2016-05-13T15:14:47-05:00 2015-06-30 990 2014-07-01 742519752 Scott & White Hospital Brenham SCOT 2542159256 2401 S 31st Street Temple TX 76508 Clayton Kolodziejczyk Chief Financial Officer 9792074042 2016-05-13 2014 2016-08-17 19:52:53Z Jason Jennings 700 Medical Parkway Brenham TX 77833 32613214 0 X www.baylorscottandwhite.com X 1989 TX Faith based acute care hospital providing exemplary patient care, medical education, medical research and community service to residents of the Central Texas region since 1989. 11 7 0 72 0 0 0 3207214 13617590 29318072 5236 -3824 38889 87848 13661715 32609310 2000 405335 0 0 6714626 14889193 0 0 0 6919330 16612176 13635956 31906704 25759 702606 20422314 21959107 11823835 10789306 8598479 11169801 X Baylor Scott & White Health exists to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. 0 0 23807290 405335 29318072 See Schedule OScott & White Hospital Brenham (SWHB) is a faith-based, nonprofit 60-bed acute care hospital providing exemplary patient care services to the residents of Washington County and the surrounding communities since 1989. SWHB is affiliated with Baylor Scott & White Health (BSWH), a faith based nationally acclaimed network of acute care hospitals and related health care entities providing quality patient care, medical education, medical research and other community services to the residents of North and Central Texas. BSWH is the largest not-for-profit health care system in Texas, and one of the largest in the United States. BSWH was formed from the 2013 combination of Baylor Health Care System and Scott & White Healthcare.SWHB has a Level III Trauma Center and provides access to quality medical services including areas of excellence such as cardiology, geriatrics, women's services and outpatient care. SWHB serves it patients through their primary care clinics, emergency department and physical medicine and rehabilitation.During the fiscal year, SWHB admitted 1,324 patients resulting in 4,606 patient days; delivered 379 babies, and received 16,277 emergency department visits. Additionally, SWHB provided community benefits (as reported to the Texas Department of State Health Services and in accordance with the State of Texas Statutory methodology) of $3,900,346 and provided community benefits (as reported on the Internal Revenue Service (IRS) Form 990, Schedule H) of $660,942 during the tax year. The Texas Annual Statement of Community Benefit Standard includes approximately $3,290,861 of unreimbursed cost of Medicare that is not included in the IRS Form 990, Schedule H. 23807290 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Laurie Hengst 2542159259 2401 S 31st Street Temple TX 76508 Tommy Ladewig Director, Chairman 1.00 1.00 X X 0 0 0 Gregg Appel Director, Treasurer 1.00 X X 0 0 0 Patricia M Currie Director, Secretary 1.00 48.00 X X 0 976115 32472 Robert G Wright PhD Director 1.00 X 0 0 0 Charles R Moser Director 1.00 X 0 0 0 Robert L Haydon MD Director 1.00 40.00 X 0 175161 33140 Shirley Herring Director 1.00 X 0 0 0 Atwood Kenjura Director 1.00 X 0 0 0 R Hal Moorman JD Director 1.00 X 0 0 0 William L Rayburn MD Director, Chief Medical Officer 1.00 41.00 X 0 602324 50199 Jason D Jennings Director, President and CEO 1.00 41.00 X X 0 320438 26267 Clayton Kolodziejczyk Chief Financial Officer 1.00 42.00 X 0 184116 20843 Michael R Schlabach MD Chief Medical Officer 1.00 40.00 X 0 252909 44829 Michael Pittman COO/CNO 40.00 X 178059 0 20469 Charlotte A Carr Nursing Director 40.00 X 122923 0 6290 Jane Wellman Financial Advisor 40.00 X 154350 0 18697 Jennifer L Mertz Education Manager 40.00 X 134536 0 9642 Susan S Roden Quality Mgmt Director 40.00 X 131210 0 12005 Jeanette Scheel Nursing Director 40.00 X 130534 0 9412 851612 2511063 284265 10 0 1 0 Shiftwise Inc 1800 SW 1st Ave Ste 510 Portland OR 97201 Staffing 970359 Nursefinders PO Box 910738 Dallas TX 753910738 Staffing 918486 Hunter Pharmacy Services Inc 3420 Executive Center Dr Ste 100 Austin TX 78731 Staffing 537969 Staff Care Inc PO Box 281923 Atlanta GA 303841923 Staffing 494387 Columbus Repiratory Care Services PO Box 307 Columbus TX 78934 Medical Services 423528 10 3207214 3207214 Patient Care 622110 29101618 29101618 Rent 900099 195228 195228 21226 21226 29318072 80 80 3904 -3904 -3904 -3904 Cafeteria/Vending 722514 78582 78582 Gift Shop/Retail 453220 9266 9266 87848 32609310 29318072 0 84024 X 405335 405335 209099 209099 10561247 9974282 586965 1927887 27538 1900349 2125402 1974701 150701 65558 60901 4657 5250 5250 7217 7217 10353999 5930539 4423460 80689 44331 36358 577454 488982 88472 380888 38544 342344 495462 495204 258 29407 20687 8720 14793 13789 1004 1102939 849322 253617 Medical Supplies 3042908 3042908 Non - Medical Supplies 436904 420083 16821 Dues and Memberships 30206 19468 10738 Recruiting 1067 1067 52993 676 52317 31906704 23807290 8099414 0 27587 2316453 573826 0 5243343 3805150 7992 4792 1152242 986287 97799 97799 10459575 3434165 7841329 7025410 386000 5478196 7337216 20422314 21959107 1824516 2718894 9999319 8070412 11823835 10789306 X 6402083 7091251 1642265 3524418 554131 554132 8598479 11169801 20422314 21959107 X 702606 1868716 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 7217 0 0 7217 0 Part II-B, Line 1: Statement Regarding Legislative Activity: Health care policy is critical to all Americans, and the Organization believes that health care providers must participate in forming health care policy by interacting with national, state and local representatives and their staff members to help them better understand the complexities and ramifications of key health care policies including, without limitation, those related to uninsured and indigent patient needs as well as the legislative and regulatory needs to assure the delivery of cost-efficient, quality health care. The Organization has established relationships with persons and industry associations that often communicate the Organization's positions on major health care issues. These contacts may include direct contact, telephone conversations and/or letters. Also, the Organization may attempt to educate the local community on certain legislative initiatives that may impact the Organization's ability to provide quality health care services to the community through direct mailings, media advertising or broadcast statements. The amount of resources (time and money) involved in these activities is insubstantial. The Organization has not intervened in any political campaign. 450998 450998 5121243 793963 4327280 4735996 2565237 2170759 151338 74965 76373 7025410 Interest in Net Assets of Related Foundations 7337216 7337216 Other Liabilities 4234344 Due to Related Organizations 3758103 Capital Lease 7965 Insurance Reserve 70000 8070412 X Part X, Line 2: The filing organization does not have separate individual audited financial statements; however, the organization is included in BSW Holdings' combined audited financial statements (System). The System follows the provisions of ASC 740 "Income Taxes". As of June 30, 2015 and 2014, the System had no material gross unrecognized tax benefits. 