FURP.ORG / PUBLIC DATA EXPLORER

COMMUNITY HOSPITAL OF BRAZOSPORT: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HOSPITAL OF BRAZOSPORT (EIN 74-1385192)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-12
IRS object ID
201213179349302926
Schema version
2011v1.3
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)
Timestamp2012-11-12T19:26:13-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12800 Post Oak Blvd Ste 3200AddressLine1
CityHOUSTONCity
StateTXState
ZIP Code77056ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN741385192EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Community Hospital of BrazosportBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% CHUCK JEFFRESSInCareOfName
Name ControlCOMMNameControl
Phone9792851803Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 MEDICAL DRIVEAddressLine1
CityLAKE JACKSONCity
StateTXState
ZIP Code77566ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameAL GUEVARAName
TitleCEOTitle
Date Signed2012-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAmanda MayaName
Phone7134994600Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonAL GUEVARANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1100 Medical DriveAddressLine1
CityLake JacksonCity
StateTXState
ZIP Code77566ZIPCode
FieldValueIRS element (for citing)
Gross Receipts116858583GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitehttp://www.brhstx.org/WebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1961YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTHCARE SERVICES TO THE PATIENTS AND COMMUNITIES SERVED IN THE LAKE JACKSON, TEXAS AREA WITH EXCELLENCE AND COMPASSION.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees760TotalNbrEmployees
Total Nbr Volunteers135TotalNbrVolunteers
Total Gross UBI100TotalGrossUBI
Contributions Grants Prior Year135000ContributionsGrantsPriorYear
Contributions Grants Current Year230373ContributionsGrantsCurrentYear
Program Service Revenue Prior Year92469809ProgramServiceRevenuePriorYear
Program Service Revenue CY95702554ProgramServiceRevenueCY
Investment Income Prior Year2841922InvestmentIncomePriorYear
Investment Income Current Year1151675InvestmentIncomeCurrentYear
Other Revenue Prior Year739739OtherRevenuePriorYear
Other Revenue Current Year775545OtherRevenueCurrentYear
Total Revenue Prior Year96186470TotalRevenuePriorYear
Total Revenue Current Year97860147TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year33528101SalariesEtcPriorYear
Salaries Etc Current Year35831728SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year59474419OtherExpensePriorYear
Other Expenses Current Year62036266OtherExpensesCurrentYear
Total Expenses Prior Year93002520TotalExpensesPriorYear
Total Expenses Current Year97867994TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3183950RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-7847RevenuesLessExpensesCY
Total Assets BOY92882222TotalAssetsBOY
Total Assets EOY86973088TotalAssetsEOY
Total Liabilities BOY36233602TotalLiabilitiesBOY
Total Liabilities EOY34710934TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY56648620NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY52262154NetAssetsOrFundBalancesEOY
Mission DescriptionHEALTHCARE WITH EXCELLENCE AND COMPASSION.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense82914766Expense
Revenue96119269Revenue
