2012-05-15T17:29:58-04:00 2011-06-30 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2010-07-01 751976930 MOTHER FRANCES HOSPITAL - JACKSONVILLE MOTH 9035315764 1315 DOCTORS DRIVE TYLER TX 75701 JOYCE HESTER 2012-05-15 true Amanda Maya 7134994600 2010 2016-02-24 21:20:13Z X B RAY THOMPSON 910 E HOUSTON SUITE 500 TYLER TX 75702 37780716 false X WWW.TMFHS.ORG X 2000 TX TO PROVIDE THE COMMUNITY WITH A FULL RANGE OF COMPREHENSIVE HEALTHCARE SERVICES WITHOUT REGARD TO RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. 7 3 214 3 0 0 0 0 35911468 37733895 0 0 27775 46821 35939243 37780716 541691 946111 0 0 9478248 9569354 0 0 0 24067806 25172933 34087745 35688398 1851498 2092318 12235284 23941694 1816931 11431023 10418353 12510671 TO PROVIDE THE COMMUNITY WITH A FULL RANGE OF COMPREHENSIVE HEALTHCARE SERVICES WITHOUT REGARD TO RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. false false 31826234 946111 37733895 THE HOSPITAL'S OPERATING PLAN INCORPORATES PROVISIONS FOR INDIVIDUALS WHO DO NOT POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. OUR COMMITMENT TO OUR COMMUNITY EXTENDS TO FREE OR SUBSIDIZED INDIVIDUAL CARE, SUBSIDIZED EDUCATION OF HEALTHCARE PROFESSIONALS, DISCOUNTED FEES FOR PARTICIPANTS IN GOVERNMENT PROGRAMS, COMMUNITY HEALTH EDUCATION AND DONATIONS TO OTHER COMMUNITY AGENCIES. SPECIFIC COMMUNITY SERVICES AND PROGRAMS INCLUDE: WELLNESS AND PREVENTION EDUCATION PROGRAMS, COMMUNITY DIAGNOSTIC SCREENING PROGRAMS, SENIOR CITIZEN HEALTH AWARENESS PROGRAMS, AWARENESS PROGRAMS FOR YOUTH AT RISK, AND AWARENESS PROGRAMS FOR PERSONS WITH SPECIAL PHYSICAL OR MENTAL NEEDS. 31826234 true false false true false false false false false true false false true true false false true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false false true X 0 0 214 true false false false false false false false false false false X 7 3 false false false false true true true true true false false true true true true true true true true false X MOTHER FRANCES HOSP ACCTG DEPT 9035315764 1315 DOCTORS DRIVE TYLER TX 75701 X THOMAS N CAMMACK JR 40.0 X X 182760 0 13258 MATTHEW A VIERKANT MD 10.0 X 0 498664 21356 RAY THOMPSON 1.0 X X 0 1459991 476648 GLEN T HAMILTON 1.0 X X 0 0 0 WILLIAM MILAWSKI MD 10.0 X 0 235647 17894 DICK STONE 1.0 X 0 0 0 RANDY GORHAM 1.0 X 0 0 0 MICHAEL LEWIS 40.0 X 109740 0 13309 BARRY L THIBODEAUX 40.0 X 215029 0 5745 JACK CAPPS 40.0 X 210583 0 15825 BEN BEATHARD 40.0 X 101817 0 11726 819929 2194302 575761 5 false true false CARDIAC IMAGING SERVICES 1737 DOMINION PLAZA TYLER TX 75703 CARDIAC IMAGING 390719 COMPLETE RX LTD 3100 S GESSNER SUITE 640 HOUSTON TX 77063 PHARMACY SERVICES 672497 TRINCARE CLINICAL LABORATORIES 3200 TROUP HWY TYLER TX 75701 LAB SERVICES 313583 SIEMENS MEDICAL SOLUTIONS PO BOX 120001 DALLAS TX 75312 SOFTWARE MAINTENANCE 292904 VIRTUAL RADIOLOGIC DEPT 7080 CAROL STREAM