2019-11-08T16:38:30-06:00 2018-12-31 752570395 DURBIN & COMPANY LLP 2950 50TH STREET LUBBOCK TX 79413 990 2018-01-01 273993262 COMANCHE COUNTY MEDICAL CENTER COMPANY COMA 2548794900 10201 STATE HIGHWAY 16 COMANCHE TX 764424462 LARRY G TOXELL CEO 2548794900 2019-11-08 GAYLE DE HAAS P01774581 8067911591 12.86.242.26 2019-11-08 16:38:26 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 0233A6F5F381DB5D6536E14B0823E12B194F9A03 2018 2020-01-14 16:20:31Z LARRY G TOXELL 10201 STATE HIGHWAY 16 COMANCHE TX 764424462 26535449 0 X WWW.COMANCHECMC.COM X 2010 TX TO PROVIDE COMPLETE AND QUALITY HEALTHCARE SERVICES TO THE CITIZENS OF COMANCHE COUNTY AND SURROUNDING AREAS. 5 5 257 1 0 0 115976 363513 22918354 25469498 26243 -89952 924866 679682 23985439 26422741 0 0 0 0 9198008 9998818 0 0 0 14598875 15266839 23796883 25265657 188556 1157084 8519121 9483320 3011620 2818735 5507501 6664585 COMANCHE COUNTY MEDICAL CENTER IS COMMITTED TO COMMUNITY TRUST. WE PLEDGE TO PROVIDE QUALITY HEALTHCARE THROUGH CARING, EFFICIENT, RESPONSIVE, AND COURTEOUS SERVICE EVERYDAY - WHILE ADDRESSING THE EVER-CHANGING HEALTHCARE NEEDS OF THE PEOPLE WE SERVE. 0 0 22006812 26036472 GENERAL AND ACUTE HOSPITAL SERVICES 22006812 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 31 0 1 257 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 X THE ORGANIZATION 2548794900 10201 STATE HIGHWAY 16 COMANCHE TX 76442 JERRY MORGAN CHAIRMAN 0.50 X 0 0 0 MIKE HARE VICE CHAIRMAN 0.50 X 0 0 0 ROBERT PRATT SECRETARY 0.50 X 0 0 0 PAUL MCKINZIE DIRECTOR 0.50 X 0 0 0 SARAH CARRUTH DIRECTOR 40.00 X X 0 0 0 J PACHERO DIRECTOR (FORMER) 0.50 X 0 0 0 LARRY TROXELL CEO 40.00 X 89955 0 0 MICAEL DAIKEN CFO 40.00 X 75374 0 0 DAVID FRESHOUR CFO (FORMER) 40.00 X 192291 0 0 JUDY HERRINGTON CFO (FORMER) 40.00 X 7385 0 0 JENNIFER TUCKER CNO 40.00 X 79888 0 0 SHARON ABBEY DIRECTOR OF PHARMACY 40.00 X 125379 0 0 LINDSEY YARBROUGH PHARMACIST 40.00 X 116358 0 0 KENDA LUKER PHYSICIAN ASSISTANT 40.00 X 135490 0 0 WESLEY MAYR PHYSICIAN ASSISTANT 40.00 X 135742 0 0 RACHEL HILLIARD NURSE PRACTITIONER 40.00 X 128193 0 0 1086055 0 0 6 0 1 0 CONCORD MEDICAL GROUP 1602 AVE Q LUBBOCK TX 79401 PHYSICIAN SERVICES 950333 XTEND HEALTHCARE 90 VOLUNTEER DR STE 150 HENDERSONVILLE TN 37075 BUSINESS OFFICE MANAGEMENT 835430 COMANCHE PHYSICAL THERAPY PO BOX 130 DE LEON TX 76444 PHYSICAL THERAPY 430065 STEPHEN HOWARD DICKEY DO 200 CR 461 DE LEON TX 76444 DENTAL SERVICES 395359 DWAYNE C MILLER 6610 HWY 2318 COMANCHE TX 76442 PHYSICIAN SERVICES 295370 10 144713 218800 363513 NET PATIENT SERVICE 621990 24916018 24916018 NET RETAIL PHARMACY 621990 553480 553480 25469498 22756 22756 1850 0 1850 1850 1850 112708 -112708 -112708 -112708 DSRIP 900099 593946 593946 CAFETERIA 900099 69004 69004 MEDICAL RECORDS 900099 7862 7862 7020 7020 677832 26422741 26036472 0 22756 X 570272 205267 365005 7647139 6787203 859936 116572 100489 16083 1080177 931148 149029 584658 503994 80664 766464 766464 25875 25875 36242 36242 3667291 3116586 550705 147152 134796 12356 329828 318284 11544 338040 294432 43608 3533279 3388493 144786 56903 49562 7341 60741 52905 