EL CAMPO MEMORIAL HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: EL CAMPO MEMORIAL HOSPITAL (EIN 45-2750258)
Tax period: 2015-04-01 to 2016-03-31
Filed: 2016-10-25
IRS object ID: 201622999349300322
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 D
Schedule H
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-10-25T09:51:07-05:00	ReturnTs
Tax Period End	2016-03-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	752570395	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	DURBIN & COMPANY LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	2950 50TH STREET	AddressLine1Txt
City	LUBBOCK	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	79413	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-04-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	452750258	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	EL CAMPO MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	ELCA	BusinessNameControlTxt
Phone	9795436251	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	303 SANDY CORNER RD	AddressLine1Txt
City	EL CAMPO	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	77437	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	TISHA ZALMAN	PersonNm
Person Title	CHIEF EXECUTIVE OFFICER	PersonTitleTxt
Phone	9795436251	PhoneNum
Signature	2016-10-25	SignatureDt

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	GAYLE DE HAAS	PreparerPersonNm
PTIN	P01774581	PTIN
Phone	8067911591	PhoneNum

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2017-02-10 21:41:12Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	TISHA ZALMAN	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	303 SANDY CORNER RD	AddressLine1Txt
City	EL CAMPO	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	77437	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$25,663,599	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.ECMH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2011	FormationYr
Legal Domicile State	TX	LegalDomicileStateCd
Activity Or Mission	THE HOSPITAL PROVIDES EL CAMPO AND SURROUNDING AREAS WITH THE HIGHEST STANDARD OF CARE THROUGH A BROAD RANGE OF SERVICES: INPATIENT, SWING BED, EMERGENCY, SURGICAL, LABORATORY, IMAGING, RESPIRATORY, ETC.	ActivityOrMissionDesc
Voting Members Governing Body	5	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	231	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$656,505	PYContributionsGrantsAmt
CY Contributions Grants	$1,006,578	CYContributionsGrantsAmt
PY Program Service Revenue	$16,724,768	PYProgramServiceRevenueAmt
CY Program Service Revenue	$23,824,322	CYProgramServiceRevenueAmt
PY Investment Income	$3,505	PYInvestmentIncomeAmt
CY Investment Income	-$8,330	CYInvestmentIncomeAmt
PY Other Revenue	$2,526,927	PYOtherRevenueAmt
CY Other Revenue	$829,850	CYOtherRevenueAmt
PY Total Revenue	$19,911,705	PYTotalRevenueAmt
CY Total Revenue	$25,652,420	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$8,792,575	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$9,144,541	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$12,704,185	PYOtherExpensesAmt
CY Other Expenses	$14,500,410	CYOtherExpensesAmt
PY Total Expenses	$21,496,760	PYTotalExpensesAmt
CY Total Expenses	$23,644,951	CYTotalExpensesAmt
PY Revenues Less Expenses	-$1,585,055	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$2,007,469	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,730,914	TotalAssetsBOYAmt
Total Assets EOY	$4,566,486	TotalAssetsEOYAmt
Total Liabilities BOY	$5,863,464	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$4,691,567	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$2,132,550	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$125,081	NetAssetsOrFundBalancesEOYAmt
Mission	THE HOSPITAL PROVIDES EL CAMPO AND SURROUNDING AREAS WITH THE HIGHEST STANDARD OF CARE THROUGH A BROAD RANGE OF SERVICES: INPATIENT, SWING BED, EMERGENCY, SURGICAL, LABORATORY, IMAGING, RESPIRATORY, ETC.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$22,372,551	ExpenseAmt
Revenue	$24,642,993	RevenueAmt
Desc	PROVIDE HEALTHCARE TO EL CAMPO AND SURROUNDING AREAS WITH A BROAD RANGE OF SERVICES: INPATIENT, SWING BED, EMERGENCY, SURGICAL, LABORATORY, IMAGING, RESPIRATORY, AND THERAPY.	Desc
Total Program Service Expenses	$22,372,551	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	66	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	231	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	5	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	TISHA ZALMAN	PersonNm