IL 60122 RADIOLOGIC IMAGING 188130 6 0 NET PATIENT REVENUE 621110 34708727 34708727 OTHER REVENUE 900099 3025168 3025168 37733895 0 0 0 46737 0 46737 46737 46737 0 0 0 0 MEDICAL RECORDS FEES 900099 84 84 84 37780716 37733895 46821 946111 946111 0 0 0 196018 159137 36881 0 7545328 6125676 1419652 0 1828008 1484210 343798 0 687567 23018 664549 0 0 0 0 0 10834422 9832199 1002223 71854 71854 169615 107015 62600 25795 10439 15356 0 2735693 2598908 136785 6866 3193 3673 0 15338 6453 8885 0 0 465207 441947 23260 0 BAD DEBT EXPENSE 6766657 6766657 MEDICAL SUPPLIES 2693205 2653027 40178 FOOD 109061 104613 4448 REPAIRS AND MAINTENANCE 504709 501491 3218 MINOR EQUIPMENT 51067 48518 2549 35877 13622 22255 35688398 31826234 3862164 0 124336 118507 3426703 4311646 233509 158986 66289 104529 8850847 7781743 1155074 1069104 7229373 18178922 12235284 23941694 1189888 1639796 36113 0 590930 9791227 1816931 11431023 X 10418353 12510671 10418353 12510671 12235284 23941694 2092318 X false true true X false X false false false false false true 1947 false false false 1947 false 8850847 7781743 1069104 1069104 DUE FROM AFFILIATES 18178922 18178922 0 THIRD PARTY PAYOR LIABILITIES 1271479 DUE TO AFFILIATES 8251148 ESTIMATED SELF INSURANCE COSTS 268600 9791227 37780716 35688398 2092318 2092318 37780716 37780716 37780716 35688398 35688398 35688398 FIN 48 DISCLOSURE MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X true X true true true false true true 1397686 1397686 0.04830 5154789 5979187 32197 34617 6584672 6013804 1397686 0.04830 17991 17991 0.00060 169564 169564 0.00590 946111 946111 0.03270 1133666 1133666 0.03920 7718338 6013804 2531352 0.08750 false 1496111 11378285 11064461 313824 X true true 1 1 MOTHER FRANCES HOSPITAL - JACKSONVILLE

1026 S JACKSON STREET JACKSONVILLE TX 75766

X X X X MOTHER FRANCES HOSPITAL - JACKSONVILLE 1 PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE STATED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL, CLINIC, JACKSONVILLE AND WINNSBORO PROVIDE AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THIRD-PARTY PAYERS ARE BILLED DIRECTLY AND BILLS ARE SENT TO THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELIQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS AFTER APPLYING THE COST-TO-CHARGE RATIO. THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. PART III, LINE 8: THE MEDICAL CENTER USES MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. PART III, LINE 9B: THE ORGANIZATION HAS A WRITTEN POLICY COVERING PROCEDURES FOR COLLECTING AND WRITING OFF BAD DEBTS. ACCORDING TO THE POLICY, IF A PATIENT APPEARS TO BE INDIGENT, ACCOUNTS SHOULD BE REVIEWED, AT ANY TIME DURING THE COLLECTION PROCESS, FOR POSSIBLE CONSIDERATION AS A CHARITY CASE IN ACCORDANCE WITH THE ORGANIZATION'S CHARITY CARE POLICY. NEEDS ASSESSMENT: THE HOSPITAL'S COMMUNITY HEALTH PROFILES PROVIDE A