7836 23424 21457 1967 424493 388850 35643 138460 126834 11626 MEDICAL SUPPLIES 2242427 2242338 89 BAD DEBT 2234010 2234010 DUES, LICENSES & SUBSCR 929752 809812 119940 DIETARY 180294 179285 1009 132164 121067 11097 25265657 22006812 3258845 0 2348345 2956502 1930394 1827648 823814 817809 101157 329090 5907183 3878801 1718020 2028382 1597391 1523889 8519121 9483320 2465036 2066177 547501 754015 -917 -1457 3011620 2818735 X 5507501 6664585 5507501 6664585 8519121 9483320 1157084 0 X 1 X 1 X 1 0 X 14000 14000 746840 184323 562517 4849179 3694478 1154701 297164 297164 2028382 DUE FROM MEDICARE COST REPORT 626774 OTHER RECEIVABLES 896249 DUE FROM HOSPITAL DISTRICT 866 1523889 DUE TP/FROM ASSISTED LIVING -1457 -1457 X 24188731 -2234010 -2234010 26422741 0 26422741 23031647 0 23031647 2234010 2234010 25265657 PART X, LINE 2: PER AUDIT REPORT, "THE HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL EVALUATES AND ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES (FORMERLY FASB INTERPRETATION 48 (FIN 48) ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THIS STANDARD REQUIRES CERTAIN DISCLOSURES ABOUT UNCERTAIN INCOME TAX POSITIONS. THE HOSPITAL EVALUATES ANY UNCERTAIN TAX POSITIONS USING THE PROVISIONS OF ASC 450, CONTINGENCIES. AS A RESULT, MANAGEMENT DOES NOT BELIEVE THAT ANY UNCERTAIN TAX POSITIONS CURRENTLY EXIST AND NO LOSS CONTINGENCY HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL HAS FILED ALL APPLICABLE TAX RETURNS." PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -2,234,010. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 2,234,010. 1 1 1 X 125.000000000000 1 X 1 1 0 0 920270 2808000 0 0.00000 920270 2808000 0 0.00000 920270 2808000 0 0.00000 1 1301754 1304475 17286325 14540640 2745685 X 1 1 1 1 COMANCHE COUNTY MEDICAL CENTER 10201 STATE HIGHWAY 16 COMANCHE TX 76442 WWW.COMANCHECMC.COM 100123 X X X X COMANCHE COUNTY MEDICAL CENTER 1 0 0 1 X X X X X X X X X 17 1 0 0 1 X WWW.COMANCHECMC.COM X 1 17 1 WWW.COMANCHECMC.COM 0 1 X 125.000000000000 200.000000000000 X X X X X 1 1 X X 1 X WWW.COMANCHECMC.ORG X WWW.COMANCHECMC.ORG X WWW.COMANCHECMC.ORG X X X X X 1 X 0 1 0 0 COMANCHE COUNTY MEDICAL CENTER PART V, SECTION B, LINE 5: THE CHNA COMPLETED INCLUDED INPUT FROM INDIVIDUALS IN THE COMMUNITY, INCLUDING MEDICAL STAFF (PHYSICIANS AND NURSING STAFF) AND BOARD MEMBERS OF CCMC AND THROUGH FOCUS GROUPS, SURVEYS AND INTERVIEWS. COMANCHE COUNTY MEDICAL CENTER PART V, SECTION B, LINE 11: CCMC IDENTIFIED THREE COMMUNITY HEALTH NEEDS IN ITS IMPLEMENTATION STRATEGY: BREAKING THROUGH THE LANGUAGE BARRIER, COMMUNITY EDUCATION AND INCREASING SPECIALISTS AND SERVICES.BREAKING THROUGH THE LANGUAGE BARRIER: CCMC WILL DEVELOP HOSPITAL AND HEALTH RELATED INFORMATION IN SPANISH, PROVIDE HOSPITAL INFORMATION PRINTED IN SPANISH TO HISPANIC CHURCHES AND COMMUNITY ORGANIZATIONS AND REACH OUT TO CHURCH COMMUNITY ORGANIZATIONS TO OFFER TO PROVIDE HEALTH RELATED PRESENTATIONS TO GROUPS IN ENGLISH AND SPANISH.COMMUNITY EDUCATION: CCMC WILL DEVELOP INFORMATION MATERIALS LISTING HOSPITAL SERVICES AND DESCRIBING FINANCIALS ASSISTANCE PROGRAMS TO BE DISTRIBUTED THROUGHOUT THE COMMUNITY, COORDINATE WITH COMMUNITY GROUPS TO PRESENT INFORMATION AND HEALTH SCREENINGS, PROVIDE HOSPITAL BOOTHS AT VARIOUS FAIRS AND ACTIVITIES, ATTEND MINISTERIAL ALLIANCE MEETINGS TO NETWORK WITH AREA CHURCHES, OFFER PRINTED HOSPITAL AND HEALTH INFORMATION MATERIALS TO OTHER COMMUNITY GROUPS AND ADVERTISE SERVICES ON LOCAL RADIO STATIONS AND IN LOCAL NEWSPAPERS. INCREASE SPECIALISTS AND SERVICES: CCMC WILL EVALUATE CURRENT VISITING SPECIALSITS, RESEARCH OPPORTUNITIES FOR NEW SPECIALISTS, RESEARCH AND DISSEMINATE INFORMATION TO THE COMMUNITY INFORMATION ON TRANSPORTATION SERVICES AVAILABLE THROUGH OTHER ORGANIZATIONS AND RESEARCH AND EVALUATE MOBILE MEDICAL SERVICES FOR MEDICAL NEEDS. SCHEDULE H, PART V, SECTION B, LINE 2 CCMC IS A MEMBER OF THE REGIONAL HEALTHCARE PARTNERSHIP 11 IN THE STATE WHICH HAS CONDUCTED AN AREA COMMUNITY NEEDS SURVEY. SCHEDULE H, PART V, SECTION B, LINE 14 CCMC POSTS NOTICE OF ITS CHARITY CARE PROGRAM AND HOW A PATIENT MAY APPLY FOR CHARITY CARE. SCHEDULE H, PART V, SECTION B, LINE 1 CCMC SERVES THE COMANCHE COUNTY WHICH IS AN AREA OF 948 SQUARE MILES. THE ESTIMATED POPULATION IN 2017 WAS 13,573 WITH A 2012-2016 MEDIAN HOUSEHOLD INCOME OF $39,504 . PART III, LINE 2: RATIO OF COST TO CHARGES PART III, LINE 3: SUM OF CHARGES AT COST PART III, LINE 4: BAD DEBTS ARE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL PROVIDES EMERGENCY AND MEDICALLY NECESSARY CARE TO PATIENTS REGARDLESS OF THE PATIENTS' ABILITY TO PAY.SEE PAGES 5-7 OF THE AUDIT REPORT. PART III, LINE 8: THE MEDICAL CENTER USES COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. PART III, LINE 9B: IT IS THE POLICY OF CCMC TO DISTINGUISH CHARITY CARE FROM BAD DEBT EXPENSE. TO BE ELIGIBLE FOR CHARITY CARE AS A FINANCIALLY INDIGENT PATIENT, A PERSON?S INCOME SHALL BE AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINES. THE HOSPITAL MAY CONSIDER OTHER FINANCIAL ASSETS AND LIABILITIES OF THE PERSON WHEN DETERMINING ELIGIBILITY. TO BE ELIGIBLE FOR CHARITY CARE AS A MEDICALLY INDIGENT PATIENT, THE AMOUNT OWED BY THE PATIENT ON THE HOSPITAL BILL AFTER PAYMENT BY THIRD-PARTY PAYERS MUST EXCEED 40% OF THE PATIENT?S ANNUAL GROSS INCOME AND THE PATIENT MUST BE UNABLE TO PAY THE REMAINING BILL. THE HOSPITAL WILL CONSIDER OTHER FINANCIAL ASSETS AND LIABILITIES OF THE PERSON WHEN DETERMINING ABILITY TO PAY.THE HOSPITAL WILL POST NOTICE OF ITS CHARITY CARE PROGRAM AND HOW THE PATIENT MAY APPLY FOR CHARITY CARE. THE BUSINESS OFFICE WILL ATTEMPT TO IDENTIFY ALL CASES THAT WILL QUALIFY AS CHARITY AT THE TIME OF ADMISSION. PATIENTS IDENTIFIED AS POSSIBLE CHARITY CASES WILL BE ASKED TO COMPLETE A FINANCIAL ASSESSMENT FORM. THE BUSINESS OFFICE WILL TRANSFER THOSE PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE FROM A GOVERNMENTAL PROGRAM TO THE APPROPRIATE PROGRAM, SUCH AS MEDICAID. PATIENTS WHO ARE ELIGIBLE FOR MEDICAID AND OTHER INDIGENT HEALTH CARE PROGRAMS DO NOT QUALIFY AS FINANCIALLY INDIGENT, BUT THE UNREIMBURSED COSTS OF PROVIDING SERVICES TO RECIPIENTS OF THESE PROGRAMS SHALL BE REPORTED AS GOVERNMENT-SPONSORED INDIGENT HEALTH CARE, AS SOON AS SUFFICIENT INFORMATION IS AVAILABLE CONCERNING THE PATIENT?S FINANCIAL RESOURCES AND ELIGIBILITY FOR GOVERNMENTAL ASSISTANCE, A DETERMINATION WILL BE MADE CONCERNING THE PATIENT?S ELIGIBILITY FOR CHARITY CARE. NO COLLECTION EFFORTS WILL BE PURSUED ON A CHARITY ACCOUNT AFTER SUCH DETERMINATION IS MADE. SCHEDULE H, PART VI, LINE 1 THE ORGANIZATION HAS A BOARD MADE UP OF VOLUNTEERS THAT REPRESENT THE COMMUNITY. ANNUALLY DURING HOSPITAL WEEK, WE PROVIDE A HEALTH FAIR AND INVITE HEALTH CARE VENDORS FROM ALL OVER THE AREA FOR INDIVIDUALS WHO ATTEND IT. AT THE HEALTH FAIR, WE OFFER TO ALL THOSE INTERESTED FREE LIPID PROFILES AND THROUGH THE VENDOR PARTNERS, THERE IS MANY OTHER FREE TESTING OFFERED AT THE EVENT AS WELL.WE ALSO HAVE EMPLOYEES WHO SPEAK AT VARIOUS EVENTS (CIVIC CLUBS, ETC.) OUR SOCIAL WORKERS WORK WITH THE PATIENTS FOR THEIR NEEDS INCLUDING NURSING HOME PLACEMENT, HOME HEALTH SERVICES, ETC. WE ALSO PROVIDE PATIENT EDUCATION MATERIAL (THROUGH A VENDOR WE CONTRACT WITH AND PAY) CONDUCT CPR AND OTHER CLASSES THAT INDIVIDUALS CAN ATTEND. WE PROVIDE FLU SHOTS TO VOLUNTEERS, FOUNDATION MEMBERS, BOARD MEMBERS, PHYSICIANS, EMPLOYEES, AND DISTRICT EMPLOYEES WHO WORK IN OUR BUILDING FREQUENTLY. WE ALSO OFFER FLU CLINICS FOR A NOMINAL CHARGE THAT JUST COVERS THE COST OF THE SHOT. WE PROVIDE FLU CLINICS FOR BUSINESSES WHEN THEY REQUEST IT TOO. WE PARTICIPATE IN THE RELAY FOR LIFE EACH YEAR AND SPONSOR THEIR PROGRAM. 0 0 0 0 0 0 0 0 0 DAVID FRESHOUR CFO (FORMER) 192291 0 0 0 0 0 0 0 0 0 192291 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE TAX RETURN IS PREPARED BY AN INDEPENDENT, THIRD-PARTY ACCOUNTANT. THE ORGANIZATION'S MANAGEMENT REVIEWS THE RETURN FOR ACCURACY, AND THE ORGANIZATION'S BOARD OF DIRECTORS APPROVES THE RETURN PRIOR TO IT BEING FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND PHYSICIANS ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST THROUGH THE SUBMISSION OF THE CCMC STATEMENT OF DISCLOSURE OF OUTSIDE INTERESTS AND ACTIVITIES AS THEY ARISE. FORM 990, PART VI, SECTION B, LINE 15 IN 2013, CCMC BOARD OF DIRECTORS APPROVED CEO CONTRACT AND COMPENSATION THROUGH REVIEW AND APPROVAL, COMPARABILITY DATA, AND COMTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS ALSO INCLUDES APPROVAL BY THE HOSPITAL'S CEO, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. FORM 990, PART VI, SECTION C, LINE 18 EXCEPT AS PROVIDED FOR IN THE ORGANIZATION'S FORM 1023 AND FORM 990S, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOUCMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONAL DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G HOSPITAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,116,586. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,116,586. ADMINISTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 550,705. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 550,705. COMANCHE COUNTY HEALTHCARE FOUNDATION PO BOX 634 COMANCHE TX 76442 202373650 SUPPORT ORGANIZATION TX 501(C)(3) 11C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMANCHE COUNTY HEALTHCARE FOUNDATION C 100000 ACV