2021-11-04T06:34:17-05:00 2020-12-31 BKD LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2020-01-01 751912147 United Regional Health Care System % STEPHEN P CALVERT UNIT 9407648299 1600 Eleventh Street Wichita Falls TX 76301 PHYLLIS COWLING PRESIDENT AND CEO 9727028262 2021-11-15 true PHYLLIS COWLING 999009999 JEANETTE VERRELLI P00742631 9727028262 2 2020 2022-09-23 18:48:47Z PHYLLIS COWLING 1600 ELEVENTH STREET WICHITA FALLS TX 76301 393433311 false X WWW.UNITEDREGIONAL.ORG X 1983 TX ORGANIZED AND OPERATED FOR THE PURPOSE OF DEVELOPING AND OPERATING AN INTEGRATED HEALTH CARE SYSTEM. 17 11 2442 178 580005 521004 1375944 12822699 405054768 369858899 14053384 8776855 49714 580005 420533810 392038458 18255010 15570711 0 0 142851680 150491129 0 0 0 218290801 199988648 379397491 366050488 41136319 25987970 826178398 925775441 64661500 118296064 761516898 807479377 X TO OPERATE NONPROFIT HOSPITALS OR HOSPITAL FACILITIES, CLINICS, AND RELATED MEDICAL AND SURGICAL SERVICES BY PROVIDING SUCH SERVICES TO PERSONS THAT DO HAVE THE ABILITY TO PAY, AND TO THEREBY PROVIDE CHARITABLE MEDICAL, SURGICAL, AND HOSPITAL CARE FOR SICK, INJURED, AFFLICTED, INFIRM, DISABLED, OR DESTITUTE PERSONS THAT DO NOT HAVE THE ABILITY TO PAY. false false 296888635 15570711 369858899 UNITED REGIONAL HEALTH CARE SYSTEM, A 325-BED HOSPITAL, PROMOTES TH HEALTH OF THE COMMUNITY BY PROVIDING A VARIETY OF HEALTH CARE SERVICES. IN ADDITION TO INPATIENT BEDS, THERE ARE 36 NEWBORN BASSINETTES INCLUDING 13 INTERMEDIATE NURSERY BASSINETTES AND 42 ER BEDS. ADDITIONAL PROGRAMS WHICH BENEFIT THE COMMUNITY INCLUDE: STUDENTS IN NURSING, PHARMACY, LABORATORY TECHNOLOGY, RADIOLOGY, RESPIRATORY THERAPY AND OTHER ASSOCIATED HEALTH SCIENCES PROFESSIONS ALSO STUDY HERE. PREVENTIVE CARE A PRIORITY: UNITED REGIONAL HEALTH CARE SYSTEM HAS TAKEN STEPS TO ENHANCE PREVENTIVE CARE FOR PEOPLE OF ALL AGES THROUGH THE DEVELOPMENT OF LOW COST SCREENING PROGRAMS, VACCINATION CLINICS, AS WELL AS OTHER OUTREACH EDUCATION SERVICES. OTHER SERVICES ARE PROVIDED THROUGH THE UNITED REGIONAL REFERENCE LAB INCLUDE BOTH LOW COST FEE-FOR-SERVICE SCREENINGS AND FREE SCREENINGS AT COMMUNITY HEALTH FAIRS (CHOLESTEROL, PSA, TRIGLYCERIDES, ETC.) DESIGNATED TRAUMA CENTER: UNITED REGIONAL IS DESIGNATED LEVEL 2 TRAUMA CENTER FOR THE REGION BY THE HEALTH AND HUMAN SERVICES COMMISSION OF THE STATE OF TEXAS. UNITED REGIONAL HEALTH CARE SYSTEM'S EMERGENCY DEPARTMENT IS STAFFED 24 HOURS A DAY/7 DAYS A WEEK MEETING THE NEEDS OF THE COMMUNITY WITH AN AVERAGE OF 174 VISITS PER DAY. COMMUNITY CONNECTIONS: UNITED REGIONAL HEALTH CARE SYSTEM REACHES OUT TO PEOPLE AND COMMUNITIES THROUGHOUT ITS PRIMARY SERVICE AREA OF WICHITA COUNTY AND ITS SECONDARY SERVICE AREA OF 8 SURROUNDING COUNTIES CONSISTING OF ARCHER, BAYLOR, CLAY, HARDEMAN, JACK, MONTAGUE, WILBARGER AND YOUNG COUNTIES. THROUGH COOPERATIVE AGREEMENTS WITH LOCAL GOVERNMENTS AND HOSPITALS, UNITED REGIONAL PROVIDES FUNDING FOR A NUMBER OF HEALTHCARE SERVICES. COMMUNITY EDUCATION: UNITED REGIONAL HEALTH CARE SYSTEM PROVIDES THE FOLLOWING TYPES OF COMMUNITY EDUCATION: COMMUNITY EDUCATION SEMINARS WITH FACEBOOK LIVE PRESENTATIONS BY PHYSICIANS ON HEALTH ISSUES AND TREATMENT OPTIONS; HEALTH EDUCATION EMAILS, SENT TO APPROXIMATELY 17,000 REGISTERED PARTICIPANTS, PROVIDING HEALTH PROMOTION AND DISEASE PREVENTION INFORMATION AND INFORMATION ON FREE EDUCATIONAL PROGRAMS; SENIOR FOCUSED PROGRAM, PROVIDING A DRIVE-THROUGH INFLUENZA VACCINATION CLINIC; AND PARTICIPATION IN A HEALTHY LIFESTYLE CLASS FOR KIDS. CHARITY CARE: UNITED REGIONAL HEALTH CARE SYSTEM PROVIDES MEDICAL CARE TO MEMBERS OF THE COMMUNITY REGARDLESS OF ABILITY TO PAY. ESTIMATED COST OF PROVIDING ADDITIONAL COMMUNITY BENEFITS DURING 2020 WAS $25,496,376 WHICH INCLUDED THE FOLLOWING: UNREIMBURSED COST OF EMERGENCY AND TRAUMA CARE $10,754,601 UNREIMBURSED COST OF FREE STANDING CLINICS $14,741,775 DONATIONS MADE BY THE HOSPITAL TO AREA CHARITABLE ORGANIZATIONS $17,301,318 TOTAL COSTS OF ADDITIONAL COMMUNITY BENEFITS $42,797,694 SOURCE: 2020 ANNUAL STATEMENT OF COMMUNITY BENEFIT STANDARDS (STATE OF TEXAS MANDATORY REPORT) 296888635 true true false true false false false false false true true false false true true false false true false false false false false false false false true true true false true false false false false false false true true false false false false false true true true false false true 228 0 2442 true true true false false false false false false false false false true false X 17 11 true false true false false true true true true false false true true true true true true true true true true X STEPHEN P CALVERT 9407648299 1600 ELEVENTH STREET WICHITA FALLS TX 76301 X PHYLLIS COWLING PRESIDENT AND CEO 40.0 2.5 X X 1183272 0 114229 NANCY TOWNLEY SR VP OF OPERATIONS 40.0 2.5 X 802975 0 59920 ROBERT PERT CHIEF FINANCIAL OFFICER 40.0 2.5 X 577535 0 63151 STEPHANIE MCDONELL CHIEF INFORMATION OFFICER 40.0 2.5 X 464182 0 43897 KRISTI FAULKNER VP OF HUMAN RESOURCES 40.0 2.5 X 408750 0 49455 JANE RITTER VP OF PATIENT CARE/CLINICAL SV 40.0 2.5 X 352010 