2015-05-14T10:48:31-05:00 2014-06-30 BKD LLP 14241 DALLAS PKWY STE 1100 DALLAS TX 75254 990 2013-07-01 752616977 Trinity Clinic % MOTHER FRANCES HOSP ACCT DEP TRIN 9035315764 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 STEVEN KEUER md 910 E HOUSTON TYLER TX 75701 169705243 false X WWW.TMFHc.ORG/trinityclinic X 1995 TX TO PROVIDE PHYSICIAN SERVICES WITH A FULL range of comprehensive health care services without regard to race, creed, sex, national origin, handicap, age, or ability to pay. 16 0 694 26 0 0 0 45998 161528332 166762561 1678504 2896684 -182669 -583 163024167 169704660 0 0 0 0 43571561 43086747 0 0 0 151639641 155474932 195211202 198561679 -32187035 -28857019 50748541 42788352 80503891 84792323 -29755350 -42003971 TO PROVIDE PHYSICIAN SERVICES WITH A FULL RANGE OF COMPREHENSIVE HEALTH CARE SERVICES WITHOUT REGARD TO RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. false false 189988227 0 166762561 OUR COMMITMENT TO OUR COMMUNITY EXTENDS TO FREE OR SUBSIDIZED INDIVIDUAL CARE, SUBSIDIZED EDUCATION OF HEALTHCARE PROFESSIONALS, DISCOUNTED FEES FOR PARTICIPANTS IN GOVERNMENT PROGRAMS, COMMUNITY HEALTH EDUCATION, AND DONATIONS TO OTHER COMMUNITY AGENCIES. SPECIFIC COMMUNITY SERVICES AND PROGRAMS INCLUDE: WELLNESS AND PREVENTION EDUCATION PROGRAMS, COMMUNITY DIAGNOSTIC SCREENING PROGRAMS, SENIOR CITIZEN HEALTH AWARENESS PROGRAMS, AWARENESS PROGRAMS FOR YOUTH AT RISK, AWARENESS PROGRAMS FOR PERSONS WITH SPECIAL PHYSICAL OR MENTAL NEEDS, CHILDREN WITH DIABETES SUMMER CAMP, SPORTS CARE PROGRAMS, SAFETY TRAINING FOR LOCAL BUSINESSES, AND RESEARCH PROGRAMS. 189988227 true true false false false false false false false true true false false false true false false true false false false false false false false false false false false true false false false false false false true false false false false false false true false false false true X 103 0 true 694 true false false false false false false false false false false X 16 0 false false false false true false true true true false false false true true true true true true true true true X MOTHER FRANCES HOSP ACCT DEP 9036065783 1315 DOCTORS DRIVE TYLER TX 75701 X STEVEN KEUER MD SYSTEM PRESIDENT/CMO/DIRECTOR 20.0 20.0 X X 447994 447992 29838 GIFFORD ECKHOUT MD EXECUTIVE VICE PRESIDENT/DIREC 16.0 24.0 X X 302357 453535 10563 MARK ANDERSON MD PHYSICAN/CHAIR 40.0 1.0 X X 454812 0 30262 WILLIAM HOBBS MD physician 40.0 0.0 X 816047 0 29781 JAMES STANFORD MD physician/VICE CHAIR 40.0 0.0 X X 299035 0 26894 KAI XIA MD physician 40.0 0.0 X 1205301 0 19652 JAMES CACCITOLO MD physician/SECRETARY 40.0 1.0 X X 785746 0 28506 HAMPTON WILLIAMS MD physician 40.0 0.0 X 494856 0 25103 OLADIMEJI AKIODE MD physician 40.0 0.0 X 419201 0 30656 BARBARA ALLEN MD PHYSICIAN 35.0 5.0 X 349910 0 27337 BRYAN LOWERY MD PHYSICIAN 40.0 0.0 X 583390 0 20771 JANET HURLEY MD physician 40.0 0.0 X 139655 0 20075 MEG REITMEYER MD physician 40.0 1.0 X 261431 0 18385 JOSEPH ZASIK DO physician 40.0 0.0 X 539086 0 15345 BRENDA MORRIS MD PHYSICIAN 40.0 0.0 X 388140 0 9031 FAGG SANFORD MD physician 20.0 20.0 X 858797 0 16577 THOMAS HARGROVE VP 40.0 0.0 X 377678 0 32281 ANN GILBERT VP 40.0 0.0 X 200866 0 11949 CHRIS GLENNEY SR. VP 40.0 0.0 X 303940 0 28768 