2021-11-12T14:55:04-06:00 2020-12-31 BKD LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2020-01-01 741461220 Frio Hospital Association % MICHAEL RUFF FRIO 8303343617 200 S IH 35 Pearsall TX 780616601 JOHN HUGHSON CEO 8303343617 2021-11-15 true John Hughson 999009999 Jeanette Verrelli P00742631 9727028262 2 2020 2022-09-23 18:48:47Z Frio Regional Hospital JOHN HUGHSON 200 S IH 35 PEARSALL TX 780616601 26513667 false X WWW.FRIOREGIONALHOSPITAL.COM X 2002 TX TO PROVIDE QUALITY AND AFFORDABLE HEALTHCARE SERVICES TO THE CITIZENS OF PEARSALL AND THE SURROUNDING COMMUNITIES. 6 6 188 14 0 0 10987 2610566 22564029 23677232 93535 134430 71696 91439 22740247 26513667 6633 5376 0 0 8377020 11733542 0 0 0 10973130 13730198 19356783 25469116 3383464 1044551 18722785 23635203 1672890 5540757 17049895 18094446 IMPROVING THE QUALITY OF LIFE IN OUR COMMUNITY BY PROVIDING EXCEPTIONAL HEALTHCARE WITH COMPASSION AND RESPECT. false false 22331061 5376 23689566 FRIO HOSPITAL ASSOCIATION (THE ASSOCIATION) OPERATES A NOT-FOR-PROFIT ACUTE CARE HOSPITAL, FRIO REGIONAL HOSPITAL (THE HOSPITAL). THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT SERVICES AS WELL AS OTHER AFFILIATED SERVICES TO FRIO COUNTY, TEXAS. INPATIENT ADMISSIONS OF 578(3,727 PATIENT DAYS); 8,823 EMERGENCY ROOM VISITS; 104 DELIVERIES; 129 SURGERIES; AND 10,678 OUTPATIENT VISITS (INCLUDING RADIOLOGY). 22331061 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 77 0 188 true false false false false false false false false false false false false X 6 6 false true true false true true false true false false false true true true true true true false false false X MICHAEL RUFF 8303343617 200 S IH 35 PEARSALL TX 780616601 X SAMER ARAB MD PHYSICIAN 40.0 0.0 X 550748 0 40915 ELVA CAMERO MD PHYSICIAN 40.0 0.0 X 355805 0 28493 CASSANDRA DUBOSE VICE PRESIDENT OF NURSING 40.0 0.0 X 139146 0 36071 MONIQUE REYNA RN 50.72 0.0 X 144950 0 27286 RYAN CONDON DIRECTOR 52.49 0.0 X 138875 0 0 ABEL TREVINO PRESIDENT ENDS: 05/20 0.45 0.0 X X 0 0 0 ROXANNE SHELTON PRESIDENT 0.45 0.0 X X 0 0 0 FRANKIE PETTY DIRECTOR 0.33 0.0 X 0 0 0 JESSE M LINDSAY DIRECTOR ENDS: 05/20 0.33 0.0 X 0 0 0 JUANITA RENDON DIRECTOR 0.33 0.0 X 0 0 0 JIM GATES DIRECTOR 0.33 0.0 X 0 0 0 MICHELLE BRYAN SECRETARY 0.33 0.0 X X 0 0 0 TROY SHAW DIRECTOR 0.33 0.0 X 0 0 0 THOMAS GRIMERT CFO 32.0 0.0 X 0 0 0 JOHN HUGHSON CEO 38.0 0.0 X 0 0 0 1329524 0 132765 20 false true false METHODIST HEALTHCARE SYSTEM 8109 FREDERICKSBURG RD SAN ANTONIO TX 78229 MANAGEMENT SERVICES 158134 METHODIST HEALTHCARE SYSTEM 8109 FREDERICKSBURG RD SAN ANTONIO TX 78229 CONTRACT SERVICES 824203 FAMILY MEDICINE CLINIC 151 MEDICAL DRIVE PEARSALL TX 78061 MEDICAL SERVICES 702870 CONCORD MEDICAL GROUP 1602 AVENUE Q LUBBOCK TX 79401 MEDICAL SERVICES 801631 TAB ANESTHESIA SERVICE 20 LOU STROUP DRIVE UVALDE TX 78801 MEDICAL SERVICES 384350 18 2570447 40119 2610566 Net Patient Revenue 621110 19419410 19419410 Medicaid Revenue 900099 3338280 3338280 OTHER OPERATING REVENUE 621110 877622 877622 CLINIC RENT 531110 41920 41920 23677232 95334 95334 0 0 25800 25800 0 25800 25800 39096 39096 39096 39096 0 0 0 0 0 0 0 0 0 Cafeteria 722210 53305 53305 Medical Records 561000 