2016-11-15T12:50:26-06:00 2015-12-31 BKD LLP 14241 DALLAS PARKWAY STE 1100 DALLAS TX 75254 990 2015-01-01 452230827 Swisher Memorial Healthcare System % LUKE BREWER SWIS 8069953581 PO Box 808 Tulia TX 79088 RYAN BARNARD CEO 9727028262 2016-08-15 true Jeanette Verrelli P00742631 9727028262 2015 2017-02-10 21:41:12Z RYAN BARNARD 539 SE SECOND STREET TULIA TX 79088 10621724 false X WWW.SWISHERHOSPITAL.COM X 2011 TX TO PROVIDE QUALITY HEALTHCARE TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. 4 4 122 4 0 0 86190 1000 10990330 10489904 2111 3500 143053 127320 11221684 10621724 0 11536 0 0 5398603 4211343 0 0 0 4474618 5347452 9873221 9570331 1348463 1051393 6770021 6164371 4527675 2870632 2242346 3293739 X TO PROVIDE QUALITY HEALTHCARE TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. false true 7743824 11536 10553229 PROVIDED ACCESSIBLE AND QUALITY HEALTHCARE SERVICES TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. THE HOSPITAL HAD 22,802 Encounters 14,035 Clinic, 1,722 ER, 236 Inpatient, 6,740 Outpatient, 62 Swingbed, 7 Respit Care; 0 Surgeries; 818 Inpatient Days; 675 Swingbed Days 7743824 true false false true false false false false false false true false false true true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false true false true false true 20 0 true 122 true false false false false false false false false false false X 4 4 false false false false false false false true false false false false true true true true true true true false X LUKE BREWER 8069958268 539 SE SECOND STREET TULIA TX 79088 Jory Runnels President 1.0 0.0 X X 0 0 0 Ray De Los Santos Vice - President 1.0 0.0 X X 0 0 0 Charlotte O'Daniel Secretary 1.0 0.0 X X 0 0 0 Steven Rossi MD Director 1.0 0.0 X 0 0 0 Ryan Barnard CEO 40.0 0.0 X 265610 0 25764 Luke Brewer CFO Start: June 2015 40.0 0.0 X 64144 0 4361 Jerry Pickett CFO Term: May 2015 40.0 0.0 X 48725 0 2553 Cynthia Archer Physician's Assistant 40.0 0.0 X 241295 0 17629 Scott Dyer Physical Therapist 40.0 0.0 X 153667 0 16961 Kelly Maxwell CNO 40.0 0.0 X 128883 0 19175 902324 0 86443 4 false true false 0 1000 1000 Net Patient Service Revenue 621110 8737440 8737440 Incentive Revenue 900099 1348364 1348364 Pharmacy 446110 404100 404100 10489904 2900 2900 0 0 0 0 0 600 600 600 600 0 0 0 GUEST & EMPLOYEE MEALS 624100 61932 61932 Vending Machines 722515 2063 2063 MISCELLANEOUS REVENUE 900099 63325 63325 127320 10621724 10553229 67495 10786 10786 750 750 0 0 411157 315623 95534 0 2704595 2080295 624300 122541 91906 30635 688405 516304 172101 284645 229760 54885 0 4064 4064 21288 21288 0 0 0 743305 427154 316151 47692 7388 40304 312925 173900 139025 246501 242802 3699 0 1104478 1069400 35078 99523 13872 85651 0 15579 5794 9785 38111 28583 9528 0 492260 369195 123065 60401 45301 15100 BAD DEBT EXPENSE 1158644 1158644 MEDICAL SUPPLIES 886770 886770 EQUIPMENT RENTAL 38257 34352 3905 DUES & SUBSCRIPTIONS 20857 4188 16669 56797 31057 25740 9570331 7743824 1826507 0 681145 1174831 0 0 0 0 1385283 1229461 0 0 0 0 5000 5000 214972 232790 62395 99153 3053235 968876 2074275 2084359 0 0 0 0 0 0 0 0 2346951 1338777 6770021 6164371 1233656 651919 0 0 0 0 0 0 0 0 0 0 187201 116476 0 0 3106818 2102237 4527675 2870632 X 2242346 3293739 0 0 0 0 2242346 3293739 6770021 6164371 1051393 X false true X false false X false false false false false false false false true 809 809 false SCHEDULE C, PART II-B, LINE 1I OTHER ACTIVITIES: Dues Paid % Lobbying Lobbying THA $2,714 19.49% $529 TORCH $2,800 10.00% $280 ---------------------------------------------------- Total $5,514 $809 0 215078 17197 197881 2418099 653155 1764944 420058 298524 121534 2084359 Due From 3rd party Payer 1338777 1338777 0 DUE TO HOSPITAL DISTRICT 2102237 2102237 X 11774967 2312487 -1158644 1153843 10621124 600 600 10621724 10723574 2312487 -600 2311887 8411687 1158644 1158644 9570331 SCHEDULE D, PART X, LINE 2 LIABILITY FOR UNCERTAIN TAX POSITIONS: THE SYSTEM HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE SYSTEM IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. ADDITIONALLY, THE SYSTEM IS SUBJECT TO ADDITIONAL REPORTING AND COMPLIANCE UNDER INTERNAL REVENUE CODE SECTION 501(R). Schedule D, Part XI, Line 2D RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: Bad Debt Expense $(1,158,644) Schedule D, Part XI, Line 4B RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: Gain on Sale of Assets $600 Schedule D, Part XII, Line 2D RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: Gain on Sale of Assets $(600) Schedule D, Part XII, Line 4B Reconciliation of expense per audited financial statements with return: Bad Debt Expense $1,158,644 true true X true X true X true true true false true true 401763 401763 0.04780 645367 565166 80201 0.00950 269258 269258 0.03200 1316388 565166 751222 0.08930 113571 113571 0.01350 11536 11536 0.00140 125107 125107 0.01490 1441495 565166 876329 0.10420 true 1158644 4766000 4023058 742942 X true true 1 1 SWISHER MEMORIAL HEALTHCARE SYSTEM 539 SE SECOND STREET TULIA TX 79088 WWW.SWISHERHOSPITAL.COM 100122 X X X 1 SWISHER MEMORIAL HEALTHCARE SYSTEM 1 false false true X X X X X X X X 14 true false false true X See Part V, Section C X true 14 true See Part V, Section C false false true X 100 300. X X X true true X X X X true X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X true X false X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY: THE HOSPITAL COMPLETED INTERVIEWS AND FOCUS GROUPS WITH REPRESENTATIVES FROM VARIOUS AREAS OF THE COMMUNITY INCLUDING: BUSINESS LEADERS, HISPANIC COMMUNITY, ELECTED CITY OFFICIALS, HOSPITAL AUXILIARY EMPLOYEES, COMMUNITY VOLUNTEERS, THE CHAMBER OF COMMERCE, SCHOOL SUPERINTENDENTS AND SCHOOL NURSES, PUBLIC HEALTH NURSE FROM TEXAS DEPARTMENT OF STATE HEALTH SERVICES, AND BOARD MEMBERS OF THE DISTRICT. ADDITIONAL INTERVIEWS WITH THE HOSPITAL DIRECTORS, THE CEO AND THE CFO WERE CONDUCTED AS WELL. SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS IDENTIFIED IN CHNA: THE STRATEGY TO ADDRESS THE NEEDS IDENTIFIED IS INCLUDED IN THE CHNA WHICH IS POSTED ON THE HOSPITAL'S WEBSITE. THE HOSPITAL COMPLETED THE COMMUNITY HEALTH NEEDS ASSESSMENT IN OCTOBER 2014. IN THE MOST RECENT CHNA, THE HOSPITAL IDENTIFIED FOUR NEEDS OF THE COMMUNITY: - AVAILABILITY OF LOCAL SPECIALISTS - CHRONIC DISEASE MANAGEMENT - COMMUNITY EDUCATION ON CHRONIC DISEASE, NUTRITION, AND HEALTHY LIFESTYLES - MARKETING OF THE HOSPITAL ALL NEEDS IDENTIFIED IN THE CHNA ARE BEING ADDRESSED BY THE HOSPITAL. Swisher Memorial Healthcare System has partnered with Covenant Health Plainview to provide specialty services monthly in our clinic including a Cardiologist, Obstetrician, Orthopedist and Podiatrist. Swisher Memorial will soon have a Chiropractor coming weekly to aide in chronic disease management. The hospital is also expanding outpatient infusion services to offer a wide variety of needs the community would otherwise have to travel for. The hospital is in the process of searching for funding for a new Assisted Living facility that will be a 12-suite residence with a large common room and kitchen. We have drawings and blueprints for the new Assisted Living Center. We also have blueprints for an indoor therapy pool for physical therapy and for our wellness members to expand our existing Wellness Center. Since the CHNA in October 2014, Swisher Memorial Healthcare System has hosted two community wide health fairs and had great participation from the community. The Health Fairs each brought in over 30 booths and over 100 community members in attendance. We had a wide range of booths from a Dietician, to resources for a free medical advice line provided by the hospital, administered influenza vaccinations, provided a booth for safe medication disposal and much more. We have also had hospital staff speak at local churches, groups and civic organization meetings over expanded and new services available to the community. Swisher Memorial Healthcare System has expanded its marketing area by expanding to the use of social media with a Face Book page where information is posted and shared regarding services available, resources and happenings at SMHS. The Face Book page hosts a weekly spotlight on a medical provider and/or department director and keeps the community up to date on upcoming events. Swisher Hospital is utilizing the local newspaper for advertising and educating the community, as well as, in a local