2018-05-10T06:10:55-05:00 2017-06-30 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE STE 4000 INDIANAPOLIS IN 46204 990 2016-07-01 750818167 Mother Frances Hospital Regional Health Care Center % CHRISSY RAMSEY MOTH 9036065639 1315 DOCTORS DRIVE TYLER TX 75701 ELIZABETH PULLIAM SYSTEM CFO 9036065639 2018-05-09 true JANICE K MARTIN P00900299 3176817940 2016 2022-09-23 18:48:47Z SEE SCHEDULE O Chris Glenney 800 E DAWSON TYLER TX 75701 1359420194 false X www.tmfhc.org X 1958 TX TO PROVIDE THE COMMUNITY WITH A FULL RANGE OF COMPREHENSIVE HEALTH CARE SERVICES WITHOUT REGARD TO RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. X 11 4 4105 351 2588597 2538984 1324694 638428005 634237294 3316219 12555502 8467847 17913620 652751055 666031110 27555482 24080890 0 0 198596294 235968490 0 0 0 367353967 315174913 593505743 575224293 59245312 90806817 860312990 548802390 380407924 301529889 479905066 247272501 X TO PROVIDE THE COMMUNITY WITH A FULL RANGE OF COMPREHENSIVE HEALTH CARE SERVICES WITHOUT REGARD TO RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. false false 478372035 24080890 634237294 THE HOSPITAL'S OPERATING PLAN INCORPORATES PROVISIONS FOR INDIVIDUALS WHO DO NOT POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. OUR COMMITMENT TO OUR COMMUNIY EXTENDS TO FREE OR SUBSIDIZED INDIVIDUAL CARE, SUBSIDIZED EDUCATION OF HEALTHCARE PROFESSIONALS, DISCOUNTED FEES FOR PARTICIPANTS IN GOVERNMENT PROGRAMS, COMMUNITY HEALTH EDUCATION AND DONATIONS TO OTHER COMMUNITY AGENCIES. SPECIFIC COMMUNITY SERVICES AND PROGRAMS INCLUDE: WELLNESS AND PREVENTION EDUCATION PROGRAMS, COMMUNITY DIAGNOSTIC SCREENING PROGRAMS, SENIOR CITIZEN HEALTH AWARENESS PROGRAMS, AWARENESS PROGRAMS FOR YOUTH AT RISK, AND AWARENESS PROGRAMS FOR PERSONS WITH SPECIAL PHYSICAL OR MENTAL NEEDS. INDIVIDUALS SERVED AMOUNTED TO 26,531 INPATIENTS ADMITTED RESULTING IN 113,014 PATIENT DAYS; 557,759 OUTPATIENTS ADMITTED RESULTING IN 360,721 PATIENT DAYS; AND 72,507 EMERGENCY ROOM VISITS RESULTING IN 9,898 PATIENT DAYS. 478372035 true true false true false false false false false true true false false false true true false true false true true false false false false false true true true false true false false false false false false true false false false false true false true true true false false true 155 0 true 4105 true true true true CJ false false false false false false false false X 11 4 false false false false true true true true true false false true true true true true true true true true true X CHRISSY RAMSEY 9036065639 1315 DOCTORS DRIVE TYLER TX 75701 John McGreevy Director (Term 10/16) 39.0 1.0 X 1351608 0 8521 Fagg Sanford MD Director 1.0 39.0 X 0 846908 26612 Jason Proctor Director (Eff 6/17) 40.0 0.0 X 294137 0 15092 Jean Coleman Director (Eff 6/17) 3.0 0.0 X 0 0 0 Lindsey Bradley Jr Director Ex-Officio-Ret. 06/17 9.0 31.0 X 1354813 4667579 18308 Mary Lauren Faulkner Director (EFF 6/17) 1.0 0.0 X 0 0 0 Noah Israel MD Director 1.0 0.0 X 0 5175 0 Pat Thomas MD Director 1.0 1.0 X 0 53729 0 Ray Thompson Director (TERM 10/16) 16.0 24.0 X 1932584 2898876 8520 Sister Irene Asztemborksa Director 7.0 0.0 X 0 0 0 Sister Malgorzata Majszczyk Director 9.0 0.0 X 0 0 0 Steven Keuer MD Director 1.0 39.0 X 0 1134411 36852 ANDY KIRKPATRICK DIRECTOR/CHAIR 1.0 39.0 X X 0 646170 43303 BEN FITZGERALD DIRECTOR (TERM 12/16) 1.0 0.0 X 0 0 0 CHRIS GLENNEY DIRECTOR (EFF 10/16) 1.0 39.0 X 0 910490 19243 Elizabeth Pulliam System CFO 15.0 25.0 X 181798 302995 11434 Lee Portwood VP-TERM 07/16 40.0 0.0 X 524904 0 9845 Patrick Simonson VP (TERM 08/16) 40.0 0.0 X 414495 0 6508 Robert Rose SVP, Patnt Care Svc-TERM 2/17 40.0 0.0 X 496472 0 18458 Todd Hancock SVP/COO (TERM 02/17) 40.0 0.0 X 725325 0 7836 Scott Smith MD Sr. Vice President 9.0 31.0 X 0 801809 11163 JEFFREY HYDE VP 40.0 0.0 X 211313 0 5901 ROBERT BIENERT CRNA 40.0 0.0 X 347748 0 9474 TOWANDA FELTON CRNA 40.0 0.0 X 338647 0 10703 JOSEPH PISTONE PHYSICIAN 40.0 0.0 X 327898 0 15140 DUSTIN VIDRINE CRNA 40.0 0.0 X 272033 0 14301 TIMOTHY CLARK CRNA 40.0 0.0 X 285008 0 16270 SCOTT FOSSEY VP 0.0 40.0 X 0 302028 11398 9058783 12570170 324882 154 true true false SOUND INPATIENT PHYSICIANS OF TEXAS 1123 PACIFIC AVENUE TACOMA WA 98402 PHYSICIAN SERVICES 9293993 W R L GENERAL CONTRACTORS 10858 FM 346 W FLINT TX 75762 CONSTRUCTION SVCS 9259158 SIEMENS MEDICAL SOLUTIONS USA INC PO BOX 120001 DEPT 0733 DALLAS TX 75312 EQUIPMT/MAINTENANCE 8519406 SODEXO INC AND AFFILIATES PO BOX 360170 PITTSBURGH PA 15251 HOUSEKEEP/DIET SVCS 3912951 HARMONY HEALTHCARE LLC 2909 WEST BAY TO BAY BLVD STE 500 TAMPA FL 33629 CONTRACT LABOR 2401001 15 181978 1142716 1324694 NET PATIENT SERVICE REVENUE 621110 620707887 620707887 0 0 LAB TESTING 900099 5154101 5154101 0 0 MEDICAL SERVICES & TESTING 900099 4476435 4476435 0 0 UNCON SUB REVENUE 900099 3730620 3730620 0 0 WELLNESS CENTER 900099 168251 168251 0 0 634237294 4674629 4674629 0 0 3170291 3170291 0 3170291 