12334 12334 65639 26513667 23689566 213535 X 5376 5376 0 0 0 0 0 9892168 9292044 600124 263099 250963 12136 758550 675083 83467 819725 778124 41601 496857 496857 139318 8095 131223 56239 56239 0 0 0 4763190 4440762 322428 231096 50602 180494 270625 180740 89885 487331 394772 92559 0 1280528 510324 770204 52453 44380 8073 0 78 78 0 0 363886 294773 69113 122821 29583 93238 Bad Debt Exp 3481802 3481802 Medical Supplies 1577707 1577707 FOOD EXPENSE 121379 118026 3353 REPAIRS & MAINTENANCE 116655 116655 168233 81250 86983 25469116 22331061 3138055 0 0 9995 12178111 16418146 0 0 2705233 3258308 0 0 0 0 0 0 258814 401896 323769 400319 8053443 5536556 2252202 2516887 0 0 0 0 0 0 0 0 1004656 629652 18722785 23635203 1557718 1755448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115172 3785309 1672890 5540757 X 17049895 18094446 0 0 17049895 18094446 18722785 23635203 1044551 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2199 2199 false SCHEDULE C, PART II-B, LINE 1I OTHER LOBBYING ACTIVITIES: THE HOSPITAL PAYS DUES TO THE TEXAS SOCIETY FOR HEALTHCARE HUMAN RESOURCES ADMINISTRATION & EDUCATION AND SOUTHWEST TEXAS REGIONAL ADVISORY COUNCIL. A PORTION OF THESE DUES IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. 44922 44922 912921 268659 644262 26059 7818 18241 6494519 5260079 1234440 575022 575022 2516887 0 Est Self-Insurance Costs 89338 Est Amounts Due to 3rd party payers 891287 PRF RECEIVED IN ADVANCE 2804684 3785309 23031865 -3481802 -3481802 26513667 26513667 21987314 21987314 3481802 3481802 25469116 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 XI, LINE 2D RECONCILIATION OF REVENUES PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT EXPENSE $(3,481,802) SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT EXPENSE $3,481,802 true true X true X true X true true false false 2404166 2404166 0.10930 3599686 1534768 2064918 0.09390 313241 119896 193345 0.00880 6317093 1654664 4662429 0.21200 5376 5376 0.00020 5376 5376 0.00020 6322469 1654664 4667805 0.21220 true 3481802 5090020 2695240 2394780 X true true 1 1 FRIO REGIONAL HOSPITAL 200 S IH 35 PEARSALL TX 78061 WWW.FRIOREGIONALHOSPITAL.COM 000441 X X X X FRIO REGIONAL HOSPITAL 1 false false true X X X X X X X X X 20 true false false true X SEE PART V, SECTION C X true 20 true SEE PART V, SECTION C false true X 100 200. X X X X true true X 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 5 PERSONS WHO REPRESENT THE COMMUNITY: THE HOSPITAL DETERMINED THE NEEDS OF THE COMMUNITY THROUGH INPUT FROM THE NINE KEY STAKEHOLDER MEETINGS AND A COMMUNITY HEALTH SURVEY INCLUDING REPRESENTATIVES FROM FRIO REGIONAL HOSPITAL, SOCIAL SERVICE AGENCIES AND NON-PROFIT ORGANIZATIONS, PUBLIC HEALTH AGENCIES, OTHER MEDICAL PROVIDERS AND LOCAL ELECTED OFFICIALS. THESE ORGANIZATIONS INCLUDED: -FRIO HOSPITAL ASSOCIATION -FRIO HOSPITAL DISTRICT -WIC -FIRST UNITED METHODIST CHURCH -FRIO COUNTY COMMISSIONER'S COURT -FRIO COUNTY EXTENSION AGENT SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS ADDRESSED AND NOT ADDRESSED: Health needs were identified based on information gathered and analyzed through the 2020 CHNA conducted by the Hospital. The Hospital was able to use the