2013-07-12T14:50:09-05:00 2012-08-31 990 2011-09-01 742967081 Hillcrest Physician Services HILL 2542159043 100 Hillcrest Medical Blvd Waco TX 76712 Richard Perkins 2542029416 2013-07-12 2011 2016-02-24 21:20:13Z Glenn Robinson 100 Hillcrest Medical Blvd Waco TX 76712 13200774 0 X www.hillcrest.net X 2000 TX Scott & White provides personalized, comprehensive, high quality health care services enhanced by medical education and research through 12 acute care hospital sites, two additional announced facilities, a 240,000+ 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 178 clinics at 65 clinic locations providing care in 46 medical specialties. Hillcrest Physician Services is a subsidiary of Hillcrest Baptist Medical Center ("HBMC"), who is controlled by Scott & White Memorial Hospital ("SWMH"). Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is the parent corporation of SWMH and 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. 5 0 31 0 0 0 2800000 4500000 9006592 8699444 470 1330 21315 0 11828377 13200774 0 0 0 0 7977888 9733934 0 0 0 3925530 3185907 11903418 12919841 -75041 280933 1531919 2047734 1052176 1420670 479743 627064 X Hillcrests mission statement is: "To personally provide the highest quality healthcare in a compassionate and Christian environment, enhanced by medical education and research." 0 0 12884783 4500000 8699444 Scott & White provides personalized, comprehensive, high quality health care services enhanced by medical education and research through 12 acute care hospital sites, two additional announced facilities, a 240,000+ 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 178 clinics at 65 clinic locations providing care in 46 medical specialties. Hillcrest Physician Services is a subsidiary of Hillcrest Baptist Medical Center ("HBMC"), who is controlled by Scott & White Memorial Hospital ("SWMH"). Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is the parent corporation of SWMH and 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 provided at cost approximately: $60 million in unreimbursed charity care, $46 million in unreimbursed Medicaid, $4.5 million in unreimbursed indigent care, $21 million in unreimbursed subsidized services, $63 million in unreimbursed health professions education, $13 million in unreimbursed research, $1 million in other community benefits, and had a Medicare shortfall of approximately $96 million in the fiscal year ending August 31, 2012.The Scott & White Healthcare System had more than 14,000 employees, including over 1,000 physicians and scientists and 300+ advanced practice professionals during the fiscal year ending August 31, 2012, and served over 537,000 patients accounting for 2.2 million patient visits. Scott & White Memorial Hospital, 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. The Hillcrest Physician Services hospitalists provided 21,892 visits during fiscal year 2012. Specialists employed by HPS provided a majority of the orthopedic and neurosurgical call coverage for the level II trauma center at Hillcrest Baptist Medical Center.Scott & White System personnel strive to do more than merely meet the healthcare needs of patients. Employees go into the community to educate about living a healthier life. Targeted populations are provided information on specific needs. For example, physicians specializing in geriatric care hold regular seminars discussing subjects such as preventing injury from falls, questions patients should be asking their doctor, how to maintain a healthy lifestyle with limited mobility, and more. Health educational programs regarding prevention and treatment are offered free or at minimal cost to all community members in a variety of subject areas, such as weight loss, smoking cessation, education on coping with a diagnosis, support groups for families, child safety, heart disease education, diabetes education, sex education for teens, domestic violence prevention and many more. Staff and physicians attend health fairs in the community and provide regular community presentations about health issues for different populations. Clinics in the region offer healthy cooking