2014-05-15T13:58:01-05:00 2013-06-30 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2012-07-01 752028241 MOTHER FRANCES HOSPITAL FOUNDATION % MOTHER FRANCES HOSP ACCTG DE MOTH 9035315764 1315 DOCTORS DRIVE Suite TYLER TX 75701 JOYCE HESTER 9035315764 2014-05-15 true Amanda Maya 7134994600 2012 2015-11-30 17:44:51Z ANDY NAVARRO 910 E HOUSTON SUITE 500 TYLER TX 75702 6897963 false X WWW.TMFHS.ORG X 1984 TX THE FOUNDATION'S PRIMARY MISSION IS TO RECEIVE FUNDS FOR THE BENEFIT OF MOTHER FRANCES REGIONAL HEALTHCARE CENTER. THE FOUNDATION SEEKS FUNDING FROM THE COMMUNITY TO SUPPORT ACTIVITIES FOR HOSPITAL GROWTH. 13 8 0 16 0 3599935 2704505 0 0 77337 179206 0 0 3677272 2883711 1589894 6160523 0 0 0 0 0 0 0 336737 646411 1926631 6806934 1750641 -3923223 12615104 8999332 549279 598297 12065825 8401035 X MOTHER FRANCES HOSPITAL FOUNDATION HAS AS ITS PRIMARY MISSION TO RECEIVE FUNDS FOR THE BENEFIT OF THE PARENT ORGANIZATION, MOTHER FRANCES REGIONAL HEALTHCARE CENTER. AS PART OF MEETING THAT MISSION, THE FOUNDATION SEEKS FUNDING FROM THE COMMUNITY AT LARGE TO SUPPORT ACTIVITIES SUCH AS CHILDREN'S MIRACLE NETWORK, PEARLS AND PROMISES GALA, AND CAPITAL CAMPAIGNS FOR HOSPITAL GROWTH. false false 6737615 6160523 MOTHER FRANCES HOSPITAL FOUNDATION SUPPORTS MOTHER FRANCES HOSPITAL REGIONAL HEALTHCARE CENTER AND TRINITY CLINIC THROUGH TRINITY MOTHER FRANCES HEALTH SYSTEM. 6737615 true true false false false false false false false true false false false false true false true false 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 false false false true X 0 0 0 false false false false true true true true false false false false false X 13 8 false false false false false false false true true false false true true true true true true false false false X MOTHER FRANCES HOSP ACCTG DE 9035315764 1315 DOCTORS DRIVE TYLER TX 75701 X RANDALL CHILDRESS 1.0 1.0 X X 0 0 0 DAVID DYKES MD 1.0 0.0 X 0 0 0 MARY FAULKNER 1.0 0.0 X 0 0 0 TERRY GILES 1.0 0.0 X 0 0 0 SISTER IRENE ASZTEMBORSKA 1.0 40.0 X 0 0 0 DANIEL SALEH 1.0 0.0 X 0 0 0 FATHER JOSEPH STRICKLAND 1.0 0.0 X 0 0 0 JOHN WILLIAMS 1.0 0.0 X 0 0 0 ANDY NAVARRO 1.0 40.0 X X 0 362635 18767 CLAYTON WHITNEY MD 1.0 40.0 X 0 832902 24974 MEG REITMEYER MD 1.0 40.0 X 0 289920 6760 JAMES CACCITOLO MD 1.0 40.0 X 0 819712 27424 LUIS HARO MD 1.0 40.0 X 0 534236 24974 PATRICK THOMAS MD 1.0 1.0 X 0 49596 0 MARY JACKSON 20.0 20.0 X 0 227706 14217 ROYAL BECKER MD 0.0 41.0 X 0 934126 24666 DAVID TEEGARDEN MD 0.0 0.0 X 0 202767 19772 0 4253600 161554 0 true true false 0 49180 2655325 2704505 0 43833 43833 0 0 0 0 0 4149625 4014252 135373 135373 135373 0 0 0 0 2883711 179206 6160523 6160523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58336 0 58336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 BAD DEBT EXPENSE 577092 577092 BANK FEES 10983 10983 6806934 6737615 69319 0 0 0 2636127 923332 1465227 995846 0 0 0 0 0 0 0 0 0 0 0 0 0 8423243 6999817 0 0 0 0 0 0 90507 80337 12615104 8999332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549279 598297 549279 598297 X 702458 2452 9230745 6347457 2132622 2051126 12065825 8401035 12615104 8999332 -3923223 258433 X false true X true false X X X false false false MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER 750818167 03 false true true 5912911 TRINITY CLINIC 752616977 03 false true true 64457 2 5977368 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2408876 0 163752 157934 2414694 2350337 30875 27664 2408876 2209013 50 141274 2350337 414414 1790794 4305 500 2209013 413932 239 243 414414 0.84944 0.15057 false false 0 DUE TO AFFILIATES 598297 598297 3142144 258433 258433 2883711 