SNAPSHOT OF SUBURBAN, URBAN, AND RURAL SERVICE AREAS WITHIN TEXAS USING KEY HEALTH INDICATORS, WHICH FACILITATE COMPARISONS LOCALLY, REGIONALLY, AND OVER TIME. COMMUNITY HEALTH PROFILES ARE INTENDED TO ASSIST INTERNAL STAKEHOLDERS, COMMUNITY HEALTH COUNCIL MEMBERS, AND THE COMMUNITY HEALTH IMPROVEMENT DEPARTMENT IN DECIDING WHERE TO ALLOCATE RESOURCES AND ADDRESS HEALTH INEQUALITIES. ALL ENTITY ADVOCATES USE NATIONAL, STATE, AND LOCAL SECONDARY AND PRIMARY DATA SOURCES 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 AND REDUCE HEALTH INEQUALITIES AND TO EMPOWER THE GREATER COMMUNITY. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND CONTACT INFORMATION IS POSTED IN VARIOUS AREAS OF THE HOSPITAL INCLUDING ADMISSIONS & REGISTRATION, EMERGENCY, AND OUTPATIENT DEPARTMENTS. ADDITIONALLY, FINANCIAL ASSISTANCE INFORMATION IS PROVIDED, VERBALLY AND IN WRITTEN BROCHURES, TO ALL SELF PAY PATIENTS BY FINANCIAL COUNSELORS. FINANCIAL ASSISTANCE INFORMATION IS ALSO INCLUDED IN EVERY PATIENT BILL. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO THE PATIENT BY FINANCIAL COUNSELORS WHO ALSO SCREEN SELF PAY PATIENTS FOR POTENTIAL ELIGIBILITY FOR OTHER GOVERNMENTAL ASSISTANCE PROGRAMS. IF IT IS DETERMINED THAT THE PATIENT IS POTENTIALLY ELIGIBLE FOR GOVERNMENTAL ASSISTANCE, THE FINANCIAL COUNSELOR WILL ASSIST THE PATIENT IN COMPLETING ANY FORMS NECESSARY TO APPLY FOR THE ASSISTANCE. AT THE SAME TIME, THE PATIENTS ARE PROVIDED WITH A CHARITY CARE APPLICATION AND INFORMATIONAL FLYER. THE PATIENT IS INFORMED THAT MOTHER FRANCES HOSPITAL-JACKSONVILLE IS A NON-PROFIT CHARITABLE ORGANIZATION OFFERING FINANCIAL ASSISTANCE TO PATIENTS WHO ARE DEEMED MEDICALLY OR FINANCIALLY INDIGENT. THE FINANCIAL COUNSELORS WILL THEN ASSIST THE PATIENT IN COMPLETING THE CHARITY CARE APPLICATION AND OBTAIN ANY AVAILABLE VERIFICATIONS. ONCE THE PATIENT IS DISCHARGED, THE FINANCIAL COUNSELORS WILL CONTINUE TO CONTACT THE PATIENT TO ENSURE ALL NEEDED FORMS AND VERIFICATIONS NEEDED TO FILE AN APPLICATION FOR GOVERNMENTAL ASSISTANCE AND CHARITY CARE HAVE BEEN PROVIDED. COMMUNITY INFORMATION: MOTHER FRANCES HOSPITAL-JACKSONVILLE IS A 25-BED ACUTE CARE MEDICARE CERTIFIED CRITICAL ACCESS HOSPITAL. CHEROKEE COUNTY, THE PRIMARY SERVICE AREA FOR MFH-JACKSONVILLE, HAS A POPULATION OF APPROXIMATELY 57,000 AND IS PRIMARILY 48,000 IN A 1,052 SQUARE MILE AREA. THE SECONDARY SERVICE AREA INCLUDES THE SOUTHERN PART OF SMITH COUNTY. PROMOTION OF COMMUNITY HEALTH: MOTHER FRANCES HOSPITAL-JACKSONVILLE PROMOTES HEALTHCARE AND WELLNESS EDUCATION BY OFFERING OUTREACH PROGRAMS AND SPECIAL INITIATIVES THAT IMPROVE THE QUALITY OF LIFE AND HEALTH IN THE COMMUNITIES SERVED. 