2015-05-14T10:48:02-05:00 2014-06-30 BKD LLP 14241 DALLAS PKWY STE 1100 DALLAS TX 75254 990 2013-07-01 752616975 Trinity Mother Frances Health System % MOTHER FRANCES HOSP ACCT DEP TRIN 9036065783 1315 Doctors Drive Suite Tyler TX 75701 JOYCE HESTER CFO 9036065783 2015-05-15 true Jeanette Verrelli P00742631 9036065783 2013 2016-02-25 16:41:14Z J LINDSEY BRADLEY JR 910 E HOUSTON TYLER TX 75701 86992230 false X WWW.TMFHc.ORG X 1995 TX COORDINATING PARENT OF CHARITABLE HEALTHCARE SYSTEM GUIDING ACTIVITIES OF AFFILIATED ENTITIES TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITY. 12 8 651 13 72355 -1626 102800 120000 82445045 86624725 0 0 69149 247505 82616994 86992230 284027 214446 0 0 42996919 47499719 0 0 0 36526045 33664040 79806991 81378205 2810003 5614025 13668828 17741579 68149248 68448877 -54480420 -50707298 COORDINATING PARENT OF CHARITABLE HEALTHCARE SYSTEM GUIDING ACTIVITIES OF AFFILIATED ENTITIES TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE COMMUNITY. false false 73261828 214446 86624725 AS THE PARENT COMPANY OF TAX-EXEMPT HOSPITALS, THE SYSTEM MONITORS AND GUIDES THE ACTIVITIES OF AFFILIATED ENTITIES TO PROVIDE HIGH QUALITY HEALTHCARE SERVICES TO THE COMMUNITY THROUGH AN EFFICIENT, ECONOMICAL, AND COORDINATED DELIVERY SYSTEM. 73261828 true true false false false false false false false true false false false true true false false true false false false false false false false false false true false true false false false false false false false false false false false false false true true true false false true X 109 0 true 651 true true true false false false false false false false false false false X 12 8 false false false false true true true true true false false true true true true true true true true false X MOTHER FRANCES HOSP ACCT DEP 9036065783 1315 DOCTORS DRIVE TYLER TX 75701 X SISTER LORETTA ROSE TALLAS DIRECTOR 40.0 0.0 X JEFF BUFORD DIRECTOR/VICE CHAIR 1.0 0.0 X X PRESTON SMITH DIRECTOR/CHAIRMAN 1.0 0.0 X X DON ARNWINE DIRECTOR 1.0 0.0 X RANDY CHILDRESS DIRECTOR 1.0 1.0 X BOBBY CURTIS DIRECTOR 1.0 0.0 X J LINDSEY BRADLEY JR SYSTEM PRESIDENT/DIRECTOR 29.0 11.0 X X 1229828 466486 25752 MARK ANDERSON DIRECTOR 1.0 40.0 X 0 454812 30262 STEVEN KEUER MD PRESIDENT/DIRECTOR 20.0 20.0 X X 447993 447993 29838 ROYCE WISENBAKER DIRECTOR 1.0 0.0 X DICK STONE DIRECTOR 1.0 1.0 X GIFFORD ECKHOUT MD EXEC VICE PRESIDENT/DIRECtor 24.0 16.0 X X 453535 302357 10563 RAY THOMPSON SYS EXEC VP/SECRETARY/treas 16.0 24.0 X 591468 887201 25752 JOYCE HESTER SR. VICE PRESIDENT/CFO 10.0 30.0 X 109418 328252 23252 andy navarro VP general counsel 40.0 0.0 X 182627 0 10721 JOHN WEBB VP MANAGED CARE/REG SVC 40.0 0.0 X 213159 0 27129 ELIZABETH PULLIAM VP FINANCE 40.0 0.0 X 257737 0 12906 JEFFREY PEARSON VP 40.0 0.0 X 251829 0 25017 DARIN SZILAGYI VP 40.0 0.0 X 218778 0 24799 THOMAS WILKEN SR VP 40.0 0.0 X 300125 0 25602 ANDREW VON ESCHENBACH vp revenue cycle 40.0 0.0 X 215831 0 24095 mary jackson vp 20.0 20.0 X 238050 0 15250 DAVID NORTHCUTT LEGAL COUNSEL 40.0 0.0 X 176306 0 22689 Richard Gilbert finance director 40.0 0.0 X 129284 0 11172 MARY E DODD PROJECT DIRECTOR epic 40.0 0.0 X 142013 0 19683 christina ramsey system controller 40.0 0.0 X 127696 0 22547 robert jehling Administrative Director 40.0 0.0 X 148159 0 20001 david teegarden md system president/cmo/director 0.0 0.0 X 0 100806 22516 william bellenfant sr sr