2021-11-15T18:41:57-06:00 2020-12-31 BKD LLP 14241 DALLAS PARKWAY STE 1100 DALLAS TX 75254 990 2020-01-01 452230827 Swisher Memorial Healthcare System % LUKE BREWER SWIS 8069953581 PO Box 808 Tulia TX 79088 LUKE BREWER CEO 9727028262 2021-11-15 true luke brewer 999009999 Jeanette Verrelli P00742631 9727028262 2 2020 2022-09-23 18:48:47Z LUKE BREWER 539 SE SECOND STREET TULIA TX 79088 13019023 false X WWW.SWISHERHOSPITAL.COM X 2011 TX TO PROVIDE QUALITY HEALTHCARE TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. 4 4 93 4 0 0 94660 2135564 11789751 10764929 6337 -56222 138709 117685 12029457 12961956 7432 4863 0 0 4795242 5319980 0 0 0 6406350 6060204 11209024 11385047 820433 1576909 6704901 11057131 1476639 4251960 5228262 6805171 TO PROVIDE QUALITY HEALTHCARE TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. false false 10116787 4863 10835350 PROVIDED ACCESSIBLE AND QUALITY HEALTHCARE SERVICES TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. THE HOSPITAL HAD 19,426 ENCOUNTERS - 10,890 CLINIC, 1,736 ER, 171 INPATIENT, 6,544 OUTPATIENT, 78 SWING BED, 7 ASSISTED LIVING; 0 SURGERIES; 515 INPATIENT DAYS; 1,029 SWING BED DAYS. IN 2020, SWISHER MEMORIAL CONTINUED TO OFFER CHIROPRACTIC SERVICES ONCE A WEEK. THE MEDICAL ADVICE LINE THAT IS AVAILABLE 24/7 TO OUR PATIENTS AND COMMUNITY IS STILL RUNNING SMOOTHLY. SMHS WAS UNABLE TO HOST THE ANNUAL COMMUNITY HEALTH FAIR DUE TO COVID. 10116787 true true false true false false false false false false true false false false true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false true 19 0 93 true false false false false false false false false false false false false X 4 4 false false false false false false false true false false false true true true true true true true true false X LUKE BREWER 8069958268 539 SE SECOND STREET TULIA TX 79088 X CYNTHIA ARCHER PHYSICIAN ASSISTANT 81.23 0.0 X 231983 0 25996 LUKE BREWER CEO 40.0 0.0 X 187656 0 27488 KELLY MAXWELL CNO 40.0 0.0 X 158375 0 48234 SCOTT DYER PT DIRECTOR 40.0 0.0 X 168604 0 34915 KARA DYER PHYSICAL THERAPIST 42.02 0.0 X 174864 0 28211 KIMBERLY GEORGE PHYSICIAN 40.0 0.0 X 111835 0 48066 AMANDA FERNANDEZ PHYSICIAN 59.0 0.0 X 117465 0 17248 LIZZIE DUTTON CFO 40.0 0.0 X 99007 0 16051 CHARLOTTE O'DANIEL SECRETARY 1.0 0.0 X X 0 0 0 GWYN ANN SHANNON DIRECTOR 1.0 0.0 X 0 0 0 KA WILFONG DIRECTOR 1.0 0.0 X 0 0 0 RAY DE LOS SANTOS PRESIDENT 1.0 0.0 X X 0 0 0 1249789 0 246209 8 false true false CERNER CORPORATION 2800 ROCKCREEK PKWY KANSAS CITY MO 64117 EHR SERVICES 290106 BKD LLP 510 N VALLEY MILLS DRIVE WACO TX 76710 ACCOUNTING SERVICES 114653 2 2135564 0 2135564 Patient Service Revenue 621110 9737647 9737647 Incentive Revenue 900099 513790 513790 Other Operating Revenue 900099 53206 53206 PHARMACY 446110 460286 460286 10764929 845 845 0 0 0 0 0 57067 -57067 -57067 -57067 0 0 0 0 0 0 0 0 0 Guest & Employee Meals 722514 46024 46024 Wellness Center Revenue 713940 6090 6090 Medical Records 561000 1839 1839 63732 62492 1240 117685 12961956 10835350 -8958 X 4863 4863 0 0 0 536812 268406 268406 0 3454075 3090840 363235 145962 134801 11161 876169 793146 83023 306962 257918 49044 0 1010 1010 114653 114653 0 0 0 1498897 1303487 195410 14165 4100 10065 199372 129711 69661 249130 239584 9546 0 1059940 1049181 10759 4275 4037 238 0 12282 6178 6104 48581 42510 6071 0 279678 244729 34949 71267 62305 8962 Bad Debt Expense 1053528 1053528 Medical Supplies 1359327 1359327 DUES & SUBSCRIPTIONS 20365 5078 15287 REPAIRS & EQUIPMENT 15432 8380 7052 58302 54678 3624 11385047 10116787 1268260 0 1746558 7289863 0 0 0 0 1318996 1018900 0 0 0 0 0 0 208615 270429 1314871 405455 4909709 3364725 1602272 1544984 0 