2014-07-14T16:24:47-05:00 2013-08-31 346565596 Ernst & Young US LLP 1901 6th Avenue North Ste 1200 Birmingham AL 35203 990 2012-09-01 741166904 Scott & White Memorial Hospital SCOT 2542159256 2401 S 31st Street Temple TX 76508 Shahin Motakef 2542159256 2014-07-11 0 Kathy H Pitts P00292940 2052541608 2014-07-14 2012 2015-11-30 17:44:51Z Shahin Motakef 2401 S 31st Street Temple TX 76508 1132550182 0 X www.sw.org X 1949 TX See Schedule O Acute care hospital providing the most personalized, comprehensive, high quality health care services enhanced by medical education and research to Central Texas residents throughout a 29,000-square mile service area. 11 4 14144 150 2413480 0 174240 9828954 948229202 859909085 1098211 6010006 5574817 5311077 955076470 881059122 111120605 712546 0 0 339535067 313126184 0 0 0 527325654 491012735 977981326 804851465 -22904856 76207657 1415707501 1060405941 695879758 223250835 719827743 837155106 X To provide the most personalized, comprehensive and highest quality health care, enhanced by medical education and research. 0 0 542131124 712546 829488000 See Schedule OScott & White provides personalized, comprehensive, high quality health care services enhanced by medical education and research through 13 acute care hospital facilities, one additional announced facility, a 215,000+ member regional health plan serving residents in a 29,000-square mile service area, and one of the nation's largest multi-specialty group practices with more than 140 clinics at over 70 clinic locations providing care in 46 medical specialties. Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is parent corporation of the Scott & White Healthcare System (the "System"). The Scott & White Healthcare Foundation ("SWF")(EIN: 27-3513154), a subsidiary of SWHC, raises funds for the priority programs and services of the entire Scott & White System. The Scott & White Healthcare System had more than 14,000 employees, including over 1,200 physicians and scientists and 300+ advanced practice professionals during the fiscal year ending August 31, 2013, and served over 537,000 patients accounting for 2.5 million patient visits. Scott & White Memorial Hospital ("SWMH"), located in Temple, Texas, is the flagship hospital of the Scott & White Healthcare System and is the only Level I Trauma Center between Dallas and Austin, Texas. The McLane Children's Hospital Scott & White is the only stand-alone children's hospital between Dallas and Austin, Texas. Scott & White Memorial Hospital operates a 613 bed acute care hospital and a 78 bed stand-alone children's hospital. Scott & White Memorial Hospital had 145,682 patient observation days (excluding newborns), 23,246 surgical cases, 27,995 admissions and 76,829 emergency room visits for the fiscal year ending August 31, 2013. The McLane Children's Hospital at Scott & White includes 48 private rooms, 16 pediatric intensive care rooms, 14 pediatric emergency room suites, and provides 24-hour emergency room services dedicated to and specifically equipped to respond to children's needs. The McLane Children's Hospital at Scott & White had 27,477 patient observation days (excluding newborns), 3,837 surgical cases, 3,863 admissions and 21,608 emergency room visits for the fiscal year ending August 31, 2013. The McLane Children's Hospital is the first dedicated children's hospital in Texas, and third in the country, to install the latest in computed tomography (CT) technology. The Sonotom Definition Flash CT system from Siemens Healthcare produces images with up to 128-slice detail at more than twice the speed of most CT systems used in children's hospitals in the U.S. Scott & White Memorial Hospital reported community benefits (as reported to the Texas Department of State Health Services and in accordance with the State of Texas Statutory methodology) of $110,429,026. All hospitals in the Scott & White Healthcare System reported combined community benefits under this same methodology of $223,575,612. 77100928 16607965 See Schedule OScott & White Healthcare ("SWHC") is the primary teaching affiliate to the Texas A&M University System Health Science Center College of Medicine (the "College of Medicine"), with the Scott & White Memorial Hospital ("SWMH") main campus in Temple, TX being the primary Scott & White teaching location. Scott & White hospital and clinical facilities in College Station, TX, Round Rock, TX, Brenham, TX and Taylor, TX also participate in teaching activities. The College of Medicine is a fully accredited, seven year medical school. Currently 325 medical students receive their basic science and clinical training at Scott & White. Virtually all physicians on the Scott & White Clinic staff hold faculty appointments at the College of Medicine and teach classes for first through fourth year students. A full four year medical education program was recently initiated on the SWMH main campus in Temple. To support this expansion on its Temple campus, SWMH has committed to self-fund over $15 million to expand classroom and lab facilities, purchase equipment and provide support for faculty research projects aimed at promoting healthcare innovations and the College of Medicine. With support from Scott & White, the College of Medicine intends to expand to an annual class size of 200 during the next five years, with four year campus locations at Scott & White facilities in Temple, Round Rock and College Station. Scott & White also hosts rotations for fourth-year students from many other medical schools. Through the fiscal year ending August 31, 2013, Scott & White has self-funded $13.1 million of their $15 million commitment to expand facilities to support expansion of the College of Medicine.The Scott & White Graduate Medical Education Program currently consists of 38 resident and fellowship programs with 452 residents and fellows receiving training for the fiscal year ending August 31, 2013. Scott & White hosted medical students in their 4th year rotations from 53 different universities. SWMH self-funded approximately $61.5 million to support medical education activities during the fiscal year ended August 31, 2013.The main SWMH campus in Temple serves as the clinical campus for the Scott & White School of Nursing at the University of Mary Hardin-Baylor in Belton, Texas. A baccalaureate degree program is offered through the School of Nursing. In addition, SWMH also facilitates the clinical training of registered nurses and licensed vocational nurses in cooperation with Temple College and Central Texas College in Killeen, Texas. A Master's of Science in Nursing degree program is offered through Texas A&M University-Corpus Christi. In total, more than 1,100 nursing students rotate through the Scott & White System annually. Scott & White also hosts allied health-training programs in its own name and in affiliation with other academic institutions, taught by nationally recognized physicians and professionals. These training programs and seminars are open to all medical professionals, as well as internal staff. In fiscal year ended August 31, 2013, approximately 9,638 physicians and 6,675 medical professionals attended continuing medical education programs hosted by Scott & White. 15968456 12369828 See Schedule OOne of the cornerstones of Scott & White Memorial Hospital's ("SWMH") mission is providing quality patient care with a focus on research activities. Efficiencies are gained through innovation. The focus of much of the research is to find innovative & cost-effective ways to treat patients, while increasing patient safety, improving quality and focusing on better outcomes. SWMH has the following research departments, centers and institutes: cancer research institute, cardiovascular research, center for applied health research (CAHR), center of cell death and differentiation, center for bone, joint and spine research, clinical simulation research, digestive disease research center, ophthalmic research, neuroscience research, podiatric research, division of research, family medicine, and ob/gyn research.The Cancer Research Institute has been created to partner research and clinical care. The mission of the Cancer Research Institute is to find effective cancer therapies quickly and cost-effectively. The Vasicek Cancer Treatment Center, a part of the Scott & White Cancer Institute, is a state-of-the-art facility that offers highly-specialized and coordinated care in one location. Patients and their families have one-stop access to cancer diagnosis and treatment, backed by research and education.The institute has performed over 550 clinical trials. Each year, Scott & White's Vasicek Cancer Treatment Center holds prevention programs designed to reduce the incidence of a specific cancer type. Screening programs are held in order to attempt to decrease the number of patients with late-stage disease. Last fiscal year 278 people participated in the free cancer screenings, 98 people participated in uninsured breast cancer screenings, and over 4, 000 people requested information on various cancer related topics.The Cardiovascular Research Institute (CVRI) is a joint effort of the Texas A&M Health Science Center, Scott & White and Central Texas Veteran's Health Care System (CTVHCS). This unique program pairs the world-class research of molecular biologists with clinical applications for the treatment of people suffering from cardiovascular disease or stroke. By discovering better strategies for prevention and intervention of these conditions, the work of the Institute will benefit patients and the entire community.To facilitate such research Scott & White has focused significant efforts on outcomes based research. SWMH has established the Center for Applied Health Research ("CAHR"). This Center focuses on diverse research areas, and brings together expertise in many areas such as health services research, community based health research, patient centered safety and patient activation research, along with research mentoring and the academic development of clinicians. The center brings together collaborators from SWMH, Texas A&M Health Science Center and the Central Texas Veteran's Health Care System ("CTVHCS"). Within the CAHR, the Patient Engagement and Safety Research Program centers on a team perspective in patient care. This program partners patients, family members, clinicians and other community and healthcare providers to create the best possible healthcare outcomes. The research is based on clinical trials, clinical simulation models, program evaluations, patient education and common intervention strategies. The Health Outcomes Core conducts health services research focusing on severe mental illnesses and the management of care for patients with complex medical