2012-11-12T19:26:13-06:00 2011-12-31 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2011-01-01 741385192 Community Hospital of Brazosport % CHUCK JEFFRESS COMM 9792851803 100 MEDICAL DRIVE LAKE JACKSON TX 77566 AL GUEVARA 2012-11-15 true Amanda Maya 7134994600 2011 2016-02-24 21:20:13Z AL GUEVARA 100 Medical Drive Lake Jackson TX 77566 116858583 false X http://www.brhstx.org/ X 1961 TX TO PROVIDE HEALTHCARE SERVICES TO THE PATIENTS AND COMMUNITIES SERVED IN THE LAKE JACKSON, TEXAS AREA WITH EXCELLENCE AND COMPASSION. 13 13 760 135 100 135000 230373 92469809 95702554 2841922 1151675 739739 775545 96186470 97860147 0 0 0 0 33528101 35831728 0 0 0 59474419 62036266 93002520 97867994 3183950 -7847 92882222 86973088 36233602 34710934 56648620 52262154 HEALTHCARE WITH EXCELLENCE AND COMPASSION. false false 82914766 96119269 PROVIDE 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. 82914766 true true false false false false false false false true false false false true false false true false false false false false false false false true true false false true true false false false false false false false false true false false false false false false true true true false false true 159 0 true 760 true true true false false false false false false false false false X 13 13 false true false false false false false true true false true true true true true true true true true false false X CHUCK JEFFRESS 9794152208 100 MEDICAL DRIVE Lake Jackson TX 77566 X MARY RUTH RHODENBAUGH 1.0 X DR MARK BONNEN 1.0 X BLANCA BUSTOS 1.0 X TOM FOWLER 1.0 X X DR FRANK GRADY 1.0 X DR HARVEY RESNICK 1.0 X BROOKS BASS 1.0 X X KEN SMITH 1.0 X X JIM MARTIN 1.0 X X ED SPEED 1.0 X X EVELYN MOORE 1.0 X MARK DAVIS 1.0 X BLAIR KRELL MD 1.0 X CANDICE FONKE 40.0 X 154790 6986 ALFRED GUEVARA 40.0 X 268642 13520 DAN BUCHE 40.0 X 0 0 0 CHUCK JEFFRESS 40.0 X 0 0 0 AHMET BULUT 40.0 X 185552 0 19062 DANNY TRAN 40.0 X 127428 0 18875 BRIAN STACKS 40.0 X 130046 0 1695 SCOTT BRINER 40.0 X 153214 18738 JOAN BETH BELL 40.0 X 122332 7769 1142004 0 86645 17 false true false ARAMARK HEALTHCARE FACILITIES JPM LOCKBOX 24863 NETWORK PLACE CHICAGO IL 606731248 CONTRACT LABOR 2678095 MILESTONE HEALTHCARE INC L-3542 COLUMBUS OH 43260 CONTRACT LABOR 928672 ANGELICA CORPORATION 1441 LATHROP HOUSTON TX 77020 LAUNDRY 501878 INPATIENT SERVICES OF TEXAS 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 HOSPITALIST 488252 MEDICAL INFORMATION TECHNOLOGY INC MEDITECH CIRCLE WESTWOOD MA 02090 SOFTWARE MAINTENANCE 2396961 19 230373 230373 NET PATIENT REVENUE 621500 95646235 95646135 100 OTHER PATIENT SERVICES 621500 56319 56319 95702554 408230 408230 0 0 65350 65350 65350 65350 19725668 16213 18998436 727232 16213 743445 743445 0 0 0 CAFETERIA SALES 722210 394820 394820 COMMUNITY EDUCATION 611710 21895 21895 REBATES 900099 136739 136739 156741 156741 710195 97860147 96119169 100 1510505 0 0 0 0 443948 443948 17344 17344 28220187 22483891 5736296 160092 128074 32018 4961308 3969046 992262 2028849 1623079 405770 1788549 1788549 190370 190370 143801 143801 0 0 0 10052435 8012269 2040166 451884 361507 90377 1534652 1050132 484520 999950 20413 979537 0 1561495 1287913 273582 286896 103717 183179 0 2398 2398 1172130 929777 242353 0 4373802 3499042 874760 1128750 903000 225750 BAD DEBT EXPENSE 26767424 26767424 MEDICAL SUPPLIES 10103675 10103675 EQUIPMENT COSTS 720637 558614 162023 LOST CHARGES 185408 182868 2540 572010 469033 102977 97867994 82914766 14953228 0 18636 7627 5253501 0 0 0 13408095 12245078 0 0 0 0 9000 0 1628129 1619591 1657382 1803419 113582520 73626597 36630184 39955923 33052594 28559604 1000 1000 0 0 1223701 1133613 0 1647233 92882222 86973088 6199418 6955954 0 0 0 0 22579558 21368302 0 0 0 0 3769093 2809456 0 0 3685533 3577222 36233602 34710934 X 56648620 52262154 0 0 0 0 56648620 52262154 92882222 86973088 X -7847 -4378619 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1530296 1530296 39824713 17704038 22570949 1250918 1102301 259523 63189678 54820258 13208169 849786 0 2386986 39955923 0 MALPRACTIVE RESERVE 1768592 ESTIMATED AMOUNTS DUE TO THIRD PARTY 1334760 CAPITAL LEASE 473870 3577222 97860147 97867994 -7847 -3526736 8122 -3518614 -3526461 96958411 -3526736 2625000 -901736 97860147 97860147 100484872 2625000 2625000 97859872 8122 