classes led by a Scott & White dietician to instruct families in creating easy and cost effective healthy meals. As an integrated health care delivery system, Scott & White is able to leverage the Scott & White Health Plan to provide health education information to the community and is actively working to make that information more widely available.Scott & White uses various forms of media to promote health in the community. The System website, blogs, social media, printed flyers, and newspaper and magazine articles written by staff and physicians throughout the year provide information that community members can use to enhance personal health. A specific website has been created to instruct on wellness initiatives (wellness.sw.org). Also, Scott & White staff dedicate many hours serving on community boards and collaborative groups whose missions are to improve the overall health of the community. In addition to these efforts, the System has designated specific funds to be used to enhance healthy initiatives occurring in each community. For example, Scott & White provides substantial financial and in-kind support for multiple free clinics to assist in providing better access and more affordable healthcare to the medically underserved. Scott & White is one of sixteen major U.S. health systems to be part of the National High Value Healthcare Collaborative ("HVHC"). This partnership is designed to improve healthcare, lower costs and make best practices available to the national provider community. The Dartmouth Institute for Health Policy and Clinical Practice leads the collaborative which is studying nine prevalent condition/disease specific areas that have been shown to have wide variation nationally in rates, costs and outcomes. Additional high variation, high cost conditions that affect diverse populations will be added over time. The healthcare systems in this group are responsible for 50 million patients and are using private dollars and research and grant funds to identify ways to get the most out of every healthcare dollar. In June of 2012 the HVHC received a $26 million grant from the Center for Medicare and Medicaid Innovation ("CMMI"). CMMI projects the service improvements funded by this grant will save $64 million over three years, largely due to reduced utilization and costs that have been shown to occur when patients are engaged and empowered to make health care decisions based on their own values and preferences.Scott & White strives to better serve patients while decreasing costs to the healthcare system. One way this is accomplished is through better communication between specialists and primary care physicians creating coordinated and integrated care. Scott & White's electronic medical records (EMR) system allows specialists to review a patient's medical history and lab results and make recommendations to a primary care physician possibly eliminating an office visit. If the specialist needs to see a patient the specialist has access to all tests and lab work prior to the office visit which can prevent a second or third specialty follow-up visit. Scott & White is also using the EMR system to practice active rather than passive medicine. The new EMR system allows Scott & White to automatically remind physicians that patients are due for preventive tests such as mammograms or cholesterol checks. The system allows doctors and nurses to use e-mail to provide patients with test results or to answer questions that previously would have required an office visit.The Scott & White Healthcare System has received numerous awards and accreditations. Scott & White Memorial Hospital was ranked for the eighth time as one of the Top 100 Hospitals by Thomson Reuters. For the second consecutive year, SWMH was named one of the nation's Best Regional Hospitals according to U.S. News & World Report. 