2016-11-11T15:56:01-06:00 2015-12-31 990 2015-01-01 751752253 Texas Health Harris Methodist Hospital Stephenville % DAVID JACKSON TEXA 2549651500 411 Belknap Stephenville TX 76401 RICK MCWHORTER Asst Secretary 6822367900 2016-11-11 2015 2017-02-10 21:41:12Z Texas Health Stephenville Christopher Leu 411 Belknap Stephenville TX 76401 48174201 false X www.texashealth.org X 1982 TX A faith-based organization whose mission is to improve the health of the people in the communities it serves regardless of their ability to pay. 11 10 330 52 0 0 23281 45727720 47979905 -60570 -20925 177303 191940 45844453 48174201 16150 13750 0 0 18605432 19835030 0 0 0 19035679 20464142 37657261 40312922 8187192 7861279 63329540 70674370 5343196 4826747 57986344 65847623 A FAITH-BASED ORGANIZATION WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES IT SERVES REGARDLESS OF THEIR ABILITY TO PAY. false false 33077100 13750 47979905 Texas Health Harris Methodist Stephenville (THS) is a 98 bed acute care, full-service hospital providing health care for residents in Erath and surrounding counties since 1982. THS offers health care services such as inpatient and outpatient surgery, women's services, advanced diagnostic imaging, inpatient physical therapy and wound care. THS has been recognized as a Nurse-Friendly and Baby-Friendly Hospital and operates a Level IV Trauma Center. During the year, THS had 6,058 patient days, 1,945 discharges, 30,351 outpatient encounters, 17,292 emergency room visits and 378 births. THS 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. THS promotes Diabetes Self-Management, a program where the hospital's Center for Diabetes Education partners with physicians and other members of the community in an effort, through education and encouragement, to promote healthy lifestyles, good nutrition, the importance of exercise and the importance of early diabetes detection. THS provided car seat safety checks to Erath and surrounding counties as well as assisted with installing car seats safely and free of charge to those in need. 33077100 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false true false false false false false false true false false false true 38 0 true 330 true false false false false false false false false false false X 11 10 true false true false true true true true true false false true true true true true true false false false X X DAVID JACKSON 6822367900 612 E LAMAR BLVD Arlington TX 76011 X Brister MD Marilyn K Ex Officio 2.0 0.0 X 0 0 0 Brown Sonja Member 2.0 0.0 X 0 0 0 Green John T Member 2.0 0.0 X 0 0 0 Heflin Jr MD Jearald D Ex Officio 2.0 0.0 X 0 0 0 Hobbs DVM Karen R Vice Chairman 2.0 0.0 X 0 0 0 Hollingsworth Wendell Member 2.0 0.0 X 0 0 0 Huddleston Joe Member 2.0 0.0 X 0 0 0 Kerr MD Kevin A Ex Officio 2.0 0.0 X 0 0 0 Koch Kory Member 2.0 0.0 X 0 0 0 Wilson Kimberly Pack Chairman 2.0 0.0 X 0 0 0 Steed Steve A Immediate Past Chairman 2.0 0.0 X 0 0 0 Berenzweig MD Harold THR Corporate Officer 0.5 40.0 X 0 758494 124731 Boes Charles W Assistant Secretary 0.5 40.0 X 0 764506 59480 Gilman Kathleen A Assistant Secretary 0.5 40.0 X 0 211365 47980 King Kirk THR Corporate Officer 0.5 40.0 X 0 689597 229313 Kramer Kenneth Assistant Secretary 0.5 40.0 X 0 669825 109536 McWhorter Rick E Assistant Secretary 0.5 40.0 X 0 517956 161844 Stout Luanne R Corporate Secretary 0.5 40.0 X 0 260435 94686 LeuChristopher T PRESIDENT THS 40.0 0.0 X 343772 0 75098 McCarthyCynthia Lou CHIEF NURSING OFFICER THS 40.0 0.0 X 187072 0 34445 DerrickMarcia G PROF & SUPPORT SVCS OFFICER 40.0 0.0 X 176803 0 48081 MooreSammy DIR PHARMACY 40.0 0.0 X 163024 0 36080 CrossCarol M ENTITY FINAN OFFICER THS 40.0 0.0 X 149581 0 53575 MartinezIlda H DIR NRSG MED SURG/CRITICAL CAR 40.0 0.0 X 137107 0 22024 HudsonTammy G DIR LAB 40.0 0.0 X 120922 0 32024 BerdanBarclay E Former Officer 0.0 40.0 X 0 1690376 220980 CanoseJeffrey L Former Officer 0.0 40.0 X 0 1018371 363705 MitchellJohn D Former Officer 0.0 40.0 X 0 417466 90554 1278281 6998391 1804136 32 true true false Texas Health Resources 612 E Lamar Blvd ARLINGTON TX 76011 Management Fee 5988259 Balfour Beatty Construction LLC 3100 McKinnon 7th floor DALLAS TX 75201 Construction 6951832 Entech Sales Service Inc 3404 Garden Brook Dr DALLAS TX 75234 Construction 861028 Northstar Anesthesia 6225 North State Hwy 161 200 IRVING TX 75038 Anesthesia Services 613328 Moreley Moss Inc 430 S Aston Dr SUNNYVALLE TX 75182 Construction 518864 14 21129 2152 23281 PATIENT SERVICE REVENUE 621500 47912589 47912589 MEDICARE/MEDICAID ADJUSTMENT 621500 26947 26947 DSRP REVENUE 541900 34939 34939 EDUCATION REVENUE 611430 5430 5430 47979905 8258 8258 0 0 0 0 0 -29183 -29193 0 0 0 CAFETERIA REVENUE 624210 127531 127531 REBATES & INCENTIVES 561000 38911 38911 VENDING 