2023-07-13T15:05:47-05:00 2022-08-31 FORVIS LLP 2700 Post Oak Blvd Ste 1500 HOUSTON TX 77056 990 2021-09-01 752660403 Hendrick Provider Network % JEREMY WALKER HEND 3256702000 PO BOX 3117 ABILENE TX 79604 JEREMY WALKER CFO 7134994600 2023-01-15 true Jeremy Walker XXX-XX-XXXX Amanda Maya P01067777 7134994600 2 2021 2023-04-26 12:10:37Z BRAD HOLLAND 1242 N 19TH ST ABILENE TX 79604 80562792 false X WWW.EHENDRICK.ORG X 1995 TX TO PROVIDE MEDICAL CARE TO THE COMMUNITIES OF ABILENE AND BROWNWOOD. MANY PATIENTS ARE ON MEDICAID. SERVICES ARE PROVIDED REGARDLESS OF ABILITY TO PAY. 10 0 995 0 0 0 0 3342951 64238762 76312607 -32562 -203761 1604113 1314756 65810313 80766553 1649 191 0 0 95240333 117613545 0 0 0 25293951 26239683 120535933 143853419 -54725620 -63086866 16422730 20701780 13851495 19714823 2571235 986957 TO PROVIDE MEDICAL CARE TO THE COMMUNITIES OF ABILENE AND BROWNWOOD. MANY PATIENTS ARE ON MEDICAID. SERVICES ARE PROVIDED TO PROMOTE BEST HEALTH PRACTICES REGARDLESS OF ABILITY TO PAY. false false 129292785 191 76314000 HENDRICK PROVIDER NETWORK PROVIDES A VARIETY OF HEALTH SERVICES ACROSS A WIDE RANGE OF SPECIALTIES FOR PATIENTS IN THE ABILENE AND BROWNWOOD AREAS, MANY OF WHOM ARE UNINSURED OR ARE ON MEDICAID. THESE SERVICES ARE PROVIDED BY PHYSICIANS EMPLOYED BY THE COMPANY. 129292785 true true false true false false false false false false true false false true true false false true false false false false false false false false false false false true false false false false false false false false false false false false true true true false false false true 65 0 true 995 true false false false false false false false false false false false false X 10 0 false false false false true true true true true false false true true true true true true true false false X JEREMY WALKER 3256702000 1900 PINE STREET ABILENE TX 79601 X BRENT MAHONEY DIRECTOR 40.0 0.0 X 1683323 0 47704 KEVIN BRIDGE PHYSICIAN 40.0 2.0 X 1644941 0 34779 DANIEL CANARIO PHYSICIAN 40.0 0.0 X 1488796 0 31751 BONNIE HAYASHI PHYSICIAN 40.0 0.0 X 1466393 0 36624 ANTAO DU PHYSICIAN 40.0 0.0 X 1363542 0 38707 HARVINDER ARORA PHYSICIAN 40.0 0.0 X 1374009 0 19911 REN ZHANG DIRECTOR 40.0 0.0 X 1331927 0 15114 BRAD HOLLAND PRESIDENT 2.0 50.0 X 0 1128376 171973 GARY BINKLEY DIRECTOR 40.0 2.0 X 1096332 0 10287 SANDIP MATHUR DIRECTOR 40.0 2.0 X 734582 0 28093 JACQUELINE ZIMMERMAN DIRECTOR 40.0 2.0 X 643528 0 32644 JEREMY WALKER CFO 2.0 50.0 X 0 536390 68532 ROBERT WILEY MD VICE PRESIDENT 2.0 42.0 X 0 515866 64285 MICHAEL MURPHY VICE PRESIDENT 2.0 44.0 X 0 496160 53404 JOHN MASTERSON DIRECTOR 40.0 0.0 X 526204 0 18671 HENRY FOSAH DIRECTOR 40.0 2.0 X 414758 0 33997 JOSE VEGA SECRETARY/PHYSICIAN 0.0 0.0 X 441663 0 0 ROBERT DICKEY DIRECTOR 40.0 0.0 X 401259 0 26181 DAVID STEPHENSON VICE PRESIDENT 30.0 14.0 X 280332 0 45776 PAUL WATTS DIRECTOR 40.0 0.0 X 245458 0 15618 DELENA MARTINEZ DIRECTOR 40.0 0.0 X 119045 0 8221 15256092 2676792 802272 178 true true false STAR GASTROENTEROLOGY PLLC 4101 PERCHERON BEND CEDAR PARK TX 78613 CONTRACT LABOR 908132 HAYES LOCUMS LLC PO BOX 88122 CHICAGO IL 606801122 CONTRACT LABOR 601730 LOCUMTENENSCOM PO BOX 405547 ATLANTA GA 303845547 CONTRACT