TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE (EIN 75-1748586)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201313189349301456
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-14T08:49:10-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN751748586EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Texas Health Harris Methodist Hospital AzleBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% DAVID JACKSONInCareOfName
Name ControlTEXANameControl
Phone8174448600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1108 Denver TrailAddressLine1
Address Line2SuiteAddressLine2
CityAzleCity
StateTXState
ZIP Code76020ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRICK MCWHORTERName
TitleAsst SecretaryTitle
Date Signed2013-11-12DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Texas Health AzleBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonBob EllzeyNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1108 Denver TrailAddressLine1
CityAzleCity
StateTXState
ZIP Code76020ZIPCode
FieldValueIRS element (for citing)
Gross Receipts32063471GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.texashealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1954YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionA faith-based organization whose mission is to improve the health of the people in the communities it serves regardless of one's ability to pay.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees334TotalNbrEmployees
Total Nbr Volunteers23TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year192511ContributionsGrantsPriorYear
Contributions Grants Current Year636347ContributionsGrantsCurrentYear
Program Service Revenue Prior Year29925508ProgramServiceRevenuePriorYear
Program Service Revenue CY30023734ProgramServiceRevenueCY
Investment Income Prior Year-4263InvestmentIncomePriorYear
Investment Income Current Year-17580InvestmentIncomeCurrentYear
Other Revenue Prior Year1375983OtherRevenuePriorYear
Other Revenue Current Year1354194OtherRevenueCurrentYear
Total Revenue Prior Year31489739TotalRevenuePriorYear
Total Revenue Current Year31996695TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2550GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year17072889SalariesEtcPriorYear
Salaries Etc Current Year17765439SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year12680029OtherExpensePriorYear
Other Expenses Current Year12436475OtherExpensesCurrentYear
Total Expenses Prior Year29753918TotalExpensesPriorYear
Total Expenses Current Year30204464TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1735821RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1792231RevenuesLessExpensesCY
Total Assets BOY10840420TotalAssetsBOY
Total Assets EOY11526563TotalAssetsEOY
Total Liabilities BOY18547468TotalLiabilitiesBOY
Total Liabilities EOY17441380TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-7707048NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-5914817NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionA faith-based organization whose mission is to improve the health of the people in the communities it serves regardless of one's ability to pay.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense25708930Expense
Grants2550Grants
Revenue31996695Revenue
DescriptionTexas Health Harris Methodist Hospital Azle (THAZ) is a 31 bed community based hospital serving Azle, Lake Worth, Springtown and the surrounding areas. Since 1954, THAZ has provided quality health care services to the northwest Tarrant County community. Located in Azle, the hospital offers many services such as cardiovascular, imaging, inpatient/outpatient surgery, Outpatient Sports and Rehabilitation Center and an intensive care unit. ******************************************************************* During the year, THAZ had 4,971 patient days, 1,630 discharges, 35,840 outpatient encounters and 26,953 emergency room visits. ******************************************************************* THAZ provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. The hospital provides care to persons covered by governmental programs including Medicare and Medicaid for reimbursement that does not always cover the cost of providing the care. Recognizing its mission to the community, services are provided to both financially indigent and medically indigent patients. ******************************************************************* ******* Community benefit is provided through many reduced price services and free programs to the community. These services are essential to provide complete healthcare to the communities served. Some of these programs include: * Various health screenings were offered to the community free of charge or for a nominal charge such as diabetes and breast cancer. * THAZ participated in community education regarding good hand hygiene to promote awareness of proper hand washing in an effort to slow the spread of infection and disease. * The Better Living through Improved Fitness and Education (L.I.F.E.) program senior adults are encouraged to focus on improving their health with a range of physical activities, health education and screenings. * THAZ provided healthy eating for children classes, smoking cessation classes and community health support groups.Description
Total Program Service Expense25708930TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109641NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees334NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDAVID JACKSONNamePerson
Telephone Number6822367900TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1612 E LAMAR BLVDAddressLine1
CityArlingtonCity
StateTXState
ZIP Code76011ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficerReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Anderson Tanya
Trustee2.0X0
Braudis Russell
Trustee2.0X
Briggs Rev Frank
Trustee2.0X
Buckel Robert
Vice Chair2.0X
Cordova MD Joseph
Trustee2.0X
Kuenstler MD Kristi
Trustee2.0X
Parker Steven
Chairman2.0X
Robbins Frankie
Trustee2.0X
Standefer Thomas
Trustee2.0X
Tatsch Kristie
Secretary2.0X
Wasson DO Lori
Trustee2.0X
Berdan Barclay
Corp Officer0.540.0X1089819114670
Berenzweig MD Harold
Clinical Leader0.540.0X52485084562
Boes Charles
Assist. Secretary0.540.0X67265474128
Canose MD Jeffrey
Ops. Leader0.540.0X73508185371
DeSio Terri
Assist. Secretary0.540.0X18894018176
Kramer Kenneth
Assist. Secretary0.540.0X39772497289
MitchellJohn D
Assist. Secretary0.540.0X31959855936
EllzeyBob S
PRESIDENT THAZ40.0204283X28232
HumphreyRichard I
