MOTHER FRANCES HOSPITAL JACKSONVILLE: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization: MOTHER FRANCES HOSPITAL JACKSONVILLE (EIN 75-1976930)
Tax period: 2009-07-01 to 2010-06-30
Filed: 2011-05-13
IRS object ID: 201131339349300613
Schema version: 2009v1.7
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 C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-05-13T07:30:33-05:00	Timestamp
Tax Period End Date	2010-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	2800 Post Oak Blvd Ste 3200	AddressLine1
City	HOUSTON	City
State	TX	State
ZIP Code	77056	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2009-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	751976930	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MOTHER FRANCES HOSPITAL - JACKSONVILLE	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MOTH	NameControl
Phone	9035315764	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1021 E IDEL	AddressLine1
City	TYLER	City
State	TX	State
ZIP Code	75701	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JOYCE HESTER	Name
Title	VP OF FINANCIAL OPERATIONS	Title
Date Signed	2011-05-16	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	M Paige Gerich	Name
Phone	7134994600	Phone

Field	Value	IRS element (for citing)
Tax Year	2009	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	RAY THOMPSON	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	910 E HOUSTON	AddressLine1
City	TYLER	City
State	TX	State
ZIP Code	75701	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	35939243	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2000	YearFormation
State Legal Domicile	TX	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE THE COMMUNITY WITH A FULL RANGE OF COMPREHENSIVE HEALTHCARE SERVICES WITHOUT REGARD TO RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	7	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	3	NbrIndependentVotingMembers
Total Nbr Employees	207	TotalNbrEmployees
Total Nbr Volunteers	3	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	0	ContributionsGrantsPriorYear
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	32318671	ProgramServiceRevenuePriorYear
Program Service Revenue CY	35911468	ProgramServiceRevenueCY
Investment Income Prior Year	0	InvestmentIncomePriorYear
Investment Income Current Year	0	InvestmentIncomeCurrentYear
Other Revenue Prior Year	28363	OtherRevenuePriorYear
Other Revenue Current Year	27775	OtherRevenueCurrentYear
Total Revenue Prior Year	32347034	TotalRevenuePriorYear
Total Revenue Current Year	35939243	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	541691	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	9325588	SalariesEtcPriorYear
Salaries Etc Current Year	9478248	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	22908563	OtherExpensePriorYear
Other Expenses Current Year	24067806	OtherExpensesCurrentYear
Total Expenses Prior Year	32234151	TotalExpensesPriorYear
Total Expenses Current Year	34087745	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	112883	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	1851498	RevenuesLessExpensesCY
Total Assets BOY	19437979	TotalAssetsBOY
Total Assets EOY	12235284	TotalAssetsEOY
Total Liabilities BOY	10871124	TotalLiabilitiesBOY
Total Liabilities EOY	1816931	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	8566855	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	10418353	NetAssetsOrFundBalancesEOY
Mission Description	TO PROVIDE THE COMMUNITY WITH A FULL RANGE OF COMPREHENSIVE HEALTHCARE SERVICES WITHOUT REGARD TO RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	30625316	Expense
Grants	541691	Grants
Revenue	35911468	Revenue
Description	The Hospital's operating plan incorporates provisions for individuals who do not possess the ability to purchase essential medical services. Our committment to our community extends to free or subsidized individual care, subsidized education of healthcare professionals, discounted fees for participants in government programs, community health education and donations to other community agencies. Specific community services and programs include: wellness and prevention education programs, community diagnostic screening programs, senior citizen health awareness programs, awareness programs for youth at risk, and awareness programs for persons with special physical or mental needs.	Description
Total Program Service Expense	30625316	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	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
Balance Sheet Amounts Reported	true	BalanceSheetAmountsReported
Independent Audit Financial Stmt	false	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
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
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
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	207	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
Nbr Voting Governing Body Members	7	NbrVotingGoverningBodyMembers
Number Independent Voting Members	3	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	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	true	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	MOTHER FRANCES HOSP ACCTG DEPT	NamePerson
Telephone Number	9035315764	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1315 DOCTORS DRIVE	AddressLine1
City	TYLER	City
State	TX	State
ZIP Code	75701	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
TOM CAMMACK
CHIEF ADMINSTRATIVE OFFICER	40.0	X	X	264671	0	14010
MATTHEW VIERKANT MD
DIRECTOR	10.0	X		0	507270	18062
RAY THOMPSON
CHAIRMAN	1.0	X	X	0	1267520	405024
GLEN HAMILTON
Secretary	1.0	X	X	0	0	0
WILLIAM MILAWSKI MD
director	10.0	X		0	264300	15517
DICK STONE
director	1.0	X		0	0	0
RANDY GORHAM
director	1.0	X		0	0	0
MICHAEL LEWIS
coo	40.0		X	115019	0	13115
BARRY THIBODEAUX
CRNA	40.0			235368	0	5831	X
JACK CAPPS
CRNA	40.0			227210	0	17639	X
BEN BEATHARD
ECC NURSE	40.0			106321	0	11703	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	948589	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	2039090	TotalReportableCompFrmRltdOrgs
Total Other Compensation	500901	TotalOtherCompensation
Number Individuals GT100 K	5	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
CARDIAC IMAGING MANAGEMENT SPECIALI
1357 DOMINION PLAZA	TYLER	TX	75703	MANAGEMENT SERVICES	174581
JOHNSON AND JOHNSON HEALTH CARE SYS
5972 COLLECTIONS CENTER DR	CHICAGO	IL	60693	ACCT MGMT CONTRACTOR	159894
MEDTRONIC USA INC
PO BOX 84086	DALLAS	TX	75284	MED TECHNOLOGY SVCS	523430
TYLER CARDIOVASCULAR
PO BOX 9015	TYLER	TX	75711	CARDIO SERVICES	147000
VIRTUAL RADIOLOGIC PROFESSIONALS OF
DEPT 7080	CAROL STREAM	IL	60122	RADIOLOGY SERVICES	174051

