HUGULEY MEDICAL ASSOCIATES INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- HUGULEY MEDICAL ASSOCIATES INC (EIN 75-2547668)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-09
- IRS object ID
- 202203139349302785
- Schema version
- 2021v4.2
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-09T12:34:59-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752547668 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Huguley Medical Associates | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HUGU | BusinessNameControlTxt |
| Phone | 8778479355 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11801 South Freeway | AddressLine1Txt |
| City | Burleson | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76028 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lynn C Addiscott | PersonNm |
| Person Title | Assistant Secretary | PersonTitleTxt |
| Phone | 8778479355 | PhoneNum |
| Signature | 2022-11-08 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Lynn | PersonFirstNm |
| Person Last | Addiscott | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Penny Johnson | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11801 South Freeway | AddressLine1Txt |
| City | Burleson | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76028 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,663,707 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | http://huguleymedicalassociates.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | Operation of physician practices and provision of related medical services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 148 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $397,800 | PYContributionsGrantsAmt |
| CY Contributions Grants | $45,855 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,678,011 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,594,875 | CYProgramServiceRevenueAmt |
| PY Investment Income | $473 | PYInvestmentIncomeAmt |
| CY Investment Income | $22,977 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $12,076,284 | PYTotalRevenueAmt |
| CY Total Revenue | $15,663,707 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,733,586 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,802,323 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,304,488 | PYOtherExpensesAmt |
| CY Other Expenses | $5,221,590 | CYOtherExpensesAmt |
| PY Total Expenses | $18,038,074 | PYTotalExpensesAmt |
| CY Total Expenses | $21,024,913 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$5,961,790 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$5,361,206 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,959,201 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,864,339 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,676,340 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,491,838 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$717,139 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$627,499 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Our Mission is to extend the healing ministry of Christ by identifying and meeting the health needs of our community, providing quality, customer oriented and cost effective services, and ensuring access to those services. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,961,827 | ExpenseAmt |
| Grant | $1,000 | GrantAmt |
| Revenue | $15,594,875 | RevenueAmt |
| Desc | The primary mission of Huguley Medical Associates is to serve the health care needs of the local community by providing broad access to services through various programs, including physician participation in Medicare, Medicaid, and by providing indigent care. There were 131,466 patient encounters during the current year. | Desc |
| Total Program Service Expenses | $18,961,827 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 148 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jesse Sutton | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8175512704 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11801 South Freeway | AddressLine1Txt |
| City | Burleson | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76028 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Key EmployeeKeyEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Johnson Penny | ||||||||||
| CEO | 5.00 | 45.00 | Yes (X) | $0 | $2,601,818 | $182,819 | ||||
| Sutton Jesse | ||||||||||
| CFO/Treasurer | 7.50 | 42.50 | Yes (X) | $0 | $575,061 | $96,781 | ||||
| Chadwick Daniel | ||||||||||
| Physician | 40.00 | 5.00 | $603,685 | $0 | $45,407 | Yes (X) | ||||
| Shama Zareena | ||||||||||
| Physician | 40.00 | 0.00 | $531,256 | $0 | $33,741 | Yes (X) | ||||
| Chellappan Chandra | ||||||||||
| Physician | 40.00 | 0.00 | $482,373 | $0 | $55,583 | Yes (X) | ||||
| Retamozo Luis | ||||||||||
| Physician | 40.00 | 0.00 | $501,378 | $0 | $33,574 | Yes (X) | ||||
| Abdussalam Abdullah | ||||||||||
| Physician | 40.00 | 0.00 | $485,447 | $0 | $16,837 | Yes (X) | ||||
| Finch Kenneth | ||||||||||
| Former CEO | 0.00 | 0.00 | $0 | $335,617 | $6,078 | Yes (X) | ||||
| Jasinski Kelly | ||||||||||
| Vice President | 41.00 | 9.00 | $0 | $246,883 | $52,096 | Yes (X) | ||||
| Seiden MD Jason | ||||||||||
| Director (Beg 01/21) | 0.10 | 18.50 | $0 | $144,543 | $0 | Yes (X) | ||||
| Hamilton MD Steve | ||||||||||
| Director | 0.10 | 1.90 | $0 | $11,950 | $0 | Yes (X) | ||||
| Japas MD Carlos | ||||||||||
| Director | 0.10 | 0.20 | $0 | $200 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,604,139 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,916,072 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $522,916 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 35 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | United Allergy Services | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 NE Loop 410 Ste 600 | AddressLine1Txt |
| City | San Antonio | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78216 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Allergy Immunotherapy Services | ServicesDesc |
