2019-11-12T08:59:12-06:00 2018-12-31 990 2018-01-01 752678857 Texas Health Harris Methodist Hospital Southwest Fort Worth % DAVID JACKSON TEXA 8174335000 6100 Harris Parkway Fort Worth TX 76132 DAVID JACKSON Assistant Secretary 6822367900 2019-11-12 12.50.9.252 80738820193165000019 2019-11-12 P 3E78A6ECC8DA71FB4B6305E1F5D71DDD1A0FACA8 1FEC91D2923A969736DE912BE8A46A37C887AF2E 2018 2020-01-14 16:20:31Z Becky Tucker 6100 Hospital Parkway Fort Worth TX 76132 318698529 false X www.texashealth.org X 1987 TX A faith-based organization whose mission is to improve the health of the people in the communities it serves regardless of their ability to pay. 16 15 1616 97 36616 21120 168971 311854 320263418 315694152 -424171 14437 1929071 2634596 321937289 318655039 4635060 329847 0 0 111454315 113174136 0 0 0 166787552 174791796 282876927 288295779 39060362 30359260 250677195 234727940 35750106 32089839 214927089 202638101 X A FAITH-BASED ORGANIZATION WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES IT SERVES REGARDLESS OF THEIR ABILITY TO PAY. false false 240130176 329847 316362034 Located in the southwest sector of Fort Worth since 1987, Texas Health Harris Methodist Hospital Southwest Fort Worth (THSW) is a 259-bed acute care hospital. THSW provides a wide array of comprehensive services including: surgical and imaging services, a 24-hour emergency department, orthopedics and sports therapy, adult critical care, and a Level II neonatal intensive care unit. THSW earned a Silver Texas Health Care Quality Improvement Award from the TMF Health Quality Institute and is a Heart Failure, Stroke and Chest Pain certified by The Joint Commission. More recently, THSW received the Truven Top 10 hospital award and Everest designation in addition to the CMS 5 Star rating. More than 1,300 employees work at the hospital and more than 650 physicians are practicing on the medical staff. During the year, THSW had 50,025 patient days, 14,287 discharges, 100,440 outpatient encounters, 67,449 emergency room visits and 3,068 births. THSW provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. The hospital provides care to persons covered by governmental programs including Medicare and Medicaid for reimbursement that does not always cover the cost of providing the care. Recognizing its mission to the community, services are provided to both financially indigent and medically indigent patients. These are some accomplishments and awards received by THSW in 2018: 1. US News & World Report Best Hospitals in Dallas-Fort Worth and the State of Texas. 2. Press Ganey Pinnacle of Excellence Award for Patient Experience 3. IBM Watson Top 100 Hospitals 4. Emergency Center of Excellency by Emergency Excellence 5. CMS Hospital Compare 5 Star Rating 6. Grade "A" patient safety by the Leapfrog Group 7. Baby Friendly designation by World Health Organization and UNICEF 240130176 true true false true false false false false false false true false false false false false 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 false false false true 75 0 true 1616 true true true false false false false false false false false false false false X 16 15 true false true false true true true true true false false true true true true true true false false false X X DAVID JACKSON 6822367900 612 E LAMAR BLVD Arlington TX 76011 X Bloemendal MD Lee C Trustee 0.04 1.55 X 0 0 0 Ferguson III John R Immediate Past Chair 0.03 1.6 X 0 0 0 Haggar III Joseph M Trustee 0.02 0.68 X 0 0 0 Hum MD Lawrence Trustee 0.02 0.68 X 0 0 0 Hunt Hunter L Trustee 0.03 1.09 X 0 0 0 Montgomery Lynn A Trustee 0.03 1.48 X 0 0 0 Reeves Kenneth W Trustee 0.02 1.12 X 0 0 0 Stripling MD Dennis Vice Chairman 0.03 1.58 X 0 0 0 Tatum Stephen L Trustee 0.03 1.52 X 0 0 0 Turner Wesley R Chairman 0.02 1.39 X 0 0 0 Vigness MD Richard M Trustee 0.06 2.01 X 0 0 0 Washington Bernice J Trustee 0.04 1.55 X 0 0 0 Weeks DNP RN Susan L Trustee 0.04 1.55 X 0 0 0 Wilder Jr Charles John Trustee 0.03 1.68 X 0 0 0 Wynne James Y Trustee 0.05 1.35 X 0 0 0 Berdan Barclay E Member/THR CEO 0.64 44.36 X X 0 2347905 302734 Berenzweig Harold K THR Corporate Officer 0.5 40.0 X 0 853069 61838 Cantu Stacy G Corporate Secretary 0.5 40.0 X 0 320135 55394 McWhorter Ricky E Assistant Secretary 0.5 40.0 X 0 1097946 95736 Kramer Kenneth J Assistant Secretary 0.5 40.0 X 0 879443 137715 Jackson David W Assistant Secretary 0.5 40.0 X 0 397637 76300 Gilman Kathleen A Assistant Secretary 0.5 40.0 X 0 221200 49968 Montgomery Gary Mark Chief Medical Officer THSW 40.0 0.0 X 567698 0 83732 DeLeon Joseph C President THSW Term Jan '18 0.0 40.0 X 0 586081 202300 Kirkham Brett Daniel Interim Pres/VP Prof Svcs 40.0 0.0 X 288574 0 52337 Tucker Rebecca D President THSW 40.0 0.0 X 263995 0 51148 Ward Charlotte M Grp Finan Officer THSW-THS 36.0 4.0 X 258567 28730 53493 Hunt Gretchen L Chief Nursing Officer THSW 40.0 0.0 X 238623 0 52374 Goins Marva Marie DIR PHARMACY 40.0 0.0 X 187567 0 34706 Williams Philip A PHARMACIST CLIN 40.0 0.0 X 180421 0 45451 Jensen Gail S PHARMACIST CLIN 40.0 0.0 X 168879 0 27994 Wallace Gary D DIR NRSG EMERGENCY SVC 40.0 0.0 X 167647 0 39793 Williams Sheila D PHARMACIST CLIN 40.0 0.0 X 167364 0 42781 Canose Jeffrey L Former Officer 0.0 40.0 X 0 1528574 189975 McClung Brett S Former Officer 0.0 40.0 X 0 924596 73349 King James Kirk Former Officer 0.0 40.0 X 0 874110 150838 Schroeder Jennifer Former Officer 0.0 40.0 X 0 323512 40659 Krejci Jacque D Former Officer 0.0 40.0 X 0 190122 37451 2489335 10573060 1958066 129 true true false Texas Health Resources 612 E Lamar Blvd ARLINGTON TX 76011 Management Fee 38526235 Texas Health Physicians Group 9229 LBJ Freeway DALLAS TX 75243 Physician Services 3838663 Vanguard Resources Inc 17300 Henderson Pass SAN ANTONIO TX 78232 Housekeeping 4109226 US Anesthesia Partners of Texas 6606 LBJ Freeway Ste 200 DALLAS TX 75240 Medical Services 1264963 Aramark Services Inc 100 Energy Way FORT WORTH TX 76102 Food Services 1030033 43 311854 311854 PATIENT REVENUE 622110 311069202 311069202 DSRP REVENUE 