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	20	NumberOfContractorsGT100K
Total Contributions	0	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Revenue	621110	35892432	35892432
Other Revenue	900099	19036	19036

Field	Value	IRS element (for citing)
Total Program Service Revenue	35911468	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

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)
Personal	27512	Personal

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Personal	27512	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	27512	TotalRevenueColumn
Exclusion	$27,512	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

Field	Value	IRS element (for citing)
Description	Medical Records Fees	Description
Business Code	900099	BusinessCode
Total Revenue Column	263	TotalRevenueColumn
Exclusion	$263	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	263	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	35939243	TotalRevenueColumn
Related Or Exempt Function Income	35911468	RelatedOrExemptFunctionIncome
Exclusion	$27,775	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	541691	Total
Program Services	541691	ProgramServices

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	406815	Total
Program Services	328962	ProgramServices
Management And General	77853	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	7266977	Total
Program Services	5875961	ProgramServices
Management And General	1391016	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	1804456	Total
Program Services	1460636	ProgramServices
Management And General	343820	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	352506	Total
Program Services	22132	ProgramServices
Management And General	330374	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	0	Total

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	10052130	Total
Program Services	9111617	ProgramServices
Management And General	940513	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	67833	Total
Management And General	67833	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	129867	Total
Program Services	83129	ProgramServices
Management And General	46738	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	18221	Total
Program Services	10189	ProgramServices
Management And General	8032	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2799156	Total
Program Services	2659198	ProgramServices
Management And General	139958	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	2820	Total
Program Services	1997	ProgramServices
Management And General	823	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	12703	Total
Program Services	4427	ProgramServices
Management And General	8276	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	0	Total

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	610339	Total
Program Services	579822	ProgramServices
Management And General	30517	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	0	Total

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
Bad Debt Expense	6589478	6589478
Medical Supplies	2664987	2619650	45337
Food	92143	88235	3908
Repairs and Maintenance	575358	569037	6321
Minor Equipment	74902	65871	9031

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	25363	Total
Program Services	13284	ProgramServices
Management And General	12079	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	34087745	Total
Program Services	30625316	ProgramServices
Management And General	3462429	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	110293	BOY
EOY	124336	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	4327075	BOY
EOY	3426703	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	185631	BOY
EOY	233509	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	78828	BOY
EOY	66289	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	8528027	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	7372953	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	1622577	BOY
EOY	1155074	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	13113575	BOY
EOY	7229373	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	19437979	BOY
EOY	12235284	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1192628	BOY
EOY	1189888	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	35994	BOY
EOY	36113	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	9642502	BOY
EOY	590930	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	10871124	BOY
EOY	1816931	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	8566855	BOY
EOY	10418353	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	8566855	BOY
EOY	10418353	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	19437979	BOY
EOY	12235284	EOY