| Compensation | $124,380 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Government Grants | $45,855 | GovernmentGrantsAmt |
| Total Contributions | $45,855 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net patient revenue | 622110 | $13,699,174 | $13,699,174 |
| Incentive revenue | 622110 | $1,890,785 | $1,890,785 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,916 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,916 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,594,875 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,092 | TotalRevenueColumnAmt |
| Exclusion | $11,092 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,885 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,885 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,885 | TotalRevenueColumnAmt |
| Exclusion | $11,885 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,663,707 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,594,875 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $22,977 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Program Services | $1,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $678,220 | TotalAmt |
| Management And General | $678,220 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,234,873 | TotalAmt |
| Program Services | $13,234,873 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,265,701 | TotalAmt |
| Program Services | $1,233,828 | ProgramServicesAmt |
| Management And General | $31,873 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $623,529 | TotalAmt |
| Program Services | $603,023 | ProgramServicesAmt |
| Management And General | $20,506 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,144 | TotalAmt |
| Management And General | $10,144 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $931 | TotalAmt |
| Management And General | $931 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,678,989 | TotalAmt |
| Program Services | $584,507 | ProgramServicesAmt |
| Management And General | $1,094,482 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,440 | TotalAmt |
| Management And General | $28,440 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $324,039 | TotalAmt |
| Program Services | $219,731 | ProgramServicesAmt |
| Management And General | $104,308 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,233 | TotalAmt |
| Program Services | $133,233 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,694,363 | TotalAmt |
| Program Services | $1,694,363 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,937 | TotalAmt |
| Management And General | $24,937 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $357 | TotalAmt |
| Management And General | $357 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,226 | TotalAmt |
| Program Services | $15,226 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,642 | TotalAmt |
| Program Services | $130,642 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $320,810 | TotalAmt |
| Program Services | $320,735 | ProgramServicesAmt |
| Management And General | $75 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $738,690 | $738,690 | |
| Dues & Memberships | $64,828 | $64,828 | |
| Repairs & maintenance | $31,967 | $31,967 | |
| Licenses & Permits | $20,009 | $20,009 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,985 | TotalAmt |
| Management And General | $3,985 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,024,913 | TotalAmt |
| Program Services | $18,961,827 | ProgramServicesAmt |
| Management And General | $2,063,086 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,848 | BOYAmt |
| EOY | $4,750 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,226 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $555,450 | BOYAmt |
| EOY | $893,253 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,631 | BOYAmt |
| EOY | $6,115 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,174,475 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $681,414 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $537,898 | BOYAmt |
| EOY | $493,061 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,823,148 | BOYAmt |
| EOY | $7,467,160 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,959,201 | BOYAmt |
| EOY | $8,864,339 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,652,529 | BOYAmt |
| EOY | $1,260,924 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,643 | BOYAmt |
| EOY | $1,643 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,022,168 | BOYAmt |
| EOY | $8,229,271 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,676,340 | BOYAmt |
| EOY | $9,491,838 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$717,139 | BOYAmt |
| EOY | -$627,499 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$717,139 | BOYAmt |
| EOY | -$627,499 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,959,201 | BOYAmt |
| EOY | $8,864,339 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$5,361,206 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $8,481 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $5,442,365 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,168,975 | OtherCostOrOtherBasisAmt |
| Depreciation | $679,948 | DepreciationAmt |
| Book Value | $489,027 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,500 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,466 | DepreciationAmt |
| Book Value | $4,034 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $493,061 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due from related | $12,722 |
| Other receivables | $236 |
| Right of Use Asset - Operating Lease | $7,434,276 |
| Other assets | $19,926 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $7,467,160 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to related | $526,723 |
| Credit balances in A/R | $22,050 |
| Accrued interest payable | $6,499 |
| Operating Lease Liability | $7,673,799 |