289787 2880504 700944652 693063779 7880873 7880873 7880873 0 0 0 0 0 0 668439 325305 343134 343134 AIR METHODS PROGRAM 900099 6761807 0 0 6761807 ALL OTHER REVENUE 900099 7638388 0 2298810 5339578 14400195 666031110 634237294 2588597 27880525 24080890 24080890 0 0 0 0 0 0 7487449 6990434 497015 0 0 0 0 0 193939448 181065786 12873662 0 0 0 0 0 22620573 21093185 1527388 0 11921020 11236290 684730 0 0 0 0 0 0 0 0 0 0 0 0 0 19136 0 19136 0 0 0 393110 393110 0 45451890 41858689 3593201 0 36622 36494 128 0 11974296 11604342 369954 0 1321076 301363 1019713 0 0 0 0 0 6647511 5540989 1106522 0 315634 191262 124372 0 0 0 0 0 273592 203849 69743 0 3521584 3521584 0 0 0 0 0 0 29834234 26557737 3276497 0 2928254 10814 2917440 0 MEDICAL SUPPLIES 123914753 123834112 80641 0 PROVISION FOR UNCOLL ACCT 17669015 17669015 0 0 MANAGEMENT ALLOCATION 68095645 0 68095645 0 SUBSCRIPTIONS 198626 142108 56518 0 2579935 2433092 146843 575224293 478372035 96852258 0 0 39775155 63386 6561307 0 0 0 61022470 52888911 0 0 0 0 0 9616885 6337430 5960809 2617742 1321509 453871329 44435653 304864166 409435676 302110179 8859300 4747805 5203 0 8243244 2679974 46000000 129596762 6407467 860312990 548802390 59330887 59574037 0 0 1487012 1525 181261874 0 0 0 0 0 876514 1099273 0 6487443 137451637 234367611 380407924 301529889 X 479262111 246788942 642955 483559 0 0 479905066 247272501 860312990 548802390 X 90806817 -4550874 0 0 0 -318888508 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false 0 true 0 false 0 false 0 true 19316 false 0 false 0 19316 false CONTACT WITH GOVERNMENT OFFICIALS AND THEIR STAFFS: SCHEDULE C, PART II-B, LINE 1B HEALTHCARE POLICY IS CRITICAL TO ALL AMERICANS. CHRISTUS BELIEVES THAT HEALTH CARE PROVIDERS MUST PARTICIPATE IN FORMING HEALTH CARE POLICY BY INTERACTING WITH NATIONAL, STATE AND LOCAL ELECTED OFFICIALS AND THEIR STAFF MEMBERS TO HELP THEM BETTER UNDERSTAND THE COMPLEXITIES AND RAMIFICATIONS OF KEY HEALTH CARE POLICIES. AT THE FEDERAL LEVEL, CHRISTUS EMPLOYEES PERSONALLY VISITED WITH TEXAS CONGRESSIONAL MEMBERS AND THEIR STAFF TO DISCUSS MEDICAID, MEDICARE, 1115 WAIVER, AND EXCHANGE INSURANCE PRODUCTS. AT THE STATE LEVEL, WE DISCUSSED THE 1115 WAIVER AND THE LOCAL PROVIDER PARTICIPATION FUNDING POTENTIAL. EXECUTIVE HRS: 64 DIRECTOR HRS: 32 ASSOCIATE HRS: 26 3185371 345766 9101 3522036 2885950 445000 -118741 26838 3185371 2762072 124878 1000 2885950 2414694 360569 13191 2762072 2408876 163752 157934 2414694 0.71220 0.28780 false true true 17014322 17014322 203223596 11844692 191378904 1759416 301335 1458081 225160272 32289626 192870646 6713723 6713723 409435676 0 PENSION LIABILITY 45795617 CAPITAL LEASE 20714722 ASSET RETIREMENT OBILIGATIONS 801504 BONDS 56895 SALES TAX 15117 INTERCOMPANY PAYABLE 166983756 234367611 X Schedule D, Part V, Line 4 Intended use of endowment funds THE ORGANIZATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR THE ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS AND ITEMS SUPPORTED BY THE ENDOWMENT WHILE SEEKING TO MAINTAIN ITS PURCHASING POWER. Schedule D, Part X, Line 2 FIN 48(ASC740) Footnote PER FOOTNOTE 3 IN THE CONSOLIDATED FINANCIAL STATEMENTS, There are no material unrecorded tax liabilities as of June 30, 2017 and 2016. Central America and the Caribbean 1 Program services INSURANCE 36685 Central America and the Caribbean Investments INVESTMENTS-BOOK VALUE 135824 1 1 172509 172509 true false true false false false true true X true X true X true true true false true true 25450294 25450294 0.04560 36992360 54967468 0.00000 1214966 764248 450718 0.00080 63657620 55731716 25901012 0.04640 426042 26630 399412 0.00070 270984 270984 0.00050 1352282 1352282 0.00240 207570 207570 0.00040 22680623 22680623 0.04070 24937501 26630 24910871 0.04470 88595121 55758346 50811883 0.09110 17669015 184285493 191067110 -6781617 X true true 2 1 MOTHER FRANCES REG HEALTHCARE CENTER 800 EAST DAWSON TYLER TX 75701 WWW.TMFHC.ORG 000286 X X X A 2 TYLER REHAB ASSOCIATES LP 3131 TROUP HIGHWAY TYLER TX 75701 WWW.TMFREHABHOSPITAL.COM 000692 X A A 12 false false true X X X X X X X 15 true false false true X SEE PART V, SECTION C X true 15 true SEE PART V, SECTION C false true X 200. 400. X X X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 Representatives from the community Both mother frances hospital regional health care center (mfh-tyler) and tyler rehab associates, lp cover the same community and are within the same health care system; therefore, they used the same community representatives. They conducted 48 interviews with the two groups outlined in irs final regulations issued December 29, 2014. During these interviews, the hospital discussed the health needs of the community, access issues, barriers, and issues related to specific populations. The interviewees included, but were not limited to, individuals from the following organizations: tyler family circle of care clinic, st.paul children's foundation, whispering pines nursing home, literacy council of tyler, northeast child advocacy center, bethesda health clinic, your philanthropy, east texas human needs network (ethnn), people attempting to help (path), Samaritan counseling center, east texas council of governments area agency on aging, and various others. Additionally, a survey was sent to a select group of 940 individuals or organizations who are members of the ethnn. Out of the selected group, 120 responses were collected and analyzed. Survey questions related to a variety of health problems as well as barriers for low income residents. A paper survey was also conducted at three tyler family circle of care clinic locations. The survey was provided to patients at check-out and surveyed items such as location of care, problems seeing a doctor, and likeliness of returning to clinics. SCHEDULE H, PART V, SECTION B, LINES 7A & 10A THE URL FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT AND MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS: HTTP://TMFHC.ORG/COMPREHENSIVE-COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS IDENTIFIED IN CHNA ADDRESSED AND NOT ADDRESSED MOTHER FRANCES HOSPITAL - TYLER IDENTIFIED AND ADDRESSED THE FOLLOWING PRIORITIES THROUGH ITS IMPLEMENTATION PLAN: 1) ACCESS TO PRIMARY CARE SERVICES 2) NEED FOR INCREASED EMPHASIS ON A COLLABORATIVE CONTINUUM OF CARE 3) PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES 4) ACCESS TO SPECIALTY CARE SERVICES 5) ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE 6) ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS PROPOSED PROGRAMS TO ADDRESS THE PRIORITIZED NEEDS: 1) SUPPORT DEVELOPMENT AND IMPLEMENTATION IN REGION 1 OF THE MEDICAID WAIVER PROGRAM IN ORDER TO ACCOMPLISH THE FOLLOWING: - EXPAND PRIMARY CARE ACCESS - EXPAND SPECIALTY CARE ACCESS - DEVELOP TELEMEDICINE PROGRAM FOR NICU - ESTABLISH AND RE-CERTIFY 19 MEDICAL HOMES - DEVELOP A PALLIATIVE CARE PROJECT THAT INCLUDES OUTPATIENT SERVICES - DEVELOP A PATIENT NAVIGATION PROJECT FOR BREAST CANCER PATIENTS - DEVELOP A CARE TRANSITION PROGRAM 2) PROVIDE SUPPORT FOR THE LITERACY COUNCIL, ALZHEIMER'S, DIABETES, AMERICAN HEART ASSOCIATION, CANCER FOUNDATION FOR LIFE, AMERICAN CANCER SOCIETY, HOSPICE OF EAST TEXAS, AND HEALTH FITNESS PROGRAMS 3) PROVIDE SUPPORT AND EXPAND THE FOLLOWING PROGRAMS: - TYLER FAMILY CIRCLE OF CARE/WOMEN'S SERVICES - TYLER FAMILY CIRCLE OF CARE/PRIMARY CARE SERVICES - TRINITY CLINIC, PEDIATRIC SPECIAL NEEDS PROGRAM - TELECARE PLUS - YOUR HEALTH INFORMATION RESOURCE - BETHESDA CLINIC SUPPORT - ST. PAUL'S CLINIC - RURAL HOSPITAL SUPPORT PROGRAM THROUGH DONATIONS - HEALTH SCREENING & PREVENTATIVE PROGRAM - NEONATAL SERVICES - TRAUMA & EMERGENCY ROOM SERVICES - ROSS BREAST CENTER MOBILE UNIT - MEDICAB, EMS - LITERACY COUNCIL - ALZHEIMER'S ASSOCIATION 4) SUPPORT OF A NEW BEHAVIORAL HEALTH COMMUNITY PROJECT 5) PARTICIPATION IN THE EPISCOPAL FOUNDATION COMMUNITY HEALTH COLLABORATION FORUMS 6) NORTHEAST TEXAS PUBLIC HEALTH DISTRICT FIT CITY CHALLENGE SPONSORSHIP 7) PROVIDE SUPPORT FOR THE SUSAN G KOMEN RACE FOR THE CURE 8) TYLER JUNIOR COLLEGE FOUNDATION TO SUPPORT NURSING AND HEALTH SCIENCES CENTER 9) TEXAS HEALTH AND HUMAN SERVICES REGIONAL ADVISORY COUNCIL MOTHER FRANCES HOSPITAL - TYLER DECIDED NOT TO ADDRESS "ACCESS TO DENTAL SERVICES" LARGELY DUE TO THE FACT THAT IT IS NOT A CORE BUSINESS FUNCTION OF THE HOSPITAL AND THE LIMITED CAPACITY OF THE HOSPITAL TO ADDRESS THIS NEED. HOSPITAL LEADERSHIP FELT THAT RESOURCES AND EFFORTS WOULD BE BETTER SPENT ADDRESSING THE 9 PRIORITIZED NEEDS ABOVE. TYLER REHAB IDENTIFIED AND ADDRESSED THE FOLLOWING PRIORITIES THROUGH ITS IMPLEMENTATION PLAN: - NEED FOR INCREASED EMPHASIS ON A COLLABORATIVE CONTINUUM OF CARE - PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES - ACCESS TO SPECIALTY CARE SERVICES - ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS THE REHAB HOSPITAL DECIDED NOT TO ADDRESS "ACCESS TO DENTAL SERVICES", "ACCESS TO PRIMARY CARE SERVICES", AND "ACCESS TO MENTAL AND BEHAVIORAL HEALTHCARE". THIS IS LARGELY DUE TO THE FACT THAT THESE ARE NOT CORE BUSINESS FUNCTIONS OF THE HOSPITAL AND THE LIMITED CAPACITY OF THE HOSPITAL TO ADDRESS THESE NEEDS. HOSPITAL LEADERSHIP FELT THAT RESOURCES AND EFFORTS WOULD BE BETTER SPENT ADDRESSING THE FOUR PRIORITIZED NEEDS ABOVE. SCHEDULE H, PART V, SECTION B, LINE 13B Income level used for FAP Eligibility Uninsured patients who apply for the Financial Assistance Program may also qualify for assistance under the policy, regardless of income level, if they have medical or hospital bills that exceed 10% of their gross family income. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C FAP Documents available to the public The hospital's FAP, FAP application form, and plain language summary are available at the following website: http://www.tmfhc.org/patients-visitors/financial-assistance 1 MFH Outpatient Surgery CENTER 415 South Fleishel Tyler TX 75702 Ambulatory Surgical Center SCHEDULE H, PART I, LINE 3C FACTORS OTHER THAN THE FPG DETERMINING FREE OR DISCOUNTED CARE THE HOSPITAL USES THE FOLLOWING FACTORS IN ITS DETERMINATION: 1) ASSET LEVEL 2) MEDICAL INDIGENCY 3) INSURANCE STATUS 4) UNDERSINSURANCE STATUS 5) GREATER THAN 400% UNDER THE CATASTROPHIC CAP PROVISION 6) RESIDENCY 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 7, COLUMN (F) PERCENT OF TOTAL EXPENSE TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) IS $575,224,293. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS $17,669,015. THIS LEAVES A TOTAL EXPENSE OF $557,555,278 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 15.89%, 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 7I CASH AND IN-KIND CONTRIBUTIONS MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE MADE OVER $22,680,623 IN CASH AND IN KIND CONTRIBUTIONS DURING FISCAL YEAR 2017. 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. 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 7G: SUBSIDIZED HEALTH SERVICES COST IS AT FMV LINE 7I: ACTUAL EXPENSE OF THE CONTRIBUTIONS SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE THE AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT AS A COMMUNITY BENEFIT THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. BAD DEBT EXPENSE SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE THIS IS UNCOMPENSATED HEALTHCARE PROVIDED TO RESIDENTS OF THE COMMUNITY. SCHEDULE H, PART III, LINE 4 Footnote to the Financial statements describing BAD DEBT EXPENSE The preparation of the accompanying consolidated financial statements in conformity with accounting principles generally accepted in the United States (U.S. 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 andcontingencies, 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 Systems health plan; determination of fair values of certain financial instruments; determination of fair value of certain goodwill and long-lived assets, including assets acquired; 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, LINE 8 COSTING METHODOLOGY The medical Center uses Medicare cost report methodology, which apportions routine costs (room and board) based on Medicare or Medicaid days to total days and apportions ancillary costs based on program charges to total charges. THE SHORTFALL ON PART III LINE 7 IS NOT COUNTED AS A COMMUNITY BENEFIT. 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 $6,781,617 IF TOTAL EXPENSES ALLOCABLE TO MEDICARE SERVICES WERE SUBSTITUTED ON SCHEDULE H, PART III, LINE 6. SCHEDULE H, PART III, LINE 9B Collection Policy The organization has a written policy covering procedures for collecting and writing off bad debts. According to the policy, if a patient appears to be indigent, accounts should be reviewed, at any time during the collection process, for possible consideration as a charity case in accordance with the organizations charity care policy. Unpaid discounted balances of patients who qualify for the financial assistance program are considered uncollectible bad debts. CHRISTUS does not conduct, or permit collection agencies to conduct on its behalf, extraordinary collection actions (ECAS), as defined under Internal Revenue Code Section 501(R), against individuals before reasonable efforts have been made to determine whether the patient is eligible for the financial assistance program. Reasonable efforts include the hospital making the determination that the patient is ineligible for the financial assistance program because the patient is covered by Medicare or Commercial insurance. The System Director of Patient Financial Services maintains oversight and responsibility for determining if CHRISTUS has made reasonable efforts and whether an ECA is appropriate. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT The hospital's community health profiles provide a snapshot of suburban, urban, and rural service areas within texas using key health indicators, which facilitate comparisons locally, regionally, and over time. Community health profiles are intended to assist internal stakeholders, community health council members, and the community health improvement department in deciding where to allocate resources and address health inequalities. All entity advocates use national, state, and local secondary and primary data sources to provide a current overview of local health needs, factors impacting disease and injury burden, socioeconomic status, access to health care, age distribution, indicators and lifestyle behaviors. This data is used to galvanize joint community health efforts to improve health and reduce health inequalities and to empower the greater community. SCHEDULE H, PART VI, LINE 3 Patient education of eligibility for assistance The hospital's financial assistance policy and contact information is posted in various areas of the hospital including admissions and registration, emergency, and