0 55189 JOHNNY ROBERTS VP UR PHYSICIAN GROUP 40.0 2.5 X 346145 0 53918 BRETT MAY MD DIRECTOR 1.0 40.0 X 0 281280 36865 MICHELLE NELSON SR DIRECTOR OF HEALTH IMPROVEM 40.0 0.0 X 195483 0 38751 DWAYNE MCKEE DIRECTOR OF CIBI 40.0 0.0 X 202834 0 31243 NATHAN WOOTEN DIRECTOR OF PHARMACY 40.0 0.0 X 187993 0 39276 STEPHEN CALVERT SR DIRECTOR OF ACCOUNTING AND 40.0 0.0 X 189499 0 36779 SHELLEY MOSER SR DIRECTOR OF QUALITY & SAFET 40.0 0.0 X 195057 0 30434 ANNE DABOVICH VP OF PATIENT CARE/CLINICAL SV 40.0 2.5 X 209945 0 11850 ANDRE DESIRE MD DIRECTOR 1.0 0.0 X 119343 0 0 KEITH WILLIAMSON MD DIRECTOR 1.0 0.0 X 32358 0 0 LINDA CASTILLO DIRECTOR 1.0 0.0 X 0 0 0 ALLEN FLACK MD DIRECTOR 1.0 0.0 X 0 0 0 ROBERT FORRESTER DBA DIRECTOR 1.0 0.0 X 0 0 0 KELLY FRISTOE DIRECTOR 1.0 0.0 X 0 0 0 BARRY HARDIN DIRECTOR 1.0 0.0 X 0 0 0 KEN HINES DIRECTOR 1.0 0.0 X 0 0 0 JOHN LUIG SECRETARY & TREASURER 1.0 0.0 X X 0 0 0 LACEY MORGAN VICE CHAIR 1.0 0.0 X X 0 0 0 STEPHANIE SPAIN DIRECTOR 1.0 0.0 X 0 0 0 MICHAEL STANFORD BOARD CHAIR 1.0 0.0 X X 0 0 0 MARGARET STEWART DIRECTOR 1.0 0.0 X 0 0 0 TIM CORNELIUS DIRECTOR 1.0 0.0 X 0 0 0 KINLEY HEGGLUND DIRECTOR 1.0 0.0 X 0 0 0 BLAKE ANDREWS DIRECTOR 1.0 0.0 X 0 0 0 DEANDREA DAVIS DIRECTOR 1.0 0.0 X 0 0 0 YVONNE HEARN MD DIRECTOR 1.0 0.0 X 0 0 0 FRED LANGNER MD DIRECTOR 1.0 0.0 X 0 0 0 TERRY PATTON DIRECTOR 1.0 0.0 X 0 0 0 5467381 281280 664957 222 false true false LA MAGNA HEALTH PLLC 1631 11TH STREET WICHITA FALLS TX 76301 CLINICAL SERVICES 6485895 MEDEFIS CONSOLIDATED PO BOX 5068 NEW YORK NY 10087 CONTRACT LABOR 4339185 WICHITA FALLS ANESTHESIA PLLC 1600 11TH STREET WICHITA FALLS TX 76301 CLINICAL SERVICES 3706443 NEUROLOGICAL SURGERY SPECIALISTS OF 3808 KEMP BLVD SUITE A WICHITA FALLS TX 76308 CLINICAL SERVICES 2651417 ACUTE CARE SURGERY TEXOMA PLLC PO BOX 3386 WICHITA FALLS TX 76301 CLINICAL SERVICES 2357675 57 645753 12120413 56533 12822699 Patient Service Revenue 621110 367584079 367584079 Supporting Revenue 900099 1619144 1619144 Related Rental Revenue 531120 655676 655676 369858899 9259503 9259503 0 0 0 0 0 900283 11922 1394853 -494570 11922 -482648 -482648 0 0 0 0 0 0 0 0 0 PASS-THROUGH REVENUE 900099 580005 580005 580005 392038458 369858899 580005 8776855 X 15570711 15570711 0 0 0 4948124 494812 4453312 127595 45736 81859 129305475 99951802 29353673 3314056 2674894 639162 3304184 2586547 717637 9491695 7118771 2372924 0 113810 113810 190432 190432 0 0 1471244 1471244 55108943 41474531 13634412 442457 331843 110614 10633435 8604878 2028557 6347200 4760400 1586800 0 3098203 2323652 774551 287463 215597 71866 0 141305 7580 133725 73973 73973 0 22666296 13821907 8844389 1336998 1336998 Bad Debt Expense 29053949 29053949 Medical Supplies 58690707 58690707 Equipment expenses 2383377 1787533 595844 Covid-19 Expenses 6157521 4618141 1539380 1791335 1343673 447662 366050488 296888635 69161853 0 215102 206660 49833386 96802582 0 0 39833456 42750579 0 0 0 0 0 0 7694090 9992217 7123202 7354328 427629813 228511558 206512096 199118255 422296527 470361824 0 0 0 0 0 0 92670539 99188996 826178398 925775441 53584440 51784837 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11077060 66511227 64661500 118296064 X 761516898 807479377 0 0 761516898 807479377 826178398 925775441 X 25987970 26640208 -6665699 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 106665 106665 false SCHEDULE C, PART II-B, LINE 1I LOBBYING ACTIVITIES: THE HOSPITAL PAID DUES TO ORGANIZATIONS, A PORTION OF WHICH IS DESIGNATED FOR LOBBYING EXPENSES. DUES %LOBBYING $LOBBYING TAVH $ 5,823 100% $ 5,823 THA $ 59,220 8.31% $ 4,921 AHA $ 49,573 25.56% $12,671 MCDERMOTT & CONSULTING $ 8,250 100% $ 8,250 DON GILBERT & ASSOC $ 180,000 41.67% $75,000 --------------------------------------------------------------------- TOTAL $ 302,866 $106,665 493631 493631 839392 345761 493631 839392 839392 839392 839392 1416349 1416349 0.59480 0.40520 false true true 15168093 15168093 220091974 106405897 113686077 190400977 120164436 70236541 1968769 1941225 27544 199118255 Due from Affiliates 85965780 Interest Receivable 308820 Est from 3rd Party Payors 12556952 REINSURANCE RECEIVABLE 357444 99188996 0 Est due to third party payors 2067915 Self Insurance liabilities 8751000 DUE TO AFFILIATE 71068 CARES ACT LIABILITIES 50174824 CHAT LIABILITY 5446420 66511227 SCHEDULE D, PART V, LINE 4 INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS: THE ENDOWMENT INCLUDES BOTH DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF DIRECTORS. FUNDS ARE USED TO ADVANCE AND PROMOTE THE HEALTH AND WELL-BEING OF PEOPLE AND ORGANIZATIONS IN THE COMMUNITY AND SURROUNDING AREAS. THE FUNDS DESIGNATED BY THE BOARD ARE NOT CURRENTLY BEING USED. 