JOYCE HESTER SR. VICE PRESIDENT/CFO 10.0 30.0 X 109418 328252 23252 William mCcrady md VP 40.0 0.0 X 452845 0 24276 LAURA O'HALLORAN MD PHYSICIAN 40.0 0.0 X 1587840 0 28506 WAYNE GLUF MD PHYSICIAN 40.0 0.0 X 1550435 0 22380 RAMON KUMAR MD PHYSICIAN 40.0 0.0 X 1284542 0 27831 TODD PATRICK MD PHYSICIAN 40.0 0.0 X 1193743 0 28506 NEELAN DOOLABH MD PHYSICIAN 40.0 0.0 X 1159517 0 17934 DAVID TEEGARDEN MD SYSTEM PRESIDENT/CMO/DIRECTOR 0.0 0.0 X 100806 0 22516 ROGER FOWLER MD PHYSICIAN 40.0 0.0 X 374366 0 20575 GREGORY STOVALL MD PHYSICIAN 40.0 0.0 X 200869 0 26897 WILLIAM BELLENFANT SR SR VP/CFO/DIRECTOR/TREASURER 0.0 0.0 X 0 213528 0 17242623 1443307 674447 322 true true false EAGLE HOSPITAL PHYSICIANS 16000 NORTH DALLAS PARKWAY STE 450 DALLAS TX 75248 PHYSICIAN SERVICES 1568922 HURON CONSULTING SERVICES LLC 4795 PAYSHERE CIRCLE CHICAGO IL 60674 CONSULTING SERVICES 1482828 DELTA LOCUM TENENS PO BOX 202940 DALLAS TX 75320 PHYSICIAN SERVICES 1341145 PATRICK DAUS DO 817 WHITE BUFFALO LANE HEATH TX 75032 PHYSICIAN SERVICES 566875 HOSPITALIST CONNECTIONS LLC 16000 NORTH DALLAS PARKWAY STE 450 DALLAS TX 75248 PHYSICIAN SERVICES 503744 22 45998 45998 NET PATIENT SERVICE REVENUE 621110 121899264 121899264 OTHER OPERATING REVENUE 900099 44697979 44697979 EHR INCENTIVE REVENUE 900099 165318 165318 166762561 2896684 2896684 0 0 583 -583 0 -583 -583 0 0 0 0 0 169704660 166762561 2896101 X 0 0 0 0 12247139 11042054 1205085 995373 910206 85167 16116951 14479230 1637721 2938574 2902203 36371 6062183 5722053 340130 4726527 4506911 219616 3338298 3329107 9191 0 0 0 0 150 150 120696137 116943008 3753129 38432 26935 11497 902173 368736 533437 3944 3246 698 0 1133890 901486 232404 83493 26653 56840 0 1038807 1033370 5437 429831 130845 298986 0 328233 260529 67704 3168166 3149448 18718 BAD DEBT EXPENSE 9827819 9827819 MEDICAL SUPPLIES 2953150 2953150 PERFORMANCE STANDARDS 1751308 1749061 2247 REPAIRS AND MAINTENANCE 100936 78191 22745 9680165 9643986 36179 198561679 189988227 8573452 0 701164 11844 0 0 0 0 14719532 14932738 0 0 0 0 1196280 1831241 230612 131330 432590 498508 3836847 2452402 1619654 1384445 24749645 22876242 86710 82544 0 0 373209 310786 6639145 728674 50748541 42788352 23809430 28834722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56694461 55957601 80503891 84792323 X -29755350 -42003971 0 0 0 0 -29755350 -42003971 50748541 42788352 X -28857019 16608398 X false true X true false X 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 0 0 1206512 325642 880870 2616036 2126760 489276 14299 14299 1384445 0 DUE TO AFFILIATES 26670877 ACCRUED PENSION LIABILITY 14903520 ESTIMATED SELF INSURANCE COSTS 5282100 DEFERRED COMPENSATION 9101104 55957601 X 156383996 -9827819 -9827819 166211815 3492845 3492845 169704660 185241015 -3492845 -3492845 188733860 9827819 9827819 198561679 SCHEDULE D, PART V, LINE 4 INTENDED USE OF THE ORGANIZATION'S 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: BAD DEBT EXPENSE $(9,827,819) SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: INTEREST INCOME $ 2,894,733 SEQUESTER REDUCTION REVENUE 584,518 REBATE INCOME 14,177 RENTal EXPENSEs (583) ------------------- TOTAL $ 3,492,845 SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: INTEREST INCOME $(2,894,733) SEQUESTER REDUCTION REVENUE (584,518) REBATE INCOME (14,177) RENTal EXPENSEs 583 ------------------- TOTAL $(3,492,845) SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT EXPENSE $ 9,827,819 X X X X X true true false false false true false false false STEVEN KEUER MD SYSTEM PRESIDENT/CMO/DIRECTOR 101090 101089 130000 130000 216904 216903 13669 13669 1250 1250 462913 462911 216904 216903 GIFFORD ECKHOUT MD EXECUTIVE VICE PRESIDENT/DIREC 245002 367502 53380 80070 3975 5963 3225 4838 1000 1500 306582 459873 3975 5963 MARK ANDERSON MD PHYSICAN/CHAIR 449490 0 0 0 5322 0 8818 0 21444 0 485074 0 0 0 WILLIAM HOBBS MD physician 592119 0 198409 0 25519 0 10837 0 18944 0 845828 0 0 0 JAMES STANFORD MD physician/VICE CHAIR 145112 0 126724 0 27199 0 9399 0 17495 0 325929 0 2285 0 KAI XIA MD physician 661555 0 520923 0 22822 0 9562 0 10090 0 1224953 0 0 0 JAMES CACCITOLO MD physician/SECRETARY 780424 0 0 0 5322 0 9562 0 18944 0 814252 0 0 0 HAMPTON WILLIAMS MD physician 489534 0 0 0 5322 0 9562 0 15541 0 519959 0 0 0 OLADIMEJI AKIODE MD physician 198037 0 199343 0 21822 0 9212 0 21444 0 449857 0 0 0 BARBARA ALLEN MD PHYSICIAN 295785 0 31303 0 22822 0 8393 0 18944 0 377247 0 0 0 BRYAN LOWERY MD PHYSICIAN 351034 0 209534 0 22822 0 9562 0 11209 0 604161 0 0 0 JANET HURLEY MD physician 119497 0 15940 0 4218 0 2580 0 17495 0 159730 0 0 0 MEG REITMEYER MD physician 238022 0 0 0 23408 0 10837 0 7548 0 279816 0 586 0 JOSEPH ZASIK DO physician 516264 0 0 0 22822 0 8712 0 6633 0 554431 0 0 0 THOMAS HARGROVE VP 332360 0 32497 0 12821 0 10837 0 21444 0 409959 0 4701 0 BRENDA MORRIS MD PHYSICIAN 382818 0 0 0 5322 0 9031 0 0 0 397171 0 0 0 FAGG SANFORD MD physician 832428 0 0 0 26369 0 8287 0 8290 0 875374 0 0 0 DAVID TEEGARDEN MD SYSTEM PRESIDENT/CMO/DIRECTOR 97133 0 0 0 3673 0 2250 0 20266 0 123322 0 0 0 LAURA O'HALLORAN MD PHYSICIAN 961682 0 620836 0 5322 0 9562 0 18944 0 1616346 0 0 0 WAYNE GLUF MD PHYSICIAN 1526613 0 1000 0 22822 0 8287 0 14093 0 1572815 0 0 0 RAMON KUMAR MD PHYSICIAN 577881 0 701339 0 5322 0 8287 0 19544 0 1312373 0 0 0 TODD PATRICK MD PHYSICIAN 1035772 0 152650 0 5322 0 9562 0 18944 0 1222249 0 0 0 NEELAN DOOLABH MD PHYSICIAN 746472 0 391223 0 21822 0 8287 0 9647 0 1177451 0 0 0 ANN GILBERT VP 154471 0 9220 0 37175 0 1974 0 9975 0 212815 0 0 0 CHRIS GLENNEY SR. VP 251415 0 41650 0 10875 0 9663 0 19105 0 332708 0 0 0 JOYCE HESTER SR. VICE PRESIDENT/CFO 80449 241347 28969 86905 0 0 2710 8128 3104 9310 115232 345690 0 0 ROGER FOWLER MD PHYSICIAN 314093 0 34427 0 25846 0 10837 0 9738 0 394941 0 0 0 GREGORY STOVALL MD PHYSICIAN 146608 0 7415 0 46846 0 7953 0 18944 0 227766 0 11251 0 WILLIAM BELLENFANT SR SR VP/CFO/DIRECTOR/TREASURER 0 0 0 0 0 213528 0 0 0 0 0 213528 0 0 William mCcrady md VP 171501 0 85475 0 195869 0 10183 0 14093 0 477121 0 4405 0 SCHEDULE J, PART I, LINE 6A COMPENSATION CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION: SOME PHYSICIANS ARE PAID BASED ON THE COMPENSATION FORMULA OF THEIR INDIVIDUAL RESPECTIVE DEPARTMENTS. SCHEDULE J, PART I, LINE 4a Severance & change of control payments: William Mccrady MD $166,469 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 MEG REITMEYER MD $586 THOMAS HARGROVE $4,701 GREGORY STOVALL MD $11,251 james