GRP FIN OFF THFW-THC-THAZ-THSH3.636.4X31831337925
GilbertValarie G
Dir CNO THAZ40.015549019619X
SneadJeffrey C
PROFESSIONAL SVCS OFFICER THAZ40.014450627121X
WardVanessa
PHARMACIST40.012369814656X
JonesPatricia Ann
RN II40.01143619212X
BlessingBrian Bradley
MGR HOSPITAL FINANCE40.011240027693X
MiaoWinjie Tang
PRESIDENT THAL0.040.028091236879X
McClungBrett S
President0.040.044296799155X
FieldValueIRS element (for citing)
Total Reportable Comp From Org854738TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4970858TotalReportableCompFrmRltdOrgs
Total Other Compensation830624TotalOtherCompensation
Number Individuals GT100 K11NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Texas Health Resources
612 E Lamar Blvd Ste 900ARLINGTONTX76011Management Fee3381775
Texas Health Single Source Staffing
524 E Lamar Blvd Ste 300ARLINGTONTX76011Contract Labor511242
Fort Worth Surgical Specialist PA
1325 Pennsylvania Ave 200FT WORTHTX76104Medical Services305610
Atlas Anesthesia Associates PA
5605 N MacArthur Blvd 220IRVINGTX75033Medical Services250650
Texas Health Physicians Group
251 West Park Way 200EULESSTX76040Medical Services232646
FieldValueIRS element (for citing)
Number Of Contractors GT100 K9NumberOfContractorsGT100K
Related Organizations107676RelatedOrganizations
Government Grants528671GovernmentGrants
Total Contributions636347TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE REVENUE2952767629527676
MEDICARE/MEDICAID REVENUE ADJUSTMENT346316346316
EDUCATION REVENUE53235323
PHYSICAL THERAPY REVENUE142469142469
PULMONARY REHAB REVENUE19501950
FieldValueIRS element (for citing)
Total Program Service Revenue30023734TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column10196TotalRevenueColumn
Exclusion$10,196ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Personal42613Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal42613Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column42613TotalRevenueColumn
Exclusion$42,613ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other39000Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other66776Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-27776Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-27776TotalRevenueColumn
Exclusion-$27,776ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
ELECTRONIC RECORDS1045833$1,045,833
CAFETERIA REVENUE82339$82,339
NATURAL GAS TESTING FEE29166$29,166

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column154243TotalRevenueColumn
Exclusion$154,243ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1311581TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column31996695TotalRevenueColumn
Related Or Exempt Function Income30023734RelatedOrExemptFunctionIncome
Exclusion$1,336,614ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2550Total
Program Services2550ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total188312Total
Program Services188312ProgramServices
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total13778344Total
Program Services13268165ProgramServices
Management And General510179ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total709826Total
Program Services709826ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2112485Total
Program Services2111774ProgramServices
Management And General711ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total976472Total
Program Services954924ProgramServices
Management And General21548ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total3381775Total
Management And General3381775ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total71365Total
Management And General71365ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total25004Total
Management And General25004ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1733969Total
Program Services1625442ProgramServices
Management And General108527ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total118473Total
Program Services117948ProgramServices
Management And General525ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total235961Total
Program Services168963ProgramServices
Management And General66998ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total248781Total
Program Services230813ProgramServices
Management And General17968ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total517241Total
Program Services515441ProgramServices
Management And General1800ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total32813Total
Program Services28741ProgramServices
Management And General4072ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total48784Total
Program Services39611ProgramServices
Management And General9173ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total250789Total
Program Services13189ProgramServices
Management And General237600ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1080233Total
Program Services1080233ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total37811Total
Program Services37725ProgramServices
Management And General86ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES2421673239916222511
PATIENT SERVICES16753001675300
REPAIRS & MAINTENANCE288190288190
COMMUNITY OUTREACH141821141331490

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total126492Total
Program Services111290ProgramServices
Management And General15202ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total30204464Total
Program Services25708930ProgramServices
Management And General4495534ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY-25981BOY
EOY45383EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2793625BOY
EOY4154514EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY143138BOY
EOY80042EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY413974BOY
EOY489855EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY32992BOY
EOY10631EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis17305657LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec10559519LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7482672BOY
EOY6746138EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY10840420BOY
EOY11526563EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3157759BOY
EOY3137977EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY15389709BOY
EOY14303403EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18547468BOY
EOY17441380EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-7707048BOY
EOY-5914817EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-7707048BOY
EOY-5914817EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10840420BOY