1 1 X 1 X 1 X 375.000000000000 1 1 0 1 1 270647 270647 0.00850 3581191 4102638 65029 2964 62065 0.00190 3916867 4105602 332712 0.01040 100036 100036 0.00310 228194 228194 0.00720 328230 328230 0.01030 4245097 4105602 660942 0.02070 3936 3936 0.00010 3936 3936 0.00010 1 10214927 8874211 12299609 -3425398 X 1 1 1 1 Scott & White Hospital Brenham 700 Medical Parkway Brenham TX 77833 www.sw.org 100098 X X X Scott & White Hospital Brenham 1 0 0 1 X X X X X X X X X 13 1 1 1 1 X www.sw.org/community-benefit/community-health-needs-assessment X 1 13 1 www.sw.org/community-benefit/community-health-needs-assessment 0 0 1 X 200.000000000000 375.000000000000 X X X X X X 1 1 X X X 1 X www.sw.org/resources/docs/patient-tools/financial-assistance-policy.pdf X X X X X 1 X 0 X X 1 X 0 0 Scott & White Hospital Brenham Part V, Section B, Line 5: Community discussion groups (CDGs), much like town hall meetings, were organized by the Center for Community Health Development staff with assistance from local contacts in many communities across the nine-county region. Staff members contacted local intermediaries to convene discussion groups with clinical and other service providers, community leaders, and general "consumers" in each of the counties. Throughout the nine-county region, over 1,000 individuals participated in 84 discussion group meetings. Those participating represented the diversity of the region's population; attendees were 33.2 percent male and 66.8 percent female, and 70.8 percent White/Caucasian, 13.9 percent Black/African American, and 13.6 percent Hispanic/Latino.These meetings served to gain perspective on the health status of the community and to provide context for analysis of the survey data. The discussion groups also allowed access to sectors of the population that are underrepresented in the household survey.CDGs were conducted in all nine counties of RHP 17 with individuals representing various sectors of the community: clinicians, social service providers, community leaders, and the general population. Extensive notes were taken by multiple observers at each meeting, and these notes were then compiled and used in the CHNA analysis. A list of the organizations involved in the survey development can be found at http://www.sw.org/community-benefit/community-health-needs-assessment Scott & White Hospital Brenham Part V, Section B, Line 6a: Conroe Regional HospitalHuntsville Memorial HospitalKingwood Medical CenterMemorial Herman The Woodlands HospitalSt. Luke's The Woodlands HospitalSt. Josephs Health SystemCollege Station Medical Center Scott & White Hospital Brenham Part V, Section B, Line 6b: Alzheimer's Association-Houston and Southeast Texas ChapterBrazos County Health DepartmentBrazos Valley Area on AgingBrazos Valley Affordable Housing CorporationBrazos Valley Community Action AgencyBrazos Valley Council of GovernmentsBrazos Valley Council on Alchol and Substance AbuseBrazos Valley Food BankBrazos Valley Health PartnershipBurleson County Health Resource CommissionCenter on Disability and Development at Texas A & M UniversityCity of BryanCity of College StationDepartment of State Health ServicesFamily PromiseGrimes County Health Resource CommissionHealth for AllHospice Brazos ValleyLeon County Health Resource CommissionMadison County Health Resource CommissionMontgomery County Hospital DistrictMontgomery County United WayMHMR Authority of Brazos ValleyThe Prenatal ClinicProject UnityTexas A & M Health Science Center School of Rural Public HealthTexas A & M UniversityTri-County ServicesTwin City MissionUnited Way of the Brazos ValleyWorkforce Solutions Brazos Valley Scott & White Hospital Brenham Part V, Section B, Line 11: The Hospital prioritized the health needs identified in the most recently conducted CHNA, and is addressing the significant needs through the adoption and execution of an implementation strategy.The Hospital recognizes the importance of all needs identified by the community. However, as stated in the implementation strategy, the Hospital will not directly address the following needs identified in the CHNA at this time:1. Transportation/ Access to Care2. Mental Health Services3. Risky Behavior of Young Adults4. Infrastructure to keep up with population growthThese priorities did not meet the defined evaluation criteria and it was determined internally that the hospital does not have the ability to directly affect change within these needs nor are there resources available to influence change. It was also determined there are other community organizations better aligned to address these priorities. Scott & White Hospital Brenham Part V, Section B, Line 13b: The organization also provides discounted care to those individuals whose amount of total charges, exceeds two times the annual household income (regardless of the level of income) if the patient is unable to pay the remaining bill. Scott & White Hospital Brenham Part V, Section B, Line 13h: The hospital has adopted a financial assistance policy written in accordance with Texas Health and Safety Code Chapter 311. In general, that statute defines charity care as providing, funding or otherwise financially supporting health care services to a person classified by the hospital as financially or medically indigent; or providing funding or otherwise financially supporting health care services provided to financially indigent persons through other nonprofit or public clinics, hospitals or hospital organizations. To determine if a patient meets the definition of financially or medically indigent in the statute, the number in the household is required. Additionally, although assets and other resources are not included in the calculation to determine whether a patient is financially or medically indigent, the organization's policy reserves the right to allow the patient's assets or other resources to be considered when determining if financial assistance will be granted. Scott & White Hospital Brenham Part V, Section B, Line 16i: Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the charity care policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's charity care program in the local newspapers: 3) information regarding financial assistance, including the organization's charity care policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization provides free financial counselors to help patients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's charity care program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital will automatically receive help from a financial counselor. These services are provided in writing and through interpretation services in the primary language of the patient requesting assistance. Though the most often needed alternate language is Spanish, the organization can accommodate multiple languages including American Sign Language. Scott & White Hospital Brenham Part V, Section B, Line 22d: The organization's financial assistance policy is developed to provide discounted care to those qualifying for financial assistance to where the amount charged under this policy will always be equal to or lower than the Medicare rates. However, for those qualifying as medically indigent and whose income level is over 375% of the federal poverty level shall not be billed more than 2 times their annual household income. Part V, Section B, Line 16 Financial Assistance Policy Website Availability Scott & White Hospital Brenham Part V, Section B, line 16a website: www.sw.org/resources/docs/patient-tools/financial-assistance-policy.pdf 1 Scott & White Outpatient Rehabilitation 2117 S Day Street Brenham TX 77833 Physical Therapy, Occupational Therapy, Speech Therapy Part I, Line 3c: The organization's financial assistance policy uses several factors in addition to FPG to determine eligibility for free or discounted care. These additional criteria are: net assets, insurance status, residency, and other financial resources.The organization also provides discounted care to those individuals whose amount of total charges, exceeds two times the annual household income (regardless of the level of income) if the patient is unable to pay the remaining bill. Part I, Line 6a: The organization prepares and files an Annual report of Community Benefit Plan with the Texas Department of State Health Services. This report is made available through the organization's website at www.sw.org/community-benefit/community-health-needs-assessment. Part I, Line 7: A ratio of patient care cost to charges, as determined in Worksheet 2, was used to report the amounts in Part I, Lines 7a - 7d. For amounts reported on lines 7e - 7k, actual expenses for each community benefit activity are