e-Newsletter. Schedule H, Part V, Section B, Lines 7a & 10a CHNA & IMPLEMENTATION STRATEGY MADE AVAILABLE: THE HOSPITAL'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY CAN BE FOUND AT THE FOLLOWING WEBSITE: HTTP://SWISHERHOSPITAL.COM/GETPAGE.PHP?NAME=COMMUNITY-HEALTH-NEEDS-ASSESSM ENT&SUB=ABOUT+US SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16C Availability of Financial Assistance Information: The Hospital's financial assistance policy, application and plain language summary can be found at the following site: http://www.swisherhospital.com/getpage.php?Name=Financial_Assistance&sub=F inancial+Assistance SCHEDULE H, PART V, SECTION B, LINE 22D METHOD TO DETERMINE MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE PATIENTS: In all situations, once the patient is determined to qualify for financial assistance that individual will not be charged more for emergency or other medically necessary care than the amounts generally billed (AGB) to individuals who have insurance covering such care. In determining AGB, SMHS has initially elected to use the Look-Back Method in which the AGB percentages are based on Medicare fee for service as the primary payer, including any associated portions of claims paid by Medicare beneficiaries in the form of co-insurance or deductibles. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE POLICY: THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. BAD DEBT EXPENSE SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE THIS IS UNCOMPENSATED HEALTHCARE PROVIDED TO RESIDENTS OF THE COMMUNITY. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT FOOTNOTE: Accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of accounts receivable, the System analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party coverage, the System analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients, which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill, the System records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts. The Systems allowance for uncollectible accounts for self-pay patients was approximately 93% of self-pay accounts receivable at December 31, 2015 and 97% at December 31, 2014. The Systems write-offs were approximately $890,000 for the year ended December 31, 2015, and the system did not write-off a significant amount for the year ended December 31, 2014. The increase in write-offs is a result of negative trends experienced in collections of amounts from self-pay patients in 2015 following the conversion to the new financial reporting system. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY: THE MEDICAL CENTER USES MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. SCHEDULE H, PART III, SECTION B, LINE 9B COLLECTION PRACTICES: Once a patient has qualified for our indigent program, no additional collection efforts are made on that account. There are different levels of charity that we award, most of the time 90%, and we do try to collect on the remaining 10%. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: SWISHER MEMORIAL HEALTHCARE SYSTEM UTILIZES HCAHPS SURVEYS TO MEASURE THE PATIENTS' PERSPECTIVES AND SATISFACTION REGARDING HOSPITAL CARE. IN ADDITION, THE SYSTEM IS ACTIVE IN ALL OF ITS COMMUNITY SERVICE ORGANIZATIONS. THE CEO ATTENDS THESE SERVICE CLUB MEETINGS TO INVITE PATIENTS, THEIR FAMILIES, AND LOCAL CITIZENS TO SHARE THEIR CONCERNS ABOUT THE COMMUNITY'S NEEDS WITH THE ORGANIZATION. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY CAN BE FOUND ON THE SYSTEM'S WEBSITE IN BOTH ENGLISH AND SPANISH AND DISCUSSED AT SERVICE ORGANIZATION MEETINGS IN OUR COMMUNITY. IT IS ALSO SHARED WITH VARIOUS GOVERNMENT AGENCIES SUCH AS HEALTH AND HUMAN SERVICES. FINALLY, ALL UNINSURED PATIENTS WHO ARE SEEN IN THE SYSTEM'S CLINIC OR EMERGENCY DEPARTMENT ARE REFERRED TO OUR PATIENT ADVOCATE WHO INVESTIGATES ALL POTENTIAL SOURCES OF ASSISTANCE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: SWISHER MEMORIAL HEALTHCARE SYSTEM SERVES ALL OF SWISHER COUNTY, TX AS WELL AS SOUTHERN RANDALL COUNTY, WESTERN BRISCOE COUNTY, AND EASTERN CASTRO COUNTY. SCHEDULE H, PART VI, LINE 5 Promotion of Community Health: OUR HOSPITAL CEO MEETS WITH LOCAL AND