2015-11-16T09:08:03-06:00 2014-12-31 752570395 DURBIN & COMPANY LLP 2950 50TH STREET LUBBOCK TX 79413 990 2014-01-01 741461220 FRIO HOSPITAL ASSOCIATION FRIO 8303343617 200 S IH 35 PEARSALL TX 780616601 MICHAEL S THOMPSON CEO 8303343617 2015-11-16 1 GAYLE DE HAAS P01774581 8067911591 2015-11-12 2014 2016-04-25 22:37:26Z FRIO REGIONAL HOSPITAL MICHAEL S THOMPSON 200 S IH 35 PEARSALL TX 780616601 16262344 0 X WWW.FRIOREGIONALHOSPITAL.COM X 2002 TX TO PROVIDE QUALITY AND AFFORDABLE HEALTHCARE SERVICES TO THE CITIZENS OF PEARSALL AND THE SURROUNDING COMMUNITIES. 7 7 142 0 0 0 10686 11440 14748700 13960045 255859 -6889 1210302 2280285 16225547 16244881 0 0 0 0 5731215 6129170 0 0 0 7980070 8428205 13711285 14557375 2514262 1687506 7786416 9995345 1207869 1729292 6578547 8266053 FRIO HOSPITAL ASSOCIATION (THE "ASSOCIATION") OPERATES A NOT-FOR-PROFIT ACUTE CARE HOSPITAL, FRIO REGIONAL HOSPITAL (THE "HOSPITAL"). THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT SERVICES AS WELL AS OTHER AFFILIATED SERVICES TO FRIO COUNTY, TEXAS. 0 0 13918959 16222867 HOSPITAL SERVICES THAT INCLUDE BUT ARE NOT LIMITED TO: 942 TOTAL PATIENT DAYS, 323 SURGERIES, 7,217 EMERGENCY ROOM VISITS, 62,268 LABORATORY PROCEDURES AND 7,296 RADIOLOGY PROCEDURES.THE HOSPITAL ALSO PROVIDED $1,275,470 IN CHARITY CARE. 13918959 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 59 0 1 142 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 0 1 0 0 0 1 1 1 1 0 0 0 0 0 X THE ORGANIZATION 8303343617 200 S IH 35 PEARSALL TX 780616601 BOB BALLENTINE PRESIDENT 0.10 X 0 0 0 MARY JO PHILIPS VICE PRESIDENT 0.10 X 0 0 0 ABEL TREVINO SECRETARY 0.10 X 0 0 0 ROBERT GORHUM DDS DIRECTOR 0.10 X 0 0 0 FRANKIE PETTY DIRECTOR 0.10 X 0 0 0 JAMES SCHORP DIRECTOR 0.10 X 0 0 0 JIM GATES DIRECTOR 0.10 X 0 0 0 MICHAEL S THOMPSON CEO 40.00 X 120915 0 0 RHETT D FRICKE CFO 40.00 X 131770 0 0 MARIA L MARTINEZ DON 40.00 X 104051 0 0 356736 0 0 3 0 0 0 FRIO HOSPITAL DISTRICT 200 S IH 35 PEARSALL TX 78061 FACILITY RENTAL 720000 POST ACUTE MEDICAL MANAGEMENT LLC 3500 MARKET ST STE 102 CAMP HILL PA 17011 MEDICAL SERVICES 450275 CPSI 6600 WALL STREET MOBILE AL 36695 SOFTWARE SUPPORT 284098 3 11440 11440 PATIENT SERVICE 621990 12595227 12595227 INDIGENT CARE SUPPORT 621990 1364818 1364818 13960045 10574 10574 12040 0 12040 12040 12040 17463 -17463 -17463 -17463 EHR INCENTIVE 900099 2090830 2090830 MISCELLANEOUS 900099 139215 139215 CAFETERIA SALES 900099 34525 34525 3675 3675 2268245 16244881 16222867 0 10574 X 356736 104051 252685 4411498 4345827 65671 147690 147690 871744 871744 341502 330654 10848 13567 13567 82502 82502 2547300 2540736 6564 16105 25 16080 185059 101670 83389 234614 234614 1359057 1351193 7864 25511 24251 1260 1405 1405 251942 251942 84756 73958 10798 BAD DEBT EXPENSE 2592094 2592094 MEDICAL SUPPLIES 881490 881490 EDUCATION & TRAINING 60085 35026 25059 PENALTY 50000 50000 42718 30589 12129 14557375 13918959 638416 0 4367759 5684307 1606998 1220468 302252 332071 110176 110524 4621805 3526450 987694 1095355 372913 636245 38624 916375 7786416 9995345 1081455 1438540 282668 126414 8084 1207869 1729292 X 6578547 7983385 282668 6578547 8266053 7786416 9995345 1687506 0 X 1 X 1 X 1 0 X 15282 