EOY11526563EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1792231ReconcilationRevenueExpenses
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteerstrueVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MemberstrueMailingsMembers
Mailings Members$100MailingsMembersAmount
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB100TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLobbying ActivitiesIdentifier
Return ReferenceSch C, Part IVReturnReference
ExplanationOfficers and/or Board Members of the corporation may, to an insubstantial degree, make comments or statements concerning legislation that may affect either the healthcare industry or the health status of the communities the Corporation serves. In pursuing this activity, Officers and/or Board Members may engage in conversations and/or write letters to various federal, state, and local officials regarding such matters. The amount of time and money involved in these activities is negligible. In no case has either the Corporation, or any person acting on behalf of the Corporation, intervened in any political campaign.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis145333OtherCostOrOtherBasis
Book Value145333BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11507680OtherCostOrOtherBasis
Depreciation7106224Depreciation
Book Value4401456BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis5620444OtherCostOrOtherBasis
Depreciation3423295Depreciation
Book Value2197149BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis32200OtherCostOrOtherBasis
Depreciation30000Depreciation
Book Value2200BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6746138TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
INTERCOMPANY PAYABLE$14,067,367
ASSET RETIREMENT OBLIGATIONS$236,036
FieldValueIRS element (for citing)
Total Of Amounts14303403TotalOfAmounts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3690922TotalCommunityBenefitExpense
Direct Offsetting Revenue17801DirectOffsettingRevenue
Net Community Benefit Expense3673121NetCommunityBenefitExpense
Percent Of Total Expense0.12160PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense2947004TotalCommunityBenefitExpense
Direct Offsetting Revenue3630443DirectOffsettingRevenue
Net Community Benefit Expense-683439NetCommunityBenefitExpense
Percent Of Total Expense0.02260PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense50799TotalCommunityBenefitExpense
Direct Offsetting Revenue20747DirectOffsettingRevenue
Net Community Benefit Expense30052NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense6688725TotalCommunityBenefitExpense
Direct Offsetting Revenue3668991DirectOffsettingRevenue
Net Community Benefit Expense3019734NetCommunityBenefitExpense
Percent Of Total Expense0.10000PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense808512TotalCommunityBenefitExpense
Direct Offsetting Revenue18145DirectOffsettingRevenue
Net Community Benefit Expense790367NetCommunityBenefitExpense
Percent Of Total Expense0.02620PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense87000TotalCommunityBenefitExpense
Net Community Benefit Expense87000NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense920583TotalCommunityBenefitExpense
Net Community Benefit Expense920583NetCommunityBenefitExpense
Percent Of Total Expense0.03050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1816095TotalCommunityBenefitExpense
Direct Offsetting Revenue18145DirectOffsettingRevenue
Net Community Benefit Expense1797950NetCommunityBenefitExpense
Percent Of Total Expense0.05960PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense8504820TotalCommunityBenefitExpense
Direct Offsetting Revenue3687136DirectOffsettingRevenue
Net Community Benefit Expense4817684NetCommunityBenefitExpense
Percent Of Total Expense0.15960PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense1496TotalCommunityBuildingExpense
Net Community Building Expense1496NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense1496TotalCommunityBuildingExpense
Net Community Building Expense1496NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$6,602,170BadDebtExpenseAmount
Amount Reimbursed By Medicare5946721AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare6486434CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-539713MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Texas Health AzleBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1108 Denver TrailAddressLine1
CityAzleCity
StateTXState
ZIP Code76020ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.texashealth.orgWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Texas Health AzleBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedfalseUsesFPGDiscounted
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Other FactorsXOtherFactors
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Other Actions TakenXOtherActionsTaken
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Patient EligibilityPart I, Line 3cPatients with family income at or below 200% of applicable FPG may be eligible for free care if the patient lacks sufficient funds and assets to pay the out-of-pocket portion of their hospital bill. All self pay patients who don't qualify for the organization's charity program, regardless of income, are eligible for a discount of 45% off the hospital's charge for general hospital services. In addition, a 60% discount is available on charges associated with certain implantable devices. Patients with family income above 200% of applicable FPG who have unpaid medical bills exceeding a specified percentage of the patient's annual gross income may be deemed medically indigent and eligible for charity care. The patient may be eligible for a charity adjustment up to 100% of the unpaid balance of their hospital bill in excess of a specified "patient responsible amount" if the patient has insufficient funds/assets to pay his hospital bill without incurring an undue financial hardship. The patient responsible amount is based on a percentage of the patient's annual income. A determination as to whether or not a patient has insufficient funds and/or assets to pay for purposes of determining both financial and medical indigence is made at the time a patient's charity care application is reviewed. Assets considered when determining eligibility include cash, stocks, bonds and other financial assets that can be readily converted to cash. An additional process to screen for charity patients using publicly available financial information is also in place for patients not submitting a charity care application.