Phone	9795436251	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	303 SANDY CORNER RD	AddressLine1Txt
City	EL CAMPO	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	77437	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
RANDY CLAPP
BOARD CHAIRMAN	1.00	Yes (X)	$0	$0	$0
STEPHEN COOPER
BOARD VICE - CHAIRMAN	1.00	Yes (X)	$0	$0	$0
MARY JOHNSON
BOARD SECRETARY	1.00	Yes (X)	$0	$0	$0
FRANK CAVALLO
DIRECTOR	1.00	Yes (X)	$0	$0	$0
WILLIAM CHIP JENKINS
DIRECTOR	1.00	Yes (X)	$0	$0	$0
TISHA ZALMAN
CEO	40.00		$154,169	$0	$0	Yes (X)
LAURIE HARVEY
CONTROLLER	40.00		$72,963	$0	$0	Yes (X)
SANDY BYSTREK
OCCUPATIONAL THERAPIST	40.00		$108,035	$0	$0		Yes (X)
DANA FOSTER
PHYSICIAN ASSISTANT	40.00		$154,587	$0	$0		Yes (X)
ASHLEY KOUDELA
PHYSICIAN ASSISTANT	40.00		$130,812	$0	$0		Yes (X)
LAURA WILLIAMS
PHYSICIAN ASSISTANT	40.00		$151,995	$0	$0		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$772,561	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	5	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
TEXAS EMERGENCY ROOM SERVICES
7032 COLLECTION CTR	CHICAGO	IL	60693	ER SERVICES	$883,925
TLC STAFFING
1001 PALMWOOD DR	VICTORIA	TX	77901	STAFFING	$149,640
JERRY D YOUNG
PO BOX 203059	DALLAS	TX	753203059	HEALTHCARE	$131,800
DONNA KNUPPEL
625 CR 364	EL CAMPO	TX	77437	TRANSCRIPTIONS	$128,254
NRACO SERVICES
PO BOX 1330	NEVADA CITY	CA	95959	HEALTHCARE	$100,000

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$1,006,578	AllOtherContributionsAmt
Total Contributions	$1,006,578	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PROGRAM SERVICE REVENU	Desc
Business	621990	BusinessCd
Total Revenue Column	$23,824,322	TotalRevenueColumnAmt
Related Or Exempt Func Income	$23,824,322	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$23,824,322	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,849	TotalRevenueColumnAmt
Exclusion	$2,849	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$47,350	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$47,350	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$47,350	TotalRevenueColumnAmt
Related Or Exempt Func Income	$47,350	RelatedOrExemptFuncIncomeAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$11,179	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$11,179	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$11,179	TotalRevenueColumnAmt
Related Or Exempt Func Income	-$11,179	RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EHR INCENTIVE	624100	$399,681	$399,681
DSRIP	624100	$261,759	$261,759
DIETARY	624100	$62,364	$62,364

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$58,696	TotalRevenueColumnAmt
Related Or Exempt Func Income	$58,696	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$782,500	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$25,652,420	TotalRevenueColumnAmt
Related Or Exempt Func Income	$24,642,993	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$2,849	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$227,132	TotalAmt
Management And General	$227,132	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$7,170,757	TotalAmt
Program Services	$6,726,908	ProgramServicesAmt
Management And General	$443,849	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$51,566	TotalAmt
Program Services	$46,889	ProgramServicesAmt
Management And General	$4,677	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,163,273	TotalAmt
Program Services	$1,057,765	ProgramServicesAmt
Management And General	$105,508	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$531,813	TotalAmt
Program Services	$503,103	ProgramServicesAmt
Management And General	$28,710	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$4,395,900	TotalAmt
Program Services	$4,184,877	ProgramServicesAmt
Management And General	$211,023	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$57,062	TotalAmt
Program Services	$52,614	ProgramServicesAmt
Management And General	$4,448	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,416,451	TotalAmt
Program Services	$1,366,784	ProgramServicesAmt
Management And General	$49,667	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$239,882	TotalAmt
Program Services	$239,882	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,853,908	TotalAmt
Program Services	$2,849,762	ProgramServicesAmt
Management And General	$4,146	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$28,633	TotalAmt
Program Services	$19,207	ProgramServicesAmt
Management And General	$9,426	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$45,693	TotalAmt