tracked and reported using both community benefit software and/or the organization's cost accounting system. Part I, Ln 7 Col(f): The amount of bad debt expense included on Form 990, Part IX, line 25, but removed for Schedule H, Part I, Line 7, Column (f) totaled $0. Part III, Line 4: As stated in the combined audited financial statements, "The System maintains allowances for uncollectible accounts for estimated losses resulting from a payor's inability to make payments on accounts. The System assesses the reasonableness of the allowance account based on the historical write-offs, cash collections, the aging of the accounts and other economic factors. Accounts are written off when collection efforts have been exhausted. Management continually monitors and adjusts its allowance associated with its receivables." Bad debt does not include amounts for patients who are known to qualify under the organization's charity care policy. The amount of bad debt attributable to patient's accounts is net of contractual allowance, payments received and recoveries of bad debt previously written off. The organization has entered zero on Schedule H, Part III, Line 3; however, based on prior experience and certain demographics and other information obtained during admission, the organization believes a portion of the bad debt expenses (estimated to range from 1-5%) would be attributable to patients that would otherwise qualify for charity care. Despite all of the effort and ways the organization educates patients about qualifying for its charity care program as demonstrated in Part VI, question 3 below, many uninsured patients either refuse or fail to complete a charity care application or provide sufficient information at the time of admission, during their stay or after being discharged to qualify for assistance under the organization's charity care policy. Part III, Line 8: The amount reported on Part III, Section B, line 7 was calculated in accordance with the Schedule H instructions utilizing the organization's allowable cost reported in the Medicare cost report based on a cost to charge ratio. The organization believes that all of the shortfall should be considered as a community benefit for the following reasons:First, the IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. IRS Revenue Ruling 69-545 provides in part, that hospitals serving patients with governmental health benefits, including for example Medicare, is an indication that the hospital operates for the promotion of health in the community. Second, the organization provides care to Medicare patients regardless of this shortfall, i.e., loss, and thereby relieves the state and federal government of the burden of paying the full cost for the care of Medicare beneficiaries. Medicare does not provide sufficient reimbursement to cover the entire cost of providing care to these patients causing the organization to use other surplus funds to cover the shortfall. It is expected that reimbursement under the Medicare program will continue to decline and therefore may further limit access to care due to the anticipated reduction of participating Medicare providers in the community. As a result, the care for these patients will likely continue to increase, and rest on the shoulders of, nonprofit hospitals and/or county hospital districts. Third, many of the Medicare participants have low fixed incomes and therefore would qualify for charity care or other means tested government programs absent being enrolled in the Medicare program. Fourth, Texas nonprofit hospitals must provide a minimum level of community benefit in order to obtain exemption from state and local taxes. According to the current Texas Health and Safety Code, the unreimbursed cost of Medicare is considered to be a community benefit in determining these state statutory requirements as it helps relieve a governmental burden of providing this care that would otherwise be provided through the county hospital system in Texas. Part III, Line 9b: The organization's debt collection policy and procedures prohibit any collection efforts for the portion of the account balance that qualifies for financial assistance under the organization's charity care policy. For any remaining balances due, the same collection policy and procedures are applied equally to all patient types. Part VI, Line 2: During the calendar year ending December 31, 2013, the Organization conducted a Community Health Needs Assessment (CHNA) to assess the health care needs of the community for each of its licensed hospital facilities and developed an implementation strategy to address the needs identified in the CHNAs. The CHNAs were conducted in accordance with state and federal guidelines including Internal Revenue Code Section 501(r) and the Texas Health and Safety Code Section 311. These CHNAs and implementation strategies have been made widely available to the public and are located on the Organization's website at the following address:www.sw.org/community-benefit/community-health-needs-assessment Part VI, Line 3: The organization is committed to promoting health in the community including providing or finding financial assistance programs to assist patients. Patients who may qualify for financial assistance through the organization's charity care program or other federal, state and local government programs are informed and educated about their eligibility in several ways including, but not limited to, the following: 1) posting signs and notices regarding the charity care policy in the emergency departments, admitting areas and business offices located throughout the organization, 2) annual posting regarding the organization's charity care program in the local newspapers, 3) information regarding financial assistance, including the organization's charity care policy, is posted on the organization's website, 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance, and 5) the organization provides free financial counselors to help patients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's charity care program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital will automatically receive help from a financial counselor. These services are provided in writing and through interpretation services in the primary language of the patient requesting assistance. Though the most often needed alternate language is Spanish, the organization can accommodate multiple languages, including American Sign Language. Part VI, Line 4: Scott & White Hospital-Brenham identifies Washington County and the cities that lie within as its primary community served. This is where the majority of the hospital facilities are located, and from where most of its patients reside. The mean age of survey respondents from Washington County was 51.1 years. Washington County has a population age similar to other counties across the Brazos Valley. Compared to Texas and the U.S., Washington County has a smaller proportion of young adults and a larger proportion of adults 65 years and older.A majority of Washington County survey respondents identified themselves as White/Caucasian (86.4%), 6.3 percent indicated Black/African American, and 6 percent indicated Hispanic/Latino. Other respondents identified themselves as Asian or Pacific Islander, Native American, and as more than one race. Because of these relatively small numbers, these last three categories were combined into a single group called "All Other Races" for the purpose of analysis (total of 1.3%). Comparing these figures to 2013 Census estimates indicates that minority groups are underrepresented in this survey sample.The median household income for Washington County residents is $39,134 and the average household income is $56,878. Slightly less than 50% of the population has not received any education beyond high school. Discussion group participants described Washington