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      <LessCostOthBasisSalesExpenses>
        <Other>0</Other>
      </LessCostOthBasisSalesExpenses>
      <GainOrLoss>
        <Other>107</Other>
      </GainOrLoss>
      <NetGainOrLossInvestments>
        <TotalRevenueColumn>107</TotalRevenueColumn>
        <ExclusionAmount>107</ExclusionAmount>
      </NetGainOrLossInvestments>
      <NetIncomeFromFundraisingEvents>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromFundraisingEvents>
      <NetIncomeFromGaming>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeFromGaming>
      <NetIncomeOrLoss>
        <TotalRevenueColumn>0</TotalRevenueColumn>
      </NetIncomeOrLoss>
      <OtherRevenueMisc>
        <Description>VENDING INCOME</Description>
        <BusinessCode>722210</BusinessCode>
        <TotalRevenueColumn>3625</TotalRevenueColumn>
        <ExclusionAmount>3625</ExclusionAmount>
      </OtherRevenueMisc>
      <OtherRevenueMisc>
        <Description>CAFETERIA INCOME</Description>
        <BusinessCode>722210</BusinessCode>
        <TotalRevenueColumn>20381</TotalRevenueColumn>
        <ExclusionAmount>20381</ExclusionAmount>
      </OtherRevenueMisc>
      <TotalOtherRevenue>24006</TotalOtherRevenue>
      <TotalRevenue>
        <TotalRevenueColumn>17442784</TotalRevenueColumn>
        <RelatedOrExemptFunctionIncome>17397171</RelatedOrExemptFunctionIncome>
        <ExclusionAmount>24113</ExclusionAmount>
      </TotalRevenue>
      <GrantsToDomesticOrgs>
        <Total>94182</Total>
        <ProgramServices>94182</ProgramServices>
      </GrantsToDomesticOrgs>
      <GrantsToDomesticIndividuals>
        <Total>0</Total>
      </GrantsToDomesticIndividuals>
      <ForeignGrants>
        <Total>0</Total>
      </ForeignGrants>
      <BenefitsToMembers>
        <Total>0</Total>
      </BenefitsToMembers>
      <CompCurrentOfficersDirectors>
        <Total>38490</Total>
        <ManagementAndGeneral>38490</ManagementAndGeneral>
      </CompCurrentOfficersDirectors>
      <CompDisqualPersons>
        <Total>0</Total>
      </CompDisqualPersons>
      <OtherSalariesAndWages>
        <Total>5453126</Total>
        <ProgramServices>4503125</ProgramServices>
        <ManagementAndGeneral>950001</ManagementAndGeneral>
      </OtherSalariesAndWages>
      <PensionPlanContributions>
        <Total>0</Total>
      </PensionPlanContributions>
      <OtherEmployeeBenefits>
        <Total>1303653</Total>
        <ProgramServices>1068995</ProgramServices>
        <ManagementAndGeneral>234658</ManagementAndGeneral>
      </OtherEmployeeBenefits>
      <PayrollTaxes>
        <Total>0</Total>
      </PayrollTaxes>
      <FeesForServicesManagement>
        <Total>531502</Total>
        <ProgramServices>435832</ProgramServices>
        <ManagementAndGeneral>95670</ManagementAndGeneral>
      </FeesForServicesManagement>
      <FeesForServicesLegal>
        <Total>6398</Total>
        <ProgramServices>5246</ProgramServices>
        <ManagementAndGeneral>1152</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
        <Total>2500</Total>
        <ProgramServices>2050</ProgramServices>
        <ManagementAndGeneral>450</ManagementAndGeneral>
      </FeesForServicesAccounting>
      <FeesForServicesLobbying>
        <Total>0</Total>
      </FeesForServicesLobbying>
      <FeesForServicesProfFundraising>
        <Total>0</Total>
      </FeesForServicesProfFundraising>
      <FeesForServicesInvstMgmntFees>
        <Total>0</Total>
      </FeesForServicesInvstMgmntFees>
      <FeesForServicesOther>
        <Total>6171443</Total>
        <ProgramServices>5060583</ProgramServices>
        <ManagementAndGeneral>1110860</ManagementAndGeneral>
      </FeesForServicesOther>
      <Advertising>
        <Total>4275</Total>
        <ProgramServices>3506</ProgramServices>
        <ManagementAndGeneral>769</ManagementAndGeneral>
      </Advertising>
      <OfficeExpenses>
        <Total>149076</Total>
        <ProgramServices>122242</ProgramServices>
        <ManagementAndGeneral>26834</ManagementAndGeneral>
