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150 4785234 4785384 54874361 51180660 51180660 150 2091 2241 51182901 RECONCILIATION OF CHANGES IN NET ASSETS SCHEDULE D, PART XI, LINE 8 CHANGE IN FINANCIAL INTEREST - FOUNDATION $4,785,234 EQUITY EARNINGS INCLUDED WITH EXPENSE ON AUDIT (2,091) --------- $4,783,143 RECONCILIATION OF AUDITED FINANCIAL STATEMENTS TO FORM 990 SCHEDULE D, PARTS XII AND XIII REVENUE ON RETURN, NOT ON BOOKS: CHANGE IN FINANCIAL INTEREST - FOUNDATION $ 4,785,234 EXPENSES ON RETURN, NOT ON BOOKS: EQUITY EARNINGS INCLUDED WITH EXPENSE ON AUDIT $ 2,091 INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS SCHEDULE D, PART V, QUESTION 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. X true true X X X X X false true false false false false false false false ROGER FOWLER MD 0 364936 0 0 0 19758 0 10413 0 5000 0 400107 0 0 J LINDSEY BRADLEY 325388 488083 176795 265192 180000 270000 4165 6248 3138 2708 689486 1032231 0 0 DAVID TEEGARDEN MD 105762 158643 0 0 45458 68189 3305 4958 6034 9052 160559 240842 43315 64974 STEVEN KEUER MD 209881 314819 108747 163121 150021 225032 4165 6248 6834 10252 479648 719472 141278 211918 RAY THOMPSON 276126 414188 139247 208871 185215 277822 215458 323187 3215 4823 819261 1228891 185215 277822 WILLIAM BELLENFANT 756355 1134533 0 0 103406 155109 0 0 894 1340 860655 1290982 103406 1340 MONTY BEASLEY 124155 0 14109 0 14041 0 1794 0 6785 0 160884 0 0 0 DAVID NORTHCUTT 153864 0 0 0 17427 0 7492 0 6840 0 185623 0 0 0 JOYCE HESTER 69697 104546 14658 21986 7486 11228 3265 4898 1613 2420 96719 145078 0 0 JEREMY J MEBANE 132528 0 0 0 11756 0 1750 0 4242 0 150276 0 0 0 GIFFORD ECKHOUT MD 0 673623 0 0 0 5358 0 0 0 14988 0 693969 0 0 LEE PORTWOOD 66892 100339 0 0 21645 32467 3646 5468 2086 3130 94269 141404 0 0 JOHN WEBB 63033 94550 14475 21713 12534 18800 2865 4298 2851 4277 95758 143638 0 0 ANDY NAVARRO 105778 158667 22499 33748 8371 12556 4165 6248 2759 4139 143572 215358 0 0 NORMAN HANCOCK 70510 105766 19123 28685 10389 15584 2550 3825 2401 3601 104973 157461 0 0 JEFFREY HYDE 60832 91247 13212 19818 9831 14746 2823 4234 1986 2980 88684 133025 0 0 MARY E JACKSON 66667 100000 11310 16965 11994 17991 3020 4531 1022 1533 94013 141020 0 0 PARTICIPATION IN OR PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PART I, QUESTION 4B PARTICIPANTS IN SERP REPORTED IN W-2 DEFERRED COMPENSATION -------------------- --------------- --------------------- LINDSEY BRADLEY NONE NONE RAY THOMPSON 463,037 NONE BILL BELLENFANT 258,515 NONE STEVEN KEUER MD 346,800 NONE DAVID TEEGARDEN MD NONE NONE PARTICIPANTS IN 457(F) REPORTED IN W-2 ---------------------- ---------------- DAVID TEEGARDEN MD 6,936 STEVEN KEUER MD 108,289 ROGER FOWLER MD NONE TRAVEL FOR COMPANIONS PART I, QUESTION 1A THE ORGANIZATION REIMBURSED BILL BELLENFANT AND LINDSEY BRADLEY FOR SPOUSAL TRAVEL EXPENSES. REIMBURSEMENTS WERE INCLUDED IN FORM W-2. CATHERINE BRADLEY SISTER OF DIRECTOR 81528 SALARIES/WAGES false DESCRIBE REVIEW PROCESS OF FORM 990 FORM 990, PART VI, QUESTION 11B THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS PRIOR TO FILING. DESCRIBE THE ORGANIZATION'S MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 THE SOLE MEMBER IS THE CONGREGATION OF THE SISTERS OF THE HOLY FAMILY OF NAZARETH, A RELIGIOUS ORDER OF THE ROMAN CATHOLIC CHURCH. MEMBERS WHO MAY ELECT MEMBERS OF THE GOVERNING BOARD FORM 990, PART VI, QUESTION 7A THE MEMBER HAS THE SOLE RIGHT AND AUTHORITY TO APPOINT ONE OF THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS. DECISIONS OF THE GOVERNING BOARD SUBJECT TO APPROVAL OF MEMBERS FORM 990, PART VI, QUESTION 7B THE MEMBER HAS THE AUTHORITY TO APPROVE OR DISAPPROVE CERTAIN ACTIONS PREVIOUSLY APPROVED BY THE BOARD OF DIRECTORS. HOW DOES THE ORGANIZATION MONITOR AND ENFORCE COMPLIANCE WITH POLICY FORM 990, PART VI, QUESTION 12C THE BOARD REVIEWS AND RESOLVES, IF NECESSARY, ANY TRANSACTIONS AS THEY ARISE THROUGHOUT THE YEAR IN ACCORDANCE WITH POLICY STANDARDS. PROCESS FOR DETERMINING COMPENSATION OF CEO, OFFICERS, OR KEY EMPLOYEES FORM 990, PART VI, QUESTIONS 15A & 15B THE ORGANIZATION USES COMPENSATION CONSULTANTS AND NATIONAL COMPENSATION SURVEYS TO DETERMINE COMPENSATION OF EMPLOYEES. COMPENSATION IS APPROVED BY THE ORGANIZATION'S GOVERNING BODY. DESCRIBE WHETHER THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE TO PUBLIC FORM 990, PART VI, QUESTION 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, QUESTION 1 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. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 OTHER CHANGES IN NET ASSETS: TRANSFERS FROM AFFILIATES ($18,201,379) CHANGE IN FINANCIAL INTEREST - TEMP RESTRICTED 2,069,478 CHANGE IN FINANCIAL INTEREST - FOUNDATION (4,785,234) EQUITY EARNINGS INCLUDED WITH EXPENSE ON AUDIT 2,091 -------------- ($20,915,044) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RANDY CHILDRESS TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROGER FOWLER MD TITLE:DIRECTOR HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J LINDSEY BRADLEY TITLE:SYSTEM PRESIDENT/DIRECTOR HOURS:13 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:STEVEN KEUER MD TITLE:SYSTEM PRESIDENT/CMO/DIRECTOR HOURS:32 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DICK STONE TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:GIFFORD ECKHOUT MD TITLE:EXECUTIVE VP/DIRECTOR HOURS:30 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RAY THOMPSON TITLE:SYS EXEC VP/CEO/DIRECTOR/SECR HOURS:27 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOYCE HESTER TITLE:SYSTEM VP, FINANCE, CFO HOURS:32 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ANDY NAVARRO TITLE:VP, LEGAL COUNSEL HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARY E JACKSON TITLE:VICE PRESIDENT HOURS:20 CHAMPION EMERGENCY SERVICES LLC 2201 S MOBBERLY AVE LONGVIEW TX 75602 752747708 AMBULANCE SVC TX 501(C)(3) 9 NA false MOTHER FRANCES HOSPITAL REGIONAL HC CTR 1315 DOCTORS DRIVE TYLER TX 75701 750818167 HOSPITAL TX 501(C)(3) 3 TMFHS true MOTHER FRANCES HOSPITAL - JACKSONVILLE 1315 DOCTORS DRIVE TYLER TX 75701 751976930 HOSPITAL TX 501(C)(3) 3 TMFHS true TRINITY MOTHER FRANCES HEALTH SYSTEM FDN 1315 DOCTORS DRIVE TYLER TX 75701 752028241 SUPPORT TX 501(C)(3) 11A I TMFHS true REGIONAL MEDICAL SERVICES ASSOCIATION 1315 DOCTORS DRIVE TYLER TX 75701 752511459 HEALTHCARE TX 501(C)(3) 3 MFH REG true TRINITY CLINIC 1315 DOCTORS DRIVE TYLER TX 75701 752616977 HEALTHCARE TX 501(C)(3) 3 TMFHS true MOTHER FRANCES HOSPITAL - WINNSBORO 1315 DOCTORS DRIVE TYLER TX 75701 752771569 HOSPITAL TX 501(C)(3) 3 TMFHS true TRI-STATE FINANCIAL LLC 1315 DOCTORS DRIVE TYLER TX 75701 752728318 COLLECTION AGENCY TX NA C-CORPORATION TRINCARE INC 1315 DOCTORS DRIVE TYLER TX 75701 752161369 RETAIL HEALTH SVC TX NA C-CORPORATION HEALTHPLAN OF TEXAS INC 514 S BECKHAM TYLER TX 75701 752636832 THIRD PARTY ADMIN TX NA C-CORPORATION THE REGIONAL HEALTHCARE ALLIANCE 1315 DOCTORS DRIVE TYLER TX 75701 752484109 PREFER PROVIDER TX NA C-CORPORATION TEXAS HEALTH FACILITIES INSUR CORP LTD PO BOX 1109 BWI GRAND CAYMAN CJ 980136025 INSURANCE CJ NA C-CORPORATION CONCORDIUM HEALTH LLC 1315 DOCTORS DRIVE TYLER TX 75701 702811022 INACTIVE TX NA C-CORPORATION EMPLOYERS SERVICES INC 1315 DOCTORS DRIVE TYLER TX 75701 752602556 INACTIVE TX NA C-CORPORATION HERITAGE HEALTH PLANS OF TX 1315 DOCTORS DRIVE TYLER TX 75701 752622622 INACTIVE TX NA C-CORPORATION QUALITY CARE ALLIANCE 1315 DOCTORS DRIVE TYLER TX 75701 752662965 INACTIVE TX NA C-CORPORATION false false false false false false false false false false true true false true false false true true MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE K 28336133 FAIR VALUE TRINITY CLINIC K 7580727 FAIR VALUE MOTHER FRANCES HOSPITAL - JACKSONVILLE K 1991520 FAIR VALUE MOTHER FRANCES HOSPITAL - WINNSBORO K 1318334 FAIR VALUE TRINCARE INC K 322502 FAIR VALUE DIRECT CONTROLLING ENTITY SCHEDULE R, PART II, COLUMN F THE FOLLOWING RELATED ORGANIZATIONS REPORTABLE IN PART II ARE DIRECTLY CONTROLLED BY TRINITY MOTHER FRANCES HEALTH SYSTEM ("TMFHS"): MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER MOTHER FRANCES HOSPITAL - JACKSONVILLE TRINITY MOTHER FRANCES HEALTH SYSTEM FOUNDATION TRINITY CLINIC MOTHER FRANCES HOSPITAL - WINNSBORO REGIONAL MEDICAL SERVICES ASSOCIATION IS DIRECTLY CONTROLLED BY MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER ("MFH REG").