15282 258690 180970 77720 16783 15012 1771 4256322 3330468 925854 74728 74728 1095355 GENERAL LIABILITY/MALPRACTICE SELF-FUNDED INSURANCE 353412 C EDWARD JONES INVESTMENTS 282833 C 636245 THIRD PARTY PAYOR RECEIVABLE 887459 STOP LOSS RECEIVABLE 28916 916375 THIRD PARTY PAYOR SETTLEMENTS PAYABLE 8084 8084 X 13652787 0 13652787 2592094 2592094 16244881 11965281 0 11965281 2592094 2592094 14557375 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND IS QUALIFIED AS A TAX-EXEMPT ORGANIZATION; THEREFORE, NO EXPENSE HAS BEEN PROVIDED FOR INCOME TAXES IN THE ACCOMPANYING FINANCIAL STATEMENTS. THEY ARE REQUIRED TO FILE THE IRS FORM 990. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 2,592,094. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 2,592,094. 1 1 1 X 20.000000000000 1 X 185.000000000000 1 1 0 0 952000 242904 709096 0.05930 3621429 4786363 -1164934 0.00000 4573429 5029267 -455838 0.05930 4573429 5029267 -455838 0.05930 1 1156778 538369 949665 299111 650554 X 1 1 1 1 FRIO HOSPITAL ASSOCIATION 200 S IH 35 PEARSALL TX 78061 WWW.FRIOREGIONALHOSPITAL.COM 000441 X X X HOSPITAL FRIO REGIONAL HOSPITAL 1 0 0 1 X X X X X X X X 14 1 0 0 1 X 1 14 0 1 0 1 X 20.000000000000 185.000000000000 X X X X X X 1 1 X X 1 X 1 0 X X X 1 X 0 0 FRIO REGIONAL HOSPITAL PART V, SECTION B, LINE 5: THE HOSPITAL DETERMINED THE NEEDS OF THE COMMUNITY THROUGH INTERVIEWS AND SURVEYS OF COMMUNITY MEMBERS AND STAFF MEMBERS (PHYSICIAN AND NON-PHYSICIAN) OF THE HOSPITAL EITHER BY PHONE OR IN PERSON. FRIO REGIONAL HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL HAS HIRED ADDITIONAL PHYSICIANS THAT WILL INCREASE ACCESS TO PRIMARY CARE FOR THE COMMUNITY AND REDUCE THE WAIT TIME FOR PATIENT APPOINTMENTS. THESE PHYSICANS ALSO WILL INCREASE THE CARE FOR PREGNANT PATIENTS. THE HOSPITAL ALSO IMPLEMENTED A TELE-MEDICINE PROGRAM IN CARDIOLOGY. THE HOSPITAL ENTERED A PROGRAM WITH THE UNIVERSITY OF TEXAS MEDICAL SCHOOL IN SAN ANTONIO THAT ALLOWS RESIDENTS AND MEDICAL STUDENTS TO PROVIDE SPECIALTY SERVICES FOR THE COMMUNITY MEMBERS. FRIO REGIONAL HOSPITAL PART V, SECTION B, LINE 22D: THE AMOUNT OF CHARITY DISCOUNT WILL BE BASED ON THE FAMILY'S INDIVIDUAL SITUATION. THE STANDARD RULE, WHICH THE CASEWORKER WILL FOLLOW, IS TO DISCOUNT THE BILL 50% AND SET UP A PAYMENT PLAN FOR THE BALANCE. EXCEPTIONS WILL BE MADE BY THE ADMINISTRATOR OR HIS DESIGNEE. 2 FRIO HOSPITAL HOME HEALTH 1317 E COLORADO PEARSALL TX 78061 HOME HEALTH FRIO REHABILITATION CENTER 209 HACKBERRY RD PEARSALL TX 78061 REHABILITATION CENTER PART I, LINE 3C: THE FOLLOWING FACTORS ARE TO BE CONSIDERED IN DETERMINING THE ELIGIBILITY OF THE PATIENT FOR CHARITY CARE:GROSS FAMILY INCOMEFAMILY SIZEEMPLOYMENT STATUS AND FUTURE EARNING CAPACITYOTHER FINANCIAL RESOURCESOTHER FINANCIAL OBLIGATIONSTHE AMOUNT AND FREQUENCY OF HOSPITAL AND OTHER MEDICAL BILLS PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,592,094. PART III, LINE 4: ASU 2011-04, AS REQUIRED, IN THE FISCAL YEAR BEGINNING JANUARY 2012. IN JULY 2011, THE FASB ISSUED ASU 2011-07, PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES, AS AN AMENDMENT TO ASC TOPIC 954. ASU 2011-07 REQUIRES THE RECLASSIFICATION OF THE PROVISION FOR BAD DEBT ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE. THIS AMENDMENT ALSO REQUIRES ENHANCED DISCLOSURE OF THE POLICIES FOR RECOGNIZING REVENUE AND ACCESSING BAD DEBTS, THE DISCLOSURE OF PATIENT SERVICE REVENUE, AND ADDITIONAL INFORMATION ABOUT CHANGES IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL WILL ADOPT ASU 2011-07, AS REQUIRED, IN THE FISCAL YEAR BEGINNING JANUARY 2012.A COST TO CHARGE RATIO OF 46.02% WAS USED TO DETERMINE THE AMOUNTS REPORTED ABOVE FOR BAD DEBT EXPENSE. THE RATIO WAS DETERMINED BY DIVIDING TOTAL OPERATING EXPENSE (EXCLUDING BAD DEBT EXPENSE) FROM THE FINANCIAL STATEMENTS BY GROSS PATIENT CHARGES. THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS CALCULATED ON THE ORGANIZATION'S ANNUAL MEDICARE & MEDICAID COST REPORT WORKSHEET S-10. PART III, LINE 8: LINE 6 IS ARRIVED BY USING THE COST TO CHARGE RATIOS BASED ON THE MEDICARE COST REPORT.LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT IN THAT THE HOSPITAL TREATS PATIENTS REGARDLESS OF THE REIMBURSEMENT BY MEDICARE. PART VI, LINE 2: NEEDS OF THE COMMUNITY ARE ASSESSED BY GEOGRAPHIC INFORMATION AVAILABLE TO THE HOSPITAL, STATISTICAL INFORMATION THAT THE HOSPITAL CAN USE TO FURTHER IT'S BENEFIT TO THE COMMUNITY. PART VI, LINE 3: THERE ARE SEVERAL WAYS THAT THE HOSPITAL EDUCATES THE PUBLIC ABOUT IT'S CHARITY CARE PROGRAMS. THE WEBSITE GIVES THE INFORMATION WHERE THE HOSPITAL'S CASEWORKER CAN BE FOUND IN ADDITION TO A STATE EMPLOYEE OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES ON CAMPUS. THERE ARE ALSO SIGNS IN BOTH ENGLISH AND SPANISH THAT DIRECTS PATIENTS TO THE ASSISTANCE THEY COULD QUALIFY FOR. PART VI, LINE 4: FRIO HOSPITAL SERVES THE FRIO COUNTY AND SURROUNDING COMMUNITIES. THESE CONSIST OF PRIMARILY 70% OF THE WORKFORCE WITH A VOCATIONAL OR TRADE BACKGROUND. PRIMARILY A HISPANIC POPULATION,11,987 OR 74% OF THE 16,252 PEOPLE LIVING IN FRIO COUNTY ARE HISPANIC ACCORDING TO THE LATEST CENSUS. FRIO HOSPITAL IS LOCATED IN PEARSALL WHICH IS APPROXIMATELY 55 MILES FROM SAN ANTONIO AND APPROXIMATELY 97 MILES FROM THE MEXICAN BORDER. MEDIAN INCOME FOR FAMILIES WAS $23,470. HOWEVER, 30.4% OF THE POPULATION OF FAMILIES WERE BELOW THE POVERTY LINE. OF THOSE, 43.2% WERE UNDER THE AGE OF 18 AND 40.0% OF THOSE WERE 65 AND OLDER. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE ORGANIZATION INCLUDE SEVERAL BUSINESS AND COMMUNITY LEADERS OF FRIO COUNTY, TEXAS FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE ORGANIZATION VOTE TO ELECT MEMBERS OF THE GOVERNING BODY THAT CONSISTS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE SEPARATE COMMITTEES TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S TAX RETURN IS REVIEWED BY THE BOARD OF DIRECTORS AND APPROVED BY MANAGEMENT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICT OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 EXCEPT AS PROVIDED FOR IN THE FORM 1023 AND FORM 990S, THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G HOSPITAL & PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 2,540,736. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,540,736. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 6,564. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,564.