information compiled by key stakeholder meetings and a community health survey to develop and adopt the implementation strategy. The assessment identified the following significant needs: 1. Lack of Health Knowledge/Education: 2. Adult Obesity: 3. Lack of Mental Health Providers/Mental Health Conditions: 4. Lack of Access to Primary Care Physicians: 5. Poverty/Children in Poverty: Provide information, educate the public through health literature, public forums, health fairs, and continued treatment of affected patients through direct treatment in collaboration with other health resources, civic, political, nonprofit, religious and business organizations to address the significant health needs. Health Care Resources The availability of health care resources is a critical component to the health of a county's residents and a measure of the soundness of the area's health care delivery system. An adequate number of health care facilities and health care providers are vital for sustaining a community's health status. Fewer health care facilities and health care providers can impact the timely delivery of services. A limited supply of health resources, especially providers, results in the limited capacity of the health care delivery system to absorb charity and indigent care as there are fewer providers upon which to distribute the burden of indigent care. Frio Regional Hospital The Hospital has 22 acute beds. Residents of the community can also take advantage of services provided by hospitals in neighboring counties, as well as services offered by other facilities and providers. There are no hospitals within a 30-mile radius available to the residents of CHNA community. Residents also travel to healthcare facilities in San Antonio to have their health needs met. Swing Bed Program at Frio Regional Hospital The goal of the swing bed program is to assist patients who have undergone surgery, an illness, or injury, with continued skilled care so they are discharged with a higher level of functioning and wellness. Patients may stay in a swing bed program so long as they are making progress - for as little as three days, or as many as 21 days. Frio Regional Primary Care and Urgent Care Clinic Services offered: Quick, walk-in access, primary care services, adult & pediatric services, extended hours, x-rays, lab services, physicals, disease management, immunizations, minor emergency treatment, women's health/gynecological care, and family planning. Frio Hospital Home Health Awarded a 4.5-star rating from Medicare Home Health Compare. Sometimes you need a little help at home. Maybe you recently left the hospital with a wound that needs more care than your family can provide. Or you're coming home after having had hip or knee replacement surgery and could benefit from physical therapy. That's where Frio Regional Hospital's Home Health Care Services come in. Our skilled nurses and other specialist can provide a wide range of care in the comfort of your own home. We serve the population of Frio County and the surrounding areas, including La Salle and Medina counties. Frio Regional Hospital Rehabilitation Services At the Frio Rehabilitation Center, we