County as a laid back, conservative community that is a great, safe place to live. The generosity of community members and the beautiful natural scenery were often mentioned as attractive community features. Participants said that local residents are friendly and share a sense of community based on local history and family values. Community discussion participants also emphasized that the community is growing, and with this growth, Washington County is becoming more diverse. This growth is bringing larger populations of younger and older residents, long-term families as well as new transplants, and increased proportions of racial/ethnic minorities to the community. Part VI, Line 5: The Organization has promoted health in the communities of Central Texas by providing exemplary health care and other community service. Under the oversight of its parent, BSW Holdings' independent volunteer community board, the Organization has promoted health and benefited the community by providing access to specialty centers designed to treat a range of medical conditions. BSW Holdings' governing body is comprised of volunteer community representatives that provide leadership and governance for the Baylor Scott & White Health System. The members of the BSW Holdings' governing body contribute their wisdom, insights, and expertise to ensure the Organization is fulfilling its mission and charitable purpose while providing efficient administrative support services and direction for the System. The Organization's board is made up of well-respected residents and/or business owners in the Organization's primary or secondary service area, and/or employees of the System, who understand the health care needs of the community served. The medical staff of the Organization is open to all qualifying physicians in the community who meet membership and clinical privileges requirements. As a nonprofit organization surplus funds are continuously invested back into the community and are utilized to maintain access to limited patient services or expand access points of care to patients. The organization has recently added an imaging center and cardiac stress testing lab. There have also and renovations to the emergency room, including the addition of an additional trauma room, lab, ICU, medical/surgical rooms, and women's services. Equipment improvements include digital surgical equipment, anesthesia machines, lab analyzer, and computers and upgraded monitoring systems in everyroom. The Organization provides a comprehensive Level III Trauma Center and access to quality medical services including areas of excellence such as cardiology, geriatrics, urology, podiatry, plastic surgery, women's services and outpatient care. The Organization has also added digital mammography and bone density screening services. The Organization serves it patients through their primary care clinics, emergency department and physical medicine and rehabilitation. The Organization offers a swing bed program which provided hospital based skilled care, and is the only labor and delivery unit within 45 - 60 minutes. The Organization also operates a community clinic benefiting low-income Washington county residents in addition to providing community education on wellness and diabetes.The Organization provides financial assistance in the form of charity care to patients who are indigent and satisfy certain requirements. Additionally, the Organization is committed to treating patients who are eligible for means tested government programs such as Medicaid and other government sponsored programs including Medicare, which is provided regardless of the reimbursement shortfall, and thereby relieves the state and federal government of the burden of paying the full cost of care for these patients. Often, patients are unaware of the federal, state and local programs open to them for financial assistance, or they are unable to access them due to the cumbersome enrollment process required to receive these benefits. The organization offers assistance in enrollment to these government programs or extends financial assistance in the form of charity care through the Organization's Financial Assistance Policy which can be located on the Organization's website at www.baylorscottandwhite.com/Tools/Pages/Financial-Assistance-Options.aspx. Part VI, Line 6: The organization is affiliated with BSWH (BSWH or the System), a faith based nationally acclaimed network of acute care hospitals and related health care entities providing quality patient care, medical education, medical research and other community services to the communities of North and Central Texas. BSWH is the largest not-for-profit health care system in Texas, and one of the largest in the United States. BSWH was formed from the 2013 combination of the Baylor Health Care and Scott & White Healthcare systems. Known for exceptional patient care for more than a century, the two organizations serve adjacent regions of Texas and operate on a foundation of complementary values and similar missions. BSWH includes 47 hospitals, more than 900 patient access points, more than 6,600 affiliated physicians, 43,500 employees, 23 retail pharmacies and the Scott & White Health Plan.The System exists to serve all people through exemplary health care, education, research and community service. Community benefits are provided through the provision of charity care, governmental sponsored programs (such as Medicaid and Medicare), medical research, medical education, community health improvement services, donations to other nonprofit health care providers, and many other community service activities. During the year, the affiliated nonprofit hospitals reported community benefits (as reported to the Texas Department of State Health Services, and in accordance with the State of Texas Statutory methodology) in excess of $742,150,000. The System's nonprofit hospitals provided community benefits (as reported on the IRS Form 990, Schedule H) in excess of $476,830,000 during the tax year. The Texas Annual Statement of Community Benefit Standard includes approximately $260,700,000 of unreimbursed cost of Medicare that is not included in the IRS Form 990, Schedule H. The System is comprised of separate legal entities including philanthropic foundations, a research institute, physician networks, acute care hospitals, short-stay hospitals, specialty hospitals, ambulatory surgery centers, pharmacies, a health plan and other health care providers all which fall under the common control of BSW Holdings. Under the guidance of an independent community board, the System follows one single mission, vision and values focusing on quality patient centered care while meeting the demands of health care reform, the changing needs of patients and extraordinary recent advances in clinical care.As part of the System, certain affiliates make grants and/or contributions to other related nonprofit affiliates to help financially support and/or fund worthy community benefits activities. The System has also established a patient transfer system among the affiliated hospitals allowing patients needing a particular level of care to be transferred as needed to a related hospital that can provide that service in an efficient and effective manner. As part of the System, all hospitals and other affiliated health care providers are required to adhere to high standards for medical quality, patient safety and patient satisfaction. These standards are set forth by BSW Holdings, the organization's parent, which helps ensures consistency across the System. Part VI, Line 7, Reports Filed With States TX 1 Faith Mission and Help Center 500 E Academy St Brenham TX 77833 742389934 501 (c)(3) 9435 General Support Scott & White Hospital-Brenham 2401 S 31st Street Temple TX 76508 742519752 501 (c)(3) 386000 General Support 2 Part I, Line 2: Monitoring Grants & Other