2011-05-09T09:25:52-05:00 2010-09-30 BKD LLP 2800 POST OAK BLVD STE 3200 HOUSTON TX 77056 990 2009-10-01 861132471 GSHS ADMINISTRATIVE SERVICES ORGANIZATIO GSHS 9033152000 700 E MARSHALL AVENUE LONGVIEW TX 75601 CEO 9033152000 2011-04-28 7134994600 2011-04-28 2009 2016-02-24 21:20:13Z EDWARD D BANOS 700 E MARSHALL AVENUE LONGVIEW TX 75601 46087803 0 X N/A X 2005 TX PROVIDEDS ADMINISTRATIVE, MANAGERIAL, AND SUPPORT SERVICES FOR RELATED ENTITIES THAT PROVIDE HEALTHCARE SERVICES AND SERVICES RELATED THERETO AS A BENEVOLENT, CHARITABLE, AND EDUCATIONAL INSTITUTION. 3 2 390 2 0 0 0 42328410 46090260 59235 231 54233 -2688 42441878 46087803 0 0 20413374 21685434 0 0 16581776 18951016 36995150 40636450 5446728 5451353 15568012 17688938 4844188 4911739 10723824 12777199 PROVIDES ADMINISTRATIVE, MANAGERIAL, AND SUPPORT SERVICES FOR RELATED ENTITIES THAT PROVIDE HEALTHCARE SERVICES AND SERVICES RELATED THERETO AS A BENEVOLENT, CHARITABLE, AND EDUCATIONAL INSTITUTION. 0 0 37712955 46090260 GSHS ADMINISTRATIVE SERVICES ORGANIZATION IS A NOT-FOR-PROFIT, TAX-EXEMPT CORPORATION FORMED IN 2005 TO PROVIDE ADMINISTRATIVE AND OTHER SERVICES TO VARIOUS ENTITIES WITH THE GOOD SHEPHERD HEALTH SYSTEM. GSHS IS THE SOLE MEMBER OF GSHS ADMINISTRATIVE SERVICES ORGANIZATION, INC. THE CORPORATION'S BOARD OF DIRECTORS IS COMPRISED OF THE PRESIDENT OF THE CORPORATION, OR A VICE PRESIDENT DESIGNATED BY THE PRESIDENT, AND SUCH ADDITIONAL PERSONS AS ARE APPOINTED BY GSHS.THE GSHS ADMINISTRATIVE SERVICES ORGANIZATION IS COMPRISED OF SERVICES THAT PROVIDE SUPPORT TO THE OTHER ENTITIES OF THE ORGANIZATION. SOME OF THESE SERVICES INCLUDE ACCOUNTING, HUMAN RESOURCES, INFOMRATION SYSTEMS, CARE MANAGEMENT, HEALTH INFORMATION MANAGEMENT, EDUCATION, MATERIALS MANAGEMENT, MANAGED CARE, INFECTION CONTROL, HOUSEKEEPING, SECURITY, AND PLANT OPERATIONS.OUR ACTIVITIES INCLUDE ADVOCACY, POLICY DEVELOPMENT, EDUCATION AND RESEARCH. WE WORK IN PARTNERSHIP WITH THE GSMC HEALTH NETWORKS ON A WIDE VARIETY OF ISSUES. WE PROVIDE EDUCATIONAL AND RESEARCH SERVICES.GSHS ADMINISTRATIVE SERVICES ORGANIZATION PROVIDES SERVICES TO THREE HOSPITALS, GOOD SHEPHERD MEDICAL CENTER, GOOD SHEPHERD MEDICAL CENTER-LINDEN, AND GOOD SHEPHERD MEDICAL CENTER-MARSHALL. THESE THREE HOSPITALS ARE 501(C)(3) ORGANIZATIONS, NOT-FOR-PROFIT COMMUNITY BASED HOSPITALS. THE HOSPITALS TOGETHER PROVIDE HEALTH SERVICES TO THE UNDERSERVED COMMUNITIES OF LONGVIEW AND NORTHEAST TEXAS, CASS, MORRIS AND MARION COUNTIES, AND HARRISON AND MARION COUNTIES, RESPECTIVELY.GSHS ADMINISTRATIVE SERVICES ORGANIZATION EXISTS FOR THE SOLE PURPOSE OF SUPPORTING OTHER NOT-FOR-PROFIT 501(C)(3) ORGANIZATIONS. 