      </OfficeExpenses>
      <InformationTechnology>
        <Total>13824</Total>
        <ProgramServices>11336</ProgramServices>
        <ManagementAndGeneral>2488</ManagementAndGeneral>
      </InformationTechnology>
      <Royalties>
        <Total>0</Total>
      </Royalties>
      <Occupancy>
        <Total>359820</Total>
        <ProgramServices>295052</ProgramServices>
        <ManagementAndGeneral>64768</ManagementAndGeneral>
      </Occupancy>
      <Travel>
        <Total>40069</Total>
        <ProgramServices>32857</ProgramServices>
        <ManagementAndGeneral>7212</ManagementAndGeneral>
      </Travel>
      <TravelEntrtnmntPublicOfficials>
        <Total>0</Total>
      </TravelEntrtnmntPublicOfficials>
      <ConferencesMeetings>
        <Total>13386</Total>
        <ProgramServices>10977</ProgramServices>
        <ManagementAndGeneral>2409</ManagementAndGeneral>
      </ConferencesMeetings>
      <Interest>
        <Total>0</Total>
      </Interest>
      <PaymentsToAffiliates>
        <Total>0</Total>
      </PaymentsToAffiliates>
      <DepreciationDepletion>
        <Total>853925</Total>
        <ProgramServices>853925</ProgramServices>
      </DepreciationDepletion>
      <Insurance>
        <Total>71059</Total>
        <ProgramServices>58268</ProgramServices>
        <ManagementAndGeneral>12791</ManagementAndGeneral>
      </Insurance>
      <OtherExpenses>
        <Description>MEDICAL SUPPLIES</Description>
        <Total>1386905</Total>
        <ProgramServices>1386905</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>BAD DEBT EXPENSE</Description>
        <Total>2940943</Total>
        <ProgramServices>2940943</ProgramServices>
      </OtherExpenses>
      <OtherExpenses>
        <Description>REPAIRS AND MAINTENANCE</Description>
        <Total>434887</Total>
        <ProgramServices>356607</ProgramServices>
        <ManagementAndGeneral>78280</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>FOOD</Description>
        <Total>92626</Total>
        <ProgramServices>75953</ProgramServices>
        <ManagementAndGeneral>16673</ManagementAndGeneral>
      </OtherExpenses>
      <OtherExpenses>
        <Description>MINOR EQUIPMENT</Description>
        <Total>31993</Total>
        <ProgramServices>26234</ProgramServices>
        <ManagementAndGeneral>5759</ManagementAndGeneral>
      </OtherExpenses>
      <AllOtherExpenses>
        <Total>53443</Total>
        <ProgramServices>43824</ProgramServices>
        <ManagementAndGeneral>9619</ManagementAndGeneral>
      </AllOtherExpenses>
      <TotalFunctionalExpenses>
        <Total>20047525</Total>
        <ProgramServices>17388642</ProgramServices>
        <ManagementAndGeneral>2658883</ManagementAndGeneral>
        <Fundraising>0</Fundraising>
      </TotalFunctionalExpenses>
      <CashNonInterestBearing>
        <BOY>147246</BOY>
        <EOY>6384</EOY>
      </CashNonInterestBearing>
      <AccountsReceivable>
        <BOY>1579425</BOY>
        <EOY>1372768</EOY>
      </AccountsReceivable>
      <InventoriesForSaleOrUse>
        <BOY>425768</BOY>
        <EOY>371839</EOY>
      </InventoriesForSaleOrUse>
      <PrepaidExpensesDeferredCharges>
        <BOY>345774</BOY>
        <EOY>620990</EOY>
      </PrepaidExpensesDeferredCharges>
      <LandBuildingsEquipmentBasis>7574710</LandBuildingsEquipmentBasis>
      <LandBldgEquipmentAccumDeprec>1301260</LandBldgEquipmentAccumDeprec>
      <LandBuildingsEquipmentBasisNet>
        <BOY>5880741</BOY>
        <EOY>6273450</EOY>
      </LandBuildingsEquipmentBasisNet>
      <OtherAssetsTotal>
        <BOY>64000</BOY>
        <EOY>0</EOY>
      </OtherAssetsTotal>
      <TotalAssets>
        <BOY>8442954</BOY>
        <EOY>8645431</EOY>
      </TotalAssets>
      <AccountsPayableAccruedExpenses>
        <BOY>632867</BOY>
        <EOY>771164</EOY>
      </AccountsPayableAccruedExpenses>
      <OtherLiabilities>
        <BOY>2645017</BOY>
        <EOY>5313938</EOY>
      </OtherLiabilities>
      <TotalLiabilities>
        <BOY>3277884</BOY>
        <EOY>6085102</EOY>