and psychiatric comorbidities. This group works jointly with SWMH, the CTVHCS, Darnall Army Medical Center at the U.S. Army's Fort Hood, and the Center of Excellence for Research on Returning War Veterans located in Waco, Texas. Clinical Simulation Research is another area directly impacting patients' healthcare quality and safety. The Clinical Simulation Center was created, in collaboration with Temple College, to allow healthcare students and providers to design and test new processes and procedures prior to performing them on patients. The Clinical Simulation Center is used by medical and nursing students, residents, fellows, nurses and other healthcare providers. Simulation work enhances communication skills and performance of healthcare providers, preparing them for the realities of patient care.The goal and objective, of the Digestive Disease Research Center (DDRC), is to discover and share cutting edge knowledge about the digestive system and the diseases that affect millions in the United States. The SWMH research team consists of basic scientists and physicians from a wide variety of backgrounds with varying interests and disciplines. These combined investigators support the practice of "bench to bedside" research to benefit and contribute to human health. Along with seasoned investigators, the DDRC also believes in training of future scientists and provides an excellent learning environment for the training of undergraduates, medical students, graduate students, postdoctoral fellows and residents.Scott & White has committed significant resources to establish a one-of-a-kind Ophthalmic Vascular Research Program (OVRP). This is a joint venture between the Division of Ophthalmology at Scott & White, the Department of Systems Biology and Translational Medicine, and Cardiovascular Research Institute at the Texas A&M Health Science Center. New theories developed regarding the pathogenesis of various eye diseases as well as potential new therapies proposed and tested in the basic science laboratory, if appropriate and promising, can be taken into the clinical setting to benefit patient care.The Neuroscience Institute (NSI) at Scott & White and Texas A&M Health Science Center College of Medicine conducts state-of-the-art translational research, with scientific interests including drug and device trials in humans. The NSI is home to an invasive human brain chemistry and electrophysiology lab, neuroinflammation, neurogenesis, a neuromodulation lab, which includes a frameless stereotactic image-guided transcranial magnetic stimulator (TMS), an autonomic psychophysiology lab and a functional neuroimaging (fMRI) lab. One of the main scientific objectives of the NSI is the multimodal analysis of human brain function in both healthy and diseased populations. Research within the NSI is highly collaborative and expanding, with an internationally recognized team of basic and clinical researchers in the Departments of Neurosurgery, Neurology, Psychiatry and Behavioral Sciences and Radiology.The podiatric research team has 12 studies in progress. They have received two National Institute of Health (NIH) grants to fund two five-year studies. The total contact cast (TCC) study focuses on foot wounds, compliance and cost of care and complications. Another study is a collaborative effort with a research team from the U.K., which will study the recurrence and prevention of foot ulcers. The podiatric research team also has studies sponsored by the American Diabetic Association (ADA) and American Podiatric Medical Association (APMA) and are looking into the occurrence of ulcers in diabetic patients that are currently undergoing dialysis and how foot care affects diabetic foot complications. They are also looking into new therapies to deal with treatment of foot infections and open amputations.The Division of Research, Family Medicine (DORFAM) has current research projects focusing on: bicycle related traumatic brain injuries, weight and contents of backpacks carried by school children, concussions among high school football players and miscommunication as a cause of medication errors in elderly ambulatory patients.SWMH has developed a virtual data warehouse which promotes Comparative Effectiveness Research. This virtual warehouse allows SWMH to share clinical and research data with other research and healthcare organizations. By partnering with other institutes, the data necessary for effective research is quickly and readily available, resulting in larger and more comprehensive data pools and increasing the cost-effectiveness of research.The Scott & White system employs many physicians, scientists and technicians devoted to various aspects of research programs. In the fiscal year ending August 31, 2013, there were approximately 552 active research projects, of which approximately 31% are self-funded. 2213202 2213202 635200508 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 X 904 0 0 14144 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 11 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 1 0 X Jon Malone 2542159259 2401 S 31st Street Temple TX 76508 X Glenda Barron PhD 1.00 X 0 0 0 Bill DiGaetano 1.00 X 0 0 0 Barry Couch 1.00 X X 0 0 0 Drayton McLane III 1.00 X 0 0 0 Robert A Probe MD 1.00 40.00 X X 0 816096 57356 Alejandro C Arroliga MD 1.00 40.00 X 0 600859 53332 Timothy M Bittenbinder MD 1.00 40.00 X 0 563687 58207 Shahin Motakef 40.00 X X 0 538490 49043 Patricia M Currie 1.00 40.00 X 0 735763 53682 Dick L Dixon 1.00 40.00 X X 0 641174 52540 Harry T Papaconstantinou MD 1.00 40.00 X 0 506898 44476 Alita Prosser 40.00 X 0 252162 40437 James Carroll 1.00 40.00 X 0 511014 46414 Stephen Sibbitt MD 1.00 40.00 X 0 536178 52358 Cynthia B Dunlap 1.00 40.00 X 0 308906 45842 Glen R Couchman MD 1.00 40.00 X 0 741071 53113 Robert W Pryor MD 1.00 40.00 X 0 1202973 52070 John L Boyd III MD 1.00 40.00 X 0 505804 57343 Matthew L Chambers 1.00 40.00 X 0 536594 54371 Marc R Hallee 1.00 40.00 X 0 496688 46603 Nancy May 40.00 X 0 204303 20524 Ellen D Hansen 40.00 X 0 200684 38194 Stephen F Sullivan 1.00 40.00 X 0 272378 12785 Paul R Illyes 40.00 X 256239 0 41273 Warren JVoegele 40.00 X 238321 0 36384 Charles S McFarling 40.00 X 276794 0 38500 Dwight C Williams 40.00 X 238854 0 31179 Daryl J Magoulick 40.00 X 239200 0 23952 Wade L Knight MD 0.00 40.00 X 0 520858 51343 Michael L Middleton MD 0.00 40.00 X 0 418110 51542 Francis P Anderson 0.00 40.00 X 0 332403 50518 Andrejs E Avots-Avotins MD 0.00 40.00 X 0 533290 53781 Stuart Donald Sequin 0.00 40.00 X 0 370000 0 J Paul Dieckert MD 0.00 40.00 X 0 741614 50448 Alfred B Knight MD 0.00 40.00 X 0 343534 51101 William L Rayburn MD 0.00 40.00 X 0 625334 54941 Peter S Brumleve 0.00 40.00 X 0 199976 14740 Nancy Birdwell 0.00 40.00 X 0 372360 41636 1249408 14629201 1480028 411 1 1 0 Scott & White Healthcare 2401 S 31st Street Temple TX 76508 Corporate Services 51587442 Epic 1979 Milky Way Verona WI 53593 Consulting 7719950 Scott & White Clinic 2401 S 31st Street Temple TX 76508 Physician Services 6056122 Jacobs Engineering 777 Main Street Fort Worth TX 76102 Engineering 5121367 Nursefinders PO Box 910738 Dallas TX 753910738 Staffing 4623539 49 8609605 1219349 501573 9828954 Patient Care Revenue 622110 829103045 826689565 2413480 Medical Education 611310 16607965 16607965 Medical Research 541712 12369828 12369828 Meaningful Use 622110 1828247 1828247 859909085 3470001 3470001 40918 40918 251099821 2931244 248978949 2512111 2120872 419133 2540005 2540005 Cafeteria/Food Service 722210 4208916 4208916 Gift Shop 453220 676288 676288 Miscellaneous 900099 384955 384955 5270159 881059122 857880560 2413480 10936128 X 503296 503296 209250 209250 1391554 1391554 255804261 247190908 8613353 267026 267026 55663343 52874296 2789047 875 875 41386 41386 1991639 1991639 202810917 51545320 151265597 2354935 2275640 79295 3661154 3537877 123277 21934286 21195722 738564 10996805 10626524 370281 2052375 1983268 69107 3010797 2909418 101379 46689900 45117774 1572126 65 65 Medical Supplies 181133490 181133490 Research 3642282 3642282 Transplant 1853223 1853223 Dues & Subscriptions 1816354 1816354 7022252 6785801 236451 804851465 635200508 169650957 0 67503747 36996085 193913490 191582565 195076289 102910742 7202300 5356026 10697302 13261934 12489370 13361121 1090741342 578251320 746241268 512490022 175184102 177755761 4294747 5068409 3104886 1623276 1415707501 1060405941 123265053 87275390 17406291 18141388 2879455 2171052 552328959 115663005 695879758 223250835 X 703101298 817640232 -20032299 14721759 36758744 4793115 719827743 837155106 1415707501 1060405941 X 76207657 19171363 21948343 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 38515 0 0 0 38515 0 Part IV, Supplemental Information: Part II-B, Line 1(f) and Line 1(g): Scott & White Memorial Hospital ("SWMH") maintains memberships in the American Hospital Association, Texas Hospital Association and other national and state medical associations. A percentage of the dues paid to those organizations is attributed to lobbying activities and is reported as grants to other organizations for lobbying purposes. 2459744 680631 221367 350576 300816 2710350 87313087 -1571577 2629200 263856 919630 84727480 2459744 78200433 2732356 9531823 267949 2883576 87313087 73389524 1512623 5602178 81802 2222090 78200433 92860194 763913 -11892140 176750 8165693 73389524 0.21000 0.79000 0 0 7575569 33894047 41469616 519101813 239002341 280099472 441511567 326251918 115259649 88658346 12997061 75661285 512490022 Payroll/Benefits 17627891 Related Organizations 78480791 Capital Lease 14308603 340(B) 3450000 Trusts 1795720 115663005 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: Fin 48 (ASC 740) Footnote: Scott & White evaluates its income tax positions in accordance with ASC 740, Income Taxes, regarding accounting for uncertainty in income taxes. ASC 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. There are no material uncertain income tax positions as of August 31, 2013 or 2012. Part V: Endowment funds and income from endowment investments are used to provide funding for program activities of Scott & White Memorial Hospital. Central America & the Caribbean 0 0 Investment 16205162 Central America & the Caribbean 0 0 Investment 9288811 Central America & the Caribbean 0 0 Investment 7378111 0 0 0 0 0 0 32872084 0 32872084 1 0 1 0 1 0 1 1 X 1 X 1 X 375.000000000000 1 1 0 1 1 23330902 23330902 0.02900 70762567 70788451 -25884 0.00000 4102315 1974938 2127377 0.00260 98195784 72763389 25432395 0.03160 77100928 16607965 60492963 0.07520 14014878 9676527 4338351 0.00540 3318019 3318019 0.00410 94433825 26284492 68149333 0.08470 192629609 99047881 93581728 0.11630 1 102768871 0 241200153 279020367 -37820214 X 1 1 1 1 Scott & White Memorial Hospital