Field	Value	IRS element (for citing)
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	true	GrantsOtherOrganizations
Grants Other Organizations	$1,218	GrantsOtherOrganizationsAmount
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	false	OtherActivities
Total Lobbying Expenditures IIB	1218	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts
Land		Land
Buildings		Buildings
Leasehold Improvements		LeaseholdImprovements

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	8528027	OtherCostOrOtherBasis
Depreciation	7372953	Depreciation
Book Value	1155074	BookValue

Field	Value	IRS element (for citing)
Other Land Buildings		OtherLandBuildings
Total Of Book Value Land Buildings	1155074	TotalOfBookValueLandBuildings

Other Assets OtherAssets

Field	Value	IRS element (for citing)
Description	DUE FROM AFFILIATES	Description
Book Value	7229373	BookValue

Field	Value	IRS element (for citing)
Total Book Value Other Assets	7229373	TotalBookValueOtherAssets
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
THIRD PARTY PAYOR LIABILITIES	$269,918
ESTIMATED SELF INSURANCE COSTS	$321,012

Field	Value	IRS element (for citing)
Total Of Amounts	590930	TotalOfAmounts
Total Revenue	35939243	TotalRevenue
Total Expenses	34087745	TotalExpenses
Excess Or Deficit For Year	1851498	ExcessOrDeficitForYear
Excess Or Deficit Per FS	1851498	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	35939243	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	35939243	RevenueSubtotal
Total Revenue Per Form990	35939243	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	34087745	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	34087745	ExpensesSubtotal
Total Expenses Per Form990	34087745	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
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

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
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1432751	TotalCommunityBenefitExpense
Net Community Benefit Expense	1432751	NetCommunityBenefitExpense
Percent Of Total Expense	0.04200	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5032727	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3656883	DirectOffsettingRevenue
Net Community Benefit Expense	1375844	NetCommunityBenefitExpense
Percent Of Total Expense	0.04040	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	33063	TotalCommunityBenefitExpense
Direct Offsetting Revenue	38481	DirectOffsettingRevenue
Net Community Benefit Expense	-5418	NetCommunityBenefitExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6498541	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3695364	DirectOffsettingRevenue
Net Community Benefit Expense	2803177	NetCommunityBenefitExpense
Percent Of Total Expense	0.08220	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	18340	TotalCommunityBenefitExpense
Net Community Benefit Expense	18340	NetCommunityBenefitExpense
Percent Of Total Expense	0.00050	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	541691	TotalCommunityBenefitExpense
Net Community Benefit Expense	541691	NetCommunityBenefitExpense
Percent Of Total Expense	0.01590	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	560031	TotalCommunityBenefitExpense
Net Community Benefit Expense	560031	NetCommunityBenefitExpense
Percent Of Total Expense	0.01640	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	7058572	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3695364	DirectOffsettingRevenue
Net Community Benefit Expense	3363208	NetCommunityBenefitExpense
Percent Of Total Expense	0.09860	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReported
Bad Debt Expense	$1,484,787	BadDebtExpenseAmount
Amount Reimbursed By Medicare	9880376	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	9532962	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	347414	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Mother Frances Hospital - Jacksonville	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1026 S Jackson St	AddressLine1
City	Jacksonville	City
State	TX	State
ZIP Code	75766	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