| Other liabilities | $200 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,229,271 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Consolidated Audited Financial Statements for the twelve-month period ended 12/31/2021 include the filing organization and its member tax-exempt hospital, Texas Health Huguley (THH or the Company). These Consolidated audited financial statements contain the following FIN 48 footnote: The Company is exempt from state and federal income taxes. Accordingly, the Company and its tax-exempt affiliates are not subject to federal, state, or local income taxes, except for any net unrelated business taxable income. For the years ended December 31, 2021 and 2020, unrelated business income activities conducted by the Company and its tax-exempt affiliates did not generate a material amount of combined federal, state, or local income tax. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Johnson Penny | ||||||||||||||
| CEO | $0 | $656,961 | $0 | $275,634 | $0 | $1,669,223 | $0 | $128,712 | $0 | $54,107 | $0 | $2,784,637 | $0 | $80,024 |
| Sutton Jesse | ||||||||||||||
| CFO/Treasurer | $0 | $384,232 | $0 | $135,338 | $0 | $55,491 | $0 | $59,071 | $0 | $37,710 | $0 | $671,842 | $0 | $33,561 |
| Chadwick Daniel | ||||||||||||||
| Physician | $304,011 | $0 | $243,248 | $0 | $56,426 | $0 | $0 | $0 | $45,407 | $0 | $649,092 | $0 | $0 | $0 |
| Shama Zareena | ||||||||||||||
| Physician | $198,856 | $0 | $330,487 | $0 | $1,913 | $0 | $0 | $0 | $33,741 | $0 | $564,997 | $0 | $0 | $0 |
| Chellappan Chandra | ||||||||||||||
| Physician | $254,227 | $0 | $226,757 | $0 | $1,389 | $0 | $0 | $0 | $55,583 | $0 | $537,956 | $0 | $0 | $0 |
| Retamozo Luis | ||||||||||||||
| Physician | $175,319 | $0 | $324,364 | $0 | $1,695 | $0 | $0 | $0 | $33,574 | $0 | $534,952 | $0 | $0 | $0 |
| Abdussalam Abdullah | ||||||||||||||
| Physician | $483,406 | $0 | $0 | $0 | $2,041 | $0 | $0 | $0 | $16,837 | $0 | $502,284 | $0 | $0 | $0 |
| Finch Kenneth | ||||||||||||||
| Former CEO | $0 | $0 | $0 | $0 | $0 | $335,617 | $0 | $0 | $0 | $6,078 | $0 | $341,695 | $0 | $0 |
| Jasinski Kelly | ||||||||||||||
| Vice President | $0 | $208,182 | $0 | $27,825 | $0 | $10,876 | $0 | $12,860 | $0 | $39,236 | $0 | $298,979 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | The individual who serves as the CEO of the filing organization is appointed and compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), an unrelated entity as disclosed in our response to Form 990, Part VI, Section A, Line 3, for that individual's role in serving as the CEO pursuant to the Management Services agreement between the filing organization's sole member, Texas Health Huguley, Inc (THH) and AHSSHC. Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation Section 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board Compensation Committee (the Committee) serves as the governing body for all executive compensation matters. The Committee is composed of certain members of the Board of Directors (the Board) of AHSSHC. Voting members of the Committee include only individuals who serve on the Board as independent representatives, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present, other than the Chief People Officer, who remains at the request of the Chairman/committee to provide assistance/information as needed. The Committee is advised by an independent third-party compensation advisor. This advisor prepares all the benchmark studies for the Committee. Compensation levels are benchmarked with a national peer group of other not-for-profit healthcare systems and hospitals of similar size and complexity to AdventHealth and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AdventHealth will not exceed the 50th percentile of comparable salaries paid by similarly situated organizations; and - Other executive salaries shall be established using market medians. The compensation philosophy, policies, and practices of AHSSHC are consistent with the organization's faith-based mission and conform to applicable laws, regulations, and business practices. As a faith-based organization sponsored by the Seventh-day Adventist Church (the Church), AHSSHC's philosophy and principles with respect to its executive compensation practices reflect the conservative approach of the Church's mission of service and were developed in counsel with the Church's leadership. |
| Part I, Lines 4a-b | During the year ending December 31, 2021, Kenneth Finch received severance payments in the amount of $329,608. Pursuant to the AHSSHC Corporate Executive Policy governing executive severance, severance agreements for executives operating at the Vice President level and above are entered into upon eligibility to facilitate the transition to subsequent employment following an involuntary separation from employment with AdventHealth. See continuation 1. |
| Part I, Line 4b - Continuation 1: | Kenneth Finch, Penny Johnson, Jesse Sutton, and Kelly Jasinski received compensation from Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the top-tier parent of the the 49% owner of the filing organization and the parent organization of the healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides supplemental executive benefit plans to eligible executives. In 2020, AdventHealth restructured its executive supplemental retirement and benefit plans to reduce complexity, to increase predictability of benefits and to consolidate multiple supplemental executive benefit plans into one plan. Effective 1/1/2020, a new supplemental executive retirement plan (SERP III) was adopted and the three existing plans, described below, were amended and restated. The newly adopted SERP III plan, as well as the amended and restated plans, were reviewed and approved by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. SERP III Plan (Effective 1/1/2020): To recognize the contribution each executive makes to the success of AdventHealth and to recognize the limitations available to executives in qualified