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 THE FOLLOWING: CHEROKEE COUNTY RELAY FOR LIFE: PROVIDED SPONSORSHIP AND STAFFING SUPPORT FOR CHEROKEE COUNTY RELAY FOR LIFE. STAFF PLANNED ACTIVITIES FOR THE ALL-NIGHT EVENT AND MANNED THE EVENT. THE PURPOSE OF THE EVENT WAS TO INCREASE AWARENESS ABOUT CANCER IN THE COUNTY WHICH HAS AN ABOVE AVERAGE RATE OF CANCER. FAMILY CARE CENTER - WOMEN'S SERVICES: OVER 319 VISITS FOR GYNECOLOGICAL SERVICES AT THE LOCAL CLINIC WERE PROVIDED FOR WOMEN THAT DID NOT HAVE A PRIMARY CARE OR SPECIALTY MEDICAL HOME. IN ADDITION, SURGERIES WERE PERFORMED BY FAMILY CARE PHYSICIANS AT MFH-JACKSONVILLE. JACKSONVILLE RODEO: HANDED OUT FANS AND WATER TO PARTICIPANTS AND SPECTATORS AT THE RODEO. HELPED EDUCATE PARTICIPANTS ABOUT THE DANGERS OF EXCESSIVE HEAT AND INJURIES CAUSED BY EXTENSIVE HEAT. REACHED OVER 1,500 PEOPLE WITH HEAT PREVENTION INFORMATION AND MEDICAL SUPPORT ON SITE. JACKSONVILLE ROTARY, ACCESS, AND OTHERS: PROVIDED SPONSORSHIP, STAFFING, AND DEVELOPMENT OF PROGRAMS AND EVENTS FOR THE LOCAL COMMUNITY. ORGANIZATIONS WHICH BENEFITED INCLUDED JACKSONVILLE LITERACY COUNCIL, LIONS CLUB, ROTARY, RED CROSS, ACCESS, HOPE CENTER, UNITED FUND, AND AMERICAN CANCER SOCIETY. MEMBERS OF THE STAFF SERVE IN LEADERSHIP POSITIONS ON VARIOUS BOARDS AND NON-PROFITS IN THE COMMUNITY. COMMUNITY HEALTH INFORMATION AND SCREENINGS: A VARIETY OF COMMUNITY EVENTS WERE HELD INCLUDING OPPORTUNITIES FOR SCREENINGS AT THE CHEROKEE COOP COUNTY HEALTH FAIR AND AT VARIOUS EDUCATIONAL FACILITIES. THESE ACTIVITIES REACHED OVER 1,000 PEOPLE HELPING TO EDUCATE AND IDENTIFY INDIVIDUALS AT RISK AND PROVIDING WAYS TO IMPROVE THEIR HEALTH. KID FEST: THE HOSPITAL CO-SPONSORED A COMMUNITY PROGRAM WHICH WAS HELD TO EDUCATE FAMILIES AND CHILDREN ON THE IMPORTANCE OF BICYCLE SAFETY. OVER 100 CHILDREN PARTICIPATED IN THE PROGRAM. AFFILIATED HEALTH CARE SYSTEM: MOTHER FRANCES HOSPITAL-JACKSONVILLE IS PART OF AN AFFILIATED HEALTH CARE SYSTEM CALLED TRINITY MOTHER FRANCES HEALTH SYSTEM. TRINITY MOTHER FRANCES IS A FAITH-BASED ORGANIZATION DEDICATED TO CREATING HEALTHY LIVES FOR PEOPLE AND COMMUNITIES. MFH-JACKSONVILLE AND ITS AFFILIATES PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING ACUTE CARE FACILITIES AND CRITICAL ACCESS FACILITIES, WHOSE OPERATIONS CONSIST PRIMARILY OF PROVIDING INPATIENT AND OUTPATIENT ACUTE CARE AND MEDICAL SERVICES TO PATIENTS RESIDING IN EAST TEXAS. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI TX, true SERVICE ORGANIZATION OF PINEY WOODS 2950 50TH STREET LUBBOCK TX 79314 260468622 501(C)(3) 946111 COMMUNITY HEALTHCARE 1 0 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. PART I, LINE 2 GRANT RECIPIENTS ARE REQUIRED TO ACKNOWLEDGE PRIOR TO THE ISSUANCE OF GRANT FUNDS THAT THE GRANT WILL BE USED IN ACCORDANCE WITH THE STATED PURPOSE OF THE GRANT APPLICATION AND ANY UNUSED FUNDS RELATED TO THE SPECIFIC PURPOSE OF THE GRANT WILL BE RETURNED TO THE ORGANIZATION. THE ORGANIZATION MONITORS AND REVIEWS THE FINANCIAL DATA OF RECIPIENTS TO ENSURE THAT THE GRANTED FUNDS