vp/cfo/director/treasurer 0.0 0.0 X 213528 0 0 lee portwood vp, operations 0.0 40.0 X 0 249658 22648 5647364 3237565 452194 26 true true false huron consulting services llc 4795 payshere circle CHICAGO IL 60674 consulting services 2237279 lsq funding group lc 2600 lucien way suite 100 MAITLAND FL 32751 it services 3190000 briggs and caldwell lp 9801 westheimer rd HOUSTON TX 77042 advertising services 858753 accudoc solutions 300 dominion drive MORRISVILLE NC 27560 collection services 601346 patient financial services 4524 southlake parkway HOOVER AL 35244 collection services 366542 30 120000 120000 OTHER OPERATING REVENUE 621110 83301034 83301034 EHR INCENTIVE REVENUE 900099 3323691 3323691 86624725 0 0 0 0 0 0 0 0 0 0 LAUNDRY 812300 72355 72355 REBATE INCOME 900099 173170 173170 MISCELLANEOUS INCOME 900099 1980 1980 247505 86992230 86624725 72355 175150 X 214446 214446 0 0 0 4812937 4331643 481294 213528 192175 21353 35854723 32269250 3585473 207810 187029 20781 3905027 3514524 390503 2505694 2255125 250569 0 660200 594180 66020 184866 166379 18487 0 0 150 135 15 9883278 8894951 988327 932217 838995 93222 2790524 2511472 279052 7894936 7105442 789494 0 670030 603027 67003 162661 146395 16266 0 392921 353629 39292 519918 467926 51992 0 5678432 5110589 567843 143431 129088 14343 REPAIRS AND MAINTENANCE 1069109 962198 106911 RECRUITMENT 1771719 1594547 177172 LAUNDRY AND LINEN 474523 427071 47452 DIETARY 96143 86529 9614 338982 305083 33899 81378205 73261828 8116377 0 0 0 712 562 0 0 0 0 0 0 0 0 0 0 0 0 2294454 2369556 0 0 0 0 0 0 0 0 0 11373662 15371461 13668828 17741579 2178955 2403167 0 0 0 0 0 0 0 0 0 0 9550907 8337070 0 0 56419386 57708640 68149248 68448877 X -62881455 -60337620 6349910 7579197 2051125 2051125 -54480420 -50707298 13668828 17741579 X 5614025 -1840903 X false true X true false X X X false false false MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER 750818167 03 true true true 36630914 TRINITY CLINIC 752616977 03 true true true 36630914 2 73261828 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2414694 360569 13191 2762072 2408876 163752 157934 2414694 2350337 30875 27664 2408876 2209013 50 141274 2350337 414414 1790794 4305 500 2209013 0.74260 0.25740 false true true INTEREST IN ASSETS OF FND 9630322 INVESTMENT IN UNCONSOL SUB 762421 DUE FROM AFFILIATES 3084686 DEFERRED FINANCING COSTS 39503 DUE FROM THIRD-PARTY PAYERS 1854529 15371461 0 DUE TO AFFILIATES 56608640 LONG-TERM CARE OBLIGATION 1100000 57708640 X 83732267 -3086793 -3086793 86819060 173170 173170 86992230 81203618 -174587 -174587 81378205 81378205 schedule d, part v, line 4 intended use of endowment funds: THE ORGANIZATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR THE ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS AND ITEMS SUPPORTED BY THE ENDOWMENT WHILE SEEKING TO MAINTAIN ITS PURCHASING POWER. schedule d, part x, line 2 liability for uncertain tax positions: The System, the Hospital, RMSA, the Clinic, Jacksonville and Winnsboro have been recognized as exempt from income taxes under Section 501 of the Internal Revenue Code (IRC) and a similar provision of state law. However, these entities are subject to federal income tax on any unrelated business taxable income. THFIC is not considered to be engaged in a United States trade or business and, therefore, is not subject to United States income taxes. If THFIC were to be considered engaged