COUNTY GOVERNMENT OFTEN TO DISCUSS ANY ACTIONS THE SYSTEM AND/OR DISTRICT MAY BE ABLE TO PARTICIPATE IN, PERFORM, OFFER, OR ENCOURAGE WITHIN OUR COMMUNITY. ALSO, OUR QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT/DISASTER PREPAREDNESS DIRECTOR AND EMS DIRECTOR ARE ACTIVE WITH THE REGIONAL ADVISORY COUNCIL AND OTHER COMMUNITY-PREPAREDNESS ACTIVITIES. WE STAY ABREAST TO SITUATIONS WITHIN OUR SCHOOL DISTRICT WITH UPDATING PROVIDED BY THE REGISTERED SCHOOL NURSE, WHO IS ALSO AN ACTIVE DISTRICT AND FOUNDATION BOARD MEMBER. OUR CLINIC OFFERS AN INFLUENZA VACCINATION CLINIC YEARLY, FOR A FLAT FEE, WITH THE OPTION TO BILL MEDICARE FOR MEDICARE PATIENTS. FOR MOST OF 2015, OUR HOME HEALTH AGENCY OFFERED MONTHLY WELLNESS CHECKS PROVIDING BLOOD PRESSURE MONITORING, BLOOD SUGAR TESTING, AND INFLUENZA VACCINATIONS, WHEN APPROPRIATE, AT OUR LOCAL SENIOR CITIZENS CENTER. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: ALTHOUGH THERE IS NOT A CONTROL OF GOVERNANCE, SWISHER MEMORIAL HEALTHCARE SYSTEM AND SWISHER MEMORIAL HOSPITAL DISTRICT DO COOPERATE IN PROVIDING HEALTH CARE TO THE COMMUNITY. AS HIGHLIGHTED IN THE SCHEDULE H, PART VI - PROMOTION OF COMMUNITY HEALTH, BOTH ENTITIES PARTICIPATE IN VARIOUS PROGRAMS AND CLINICS TO FURTHER THE HEALTH OF SWISHER COUNTY. SWISHER MEMORIAL HOSPITAL DISTRICT OPERATES A TRAINED AND CERTIFIED AMBULATORY UNIT TO THE WHOLE POPULATION OF SWISHER COUNTY. SWISHER MEMORIAL HEALTHCARE SYSTEM OFFERS A LEVEL 4 EMERGENCY DEPARTMENT, CRITICAL ACCESS HOSPITAL WITH TWENTY BEDS, SWISHER MEMORIAL HOME HEALTH PROGRAM, AND TULIA RURAL HEALTH CLINIC THAT SERVICES THE MAJORITY OF SWISHER COUNTY. THE DISTRICT AND THE SYSTEM WORK TOGETHER COHESIVELY IN PROVIDING EXCELLENT CARE TO ALL PATIENTS THAT UTILIZE OUR SERVICES. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: TEXAS SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: BAD DEBT EXPENSE OF $1,158,644 WAS INCLUDED IN TOTAL EXPENSE ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSE IN COLUMN (F). Schedule H, Part I, Line 3C FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING OTHER CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: - MEDICAL INDIGENCY - INSURANCE STATUS - UNDERINSURANCE STATUS X X X false false false false false false false false false Ryan Barnard CEO 171621 0 70442 0 23547 0 5418 0 20346 0 291374 0 0 0 Cynthia Archer Physician's Assistant 240859 0 436 0 0 12267 0 5362 0 258924 0 0 0 Scott Dyer Physical Therapist 147673 0 2997 0 2997 0 7738 0 9223 0 170628 0 0 0 FORM 990, PART III, LINE 3 Program services ceased or significant changes: WE DISCONTINUED OUR HOME HEALTH OPERATIONS IN NOVEMBER 2015. FORM 990, PART VI, SECTION A, LINE 8B DOCUMENTATION OF COMMITTEES ACTING ON BEHALF OF THE GOVERNING BODY: ANY COMMITTEES (MEDICAL STAFF, QAPI, NURSING) THAT ARE PART OF THE SYSTEM'S OPERATION ARE REPORTED BY THE CNO/CEO AT QUARTERLY BOARD MEETINGS. THERE ARE NO COMMITTEES OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE ORGANIZATION'S CEO AND CFO REVIEW THE RETURN PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: BOARD MEMBERS ARE POLLED ANNUALLY TO DETERMINE IF/WHERE CONFLICTS MAY OCCUR. FORM 990, PART VI, SECTION B, LINEs 15a & 15B COMPENSATION REVIEW: ALL KEY POSITIONS ARE EVALUATED IN COMPARISON TO THE TORCH ANNUAL SURVEY OF HOSPITAL SALARIES AND OTHER SOURCES. Evaluations are conducted each year on compensation. Once they have been reviewed, we take it to the board for further review and approval. This is usually done in October and presented to the board at the October board meeting. All of the compensation approval is documented in the board meeting minutes. meeting. All of the compensation approval is in the board meeting minutes. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST AT THE ORGANIZATION'S OFFICE. SWISHER MEMORIAL HOSPITAL DISTRICT 539 SE SECOND STREET TULIA TX 79088 756002556 HEALTHCARE TX GOVT N/A NA false SWISHER MEMORIAL HOSPITAL FOUNDATION 539 SE SECOND STREET TULIA TX 79088 260290687 SUPPORT TX 501(C)(3) 11, Type I SMHD false false false false false false false false false false false true false false false false false false false false SWISHER MEMORIAL HOSPITAL DISTRICT K 1000000 FMV