DescriptionPROVIDE VARIOUS HEALTHCARE SERVICES TO THE CITIZENS OF BRAZOSPORT AND THE SURROUNDING BRAZORIA COUNTY AREAS. 6,103 PATIENTS WERE SERVED BY OUR MEDICAL PROFESSIONALS. SPECIALTIES AVAILABLE WERE ALLERGY, ANESTHESIA, CARDIOLOGY, EMERGENCY CARE, OTOLARYNGOLOGY, FAMILY PRACTICE, INTERNAL MEDICINE, NEPHROLOGY, NEUROLOGY, OBSTETRICS/GYNECOLOGY, ONCOLOGY, OPTHALMOLOGY, ORAL SURGERY, ORTHODPEDICS, PATHOLOGY, PEDIATRICS, REHABILITATION, GENERAL SURGERY, AND UROLOGY.Description
Total Program Service Expense82914766TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
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 BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096159NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees760NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
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 Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
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 ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
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 OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCHUCK JEFFRESSNamePerson
Telephone Number9794152208TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 MEDICAL DRIVEAddressLine1
CityLake JacksonCity
StateTXState
ZIP Code77566ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationOther CompensationOtherCompensationReportable Comp From Related OrgsReportableCompFromRelatedOrgsHighest Compensated EmployeeHighestCompensatedEmployee
MARY RUTH RHODENBAUGH
MEMBER1.0X
DR MARK BONNEN
MEMBER1.0X
BLANCA BUSTOS
MEMBER1.0X
TOM FOWLER
SECRETARY1.0XX
DR FRANK GRADY
MEMBER1.0X
DR HARVEY RESNICK
MEMBER1.0X
BROOKS BASS
VICE PRESIDENT1.0XX
KEN SMITH
TREASURER1.0XX
JIM MARTIN
FORMER PRESIDENT1.0XX
ED SPEED
PRESIDENT1.0XX
EVELYN MOORE
MEMBER1.0X
MARK DAVIS
MEMBER1.0X
BLAIR KRELL MD
MEMBER1.0X
CANDICE FONKE
CNO40.0X1547906986
ALFRED GUEVARA
COO40.0X26864213520
DAN BUCHE
CEO40.0X000
CHUCK JEFFRESS
CFO40.0X000
AHMET BULUT
MEDICAL PHYSICIST40.0185552190620X
DANNY TRAN
DOSIMETRIST40.0127428188750X
BRIAN STACKS
PHARMACIST40.013004616950X
SCOTT BRINER
VP-PROFESSIONAL SERVICES40.015321418738X
JOAN BETH BELL
VP-QUALITY MANAGEMENT40.01223327769X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1142004TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation86645TotalOtherCompensation
Number Individuals GT100 K17NumberIndividualsGT100K
Formers ListedfalseFormersListed
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
ARAMARK HEALTHCARE FACILITIES
JPM LOCKBOX 24863 NETWORK PLACECHICAGOIL606731248CONTRACT LABOR2678095
MILESTONE HEALTHCARE INC
L-3542COLUMBUSOH43260CONTRACT LABOR928672
ANGELICA CORPORATION
1441 LATHROPHOUSTONTX77020LAUNDRY501878
INPATIENT SERVICES OF TEXAS
7032 COLLECTION CENTER DRIVECHICAGOIL60693HOSPITALIST488252
MEDICAL INFORMATION TECHNOLOGY INC
MEDITECH CIRCLEWESTWOODMA02090SOFTWARE MAINTENANCE2396961
FieldValueIRS element (for citing)
Number Of Contractors GT100 K19NumberOfContractorsGT100K
Related Organizations230373RelatedOrganizations
Total Contributions230373TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT REVENUE6215009564623595646135100
OTHER PATIENT SERVICES6215005631956319
FieldValueIRS element (for citing)
Total Program Service Revenue95702554TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column408230TotalRevenueColumn
Exclusion$408,230ExclusionAmount