outpatient departments. Additionally, financial assistance information is provided, verbally and in written brochures, to all self-pay patients by financial counselors. Financial assistance information is also included in every patient bill. The hospital's financial assistance policy is communicated to the patient by financial counselors who also screen self-pay patients for potential eligibility for other governmental assistance programs. If it is determined that the patient is potentially eligible for governmental assistance, the financial counselor will assist the patient in completing any forms necessary to apply for the assistance. At the same time, the patients are provided with a charity care application and informational Flyer. The patient is informed that mother frances hospital-tyler is a non-profit charitable organization offering financial assistance to patients who are deemed medically or financially indigent. The financial counselors will then assist the patient in completing the charity care application and obtaining any available verifications. Once the patient is discharged, the financial counselors will continue to contact the patient to ensure all needed forms and verifications needed to file an application for governmental assistance and charity care have been provided. SCHEDULE H, PART VI, LINE 4 Community information The hospital owns and operates a 476 licensed bed general acute care hospital and related healthcare facilities in tyler, texas. The hospital's primary service area consists of Smith County with a population of approximately 200,000. The secondary service area of the hospital consists of anderson, cherokee, gregg, henderson, rains, rusk, upshur, wood, and van zandt counties with a total population of approximately 500,000. SCHEDULE H, PART VI, LINE 5 Promotion of community health 1. Tyler Family Circle of Care Womens Services/Childrens Services/Family and Special Needs Clinics Description: These clinics provide medical care services to all ages of patients. The clinics see Medicaid, Medicare, CHIP/CHIP Perinate, self-pay, uninsured/underserved, and serving those without the ability to pay regardless of their county of residence. A community benefit is paid to cover the costs of 60% of the IT services and system. The primary objective is to reduce the number of women who delivered babies with no prenatal care or childbirth education and reduce the number of sick infants born. Social workers help clients become eligible for Medicaid, WIC, and other financial assistance. This facility provides access to well-baby care and sick baby care for new mothers who were provided care at the Tyler Family Circle of Care Womens Service and for the medically underserved children of east Texas. This clinic has the highest percentage of at-rick ethnic groups. 2. Emergency Education Description: Detailed instruction and hands on participation is offered for certification in areas including CPR, first aid, and AED use. Courses are offered to school district and sponsors for UIL programs on an as needed basis. Nearly 650 people were trained across multiple counties, school districts, and churches. 3. Bethesda Clinic Support DESCRIPTION: BETHESDA CLINIC IS A "FREE" MEDICAL CLINIC, WHICH IS SUPPORTED FINANCIALLY AND BY SUPPORT SERVICES FROM THE COMMUNITY. Mother Frances Hospital provides support in all areas and on special projects as requested. 4. Trinity Mother Frances Health System Website Description: The TMFHS website at www.tmfhs.org provides a large amount of information about the health system, Trinity Physicians, upcoming classes and events and a wealth of health information. This now includes the implementation of MYCHART for personal health information directly. 5. Community Partnerships Description: Assistance was provided both financially and with staffing for groups and organizations to provide collaborative programs, services, and health information. Projects included over 80 opportunities, including school-based programs, youth programs, and general public events. To provide assistance and support and to educate the public on programs offered by Komen Foundation, American Heart Association, American Cancer Society, Alzheimer Association, Bethesda Health Clinic, Boy Scouts, Childrens Advocacy Center, nursing programs, and public and private schools. 6. United Way Description: TMFHS and our employees provided financial support of over $32,000. To assist with the design, development, funding, and mission development of over 30 non-profit agencies in the community providing services to children and families at-risk regardless of their ability to pay for those services. 7. Health Education /Screening Programs Description: Community education for healthy life styles was offered throughout the region for a variety of conditions. The Fit City Tyler Program and various walks are included as well as stress management, diabetes education, heart health, and cancer awareness screenings. The Women with Heart program also offered education on heart disease in 4 counties. 