retirement plans due to compensation limits set on such plans, AdventHealth adopted a new supplemental executive retirement plan (SERP III) in 2020. The SERP III plan effectively replaces the prior SERP II plan, the Executive Flex Benefit Program Plan, and the Senior Executive Death Benefit Plan for qualified executives except for certain grandfathered executive employees. The SERP III plan provides eligible executives a percentage of their base pay, which is credited to a deferred compensation account. The plan also provides for compensation deferral and selection of life insurance coverage and long-term care insurance. To be eligible to participate in the SERP III plan, executives must be on the AHSSHC corporate payroll and be either a CEO of an AdventHealth entity, an AHSSHC Vice President (VP) or VP of an AdventHealth entity with a base salary of at least $290,000 in 2021 (adjusted annually by the same percentage as IRC Section 401(a)(17) limit increases), or other leader specifically approved by the AdventHealth President. Eligible executives do not include grandfathered executives, meaning those executives who would satisfy all the eligibility requirements of the SERP II plan prior to Dec 31, 2027, had the plan not been amended and restated as of Jan. 1, 2020. Contribution credits will be established and maintained by class year accounts for each participant using tiered contribution credit percentages of annual base compensation. Contribution credit percentages range between 15% and 19% of base compensation. Contribution credits will be made each quarter in 25% increments with reductions in contributions if the executive is also a grandfathered FLEX participant (see below). SERP III provides for a class year vesting and payment schedule (7 years for each class year) with respect to amounts accumulated in the executive's deferred compensation account. Upon attainment of a normal retirement age (age 62), or upon certain other circumstances as defined in the SERP III plan document, all deferred amounts are paid immediately to the participant. For any executives working beyond the normal retirement age, future employer contributions will be made quarterly from SERP III directly to the participant as a taxable cash bonus. SERP II Plan (Amended and Restated in 2020): In 2020, the SERP II plan was amended and restated to provide that eligible employees are restricted to those executives who, as of January 1, 2020, satisfied, or if employment continues, will satisfy the eligibility requirements of SERP II prior to December 31, 2027. The SERP II plan is a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AdventHealth and/or to other Seventh-day Adventist Church hospitals or health care institutions. Under the provisions of the SERP II plan, benefits are provided to qualifying executive participants on a pro-rata schedule beginning with 20 years of service as an employee of AdventHealth and/or another hospital or health care institution controlled by the Seventh-day Adventist Church and who satisfy certain other qualifying criteria. This supplemental executive retirement plan (SERP II) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, five or seven highest years of base salary from AdventHealth active employment inclusive of income from all other Seventh-day Adventist Church healthcare employer-financed retirement income sources and investment income earned on those contributions through social security normal retirement age as defined in the plan. The number of years included in highest average compensation is determined by the individual's year of entry to SERP II and by the individual's year of entry to the AdventHealth Executive FLEX Benefit Program. FLEX Plan (Amended and Restated in 2020): In 2020, the Flex Plan was amended and restated to exclude employed executives who are hired or promoted after a certain date from being eligible to participate in the Flex Plan except for certain insurance coverage features of the plan. Additionally, a provision was added to place a maximum limit on the amount of a participant's annual Flex allowance to not be greater than a maximum dollar amount or percentage of compensation as established by the AdventHealth Benefits Administration Committee. The Flex Plan was originally designed to provide eligible executives an opportunity to select from among a variety of supplemental benefits, including a split dollar life insurance policy and long-term care insurance, to individually tailor a benefits program appropriate to each executive's needs. The Flex Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which the cost of mandatory and elective employee benefits is deducted. The benefits allowance credit percentage is determined by the AdventHealth Benefits Administration Committee. For grandfathered eligible employees, the annual pre-determined Flex allowance is contributed and any funds that remain after the cost of mandatory and elective benefits are subtracted are, at the employee's option, contributed to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. Upon attainment of age 65, all previous 457(f) deferred amounts are paid immediately to the participant and any future employer contributions are made quarterly from the Plan directly to the participant. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account will be forfeited by the executive upon a voluntary separation. With respect to grandfathered participants, the Flex Plan documents define eligible employees to include the Chief Executive Officers of AdventHealth entities and Vice Presidents of all AdventHealth entities whose base salary was at least equal to the Internal Revenue Code Section 401(a)(17) compensation limit each year. See continuation 2. |