understand how important it is to get back on your feet as quickly as possible after an illness, injury, or surgery. Our new-hospital rehabilitation gym makes it easier and even more convenient to get back to living a full life. If you're living with a health problem that makes difficult to function independently, we can help with that, too. Our team of highly skilled rehab specialist are trained to help you recover by providing the highest quality care. We offer: Comprehensive Care, Physical Therapy, Occupational Therapy, Speech Therapy, and Pediatric Therapy. Health Department The Hospital's CHNA community is served by the Texas Department of State Health Services - Region 8. The Health Services Department is responsible for wide array of public health issues. Some of the services provided to the counties it serves include: epidemiology, family and community health, HIV/STD prevention, immunizations, oral health programs, tobacco prevention and control, and tuberculosis treatment. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C FINANCIAL ASSISTANCE DOCUMENTS: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEB ADDRESS: WWW.FRIOREGIONALHOSPITAL.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINES 7 & 10 CHNA & IMPLEMENTATION STRATEGY: THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEB ADDRESS: www.frioregionalhospital.com/about-us/community-health-needs-assessment/ 2 FRIO HOSPITAL HOME HEALTH 1317 E COLORADO PEARSALL TX 78061 HOME HEALTH FRIO REHABILITATION CENTER 205 EAST HACKBERRY RD PEARSALL TX 78061 REHABILITATION CENTER SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: FOR GENERAL LEDGER PURPOSES, A MONTHLY REPORT CALCULATES ALLOWANCES BASED ON A HISTORICAL PERCENTAGE FOR ALL PATIENTS WITH THIRD-PARTY COVERAGE. FOR ALL PRIVATE PAY PATIENTS, AND AS ALL OTHER ACCOUNTS AGE BEYOND 180 DAYS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION (95% - 100%) FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF PAST EXPERIENCE. 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 HOSPITAL 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. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION PRACTICES: THE HOSPITAL PAYS FOR OUTSOURCED EARLY OUT COLLECTIONS UP TO 120 DAYS WHERE THE PATIENT PORTION OF THE CHARGES ARE HANDLED BY A THIRD PARTY VENDOR. THOSE WHO QUALIFY FOR CHARITY OR INDIGENT PROGRAMS APPLY FOR THOSE SERVICES WITH HELP OF TWO DEDICATED STAFF MEMBERS. ONCE A PATIENT HAS QUALIFIED FOR THE CHARITY OR INDIGENT PROGRAMS, ALL COLLECTIONS PROCESSES CEASE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: NEEDS OF THE COMMUNITY ARE ASSESSED BY GEOGRAPHIC INFORMATION AVAILABLE TO THE HOSPITAL, AS WELL AS STATISTICAL INFORMATION THAT THE HOSPITAL CAN USE TO FURTHER ITS BENEFIT TO THE COMMUNITY. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THERE ARE SEVERAL WAYS THAT THE HOSPITAL EDUCATES THE PUBLIC ABOUT ITS CHARITY CARE PROGRAMS. THE WEBSITE GIVES THE INFORMATION WHERE THE HOSPITAL'S CASEWORKER CAN BE FOUND IN ADDITION TO A STATE EMPLOYEE OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES ON CAMPUS. THERE ARE ALSO SIGNS IN BOTH ENGLISH AND SPANISH THAT DIRECT PATIENTS TO THE ASSISTANCE THEY COULD QUALIFY FOR. INFORMATION ABOUT FINANCIAL ASSISTANCE IS ALSO PROVIDED TO PATIENTS DURING THE INTAKE AND DISCHARGE PROCESS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: FRIO HOSPITAL SERVES THE FRIO COUNTY AND SURROUNDING COMMUNITIES INCLUDING LA SALLE COUNTY. THESE CONSIST OF PRIMARILY A HISPANIC POPULATION, 15,279 OR 78.8% OF THE 19,394 PEOPLE LIVING IN FRIO COUNTY AND 6,104 OR 82.4% OF THE 7,409 PEOPLE LIVING IN LA SALLE COUNTY ARE HISPANIC ACCORDING TO THE LATEST CENSUS. FRIO HOSPITAL IS LOCATED IN PEARSALL WHICH IS APPROXIMATELY 55 MILES FROM SAN ANTONIO AND APPROXIMATELY 97 MILES FROM THE MEXICAN BORDER. 8.9% OF THE POPULATION AGE 25 HAD AN BACHELOR'S DEGREE OR HIGHER. HOWEVER, 20.2% OF THE POPULATION IN FRIO COUNTY AND 12.2% OF THE POPULATION IN LA SALLE COUNTY WERE BELOW THE POVERTY LINE. FRIO HOSPITAL HAS ALSO STARTED TO SERVE DILLEY AND COTULLA. THESE CITIES HAVE A TOTAL POPULATION OF 4,401 AND 4,168 RESPECTIVELY. THERE IS A LARGE DISPARITY BETWEEN THESE CITIES WITH DILLEY HAVING PER CAPITA INCOME OF $12,268 AND COTULLA HAVING $26,890 WHICH ARE BOTH WELL BELOW TEXAS AND THE UNITED STATES. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: FRIO REGIONAL HOSPITAL PROVIDES INFORMATION AND EDUCATES THE PUBLIC THROUGH HEALTH LITERATURE, PUBLIC FORUMS, AND COLLABORATION WITH OTHER HEALTH RESOURCES. THE HOSPITAL REACHES OUT TO CIVIC, POLITICAL, NONPROFIT, RELIGIOUS AND BUSINESS ORGANIZATIONS BY DISTRIBUTING HOSPITAL/HEALTH RELATED MATERIAL, EDUCATIONAL INFORMATION AND FREE SCREENINGS AT VARIOUS LOCAL EVENTS AND LOCATIONS. THE HOSPITAL ALSO ASSISTS AND COLLABORATES WITH COMMUNITY ORGANIZATIONS WITH HEALTH FAIRS, COMMUNITY EVENTS, PARTNERSHIPS AND PROVIDES BOOTH SPONSORSHIPS TO RAISE HEALTH AWARENESS. SEE THE SCHEDULE H, PART V, SECTION B, LINE 11 DISCLOSURE FOR ADDITIONAL INFORMATION IN REGARDS TO THE HOSPITAL'S PROMOTION OF COMMUNITY HEALTH DURING 2020. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: N/A SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: THE HOSPITAL HAS NOT FILED A COMMUNITY BENEFIT REPORT FOR THE 2020 TAX YEAR. SCHEDULE H, PART I, LINE 7, COLUMN F Percent of total expenses: BAD DEBT EXPENSE OF $3,481,802 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 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 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. THE COST COMPUTED ON WORKSHEET 8 WAS FROM THE HOSPITAL'S INCOME STATEMENT. 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: - GROSS FAMILY INCOME - FAMILY SIZE - EMPLOYMENT STATUS AND FUTURE EARNING CAPACITY - OTHER FINANCIAL RESOURCES - OTHER FINANCIAL OBLIGATIONS - THE AMOUNT AND FREQUENCY OF HOSPITAL AND OTHER MEDICAL BILLS - ASSET LEVEL - MEDICAL INDIGENCY - INSURANCE & UNDERINSURANCE STATUS false false false false false false false true false SAMER ARAB MD PHYSICIAN 496736 0 53862 0 150 0 20231 0 20684 0 591663 0 0 0 ELVA CAMERO MD PHYSICIAN 344840 0 9212 0 1753 0 17377 0 11116 0 384298 0 0 0 MONIQUE REYNA RN 129401 0 12889 0 2660 0 6974 0 20312 0 172236 0 0 0 CASSANDRA DUBOSE VICE PRESIDENT OF NURSING 115435 0 22967 0 744 0 5134 0 30937 0 175217 0 0 0 SCHEDULE J, PART I, LINE 7 NONFIXED PAYMENTS: DR. ARAB HAS INCENTIVE COMPENSATION BASED ON MEETING MONTHLY PATIENT VISITATION GOALS. FORM 990, PART VI, SECTION A, LINE 3 DELEGATION OF MANAGEMENT DUTIES: IN 2015, FRIO REGIONAL HOSPITAL ENTERED INTO A MANAGEMENT AGREEMENT WITH METHODIST HEALTHCARE SYSTEM (METHODIST). THIS AGREEMENT REQUIRES METHODIST PROVIDE PERSONNEL TO PERFORM DUTIES AS THE HOSPITAL'S EXECUTIVE EMPLOYEES. PER IRS GUIDANCE, NO COMPENSATION IS SHOWN ON FORM 990, PART VII, FOR THESE INDIVIDUALS: JOHN HUGHSON THOMAS A. GRIMERT THE TOTAL COMPENSATION PAID TO METHODIST ACCORDING TO THE CONTRACT WAS $496,857. THE HOSPITAL IS UNABLE TO SEPARATE THE AMOUNTS BETWEEN THE INDIVIDUALS LISTED. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: THE HOSPITAL AMENDED ITS BYLAWS DECEMBER 2020. THE AMENDED ARTICLES REMOVED ALL MENTION OF MEMBERS IN THE SENSE OF AN OWNER LIKE A SHARE/STOCK HOLDER OF THE ORGANIZATION. THIS NO LONGER REFLECTS HOW THE HOSPITAL HAS BEEN OPERATING AND THE UPDATED BYLAWS AFFIRMS THE TRUE VOTING, GOVERNING POWER LIES WITH THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 MAKEUP OF THE ORGANIZATION'S MEMBERS: MEMBERS OF THE ORGANIZATION INCLUDE BUSINESS AND COMMUNITY LEADERS OF FRIO COUNTY, TEXAS. AS OF THE AMENDMENT OF THE BYLAWS IN DECEMBER 2020, THE HOSPITAL NO LONGER HAS ANY MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A POWER TO ELECT OR APPOINT MEMBERS OF THE GOVERNING BODY: MEMBERS OF THE ORGANIZATION VOTE TO ELECT MEMBERS OF THE GOVERNING BODY THAT CONSISTS OF THE BOARD OF DIRECTORS. THIS PROVISION WAS OVERTURNED WITH THE AMENDED BYLAWS. GOING FORWARD, THE MEMBERS OF THE GOVERNING BODY IS DETERMINED BY A NOMINATION AND VOTE OF THE CURRENT MEMBERS. FORM 990, PART VI, SECTION A, LINE 8B DOCUMENTATION BY EACH COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY: THE ORGANIZATION DOES NOT HAVE SEPARATE COMMITTEES TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: THE ORGANIZATION'S TAX RETURN IS REVIEWED AND APPROVED BY MANAGEMENT. AFTER MANAGEMENT'S REVIEW, THE BOARD OF DIRECTORS WILL REVIEW THE RETURN AT THEIR MEETING BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE HOSPITAL RECENTLY ADOPTED A WRITTEN CONFLICT OF INTEREST POLICY. BOARD MEMBERS AND OFFICERS ARE REQUIRED TO COMPLETE ANNUAL QUESTIONNAIRES TO REPORT POTENTIAL CONFLICTS OF INTEREST. IF A CONFLICT IS FOUND TO EXIST, THE CONFLICTED INDIVIDUAL IS REQUIRED TO ABSTAIN FROM DISCUSSION AND VOTING ON THAT MATTER. FORM 990, PART VI, SECTION B, LINE 15A & 15B DETERMINING COMPENSATION OF OFFICERS: OUR CFO & CEO ARE HOSPITAL CORPORATION OF AMERICA (HCA) EMPLOYEES AS PART OF THE METHODIST MANAGEMENT AGREEMENT. HCA SEPERATES ITS HOSPITALS INTO SEVERAL CATEGORIES BASED ON ANNUAL NET REVENUE AVERAGED OVER THE LAST 3 YEARS. OUR HOSPITAL IS A LEVEL A AND BOTH CEO AND CFO ARE PAID WITHIN THE RANGES OF COMPARABLE FACILITIES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE TO PUBLIC: EXCEPT AS INCLUDED IN THE FORM 1023 AND FORM 990S, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:3651221 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:24395 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:682673 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:404901