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)
Real65350Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real65350Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column65350TotalRevenueColumn
Exclusion$65,350ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities19725668Securities
Other16213Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities18998436Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities727232Securities
Other16213Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column743445TotalRevenueColumn
Exclusion$743,445ExclusionAmount

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)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
CAFETERIA SALES722210394820394820
COMMUNITY EDUCATION6117102189521895
REBATES900099136739$136,739

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column156741TotalRevenueColumn
Exclusion$156,741ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue710195TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column97860147TotalRevenueColumn
Related Or Exempt Function Income96119169RelatedOrExemptFunctionIncome
Unrelated Business Revenue100UnrelatedBusinessRevenue
Exclusion$1,510,505ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

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)
Total443948Total
Program Services443948ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total17344Total
Program Services17344ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total28220187Total
Program Services22483891ProgramServices
Management And General5736296ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total160092Total
Program Services128074ProgramServices
Management And General32018ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4961308Total
Program Services3969046ProgramServices
Management And General992262ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2028849Total
Program Services1623079ProgramServices
Management And General405770ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1788549Total
Management And General1788549ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total190370Total
Management And General190370ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total143801Total
Management And General143801ManagementAndGeneral

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)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total10052435Total
Program Services8012269ProgramServices
Management And General2040166ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total451884Total
Program Services361507ProgramServices
Management And General90377ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1534652Total
Program Services1050132ProgramServices
Management And General484520ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total999950Total
Program Services20413ProgramServices
Management And General979537ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1561495Total
Program Services1287913ProgramServices
Management And General273582ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total286896Total
Program Services103717ProgramServices
Management And General183179ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2398Total
Management And General2398ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1172130Total
Program Services929777ProgramServices
Management And General242353ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4373802Total
Program Services3499042ProgramServices
Management And General874760ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1128750Total
Program Services903000ProgramServices
Management And General225750ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE2676742426767424
MEDICAL SUPPLIES1010367510103675
EQUIPMENT COSTS720637558614162023
LOST CHARGES1854081828682540

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total572010Total
Program Services469033ProgramServices
Management And General102977ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total97867994Total
Program Services82914766ProgramServices
Management And General14953228ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY18636BOY
EOY7627EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5253501BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY13408095BOY
EOY12245078EOY

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)
BOY9000BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1628129BOY
EOY1619591EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1657382BOY
EOY1803419EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis113582520LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec73626597LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY36630184BOY
EOY39955923EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY33052594BOY
EOY28559604EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1000BOY
EOY1000EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY1223701BOY
EOY1133613EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY1647233EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY92882222BOY
EOY86973088EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6199418BOY
EOY6955954EOY

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)
BOY22579558BOY
EOY21368302EOY

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)
BOY3769093BOY
EOY2809456EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3685533BOY
EOY3577222EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY36233602BOY
EOY34710934EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY56648620BOY
EOY52262154EOY

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)
BOY56648620BOY
EOY52262154EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY92882222BOY
EOY86973088EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-7847ReconcilationRevenueExpenses
Reconcilation Other Changes-4378619ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

