2015-08-13T08:50:01-05:00 2014-09-30 450250958 EIDE BAILLY LLP 1601 NW EXPRESSWAY SUITE 1900 OKLAHOMA CITY OK 73118 990 2013-10-01 750703337 Parmer County Community Hospital PARM 8062502754 1307 Cleveland Street Friona TX 79035 Gayla Quillin Administrator 8062502754 2015-07-21 1 Kim Hunwardsen CPA P00484560 4054783334 2015-07-21 2013 2016-02-25 16:41:14Z Parmer Medical Center Gayla Quillin 1307 Cleveland Street Friona TX 79035 11168948 0 X www.parmermedicalcenter.com X 1956 TX Acute care hospital with personalized service and state-of-the-art care. 5 5 130 48 0 0 347455 370696 9871932 10687619 16112 89833 40165 -4758 10275664 11143390 3869 9750 0 0 4315043 4989397 0 0 0 5050485 5424264 9369397 10423411 906267 719979 10609873 10959129 1104130 733407 9505743 10225722 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. 0 0 8601009 9750 10687619 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. The amounts of charges foregone for services provided under the Organization's charity care policy was approximately $108,000 for the year ended September 30, 2014. Total direct and indirect cost related to those forgone charges was approximately $91,000 at September 30, 2014. Program service accomplishments include: 1. Exercise and fitness program for ongoing physical therapy patients.2. Provide access for Harrington Cancer Center patients to receive mammograms.3. Involvement in bioterrorism prevention for the area.4. Participate in cancer research treatment and education through 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 a 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. 8601009 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 30 0 1 130 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 0 0 X Heidi Eichenauer 8062502754 1307 Cleveland Street Friona TX 79035 Daniel M Kendrick President 1.00 X X 0 0 0 Dale Schueler Vice President 1.00 X X 0 0 0 Dennis Anthony Secretary 1.00 X X 0 0 0 Bret Whitten Member 1.00 X 0 0 0 Robert Neelley Member 1.00 X 0 0 0 Gayla Quillin- Mgmt Company Administrator 40.00 X 0 0 0 Michael Sermon PA-C Physician assistant 40.00 X 120709 0 17156 Nimfa Martin Physical Therapist 40.00 X 104068 0 14092 224777 0 31248 2 0 0 0 Community Care Specialists Inc 120 W MacArthur Suite 121 Shawnee OK 74804 Physician providers 744165 Preferred Management Corporation 120 W MacArthur Suite 121 Shawnee OK 74804 Management & accounting services 352130 Quality Systems Inc PO Box 511449 Los Angeles CA 90051 EHR software service provider 219619 Concord Medical Group Inc 3004 50th St Suite D Lubbock TX 794134129 ER physicians (locums) 199735 Shared Imaging LLC PO Box 88544 Milwaukee WI 532880544 CT scan equipment lease 166800 9 317040 53656 370696 Patient service revenue 622110 10077257 10077257 EHR incentive 900099 570250 570250 Supporting revenue 900099 40112 40112 10687619 89833 89833 20800 25558 -4758 -4758 -4758 11143390 10687619 0 85075 9750 9750 3883252 3414580 468672 802199 625280 176919 303946 266608 37338 351420 351420 4395 4395 77579 77579 1677385 1544588 132797 40646 3072 37574 504716 438963 65753 306603 306603 164241 164241 55295 30641 24654 29061 18538 10523 240832 240832 89804 89804 Bad debt 1105795 1105795 Medical supplies 673900 673900 Dues and licenses 34116 12409 21707 Publications and subcri 5581 2425 3156 62895 49387 13508 10423411 8601009 1822402 0 6503142 6941255 1676416 1759530 133515 160348 97923 112012 3883797 2585883 1491912 1297914 54830 129853 78358 59921 573777 498296 10609873 10959129 755072 733407 349058 0 1104130 733407 X 8474876 8927808 1030867 1297914 9505743 10225722 10609873 10959129 719979 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17741 17741 1354276 369300 984976 2511780 2216583 295197 1297914 X Part X, Line 2: As an essential function of Parmer County, the District is exempt from income taxes under section 115 of the internal revenue code and similar provision of state law. The Hospital is organized as a Texas nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Hospital believes that they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, do not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 1 1 0 0 91000 91000 0.00980 513186 311208 201978 0.02170 604186 311208 292978 0.03150 12872 12872 0.00140 10213 10213 0.00110 1305884 879902 425982 0.04570 1328969 879902 449067 0.04820 1933155 1191110 742045 0.07970 0 1105795 110580 4688885 4780512 -91627 X 1 1 1 1 Parmer County Community Hospital Inc 1307 Cleveland Ct Friona TX 79035 www.parmermedicalcenter.com 000200 X X X Provider Based RHC Parmer County Community Hospital Inc 1 1 X X X X X X 12 1 0 1 X www.parmermedicalcenter.com X X X X X 1 0 1 1 100.000000000000 1 200.000000000000 1 X X X X 1 1 X X X 1 0 X X X X 1 X 0 0 Parmer County Community Hospital, Inc. Part V, Section B, Line 3: 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 6i: The Implementation Strategy is available on the Medical Center website at www.parmermedicalcenter.com and available upon request at the facility. Parmer County Community Hospital, Inc. Part V, Section B, Line 12i: Even if patients do not qualify for financial assistance based on the other factors, physician referrals may be taken into consideration. Parmer County Community Hospital, Inc. Part V, Section B, Line 14g: 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 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 2013/2014. 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, line 7e, and health professions education, line 7f, was reported based on actual expenses recorded in the Organization's 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 $1,105,795. 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 in prior years has not shown a Medicare shortfall. There was a shortfall in FY 2014 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: PMC used the resources of the physicians of Friona Rural Health Clinic (FRHC) to assist in assessing the needs of the community. In addition, community feedback on a one-on-one basis was considered. The community needs assessment was reviewed and additional information was supplied. The new information includes our implementation of a Chronic Care Clinic to address health care needs of a particular population in the service area. The Chronic Care Clinic is offered free to Diabetic patients with HbA1c lab values >9. The clinic provides education about the disease, medications, nutrition, physical activity, case management and social issues. The goal of the clinic is to provide patients with the tools to better self-manage their Diabetes as they work alongside the healthcare team. 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 10,269 people. With 3,299 households in 2010, the median income is approximately $10,000 below the state average. The 2010 Hispanic or Latino population was 60.0%, well above the statewide average of 37.6%. (Statistics from the U.S. Census Bureau website)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 for 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 6 9750 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 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 Medical Center's Board of Directors uses the processes described in Part I, Question 3 to determine appropriate compensation for the Administrator. The Board of Directors also approves the Organization's contract with the Management Company. 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 15 The governing Board serves on a volunteer basis and does not receive compensation of any type for their service. The Administrator is paid by a management company. No other employees meet the definition of a key employee. 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. Form 990, Part VI, Section C, line 19 Governing documents and financial statements are available upon request or at the annual membership meeting. 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