      </TotalLiabilities>
      <FollowSFAS117>X</FollowSFAS117>
      <UnrestrictedNetAssets>
        <BOY>5165070</BOY>
        <EOY>2560329</EOY>
      </UnrestrictedNetAssets>
      <TotalNetAssetsFundBalances>
        <BOY>5165070</BOY>
        <EOY>2560329</EOY>
      </TotalNetAssetsFundBalances>
      <TotalLiabNetAssetsFundBalances>
        <BOY>8442954</BOY>
        <EOY>8645431</EOY>
      </TotalLiabNetAssetsFundBalances>
      <ReconcilationRevenueExpenses>-2604741</ReconcilationRevenueExpenses>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <Hospital170b1Aiii>X</Hospital170b1Aiii>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <ContributorInfo>
        <ContributorNumber>RESTRICTED</ContributorNumber>
        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
      </ContributorInfo>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="IRS990ScheduleC">
      <TotalGrassrootsLobbying />
      <TotalDirectLobbying />
      <TotalLobbyingExpenditures />
      <OtherExemptPurposeExpenditures />
      <TotalExemptPurposeExpenditures />
      <LobbyingNontaxableAmount />
      <GrassrootsNontaxableAmount />
      <TotLobbyingGrassrootMinusNonTx />
      <TotLobbyExpendMnsLobbyingNontx />
      <Volunteers>false</Volunteers>
      <PaidStaffOrManagement>false</PaidStaffOrManagement>
      <MediaAdvertisements>false</MediaAdvertisements>
      <MailingsMembers>false</MailingsMembers>
      <PublicationsOrBroadcast>false</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>true</GrantsOtherOrganizations>
      <GrantsOtherOrganizationsAmount>949</GrantsOtherOrganizationsAmount>
      <DirectContactLegislators>false</DirectContactLegislators>
      <RalliesDemonstrations>false</RalliesDemonstrations>
      <OtherActivities>false</OtherActivities>
      <TotalLobbyingExpendituresIIB>949</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>false</NotDescribedIn501c3>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmts />
      <HeldWorksOfArtAmts />
      <Land>
        <OtherCostOrOtherBasis>265577</OtherCostOrOtherBasis>
        <BookValue>265577</BookValue>
      </Land>
      <Buildings>
        <OtherCostOrOtherBasis>3000867</OtherCostOrOtherBasis>
        <Depreciation>181761</Depreciation>
        <BookValue>2819106</BookValue>
      </Buildings>
      <LeaseholdImprovements>
        <OtherCostOrOtherBasis>365033</OtherCostOrOtherBasis>
        <Depreciation>75731</Depreciation>
        <BookValue>289302</BookValue>
      </LeaseholdImprovements>
      <Equipment>
        <OtherCostOrOtherBasis>3943233</OtherCostOrOtherBasis>
        <Depreciation>1043768</Depreciation>
        <BookValue>2899465</BookValue>
      </Equipment>
      <OtherLandBuildings />
      <TotalOfBookValueLandBuildings>6273450</TotalOfBookValueLandBuildings>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>DUE TO AFFILIATES</Description>
        <Amount>2724192</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>EST SELF-INSURANCE COSTS</Description>
        <Amount>73500</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>DUE TO THIRD-PARTY PAYORS</Description>
        <Amount>2516246</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>5313938</TotalOfAmounts>
      <TotalRevenue>17442784</TotalRevenue>
      <TotalExpenses>20047525</TotalExpenses>
      <ExcessOrDeficitForYear>-2604741</ExcessOrDeficitForYear>
      <ExcessOrDeficitPerFS>-2604741</ExcessOrDeficitPerFS>
      <TotRevenueEtcAuditedFinclStmt>17442677</TotRevenueEtcAuditedFinclStmt>
      <RevenueSubtotal>17442677</RevenueSubtotal>
      <OtherRevenuesNotIncluded>107</OtherRevenuesNotIncluded>
      <RevenueNotRptdOnFinStmt>107</RevenueNotRptdOnFinStmt>
      <TotalRevenuePerForm990>17442784</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>20047418</TotExpensesEtcAuditedFinclStmt>
      <ExpensesSubtotal>20047418</ExpensesSubtotal>
      <OtherExpensesNotIncluded>107</OtherExpensesNotIncluded>
      <ExpensesNotRptdOnFinStmt>107</ExpensesNotRptdOnFinStmt>