Program Services	$16,575	ProgramServicesAmt
Management And General	$29,118	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$90,461	TotalAmt
Program Services	$90,461	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$362,037	TotalAmt
Program Services	$362,037	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$159,126	TotalAmt
Program Services	$143,198	ProgramServicesAmt
Management And General	$15,928	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
BAD DEBT	$3,985,039	$3,985,039
MEDICAL SUPPLIES	$623,092	$623,092
DUES AND SUBSCRIPTIONS	$132,924	$102,064	$30,860
MISCELLANEOUS	$110,202	$2,294	$107,908

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$23,644,951	TotalAmt
Program Services	$22,372,551	ProgramServicesAmt
Management And General	$1,272,400	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$492,675	BOYAmt
EOY	$645,161	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,690,821	BOYAmt
EOY	$2,139,999	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$435,699	BOYAmt
EOY	$422,687	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$117,792	BOYAmt
EOY	$111,155	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$2,878,217	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$2,109,889	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$697,666	BOYAmt
EOY	$768,328	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$296,261	BOYAmt
EOY	$479,156	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,730,914	BOYAmt
EOY	$4,566,486	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,805,292	BOYAmt
EOY	$3,576,713	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$725,186	BOYAmt
EOY	$754,014	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$332,986	BOYAmt
EOY	$360,840	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,863,464	BOYAmt
EOY	$4,691,567	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$2,132,550	BOYAmt
EOY	-$125,081	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$2,132,550	BOYAmt
EOY	-$125,081	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,730,914	BOYAmt
EOY	$4,566,486	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$2,007,469	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	Yes (1)	AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	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 D IRS990ScheduleD

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$77,002	OtherCostOrOtherBasisAmt
Depreciation	$30,791	DepreciationAmt
Book Value	$46,211	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,801,215	OtherCostOrOtherBasisAmt
Depreciation	$2,079,098	DepreciationAmt
Book Value	$722,117	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$768,328	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
DUE TO/FROM MEDICARE	$114,088
ACCOUNTS RECEIVABLE MISCELLANEOUS	$363,399
ACCOUNTS RECEIVABLE EL CAMPO EMS	$1,429
ACCOUNTS RECEIVABLE HHH COMMUNITY SERVICES	$240

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$479,156	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
REFUND CLEARING	$238,159
HEALTH PAYABLE	$122,681

Field	Value	IRS element (for citing)
Total Liability	$360,840	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$21,667,381	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$3,985,039	OtherRevenueAmt
Revenue Not Reported	-$3,985,039	RevenueNotReportedAmt
Revenue Subtotal	$25,652,420	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$25,652,420	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$19,659,912	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$19,659,912	ExpensesSubtotalAmt
Other Expenses Not Included	$3,985,039	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$3,985,039	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$23,644,951	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART X, LINE 2:	THE HOSPITAL IS NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL EVALUATES AND ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES (FORMERLY FASB INTERPRETATION 48 (FIN 48) ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THIS STANDARD REQUIRES CERTAIN DISCLOSURES ABOUT UNCERTAIN INCOME TAX POSITIONS. THE HOSPITAL EVALUATES ANY UNCERTAIN TAX POSITIONS USING THE PROVISIONS OF ASC 450, CONTINGENCIES. AS A RESULT, MANAGEMENT DOES NOT BELIEVE THAT ANY UNCERTAIN TAX POSITIONS CURRENTLY EXIST AND NO LOSS CONTINGENCY HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL HAS FILED ALL APPLICABLE TAX RETURNS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE -3,985,039.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBT EXPENSE 3,985,039.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent150	Yes (X)	Percent150Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent200 D	Yes (X)	Percent200DInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	0	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$858,450	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$197,957	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$660,493	NetCommunityBenefitExpnsAmt