2401 S 31st Street Temple TX 76508

X X X X X Scott & White Memorial Hospital 1 1 X X X X X X X X X 12 1 1 1 X X X X X X X X 1 0 1 1 100.000000000000 1 375.000000000000 1 X X X X X X 1 1 X X X 1 0 X X X X 1 X 0 0 38 Temple Clinic

2401 S 31st Street Temple TX 76508

Specialty clinic Waco Clinic

7700 Fish Pond Rd Waco TX 76710

General and specialty clinic Killeen Clinic

3801 Scott White Drive Killeen TX 76543

General and specialty clinic Temple Center for Diagnostic Medicine

1605 S 31st Street Temple TX 76508

General and specialty clinic Temple South Loop Clinic

2601 Thorton Lane Temple TX 76502

Specialty clinic Santa Fe

600 S 25th Street Temple TX 76504

Physical Therapy Belton Clinic

1505 N Main Street Belton TX 76518

General and specialty clinic Temple Northside Family Medicine Clinic

409 W adams Street Temple TX 76501

Family medicine Temple Santa Fe Family Medicine Clinic

1402 West Ave H Temple TX 76504

Family medicine Temple Clinic-Westfield

7556 Honeysuckle Temple TX 76502

General and specialty clinic ObGyn Waco

120 Hillcrest Blvd Office Bldg II Waco TX 76712

General and specialty clinic Salado Family Medicine Clinic

3525 FM 2484 Salado TX 76571

Family medicine South Belton Clinic

1001 Arbor Park Dr Belton TX 76513

General and specialty clinic Cameron Clinic

101-B Lafferty Ave Cameron TX 76520

General and specialty clinic Harker Heights Family Medicine Clinic

907 Mountain Lion Circle Harker Heights TX 76548

Family medicine Hewitt Clinic

510 N Hewitt Dr Hewitt TX 76643

Family medicine Gatesville Clinic

227 Memorial Dr Gatesville TX 76528

General and specialty clinic Temple Towne Center Pediatric Clinic

2112 Loop 363 Temple TX 76504

General and specialty clinic Scott & White Pediatrics at MacArthur

2201 MacArthur Dr Ste 103 Waco TX 76708

General and specialty clinic West Temple Pediatric Clinic

6684 West Adams Temple TX 76502

General and specialty clinic Moody Clinic

498 Ave E Moody TX 76557

General and specialty clinic Belton Pediatric Clinic

1009 Arbor Park Dr Belton TX 76513

General and specialty clinic Scott & White Pavilion-Temple

1815 S 31st Street Temple TX 76504

Specialty clinic Hewitt Sports Therapy

511 N Hewitt Dr Hewitt TX 76643

Sports medicine Waco Pain Clinic

50 Hillcrest Medical Blvd Bldg 1 Waco TX 76710

Specialty clinic Waco Nephrology Clinic

50 Hillcrest Medical Blvd Bldg 1 Waco TX 76708

Specialty clinic Waco Pulmonary Clinic

50 Hillcrest Medical Blvd Bldg 1 Waco TX 76708

Specialty clinic Waco Spine Center

50 Hillcrest Medical Blvd Bldg 1 Waco TX 76708

Specialty clinic Scott & White Counseling Center

1713 SW HK Dodgen Loop ste 102 Temple TX 76502

Specialty clinic Killeen West Clinic

1002 Wales Dr Ste 8 Killeen TX 76549

Family medicine Killeen Hemingway Medical Building

2405 S Clear Creek Rd Killeen TX 76549

General and specialty clinic Killeen Cancer Center

2207 S Clear Creek Rd Killeen TX 76549

Specialty clinic Waco Pediatric Clinic at Hillcrest

120 Hillcrest Blvd Office Bldg II Waco TX 76712

General and specialty clinic Scott & White Sleep Institute

2401 S 31st Street Temple TX 76508

Specialty clinic Temple Dialysis Center

2601 Thorton Lane Temple TX 76502

Specialty clinic McLanes Childrens Specialty Clinic

1901 SW HK Dodgen Loop Temple TX 76502

Specialty clinic Temple Mental Health Center

2401 S 31st Street Temple TX 76508

Specialty clinic Temple Pediatric Clinic

2401 S 31st Street Temple TX 76508

General and specialty clinic Part I, Line 3c: Scott & White provides free or discounted care to uninsured patients who are considered Financially Indigent. In order to qualify for financial assistance a patient must live within the 31 county service area of the Scott & White Health Care System. To determine eligibility for free or discounted care, in addition to income and residency; net assets, other financial resources, credit report, and other relevant information are considered. The Scott & White financial assistance policy also provides for exceptional circumstances in which a patient with income over 375% FPG could qualify for financial assistance if the cost exceeds two times their annual household income. Part I, Line 6a: The organization prepares and files an Annual Report of Community Benefit Plan with the Texas Department of State Health Services. These reports are made available through the organization's website at www.sw.org. Part I, Line 7: The costing method used for Schedule H is the cost to charge ratio, as calculated in Schedule H, Worksheet 2. This method was applied to the costs reported on lines 7a, 7b, and 7c. Part III, Line 4: Audited financial statement footnote Page 18: The presentation of the provision for bad debts as a reduction of patient service revenue is based on an entity-wide assessment of the significance of patient revenue that is recognized without assessing patients' ability to pay. As stated in the combined audited financial statements, the organization maintains allowances for uncollectible accounts for estimated losses resulting from a payer's inability to make payments on accounts. The organization assesses the reasonableness of the allowance account based on the historical write-offs, cash collections, the aging of the accounts and other economic factors. Accounts are written off when collection efforts have been exhausted. Management continually monitors and adjusts its allowance associated with its receivable. Bad debt does not include amounts for patients who are known to qualify under the organization's charity care policy. The amount of bad debt attributable to patient's accounts is net of contractual allowance, payments received and recoveries of bad debt previously written off. The organization has entered zero on Schedule H, Part III, Line 3; however, based on prior experience and certain demographics and other information obtained during admission, the organization believes a portion of the bad debt expenses (estimated to range from 1-5%) would be attributable to patients that would otherwise qualify for charity care. Despite all of the effort and ways the organization educates patients about qualifying for its charity care program as demonstrated in Part VI, question 3 below, many uninsured patients either refuse or fail to complete a charity care application or provide sufficient information at the time of admission, during their stay or after being discharged to qualify for assistance under the organization's charity care policy. Part III, Line 8: The amount reported on Part III, Section B, line 7 was calculated in accordance with the Schedule H instructions utilizing the organization's allowable cost reported in the Medicare cost report based on a cost to charge ratio. However, the allowable costs in the Medicare cost report do not reflect the actual cost of providing care to patients since the Medicare cost report excludes many direct patient care costs that are essential to providing quality care to these patients. For example, certain coverage fees to physicians, cost of Medicare C and D, and other similar direct patient care expenses are specifically excluded as allowable cost in the cost reports. Using the same methodology to calculate the unreimbursed cost of providing charity care and Medicaid (using applicable Schedule H Worksheets) would result in a shortfall higher than the shortfall reported on Part III, Section B, Line 7. The organization believes that all of the shortfall should be considered as a community benefit for the following reasons. First, the IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. IRS Revenue Ruling 69-545 provides in part, that hospitals serving patients with governmental health benefits, including for example Medicare, is an indication that the hospital operates for the promotion of health in the community. Second, the organization provides care to Medicare patients regardless of this shortfall, i.e., loss, and thereby relieves the state and federal government of the burden of paying the full cost for the care of Medicare beneficiaries. Medicare does not provide sufficient reimbursement to cover the entire cost of providing care to these patients causing the organization to use other surplus funds to cover the shortfall. It is expected that reimbursement under the Medicare program will continue to decline and therefore may further limit access to care due to the anticipated reduction of participating Medicare providers in the community. As a result, the care for these patients will likely continue to increase, and rest on the shoulders of, nonprofit hospitals and/or county hospital districts. Third, many of the Medicare participants have low fixed incomes and therefore would qualify for charity care or other means tested government programs absent being enrolled in the Medicare program. Fourth, Texas nonprofit hospitals must provide a minimum level