      <TotalExpensesPerForm990>20047525</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIV>
        <Identifier>FIN 48 DISCLOSURE</Identifier>
        <Explanation>MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>RECONCILIATION OF AUDITED FINANCIAL STATEMENTS TO FORM 990</Identifier>
        <ReturnReference>PART XII, LINE 4B &amp; PART XIII, LINE 4B</ReturnReference>
        <Explanation>REVENUE INCLUDED ON RETURN, NOT ON BOOKS: GAIN ON SALE OF ASSETS $ 107 EXPENSES INCLUDED ON BOOKS, NOT ON RETURN: GAIN ON SALE OF ASSETS $ 107</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <PolicyAppliedToAllHospitals>X</PolicyAppliedToAllHospitals>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent200D>X</Pcent200D>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>true</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>788951</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>788951</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.04610</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>1369954</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>767270</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>602684</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.03520</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <UnreimbursedCosts>
        <TotalCommunityBenefitExpense>343528</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>343528</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02010</PercentOfTotalExpense>
      </UnreimbursedCosts>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>2502433</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>767270</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>1735163</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.10140</PercentOfTotalExpense>
      </TotalCharityCare>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>91973</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>91973</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00540</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>91973</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>91973</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00540</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>2594406</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>767270</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>1827136</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.10680</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>1466648</BadDebtExpenseAmount>
      <AmountReimbursedByMedicare>8784122</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>9434894</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-650772</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>MOTHER FRANCES HOSPITAL-WINNSBORO</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>719 WEST COKE ROAD</AddressLine1>
          <City>WINNSBORO</City>
          <State>TX</State>
          <ZIPCode>75494</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <CriticalAccessHospital>X</CriticalAccessHospital>
        <Er24Hours>X</Er24Hours>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>MOTHER FRANCES HOSPITAL-WINNSBORO</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVI>
        <Identifier>PART III, LINE 4:</Identifier>
        <Explanation>PATIENT ACCOUNTS RECEIVABLE ARE STATED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THIRD-PARTY PAYERS ARE BILLED DIRECTLY AND BILLS ARE SENT TO THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS AFTER APPLYING THE COST-TO-CHARGE RATIO. THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PART III, LINE 8:</Identifier>
        <Explanation>THE ORGANIZATION HAD A MEDICARE SHORTFALL IN THE AMOUNT OF $650,772. THE STATE OF TEXAS TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT FOR MEETING STATUTORY REQUIREMENTS FOR CHARITY CARE AND COMMUNITY BENEFIT. THE HOSPITAL USES MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PART III, LINE 9B:</Identifier>