| Part I, Line 4b - Continuation 2: | Senior Executive Death Benefit Plan (SEDB) (Amended and Restated in 2020): The SEDB plan was originally designed to provide a benefit in an amount equal to the amount the executive's benefit would have been under the SERP II Plan assuming that, on the date of the executive's death (and not before), the executive satisfied the last of the eligibility requirements of the SERP II Plan with present value recognizing an early benefit commencement. In conjunction with the amendment and restatement of the SERP II Plan, the SEDB was similarly amended in 2020 to limit eligible employees to only those who either satisfy the eligibility requirements of SERP II as of January 1 2020, or remain in active employment and will satisfy those requirements prior to December 31, 2027. An eligible executive becomes a participant in the SEDB Plan if the executive dies prior to termination of employment, provided the executive has not satisfied all the eligibility requirements of SERP II as of the executive's date of death but would have satisfied all those requirements within five (5) years following death had the executive lived and continued employment. The SEDB Plan will terminate automatically after December 31, 2027. FLEX Plan FLEX Plan SERP II SERP III Contr. Distr.* Contr./Distr. Contr. Johnson,Penny $ 113,164 $ 96,451 $ 1,549,952 $ 0 Sutton,Jesse $ 43,523 $ 39,691 $ 0 $ 0 * Including Investment Earnings |
| Part I, Line 6: | The filing organization's physician compensation formula is designed to result in total compensation that would be reasonable for each physician. The filing organization utilizes national survey productivity, cost, and compensation data in formulating all aspects of the compensation plan. Physician compensation contractual agreements include a ceiling or reasonable maximum on the amount a physician may earn. The filing organization's employed physicians enter into a written agreement that requires the physicians to provide medical care to individuals who are referred by the filing organization. The filing organization's compensation arrangement does not use a method of compensation that is based upon a percentage of the organization's net income. Under the compensation arrangement, physician base salary, including any additional compensation based on a percentage of the practice/location net revenue, is documented as being within a range of Fair Market Value. |
| Part VII, Section A, Line 5: | Penny Johnson, CEO, Jesse Sutton, CFO, Kenneth Finch, former CEO, and Kelly Jasinksi were compensated by AHSSHC in 2021 for services provided to the filing organization. Please see our response to Form 990, Part VI, Section A, Line 3 for a discussion concerning the filing organizations affiliation with AHSSHC. Compensation for these individuals is disclosed in Schedule J, Part II. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part V, Line 1a: | The sole member of the filing organization is Texas Health Huguley, Inc. (THH). THH is 49% owned by Adventist Health System/Sunbelt, Inc. (AHSSI). The parent corporation and sole top-tier member of AHSSI is Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is a Florida, not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). AHSSHC has established a shared service center to centralize the Accounts Payable (A/P) function for all AHSSHC subsidiary organizations. The filing organization has entered "0" in Part V, Line 1a because the filing organization does not issue Form 1099 returns, rather, all such returns are filed by and under the name and EIN of AHSSHC as the payor subject to the information reporting requirements of Section 6041. The facts and circumstances support a position that AHSSHC, as a payor on behalf of its subsidiary organizations in a shared service environment, will have sufficient management and oversight in connection with the subsidiary organizations' payments to meet the standard set forth in Treas. Reg. Section 1.6041-1(e). AHSSHC will not merely be making payments at the direction of its subsidiary organizations. Accordingly, AHSSHC is considered the payor subject to the information reporting requirements of Section 6041. |
| Form 990, Part VI, Section A, line 3 | Effective January 1, 2012, Texas Health Huguley (THH), the sole member of Huguley Medical Associates (the filing organization) entered into a Management Services Agreement with Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). AHSSHC is the parent organization of a system of tax-exempt hospitals and other health care provider organizations that operate 48 hospitals throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC is exempt from federal income tax under Internal Revenue Code Section 501(c)(3). Under the Management Services Agreement (the Agreement), AHSSHC must follow the policies of the filing organization's Board of Directors. Managerial services provided by AHSSHC included oversight and day to day management of the filing organization, including the following functions: Personnel administration, including recruitment, hiring, training, promoting, directing and terminating personnel; Procurement, including the acquisition of food and beverage items, supplies, devices, furniture, and medical equipment; Health Information Management; Maintenance and Security; Contracting for services and consulting services; Financial accounting systems; Development of operational and capital budgets; Billing and collection of receivables and remittances of payables; Patient safety and quality systems; Marketing; Regulatory compliance; Administration - Policies and Procedures, including appointment of the CFO, COO, and CNO. The individuals who serve as officers of the filing organization in the roles of CEO and CFO are listed in Part VII, Section A. These individuals were compensated by and on the payroll of AHSSHC for services rendered to the filing organization. The individual who serves as the Key Employee of the filing organization is listed in Part VII, Section A and is compensated by AHSSHC. Their compensation has been reported on Part VII and Schedule J in accordance with the instructions for Part VII, Section A, Line 5. |