of community benefit in order to obtain exemption from state and local taxes. According to the current Texas Health and Safety Code, the unreimbursed cost of Medicare is considered to be a community benefit in determining these state statutory requirements as it helps relieve a governmental burden of providing this care that would otherwise be provided through the county hospital system in Texas. Part III, Line 9b: The Scott & White Healthcare Financial Assistance Policy has a section for coordination with collection policies. It states: "not withstanding any other provision of any other policy or provision at S&W regarding billing and collection matters, S&W will not engage in extraordinary collection actions before it makes reasonable efforts to determine whether an individual who has an unpaid billing from S&W is eligible for financial assistance under this Policy. "Reasonable efforts" includes notification to the patient by S&W of this Policy upon admission or discharge and in written and oral communications with the patient regarding the patient's billings, including invoices, telephone calls, and such other communications as may be set forth in future guidance from the U.S. Department of the Treasury or Internal Revenue Service." Scott & White Memorial Hospital Part V, Section B, Line 3: The Community Benefit Task Force identified methods, participants, questions, and procedures for gathering input from community members around issues of health in Bell County. It was critical that this report be developed with input from people representing the broad interest of the community and people with special knowledge or expertise in public health as well as those who understand the health needs of the medically underserved, low-income and minority population. Direct input from these sources in the form of community surveys and one-on-one interviews, strategically helped us to better understand how best to meet needs based on the community's readiness to change, ability to access, or willingness to access specific services and resources. This ensured that hospital resources would be put to the best use.Several specific locations and community populations were targeted based on the challenges they face acquiring healthcare and maintaining a healthy lifestyle due to lower income situations. For 3 weeks in February, Scott & White sought input from those that are medically underserved in an attempt to focus efforts reaching those who need it most. Clients at The Greater Killeen Free Clinic, located on the West side of the county, and the Temple Community Clinic, located on the East side, were surveyed. Clients seeking assistance at a local health and human service agency, the Bell County HELP Center, and a local food pantry, Helping Hands Ministry in Belton, also participated. To gain input from the broad community, surveys were completed at various health fairs, cultural activities and civic organization meetings across the county as well.Five key informants were selected and interviewed based on their special knowledge around local health issues or their service with medically underserved populations. Each key informant interview began with a description of the findings from the CHNA and an explanation of the needs that were identified as priorities in the community. During the interview, each was asked to comment on all of the needs to either verify or refute the issue as a major concern based on their experiences with serving community members. All 5 felt that the issues identified were indeed priority problems that needed to be addressed. Through their work in the community, they had first-hand knowledge of the impact these issues caused. Interviews were concluded by extending the discussion to learn what resources might currently be available in the community to address the identified needs.Marlene DiLillo has served as the Killeen Free Clinic's Executive Director for 17 years. She is a spokeswoman for the underserved population with health needs. Marlene helped to found the Texas State Association of Charitable Clinics and has served at, and mentored, several charity clinics around Texas. She has a Master's degree in Human Resources, and holds certificates in non-profit management and volunteer management. DiLillo has also has served on many health related boards including the regional Susan G. Komen board.Judy Morales currently serves as the District 2 representative on the City Council of Temple and was elected Mayor Pro-Tem in May 2013. She has a Master's degree in Education and has served as the Executive Director of the Bell County HELP Centers social service agency administrating, planning and implementing community based outreach services and programs since 1972. Judy also serves as the Vice Chair of LULAC Council #4971, and is a volunteer member of numerous community service organizations in the county including Work Force Solutions, the local NAACP Chapter, and Citizens for Progress, the Heart of Temple Angels Alliance and the EMBRACE (Embracing Mentoring Bridging Reaching Assimilating Caring and Educating) Task Force. She also serves on the Executive Boards of Catholic Charities, Family Promise, Hill Country Community Action Association, Central Texas Homeless Alliance, and the Committee for Persons with Disabilities.Dell Ingram-Walker has served as the Administrator of Pediatrics for McLane Children's Hospital and Clinics since 2012. For 5 years prior, she was the Director of Clinic Operations for the Children's Hospital. Ingram-Walker holds a Bachelor of Science Degree in Health Care Management. Through her experience with pulmonary physicians and understanding of medical operations, she was able to provide justification of the need to address pediatric asthma hospitalization rates as well as an overview of the resources and procedures Scott & White has to implement change.Rita Kelley has worked with indigent health care since 1986 serving up to 5 different counties. She has been in her current role with the Bell County Indigent Health Services for nearly 8 years. Her position involves interaction, coordination and planning with other community organizations to address health and human service infrastructure and safety net services. She also monitors state and federal health and human service trends, policy and legislations to assure the county is best represented and served when changes are being considered. Rita was instrumental in the completion of the 2010 community needs assessment for Bell County and has been involved in a multitude of health service organizations including working for Central Texas Council on Alcohol and Drug Abuse, MHMR and the Bell County Human Services-Killeen HELP Center.Bonnie Scurzi has been as a Registered Nurse and a Woman's Health Nurse Practitioner with the Bell County Public Health District for more than 20 years. She also has a degree in Nursing Administration and served as the Nursing Director for the BCHD for over 12 years before becoming the District Director in the fall of 2012. She oversees the BCHD medical and nursing facilities that provide a variety of clinical, health counseling, and health educational services, focusing on treating and preventing disease and promoting healthy lifestyles. Scott & White Memorial Hospital Part V, Section B, Line 4: Scott & White Continuing Care Hospital Scott & White Memorial Hospital Part V, Section B, Line 7: The Hospital recognizes the importance of all needs identified in the community, but will not directly address the following needs identified in the CHNA at this time as other organizations are better equipped to address them. SmokingHospitalization Rate due to Pediatric AsthmaThese priorities did not meet the defined evaluation criteria:1. Severity or prevalence of the issue2. Notable health disparities in specific populations3. Feasibility of possible interventions to affect change4. Community population readiness to change5. Ability to evaluate outcomes6. Resources available to impact the needAnd it was determined internally that the hospital does not have the ability to directly affect change within these needs nor are there resources available to influence change. It was also determined that there are other community or governmental organizations better aligned to address this priority.Through the course of the assessment, it was determined that The Hospital has a comprehensive program to prevent or treat Sexually Transmitted Diseases in adolescents; and intends to strengthen programs towards the population over the age of 18. As the Hospital evaluates feasible measures to impact this issue, existing County efforts will continue to result in positive outcomes.The Bell County Public Health District provides various services through the Family Planning program to assist in this issue. Clinical services provided at Health District clinics