37712955 1 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 71 0 1 390 1 0 0 0 0 0 0 0 0 0 0 3 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JANET ANDERSEN 9033155177 700 E MARSHALL AVE LONGVIEW TX 75601 RICHARD DIAL 1.00 X 0 0 0 EDWARD BANOS 40.00 X X 675303 0 24829 TOM MOBLEY 1.00 X 0 0 0 PAT KEEL 40.00 X 134750 0 0 LEORA WILLIAMS 34.00 X 85549 0 23112 CONNIE HEIDBREDER 34.00 X 42918 0 3368 MARION BENSON 40.00 X 174080 0 17865 KENNETH CUNNINGHAM 40.00 X 258988 0 30683 TROY THIBODEAUX 40.00 X 250422 0 19311 KAREN WATTS 40.00 X 197529 0 28267 RUBY BREWER 40.00 X 194247 0 29541 BETH CHRISMER 40.00 X 160832 0 28760 MARK E MOFFIT 40.00 X 127750 0 7923 CHRISSY RAMSEY 40.00 X 130477 0 15475 RONALD DEAN SHORT III 40.00 X 133355 0 30021 JOSEPH REPPERT 40.00 X 123846 0 0 2690046 0 259155 12 1 1 0 HOSPITAL HOUSEKEEPING SYSTEMS LTD PO BOX 826 SAN ANTONIO TX 782930826 CLEANING 3083765 SHAMS 701 CANYON DR COPPELL TX 75019 SOFTWARE SUPPORT 376766 MANZIEL LAW OFFICES 8330 MEADOW ROAD STE 100 DALLAS TX 75231 LEGAL SERVICES 307518 PERMIER INC 5882 COLLECTIONS CENTER DR CHICAGO IL 60693 COLLECTIONS 199090 NATIONWIDE RECOVER SYSTEMS LTD 2304 TARPLY ROAD STE 134 CARROLLTON TX 75006 COLLECTIONS 130654 9 MANAGEMENT SERVICES 541610 45988879 45988879 NET PATIENT SERVICE RE 621110 101381 101381 46090260 231 231 MISCELLANEOUS REVENUE 900099 -2688 -2688 -2688 46087803 46087572 0 231 2168329 2168329 14613386 13606483 1006903 450023 423022 27001 3309439 3110873 198566 1144257 1075602 68655 941552 922721 18831 146194 144732 1462 10325 9600 725 1867473 1755425 112048 4176 4134 42 1111587 1000428 111159 2507391 2356948 150443 138580 130265 8315 20491 20491 2402472 2258324 144148 126591 117730 8861 HOUSEKEEPING 5038299 4332937 705362 BILLINGS AND COLLECTION 1397284 1383311 13973 PLANT OPERATIONS 1301869 1041495 260374 LAUNDRY 834166 834166 LEASE AND RENTAL 815168 766258 48910 287398 270172 17226 40636450 37712955 2923495 0 5140981 6127053 19980 235883 70425 76201 944803 1237699 29866403 24356731 5414252 5509672 3977571 4502430 15568012 17688938 2648964 3846139 238085 360031 1957139 705569 4844188 4911739 X 10723824 12777199 10723824 12777199 15568012 17688938 X 0 1 1 X 0 X X X 0 0 0 THE GOOD SHEPHERD HOSPITAL INC 751041154 3 1 1 1 0 GOOD SHEPHERD MEDICAL CENTER-LINDEN 010829282 3 1 1 1 0 2 0 0 0 0 0 0 1 8623 0 0 0 8623 0 28669 23341 5328 5567 1219 4348 29832167 24332171 5499996 5509672 DUE FROM AFFILIATES 4502430 4502430 DUE TO AFFILIATES 705569 705569 46087803 40636450 5451353 -3397978 -3397978 2053375 46087803 0 46087803 0 46087803 40636450 0 40636450 0 40636450 Part X: Description of Uncertain Tax Positions Under FIN 48: The System, GSHS ASO, the Medical Center, GSMC Linden, GSMC Marshall, the GSMC Foundation and the GSMC Linden Foundation are exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code and a similar provision of state law. These entities are subject to federal income tax on any unrelated business taxable income. Enterprises is a taxable corporation. CSC is taxed as a partnership. Deferred tax assets and liabilities are recognized for Enterprises for the tax effects of differences between the financial statements and tax bases of assets and liabilities. A valuation allowance is established to reduce deferred tax assets if it is more likely than not that a deferred tax asset will not be