2016-08-10T13:11:42-05:00 2015-09-30 450250958 EIDE BAILLY LLP 1601 NW EXPRESSWAY SUITE 1900 OKLAHOMA CITY OK 73118 990 2014-10-01 750703337 Parmer County Community Hospital PARM 8062502754 1307 Cleveland Street Friona TX 79035 Gayla Quillin Administrator 8062502754 2016-08-09 1 Kim Hunwardsen CPA P00484560 4054783334 2016-08-09 2014 2016-09-27 15:27:22Z Parmer Medical Center Gayla Quillin 1307 Cleveland Street Friona TX 79035 10417770 0 X www.parmermedicalcenter.com X 1956 TX Acute care hospital with personalized service and state-of-the-art care. 5 5 146 42 0 0 370696 324157 10687619 10026585 89833 39928 -4758 21384 11143390 10412054 9750 9410 0 0 4989397 5265754 0 0 0 5424264 5563994 10423411 10839158 719979 -427104 10959129 10829115 733407 1030497 10225722 9798618 X We are dedicated to serving the health needs of the people of our area, utilizing the skills of our healthcare family to provide compassionate and effective care. 1 0 9035498 9410 10026585 Parmer County Community Hospital is a 25 bed Critical Access Hospital and an on-campus rural health clinic located in Friona, Texas. The Organization provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Organization does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. Program service accomplishments include: 1. Exercise and fitness program for physical therapy patients.2. Provide access for patients to receive mammograms through Harrington Cancer Center.3. Community Education related to various healthcare topics (ie. Influenza, Pneumonia, Heat Stroke).4. Participate in cancer treatment and education through the Parmer County Cancer Coalition activities.5. Provided a children's health and safety fair.6. Provided charity care.7. In coordination with area schools, the Hospital and its staff participated in "Shattered Dreams". This program is intended to educate high school students of the dangers of driving under the influence, and is scheduled to coincide with Prom and Graduation.8. The Hospital started a shadowing program, in conjunction with Friona High School, to allow students with an interest in a health care career the opportunity to visit the hospital on a weekly basis and get hands on view of the variety of careers available in the health care field.9. Provide local access to Specialists (ie. Cardiologist, Urologist) through its Specialty Clinics. This allows patients the opportunity to see a specialist without having to travel long distances to major cities for their health care. 9035498 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 26 0 1 146 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 1 0 0 1 0 0 0 1 1 1 1 0 0 0 1 0 X Doug Thornton 8062502754 1307 Cleveland Street Friona TX 79035 Daniel M Kendrick President 1.00 X X 0 0 0 Dale Schueler DVM Vice President 1.00 X X 0 0 0 Dennis Anthony Secretary 1.00 X X 0 0 0 Bret Whiten DVM Member 1.00 X 0 0 0 Robert Neelley Member 1.00 X 0 0 0 Gayla Quillin Administrator 40.00 X 0 0 0 Doug Thornton Director of Finance 40.00 X 73726 0 19250 Michael Sermon Physician Assistant 40.00 X 134320 0 26380 Rita McDaniel RN 48.50 X 116475 0 8081 Carment Putman Nurse Practitioner 40.00 X 114534 0 12545 439055 0 66256 3 0 1 0 Community Care Specialists Inc 120 W MacArthur Suite 121 Shawnee OK 74804 Physician providers 1100466 Preferred Management Corporation 120 W MacArthur Suite 121 Shawnee OK 74804 Management services 357981 Ranger Construction Services 14023 FM 2100 Suite A Crosby TX 77532 General Contractor 279154 Amerisource Bergen PO Box 978526 Dallas TX 753978526 Pharmaceutical Distributor 269737 Quality Systems Inc PO Box 511449 Los Angeles CA 90051 EHR software service provider 193768 6 317040 7117 324157 Patient service revenue 622110 9911621 9911621 Supporting revenue 900099 114964 114964 10026585 39928 39928 8400 5716 2684 2684 2684 Gain on Sales Tax, Interest Incom 900999 18700 18700 18700 10412054 10026585 0 61312 X 660 660 8750 8750 89356 89356 3950802 3550336 400466 68763 60677 8086 833866 669864 164002 322967 285822 37145 350298 350298 58454 2613 55841 1609961 1489210 120751 23211 4005 19206 497647 426399 71248 345744 345744 154852 154852 37723 16397 21326 62355 35559 26796 153626 153626 66013 8168 57845 Bad debt 1408236 1408236 Medical supplies 690102 690102 Dues and licenses 38828 18217 20611 Publications and subcri 11775 7341 4434 55169 44664 10505 10839158 9035498 1803660 0 0 6941255 6847419 1759530 1051662 160348 153465 112012 122985 4464938 2721071 