ARE BEING USED PROPERLY. X X X X X false true false false false false false false false THOMAS N CAMMACK JR 139954 0 42806 0 0 0 4283 0 8975 0 196018 0 0 0 MATTHEW A VIERKANT MD 0 498664 0 0 0 0 0 4900 0 16456 0 520020 0 0 RAY THOMPSON 0 678212 0 394861 0 386918 0 467937 0 8711 0 1936639 0 386918 BARRY L THIBODEAUX 215029 0 0 0 0 0 4293 0 1452 0 220774 0 0 0 JACK CAPPS 210583 0 0 0 0 0 4661 0 11164 0 226408 0 0 0 WILLIAM MILAWSKI MD 0 235647 0 0 0 0 0 4124 0 13770 0 253541 0 0 PARTICIPATION IN OR PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PART I, QUESTION 4B PARTICIPANTS IN SERP REPORTED IN W-2 DEFERRED COMPENSATION -------------------- --------------- --------------------- RAY THOMPSON $386,918 $463,037 DESCRIBE REVIEW PROCESS OF FORM 990 FORM 990, PART VI, QUESTION 11A THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS PRIOR TO FILING. DESCRIBE THE ORGANIZATION'S MEMBERS OR STOCKHOLDERS FROM 990, PART VI, QUESTION 6 TRINITY MOTHER FRANCES HEALTH SYSTEM IS THE SOLE MEMBER OF MOTHER FRANCES HOSPITAL - JACKSONVILLE. MEMBERS OR STOCKHOLDERS WHO MAY ELECT MEMBERS OF THE GOVERNING BOARD FORM 990, PART VI, QUESTION 7A THE SOLE MEMBER, TRINITY MOTHER FRANCES HEALTH SYSTEM, APPOINTS ALL DIRECTORS AND THEIR SUCCESSORS TO THE GOVERNING BOARD. DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY MEMBER FORM 990, PART VI, QUESTION 7B THE MEMBER HAS THE RIGHT TO APPROVE OR DISAPPROVE CERTAIN ACTIONS THAT HAVE BEEN APPROVED BY THE BOARD OF DIRECTORS. HOW DOES THE ORGANIZATION MONITOR AND ENFORCE COMPLIANCE WITH POLICY FORM 990, PART VI, QUESTION 12C THE BOARD REVIEWS AND RESOLVES, IF NECESSARY, ANY TRANSACTIONS AS THEY ARISE THROUGHOUT THE YEAR IN ACCORDANCE WITH POLICY STANDARDS. PROCESS FOR DETERMINING COMPENSATION OF CEO, OFFICERS, OR KEY EMPLOYEES FORM 990, PART VI, QUESTIONS 15A & 15B THE ORGANIZATION USES COMPENSATION CONSULTANTS AND NATIONAL COMPENSATION SURVEYS TO DETERMINE COMPENSATION OF EMPLOYEES. COMPENSATION IS APPROVED BY THE ORGANIZATION'S GOVERNING BODY. DESCRIBE WHETHER THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE TO PUBLIC FORM 990, PART VI, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. COMPENSATION FROM RELATED ORGANIZATIONS FORM 990, PART VII & SCHEDULE J THE GOVERNING BOARD OF TRINITY MOTHER FRANCES HEALTH SYSTEM, UPON ADVICE FROM NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS, WHO PERIODICALLY REVIEW ALL EXECUTIVE COMPENSATION, APPROVED A DEFERRED COMPENSATION PLAN THAT PROVIDES A 65% TOTAL RETIREMENT BENEFIT FOR SENIOR EXECUTIVES THAT SERVE 20 YEARS OR MORE. THIS PROGRAM HAS BOTH RETENTION AND NON-COMPETITION CLAUSES THAT CREATE A RISK OF FORFEITURE. DEFERRED COMPENSATION IS SUBJECT TO A RISK OF FORFEITURE BASED ON RETENTION, NON-COMPETITION AND OTHER CONTRACTUAL FACTORS. ACCRUALS OF DEFERRED COMPENSATION ARE NOT INCLUDIBLE IN W-2 COMPENSATION UNTIL PAID. OTHER EMPLOYEE BENEFITS INCLUDE QUALIFIED PENSION PLANS. HEALTH, DENTAL AND LIFE INSURANCE PLANS, DISABILITY INSURANCE, ETC. TAXABLE EXPENSES ARE INCLUDED IN THE W-2 PAID COMPENSATION SALARY AMOUNT. 