8. School Assistance Description: Over 4,000 high school physicals and pre-participation exams and were done at no cost to the schools. Additionally, over 200 student athletes were seen for free in Saturday sports clinics. All programs are open to anyone to participate provided they have parental approval. Support for on-site trainers is also provided on an as needed basis. 9. Youth Fitness Description: Sports training programs, injury prevention and healing, running classes, walking programs, and nutritional programs were offered to educate youths and young adults on the potentials for injuries and the long term effects of not caring for the body. Examples would include: Tyler Soccer Association, summer football while other programs would include assistance with local basketball, volleyball, football, and other traditional group programs with non-profits and school districts. Added is the FCA all-star games. 10. Young Adults and Students and Learning Skills Description: TMFHS made a decision to participate and lead the way on helping to develop skills children need to learn and become interested in healthcare careers. Through our volunteer services programs training, job shadowing, REACH training for special need students, student programs, etc. are offered to individuals, schools, community colleges and four year institutions not only in our main hospitals but in clinics throughout our service area. 11. Care Management for Discharged Patients Description: Funds are utilized as designated by the Care Management Department to assist patients with continuity of care needs from the hospital discharge time. These funds could be used for transportation costs to home, home health visits, durable medical equipment, walkers, crutches, medications, as well as minimal days in a skilled nursing home. 12. Respite Care Program Description: The Respite Care Program provides services to families of over 100 children with special health care needs by providing parents with respite, which is a brief time away from the 24/7 attention required by a special needs child. These children received 3,619 hours of respite care for their families. Additionally, there is a support group for families that includes 90 members. 13. Ross Breast Center Description: Ross Breast Centers mobile unit covers special events reaching people with education and screenings. 14. Community Breast Health Education Description: A team of educators in collaboration with Komen reach out to women across the community to provide breast self-exam and prescreening information to individuals of all ages from teenagers to seniors. Through the Hopeful Journey program 1,200 individuals from 200 events were reached. 15. Community Non Profits and Rural Hospital Support Programs Description: TMFHS pro SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM MOTHER FRANCES HOSPITAL-TYLER IS PART OF AN AFFILIATED HEALTH CARE SYSTEM CALLED CHRISTUS TRINITY MOTHER FRANCES HEALTH SYSTEM. CHRISTUS TRINITY MOTHER FRANCES IS A FAITH-BASED ORGANIZATION DEDICATED TO CREATING HEALTHY LIVES FOR PEOPLE AND COMMUNITIES. MFH-TYLER AND ITS AFFILIATES PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING ACUTE CARE FACILITIES AND CRITICAL ACCESS FACILITIES WHOSE OPERATIONS CONSIST PRIMARILY OF PROVIDING INPATIENT AND OUTPATIENT ACUTE CARE AND MEDICAL SERVICES TO PATIENTS RESIDING IN EAST TEXAS. 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 2012 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 2015. 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 SISTERS OF THE HOLY FAMILY OF NAZARETH 310 N RIVER ROAD DES PLAINS IL 60016 205728802 501(c)(3) 100000 GENERAL SUPPORT AMERICAN CANCER SOCIETY INC 1301 S BROADWAY TYLER TX 75701 131788491 501(c)(3) 20000 community healthcare AMERICAN HEART ASSOCIATION INC POBOX 50040 PRESCOTT AR 86304 135613797 501(c)(3) 35900 COMMUNITY HEALTHCARE BETHESDA HEALTHCARE INC 409 W FERGUSON TYLER TX 75702 311027660 501(c)(3) 16500 Community healthcare CANCER FOUNDATION FOR LIFE PO BOX 8257 TYLER TX 75711 752957440 501(c)(3) 25000 Community healthcare GRACE COMMUNITY SCHOOL 3025 UNIVERSITY BLVD TYLER TX 75701 751245705 501(c)(3) 10000 Sponsorship ST GREGORY CATHEDRAL SCHOOL 500 S COLLEGE AVENUE TYLER TX 75702 272769354 501(c)(3) 10250 Sponsorship TYLER AREA CHAMBER OF COMMERCE 315 N BROADWAY TYLER TX 75702 750624670 501(c)(3) 12740 Sponsorship TYLER ECONOMIC DEVELOPMENT COUNCIL 315 N BROADWAY TYLER TX 75702 752254467 501(c)(3) 30000 sponsorship TYLER JUNIOR COLLEGE FOUNDATION PO BOX 9020 TYLER TX 75711 756046816 501(C)(3) 10000 PLEDGE SERVICE ORGANIZATION OF PINEY WOODS 2950 50TH STREET LUBBOCK TX 79314 300630886 501(c)(3) 13702750 Community Healthcare SERVICE ORGANIZATION OF NORTH & EAST TEXAS 2950 50TH STREET LUBBOCK TX 79314 260468622 501(c)(3) 9057750 Community Healthcare CHRISTUS HOPKINS HEALTH ALLIANCE 115 AIRPORT RD SULPHUR SPRINGS TX 75482 811708177 501(c)(3) 1020000 Community Healthcare CHRISTUS TRINITY MOTHER FRANCES FOUNDATION 1315 DOCTORS DRIVE TYLER TX 75701 752028241 501(c)(3) 30000 Sponsorship 14 0 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. SCHEDULE I, PART I, LINE 2 GRANT RECIPIENTS ARE REQUIRED TO ACKNOWLEDGE PRIOR TO THE ISSUEANCE OF GRANT FUNDS THAT THE GRANT WILL BE USED IN ACCORDANCE WITH THE STATED PURPOSE OF THE GRANT APPLICATION AND ANY UNUSED FUNDS RELATED TO THE SPECIFIC PURPOSE OF THE GRANT WILL BE RETURNED TO THE ORGANIZATION. THE ORGANIZATION MONITORS AND REVIEWS THE FINANCIAL DATA OF RECIPIENTS TO ENSURE THAT THE GRANTED FUNDS ARE BEING USED PROPERLY. X true true true true false false false false false false false Elizabeth Pulliam System CFO 92375 153957 85036 141726 4387 7312 2971 4952 1317 2194 186086 310141 0 0 John McGreevy Director (Term 10/16) 363941 0 987667 2650 5871 1360129 0 Lee Portwood VP-TERM 07/16 179602 0 32795 0 312507 0 5743 0 4102 0 534749 0 0 0 Patrick Simonson VP (TERM 08/16) 139970 0 32000 0 242525 0 3758 0 2750 0 421003 0 0 0 Robert Rose SVP, Patnt Care Svc-TERM 2/17 254342 0 230382 0 11748 0 9809 0 8649 0 514930 0 0 0 Todd Hancock SVP/COO (TERM 02/17) 337704 0 387621 0 0 0 5697 0 2139 0 733161 0 0 0 Fagg Sanford MD Director 0 842468 0 0 0 4440 0 26612 0 0 0 873520 0 0 Jason Proctor Director (Eff 6/17) 212324 70708 11105 6449 8643 309229 0 Lindsey Bradley Jr Director Ex-Officio-Ret. 06/17 216156 745538 101250 348750 1037407 3573291 2534 8729 1585 5460 1358932 4681768 0 0 Ray Thompson Director (TERM 10/16) 318094 477141 188000 282000 1426490 2139735 1060 1590 2348 3522 1935992 2903988 0 0 Scott Smith MD Sr. Vice President 649309 152500 0 8613 2550 812972 0 Steven Keuer MD Director 0 641694 0 384712 0 108005 0 29263 0 7589 0 1171263 0 0 ANDY KIRKPATRICK DIRECTOR/CHAIR 0 646170 0 0 0 0 0 29263 0 14040 0 689473 0 0 CHRIS GLENNEY DIRECTOR (EFF 10/16) 0 369959 0 540531 0 0 0 11263 0 7980 0 929733 0 0 ROBERT BIENERT CRNA 347469 0 0 0 279 0 7262 0 2212 0 357222 0 0 0 TOWANDA FELTON CRNA 337976 0 0 0 671 0 8059 0 2644 0 349350 0 0 0 JOSEPH PISTONE PHYSICIAN 323608 0 4290 1644 13496 343038 0 DUSTIN VIDRINE CRNA 271808 0 225 6589 7712 286334 0 TIMOTHY CLARK CRNA 284617 0 0 0 391 0 7791 0 8479 0 301278 0 0 0 JEFFREY HYDE VP 205497 0 5816 3999 1902 217214 0 SCOTT FOSSEY VP 0 225721 0 64988 0 11319 0 5914 0 5484 0 313426 0 0 SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 1A, COMPANION TRAVEL TAXABLE COMPENSATION WAS REPORTED TO VARIOUS OFFICERS AND BOARD MEMBERS RELATED TO COMPANION TRAVEL TO CHRISTUS MEETINGS. FORM 990, PART VII, LINE 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. OFFICERS, KEY EMPLOYEES AND HIGHEST PAID EMPLOYEES ARE FULL-TIME EMPLOYEES. BOARD MEMBERS SPEND TIME AS NEEDED FOR BOARD MEETINGS AND FUNCTIONS. RELATED ORG DETERMINING CEO/EXECUTIVE DIRECTOR'S COMPENSATION SCHEDULE J, PART I, LINE 3 THE FILING ORGANIZATION'S 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 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 ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. THIS COMMITTEE USES AN INDEPENDENT COMPENSATION CONSULTANT WHO PERFORMS BI-ANNUAL COMPENSATION SURVEY. SEVERANCE PAYMENT SCHEDULE J, PART I, LINE 4A UNDER THE SEVERANCE PLAN, ALL OR A PORTION OF THE BASE SALARY OF A PARTICIPATING EXECUTIVE WILL CONTINUE TO BE PAID TO THE EXECUTIVE FOR A LIMITED PERIOD OF TIME IF THE EXECUTIVE'S EMPLOYMENT WITH CHRISTUS AND ITS AFFILIATES IS INVOLUNTARILY TERMINATED. LEE PORTWOOD RECEIVED $304,828 AS A SEVERANCE PAYMENT DURING CALENDAR YEAR 2016. PATRICK SIMONSON RECEIVED $233,707 AS A SEVERANCE PAYMENT DURING CALENDAR YEAR 2016. RAYMOND THOMPSON RECEIVED $3,566,225 AS A SEVERANCE PAYMENT DURING CALENDAR YEAR 2016. JOHN MCGREEVY RECEIVED $987,667 AS A SEVERANCE PAYMENT DURING CALENDAR YEAR 2016. LINDSEY BRADLEY, JR. RECEIVED $4,610,698 AS A SEVERANCE PAYMENT DURING CALENDAR YEAR 2016. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN 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 PESNION 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. PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B AND FORM 990, SCHEDULE J, PART II, COLUMN (F), COMPENSATION REPORTED AS DEFERRED IN PRIOR FORM 990 STEVEN KEUER, M.D. RECEIVED $108,005 DURING CALENDAR YEAR 2016 UNDER SECTION 457(F). SUPPLEMENTAL COMPENSATION INFORMATION 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. 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 CALENDAR YEAR 2016. 