Assistance: As part of its mission, the organization provides grants and other assistance to related organizations and/or unrelated not-for-profit organizations which are religious, charitable, scientific, or educational in nature, within the meaning of Internal Revenue Code Section 501(c)(3), when the use will further one or more tenets of the organization's charitable mission and one of the following criteria for use of these funds is met: (1) Fulfills a need identified by a community needs assessment conducted by the organization and/or outlined in an implementation strategy, (2) Serves an under-served community or group of people through medical mission work to improve their health status (3) promotes health in the community, (4) supports community buildings activities that protect or improves the community's health or safety and/or (5) provides positive visibility and good community relations with other organization serving the health needs of the community. For related organizations, all grants and other assistance are subject to the policies and procedures set forth by BSWH which ensures all funds are used in accordance with the guidelines set forth above and in accordance with the related organization's exempt purpose. Grants and other assistance provided to unrelated organizations are typically monitored by personal inspection. Examples include providing assistance to entities where the filing organization's employee serves as a Board Member for the recipient organization or through attendance at community events where the filing organization employees work as volunteers or to help coordinate these events. Grants and other assistance provided to unrelated organizations are given as a restricted gift and the receiving organization must sign a statement indicating they will use the funds for the stated purpose. X 1 1 X X X X 0 0 0 0 0 0 0 1 0 Patricia M Currie Director, Secretary 0 559048 0 391893 0 25174 0 15763 0 16709 0 1008587 0 0 Robert L Haydon MD Director 0 173889 0 7 0 1265 0 23235 0 9905 0 208301 0 0 William L Rayburn MD Director, Chief Medical Officer 0 526367 0 63244 0 12713 0 32659 0 17540 0 652523 0 0 Jason D Jennings Director, President and CEO 0 282958 0 33536 0 3944 0 13000 0 13267 0 346705 0 0 Clayton Kolodziejczyk Chief Financial Officer 0 168776 0 15166 0 174 0 9494 0 11349 0 204959 0 0 Michael R Schlabach MD Chief Medical Officer 0 249993 0 7 0 2909 0 33562 0 11267 0 297738 0 0 Michael Pittman COO/CNO 162887 0 14956 0 216 0 9218 0 11251 0 198528 0 0 0 Jane Wellman Financial Advisor 145355 0 8515 0 480 0 7947 0 10750 0 173047 0 0 0 Part I, Line 1a Tax indemnification and gross up payments - The organization provides tax indemnification where an authorized member of management determines there is justification to reimburse an individual for the tax impact on certain taxable, non-cash benefits provided to them. All tax indemnification payments provided are treated as taxable compensation. Six of the persons listed in the Form 990, Part VII, Section A, received this benefit during the tax year. Part I, Line 3 Process for determining compensation: The organization, a controlled affiliate of BSW Holdings, recognizes that those chosen to lead the organization are vital to its ongoing success and growth. Thus, it must attract, retain and engage the highest quality officers and key employees to lead the organization and help the organization maintain its national reputation for achieving high targets for medical quality, patient safety, and patient satisfaction. A significant portion of the organization's officers and key employees' total compensation is based on significant performance achievements. This strategy, known as the Annual Incentive Plan, places a greater emphasis on the importance of the organization achieving targeted improvements in the areas of people, quality, patient satisfaction and financial stewardship, annually. Total executive compensation is part of an integrated talent management strategy developed by the BSW Holdings' Board of Trustees and its Compensation and Governance Committee (C&G Committee) to attract, motivate, and retain the best leadership resources for the organization. Executive compensation is determined pursuant to guidelines outlined in the intermediate sanction rules under IRC Section 4958 including taking steps to meet the rebuttable presumption standard of reasonableness under Treasury Regulation 53.4958-6, as summarized below. When making compensation decisions, the organization compares itself to similar-sized, and structured businesses including other integrated health care service systems and other similar-sized organizations, both locally and nationally. The BSW Holdings' Board of Trustees and C&G Committee, on behalf of the organization, work directly with an independent compensation expert(s) to identify reasonable and competitive market rates as well as provide an annual review of the total compensation of the organization's top management officials and key employees. The C&G Committee is made up of members of the BSW Holdings' Board of Trustees, who are independent, community volunteers Guided by the information provided by the independent compensation expert(s), the C&G Committee approves and recommends to the BSW Holdings' Board of Trustees salary increases, earned incentives, and benefit offerings for the organization's President, other officers and/or key employees to be comparable to similar organizations for similar services and/or positions. Furthermore, the C&G Committee is charged with the responsibility of reviewing annually the major elements of the executive compensation program to assure designs remain consistent with the business needs, market practices, and compensation philosophy. As part of the decision making process, the C&G Committee will often meet in executive session to discuss and review recommendations made by the independent compensation expert(s). During the executive session no officer or key employee whose compensation is being reviewed is present during these discussions. All decisions are contemporaneously documented in the C&G Committee minutes which are timely reviewed and approved by the C&G Committee. Part I, Line 7 The organization has adopted and implemented BSW Holdings', the organization's ultimate parent, Annual Incentive Program to provide a market competitive total cash compensation incentive program that is designed to attract and retain key leaders and establish greater individual accountability and alignment to business performance. Payout targets are based upon a percentage of base pay and are developed by independent third party expert(s) using comparable market competitive data within the bounds of reasonableness and that are reviewed and approved by BSW Holdings' governing body. Payout levels are based upon a combination of system, entity, and individual performance using various metrics related to quality, patient satisfaction, employee retention, and financial stewardship. BSW Holdings' governing body may approve modifications to annual incentive awards provided under the program consistent with market comparability data. Robert L Haydon MD Director of Organization 37200 Building Lease 0 Form 990, Part V, Line 1a The Organization does not file Forms 1096 or 1099. All expenditures for goods and services are made by Scott & White Memorial Hospital (SWMH), which has filed all required reporting forms. Form 990, Part V, Line 2a Employees of certain BSWH affiliates located in Central Texas are employed by SWMH (EIN: 74-1166904) or Scott & White Clinic (SWC)(EIN: 74-2958277). This is done to achieve parity and consistency in compensation and benefits offered to employees and to reduce administration costs. Consistent with this practice, employee Forms W-2 are filed by SWMH or SWC. For financial reporting purposes, compensation, benefits and other employee