realized. The System files tax returns in the U.S. federal jurisdiction. With a few exceptions, the System is no longer subject to U.S. federal examinations by tax authorities for years before 2007. TRANSFERS TO AFFILIATES (3,397,978) X X 0 0 0 0 0 0 0 0 0 EDWARD BANOS 472803 0 202500 0 0 0 16500 0 8329 0 700132 0 0 0 MARION BENSON 148858 0 25222 0 0 0 11802 0 6063 0 191945 0 0 0 KENNETH CUNNINGHAM 191903 0 67085 0 0 0 16500 0 14183 0 289671 0 0 0 TROY THIBODEAUX 250422 0 0 0 0 0 16500 0 2811 0 269733 0 0 0 KAREN WATTS 197529 0 0 0 0 0 24300 0 3967 0 225796 0 0 0 RUBY BREWER 155060 0 39187 0 0 0 16500 0 13041 0 223788 0 0 0 BETH CHRISMER 134707 0 26125 0 0 0 21788 0 6972 0 189592 0 0 0 RONALD DEAN SHORT III 133355 0 0 0 0 0 16500 0 13521 0 163376 0 0 0 JOSEPH REPPERT 44479 0 79367 0 0 0 0 0 0 0 123846 0 0 0 Form 990, Part VI, Section A, line 6 THE SOLE MEMBER OF THE ORGANIZATION IS GOOD SHEPHERD HEALTH SYSTEM, INC. Form 990, Part VI, Section A, line 7a AS THE SOLE MEMBER, GOOD SHEPHERD HEALTH SYSTEM, INC. HAS THE POWER TO APPROVE MEMBERS TO THE ORGANIZATION'S BOARD. Form 990, Part VI, Section A, line 7b A NUMBER OF DECISIONS OF THE ORGANIZATION ARE SUBJECT TO APPROVAL OF THE MEMBER OF THE ORGANIZATION. THESE RESERVED POWERS ARE STATED BELOW: A) APPROVE THE MEMBERS OF THE BOARD; B) APPROVE REMOVAL AND APPOINTMENTS TO FILL VACANCIES ON THE BOARD AND SET SIZE OF BOARD; C) APPROVE ELECTION AND REMOVAL OF OFFICERS OF THE CORPORATION AND ESTABLISH, TERMINATE AND/OR REVISE ALL EMPLOYMENT CONTRACTS, COMPENSATION AND BENEFITS PACKAGES OF THE OFFICERS OF THE CORPORATION REGARDLESS OF WHICH ENTITY ACTUALLY PAYS SUCH COMPENSATION OR BENEFITS; D) DESIGNATE THE FISCAL YEAR; E) APPROVE THE SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, OUTSIDE GENERAL LEGAL COUNSEL, AND OUTSIDE INVESTMENT ADVISORS; F) AMEND THE ARTICLES OF INCORPORATION; G) AMEND OR REPEAL THE BYLAWS; H) APPROVAL OF ALL MERGERS, ACQUISITIONS, CONSOLIDATIONS, OR AFFILIATIONS WITH OTHER ENTITIES, THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE SALE, MORTGAGE, OR ENCUMBRANCE OF ANY REAL PROPERTY OWNED BY THE CORPORATION; I) APPROVE THE DISSOLUTION OR LIQUIDATION OF THE CORPORATION; J) APPROVE CAPITAL PLANS, STRATEGIC PLANS, AND ANNUAL OPERATING AND CAPITAL BUDGETS; K) APPROVE ANY EXCEPTION TO THE CAPITAL BUDGET FOR A SINGLE ITEM OR RELATED ITEM THAT EXCEEDS $100,000 AND/OR APPROVE ANY AGGREGATE ANNUAL OPERATING EXPENDITURES THAT EXCEED THE BUDGET BY $50,000; L) SELECT OFFICIAL DEPOSITORIES FOR THE CORPORATION'S FUNDS; M) CREATE OR INVEST IN ANY SUBSIDIARY ENTITY OR ENTER INTO ANY PARTNERSHIP OR JOINT VENTURE; N) AUTHORIZE ANY LOANS, GUARANTEES, OR INCURRENCE OF DEBT; O) COMMENCE ANY LITIGATION OR OTHER LEGAL PROCEEDING, OR SETTLE, DISPOSE, OR TERMINATE OF ANY SUCH LITIGATION OR OTHER LEGAL PROCEEDING OR OF ANY CLAIM OR THREAT OF LITIGATION OR OTHER LEGAL PROCEEDING NOT FULLY COVERED BY INSURANCE; AND P) APPROVAL OF THE ADMISSION OF ADDITIONAL MEMBERS. Form 990, Part VI, Section B, line 