1297914 1743867 129853 138354 59921 41483 498296 729880 10959129 10829115 733407 739097 0 291400 733407 1030497 X 8927808 8054751 1297914 1743867 10225722 9798618 10959129 10829115 -427104 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17741 17741 1930417 415246 1515171 2516780 2305825 210955 1743867 Interest Receivable 14881 Other Receivable 98650 Estimated third-party payor settlements 616349 729880 Due to Parmer County Hospital District 291400 291400 1 1 X 1 X 1 X 1 1 1 0 0 91000 91000 0.00960 535210 317594 217616 0.02310 626210 317594 308616 0.03270 32860 32860 0.00350 8500 8500 0.00090 1441073 958697 482376 0.05110 1482433 958697 523736 0.05550 2108643 1276291 832352 0.08820 0 1408236 128149 4405264 4475123 -69859 X 1 1 1 1 Parmer County Community Hospital Inc 1307 Cleveland St Friona TX 79035 www.parmermedicalcenter.com 000200 X X X Provider Based RHC Parmer County Community Hospital Inc 1 0 0 1 X X X X X X 12 1 0 0 1 X www.parmermedicalcenter.com X 1 12 1 www.parmermedicalcenter.com 0 0 1 X 100.000000000000 200.000000000000 X X X 1 1 X X X 1 X www.parmermedicalcenter.com X X X X 1 X 0 X X X 1 X 0 0 Parmer County Community Hospital, Inc. Part V, Section B, Line 5: Texas Tech University Health Sciences Center F. Marie Hall Institute for Rural & Community Health used focus groups and telephone surveys to solicit input from persons from the community. Parmer County Community Hospital, Inc. Part V, Section B, Line 11: The Hospital addressed a major need identified through the 1115 Waiver program. Chronic Care Clinic for persons with diabetes who had an A1C of >9 was implemented. Persons participating receive A1C testing at no cost, are given education on their disease, nutritional guidance, and one on one consultations with a Nutritionist, Social Worker, Nurse Practitioner and others as needed. If the cost of medication is a contributing factor in not being able to manage their diabetes, the hospital has paid for the medication and supplies needed, and, helped the participant find resources (insurance, discount programs, etc) to pay for the medication on an on-going basis. Parmer County Community Hospital, Inc. Part V, Section B, Line 13h: The organization uses an internal schedule to calculate percentage discounts ranging from 65% to 100% based on annual household income and number of dependents for the patient or guarantor. The schedule is based on 200% of the US Department of HHS poverty income guidelines for 2014/2015.Even if patients do not qualify for financial assistance based on other factors, physician referrals may be taken into consideration. Parmer County Community Hospital, Inc. Part V, Section B, Line 16i: The Hospital posts a summary of its charity care policy with financial assistance contact information in the emergency room and in the Hospital facility's admissions offices. A summary of the policy is provided in all financial literature the patient receives. Part V, Section B, Line 16 Financial Assistance Policy Website Availability Parmer County Community Hospital, Inc. Part V, Section B, line 16a website: www.parmermedicalcenter.com Part I, Line 3c: The organization uses an internal schedule to calculate percentage discounts ranging from 65% to 100% based on annual household income and number of dependents for the patient or guarantor. The schedule is based on 200% of the US Department of HHS poverty income guidelines for 2014/2015.Even if patients do not qualify for financial assistance based on other factors, physician referrals may be taken into consideration. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Community health improvement services and health professions education are reported from the costs reported in the general ledger. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part I, Ln 7 Col(f): The amount of bad debt expense removed from the denominator to determine the percentage was $1,408,236. Part III, Line 2: Accounts are not written off to bad debt until all payments, discounts and contractual allowances are applied. When a payment is received on an account previously written off to bad debt, the payment reduces the current year's bad debt expense.Bad debt expense on line 2 is reported at charges as presented on the financial statements. Part III, Line 3: The amount of bad debt expense attributable to patients eligible under the Organization's charity care policy represents the percentage of total patient revenue written off to charity care during the year. The Organization believes it is reasonable that the payor mix in bad debts is consistent with overall revenue. Part III, Line 4: The footnote to the Organization's financial statements can be found on page 13 of the attached audited financial statements. Part III, Line 8: Parmer County Community Hospital is a critical access hospital and is showing a shortfall due to sequestration. Even though Medicare was at a loss, the Hospital provides services to these patients because access to healthcare and individual's health is important to the Hospital. Therefore, the Medicare shortfall is considered a community benefit.Total revenue received from Medicare (including DSH and IME) is the gross reimbursement plus settlement (including LSA). Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicaid and Medicare Services. Part III, Line 9b: Based on the completed "Eligibility Determination" form and mandatory documentation, the initial determination is effective for a six (6) month period. Eligibility status will be reviewed every six (6) months based on the anniversary date the client was deemed eligible. Recertification is effective for a six (6) month period, and requires the family to complete and submit any documentation necessary to determine continued eligibility. Collection procedures will be reversed if a patient completes the charity application and is considered eligible for financial assistance. Any personal portion owed by a patient will follow normal collection procedures. Part VI, Line 2: Parmer County Community Hospital prepared their community health needs assessment with F. Marie Hall Institute for Rural and Community Health, Texas Tech University Health Sciences Center and the Department of Political Science - Angelo State University. The completed assessment is included on the Hospital's website. The second CHNA is in preparation and will be posted to the Hospital's website by 10/1/16. Part VI, Line 3: The Hospital posts a summary of its charity care policy with financial assistance contact information in the emergency room and in the Hospital facility's admissions offices. A summary of the policy is provided in all financial literature the patient receives. Part VI, Line 4: Parmer County Community Hospital, Inc., DBA Parmer Medical Center (PMC) is a Critical Access Hospital located in Friona, a rural community in the Northwest Panhandle of Texas. Parmer County is a medically underserved area, as well as a Health Professional Shortage Area and is home to approximately 9,965 people. The 2010 Hispanic or Latino population was 69.9%, well above the statewide average of 37.6%. The median income for 2013 was $46,075 compared to $51,704 in the state of Texas. Unemployment in September 2015 was 2.5% compared to 4.4% in the state of Texas. The percentage of residents living in poverty in 2013 was 26.9%. A majority were American Indian residents. The most common industries were manufacturing and production. PMC and the town's rural health clinic, Friona Rural Health Clinic, have a wide service area of approximately 882 square miles. Unlike urban areas in which residents generally have access to a hospital, physician clinic, or urgent care facility in close proximity to their homes, the nearest hospital and/or clinic to PMC is approximately 25 miles away. Part VI, Line 5: All governing bodies of the Organization reside in the Organization's service area. They are neither employees, nor contractors of the Organization, nor family members thereof. The Hospital extends medical staff privileges to all qualified physicians in the community. The Hospital operates an emergency room available to all regardless of ability to pay. Surplus funds are applied to improvements in patient care and medical education.The Hospital participates in education and training of healthcare professionals by participating as a clinical rotation site for physician assistant and nursing students; offering free Certified Nurse Assistant classes; and by providing scholarships for area students who are committed to pursuing careers in the healthcare/medical field.PMC operates an emergency department that provides care to all regardless of ability to pay; participates in Medicare and Medicaid programs; and offers volunteer opportunities for community members in our Auxiliary program. 1 Academic scholarships 4 8750 Part I, Line 2: Academic scholarship recipients are determined by the Board of Directors. Applications are completed and reviewed. Payment is made to the individual and school ensuring proper use of the funds. 0 0 0 0 0 0 0 0 0 Michael Sermon Physician Assistant 115206 0 744 0 18370 0 10755 0 15625 0 160700 0 0 0 Schedule J, Part I, Question 3: Parmer Medical Center does not pay compensation to the Administrator directly. The Administrator is compensated by an unrelated management company, Preferred Management Corporation. The management company uses the processes described in Part I, Question 3 to determine appropriate compensation for the Administrator. The Board of Directors approves the Organization's contract with the management company. Form 990, Part III, line 2 Beginning in October of 2014, the hospital began a Chronic Care Clinic for community members who have diabetes. This Clinic provides support and education for these community members at no cost in order to assist and educate them regarding the disease. Free lab tests, drugs, supplies and education were included for those who participated. Form 990, Part VI, Section A, line 3 Parmer Medical Center has a management agreement with Preferred Management Corporation for the day-to-day management of the Hospital. Preferred Management provides technical assistance and management personnel (Hospital Administrator) to the Board of Directors of Parmer Medical Center. Gayla Quillin, Administrator, was compensated $145,000 to provide these services. Form 990, Part VI, Section A, line 6 Parmer County Community Hospital has members that are individuals of the community. These individuals paid a fee to fund the construction of the Hospital and become Members. Members meet annually. Form 990, Part VI, Section A, line 8b There are no committees that can act on behalf of the governing board. Form 990, Part VI, Section B, line 11 The Form 990 is reviewed by the Administrator and presented to the Board of Directors before it is filed. Form 990, Part VI, Section B, line 12c All officers and key employees are covered by the policy. Auditors, Administration, Board of Directors, Officers or any key employee can determine whether conflicts exist. Persons with conflicts are not allowed to work within the same department or with authority over another. The Board of Directors reviews for potential conflicts and reports on the conflicts at the next Board meeting. The individuals who have conflicts are not present during discussions by the Board or vote regarding the conflicts. Form 990, Part VI, Section B, line 15b The organization's Administrator is paid by Preferred Management Corporation, an unrelated management company. The organization relies on Preferred Management Corporation to determine the compensation paid for services rendered to the organization. Compensation for the Director of Finance is reviewed annually and approved by the board. The compensation for this position was based on a salary survey performed by TORCH for hospitals in the area of Texas. The process and determination is documented in the board minutes and personnel file. Form 990, Part VI, Section C, line 19 Governing documents and financial statements are available upon request or at the annual membership meeting. Form 990, Part IX, line 11g Contract Services: Program service expenses 200,364. Management and general expenses 24,687. Fundraising expenses 0. Total expenses 225,051. Maintenance: Program service expenses 136,780. Management and general expenses 1,858. Fundraising expenses 0. Total expenses 138,638. Professional Fees: Program service expenses 947,387. Management and general expenses 0. Fundraising expenses 0. Total expenses 947,387. Transcription: Program service expenses 760. Management and general expenses 0. Fundraising expenses 0. Total expenses 760. Collections: Program service expenses 9,316. Management and general expenses 28,485. Fundraising expenses 0. Total expenses 37,801. Inspections: Program service expenses 2,452. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,452. Physician Coverage: Program service expenses 192,151. Management and general expenses 0. Fundraising expenses 0. Total expenses 192,151. Recruitment: Program service expenses 0. Management and general expenses 65,721. Fundraising expenses 0. Total expenses 65,721. Parmer County Hospital District 1307 Cleveland Street Friona TX 79035 752383041 Political subdivision of the state of Texas TX N/A 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0