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 D IRS990ScheduleD

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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1530296OtherCostOrOtherBasis
Book Value1530296BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis39824713OtherCostOrOtherBasis
Depreciation17704038Depreciation
Book Value22570949BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1250918OtherCostOrOtherBasis
Depreciation1102301Depreciation
Book Value259523BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis63189678OtherCostOrOtherBasis
Depreciation54820258Depreciation
Book Value13208169BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis849786OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value2386986BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings39955923TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
MALPRACTIVE RESERVE$1,768,592
ESTIMATED AMOUNTS DUE TO THIRD PARTY$1,334,760
CAPITAL LEASE$473,870
FieldValueIRS element (for citing)
Total Of Amounts3577222TotalOfAmounts
Total Revenue97860147TotalRevenue
Total Expenses97867994TotalExpenses
Excess Or Deficit For Year-7847ExcessOrDeficitForYear
Net Unrealized GL On Investments-3526736NetUnrealizedGLOnInvestments
Other$8,122OtherAmount
Total Adjustments-3518614TotalAdjustments
Excess Or Deficit Per FS-3526461ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt96958411TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-3526736NetUnrealizedGainsInvestments
Other Revenues2625000OtherRevenues
Revenue Not Rptd F990-901736RevenueNotRptdF990
Revenue Subtotal97860147RevenueSubtotal
Total Revenue Per Form99097860147TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt100484872TotExpensesEtcAuditedFinclStmt
Other Expenses Included2625000OtherExpensesIncluded
Expenses Not Rptd F9902625000ExpensesNotRptdF990
Expenses Subtotal97859872ExpensesSubtotal
Other Expenses Not Included8122OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt8122ExpensesNotRptdOnFinStmt
Total Expenses Per Form99097867994TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION OF CHANGE IN NET ASSETS FROM FORM 990 TO FINANCIALSSch D, Part XI, LINE 8TRANSFERS TO AFFILIATES $8,122
RECONCILIATION OF REVENUE AND EXPENSES PER AUDITED F/S WITH RETURNSch D, Part XII AND PART XIII, LINE 2DADJUSTMENT FOR AFFILIATION AGREEMENT CONTRIBUTION $2,625,000
RECONCILIATION OF EXPENSES PER AUDITED F/S WITH RETURNSCHEDULE D, PART XIII, LINE 2DTRANSFER TO AFFILIATES $8,122
FIN 48 FOOTNOTESCHEDULE D, PART X, LINE 2MANAGEMENT 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.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense564319TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense564319NetCommunityBenefitExpense
Percent Of Total Expense0.00790PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense6962371TotalCommunityBenefitExpense
Direct Offsetting Revenue6697141DirectOffsettingRevenue
Net Community Benefit Expense265230NetCommunityBenefitExpense
Percent Of Total Expense0.00370PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense1078082TotalCommunityBenefitExpense
Direct Offsetting Revenue1105552DirectOffsettingRevenue
Net Community Benefit Expense-27470NetCommunityBenefitExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense8604772TotalCommunityBenefitExpense
Direct Offsetting Revenue7802693DirectOffsettingRevenue
Net Community Benefit Expense802079NetCommunityBenefitExpense
Percent Of Total Expense0.01160PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense7278315TotalCommunityBenefitExpense
Direct Offsetting Revenue5989354DirectOffsettingRevenue
Net Community Benefit Expense1288961NetCommunityBenefitExpense
Percent Of Total Expense0.01810PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense38867TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense38867NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense7317182TotalCommunityBenefitExpense
Direct Offsetting Revenue5989354DirectOffsettingRevenue
Net Community Benefit Expense1327828NetCommunityBenefitExpense
Percent Of Total Expense0.01860PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense15921954TotalCommunityBenefitExpense
Direct Offsetting Revenue13792047DirectOffsettingRevenue
Net Community Benefit Expense2129907NetCommunityBenefitExpense
Percent Of Total Expense0.03020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$26,767,424BadDebtExpenseAmount
Amount Reimbursed By Medicare24920142AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare25707449CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-787307MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
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 Line1COMMUNITY HOSPITAL OF BRAZOSPORTBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1100 MEDICAL DRIVEAddressLine1
CityLAKE JACKSONCity
StateTXState
ZIP Code77566ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
OtherURGENT CARE CENTEROther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HOSPITAL OF BRAZOSPORTBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Needs Assessment Conducted11NeedsAssessmentConducted
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
BAD DEBT EXPENSEPART III, LINE 4:THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES 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, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. BAD DEBT EXPENSE CONSISTS OF THOSE ACCOUNTS WHICH HAVE AGED TO 150 DAYS OLD. AT THIS POINT ACCOUNTS ARE NOT EXPECTED TO BE COLLECTED AND ARE WRITTEN OFF AS BAD DEBT. BAD DEBT EXPENSE SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE HEALTH CARE SERVICES HAVE BEEN PROVIDED TO THE COMMUNITY WITHOUT REIMBURSEMENT TO THE FACILITY. IN EFFECT THESE SERVICES HAVE BEEN PROVIDED FREE OF CHARGE TO THE COMMUNITY.