        <Explanation>THE ORGANIZATION HAS A WRITTEN POLICY COVERING PROCEDURES FOR COLLECTING AND WRITING OFF BAD DEBTS. ACCORDING TO THE POLICY, IF A PATIENT APPEARS TO BE INDIGENT, ACCOUNTS SHOULD BE REVIEWED, AT ANY TIME DURING THE COLLECTION PROCESS, FOR POSSIBLE CONSIDERATION AS A CHARITY CASE IN ACCORDANCE WITH THE ORGANIZATION'S CHARITY CARE POLICY.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>NEEDS ASSESSMENT:</Identifier>
        <Explanation>THE HOSPITAL'S COMMUNITY HEALTH PROFILES PROVIDE A SNAPSHOT OF 13 SUBURBAN, URBAN, AND RURAL SERVICE AREAS WITHIN NORTH TEXAS USING KEY HEALTH INDICATORS, WHICH FACILITATE COMPARISONS LOCALLY, REGIONALLY, AND OVER TIME. COMMUNITY HEALTH PROFILES ARE INTENDED TO ASSIST INTERNAL STAKEHOLDERS, COMMUNITY HEALTH COUNCIL MEMBERS, AND THE COMMUNITY HEALTH IMPROVEMENT DEPARTMENT IN DECIDING WHERE TO ALLOCATE RESOURCES AND ADDRESS HEALTH INEQUALITIES. ALL ENTITY ADVOCATES USE NATIONAL, STATE, AND LOCAL SECONDARY AND PRIMARY DATA SOURCES TO PROVIDE A CURRENT OVERVIEW OF LOCAL HEALTH NEEDS, FACTORS IMPACTING DISEASE AND INJURY BURDEN, SOCIOECONOMIC STATUS, ACCESS TO HEALTH CARE, AGE DISTRIBUTION, INDICATORS AND LIFESTYLE BEHAVIORS. THIS DATA IS USED TO GALVANIZE JOINT COMMUNITY HEALTH EFFORTS TO IMPROVE HEALTH AND REDUCE HEALTH INEQUALITIES AND TO EMPOWER THE GREATER COMMUNITY.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:</Identifier>
        <Explanation>THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND CONTACT INFORMATION IS POSTED IN VARIOUS AREAS OF THE HOSPITAL INCLUDING ADMISSIONS &amp; REGISTRATION, EMERGENCY, AND OUTPATIENT DEPARTMENTS. ADDITIONALLY, FINANCIAL ASSISTANCE INFORMATION IS PROVIDED, VERBALLY AND IN WRITTEN BROCHURES, TO ALL SELF PAY PATIENTS BY FINANCIAL COUNSELORS. FINANCIAL ASSISTANCE INFORMATION IS ALSO INCLUDED IN EVERY PATIENT BILL. PATIENTS WHO DISCHARGE PRIOR TO MEETING WITH A FINANCIAL COUNSELOR ARE ADVISED OF FINANCIAL ASSISTANCE THROUGH PHONE CALLS AND LETTERS IN BOTH ENGLISH AND SPANISH. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO THE PATIENT BY FINANCIAL COUNSELORS WHO ALSO SCREEN SELF PAY PATIENTS FOR POTENTIAL ELIGIBILITY FOR OTHER GOVERNMENTAL ASSISTANCE PROGRAMS. IF IT IS DETERMINED THAT THE PATIENT IS POTENTIALLY ELIGIBLE FOR GOVERNMENTAL ASSISTANCE, THE FINANCIAL COUNSELOR WILL ASSIST THE PATIENT IN COMPLETING ANY FORMS NECESSARY TO APPLY FOR THE ASSISTANCE. AT THE SAME TIME, THE PATIENTS ARE PROVIDED WITH A CHARITY CARE APPLICATION AND INFORMATIONAL FLYER. THE PATIENT IS INFORMED THAT MOTHER FRANCES HOSPITAL-WINNSBORO IS A NON-PROFIT CHARITABLE ORGANIZATION OFFERING FINANCIAL ASSISTANCE TO PATIENTS WHO ARE DEEMED MEDICALLY OR FINANCIALLY INDIGENT. THE FINANCIAL COUNSELORS WILL THEN ASSIST THE PATIENT IN COMPLETING THE CHARITY CARE APPLICATION AND OBTAIN ANY AVAILABLE VERIFICATIONS. ONCE THE PATIENT IS DISCHARGED, THE FINANCIAL COUNSELORS WILL CONTINUE TO CONTACT THE PATIENT TO ENSURE ALL NEEDED FORMS AND VERIFICATIONS NEEDED TO FILE AN APPLICATION FOR GOVERNMENTAL ASSISTANCE AND CHARITY CARE HAVE BEEN PROVIDED.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COMMUNITY INFORMATION:</Identifier>
        <Explanation>THE HOSPITAL IS LOCATED IN A RURAL AREA WITH A POPULATION OF JUST OVER 59,000 WITH AN AVERAGE HOUSEHOLD INCOME FOR THE SERVICE AREA OF $52,925. OVER 12% OF THE HOSPITAL'S PATIENTS ARE UNINSURED AND 12.8% ARE MEDICAID RECIPIENTS. THE HOSPITAL'S SERVICE AREA HAS AN UNINSURED RATE OF 19.3% OF THE POPULATION. THERE ARE FIVE OTHER NOT-FOR-PROFIT HOSPITALS, ONE COMMUNITY HOSPITAL, AND ONE FOR-PROFIT COMPANY IN THE SAME SERVICE AREA.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PROMOTION OF COMMUNITY HEALTH:</Identifier>
        <Explanation>MOTHER FRANCES HOSPITAL-WINNSBORO PROMOTES HEALTHCARE AND WELLNESS EDUCATION BY OFFERING OUTREACH PROGRAMS AND SPECIAL INITIATIVES THAT IMPROVE THE QUALITY OF LIFE AND HEALTH IN THE COMMUNITIES SERVED. COMMUNITY BENEFIT IS PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS TO THE COMMUNITY. THESE SERVICES ARE ESSENTIAL TO PROVIDE COMPLETE HEALTHCARE TO THE COMMUNITIES SERVED. SOME OF THESE PROGRAMS INCLUDE: PROJECT GRADUATION - AN ANNUAL DRUG AND ALCOHOL FREE PARTY FOR AREA GRADUATING SENIORS; VARIOUS HEALTH AND SAFETY AWARENESS COURSES; AND VARIOUS HEALTH FAIRS AND IMMUNIZATIONS SUCH AS DIABETIC SUPPORT GROUPS AND BLOOD DRIVES.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>AFFILIATED HEALTH CARE SYSTEM ROLES:</Identifier>