in a United States trade or business, it could be subject to federal income tax. THFIC is currently exempt from income taxes in the Cayman Islands. Accordingly, no provision for taxes has been made. With a few exceptions, the Health System is no longer subject to U.S. federal examinations by tax authorities for years before 2011. schedule d, part xi, line 2d reconciliation of revenue per audited financial statements with return: equity in earnings of affiliate - foundation $(3,086,793) schedule d, part xi, line 4b reconciliation of revenue per audited financial statements with return: rebate income $ 173,170 schedule d, part xii, line 2d reconciliation of expense per audited financial statements with return: rebate income $(173,170) equity in income of consolidated subsidiary (1,417) -------------- total $(174,587) true FOUNDATION OF THE NATIONAL STUDENT NURSE 45 MAIN STREET STE 606 BROOKLYN NY 11201 133123125 501(C)(3) 7500 community healthcare EAST TEXAS CRISIS CENTER 2401 OLD NOONDAY RD TYLER TX 75701 751641173 501(C)(3) 6500 community healthcare AMERICAN HEART ASSOC - S WEST AFFILIATE PO BOX 4002903 DES MOINES IA 50340 135613797 501(C)(3) 30000 community healthcare AMERICAN CANCER SOCIETY 1301 S BROADWAY TYLER TX 75701 131788491 501(C)(3) 15000 2011 CATTLE BARONS TEXAS ROSE FESTIVAL PO BOX 8224 TYLER TX 75711 751171774 501(C)(3) 12000 FESTIVAL SPONSORSHIP BISHOP GORMAN REGIONAL CATHOLIC SCHOOL 1405 E SE LOOP 323 TYLER TX 75701 272769397 501(C)(3) 25000 community healthcare ST GREGORY CATHEDRAL SCHOOL PTO 500 S COLLEGE AVE TYLER TX 75702 272769354 501(C)(3) 10000 community healthcare 7 schedule i, part i, line 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: GRANT RECIPIENTS ARE REQUIRED TO ACKNOWLEDGE PRIOR TO THE ISSUANCE OF GRANT FUNDS THAT THE GRANT WILL BE USED IN ACCORDANCE WITH THE STATED PURPOSE OF THE GRANT APPLICATION AND ANY UNUSED FUNDS RELATED TO THE SPECIFIC PURPOSE OF THE GRANT WILL BE RETURNED TO THE ORGANIZATION. THE ORGANIZATION MONITORS AND REVIEWS THE FINANCIAL DATA OF RECIPIENTS TO ENSURE THAT THE GRANTED FUNDS ARE BEING USED PROPERLY. X true true X X X X X true true false false false false false false false J LINDSEY BRADLEY JR SYSTEM PRESIDENT/DIRECTOR 634408 240637 595420 225849 0 0 7858 2980 10813 4101 1248499 473567 0 0 MARK ANDERSON DIRECTOR 0 449490 0 0 0 5322 0 8818 0 21444 0 485074 0 0 STEVEN KEUER MD PRESIDENT/DIRECTOR 101089 101090 130000 130000 216904 216903 13669 13669 1250 1250 462912 462912 216904 216903 RAY THOMPSON SYS EXEC VP/SECRETARY/treas 295700 443550 295768 443651 0 0 4335 6503 5966 8948 601769 902652 0 0 JOYCE HESTER SR. VICE PRESIDENT/CFO 80449 241347 28969 86905 0 0 2710 8128 3104 9310 115232 345690 0 0 DAVID NORTHCUTT LEGAL COUNSEL 175791 0 500 0 15 0 7086 0 15603 0 198995 0 0 0 GIFFORD ECKHOUT MD EXEC VICE PRESIDENT/DIRECtor 367502 245002 80070 53380 5963 3975 4838 3225 1500 1000 459873 306582 5963 3975 andy navarro VP general counsel 146679 0 0 0 35948 0 3789 0 6932 0 193348 0 0 0 JOHN WEBB VP MANAGED CARE/REG SVC 185766 0 16578 0 10815 0 7196 0 19933 0 240288 0 0 0 ELIZABETH PULLIAM VP FINANCE 212564 0 34208 0 10965 0 4604 0 8302 0 270643 0 0 0 JEFFREY PEARSON VP 213223 0 27716 0 10890 0 5871 0 19146 0 276846 0 0 0 DARIN SZILAGYI VP 191265 0 16698 0 10815 0 6278 0 18521 0 243577 0 0 0 THOMAS WILKEN SR VP 247599 0 41651 0 10875 0 7697 0 17905 0 325727 0 0 0 ANDREW VON ESCHENBACH