622110 3271898 3271898 MEDICARE/MEDICAID ADJ 622110 1332845 1332845 EDUCATION 624190 20207 20207 315694152 35539 35539 0 41695 41695 0 0 0 22388 43490 -21102 -21102 -21102 0 0 0 0 0 0 0 0 0 CAFETERIA REVENUE 722514 1181418 1181418 REBATES & INCENTIVES 622110 654853 654853 GIFT SHOP 453220 287117 287117 469513 13029 36616 419868 2592901 318655039 316362034 36616 1944535 329847 329847 0 0 0 1873882 1873882 0 87278990 86742526 536464 0 3696835 3696835 13914632 13914632 6409797 6365933 43864 38526235 38526235 2645 2645 0 0 0 0 16940573 10715334 6225239 263805 203169 60636 2024879 1805400 219479 742419 742419 0 4668015 4580303 87712 32758 31741 1017 0 58818 56100 2718 7157868 7157868 0 18210972 17888825 322147 2228313 2228313 SUPPLIES 67229824 67192047 37777 LPPF ASSESSMENTS 3338010 3338010 REPAIRS AND MAINTENANCE 4814204 4814204 FURNITURE AND EQUIPMENT 2935674 2935013 661 5616784 5389012 227772 288295779 240130176 48165603 0 73942 -11547 0 0 0 0 41822969 39942146 0 0 0 0 566503 1016486 5574129 5657161 400848 357886 323927671 136174282 195493130 187753389 0 0 0 0 0 0 0 0 6745674 12419 250677195 234727940 35750106 32089839 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35750106 32089839 X 214927089 202638101 0 0 0 0 214927089 202638101 250677195 234727940 X 30359260 -42648248 X X false true X true false X true true false true false false false false false false Schedule C, Part II-B - Additional Information Officers and/or Board Members of the corporation may, to an insubstantial degree, make comments or statements concerning legislation that may affect either the healthcare industry or the health status of the communities the Corporation serves. In pursuing this activity, Officers and/or Board Members may engage in conversations and/or write letters to various federal, state, and local officials regarding such matters on a personal level, and not as a representative of the organization. The amount of time and money involved in these activities is negligible. In no case has either the Corporation, or any person acting on behalf of the Corporation, intervened in any political campaign. 10414255 10414255 184136008 66451783 117684225 7789655 4176125 3613530 117783781 65546374 52237407 3803972 3803972 187753389 true true X true X true X 500. true true true false true true 19440213 5358369 14081844 0.04890 26608141 16381102 10227039 0.03550 25903 38113 0 0.00000 46074257 21777584 24308883 0.08440 134026 134026 0.00050 1328015 1328015 0.00460 501655 501655 0.00170 74997 74997 0.00030 2038693 2038693 0.00710 48112950 21777584 26347576 0.09150 18149 18149 40178 40178 0.00020 58327 58327 0.00020 false 24171603 50907133 64208276 -13301143 X true true 1 1 Texas Health Southwest 6100 Harris Parkway Fort Worth TX 76132 www.texashealth.org TDH #627 X X X Texas Health Southwest 1 false false true X X X X X X X X X 16 true true false true X www.texashealth.org/chna X true 17 true www.texashealth.org/chna false true X 200. 500. X X X true true X X X true X See Section C X See Section C X See Section C X X X X X X true X false X X X X true X false false Texas Health Southwest Part V. Section B, Line 3e The CHNA contains a prioritized description of the significant health needs of the community as identified through the CHNA. Part V. Section B, Line 5 Texas Health Southwests (THSW) Community Health Needs Assessment (CHNA) was a one-year collaborative process which utilized qualitative and quantitative data to assess the health needs of persons in the communities served by the hospital. As a means to further understand the needs of the community, THSW gathered feedback through key informant interviews conducted between 11/30/2015 and 1/29/2016, focus group discussions and an online community survey. Key informants and focus group participants included, but were not limited to: faith community representatives, public health officials, lay community members, school officials and city administration. Eleven persons with interests specific to the health of THSWs community participated in a focus group, five served as key informants and 560 individuals responded to the online survey. The online survey was conducted only in English. While the online survey may not have reached the medically underserved, low-income or minority populations directly, organizations serving those populations were present at the focus group and served as key informants; these organizations included: Healthy Tarrant County Collaboration, Tarrant County Public Health, the Mercy Clinic, and the YMCA of Metropolitan Fort Worth. In order to gain a comprehensive understanding of the significant health needs for THSWs service area, the findings from all three data sets (secondary data, interviews and focus groups, and the online community survey) were compared and studied together. The top five to seven health needs identified by each data source were analyzed for areas of overlap with the other two data sources. Health needs were determined to be significant if they were cited as a top need in at least two of the three data sources. Part V. Section B, Line 6a The CHNA for USMD Hospital at Fort Worth was conducted in collaboration with Texas Health Southwest. Part V. Section B, Line 11 Following a CHNA conducted in 2016, Texas Health Southwest adopted an implementation strategy in May 2017. THSW is part of the Texas Health hospital system (Texas Health), which developed a system-wide community benefit strategy to leverage internal and external resources and increase its ability to impact community health needs. The significant health needs across the Texas Health system were: 1. Mental Health & Substance Abuse 2. Exercise, Nutrition, & Weight 3. Access to Health Services and Healthcare Navigation & Literacy 4. Older Adults & Aging From 2017-2019, THSW has committed to implement strategies and activities aimed at addressing these areas. Mental Health & Substance Abuse is categorized as Behavioral Health; Exercise, Nutrition, & Weight is grouped under Chronic Disease, which has been a strategic area of focus for Community Health Improvement since the 2013 CHNA; Access to Health Services and Healthcare Navigation & Literacy is jointly titled Awareness, Health Literacy, & Navigation; and Older Adults & Aging. In 2018, Texas Health Southwest addressed significant health needs with the following approaches: 1. Behavioral Health 1a. In 2018 the Texas Health Community Impact Leadership Council for the Tarrant/Parker region, which serves the THSW community, released a Request for Proposal to provide support to community organizations to deliver behavioral health services to underserved communities. It also addressed behavioral health needs identified in the 2016 Community Health Needs Assessment. Programs in the Tarrant/Parker region will focus on depression and social isolation among low-income adults ages 55+. Programs will receive funding in April of 2019. 