in East and West Bell County include complete exams, birth control, STD testing and treatment, pregnancy testing, and Immunizations (in addition to the Outreach Education, WIC, Food Protection, Environmental Health, and Preparedness services provided by the Health District). The Health District plans to increase the times and days that STD testing is offered and the services will be provided on a walk in basis. Through outreach as well as availability of services and times, they will increase the number clients who access care, and reduce the number of Medicaid clients who utilize our Emergency Department for routine STD testing services. There is also a high rate of reinfection for STD's. The Bell County Public Health District also has plans to increase the number of clients retested at 3 months for Chlamydia and Gonorrhea. Additionally, the Health District will ensure clients diagnosed with Syphilis receive follow up care according to schedule based on their stage at diagnosis. Efforts will also address the need for more STD testing of females of child-bearing age, to find and treat asymptomatic Gonorrhea, Chlamydia, and Syphilis infections, to reduce the potential secondary consequences such as Pelvic Inflammatory Disease (PID), sterility, ectopic pregnancy, poor pregnancy outcomes, neonatal infection, and chronic pain. The Hospital will not be directly addressing the need to reduce smoking as another hospital within our System is targeting that area. Details for addressing this need are outlined in the implementation strategy for the Scott & White Continuing Care Hospital.Additionally McLane Children's Hospital-Scott & White has a pediatric asthma coordinator who works full time on outreach and coordinating care. The established program at McLane Children's will address this priority need and is outlined in that implementation strategy. Scott & White Memorial Hospital Part V, Section B, Line 12h: The Scott & White Healthcare Patient Financial Assistance Policy ("PFAP") requires patients to be a Permanent Resident of the Scott & White Provider Service Area. Permanent Resident is defined as "an individual who has established and maintained residency within a Scott & White Provider Service Area for a period of at least six (6) months immediately prior to submitting an application for financial assistance." The Scott & White Provider Service Area as defined in the PFAP "is the geographic area, defined by Texas counties and determined by Scott & White, in which a patient must be a Permanent Resident in order to be eligible to receive financial assistance under this Policy." Schedule A of the PFAP lists the 31 Texas Counties that Scott & White has defined as their service area to meet the residency requirement. Scott & White Memorial Hospital Part V, Section B, Line 14g: The organization is committed to promoting health in the community including providing or finding financial assistance programs to assist patients. Patients who may qualify for financial assistance through the organization's charity care program or other federal, state and local government programs are informed and educated about their eligibility in several ways including, but not limited to, the following: 1) posting signs and notices regarding the charity care policy in the emergency departments, admitting areas and business offices located throughout the organization, 2) annual posting regarding the organization's charity care program in the local newspapers, 3) information regarding financial assistance, including the organization's charity care policy, is posted on the organization's website, 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance, and 5) the organization provides free financial counselors to help patients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's charity care program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital will automatically receive help from a financial counselor. These services are provided in writing and through interpretation services in the primary language of the patient requesting assistance. Though the most often needed alternate language is Spanish. Scott & White Memorial Hospital Part V, Section B, Line 20d: The organization's financial assistance policy is developed to provide discounted care to those qualifying for financial assistance to where the amount charged under this policy will always be equal to or lower than the Medicare rates. However, for those qualifying as medically indigent and whose income level is over 375% of the federal poverty level shall not be billed more than 2 times their annual household income, which is generally lower than the methodology listed above and the three methods listed in Schedule H Part V, Line a-c. Part VI, Line 2: Data collection is critical to understanding and meeting community health needs. Scott & White continually monitors local health trends, reviews hospitalization inpatient and outpatient records, and takes feedback from community leaders and public health officials as to what the current needs are. S&W staff members participate regularly in exchanges with government, education, and human service organizations to learn what other issues are in the community that are perhaps underlying causes of healthcare problems. And S&W executives assist with strategic planning processes for other organizations that provide healthcare services for the medically underserved. In an effort to get regular feedback from the community, Scott & White created a new department to actively engage the patients and community in continuous dialogue to provide an opportunity for them to share what their unmet needs are when they seek medical care. We believe this platform will allow the opportunity to view shortcomings from the community perspective. Additionally a strategic plan for conducting lengthy assessments on a 3 year cyclical basis has been made for upcoming years. Data pertaining to the changing demographics, hospitalization rates for the top 15 conditions, and 100 health and quality of life indicators will be collected, monitored and reported on a regular basis on the hospital's website. The data will show how counties within the Scott & White service area stand in relation to other Texas Counties, U.S. Counties and Healthy People 2020 goals for the indicators. Also, gaps in information in the current collection of data will be identified and targeted for future exploration in the form of surveys, key informant interviews and focus groups. The 2013 community health needs assessment and corresponding implementation strategy to address identified health needs was presented to and adopted by the Hospital Board of Directors.The CHNA was posted onto the Scott & White website: http://assets.thehcn.net/content/sites/sw/FINAL_2013_CHNA_Memorial.pdfThe Implementation Strategy was posted onto the Scott & White website: http://assets.thehcn.net/content/sites/sw/FINAL_2013_IMPLEMENTATION_ STRATEGY_MEMORIAL.pdfThe CHNA for McLane Children's Hospital was posted onto the Scott & White website: http://assets.thehcn.net/content/sites/sw/FINAL_2013_CHNA_McLaneChildrens .pdfThe Implementation Strategy for McLane Children's Hospital was posted onto the Scott & White website: http://assets.thehcn.net/content/sites/sw/FINAL_2013_IMPLEMENTATION_ STRATEGY_CHILDRENS.pdf Part VI, Line 3: The organization is committed to promoting health in the community including providing or finding financial assistance programs to assist patients. Patients who may qualify for financial assistance through the organization's charity care program or other federal, state and local government programs are informed and educated about their eligibility in several ways including, but not limited to, the following: 1) posting signs and notices regarding the charity care policy in the emergency departments, admitting areas and business offices located throughout the organization, 2) annual posting regarding the organization's charity care program in the local newspapers, 3) information regarding financial assistance, including the organization's charity care policy, is posted on the organization's website, 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance, and 5) the organization provides free financial counselors to help patients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's charity care program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital will automatically receive help from a financial counselor. These services are provided in writing and through interpretation services in the primary language of the patient requesting assistance. Though the most often needed alternate language is Spanish. Part VI, Line 4: Scott & White Memorial Hospital serves children and families across the greater Central Texas area with the majority of its patient population residing in Bell County. The Hospital defines Bell County as its primary community served: Bell County encompasses 16 zip codes in 11 cities which include Belton, Fort Hood, Harker Heights, Killeen, Moody, Morgans Point Resort, Nolanville, Rogers, Salado, Temple and Troy. Bell County is centrally located along the I-35 corridor, is serviced by two major railroads and is home to Fort Hood.With a capacity of 50,000 troops, it is one of the largest military installations in the world. The most recent census data shows that nearly 321,000 people live in Bell County which is nearly a 3.5% growth across the last 3 years. The gender split is nearly even with 49.48% male and 50.52% female. Altered as a result of the large military presence in Fort Hood, the base itself is fairly self-contained both as a community and in terms of healthcare services received. The base inflates the 25-34 age group which is the largest in Bell County accounting for nearly 17% of the population. More than 60% of the residents living in the county are White. 