12884783 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 16 0 1 31 1 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Richard W Perkins 2542029416 100 Hillcrest Medical Blvd Waco TX 76712 X Twila Lovett MD 40.00 X 265309 0 50205 Saramma George MD 40.00 X 207261 0 44839 Jon Ellis MD 40.00 X 532762 0 69804 Marc Elieson MD 40.00 X 0 309273 47675 James Morrison MD 40.00 X X 0 342843 48214 Glenn Robinson 40.00 X 0 619432 41894 Richard W Perkins 40.00 X 0 264260 51214 Brad Crye 40.00 X 0 180322 42814 Robert W Pryor MD 40.00 X 0 866989 46463 Patricia M Currie 40.00 X 0 480343 46740 Glen R Couchman MD 40.00 X 0 573830 53381 Cynthia B Dunlap 40.00 X 0 202857 38845 Dennis L Laraway 40.00 X 0 444702 42397 Dick L Dixon 40.00 X 0 313365 48214 Matthew L Chambers 40.00 X 0 188235 6084 Marc R Hallee 40.00 X 0 450015 6951 Luiz Cesar MD 40.00 X 600929 0 12605 David Haynes MD 40.00 X 395142 0 44251 Christopher Miars MD 40.00 X 322388 0 39136 Vikas Patel MD 40.00 X 273217 0 47950 Asif Farooq MD 40.00 X 229993 0 13391 2827001 5236466 843067 17 0 1 1 South Texas Orthopedic Specialty Group 1504 Redcloud Peak Canyon Lake TX 78133 Physician Services 911777 Seavest Properties II 50 Hillcrest medical Blvd Ste 302 Waco TX 76712 Property Rent 656615 Medicus Hospitalists LLC 7 Industrial Way Ste 5 Salem NH 03079 Physician Services 453453 Linde Health Care Staffing Inc 3668 S Geyer Rd Ste 100 Sunset Hills MO 63127 Staffing 104887 4 4500000 4500000 Net Patient Care 621110 8699444 8699444 8699444 1330 1330 13200774 8699444 0 1330 1558189 1558189 7158797 7158797 1016948 1016948 20483 20483 918058 903483 14575 553 553 91287 91287 59075 59075 614844 614844 115581 115581 40276 40276 Bad Debt 864128 864128 Patient Care 370865 370865 Miscellaneous 77959 77959 Maintenance 12798 12798 12919841 12884783 35058 0 422123 289810 1059469 1443349 0 56256 50327 100238 150144 7937 1531919 2047734 943173 999549 23136 25178 85867 395943 1052176 1420670 X 479743 627064 479743 627064 1531919 2047734 X 280933 -133614 X 0 1 1 X 0 X X X 0 0 0 Hillcrest Baptist Medical Center 741161944 3 1 1 1 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 Intercompany Investment 150144 C 150144 Due to Related Organization 395943 395943 Description of Uncertain Tax Positions Under FIN 48: Part X: The Organization accounts for income taxes persuant to Accounting Standards Codification (ASC) 740, Income Taxes, which prescribes a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. There were no material uncertain tax positions at August 31, 2012 and 2011. X 1 1 0 0 0 0 0 0 0 0 0 Twila Lovett MD 228939 0 35670 0 700 0 29600 0 20605 0 315514 0 0 0 Saramma George MD 195675 0 11312 0 274 0 26903 0 17936 0 252100 0 0 0 Jon Ellis MD 532433 0 25 0 304 0 51783 0 18021 0 602566 0 0 0 Marc Elieson MD 0 261292 0 47603 0 378 0 31850 0 15825 0 356948 0 0 James Morrison MD 0 341877 0 0 0 966 0 31850 0 16364 0 391057 0 0 Glenn Robinson 0 479412 0 0 0 140020 0 17150 0 24744 0 661326 0 0 Richard W Perkins 0 262454 0 0 0 1806 0 31850 0 19364 0 315474 0 0 Brad Crye 0 179692 0 0 0 630 0 24497 0 18317 0 223136 0 0 Robert W Pryor MD 0 864217 0 0 0 2772 0 31850 0 14613 0 913452 0 0 Patricia M Currie 0 479377 0 0 0 966 0 31850 0 14890 0 527083 0 0 Glen R Couchman MD 0 572024 0 0 0 1806 0 31850 0 21531 0 627211 0 0 Cynthia B Dunlap 0 201891 0 0 0 966 0 26914 0 11931 0 241702 0 0 Dennis L Laraway 0 444256 0 0 0 446 0 31850 0 10547 0 487099 0 0 Dick L Dixon 0 311559 0 0 0 1806 0 31850 0 16364 0 361579 0 0 Matthew L Chambers 0 172585 0 10000 0 5650 0 0 0 6084 0 194319 0 0 Marc R Hallee 0 346430 0 90000 0 13585 0 0 0 6951 0 456966 0 0 Luiz Cesar MD 595143 0 25 0 5761 0 0 0 12605 0 613534 0 0 0 David Haynes MD 394813 0 25 0 304 0 43289 0 962 0 439393 0 0 0 Christopher Miars MD 322089 0 25 0 274 0 37757 0 1379 0 361524 0 0 0 Vikas Patel MD 236684 0 36260 0 273 0 29600 0 18350 0 321167 0 0 0 Asif Farooq MD 193081 0 36775 0 137 0 7687 0 5704 0 243384 0 0 0 Part I, Line 1a Dr. Luiz Cesar was provided a housing allowance in the amount of $5,761.09 during the year. This amount was reported as taxable compensation on Form W-2. Supplemental Information Part III Community Hospital Corporation, a management company, paid Glenn Robinson $619,432 for his services as President of Hillcrest Baptist Medical Center, the parent corporation of Hillcrest Physician Services. Glenn Robinson serves as president of Hillcrest Physician Services. Community Hospital Corporation is an