Community BuildingPart II
Cost to Charge RatioPart I, Line 7A cost to charge ratio is used in computing the amounts reported in Lines 7a-7c. The amounts reported on Lines 7e-7i were obtained using direct costs, as determined by a cash outlay or, in the case of reporting employee volunteer hours, by using an average national volunteer wage rate.
Bad Debt ExpensePart III, Line 4Bad debt expense is not included as a community benefit for purposes of reporting community benefits to Texas. We treat each patient qualifying for charity care as a charity patient and no charges related to that patient are included in bad debt expense. The hospital is part of a consolidated system of hospitals which operate under the name Texas Health Resources (THR). THR's annual audit is conducted on a system-wide basis with a single consolidated audit report issued for THR and its affiliates. The audited financial statements of THR, which includes the activity of the organization, contain a footnote regarding Accounts Receivable and Allowance for Doubtful Accounts, that reads as follows. Patient accounts receivable are reported net of estimated allowances for doubtful accounts and contractual adjustments in the consolidated balance sheets. The provision for bad debts is based upon a combination of the aging of receivables and management's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage and other collection indicators. Management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience and payment trends by payor category. Patient accounts are also monitored and, if necessary, past due accounts are placed with collection agencies in accordance with guidelines established by management.
Medicare ShortfallPart III, Line 8The state of Texas treats any Medicare shortfall as a community benefit for meeting the state statutory requirements for charity care & community benefit. For state purposes, the shortfall is computed by comparing actual Medicare reimbursements with the estimated cost the hospital incurs in providing these services to Medicare patients. Cost is determined by applying a cost-to-charge ratio (with costs determined in accordance with generally accepted accounting principles) to billed charges. The shortfall amount reported to the state of Texas for 2012 is $5,829,306.
Debt CollectionPart III, Line 9bDuring the year, standard collection procedures were in place and uniformly applicable to all patient accounts. Except to the extent a patient receives a recovery from any third party or other source, no attempts are made to collect unpaid charges from patient accounts approved for adjustment under the Charity Care Program.
Discounted CarePart V, Sec B, Line 11See response to Part I Line 3c
Calculating ChargesPart V, Sec B, Line 12hSee response to Part I, Line 3c and Part V Sec B, Line 11
Publicize FAPPart V, Sec B, Ln 14gA full copy of the Charity Care Policy is provided upon request. Notice of financial assistance and a summary of the policy are communicated to the public and to patients. A summary of the policy is in each of the following. - posted on the hospital's website, - attached to billing invoices, - posted at the emergency room and waiting rooms, - posted in Admissions office, and - provided, in writing, to patients on admission to the hospital
FAP OutreachPart V, Sec B, Ln 18eAll uninsured patients who have not completed a charity care application are screened using analytics technology. Patients meeting the charity care qualifications using this methodology are granted a presumptive charity reduction and collection efforts will cease.
Needs AssessmentPart VI, Line 2The organization is developing strategies to ensure that it is in full compliance with the 2013 Community Health Needs Assessment (CHNA) requirements, and has completed work on the community profile for the defined community or service area in preparation for conducting the CHNA. Special attention will be given to persons facing disproportionate unmet health related needs. The organization is in the process of identifying resources for strategic planning and community health improvement project planning. The CHNA process will result in the compilation of data, opinion, and observation about the health and well-being of the surrounding community. The goals identified for action at the end of this process will translate the organization's mission and priorities into a strategy with specific activities and projects focusing on a positive community impact that is demonstrative, sustainable and measurable. The organization's community health profile provides a snapshot of the service area using key health indicators, which facilitate comparisons locally, regionally and over time. National, state and local secondary and primary data sources are used to provide a current overview of local health needs, factors impacting disease and injury burden, socioeconomic status, access to health care, age distribution, indicators and lifestyle behaviors. This data is used to galvanize joint community health efforts to improve health, to reduce inequalities and to empower the greater community.
Patient EducationPart VI, Line 3A description of both the Charity Care program and application are available on the THR website at www.TexasHealth.org in English and Spanish. Signs alerting patients of charity care assistance and related contact information are posted in various areas of the hospital including admissions & registration, the emergency room and other outpatient departments. Additionally, financial assistance information is provided verbally and in writing to self-pay patients by financial counselors. As part of the financial counseling meeting, patients are screened for potential eligibility in other governmental assistance programs. If it is determined that the patient is potentially eligible for governmental assistance, the counselor will assist the patient in completing forms necessary to apply for the assistance. At the same time, patients are provided with a Charity Care application and information flyer. The patient is informed that the hospital is a non-profit organization offering financial assistance to patients deemed medically or financially indigent. The financial counselors may assist the patient in completing the application and obtain available verification information. Once the patient is discharged, the counselors will continue to contact the patient to ensure all forms and verifications needed to file an application for governmental assistance and Charity Care have been provided. In certain cases, self-pay patients who are discharged before seeing a financial counselor receive both a phone call and a letter to alert them to the existence of the financial assistance program. Each bill sent for hospital services also contains contact information alerting patients that Texas Health has a charity care program.