Total Expense	0.03360	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,480,217	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,438,473	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,041,744	NetCommunityBenefitExpnsAmt
Total Expense	0.61250	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,338,667	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,636,430	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,702,237	NetCommunityBenefitExpnsAmt
Total Expense	0.64610	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,338,667	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,636,430	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,702,237	NetCommunityBenefitExpnsAmt
Total Expense	0.64610	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$2,235,805	BadDebtExpenseAmt
Bad Debt Expense Attributable	$1,068,908	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$12,825,505	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$6,083,888	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$6,741,617	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	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	EL CAMPO MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	303 SANDY CORNER RD	AddressLine1Txt
City	EL CAMPO	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	77437	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.ECMH.ORG	WebsiteAddressTxt
State License	000426	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Emergency Room Other	Yes (X)	EmergencyRoomOtherInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	EL CAMPO MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	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 (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.ECMH.ORG	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	13	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.ECMH.ORG	StrategyWebsiteURLTxt
Strategy Attached	Yes (1)	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	150.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	200.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit Report To Credit Agency	Yes (X)	PermitReportToCreditAgencyInd
Permit Legal Judicial Process	Yes (X)	PermitLegalJudicialProcessInd
Collection Activities	0	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
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
EL CAMPO MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR EL CAMPO MEMORIAL HOSPITAL INCLUDED INTERVIEWS/FOCUS GROUPS WITH REPRESENTATIVES OF THE FOLLOWING CONSTITUENCIES: BUSINESS LEADERS (CHAMBER OF COMMERCE, WHARTON COUNTY LIBRARY, NORTHSIDE EDUCATION CENTER) MEMBERS OF THE AFRICAN AMERICAN COMMUNITY MEMBERS OF THE HISPANIC COMMUNITY MEMBERS OF THE MENNONITE COMMUNITY SUPERINTENDENT OF THE SCHOOL DISTRICT AUXILIARY/VOLUNTEERS MAYOR OF EL CAMPO, CHIEF OF POLICE, EMS DIRECTOR MINISTERIAL ALLIANCE COMMUNITY RESOURCE COORDINATION GROUP
EL CAMPO MEMORIAL HOSPITAL	PART V, SECTION B, LINE 16I: EACH PATIENT APPLYING FOR CHARITY CARE WILL BE ASKED TO COMPLETE AN EL CAMPO MEMORIAL HOSPITAL APPLICATION FOR HEALTH CARE ASSISTANCE ("ASSISTANCE APPLICATION"). ASSISTANCE APPLICATIONS CAN BE REQUESTED FROM THE INDIGENT /CHARITY PROGRAM COORDINATOR AT EL CAMPO MEMORIAL HOSPITAL, 303 SANDY CORNER RD, EL CAMPO, TX 77437, (979) 543-6251 EXTENSION 262. ASSISTANCE APPLICATIONS CAN ALSO BE PICKED UP IN THE HOSPITAL BUSINESS OFFICE AND FROM A MID COAST MEDICAL CLINIC RECEPTIONIST. EL CAMPO MEMORIAL HOSPITAL STAFF MUST GIVE OR MAIL ASSISTANCE APPLICATIONS THE SAME DAY THEY ARE REQUESTED. A BRIEF EXPLANATION, IF POSSIBLE, SHOULD BE GIVEN TO THE APPLICANT EXPLAINING THE PROCESS AND THE APPLICANT'S RESPONSIBILITIES. ASSISTANCE IN COMPLETING THE ASSISTANCE APPLICATION WILL BE PROVIDED IF NEEDED. APPLICANTS SHALL BE INFORMED THAT THEY SHOULD CONTACT THE INDIGENT/CHARITY PROGRAM COORDINATOR AT EL CAMPO MEMORIAL HOSPITAL AT (979) 578-5194.
EL CAMPO MEMORIAL HOSPITAL	PART V, SECTION B, LINE 22D: PER THE ORGANIZATION'S CHARITY CARE POLICY: "EL CAMPO MEMORIAL HOSPITAL SHALL PROVIDE CHARITY CARE WITH NO OBLIGATION (100% DISCOUNT OF AGB) TO PAY FOR SERVICES RENDERED TO THOSE UNINSURED AND UNDERINSURED PATIENTS WHO HAVE A NET MONTHLY INCOME LESS THAN OR EQUAL TO 150% OF THE FEDERAL POVERTY GUIDELINES FOR THE HOUSEHOLD'S SIZE. THOSE UNINSURED AND UNDERINSURED PATIENTS WHO HAVE A NET MONTHLY INCOME BETWEEN 151% AND 200% OF THE FEDERAL POVERTY GUIDELINES FOR THE HOUSEHOLD'S SIZE SHALL RECEIVE 0% DISCOUNT OF AMOUNTS GENERALLY BILLED. IN ADDITION, PATIENTS WHO ARE OVER 200% AND ARE UNINSURED OR UNDERINSURED CAN APPLY FOR THE DISCOUNT CARD PROGRAM. THE CARD IS FREE AND THERE IS NO ASSET OR INCOME REQUIREMENTS TO MEET FOR PATIENTS TO BECOME ELIGIBLE. BECAUSE THE DISCOUNT CARD PROGRAM IS NOT A MEANS-TESTED PROGRAM, IT IS NOT CONSIDERED CHARITY CARE OR FINANCIAL ASSISTANCE."

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	1 - MID COAST MEDICAL CLINIC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	305 SANDY CORNER	AddressLine1Txt
City	EL CAMPO	CityNm
State Abbreviation	TX	StateAbbreviationCd
ZIP	77437	ZIPCd

Field	Value	IRS element (for citing)
Facility	RURAL HEALTH CLINIC	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	EL CAMPO MEMORIAL HOSPITAL SHALL REQUEST THAT THE APPLICANT VERIFY HIS OR HER GROSS ANNUAL HOUSEHOLD INCOME BY SUPPLYING THE FOLLOWING: TAX RETURN AND IRS FORM W-2, WAGE AND EARNINGS STATEMENT, PAY CHECK REMITTANCE, SOCIAL SECURITY, WORKERS COMPENSATION, UNEMPLOYMENT COMPENSATION OR GOVERNMENT PROGRAM DETERMINATION LETTERS, TELEPHONE VERIFICATION BY EMPLOYER OF THE APPLICANT'S ANNUAL GROSS INCOME, AND/OR BANK STATEMENTS. CURRENT ELIGIBILITY BEGINS ON THE FIRST CALENDAR DAY IN THE MONTH THAT AN IDENTIFIABLE APPLICATION IS FILED OR THE EARLIEST, SUBSEQUENT MONTH IN WHICH ALL ELIGIBILITY CRITERIA ARE MET. THE APPLICANT MAY BE RETROACTIVELY ELIGIBLE IN ANY OF THE THREE CALENDAR MONTHS BEFORE THE MONTH THE IDENTIFIABLE APPLICATION IS RECEIVED IF ALL ELIGIBILITY CRITERIA ARE MET.