unrelated organization. Julie Couchman Family of Key Employee 35406 Employee of the Scott & White Healthcare System 0 Jarrod Pryor Family of Key Employee 67026 Employee of the Scott & White Healthcare System 0 Brett Dixon Family of Key Employee 14995 Employee of the Scott & White Healthcare System 0 Form 990, Part VI, Section A, line 6 Hillcrest Physician Services ("HPS") sole member is Hillcrest Baptist Medical Center ("HBMC")(EIN: 74-1161944), an organization exempt from tax under IRC section 501(c)(3) and a public charity under IRC section 509(a)(1). Form 990, Part VI, Section A, line 7a Hillcrest Physician Services ("HPS") sole member is Hillcrest Baptist Medical Center ("HBMC")(EIN: 74-1161944), an organization exempt from tax under IRC section 501(c)(3) and a public charity under IRC section 509(a)(1). Election of the HPS Board of Directors requires the approval of the Hillcrest Baptist Medical Center's Board of Directors, by majority vote. Form 990, Part VI, Section A, line 7b Hillcrest Physician Services ("HPS") sole member is Hillcrest Baptist Medical Center ("HBMC")(EIN: 74-1161944), an organization exempt from tax under IRC section 501(c)(3) and a public charity under IRC section 509(a)(1). Actions taken by the HPS Board of Directors are subject to oversight and approval of the Hillcrest Baptist Medical Center Board of Directors. Form 990, Part VI, Section B, line 11 Hillcrest Physician Services ("HPS") A copy of Form 990 was provided to the Hillcrest Physician Services ("HPS") Board of Directors for review prior to filing with the IRS. A meeting was held to allow the Directors to ask questions and provide feedback with respect to the information presented in the Form 990. Form 990, Part VI, Section B, line 12c Annually, a written questionnaire is provided to all persons identified as being subject to the Scott & White Healthcare System Conflict of Interest Policy (Tax), requesting responses to questions designed to identify potential conflicts. Responses are monitored and reviewed by system personnel and follow-ups are initiated as required. The Conflict of Interest Policy (Tax) is reviewed before each board meeting or board committee meeting. Board members or persons having business with the Board are asked to identify conflicts which may arise with respect to business conducted by the Board or committee during the meeting. 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. Hillcrest Baptist Medical Center ("HBMC") is the sole corporate member of Hillcrest Physician Services ("HPS"). HBMC is a subsidiary of Scott & White Memorial Hospital ("SWMH"). Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is the parent corporation of SWMH and the entire Scott & White Healthcare System (the "System"). Compensation for the Scott and White Healthcare 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 Hillcrest Physician Services ("HPS") governing documents and Conflict of Interest Policy (Tax) are available to the public upon request. HPS does not have separately audited financial statements, but the consolidated audited financial statements of the Scott & White Healthcare System are available at http://www.dacbond.com and upon request. Record Retention and Destruction Policy Part VI, Line 14 Hillcrest Physician Services ("HPS") follows the written Record Retention and Destruction Policy of their sole corporate member, Hillcrest Baptist Medical Center ("HBMC"). Conflict of Interest Policy Part VI, Line 12a Hillcrest Physician Services ("HPS") follows the written Conflict of Interest Policy of their sole corporate member, Hillcrest Baptist Medical Center ("HBMC"). Estimated Average Per Week Form 990 Part VII, Column B 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. Compensation Paid to Officers Form 990 Part VII, Column D Officers and Directors are not compensated in their capacity as Directors and Officers of the Corporation. However, some of the directors provide medical services for the corporation pursuant to employment agreements, and compensation is paid to them in their capacity as medical service providers. Depreciation Form 990 Part IX Line 22 and Part X Line 10c All assets are owned by Hillcrest Baptist Medical Center. Depreciation expense is charged to Hillcrest Physician Services for the assets owned by Hillcrest Baptist Medical Center and used by Hillcrest Physician Services. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Transfer to captive -133,614. Total to Form 990, Part XI, Line 5: -133,614. Form 5471 Disclosure Statement Related to Forms 5471, Information Return of U.S. Persons With Respect to Certain Foreign Corporations, Filed on Behalf of the Taxpayer: Under the constructive ownership rules of IRC Sections 958(a) and (b). The taxpayer is required to file Forms 5471, Information Return of U.S. Persons With Respect to Certain Foreign Corporations, as a Category 5 filer with respect to certain controlled foreign corporations (CFCs). These filing requirements are or will be satisfied through the filing of Forms 5471 for these CFCs by other U.S. taxpayers identified below who have the same filing requirement. Taxpayer Name: Scott & White Memorial Hospital Taxpayer Address: 2401 S. 31st Street Temple, TX 76508 Taxpayer Identification Number of U.S. tax return with which the Forms 5471 were or will be filed: 74-1166904 IRS Service Center where U.S. tax return was or will be filed: efile Scott & White Properties Opportunities LLC 2401 S 31st Street Temple TX 76508 452920812 Investment TX Scott & White Properties Holdings Inc Scott & White Properties Management LLC 2401 S 31st Street Temple TX 76508 452920980 Investment TX Scott & White Properties Opportunities LLC 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 Memorial Hospital 2401 S 31st Street Temple TX 76508 741166904 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 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 Hospital-Round Rock 2401 S 31st Street Temple TX 76508 203749695 Hospital Services TX 501 (c) (3) Line 3 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 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 Healthplan 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 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 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 11c, III-FI Hillcrest Baptist Medical Center 1 Scott & White Lake of the Hills Regional Medical Center 2401 S 31st Street Temple TX 76508 451608264 Hospital Services TX 501 (c) (3) Line 3 Scott & White Healthcare 1 Scott & White Properties Holdings Inc 2401 S 31st Street Temple TX 76508 452920596 Investment TX N/A C Scott & White Properties Inc 2401 S 31st Street Temple TX 76508 742497061 Hotel Services TX N/A C Scott & White Assurance Ltd 23 Lime Tree Bay Grand Cayman Grand Cayman CJ 980589956 Investment CJ N/A C Hillcrest Holdings Inc 3000 Herring St Waco TX 76708 742793367 Operational Support TX N/A C Atumida 2401 S 31st Street Temple TX 76508 270583030 Research TX N/A C Insurance Company of Scott & White 2401 S 31st Street Temple TX 76508 743092083 Investment TX N/A C Charitable Remainder Trust #1 PO Box 6101 Temple TX 765036101 526854329 Investment Trust TX N/A T Charitable Remainder Trust #2 PO Box 6101 Temple TX 765036101 206463694 Investment Trust TX N/A T Charitable Remainder Trust #3 PO Box 6101 Temple TX 765036101 416504860 Investment Trust TX N/A T Charitable Remainder Trust #4 PO Box 6101 Temple TX 765036101 742751167 Investment Trust TX N/A T Charitable Remainder Trust #5 PO Box 6101 Temple TX 765036101 746391353 Investment Trust TX N/A T Charitable Remainder Trust #6 PO Box 6101 Temple TX 765036101 746397360 Investment Trust TX N/A T Charitable Remainder Trust #7 PO Box 6101 Temple TX 765036101 742751168 Investment Trust TX N/A T Charitable Remainder Trust #8 PO Box 6101 Temple TX 765036101 746423552 Investment Trust TX N/A T Phil and June Hivnor Charitable 2401 S 31st Street Temple TX 765080001 900850773 Investment Trust TX N/A T Nelda I Staller Charitable Remainder Unitrust No 1 2401 S 31st Street Temple TX 765080001 326224724 Investment Trust TX N/A T 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 Hillcrest Baptist Medical Center C 4500000 Cost Hillcrest Baptist Medical Center J 645185 Cost Hillcrest Baptist Medical Center N 1658564 Cost