8122 97867994 RECONCILIATION OF CHANGE IN NET ASSETS FROM FORM 990 TO FINANCIALS Sch D, Part XI, LINE 8 TRANSFERS TO AFFILIATES $8,122 RECONCILIATION OF REVENUE AND EXPENSES PER AUDITED F/S WITH RETURN Sch D, Part XII AND PART XIII, LINE 2D ADJUSTMENT FOR AFFILIATION AGREEMENT CONTRIBUTION $2,625,000 RECONCILIATION OF EXPENSES PER AUDITED F/S WITH RETURN SCHEDULE D, PART XIII, LINE 2D TRANSFER TO AFFILIATES $8,122 FIN 48 FOOTNOTE SCHEDULE D, PART X, LINE 2 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 true X true X true true false false 564319 0 564319 0.00790 6962371 6697141 265230 0.00370 1078082 1105552 -27470 8604772 7802693 802079 0.01160 0 0 0 0.00000 0 0 0 0.00000 7278315 5989354 1288961 0.01810 0 0 0 0.00000 38867 0 38867 0.00050 7317182 5989354 1327828 0.01860 15921954 13792047 2129907 0.03020 false 26767424 24920142 25707449 -787307 X true true 1 1 COMMUNITY HOSPITAL OF BRAZOSPORT

100 MEDICAL DRIVE LAKE JACKSON TX 77566

X X X URGENT CARE CENTER COMMUNITY HOSPITAL OF BRAZOSPORT 1 false 11 true true 200. true 400. true X X X X X X X true true X X X X true false X X X true X false false BAD DEBT EXPENSE PART 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. MEDICARE PART 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 PRACTICES PART 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 EXPENSE PART I, LINE 7, COLUMN F BAD 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 ASSISTANCE SCHEDULE H, PART V, LINE 19D THE 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 POLICY SCHEDULE H, PART V, QUESTION 13G THE 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 COLLECTIONS SCHEDULE H, PART V, LINE 15, 16, & 17 NEITHER 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. X true true X false false false false false false false false false AHMET BULUT 183438 0 0 0 2114 0 1893 0 17169 0 204614 0 0 0 SCOTT BRINER 132618 10000 10596 1569 17169 171952 0 CANDICE FONKE 137997 5000 11793 465 6521 161776 0 ALFRED GUEVARA 216710 28352 23580 2724 10796 282162 Travel for companions Sch J, Part I, Question 1a The 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. BRAZORIA COUNTY HEALTH FACILITIES DEVELOPMENT CORP 531306936 106045CR6 2004-08-31 28625115 series 2004 hospital revenue bond false false false 0 0 28625115 2223423 0 10233389 498450 1145313 0 14524541 0 0 2006 true false true true false false false false false false 0.00000 0.00000 0.00000 true true false false 0 false 0 false false Janice Buche spouse of BRHS officer 17344 Salaries/Wages false Describe delegation of control over management duties Form 990, Part VI, Question 3 The 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 & enforced Form 990, Part VI, Question 12c Annual disclosures are filled out by the board members which are then kept on file by the board secretary. Describe process for determining compensation Form 990, Part VI, Question 15a Review 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 public Form 990, Part VI, Question 19 The organization's governing documents are made available to the public upon request. Describe review process of Form 990 by organization's governing body Form 990, Part VI, Question 11 A 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 BALANCES FORM 990, PAGE 12, PART XI, LINE 5 INTERCOMPANY TRANSFER $ (851,878) UNREALIZED GAINS & LOSSES (3,526,736) ------------ $(4,378,614) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DR. MARK BONNEN TITLE:MEMBER HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAN BUCHE TITLE:CEO HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CHUCK JEFFRESS TITLE:CFO HOURS:1 Brazosport Health Foundation PO Box 90 Lake Jackson TX 77566 760080110 Fundraising TX 501(C)(3) 11A BRHS true BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DR LAKE JACKSON TX 77566 800240261 HEALTHCARE TX 501(C)(3) 3 BRHS true Diversified Health Resources 100 Medical Drive Lake Jackson TX 77566 760222679 HEALTH CARE TX BRHS C CORPORATION -3721 36180 1.00000 Brazosport Health Alliance 129 circle way st suite a lake jackson TX 77566 760518376 health care TX BRHS C Corporation 30915 156089 1.00000 false false true false false false false false false false false false false false false true false false Brazosport Health Foundation c 230373 FMV