costs are assigned to the BSWH entity for which services are rendered. Oversight of and responsibility for the activities of employees are vested in the board of directors and management of the BSWH entity to which such employees are assigned. All required employment forms have been filed by SWMH and SWC. Form 990, Part VI, Section A, line 6 Members or stockholders: The organization is a Texas nonprofit membership organization in which Scott & White Healthcare, a tax exempt, Texas nonprofit corporation, is the sole member. Form 990, Part VI, Section A, line 7a Election of members of governing body by members, stockholders, or other persons: Baylor Scott & White Holdings (BSW Holdings), a tax exempt, Texas nonprofit corporation is the ultimate parent entity of the organization. BSW Holdings has control and substantial reserved powers over the organization, including those to elect and remove the governing body of the organization. The BSW Holdings' Board of Trustees is comprised of a majority of independent community representatives that provide leadership and governance to BSW Holdings and its affiliated tax exempt entities, including the filing organization, to ensure it is meeting its charitable purpose. Form 990, Part VI, Section A, line 7b Governing body decisions subject to approval: All rights and powers were reserved to the organization's ultimate parent, BSW Holdings, except only those rights and powers expressly set forth in the bylaws, required by state or federal law, or to meet the requirements and standards promulgated by joint commission. For example, BSW Holdings' substantial reserved rights and powers include, without limitation, approval of the organization's articles of incorporation and bylaws and amendments thereto, appointment and removal of members of the organization's governing body, approval of dissolutions and mergers, and other similar decisions over the organization. The BSW Holdings' Board of Trustees is comprised of a majority of independent community representatives that provide leadership and governance to BSW Holdings and its affiliated tax exempt entities, including the filing organization, to ensure it is meeting its charitable purpose. Form 990, Part VI, Section B, line 11 Process used to review the Form 990: The Form 990 is prepared and reviewed by the BSWH tax department. During the return preparation process the tax department works with other functional areas including finance, accounting, treasury, legal, human resources, and corporate compliance for advice, information and assistance to prepare a complete and accurate return. Upon completion, the Form 990 is reviewed by the organization's President, financial officer and/or other key officers. A complete final copy of the return is provided to the organization's governing body prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Process used to monitor and enforce compliance with the organization's conflict of interest policy: Persons with an actual or perceived ability to influence the organization have the duty to disclose annually and otherwise promptly as potential conflicts are identified, any familial, professional or financial relationships with entities or individuals that do, or seek to do business with the organization or that compete with the organization. These individuals include the organization's officers, governing body, management, physicians with administrative services agreements and other key personnel who interact with outside organizations or businesses on behalf of the organization. The BSW Holdings' Board of Trustees Audit and Compliance Committee and the BSW Holdings' Corporate Compliance Committee review all relevant disclosures submitted by these individuals to determine whether a conflict of interest exists and to determine an appropriate resolution, if necessary any individual with a perceived or potential conflict is prohibited from voting or participating in the decision making process regarding such transaction with that individual. Form 990, Part VI, Section B, line 15 Process for determining compensation: The organization, a controlled affiliate of BSW Holdings, recognizes that those chosen to lead the organization are vital to its ongoing success and growth. Thus, it must attract, retain and engage the highest quality officers and key employees to lead the organization and help the organization maintain its national reputation for achieving high targets for medical quality, patient safety, and patient satisfaction. A significant portion of the organization's officers and key employees' total compensation is based on significant performance achievements. This strategy places a greater emphasis on the importance of the organization achieving targeted improvements in the areas of people, quality, patient satisfaction and financial stewardship, annually. Total executive compensation is part of an integrated talent management strategy developed by the BSW Holdings' Board of Trustees and its Compensation and Governance Committee (C&G Committee) to attract, motivate, and retain the best leadership resources for the organization. Executive compensation is determined pursuant to guidelines outlined in the intermediate sanction rules under IRC Section 4958 including taking steps to meet the rebuttable presumption standard of reasonableness under Treasury Regulation 53.4958-6, as summarized below. When making compensation decisions, the organization compares itself to similar-sized, and structured businesses including other integrated health care service systems and other similar-sized organizations, both locally and nationally. The BSW Holdings' Board of Trustees and C&G Committee, on behalf of the organization, works directly with an independent compensation expert(s) to identify reasonable and competitive market rates as well as provide an annual review of the total compensation of the system's top management officials and key employees. For the organization's officers or key employees that don't meet the threshold for annual review by the C&G Committee of the new combined BSWH System have been through a similar process by the one of the legacy parent board's (BHCS or SWHC) compensation committees in a prior year. The C&G Committee is made up of members of the BSW Holdings' Board of Trustees, who are independent, community volunteers guided by the information provided by the independent compensation expert(s), the C&G Committee approves and recommends to the BSW Holdings' Board of Trustees salary increases, earned incentives, and/or benefit offerings for the organization's President, other officers and/or key employees to be comparable to similar organizations for similar services and/or positions. Furthermore, the C&G Committee is charged with the responsibility of reviewing annually the major elements of the executive compensation program to assure designs remain consistent with the business needs, market practices, and compensation philosophy. As part of the decision making process, the C&G Committee will often meet in executive session to discuss and review recommendations made by the independent compensation expert(s). During the executive session no officer or key employee whose compensation is being reviewed is present during these discussions. All decisions are contemporaneously documented in the C&G Committee minutes which are timely reviewed and approved by the C&G Committee. Form 990, Part VI, Section C, line 19 Process for making governing documents, conflict of interest policy, & financial statements available to the public: The organization's articles of incorporation and amendments thereto are made available to the public by the filing of those documents with the Texas Secretary of State. Also, the organization is included within the combined financial statements of BSW Holdings that are made available to the public by the posting