| Form 990, Part VI, Section A, line 6 | Huguley Medical Associates has one member. The sole member of the filing organization is Texas Health Huguley, Inc. Texas Health Huguley, Inc, (THH) is a Florida not-for-profit corporation that is exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). There are no other classes of membership in the filing organization. |
| Form 990, Part VI, Section A, line 7a | The sole member of the filing organization is THH. The Board of Directors of the filing organization are appointed by the sole member, THH, who has the right to elect, appoint or remove any member of the Board of Directors of the filing organization. |
| Form 990, Part VI, Section A, line 7b | THH, as the sole member of the filing organization, has certain reserved powers as set forth in the Bylaws of the filing organization. These reserved powers include the following: a) to approve and disapprove the admission of new Members of the Corporation; b) to alter, amend or repeal the Articles of Incorporation; c) to alter, amend or repeal the Bylaws of the Corporation with the approval of a majority of the Board of Directors; d) the authorization of the Corporation to borrow; e) to approve or disapprove the budget of the Corporation and expenditures in excess of the amounts provided in a budget of the Corporation approved by the Members; f) to approve or disapprove of contracts where the Corporation is at financial risk; g) the distributions of any cash or property of the Corporation; h) the engagement or dismissal of a management company or medical service organization to manage the affairs of the Corporation, or the decision of the Corporation to manage its own affairs; i) the engagement and dismissal of the independent auditing firm for the Corporation; j) the engagement and dismissal of legal counsel; k) the engagement or dismissal of the firm performing utilization management for the Corporation; l) the subcontracting of any of the obligations of the Corporation; m) the hiring or termination of employee's or independent contractors; n) the purchase or acquisition of any property, real, personal, or mixed, by the Corporation exceeding Five Thousand Dollars ($5,000.00) in value; and o) the sale, exchange or other disposition of any property, real, personal or mixed, of the Corporation exceeding Five Thousand Dollars ($5,000.00) in value. |
| Form 990, Part VI, Section B, line 11b | The filing organization's current year Form 990 was reviewed by the CEO and CFO prior to its filing with the IRS. The review conducted by these individuals did not include the review of any supporting workpapers that were used in preparation of the current year Form 990, but did include a review of the entire Form 990 and all supporting schedules. |
| Form 990, Part VI, Section B, line 12c | The Conflict of Interest Policy of the filing organization applies to members of its Board of Directors and its principal officers (to be known as Interested Persons). In connection with any actual or possible conflicts of interest, any member of the Board of Directors of the filing organization or any principal officer of the filing organization (i.e. Interested Persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Directors of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Board member or principal officer, the remaining members of the Board of Directors or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's Conflict of Interest Policy, an Interested Person may make a presentation to the Board of Directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes. |
| Form 990, Part VI, Section C, line 19 | The financial statements of the filing organization, its governing documents and conflict of interest policy are not generally made available to the public as a whole. |
| Part VII, Section A, Column (B): | For those Board of Director members (not including physician members of the board), officer(s) and key employees who devote less than full-time to the filing organization (based upon the average number of hours per week shown in column (B) on page 7 of the return) the compensation amounts shown in columns (E) and (F) on page 7 were provided in conjunction with that person's responsibilities and roles in serving in an executive leadership position within Texas Health Huguley, Inc. Physician members of the Board of Directors received compensation from related organizations as a result of providing various medical services to those related entities. |
| Form 990, Part VIII, Line 7a, b and c: | The amount shown in Part VIII, Line 7c(i) of the Form 990 represents an allocated share of capital gain/(loss) from a system wide, corporate administered, investment program. |
| Form 990, Part XI, line 9: | Transfer to/from related tax-exempt organizations 5,442,365. |
| Form 990, Part XII, Line 3b: | Although the taxpayer is not required to undergo an audit as set forth in the Single Audit Act and OMB Circular A-133, the taxpayer is part of a controlled group of organizations that comprise a consolidated financial statement audit. The controlled group's parent is Texas Health Huguley, Inc. (THH), a 501(c)(3) organization. For the year ended December 31, 2021, THH will file a consolidated Single Audit which will include all entities that are part of the controlled group. Accordingly, the taxpayer has checked yes to the questions on Part XII, line 3a and 3b. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (30 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Huguley Medical Associates | |||||||||||
| 11801 South Freeway | Burleson | TX | 76028 | 752547668 | Phys. Clinic | TX | 501(c)(3) | Line 3 | TH Huguley | Yes (1) | |
| North Texas Healthy Communities | |||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 464513182 | Comm Support | TX | 501(c)(3) | Line 7 | TH Resources | 0 | |
| Southwestern Health Resources JOC | |||||||||||
| 5323 Harry Hines Blvd | Dallas | TX | 75390 | 811575989 | Management Org. | TX | 501(c)(3) | Line 12b | TH Resources | 0 | |