2. Chronic Disease Prevention & Management 2a. Continued implementation of evidence-based chronic disease self-management programs in partnership with the Community Council of Greater Dallas/Area Agency on Aging of Dallas County, North Central Texas Council of Governments Area Agency on Aging, Sixty and Better, Tarrant County Public Health, and the United Way of Tarrant County/Area Agency on Aging of Tarrant County. 2b. THSW continued to manage and strengthen the Delivery System Reform Incentive Payment (DSRIP) programs under the Medicaid 1115 Waiver to continue implementation of diabetes education and management program with the delivery of the Healthy Education and Lifestyle Education (HELP) program. The program is designed to address underserved persons with chronic disease(s), such as hypertension, diabetes, and high cholesterol. The program operates from a three-pronged approach: group and individual education, clinical management and social determinants of health support. Awareness, Literacy, & Navigation (ALN) 3a. Invested in offering a free online community resource guide called Aunt Bertha that provides a database of free and reduced-cost social services. 3b. Managed and strengthened DSRIP programs under the Medicaid 1115 Waiver to provide Emergency Department (ED) navigation program and palliative care program to underserved populations. 4. Older Adults & Aging 4a. Continued the implementation of A Matter of Balance Fall Prevention Program in partnership with the Community Council of Greater Dallas/Area Agency on Aging of Dallas County, North Central Texas Council of Governments Area Agency on Aging, Sixty and Better, Tarrant County Public Health, and the United Way of Tarrant County/Area Agency on Aging of Tarrant County. All significant health needs identified are being addressed by the hospital in one of the categories listed above. Part V. Section B, Lines 16 a, b & c The FAP, FAP Application and the Plain Language Summary of the FAP were widely available at this website: www.texashealth.org/patient-and-visitor-information/billing-and-payment-in formation/financial-help-for-those-in-need Texas Health Southwest Part I, Line 3c - Patient Eligibility Patients with family income at or below 200% of applicable Federal Poverty Guidelines (FPG) may be eligible for free care if the patient lacks sufficient funds and assets to pay the out-of-pocket portion of their hospital bill. Patients with a family income above 200% of applicable FPG who have unpaid medical bills exceeding a specified percentage of the patient's annual gross income, as determined on a sliding scale based on FPG, may be deemed medically indigent and eligible for charity care. The patient may be eligible for a charity adjustment up to 100% of the unpaid balance of their hospital bill in excess of a specified patient responsible amount if the patient has insufficient funds/assets to pay his hospital bill without incurring an undue financial hardship. The patient responsible amount is based on a percentage of the patient's annual income in relation to FPG. A determination as to whether or not a patient has insufficient funds and/or assets to pay for purposes of determining both financial and medical indigence is made at the time a patient's financial assistance application is reviewed. Assets considered when determining eligibility include cash, stocks, bonds and other financial assets that can be readily converted to cash. An additional process to screen for charity patients using publicly available financial information is also in place for patients not submitting a financial assistance application. Part I, Line 7 Cost-to-Charge Ratio A cost-to-charge ratio is used to compute the amounts reported on Lines 7a-7c. The cost-to-charge ratio is derived from Worksheet 2 Ratio of Patient Care Cost-to-Charges, as found in the Schedule H Instructions. The amounts reported on Lines 7e-7i were computed using direct costs, as determined by a cash outlay. Part II - Community Building The organization participates in community building activities that aim to address the socio-economic factors that influence the overall health of individuals in the communities served. As identified in the community health needs assessment, there are areas of need that are not in alignment with the operations of a hospital system. Our volunteerism, collaborations and partnerships with various aid organizations and various area coalitions help in addressing the socio-economic factors that are the backbone for many underlying health concerns. Part III, Lines 2, 3 & 4 - Bad Debts Bad debt expense is not included for purposes of reporting community benefits. Each patient qualifying for charity care is treated as a charity patient and no charges related to that patient are included in bad debt expense. The hospital is part of a consolidated system of hospitals which operate under the name Texas Health Resources (THR). THR's annual audit is conducted on a system-wide basis with a single consolidated audit report issued for THR and its affiliates. The audited financial statements of THR, which includes the activity