PART III, LINE 4:	THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, CHARITY CARE IS EXCLUDED FROM NET PATIENT REVENUE.THE VALUE OF CHARITY CARE PROVIDED BY THE HOSPITAL BASED UPON ITS ESTABLISHED RATES, WAS $1,530,078 IN 2015 AND $1,293,492 IN 2014. ASU 2010-23 REQUIRES CHARITY CARE TO BE DISCLOSED ON A COST BASIS. THE HOSPITAL UTILIZES THE COST TO CHARGE RATIO, AS CALCULATED BASED ON ITS MOST RECENT COST REPORTS, TO DETERMINE THE TOTAL COST. THE HOSPITAL'S COST OF PROVIDING CHARITY CARE WAS ESTIMATED AT $858,450 AND $800,703 FOR THE PERIODS ENDING MARCH 31, 2016 AND 2015, RESPECTIVELY.THE EVALUATION OF NECESSITY FOR MEDICAL TREATMENT OF ANY PATIENT WILL BE BASED UPON CLINICAL JUDGMENT REGARDLESS OF THE FINANCIAL STATUS OF THE PATIENT. THE CLINICAL JUDGMENT OF THE PATIENT'S PERSONAL PHYSICIAN OR THE EMERGENCY DEPARTMENT PHYSICIAN WILL BE THE SOLE DETERMINING CRITERION FOR A PATIENT'S ADMISSION TO EL CAMPO MEMORIAL HOSPITAL IN ACCORDANCE WITH THE MEDICAL STAFF BYLAWS. IN CASES WHERE A MEDICAL EMERGENCY CONDITION EXISTS, EL CAMPO MEMORIAL HOSPITAL'S EVALUATION OF POSSIBLE PAYMENT ALTERNATIVES WILL OCCUR ONLY AFTER URGENT MEDICAL CARE EVALUATION AND TREATMENT HAVE BEEN RENDERED IN ACCORDANCE WITH FEDERAL [EMTALA], STATE OR LOCAL LAW.
PART III, LINE 8:	THE HOSPITAL USES A COST TO CHARGE RATIO CALCULATED THROUGH THE ANNUAL MEDICARE/MEDICAID COST REPORT TO REPORT THE AMOUNT REPRESENTED ON LINE 7.
PART III, LINE 9B:	THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS FROM THOSE WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	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
TISHA ZALMAN
CEO	$154,169	$0	$0	$0	$0	$0	$0	$0	$0	$0	$154,169	$0	$0	$0
DANA FOSTER
PHYSICIAN ASSISTANT	$154,587	$0	$0	$0	$0	$0	$0	$0	$0	$0	$154,587	$0	$0	$0
LAURA WILLIAMS
PHYSICIAN ASSISTANT	$151,995	$0	$0	$0	$0	$0	$0	$0	$0	$0	$151,995	$0	$0	$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11	THE HOSPITAL HAS A THIRD-PARTY ACCOUNTING FIRM PREPARE FORM 990. ONCE THE 990 IS COMPLETED IT IS PRESENTED TO THE BOARD OF DIRECTORS IN DRAFT FORM. ANY QUESTIONS OR CONCERNS ARE THEN ADDRESSED, AND THE FINAL FORM 990 IS PREPARED WITH THE NECESSARY ADJUSTMENTS AND FILED.
FORM 990, PART VI, SECTION B, LINE 12C	EACH DIRECTOR SHALL INDIVIDUALLY DISCLOSE TO EL CAMPO MEMORIAL HOSPITAL AND TO THE BOARD OF DIRECTORS AT THE TIME OF NOMINATION AND APPOINTMENT AND TO THE TEXAS STATE BOARD OF MEDICAL EXAMINERS AT THE TIMES OF INITIAL APPLICATION AND BENNIAL REPORT THE IDENTITY OF EACH FINANCIAL RELATIONSHIP KNOWN TO THE DIRECTOR, IF ANY, WHICH HE OR SHE HAS WITH ANY OTHER DIRECTOR OR ANY SUPPLIER OF THE ORGANIZATION, AND TO PROVIDE A CONCISE EXPLANATION OF THE NATURE OF EACH SUCH FINANCIAL RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 15A	THE PROCESS FOR DETERMINING COMPENSATION FOR EL CAMPO MEMORIAL HOSPITAL'S CEO INCLUDES AN ANNUAL REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS, COMPARABILITY DATA FOR SIMILAR HOSPITALS AND HOSPITAL ORGANIZATIONS IN NEARBY COMMUNITIES OR SIMILAR ECONOMIES OF SCALE, AND CONTEMPORANEOUS DOCUMENTATION OF THE DELIBERATION AND DISCUSSION BETWEEN THE HOSPITAL AND ITS ADMINISTRATOR.
FORM 990, PART VI, SECTION C, LINE 19	THE HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11G	OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,184,877. MANAGEMENT AND GENERAL EXPENSES 211,023. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,395,900.