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. SCHEDULE D, PART V, COLUMNS C & D RESTATEMENT OF ENDOWMENT FUNDS: THE ENDOWMENT FUND BALANCES PER THE FINANCIAL STATEMENTS FOR 2017 AND 2018 WERE RESTATED DUE TO THE RECLASSIFICATION OF NET ASSETS. BOARD DESIGNATED ASSETS WERE RECLASSIFIED TO REMOVE THE DESIGNATION AND COMBINED WITH TEMPORARY RESTRICTED NET ASSETS IN MARCH OF 2019. true true X true X true X true true false true true 39461732 19385503 20076229 0.05960 37429459 34640001 2789458 0.00830 3044628 707967 2336661 0.00690 79935819 54733471 25202348 0.07480 73805 73805 0.00020 48170223 22673847 25496376 0.07560 15570711 15570711 0.04620 63814739 22673847 41140892 0.12200 143750558 77407318 66343240 0.19680 19 30956 31722 14880 16842 0.00010 19 30956 31722 14880 16842 0.00010 false 29053949 2905395 108558772 114129585 -5570813 X true true UNITED REGIONAL CARDIOVASCULAR SERVICES 0.5 0.5 health care system cardiology LLC united regional surgical management 0.5 0.5 health care system surgery llc 1 1 UNITED REGIONAL HEALTH CARE SYSTEM 1600 ELEVENTH STREET WICHITA FALLS TX 76301 WWW.UNITEDREGIONAL.ORG 000417 X X X X UNITED REGIONAL HEALTH CARE SYSTEM false false true X X X X X X X X X 19 true false false true X SEE PART V, SECTION C X true 19 true SEE PART V, SECTION C false true X 200. 400. 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 X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 PERSONS WHO REPRESENT THE COMMUNITY: UNITED REGIONAL CONDUCTED 27 INTERVIEWS WITH THE TWO GROUPS OUTLINED IN IRS FINAL REGULATIONS RELEASED ON DECEMBER 29, 2014. DURING THESE INTERVIEWS, THE HOSPITAL DISCUSSED THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. BACKGROUND INFORMATION ON EACH INTERVIEWEE WAS ALSO GATHERED. THE INTERVIEWEES WERE INDIVIDUALS FROM VARIOUS NOT-FOR-PROFIT GROUPS, HEALTH CARE FACILITIES, GOVERNMENTAL AGENCIES AND OTHER AREAS OF THE COMMUNITY. THESE INDIVIDUALS WERE FROM THE FOLLOWING ORGANIZATIONS: -HELEN FARABEE CENTER -WICHITA FALLS AREA FOOD BANK -WICHITA FALLS CITY COUNCIL -GUFFEY'S PHARMACY -HOSPICE OF WICHITA FALLS -WICHITA COUNTY HEALTH DEPARTMENT -UNITED REGIONAL HEALTH CARE SYSTEM -FINANCIAL PARTNERS -WICHITA COUNTY -THE KITCHEN -UNITED REGIONAL FOUNDATION -ELECTRA MEMORIAL HOSPITAL -WICHITA FALLS ISD -PRESBYTERIAN MANOR -NORTH CENTRAL TEXAS COMMUNITY HEALTH CENTER -WICHITA FALLS FAITH MISSION -NORTH TEXAS AREA UNITED WAY -BOYS AND GIRLS CLUB OF WICHITA FALLS -WILSON SCHOOL OF NURSING -AMERICAN CANCER SOCIETY SCHEDULE H, PART V, SECTION B, LINE 7A & 10A CHNA & Implementation strategy website: The CHNA And implementation strategy can be found at WWW.UNITEDREGIONAL.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 20E EFFORTS TO NOTIFY INDIVIDUALS OF FINANCIAL ASSISTANCE POLICY: NEITHER THE UNITED REGIONAL HEALTH CARE SYSTEM, NOR THIRD PARTIES AUTHORIZED BY URHCS, TAKE ANY ACTIONS UPON NON-PAYMENT FROM A PATIENT BEFORE MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR THE FACILITY'S FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS ADDRESSED AND NOT ADDRESSED: UNITED REGIONAL IDENTIFIED AND PRIORITIZED 6 NEEDS USING A STRUCTURED MATRIX IN THE IMPLEMENTATION STRATEGY. THE NEEDS ARE: 1. ACCESS TO PRIMARY CARE SERVICES AND PROVIDERS: UNITED REGIONAL WILL CONTINUE TO RECRUIT AND EMPLOY ADDITIONAL PHYSICIANS TO THE COMMUNITY, AS WELL AS PHYSICIANS EMPLOYED BY THE UNITED REGIONAL PHYSICIAN GROUP. VIA ITS EMPLOYED PHYSICIAN GROUP, UNITED REGIONAL WILL CONTINUE TO OPERATE A PRIMARY CARE WALK-IN CLINIC, CAREPLUS, AS WELL AS ECARE, A VIRTUAL OPTION FOR RESIDENTS. 2. ACCESS TO SPECIALTY CARE SERVICES AND PROVIDERS: UNITED REGIONAL WILL CONTINUE TO EXPAND SPECIALTY CARE CAPACITY BY RECRUITING AND EMPLOYING ADDITIONAL SPECIALTY PHYSICIANS TO THE COMMUNITY. UNITED REGIONAL WILL CONTINUE TO OFFER PALLIATIVE CARE/SUPPORTIVE CARE SERVICES, DESIGNED TO ASSIST PATIENTS WHO HAVE CHRONIC DISEASES TO ACCESS THE MEDICAL AND EMOTIONAL SUPPORT NEEDED TO BEST MANAGE THEIR DISEASE PROCESSES WITH A FOCUS ON PRLIEF OF PAIN, STRESS AND OTHER DEBILITATING SYMPTOMS OF SERIOUS ILLNESS. 3. PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES: UNITED REGIONAL WILL CONTINUE TO INCREASE EDUCATIONAL OPPORTUNITIES FOR THE PUBLIC CONCERNING WELLNESS TOPICS AND HEALTH RISK CONCERNS, PREVENTIVE CARE AND HEALTHY LIFESTYLE CHOICES THROUGH MEDIA OUTLETS AND HOSTING AND/OR PARTICIPATING IN LOCAL HEALTH-RELATED EVENTS. CURRENT EXAMPLES INCLUDE: CPR, PREPARED CHILDBIRTH, SMOKING CESSATION, BREAST FEEDING, HEALTHY YOU TV SERIES, DIABETES EDUCATION, PRENATAL CLASSES, 55 ADVANTAGE, SENIOR FOCUS AND WOMEN'S EXPO. 4. ACCESS TO AFFORDABLE, HIGH NUTRITIONAL QUALITY FOOD OPTIONS: IN CONJUNCTION WITH THE WICHITA FALLS AREA FOOD BANK, UNITED REGIONAL WORKS TO PROVIDE HEALTHY FOOD BOXES FOR PATIENTS PARTICIPATING IN DIABETES EDUCATION, HEART FAILURE CLINIC AND OUTPATIENT INFUSION AND POST-OPERATIVE PATIENTS WHO ARE FOOD INSECURE. ALSO, IN CONJUNCTION WITH THE WICHITA FALLS AREA FOOD BANK, UNITED REGIONAL OFFERS A MOBILE FOOD PANTRY AT SIX DIFFERENT LOCATIONS-ONCE EACH PER MONTH-IN AN EFFORT TO HAVE A HUNGER-FREE COMMUNITY. 5. ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS: UNITED REGIONAL WILL CONTINUE TO PROVIDE CASE MANAGEMENT SERVICES AND APPROPRIATE REFERRALS FOR PATIENTS WHO PRESENT TO THE HOSPITAL OR EMERGENCY DEPARTMENT WITH MENTAL OR BEHAVIORAL HEALTH CONDITIONS ON AN AS NEEDED BASIS. UNITED REGIONAL WILL CONTINUE TO PROVIDE PSYCHIATRIC TELEHEALTH SERVICES FOR APPLICABLE PATIENTS. 6. ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS: UNITED REGIONAL WILL CONTINUE TO PROVIDE MEDICAL CARE TO ALL PATIENTS IN NEED, REGARDLESS OF THEIR ABILITY TO PAY. UNITED REGIONAL WILL CONTINUE TO OPERATE ITS HEART FAILURE CLINIC. UNITED REGIONAL'S IMPLEMENTATION PLAN ADDRESSES ALL NEEDS IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. SEE THE SCHEDULE H, PART VI, LINE 5 DISCLOSURE FOR ADDITIONAL INFORMATION UPDATING UNITED REGIONAL'S PROGRESS ADDRESSING THESE NEEDS. SCHEDULE H, PART V, SECTION B, LINE 16A, 16B & 16C MEASURES TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUmmary are AVAILABLE AT THE FOLLOWING ADDRESS: https://www.unitedregional.org/patients-and-visitors/billing-questions-and -answers/financial-assistance/ SCHEDULE H, PART V, SECTION B 501R COMPLIANCE: DURING A COMPLIANCE REVIEW OF THE ORGANIZATION'S FINANCIAL ASSISTANCE DOCUMENTS, MANAGEMENT BECAME AWARE OF AN INADVERTENT ERROR WHICH RESULTED IN NON-COMPLIANCE WITH 501R REGULATIONS. THE PLAIN LANGUAGE SUMMARY ON THE FACE OF THE WEBSITE AND THE DOWNLOADABLE DOCUMENT REFERENCE 2016 AND 2017 FOR THE CALCULATION OF AMOUNTS GENERALLY BILLED (AGB). MANAGEMENT IS IN THE PROCESS OF UPDATING THE STATEMENT WITH CURRENT INFORMATION. SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT ADJUSTMENTS: THE ORGANIZATION'S BAD DEBT ADJUSTMENTS WERE CALCULATED USING THE ADJUSTMENT AMOUNT REPORTED AS REVENUE DEDUCTIONS ON THE INTERNAL FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS DETERMINED BY ESTIMATING THAT 10% OF THE BAD DEBT WOULD LIKELY BE CHARITY CARE. THIS IS THE APPROXIMATE PERCENTAGE OF PATIENTS NOT COMPLETING THE PAPER WORK TO APPLY FOR CHARITY CARE. BAD DEBT EXPENSE REPRESENTS GROSS CHARGES ADJUSTED FOR APPROPRIATE DISCOUNTS AND PAYMENTS ON ACCOUNTS. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT FOOTNOTE: PATIENT CARE SERVICE REVENUE ON PAGE 16 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY: THE HOSPITAL USES MEDICARE COST REPORT METHODOLOGY TO DETERMINE MEDICARE ALLOWABLE COST, 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. THE ORGANIZATION HAD A MEDICARE SHORTFALL IN THE AMOUNT OF $5,570,813. THE STATE OF TEXAS TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT FOR MEETING STATUTORY REQUIREMENTS FOR CHARITY CARE AND COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION PRACTICES: HOSPITAL PERSONNEL MAKE GOOD FAITH EFFORTS TO INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE, GOVERNMENTAL PROGRAMS AND ASSISTANCE IN APPLYING. SECTION 7.2 OF THE CHARITY AND BAD DEBT POLICY STATES: REQUIRED INFORMATION AND DOCUMENTATION AS NOTED IN THIS POLICY MUST BE PROVIDED BEFORE ELIGIBILITY FOR FINANCIAL ASSISTANCE WILL BE DETERMINED. ONCE THE REQUIREMENTS HAVE BEEN MET, A WRITTEN NOTICE WILL BE MAILED TO THE PATIENT INFORMING THEM OF THE DETERMINATION DECISION. NO COLLECTION EFFORTS WILL BE PURSUED ON A FINANCIAL ASSISTANCE APPLICATION FOR THE ELIGIBLE AMOUNT AFTER SUCH DETERMINATION IS MADE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: UNITED REGIONAL HEALTH CARE SYSTEM (URHCS) PROVIDES EMERGENCY, TRAUMA, OUTPATIENT AND SHORT TERM GENERAL ACUTE CARE INPATIENT CARE IN THE WICHITA FALLS AREA. IN CONJUNCTION WITH OTHER INTERESTED ORGANIZATIONS, IT UNDERTAKES PROJECTS TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES. FOR EXAMPLE, URHCS COLLABORATES WITH OTHER COMMUNITY HEALTH ORGANIZATIONS TO CREATE A HEALTHY WICHITA REPORT WHICH IS UPDATED PERIODICALLY. THIS REPORT ASSESSES THE HEALTHCARE SERVICES PROVIDED IN THE COMMUNITY TO COMPARE THE OUTCOMES TO STATE AND FEDERAL OUTCOMES AND DETERMINE IF THE COMMUNITY HEALTH NEEDS ARE BEING MET OR ADDITIONAL RESOURCES NEED TO BE DIRECTED TO PARTICULAR HEALTH AREAS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL INFORMS PATIENTS OF THE CHARITY CARE PROGRAM AND HOW TO APPLY FOR CHARITY CARE. THIS IS DONE BY POSTING NOTICES IN PATIENT REGISTRATION AREAS AND PROVIDING WRITTEN NOTICES TO PATIENTS. ALL PATIENT STATEMENTS HAVE AN ASSISTANCE APPLICATION ON THE REVERSE SIDE AND AN ALERT ON THE FRONT FOR THOSE ELIGIBLE OR INTERESTED IN APPLYING. THIS INCLUDES ALL STATEMENT NOTIFICATIONS AND NOT JUST PATIENT SHARE STATEMENTS. FURTHERMORE IT IS THE POLICY OF URHCS TO ASSIST PATIENTS WITH INFORMATION AND RESOURCES FOR POTENTIALLY QUALIFYING FOR GOVERNMENTAL OR OTHER FINANCIAL ASSISTANCE PROGRAMS. THE BUSINESS OFFICE WILL REFER THOSE PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE FROM A GOVERNMENTAL PROGRAM TO THE APPROPRIATE PROGRAM, SUCH AS MEDICAID, COUNTY INDIGENT, CRIME VICTIMS, OR OTHER PROGRAM, OR TO THE HOSPITAL'S CONTRACTED ELIGIBILITY VENDOR FOR SCREENING FOR GOVERNMENTAL PROGRAM COVERAGE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: URHCS PRIMARY SERVICE AREA IS MADE UP OF WICHITA COUNTY. WICHITA COUNTY CONTAINS THE CITY OF WICHITA FALLS WHERE URHCS IS LOCATED. ACCORDING TO THE HUMAN RESOURCES AND SERVICES ADMINISTRATION, US DEPARTMENT OF HEALTH AND HUMAN SERVICES, WICHITA FALLS HAS SEVERAL CENSUS TRACTS FEDERALLY DESIGNATED AS MEDICALLY UNDER-SERVED, INCLUDING CENSUS TRACT 102 WHERE URHCS IS LOCATED. CENSUS DATA FOR WICHITA FALLS IS AS FOLLOWS: MEDIAN HOUSEHOLD INCOME (2019 EST.): $ 47,476 PER CAPITA INCOME (2019 EST.): $ 24,330 UNDER AGE 18 CHILDREN BELOW POVERTY LEVEL (2019 EST.): 22% MEDIAN EARNINGS OF FULL-TIME WORKERS, FEMALE (2019 EST.): $32,535 PERSONS BELOW POVERTY LEVEL (2019 EST.): 18.4% EMPLOYED PERSON WITHOUT HEALTH INSURANCE COVERAGE 19 TO 64 YEARS (2019 EST.) : 17.3%. URHCS IS RECOGNIZED BY MEDICARE AS QUALIFYING FOR SOLE COMMUNITY HOSPITAL STATUS AND SERVES A DISPROPORTIONATE SHARE OF LOW-INCOME PATIENTS. UNITED REGIONAL QUALIFIES AS A DISPROPORTIONATE SHARE HOSPITAL FOR BOTH THE MEDICARE AND MEDICAID PROGRAMS. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: THE HOSPITAL IS GOVERNED BY A BOARD OF DIRECTORS THAT REPRESENTS THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. UNITED REGIONAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. UNITED REGIONAL OPERATES A LEVEL 2 TRAUMA UNIT FOR THE REGION. THE HOSPITAL PROVIDES TRAINING COURSES FOR NURSING AND ALLIED HEALTH PROFESSIONALS FOR THE COMMUNITIES IT SERVES. THE HOSPITAL PARTICIPATES IN MEDICAID AND IS THE MANDATED WICHITA COUNTY HEALTHCARE FACILITY. THE HOSPITAL ALSO PROVIDES NUMEROUS AVENUES TO EDUCATE THE COMMUNITY ON HEALTH INITIATIVES SUCH AS HEALTH FAIRS, NEWSLETTERS/EMAILS, SOCIAL MEDIA OUTREACH AND LECTURE SERIES ON CHRONIC AND ACUTE HEALTH ISSUES. UNITED REGIONAL REINVESTS SURPLUS FUNDS IN THE FACILITIES TO ENSURE PATIENTS ARE PROVIDED WITH STATE OF THE ART MEDICAL CARE. IN 2019 THE HOSPITAL CONDUCTED A COMPREHENSIVE SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT. SIX SIGNIFICANT COMMUNITY HEALTH NEEDS WERE IDENTIFIED AND AN IMPLEMENTATION PLAN WAS DEVELOPED TO DIRECTLY ADDRESS THE SIX IDENTIFIED PRIORITIES. DURING 2020, THE HOSPITAL CONTINUED TO ADDRESS ITEMS FROM THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. THE NEEDS AND PROGRAMS ADDRESSED IN 2020 ARE: -ACCESS TO PRIMARY CARE SERVICES AND PROVIDERS: IN 2020 UNITED REGIONAL HAS RECRUITED OR ASSISTED WITH RECRUITMENT OF 3 PRIMARY CARE PHYSICIANS. UNITED REGIONAL CONTINUED TO OFFER THE FUTURE IN THE FALLS PROGRAM. THIS PROGRAM STAYS IN CONTACT WITH MEDICAL STUDENTS, INTERNS AND RESIDENTS FROM THE WICHITA FALLS AREA TO ENCOURAGE THEM TO RETURN TO PRACTICE IN WICHITA FALLS ONCE THEY GRADUATE FROM RESIDENCY. THIS PROGRAM PROVIDES STIPENDS AND SHADOWING OF SPECIALISTS TO ASSIST WITH THEIR EDUCATION. -ACCESS TO SPECIALTY CARE SERICES AND PROVIDERS: IN 2020 UNITED REGIONAL HAS RECRUITED OR ASSISTED WITH RECRUITMENT OF PHYSICIANS IN THE FOLLOWING SPECIALTIES: - OBGYN (1) - FAMILY MEDICINE (3) - NEUROLOGY (1) - ORTHO (1) - INTERVENTIONAL CARDIOLOGIST (1) - THORACIC SURGEON (1) -PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES: IN 2020, UNITED REGIONAL SPONSORED COMMUNITY EDUCATION PROGRAMS, CLASSES, HEALTH FAIRS, SEMINARS AND OTHER EVENTS. THE EVENTS INCLUDED PREVENTATIVE HEART HEALTH, COVID READINESS, SPORTS PHYSICALS, ADVANCE DIRECTIVES, MAMMOGRAMS, DIABETES TELEHEALTH, HAND CONDITIONS, HOSPITALS ARE SAFE AND READY, LAP BAND REDO, COVID TESTING AND FLU SHOT PROMOTIONS. TOTAL ATTENDANCE WAS OVER 1,000 COMMUNITY MEMBERS IN ATTENDANCE THROUGH MEDIA OUTLETS AND HOSTING AND/OR PARTICIPATING IN LOCAL HEALTH-RELATED EVENTS. -ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE: IN 2020, 1,838 PATIENTS WERE IDENTIFIED FOR MENTAL/BEHAVIORAL HEALTH REFERRAL OR INTERVENTION. UNITED REGIONAL STAFFS A SANE (SEXUAL ASSAULT NURSE EXAMINER) THAT IS TRAINED TO TREAT SEXUALLY ASSAULTED PATIENTS. UNITED REGIONAL CONTINUES TO PROVIDE ADDITIONAL SERVICES THROUGH PSYCHIATRIC TELEHEALTH. -ACCESS TO AFFORDABLE, HIGH NUTRITIONAL QUALITY FOOD: IN CONJUNCTION WITH THE WICHITA FALLS AREA FOOD BANK, UNITED REGIONAL PROVIDED 488 FOOD BOXES TO PATIENTS AND THEIR FAMILIES. A MOBILE FOOD PANTRY WAS OFFERED AT SIX DIFFERENT LOCATIONS-ONCE EACH PER MONTH-IN AN EFFORT TO HAVE A HUNGER-FREE COMMUNITY. UNITED REGIONAL ALSO SENT A NURSE TO EACH MOBILE PANTRY DISTRIBUTION SITE TO OFFER FREE, VOLUNTARY BLOOD PRESSURE AND BLOOD SUGAR CHECKS. -ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS: PHYSICIAN REFERRAL, CLASS REGISTRATION, AND NURSE TRIAGE SERVICES WERE OFFERED AT NO CHARGE TO THE COMMUNITY THROUGH THE UNITED REGIONAL'S "CALL-A-NURSE" PHONE LINE. REFERRALS ARE PROVDED FOR LOCAL PHYSICIANS AS WELL AS OTHER COMMUNITY HEALTH CARE SERVICES. IN 2020, THEIR WERE 793 PHYSICIAN AND SERVICE REFERRAL CALLS RECEIVED. THEIR WERE 4,802 NURSE TRIAGE CALLS AND 247 COMMUNITY MEMBERS ENROLLED IN VARIOUS CLASSES. IN 2020, UNITED REGIONAL PROVIDED 41 MAMMOGRAMS THROUGH CHARITY CARE FOR FEMALES THAT WERE QUALIFIED. UNITED REGIONAL CONTINUED TO OFFER A TRANSITION CLINIC TO PROVIDE CARE COODINATION ACTIVITIES TO VARIOUS AT-RISK PATIENT POPULATIONS. IT PROVIDES TEMPORARY COVERAGE FOR PATIENTS WITH HEART FAILURE, DIABETES, PNEUMONIA, COPD, SEPSIS, AND SURGICAL SITE INFECTION FOLLOW UP. IN 2020 THE TRANSITION CLINIC HAD 4,156 KEPT APPOINTMENTS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: N/A SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: URHCS FILES AN ANNUAL STATEMENT OF COMMUNITY BENEFIT STANDARDS (ASCBS) WITH THE STATE OF TEXAS. THE CALCULATION OF COMMUNITY BENEFIT FOR THE ASCBS DIFFERS FROM THE CALCULATIONS REQUIRED FOR THE IRS SCHEDULE H REPORTING. THEREFORE, THE INFORMATION REPORTED IN THE TWO REPORTS IS INCONSISTENT. SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSES: BAD DEBT EXPENSE OF $29,053,949 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 II COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL CONDUCTED ACTIVITIES TO PROMOTE AND SUPPORT THE HEALTH OF THE COMMUNITY THROUGH EDUCATION AND SUPPORT GROUPS. THESE ACTIVITIES INCLUDED THE FOLLOWING: -Breathsavers: A pulmonary support group that is held quarterly for adults with pulmonary diseases (COPD, asthma, emphysema and chronic bronchitis) and is designed to assist those with pulmonary disease to develop self-care skills for a more active life and to find support among others with the disease. No programs were held in 2020 due to the Covid-19 virus. -Child Passenger Safety Education: A program in which parents view a "Safe Riders of Texas" video and car seats are checked for appropriateness for the child. A child passenger safety certified technician is available for education and performs safety seat inspections at the hospital as well as participates in community education programs on proper installation and safety. Due to Covid-19 precautions, public events were cancelled. However, a few seats were checked and/or replaced on an individual basis. -Community Education Seminars: Provides health seminars to the community on a variety of health topics including weight loss surgery, cardiac and heart rhythm disorders, gynecological issues, orthopedic conditions and urological conditions. -Continuing Nursing Education: Provides nursing education to employees, community nurses and emergency response personnel from the local and surrounding communities. -Diabetes Education Self-Management Program: Provides a Diabetes Education program to help instruct patients on how to manage their medication and diet to maintain a better quality of life. -Diabetes Support Group: A Type 2/Type 1 Diabetes Support Group for the community to provide ongoing support and education to diabetes patients. -Family Health Education Class Offerings: To help new parents make an easier transition to parenthood, the hospital offers a variety of prenatal classes. In addition, the hospital assists Sheppard Air Force Base with their monthly prenatal orientation. -Health Education - Emails: Emails are sent to those who registered to receive monthly health education providing information on upcoming educational programs offered free of charge as well as education on a variety of health topics. -Healthy Lifestyle Class for Kids: In collaboration with the YMCA an after school program was developed to reduce diabetes and obesity and to improve the overall health of children in the community by teaching them healthy eating habits, learning about the importance of staying active and reducing screen time as well as the affects of diabetes on one's overall health. -Heart Failure Clinic: A clinic that assesses patient's post-discharge health and address lifestyle changes to stay healthy and avoid readmission. Patients participate in the clinic once a week for a month and then return to their cardiologist for scheduled appointments. -Joint Camp: Prepares patients for upcoming hip, knee or shoulder replacement surgery. -Preventive Care for All Ages: An educational guide that offers information on the preventive care services that are provided to everyone under health insurance plans and which services men, women and children should receive throughout their lives. -Primary Care Education: A brochure providing young families who frequent the Emergency Department for pediatric care with information about establishing a relationship with a primary care physician. -Senior Focus: AN EDUCATION FAIR FOR SENIOR ADULTS THAT PROVIDES HEALTH INFORMATION, CHOLESTEROL SCREENINGS AND FLU SHOTS. Due to concerns with Covid-19 the Senior Focus event typically held was transformed into a drive-through influenza vaccination clinic to reduce crowds and maintain social distancing. -Smoking Cessation Course: A course designed to educate and help individuals stop smoking. -Sports Medicine Services: Provided sports physicals for local high school and college athletes and provides medical coverage at high school football games. SCHEDULE H, PART I, LINE 6B COMMUNITY BENEFIT REPORT: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT CAN BE OBTAINED BY REQUEST FROM UNITED REGIONAL ADMINISTRATION OFFICES OR COMMUNITY BENEFITS OFFICES. THE COMMUNITY BENEFIT REPORT IS ALSO ON FILE WITH THE HEALTH AND HUMAN SERVICES COMMISSION OF THE STATE OF 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 - UNDERINSURANCE STATUS - RESIDENCY 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. COST COMPUTED ON IRS WORKSHEETS 5 and 6 WERE COMPUTED FROM THE MEDICARE COST