0 0 0 0 0 0 0 513589 527500 6704901 11057131 484791 498308 0 0 0 2483000 0 0 0 0 0 0 747204 509499 0 0 244644 761153 1476639 4251960 X 5228262 6805171 0 0 5228262 6805171 6704901 11057131 1576909 X X false true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1351 1351 false SCHEDULE C, PART II-B, LINE 1I OTHER ACTIVITIES: Dues Paid % Lobbying Lobbying THA $9,263 8.00% $741 AHA $3,109 10.00% $311 TORCH $2,995 10.00% $299 ---------------------------------------------------- Total $15,367 $1,351 1059595 726162 333433 3850114 2638563 1211551 1544984 0 Est Amounts Due to Third-party Payors 527093 Est Self-Insurance Costs 234060 761153 13043487 1200373 -1053528 146845 12896642 65314 65314 12961956 11588959 1200373 57067 1257440 10331519 1053528 1053528 11385047 SCHEDULE D, PART XI, LINE 2D Reconciliation of revenue per audited financial statements with return: Bad Debt Expense $(1,053,528) Schedule D, Part XI, Line 4b RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: Contribution for acquisition of Property & Equipment $122,381 Loss on Disposal of Property & Equipment (57,067) ----------- Total $65,314 Schedule D, Part XII, Line 4b Reconciliation of expenses per audited financial statements with return: Bad Debt Expense $1,053,528 SCHEDULE D, PART XII, LINE 2D Reconciliation of Expenses per Audited Financial Statements with Return: Loss on Disposal of Property & Equipment $57,067 SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE: 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. true true X true X 300. true X true true true false true false 1679855 659897 1019958 0.09870 746898 673481 73417 0.00710 423853 423853 0.04100 2850606 1333378 1517228 0.14680 77828 77828 0.00750 4863 4863 0.00050 82691 82691 0.00800 2933297 1333378 1599919 0.15480 true 1053528 5083644 5133407 -49763 X true true 1 1 SWISHER MEMORIAL HEALTHCARE SYSTEM 539 SE SECOND STREET TULIA TX 79088 WWW.SWISHERHOSPITAL.COM 100122 X X X 1 SWISHER MEMORIAL HEALTHCARE SYSTEM 1 false false false true true 50000 true X 300. 300. X X X X X true true X X X true X See Part V, Section C X See Part V, Section C X See Part V, Section C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 13H OTHER CRITERIA FOR FINANCIAL ASSISTANCE: THE OTHER ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE IS THE PATIENT'S HOUSEHOLD SIZE. SCHEDULE H, PART V, SECTION B COMPLIANCE WITH 501R: SWISHER MEMORIAL HEALTHCARE SYSTEM IDENTIFIED A COUPLE AREAS WHERE IT WAS NOT YET FULLY COMPLIANT WITH THE FINAL 501R REGULATIONS. DUE TO THE COVID-19 PANDEMIC, THE HOSPITAL HAD DIFFICULTY GATHERING THE REQUIRED DATA NEEDED TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). WITH THE GOVERNMENTAL LOCKDOWNS AND RESTRICTIONS FOR TRAVELING, THE CONSULTANT COMPLETING THE CHNA WITH THE HOSPITAL COULD NOT COMPLETE A SITE VISIT OR GATHER INFORMATION FROM PUBLIC INTERVIEWS AND FOCUS GROUPS. THE HOSPITAL WAS ABLE TO GET IT COMPLETED JANUARY 2021, ONE MONTH AFTER THE EXTENDED CHNA DUE DATE OF DECEMBER 31, 2020. THE HOSPITAL ALSO REALIZED THE MOST RECENT IMPLEMENTATION STRATEGY WAS NOT ON THE HOSPITAL'S WEBSITE. ONCE THIS WAS IDENTIFIED, THE HOSPITAL UPLOADED THE DOCUMENT. SWISHER MEMORIAL HEALTHCARE SYSTEM PERSONNEL ARE WORKING DILIGENTLY TO MAINTAIN COMPLIANCE AND WILL CORRECT ANY ADDITIONAL FAILURES TO COMPLY AS THEY ARE IDENTIFIED. TOP MANAGEMENT WILL MONITOR THE WEBSITE ANNUALLY TO CONFIRM THE HOSPITAL CONTINUES TO STAY COMPLIANT WITH THE WIDELY PUBLICIZED REQUIREMENTS UNDER 501R. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C AVAILABILITY OF FINANCIAL ASSISTANCE INFORMATION: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE FOUND AT THE FOLLOWING SITE: HTTP://WWW.SWISHERHOSPITAL.COM/GETPAGE.PHP?NAME=FINANCIAL_ASSISTANCE&SUB=F INANCIAL+ASSISTANCE SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: AN ATB IS PROCESSED FOR INPATIENTS AND OUTPATIENTS BY CURRENT FINANCIAL CLASS MONTHLY. BASED ON THE HISTORICAL DATA, A SET PERCENTAGE IS ESTABLISHED AND THAT PERCENTAGE IS APPLIED AND ASSUMED UNCOLLECTIBLE. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE POLICY: THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. BAD DEBT EXPENSE SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE THIS IS UNCOMPENSATED HEALTHCARE PROVIDED TO RESIDENTS OF THE COMMUNITY. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT FOOTNOTE: NOT APPLICABLE DUE TO ADOPTION OF ASU 606 REVENUE FROM CONTRACTS WITH CUSTOMERS. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY: THE SYSTEM USES MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. IN ADDITION, THE ORGANIZATION PROVIDES CARE TO ALL PATIENTS REGARDLESS OF SOURCE OF PAYMENT; THEREFORE, COSTS TO PROVIDE CARE TO MEDICARE PATIENTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT TO THE EXTENT COSTS EXCEED MEDICARE REIMBURSEMENT. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION PRACTICES: ONCE A PATIENT HAS QUALIFIED FOR OUR INDIGENT PROGRAM, NO ADDITIONAL COLLECTION EFFORTS ARE MADE ON THAT ACCOUNT. THERE ARE DIFFERENT LEVELS OF CHARITY THAT WE AWARD, MOST OF THE TIME 75-100%, AND WE DO TRY TO COLLECT ON THE REMAINING 25%. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: SWISHER MEMORIAL HEALTHCARE SYSTEM UTILIZES HCAHPS SURVEYS TO MEASURE THE PATIENTS' PERSPECTIVES AND SATISFACTION REGARDING HOSPITAL CARE. IN ADDITION, THE SYSTEM IS ACTIVE IN ALL OF ITS COMMUNITY SERVICE ORGANIZATIONS. THE CEO ATTENDS THESE SERVICE CLUB MEETINGS TO INVITE PATIENTS, THEIR FAMILIES, AND LOCAL CITIZENS TO SHARE THEIR CONCERNS ABOUT THE COMMUNITY'S NEEDS WITH THE ORGANIZATION. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY CAN BE FOUND ON THE SYSTEM'S WEBSITE IN BOTH ENGLISH AND SPANISH AND DISCUSSED AT SERVICE ORGANIZATION MEETINGS IN OUR COMMUNITY. IT IS ALSO SHARED WITH VARIOUS GOVERNMENT AGENCIES SUCH AS HEALTH AND HUMAN SERVICES. FINALLY, ALL UNINSURED PATIENTS WHO ARE SEEN IN THE SYSTEM'S CLINIC OR EMERGENCY DEPARTMENT ARE REFERRED TO OUR PATIENT ADVOCATE WHO INVESTIGATES ALL POTENTIAL SOURCES OF ASSISTANCE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: SWISHER MEMORIAL HEALTHCARE SYSTEM SERVES ALL OF SWISHER COUNTY, TX AS WELL AS SOUTHERN RANDALL COUNTY, WESTERN BRISCOE COUNTY, AND EASTERN CASTRO COUNTY. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: OUR HOSPITAL CEO AND CNO MEET WITH LOCAL AND COUNTY GOVERNMENT OFTEN TO DISCUSS ANY ACTIONS THE SYSTEM AND/OR DISTRICT MAY BE ABLE TO PARTICIPATE IN, PERFORM, OFFER, OR ENCOURAGE WITHIN OUR COMMUNITY. ALSO, OUR QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT/DISASTER PREPAREDNESS DIRECTOR AND TRAUMA COORDINATOR ARE ACTIVE WITH THE REGIONAL ADVISORY COUNCIL AND OTHER COMMUNITY PREPAREDNESS ACTIVITIES. OUR CLINIC OFFERS AN INFLUENZA VACCINATION CLINIC YEARLY, FOR A FLAT FEE, WITH THE OPTION TO BILL MEDICARE FOR MEDICARE PATIENTS. WE CONTINUE TO PROVIDE A MEDICAL ADVICE LINE TO OUR PATIENTS FREE OF CHARGE THROUGH THE 1115 WAIVER. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: ALTHOUGH THERE IS NOT A CONTROL OF GOVERNANCE, SWISHER MEMORIAL HEALTHCARE SYSTEM AND SWISHER MEMORIAL HOSPITAL DISTRICT DO COOPERATE IN PROVIDING HEALTH CARE TO THE COMMUNITY. AS HIGHLIGHTED IN THE SCHEDULE H, PART VI - PROMOTION OF COMMUNITY HEALTH, BOTH ENTITIES PARTICIPATE IN VARIOUS PROGRAMS AND CLINICS TO FURTHER THE HEALTH OF SWISHER COUNTY. SWISHER MEMORIAL HOSPITAL DISTRICT CONTRACTS OUT THE EMERGENCY SERVICES TO AMR. SWISHER MEMORIAL HEALTHCARE SYSTEM OFFERS A LEVEL 4 EMERGENCY DEPARTMENT, CRITICAL ACCESS HOSPITAL WITH TWENTY BEDS, AND TULIA RURAL HEALTH CLINIC THAT SERVICES THE MAJORITY OF SWISHER COUNTY. THE DISTRICT AND THE SYSTEM WORK TOGETHER COHESIVELY IN PROVIDING EXCELLENT CARE TO ALL PATIENTS THAT UTILIZE OUR SERVICES. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: TEXAS Schedule H, Part I, Line 3C FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING OTHER CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: - Asset level - MEDICAL INDIGENCY - INSURANCE STATUS - UNDERINSURANCE STATUS - Household size SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: BAD DEBT EXPENSE OF $1,053,528 WAS INCLUDED IN TOTAL EXPENSE ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSE IN COLUMN (F). SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. COSTS COMPUTED ON WORKSHEET 4 AND 8 WERE COMPUTED USING INTERNAL COST SYSTEMS. X X X false false false false false false false true false LUKE BREWER CEO 148595 0 30600 0 8461 0 7731 0 19757 0 215144 0 0 0 CYNTHIA ARCHER PHYSICIAN ASSISTANT 230752 0 1231 0 0 0 11787 0 14209 0 257979 0 0 0 KARA DYER PHYSICAL THERAPIST 173753 0 1111 0 0 0 8501 0 19710 0 203075 0 0 0 SCOTT DYER PT DIRECTOR 158429 0 3816 0 6359 0 8267 0 26648 0 203519 0 0 0 KELLY MAXWELL CNO 131011 0 22004 0 5360 0 6947 0 41287 0 206609 0 0 0 KIMBERLY GEORGE PHYSICIAN 106835 0 851 0 4149 0 5730 0 42336 0 159901 0 0 0 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: A PERCENTAGE OF INCENTIVE COMPENSATION REPORTED BY THE INDIVIDUALS LISTED ON PART VII, SECTION A IS CONTINGENT ON MEETING THE ANNUAL BUDGET. FORM 990, PART VI, SECTION A, LINE 8B DOCUMENTATION OF COMMITTEES ACTING ON BEHALF OF THE GOVERNING BODY: ANY ACTIONS OF THE COMMITTEES (MEDICAL STAFF, QAPI, NURSING) THAT ARE PART OF THE SYSTEM'S OPERATION ARE REPORTED BY THE CNO/CEO/CFO AT QUARTERLY BOARD MEETINGS. THERE ARE NO COMMITTEES OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE ORGANIZATION'S CEO REVIEWS THE RETURN PRIOR TO FILING. A COPY IS ALSO SENT OUT TO THE GOVERNING BODY FOR REVIEW AND APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: BOARD MEMBERS ARE POLLED ANNUALLY TO DETERMINE IF/WHERE CONFLICTS MAY OCCUR. DEBBIE GARZA OF THE HR DEPARMENT MONITORS COMPLIANCE, AND IF A MEMBER HAS A POSSIBLE CONFLICT THEY ABSTAIN FROM VOTING ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION REVIEW: ALL KEY POSITIONS ARE EVALUATED IN COMPARISON TO THE TORCH ANNUAL SURVEY OF HOSPITAL SALARIES AND OTHER SOURCES. EVALUATIONS ARE CONDUCTED EACH YEAR ON COMPENSATION. ONCE THEY HAVE BEEN REVIEWED, WE TAKE IT TO THE BOARD FOR FURTHER REVIEW AND APPROVAL. THIS WAS DONE IN OCTOBER IN PRIOR YEARS AND PRESENTED TO THE BOARD AT THE OCTOBER BOARD MEETING. HOWEVER, WE HAVE SINCE MOVED ANNUAL REVIEWS AND RAISES TO BE CONDUCTED IN APRIL AND AWARDED IN MAY. ALL OF THE COMPENSATION APPROVAL IS DOCUMENTED IN THE BOARD MEETING MINUTES. THE LAST COMPENSATION REVIEW WAS COMPLETED IN 2020 BY THE HOSPITAL CEO. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST AT THE ORGANIZATION'S OFFICE. FORM 990, PART XII, LINE 2C RESPONSIBILITY FOR OVERSIGHT OF AUDIT: DUE TO THE SIZE OF THE BOARD, THERE IS NO COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT. INSTEAD, THE FULL BOARD IS RESPONSIBLE. FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:493828 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:298514 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:600186 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:106369