX | 76011 | VT | |||||
| Texas Health Resources Bundled Products | ||||||||||||||
| 465588632 | Inactive | NA | C Corp | false | 612 E Lamar Blvd | Arlington | TX | 76011 | TX | |||||
| TH Resources Primary Care Ext Physcian N | ||||||||||||||
| 465365421 | Inactive | NA | C Corp | false | 612 E Lamar Blvd | Arlington | TX | 76011 | TX | |||||
| Texas Health Resources Spine Services | ||||||||||||||
| 465347751 | Inactive | NA | C Corp | false | 612 E Lamar Blvd | Arlington | TX | 76011 | TX | |||||
| Texas Health Resources Women's Services | ||||||||||||||
| 465330487 | Inactive | NA | C Corp | false | 612 E Lamar Blvd | Arlington | TX | 76011 | TX | |||||
| Charitable Remainder Trusts (4) | ||||||||||||||
| CR Trust | NA | Trust | false | 612 E Lamar Blvd | Arlington | TX | 76011 | TX | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Related Transactions- Part V, Line 2 | FormAndLineReferenceDesc |
| Explanation | Texas Health Resources (THR) is the parent organization in a large healthcare system made up of both wholly owned entities as well as related controlled joint ventures as listed on Schedule R. THR's role is to plan, manage and coordinate the activities of the affiliated healthcare system in order to maximize opportunities to deliver cost effective quality medical care to residents of north central Texas. THR provides direction and oversight to its wholly owned affiliates through centralized services. They also provide oversight for the controlled joint ventures. As an integral part of providing centralized services to the affiliates, THR maintains intercompany receivable/payable accounts, most of which do not fall within the scope of IRC Section 512(b)(13). The range of centralized services provided by THR include information services, managed care contracting, Human resources, revenue cycle, billing and collections, patient access/admissions, legal, tax, compliance, supply chain, quality, business development, insurance, treasury, marketing, general accounting, real estate services, coding, transcription and strategic planning. In addition, THR does daily cash sweeps of all controlled tax exempt entity cash accounts. As a result, THR has numerous daily transactions with controlled tax exempt entities, none of which fall within the scope of IRC Section 512(b)(13). A management fee is charged for the centralized services and reported on Form 990, Part VII, Section B as a professional services fee. Transactions with related tax exempt organizations falling within the meaning of centralized services as described above, are not listed on Schedule R, Part V, Line 2. | ExplanationTxt |
Comments