LABOR 583703 METROPLEX GASTROENTEROLOGY 3760 AVIEMOEW DRIVE FORT WORTH TX 76109 CONTRACT LABOR 454738 ELANGO VINJIRAYER MD PA 5808 FARR OAK DRIVE PLANO TX 75093 CONTRACT LABOR 451000 14 3342951 3342951 Net Patient Fees 621500 76309361 76309361 Related NMTC Rental Revenue 531120 3246 3246 76312607 0 0 0 1393 0 1393 0 1393 1393 -203761 203761 -203761 -203761 0 0 0 0 0 0 0 0 0 Miscellaneous Income 900099 1313363 1313363 1313363 80766553 76314000 0 1109602 191 191 0 0 0 7759054 7295497 463557 441663 441663 95806497 90359692 5446805 1620324 1480930 139394 7485462 6205537 1279925 4500545 4076233 424312 113398 113398 0 21400 21400 0 0 0 7284457 4071919 3212538 184339 138647 45692 853290 616904 236386 1203050 604289 598761 0 4537463 4527666 9797 117925 112510 5415 0 0 268633 268633 0 3005054 925171 2079883 822810 819716 3094 Medical Supplies 5139222 5139222 Minor Equipment 311558 241718 69840 Recruiting and Placement 42119 42119 Bad Debt 952199 952199 1382766 1127564 255202 143853419 129292785 14560634 0 418672 782879 220527 408739 0 0 7493577 7553861 0 0 0 0 0 0 1110231 302786 205136 115270 13792296 9332224 6796751 4460072 0 0 0 0 0 0 13466 125220 164370 6952953 16422730 20701780 9836987 12081651 0 0 2086575 0 0 0 0 0 0 0 0 0 0 0 1927933 7633172 13851495 19714823 X 2571235 986957 0 0 2571235 986957 16422730 20701780 X -63086866 61502588 X false true X true false X 0 0 0 0 3342951 3342951 40372916 44303235 46926563 64238762 76312607 272154083 0 0 0 40372916 44303235 46926563 64238762 79655558 275497034 0 0 0 275497034 1628 1373 1647 1688 1393 7729 0 1628 1373 1647 1688 1393 7729 0 824744 1406074 2539986 1602425 1313363 7686592 41199288 45710682 49468196 65842875 80970314 283191355 0.97283 0.96944 0.00003 0.00003 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5750 5750 false PART II-B, QUESTION 1I Amount reported in Part II-B, Question 1I represents portion of dues paid to trade associations that is attributable to lobbying activities. 14667 13425 1242 38478 38478 13704182 9263364 4440818 34969 16957 18012 4460072 Right of Use Operating Leases 6952953 6952953 0 Operating Lease Liabilities 7060859 Deferred Payroll Taxes Payable 572313 7633172 80018115 -952199 -952199 80970314 -203761 -203761 80766553 143104981 203761 203761 142901220 952199 952199 143853419 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 REVENUE ON BOOKS, NOT ON RETURN: BAD DEBT EXPENSE IN AUDIT REVENUE $ (952,199) SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 REVENUE ON RETURN, NOT ON BOOKS: REALIZED LOSS ON DISPOSAL OF ASSETS IN AUDIT EXPENSE $ (203,761) SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 EXPENSE ON BOOKS, NOT ON RETURN: REALIZED LOSS ON DISPOSAL OF ASSETS IN AUDIT EXPENSE $ 203,761 SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 EXPENSE ON RETURN, NOT ON BOOKS: BAD DEBT EXPENSE IN AUDIT REVENUE $ 952,199 X X X X X false true false false false false false false false BRAD HOLLAND PRESIDENT 0 663521 0 272230 0 192625 0 145269 0 26704 0 1300349 0 183075 JEREMY WALKER CFO 0 353208 0 128895 0 54287 0 45898 0 22634 0 604922 0 44473 MICHAEL MURPHY VICE PRESIDENT 0 352002 0 131299 0 12859 0 28200 0 25204 0 549564 0 0 ROBERT WILEY