21.63% are Black/African American, and just under 23% of the population in Bell County claim to have Hispanic/Latino ethnicity. The zip codes with the highest Hispanic population (more than population speaks Spanish at home including nearly 20% of the households in the 76504 and 76541 zip codes.The median household income in the county is $49,736 and the average household income is $61,315. Nearly one-third of the population has at least an Associate Degree.The census reported that 9,341 families in Bell County live in poverty and of those, approximately 89% have children living with them.77.4% of Adults and 90.4% of Children in Bell County have some form of health insurance coverage. Medical costs in the United States are extremely high, and many people without health insurance likely cannot afford medical treatment or prescription drugs. They are also less likely to get routine checkups and screenings, so if they do become ill they are less likely to seek treatment until the condition is more advanced and therefore more difficult and costly to treat. Bell County's demographics are slightly altered as a result of the large military presence in Fort Hood. The base inflates the 25-34 age group which is the largest in Bell County accounting for nearly 17% of the population. The median household income is $49,736 and the average household income is $61,315. Nearly a third of the population has at least an Associate Degree. Part VI, Line 5: All Scott & White Healthcare System facilities are operated in a manner that furthers exempt purposes. Scott & White Healthcare officers and executives plan and direct the activities of all System facilities under the direction and oversight of the Scott & White Healthcare Board of Trustees. The Scott & White Memorial Hospital ("SWMH") Board of Directors is comprised of persons residing in the service area. As explained in response to Form 990 Part VI, Section A, Question 7b, the SWMH Board of Directors does not consist of a majority of independent directors because SWMH relies on the Scott & White Healthcare Board of Trustees, which is controlled by a majority of community trustees, to meet community board standards. Surplus funds are reinvested in facilities, equipment and programs to further SWMH's exempt purposes. SWMH is operated for the benefit of the public and no part of income inures to any private individual or serves a private interest. Surplus funds are used to improve the quality of patient care, expand facilities, advance medical training and education and fund research. Scott & White Healthcare has a Financial Assistance Policy that all hospitals in the Scott & White Healthcare System, including SWMH, follow, which provides assistance to individuals with incomes up to 375% of the Federal Poverty Guidelines. Part VI, Line 6: Scott & White provides personalized, comprehensive, high quality health care services enhanced by medical education and research through 13 acute care hospital facilities, one additional announced facility, a 215,000+ member regional health plan serving residents in a 29,000-square mile service area, and one of the nation's largest multi-specialty group practices with more than 140 clinics at over 70 clinic locations providing care in 46 medical specialties. Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is parent corporation of the Scott & White Healthcare System (the "System"). The Scott & White Healthcare Foundation ("SWF")(EIN: 27-3513154), a subsidiary of SWHC, raises funds for the priority programs and services of the entire Scott & White System. The Scott & White Healthcare System had more than 14,000 employees, including over 1,200 physicians and scientists and 300+ advanced practice professionals during the fiscal year ending August 31, 2013, and served over 537,000 patients accounting for 2.5 million patient visits. Scott & White Memorial Hospital ("SWMH"), located in Temple, Texas, is the flagship hospital of the Scott & White Healthcare System and is the only Level I Trauma Center between Dallas and Austin, Texas. The McLane Children's Hospital Scott & White is the only stand-alone children's hospital between Dallas and Austin, Texas. Scott & White Memorial Hospital operates a 613 bed acute care hospital and a 78 bed stand-alone children's hospital. Scott & White Memorial Hospital had 145,682 patient observation days (excluding newborns), 23,246 surgical cases, 27,995 admissions and 76,829 emergency room visits for the fiscal year ending August 31, 2013. The McLane Children's Hospital at Scott & White includes 48 private rooms, 16 pediatric intensive care rooms, 14 pediatric emergency room suites, and provides 24-hour emergency room services dedicated to and specifically equipped to respond to children's needs. The McLane Children's Hospital at Scott & White had 27,477 patient observation days (excluding newborns), 3,837 surgical cases, 3,863 admissions and 21,608 emergency room visits for the fiscal year ending August 31, 2013. The McLane Children's Hospital is the first dedicated children's hospital in Texas, and third in the country, to install the latest in computed tomography (CT) technology. The Sonotom Definition Flash CT system from Siemens Healthcare produces images with up to 128-slice detail at more than twice the speed of most CT systems used in children's hospitals in the U.S. Scott & White Memorial Hospital reported community benefits (as reported to the Texas Department of State Health Services and in accordance with the State of Texas Statutory methodology) of $110,429,026. The combined hospital reported community benefits of the entire Scott & White Healthcare System under this same methodology was $223,575,612. Reports Filed With States Part VI, Line 7 TX 1 AMERICAN CANCER SOCIETY 2433 Ridgepoint Drive Austin TX 78754 741185665 501(c)(3) 10500 General Support AMERICAN HEART ASSOCIATION 7272 Greenvil Ave Dallas TX 75231 133561379 501(c)(3) 10000 General Support AMERICAN KIDNEY FUND 11921 Rockvile Pike No 300 Rockville MD 20852 237124261 501(c)(3) 235179 General Support BAYLOR UNIVERSITY One Bear Place 97043 Waco TX 76798 741159753 501(c)(3) 10000 General Support CENTRAL TEXAS Regional Science Fair One Bear Place 97041 Waco TX 76798 742143475 501(c)(3) 10000 General Support CITY OF TEMPLE 2 North Main Street Temple TX 76501 746002368 170 (c) (1) 20000 General Support GREATER KILLEEN FREE CLINIC INC 718 N 2nd Street No A Killeen TX 76541 742724725 501(c)(3) 35000 General Support HELPING HANDS MINISTRY OF BELTON PO Box 1923 Belton TX 76513 742759918 501(c)(3) 10000 General Support MCLENNAN COMMUNITY COLLEGE 1400 College Dr Waco TX 76708 742550278 501(c)(3) 16667 General Support RALPH WILSON YOUTH CLUB PO Box 1346 Temple TX 76503 741539786 501(c)(3) 6000 General Support TEMPLE INDEPENDENT SCHOOL DISTRICT PO Box 788 Temple TX 76503 746002380 170 (c) (1) 26450 General Support TEMPLE PARKS FOUNDATION PO Box 1586 Temple TX 76503 743008152 501(c)(3) 12000 General Support TEXAS A&M UNIVERSITY-CENTRAL TEXAS FOUNDATION 1001 Leadership Place Killeen TX 76549 260895118 501(c)(3) 20000 General Support YMCA OF CENTRAL TEXAS PO Box 20515 Waco TX 76702 742668685 501(c)(3) 10000 General Support United Way Day of Caring PO Box 1312 Temple TX 76503 742575728 501(c)(3) 16795 Cost Labor on Community Projects General Support 15 Nursing/Other Health-Related Scholarships 40 209250 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: As part of its mission, the organization provides grants and other assistance to related organizations and/or unrelated not-for-profit organizations which are religious, charitable, scientific, or educational in nature, within the meaning of Internal Revenue Code Section 501(c)(3), when the use will fulfill an identified community need, serve an underserved population, be in line with the mission of the organization, or provide the organization