        <Explanation>MOTHER FRANCES HOSPITAL-WINNSBORO IS PART OF AN AFFILIATED HEALTH CARE SYSTEM CALLED TRINITY MOTHER FRANCES HEALTH SYSTEM. TRINITY MOTHER FRANCES IS A FAITH-BASED ORGANIZATION DEDICATED TO CREATING HEALTHY LIVES FOR PEOPLE AND COMMUNITIES. MFH-WINNSBORO AND ITS AFFILIATES PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING ACUTE CARE FACILITIES AND CRITICAL ACCESS FACILITIES, WHOSE OPERATIONS CONSIST PRIMARILY OF PROVIDING INPATIENT AND OUTPATIENT ACUTE CARE AND MEDICAL SERVICES TO PATIENTS RESIDING IN EAST TEXAS.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>STATE FILING OF COMMUNITY BENEFIT REPORT</Identifier>
        <ReturnReference>990 SCHEDULE H, PART VI</ReturnReference>
        <Explanation>TX,</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="IRS990ScheduleI">
      <RecordsMaintained>true</RecordsMaintained>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>SERVICE ORGANIZATION OF PINEY WOODS</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>2950 50TH STREET</AddressLine1>
          <City>LUBBOCK</City>
          <State>TX</State>
          <ZIPCode>79314</ZIPCode>
        </AddressUS>
        <EINOfRecipient>260468622</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>91973</AmountOfCashGrant>
        <PurposeOfGrant>COMMUNITY HEALTHCARE</PurposeOfGrant>
      </RecipientTable>
      <TotalNbrOf501C3AndGovtGrants>1</TotalNbrOf501C3AndGovtGrants>
      <TotalNbrOfOtherOrganizations>0</TotalNbrOfOtherOrganizations>
      <Form990ScheduleIPartIV>
        <Identifier>PROCEDURES TO MONITOR THE USE OF GRANT FUNDS IN THE U.S.</Identifier>
        <ReturnReference>PART I, QUESTION 2</ReturnReference>
        <Explanation>GRANT RECIPIENTS ARE REQUIRED TO ACKNOWLEDGE PRIOR TO THE ISSUANCE OF GRANT FUNDS THAT THE GRANT WILL BE USED IN ACCORDANCE WITH THE STATED PURPOSE OF THE GRANT APPLICATION AND ANY UNUSED FUNDS RELATED TO THE SPECIFIC PURPOSE OF THE GRANT WILL BE RETURNED TO THE ORGANIZATION. THE ORGANIZATION MONITORS AND REVIEW THE FINANCIAL DATA OF RECIPIENTS TO ENSURE THAT THE GRANTED FUNDS ARE BEING USED PROPERLY.</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>RAY THOMPSON</NamePerson>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>678212</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>394861</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>386918</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>467937</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>0</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>8711</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>0</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>1936639</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>386918</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>PARTICIPATION IN OR PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN</Identifier>
        <ReturnReference>PART I, QUESTION 4B</ReturnReference>
        <Explanation>PARTICIPANTS IN SERP REPORTED IN W-2 DEFERRED COMPENSATION -------------------- ---------------- --------------------- RAY THOMPSON $386,918 $463,037</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>DESCRIBE PROCESS TO REVIEW FORM 990</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTION 11A</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DOES THE ORGANIZATION MONITOR AND ENFORCE COMPLIANCE WITH POLICY</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTION 12C</ReturnReference>
        <Explanation>THE BOARD REVIEWS AND RESOLVES, IF NECESSARY, ANY TRANSACTIONS AS THEY ARISE THROUGHOUT THE YEAR IN ACCORDANCE WITH PRESCRIBED STANDARDS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>PROCESS FOR DETERMINING COMPENSATION OF CEO, OFFICERS, OR KEY EMPLOYEES</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTIONS 15A &amp; 15B</ReturnReference>