stanford md $2,285 William Mccrady md $4,405 fagg sanford md none oladimeji akiode md none Karen Zasik wife of director 66455 salaries/wages false FORM 990, PART V, LINE 1A 1099S REPORTED BY ORGANIZATION: FORMS 1099-INT ARE ISSUED BY THE FILING ORGANIZATION. HOWEVER, THE ORGANIZATION'S FORMS 1099-MISC ARE ISSUED BY A RELATED ORGANIZATION, MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER, WHICH REPORTS ALL FORMS 1099-MISC FOR THE ENTIRE SYSTEM AND ALLOCATES EXPENSES TO THE APPROPRIATE RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS: TRINITY MOTHER FRANCES HEALTH SYSTEM IS THE SOLE MEMBER OF TRINITY CLINIC. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY THE MEMBER: THE MEMBER HAS THE AUTHORITY TO APPROVE OR DISAPPROVE CERTAIN MATTERS 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 MADE AVAILABLE TO THE BOARD OF DIRECTORS UPON THEIR REQUEST. 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 AND ULTIMATELY APPROVED BY TRINITY MOTHER FRANCES HEALTH SYSTEM. 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: PROFEsSIONAL FEES $ 117,782,937 PURCHASED SERVICES 1,506,560 DIRECTOR FEES 1,495,932 CONSULTING 937,707 DIRECT CARE FEES 158,588 PHYSICIAN FEES 100,420 CONTRACT LABOR 68,559 corporate allocation (1,354,566) --------------------------- TOTAL $ 120,696,137 FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: TranFERS FROM AFFILIATE $ 16,608,398 MOTHER FRANCES HOSPITAL REGIONAL HC CTR 1315 DOCTORS DRIVE TYLER TX 75701 750818167 HOSPITAL TX 501(c)(3) 3 TMFHS false MOTHER FRANCES HOSPITAL - JACKSONVILLE 1315 DOCTORS DRIVE TYLER TX 75701 751976930 HOSPITAL TX 501(c)(3) 3 TMFHS false TRINITY MOTHER FRANCES HEALTH SYSTEM FDN 1315 DOCTORS DRIVE TYLER TX 75701 752028241 SUPPORT TX 501(c)(3) 11, type i TMFHS false REGIONAL MEDICAL SERVICES ASSOCIATION 1315 DOCTORS DRIVE TYLER TX 75701 752511459 HEALTHCARE TX 501(c)(3) 3 MFH REG false TRINITY MOTHER FRANCES HEALTH SYSTEM 1315 DOCTORS DRIVE TYLER TX 75701 752616975 support TX 501(c)(3) 11, type i NA false MOTHER FRANCES HOSPITAL - WINNSBORO 1315 DOCTORS DRIVE TYLER TX 75701 752771569 HOSPITAL TX 501(c)(3) 3 TMFHS false TRI-STATE FINANCIAL LLC 1315 DOCTORS DRIVE TYLER TX 75701 752728318 DORMANT TX TMFHS C-CORPORATION false TRINCARE INC 1315 DOCTORS DRIVE TYLER TX 75701 752161369 RETAIL HEALTH SVC TX TMFHS C-CORPORATION false HEALTHPLAN OF TEXAS INC 1315 DOCTORS DRIVE TYLER TX 75701 752636832 THIRD PARTY ADMIN TX TMFHS C-CORPORATION false THE REGIONAL HEALTHCARE ALLIANCE 1315 DOCTORS DRIVE TYLER TX 75701 752484109 PREFER PROVIDER TX TMFHS C-CORPORATION false TEXAS HEALTH FACILITIES INSUR CORP LTD PO BOX 1109 BWI CAYMAN ISLANDS CJ 980136025 INSURANCE CJ MFH REG C-CORPORATION false CONCORDIUM HEALTH LLC 1315 DOCTORS DRIVE TYLER TX 75701 702811022 INACTIVE TX NA C-CORPORATION false false false true false true false false true false false true true true true true true true false true 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 HEALTHCARE CENTER MOTHER FRANCES HOSPITAL - JACKSONVILLE MOTHER FRANCES HOSPITAL - WINNSBORO TRINITY MOTHER FRANCES HEALTH SYSTEM FOUNDATION REGIONAL MEDICAL SERVICES ASSOCIATION IS DIRECTLY CONTROLLED BY MOTHEr FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER ("MFH REG").