Field	Value	IRS element (for citing)
Bad Debt Footnote	PATIENT ACCOUNTS RECEIVABLE ARE STATED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL, THE CLINIC, JACKSONVILLE AND WINNSBORO PROVIDE 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. 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.	BadDebtFootnote
Shortfall As Community Benefit	THE HOSPITAL USES MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED ON MEDICAID OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES.	ShortfallAsCommunityBenefit
Debt Collection Policy	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.	DebtCollectionPolicy
Needs Assessment	THE HOSPITAL'S COMMUNITY HEALTH PROFILES PROVIDE A SNAPSHOT OF SUBURBAN, URBAN, AND RURAL SERVICE AREAS WITHIN 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.	NeedsAssessment
Patient Education Assistance	THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND CONTACT INFORMATION IS POSTED IN VARIOUS AREAS OF THE HOSPITAL INCLUDING ADMISSIONS & 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. 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-JACKSONVILLE 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.	PatientEducationAssistance
Community Information	MOTHER FRANCES HOSPITAL-JACKSONVILLE IS A 25-BED ACUTE CARE MEDICARE CERTIFIED CRITICAL ACCESS HOSPITAL. CHEROKEE COUNTY, THE PRIMARY SERVICE AREA FOR MFH-JACKSONVILLE, HAS A POPULATION OF APPROXIMATELY 57,000 AND IS PRIMARILY 48,000 IN A 1,052 SQUARE MILE AREA. THE SECONDARY SERVICE AREA INCLUDES THE SOUTHERN PART OF SMITH COUNTY.	CommunityInformation
Community Building Activities	MOTHER FRANCES HOSPITAL-JACKSONVILLE 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 THE FOLLOWING: CHEROKEE COUNTY RELAY FOR LIFE: PROVIDED SPONSORSHIP AND STAFFING SUPPORT FOR CHEROKEE COUNTY RELAY FOR LIFE. STAFF PLANNED ACTIVITIES FOR THE ALL-NIGHT EVENT AND MANNED THE EVENT. THE COUNTY HAS AN ABOVE AVERAGE RATE OF CANCER. FAMILYCARE CENTER-WOMEN'S SERVICES: OVER 315 VISITS FOR GYNECOLOGICAL SERVICES AT THE LOCAL CLINIC WERE PROVIDED FOR WOMEN THAT DID NOT HAVE A PRIMARY CARE OR SPECIALTY MEDICAL HOME. IN ADDITION, SURGERIES WERE PERFORMED BY FAMILYCARE PHYSICIANS AT MFH-JACKSONVILLE. JACKSONVILLE RODEO: HANDED OUT FANS AND WATER TO PARTICIPANTS AND SPECTATORS AT THE RODEO. HELPED EDUCATE PARTICIPANTS ABOUT THE DANGERS OF EXCESSIVE HEAT AND INJURIES CAUSED BY EXTENSIVE HEAT. REACHED OVER 1,000 PEOPLE WITH HEAT PREVENTION INFORMATION AND MEDICAL SUPPORT ON SITE. JACKSONVILLE ROTARY, ACCESS, AND OTHERS: PROVIDED SPONSORSHIP, STAFFING, AND DEVELOPMENT OF PROGRAMS AND EVENTS FOR THE LOCAL COMMUNITY. ORGANIZATIONS INCLUDED LITERACY COUNCIL, LIONS CLUB, ROTARY, RED CROSS, ACCESS, HOPE CENTER, UNITED FUND, AND AMERICAN CANCER SOCIETY. MEMBERS OF THE STAFF SERVE IN LEADERSHIP POSITIONS ON VARIOUS BOARDS AND NON PROFITS IN THE COMMUNITY. COMMUNITY HEALTH INFORMATION AND SCREENINGS: A VARIETY OF COMMUNITY EVENTS AND OPPORTUNITIES FOR SCREENINGS WERE HELD INCLUDING COMMUNITY HEALTH FAIRS, TOMATO FEST, BLOOD DRIVES, HEALTH FAIRS FOR COMMERCIAL AND INDUSTRIAL SITES, AND EDUCATIONAL FACILITIES. THESE PROGRAMS INCLUDED SPEAKERS FROM TRINITY CLINIC TO LIONS CLUB, KIWANIS, AND HOPE. HOPE CENTER: SUPPORTED A COMMUNITY WIDE EVENT TO BENEFIT THE RESIDENTS OF ANDERSON AND CHEROKEE COUNTIES. PROVIDED FOOD FOR THE RESIDENTS OF THE AREA.	CommunityBuildingActivities
Affiliated Health Care System	MOTHER FRANCES HOSPITAL-JACKSONVILLE 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-JACKSONVILLE 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.	AffiliatedHealthCareSystem
Reports Filed With States	TX	ReportsFiledWithStates

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	SERVICE ORGANIZATION OF NORTH AND EAST TEXAS	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2950 50TH STREET	AddressLine1
City	LUBBOCK	City
State	TX	State
ZIP Code	79314	ZIPCode