vp revenue cycle 176631 0 35630 0 3570 0 3109 0 20986 0 239926 0 0 0 MARY E DODD PROJECT DIRECTOR epic 141998 0 0 0 15 0 6042 0 13641 0 161696 0 0 0 christina ramsey system controller 126901 0 0 0 795 0 4277 0 18270 0 150243 0 0 0 robert jehling Administrative Director 137573 0 0 0 10586 0 1735 0 18266 0 168160 0 0 0 david teegarden md system president/cmo/director 0 97133 0 0 0 3673 0 2250 0 20266 0 123322 0 0 mary jackson vp 194398 0 30212 0 13440 0 7902 0 7348 0 253300 0 0 0 william bellenfant sr sr vp/cfo/director/treasurer 0 0 0 0 213528 0 0 0 0 0 213528 0 0 0 lee portwood vp, operations 0 219945 0 18913 0 10800 0 9341 0 13307 0 272306 0 0 SCHEDULE J, PART I, LINE 1A TAX INDEMNIFICATION & GROSS UP PAYMENTS: AMOUNTS PAID FOR "GROSSED UP" GIFT CARDS ARE INCLUDED AS TAXABLE COMPENSATION TO THE FOLLOWING INDIVIDUALS: Elizabeth Pulliam, Jeffrey Pearson, Mary Jackson, Andrew Von Eschenbach, John Webb, Darin Szilagyi, Richard Gilbert, Mary Dodd, Christina Ramsey, AND David Northcutt SCHEDULE J, PART I, LINE 4A SEVERANCE & CHANGE OF CONTROL PAYMENTS: ANDY NAVARRO $35,948 william bellenfant sr $213,528 SCHEDULE J, PART I, LINE 4B PARTICIPATION IN OR PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PARTICIPANTS IN SERP REPORTED IN W-2 DEFERRED COMPENSATION -------------------- --------------- --------------------- STEVEN KEUER MD $426,080 NONE PARTICIPANTS IN 457(F) REPORTED IN W-2 ---------------------- ----------------- STEVEN KEUER MD $7,727 GIFFORD ECKHOUT MD $9,938 FORM 990, PART V, LINE 1A 1099S REPORTED BY ORGANIZATION: THE ORGANIZATION'S 1099S ARE ISSUED BY A RELATED ORGANIZATION, MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER, WHO REPORTS ALL 1099S FOR THE ENTIRE SYSTEM AND ALLOCATES EXPENSES TO THE APPROPRIATE RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS: THE SOLE MEMBER IS THE CONGREGATION OF THE SISTERS OF THE HOLY FAMILY OF NAZARETH, A RELIGIOUS ORDER OF THE ROMAN CATHOLIC CHURCH. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS WHO MAY ELECT MEMBERS OF THE GOVERNING BODY: THE MEMBER HAS THE SOLE RIGHT AND AUTHORITY TO APPOINT ONE OF THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL BY THE MEMBER: THE MEMBER HAS THE RIGHT TO APPROVE OR DISAPPROVE CERTAIN ACTIONS THAT HAVE BEEN PREVIOUSLY APPROVED BY THE BOARD OF DIRECTORS. 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 FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS AND A COPY IS PROVIDED TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR AND ENFORCE CONFLICT OF INTEREST POLICY: THE BOARD REVIEWS AND RESOLVES, IF NECESSARY, ANY TRANSACTIONS AS THEY ARISE THROUGHOUT THE YEAR IN ACCORDANCE WITH POLICY STANDARDS. FORM 990, PART VI, SECTION B, LINES 15A & 15B REVIEW OF COMPENSATION OF CEO, OFFICER, OR KEY EMPLOYEES: THE ORGANIZATION USES COMPENSATION CONSULTANTS AND NATIONAL COMPENSATION SURVEYS TO DETERMINE COMPENSATION OF EMPLOYEES. COMPENSATION IS APPROVED BY THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A & schedule j, part ii COMPENSATION FROM RELATED ORGANIZATIONS: THE GOVERNING BOARD OF TRINITY MOTHER FRANCES HEALTH SYSTEM UPON ADVICE FROM NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS, WHO PERIODICALLY REVIEW ALL EXECUTIVE COMPENSATION, APPROVED A DEFERRED COMPENSATION PLAN THAT PROVIDES A 65% TOTAL RETIREMENT BENEFIT FOR SENIOR EXECUTIVES THAT SERVE 20 YEARS OR MORE. THIS PROGRAM HAS BOTH RETENTION