        <Explanation>THE ORGANIZATION USES COMPENSATION CONSULTANTS AND NATIONAL COMPENSATION SURVEYS TO DETERMINE COMPENSATION OF EMPLOYEES. COMPENSATION IS APPROVED BY THE ORGANIZATION'S GOVERNING BODY.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DESCRIBE WHETHER THE ORGANIZATION MAKES IT DOCUMENTS AVAILABLE TO PUBLIC</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTION 19</ReturnReference>
        <Explanation>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DESCRIBE THE ORGANIZATION'S MEMBERS OR STOCKHOLDERS</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTION 6</ReturnReference>
        <Explanation>TRINITY MOTHER FRANCES HEALTH SYSTEM IS THE SOLE MEMBER OF MOTHER FRANCES HOSPITAL-WINNSBORO.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>1099S REPORTED BY ORGANIZATION</Identifier>
        <ReturnReference>FORM 990, PART V, QUESTION 1</ReturnReference>
        <Explanation>NO 1099S WERE ISSUED BY THE FILING ORGANIZATION. THE ORGANIZATION'S 1099S ARE ISSUED BY A RELATED ORGANIZATION, MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER, WHO REPORTS ALL 1099S FOR THE ENTIRE SYSTEM AND ALLOCATES EXPENSES TO THE APPROPRIATE RELATED ORGANIZATION; THEREFORE, THIS QUESTION IS ANSWERED AS "NONE" FOR THIS FILING ORGANIZATION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>MEMBERS OR STOCKHOLDERS WHO MAY ELECT MEMBERS OF THE GOVERNING BOARD</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTION 7A</ReturnReference>
        <Explanation>THE SOLE MEMBER, TRINITY MOTHER FRANCES HEALTH SYSTEM, HAS THE POWER TO APPOINT ALL DIRECTORS AND THEIR SUCCESSORS TO THE GOVERNING BOARD.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY MEMBER</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTION 7B</ReturnReference>
        <Explanation>THE MEMBER HAS THE RIGHT TO APPROVE OR DISAPPROVE CERTAIN ACTIONS THAT HAVE BEEN PREVIOUSLY APPROVED BY THE BOARD OF DIRECTORS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DELEGATION OF MANAGEMENT DUTIES</Identifier>
        <ReturnReference>FORM 990, PART VI, QUESTION 3</ReturnReference>
        <Explanation>THE ORGANIZATION HAS HIRED A MANAGEMENT COMPANY TO PERFORM THE DUTIES OF THE CEO, CNO, AND JR CFO. UNDER EMPLOYMENT FOR THE UNRELATED MANAGEMENT COMPANY, THE FOLLOWING INDIVIDUALS SERVE AS OFFICERS FOR THE HOSPITAL AND ARE PAID COMPENSATION BY THE MANAGEMENT COMPANY FOR SERVICES TO THE HOSPITAL. PER IRS GUIDANCE, NO COMPENSATION IS SHOWN ON FORM 990, PART VII, FOR THESE INDIVIDUALS: JANET COATES $144,122 GARY LOOPER 160,313 KEVIN JABLONSKI 31,854 SHELLE DIEHM 133,375</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:RAY THOMPSON TITLE:CHAIRMAN OF THE BOARD HOURS:42</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>CHAMPION EMERGENCY SERVICES LLC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2201 S MOBBERLY AVE</AddressLine1>
          <City>LONGVIEW</City>
          <State>TX</State>
          <ZIPCode>75602</ZIPCode>
        </AddressUS>
        <EIN>752747708</EIN>
        <PrimaryActivities>AMBULANCE SVC</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11A</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>MOTHER FRANCES HOSPITAL - JACKSONVILLE</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>751976930</EIN>
        <PrimaryActivities>HOSPITAL</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>TRINITY MOTHER FRANCES HEALTH SYSTEM FDN</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752028241</EIN>
        <PrimaryActivities>SUPPORT</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11C</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>REGIONAL MEDICAL SERVICES ASSOCIATION</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752511459</EIN>
        <PrimaryActivities>HEALTHCARE</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>TRINITY MOTHER FRANCES HEALTH SYSTEM</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752616975</EIN>