of those documents through DAC Bond and are attached to this return. The organization's other governing documents and conflicts of interest policy are not made available to the public. Form 990, Part VI, Line 14 The BSW Holdings' Board of Trustees approved a System wide Business Record Retention and Destruction Policy. While BSW Holdings' Board of Trustees does have certain rights and powers over the organization, it is not the official governing body of the organization. The organization does follow the Baylor Scott & White Business Record Retention and Destruction Policy, and we expect the governing body of the organization to formally adopt the policy within the next fiscal year. Form 990, Part IX, line 11g Other Purchased Services : Program service expenses 25,206. Management and general expenses 6,218. Fundraising expenses 0. Total expenses 31,424. Contract Labor : Program service expenses 5,289,548. Management and general expenses 34,966. Fundraising expenses 0. Total expenses 5,324,514. Laboratory : Program service expenses 239,145. Management and general expenses 0. Fundraising expenses 0. Total expenses 239,145. Repairs & Maintenance : Program service expenses 207,487. Management and general expenses 742. Fundraising expenses 0. Total expenses 208,229. Patient Care : Program service expenses 169,153. Management and general expenses 0. Fundraising expenses 0. Total expenses 169,153. Corporate Overhead : Program service expenses 0. Management and general expenses 4,381,534. Fundraising expenses 0. Total expenses 4,381,534. Form 990, Part XI, line 9: Self-Insurance Liability Reserve -376,304. Change in Net Assets of Related Foundation 1,859,020. Transfers Between Entities Under Common Control 386,000. Supplemental Information: IRC Section 6038 Statement: Disclosure Statement Related to Forms 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations, Filed on Behalf of the Taxpayer: In accordance with IRC Section 6038 and the constructive ownership rules of IRC Sections 958(a) and (b), the taxpayer is required to file Forms 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations, with respect to certain controlled foreign corporations (CFCs) including Baylor Scott & White Assurance SPC. These filing requirements are or will be satisfied through the filing of Forms 5471 for this CFCs by the U.S. taxpayer identified below who has the same filing requirement. Taxpayer Name: Baylor University Medical Center Taxpayer Address: 2001 Bryan Street Suite 2200 Dallas, TX 75201 Taxpayer Identification Number of U.S. tax return with which the Forms 5471 were or will be filed: 75-1837454 IRS Service Center where U.S. tax return was or will be filed: Ogden All Saints Health Foundation 2001 Bryan Street Suite 2200 Dallas TX 75201 751947007 Fundraising TX 501(c)(3) Line 7 Baylor All Saints Medical Center 1 Baylor All Saints Medical Center 2001 Bryan Street Suite 2200 Dallas TX 75201 751008430 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Health Care System 2001 Bryan Street Suite 2200 Dallas TX 75201 751812652 Management Services TX 501(c)(3) Line 11b, II Baylor Scott & White Holdings 1 Baylor Health Care System Employee Benefit Trust 2001 Bryan Street Suite 2200 Dallas TX 75201 751848557 VEBA TX 501(c)(9) Baylor Health Care System 1 Baylor Health Care System Foundation 2001 Bryan Street Suite 2200 Dallas TX 75201 751606705 Fundraising TX 501(c)(3) Line 7 Baylor Health Care System 1 Baylor Health Services 2001 Bryan Street Suite 2200 Dallas TX 75201 751917311 Inactive TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Institute for Rehabilitation at Gaston Episcopal Hospital 2001 Bryan Street Suite 2200 Dallas TX 75201 751037226 Rehabilitation Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Medical Center at Carrollton 2001 Bryan Street Suite 2200 Dallas TX 75201 454510252 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Medical Center at Irving 2001 Bryan Street Suite 2200 Dallas TX 75201 752586857 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Medical Center at Waxahachie 2001 Bryan Street Suite 2200 Dallas TX 75201 751844139 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Medical Centers at Garland and McKinney 2001 Bryan Street Suite 2200 Dallas TX 75201 751037591 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Regional Medical Center at Grapevine 2001 Bryan Street Suite 2200 Dallas TX 75201 751777119 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Regional Medical Center at Plano 2001 Bryan Street Suite 2200 Dallas TX 75201 820551704 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Research Institute 2001 Bryan Street Suite 2200 Dallas TX 75201 751921898 Research TX 501(c)(3) Line 4 Baylor Health Care System 1 Baylor Scott & White Health 2001 Bryan Street Suite 2200 Dallas TX 75201 463131350 Management Services TX 501(c)(3) Line 11b, II Baylor Scott & White Holdings 1 Baylor Scott & White Holdings 2001 Bryan Street Suite 2200 Dallas TX 75201 463130985 Parent TX 501(c)(3) Line 11b, II N/A 0 Baylor Specialty Health Centers 2001 Bryan Street Suite 2200 Dallas TX 75201 751765385 Long Term Acute Care Hospitals TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor University Medical Center 2001 Bryan Street Suite 2200 Dallas TX 75201 751837454 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Brenham Care Center 2401 S 31st Street Temple TX 76508 742663229 Inactive TX 501(c)(3) Line 9 Scott & White Hospital-Brenham 1 HealthTexas Provider Network 2001 Bryan Street Suite 2200 Dallas TX 75201 752536818 Physician Services TX 501(c)(3) Line 3 Baylor Health Care System 1 Hillcrest Baptist Medical Center 100 Hillcrest Medical Blvd Waco TX 76712 741161944 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Memorial Hospital 1 Hillcrest Family Health Center 100 Hillcrest Medical Blvd Waco TX 76712 742730350 Physician Services TX 501(c)(3) Line 11a, I Hillcrest Baptist Medical Center 1 Hillcrest Physician Services 100 Hillcrest Medical Blvd Waco TX 76712 742967081 Physician Services TX 501(c)(3) Line 11a, I Hillcrest Baptist Medical Center 1 Irving Healthcare Foundation 2001 Bryan Street Suite 2200 Dallas TX 75201 751570933 Fundraising TX 501(c)(3) Line 3 Baylor Medical Center at Irving 1 Scott & White Clinic 2401 S 31st Street Temple TX 76508 742958277 Physician Services TX 501(c)(3) Line 9 Scott & White Healthcare 1 Scott & White Continuing Care Hospital 2401 S 31st Street Temple TX 76508 202850920 Long Term Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White EMS Inc 2401 S 31st Street Temple TX 76508 753242749 Emergency Transport TX 501(c)(3) Line 9 Scott & White Memorial Hospital 1 Scott & White Foundation-Brenham 2401 S 31st Street Temple TX 76508 742460815 Fundraising TX 501(c)(3) Line 7 Scott & White Hospital-Brenham 1 Scott & White Health Plan 2401 S 31st Street Temple TX 76508 742052197 HMO/Insurance TX 501(c)(4) Baylor Scott & White Holdings 1 Scott & White Healthcare 2401 S 31st Street Temple TX 76508 264532547 Management Services TX 501(c)(3) Line 11a, I Baylor Scott & White Holdings 1 Scott & White Healthcare Foundation 2401 S 31st Street Temple TX 76508 273513154 Fundraising TX 501(c)(3) Line 7 Scott & White Healthcare 1 Scott & White Hospital-College Station 2401 S 31st Street Temple TX 76508 274434451 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-Llano 2401 S 31st Street Temple TX 76508 273026151 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-Marble Falls 2401 S 31st Street Temple TX 76508 464007700 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-Round Rock 2401 S 31st Street Temple TX 76508 203749695 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-Taylor 2401 S 31st Street Temple TX 76508 741595711 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Medical Plan Trust 2401 S 31st Street Temple TX 76508 742866102 VEBA TX 501(c)(9) Scott & White Healthcare 1 Scott & White Memorial