Field	Value	IRS element (for citing)
EIN Of Recipient	260468622	EINOfRecipient
IRC Section	501(c)(3)	IRCSection
Amount Of Cash Grant	541691	AmountOfCashGrant
Purpose Of Grant	CONTRIBUTION	PurposeOfGrant

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	1	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.	Identifier
Return Reference	SCHEDULE I, PART I, LINE 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 REVIEWS THE FINANCIAL DATA OF RECIPIENTS TO ENSURE THAT THE GRANTED FUNDS ARE BEING USED PROPERLY.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
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	false	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 (6 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
TOM CAMMACK
233980	0	30691	0	0	0	3631	0	10379	0	278681	0
MATTHEW VIERKANT MD
0	507270	0	0	0	0	0	4900	0	13162	0	525332
RAY THOMPSON
0	603880	0	222843	0	440797	0	391818	0	13206	0	1672544	0	418686
BARRY THIBODEAUX
235368	0	0	0	0	0	4342	0	1490	0	241200	0
JACK CAPPS
227210	0	0	0	0	0	4350	0	13289	0	244849	0
WILLIAM MILAWSKI MD
0	264300	0	0	0	0	0	4671	0	10846	0	279817

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Identifier	PARTICIPATION IN OR PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN	Identifier
Return Reference	SCHEDULE J, PART I, QUESTION 4B	ReturnReference
Explanation	PARTICIPANTS IN SERP REPORTED IN W-2 DEFERRED COMPENSATION -------------------- --------------- --------------------- RAY THOMPSON $418,686 $386,918	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIBE REVIEW PROCESS OF FORM 990	FORM 990, PART VI, QUESTION 11A	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.
DESCRIBE THE ORGANIZATION'S MEMBERS OR STOCKHOLDERS	FROM 990, PART VI, QUESTION 6	TRINITY MOTHER FRANCES HEALTH SYSTEM IS THE SOLE MEMBER OF MOTHER FRANCES HOSPITAL - JACKSONVILLE.
MEMBERS OR STOCKHOLDERS WHO MAY ELECT MEMBERS OF THE GOVERNING BOARD	FORM 990, PART VI, QUESTION 7A	THE SOLE MEMBER, TRINITY MOTHER FRANCES HEALTH SYSTEM, APPOINTS ALL DIRECTORS AND THEIR SUCCESSORS TO THE GOVERNING BOARD.
DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY MEMBER	FORM 990, PART VI, QUESTION 7B	THE MEMBER HAS THE RIGHT TO APPROVE OR DISAPPROVE CERTAIN ACTIONS THAT HAVE BEEN APPROVED BY THE BOARD OF DIRECTORS.
HOW DOES THE ORGANIZATION MONITOR AND ENFORCE COMPLIANCE WITH POLICY	FORM 990, PART VI, QUESTION 12C	THE BOARD REVIEWS AND RESOLVES, IF NECESSARY, ANY TRANSACTIONS AS THEY ARISE THROUGHOUT THE YEAR IN ACCORDANCE WITH POLICY STANDARDS.
PROCESS FOR DETERMINING COMPENSATION OF CEO, OFFICERS, OR KEY EMPLOYEES	FORM 990, PART VI, QUESTIONS 15A & 15B	THE ORGANIZATION USES COMPENSATION CONSULTANTS AND NATIONAL COMPENSATION SURVEYS TO DETERMINE COMPENSATION OF EMPLOYEES. COMPENSATION IS APPROVED BY THE ORGANIZATION'S GOVERNING BODY.
DESCRIBE WHETHER THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE TO PUBLIC	FORM 990, PART VI, QUESTION 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
COMPENSATION FROM RELATED ORGANIZATIONS	FORM 990, PART VII & SCHEDULE J	THE GOVERNING BOARD OF TRINITY MOTHER FRANCES HEALTH SYSTEM UPON ADVICE FROM NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS, WHO PERIODICALLY REVIEW ALL EXECUTIVE COMPENSATION, APPROVED A DEFERRED COMPENSATION PLAN THAT PROVIDES A 65% TOTAL RETIREMENT BENEFIT FOR SENIOR EXECUTIVES THAT SERVE 20 YEARS OR MORE. THIS PROGRAM HAS BOTH RETENTION AND NON-COMPETITION CLAUSES THAT CREATE A RISK OF FORFEITURE. DEFERRED COMPENSATION IS SUBJECT TO A RISK OF FORFEITURE BASED ON RETENTION, NON-COMPETITION AND OTHER CONTRACTUAL FACTORS. ACCRUALS OF DEFERRED COMPENSATION ARE NOT INCLUDIBLE IN W-2 COMPENSATION UNTIL PAID. OTHER EMPLOYEE BENEFITS INCLUDE QUALIFIED PENSION PLANS. HEALTH, DENTAL AND LIFE INSURANCE PLANS, DISABILITY INSURANCE, ETC. TAXABLE EXPENSES ARE INCLUDED IN THE W-2 PAID COMPENSATION SALARY AMOUNT.
AVERAGE HOURS WORKED FOR RELATED ORGANIZATIONS	FORM 990, PART VII	AVG HOURS WORKED FOR RELATED ORGS WILLIAM MILAWSKI MD 30 MATTHEW VIERKANT MD 30 RAY THOMPSON 41
1099S REPORTED BY ORGANIZATION	FORM 990, PART V, QUESTION 1	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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 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
CHAMPION EMERGENCY SERVICES LLC
2201 S MOBBERLY AVE	LONGVIEW	TX	75602	752747708	AMBULANCE SVC	TX	501(C)(3)	11	na
MOTHER FRANCES HOSP REGIONAL HC CENTER
1021 E IDEL	TYLER	TX	75701	750818167	HOSPITAL	TX	501(C)(3)	3	NA
TRINITY MOTHER FRANCES HEALTH SYSTEM FDN
1021 E IDEL	TYLER	TX	75701	752028241	SUPPORT	TX	501(C)(3)	11	NA
REGIONAL MEDICAL SERVICES ASSOCIATION
1021 E IDEL	TYLER	TX	75701	752511459	HEALTHCARE	TX	501(C)(3)	3	NA
TRINITY MOTHER FRANCES HEALTH SYSTEM
1021 E IDEL	TYLER	TX	75701	752616975	HEALTHCARE	TX	501(C)(3)	11	NA
TRINITY CLINIC
1021 E IDEL	TYLER	TX	75701	752616977	HEALTHCARE	TX	501(C)(3)	3	NA
MOTHER FRANCES HOSPITAL- WINNSBORO
1021 E IDEL	TYLER	TX	75701	752771569	HOSPITAL	TX	501(c)(3)	3	NA

Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership	Address Line1AddressForeign/AddressLine1	Province Or StateAddressForeign/ProvinceOrState	CountryAddressForeign/Country	Legal Domicile Foreign CountryLegalDomicileForeignCountry
TRI-STATE FINANCIAL LLC
1021 E IDEL	TYLER	TX	75701	752728318	COLLECTION AGENCY	TX	NA	C-CORPORATION	0	0	0.00000
TRINCARE INC
1021 E IDEL	TYLER	TX	75701	752161369	MANAGEMENT SVCS	TX	NA	C-CORPORATION	0	0	0.00000
HEALTHPLAN OF TEXAS INC
1021 E IDEL	TYLER	TX	75701	752636832	THIRD PARTY ADMIN	TX	NA	C-CORPORATION	0	0	0.00000
REGIONAL HEALTHCARE ALLIANCE
1021 E IDEL	TYLER	TX	75701	752484109	PREFER. PROVIDER	TX	NA	C-CORPORATION	0	0	0.00000
TEXAS HEALTH FACILITIES INSUR CORP LTD
				980136025	INSURANCE		NA	C-CORPORATION	0	0	0.00000	PO Box 1109 BWI	GRAND CAYMAN	CJ	CJ
CONCORDIUM HEALTH LLC
1021 E IDEL	TYLER	TX	75701	702811022	INACTIVE	TX	NA	C-CORPORATION	0	0	0.00000
EMPLOYER SERVICES INC
1021 E IDEL	TYLER	TX	75701	752602556	INACTIVE	TX	NA	C-CORPORATION	0	0	0.00000
HERITAGE HEALTH PLANS OF TX
1021 E IDEL	TYLER	TX	75701	752622622	INACTIVE	TX	NA	C-CORPORATION	0	0	0.00000
QUALITY CARE ALLIANCE
1021 E IDEL	TYLER	TX	75701	752662965	INACTIVE	TX	NA	C-CORPORATION	0	0	0.00000

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	true	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg