2020-06-26T14:43:31-05:00 2019-06-30 ERNST & YOUNG US LLP 111 MONUMENT CIR 4000 INDIANAPOLIS IN 46204 990 2018-07-01 752796815 Christus Health Ark-La-Tex % M GLEN BOLES CHRI 9036141000 2600 St Michael Drive Texarkana TX 75503 M GLEN BOLES VICE PRESIDENT/CFO 9036142007 2020-06-25 true JANICE K MARTIN P00900299 3176817000 76.184.247.124 35057220201785000003 2020-06-26 P 5CE73037D4FDB6F0451D0338C4FAD669BE5054B0 7237A1E04908D4B4BF2EBE128B3D616BBF5BAACB 2018 2020-09-23 17:36:50Z SEE SCHEDULE O CHRIS KARAM 2600 ST MICHAEL DRIVE TEXARKANA TX 75503 361538721 false 0928 X www.christusstmichael.org X 1999 TX SUPPORT THE HEALTH CARE MINISTRIES OF THE SPONSORING CONGREGATIONS IN EXTENDING THE HEALING MINISTRY OF JESUS CHRIST IN CONFORMITY WITH THE ROMAN CATHOLIC CHURCH. 15 13 2239 57 1554688 0 932559 390655 324277621 358447411 1196659 1281640 843330 792905 327250169 360912611 3206462 3192916 0 0 114496210 122642451 0 0 8482 182915951 210190768 300618623 336026135 26631546 24886476 377440610 389050138 72359711 56355677 305080899 332694461 X THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR, CHARITABLE, SCIENTIFIC, EDUCATIONAL AND RELIGIOUS PURPOSES OF ADVANCING, PROMOTING AND SUPPORTING THE HEALTH CARE MINISTRIES OF THE SPONSORING CONGREGATIONS WHICH OPERATE AND ARE CONTROLLED IN CONFORMITY WITH THE ETHICAL AND MORAL TEACHINGS OF THE ROMAN CATHOLIC CHURCH, AND PROMOTING EFFICIENT GOVERNANCE AND MANAGEMENT, COOPERATIVE PLANNING AND THE SHARING OF RESOURCES AMONG SUCH HEALTH CARE MINISTRIES. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE CORPORATION'S MISSION SHALL BE TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST, AND CONSISTENT THEREWITH, SHALL OPERATE ACCORDING TO THE DOCTRINES, RESOLUTIONS, DECREES AND ETHICAL PRINCIPLES OF THE SPONSORING CONGREGATIONS, AND ETHICAL AND RELIGIOUS DIRECTORS FOR CATHOLIC HEALTH CARE SERVICES AS PROMULGATED OR AMENDED FROM TIME TO TIME BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS. IT IS ALSO A PURPOSE OF THE CORPORATION TO AID, LEND FINANCIAL SUPPORT AND ASSIS false false 78243346 0 156825450 COMMITMENT TO BENEFITING OUR COMMUNITIES PATIENT CARE SERVICES - CHRISTUS HEALTH ARK-LA-TEX IS A REGION OF CHRISTUS HEALTH, WHICH WAS FORMED IN 1999 TO STRENGTHEN THE 154-YEARS-OLD, FAITH-BASED HEALTH CARE MINISTRIES OF THE CONGREGATIONS OF THE SISTERS OF CHARITY OF THE INCARNATE WORD OF HOUSTON AND SAN ANTONIO. FOUNDED ON THE MISSION "TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST," CHRISTUS IS CHALLENGED TO REACH OUT TO, AND BEYOND, THE MORE THAN 60 COMMUNITIES WE SERVE TO HELP THOSE IN NEED. THE VISION OF CHRISTUS HEALTH, A CATHOLIC, FAITH-BASED HEALTH MINISTRY, IS TO BE A LEADER, A PARTNER AND AN ADVOCATE IN THE CREATION OF INNOVATIVE HEALTH AND WELLNESS SOLUTIONS THAT IMPROVE THE LIVES OF INDIVIDUALS AND COMMUNITIES SO THAT ALL MAY EXPERIENCE GOD'S HEALING PRESENCE AND LOVE. THE CHRISTUS HEALTH ARK-LA-TEX REGION RESPONDS TO HEALTH CARE NEEDS THROUGH SERVICES PROVIDED AT CHRISTUS ST. MICHAEL SYSTEM, WHICH INCLUDES CHRISTUS ST. MICHAEL HOSPITAL, A 311-BED ACUTE CARE HOSPITAL, CHRISTUS ST. MICHAEL HOSPITAL-ATLANTA, A 43-BED ACUTE CARE HOSPITAL, 50-BED CHRISTUS ST. MICHAEL REHABILITATION HOSPITAL, CHRISTUS ST. MICHAEL OUTPATIENT REHABILITATION CENTER, CHRISTUS ST. MICHAEL HEALTH & FITNESS CENTER, CHRISTUS ST. MICHAEL IMAGING CENTER AND CHRISTUS ST. MICHAEL HOME HEALTH-ATLANTA. EACH OF OUR HEALTH CARE ENTITIES HAS THE SAME OBJECTIVE - TO FULFILL OUR MISSION OF EXTENDING THE HEALING MINISTRY OF JESUS CHRIST, WHICH INCLUDES LEADING THE WAY TO A HEALTHIER COMMUNITY. CHRISTUS HEALTH ARK-LA-TEX IS LOCATED IN TEXARKANA, TEXAS AND SERVICES NORTHEAST TEXAS, SOUTHWEST ARKANSAS, AND SOUTHEAST OKLAHOMA, WHICH COVERS A POPULATION OF MORE THAN 338,000 INDIVIDUALS. IN FISCAL YEAR 2019 ALONE, WE WERE PRIVILEGED TO SERVE HUNDREDS OF THOUSANDS OF INDIVIDUALS IN VARIOUS WAYS INCLUDING; 66,132 VISITS TO OUR EMERGENCY DEPARTMENTS; 3,182 SURGERY PROCEDURES WITHIN OUR HOSPITALS; 4,703 OUTPATIENT SURGERY PROCEDURES; 14,958 PATIENTS WHO WERE ADMITTED TO OUR HOSPITALS FOR CARE AND 280,922 PATIENTS WHO RECEIVED OUTPATIENT CARE AT OUR FACILITIES. TOUCHING THE LIVES OF PEOPLE AROUND US IS WHAT MAKES CHRISTUS HEALTH ARK-LA-TEX STAND APART. ALLOWING OTHERS TO TOUCH US GIVES CHRISTUS HEALTH A VISION FOR THE MEDICALLY NEEDY IN EACH OF THE COMMUNITIES WE SERVE. WHETHER IT IS THE LIFE OF A CHILD EXPECTING A FUTURE FILLED WITH MIRACLES, THE LIFE OF A MAN IN NEED OF A CRITICAL HEART SURGERY, OR THE LIFE OF A WOMAN ABOUT TO GIVE BIRTH TO HER FIRST CHILD, CHRISTUS HEALTH ARK-LA-TEX'S HEALTH CARE SERVICES WORK TO PROVIDE THE BEST CARE POSSIBLE REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. BY COLLABORATING WITH COMMUNITIES, CHURCHES, BUSINESSES AND OTHER HEALTH CARE ORGANIZATIONS, CHRISTUS HEALTH'S VARIOUS ENTITIES HAVE STRENGTHENED THEIR ROLES AS MAJOR PROVIDERS OF COMPREHENSIVE, ACCESSIBLE HEALTH CARE SERVICES. THESE PARTNERSHIPS WITHIN THE COMMUNITY HAVE BEEN A BLESSING BY HELPING CHRISTUS HEALTH ARK-LA-TEX BETTER SERVE THOSE IN NEED. FURTHERMORE, INVESTMENT IN COMMUNITY SERVICES WOULD NOT BE POSSIBLE WITHOUT DEDICATED EMPLOYEES AND VOLUNTEERS. THEY HELP TO BUILD STRONG RELATIONSHIPS BETWEEN CHRISTUS' HOSPITALS AND OTHER HEALTH CARE MINISTRIES AND THE COMMUNITY, NURTURING CHRISTUS' MISSION TO MEET HEALTH CARE NEEDS AND MAKE A DIFFERENCE IN THE LIVES OF OTHERS. OUR EMPLOYEES WORK BOTH INSIDE AND OUTSIDE THE WALLS OF OUR HEALTH CARE FACILITIES AND ARE COMMITTED TO REACHING BEYOND THE TRADITIONAL HOSPITAL STRUCTURE TO HELP OUR COMMUNITIES MAINTAIN GOOD HEALTH. UNDERSTANDING THE NEED TO PROVIDE ACCESS TO HEALTH CARE TO AS MUCH OF OUR PUBLIC AS POSSIBLE, CHRISTUS HEALTH PARTICIPATES IN GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS INCLUDING MEDICAID, MEDICARE, CHAMPUS, TRICARE AND OTHERS. IN ADDITION, WE OFFER SPECIFIC DISCOUNTS ON A SLIDING SCALE FOR NECESSARY SERVICES PROVIDED TO PATIENTS WHO DO NOT HAVE MEDICAL INSURANCE OR WHO DO NOT PARTICIPATE IN GOVERNMENT SPONSORED PROGRAMS. CHRISTUS HEALTH ARK-LA-TEX PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE FROM THE COMMUNITIES IT SERVES. IT CONDUCTS ITS ACTIVITIES AND SERVES ALL PATIENTS WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER, ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. AMONG THE GENERAL MEDICAL/SURGERY SERVICES OFFERED ARE: DAY SURGERY, OPEN-HEART SURGERY, ORTHOPEDICS, LEVEL III NEONATAL INTENSIVE CARE UNIT, CARDIAC AND PULMONARY REHABILITATION, DIAGNOSTIC, THERAPEUTIC, WELLNESS PROGRAMS, OCCUPATIONAL AND SPEECH THERAPY, CARDIAC/PULMONARY OUTPATIENT REHABILITATION, RESPIRATORY CARE, NUTRITION AND DIETARY SERVICES AND PHARMACY. CHRISTUS ST. MICHAEL HEALTH SYSTEM PROVIDES 24-HOUR EMERGENCY DEPARTMENTS, LEVEL III TRAUMA DESIGNATION IN TEXARKANA AND LEVEL IV TRAUMA DESIGNATION IN ATLANTA, THAT ARE OPEN TO SERVE ALL THOSE IN NEED OF EMERGENCY CARE, REGARDLESS OF THEIR ABILITY TO PAY. CHRISTUS HEALTH ARK-LA-TEX ALSO SUPPORTS MANY LOCAL COMMUNITY HEALTH SERVICES, SUCH AS THE RANDY SAMS SHELTER FOR THE HOMELESS AND THE SPIRIT OF ST. MICHAEL MOBILE CLINIC, WHICH SERVES A SEVEN-COUNTY AREA. AS A NOT-FOR-PROFIT ORGANIZATION AND AS PART OF CHRISTUS HEALTH, A REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE AREA WE SERVE GUIDES CHRISTUS HEALTH ARK-LA-TEX. WE ARE PRIVILEGED TO HAVE AN OPEN MEDICAL STAFF COMPRISED OF QUALIFIED PHYSICIANS WHO WORK WITH US TO PROVIDE CARE TO OUR COMMUNITIES. ALL QUALIFIED PHYSICIANS WHO ARE GRANTED PRIVILEGES TO SERVE WITH US IN OUR HOSPITALS MUST UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING PROCESS. 172600283 0 146663363 OTHER GOVERNMENT SPONSORED SERVICES IN ADDITION TO THE PROVISION OF CHARITY CARE AND OTHER COMMUNITY SERVICES, CHRISTUS HEALTH PROVIDES SERVICES TO PERSONS COVERED UNDER GOVERNMENT-SPONSORED PROGRAMS, INCLUDING MEDICARE AND TRICARE. THE UNREIMBURSED COSTS OF THESE SERVICES ARE REPORTED TO THE STATE OF TEXAS BUT ARE NOT INCLUDED IN REPORTS PREPARED FOLLOWING CATHOLIC HEALTH ASSOCIATION GUIDELINES. CHRISTUS HEALTH PROVIDES SERVICES TO PERSONS COVERED UNDER THE FEDERAL MEDICARE PROGRAM, AND IN FACT, THIS IS THE LARGEST SINGLE PAYOR CLASSIFICATION OF PATIENTS SERVED BY THIS HEALTH SYSTEM. THE PAYMENT RATE FOR INPATIENT SERVICES IS ON A PER-CASE RATE, CALCULATED BASED ON THE DIAGNOSTIC-RELATED GROUP (DRG) INTO WHICH THE PATIENT IS CATEGORIZED. MEDICARE, BASED ON THEIR FEE SCHEDULE, REIMBURSES OUTPATIENT SERVICES. CHRISTUS HEALTH ALSO PARTICIPATES IN THE TRICARE STANDARD PROGRAM AND MANY OF OUR HOSPITALS CONTRACT WITH THE MANAGED CARE SUPPORT CONTRACTOR FOR THE SOUTH REGION TO PROVIDE SERVICES UNDER THE PROVISION OF TRICARE PRIME. 43268711 0 54958598 COMMUNITY BENEFIT REPORTING - CHARITY CARE AND MEDICAID CHRISTUS ADHERES TO THE CATHOLIC HEALTH ASSOCIATIONS A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT (2012), AND COMPLIES WITH THE STATE OF TEXAS REQUIREMENTS FOR REPORTING. COMMUNITY BENEFIT, REPORTED AS UNPAID COSTS, INCLUDES BOTH CHARITY CARE AND COMMUNITY SERVICES. TO THE LIMITS OF ITS RESOURCES, CHRISTUS HEALTH IS AN INSTITUTION OF PURELY PUBLIC CHARITY; THUS, THE MOST TANGIBLE EXPRESSION OF CHRISTUS HEALTHS CHARITABLE PURPOSE IS THE PROVISION OF HEALTH CARE SERVICES TO THOSE PERSONS WHO ARE UNABLE TO PAY. THIS FALLS INTO TWO CATEGORIES: CHARITY CARE AND UNPAID GOVERNMENT INDIGENT CARE. IN KEEPING WITH THE MISSION, VALUES, AND VISION OF CHRISTUS HEALTH, CHRISTUS HEALTH PROVIDES CHARITY CARE SERVICES IN A MANNER THAT RESPECTS THE DIGNITY OF THE PATIENTS AND THEIR FAMILIES. CHARITY CARE IS PROVIDED WITH OUT CHARGE OR AT A CHARGE THAT IS LESS THAN THE USUAL CHARGE FOR SUCH SERVICES. THE DETERMINATION AS TO THE AMOUNT TO BE CHARGED, IF ANY, IS MADE ACCORDING TO A PATIENTS ABILITY TO PAY AS DETERMINED BY ESTABLISHED ELIGIBILITY CRITERIA. FOR UNINSURED PATIENTS WHOSE ECONOMIC CIRCUMSTANCES PLACE THEM AT OR UNDER 200 PERCENT OF THE FEDERAL POVERY LEVEL (FPL), SERVICES ARE PROVIDED WITHOUT ANY EXPECTATION OF PAYMENT. UNINSURED PATIENTS WHOSE ECONOMIC CIRCUMSTANCES PLACE THEM BETWEEN 200 AND 400 PERCENT OF FPL ARE CHARGED BASED ON A SLIDING SCALE, AND THOSE ABOVE 400 PERCENT RECEIVE DISCOUNTS BASED ON THE UNINSURED FEE SCHEDULE. CHRISTUS HEALTH IS AN ACTIVE PARTICIPANT IN TEXAS, LOUISIANA, AND ARKANSAS MEDICAID PROGRAMS. THOSE PROGRAMS SEEK TO PROVIDE PAYMENT FOR HEALTH CARE SERVICES TO INDIVIDUALS WHO MEET CERTAIN FINANCIAL AND OTHER REQUIREMENTS, WHICH INCLUDE EVALUATION OF BOTH ASSETS AND INCOME. 2280668 3192916 0 296393008 true true false true false false false false false false true false false false true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 176 0 true 2239 true true true false false false false false false false false false false false X 15 13 true false false false true true true true true false false true true true true true true true true true true X M GLEN BOLES 9036142007 2600 ST MICHAEL DRIVE TEXARKANA TX 75503 Bobbie L Wright Director 12.0 0.0 X 0 0 0 Sonja Y Hubbard Director 6.0 0.0 X 0 0 0 Christopher Karam Ex-Officio,Pres/CEO(THRU 9/18) 3.0 37.0 X X 0 1252076 274559 Jason G Rounds CEO (AS OF 09/2018) 9.0 31.0 X X 0 485224 112294 DENNIS D O'BANION MD DIRECTOR 12.0 0.0 X 0 0 0 FRED HARRIS JR DIR./VICE CHAIR 9.0 0.0 X X 0 0 0 ERIC B CAIN DIRECTOR 9.0 0.0 X 0 0 0 JOE DAN NICHOLS JR MD DIRECTOR 9.0 0.0 X 0 0 0 Jason Harris MD DIRECTOR (THRU 12/2018) 3.0 0.0 X 0 0 0 Sister Michele O'Brien Director (THRU 12/18) 6.0 0.0 X 0 0 0 MARY C HAYNES DIRECTOR/VICE CHAIR 12.0 0.0 X X 0 0 0 LARESEA WOODS DIRECTOR 6.0 0.0 X 0 0 0 LATONYA MCELROY DIRECTOR 12.0 0.0 X 0 0 0 ROBERT MARTINEZ DIRECTOR 12.0 0.0 X 0 0 0 James W Bramlett DIR./CHAIRPERSON 12.0 0.0 X X 0 0 0 HEATHER MCKNIGHT DIRECTOR (EFF 01/19) 3.0 0.0 X 65670 0 15150 KIRAN KURICHETY MD DIRECTOR (AS OF 10/2018) 6.0 0.0 X 0 0 0 SISTER ETHEL PUNO DIRECTOR 9.0 0.0 X 0 0 0 M GLEN BOLES CHIEF FIN. OFFICER/ Treasurer 40.0 0.0 X 0 398663 84812 Gail White Corporate Secretary 40.0 0.0 X 54451 0 21558 G Michael Finley MD Chief Medical Officer 32.0 8.0 X 0 580334 125627 John W Graham MD VP MEDICAL AFFAIRS (THRU 1/19) 40.0 0.0 X 0 374541 17044 LOUISE THORNELL CHIEF NURSE EXECUTIVE 40.0 0.0 X 0 258628 57489 JENNIFER WRIGHT VP HUMAN RESOURCES (EFF 2/19) 40.0 0.0 X 0 180825 27686 LAWRENCE CHELLAIAN VP MISSION INT. 40.0 0.0 X 0 174927 32424 PATRICK FLANNERY ST MICHAEL REHAB HOSP ADMIN 40.0 0.0 X 0 242796 12016 WILLIAM MICAH JOHNSON DIRECTOR 40.0 0.0 X 0 183010 20883 JEREMY K DOBBINS PHARMACIST 40.0 0.0 X 191331 0 36431 NANCY E BARLOW DIRECTOR OF OUTPATIENT SERVICE 40.0 0.0 X 187640 0 21663 KEN L KELLY PHARMACIST 40.0 0.0 X 171599 0 22310 DALE SMITH DIRECTOR PHARMACY 40.0 0.0 X 158812 0 20755 WILLIAM AINSLEY PERFUSIONIST 40.0 0.0 X 157588 0 31170 THOMAS MCKINNEY THRU 032018 ADMIN CHRISTUS ST MICHAEL HOSP 0.0 40.0 X 0 354536 71466 987091 4485560 1005337 72 true true false ATLANTA HOSPITAL AUTHORITY 145 Edgewood Ave SE ATLANTA GA 30303 RENT 2462648 HOSPITAL HOUSEKEEPING SYSTEMS LLC 216 EAST 4TH STREET AUSTIN TX 78701 HOSPITAL SERVICES 1810671 EA HEALTH TEXAS PA 12230 WORLD TRADE DRIVE STE 250 SAN DIEGO CA 921283799 MEDICAL SERVICES 1757522 ANESTHESIOLOGY ASSOCIATES 755 North 11th Street BEAUMONT TX 77702 MEDICAL SERVICES 1741235 LIFESHARE BLOOD CENTERS 8910 Linwood Ave SHREVEPORT LA 71106 MEDICAL SERVICES 1657684 48 0 159926 230729 0 0 390655 NET PATIENT SERVICE REVENUE 621990 349401183 349132870 268313 0 PHARMACY 446110 3721275 3102603 618672 0 RENT RELATED TO EXEMPT PURPOSE 900001 4298900 4298900 0 0 FITNESS CENTER 713940 782625 114922 667703 0 OUTREACH AND EDUCATION 900001 151154 151154 0 0 92274 92274 0 358447411 0 0 0 0 0 0 1907750 626110 1281640 1281640 1281640 0 0 0 0 0 0 0 0 0 MANAGEMENT FEES 900099 389918 0 389918 GIFT SHOP 900099 191087 0 191087 VENDING MACHINE 900099 1074 0 1074 210826 0 210826 792905 360912611 356892723 1554688 2074545 X 3192573 3192573 343 343 0 0 0 0 156829 140735 16094 0 0 0 0 0 97387319 87393404 9993915 0 736254 719114 17140 0 17360070 14308410 3051660 7001979 6313143 688836 0 0 0 0 1625266 8534 1616732 0 891989 136637 755352 0 29806 29806 0 0 0 0 0 0 0 38472037 23640823 14831214 0 3128 3128 0 0 31719302 25505917 6213385 12641406 12641406 0 0 0 0 0 0 4263744 2965245 1298499 520979 254888 263062 3029 0 0 0 0 263068 131739 131168 161 5082708 5082708 0 0 0 0 0 0 14301852 14100592 201260 0 2747741 2745351 2390 0 MEDICAL SUPPLIES 59388632 58962729 420611 5292 PROV FOR UNCOLLECT ACCTS 23600722 23600722 0 0 LOCAL PROVIDER PART. FEE 14345849 14345849 0 0 RECRUITMENT/PLACEMENT FEE 292539 199018 93521 0 336026135 296393008 39624645 8482 210338355 224857506 0 0 0 0 32348751 32388527 0 0 0 0 465063 538392 5755031 5544288 7485889 8080128 321665166 205462504 117841005 116202662 14344 8174 0 0 120000 120000 508828 307568 2563344 1002893 377440610 389050138 23746660 13203234 0 0 389667 375667 0 0 0 0 0 0 0 44384 0 0 48223384 42732392 72359711 56355677 X 305062605 329702016 18294 2992445 0 0 305080899 332694461 377440610 389050138 X 24886476 0 0 0 -1310648 4037734 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false true false false true 29806 false false 29806 false LOBBYING DESCRIPTION SCHEDULE C, PART II-B, LINE 1G AT THE STATE LEVEL, CHRISTUS HEALTH ARK-LA-TEX had direct contact with members and staff of the Texas State Legislature and Arkansas State Legislature, Texas and Arkansas US Representatives and US Senators and their staff through emails, phone calls and meetings on issues such as uninsured health, telehealth, Medicaid waiver, GME, behavioral health, Arkansas Works, Surprise billing, LPPF, Palliative Care and Hospice education. Worked closely with Texas Hospital Association and Arkansas Hospital Association to meet with key legislators throughout the legislative session. AT THE FEDERAL LEVEL, WE HAD DIRECT CONTACT WITH MEMBERS AND STAFF THROUGH EMAILS, LETTERS, TELEPHONE CALLS AND MEETINGS TO DISCUSS ISSUES RELATED TO SAFETY-NET PROVIDERS, ACCESS TO CARE, HEALTHCARE REFORM PROPOSALS, QUALITY PROGRAM IMPLEMENTATION, RURAL HOSPITALS, REMOTE MEDICAL TECHNOLOGY, 340B DRUG PROGRAM, CHILDRENS HEALTH ISSUES, CHIP REAUTHORIZATION, RURAL HEALTH PROGRAM RAUTHORIZATION, AND HEALTHCARE FOR VETERANS. EXC HRS. 87.5; DIR HRS.80.5 CHRISTUS HEALTH ARK-LA-TEX DID NOT SUBSTANTIALLY LOBBY DURING THE FISCAL YEAR ENDING 6-30-19. 18134404 18134404 192339701 126704791 65634910 3108452 1429956 1678496 97012902 70237584 26775318 11069707 7090173 3979534 116202662 0 DUE TO CHRISTUS HEALTH BOND FUND 42650138 OTHER LONG TERM LIABILITIES 48061 CURRENT PORTION-CAPITAL LEASE EQUIPMENT 32458 STATE SALES TAX PAYABLE 1735 42732392 X CASH-NON-BEARING INTEREST FORM 990, SCHEDULE D, PART X, LINE 1 CHRISTUS HEALTH SYSTEM MAINTAINS A CENTRALIZED CASH MANAGEMENT SYSTEM. THIS CASH MANAGEMENT SYSTEM (CMS) INCLUDES A CONCENTRATION ACCOUNT WHEREIN DEPOSITS AND DISBURSEMENTS FOR RELATED CHRISTUS EXEMPT ORGANIZATIONS FLOW THROUGH THIS ACCOUNT AND OVER TO THE MANAGED INVESTMENT ACCOUNTS. EACH PARTICIPATING ORGANIZATION REPORTS A BALANCE IN THE CMS REFLECTIVE OF ITS CUMULATIVE CASH ACTIVITY. CASH BALANCES FOR EACH CHRISTUS ORGANIZATION ARE REPORTED ON FORM 990 IN ACCORDANCE WITH FINANCIAL STATEMENT REPORTING. CMS OWNERSHIP IS MAINTAINED BY CHRISTUS HEALTH (EIN 76-0590551) AND ALL ASSOCIATED INVESTMENT INCOME IS PROPERLY REPORTED ON THE CHRISTUS HEALTH FORM 990. UNCERTAIN TAX POSITION UNDER ASC 740 FORM 990, SCHEDULE D, PART X, LINE 2 PER FOOTNOTE 3 IN THE CONSOLIDATED FINANCIAL STATEMENTS, THERE ARE NO MATERIAL UNRECORDED TAX LIABILITIES AS OF JUNE 30, 2019 AND 2018. true true X true X 300. true X true true false true true 18070816 18070816 0.05780 36476972 35517157 959815 0.00310 54547788 35517157 19030631 0.06090 9 21117 629867 20470 609397 0.00200 1 12 872704 336217 536487 0.00170 12 359 979871 1500 978371 0.00310 22 21488 2482442 358187 2124255 0.00680 22 21488 57030230 35875344 21154886 0.06770 1 100000 100000 0.00030 1 8697 8697 1 47716 47716 0.00020 3 156413 156413 0.00050 true 23600722 155765 109995272 122866146 -12870874 X true true BOWIE CTY CLNCL SRVS County Indigent Program 0.5 3 1 CHRISTUS ST MICHAEL HEALTH SYSTEM 2600 ST MICHAEL DRIVE TEXARKANA TX 75503 WWW.CHRISTUSSTMICHAEL.ORG 000788 X X X A 2 CHRISTUS ST MICHAEL REHAB HOSPITAL 2400 ST MICHAEL DRIVE TexaRkana TX 75503 WWW.CHRISTUSSTMICHAEL.ORG 000713 X REHABILITATION HOSP A 3 CHRISTUS ST MICHAEL HOSPITAL-ATLANTA 1007 S WILLIAMS ST ATLANTA TX 75551 WWW.CHRISTUSSTMICHAEL.ORG 000788 X X X A A 13 false false true X X X X X X X X X 16 true false false true X SEE SCHEDULE H, PART V, SECTION C X SEE SCHEDULE H, PART V, SECTION C X true 16 true SEE SCHEDULE H, PART V, SECTION C false true X 300. 400. X X X X true true X X X X X true X SEE SCHEDULE H, PART V, SECTION C X SEE SECTION C X SEE SECTION C X X X X X X X true X false X X X X X true X false false PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY NEEDS PRIORITIZATION OCCURRED IN TWO PHASES. THE FIRST PHASE INCLUDED A DATA-BASED PRIORITIZATION FROM THE THI TEAM IN ADVANCE OF CONVENING A NEEDS PRIORITIZATION COMMITTEE COMPRISED OF LOCAL STAKEHOLDERS. THE SECOND STEP WAS TO FACILITATE A COMMMUNITY-DRIVEN REFINEMENT OF THE DATA-BASED PRIORITIES, USING NOMINAL GROUP TECHNIQUE TO GENERATE A PRIORITIZED NEEDS LIST. THI STAFF FACILITATED THE NOMINAL GROUP TECHNIQUE AT A NEEDS PRIORITIZATION MEETING THAT TOOK PLACE IN MAY 2016. THI STAFF INFORMED THE CSMHS LIAISON ABOUT THE PURPOSE OF THIS MEETING AND APPROPRIATE LOGISTICS WERE ARRANGED. THE LOCAL LIAISON RECRUITED 16 PARTICIPANTS TO SERVE ON THE NEEDS PRIORITIZATION COMMITTEE, AND ELEVEN PEOPLE ULTIMATELY ATTENDED THE MEETING. THI STAFF PRESENTED THE INITIAL ANALYSIS OF BOTH PRIMARY AND SECONDARY DATA, A LIST OF DATA-BASED PRIORITIES, AND LED THE GROUP IN THE NOMINAL GROUP TECHNIQUE EXERCISE TO DISTILL A FINAL LIST OF TOP PRIORITIES. PARTICIPANTS IDENTIFIED AND SCORED THEIR TOP PRIORITIES, AND THE FACILITATORS FROM THI CONSOLIDATED INDIVIDUAL PARTICIPANTS' SCORES TO GENERATE AN OVERALL RANKING, WHICH WAS RELAYED BACK TO THE GROUP FOR FURTHER DISCUSSION. THE PRIORITIZATION COMMITTEE REACHED CONSENSUS ON THE COMPOSITE RANKING BEFORE FINALIZING THE PRIORITY HEALTH NEEDS LIST. SIGNIFICANT NEEDS ARE PRIORITIZED AND PRESENTED IN THIS SECTION ARE A SERIES OF IMPLEMENTATION STRATEGIES CONTAINING: 1.ACCESS TO HEALTHY LIVING RESOURCES IMPROVEMENT STRATEGY: CSMHS SEEKS TO ENHANCE AVAILABILITY OF FREE SCREENINGS, HEALTH EDUCATION, PATIENT NAVIGATION, AND FITNESS ACTIVITIES IN THE COMMUNITY BY EXPANDING ITS EXISTING PARTNERSHIP WITH CATHOLIC CHARITIES OF EAST TEXAS' PARISH NURSING MINISTRY. 2.UNHEALTHY BEHAVIOR IMPROVEMENT STRATEGY: CSMHS SEEKS TO ADDRESS UNHEALTHY BEHAVIORS IN THE COMMUNITY BY COLLABORATING WITH AREA SCHOOL DISTRICTS TO REDUCE OBESITY AND INCREASE PHYSICAL ACTIVITY AMONG AREA STUDENTS THROUGH GONOODLE AND HEALTH TEACHER INTERACTIVE HEALTH EDUCATION MODULES. 3.ACCESS TO PRIMARY CARE IMPROVEMENT STRATEGY: CSMHS SEEKS TO COLLABORATE WITH GENESIS PRIMECARE, A LOCAL FQHC, TO SUPPORT THEIR CONTINUED DELIVERY AND EXPANSION ACCESS OF PRIMARY CARE SERVICES. 4.SOCIAL AND EMOTIONAL SUPPORT IMPROVEMENT STRATEGY: CSMHS AIMS TO IMPROVE ACCESS TO AVAILABLE HEALTH-RELATED RESOURCES IN IDENTIFIED COMMUNITY AREAS THROUGH CREATION OF A COMMUNITY RESOURCE CALL CENTER. 5.CHRONIC DISEASE REDUCTION STRATEGY: CSMHS SEEKS TO EXPAND ACCESS TO ITS TRANSITIONAL CARE PROGRAM BY INCREASING THE NUMBER OF CHRONIC DISEASES THE PROGRAM'S STAFF AND TECHNOLOGY ARE EQUIPPED TO SUPPORT. PART V, SECTION B, LINE 5 CHNA INPUT FROM PERSONS REPRESENTING THE COMMUNITY METHODOLOGY: REVIEW OF LITERATURE AND QUANTITATIVE DATA - THI staff conducted a literature review using previously published community health needs assessments and other reports focused on health in the Texarkana region. The findings from previous community needs assessments and progress reporting on initiatives launched in response to these needs assessments were incorporated into project design, interviews and focus groups, and this report as applicable. In an effort to standardize the CHNA process across all CHRISTUS facilities, THI staff collaborated with the Louisiana Public Health Institute (LPHI) to design and conduct the needs assessments. THI and LPHI followed a mixed methods approach of data collection, accessed from both primary and secondary data sources, including both qualitative and quantitative measures. The construction of this CHNA began with collection and review of the quantitative data that derive from secondary sources. Unless otherwise specified, all data were accessed from Community Commons, a repository of community-level data compiled from sources including, but not limited to, the American Community Survey, U.S. Census Bureau, the CDC Behavioral Risk Factor Surveillance System, and the National Vital Statistics System. The most recent data available from this source were examined for the report area in aggregate and by county across several dimensions, including socio-demographics, health risk behaviors, access to care, and clinical outcomes. The THI team subsequently obtained internal data from the two CSMHS acute care hospitals and conducted a descriptive analysis. Together, THI staff reviewed over 40 measures and categorized them for higher-level examination. KEY INFORMANT INTERVIEWS Purpose The purpose of in-depth interviews was to gather a broad sample of perspectives on significant health needs in the community. Findings from interviews informed the design of the focus group and were incorporated into the results to lend context to quantitative patterns and trends. Semi-structured interviews followed a pre-designed questionnaire covering the identification of health needs, community resources, and possible opportunities for action. The interviewer asked about barriers and reasons for unmet health needs, existing capacity, needed resources, and potential solutions that could enhance well-being in the community, either for specific subgroups or the population at-large. The full length Key Informant Interview Protocol can be found in Appendix B of this report. Sample and Recruitment: Representatives from CSMHS contributed contact information for 41 people who represent the broad interests of Texarkana and who possess knowledge about the regions health-related challenges. These key stakeholders included nonprofit leaders, health department authorities, public school leaders, healthcare providers or leaders, elected officials, local and state agencies, law enforcement agencies, people representing distinct geographic areas, and people representing diverse racial/ethnic groups. To recruit interviewees, THI staff shortlisted 16 potential interviewees from the 41 individuals suggested based on their professional background, organization, and geographical area they represent. The THI team contacted these 16 key informants by email and telephone, and eight individuals responded to the request. THI conducted eight interviews between February and May 2016, each lasting between 45 and 60 minutes. Transcription: The identities of key informants and transcribed content of their statements will remain confidential. FOCUS GROUP: Purpose and Questions to Address- The purpose of the focus group was to obtain clarity around needs and concepts proposed for inclusion in the CHNA report, and to approximate a group response to all ideas put forth. The group followed a semi-structured protocol intended to elicit responses aligned with the following objectives: 1. Identify significant health needs, 2. Identify community resources to meet its health needs, 3. Identify barriers and reasons for unmet health needs, and 4. Identify supports, programs, and services that would help to improve the needs or issues. THI staff finalized the design of the focus group guide after discussions with CSMHS staff, a review of the quantitative data, and analysis of interview data collected prior to the focus group. Recruitment and Sample: Potential participants were identified by CSMHS leadership. Most participants were recruited through organizations that provide health care or related services to community residents (e.g., clinics, community organizations, social service agencies). Elected officials and government leaders were also invited to participate. To assist with recruitment, the local CHRISTUS liaison recruited 21 stakeholders who represented specific groups, occupations, or perspectives important to the project. Thirteen people participated in the focus group. Administering Focus Group and Collecting Data: The focus group lasted two hours. The facilitator opened with a general assessment of the focus group participants views of the health profile of their community, inviting general comments with open-ended questions about health needs. Next, the facilitator followed with probes regarding any health needs that arose in the quantitative and qualitative analyses but did not appear in the group members' initial responses. An assistant moderator took notes and recorded the group responses. THI staff coded all transcripts, identifying and consolidating the main themes. From successive readings of transcripts, the THI team methodically analyzed transcript content to produce a progressively refined coding scheme. From this coding scheme, several predominant themes emerged that were used to construct the final summaries. NEEDS PRIORITIZATION: Needs prioritization occurred in two phases. The first phase included a data-based prioritization from the THI team in advance of convening a needs prioritization committee comprised of local stakeholders. The second step was to facilitate a community-driven refinement of the data-based priorities, using Nominal Group Technique to generate a prioritized needs list. THI staff facilitated the Nominal Group Technique at a needs pri PART V, SECTION B, LINES 7a and 7b The URL for the organization's most recently adopted community health needs assessment is: HTTPS://WWW.CHRISTUSHEALTH.ORG/-/MEDIA/FILES/HOMEPAGE/GIVING-BACK/CHNA/201 7--2019-CHNA-CHRISTUS-ST-MICHAEL-APPROVED.ASHX?LA=EN PART V, SECTION B, LINE 10a The URL for the organization's most recently adopted implementation strategy is: https://www.christushealth.org/about/donate/community-health/community-hea lth-needs-assessment-and-implementation-plan PART V, SECTION B, LINE 11 SIGNIFICANT NEEDS IDENTIFIED AND ADDRESSED OR NOT ADDRESSED SELECTED IMPLEMENTATION STRATEGY: Presented in this section are a series of implementation strategies containing the detailed goals and actions CSMHS is undertaking in a three year period to respond to each priority health need listed. A priority strategy statement describes each objective and introduces major actions that will be pursued to deliver improvements. Major actions are presented with sub-actions identifying specific partners and resources to be engaged in the improvement effort. Actions and sub-actions are linked with anticipated outcomes, which present a vision of how the status of each health need will change when the actions are completed. 1.ACCESS TO HEALTHY LIVING RESOURCES IMPROVEMENT STRATEGY: CSMHS seeks to enhance availability of free screenings, health education, patient navigation, and fitness activities in the community by expanding its existing partnership with Catholic Charities of East Texas Parish Nursing Ministry. 2.UNHEALTHY BEHAVIOR IMPROVEMENT STRATEGY: CSMHS seeks to address unhealthy behaviors in the community by collaborating with area school districts to reduce obesity and increase physical activity among area students through GoNoodle and Health Teacher interactive health education modules. 3.ACCESS TO PRIMARY CARE IMPROVEMENT STRATEGY: CSMHS seeks to collaborate with Genesis Primecare, a local FQHC, to support their continued delivery and expansion access of primary care services. 4.SOCIAL AND EMOTIONAL SUPPORT IMPROVEMENT STRATEGY: CSMHS aims to improve access to available health-related resources in identified community areas through creation of a community resource call center. 5.CHRONIC DISEASE REDUCTION STRATEGY: CSMHS seeks to expand access to its Transitional Care program by increasing the number of chronic diseases the programs staff and technology are equipped to support. COMMUNITY NEEDS THAT CANNOT BE ADDRESSED: In an effort to maximize any resources available for the priority areas listed above, leaders and staff at CSMHS determined that the following issues would not be explicitly included in their CHIP: Prenatal care, Unemployment, Heart disease, Diabetes, Cancer, Suicide/Mental Health, and Obesity. Heart disease, cancer, diabetes, suicide/mental health, and obesity received few high-priority votes from the data-based priority list individually. However, the needs prioritization committee of local stakeholders coalesced these priorities into a single Chronic Disease category, which this CHIP does address. The rationale for this decision was the relative value of pursuing prevention-focused efforts aimed at upstream risky behaviors or systemic barriers, rather than intervening on particular health outcomes. In addition, the committee stressed that unemployment, prenatal care, and suicide/mental health needs remain pressing but ultimately recommended against including them in the CHIP, primarily because CSMHS may not be as optimally positioned to address these needs. PART V, SECTION B, LINE 13B ELIGIBILITY CRITERIA EXPLAINED IN THE FAP UNDER THE HOSPITALS POLICY, PATIENTS WHO WERE UNINSURED AND MET CERTAIN FINANCIAL CRITERIA WERE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE POLICY ALSO PROVIDED FOR ASSISTANCE FOR MEDICALLY INDIGENT PATIENTS. IN GENERAL, PATIENTS WHO WERE BELOW 300% OF FEDERAL POVERTY GUIDELINES RECEIVED FREE CARE. PATIENTS WHO WERE UNINSURED AND ABOVE 300% OF THE FEDERAL POVERTY GUIDELINE WERE BILLED RATES CONSISTENT WITH AMOUNTS GENERALLY BILLED TO COMMERCIAL PAYERS. PATIENTS WHO WERE UNINSURED AND BETWEEN 300% to 400% OF FEDERAL POVERTY GUIDELINES COULD APPLY FOR ADDITIONAL ASSISTANCE TO PAY AMOUNTS LESS THAN AGB. PART V, SECTION B, LINE 15E FAP APPLICATION FORM'S METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE IN ADDITION TO REGULAR APPLICATIONS, THE HOSPITAL ALSO ASSESSED PATIENTS FOR PRESUMPTIVE ELIGIBILITY TO FACILITATE GIVING ASSISTANCE TO NEEDY PATIENTS. THE HOSPITAL IMPLEMENTED ELECTRONIC ELIGIBILITY TOOLS THAT USED PATIENT DEMOGRAPHIC DATA, CREDIT REPORTS, AND OTHER PUBLICLY AVAILABLE INFORMATION TO ESTIMATE A PATIENT'S INCOME, ASSETS, AND LIQUIDITY. PATIENTS WERE SCREENED AS PART OF THE COLLECTION ATTEMPT PROCESS. WHEN ELECTRONIC SCREENING WAS USED AS THE BASIS FOR PRESUMPTIVE ELIGIBILITY, THE HIGHEST DISCOUNT OF FULL FREE CARE WAS GRANTED FOR ELIGIBLE SERVICES FOR RETROSPECTIVE DATES OF SERVICE ONLY. IF A PATIENT DID NOT QUALIFY UNDER THE ELECTRONIC ENROLLMENT PROCESS, THE PATIENT COULD STILL BE CONSIDERED UNDER THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. PART V, SECTION B, LINES 16A, 16B, AND 16C THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY WERE WIDELY AVAILABLE AT THE FOLLOWING URL FOR CHRISTUS ST. MICHAEL HEALTH SYSTEM, CHRISTUS ST. MICHAEL REHAB HOSPITAL, AND CHRISTUS ST. MICHAEL HOSPITAL-ATLANTA: HTTPS://WWW.CHRISTUSHEALTH.ORG/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 16J HOW THE HOSPITAL FACILITY PUBLICIZES THE FINANCIAL ASSISTANCE POLICY THE HOSPITAL POSTED SIGNS TO INFORM PATIENTS ABOUT THE AVAILABILITY OF CHARITY CARE IN THE EMERGENCY DEPARTMENT, LOBBY AND ADMISSIONS AREAS. (THE SIGNS DID NOT SPECIFICALLY REFERENCE THE POLICY WHICH IS WHY THE HOSPITAL DID NOT SELECT YES IN RESPONSE TO LINE 16F.) IN ADDITION, A SUMMARY OF THE POLICY AND DOCUMENTS NEEDED TO APPLY FOR ASSISTANCE WAS WIDELY AVAILABLE AT WWW.CHRISTUSHEALTH.ORG/CHARITYCARE. (THIS WEBSITE WAS THE FIRST RESULT IN GOOGLE WHEN PATIENTS SEARCHED FOR THE HOSPITAL NAME AND CHARITY CARE OR FINANCIAL ASSISTANCE.) EFFECTIVE JULY 1, 2016, THE INDIVIDUAL HOSPITAL'S HOMEPAGE HAD A CONSPICUOUS FINANCIAL ASSISTANCE LINK DIRECTING PATIENTS TO THE CHARITY CARE HOMEPAGE. FINANCIAL COUNSELORS ALSO PUBLICIZED THE AVAILABILITY OF FINANCIAL ASSISTANCE DURING ONE-ON-ONE VISitS WITH PATIENTS. THE HOSPITAL ATTEMPTED TO PROVIDE ALL UNINSURED PATIENTS WITH FINANCIAL COUNSELING. SPENDING THE TIME FACE-TO-FACE WITH PATIENTS ALLOWED COUNSELORS TO FACILITATE THE APPLICATION PROCESS FOR PATIENTS WHO OTHERWISE MIGHT NOT HAVE SOUGHT ASSISTANCE. COUNSELORS HELPED COMPLETE FINANCIAL ASSISTANCE APPLICATIONS AND EVALUATE PAYMENT PLANS FOR OUTSTANDING BALANCES. UNINSURED PATIENTS WERE SCREENED FOR MEDICAID ELIGIBILITY, AND COUNSELORS ALSO ASSISTED ELIGIBLE PATIENTS IN COMPLETING THOSE APPLICATIONS. PART V, SECTION B, LINE 17 DID THE HOSPITAL FACILITY HAVE IN PLACE DURING THE TAX YEAR A SEPARATE BILLING AND COLLECTIONS POLICY, OR A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINED ACTION THE HOSPITAL FACILITY MAY TAKE UPON NON-PAYMENT? THE HOSPITAL DID NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS DURING THE TAX YEAR. THE POLICY STRICTLY PROHIBITED TAKING LEGAL ACTION AGAINST PATIENTS AND ALSO FORBADE PLACING A LIEN ON THE PATIENT'S HOME. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS. PART V, SECTION B, LINE 20E NOTIFICATION OF FINANCIAL ASSISTANCE POLICY WHEN COLLECTION CALLS RESULTED IN PATIENT CONTACT, BUSINESS AGENTS PERFORMED A VERBAL SCREENING TO SEE IF THE PATIENT MIGHT BE ELIGIBLE FOR CHARITY CARE. IN ADDITION, BILLING STATEMENTS CONTAINED THE FOLLOWING NOTICE: YOU MAY QUALIFY FOR FINANCIAL ASSISTANCE BASED UPON YOUR INCOME LEVEL. IF YOU DO NOT QUALIFY AND CANNOT MAKE PAYMENT IN FULL, WE WILL WORK WITH YOU TO SET UP AN ACCEPTABLE PAYMENT PLAN. PART V, SECTION B, LINE 22D THE HOSPITAL USED THE AVERAGE COMMERCIAL INSURANCE REIMBURSEMENT RATE FROM FISCAL YEAR ENDING 6/30/09 TO DETERMINE AMOUNTS GENERALLY BILLED TO PATIENTS WITH INSURANCE. THIS AVERAGE RATE WAS THE AVERAGE REIMBURSEMENT RECEIVED FOR CATEGORIES OF SERVICES FROM ALL PRIVATE INSURERS THAT REIMBURSE HOSPITALS ACROSS THE CHRISTUS HEALTH SYSTEM, EXCEPT FOR ST. VINCENT AND LONG-TERM HOSPITALS, AND EXCLUDING IMPLANT AND DRUG CONTRIBUTION DOLLARS. ALL UNINSURED PATIENTS WERE CHARGED NO MORE THAN THE AVERAGE REIMBURSEMENT RATE FOR THE RELEVANT SERVICE LINE. PATIENTS ELIGIBLE FOR ADDITIONAL FINANCIAL ASSISTANCE WERE CHARGED THE AMOUNT GENERALLY BILLED (AGB) RATE (FOR INCOME LEVELS FROM 301% TO 400% OF FPL) OR RECEIVED FREE CARE (INCOMES BELOW 300% FPL). FOR LAB SERVICES, ELIGIBLE PATIENTS WERE CHARGED A PERCENTAGE OF THE MEDICARE RATE. SCHEDULE H, PART I, LINE 3c THE ORGANIZATION USES FEDERAL PROVERTY GUIDELINES. SCHEDULE H, PART I, LINE 5 BUDGETED CHARITY CARE THE ORGANIZATION BUDGETS CHARITY CARE FOR INTERNAL FINANCIAL REVIEW PURPOSES ONLY. THE PROVISION OF CHARITY CARE IS NOT LIMITED TO AMOUNTS ESTABLISHED FOR BUDGETARY PURPOSES. SCHEDULE H, PART I, LINE 6A ANNUAL COMMUNITY BENEFIT REPORT A REPORT OF COMMUNITY BENEFIT IS INCLUDED IN A WRITTEN ANNUAL REPORT FOR CHRISTUS HEALTH, THE ORGANIZATION'S PARENT COMPANY. CHRISTUS HEALTH IS AN INTERNATIONAL, CATHOLIC, FAITH BASED, NONPROFIT HEALTH SYSTEM FORMED IN 1999 WITH A MISSION "TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST." THE ANNUAL COMMUNITY BENEFIT REPORT SUMMARIZES ACTIVITIES AND PROGRAMS CONDUCTED DURING THE PAST YEAR TO IMPROVE HEALTH INCLUDING PROACTIVE COMMUNITY HEALTH SERVICES. HOWEVER, THE ANNUAL REPORT IS ONLY A SNAPSHOT OF HOW THE ORGANIZATION DISTINGUISHES ITSELF IN ITS VISION TO BE A LEADER, A PARTNER, AND AN ADVOCATE IN CREATING INNOVATIVE HEALTH AND WELLNESS SOLUTIONS THAT IMPROVE THE LIVES OF INDIVIDUALS AND COMMUNITIES. SCHEDULE H, PART I, LINE 7B UNREIMBURSED MEDICAID CHRISTUS HEALTH ARK-LA-TEX REINVESTS ALL SURPLUS FUNDS BACK IN TO THE COMMUNITIES WE SERVE THROUGH EXPANDED HEALTH SERVICES, NEW TECHNOLOGIES, AND BETTER FACILITIES. SCHEDULE H, PART I, LINE 7, COLUMN(F) PERCENT OF TOTAL EXPENSE TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN(A) IS $336,026,135. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS $23,600,722. THIS LEAVES A TOTAL EXPENSE OF $312,425,413 FOR PURPOSES OF CALCULATING LINE 7, COLUMN(F). SCHEDULE H, PART I, LINE 7, COLUMN(F) DESCRIPTION OF FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS AS PERCENTAGE OF TOTAL COSTS THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS REPORTED ON PART I,LINE 7K, COLUMN(C) AS A PERCENTAGE OF TOTAL EXPENSE IS 18.25%, WHICH EXCEEDS THE AMOUNT REPORTED ON PART I, LINE 7K COLUMN(F) WHICH IS COMPUTED USING NET COMMUNITY BENEFIT EXPENSE. SCHEDULE H, PART I, LINE 7(I) CASH AND IN-KIND CONTRIBUTIONS CHRISTUS HEALTH ARK-LA-TEX MADE OVER $531,762 IN CASH AND IN KIND CONTRIBUTIONS DURING FISCAL YEAR 2019. THE AFOREMENTIONED AMOUNT IS DETERMINED IN ACCORDANCE WITH REPORTING RULES FOR SCHEDULE H, WORKSHEET 8. AS SUCH THIS AMOUNT DIFFERS FROM GRANTS REPORTED AT FORM 990, SCHEDULE I, GRANTS AND OTHER ASSISTANCE TO ORGANIZATIONS, GOVERNMENTS, AND INDIVIDUALS AND PART IX, LINES 1 THROUGH 3 GRANTS AND OTHER ASSISTANCE. CHRISTUS HEALTH ESTABLISHED THE CHRISTUS FUND, A GRANT FUND TO PROVIDE RESOURCES TO NONPROFIT AGENCIES AND GROUPS WHOSE VISION, MISSION, AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTH'S MISSION, VALUES AND PHILOSOPHY OF A HEALTHY COMMUNITY. CHRISTUS FUND GRANTS TOTALING $130,000 WERE DONATED BY CHRISTUS HEALTH TO NONPROFIT ORGANIZATIONS LOCATED IN THE COMMUNITY SERVED BY CHRISTUS HEALTH ARK-LA-TEX. THE GRANT DOLLARS ARE USED TO SUPPORT PROGRAMS THAT PROMOTE THE HEALTH OF THE COMMUNITY THAT CHRISTUS HEALTH ARK-LA-TEX SERVES. ALL GRANTS MADE TO OUTSIDE ORGANIZATIONS THROUGH THE CHRISTUS FUND ARE MADE TO NONPROFIT ORGANIZATIONS THAT SUPPORT THE HEALTH OF THE COMMUNITY. THESE GRANT DOLLARS ARE NOT INCLUDED ON SCHEDULE H, PART I, LINE 7(I). INDIGENT FUNDING EXPENSE OF $373,489 IS INCLUDED IN SCHEDULE H, PART I, LINE 7(I). SCHEDULE H, PART I, LINE 7 LINE 7A: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7B: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7E: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7F: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7I: ACTUAL EXPENSE OF THE CONTRIBUTIONS SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES THE CHRISTUS HEALTH ADVOCACY DEPARTMENT WORKS IN PARTNERSHIP WITH LOCAL, STATE AND FEDERAL POLICY MAKERS TO ENSURE ACTIVITIES AND PROGRAMS ARE IN PLACE THAT WILL ENHANCE PUBLIC HEALTH THROUGH IMPROVED ACCESS TO HEALTH SERVICES AND ADVANCE GENERAL KNOWLEDGE. DURING FY 2019, CHRISTUS HEALTH ADVOCATED FOR IMPROVING PUBLIC POLICIES BY WORKING TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY AND GREATER ACCESS TO HEALTHCARE SERVICES FOR THE CONSTITUENTS WE SERVE. ADVOCACY EFFORTS FOCUS ON THE NEEDS OF CHILDREN, SENIORS AND OTHER VULNERABLE POPULATIONS BY PROMOTING PROGRAMS SUCH AS HEALTH SCREENINGS AND EDUCATION FOR EARLY DETECTION OF CANCER AND HEART DISEASE AS WELL AS PROVIDING IMMUNIZATIONS TO THESE POPULATIONS. SCHEDULE H, PART III, SECTION A, LINE 1 BAD DEBT REPORTING IN ACCORDANCE WITH HFMA STATEMENT 15 CHRISTUS HEALTH FOLLOWS IN PRINCIPLE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. THE SYSTEM HAS ADOPTED AN UNCOMPENSATED CARE POLICY WHERE REVENUE FROM SERVICES PROVIDED TO THE UNINSURED IS RECOGNIZED AT THE TIME OF PAYMENT, RATHER THAN AT THE TIME OF SERVICE. THIS POLICY IS THE RESULT OF A LACK OF REASONABLE ASSURANCE OF COLLECTION FOR SERVICES PROVIDED TO THE UNINSURED DUE TO THE SYSTEM'S HISTORICALLY LOW COLLECTION RATE. MANAGEMENT HAS ESTIMATED THAT THE DIFFERENCE BETWEEN RECORDING REVENUE FROM THE UNINSURED ON A CASH BASIS, RATHER THAN THE ACCRUAL BASIS, IS IMMATERIAL. ACCORDINGLY, ALL ACCOUNTS RECEIVABLE FROM THE UNINSURED HAVE BEEN FULLY RESERVED IN THE ALLOWANCE FOR UNCOMPENSATED CARE. SCHEDULE H, PART III, SECTION A, LINE 2 METHODOLOGY USED IN DETERMINING BAD DEBT THE ORGANIZATION'S TOTAL BAD DEBT EXPENSE (TOTAL OF ALL HOSPITAL FACILITIES) IS IN ACCORDANCE WITH THE ORGANIZATION'S FINANCIAL STATEMENTS, WHICH IS COMPUTED AS BAD DEBT NET OF CONTRACTUAL ALLOWANCE, PAYMENTS RECEIVED AND RECOVERIES OF BAD DEBT PREVIOUSLY WRITTEN OFF. SCHEDULE H, PART III, SECTION A, LINE 3 ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ORGANIZATION'S CHARITY CARE POLICY THE FILING ORGANIZATION RECOGNIZES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO SEEK FINANCIAL ASSISTANCE DUE TO BARRIERS SUCH AS EDUCATIONAL LEVEL, LITERACY, DOCUMENTATION REQUIREMENTS, OR BEING INTIMIDATED BY THE APPLICATION PROCESS. IN ORDER TO ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT SUBMITTED AN APPLICATION, THE ORGANIZATION ENGAGED PARO DECISION SUPPORT, LLC. PARO CHARITY SCORE IS DESIGNED TO IDENTIFY PATIENTS THAT LIKELY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON A PREDICTIVE MODEL AND OTHER FINANCIAL AND ASSET ESTIMATES FOR THE PATIENT DERIVED FROM PUBLIC RECORD SOURCES. FOR THE FISCAL YEAR ENDING JUNE 30, 2011, THE ORGANIZATION REPORTED THAT 30% OF BAD DEBT EXPENSES WERE ATTRIBUTABLE TO PATIENTS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE BUT WERE NOT RESPONSIVE TO THE APPLICATION PROCESS EXISTING AT THAT TIME. THIS FIGURE WAS BASED ON THE PARO ANALYSIS AND ESTIMATES OF PATIENTS' FINANCIAL NEEDS THAT EXAMINED WHETHER PATIENTS WERE CHARACTERISTIC OF OTHERS WHO HISTORICALLY QUALIFIED FOR ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. THE PRESUMPTIVE CHARITY CARE ANALYSIS PERFORMED FOR THE PRIOR FISCAL YEAR DETERMINED A BENCHMARK OF BAD DEBT ACCOUNTS IN THE CHRISTUS HEALTH SYSTEM THAT LACKED THE INFORMATION TO QUALIFY FOR CHARITY CARE UNDER THE FILING ORGANIZATION'S CUSTOMARY PROCESS BUT WOULD HAVE LIKELY QUALIFIED FOR ASSISTANCE. DURING THE FISCAL YEAR ENDING JUNE 30, 2019, THE ORGANIZATION UTILIZED THE PARO SCORE TO IDENTIFY THE ACCOUNTS OF INDIVIDUAL PATIENTS THAT WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE DESPITE HAVING NOT COMPLETED AN APPLICATION, AND SUCH ANALYSIS DETERMINED THAT 42.9% OF SUCH ACCOUNTS WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE. THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY FOR THESE ACCOUNTS AND THEY WERE RECLASSIFIED UNDER OUR FINANCIAL ASSISTANCE POLICY. THESE AMOUNTS WERE NOT REPORTED AS BAD DEBT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3 IS THE DIFFERENCE BETWEEN THE PRESUMPTIVE CHARITY CARE BENCHMARK ESTABLISHED IN THE FISCAL YEAR ENDING JUNE 30, 2011 AND THE AGGREGATE OF INDIVIDUAL ACCOUNTS FOR WHICH THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY IN THE FISCAL YEAR ENDING JUNE 30, 2019. THUS, THE ORGANIZATION ESTIMATES THAT ONLY 0.66% OF THE BAD DEBT EXPENSES IN FISCAL YEAR ENDING JUNE 30, 2019 ARE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. IT IS IMPORTANT TO NOTE THAT THE FIGURE CALCULATED FOR FISCAL YEAR ENDING JUNE 30, 2011 WAS ESTIMATED AND NOT EXACT, AND THEREFORE THE DIFFERENCE BETWEEN THE AMOUNTS QUALIFIED AS PRESUMPTIVE CHARITY CARE IN ANY FISCAL YEAR MAY VARY FROM THE BENCHMARK ESTABLISHED IN FISCAL YEAR ENDING JUNE 30, 2011. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT EXPENSE FOOTNOTE THE FOOTNOTE TO THE CHRISTUS HEALTH CONSOLIDATED FINANCIAL STATEMENTS SAYS, "THE PREPARATION OF THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES (US GAAP) REQUIRES MANAGEMENT OF THE SYSTEM TO MAKE ASSUMPTIONS, ESTIMATES, AND JUDGMENTS THAT AFFECT THE AMOUNTS REPORTED IN THE FINANCIAL STATEMENTS, INCLUDING THE NOTES THERETO, AND RELATED DISCLOSURES OF COMMITMENTS AND CONTINGENCIES, IF ANY. THE SYSTEM CONSIDERS CRITICAL ACCOUNTING POLICIES TO BE THOSE THAT REQUIRE MORE SIGNIFICANT JUDGMENTS AND ESTIMATES IN THE PREPARATION OF ITS FINANCIAL STATEMENTS, INCLUDING THE FOLLOWING: RECOGNITION OF NET PATIENT SERVICE REVENUES, WHICH INCLUDE CONTRACTUAL ALLOWANCES AND THE PROVISION FOR BAD DEBT; ESTIMATES FOR REIMBURSEMENT UNDER THE UPPER PAYMENT LIMIT, DISPROPORTIONATE SHARE AND MEDICAID 1115 WAIVER PROGRAMS; RESERVES FOR LOSSES AND EXPENSES RELATED TO HEALTH CARE PROFESSIONAL AND GENERAL LIABILITIES; ACCRUALS FOR CLAIMS INCURRED BUT NOT YET REPORTED RELATED TO THE SYSTEM'S HEALTH PLANS; DETERMINATION OF FAIR VALUES OF CERTAIN FINANCIAL INSTRUMENTS; DETERMINATION OF FAIR VALUE OF CERTAIN GOODWILL AND LONG-LIVED ASSETS INCLUDING ACQUIRED ASSETS; AND RISKS AND ASSUMPTIONS FOR MEASUREMENT OF PENSION AND RETIREE MEDICAL LIABILITIES. MANAGEMENT RELIES ON HISTORICAL EXPERIENCE AND ON OTHER ASSUMPTIONS BELIEVED TO BE REASONABLE UNDER THE CIRCUMSTANCES IN MAKING ITS JUDGMENTS AND ESTIMATES. ACTUAL RESULTS COULD DIFFER MATERIALLY FROM THESE ESTIMATES." SCHEDULE H, PART III, SECTION B, LINE 8 EXTENT TO WHICH SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT COSTING METHODOLOGY THE AMOUNT ON SCHEDULE H, PART III, LINE 6 IS DETERMINED BY CALCULATING MEDICARE ALLOWABLE COSTS USING WORKSHEET A OF THE MEDICARE COST REPORT. WORKSHEET A OF THE MEDICARE COST REPORT REQUIRES THE ORGANIZATION TO REMOVE NON-ALLOWABLE EXPENSES FROM TOTAL EXPENSES VIA THE ADJUSTMENTS TO EXPENSES WORKSHEETS WITHIN THE MEDICARE COST REPORT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE FILING ORGANIZATION ASSOCIATED WITH THE FILING ORGANIZATION'S PROVISIONS OF SERVICES TO MEDICARE PATIENTS. SCHEDULE H, PART III, LINE 7 WOULD EQUAL A SHORTFALL OF ($12,870,874) IF TOTAL EXPENSES ALLOCABLE TO MEDICARE SERVICES WERE SUBSTITUTED ON SCHEDULE H, PART III, LINE 6. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY IT IS THE POLICY OF THE ORGANIZATION TO PURSUE COLLECTIONS OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR THESE SERVICES. THE ORGANIZATION APPLIES ITS COLLECTION EFFORTS CONSISTENTLY AND FAIRLY TO ALL PATIENTS REGARDLESS OF INSURANCE. IF A PATIENT DOES NOT HAVE THE FINANCIAL RESOURCES TO PAY THEIR OUTSTANDING BALANCES, THE GOAL OF THE ORGANIZATION IS TO QUALIFY THESE PATIENTS THROUGH THE ORGANIZATION'S CHARITY POLICY OR SCREEN THE PATIENTS THROUGH THE ORGANIZATION'S PRESUMPTIVE CHARITY TESTS. IF THE PATIENT QUALIFIES UNDER EITHER POLICY THE ACCOUNT WILL BE WRITTEN OFF BASED UPON LEVEL OF QUALIFICATION. THESE POLICIES SUPPORT THE MISSION AND VISION OF THE ORGANIZATION AND ARE APPROVED BY SENIOR LEADERSHIP. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT CHRISTUS HEALTH ARK-LA-TEX, IN COLLABORATION WITH AREA COMMUNITY STAKEHOLDERS DEVELOPED THE 2017 - 2019 COMMUNITY BENEFIT PLAN. AREA COMMUNITY STAKEHOLDERS PARTICIPATED IN A COMMUNITY NEEDS SURVEY TO EXAMINE AND AFFIRM FINDINGS OF THE COMMUNITY HEALTH NEEDS AS WELL AS THE TIME AND RESOURCES REQUIRED TO ADDRESS ALL OF THE UNMET NEEDS IN THE CHRISTUS ARK-LA-TEX REGION. THE GROUP HAS COMMITTED TO CONTINUE WORK RELATED TO THE COMMUNITY HEALTH NEEDS ASSESSMENT IN THE ARK-LA-TEX REGION FOR THE LONG-TERM. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE CHRISTUS HEALTH ARK-LA-TEX MAKES EVERY EFFORT TO EDUCATE PATIENTS ON ITS CHARITY AND DISCOUNT POLICY AND ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS DURING REGISTRATION, PRE-REGISTRATION (FOR SCHEDULED TESTS AND SURGERIES), POST REGISTRATION (DURING THEIR HOSPITALIZATION) AND FOLLOWING DISCHARGE (TELEPHONE OR WRITTEN INQUIRY) IN LANGUAGES APPROPRIATE FOR THE POPULATION BEING SERVED. PATIENTS ARE GIVEN INFORMATION AND FORMS BY A FINANCIAL COUNSELOR WHO HELPS THEM COMPLETE THE FORMS DURING THEIR INPATIENT OR OUTPATIENT VISITS. PATIENTS ARE ASKED TO BRING OR MAIL SUPPORTING DOCUMENTATION TO DETERMINE INCOME, ASSETS AND HOUSEHOLD EXPENSES. THE BUSINESS OFFICE REVIEWS THE APPLICATION BASED ON THE INFORMATION PROVIDED BY THE PATIENT. IF THE PATIENT QUALIFIES FOR CHARITY CARE OR A DISCOUNT, A NEW BILL IS GENERATED. PATIENTS WHO DO NOT PROVIDE THE REQUIRED DOCUMENTATION ARE CONSIDERED INELIGIBLE AND ARE BILLED ACCORDINGLY. IF THE DOCUMENTATION IS PROVIDED AT A LATER TIME, THE PATIENT MAY THEN BE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR A DISCOUNT. DOCUMENTATION IS RETAINED BY THE BILLING OFFICE FOR SEVEN YEARS. A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY IS POSTED IN PROMINENT PLACES THROUGHOUT THE HOSPITALS, INCLUDING BUT NOT LIMITED TO THE EMERGENCY ROOM WAITING AREAS AND THE ADMISSIONS OFFICE WAITING AREAS, AS REQUIRED BY BOTH THE STATE OF TEXAS COMMUNITY BENEFIT STANDARD (WHICH ADDRESSES THE DUTIES AND RESPONSIBILITIES OF NONPROFIT HOSPITALS) AND CHRISTUS HEALTH COMMUNITY BENEFIT GUIDELINES #50. IN ADDITION, A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY AND INFORMATION OF FINANCIAL ASSISTANCE ARE ALSO POSTED ON THE CHRISTUS HEALTH WEBSITE. THE INFORMATION OF FINANCIAL ASSISTANCE INCLUDES EXPLANATIONS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE, WHO QUALIFIES, AND HOW TO APPLY FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION CHRISTUS HEALTH ARK-LA-TEX IS LOCATED IN TEXARKANA, TEXAS. THE REPORT AREA CONSISTS OF BOWIE AND CASS COUNTIES IN TEXAS AND MILLER AND LITTLE RIVER COUNTIES IN ARKANSAS CONSISTING OF A TOTAL POPULATION OF 179,807 RESIDENTS. MORE THAN TWO-THIRDS OF THE REPORT AREA'S POPULATION RESIDES IN BOWIE COUNTY AND MILLER COUNTY, AND THE REMAINING ONE-THIRD RESIDE IN CASS COUNTY AND LITTLE RIVER COUNTY. 55% RESIDENTS OF THE REPORT AREA LIVE IN AN URBAN ENVIRONMENT, WHILE THE REMAINING 45% ARE RURAL WHICH MIRRORS THE URBAN-RURAL BREAKDOWN OF ARKANSAS' POPULATION STATEWIDE. TEXARKANA, TEXAS AND TEXARKANA, ARKANSAS ARE THE LARGEST CITIES IN THE REPORT AREA AND ARE LOCATED IN BOWIE AND MILLER COUNTIES, RESPECTIVELY. THE REPORT AREA POPULATION CONSISTS OF APPROXIMATELY 72.0 PERCENT CAUCASIANS AND 22.9 PERCENT AFRICAN-AMERICANS ACCORDING TO 2014 US CENSUS DATA. THE 2013-2014 HIGH SCHOOL GRADUATION RATE IN THE REPORT AREA (92.1%) EXCEEDS THAT OF BOTH TEXAS (89.6%) AND ARKANSAS (87.2%). COUNTY LEVEL DATA SHOW MEDIAN HOUSEHOLD INCOME $53,776 FOR BOWIE COUNTY AND $50,799 FOR MILLER COUNTY WHICH IN TURN IS HIGHER THAN LITTLE RIVER COUNTY ($48,955) AND CASS COUNTY ($46,875) AS OF 2014. THIS INCOME LEVEL IS ON PAR WITH THE STATEWIDE MEDIAN INCOME OF ARKANSANS ($48,955) BUT SUBSTANTIALLY LOWER THAN TEXAS' MEDIAN FAMILY INCOME ($61,958). CHRISTUS ARK-LA-TEX PROVIDES THE BEST CARE POSSIBLE REGARDLESS OF AN INDIVIDUALS'S ABILITY TO PAY. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH CHRISTUS HEALTH ARK-LA-TEX RESPONDS TO THE HEALTH CARE NEEDS OF THE COMMUNITY THROUGH SERVICES PROVIDED AT CHRISTUS ST. MICHAEL HEALTH SYSTEM, WHICH INCLUDES CHRISTUS ST. MICHAEL HOSPITAL, A 311-BED ACUTE CARE HOSPITAL; CHRISTUS ST. MICHAEL HOSPITAL-ATLANTA, A 43-BED ACUTE CARE HOSPITAL; CHRISTUS ST. MICHAEL REHABILITATION HOSPITAL, A 50-BED HOSPITAL; CHRISTUS ST. MICHAEL OUTPATIENT REHABILITATION CENTER; CHRISTUS ST. MICHAEL IMAGING CENTER, AND CHRISTUS ST. MICHAEL HOME HEALTH-ATLANTA. CHRISTUS HEALTH ARK-LA-TEX PROVIDES 24 HOUR EMERGENCY DEPARTMENTS, LEVEL III TRAUMA DESIGNATION AT CHRISTUS ST. MICHAEL AND LEVEL IV TRAUMA DESIGNATION AT CHRISTUS ST. MICHAEL HOSPITAL-ATLANTA, THAT ARE OPEN TO SERVE ALL THOSE IN NEED OF EMERGENCY CARE, REGARDLESS OF THEIR ABILITY TO PAY. CHRISTUS HEALTH ARK-LA-TEX WORKS TO STRENGTHEN ACCESSIBILITY OF QUALITY COMPREHENSIVE HEALTH CARE SERVICES FOR ALL, ESPECIALLY THE VULNERABLE AND UNDERSERVED POPULATIONS. THE BOWIE COUNTY, TEXAS POPULATION AND MILLER COUNTY, ARKANSAS POPULATION IS 136,605. TEXARKANA, TEXAS AND TEXARKANA, ARKANSAS ARE THE LARGEST CITIES SURROUNDING CHRISTUS HEALTH ARK-LA-TEX. ROOTED IN OUR MISSION AND TRADITION, THE FOUNDERS AND SPONSORS OF CHRISTUS HEALTH ARE CONSTANTLY SEEKING INNOVATIVE WAYS OF DELIVERING QUALITY HEALTH CARE THAT IS BOTH AFFORDABLE AND ACCESSIBLE TO ALL. COLLABORATIVE EFFORTS WITH GENESIS PRIME CARE, ALL FOR KIDS PEDIATRIC CLINIC, AND RANDY SAMS HOMELESS SHELTER PROVIDE PRIMARY CARE TO MEET THE NEEDS OF THE POOR, UNDERSERVED AND THE HOMELESS. CHRISTUS HEALTH ARK-LA-TEX ALSO SUPPORTS THE NEEDS OF SPECIAL POPULATIONS IN THE COMMUNITY BY PROVIDING EDUCATION FOR EARLY DETECTION OF CANCER AND HEART DISEASE AS WELL AS HEALTH SCREENINGS AND IMMUNIZATIONS FOR DISEASE DETECTION AND PREVENTION WITH SPECIAL ATTENTION GIVEN TO CHILDREN, SENIORS AND OTHER VULNERABLE POPULATIONS THROUGH A MOBILE HEALTH CLINIC. HEALTH EDUCATION PROGRAMS, SCREENINGS AND ADULT IMMUNIZATIONS ASSIST OTHER TARGETED POPULATIONS SUCH AS PERSONS AGE 65 OR OLDER AND AFRICAN-AMERICANS. CHRISTUS HEALTH ARK-LA-TEX PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE FROM THE COMMUNITIES IT SERVES. IT CONDUCTS ITS ACTIVITIES AND SERVES ITS HEALTH CARE MISSION WITHOUT REGARD TO RACE,COLOR, CREED, RELIGION, GENDER, ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. CHRISTUS HEALTH ARK-LA-TEX COLLABORATES WITH COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTH CARE ORGANIZATIONS TO STRENGTHEN ITS ROLE AS A MAJOR PROVIDER OF COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES. CHRISTUS HEALTH ARK-LA-TEX PROVIDES MEDICATION ASSISTANCE FOR COMMUNITY RESIDENTS WHO ARE UNABLE TO AFFORD THE MEDICATIONS THEY NEED. THE HOSPITALS WORK WITH COMMUNITY PHARMACIES AND OTHER PHARMACEUTICAL COMPANIES TO IDENTIFY THESE PATIENTS AND DISTRIBUTE THE NEEDED MEDICATIONS TO SUCH PERSONS. "COMMUNITY SERVICES FOR A BROADER COMMUNITY" IS ALSO A PART OF CHRISTUS HEALTH ARK-LA-TEX'S OVERALL COMMUNITY BENEFIT. THE GREATEST SHARE OF THESE EXPENSES IS FOR EDUCATING HEALTH PROFESSIONALS (GRADUATE MEDICAL EDUCATION, NURSING STUDENTS, ALLIED HEALTH PROFESSIONALS, PHARMACISTS, ETC). HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGUISHING CHARACTERISTIC OF NOT-FOR-PROFIT HEALTH CARE AND CONSTITUTES A SIGNIFICANT COMMUNITY BENEFIT. CHRISTUS ARK-LA-TEX HAD OVER $536,487 IN HEALTH PROFESSIONS EDUCATION EXPENSES DURING FY 2019 THAT INCLUDED STUDENT INTERNSHIPS, CLINICAL EXPERIENCE AND OTHER EDUCATION FOR PHYSICIANS, NURSES, TECHNICIANS, ADMINISTRATORS, SOCIAL WORKERS, THERAPISTS AND PASTORAL CARE PROFESSIONALS. CHRISTUS HEALTH HAS ESTABLISHED THE CHRISTUS FUND TO PROVIDE RESOURCES TO NOT-FOR-PROFIT AGENCIES AND GROUPS WHOSE VISION, MISSION AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTH'S MISSION, VALUES, AND PHILOSOPHY OF A HEALTHY COMMUNITY. WE BELIEVE THAT BY WORKING TOGETHER, WE CAN MAKE A PROFOUND DIFFERENCE IN THE QUALITY OF PEOPLES' LIVES AND CREATE SUSTAINABLE HEALTH IN OUR COMMUNITIES. DURING FY 2019 THE TOTAL GRANT MONEY DISTRIBUTED BY CHRISTUS HEALTH TO THE ARK-LA-TEX REGION WAS $130,000. CHRISTUS HEALTH ARK-LA-TEX ALSO USED CASH DONATIONS AS A VEHICLE TO HELP OUR COMMUNITIES. CASH DONATIONS, IN ADDITION TO GRANTS AWARDED THROUGH THE CHRISTUS FUND, SUPPORT CAUSES LIKE THE FIGHT AGAINST CANCER, DIABETES, HEART DISEASE, PROVISION OF A CONTINUUM OF CARE FOR OUR ELDERLY, HIV/AIDS PREVENTION, AND MANY OTHER EQUALLY WORTHY PURPOSES. CHRISTUS HEALTH REINVESTS ALL SURPLUS FUNDS BACK INTO THE COMMUNITIES IT SERVES THROUGH EXPANDED HEALTH SERVICES, NEW TECHNOLOGIES, AND BETTER FACILITIES. DURING FY 2019, CHRISTUS HEALTH ADVOCATED FOR IMPROVEMENT PUBLIC POLICES AND WORKED TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY FOR GREATER ACCESS TO HEALTH CARE SERVICES FOR ALL. AS A NOT FOR PROFIT ORGANIZATION AND AS PART OF CHRISTUS HEALTH, A REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE MAKEUP OF THE AREA WE SERVE GUIDES CHRISTUS HEALTH ARK-LA-TEX. WE ARE PRIVILEGED TO HAVE AN OPEN MEDICAL STAFF COMPRISED OF QUALIFIED PHYSICIANS WHO WORK WITH US TO PROVIDE CARE TO OUR COMMUNITIES. ALL QUALIFIED PHYSICIANS WHO ARE GRANTED PRIVILEGES TO SERVE WITH US IN OUR HOSPITALS MUST UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING AND ORIENTATION PROCESS. REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE MAKEUP OF THE AREA WE SERVE GUIDES CHRISTUS HEALTH ARK-LA-TEX. ALL PERSONS EMPLOYED AND AFFILIATED WITH CHRISTUS ARK-LA-TEX ARE REQUIRED TO COMPLETE ANNUAL CONFLICT OF INTEREST STATEMENTS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM DESCRIPTION CHRISTUS HEALTH ARK-LA-TEX IS PART OF CHRISTUS HEALTH, AN INTERNATIONAL, CATHOLIC, FAITH BASED, NONPROFIT HEALTH SYSTEM COMPRISED OF ALMOST 350 SERVICES AND FACILITIES INCLUDING MORE THAN 60 HOSPITALS AND LONG TERM CARE FACILITIES, 175 CLINICS AND OUTPATIENT CENTERS, AND OTHER COMMUNITY HEALTH MINISTRIES AND COMMUNITY DEVELOPMENT VENTURES. CHRISTUS SERVICES CAN BE FOUND IN THE STATES OF ARKANSAS, GEORGIA, IOWA, LOUISIANA, NEW MEXICO, TEXAS, AND INTERNATIONALLY IN THE COUNTRIES OF MEXICO AND CHILE. A COMMON MISSION, CORE VALUES, AND VISION UNITE THE HEALTH SYSTEM. EACH REGION, INCLUDING CHRISTUS HEALTH ARK-LA-TEX, DEVELOPS FIVE-YEAR AND TEN-YEAR STRATEGIC PLANS THAT HELP SET THE YEARLY OPERATIONAL PLANS AND BUDGETS. REGIONAL STRATEGIC GOALS ARE SET IN COLLABORATION WITH CHRISTUS HEALTH AND INCLUDE METRICS THAT WILL BE USED TO MEASURE COMMUNITY BENEFIT, CLINICAL OUTCOMES, PATIENT SATISFACTION, AND ASSOCIATE ENGAGEMENT. CHRISTUS HEALTH PROVIDES UPDATED MARKET, DEMOGRAPHICS, AND HEALTH INDICATOR DATA ON AN ANNUAL BASIS. THE DATA SUPPLIED FROM CHRISTUS HEALTH ALONG WITH THE SYSTEM WIDE STRATEGIC INITIATIVES ARE CONSISTENT WITH THE COMMUNITY NEEDS ASSESSMENT OF THE REGION. CHRISTUS HEALTH ARK-LA-TEX, IN TURN, PARTNERS WITH OTHER NONPROFIT GROUPS (CHURCHES, HEALTH CARE PROVIDERS, AND GOVERNMENT AGENCIES) TO CREATE COLLABORATIONS WHERE HEALTH NEEDS CAN BE ADDRESSED AND THE GENERAL HEALTH OF INDIVIDUALS AND THE COMMUNITY IS IMPROVED. SCHEDULE H, PART VI, LINE 7 Community Benefit Report A COMMUNITY BENEFIT REPORT IS FILED FOR THE STATE OF TEXAS IN THE FORM OF THE ANNUAL STATEMENT OF COMMUNITY BENEFITS STANDARD (ASCBS) FORM AS REQUIRED BY THE HEALTH AND SAFETY CODE, SECTIONS 311.045 AND 311.046. THE CODE REQUIRES NONPROFIT HOSPITALS TO FILE THE ASCBS FORM AND ANNUAL REPORT OF THE COMMUNITY BENEFITS PLAN WITH THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES (DSHS).THE 2013 ASCBS FORM IS EXPANDED TO COLLECT THE INFORMATION ON CHARITY CARE POLICIES AND COMMUNITY BENEFITS IN A STANDARDIZED FORMAT. ALL CHRISTUS HEALTH ENTITIES INCLUDING FACILITIES LOCATED IN STATES THAT DO NOT REQUIRE ANNUAL COMMUNITY BENEFIT REPORTING (I.E., LOUISIANA, AND NEW MEXICO), FOLLOW THE SAME REPORTING RULES AS OUTLINED IN THE CATHOLIC HEALTH ASSOCIATION GUIDE TO PLANNING AND REPORTING COMMUNITY BENEFIT, COPYRIGHT 2012. TOTAL COMMUNITY BENEFIT FOR CHRISTUS HEALTH IS ALSO REPORTED IN THE ANNUAL REPORT PREPARED AND DISTRIBUTED BY THE SYSTEM OFFICE. STATE FILING OF COMMUNITY BENEFIT REPORT: TX true UNIVERSITY OF AR AREA HLTH EDUCATION CTR SW 300 East 6th Street Texarkana AR 71854 716046242 501(c)(3) 898307 MEDICAL EDUCATION PROGRAM MAINTAINED BY NET REVENUE TEAM BOWIE COUNTY CLINICAL SERVICES INC 2801 Via Fortuna STE 500 AUSTIN TX 78746 113794900 501(c)(3) 400690 Indigent Care Program Funding CHRISTUS ST MICHAEL FOUNDATION 2600 St Michael drive Texarkana TX 75503 471655865 501(c)(3) 584508 DONATION FOR SUPPORT OF THE PREMIUM SUPPORT PROGRAM EAST TEXAS BORDER HEALTH 502 East Rusk Street Marshall TX 75670 030538912 501(c)(3) 647177 DONATION FOR COMMUNITY HEALTH CONTRIBUTION GRANT HEALTH TEACHER INC 209 10th Ave South STE 350 Nashville TN 37203 203456491 501(c)(3) 98725 DONATION FOR HEALTH EDUCATION PROGRAM AR-TEX REGIONAL ECONOMIC 5131 SummerHill Texarkana TX 75503 830517428 501(c)(3) 100000 Financial Assistance to RDEI to work TEXARKANA INDEPENDENT SCHOOL DISTRICT 4241 SUMMERHILL RD TEXARKANA TX 75503 756002579 GOVT 7331 DONATION FOR HEALTH AND WELLNESS GRANT SUSAN G KOMEN ARKANSAS AFFILIATE 2801 RICHMOND RD TEXARKANA TX 75503 710724439 501(c)(3) 10000 RACE FOR THE CURE TDA SMILES FOUNDATION 1946 S IH 35 SUITE 300 AUSTIN TX 78704 742897487 501(c)(3) 34379 LOCAL DENTAL SUPPORT PGISD 8500 N KINGS HWG TEXARKANA TX 75503 751621780 170(C)(1) 300000 LAND SWAP 9 1 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS FORM 990, SCHEDULE I, PART I, LINE 2 THE ORGANIZATION FOLLOWS CHRISTUS HEALTH MANAGEMENT DIRECTIVE NO. 0006, "CONTRIBUTIONS/DONATIONS TO OTHER ORGANIZATIONS". BEFORE ANY DONATION IS MADE, TWO CRITERIA ARE ADDRESSED: (1) ORGANIZATION TEST AND (2) IRS TEST. THE ORGANIZATION TEST ENSURES THAT DONATIONS ARE EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, EDUCATIONAL, AND RELIGIOUS PURPOSES, AND IN FURTHERANCE OF OUR PURPOSE OF SUPPORTING THE HEALING MINISTRY OF JESUS CHRIST AND ADVANCING, PROMOTING AND SUPPORTING THE HEALTHCARE MINISTRIES OF THE SPONSORING CONGREGATIONS. CONTRIBUTIONS CAN BE MADE TO SUPPORT CHRISTUS SYSTEM MEMBERS AND TO OTHER QUALIFYING TAX-EXEMPT ORGANIZATIONS, PARTICULARLY THOSE DESIGNED TO SUPPORT AND BENEFIT THE POOR AND UNDERSERVED. THE ORGANIZATION CONSIDERED FOR DONATIONS MUST BE AN IRS SECTION 501(C)(3) ORGANIZATION AND DOCUMENTATION TO THAT EFFECT OBTAINED. TO SATISFY THE IRS TEST CONTRIBUTIONS GIVEN MUST BE DEDICATED TO ACHIEVING CHARITABLE PURPOSES NOT FOR PERSONAL BENEFIT BUT FOR PUBLIC BENEFIT. CONTRIBUTIONS ARE PROHIBITED TO ORGANIZATIONS THAT CONTRIBUTE TO POLITICAL CAMPAIGNS, CANDIDATES FOR OFFICE, OR CONDUCT MORE THAN INCIDENTAL LOBBYING. DOCUMENTATION MUST SUPPORT HOW THE DONATION MEETS ORGANIZATIONAL PURPOSES AND FURTHERANCE OF MISSION. DONATIONS SHOULD BE MODEST IN SCOPE. IN ADDITION TO FOLLOWING CHRISTUS HEALTH MANAGEMENT DIRECTIVE NO. 0006, THE ORGANIZATION HAS ADDITIONAL GUIDELINES AND PROCEDURES FOR GRANT-MAKING. IN ACCORDANCE WITH THE ORGANIZATION'S DONATION POLICY, PRIORITY WILL BE GIVEN TO CHARITY CASES AS FOLLOWS: (A) SERVICES AND CONTRIBUTIONS TO ORGANIZATIONS WHICH PROVIDE CARE FOR THE POOR AND UNDERSERVED; (B) HEALTH EDUCATION AND PREVENTION; AND (C) OTHER HEALTH RELATED CAUSES. ALL REQUESTS FOR CONTRIBUTIONS, SPONSORSHIPS, ETC., REGARDLESS OF AMOUNT, MUST BE SUBMITTED IN WRITING TO THE CHRISTUS ST. MICHAEL FOUNDATION DIRECTOR. DOCUMENTATION MUST SUPPORT HOW THE DONATION MEETS ORGANIZATIONAL PURPOSES PARTICULARLY RELATING TO THE HEALING MINISTRY AND HEALTH CARE. THE FILING ORGANIZATION PROVIDES INDIGENT FUNDING GRANTS TO THE COUNTIES IN WHICH IT SERVES VIA GRANTS PAID TO OTHER HOSPITALS AND HEALTHCARE ORGANIZATIONS LOCATED WITHIN SUCH COUNTIES. THIS CHARITABLE DONATION HELPS RELIEVE THE ADDITIONAL EXPENSE OF HEALTHCARE FOR THE INDIGENT POPULATION WITHIN OUR COMMUNITIES THAT THE FILING ORGANIZATION MAY NOT DIRECTLY SERVE IN ONE OF ITS HOSPITALS. THIS IS A RESULT OF OUR MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST, ESPECIALLY TO THE POOR AND UNDERSERVED. X true true false true false false false false false false false Christopher Karam Ex-Officio,Pres/CEO(THRU 9/18) 724486 435363 92227 254291 20268 1526635 G Michael Finley MD Chief Medical Officer 303979 112850 163505 101772 23855 705961 Jason G Rounds CEO (AS OF 09/2018) 311274 96514 77436 86718 25576 597518 John W Graham MD VP MEDICAL AFFAIRS (THRU 1/19) 218322 65747 90472 8264 8780 391585 THOMAS MCKINNEY THRU 032018 ADMIN CHRISTUS ST MICHAEL HOSP 221258 80489 52789 47085 24381 426002 M GLEN BOLES CHIEF FIN. OFFICER/ Treasurer 237571 82726 78366 59739 25073 483475 LOUISE THORNELL CHIEF NURSE EXECUTIVE 186627 61946 10055 48397 9092 316117 JENNIFER WRIGHT VP HUMAN RESOURCES (EFF 2/19) 147853 31246 1726 12491 15195 208511 LAWRENCE CHELLAIAN VP MISSION INT. 129504 40221 5202 27441 4983 207351 PATRICK FLANNERY ST MICHAEL REHAB HOSP ADMIN 183987 50609 8200 7474 4542 254812 WILLIAM MICAH JOHNSON DIRECTOR 138085 17099 27826 9774 11109 203893 JEREMY K DOBBINS PHARMACIST 180234 11007 90 12676 23755 227762 NANCY E BARLOW DIRECTOR OF OUTPATIENT SERVICE 166499 14213 6928 10404 11259 209303 KEN L KELLY PHARMACIST 168934 1015 1650 14318 7992 193909 DALE SMITH DIRECTOR PHARMACY 141431 17381 5050 15705 179567 WILLIAM AINSLEY PERFUSIONIST 156581 1007 13714 17456 188758 SUPPLEMENTAL COMPENSATION INFORMATION COMPANION TRAVEL FORM 990, SCHEDULE J, PART I, LINE 1A TAXABLE COMPENSATION WAS REPORTED TO VARIOUS OFFICERS AND BOARD MEMBERS RELATED TO COMPANION TRAVEL TO CHRISTUS MEETINGS. FORM 990, PART VII, QUESTION 1A AND SCHEDULE J, PART II DIRECTORS AND EX-OFFICIO DIRECTORS PROVIDE THEIR SERVICES AS MEMBERS OF THE BOARD WITHOUT COMPENSATION OR BENEFITS. ANY COMPENSATION AND BENEFITS DISCLOSED FOR SUCH PERSONS IS EARNED IN THE RESPECTIVE INDIVIDUAL'S ROLE AS AN OFFICER OR EMPLOYEE OF THE ORGANIZATION, NOT FOR THE INDIVIDUAL'S ROLE AS A BOARD MEMBER OR DIRECTOR. BOARD MEMBERS SPEND TIME AS NEEDED FOR BOARD MEETINGS AND FUNCTIONS. RELATED ORGANIZATION DETERMINING CEO/EXECUTIVE DIRECTOR'S COMPENSATION FORM 990, SCHEDULE J, PART I, LINE 3 THE FILING ORGANIZATIONS CEO/EXECUTIVE DIRECTOR IS AN EMPLOYEE OF CHRISTUS HEALTH, A RELATED ORGANIZATION. AS A RESULT, COMPENSATION IS ESTABLISHED AT THE CHRISTUS HEALTH LEVEL AND THE FILING ORGANIZATION DOES NOT HAVE A ROLE IN IMPLEMENTING THE METHODS USED TO ESTABLISH COMPENSATION OR IN DETERMINING CEO/EXECUTIVE DIRECTOR COMPENSATION. CHRISTUS HEALTH USES AN EXECUTIVE COMPENSATION COMMITTEE TO ESTABLISH AND APPROVE THE COMPENSATION OF THE FILING ORGANIZATIONS CEO/EXECUTIVE DIRECTOR. THIS COMMITTEE USES AN INDEPENDENT COMPENSATION CONSULTANT WHO PERFORMS A BI-ANNUAL COMPENSATION SURVEY. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FORM 990, SCHEDULE J, PART I, LINE 4B DEFERRED COMPENSATION INCLUDES EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, AND PENSION RESTORATION PLAN. ESTIMATED PENSION BENEFITS WERE CALCULATED BASED ON THE PROVISIONS OF THE CURRENT PENSION RESTORATION PLAN AT 6% OF PENSIONABLE EARNINGS WHICH ARE OVER THE IRS LEGISLATIVE COMPENSATION LIMIT. SOME ASSOCIATES ARE GRANDFATHERED UNDER AN EARLIER LEGACY PENSION PLAN. IF A PARTICIPANT HAS PROTECTED PENSION BENEFITS UNDER SUCH LEGACY PLANS, HIS/HER PERCENTAGE IS ZERO UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, AS THE PROTECTED BENEFIT IS ALREADY EQUAL TO OR BETTER THAN CURRENT MARKET. SUPPLEMENTAL COMPENSATION INFORMATION FORM 990, SCHEDULE J, PART II W-2 COMPENSATION MAY INCLUDE PAYMENTS RELATED TO COMPENSATION DEFERRED IN PRIOR YEARS. DEFERRED COMPENSATION MAY INCLUDE DEFERRALS OF CURRENT YEAR COMPENSATION UNDER EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN AND PENSION RESTORATION PLAN. SUPPLEMENTAL COMPENSATION INFORMATION FORM 990, SCHEDULE J, PART II, COLUMN B (II) BONUS AND INCENTIVE COMPENSATION MAY INCLUDE AMOUNTS THAT WERE DEFERRED IN A PRIOR YEAR BUT PAID OUT IN CALENDER YEAR 2018. DEFERRED COMPENSATION FORM 990, SCHEDULE J, PART II, COLUMN C DEFERRED COMPENSATION INCLUDES EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, EMPLOYER CONTRIBUTION TO 403(B) MATCHED SAVINGS PLAN, PENSION RESTORATION PLAN AND ESTIMATED PENSION BENEFITS UNDER CHRISTUS HEALTH CASH BALANCE PLAN. ESTIMATED PENSION BENEFITS WERE CALCULATED BASED ON THE PROVISIONS OF THE CURRENT CASH BALANCE PLAN AT 6% OF PENSIONABLE EARNINGS. SOME ASSOCIATES ARE GRANDFATHERED UNDER AN EARLIER PENSION PLAN. THESE GRANDFATHERED PARTICIPANTS, BASED ON COMPUTATION AT THE TIME OF THEIR RETIREMENT, WILL RECEIVE THE LARGER OF THE RETIREMENT BENEFIT COMPUTED UNDER THE CASH BALANCE PLAN COMPARED TO THE PREVIOUS PENSION PLAN. DUE TO THE COMPLEXITY OF CALCULATING AN ACCURATE BENEFIT COST FOR GRANDFATHERED PARTICIPANTS, THE FORM 990 REPORTS AS PENSION BENEFITS THEIR ANNUAL ESTIMATED CASH BALANCE PLAN ACCRUAL. SUPPLEMENTAL COMPENSATION INFORMATION FORM 990, PART VII, SECTION A AND SCHEDULE J, PART II THE BONUS AND INCENTIVE COMPENSATION REPORTED AS RELATED COMPENSATION WAS PAID TO THE FOLLOWING PERSONS BY CHRISTUS HEALTH, A RELATED ORGANIZATION OF THE FILING ENTITY: CHRISTOPHER KARAM, G. MICHAEL FINLEY, M.D., JASON G. ROUNDS, JOHN W. GRAHAM, M.D., THOMAS MCKINNEY, M. GLEN BOLES, LOUISE THORNELL, JENNIFER WRIGHT, LAWRENCE CHELLAIAN, PATRICK FLANNERY, AND WILLIAM MICAH JOHNSON. DOING BUSINESS AS FORM 990, PAGE 1, ITEM C CHRISTUS HEALTH ARK-LA-TEX OPERATES UNDER THE FOLLOWING NAMES: CHRISTUS ST. MICHAEL HEALTH SYSTEM CHRISTUS ST. MICHAEL FAMILY CLINIC CHRISTUS ST. MICHAEL REHABILIATION HOSPITAL CHRISTUS ST. MICHAEL SENIOR HEALTH CENTER HEALTH CARE CENTER PHARMACY GLENWOOD PHARMACY CHRISTUS ST. MICHAEL GLENWOOD PHARMACY CHRISTUS ST. MICHAEL HEALTH CARE CENTER PHARMACY CHRISTUS ST. MICHAEL QUICK CLINIC NEW BOSTON CHRISTUS ST. MICHAEL SPINE CENTER CHRISTUS ST. MICHAEL HIP FRACTURE CENTER CHRISTUS ST. MICHAEL HOSPITAL - ATLANTA CHRISTUS ST. MICHAEL HEALTH & FITNESS CENTER - ATLANTA CHRISTUS ST. MICHAEL OUTPATIENT REHABILITATION CENTER - ATLANTA CHRISTUS ST. MICHAEL HOME HEALTH ATLANTA CHRISTUS ST. MICHAEL PROVIDER SERVICES (ATLANTA) CHRISTUS ST. MICHAEL PROVIDER SERVICES CHRISTUS ST. MICHAEL HEALTH CARE CENTER CHRISTUS ST. MICHAEL ONCOLOGY CLINIC CHRISTUS ST. MICHAEL HEALTH & FITNESS CENTER CHRISTUS ST. MICHAEL HEALTH CENTER PRESCOTT CHRISTUS ST. MICHAEL ONCOLOGY CLINIC - COWHORN CREEK CHRISTUS ST. MICHAEL RHEUMATOLOGY CLINIC - COWHORN CREEK OTHER PROGRAM SERVICE FORM 990, PART III, LINE 4D COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED ROOTED IN OUR MISSION AND TRADITION, THE FOUNDERS AND SPONSORS OF CHRISTUS HEALTH AND THOSE WHO CO-MINISTER WITH THEM SEEK NEW AND INNOVATIVE WAYS OF DELIVERING QUALITY HEALTH CARE THAT IS BOTH AFFORDABLE AND ACCESSIBLE TO ALL. TODAY, MORE THAN EVER, WE MUST AIM TO IMPROVE THE TOTAL HEALTH STATUS OF THE COMMUNITY THROUGH PROGRAMS THAT PLACE OUR SERVICES WHERE THEY ARE NEEDED MOST, WITH SPECIAL ATTENTION AND PREFERENCE GIVEN TO PROGRAMS THAT SUPPORT AND BENEFIT THE HEALTH AND WELFARE OF THE POOR AND UNDERSERVED. COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED REPRESENT THE UNPAID COST OF SERVICES PROVIDED FOR WHICH A PATIENT IS NOT BILLED, OR FOR WHICH A FEE HAS BEEN ASSESSED THAT RECOVERS ONLY A PORTION OF THE COST OF THE RENDERED SERVICE. THIS CATEGORY INCLUDES INITIATIVES THAT REACH OUT TO THOSE IN NEED THROUGH COMMUNITY HEALTH AND SOCIAL PROGRAMS. THESE PROGRAMS SEEK JUSTICE FOR THE VULNERABLE AND WORK TO BRING ABOUT CHANGES IN OUR POLITICAL AND ECONOMIC SYSTEMS. THE PROGRAMS COVER A BROAD SPECTRUM OF SERVICES FROM CHARITY CLINICS TO IMMUNIZATIONS FOR CHILDREN AND SENIORS, TRANSPORTATION SERVICES, AND A VARIETY OF OTHER SOCIAL SERVICES. CHRISTUS HEALTH ARK-LA-TEX PROVIDES MEDICATION ASSISTANCE FOR COMMUNITY RESIDENTS WHO ARE UNABLE TO AFFORD THE MEDICATIONS THEY NEED. THE HOSPITALS WORK WITH COMMUNITY PHARMACIES AND OTHER PHARMACEUTICAL COMPANIES TO IDENTIFY THESE PATIENTS AND THEN DISTRIBUTE THE NEEDED MEDICATIONS TO THEM. COLLABORATIVE EFFORTS WITH GENESIS PRIME CARE, ALL FOR KIDS PEDIATRIC CLINIC AND RANDY SAMS HOMELESS SHELTER PROVIDE PRIMARY CARE TO MEET THE NEEDS OF THE POOR, UNDERSERVED AND HOMELESS. CHRISTUS HEALTH ARK-LA-TEX ALSO SUPPORTS THE NEEDS OF SPECIAL POPULATIONS IN THE COMMUNITY BY PROVIDING HEALTH SCREENINGS AND EDUCATION FOR EARLY DETECTION OF CANCER AND HEART DISEASE AS WELL AS SCREENINGS AND IMMUNIZATIONS FOR CHILDREN THROUGH A MOBILE HEALTH CLINIC. HEALTH EDUCATION PROGRAMS, SCREENINGS AND ADULT IMMUNIZATIONS ASSIST OTHER TARGETED POPULATIONS SUCH AS PERSONS AGE 65 OR OLDER AND AFRICAN-AMERICANS. CHRISTUS HEALTH HAS ESTABLISHED THE CHRISTUS FUND TO PROVIDE RESOURCES TO NOT-FOR-PROFIT AGENCIES AND GROUPS WHOSE VISION, MISSION AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTHS MISSION, VALUES AND PHILOSOPHY OF A HEALTHY COMMUNITY. WE BELIEVE THAT BY WORKING TOGETHER, WE CAN MAKE A PROFOUND DIFFERENCE IN THE QUALITY OF PEOPLES LIVES AND CREATE SUSTAINABLE HEALTH IN OUR COMMUNITIES. THE CHRISTUS FUND HAS INVESTED A TOTAL OF $130,000 IN THE ARK-LA-TEX REGION IN FY 2019. HARVEST TEXARKANA AND CASA OF NORTHEAST TX, TWO COMMUNITY AGENCIES SERVING TO IMPROVE THE HEALTH OF THEIR COMMUNITIES WERE RECIPIENTS OF THESE FUNDS. SEVERAL CHRISTUS REGIONS PROVIDE INDIGENT FUNDING DONATIONS OR "GRANTS" TO AID THE COUNTIES IN WHICH THEY, OR ANOTHER CHRISTUS REGION, SERVE. SUCH GRANTS MAY BE PAID TO THE COUNTY DIRECTLY OR VIA ANOTHER HOSPITAL OR HEALTHCARE ORGANIZATION IN THE AREA. THIS CHARITABLE DONATION HELPS RELIEVE THE ADDITIONAL EXPENSE OF HEALTH CARE FOR THE INDIGENT POPULATION WITHIN OUR COMMUNITIES THAT CHRISTUS MAY NOT DIRECTLY SERVE IN ONE OF OUR HOSPITALS. THIS IS A RESULT OF OUR MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST, ESPECIALLY TO THE POOR AND UNDERSERVED. COMMUNITY SERVICES FOR THE BROADER COMMUNITY THE GREATEST SHARE OF THESE EXPENSES IS FOR EDUCATING HEALTH PROFESSIONALS. IN ORDER TO PROVIDE CLINICALLY TRAINED PROFESSIONALS, CHRISTUS HEALTH ARK-LA-TEX COOPERATES WITH THE UNIVERSITY OF ARKANSAS MEDICAL SCIENCES AREA HEALTH EDUCATION CENTER-SOUTHWEST TO PROVIDE SUPPORT FOR THE MEDICAL LABORATORY SCIENCES PROGRAM. IN EFFORTS TO MEET THE NEEDS FOR PRIMARY CARE PHYSICIANS IN THE AREA, CHRISTUS PROVIDES SUPPORT FOR A THREE-YEAR PRIMARY CARE RESIDENCY PROGRAM FOR PHYSICIANS THROUGH THE UNIVERSITY OF ARKANSAS MEDICAL SCIENCES AREA HEALTH EDUCATION CENTER-SOUTHWEST. HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGISHING CHARACTERISTIC OF NOT-FOR-PROFIT HEALTH CARE AND CONSTITUTES A SIGNIFICANT COMMUNITY BENEFIT. CHRISTUS HEALTH ALSO USED CASH DONATIONS AS A VEHICLE TO HELP OUR COMMUNITIES. WE MADE CASH DONATIONS, IN ADDITION TO GRANTS AWARDED THROUGH THE CHRISTUS FUND, TO SUPPORT CAUSES LIKE THE FIGHT AGAINST CANCER, PROVISION OF A CONTINUUM OF CARE FOR OUR ELDERLY, HIV/AIDS AND FOR MANY OTHER EQUALLY WORTHY PURPOSES. DURING FY 2019, CHRISTUS HEALTH ADVOCATED FOR IMPROVING PUBLIC POLICIES, WORKING TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY FOR GREATER ACCESS TO HEALTH CARE SERVICES FOR THE CONSTITUENTS WE SERVE. DESCRIPTION OF RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2 CHRIS KARAM, M.GLEN BONES, AND JASON ROUNDS SERVE AS OFFICERS OF ARK-LA-TEX HEALTH NETWORK, A WHOLLY OWNED SUBSIDIARY OF CHRISTUS HEALTH ARK-LA-TEX. CHRIS KARAM, GAIL WHITE, AND M. GLEN BOLES SERVE AS OFFICERS OF ARKANSAS INTEGRATED COMMUNITY HEALTH NETWORK, A WHOLLY OWNED SUBSIDIARY OF CHRISTUS HEALTH ARK-LA-TEX. CHRIS KARAM AND M. GLEN BOLES SERVE AS MANAGEMENT COMMITTEE MEMBERS OF SOUTHWEST HEALTH LINK, LLC. DESCRIPTION OF CLASSES OF MEMBERS OF STOCKHOLDERS FORM 990, PART VI, SECTION A, LINE 6 CHRISTUS HEALTH IS THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, SECTION A, LINE 7A CHRISTUS HEALTH, THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION, HAS THE POWER TO APPOINT ALL MEMBERS OF THE FILING ORGANIZATIONS GOVERNING BODY. DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, SECTION A, LINE 7B CHRISTUS HEALTHS BOARD OF DIRECTORS HAS THE FOLLOWING POWERS: APPROVE, CHANGE AND/OR INTERPRET THE FILING ORGANIZATIONS PHILOSOPHY, MISSION AND VISION; APPROVE THE ADOPTION OR AMENDMENT OF THE FILING ORGANIZATIONS ARTICLES OF INCORPORATION AND BYLAWS; APPOINT AND REMOVE MEMBERS OF THE FILING ORGANIZATIONS BOARD OF DIRECTORS; APPOINT AND REMOVE THE FILING ORGANIZATIONS CHAIR OF THE BOARD OF DIRECTORS AND VICE CHAIRPERSON OF BOARD OF DIRECTORS; APPROVE INCURRENCE OF DEBT THAT EXCEEDS $5 MILLION PER INCURRENCE OR $25 MILLION ANNUALLY; APPROVE ANY MERGER, CONSOLIDATION, ACQUISITION, DISSOLUTION OR LIQUIDATION BY THE FILING ORGANIZATION; APPROVE THE IMPLEMENTATION OF SYSTEM-WIDE POLICIES FOR THE FILING ORGANIZATION; APPROVE SYSTEM-WIDE CONSOLIDATED BUDGET AND PERFORMANCE INDICATORS FOR THE FILING ORGANIZATION; APPROVE THE INDEPENDENT AUDIT REPORTS OF THE FILING ORGANIZATION; APPROVE CAPITAL PROJECTS GREATER THAN $10 MILLION FOR THE FILING ORGANIZATION; APPROVE ANY TRANSACTION BY THE FILING ORGANIZATION THE EFFECT OF WHICH IS TO CREATE A NEW LEGAL ENTITY OR JOINT VENTURE, ANY TRANSACTION INVOLVING A SYSTEM PARTICIPANT OR LOCAL ENTITY WHICH CREATES A NEW LEGAL ENTITY OR JOINT VENTURE, OR CHANGES IN BUSINESS PURPOSE OR RELATIONSHIP OF ANY LOCAL ENTITY; AND APPROVE AND AUTHORIZE ACTIONS RESERVED IN ORGANIZATION DOCUMENTS OR SIMILAR GOVERNANCE DOCUMENTS. THE CHRISTUS HEALTH CEO HAS THE FOLLOWING POWERS: POWER TO APPOINT AND REMOVE THE PRESIDENT OF THE FILING ORGANIZATION; APPROVE THE SALE, LEASE, MORTGAGE, TRANSFER, EASEMENT OR ENCUMBRANCE OF THE FILING ORGANIZATIONS REAL PROPERTY DESIGNATED AS NON-DESIGNATED MINISTRY PROPERTY UNDER $5 MILLION BUT MORE THAN $1 MILLION; APPROVE THE INCURRENCE OF DEBT UP TO A $5 MILLION CAP OR $25 MILLION ANNUALLY BY THE FILING ORGANIZATION; APPROVE STRATEGIC PLANS OF THE FILING ORGANIZATION; APPROVE THE FILING ORGANIZATIONS BUDGET; SET THE THRESHOLD OF CAPITAL PROJECTS LESS THAN $10 MILLION BY THE FILING ORGANIZATION; AND APPROVE MANAGEMENT DIRECTIVES FOR THE FILING ORGANIZATION. THE CHRISTUS HEALTH MEMBERS ARE THE CONGREGATION OF SISTERS OF CHARITY OF THE INCARNATE WORD, HOUSTON, TEXAS AND THE CONGREGATION OF SISTERS OF CHARITY OF THE INCARNATE WORD (OF SAN ANTONIO). THE CHRISTUS HEALTH MEMBERS HAVE THE FOLLOWING POWERS: APPROVE THE ADOPTION AND AMENDMENT OF ARTICLES OF INCORPORATION AND BYLAWS OF THE FILING ORGANIZATION IF THE CHANGE IS RELATED TO RESERVED POWERS OF MEMBERS; APPROVE THE SALE, LEASE, MORTGAGE, TRANSFER, EASEMENT OR ENCUMBRANCE OF REAL PROPERTY IN EXCESS OF A $5 MILLION THRESHOLD DOLLAR AMOUNT REQUIRED BY CANON LAW FOR THE FILING ORGANIZATION; APPROVE THE SALE, LEASE, MORTGAGE, TRANSFER, EASEMENT, OR ENCUMBRANCE OF REAL PROPERTY DESIGNATED AS DESIGNATED MINISTRY PROPERTY BY THE FILING ORGANIZATION, BUT NOT IN EXCESS OF $5 MILLION; APPROVE THE CHANGE OF OWNERSHIP, MANAGEMENT OR CONTROL, (EXCEPT IN THE ORDINARY COURSE OF BUSINESS OFFICE AND SPACE LEASES) THE FUNDAMENTAL USE BY CHANGE IN LICENSE THAT WOULD SIGNIFICANTLY CHANGE A FACILITY, OR THE ELIMINATION OF OB, PED, PSYCH OR EMERGENCY SERVICES ON REAL PROPERTY PROVIDED IN CONNECTION WITH DESIGNATED MINISRY PROPERTY OWNED BY THE FILING ORGANIZATION; AND APPROVE THE MERGER, CONSOLIDATION, ACQUISITION, DISSOLUTION OR LIQUIDATION OF THE FILING ORGANIZATION IF IT OWNS DESIGNATED MINISTRY PROPERTY. EXPLAIN HOW ORG ENSURES LOCAL UNIT ACTIVITIES ARE CONSISTENT WITH ITS OWN FORM 990, PART VI, SECTION B, LINE 10B CHRISTUS ST. MICHAEL HEALTH SYSTEM AUXILIARY IS TREATED AS A DEPARTMENT OF CHRISTUS HEALTH ARK-LA-TEX (OPERATES UNDER THE SAME TAX ID NUMBER AS CHRISTUS HEALTH ARK-LA-TEX) AND IS REQUIRED TO FOLLOW CHRISTUS ST. MICHAELS POLICIES AND PROCEDURES. THE CEO/PRESIDENT OR DESIGNEE IS A MEMBER OF THE AUXILIARY BOARD. VOLUNTEERS ARE SUPERVISED AND OPERATE UNDER THE DIRECTION OF THE CEO/PRESIDENT OR OTHER DESIGNEE. NEW VOLUNTEER CANDIDATES ARE REQUIRED TO SUBMIT APPLICATIONS, UNDERGO BACKGROUND CHECKS AND COMPLETE OTHER REQUIREMENTS THAT ARE APPLICABLE TO CHRISTUS ST. MICHAEL APPLICANTS. ALL VOLUNTEERS ARE REQUIRED TO ATTEND ORIENTATION, SIGN CODE OF ETHICS, COMPLETE THE CONFLICT OF INTEREST STATEMENTS, ETC., ALL OF WHICH ARE RETAINED ON FILE. REVENUES AND EXPENSES ARE SUBMITTED TO THE ACCOUNTING DEPARTMENT AT MONTH-END CLOSE AND EACH MONTH ARE RECORDED ON THE CHRISTUS ST. MICHAEL FINANCIAL STATEMENTS AND ARE INCLUDED IN AUDITS. THE ACCOUNTING DEPARTMENT RETAINS COPIES OF ALL BANK STATEMENTS, DEPOSITS, AND DISBURSEMENTS. THE ACCOUNTING DEPARTMENT RECONCILES THE MONTHLY BANK STATEMENTS. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED AND REVIEWED BY THE ORGANIZATIONS EXTERNAL INDEPENDENT ACCOUNTANTS. THE CHRISTUS HEALTH ACCOUNTING DEPARTMENT WORKS WITH AN EXTERNAL ACCOUNTING FIRM IN PREPARATION AND REVIEW OF THE FORM 990. THE FILING ORGANIZATIONS CFO, OR OTHER DESIGNEE, REVIEWS THE FORM 990. THE FINAL FORM 990 THAT WILL BE FILED WITH THE IRS IS POSTED TO A SECURE INTERNET PORTAL FOR ALL MEMBERS OF THE BOARD OF DIRECTORS TO VIEW. REVIEW OF THE FINAL FORM 990 OCCURS PRIOR TO FILING WITH THE IRS IN THE SPRING 2020 VIA EITHER MEETING, CONFERENCE CALL, OR WEB PORTAL POLLING TOOL BY THE RESPECTIVE CHRISTUS ORGANIZATIONS BOARD, BASED ON A SET OF SUGGESTED REVIEW PROCESSES DEVELOPED BY CHRISTUS HEALTH. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, SECTION B, LINE 12C AT THE END OF EACH CALENDAR YEAR, THE CHRISTUS HEALTH CORPORATE SECRETARY DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE TO ALL OF THE ORGANIZATION'S BOARD AND COMMITTEE MEMBERS FOR COMPLETION PRIOR TO THE 1ST OF JANUARY IN THE NEXT YEAR. THE CORPORATE SECRETARY THOROUGHLY REVIEWS ALL COMPLETED AND EXECUTED CONFLICT OF INTEREST QUESTIONNAIRE FORMS TO ENSURE ACCURACY AND THAT NO POTENTIAL OR IDENTIFIED CONFLICT IS DISCLOSED OR EXISTS. THE ORGANIZATION'S BOARD OF DIRECTORS IS RESPONSIBLE FOR ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY OF THE ORGANIZATION. COMPENSATION DETERMINATION PROCESS FORM 990, PART VI, SECTION B, LINES 15A & 15B THE EXECUTIVE COMPENSATION COMMITTEE OF CHRISTUS HEALTH DETERMINES THE COMPENSATION OF THE CEO (OR EXECUTIVE DIRECTOR, AS APPLICABLE), OFFICERS AND KEY EMPLOYEES OF CHRISTUS HEALTH AND CERTAIN OTHER OFFICERS AND KEY EMPLOYEES OF RELATED ORGANIZATIONS, INCLUDING Christus Health Ark-La-Tex. THE EXECUTIVE COMPENSATION COMMITTEE IS COMPOSED OF INDIVIDUALS WHO HAVE NO CONFLICT OF INTEREST WITH THE COMPENSATION ARRANGEMENTS AT HAND. THE EXECUTIVE COMPENSATION COMMITTEE OF THE CHRISTUS HEALTH BOARD SELECTS AN INDEPENDENT EXTERNAL FIRM TO PERFORM AN INDEPENDENT COMPENSATION REVIEW, TO ENSURE THAT ALL COMPENSATION IS REASONABLE AND COMPARABLE TO OTHER SIMILARLY SITUATED ORGANIZATIONS, FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS, AND TO PROVIDE SUPPORTING INFORMATION OF COMPENSATION DECISIONS. ON AN ANNUAL BASIS THE EXTERNAL CONSULTANT: 1. DEVELOPS THE MERIT INCREASE RECOMMENDATIONS FOR ALL DESIGNATED SYSTEM EXECUTIVES BASED ON MARKET COMPARABILITY. 2. RECOMMENDS THE CHANGES IN THE COMPENSATION STRUCTURE (GRADES) BASED ON THE MARKET CHANGES. 3. COMPLETES A REVIEW AND EVALUATION OF NEWLY CREATED POSITIONS TO RECOMMEND A GRADE PLACEMENT TO THE COMMITTEE FOR ITS DISCUSSION AND APPROVAL. ON A BI-ANNUAL BASIS, THE EXTERNAL CONSULTANT COMPLETES A DETAILED REVIEW OF ALL OTHER DESIGNATED SYSTEM EXECUTIVES COMPENSATION AND BENEFITS. THIS GROUP INCLUDES ALL TOP MANAGEMENT OFFICIALS, OTHER OFFICERS AND KEY LEADERS OF THE ORGANIZATION. THE REVIEW INCLUDES RECOMMENDATIONS TO THE COMMITTEE ON ANY CHANGES NECESSARY IN EITHER SPECIFIC COMPENSATION OR COMPENSATION STRUCTURE TO ENSURE MARKET COMPETITIVENESS, REASONABLENESS AND INTERNAL EQUITY. UPON RECOMMENDATIONS FROM THE INDEPENDENT EXTERNAL FIRM, THE EXECUTIVE COMPENSATION COMMITTEE MAKES FINAL COMPENSATION DECISION. ADDITIONALLY, THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS ALL COMPENSATION PAYMENTS FOR EXCESS BENEFIT TRANSACTIONS. THE DISCUSSION AND DECISIONS OF THE COMMITTEE ARE DOCUMENTED AND FORMALIZED IN THE COMMITTEE MINUTES AND MAINTAINED ON RECORD. THE FILING ORGANIZATION DETERMINES THE COMPENSATION OF THE SECRETARY BY USE OF AN INDEPENDENT AND EXTERNAL CONSULTANT. THE CONSULTANT HELPS DETERMINE PAY RATES FOR THE ASSOCIATES OF THE FILING ORGANIZATION, TAKING INTO ACCOUNT MARKET DATA AND SHIFT DIFFERENTIAL. THE COMPENSATION RATES ARE APPROVED BY THE FILING ORGANIZATION. BASED ON THE AFOREMENTIONED PROCEDURE, THE SECRETARYS COMPENSATION IS NOT REVIEWED BY A COMPENSATION COMMITTEE. PUBLIC DISCLOSURE OF 1023 AND FORMS 990 & 990-T FORM 990, PART VI, SECTION C, LINE 18 CHRISTUS HEALTH AND MOST OF ITS AFFILIATED ENTITIES DO NOT HAVE FORMS 1023 BECAUSE OF THEIR INCLUSION IN THE IRS GROUP RULING WITH THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS, WHICH COVERS THE ORGANIZATIONS LISTED IN THE ANNUAL OFFICIAL CATHOLIC DIRECTORY. CHRISTUS HEALTHS WEBSITE DISPLAYS THE IRS GROUP RULING AND RELEVANT ANNUAL OFFICIAL CATHOLIC DIRECTORY PAGES FOR THE ORGANIZATIONS RELATED TO CHRISTUS HEALTH. FORMS 990 AND 990-T ARE MADE AVAILABLE UPON REQUEST. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, SECTION C, LINE 19 THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CHRISTUS HEALTH ARE MADE AVAILABLE TO THE PUBLIC VIA THE CHRISTUS HEALTH WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 PENSION FUNDING $102,780 INTERCOMPANY $1,005,188 RESTRICTED CASH CONTRIBUTIONS $2,974,152 OTHER $(44,384) ROUNDING $(2) ----------- TOTAL $4,037,734 FORM 990 PART IX LINE 11G DESCRIPTION:OCCUPANCY RELATED SERVICES TOTAL FEES:3067002 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:51846 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:10281474 FORM 990 PART IX LINE 11G DESCRIPTION:REPAIRS & MAINTENANCE SERVICES TOTAL FEES:3059619 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION SERVICES TOTAL FEES:2399841 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING SERVICES TOTAL FEES:816859 FORM 990 PART IX LINE 11G DESCRIPTION:MARKETING SERVICES TOTAL FEES:117208 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL SERVICES TOTAL FEES:17330782 FORM 990 PART IX LINE 11G DESCRIPTION:INTERCOMPANY EXPENSE TOTAL FEES:1347406 CHRISTUS HEALTH 919 HIDDEN RIDGE DRIVE IRVING TX 75038 760590551 SPT HLTH SVCS TX 501(c)(3) 10 NA false CHRISTUS HEALTH CENTRAL LOUISIANA 3330 MASONIC DRIVE ALEXANDRIA LA 71301 720408984 HLTHCARE SVCS LA 501(c)(3) 3 CH true CHRISTUS HEALTH GULF COAST PO BOX 922037 HOUSTON TX 77292 760591592 HLTHCARE SVCS TX 501(c)(3) 3 CH true CHRISTUS HEALTH NORTHERN LOUISIANA ONE SAINT MARY PLACE SHREVEPORT LA 71101 720408982 HLTHCARE SVCS LA 501(c)(3) 3 CH true CHRISTUS SPOHN HEALTH SYSTEM CORPORATION 600 ELIZABETH STREET CORPUS CHRISTI TX 78404 741109836 HLTHCARE SVCS TX 501(c)(3) 3 CH true CHRISTUS HEALTH SOUTHEAST TEXAS 2830 CALDER STREET BEAUMONT TX 77726 760591590 HLTHCARE SVCS TX 501(c)(3) 3 CH true CHRISTUS HEALTH SOUTHWESTERN LOUISIANA 524 DR MICHAEL DEBAKEY DRIVE LAKE CHARLES LA 70601 720411322 HLTHCARE SVCS LA 501(c)(3) 3 CH true CHRISTUS SANTA ROSA HEALTH CARE CORP 333 N SANTA ROSA STREET SAN ANTONIO TX 78207 741109665 HLTHCARE SVCS TX 501(c)(3) 3 CH true CHRISTUS CONTINUING CARE 1700 WEST LOOP SOUTH STE 1100 HOUSTON TX 77027 742898615 HLTHCARE SVCS TX 501(c)(3) 3 CH true CH WILKINSON PHYSICIAN NETWORK 1700 WEST LOOP SOUTH STE 400B HOUSTON TX 77027 760422435 HLTHCARE SVCS TX 501(c)(3) 12-TYPE I CH true DUBUIS HEALTH SYSTEM INC 1700 WEST LOOP SOUTHSTE 1100A HOUSTON TX 77027 721270964 HLTHCARE SVCS TX 501(c)(3) 3 CH true CHRISTUS HEALTH FOUNDATION 919 HIDDEN RIDGE DRIVE IRVING TX 75038 611500100 SPT HLTH SVCS TX 501(c)(3) 12-TYPE I CH true CHRISTUS HEALTH STRATEGIC GROWTH 919 HIDDEN RIDGE DRIVE IRVING TX 75038 462798043 SPT HLTH SVCS TX 501(c)(3) 12-TYPE I CH true CHRISTUS HEALTH PLAN LOUISIANA 919 HIDDEN RIDGE DRIVE IRVING TX 75038 464617988 MEDICAID HMO LA 501(c)(4) CH true CHRISTUS PEDIATRIC PHYSICIAN GROUP 919 HIDDEN RIDGE DRIVE IRVING TX 75038 465203505 HLTHCARE SVCS TX 501(c)(3) 3 CH true CHRISTUS ST MICHAEL FOUNDATION 2600 ST MICHAEL DRIVE TEXARKANA TX 75503 471695865 SPT HLTH SVCS TX 501(c)(3) 7 ALT true CHRISTUS HOPKINS HEALTH ALLIANCE 115 AIRPORT ROAD SULPHUR SPRINGS TX 75482 811708177 HEALTH SVCS TX 501(c)(3) 3 CH true CHRISTUS ARK-LA-TEX HEALTH SYSTEM 919 HIDDEN RIDGE DRIVE IRVING TX 75038 822109465 HLTHCARE SVCS TX 501(c)(3) 12-TYPE II CH true CHRISTUS TRINITY MOTHER FRANCES HS 1315 DOCTORS DRIVE TYLER TX 75701 752616975 HLTHCARE SVCS TX 501(c)(3) 12-TYPE II CH true CHRISTUS FOUNDATION FOR HEALTHCARE PO BOX 1919 HOUSTON TX 77251 746074210 SUPP HLH SVCS TX 501(c)(3) 7 CH true CHRISTUS GSHS INC 700 E MARSHALL AVE LONGVIEW TX 75601 752027157 HLTHCARE SVCS TX 501(C)(3) 12-TYPE II CH true CHRISTUS CONNECTED CARE NETWORK 919 HIDDEN RIDGE DRIVE IRVING TX 75038 473405546 SPT HLTH SVCS 501(C)(4) CH true ARK-LA-TEX HEALTH NETWORK PO BOX 2911 TEXARKANA TX 755042911 752562459 HLTHCARE SVCS TX ALT C Corporation 900625 1011427 1.00000 true ARKANSAS INTEGRATED COMM HEALTH NETWORK 2600 ST MICHAEL DRIVE TEXARKANA TX 75503 760480684 HEALTHCARE SVC TX ALT C Corporation 0 0 1.00000 true CHRISTUS MUGUERZA SAPI DE CV HIDALGO PTE 2525 COL OBISPADO MONTERREY N.L. MX 64060 HLTHCARE SVCS MX CH C Corporation true EMERALD ASSURANCE CAYMAN LTD PO BOX 1051 GRAND CAYMAN CJ KY1-1102 980407545 INSURANCE CJ CH C Corporation true CHRISTUS TEXARKANA UNIT OWNERS ASSOC 2600 ST MICHAEL DRIVE TEXARKANA TX 75503 472486362 BUILDING ASSOC TX ALT C CORPORATION 0 0 0.70200 true CHRISTUS LOUISIANA QUALITY ALLIANCE 919 HIDDEN RIDGE DRIVE IRVING TX 75038 474618648 ACO LA CH C Corporation true false true true false false false false false false true true true false true true true true false ARK-LA-TEX HEALTH NETWORK L 277042 ACCRUAL ARK-LA-TEX HEALTH NETWORK M 277042 ACCRUAL ARK-LA-TEX HEALTH NETWORK O 661275 ACCRUAL ARK-LA-TEX HEALTH NETWORK Q 216852 ACCRUAL CH WILKINSON PHYSICIAN NETWORK L 5591639 ACCRUAL CHRISTUS HOPKINS HEALTH ALLIANCE L 240216 ACCRUAL CHRISTUS HOPKINS HEALTH ALLIANCE M 240216 ACCRUAL CHRISTUS SPOHN HEALTH SYSTEM CORPORATION L 113039 ACCRUAL CHRISTUS SPOHN HEALTH SYSTEM CORPORATION M 191339 ACCRUAL CHRISTUS SPOHN HEALTH SYSTEM CORPORATION O 123470 ACCRUAL CHRISTUS ST MICHAEL FOUNDATION B 584508 ACCRUAL CHRISTUS ST MICHAEL FOUNDATION C 149926 ACCRUAL CHRISTUS ST MICHAEL FOUNDATION M 50942 ACCRUAL CHRISTUS ST MICHAEL FOUNDATION O 154437 ACCRUAL TRINITY CLINIC L 5245814 ACCRUAL TRINITY CLINIC Q 470871 ACCRUAL