MD VICE PRESIDENT 0 375090 0 135453 0 5323 0 36361 0 27924 0 580151 0 0 DAVID STEPHENSON VICE PRESIDENT 225277 0 54396 0 659 0 18038 0 27738 0 326108 0 0 0 REN ZHANG DIRECTOR 668007 0 639804 0 24116 0 8700 0 6414 0 1347041 0 0 0 ROBERT DICKEY DIRECTOR 328946 0 46082 0 26231 0 8700 0 17481 0 427440 0 0 0 HENRY FOSAH DIRECTOR 255185 0 157557 0 2016 0 5213 0 28784 0 448755 0 0 0 BRENT MAHONEY DIRECTOR 817506 0 843445 0 22372 0 8700 0 39004 0 1731027 0 0 0 GARY BINKLEY DIRECTOR 665700 0 409522 0 21110 0 8700 0 1587 0 1106619 0 0 0 JOHN MASTERSON DIRECTOR 522332 0 0 0 3872 0 8700 0 9971 0 544875 0 0 0 SANDIP MATHUR DIRECTOR 564121 0 164538 0 5923 0 8700 0 19393 0 762675 0 0 0 JACQUELINE ZIMMERMAN DIRECTOR 369458 0 273567 0 503 0 8700 0 23944 0 676172 0 0 0 PAUL WATTS DIRECTOR 179185 0 46233 0 20040 0 5508 0 10110 0 261076 0 0 0 BONNIE HAYASHI PHYSICIAN 293800 0 1172185 0 408 0 8700 0 27924 0 1503017 0 0 0 HARVINDER ARORA PHYSICIAN 468518 0 885281 0 20210 0 8700 0 11211 0 1393920 0 0 0 DANIEL CANARIO PHYSICIAN 558650 0 928198 0 1948 0 8700 0 23051 0 1520547 0 0 0 KEVIN BRIDGE PHYSICIAN 955417 0 688043 0 1481 0 8700 0 26079 0 1679720 0 0 0 ANTAO DU PHYSICIAN 716921 0 624593 0 22028 0 8700 0 30007 0 1402249 0 0 0 JOSE VEGA SECRETARY/PHYSICIAN 317201 0 124462 0 0 0 0 0 0 0 441663 0 0 0 PART 1, LINE 4B PARTICIPATION IN OR PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPANTS IN 457(F) REPORTED W-2 DEFERRED COMP. PAID BY --------------------- ------------ -------------- ------- JEREMY WALKER $ 44,473 $ 37,198 HMC DAVID STEPHENSON $ NONE $ 14,245 HPN BRAD HOLLAND $ 183,075 $ 136,569 HMC ROBERT WILEY $ NONE $ 35,759 HMC FORM 990, PART VI, SECTION A, LINE 6 HENDRICK MEDICAL CENTER IS THE SOLE MEMBER OF HENDRICK PROVIDER NETWORK. FORM 990, PART VI, SECTION A, LINE 7A PERSONS WHO MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY: THE MEMBER, HENDRICK MEDICAL CENTER, SHALL ELECT THE SUCCESSORS OF THE INITIAL DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY OTHER PERSONS: ARTICLE VII OF THE RESTATED ARTICLES OF INCORPORATION PROVIDES, IN PART, THAT AN AMENDMENT TO ARTICLE II RELATING TO THE PURPOSE OF THE CORPORATION AND ARTICLE VI RELATING TO THE NUMBER AND METHOD OF THE ELECTION OR APPOINTMENT OF THE BOARD OF TRUSTEES SHALL OCCUR ONLY WITH THE CONSENT OF THE BAPTIST GENERAL CONVENTION OF TEXAS OR ITS EXECUTIVE BOARD. FORM 990, PART VI, SECTION B, LINE 11B DESCRIBE REVIEW PROCESS OF FORM 990: 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. FORM 990, PART VI, SECTION B, LINE 12C DESCRIBE THE ORGANIZATION'S PRACTICE FOR MONITORING COMPLIANCE WITH POLICY: THE ORGANIZATION CONDUCTS, AT A MINIMUM, ANNUAL REVIEWS OF THE POSSIBLE CONFLICTS OF INTEREST AND OTHER FINANCIAL RELATIONSHIPS IDENTIFIED UNDER THIS CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15A PROCESS FOR DETERMINING COMPENSATION OF CEO, DIRECTORS, OR TOP OFFICIALS: A COMPREHENSIVE REVIEW OF COMPENSATION IS CONDUCTED BY AN INDEPENDENT PARTY AT LEAST EVERY THREE YEARS. THIS REPORT PRESENTS THE RESULTS OF THE ANALYSIS OF SALARY, INCENTIVE, TOTAL CASH COMPENSATION (SALARY PLUS INCENTIVE), BENEFITS, AND TOTAL COMPENSATION (TOTAL CASH AND BENEFITS). INTEGRATED