of the organization, contain a footnote regarding Accounts Receivable and Allowance for Doubtful Accounts that reads as follows: Effective January 1, 2018, THR adopted the new revenue recognition standard, Accounting Standards Update (ASU) 2014-09, Revenue from Contracts with Customers (Topic 606), issued by the FASB in 2014, using the modified retrospective method. With the adoption of the new revenue recognition standard, net patient service revenue is reported at the amount that reflects the consideration to which THR expects to be entitled in exchange for providing patient care. Healthcare services promised in the contract with a patient represent a bundle of goods and (or) services that is distinct and accounted for as a single performance obligation. The transaction price for the bundled goods and (or) services provided is estimated by reducing the total standard charges by variable price concessions, including contractual adjustments based on the terms provided by (in the case of Medicare and Medicaid) or negotiated with (in the case of managed care and commercial insurance companies) third-party payors, THR discount policies, and other implicit price concessions based on historical collections experience for uninsured and under-insured patients who do not qualify for financial assistance. A portfolio approach by major payor categories and types of service was used to estimate the historical collections experience. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to net patient service revenue in the period of the change. Portfolio collection estimates are updated at least quarterly based on actual collections experience. THR believes that revenue recognized by utilizing the portfolio approach approximates the revenue that would have been recognized if an individual contract approach was used. Subsequent changes that are determined to be the result of an adverse change in the patients ability to pay are recorded as bad debt expense. Under THRs financial assistance policy, the Tax-Exempt Hospitals, Texas Health Rockwall, and Texas Health Physicians Group provide care to patients without charge or at amounts less than their established rates if the patient meets certain established criteria. The consolidated joint venture hospitals and healthcare entities have similar financial assistance policies, or have adopted the THR financial assistance policy. As the System does not pursue collection of amounts determined to qualify as financial assistance, those amounts are not reported as net patient service revenue or patient accounts receivable. Revenue related to providing care to patients is recognized as the performance obligation is satisfied over the period of time the patient is receiving treatment, as the patient is simultaneously receiving and consuming the benefits provided by THR. The performance obligation is generally satisfied over an average period of less than five days for inpatient services and one day for outpatient services. Generally, patients and third-party payors are billed within days after the services are performed and (or) the patient is discharged. The transaction price related to unsatisfied or partially unsatisfied performance obligations at the end of the reporting period primarily relate to inpatient acute care services for patients who remain admitted at that time (in-house patients). These contract assets were $37,668,000 on January 1, 2018 at the adoption of the new revenue recognition standard. As of December 31, 2018, contract assets of $38,520,000 were recorded in patient accounts receivable on the consolidated balance sheet. Patient accounts receivable is reported at the amount that reflects the consideration to which THR expects to be entitled in exchange for providing patient care. The primary collection risks relate to uninsured patient accounts, including patient accounts for which the primary insurance company has paid the amounts covered by the applicable agreement, but patient responsibility amounts remain outstanding. Implicit price concessions relate primarily to amounts due directly from patients based upon managements assessment of historical write-offs and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Patient accounts are monitored and, if necessary, past due accounts are placed with collection agencies in accordance with guidelines established by management. Accounts are written off when all reasonable internal and external collection efforts have been performed. Estimated implicit price concessions of $379,437,000 were recorded as reductions to patient accounts receivable at December 31, 2018 on the consolidated balance sheets. Prior to January 1, 2018 and the adoption of the new revenue recognition standard, net patient service revenue was recognized as services were provided and reported at the estimated net realizable amounts from patients, third-party payors and others for services rendered, including estimated retroactive adjustments under reimbursement agreements with third-party payors. Retroactive adjustments were accrued on an estimated basis in the period the related services were rendered and adjusted in future periods as final settlements were determined. Patient accounts receivable was reported net of estimated allowances for doubtful accounts and contractual adjustments on the consolidated balance sheets. The allowance and resulting provision for bad debts were based upon a combination of the aging of receivables and managements assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators for each of its major payor sources of revenue. Management assessed the adequacy of the allowance for doubtful accounts based upon historical write-off experience and payment trends by payor category. For receivables true Tarrant County Indigent Care Corporation 612 E Lamar Blvd Arlington TX 76011 260648532 501(c)(3) 28486 Indigent Health Care Tarrant Safety Net Support Corporation 612 E Lamar Blvd Arlington TX 76011 823171862 501(c)(3) 284411 Indigent Health Care 2 0 Part I, Line 2 - Monitoring Grants Texas Health Southwest (THSW) is a member of the Texas Health Resources (THR) Healthcare system. The majority of the grants distributed by the system are to related tax exempt organizations. The hospital does not specifically monitor the use of grants paid to related organizations since THR administration monitors the use of these grants on a system basis for all members of the THR healthcare system. Grants to non-related tax exempt organizations are generally given to entities that are in the hospital's community and/or service area or to certain organizations which will specifically impact the hospital's community. These grants are typically monitored by hospital personnel who are working closely with the non-related nonprofit organization. X true true false true false false false false false false false Berdan Barclay E Member/THR CEO 0 1199718 0 890661 0 257526 0 259398 0 43336 0 2650639 0 207003 Berenzweig Harold K THR Corporate Officer 0 513374 0 250830 0 88865 0 20625 0 41213 0 914907 0 82585 Cantu Stacy G Corporate Secretary 0 224390 0 66978 0 28767 0 11282 0 44112 0 375529 0 0 McWhorter Ricky E Assistant Secretary 0 411087 0 611800 0 75059 0 61424 0 34312 0 1193682 0 460488 Kramer Kenneth J Assistant Secretary 0 498252 0 252677 0 128514 0 98360 0 39355 0 1017158 0 50254 Jackson David W Assistant Secretary 0 275133 0 70616 0 51888 0 43044 0 33256 0 473937 0 0 Gilman Kathleen A Assistant Secretary 0 204377 0 16623 0 200 0 13264 0 36704 0 271168 0 0 Montgomery Gary Mark Chief Medical Officer THSW 362285 0 165185 0 40228 0 40455 0 43277 0 651430 0 31310 0 DeLeon Joseph C President THSW Term Jan '18 0 354245 0 174069 0 57767 0 150262 0 52038 0 788381 0 31904 Kirkham Brett Daniel Interim Pres/VP Prof Svcs 181193 0 72815 0 34566 0 7655 0 44682 0 340911 0 0 0 Tucker Rebecca D President THSW 183738 0 46732 0 33525 0 15274 0 35874 0 315143 0 0 0 Ward Charlotte M Grp Finan Officer THSW-THS 179614 19957 54618 6069 24335 2704 11127 1236 37017 4113 306711 34079 0 0 Hunt Gretchen L Chief Nursing Officer THSW 204497 0 12073 0 22053 0 22970 0 29404 0 290997 0 0 0 Canose Jeffrey L Former Officer 0 846285 0 497960 0 184329 0 147838 0 42137 0 1718549 0 112689 McClung Brett S Former Officer 0 516611 0 291950 0 116035 0 20625 0 52724 0 997945 0 81911 King James Kirk Former Officer 0 512688 0 241960 0 119462 0 99714 0 51124 0 1024948 0 75344 Schroeder Jennifer Former Officer 0 257662 0 34437 0 31413 0 16826 0 23833 0 364171 0 0 Krejci Jacque D Former Officer 0 175841 0 14056 0 225 0 10930 0 26521 0 227573 0 0 Goins Marva Marie DIR PHARMACY 176543 0 10154 0 870 0 4267 0 30439 0 222273 0 0 0 Williams Philip A PHARMACIST CLIN 178001 0 766 0 1654 0 13642 0 31809 0 225872 0 0 0 Jensen Gail S PHARMACIST CLIN 167266 0 753 0 860 0 10624 0 17370 0 196873 0 0 0 Wallace Gary D DIR NRSG EMERGENCY SVC 157207 0 9378 0 1062 0 11963 0 27830 0 207440 0 0 0 Williams Sheila D PHARMACIST CLIN 163208 0 762 0 3394 0 10280 0 32501 0 210145 0 0 0 SCHEDULE J, PART I, LINE 1A - DISCRETIONARY SPENDING ACCOUNT EACH EXECUTIVE AT THE VICE PRESIDENT LEVEL AND ABOVE RECEIVES A PERK ALLOWANCE WHICH IS INCLUDED IN THE TAXABLE COMPENSATION OF THE EMPLOYEE. THIS ALLOWANCE COVERS COSTS SUCH AS BUSINESS USE OF THEIR PERSONAL VEHICLES IN LIEU OF REIMBURSEMENT FOR AUTO MILEAGE. IT ALSO ALLOWS ACCESS TO CERTAIN EXECUTIVE BENEFITS INCLUDING INDIVIDUAL LONG TERM DISABILITY, LONG TERM CARE, AND INDIVIDUAL LIFE INSURANCE. Schedule J, Part I, Line 3 - CEO Compensation The organization relied on Texas Health Resources (THR), a related 501(c)(3) organization with centralized compensation professionals to use the following methods to establish the compensation of the organization's President. *The Compensation committee (which includes independent persons) performs reviews and makes recommendations to the THR Board. *An Independent compensation consultant may be hired. *Compensation surveys or studies are utilized. *Approval by the Board or Compensation committee is required. SCHEDULE J, PART I, LINE 4B - NONQUALIFIED RETIREMENT PLAN PARTICIPATION IN THE PLAN IS MADE AVAILABLE TO A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES, AS DETERMINED BY THE THR BOARD OF TRUSTEES, WHO ARE PROVIDING SERVICES IN KEY POSITIONS OF MANAGEMENT AND RESPONSIBILITY. FOR THE ACTIVE RESTORATION ACCOUNT (ACCOUNT BALANCES AFTER 12/31/2009), SERP BENEFITS VEST WHILE THE PARTICIPANT IS EMPLOYED IF THE PARTICIPANT: * REACHES AGE 65, * BECOMES DISABLED OR DIES, * REACHES THE FOLLOWING YEARS OF SERVICE: 2 YEARS - 25%; 3 YEARS -50%; 4 YEARS - 75%; AND 5 OR MORE - 100%. PARTICIPANTS MUST BE EMPLOYED ON DEC 1 TO QUALIFY FOR THE CURRENT YEAR'S SERP BENEFIT UNLESS SEPARATION IS DUE TO DEATH, DISABILITY, RETIREMENT (AGE 65) OR EARLY RETIREMENT (SEPARATION FROM SERVICE AT OR AFTER AGE 55 WITH 75 YEARS OF COMBINED AGE AND CONTINUOUS SERVICE WITH THE SYSTEM). SERP BENEFITS ARE CALCULATED EACH DEC 1. VESTED BALANCES ARE TAXED TO THE EMPLOYEE AND THE NET BALANCES BEGIN ACCRUING EARNINGS. VESTED BALANCES ARE PAID IN A CASH LUMP SUM WITHIN A 90 DAY PERIOD COMMENCING ON THE EARLIER OF DEATH, DISABILITY, OR SEPARATION FROM SERVICE. THE DEFERRED PORTION IS INCLUDED IN SCHEDULE J, PART II, COLUMN C. IN FROZEN RESTORATION ACCOUNTS (ACCOUNT BALANCES PRIOR TO 1/1/2010), THE PARTICIPANT OR BENEFICIARY SHALL BE TAXED ON HIS OR HER VESTED SERP BENEFITS UPON THE EARLIEST OF: * CONTINUED EMPLOYMENT IN THR UNTIL AGE 68 * TERMINATION OF EMPLOYMENT FOR DISABILITY OR DEATH * INVOLUNTARY TERMINATION OF EMPLOYMENT WITHOUT REASONABLE CAUSE; OR * SATISFYING A 24 MONTH NON-COMPETE PERIOD FOLLOWING HIS/HER TERMINATION OF EMPLOYMENT. PAYMENT FOLLOWS THE BEFORE MENTIONED EVENTS, EXCEPT IN THE CASE OF INVOLUNTARY SEPARATION WHEN THE PARTICIPANT MUST WAIT 24 MONTHS TO RECEIVE THE PREVIOUSLY TAXED BENEFIT. PAYOUTS TO THE FOLLOWING EMPLOYEES WERE MADE DURING THE YEAR. THE AMOUNTS BELOW ARE INCLUDED IN THE AMOUNT REPORTED ON SCH J, PART II, COLUMN B(III) AND COLUMN (F). Berdan Barclay $207,003 Harold Berenzweig $82,585 Jeffrey Canose $112,689 Joseph Deleon $31,904 James Kirk King $75,344 Kenneth Kramer $50,254 Brett McClung $81,911 Rick McWhorter $460,488 Gary Montgomery $24,922 990, Part VI, Section A, Line 2 - Business Relationship Texas Health Resources (THR) and its related organizations included in the THR healthcare system encourage employees to become involved in philanthropic endeavors in their communities. As a result, THR healthcare system employees who are serving as officers, board members, or key employees may, from time to time, also serve on the boards of various community organizations such as church boards, United Way, etc. There may be a business relationship as a result of multiple THR employees serving on the same community boards. THR employees serve as the corporate officers of each subsidiary organization. As THR system employees, all officers have a business relationship within the organizations of the THR healthcare system. THR also appoints system officers to the boards of various controlled joint ventures. As THR system employees, various officers of the organization may have a business relationship through serving on THR controlled joint venture boards. 990, Part VI, Section A, Line 4 - Changes in Organizational Documents The bylaws were amended effective 1/1/18 to improve the governance of the Texas Health Resources (THR) Healthcare System. Below is a summary of the significant changes. . The composition of the hospital board membership will be the same as the membership of the THR (parent entity) board. . The composition of the board officers (Chair, Vice, & Immediate Past Chair) is changed to be comprised of the THR Board Chair, Vice Chair, and Immediate Past Chair. . The election and term of the board officers is the same as the election and term of the THR Board. . The THR CEO appoints the entity officers without approval by the THR board. The board will be comprised of up to 16 voting members and 5 non-voting members. Up to 14 of these board members will be community representatives. At least 3 members shall be licensed physicians. 990, Part VI, Section A, Line 6&7a - Members Texas Health Resources (THR) is the sole member of the organization. 990, Part VI, Section A, Line 7b - Governance Decisions Reserved The following actions require the approval of Texas Health Resources (THR): (a) Amendment, restatement or repeal of the Certificate of Formation or these Bylaws. (b) Sale, exchange, lease or other transfer of all or substantially all of the assets of the Corporation. (c) Merger or consolidation of the Corporation. (d) Dissolution of the Corporation. (e) Election of members of the Board of Trustees (f) Removal of a member of the Board of Trustees (g) Creation of affiliates or subsidiaries and approval of the initial governing documents. (h) Incurrence of debt not included in the budgets. (i) Discontinuing the operations of a licensed health care facility controlled by the corporation. (j) Activities involving winding up, distribution, conversion or exchange under Chapter 11 990, Part VI, Section B, Line 11b - Form 990 Filing The Texas Health Resources (THR) tax department staff prepares the Forms 990 for THR and all of its wholly controlled affiliates. In order to accurately prepare the returns, the tax staff works closely with various other departments to gather and review the information needed to complete the return. The departments involved in this process include, but are not limited to accounting, finance, treasury, human resources, payroll, legal, governance, and corporate compliance. The returns are then reviewed twice within the tax department before being given to the Financial Reporting department to review and to ensure that the financial information is accurate and up to date. All THR System Forms 990 are provided to members of the Audit and Compliance Committee of the THR Board, giving them an opportunity to review, comment and ask questions regarding the Forms 990. The tax department Vice President provides an overview presentation to the committee highlighting various areas of the Form 990. A resolution to approve all of the returns is voted upon at this meeting. Once the Audit and Compliance Committee has approved the returns, each return is then reviewed and signed by the Chief Accounting Officer/Assistant Secretary. The members of the governing Boards are provided a copy of the Form 990 for their respective entity after the Audit and Compliance Committee approval process and before the Form 990 is filed. 990, Part VI, Section B, Lines 12c Conflict of Interest Texas Health Resources (THR) has adopted a Conflict of Interest Policy that applies to THR and all of its wholly owned or wholly controlled affiliates. During the first quarter of each fiscal year, a Duality and Conflict of Interest Statement Form is distributed by the THR Chief Compliance Officer to all board members, officers, contracted medical directors, employees with a title of manager or above, employed physicians, and certain committee members and other employees based upon function. All disclosed conflicts are reviewed by the THR Chief Compliance Officer. A report, listing each reported Duality of Interest or Conflict of Interest is given to both the Chair of the Governing body and the President of the Corporation with which the reporting person is affiliated. The THR Board of Trustees receives a report when the Annual Disclosure process is complete. Progressive corrective action is taken for any identified noncompliance which may include removal from a board or committee or physician/employee counseling if the person fails to provide the disclosure. In addition, THR monitors physician payments through a public database implemented by CMS. Management plans are executed as needed based upon disclosures. THR also educates the Boards and workforce annually through either a web based or live compliance training. 