11 THE ORGANIZATION PREPARES THE 990 INTERNALLY AND ENGAGES AN OUTSIDE ACCOUNTING FIRM TO REVIEW THE FORM 990. ONCE PREPARED AND REVIEWED, THE FORM IS REVIEWED BY INTERNAL ACCOUNTANTS AND BOARD OF DIRECTORS PRIOR TO FILING. Form 990, Part VI, Section B, line 12c DISCLOSURES ARE OBTAINED ANNUALLY. THE BOARD REVIEWS AND APPROVES BOARD DISCLOSURES, AND THE CEO REVIEWS AND APPROVES EMPLOYEE DISCLOSURES. BOARD MINUTES NOTE WHEN A BOARD MEMBER DECLARES A CONFLICT AND DOES NOT VOTE. Form 990, Part VI, Section B, line 15 A COMPENSATION SUBCOMMITTE OF THE BOARD NEGOTIATES CONTRACTS WITH EXECUTIVES THROUGH HAY GROUP. THIS SUBCOMMITTEE OF THE BOARD REVIEWS AND APPROVES COMPENSATION AND BONUSES. Form 990, Part VI, Section C, line 19 THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. THE ORGANIZATION HAS AN INTERNAL DEPARTMENT THAT ASSISTS AND OVERSEAS THE AUDIT. ONCE COMPLETE, THE AUDIT IS REVIEWED BY THE BOARD AND INTERNAL COMMITTEE. GOOD SHEPHERD MEDICAL CENTER-LINDEN 404 N KAUFMAN STREET LINDEN TX 75563 010829282 HEALTHCARE TX 501(c)(3) Line 3 N/A GOOD SHEPHERD HEALTH SYSTEM INC 700 E MARSHALL AVE LONGVIEW TX 75601 752027157 SUPPORT GSMC TX 501(c)(3) Line 11b, II N/A GOOD SHEPHERD MEDICAL CENTER-MARSHALL 811 SOUTH WASHINGTON AVENUE MARSHALL TX 75670 750974351 HEALTHCARE TX 501(c)(3) Line 3 N/A GOOD SHEPHERD MEDICAL CENTER 700 E MARSHALL AVE LONGVIEW TX 75601 751041154 HEALTHCARE TX 501(c)(3) Line 3 N/A GSMC-LINDEN FOUNDATION INC 404 N KAUFMAN STREET LINDEN TX 75563 200845127 SUPPORT TX 501(c)(3) Line 11a, I N/A GOOD SHEPHERD FOUNDATION INC 700 E MARSHALL AVE LONGVIEW TX 75601 200845127 SUPPORT TX 501(c)(3) Line 11a, I N/A MARSHALL HOSPITAL FOUNDATION INC 811 SOUTH WASHINGTON AVENUE MARSHALL TX 75670 752605699 HEALTHCARE TX 501(c)(3) Line 7 N/A MARSHALL HEALTH SERVICES INC 811 SOUTH WASHINGTON AVENUE MARSHALL TX 75670 752580686 HEALTHCARE TX 501(c)(3) Line 3 N/A GOOD SHEPHERD HOSPITAL AUXILIARY 700 E MARSHALL AVE LONGVIEW TX 75601 237203364 SUPPORT TX 501(c)(3) Line 9 N/A GSHS ENTERPRISES INC 700 E MARSHALL AVE LONGVIEW TX 75601 752027162 HEALTHCARE TX N/A C GOOD SHEPHERD HEALTH NETWORK 700 E MARSHALL AVE LONGVIEW TX 75601 752554695 INACTIVE TX N/A C NORTHEAST TEXAS PHYSICIAN SERVICES 700 E MARSHALL AVE LONGVIEW TX 75601 752712245 MGMT SERVICES TX N/A C GS PHYSICIAN SERVICES INC 700 E MARSHALL AVE LONGVIEW TX 75601 752762417 MEDICAL SERVICES TX N/A C GSHS ENTERPRISES HOLDING INC 700 E MARSHALL AVE LONGVIEW TX 75601 510412465 HOLDING COMPANY TX N/A C GSHS ENTERPRISES OPERATING 1 700 E MARSHALL AVE LONGVIEW TX 75601 752954772 HEALTHCARE TX N/A C GSHS ENTERPRISES OPERATING 2 700 E MARSHALL AVE LONGVIEW TX 75601 752954777 HEALTHCARE TX N/A C GSHS ENTERPRISES OPERATING 3 700 E MARSHALL AVE LONGVIEW TX 75601 750896512 HEALTHCARE TX N/A C GSHS MEDICAL PLAZA LTD 700 E MARSHALL AVE LONGVIEW TX 75601 752955157 HEALTHCARE TX N/A C GSHS MEDICAL PLAZA III LTD 700 E MARSHALL AVE LONGVIEW TX 75601 731654263 HEALTHCARE TX N/A C 0 1 0 0 1 0 0 0 1 0 1 0 0 1 1 1 0 0