MEDICAREPART III, LINE 8:THE HOSPITAL USED MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS BASED ON MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. THE ORGANIZATION HAD A MEDICARE SHORTFALL IN THE AMOUNT OF $787,307 lessening the burden of government. in addition, THE STATE OF TEXAS TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT FOR MEETING STATUTORY REQUIREMENTS FOR CHARITY CARE AND COMMUNITY BENEFIT.
COLLECTION PRACTICESPART III, LINE 9B:PATIENT ACCOUNTS IN A BAD DEBT POSITION ARE EVALUATED BY THE BUSINESS DEPARTMENT CHARITY SPECIALIST TO DETERMINE IF THE PATIENT QUALIFIES FOR CHARITY CARE TREATMENT.
NEEDS ASSESSMENT:Brazosport Regional Health System conducts a comprehensive environmental analysis, including a physician manpower analysis and meeting with key community stakeholders, as part of the 3 year strategic planning process. The Brazosport Regional Board of Directors analyzes the data from the primary service area to identify specific health care needs for the area residents.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE HOSPITAL USES A THIRD PARTY RESOURCE CORPORATION OF AMERICA TO SCREEN ALL SELF PAY ADMISSIONS FOR ASSISTANCE. IF THEY DO NOT QUALIFY, THEY ARE REFERRED TO OUR CHARITY CARE COUNSELOR. ASSISTANCE INFORMATION IS AVAILABLE IN THE HOSPITAL HANDBOOK, ON BRHS WEB SITE, AND ON PATIENT STATEMENTS.
COMMUNITY INFORMATION:Brazosport Regional Health System serves the southern region of Brazoria County, Texas, with an approximate total population of 130,000 residents. The primary service area includes the towns of Lake Jackson, Clute, Freeport and Brazoria, Texas. The service area is predominantly rural and covers nearly a 30 mile radius from the main campus in Lake Jackson. The percentage of indigent patients is below the statewide average and the average income per household is above the statewide average. The demographic analysis of the population served reveals a predominantly Caucasian-American population (60%), and 25% of the population being Hispanic. The 18-49 age category represents the highest percentage of age distribution for the population served (37.2%) and the 65+ category accounts for approximately 6%.
PROMOTION OF COMMUNITY HEALTH:Brazosport Regional participates in a number of community building activities that promote the health of the communities the organization serves. Brazosport Regional provides a free monthly community education session, presented by medical providers, that is open to the public and covers a broad range of health related topics, such as Allergies and Asthma, Diabetes, Breast Health and Understanding Epilepsy. Brazosport Regional has also developed and offers numerous support groups that are free for community members, including support groups for Breast Cancer, Diabetes, Stroke, Weight Loss and Mental Illness. Annually, Brazosport Regional provides several community based free screening and immunization clinics, such as a free Flu Shot Clinic that delivers over 1,000 free flu shots over a two day period, a free Prostate Screening Exam for nearly 200 local men, and providing various health screens (blood pressure, blood sugar, and cholesterol) at local community and business events such as the Senior Fest, the Disabilities Expo, the Dow Retiree Reunion and the Clute Festival. The Brazosport Regional Auxiliary also coordinates a community wide blood drive that occurs every two months in the classrooms at Brazosport Regional. Brazosport Regional is a community owned 501c3 that maintains an open medical staff, consisting of approximately 130 physicians and mid level providers. The organization is governed by a 12 member board, comprised of local community members, and actively participates in furthering the health of the community by providing financial support for community activities and civic organizations, providing facilities for free community education, support groups, screenings and immunizations, and reinvesting all surplus funds in the expansion and improvement of medical equipment and facilities for the benefit of the communities served.
PERCENT OF TOTAL EXPENSEPART I, LINE 7, COLUMN FBAD DEBT EXPENSE OF $26,767,424 WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR THE CALCULATION OF "PERCENT OF TOTAL EXPENSE" IN THIS COLUMN.
INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCESCHEDULE H, PART V, LINE 19DTHE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE ARE CALCULATED USING A SLIDING SCALE BASED UPON FEDERAL POVERTY GUIDELINES. IN ALL CASES, AMOUNTS CHARGED TO PATIENTS WILL BE BELOW THE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATE, THE AVERAGE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATE, AND MEDICARE RATES.
PUBLICIZED POLICYSCHEDULE H, PART V, QUESTION 13GTHE FINANCIAL ASSISTANCE POLICY IS ALSO AVAILABLE IN THE HOSPITAL HANDBOOK AND PATIENTS ARE NOTIFIED OF THE POLICY PRIOR TO DISCHARGE FROM THE HOSPITAL.
BILLING AND COLLECTIONSSCHEDULE H, PART V, LINE 15, 16, & 17NEITHER THE BRAZOSPORT REGIONAL HEALTH SYSTEM, NOR THIRD PARTIES AUTHORIZED BY BRHS, TAKE ANY ACTIONS UPON NON-PAYMENT FROM A PATIENT BEFORE MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR THE FACILITY'S FINANCIAL ASSISTANCE POLICY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
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 (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
AHMET BULUT
1834380002114018930171690204614000
SCOTT BRINER
13261810000105961569171691719520
CANDICE FONKE
13799750001179346565211617760
ALFRED GUEVARA
2167102835223580272410796282162