| Texas Health Arlington Memorial Hospital | |||||||||||
| 800 West Randol Mill Rd | Arlington | TX | 76012 | 750972805 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Back Care | |||||||||||
| 9250 Amberton Pkwy | Dallas | TX | 75243 | 474724257 | Phys. Clinic | TX | 501(c)(3) | Line 10 | TH Phys Group | 0 | |
| Texas Health Harris Methodist Hospital Alliance | |||||||||||
| 10864 Texas Health Trail | Fort Worth | TX | 76244 | 451502252 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Harris Methodist Hospital Azle | |||||||||||
| 108 Denver Trail | Azle | TX | 76020 | 751748586 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Harris Methodist Hospital Cleburne | |||||||||||
| 201 Walls Dr | Cleburne | TX | 76033 | 751977850 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Harris Methodist Hospital Fort Worth | |||||||||||
| 1301 Pennsylvania Ave | Fort Worth | TX | 76104 | 756001743 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Harris Methodist Hospital Hurst-Euless-Bedford | |||||||||||
| 1600 Hospital Parkway | Bedford | TX | 76022 | 751438726 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Harris Methodist Hospital Southwest Fort Worth | |||||||||||
| 6100 Harris Parkway | Fort Worth | TX | 76132 | 752678857 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Harris Methodist Hospital Stephenville | |||||||||||
| 411 Belknap Street | Stephenville | TX | 76401 | 751752253 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Hospital Frisco | |||||||||||
| 12400 Dallas Pkwy | Frisco | TX | 75033 | 831954982 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Hospital Mansfield | |||||||||||
| 2300 Lone Star Rd | Mansfield | TX | 76063 | 831869297 | Hospital | TX | 501(c)(3) | Line 3 | TH Huguley | Yes (1) | |
| Texas Health Huguley Inc | |||||||||||
| 11801 S Freeway | Burleson | TX | 76028 | 452694620 | Hospital | FL | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Medical Support | |||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 812833150 | Spec Drugs | TX | 501(c)(3) | Line 10 | TH Resources | 0 | |
| Texas Health Physicians Group | |||||||||||
| 9250 Amberton Pkwy | Dallas | TX | 75243 | 752613493 | Phys. Clinic | TX | 501(c)(3) | Line 10 | TH Resources | 0 | |
| Texas Health Presbyterian Hospital Allen | |||||||||||
| 1105 Central Expressway N | Allen | TX | 75013 | 752890358 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Presbyterian Hospital Dallas | |||||||||||
| 8200 Walnut Hill Ln | Dallas | TX | 75231 | 751047527 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Presbyterian Hospital Denton | |||||||||||
| 3000 North Interstate 35 | Denton | TX | 76201 | 432008974 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Presbyterian Hospital Kaufman | |||||||||||
| 850 Ed Hall Drive | Kaufman | TX | 75142 | 752771437 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Presbyterian Hospital Plano | |||||||||||
| 6200 W Parker Rd | Plano | TX | 75093 | 752770738 | Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Recovery and Wellness Center | |||||||||||
| 240 Miller Road | Mansfield | TX | 76063 | 812813227 | Resd Trmt Ctr | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Research & Education Institute | |||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 752562191 | Educ & Research | TX | 501(c)(3) | Line 4 | TH Resources | 0 | |
| Texas Health Resources | |||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 752702388 | System Management | TX | 501(c)(3) | Line 12c | 0 | N/A | |
| Texas Health Resources Foundation | |||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 752022128 | Fundraising | TX | 501(c)(3) | Line 7 | TH Resources | 0 | |
| Texas Health Specialty Hospital Fort Worth | |||||||||||
| 1301 Pennsylvania Ave | Fort Worth | TX | 76104 | 751648589 | LT Hospital | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Urgent Care | |||||||||||
| 3805 W University Park 100 | McKinney | TX | 75071 | 814317635 | Urgent Care Ctr | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| Texas Health Virtual Care | |||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 873611585 | Virtual Care | TX | 501(c)(3) | Line 3 | TH Resources | 0 | |
| WW Ward Endowment Fund Trust | |||||||||||
| 612 E Lamar Blvd | Arlington | TX | 76011 | 756196065 | Nursing Grants | TX | 501(c)(3) | Line 12a | TH Foundation | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (43 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| AMH Cath Labs LLC | |||||||||
| 811 Wright Street | Arlington | TX | 76012 | 203003947 | Hospital | TX | N/A | 0 | 0 |
| Arlington Surgery Center LLC | |||||||||
| 918 N Davis Drive | Arlington | TX | 76012 | 752055800 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Cleburne Surgical Center LLC | |||||||||
| 2010 W Katherine P Raines Blvd Ste | Cleburne | TX | 76033 | 203742012 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Cross Timbers Surgery Center LLC | |||||||||
| 1001 N Waldrop Drive Ste 705 | Arlington | TX | 76102 | 752862780 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Denton Surgery Center LLC | |||||||||
| 207 North Bonnie Brae Street | Denton | TX | 76201 | 470926556 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Flower Mound Hospital Prts LLC | |||||||||
| 4400 Long Prairie Road | Flower Mound | TX | 75028 | 260684968 | Hospital | TX | N/A | 0 | 0 |
| Fort Worth Endoscopy Center LLC | |||||||||
| 900 W Magnolia Avenue 101 | Fort Worth | TX | 76104 | 770368346 | Endoscopy Center | TX | N/A | 0 | 0 |
| Greenville Surgery Center LLC | |||||||||
| 7150 Greenville Avenue Ste 200 | Dallas | TX | 75231 | 742411643 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Health Imaging Partners LLC | |||||||||
| 8610 Explorer Drive Ste 300 | Colorado Springs | CO | 80920 | 271385885 | Medical Imaging | TX | N/A | 0 | 0 |
| Mansfield Endoscopy Center LLC | |||||||||
| 647 N Miller Road | Mansfield | TX | 76063 | 861354607 | Endoscopy Center | TX | N/A | 0 | 0 |