990, Part VI, Section B, Lines 15a&b - Compensation Determination The organization relied on Texas Health Resources (THR) with centralized compensation professionals to review and establish the compensation of the organizations officers. The THR Board approves the compensation of certain officer of this organization. See Schedule J, Part III. 990, Part VI, Line 19 - Public Disclosure The organization does not make its governing documents or conflict of interest policy available to the public. The consolidated financial statements of Texas Health Resources (THR) are made available to the public on the website www.dacbond.com. Consolidated financial statements are posted to this website quarterly and the audited financial statements are posted annually. The financial statements of the wholly controlled affiliates of THR are not posted to the website nor are they generally made available to the public in any other manner. 990, Part XI, Line 9 - Other Changes in Net Assets Adjustment for Intercompany Transactions of a Controlled Group ($42,648,248) The intercompany adjustment eliminated the receivable/payable balance as of the end of the year between Texas Health Resources (THR) and all wholly controlled tax-exempt entities included in the THR Healthcare System. The adjustment represents current year activity. The THR Healthcare System records all related transactions through the intercompany Receivable/Payable accounts for each entity. The types of transactions recorded in the Intercompany accounts include management fees charged by the parent organization, services purchased between related organizations, supplies purchased by a centralized purchasing department, daily cash sweeps and similar transactions. 990, Part XII, Line 2c - Consolidated Financial Statements Texas Health Resources (THR) prepares consolidated financial statements with its related entities. The THR Board appoints an audit and compliance sub-committee that assumes responsibility for oversight of the consolidated audit for all related entities. The related entities do not have a separate audit committee, but abide by the THR committee's oversight. There has been no change during the year in the organizations oversight selection process. Johnson County Community Care Corp 612 E Lamar Blvd Arlington TX 76011 452793120 Indigent Care TX 501(c)(3) 12a TH Cleburne false Huguley Medical Associates Inc 11801 South Freeway Burleson TX 76028 752547668 Phys Clinic TX 501(c)(3) 3 TH Huguley false North Texas Healthy Communities 612 E Lamar Blvd Arlington TX 76011 464513182 Comm Support TX 501(c)(3) 7 TH Resources false Southwestern Health Resources JOC 5323 Harry Hines Blvd Dallas TX 75390 811575989 Mgmt Org TX 501(c)(3) 12b TH Resources false Texas Health Arlington Memorial Hospital 800 West Randol Mill Rd Arlington TX 76012 750972805 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Back Care 9229 LBJ Freeway Dallas TX 75243 474724257 Phys. Clinic TX 501(c)(3) 10 TH Phys Grp false TH Behavioral Health Hospital Corinth 612 E Lamar Blvd Arlington TX 76011 814317635 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Medical Support 612 E Lamar Blvd Arlington TX 76011 812833150 Spec Drugs TX 501(c)(3) 10 TH Resources false Texas Health Alliance 10864 Texas Health Trail Fort Worth TX 76244 451502252 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Azle 108 Denver Trail Azle TX 76020 751748586 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Cleburne 201 Walls Dr Cleburne TX 76033 751977850 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Fort Worth 1301 Pennsylvania Ave Fort Worth TX 76104 756001743 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Hurst-Euless-Bedford 1600 Hospital Parkway Bedford TX 76022 751438726 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Southwest Fort Worth 6100 Harris Parkway Fort Worth TX 76132 752678857 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Stephenville 411 Belknap Stephenville TX 76401 751752253 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Frisco 612 E Lamar Blvd Arlington TX 76011 831954982 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Mansfield 612 E Lamar Blvd Arlington TX 76011 831869297 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Huguley Inc 11801 S Freeway Burleson TX 76028 452694620 Hospital FL 501(c)(3) 3 TH Resources false TX Health Outpatient Surg Ctr Alliance 10840 Texas Health Trail Fort Worth TX 76244 800800294 Inactive TX 501(c)(3) 3 TH Alliance false Texas Health Physicians Group 9229 LBJ Freeway Dallas TX 75243 752613493 Phys. Clinic TX 501(c)(3) 10 TH Resources false TH Recovery and Wellness Center 240 Miller Road Mansfield TX 76063 812813227 Resd Trmt Ctr TX 501(c)(3) 3 TH Resources false Texas Health Resources Foundation 612 E Lamar Blvd Arlington TX 76011 752022128 Fundraising TX 501(c)(3) 7 TH Resources false Texas Health Allen 1105 Central Expressway N Allen TX 75013 752890358 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Dallas 8200 Walnut Hill Ln Dallas TX 75231 751047527 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Denton 3000 North Interstate 35 Denton TX 76201 432008974 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Kaufman 850 Ed Hall Drive Kaufman TX 75142 752771437 Hospital TX 501(c)(3) 3 TH Resources false Texas Health Plano 6200 W Parker Rd Plano TX 75093 752770738 Hospital TX 501(c)(3) 3 TH Resources false TX Health Research & Education Institute 612 E Lamar Blvd Arlington TX 76011 752562191 Edu& Research TX 501(c)(3) 4 TH Resources false Texas Health Resources 612 E Lamar Blvd Arlington TX 76011 752702388 System Mgmt TX 501(c)(3) 12c NA false TH Behavioral Health Hospital Plano 6110 W Parker Rd Plano TX 75093 812792484 Inactive TX 501(c)(3) 3 TH Resources false TH Behavioral Health Hospital Bedford 2717 Tibbets Dr Bedford TX 76022 812798838 Inactive TX 501(c)(3) 3 TH Resources false TH Specialty Hospital Fort Worth 1301 Pennsylvania Ave Fort Worth TX 76104 751648589 LT Hospital TX 501(c)(3) 3 TH Resources false WW Ward Endowment Fund Trust 612 E Lamar Blvd Arlington TX 76011 756196065 Nursing Grant TX 501(c)(3) 