REPORT, INCLUDING DIRECT COSTS PLUS OVERHEAD ALLOCATIONS COMPUTED IN THE COST REPORT. The cost computed on worksheet 8 were from the hospital's income statement and grant schedule. true UNITED REGIONAL HEALTH CARE FOUNDATION 1600 11TH ST WICHITA FALLS TX 76301 752761467 501(C)(3) 445711 General support WICHITA FALLS AREA FOOD BANK 1230 MIDWESTERN PARKWAY WICHITA FALLS TX 76307 751812865 501(C)(3) 250000 MOBILE PANTRY PROGRAM THE WICHITA COUNTY MEDICAL ALLIANCE PO BOX 13 WICHITA FALLS TX 76307 352173373 501(C)(3) 40000 General Support SERVICE ORGANIZATION OF NORTH TEXAS 2950 50TH STREET LUBBOCK TX 79413 800368789 501(C)(3) 14835000 GENERAL SUPPORT 4 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: UNITED REGIONAL HEALTH CARE SYSTEM PROVIDES GENERAL CONTRIBUTIONS TO THE COMMUNITY, NATIONAL CHARITIES AND OTHER COMPANIES FOR THE FURTHERANCE OF THEIR MISSION OR PURPOSE. THE ORGANIZATIONS MAKE THEIR REQUESTS IN WRITING. THESE CONTRIBUTIONS ARE REVIEWED AND APPROVED BY APPROPRIATELY AUTHORIZED BOARD ACTION; OR OFFICERS; OR EMPLOYEES AS APPROPRIATE IN THE CIRCUMSTANCE IN EACH INSTANCE OF SUCH CONTRIBUTION BEING MADE. UNITED REGIONAL FOLLOWS UP WITH EACH ORGANIZATION TO MAKE SURE EACH CONTRIBUTION WAS USED FOR ITS INTENDED PURPOSE. X X X false true false false false true true false false BRETT MAY MD DIRECTOR 0 260427 0 0 0 20853 0 5536 0 31329 0 318145 PHYLLIS COWLING PRESIDENT AND CEO 747808 0 298865 0 136599 0 101400 0 12829 0 1297501 0 74644 NANCY TOWNLEY SR VP OF OPERATIONS 579533 0 205914 0 17528 0 30900 0 29020 0 862895 0 ROBERT PERT CHIEF FINANCIAL OFFICER 420784 0 148033 0 8718 0 30900 0 32251 0 640686 0 STEPHANIE MCDONELL CHIEF INFORMATION OFFICER 349906 0 109762 0 4514 0 30900 0 12997 0 508079 0 ANNE DABOVICH VP OF PATIENT CARE/CLINICAL SV 202864 0 1425 0 5656 0 9800 0 2050 0 221795 0 KRISTI FAULKNER VP OF HUMAN RESOURCES 304096 0 99463 0 5191 0 29856 0 19599 0 458205 0 JOHNNY ROBERTS VP UR PHYSICIAN GROUP 283764 0 53019 0 9362 0 29710 0 24208 0 400063 0 JANE RITTER VP OF PATIENT CARE/CLINICAL SV 244765 0 103963 0 3282 0 27845 0 27344 0 407199 0 STEPHEN CALVERT SR DIRECTOR OF ACCOUNTING AND 187853 0 1425 0 221 0 7623 0 29156 0 226278 0 MICHELLE NELSON SR DIRECTOR OF HEALTH IMPROVEM 193098 0 1425 0 960 0 5746 0 33005 0 234234 0 NATHAN WOOTEN DIRECTOR OF PHARMACY 183843 0 3925 0 225 0 8094 0 31182 0 227269 0 DWAYNE MCKEE DIRECTOR OF CIBI 198619 0 1425 0 2790 0 6717 0 24526 0 234077 0 SHELLEY MOSER SR DIRECTOR OF QUALITY & SAFET 190041 0 2425 0 2591 0 8051 0 22383 0 225491 0 SCHEDULE J, PART I, LINE 6 EXPLANATION OF COMPENSATION CONTINGENT ON NET EARNINGS: A RANGE BETWEEN 20% AND 25% OF ANNUAL BONUS IS BASED ON CONSOLIDATED NET OPERATING INCOME. OTHER BONUS CRITERIA INVOLVE QUALITY SCORES, SERVICE SCORES AND INDIVIDUAL GOALS. Schedule J, Part I, Line 4B DEFERRED COMPENSATION PLAN: UNITED REGIONAL HEALTH CARE SYSTEM OFFERS A DEFERRED COMPENSATION PLAN. CERTAIN MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES MAY ELECT TO PARTICIPATE, IF ELIGIBLE, IN A DEFERRED COMPENSATION PLAN WHICH IS IN COMPLIANCE WITH THE IRC SECTION 457(F), ELIGIBLE DEFERRED COMPENSATION PLAN SPONSORED BY A TAX EXEMPT ORGANIZATION. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE PLAN DURING THE 2020 TAX YEAR: NAME AMOUNT IN W-2 AMOUNT DEFERRED --------------------------------------------------------------------- PHYLLIS COWLING $74,644 $70,500 NATALIE STARY DAUGHTER OF OFFICER 90954 SALARY false LA MAGNA HEALTH PLLC SEE PART V 6485895 HOSPITALIST FEES false ABBY CHANDLER SISTER-IN-LAW OF DIRECTOR 36641 SALARY false PATHOLOGY ASSOCIATES OF NORTH TEXAS SEE PART V 2206922 PROFESSIONAL FEES false SCHEDULE L, PART IV, COLUMN(B) ADDITIONAL INFORMATION ON TRANSACTIONS WITH INTERESTED PERSONS: Andre Desire, MD, Director, is a more than 35% owner of La Magna Health PLLC, an organization doing business with the hospital. ALLEN FLACK, MD, DIRECTOR, IS A MORE THAN 35% OWNER OF PATHOLOGY ASSOCIATES OF NORTH TEXAS, PA, AN ORGANIZATION DOING BUSINESS WITH THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 2 FAMILY OR BUSINESS RELATIONSHIP: BRETT MAY, MD AND FREDERICK LANGNER ARE BOTH MORE THAN 5% OWNERS IN ACUTE CARE SURGERY TEXOMA PLLC. YVONNE HEARN, MD IS AN EMPLOYEE OF PATHOLOGY ASSOCIATES OF NORTH TEXAS WHERE ALLEN FLACK, MD IS A MORE THAN 35% OWNER. FORM 990, PART VI, SECTION A, LINE 4 CHANGES TO GOVERNING DOCUMENTS: THE BYLAWS WERE AMENDED AND RESTATED EFFECTIVE MARCH 11, 2020. A CHANGE WAS MADE TO THE QUALIFICATIONS AND ELECTION OF OFFICERS. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS OF THE GOVERNING BODY: THE WICHITA COUNTY-CITY OF WICHITA FALLS, TEXAS HOSPITAL BOARD (WHB) APPOINTS ONE INDIVIDUAL TO SERVE EX OFFICIO AS A VOTING DIRECTOR. THE INDIVIDUAL APPOINTED BY THE WHB DOES NOT HAVE TO BE A MEMBER OF THE WHB BUT MUST MEET THE QUALIFICATIONS FOR DIRECTORS SET FORTH BY THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL: THE JOINT CITY-COUNTY BOARD HAS APPROVAL REGARDING BOND FINANCING AND APPROVAL OF THE BUDGET. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: THE EXECUTIVE COMMITTEE CHARTER, AS APPROVED BY THE UNITED REGIONAL HEALTH CARE SYSTEM BOARD, DELEGATES THE REVIEW OF 990S TO THE EXECUTIVE COMMITTEE AND THE FINANCE/AUDIT COMMITTEE. ALL MEMBERS OF THE COMMITTEE ARE PROVIDED A COPY OF THE FORM 990 PRIOR TO FILING WITH THE IRS. THE 990 IS REVIEWED BY MANAGEMENT OFFICIALS OF THE HOSPITAL AND THE EXECUTIVE COMMITTEE OF THE BOARD. FOLLOWING OPPORTUNITY TO REVIEW AND UPON RECOMMENDATION OF THE EXECUTIVE AND FINANCE/AUDIT COMMITTEES, THE SYSTEM'S BOARD APPROVES THE FORM 990S. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ALL OFFICERS, DIRECTORS, AND CERTAIN EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. THE FORMS ARE REVIEWED INITIALLY BY THE CHIEF COMPLIANCE OFFICER AND THE CEO FOR POTENTIAL CONFLICTS. ANY ACTUAL CONFLICTS ARE REVIEWED BY THE BOARD OF DIRECTORS. A PERSON WITH A CONFLICT IS RESTRICTED FROM VOTING ON RELATED MATTERS. FORM 990, PART VI, SECTION B, LINE 15A & 15B PROCESS USED TO DETERMINE COMPENSATION OF MANAGEMENT AND OTHER OFFICERS: THE EXECUTIVE COMMITTEE PERFORMS AN ANNUAL REVIEW OF COMPENSATION OF THE CEO. ADDITIONALLY, A COMPENSATION CONSULTANT PROVIDES MARKET COMPARISONS ON AN EVERY OTHER YEAR BASIS. THIS WAS LAST COMPLETED IN 2019. AN ANNUAL COMPENSATION REVIEW IS PERFORMED BY THE CEO FOR ALL OTHER OFFICERS OF THE ORGANIZATION WITHIN THE PARAMETERS SET BY THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE REVIEWS ALL OTHER CORPORATE OFFICERS EVERY OTHER YEAR UTILIZING THE MARKET COMPARISONS PROVIDED BY THE COMPENSATION CONSULTANT. ALL COMPENSATION REVIEWS ARE DOCUMENTED IN THE EXECUTIVE COMMITTEE'S MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE TO THE PUBLIC: AN AD IS RUN IN THE LOCAL PAPER ON AN ANNUAL BASIS INFORMING THE COMMUNITY THE FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE OTHER DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION A, LINE 1A DELEGATION OF AUTHORITY: THE EXECUTIVE COMMITTEE HAS AUTHORITY TO TRANSACT ALL BUSINESS OF THE BOARD IN THE GOVERNANCE OF THE CORPORATION DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD, SUBJECT TO THE LIMITATIONS SET FORTH IN THE BYLAWS AND ANY LIMITATIONS OTHERWISE IMPOSED BY THE BOARD. FORM 990, PART VII, SECTION A Compensation of Officers and Directors: Directors reported on part vii, section a are compensated for professional services as physicians and not as directors. Directors receiving 1099 income from united regional is compensation related to administrative and general services rendered to clinical areas of the organization, other professional services and for trauma or other off-hour availability. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: INTERCOMPANY TRANSFERS ($6,665,699) FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:28547223 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:9441092 FORM 990 PART IX LINE 11G DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:8709677 FORM 990 PART IX LINE 11G DESCRIPTION:TEMPORARY LABOR TOTAL FEES:6210657 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:1963867 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSPORT TOTAL FEES:175211 FORM 990 PART IX LINE 11G DESCRIPTION:CATERING EXPENSE TOTAL FEES:61216 UNITED REGIONAL HEALTH CARE FOUNDATION 1600 ELEVENTH STREET WICHITA FALLS TX 76301 752761467 SUPPORT TX 501(C)(3) 12, TYPE I URHCS true CITY OF WICHITA FALLS-WC HOSPITAL BOARD 1300 SEVENTH STREET WICHITA FALLS TX 76301 756002771 OVERSIGHT TX GOVT N/A NA false RATHGEBER HOSPITALITY HOUSE 1615 TWELFTH STREET WICHITA FALLS TX 76301 752811394 LODGING TX 501(C)(3) 7 URHC FDN true UNITED REGIONAL HEALTH CARE SYSTEM AUXIL 1600 ELEVENTH STREET WICHITA FALLS TX 76301 756004656 BENEVOL SVCS TX 501(C)(3) 12, TYPE I URHCS true UNITED REGIONAL PHYSICIAN GROUP 1600 ELEVENTH STREET WICHITA FALLS TX 76301 752925491 HEALTH CARE TX 501(C)(3) 10 URHCS true TEXOMA HIE 1600 ELEVENTH STREET WICHITA FALLS TX 76301 463617299 HTH INFO EXCH TX 501(C)(3) 10 URHCS true UNITED REGIONAL PROFESSIONAL SERVICES 1600 ELEVENTH STREET WICHITA FALLS TX 76301 752549298 MGMT SERVICES TX URHCS C-CORPORATION 3870234 19091771 1.00000 true true true true true true false false false false false false false true false true false true true true UNITED REGIONAL HEALTH CARE FOUNDATION B 445711 Cash Value UNITED REGIONAL HEALTH CARE FOUNDATION C 645753 Cash Value UNITED REGIONAL PHYSICIAN GROUP A 449738 FMV UNITED REGIONAL PHYSICIAN GROUP Q 7987575 CASH VALUE United regional prof services corp r 606426 cash value UNITED REGIONAL HEALTH CARE FOUNDATION r 62040 cash value united regional physician group r 5997261 cash value SCHEDULE R, PART V, LINE 2, COLUMN (D) METHOD OF DETERMINING AMOUNTS FOR TRANSACTIONS DESCRIBED IN LINES 1B, 1C, 1Q, 1R: AMOUNTS REPORTED IN LINE 2, COLUMN (C) FOR THESE TRANSACTION TYPES ARE STATED AT CASH VALUE. METHOD OF DETERMINING AMOUNTS FOR TRANSACTIONS DESCRIBED IN LINE 1A: AMOUNTS REPORTED ON LINE 2, COLUMN (C) FOR THESE TRANSACTION TYPES ARE AT FAIR MARKET VALUE AND ARE COMPARABLE TO TRANSACTIONS BETWEEN TWO OR MORE UNRELATED PARTIES DEALING AT ARM'S LENGTH.