Hospital 2401 S 31st Street Temple TX 76508 741166904 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Memorial Hospital Employee Welfare Benefit Trust 2401 S 31st Street Temple TX 76508 742939712 VEBA TX 501(c)(9) Scott & White Healthcare 1 Southern Sector Health Initiative 2001 Bryan Street Suite 2200 Dallas TX 75201 263087442 Diabetes Health & Wellness Center TX 501(c)(3) Line 11a, I Baylor University Medical Center 1 Arlington Ortho & Spine Hospital LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 261578178 Short Stay Hospital TX N/A Arlington Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752748040 Ambulatory Surgery Center TX N/A Baylor Affiliated Services LLC 2001 Bryan Street Suite 2200 Dallas TX 75201 260614730 Benefit Plans TX N/A Baylor Heart and Vascular Center LLP 2001 Bryan Street Suite 2200 Dallas TX 75201 752834135 Specialty Hospital TX N/A Baylor Scott & White Health LLC 4005 Crutcher Suite 310 Dallas TX 75246 463748258 Parent TX N/A Baylor Surgicare at Ennis LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 274202856 Ambulatory Surgery Center TX N/A Baylor Surgicare at Granbury LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 263896477 Ambulatory Surgery Center TX N/A Baylor Surgicare at Mansfield LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 271835675 Ambulatory Surgery Center TX N/A Baylor Surgicare at Plano Parkway LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 274282604 Ambulatory Surgery Center TX N/A Baylor Surgicare at Plano LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 260308454 Ambulatory Surgery Center TX N/A Bellaire Outpatient Surgery Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 562297308 Ambulatory Surgery Center TX N/A BIR JV LLP 4714 Gettysburg Rd Mechanicsburg PA 17055 274586141 Rehabilitation Hospitals TX N/A BTDI JV LLP 5214 Maryland Way Suite 200 Brentwood TN 37207 462908086 Imaging Centers TX N/A Dallas Surgical Partners LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 722183815 Ambulatory Surgery Center TX N/A Denton Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752708579 Ambulatory Surgery Center TX N/A Desoto Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752592508 Ambulatory Surgery Center TX N/A EBD JV LLP 10077 Grogans Mill Rd Suite 100 The Woodlands TX 77380 455434614 Free Standing Emergency Hospitals TX N/A ESWCT LLC 10077 Grogans Mill Rd Ste 100 The Woodlands TX 77380 900899017 Free Standing Emergency Hospitals TX N/A Frisco Medical Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 752865177 Short Stay Hospital TX N/A Ft Worth Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752658178 Short Stay Hospital TX N/A Garland Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752764855 Ambulatory Surgery Center TX N/A GlobalRehab LP 4714 Gettysburg Rd Mechanicsburg PA 17055 288077072 Rehabilitation Hospitals TX N/A GlobalRehab-Fort Worth LP 4714 Gettysburg Rd Mechanicsburg PA 17055 205558682 Rehabilitation Hospitals TX N/A Grapevine Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752854711 Ambulatory Surgery Center TX N/A HealthTexas Provider Network-Gastro Serv LLP 2001 Bryan St Ste 2200 Dallas TX 75201 731697736 Physician Services TX N/A Heritage Park Surgical Hospital LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 611762781 Short Stay Hospital TX N/A Irving Coppell Surgical Hospital LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 542086863 Short Stay Hospital TX N/A Lewisville Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752862263 Ambulatory Surgery Center TX N/A Lone Star Endoscopy Center LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 273635726 Ambulatory Surgery Center TX N/A MEDCO Construction LLC 2001 Bryan Street Suite 2200 Dallas TX 75201 205965871 Construction TX N/A Metrocrest Surgery Center LP 15305 Dallas Parkway Suite 1600 Addison TX 75001 030380493 Ambulatory Surgery Center TX N/A Metroplex Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752567179 Ambulatory Surgery Center TX N/A MSH Partners LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 752829613 Short Stay Hospital TX N/A North Central Surgical Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 201508140 Short Stay Hospital TX N/A North Garland Surgery Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 562399993 Ambulatory Surgery Center TX N/A Park Cities Surgery Center LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 562357079 Ambulatory Surgery Center TX N/A Physicians Surgical Center of Ft Worth LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 208303422 Ambulatory Surgery Center TX N/A Rockwall Ambulatory Surgery Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 205506447 Ambulatory Surgery Center TX N/A RockwallHeath Surgery Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 200334166 Ambulatory Surgery Center TX N/A SeniorCare Associates LP 4714 Gettysburg Rd Mechanicsburg PA 17055 201937212 Rehabilitation Hospitals TX N/A Specialty Surgery Center of Fort Worth LP 15305 Dallas Parkway Suite 1600 Addison TX 75001 201942281 Ambulatory Surgery Center TX N/A Surgery Center of Richardson Phys Pship LP 15305 Dallas Parkway Suite 1600 Addison TX 75001 200606781 Ambulatory Surgery Center TX N/A Texas Endoscopy Center LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 470985876 Ambulatory Surgery Center TX N/A Texas Health Venture Group LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 752696845 Holds interests in ASCs/ Short Stay Hospitals TX N/A Texas Heart Hospital of the Southwest LLP 2001 Bryan Street Suite 2200 Dallas TX 75201 412101361 Specialty Hospital TX N/A THVG Bariatric LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 383894636 Holds interests in Ambulatory Surgery Centers TX N/A Trophy Club Medical Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 481260190 Short Stay Hospital TX N/A Tuscan Surgery Center at Las Colinas LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 273578014 Ambulatory Surgery Center TX N/A University Surgical Partners of Dallas LLP 15305 Dallas Pkwy Suite 1600 Addison TX 75001 550823809 Ambulatory Surgery Center TX N/A Valley View Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752900902 Ambulatory Surgery Center TX N/A Baylor All Saints Med Cntr at Ft Worth Condo Owners Association Inc 2001 Bryan Street Suite 2200 Dallas TX 75201 261661900 Condo Association TX N/A C 1 Baylor Health Enterprises LP 2001 Bryan Street Suite 2200 Dallas TX 75201 751997378 Fitness Center/Pharmacy/ Hotel TX N/A C 1 Baylor Health Network Inc 2001 Bryan Street Suite 2200 Dallas TX 75201 752463251 Billing/Collection TX N/A C 1 Baylor Med Ctr at Grapevine Condo Owners Association Inc 2001 Bryan Street Suite 2200 Dallas TX 75201 752747555 Condo Association TX N/A C 1 Baylor Quality Health Care Alliance LLC 2001 Bryan Street Suite 2200 Dallas TX 75201 454015863 ACO TX N/A C 1 BMP Incorporated 2001 Bryan Street Suite 2200 Dallas TX 75201 751436779 Post Office TX N/A C 1 BUMCRoberts Condominium Owners Association Inc 2001 Bryan Street Suite 2200 Dallas TX 75201 752897806 Condo Association TX N/A C 1 Charitable Remainder Trust (66) Investment TX N/A T 1 Charitable Lead Trust (2) Investment TX N/A T 1 Hillcrest Holdings Inc 3000 Herring St Waco TX 76708 742793367 Management Services TX N/A C 1 Insurance Company of Scott & White 2401 S 31st Street Temple TX 76508 743092083 Insurance TX N/A C 1 Baylor Scott & White Assurance 23 Lime Tree Bay Grand Cayman CJ 980589956 Investment CJ N/A C 1 Scott & White Properties Holdings Inc 2401 S 31st Street Temple TX 76508 452920596 Investment TX N/A C 1 Scott & White Properties Inc 2401 S 31st Street Temple TX 76508 742497061 Hotel Services TX N/A C 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 Scott & White Foundation-Brenham C 1600000 GAAP Brenham Care Center C 1607214 GAAP Scott & White 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