opportunities to build relationships with the community members and nonprofit organizations serving the community. For related organizations, all grants and other assistance are subject to the policies and procedures set forth by Scott & White Healthcare which ensures all funds are used in accordance with the guidelines set forth above and in accordance with the related organization's exempt purpose. Grants and other assistance provided to unrelated organizations are given as a restricted gift and the receiving organization must sign a statement indicating they will use the funds for the stated purpose. X X X X 1 0 0 0 0 0 0 1 0 Robert A Probe MD 0 743511 0 70521 0 2064 0 32500 0 24856 0 873452 0 0 Alejandro C Arroliga MD 0 542498 0 57000 0 1361 0 32500 0 20832 0 654191 0 0 Timothy M Bittenbinder MD 0 510202 0 52000 0 1485 0 32500 0 25707 0 621894 0 0 Shahin Motakef 0 429278 0 108750 0 462 0 28275 0 20768 0 587533 0 0 Patricia M Currie 0 540415 0 192500 0 2848 0 32500 0 21182 0 789445 0 0 Dick L Dixon 0 431778 0 207750 0 1646 0 32500 0 20040 0 693714 0 0 Harry T Papaconstantinou MD 0 467440 0 39000 0 458 0 32500 0 11976 0 551374 0 0 Alita Prosser 0 218708 0 33250 0 204 0 32500 0 7937 0 292599 0 0 James Carroll 0 375213 0 132300 0 3501 0 32500 0 13914 0 557428 0 0 Stephen Sibbitt MD 0 435416 0 100000 0 762 0 32500 0 19858 0 588536 0 0 Cynthia B Dunlap 0 245315 0 62750 0 841 0 32500 0 13342 0 354748 0 0 Glen R Couchman MD 0 545222 0 192500 0 3349 0 32500 0 20613 0 794184 0 0 Robert W Pryor MD 0 895623 0 300000 0 7350 0 32500 0 19570 0 1255043 0 0 John L Boyd III MD 0 409998 0 92400 0 3406 0 32500 0 24843 0 563147 0 0 Matthew L Chambers 0 392598 0 140000 0 3996 0 32500 0 21871 0 590965 0 0 Marc R Hallee 0 366554 0 129750 0 384 0 32500 0 14103 0 543291 0 0 Nancy May 0 176543 0 27100 0 660 0 13113 0 7411 0 224827 0 0 Ellen D Hansen 0 165953 0 34400 0 331 0 24721 0 13473 0 238878 0 0 Stephen F Sullivan 0 230513 0 40833 0 1032 0 0 0 12785 0 285163 0 0 Paul R Illyes 247902 0 6901 0 1436 0 25000 0 16273 0 297512 0 0 0 Warren JVoegele 224588 0 12096 0 1637 0 24248 0 12136 0 274705 0 0 0 Charles S McFarling 268075 0 7552 0 1167 0 26240 0 12260 0 315294 0 0 0 Dwight C Williams 226217 0 11201 0 1436 0 24030 0 7149 0 270033 0 0 0 Daryl J Magoulick 233390 0 5201 0 609 0 23860 0 92 0 263152 0 0 0 Wade L Knight MD 0 516286 0 0 0 4572 0 32500 0 18843 0 572201 0 0 Michael L Middleton MD 0 416403 0 633 0 1074 0 32500 0 19042 0 469652 0 0 Francis P Anderson 0 263244 0 67750 0 1409 0 32500 0 18018 0 382921 0 0 Andrejs E Avots-Avotins MD 0 521642 0 8980 0 2668 0 32500 0 21281 0 587071 0 0 Stuart Donald Sequin 0 0 0 0 0 370000 0 0 0 0 0 370000 0 0 J Paul Dieckert MD 0 645873 0 89185 0 6556 0 32500 0 17948 0 792062 0 0 Alfred B Knight MD 0 242623 0 87500 0 13411 0 32500 0 18601 0 394635 0 0 William L Rayburn MD 0 528372 0 94000 0 2962 0 32500 0 22441 0 680275 0 0 Peter S Brumleve 0 118744 0 0 0 81232 0 10219 0 4521 0 214716 0 0 Nancy Birdwell 0 273468 0 96500 0 2392 0 32500 0 9136 0 413996 0 0 Part I, Line 4a Stuart D. Sequin received $370,000. Part I, Line 7 Discretionary bonuses are an element of various Scott & White Healthcare System (the "System") compensation plans. The Scott & White Healthcare Board of Trustees, which is the governing body of the Scott & White Healthcare System and the Board Compensation Committee have approved plans designed to measure performance based on differing job functions. The Board of Trustees approves the bonus pools reserved for the various plans. The Board of Trustees determines and approves the bonus, if any, for the System's Chief Executive Officers and other executive level personnel. Brett Dixon Family of Officer 58743 Employee of the Scott & White Healthcare System 0 John Carroll Family of Key Employee 92274 Employee of the Scott & White Healthcare System 0 Marjo Carroll Family of Key Employee 64960 Employee of the Scott & White Healthcare System 0 Phillip Couchman Family of Key Employee 59332 Employee of the Scott & White Healthcare System 0 Jared Pryor Family of Key Employee 101038 Employee of the Scott & White Healthcare System 0 0 Hillary Burgess Family of Key Employee 15327 Employee of the Scott & White Healthcare System 0 Kristin A Murphy Family of Former Officer 89531 Employee of the Scott & White Healthcare System 0 Scott & White Properties Robert Probe, M.D. Chairman of SWMH, serves as Board Member of SWP 42792 Interest Paid 0 Scott & White Properties Robert Probe, M.D. Chairman of SWMH, serves as Board Member of SWP 151590 Reimbursement of Expenses 0 Schedule L, Part IV, Transactions Involving Interested Persons: The interested person listed above in Part IV, Scott and White Properties ("SWP"), is a controlled affiliate of the organization. The organization's officers, key employees or former officers (Robert W. Pryor, M.D., Francis Anderson, Dick L. Dixon, Andrejs E. Avots-Avotins, M.D., Robert Probe, M.D., James Carroll and Stephen Sibbitt, M.D.) serve as board members of the controlled affiliate. These individuals serve as board representatives of those controlled affiliate to ensure they are operated in a charitable manner and in accordance with the organization's tax exempt status. X 501573 Selling Price 0 1 0 Form 990, Part V, Line 2a: Employees of the Scott & White Healthcare System are employed by Scott & White Memorial Hospital ("SWMH")(EIN: 74-1166904) or Scott & White Clinic ("SWC")(EIN: 74-2958277). This is done to achieve parity and consistency in compensation and benefits offered to employees and to reduce administration costs. Consistent with this practice, employee Form W-2's are filed by Scott & White Memorial Hospital or Scott & White Clinic. For financial reporting purposes, compensation, benefits and other employee costs are assigned to the Scott & White entity for which services are rendered. Oversight of and responsibility for the activities of employees are vested in the board of directors and management of the Scott & White entity to which such employees are assigned. All required employment forms have been filed by Scott & White Memorial Hospital and Scott & White Clinic. Form 990, Part VI, Section A, line 6 Scott & White Healthcare ("SWHC")(EIN: 26-4532547), an organization exempt from tax under IRC section 501(c)(3) and a public charity under IRC section 509(a)(3) is the sole member. Form 990, Part VI, Section A, line 7a Scott & White Healthcare ("SWHC")(EIN: 26-4532547), an organization exempt from tax under IRC section 501(c)(3) and a public charity under IRC section 509(a)(3) is the sole member. Election of the Hospital Board of Directors requires the approval of the Scott & White Healthcare Board of Trustees, by majority vote. The majority of the Scott & White Healthcare Board of Trustees is comprised of individuals who are representative of the community. Form 990, Part VI, Section A, line 7b Scott & White Healthcare ("SWHC")(EIN: 26-4532547), an organization exempt from tax under IRC section 501(c)(3) and a public charity under IRC section 509(a)(3) is the sole member. Actions taken by the Hospitals Board of Directors are subject to oversight and approval of the Scott & White Healthcare Board of Trustees. The majority of the Scott & White Healthcare Board of Trustees is comprised of individuals who are representative of the community. Form 990, Part VI, Section B, line 11 The Form 990 is prepared and reviewed by Scott & White Healthcare's ("SWHC") tax department. During the return preparation process the tax department works with other functional areas including finance, accounting, treasury, legal, human resources, and corporate compliance for advice, information and assistance to prepare a complete and accurate return. A complete final copy of the return is provided to the organization's governing body prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Persons with an actual or perceived ability to influence the organization have a duty to disclose annually and otherwise promptly as potential conflicts are identified, any familial, professional or financial relationships with entities or individuals that do, or seek to do business with the organization or that compete with the organization. These individuals include the organization's officers, governing body, management, physicians with administrative services agreements and other key personnel who interact with outside organizations or businesses on behalf of the organization. Scott & White Healthcare ("SWHC")Board of Trustees Audit and Compliance Committee and the SWHC Corporate Compliance Committee reviewed all relevant disclosures submitted by these individuals to determine whether a conflict of interest exists and to determine an appropriate resolution, if necessary. Any individual with a perceived or potential conflict is prohibited from voting or participating in the decision making process regarding such transaction with that individual. Form 990, Part VI, Section B, line 15 The compensation review process is performed annually. All physician compensation is reviewed including pay, production data and total compensation. The physician compensation is then benchmarked against industry standards using data from ten different industry surveys. This review is performed by an independent consultant and presented to the Scott & White Healthcare Board of Trustees Compensation Committee. Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is the parent corporation of the Scott & White Healthcare System (the "System"). System Officers along with regional Chief Executive Officers and Chief Medical Officers are reviewed annually. An independent consultant compares total compensation to benchmark surveys. The Scott & White Healthcare Board of Trustees Compensation Committee reviews the compensation and comparability data annually. Form 990, Part VI, Section C, line 19 The Scott & White governing documents and Conflict of Interest Policy (Tax) are available to the public upon request. This entity does not have separately audited financial statements. The audited financial statements of the Scott & White Healthcare System are available at http://www.dacbond.com and upon request. Part VI, Line 16b: To protect the assets of the exempt organization one or both of the following actions may be taken: Board of director representation or majority ownership. While not formally adopted as of the organizations tax year end, the organization is in the process of formalizing a written policy to incorporate the previous measures, and take additional steps to safeguard the assets in these ventures. The organization anticipates these procedures will be adopted within the next fiscal year. Part VI, Line 14: While not formally adopted as of the organization's tax year end, written policies and procedures have been drafted by the organization that address the procedures followed with respect to written document retention and destruction compliance. The organization anticipates these procedures will be adopted within the next fiscal year. Form 990, Part VII: Average hours per week recorded in column B for the Officers, Directors, Key Employees and Highly Compensated Employees represent total hours worked for the entire Scott & White Healthcare System. Other Fees Form 990, Part IX, line 11g Corporate Services: Program service expenses 0. Management and general expenses 149,469,503. Fundraising expenses 0. Total expenses 149,469,503. Contract Labor: Program service expenses 11,352,515. Management and general expenses 395,578. Fundraising expenses 0. Total expenses 11,748,093. Other Purchased Services: Program service expenses 26,446,408. Management and general expenses 921,524. Fundraising expenses 0. Total expenses 27,367,932. Repairs: Program service expenses 13,746,397. Management and general expenses 478,992. Fundraising expenses 0. Total expenses 14,225,389. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Contributed Capital-Foreign Captive -3,073,319. Change in Subsidiaries -47,175,096. Unconsolidated Earnings 38,052. Other Changes in Net Assets 15,271,746. Nondeductible Penalties -281. SWAP - Change in Value 54,661,902. Subpart F 2,225,339. Scott & White Healthcare 2401 S 31st Street Temple TX 76508 264532547 Operational Support TX 501(c)(3) Line 11a, I N/A 0 Scott & White Hospital-Round Rock 2401 S 31st Street Temple TX 76508 203749695 Hospital Services TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Continuing Care Hospital 2401 S 31st Street Temple TX 76508 202850920 Hospital Services TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Clinic 2401 S 31st Street Temple TX 76508 742958277 Physician Services TX 501(c)(3) Line 9 Scott & White Healthcare 1 Hillcrest Baptist Medical Center 100 Hillcrest Medical Blvd Waco TX 76712 741161944 Hospital Services TX 501(c)(3) Line 3 Scott & White Memorial Hospital 1 Scott & White EMS Inc 2401 S 31st Street Temple TX 76508 753242749 Emergency Transportation TX 501(c)(3) Line 9 Scott & White Memorial Hospital 1 Scott & White Hospital-Brenham 2401 S 31st Street Temple TX 76508 742519752 Hospital Services TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Healthcare Foundation 2401 S 31st Street Temple TX 76508 273513154 Fundraising TX 501(c)(3) Line 7 Scott & White Healthcare 1 Scott & White Health Plan 2401 S 31st Street Temple TX 76508 742052197 HMO/Insurance TX 501(c)(4) Scott & White Healthcare 1 Scott & White Hospital-Taylor 2401 S 31st Street Temple TX 76508 741595711 Hospital Services TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-Llano 2401 S 31st Street Temple TX 76508 273026151 Hospital Services TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-College Station 2401 S 31st Street Temple TX 76508 274434451 Hospital Services TX 501(c)(3) Line 3 Scott & White Healthcare 1 Brenham Hospital Services Corporation 2401 S 31st Street Temple TX 76508 742605157 Operational Support TX 501(c)(3) Line 11a, I Scott & White Healthcare 1 Scott & White Foundation-Brenham 2401 S 31st Street Temple TX 76508 742460815 Fundraising TX 501(c)(3) Line 7 Scott & White Hospital-Brenham 1 Brenham Care Center 2401 S 31st Street Temple TX 76508 742663229 Healthcare TX 501(c)(3) Line 9 Scott & White Hospital-Brenham 1 Hillcrest Family Health Center 100 Hillcrest Medical Blvd Waco TX 76712 742730350 Physician Services TX 501(c)(3) Line 11a, I Hillcrest Baptist Medical Center 1 Hillcrest Physician Services 100 Hillcrest Medical Blvd Waco TX 76712 742967081 Physician Services TX 501(c)(3) Line 11a, I Hillcrest Baptist Medical Center 1 Scott & White Hospital-Marble Falls 2401 S 31st Street Temple TX 76508 464007700 Hospital Services TX Applied for 501 (c) Applied for Line 3 Scott & White Healthcare 1 ESWCT LLC 10077 Grogans Mill Rd Ste 100 The Woodlands TX 77380 900899017 Investment TX N/A Scott & White Properties Holdings Inc 2401 S 31st Street Temple TX 76508 452920596 Investment TX Scott & White Memorial Hospital C 622512 10947656 1.00000 1 Scott & White Properties Inc 2401 S 31st Street Temple TX 76508 742497061 Hotel Services TX N/A C 1 Scott & White Assurance Ltd 23 Lime Tree Bay Grand Cayman CJ 980589956 Investment CJ Scott & White Memorial Hospital C 1.00000 1 Hillcrest Holdings Inc 3000 Herring St Waco TX 76708 742793367 Operational Support TX N/A C 1 Atumida 2401 S 31st Street Temple TX 76508 270583030 Research TX N/A C 249235 0.72000 1 Insurance Company of Scott & White 2401 S 31st Street Temple TX 76508 743092083 Insurance TX Scott & White Health Plan C 1.00000 1 Charitable Remainder Trust #1 PO Box 6101 Temple TX 765036101 526854329 Investment TX Scott & White Memorial Hospital T 1602498 1.00000 1 Charitable Remainder Trust #2 PO Box 6101 Temple TX 765036101 206463694 Investment TX Scott & White Memorial Hospital T 225688 1.00000 1 Charitable Remainder Trust #3 PO Box 6101 Temple TX 765036101 416504860 Investment TX Scott & White Memorial Hospital T 2 1.00000 1 Charitable Remainder Trust #4 PO Box 6101 Temple TX 765036101 742751167 Investment TX Scott & White Memorial Hospital T 20778 1.00000 1 Charitable Remainder Trust #5 PO Box 6101 Temple TX 765036101 746391353 Investment TX Scott & White Memorial Hospital T 213092 1.00000 1 Charitable Remainder Trust #6 PO Box 6101 Temple TX 765036101 746397360 Investment TX Scott & White Memorial Hospital T 1.00000 1 Charitable Remainder Trust #7 PO Box 6101 Temple TX 765036101 742751168 Investment TX Scott & White Memorial Hospital T 99962 1.00000 1 Charitable Remainder Trust #8 PO Box 6101 Temple TX 765036101 746423552 Investment TX Scott & White Memorial Hospital T 322073 1.00000 1 Charitable Remainder Trust #9 PO Box 6101 Temple TX 765036101 456783659 Investment TX Scott & White Memorial Hospital T 98414 1.00000 1 Phil and June Hivnor Charitable 2401 S 31st Street Temple TX 765080001 900850773 Investment TX N/A T 1 Nelda I Staller Charitable Remainder Unitrust No 1 2401 S 31st Street Temple TX 765080001 326224724 Investment TX N/A T 1 Scott & White Lake of the Hills Regional Medical Center 2401 S 31st Street Temple TX 765080001 451608264 Hospital Services TX N/A C 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 Scott & White Clinic Q 50269369 Cost Scott & White Hospital Round Rock Q 55287325 Cost Scott & White Continuing Care Hospital Q 7963580 Cost Scott & White EMS Q 4485448 Cost Scott & White Health Plan P 27347151 Cost Scott & White Hospital-Llano Q 14987975 Cost Scott & White Hospital-Brenham Q 13793055 Cost Scott & White Hospital-Taylor Q 7301212 Cost Scott & White Healthcare P 691924023 Cost Scott & White Healthcare Foundation Q 1978697 Cost Scott & White Hospital-College Station Q 4462066 Cost Scott & White Properties Q 151590 Cost Scott & White Properties A 42792 Cost Scott & White Properties S 367253 Cost Scott & White Healthcare Foundation C 8609605 Cost