| North Dallas Surgical Center LLC | |||||||||
| 17980 Dallas Parkway Ste 100 | Dallas | TX | 75287 | 272248103 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Opthalmology Surgery Center of Dallas | |||||||||
| 10740 N Central Expy | Dallas | TX | 75231 | 261914835 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Park Hill Surgery Center LLC | |||||||||
| 3455 Locke Avenue | Fort Worth | TX | 76107 | 451484375 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Physician Medical Center LLC | |||||||||
| 6020 W Parker Road | Plano | TX | 75093 | 481281376 | Hospital | TX | N/A | 0 | 0 |
| Presbyterian Cancer Center-Dallas LLC | |||||||||
| PO Box 819067 | Dallas | TX | 75381 | 260422749 | Cancer Ctr | TX | N/A | 0 | 0 |
| Rockwall Regional Hospital LLC | |||||||||
| 3150 Horizon Road | Rockwall | TX | 75032 | 202848116 | Hospital | TX | N/A | 0 | 0 |
| South Arlington Surgical Providers LLC | |||||||||
| 350 E Interstate 20 Ste 200 | Arlington | TX | 76018 | 752723958 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Southlake Specialty Hospital LLC | |||||||||
| 1545 E Southlake Blvd | Southlake | TX | 76092 | 020555370 | Hospital | TX | N/A | 0 | 0 |
| Surgical Caregivers of Fort Worth LLC | |||||||||
| 2001 W Rosedale Street | Fort Worth | TX | 76104 | 751925497 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Texas Health Craig Ranch Surgery Center LLC | |||||||||
| 8080 State Hwy 121 Ste 100 | McKinney | TX | 75070 | 383897811 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Texas Health Huguley Surgery Center LLC | |||||||||
| 12001 S Freeway | Burleson | TX | 76028 | 821289045 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Texas Health Orthopedic Surgery Center Alliance LLC | |||||||||
| 9848 N Beach Street | Fort Worth | TX | 76244 | 814977249 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Texas Health Spine Surgery Center Allen LLC | |||||||||
| 1120 Raintree Circle Ste 100 | Allen | TX | 75013 | 300957868 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Texas Health Supply Chain Services LLC | |||||||||
| 612 E Lamar Blvd Ste 600 | Arlington | TX | 76011 | 841833532 | Purchasing Co | TX | N/A | 0 | 0 |
| Texas Health Surgery Center Alliance LLC | |||||||||
| 10840 Texas Health Trail Ste 100 | Fort Worth | TX | 76244 | 822296081 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Texas Health Surgery Center Bedford LLC | |||||||||
| 1605 Airport Freeway Ste 100 | Bedford | TX | 76021 | 821307876 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Texas Health Surgery Center Irving LLC | |||||||||
| 2120 N MacArthur Blvd Ste 200 | Irving | TX | 75061 | 831085415 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Texas Health Surgery Center Waxahachie LLC | |||||||||
| 1434 US Hwy 287 Bypass Ste 100 | Waxahachie | TX | 75165 | 831464243 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Texas Health Surgery Center Willow Park LLC | |||||||||
| 612 E Lamar Blvd Ste 600 | Arlington | TX | 76011 | 841953918 | Inactive | TX | N/A | 0 | 0 |
| Texas Hlth Spine Surgery Center Alliance LLC | |||||||||
| 1545 E Southlake Blvd Ste 100 | Southlake | TX | 76092 | 320571301 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Texas Institute for Surgery LLP | |||||||||
| 7115 Greenville Avenue Ste 100 | Dallas | TX | 75231 | 770628004 | Hospital | TX | N/A | 0 | 0 |
| TH Flower Mound Orthopedic Surgery Center LLC | |||||||||
| 5000 Long Prairie Road | Flower Mound | TX | 75028 | 800866449 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| TH Surgery Center Chisholm Trail LLC | |||||||||
| 5900 Altamesa Blvd | Fort Worth | TX | 76132 | 851225852 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| TH Surgery Center Preston Plaza LLC | |||||||||
| 17950 Preston Road Ste 75 | Dallas | TX | 75252 | 203991622 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| TH Surgery Center Rockwall LLC | |||||||||
| 3144 Horizon Road Ste 120 | Rockwall | TX | 75032 | 474425996 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| TH Surgery Center SW Fort Worth LLC | |||||||||
| 6317 Harris Parkway Ste 200 | Fort Worth | TX | 76132 | 843814490 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| THR-STT Rockwall ASC LLC | |||||||||
| 1545 E Southlake Blvd | Southlake | TX | 76092 | 262429878 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| THR-STT Southlake ASC LLC | |||||||||
| 1545 E Southlake Blvd | Southlake | TX | 76092 | 201728912 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| USMD Hospital at Arlington LP | |||||||||
| 801 I -20 West | Arlington | TX | 76017 | 731662763 | Hospital | TX | N/A | 0 | 0 |
| USMD Hospital at Fort Worth LP | |||||||||
| 5900 Altamesa Blvd | Fort Worth | TX | 76132 | 203571243 | Hospital Closed | TX | N/A | 0 | 0 |
| Walnut Hill Surgery Center LLC | |||||||||
| 5494 Glen Lakes Drive | Dallas | TX | 75231 | 364499777 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Wilson Creek Surigcal Center LLC | |||||||||
| 8855 Synergy Drive | McKinney | TX | 75070 | 274816583 | Amb Surg Ctr | TX | N/A | 0 | 0 |
| Women's Specialty Surgery Center of Dallas LLC | |||||||||
| 8230 Walnut Hill Lane Ste 101 | Dallas | TX | 75231 | 262310072 | Amb Surg Ctr | TX | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Grace Indemnity Company SPC Ltd | |||||||||||||
| 1159 Caribbean Plaza | Grand Cayman | CJ | 981209573 | Captive Insurance | CJ | N/A | C | 0 | |||||
| Texas Health Biomedical Advancement Center Inc | |||||||||||||
| 752636884 | Research | N/A | C | 0 | 612 E Lamar Blvd | Arlington | TX | 76011 | TX | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Texas Health Huguley Inc | ||
| K | $642,163 | FMV Rental Rate |
| Texas Health Huguley Inc | ||
| M | $60,000 | Cost |
| Texas Health Huguley Inc | ||
| P | $1,852,605 | Cost |
| Texas Health Huguley Inc | ||
| R | $5,442,365 | Actual Amount Given |
| Texas Health Hospital Mansfield | ||
| Q | $80,283 | Cost |