2883711 6806934 6806934 6806934 INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 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. true MOTHER FRANCES HOSPITAL REGIONAL HC CTR 1315 DOCTORS DRIVE TYLER TX 75701 750818167 501(c)(3) 693947 HEART HOSP/EQPMT MOTHER FRANCES HOSPITAL REGIONAL HC CTR 1315 DOCTORS DRIVE TYLER TX 75701 750818167 501(c)(3) 5218964 HEART HOSP/EQPMT TRINITY CLINIC 1315 DOCTORS DRIVE TYLER TX 75701 752616977 501(C)(3) 64457 RESPITED PROGRAM 2 PROCEDURES FOR MONITORING THE USE OF FUNDS IN THE UNITED STATES SCHEDULE I, PART I, LINE 2 THE FOUNDATION EVALUATES AND MONITORS DONEES BASED ON PUBLIC AND PRIVATE DATA. X true false X X X X X false true false false false false false false false ANDY NAVARRO 0 312339 0 50296 0 0 0 10625 0 8142 0 381402 0 0 CLAYTON WHITNEY MD 0 583911 0 227163 0 21828 0 8125 0 16849 0 857876 0 0 MEG REITMEYER MD 0 267592 0 0 0 22328 0 0 0 6760 0 296680 0 0 JAMES CACCITOLO MD 0 798800 0 15584 0 5328 0 9375 0 18049 0 847136 0 0 LUIS HARO MD 0 508500 0 0 0 25736 0 8125 0 16849 0 559210 0 0 ROYAL BECKER MD 0 434450 0 492785 0 6891 0 10625 0 14041 0 958792 0 0 MARY JACKSON 0 185709 0 28797 0 13200 0 7685 0 6532 0 241923 0 0 DAVID TEEGARDEN MD 0 197563 0 0 5204 0 2250 0 17522 0 222539 0 0 PARTICIPATION IN OR PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B PARTICIPANTS IN SERP REPORTED IN W-2 DEFERRED COMPENSATION -------------------- --------------- --------------------- DAVID TEEGARDEN MD NONE NONE PARTICIPANTS IN 457(F) REPORTED IN W-2 ---------------------- --------------- DAVID TEEGARDEN MD NONE TAX INDEMNIFICATION & GROSS UP PAYMENTS SCHEDULE J, PART I, LINE 1A Amounts paid for "grossed up" gift cards are included as taxable compensation for the following directors: MARY JACKSON, ANDY NAVARRO, CLAYTON WHITNEY, JAMES CACCITOLO, AND ROYAL BECKER DESCRIBE REVIEW PROCESS OF FORM 990 FORM 990, PART VI, SECTION B, LINE 11B 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. HOW DOES THE ORGANIZATION MONITOR AND ENFORCE COMPLIANCE WITH POLICY FORM 990, PART VI, SECTION B, LINE 12C THE BOARD REVIEWS AND RESOLVES, IF NECESSARY, ANY TRANSACTIONS AS THEY ARISE THROUGHOUT THE YEAR IN ACCORDANCE WITH POLICY STANDARDS. DESCRIBE WHETHER THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE TO PUBLIC FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. COMPENSATION FROM RELATED ORGANIZATIONS FORM 990, PART VII & SCHEDULE J 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. 1099S REPORTED BY ORGANIZATION FORM 990, PART V, LINE 1A NO 1099S WERE ISSUED BY THE FILING 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; THEREFORE, THIS QUESTION IS ANSWERED AS "NONE" FOR THIS FILING ORGANIZATION. TRINITY CLINIC 1315 DOCTORS DRIVE TYLER TX 75701 752616977 HEALTHCARE TX 501(C)(3) 3 TMFHS false 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 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 COLLECTION AGENCY 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 GRAND CAYMAN 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 true false false false false false false false false false false false false true true true false false DIRECT CONTROLLING ENTITY SCHEDULE R, PART II, COLUMN F AND PART III, COLUMN D THE FOLLOWING RELATED ORGANIZATIONS REPORTABLE IN PART II ARE DIRECTLY CONTROLLED BY TRINITY MOTHER FRANCES HEALTH SYSTEM ("TMFHS"): MOTHER FRANCES HOSPITAL - JACKSONVILLE TRINITY CLINIC MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER MOTHER FRANCES HOSPITAL - WINNSBORO REGIONAL MEDICAL SERVICES ASSOCIATION IS DIRECTLY CONTROLLED BY MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER ("MFH REG").