Community InformationPart VI, Line 4The service area of Texas Health Harris Methodist Hospital Azle (THAZ) includes a suburban area of 137,198 people. The average household income for the service area is $66,031. During the year, 25.2% of THAZ's patients are uninsured and 18.1% are Medicaid recipients. THAZ's service area has an uninsured rate of 19.4% of the population. There are no other acute care hospitals in the service area.
Promotion of Community HealthPart VI, Line 5The board of trustees is comprised of community members including medical and business professionals. A majority of these trustees reside in the hospital's service area and volunteer their time to serve on the board. The hospital has an open medical staff and privileges are offered to qualified physicians in the community. The organization utilizes surplus funds to maintain access to patient services and to expand access to healthcare. The uses of these surplus funds include providing community benefit programs and expended capital improvements to the healthcare facilities of the organization. Of the $920,583 in contributions to community groups reported on Sch H, Part I, line 7i, $919,087 was contributed to or at the direction of Tarrant County Indigent Care Corporation, a charitable organization that provides various local organizations with funds to cover healthcare provided to indigent patients.
Affiliated Health Care SystemPart VI, Line 6The organization is part of the THR healthcare system. THR is one of the largest faith-based, nonprofit healthcare delivery systems in the US and the largest in North TX in terms of patients served. The system of 14 wholly controlled hospitals includes an organization for medical research and education. The system also includes two foundations that foster philanthropic relationships which support the programs and services of the hospitals they support. The mission of the hospitals in the THR system is to improve the health of the people in the communities we serve. THR takes its responsibility to its communities seriously and invests charitable resources to promote good health and prevent disease. Not only does THR provide health care to those who do not have the means to pay, its hospitals also conduct a variety of programs designed to improve health and prevent illness in the community. The community health strategies of THR and its affiliated healthcare organizations are driven by community health needs, are community-based and include confronting health problems at the source and emphasize health promotion, disease prevention, and early treatment of illness.
State Community Benefit ReportPart VI, Line 7The organization files a Texas an Annual Statement of Community Benefit Standard. Texas has established a minimum level of charity care and community benefit that must be provided by nonprofit hospitals in order to retain their Texas tax-exempt status. The standard set by the state is met when charity care and community benefits are provided in a combined amount equal to at least five percent of the hospital's or hospital system's net patient revenue, provided that charity care and government-sponsored indigent health care are provided are at least four percent of net patient revenue. The hospital is part of the THR system of healthcare organizations. During the year, the THR system, as a whole, reported to Texas the following charity care and community benefits amounts. $184,105,171 in patient charity care, $78,797,336 in support provided by others, $17,705,611 in unreimbursed Medicaid, $16,825,521 in other community benefits and $486,116,291 in unreimbursed Medicare

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Discretionary Spending AccountXDiscretionarySpendingAccount
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

TitleTitleComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgBonus Filing OrgBonusFilingOrg
Berdan Barclay
Corp Officer58892833723416365791374232961204489140760
Berenzweig MD Harold
Clinical Leader36647581748766276847016092609412
Boes Charles
Assist. Secretary36540120725699997600681406074678289313
Canose MD Jeffrey
Ops. Leader42890621455891617673511802082045266895
DeSio Terri
Assist. Secretary171228105127200107087468207116
Kramer Kenneth
Assist. Secretary23657610181759331707502653949501340686
MitchellJohn D
Assist. Secretary20959443454665503493321003375534159
EllzeyBob S
PRESIDENT THAZ172256320271574412488232515
HumphreyRichard I
GRP FIN OFF THFW-THC-THAZ-THSH21160349011576991211925806356238285
GilbertValarie G
Dir CNO THAZ14164147621095686631751099087
SneadJeffrey C
PROFESSIONAL SVCS OFFICER THAZ131305167582231889817162711526
MiaoWinjie Tang
PRESIDENT THAL183624631453414328907797231779120305
McClungBrett S
President26956811822455175794791967654212238151

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Gross-Up PaymentsSchedule J, Part I, Line 1aCertain imputed income is grossed-up to include the employment taxes paid on the listed person's behalf. The grossed up amount is included in the taxable compensation of the employee.
Discretionary Spending AccountSchedule J, Part I, Line 1aEach Executive at the vice president level and above receives a perk allowance which is included in the taxable compensation of the employee.
Personal ServicesSchedule J, Part I, Line 1aOfficers can use their discretionary spending account to pay for financial planning services. The organization does not directly pay for any officer's personal services.
CEO CompensationSchedule J, Part I, Line 3The organization relied on Texas Health Resources (THR), a related 501(c)(3) organization with centralized compensation professionals to use the following methods to establish the compensation of the organization's President. * THR has a compensation committee comprised of external Board Members that review compensation philosophy and design. * THR Board hired independent compensation consultants. * THR & the independent compensation consultants utilize published third-party compensation surveys. An independent third party compensation consultant is hired by the THR Board of Trustees (Board) to review base pay annually as compared to a peer group of employers similar in size and scope to THR. Every three years the independent compensation consultant reviews all aspects of executive compensation (base, incentives, benefits, etc.) which includes: * Review and confirmation of the executive compensation philosophy. * Market review of base and incentive pay for all positions. National, regional, and local data is reviewed when available. * Market review of benefits and perquisites, * Interview of selected officers and members of the Governance Committee (Compensation Committee) of the THR Board of Trustees, and * Review of financial reports, job descriptions, organizational charts, current salaries, incentive opportunities, incentive payments, benefits, perquisites and plan documents. The independent compensation consultant meets directly with the executive compensation & benefits sub-committee which is made up of six independent Board members and the governance committee to report the results of the total compensation study. At the beginning of each year, the executive compensation & benefits sub-committee and the governance committee review a detailed report containing the below information. The Board reviews an executive summary of the detailed report. * Market analysis based on the results of the outside consultant's review * Officer base salary adjustments including merit and market/equity adjustments * Prior year executive annual incentive awards * Current year executive annual incentive plan targets, key performance indicators and potential payout amounts.
Nonqualified Retirement PlanSchedule J, Part I, Line 4bParticipation in the plan is made available to a select group of management and highly compensated employees, as determined by the THR Board of Trustees, who are providing services to an employer in key positions of management and responsibility. Benefits are calculated for eligible employees when base pay and incentives exceed the IRS qualified plan compensation limit. SERP benefits vest while the participant is employed if the participant: reaches age 65, becomes disabled, dies, or reaches the following years of service: 2 years - 25%; 3 years -50%; 4 years - 75%; and 5 or more - 100%. For Frozen Restoration Accounts (account balances prior to 1/1/2010), the participant or beneficiary shall be taxed on his or her vested SERP benefits upon the earliest of: * Remaining employed by THR to age 68 * Termination of employment for disability or death * Involuntary termination of employment without reasonable cause; or * Satisfying a 24 month non-compete period following his or her termination of employment. Payment is made following the before mentioned events, except in the case of involuntary separations for which the participant must wait until after 24 months to receive the previously taxed benefit. For the Active Restoration Account (account balances after 12/31/2009) participants must be employed on Dec 1 to qualify for the current year's SERP amount unless separation is due to death, disability, retirement (age 65) or early retirement (age 60 or above with 15 or more years of service). SERP amounts are calculated each Dec 1; vested balances are taxed; and the net balances can begin accruing earnings. Vested balances are paid in cash lump sums within the 90 day period commencing upon the earlier of death, disability, or separation from service. THR owns any investments purchased in connection with its obligations under the SERP Plan. If THR becomes insolvent, executives are unsecured creditors and will have no preferred claim to any assets.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Business RelationshipPt VI, Sec A, Ln 2Texas Health Resources (THR) and its related organizations included in the THR healthcare system encourage employees to become involved in philanthropic endeavors in their communities. As a result, THR healthcare system employees who are serving as officers, board members, or key employees may, from time to time, also serve on the boards of various community organizations such as church boards, United Way, etc. There may be a business relationship as a result of multiple THR employees serving on the same community boards. THR employees serve as the corporate officers of each subsidiary organization. As THR system employees, all officers have a business relationship within the organizations of the THR healthcare system. THR also appoints system officers to the boards of various controlled joint ventures. As THR system employees, various officers of the organization may have a business relationship through serving on THR controlled joint venture boards. THR employees serve as the corporate officers of each subsidiary organization. As THR system employees, all officers have a business relationship within the organizations of the THR healthcare system. THR also appoints system officers to the boards of various controlled joint ventures. As THR system employees, various officers of the organization may have a business relationship through serving on THR controlled joint venture boards.
Form 990 FilingPt VI, Sec B, Ln 11bA full copy of the Form 990 is provided to members of the governing board before filing. In addition, the Audit & Compliance Committee of the Texas Health Resources (THR) Board of trustees is given the opportunity to review, comment, and ask questions regarding the Form 990s filed for THR and each of its wholly controlled affiliates.