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. Susan Rippy PAT THOMAS BRD MEMBER 48555 SEE PART V false SCHEDULE L, PART IV DESCRIPTION OF TRANSACTION 1) WAGES OF $48,555 WERE PAID TO THE DAUGHTER OF BOARD MEMBER, PAT THOMAS. CASH TRANSFERRED TO AFFILIATES 2017-06-30 347243880 BOOK VALUE 752616975 TRINITY MOTHER FRANCES HEALTH SYSTE 1315 DOCTORS DRIVE TYLER TX 75701 501(C)(3) false false false false FORM 990, PAGE 1, BOX C MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER OPERATES UNDER THE FOLLOWING NAMES: LOUIS & PEACHES OWEN HEART HOSPITAL MOTHER FRANCES HOSPITAL OUTPATIENT SURGERY CENTER FLIGHT FOR LIFE TRINITY MOTHER FRANCES ENDOSCOPY CENTER Tyler Square Ambulatory Services Center CHRISTUS MOTHER FRANCES HOSPITAL CHRISTUS MOTHER FRANCES HOSPITAL - TYLER CHRISTUS MOTHER FRANCES HOSPITAL - SOUTH TYLER CHRISTUS TRINITY MOTHER FRANCES ENDOSCOPY CENTER FORM 990, PART VI, LINE 6 Members or stockholders CHRISTUS TRINITY MOTHER FRANCES HEALTH SYSTEM IS THE SOLE MEMBER OF MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER. FORM 990, PART VI, LINE 7A Power to elect or appoint members THE SOLE MEMBER, CHRISTUS TRINITY MOTHER FRANCES HEALTH SYSTEM, HAS THE POWER TO APPOINT ALL DIRECTORS AND THEIR SUCCESSORS TO THE GOVERNING BOARD. FORM 990, PART VI, LINE 7B Decisions reserved to members or stockholders THE MEMBER HAS THE RIGHT TO APPROVE OR DISAPPROVE CERTAIN ACTIONS THAT HAVE BEEN PREVIOUSLY APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B Process used to review the Form 990 THE FORM 990 IS PREPARED AND REVIEWED BY THE ORGANIZATION'S EXTERNAL INDEPENDENT ACCOUNTANTS. THE CHRISTUS HEALTH ACCOUNTING DEPARTMENT WORKS WITH AN EXTERNAL ACCOUNTING FIRM IN PREPARATION AND REVIEW OF THE FORM 990. THE FILING ORGANIZATION'S 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 OF 2018 VIA EITHER MEETING, CONFERENCE CALL, OR WEB PORTAL POLLING TOOL BY THE RESPECTIVE CHRISTUS ORGANIZATION'S BOARD, BASED ON A SET OF SUGGESTED REVIEW PROCESSES DEVELOPED BY CHRISTUS HEALTH. FORM 990, PART VI, SECTION B, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICT OF INTEREST 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. FORM 990, PART VI, LINES 15A & 15B Process for determining compensation THE ORGANIZATION USES COMPENSATION CONSULTANTS AND NATIONAL COMPENSATION SURVEYS TO DETERMINE COMPENSATION OF EMPLOYEES. COMPENSATION IS APPROVED BY THE ORGANIZATION'S GOVERNING BODY. THE MOST RECENT REVIEW OF OFFICER COMPENSATION WAS CONDUCTED IN 2016 BY LAURA LOCKHART, CTMFHS DIRECTOR OF TOTAL REWARDS, AND CANDY LAND, CTMFHS COMPENSATION ANALYST. ALL REVIEWS ARE DOCUMENTED IN THE MARKET ADJUSTMENT FILES. FORM 990, PART VI, QUESTION 18 PUBLIC DISCLOSURE OF 1023 AND FORMS 990 & 990-T 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 ORGANIZATION LISTED IN THE ANNUAL OFFICIAL CATHOLIC DIRECTORY. CHRISTUS HEALTH'S 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. FORM 990, PART VI, SECTION C, LINE 19 AVAIL OF GOVERNING DOCS, CONFLICT OF INTEREST POLICY AND FIN STMTS 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. Form 990, Part XI, Line 9 Other changes in net assets: Change in pension liability $27,201,965 Net Assets Released from restrictions $1,152,199 Miscellaneous $1,208 Transfer to Affiliate ($347,243,880) _______________ Total ($318,888,508) MOTHER FRANCES HOSPITAL-WINNSBORO 1315 DOCTORS DRIVE TYLER TX 75701 752771569 HOSPITAL TX 501(C)(3) 3 CTMFHS true CHRISTUS-TRINITY MOTHER FRANCES FDN 1315 DOCTORS DRIVE TYLER TX 75701 752028241 SUPPORT TX 501(C)(3) 12, TYPE I CTMFHS true REGIONAL MEDICAL SERVICES ASSOCIATION 1315 DOCTORS DRIVE TYLER TX 75701 752511459 HEALTHCARE TX 501(C)(3) 3 MFH REG true CHRISTUS TRINITY MF HEALTH SYSTEM 1315 DOCTORS DRIVE TYLER TX 75701 752616975 SUPPORT TX 501(C)(3) 12, TYPE II CH false TRINITY CLINIC 1315 DOCTORS DRIVE TYLER TX 75701 752616977 HEALTHCARE TX 501(C)(3) 3 CTMFHS true MOTHER FRANCES HOSPITAL - JACKSONVILLE 1315 DOCTORS DRIVE TYLER TX 75701 751976930 HOSPITAL TX 501(C)(3) 3 CTMFHS true ALIGNED PROVIDERS OF EAST TEXAS 1315 DOCTORS DRIVE TYLER TX 75701 465720165 HEALTHCARE TX 501(C)(3) 3 MFH REG true CSFN MISSION AND MINISTRY INC 4001 GRANT AVENUE PHILADELPHIA PA 19114 205728802 SPONSORSHIP PA 501(C)(3) 1 NA false CHRISTUS HEALTH 919 HIDDEN RIDGE DRIVE IRVING TX 75038 760590551 SPT HLTH SVCS TX 501(C)(3) 10 NA false TYLER RADIATION EQUIP LEASING LLC 10101 WOODLOCH FOREST DRIVE THE WOODLANDS TX 77380 262554738 EQUIPMENT LEASING TX MFH REG UNRELATED 289787 304846 false 289787 false 0.51000 TRINCARE INC 1315 DOCTORS DRIVE TYLER TX 75701 752161369 RETAIL HEALTH SVC TX CTMFHS C-CORPORATION true HEALTHPLAN OF TEXAS INC 1315 DOCTORS DRIVE TYLER TX 75701 752636832 THIRD PARTY ADMIN TX CTMFHS C-CORPORATION true THE REGIONAL HEALTHCARE ALLIANCE 1315 DOCTORS DRIVE TYLER TX 75701 752484109 PREFER PROVIDER TX CTMFHS C-CORPORATION true TEXAS HEALTH FACILITY INSUR CORP LTD PO BOX 1109 BWI CJ CJ 980136025 INSURANCE CJ MFH REG C-CORPORATION 152 135824 1.00000 true true true true false false false false false false false false true true false true true true true false CH WILKINSON PHYSICIAN NETWORK L 4467285 ACCRUAL CHRISTUS HOPKINS HEALTH ALLIANCE B 1020000 ACCRUAL CHRISTUS-TRINITY MOTHER FRANCES FOUNDATION C 170940 ACCRUAL