12a TH Foundatio false AMH Cath Labs LLC 811 Wright St Arlington TX 76012 203003947 Hospital TX na Arlington Surgery Center LLC 918 N Davis Dr Arlington TX 76012 752055800 Amb Surg Ctr TX na Cleburne Imaging LLC PO Box 820519 Dallas TX 75382 460767278 Medical Imagi TX na Cleburne Surgical Center LLC 2010 W Katherine P Raines Blvd St Cleburne TX 76033 203742012 Amb Surg Ctr TX na Denton Surgery Center LLC 207 North Bonnie Brea Denton TX 76201 470926556 Amb Surg Ctr TX na Flower Mound Hospital Partners LLC 4400 Long Prairie Rd Flower Mound TX 75028 260684968 Hospital TX na Fort Worth Endoscopy Centers LLC 900 W Magnolia Ave 101 Fort Worth TX 76104 770368346 Endoscopy Ctr TX na FTH DFW Partners LLC 1401 E Trinity Mills Rd Carrollton TX 75006 473381640 Hospital/ER TX na Greenville Surgery Center LLC 7150 Greenville Ave Ste 200 Dallas TX 75231 742411643 Amb Surg Ctr TX na Health Imaging Partners LLC 8610 Explorer Drive Ste 300 Colorado Springs CO 80920 271385885 Medical Imagi TX na North Dallas Surgical Center LLC 17980 Dallas Parkway Ste 100 Dallas TX 75287 272248103 Amb Surg Ctr TX na Opthalmology Surgery Center of Dallas LL 10740 N Central Expy Dallas TX 75231 261914835 Amb Surg Ctr TX na Park Hill Surgery Center LLC 3455 Locke Ave Fort Worth TX 76107 451484375 Amb Surg Ctr TX na Physicians Medical Center LLC 6020 W Parker Rd Plano TX 75093 481281376 Hospital TX na Presbyterian Cancer Ctr-Dallas LLC PO Box 819067 Dallas TX 75381 260422749 Cancer Ctr TX na Rockwall Regional Hospital LLC 3150 Horizon Rd Rockwall TX 75032 202848116 Hospital TX na Southlake Specialty Hospital LLC 1545 E Southlake Blvd Southlake TX 76092 020555370 Hospital TX na Surgical Caregivers of Fort Worth LLC 2001 W Rosedale Street Fort Worth TX 76104 751925497 Amb Surg Ctr TX na Texas Health Craig Ranch Surgery Center 8080 State Hwy 121 Ste 100 McKinney TX 75070 383897811 Amb Surg Ctr TX na Texas Health Spine Surgery Center Allen 1120 Raintree Cir Ste 100 Allen TX 75013 300957868 Amb Surg Ctr TX na Texas Health Spine Surgery Center Allian 1545 E Southlake Blvd Ste 100 Southlake TX 76092 320571301 Inactive TX na Texas Health Orthopedic Surgery Center A 9848 North Beach St Fort Worth TX 76244 814977249 Amb Surg Ctr TX na Texas Health Surgery Center Alliance LLC 10840 Texas Health Trail Ste 100 Fort Worth TX 76244 822296081 Amb Surg Ctr TX na Texas Health Surgery Center Bedford LLC 1605 Airport Freeway Suite 100 Bedford TX 76021 821307876 Amb Surg Ctr TX na Texas Health Surgery Center Irving LLC 2120 N MacArthur Blvdd Ste 200 Irving TX 75061 831085415 Amb Surg Ctr TX na Texas Health Flower Mound Orthopedic Sur 5000 Long Prairie Road Flower Mound TX 75028 800866449 Amb Surg Ctr TX na Texas Health Surgery Center Preston Plaz 17950 Preston Road Ste 75 Dallas TX 75252 203991622 Amb Surg Ctr TX na Texas Health Surgery Center Rockwall LLC 3144 Horizon Rd Ste 120 Rockwall TX 75032 474425996 Amb Surg Ctr TX na Texas Health Surgery Center South Arling 569 Brookwood Village ste 901 Birmingham AL 35209 999999999 Inactive TX na Texas Institute for Surgery LLP 7715 Greenville Ave Ste 100 Dallas TX 75231 770628004 Hospital TX na THR-STT Rockwall ASC LLC 1545 E Southlake Blvd Southlake TX 76092 262429878 Amb Surg Ctr TX na THR-STT Southlake ASC LLC 1545 E Southlake Blvd Southlake TX 76092 201728912 Amb Surg Ctr TX na USMD Hospital at Arlington LP 801 I -20 West Arlington TX 76017 731662763 Hospital TX na USMD Hospital at Fort Worth LP 5900 Altamesa Blvd Fort Worth TX 76132 203571243 Hospital TX na Wilson Creek Surigcal Center LLC 8855 synergy Dr McKinney TX 75070 274816583 Amb Surg Ctr TX na Women's Specialty Surgery Center of Dall 8230 Walnut Hill Ln Ste 101 Dallas TX 75231 262310072 Amb Surg Ctr TX na Grace Indemnity Company Ltd 1159 Caribbean Plaza Grand Cayman CJ KY 1-1102 981209573 Captive Insur CJ NA C Corp false Texas Health Biomedical Advancement Cent 612 E Lamar Blvd Arlington TX 76011 752636884 Research TX NA C Corp false THR Primary Care Ext Physcian Network 612 E Lamar Blvd Arlington TX 76011 465365421 Inactive TX NA C Corp false Charitable Remainder Trusts (4) 612 E Lamar Blvd Arlington TX 76011 CR Trust TX NA Trust false false true true false false false false false false false true false true false false true true true true See Part VII for Explanation Schedule R, Part V, Line 2 - Related Transactions Texas Health Resources (THR) is the parent organization of a large healthcare system made up of both wholly owned entities as well as related controlled joint ventures as listed on Schedule R. THR's role is to plan, manage and coordinate the activities of the affiliated healthcare system in order to maximize opportunities to deliver cost effective quality medical care to residents of north central Texas. THR provides direction and oversight to its wholly owned affiliates through centralized services. They also provide oversight for the controlled joint ventures. As an integral part of providing centralized services to the affiliates, THR maintains intercompany receivable/payable accounts, most of which do not fall within the scope of IRC Section 512(b)(13). The range of centralized services provided by THR include information services, managed care contracting, Human Resources, revenue cycle, billing and collections, patient access/admissions, legal, tax, compliance, supply chain, quality, business development, insurance, treasury, marketing, general accounting, real estate services, coding, transcription and strategic planning. In addition, THR does daily cash sweeps of all controlled tax exempt entity cash accounts. As a result, THR has numerous daily transactions with controlled tax exempt entities, none of which fall within the scope of IRC Section 512(b)(13). A management fee is charged for the centralized services and reported on Form 990, Part VII, Section B as a professional services fee. Transactions with related tax exempt organizations falling within the meaning of centralized services as described above, are not listed on schedule R, Part V, Line 2.