2012-05-11T18:43:04-04:00 2011-06-30 ERNST & YOUNG US LLP 55 IVAN ALLEN BLVD SUITE 1000 ATLANTA GA 30308 990 2010-07-01 743019849 St Mark's Medical Center STMA 9792422200 ONE ST MARKS PLACE LA GRANGE TX 789452040 Nathan Staggs 3080830903 2012-05-15 4048748300 2010 2016-02-24 21:20:13Z NATHAN STAGGS ONE ST MARKS PLACE LA GRANGE TX 789452040 29254143 false X WWW.STMARKSMEDICALCENTER.ORG X 2001 TX To provide quality, commpassionate health care and promote wellness for our community through modern technology and caring professionals. 10 9 289 7 0 0 270453 161347 27454201 28086820 33899 82377 158858 518676 27917411 28849220 0 0 0 0 9511714 10507821 0 0 0 18146031 17707075 27657745 28214896 259666 634324 29930062 40815724 29254612 30764493 675450 10051231 To provide quality, commpassionate health care and promote wellness for our community through modern technology and caring professionals. false false 23366000 0 28086820 See Schedule O 23366000 true true false false false false false false false true true false false true false true true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false false false false true 34 0 true 289 true false false false false false false false false false false X 10 9 true true true false true true true true true false false true true true true true true false true false X DENNIS BOYD 9792422111 ONE ST MARKS PLACE LA GRANGE TX 789452040 J Weldon Koenig 1.0 X X 0 0 0 Linda Adkins 1.0 X X 0 0 0 Joe Bailey 1.0 X 0 0 0 Albert Chorens MD 1.0 X 0 0 0 Bonnie Sue Holt 1.0 X X 0 0 0 Ronald Clay Rightmer 1.0 X 0 0 0 Mark Clayton 1.0 X 0 0 0 Allyson Borgstedte DO 1.0 X 0 0 0 Thomas Borgstedte DO 1.0 X 0 0 0 Michael D Williams 1.0 X 0 1074526 34315 Nathan Staggs 40.0 X 0 224110 26262 Dennis Boyd 40.0 X 0 149862 26563 Carol Drozd 40.0 X 109577 0 0 Tammy Hartfield 40.0 X 103754 0 0 213331 1448498 87140 2 false true false 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 8 18236 90587 52524 161347 Net patient service revenue 622110 13978578 13978578 Medicare/Medicaid payments 622110 14108242 14108242 28086820 82377 82377 0 0 736424 404923 331501 331501 331501 0 0 0 0 Vending / Cafeteria 722210 174717 174717 OTHER REVENUE 900099 12458 12458 187175 28849220 28086820 601053 0 0 0 0 604812 604812 0 7678149 6516917 1161232 0 1592712 1550284 42428 632148 534563 97585 0 79662 79662 270245 270245 0 0 0 4615806 3596956 1018850 55696 55696 3575963 3392922 183041 0 0 1966858 962176 1004682 57565 24794 32771 0 0 150369 150369 0 1703113 1703113 227455 110312 117143 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 28214896 23366000 4848896 0 793030 2187239 15325 8179 44996 0 2884009 2254967 712150 582681 662378 703669 281541 633253 29470745 830336 18372987 28640409 4339492 4697649 750000 1824154 357678 29930062 40815724 3805166 3959067 80213 0 23214428 20926429 475000 4423801 1679805 1455196 29254612 30764493 X 675450 10051231 675450 10051231 29930062 40815724 X 634324 8741457 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1065980 1065980 21246417 285104 20961313 4148731 545232 3603499 3009617 3009617 28640409 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 4697649 0 Advances from SMMC Foundation 1315026 OTHER 140170 1455196 28849220 28214896 634324 634324 28849220 28849220 28849220 28214896 28214896 28214896 true true X true X true X 150. true true false true false 930404 1895477 -965073 0.03790 2473748 1053689 1420059 0.05570 260379 43248 217131 0.00850 3664531 2992414 672117 0.02630 0 0 0 0.00000 0 0 0 0.00000 0 0 0 0.00000 0 0 0 0.00000 0 0 0 0.00000 0 0 0 0.00000 3664531 2992414 672117 0.02630 true 1352780 86700 10523263 10735235 -211972 X true true 1 1 ST MARK'S MEDICAL CENTER

ONE ST MARKS PLACE LA GRANGE TX 78945

X X X ST MARK'S MEDICAL CENTER 1 true true 100 true 150. true X X X X true true X X X X X X true X true X X X X X true X true true SUPPLEMENTAL INFORMATION SCHEDULE H PART VI QUESTIONS 1 THROUGH 7 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 false true false false false true false false false 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 Supplemental Compensation Information 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. FAYETTE COUNTY HEALTH FACILITIES DEVELOPMENT CORP 742914989 312525AY4 2004-03-25 26044533 New Facility Construction false false false 5118104 0 26044533 1703000 0 0 520308 958810 185000 22681477 0 0 2005 false false true true false false false false true 0.00000 0.00000 0.00000 true true false false false false true 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 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 COMMUNITY HEALTH ASSURANCE SPC LTD POB 69GT CAYMAN ISLANDS GRAND CAYMAN CJ CAPTIVE INSURANCE CJ NA C CORP CHC ACQUISITION CORP 5801 TENNYSON PKWY STE 550 PLANO TX 75024 752750360 CONSULTING TX NA C CORP COMMUNITY HOSPITAL CONSULTING INC 5801 TENNYSON PKWY STE 550 PLANO TX 75024 204710183 MGMT CONSULTING TX NA C CORP false false false false false false false false false false false false false true true false false false