AND NON-COMPETITION CLAUSES THAT CREATE A RISK OF FORFEITURE. DEFERRED COMPENSATION IS SUBJECT TO A RISK OF FORFEITURE BASED ON RETENTION, NON-COMPETITION AND OTHER CONTRACTUAL FACTORS. ACCRUALS OF DEFERRED COMPENSATION ARE NOT INCLUDIBLE IN W-2 COMPENSATION UNTIL PAID. OTHER EMPLOYEE BENEFITS INCLUDE QUALIFIED PENSION PLANS, HEALTH, DENTAL AND LIFE INSURANCE PLANS, DISABILITY INSURANCE, ETC. TAXABLE EXPENSES ARE INCLUDED IN THE W-2 PAID COMPENSATION SALARY AMOUNT. FORM 990, PART IX, LINE 11G Other fees for SERVICES: PURCHASED SERVICES $ 4,811,627 COLLECTION FEES 3,797,422 CONSULTING 3,507,631 CONTRACT LABOR 300,330 PROFESSIONAL FEES 245,295 SPONSORSHIPS 160,007 CORPORATE EXPENSE (2,939,034) ---------------- TOTAL $ 9,883,278 FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: TRANSFERS FROM AFFILIATES $ 15,186 CHANGE IN FINANCIAL INTEREST - TEMP RESTRICTED 1,229,287 EQUITY IN EARNINGS OF AFFILIATE - FOUNDATION (3,086,793) EQUITY in INCOME OF CONSOLIDATED SUBSIDIARY 1,417 --------------- TOTAL $ (1,840,903) MOTHER FRANCES HOSPITAL - JACKSONVILLE 1315 DOCTORS DRIVE TYLER TX 75701 751976930 HOSPITAL TX 501(C)(3) 3 TMFHS true TRINITY MOTHER FRANCES HEALTH SYSTEM FDN 1315 DOCTORS DRIVE TYLER TX 75701 752028241 SUPPORT TX 501(C)(3) 11, type i TMFHS true REGIONAL MEDICAL SERVICES ASSOCIATION 1315 DOCTORS DRIVE TYLER TX 75701 752511459 HEALTHCARE TX 501(C)(3) 3 MFH REG true MOTHER FRANCES HOSPITAL - WINNSBORO 1315 DOCTORS DRIVE TYLER TX 75701 752771569 HOSPITAL TX 501(C)(3) 3 TMFHS true TRINITY CLINIC 1315 DOCTORS DRIVE TYLER TX 75701 752616977 HEALTHCARE TX 501(C)(3) 3 TMFHS true MOTHER FRANCES HOSPITAL REGIONAL HC CTR 1315 DOCTORS DRIVE TYLER TX 75701 750818167 HOSPITAL TX 501(C)(3) 3 TMFHS true TRI-STATE FINANCIAL LLC 1315 DOCTORS DRIVE TYLER TX 75701 752728318 DORMANT TX TMFHS C-corporation 0 0 1.00000 true TRINCARE INC 1315 DOCTORS DRIVE TYLER TX 75701 752161369 RETAIL HEALTH SVC TX TMFHS C-corporation 0 1177616 1.00000 true HEALTHPLAN OF TEXAS INC 1315 DOCTORS DRIVE TYLER TX 75701 752636832 THIRD PARTY ADMIN TX TMFHS C-corporation -12318 87647 1.00000 true THE REGIONAL HEALTHCARE ALLIANCE 1315 DOCTORS DRIVE TYLER TX 75701 752484109 PREFER PROVIDER TX TMFHS C-corporation 0 0 1.00000 true TEXAS HEALTH FACILITIES INSUR CORP LTD PO BOX 1109 BWI GRAND CAYMAN CJ 980136025 INSURANCE CJ MFH REG C-corporation 0 0 true CONCORDIUM HEALTH LLC 1315 DOCTORS DRIVE TYLER TX 75701 702811022 INACTIVE TX NA C-corporation 0 0 false false false true false false false false false false false false true false true true false false false false MOTHER FRANCES HOSPITAL REGIONAL HC Center l 56724550 FAIR VALUE TRINITY CLINIC l 14078711 FAIR VALUE MOTHER FRANCES HOSPITAL - JACKSONVILLE l 4071181 FAIR VALUE MOTHER FRANCES HOSPITAL - WINNSBORO l 2064653 FAIR VALUE TRINCARE INC l 698004 FAIR VALUE trinity mother frances health system fdn c 120000 fair value SCHEDULE R, PART II, COLUMN F direct controlling entity: THE FOLLOWING RELATED ORGANIZATIONS REPORTABLE IN PART II ARE DIRECTLY CONTROLLED BY TRINITY MOTHER FRANCES HEALTH SYSTEM ("TMFHS"): MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER MOTHER FRANCES HOSPITAL - JACKSONVILLE TRINITY MOTHER FRANCES HEALTH SYSTEM FOUNDATION TRINITY CLINIC MOTHER FRANCES HOSPITAL - WINNSBORO REGIONAL MEDICAL SERVICES ASSOCIATION IS DIRECTLY CONTROLLED BY MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER ("MFH REG").