ST MARKS MEDICAL CENTER: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- ST MARKS MEDICAL CENTER (EIN 74-3019849)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-11
- IRS object ID
- 201231329349303573
- Schema version
- 2010v3.7
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-11T18:43:04-04:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 IVAN ALLEN BLVD SUITE 1000 | AddressLine1 |
| City | ATLANTA | City |
| State | GA | State |
| ZIP Code | 30308 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 743019849 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Mark's Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STMA | NameControl |
| Phone | 9792422200 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE ST MARKS PLACE | AddressLine1 |
| City | LA GRANGE | City |
| State | TX | State |
| ZIP Code | 789452040 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Nathan Staggs | Name |
| Title | CEO | Title |
| Phone | 3080830903 | Phone |
| Date Signed | 2012-05-15 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4048748300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | NATHAN STAGGS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE ST MARKS PLACE | AddressLine1 |
| City | LA GRANGE | City |
| State | TX | State |
| ZIP Code | 789452040 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 29254143 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.STMARKSMEDICALCENTER.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2001 | YearFormation |
| State Legal Domicile | TX | StateLegalDomicile |
| Activity Or Mission Description | To provide quality, commpassionate health care and promote wellness for our community through modern technology and caring professionals. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 289 | TotalNbrEmployees |
| Total Nbr Volunteers | 7 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 270453 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 161347 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 27454201 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 28086820 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 33899 | InvestmentIncomePriorYear |
| Investment Income Current Year | 82377 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 158858 | OtherRevenuePriorYear |
| Other Revenue Current Year | 518676 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 27917411 | TotalRevenuePriorYear |
| Total Revenue Current Year | 28849220 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9511714 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10507821 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 18146031 | OtherExpensePriorYear |
| Other Expenses Current Year | 17707075 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 27657745 | TotalExpensesPriorYear |
| Total Expenses Current Year | 28214896 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 259666 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 634324 | RevenuesLessExpensesCY |
| Total Assets BOY | 29930062 | TotalAssetsBOY |
| Total Assets EOY | 40815724 | TotalAssetsEOY |
| Total Liabilities BOY | 29254612 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 30764493 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 675450 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 10051231 | NetAssetsOrFundBalancesEOY |
| Mission Description | To provide quality, commpassionate health care and promote wellness for our community through modern technology and caring professionals. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 23366000 | Expense |
| Grants | 0 | Grants |
| Revenue | 28086820 | Revenue |
| Description | See Schedule O | Description |
| Total Program Service Expense | 23366000 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 34 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 289 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DENNIS BOYD | NamePerson |
| Telephone Number | 9792422111 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE ST MARKS PLACE | AddressLine1 |
| City | LA GRANGE | City |
| State | TX | State |
| ZIP Code | 789452040 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| J Weldon Koenig | ||||||||
| Chairman | 1.0 | X | X | 0 | 0 | 0 | ||
| Linda Adkins | ||||||||