721210 8264 8264 17234 17234 191940 48174201 47979905 171005 12750 12750 1000 1000 0 0 629795 629795 0 15295426 14963896 331530 705676 705676 2120504 2120504 1083629 1083629 5988259 5988259 1434 1434 0 0 0 0 3066111 3015113 50998 103799 103799 469123 409800 59323 296765 285715 11050 0 528039 528039 30649 28907 1742 0 49544 27456 22088 251265 251265 0 1538968 1499125 39843 67060 67060 SUPPLIES 6076712 6037670 39042 REPAIRS & MAINTENANCE 605306 605306 PATIENT SERVICES 597569 597569 FURNITURE & EQUIPMENT 629637 592409 37228 163902 140412 23490 40312922 33077100 7235822 0 -25266 -5779 0 0 0 0 4385990 4358328 0 0 0 0 0 394165 674284 705375 31689 28124 45696697 18079826 18451009 27616871 0 0 0 0 0 0 275365 275365 39536469 37301921 63329540 70674370 5122417 4602242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220779 224505 5343196 4826747 X 57986344 65847623 0 0 0 0 57986344 65847623 63329540 70674370 7861279 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false true false false false false false false Part II-B -Lobbying Activities 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. 0 1231335 1231335 0 19025614 10631261 8394353 207015 156252 50763 0 13591376 7292313 6299063 0 11641357 0 11641357 27616871 INTERCOMPANY RECEIVABLE 37301921 37301921 0 ASSET RETIREMENT OBLIGATIONS 224505 224505 true true X true X true X 900. true true true false true true 3836799 125023 3711777 0.09210 3881918 3590060 291858 0.00720 97650 98967 7816367 3814050 4003635 0.09930 54368 160 54208 0.00130 48286 48286 0.00120 1244 1244 103898 160 103738 0.00250 7920265 3814210 4107373 0.10180 2018 2018 0.00010 1284 1284 3302 3302 0.00010 false 3189274 11643501 13306338 -1662837 X true true 1 1 Texas Health Stephenville 411 Belknap Stephenville TX 76401 www.texashealth.org TDH #256 X X X Texas Health Stephenville 1 false false true X X X X X X X X X 13 true false false true X www.texashealth.org/chna X X true 15 true www.texashealth.org/chna false false true X 200. 900. X X X true true X X X true X See Section C X See Section C X See Section C X X X X X true X false X X X X X true X false false Texas Health Stephenville Part V. Section B, Line 5 Texas Health Stephenvilles (THS) 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, THS 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. Seven persons with interests specific to the health of the hospitals community completed a survey, and seven 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: Texas A&M AgriLife Extension and Cowboy Church of Erath County. 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 Stephenville (THS) 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 (ALN) and Chronic Disease. In addition, in 2015 THS 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 THS. 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 continues. Texas Health Stephenville has maintained and supported relationships with key partners, such as Texas A&M AgriLife and Tarleton State University. 1d. 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, THS educated 170 families. 1e. The Faith Community Nursing (FCN) program is offered by THS to link faith communities with health-related resources that focus on holistic care including body, mind, and spirit. Program emphasis is place on prevention and wellness through education, coaching, advocacy, and coordination of healthcare. 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. Texas Health Stephenville, in partnership with Texas A&M AgriLife, provides nutrition education for school-aged children and their parents through healthy cooking classes in the community. 2c. Texas Health Stephenville also provides diabetes education and support groups for community members through monthly educational group meetings, monthly Diabetes Basics and Gestational Diabetes Basics classes, and free community-based educational events. Texas Health Stephenville 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 current level of support. 3. Injury and Violence Lack of expertise and low priority assigned. This need is currently being addressed by multiple organizations in the community, and the facility will continue to address the need at its current level of support. 4. Maternal, Infant, & Child Health This need is currently being addressed by multiple outside organizations in the community. The facility will continue to address the need at its current level of support. 5. Mental Health Resource constraints and lack of effective intervention. The facility will continue to address the need at its current level of support. 6. Oral Health Lack of expertise. 7. Other Clinical/Preventive The facility will continue to address the need at its current level of support. 