        <PrimaryActivities>HEALTHCARE</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>11C</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>TRINITY CLINIC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752616977</EIN>
        <PrimaryActivities>HEALTHCARE</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>MOTHER FRANCES HOSPITAL REGIONAL HC CTR</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>750818167</EIN>
        <PrimaryActivities>HOSPITAL</PrimaryActivities>
        <LegalDomicileState>TX</LegalDomicileState>
        <ExemptCodeSection>501(C)(3)</ExemptCodeSection>
        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>TRI-STATE FINANCIAL LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752728318</EIN>
        <PrimaryActivity>COLLECTION AGENCY</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>0</ShareOfEOYAssets>
        <PercentageOwnership>0.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>TRINCARE INC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752161369</EIN>
        <PrimaryActivity>RETAIL HEALTH SVC</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>0</ShareOfEOYAssets>
        <PercentageOwnership>0.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>HEALTHPLAN OF TEXAS INC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>514 S BECKHAM</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752636832</EIN>
        <PrimaryActivity>THIRD PARTY ADMIN</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>0</ShareOfEOYAssets>
        <PercentageOwnership>0.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>THE REGIONAL HEALTHCARE ALLIANCE</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752484109</EIN>
        <PrimaryActivity>PREFER PROVIDER</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>0</ShareOfEOYAssets>
        <PercentageOwnership>0.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>TEXAS HEALTH FACILITIES INSUR CORP LTD</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressForeign>
          <AddressLine1>PO BOX 1109 BWI</AddressLine1>
          <Country>CJ</Country>
        </AddressForeign>
        <EIN>980136025</EIN>
        <PrimaryActivity>INSURANCE</PrimaryActivity>
        <LegalDomicileForeignCountry>CJ</LegalDomicileForeignCountry>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>0</ShareOfEOYAssets>
        <PercentageOwnership>0.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>CONCORDIUM SERVICES INC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>702811022</EIN>
        <PrimaryActivity>INACTIVE</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>0</ShareOfEOYAssets>
        <PercentageOwnership>0.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>EMPLOYERS SERVICES INC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752602556</EIN>
        <PrimaryActivity>INACTIVE</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>0</ShareOfEOYAssets>
        <PercentageOwnership>0.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>HERITAGE HEALTH PLANS OF TX</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752622622</EIN>
        <PrimaryActivity>INACTIVE</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>0</ShareOfEOYAssets>
        <PercentageOwnership>0.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>QUALITY CARE ALLIANCE</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>1315 DOCTORS DRIVE</AddressLine1>
          <City>TYLER</City>
          <State>TX</State>
          <ZIPCode>75701</ZIPCode>
        </AddressUS>
        <EIN>752662965</EIN>
        <PrimaryActivity>INACTIVE</PrimaryActivity>
        <LegalDomicileState>TX</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-CORPORATION</TypeOfEntity>
        <ShareOfTotalIncome>0</ShareOfTotalIncome>
        <ShareOfEOYAssets>0</ShareOfEOYAssets>
        <PercentageOwnership>0.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>true</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>false</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>false</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
    </IRS990ScheduleR>
  </ReturnData>
</Return>