1099S REPORTED BY ORGANIZATION FORM 990, PART V, QUESTION 1 NO 1099S WERE ISSUED BY THE FILING ORGANIZATION. THE ORGANIZATION'S 1099S ARE ISSUED BY A RELATED ORGANIZATION, MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER, WHO REPORTS ALL 1099S FOR THE ENTIRE SYSTEM AND ALLOCATES EXPENSES TO THE APPROPRIATE RELATED ORGANIZATION; THEREFORE, THIS QUESTION IS ANSWERED AS "NONE" FOR THIS FILING ORGANIZATION. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MATTHEW A VIERKANT MD TITLE:DIRECTOR HOURS:30 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RAY THOMPSON TITLE:CHAIRMAN HOURS:42 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLIAM MILAWSKI MD TITLE:DIRECTOR HOURS:30 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DICK STONE TITLE:DIRECTOR HOURS:1 CHAMPION EMERGENCY SERVICES LLC 2201 S MOBBERLY AVE LONGVIEW TX 75602 752747708 AMBULANCE SVC TX 501(C)(3) 11A NA MOTHER FRANCES HOSP REGIONAL HC CENTER 1315 DOCTORS DRIVE TYLER TX 75701 750818167 HOSPITAL TX 501(C)(3) 3 NA TRINITY MOTHER FRANCES HEALTH SYSTEM FDN 1315 DOCTORS DRIVE TYLER TX 75701 752028241 SUPPORT TX 501(C)(3) 11C NA REGIONAL MEDICAL SERVICES ASSOCIATION 1315 DOCTORS DRIVE TYLER TX 75701 752511459 HEALTHCARE TX 501(C)(3) 3 NA TRINITY MOTHER FRANCES HEALTH SYSTEM 1315 DOCTORS DRIVE TYLER TX 75701 752616975 HEALTHCARE TX 501(C)(3) 11C NA TRINITY CLINIC 1315 DOCTORS DRIVE TYLER TX 75701 752616977 HEALTHCARE TX 501(C)(3) 3 NA MOTHER FRANCES HOSPITAL - WINNSBORO 1315 DOCTORS DRIVE TYLER TX 75701 752771569 HOSPITAL TX 501(C)(3) 3 NA TRI-STATE FINANCIAL LLC 1315 DOCTORS DRIVE TYLER TX 75701 752728318 COLLECTION AGENCY TX NA C-CORPORATION 0 0 0.00000 TRINCARE INC 1315 DOCTORS DRIVE TYLER TX 75701 752161369 RETAIL HEALTH SVC TX NA C-CORPORATION 0 0 0.00000 HEALTHPLAN OF TEXAS INC 514 S BECKHAM TYLER TX 75701 752636832 THIRD PARTY ADMIN TX NA C-CORPORATION 0 0 0.00000 REGIONAL HEALTHCARE ALLIANCE 1315 DOCTORS DRIVE TYLER TX 75701 752484109 PREFER PROVIDER TX NA C-CORPORATION 0 0 0.00000 TEXAS HEALTH FACILITIES INSUR CORP LTD PO BOX 1109 BWI GRAND CAYMAN CJ 980136025 INSURANCE CJ NA C-CORPORATION 0 0 0.00000 CONCORDIUM HEALTH LLC 1315 DOCTORS DRIVE TYLER TX 75701 702811022 INACTIVE TX NA C-CORPORATION 0 0 0.00000 EMPLOYER SERVICES INC 1315 DOCTORS DRIVE TYLER TX 75701 752602556 INACTIVE TX NA C-CORPORATION 0 0 0.00000 HERITAGE HEALTH PLANS OF TX 1315 DOCTORS DRIVE TYLER TX 75701 752622622 INACTIVE TX NA C-CORPORATION 0 0 0.00000 QUALITY CARE ALLIANCE 1315 DOCTORS DRIVE TYLER TX 75701 752662965 INACTIVE TX NA C-CORPORATION 0 0 0.00000 false false false false false false false false false true false true false false false false false false