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierTravel for companionsIdentifier
Return ReferenceSch J, Part I, Question 1aReturnReference
ExplanationThe organization has a hospital policy regarding travel for an employee's spouse. The purpose of the policy is to identify allowable business expenses and processes associated with spousal travel on business trips on behalf of Brazosport Regional Health System. A form must be completed by the employee when claiming reimbursement for travel costs incurred by the employee's spouse to accompany him/her on a business trip. Reimbursement for spousal travel is allowed only if a bona fide business purpose exists for the employee's spouse to make the trip.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1BRAZORIA COUNTY HEALTH FACILITIES DEVELOPMENT CORPBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN531306936IssuerEIN
CUSIP Number106045CR6CUSIPNumber
Date Issued2004-08-31DateIssued
Issue Price28625115IssuePrice
Description Of Purposeseries 2004 hospital revenue bondDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds28625115TotalProceeds
Amount In Reserve Fund2223423AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow10233389RefundingEscrow
Issuance Costs From Proceeds498450IssuanceCostsFromProceeds
Credit Enhancement1145313CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures14524541CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2006YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Engage Bond Counsel ContractsfalseEngageBondCounselContracts
Any Research AgreementsfalseAnyResearchAgreements
Engage Bond Counsel ResearchfalseEngageBondCounselResearch
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledtrueForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonJanice BucheNamePerson
FieldValueIRS element (for citing)
Relationshipspouse of BRHS officerRelationship
Amount Of Transaction17344AmountOfTransaction
Description Of TransactionSalaries/WagesDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Describe delegation of control over management dutiesForm 990, Part VI, Question 3The Hospital is managed by Quorum Health Resources pursuant to a management agreement that will expire December 31, 2015. Management fees paid to Quorum Health Resources were approximately $450,000 in 2011 and $434,000 in 2010. DAN BUCHE AND CHUCK JEFFRESS ARE EMPLOYEES OF QHR, UNRELATED ORGANIZATION, AND, UNDER THEIR EMPLOYMENT FOR QHR, THEY SERVE AS THE CEO AND CFO, RESPECTIVELY. QHR PAID COMPENSATION TO DAN BUCHE AND CHUCK JEFFRESS IN THE AMOUNTS OF $682,226 AND $333,856, RESPECTIVELY, FOR 2011. PER IRS GUIDANCE, NO COMPENSATION IS SHOWN ON FORM 990, PART VII, FOR THEM.
Describe how conflict of interest policy is monitored & enforcedForm 990, Part VI, Question 12cAnnual disclosures are filled out by the board members which are then kept on file by the board secretary.
Describe process for determining compensationForm 990, Part VI, Question 15aReview of the compensation was conducted by the Board of Directors, most recently in April of 2009. Compensation is determined based on the hospital's performance as well as industry standards. Other determining factors are the hospital's press ganey scores, employee retention program, and meeting strategies and goals.
Describe how documents are made available to the publicForm 990, Part VI, Question 19The organization's governing documents are made available to the public upon request.
Describe review process of Form 990 by organization's governing bodyForm 990, Part VI, Question 11A copy of the organization's Form 990 will be provided to the organization's Finance Committee members for review. The 990 will also be presented to the finance committee members by the organization's accounting firm to allow further review before it is filed.
OTHER CHANGES IN NET ASSETS OR FUND BALANCESFORM 990, PAGE 12, PART XI, LINE 5INTERCOMPANY TRANSFER $ (851,878) UNREALIZED GAINS & LOSSES (3,526,736) ------------ $(4,378,614)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DR. MARK BONNEN TITLE:MEMBER HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DAN BUCHE TITLE:CEO HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:CHUCK JEFFRESS TITLE:CFO HOURS:1

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Brazosport Health Foundation
PO Box 90Lake JacksonTX77566760080110FundraisingTX501(C)(3)11ABRHStrue
BRAZOSPORT REGIONAL PHYSICIAN SERVICES
100 MEDICAL DRLAKE JACKSONTX77566800240261HEALTHCARETX501(C)(3)3BRHStrue

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Diversified Health Resources
100 Medical DriveLake JacksonTX77566760222679HEALTH CARETXBRHSC CORPORATION-3721361801.00000
Brazosport Health Alliance
129 circle way st suite alake jacksonTX77566760518376health careTXBRHSC Corporation309151560891.00000
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
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 OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Brazosport Health FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypecTransactionType
Amount Involved230373AmountInvolved
Method Of Amt DeterminationFMVMethodOfAmtDetermination