HEALTHCARE STRATEGIES (IHS) WORKS WITH THE PERSONNEL COMMITTEE TO FORMALLY DEFINE AN EXECUTIVE TOTAL COMPENSATION PHILOSOPHY. HENDRICK HEALTH SYSTEM'S CURRENT PHILOSOPHY IS TO USE RANGES BUILT AROUND THE MEDIAN OF THE MARKET WITH A 50% SPREAD FROM MINIMUM TO MAXIMUM. INCENTIVE OPPORTUNITY LEVELS ARE COMPETITIVE WITH PRACTICES OF PEER GROUPS AND BENEFITS WILL BE DELIVERED AT MARKET COMPETITIVE LEVELS. SEVERANCE AND PERQUISITES REFLECT A CONSERVATIVE PHILOSOPHY. THE COMMITTEE DETERMINED THAT THE PEER GROUP WOULD BE PRIMARILY REGIONAL NOT-FOR-PROFIT HOSPITALS OF SIMILAR SIZE AND COMPLEXITY. NATIONAL PEER GROUP WILL BE USED FOR REFERENCE PURPOSES WHERE APPROPRIATE. THE HENDRICK HEALTH SYSTEM PERSONNEL COMMITTEE IS DELEGATED THE RESPONSIBILITY FOR THE EXECUTIVE COMPENSATION PROGRAM BY THE BOARD OF TRUSTEES. THE COMMITTEE: SETS THE OVERALL EXECUTIVE COMPENSATION PHILOSOPHY TO BE IMPLEMENTED BY HENDRICK HEALTH SYSTEM; SETS COMPENSATION COMPONENTS FOR THE PRESIDENT AND CEO; REVIEWS, DISCUSSES AND MAKES DECISIONS BASED ON THE PRESIDENT AND CEO'S RECOMMENDATIONS FOR HIS DIRECT REPORTS; REPORTS A SUMMARY OF THE PROCESS BACK TO THE BOARD OF TRUSTEES ALONG WITH THE ACTUAL COMPENSATION APPROVED FOR THE PRESIDENT AND CEO; AND APPROVES ALL INCENTIVE GOALS AND AWARDS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART V, LINE 15 THE ORGANIZATION HAS SEVERAL INDIVIDUALS WITH REPORTABLE COMPENSATION EXCEEDING $1,000,000. THESE REPORTED INDIVIDUALS ARE LICENSED MEDICAL PROFESSIONALS THAT ARE PAID FOR MEDICAL SERVICES WHICH ARE EXCLUDED FROM THE SECTION 4960 EXCISE TAX ON EXCESS EXECUTIVE COMPENSATION. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: TRANSFERS FROM AFFILIATES $ 61,502,588 HPN RO BILLING SERVICES LLC 1900 PINE ST ABILENE TX 79601 813892121 RADIOLOGY SVC TX 738070 0 HPN HPN PHYSICIAN BILLING LLC 1900 PINE ST ABILENE TX 79601 815158335 BILLING SRVCS TX 12395477 0 HPN HENDRICK CLINIC BILLING PLLC 1900 PINE ST ABILENE TX 79601 862815377 BILLING SRVCS TX 3829426 0 HPN HENDRICK MEDICAL CENTER PO BOX 3117 ABILENE TX 79604 750827446 HOSPITAL TX 501(C) (3) 3 NA false HENDRICK ANESTHESIA NETWORK PO BOX 3117 ABILENE TX 79604 752728889 ANESTHESIA TX 501(C) (3) 10 HMC true HENDRICK HOSPICE CARE PO BOX 3117 ABILENE TX 79604 751835287 HOSPICE CARE TX 501(C) (3) 10 HMC true HMC HOSPICE PROPERTIES PO BOX 3117 ABILENE TX 79604 814244839 PROPERTY MGMT TX 501(C) (3) 12A, TYPE 1 HMC true HENDRICK MEDICAL CENTER FOUNDATION PO BOX 3117 ABILENE TX 79604 237413284 FUNDRAISING TX 501(C) (3) 7 HMC true HENDRICK MEDICAL CENTER BROWNWOOD 1900 PINE ST ABILENE TX 79601 851941193 HEALTHCARE TX 501(C) (3) 3 HMC true HENDRICK DIALYSIS CENTER 1900 PINE ST ABILENE TX 79601 834206582 DIALYSIS CENTER TX HMC RELATED false false TEXAS MIDWEST SURGERY CENTER 751 N 18TH STREET ABILENE TX 79601 752800127 SURGERY CENTER TX HMC RELATED false false HENDRICK HEALTH NETWORK PO BOX 3117 ABILENE TX 79604 721619011 HEALTH INSURANCE TX HMC C-CORPORATION true HENDRICK SOUTHWESTERN HEALTH DEV CORP PO BOX 3117 ABILENE TX 79604 751598794 RETAIL SALES TX HMC C-CORPORATION true false false true false false false false false false false true false false false false false false false false