| Secretary | 1.0 | X | X | 0 | 0 | 0 | ||
| Joe Bailey | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Albert Chorens MD | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Bonnie Sue Holt | ||||||||
| DIRECTOR | 1.0 | X | X | 0 | 0 | 0 | ||
| Ronald Clay Rightmer | ||||||||
| Director (7/22/10) | 1.0 | X | 0 | 0 | 0 | |||
| Mark Clayton | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Allyson Borgstedte DO | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Thomas Borgstedte DO | ||||||||
| Director | 1.0 | X | 0 | 0 | 0 | |||
| Michael D Williams | ||||||||
| Director | 1.0 | X | 0 | 1074526 | 34315 | |||
| Nathan Staggs | ||||||||
| CEO | 40.0 | X | 0 | 224110 | 26262 | |||
| Dennis Boyd | ||||||||
| CFO | 40.0 | 0 | 149862 | 26563 | X | |||
| Carol Drozd | ||||||||
| COO | 40.0 | 109577 | 0 | 0 | X | |||
| Tammy Hartfield | ||||||||
| CNO | 40.0 | 103754 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 213331 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1448498 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 87140 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Rehabilitation Services | |||||
| Two St Marks Place - Suite 120 | LA GRANGE | TX | 78945 | Rehab services | 631490 |
| Prince Foods | |||||
| 11001 Wilcrest Drive 200 | HOUSTON | TX | 77099 | Dietary | 385148 |
| Lorry Beck | |||||
| 4515 FM154 | MULDOON | TX | 78947 | Ultrasound | 274850 |
| Hunter Pharmacy | |||||
| 3420 Executive Center Drive 100 | AUSTIN | TX | 78731 | Pharmacy | 191734 |
| Premier Sleep | |||||
| 111 Northpark Drive | VICTORIA | TX | 77901 | Sleep Studies | 160600 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Related Organizations | 18236 | RelatedOrganizations |
| Government Grants | 90587 | GovernmentGrants |
| All Other Contributions | 52524 | AllOtherContributions |
| Total Contributions | 161347 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net patient service revenue | 622110 | 13978578 | 13978578 |
| Medicare/Medicaid payments | 622110 | 14108242 | 14108242 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 28086820 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 82377 | TotalRevenueColumn |
| Exclusion | $82,377 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 736424 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 404923 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 331501 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 331501 | TotalRevenueColumn |
| Exclusion | $331,501 | ExclusionAmount |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Vending / Cafeteria | 722210 | 174717 | $174,717 |
| OTHER REVENUE | 900099 | 12458 | $12,458 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 187175 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 28849220 | TotalRevenueColumn |
| Related Or Exempt Function Income | 28086820 | RelatedOrExemptFunctionIncome |
| Exclusion | $601,053 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 604812 | Total |
| Management And General | 604812 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7678149 | Total |
| Program Services | 6516917 | ProgramServices |
| Management And General | 1161232 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1592712 | Total |
| Program Services | 1550284 | ProgramServices |
| Management And General | 42428 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 632148 | Total |
| Program Services | 534563 | ProgramServices |
| Management And General | 97585 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 79662 | Total |
| Management And General | 79662 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 270245 | Total |
| Management And General | 270245 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4615806 | Total |
| Program Services | 3596956 | ProgramServices |
| Management And General | 1018850 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55696 | Total |
| Management And General | 55696 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3575963 | Total |
| Program Services | 3392922 | ProgramServices |
| Management And General | 183041 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1966858 | Total |
| Program Services | 962176 | ProgramServices |
| Management And General | 1004682 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57565 | Total |