Conflict of InterestPt VI, Sec B, Ln 12cTexas Health Resources (THR) has adopted a Conflict of Interest Policy that applies to THR and all of its wholly owned or wholly controlled affiliates. During the first quarter of each fiscal year, a Duality and Conflict Statement Form is distributed by the THR Chief Compliance Officer to all persons who are covered by this policy. All disclosed conflicts are reviewed by the THR Chief Compliance Committee. A report, listing each reported Duality of Interest or Conflict of Interest is given to both the Chair of the Governing body and the President of the Corporation with which the reporting person is affiliated. The THR Board of Trustees receives a report when the Annual Disclosure process is complete.
Compensation DeterminationPt VI, Sec B, Line 15 a&bAn independent third party compensation consultant is hired by the THR Board of Trustees (Board) to review base pay annually as compared to a peer group of employers similar in size and scope to THR. Every three years the independent compensation consultant reviews all aspects of executive compensation (base, incentives, benefits, etc.) which includes: * Review and confirmation of the executive compensation philosophy. * Market review of base and incentive pay for all positions. National, regional, and local data is reviewed when available. * Market review of benefits and perquisites, * Interview of selected officers and members of the Governance Committee (Compensation Committee) of the THR Board of Trustees, and * Review of financial reports, job descriptions, organizational charts, current salaries, incentive opportunities, incentive payments, benefits, perquisites and plan documents. The independent compensation consultant meets directly with the executive compensation & benefits sub-committee which is made up of six independent Board members and the governance committee to report the results of the total compensation study. At the beginning of each year, the executive compensation & benefits sub-committee and the governance committee review a detailed report containing the below information. The Board reviews an executive summary of the detailed report. * Market analysis based on the results of the outside consultant's review * Officer base salary adjustments including merit and market/equity adjustments * Prior year executive annual incentive awards * Current year executive annual incentive plan targets, key performance indicators and potential payout amounts.
Public DisclosurePt VI, Sec C, Ln 19The organization does not make its governing documents or conflict of interest policy available to the public. The consolidated financial statements of Texas Health Resources (THR) are made available to the public on the website www.dacbond.com. Consolidated financial statements are posted to this website quarterly and the audited financial statements are posted annually. The financial statements of the wholly controlled affiliates of THR are not posted to the website nor are they generally made available to the public in any other manner.
Consolidated Financial StatementsPt XII, Ln 2cTexas Health Resources (THR) prepares consolidated financial statements with its related entities. The THR Board appoints an audit and compliance sub-committee that assumes responsibility for oversight of the consolidated audit for all related entities. The related entities do not have a separate audit committee, but abide by the THR committee's oversight. There has been no change during the year in the organizations oversight selection process.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (28 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Harris Methodist Health System
612 E Lamar BlvdArlingtonTX76011751823547Support Org.TX501(c)(3)11 Type 1NAfalse
Johnson County Community Care Corp
612 E Lamar BlvdArlingtonTX76011452793120Support Org.TX501(c)(3)11 Type 1TH Cleburnefalse
Presbyterian Healthcare Resources
612 E Lamar BlvdArlingtonTX76011510190395Support Org.TX501(c)(3)11 III FINAfalse
Texas Health Arlington Memorial Hospital
800 West Randol Mill RdArlingtonTX76012750972805HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Harris Methodist Foundation
612 E Lamar BlvdArlingtonTX76011752401033FundraisingTX501(c)(3)9TH Resourcesfalse
Texas Health Alliance
10864 Texas Health TrailFort WorthTX76244451502252HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Azle
108 Denver TrailAzleTX76020751748586HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Cleburne
201 Walls DrCleburneTX76033751977850HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Fort Worth
1301 Pennsylvania AveFort WorthTX76104756001743HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Hurst-Euless-Bedford
1600 Hospital ParkwayBedfordTX76022751438726HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Southwest Fort Worth
6100 Harris ParkwayFort WorthTX76132752678857HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Stephenville
411 BelknapStephenvilleTX76401751752253HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Huguley Inc
11801 South FreewayBurlesonTX76028452694620HospitalFL501(c)(3)3TH Resourcesfalse
TX Health Outpatient Surg Ctr Alliance
10840 Texas Health TrailFort WorthTX76244800800294HospitalTX501(c)(3)3TH Alliancefalse
Texas Health Physicians Group
1301 Pennsylvania AveFort WorthTX76104752613493Phys. ClinicTX501(c)(3)11 Type 1TH Resourcesfalse
Texas Health Presbyterian Foundation
612 E Lamar BlvdArlingtonTX76011752022128FundraisingTX501(c)(3)9TH Resourcesfalse
Texas Health Allen
1105 Central Expressway NAllenTX75013752890358HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Dallas
8200 Walnut Hill LnDallasTX75231751047527HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Denton
3000 North Interstate 35DentonTX76201432008974HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Kaufman
850 Ed Hall DriveKaufmanTX75142752771437HospitalTX501(c)(3)3TH Resourcesfalse
Texas Health Plano
6200 W Parker RdPlanoTX75093752770738HospitalTX501(c)(3)3TH Resourcesfalse
TX Health Research & Education Institute
612 E Lamar BlvdArlingtonTX76011752562191Edu& ResearchTX501(c)(3)4TH Resourcesfalse
Texas Health Resources
612 E Lamar BlvdArlingtonTX76011752702388Mgmt Supp OrgTX501(c)(3)11 III FINAfalse
TX Health Resources Self-Insurance Trust
612 E Lamar BlvdArlingtonTX76011756335901Insur TrustTX501(c)(3)11 III FITH Resourcesfalse
TH Specialty Hospital Fort Worth
1301 Pennsylvania AveFort WorthTX76104751648589LT HospitalTX501(c)(3)3TH Resourcesfalse
WW Ward Endowment Fund Trust
612 E Lamar BlvdArlingtonTX76011756196065Support Org.TX501(c)(3)11 Type 1TH Ft Worthfalse
Healty Tarrant County Collaboration
PO Box 8040Fort WorthTX76124432087946Support Org.TX501(c)(3)11 Type 1TH Resourcesfalse
TH Hospital Azle Auxiliary
108 Denver TrailAzleTX76020752176824Support Org.TX501(c)(3)11 III FINAfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (21 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileState
AMH Cath Labs LLC
811 Wright StArlingtonTX76012203003947HospitalTX
Cleburne Imaging LLC
6301 Abrams Road Ste 131DallasTX75231460767278Outpatient DiagnoTX
Denton Surgery Center LLC
3000 Riverchase Galleria Ste 500BirminghamAL35244470926556Amb Surg CtrTX
Flower Mound Hospital Partners LLC
14131 Midway Rd Ste 1050AddisonTX75001260684968HospitalTX
Greenville Surgery Center Ltd
3000 Riverchase Galleria Ste 500BirminghamAL35244742411643Amb Surg CtrTX
Health Imaging Partners LLC
8610 Explorer Drive Ste 300Colorado SpringsCO80920271385885Outpatient DiagnoTX
Physician Medical Center LLC
14131 Midway Road Ste 1050AddisonTX75001481281376HospitalTX
Presbyterian Cancer Center-Dallas LLC
1221 Merit Dr Ste 500DallasTX75251260422749Medical MgmtTX
Rockwall Regional Hospital LLC
14131 Midway Rd Ste 1050AddisonTX75001202848116HospitalTX
ShermanGrayson Healthcare System LLC
2400 Dallas PkwyPlanoTX75093272025497HospitalTX
Southlake Specialty Hospital LLC
14131 Midway Rd Ste 1050AddisonTX75001020555370HospitalTX
Surgical Caregivers of Fort Worth LP
3000 Riverchase Galleria Ste 500BirminghamAL35244751925497Amb Surg CtrTX
Texas Health Flower Mound Orthopedic Sur
5000 Long Prairie RoadFlower MoundTX75028800866449Amb Surg CtrTX
Texas Health MedSynergies LLC
12550 Corporate Drive Flr 3 IrvinIrvingTX75038800272951Mgmt ServicesTX
Texas Health SingleSource Staffing LLC
612 E Lamar Blvd Ste 1400ArlingtonTX76011270324828Temp StaffingTX
Texas Institute for Surgery LLP
7715 Greenville Ave Ste 100DallasTX75231770628004HospitalTX
THR-STT Rockwall ASC LLC
1545 E Southlake BlvdSouthlakeTX76092262429878Amb Surg CtrTX
THR-STT Southlake ASC LLC
1545 E Southlake BlvdSouthlakeTX76092201728912Amb Surg CtrTX
USMD Hospital at Arlington LP
801 I -20 WestArlingtonTX76017731662763HospitalTX
USMD Hospital at Fort Worth LP
6333 North State Hwy 161 Ste 200IrvingTX75038203571243HospitalTX
Women's Specialty Surgery Center
8230 Walnut Hill Ln Ste 101DallasTX75231262310072Amb Surg CtrTX

Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntity
AMH Health Ventures Inc
800 W Randol Mill RoadArlingtonTX76012752141114Comp/Billing SvcTXC Corp
Fort Worth Surgical Care Givers Inc
3000 Riverchase Galleria Ste 500BirminghamAL35244621204446Holding CompanyTXC Corp
Greenville Surgery Center Inc
3000 Riverchase Galleria Ste 500BirminghamAL35244752123689Holding CompanyTXC Corp
Texas Health Biomedical Advancement Ctr
612 E Lamar BlvdArlingtonTX76011752636884InactiveTXC Corp
Texas Health Resources Casualty Company
612 E Lamar BlvdArlingtonTX76011030310676InsuranceVTC Corp
Charitable Remainder Trusts (4)
612 E Lamar BlvdArlingtonTX76011CR TrustTXTrust
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg

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