8. Preventive/Wellness This need is currently being addressed by multiple organizations in the community, and the facility will continue to address the need at its current level of support. 9. Social Determinants Resource constraints, low priority assigned, and lack of effective intervention. 10. Substance Abuse Resource constraints. The facility will continue to address the need at its current level of support. 11. Tobacco Low priority assigned. 12. Transportation Lack of expertise. Part V. Section B, Lines 16 a, b & c The FAP, FAP Application and the Plain Language Summary of the FAP were widely available at this website: www.texashealth.org/financial-assistance. Part V. Section B, Line 20e A Plain Language Summary (PLS) of the charity policy is provided on the back of all billing statements. Part V. Section B, Line 22d The hospital used the look-back method described in IRC Section 501(r) when determining the Amount Generally Billed (AGB) for all payors (excluding uninsured, traditional Medicaid, and managed Medicaid) based on the actual past claims paid during the previous twelve months. Because the hospital is a part of a system of hospitals, all members elected to offer a more generous AGB than was calculated in order to use a single AGB and to show systemness to the community. Texas Health Stephenville 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 $3,501,653. 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 X true true false true false false false false false false false Berenzweig MD Harold THR Corporate Officer 0 511183 0 164509 0 82802 0 84227 0 40504 0 883225 0 24136 Boes Charles W Assistant Secretary 0 493855 0 157708 0 112943 0 19875 0 39605 0 823986 0 25860 Gilman Kathleen A Assistant Secretary 0 197001 0 14139 0 225 0 12942 0 35038 0 259345 0 0 King Kirk THR Corporate Officer 0 461755 0 122904 0 104938 0 181515 0 47798 0 918910 0 25734 Kramer Kenneth Assistant Secretary 0 306934 0 288282 0 74609 0 59034 0 50502 0 779361 0 213851 McWhorter Rick E Assistant Secretary 0 361032 0 94454 0 62470 0 129475 0 32369 0 679800 0 11875 Stout Luanne R Corporate Secretary 0 190958 0 41692 0 27785 0 65856 0 28830 0 355121 0 0 LeuChristopher T PRESIDENT THS 231749 0 74724 0 37299 0 36729 0 38369 0 418870 0 9112 0 McCarthyCynthia Lou CHIEF NURSING OFFICER THS 153438 0 28112 0 5522 0 9448 0 24997 0 221517 0 1479 0 BerdanBarclay E Former Officer 0 1073202 0 417182 0 199992 0 181176 0 39804 0 1911356 0 49442 CanoseJeffrey L Former Officer 0 687287 0 220259 0 110825 0 322467 0 41238 0 1382076 0 29378 MitchellJohn D Former Officer 0 274141 0 79766 0 63559 0 44435 0 46119 0 508020 0 10605 DerrickMarcia G PROF & SUPPORT SVCS OFFICER 162662 0 13191 0 950 0 12619 0 35462 0 224884 0 0 0 MooreSammy DIR PHARMACY 154593 0 7119 0 1312 0 8079 0 28001 0 199104 0 0 0 CrossCarol M ENTITY FINAN OFFICER THS 136176 0 11154 0 2251 0 10768 0 42807 0 203156 0 0 0 MartinezIlda H DIR NRSG MED SURG/CRITICAL CAR 129102 0 6391 0 1614 0 5008 0 17016 0 159131 0 0 0 HudsonTammy G DIR LAB 114093 0 5205 0 1624 0 8896 0 23128 0 152946 0 0 0 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 Plans 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 E. $9,818.51 0 Lacee Brown family of Board Member 35545 Compensation -Employee false 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, Liner 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. 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 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 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 11801 South Freeway Burleson TX 76028 752547668 Phys Clinics TX NA C Corp false Magnum Health Holdings Inc 612 E Lamar Blvd Ste 600 Arlington TX 76011 475486814 Inactive TX NA C Corp false Magnum Health Plan Inc 612 E Lamar Blvd Ste 600 Arlington TX 76011 475548221 Inactive TX NA C Corp false Texas Health Biomedical Advancement Cent 612 E Lamar Blvd Arlington TX 76011 752636884 Research TX NA C Corp false Texas Health Resources Casualty Company 612 E Lamar Blvd Arlington TX 76011 030310676 Insurance VT NA C Corp false Texas Health Resources Bundled Products 612 E Lamar Blvd Arlington TX 76011 465588632 Inactive TX NA C Corp false TH Resources Primary Care Ext Physcian N 612 E Lamar Blvd Arlington TX 76011 465365421 Inactive TX NA C Corp false Texas Health Resources Spine Services 612 E Lamar Blvd Arlington TX 76011 465347751 Inactive TX NA C Corp false Texas Health Resources Women's Services 612 E Lamar Blvd Arlington TX 76011 465330487 Inactive TX NA C Corp false Charitable Remainder Trusts (4) 612 E Lamar Blvd Arlington TX 76011 CR Trust TX NA Trust false false false true false false false false false false false true true true false false true true true true Related Transactions- Part V, Line 2 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.