| Program Services | 24794 | ProgramServices |
| Management And General | 32771 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150369 | Total |
| Management And General | 150369 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1703113 | Total |
| Program Services | 1703113 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 227455 | Total |
| Program Services | 110312 | ProgramServices |
| Management And General | 117143 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad debt expense | 2742862 | 2742862 | |
| Leases and rentals | 776400 | 764132 | 12268 |
| LABORATORY REAGENTS | 625622 | 625622 | |
| Repairs and maintenance | 234621 | 216509 | 18112 |
| SERVICE CONTRACTS | 624838 | 624838 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28214896 | Total |
| Program Services | 23366000 | ProgramServices |
| Management And General | 4848896 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 793030 | BOY |
| EOY | 2187239 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15325 | BOY |
| EOY | 8179 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44996 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2884009 | BOY |
| EOY | 2254967 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 712150 | BOY |
| EOY | 582681 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 662378 | BOY |
| EOY | 703669 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 281541 | BOY |
| EOY | 633253 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 29470745 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 830336 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18372987 | BOY |
| EOY | 28640409 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4339492 | BOY |
| EOY | 4697649 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 750000 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1824154 | BOY |
| EOY | 357678 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29930062 | BOY |
| EOY | 40815724 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3805166 | BOY |
| EOY | 3959067 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 80213 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23214428 | BOY |
| EOY | 20926429 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 475000 | BOY |
| EOY | 4423801 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1679805 | BOY |
| EOY | 1455196 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29254612 | BOY |
| EOY | 30764493 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 675450 | BOY |
| EOY | 10051231 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 675450 | BOY |
| EOY | 10051231 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29930062 | BOY |
| EOY | 40815724 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 634324 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 8741457 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1065980 | OtherCostOrOtherBasis |
| Book Value | 1065980 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21246417 | OtherCostOrOtherBasis |
| Depreciation | 285104 | Depreciation |
| Book Value | 20961313 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4148731 | OtherCostOrOtherBasis |
| Depreciation | 545232 | Depreciation |
| Book Value | 3603499 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3009617 | OtherCostOrOtherBasis |
| Book Value | 3009617 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 28640409 | TotalOfBookValueLandBuildings |
| Financial Derivatives | FinancialDerivatives | |
| Closely Held Equity Interests | CloselyHeldEquityInterests |
Other Securities OtherSecurities (7 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Bond Debt Service Fund | 575019 | F |
| Bond Surplus Fund | 23511 | F |
| Bond Reserve Account | 1703000 | F |
| Mortgage Reserve Fund | 1974013 | F |
| Collateral Fund | 333955 | F |
| INTEREST RECEIVABLE-BOND FUNDS | 19624 | F |
| Escrow Reserves | 68527 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 4697649 | TotalOfBookValueSecurities |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Advances from SMMC Foundation | $1,315,026 |
| OTHER | $140,170 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1455196 | TotalOfAmounts |
| Total Revenue | 28849220 | TotalRevenue |
| Total Expenses | 28214896 | TotalExpenses |
| Excess Or Deficit For Year | 634324 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 634324 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 28849220 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 28849220 | RevenueSubtotal |
| Total Revenue Per Form990 | 28849220 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 28214896 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 28214896 | ExpensesSubtotal |
| Total Expenses Per Form990 | 28214896 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 150. | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | false | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 930404 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1895477 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -965073 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03790 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2473748 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1053689 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1420059 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05570 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 260379 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 43248 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 217131 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00850 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3664531 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2992414 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 672117 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02630 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3664531 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2992414 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 672117 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02630 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,352,780 | BadDebtExpenseAmount |
| Amount Attributable To | 86700 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 10523263 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 10735235 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -211972 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARK'S MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE ST MARKS PLACE | AddressLine1 |
| City | LA GRANGE | City |
| State | TX | State |
| ZIP Code | 78945 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARK'S MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 150. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Other Factors | X | OtherFactors |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | true | AmountsGenerallyBilled |
| Gross Charges | true | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | SCHEDULE H PART VI QUESTIONS 1 THROUGH 7 | ReturnReference |
| Explanation | PART I, LINE 3C Used the Federal Poverty Guidelines. Can qualify for partial charity up to 150% of Federal Poverty Guidelines. PART I, LINE 6A Our community benefit report for FY 2011 was prepared with the assistance of our corporate office. PART I, LINE 7 COLUMN F TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) WAS $28,214,896. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $2,742,862. THIS LEFT A TOTAL EXPENSE OF $25,472,034 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). PART I, LINE 7 Line 7A: Ratio of Cost to Charges for the patients that received a Charity Discount based on the hospitals cost accounting system. Line 7B: Ratio of cost to charges for the Medicaid Patients based on the hospitals cost accounting system. Line 7C: Ratio of cost to charges for CHIP Patients based on the hospitals cost accounting system. Line 7E: Actual expenses less any direct offsetting revenue Line 7F: Actual Expenses less any direct offsetting revenue. Line 7G: Ratio of cost to charges based on the hospitals cost accounting system. Line 7I: Actual expense of the contributions. PART III, LINE 4 The Medical Center reports patient accounts receivable for services rendered at net realizable amounts from government payers, managed care plans, patients and others. Amounts due from patients include both amounts due from uninsured patients and copayments and deductibles for which insured patients are responsible. As a service to the patient, the Medical Center 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. The Medical Center provides an allowance for doubtful accounts for estimated losses resulting from payers inability to make payments on accounts. The Medical Center estimates its allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. Accounts are considered delinquent and subsequently written off, based on individual credit evaluation and specific circumstances of the account. PART III, LINE 8 Medicare pays less than actual cost to provide those services. The hospital believes the shortfall is part of the community benefit provided by the hospital. Medicare is approximately 1/3 of our business from a cost standpoint. We are a community hospital that provides patient have easy access to health care at a reasonable distance from their home so they do not have to drive to the next town for emergency services and or inpatient services. The cost information provided was obtained from our Medicare cost report. PART III, LINE 9B If a Patient qualifies for partial charity, the balance on the account after application of the charity discount are handled consistent with the hospital's collection policy. PART V, SECTION B, LINE 11H ALL PATIENTS AND INSURANCES ARE BILLED AT 100% OF CHARGES. WE CONTRACTUALLY NEGOTIATE WITH PAYORS TO ACCEPT SOMETHING LESS THAN 100% OF CHARGES. MEDICARE PAYS ON FEE SCHEDULES AND DRG ETC. SELF PAY AND THOSE QUALIFYING FOR FINANCIAL ASSISTANCE ARE ALL BILLED AT 100% OF CHARGES UNTIL SUCH TIME IT IS DETERMINED THAT THEY QUALIFY FOR FINANCIAL ASSISTANCE. BASED UPON THE HOSPITALS FINANCIAL ASSISTANCE POLICY A PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE ON A SLIDING SCALE, UP TO A MAXIMUM OF 95%. PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE HAVE THEIR ACCOUNTS REDUCED BASED ON THE LEVEL OF FINANCIAL ASSISTANCE. THE BALANCE OF THE ACCOUNT AFTER APPLICATION OF THE DISCOUNT IS HANDLED CONSISTENT WITH THE HOSPITALS COLLECTION POLICY. PART V, SECTION B, LINE 13G Financial Assistance applications are available when registering, through discharge planning etc. Our statements for self pay have a tag line stating if they think they qualify for financial assistance to please call this number. Whenever a bill is discussed and a patient indicates they can't pay upfront, financial assistance is explained to them so that in the event it applies they know about it. It is also posted on bulletin boards through out the hospital that Financial Assistance is available. PART V, SECTION B, LINE 20 AND 21 ALL PATIENTS AND INSURANCES ARE BILLED AT 100% OF CHARGES. WE CONTRACTUALLY NEGOTIATE WITH PAYORS TO ACCEPT SOMETHING LESS THAN 100% OF CHARGES. MEDICARE PAYS ON FEE SCHEDULES AND DRG ETC. SELF PAY AND THOSE QUALIFYING FOR FINANCIAL ASSISTANCE ARE ALL BILLED AT 100% OF CHARGES UNTIL SUCH TIME IT IS DETERMINED THAT THEY QUALIFY FOR FINANCIAL ASSISTANCE. BASED UPON THE HOSPITALS FINANCIAL ASSISTANCE POLICY A PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE ON A SLIDING SCALE, UP TO A MAXIMUM OF 95%. PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE HAVE THEIR ACCOUNTS REDUCED BASED ON THE LEVEL OF FINANCIAL ASSISTANCE. THE BALANCE OF THE ACCOUNT AFTER APPLICATION OF THE DISCOUNT IS HANDLED CONSISTENT WITH THE HOSPITALS COLLECTION POLICY. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE All self pay with out ability to pay at time of service are referred to our Eligibility vendor. This allows them to be assessed for any programs that may cover their medical expenses such as Medicaid, county programs or any other state programs that may be available. STATE OF FILING OF COMMUNITY BENEFIT REPORT TEXAS | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | true | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Michael D Williams | |||||||||||||
| 0 | 617120 | 0 | 318397 | 0 | 139009 | 0 | 17107 | 0 | 17208 | 0 | 1108841 | 0 | 0 |
| Nathan Staggs | |||||||||||||
| 0 | 187779 | 0 | 27550 | 0 | 8781 | 0 | 10996 | 0 | 15266 | 0 | 250372 | 0 | 0 |
| Dennis Boyd | |||||||||||||
| 0 | 120546 | 0 | 8814 | 0 | 20502 | 0 | 6706 | 0 | 19857 | 0 | 176425 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Supplemental Compensation Information | Identifier |
| Explanation | THE ORGANIZATION'S EXECUTIVES ARE EMPLOYED BY THE PARENT ORGANIZATION, VHA SOUTHWEST COMMUNITY HEALTH CORPORATION (CHC), AND THEREFORE FOLLOW THE COMPENSATION POLICY OF CHC. CHC ENGAGED SULLIVAN COTTER TO CONDUCT A COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO ON JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITY, AND CURRENT INCUMBENTS' COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THE ORGANIZATION FOLLOWED THIS PROCESS FOR THE YEAR ENDED 6/30/2011 FOR ITS OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER MANAGEMENT OFFICIALS. SCHEDULE J, PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN PARTICIPATION WAS PAID TO: MICHAEL D. WILLIAMS - $141,442 SCHEDULE J, PART I, LINE 6A A portion of the discretionary incentive compensation program was based on the hospitals earnings before interest depreciation and amortization. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAYETTE COUNTY HEALTH FACILITIES DEVELOPMENT CORP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 742914989 | IssuerEIN |
| CUSIP Number | 312525AY4 | CUSIPNumber |
| Date Issued | 2004-03-25 | DateIssued |
| Issue Price | 26044533 | IssuePrice |
| Description Of Purpose | New Facility Construction | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Retired | 5118104 | AmountRetired |
| Amount Bond Defeased | 0 | AmountBondDefeased |
| Total Proceeds | 26044533 | TotalProceeds |
| Amount In Reserve Fund | 1703000 | AmountInReserveFund |
| Capitalized Interest | 0 | CapitalizedInterest |
| Refunding Escrow | 0 | RefundingEscrow |
| Issuance Costs From Proceeds | 520308 | IssuanceCostsFromProceeds |
| Credit Enhancement | 958810 | CreditEnhancement |
| Working Capital Expenditures | 185000 | WorkingCapitalExpenditures |
| Capital Expenditures | 22681477 | CapitalExpenditures |
| Other Spent Proceeds | 0 | OtherSpentProceeds |
| Amount Unspent | 0 | AmountUnspent |
| Year Of Subst Completion | 2005 | YearOfSubstCompletion |
| Current Refunding | false | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | false | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | false | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | false | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | true | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | true | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | true | Form8038TFiled |
| Variable Rate Issue | false | VariableRateIssue |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Exception To Rebate | true | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SCHEDULE O | SUPPLEMENTAL INFORMATION | Program Services Form 990, Part III, Question 4a St. Mark's Medical Center (SMMC) is a community health provider that serves the community regardless of any individual's race, creed, nationality, or ability to pay for services including inpatient, outpatient and emergency care in support of the Hospital's healthcare mission. During the year ended June 30, 2011, we had 2,313 admissions, 8,829 patient days, 10,344 ER Visits, 739 inpatient surgeries and 1,308 outpatient surgeries. SMMC utilizes the most advanced technologies rivaling those of major cities in a comfortable environment close to home. We offer inpatient, outpatient, and emergency services with compassionate care, focusing on respect and care for the whole person. SMMC isn't just convenient, it's a place for advanced medical care that just happens to be close to home. St. Mark's has the expertise and resources for you and your family. Working together, our goal is to provide members of the community with "Advanced Hometown Healthcare." St. Mark's is a hospital designed to change the way you think about hospitals. From advanced technologies that rival those of major metropolitan institutions, to a level of service surpassing that of any hospital anywhere, we are making "Advanced Hometown Healthcare" the center of everything we do. Our guiding principles focus on respect and care for the whole person, with our beliefs centered on the Golden Rule as the standard by which we treat every patient. At St. Mark's Medical Center, we are determined to build an unrivaled reputation for our outstanding service and delivery of care. We offer advanced services and programs including a serene birthing center, specialty clinics, comprehensive public health services and specialized nutrition programs for women, infants and children. Best of all, St. Mark's brings all of this within reach, so you don't have to travel to get the care you need. DESCRIPTION OF MANAGEMENT ARRANGEMENT FORM 990, PART VI, QUESTION 3 VHA SOUTHWEST COMMUNITY HEALTH CORPORATION D/B/A COMMUNITY HOSPITAL CORPORATION (CHC) PROVIDES CERTAIN FINANCIAL, TECHNICAL AND MANAGERIAL SUPPORT SERVICES TO THE HOSPITAL. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 VHA SOUTHWEST COMMUNITY HEALTH CORPORATION, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF SAINT MARK'S MEDICAL CENTER. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, QUESTION 7A VHA SOUTHWEST COMMUNITY HOSPITAL CORPORATION ("CHC") AS THE SOLE MEMBER OF SAINT MARK'S MEDICAL CENTER ("SMMC") ELECTS THE MEMBERS OF THE BOARD OF DIRECTORS OF SMMC AND IS EMPOWERED WITH THE ABILITY TO REMOVE DIRECTORS, WITH OR WITHOUT CAUSE. DESCR CLASSES OF PERSONS/DECISIONS REQUIRING APPR/TYPE OF VOTING RIGHTS FORM 990, PART VI, QUESTION 7B RESERVED POWERS OF THE MEMBER: WHILE THE AFFAIRS OF THE CORPORATION SHALL BE MANAGED BY ITS BOARD OF DIRECTORS, THE APPROVAL OF THE MEMBER FOLLOWING APPROVAL BY THE BOARD OF DIRECTORS SHALL BE NECESSARY FOR THE FOLLOWING MATTERS: (a) THE ESTABLISHMENT OF OR ANY CHANGE IN THE ACTIVITIES, PHILOSOPHY, MISSION OR PURPOSE OF THE CORPORATION AS SET BY THE MEMBER; (b) ANY AMENDMENTS OR REVISIONS TO THE CERTIFICATE OF FORMATION OR BYLAWS OF THE CORPORATION; (c) ANY AMENDMENTS OR REVISIONS OF THE CERTIFICATE OF FORMATION OR BYLAWS OF ANY SUBSIDIARY CORPORATION OF THE CORPORATION; (d) THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY, PARTNERSHIP OR VENTURE; (e) ANY AMENDMENT, REVISION OR TERMINATION OF THE PARTNERSHIP AGREEMENT OF ANY PARTNERSHIP OR REGULATIONS OF ANY LIMITED LIABILITY COMPANY TO WHICH THE CORPORATION IS A PARTY; (f) THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; (g) ALL MATERIAL EXPENDITURE DEVIATIONS ($25,000 IN ANY SINGLE OR SERIES OF TRANSACTIONS) FROM THE ANNUAL OPERATING AND CAPITAL BUDGETS; (h) THE PURCHASE OR ACQUISITION OF ANY REAL PERSONAL, OR MIXED PROPERTY BY THE CORPORATION IN EXCESS OF $25,000 THAT IS NOT PROVIDED FOR IN THE CORPORATION'S ANNUAL OPERATING OR CAPITAL BUDGETS; (i) THE SALE, MORTGAGE, ENCUMBRANCE, TRANSFER, LEASE, GIFT, OR OTHER DISPOSITION OF ANY REAL PROPERTY OF THE CORPORATION; (j) ANY SALE, GIFT, EXCHANGE, LEASE, MORTGAGE OR OTHER TRANSFER OR ENCUMBRANCE (COLLECTIVELY, "TRANSFER") OF THE PERSONAL PROPERTY OF THE CORPORATION (TANGIBLE OR INTANGIBLE) IF THE SUM OF SUCH TRANSFER AND THE SUM OF ALL PRIOR TRANSFERS PER FISCAL YEAR, EXCEED $50,000.00; (k) ANY DEBT OR FINANCING ARRANGEMENT OF THIS CORPORATION, EXCEPT USUAL AND CUSTOMARY TRADE DEBTS WHICH IS INCURRED IN THE ORDINARY COURSE OF BUSINESS OF THE CORPORATION; (l) SETTLEMENT OF ANY CLAIMS OR LITIGATION INVOLVING THE CORPORATION; (m) THE MERGER, DISSOLUTION, OR CONSOLIDATION OF THE CORPORATION OR SUBSIDIARY CORPORATION; (n) THE EXECUTION, REVISION, AMENDMENT, EXTENSION, NON-RENEWAL OR TERMINATION OF ANY MANAGEMENT, EMPLOYMENT, LEASE, OR SERVICE CONTRACT, WITH AN ANNUAL COMPENSATION IN EXCESS OF $30,000 OR AN AGGREGATE COMPENSATION IN EXCESS OF $50,000; (o) ANY DEBTS, LOANS, GUARANTIES, OR GRANTS NOT INCLUDED AND APPROVED AS PART OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS; (p) THE ELECTION OF THE MEMBERS OF THE BOARD OF DIRECTORS OR THE REMOVAL OF SAID BOARD MEMBER, WHETHER WITH OR WITHOUT CAUSE; (q) THE APPROVAL OF THE EMPLOYEE POLICIES AND BENEFITS PROGRAMS OF THE CORPORATION; (r) THE APPROVAL OF MAJOR DEVELOPMENT CAMPAIGNS AND FUND-RAISING; AND (s) THE APPROVAL OF THE FINANCE MANAGEMENT SYSTEM FOR THE CORPORATION. Officer, Director, Trustee, Key Employee Family Relationship or Business relationship Form 990, Part VI, Question 2 DR. THOMAS BORGSTEDTE AND DR. ALLYSON BORGSTEDTE ARE MARRIED. |
| DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 | FORM 990, PART VI, QUESTION 11B | 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. ELECTRONIC COPIES ARE PROVIDED TO EACH BOARD MEMBER VIA EMAIL UPON COMPLETION OF THE FORM PRIOR TO FILING WITH THE IRS. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C A FINANCIAL INTEREST IS NOT NECESSARILY A CONFLICT OF INTEREST. A PERSON WHO HAS A FINANCIAL INTEREST MAY HAVE A CONFLICT OF INTEREST ONLY IF THE APPROPRIATE BOARD OR COMMITTEE DECIDES THAT A CONFLICT OF INTEREST EXISTS. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST. (1)AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. (2)THE CHAIR OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. (3)AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. (4)IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE AND DISCIPLINARY AND CORRECTIVE ACTION. |
| OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN | FORM 990, PART VI, QUESTIONS 15A & 15B | THE ORGANIZATION'S EXECUTIVES, INCLUDING THE CEO, ARE EMPLOYED BY THE PARENT ORGANIZATION CHC AND THEREFORE FOLLOW THE COMPENSATION POLICY OF CHC. CHC ENGAGED SULLIVAN COTTER TO CONDUCT A COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO ON JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITY, AND CURRENT INCUMBENTS' COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THIS PROCESS IS PERFORMED EACH YEAR PRIOR TO THE ANNUAL EMPLOYEE EVALUATION PROCESS, WHICH ENDS ON JULY 1ST OF EACH YEAR. |
| GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AVAILABLE TO PUBLIC | FORM 990, PART VI, QUESTION 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE AT ITS BUSINESS OFFICE UPON REQUEST. |
| NET ASSET RECONCILIATION | FORM 990, PART XI, LINE 5 | $8,741,457 fair value adjustment resulting from CHC purchase as required by Accounting Standards Codifications 958-805. All assets and liabilities were revalued as of the aquisition date of 1/1/2011 to fair value. |
| AVERAGE RELATED HOURS DISCLOSURE | PART VII, SECTION A, COLUMN B | ESTIMATED HOURS WORKED BY OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES AT RELATED ENTITIES: MICHAEL D. WILLIAMS: VHASW COMMUNITY HEALTH CORPORATION - 32 HOURS BAPTIST HOSPITALS OF SE TEXAS - 1 HOUR CHC COMMUNITY CARE - 1 HOUR CONTINUECARE HOSPITAL OF TYLER - 1 HOUR YOAKUM COMMUNITY HOSPITAL - 1 HOUR COMMUNITY HOSPITAL CONSULTING, INC. - 8 HOUR SOUTHWEST COMMUNITY HOSPITAL - 0.01 HOUR J WELDON KOENIG: VHASW COMMUNITY HEALTH CORPORATION - 1 HOUR |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| BAPTIST HOSPITAL OF SE TEXAS | |||||||||
| POST OFFICE BOX 1591 | BEAUMONT | TX | 77704 | 741303720 | HOSPITAL | TX | 501(C)(3) | 3 | SW CH INC |
| BAPTIST PHYSICIAN NETWORK | |||||||||
| 3080 COLLEGE STREET | BEAUMONT | TX | 77701 | 760453250 | PRIMARY CARE | TX | 501(C)(3) | 3 | BP HSP SETX |
| LAIRD MEMORIAL HOSPITAL | |||||||||
| 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 020643367 | HOSPITAL | TX | 501(C)(3) | 3 | CHC |
| SOUTHWEST COMMUNITY HOSPITAL INC | |||||||||
| 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 752725353 | HOSPITAL | TX | 501(C)(3) | 3 | CHC |
| YOAKUM COMMUNITY HOSPITAL | |||||||||
| 1200 CARL RAMERT DRIVE | YOAKUM | TX | 77995 | 742323822 | HOSPITAL | TX | 501(C)(3) | 3 | CHC |
| CONTINUECARE HOSPITAL OF TYLER | |||||||||
| 800 E DAWSON STREET | TYLER | TX | 75701 | 200991990 | HOSPITAL | TX | 501(C)(3) | 3 | CHC CM CARE |
| CONTINUECARE HOSPITAL OF SE TEXAS | |||||||||
| 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 201150480 | HOSPITAL | TX | 501(C)(3) | 3 | CHC CM CARE |
| ARTESIA GENERAL HOSPITAL | |||||||||
| 702 NORTH 13TH STREET | ARTESIA | NM | 88210 | 742851819 | HOSPITAL | TX | 501(C)(3) | 3 | CHC |
| CHC COMMUNITY CARE LLC | |||||||||
| 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 371485773 | SUPPORT ORG | TX | 501(C)(3) | 11C | CHC |
| VHASW COMMUNITY HEALTH CORPORATION | |||||||||
| 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 752638469 | SUPPORT ORG | TX | 501(C)(3) | 11D | NA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Legal Domicile StateLegalDomicileState |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH ASSURANCE SPC LTD | |||||||||||||
| POB 69GT | CAYMAN ISLANDS | GRAND CAYMAN | CJ | CAPTIVE INSURANCE | CJ | NA | C CORP | ||||||
| CHC ACQUISITION CORP | |||||||||||||
| CONSULTING | NA | C CORP | 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 752750360 | TX | |||||
| COMMUNITY HOSPITAL CONSULTING INC | |||||||||||||
| MGMT CONSULTING | NA | C CORP | 5801 TENNYSON PKWY STE 550 | PLANO | TX | 75024 | 204710183 | TX | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
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