2017-11-15T08:59:01-06:00 2016-12-31 BKD LLP 14241 DALLAS PARKWAY STE 1100 DALLAS TX 75254 990 2016-01-01 452230827 Swisher Memorial Healthcare System % LUKE BREWER SWIS 8069953581 PO Box 808 Tulia TX 79088 RYAN BARNARD CEO 9727028262 2017-11-15 true Jeanette Verrelli P00742631 9727028262 167.68.126.162 70234720173195000000 2017-11-15 P 1A2413E04CDF926160306216DBAC6B7CCB48C9D2 ACBA2431EF37DEF71821A9057AFD5F2E9C389335 2016 2021-01-29 14:40:06Z RYAN BARNARD 539 SE SECOND STREET TULIA TX 79088 9914371 false X WWW.SWISHERHOSPITAL.COM X 2011 TX TO PROVIDE QUALITY HEALTHCARE TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. 4 4 97 4 0 0 1000 98504 10489904 9617275 3500 78910 127320 119682 10621724 9914371 11536 12004 0 0 4211343 4212771 0 0 0 5347452 5115235 9570331 9340010 1051393 574361 6164371 4966715 2870632 1098615 3293739 3868100 TO PROVIDE QUALITY HEALTHCARE TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. false false 7423495 12004 9669430 PROVIDED ACCESSIBLE AND QUALITY HEALTHCARE SERVICES TO THE CITIZENS OF SWISHER COUNTY AND THE SURROUNDING AREAS. THE HOSPITAL HAD 22,162 ENCOUNTERS - 13,931 CLINIC, 2,026 ER, 207 INPATIENT, 5,859 OUTPATIENT, 93 SWINGBED, 40 OBSERVATION, 6 RESPIT CARE; 0 SURGERIES;650 INPATIENT DAYS; 1,136 SWINGBED DAYS IN 2016, SWISHER MEMORIAL OPENED UP A MEDICAL ADVICE LINE THAT IS AVAILABLE 24/7 TO OUR PATIENTS AND COMMUNITY. SMHS HOSTED ITS 2ND ANNUAL COMMUNITY WIDE HEALTH FAIR. THE HEALTH FAIR INCLUDED HEALTH EDUCATION, SCREENINGS, INFLUENZA, AND MORE. 7423495 true true false true false false false false false false true false false false true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false true 27 0 97 true false false false false false false false false false false X 4 4 false false false false false false false true false false false true true true true true true true true false X LUKE BREWER 8069958268 539 SE SECOND STREET TULIA TX 79088 X Jory Runnels President 1.0 0.0 X X 0 0 0 Ray De Los Santos Vice - President 1.0 0.0 X X 0 0 0 CHARLOTTE O'DANIEL SECRETARY 1.0 0.0 X X 0 0 0 SCOT BLAKEMAN DO DIRECTOR 1.0 0.0 X 0 0 0 Ryan Barnard CEO 40.0 0.0 X 273339 0 24101 Luke Brewer CFO 40.0 0.0 X 125925 0 13224 Cynthia Archer Physician's Assistant 40.0 0.0 X 228729 0 17775 Scott Dyer Physical Therapist 40.0 0.0 X 163630 0 20903 Kelly Maxwell CNO 40.0 0.0 X 144575 0 28377 936198 0 104380 5 false true false BKD 14241 DALLAS PKWY STE 1100 DALLAS TX 75254 AUDIT/TAX SERVICES 113238 CERNER CORPORATION 2800 ROCKCREEK PKWY KANSAS CITY KS 64117 EHR SERVICES 273308 COMFORT AIR SOLUTIONS 116 S MAXWELL TULIA TX 79088 REPAIR SERVICES 147419 3 98504 98504 Net Patient Service Revenue 621110 8569757 8569757 Incentive Revenue 900099 535944 535944 PHARMACY 446110 511574 511574 9617275 78910 78910 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 GUEST & EMPLOYEE MEALS 624100 64925 64925 Vending Machines 722515 2602 2602 MEDICAL RECORDS REVENUE 561000 2867 2867 49288 49288 119682 9914371 9669430 146437 12004 12004 0 0 0 436589 327369 109220 0 2648694 1986038 662656 122511 91883 30628 726184 544638 181546 278793 219872 58921 0 5542 5542 113238 113238 0 0 0 627092 330591 296501 34225 4973 29252 299184 173752 125432 272130 257110 15020 0 1108474 1068533 39941 50539 5846 44693 0 22354 8677 13677 29559 22169 7390 0 526191 394643 131548 70087 52565 17522 BAD DEBT EXPENSE 930413 930413 MEDICAL SUPPLIES 916792 916792 EQUIPMENT RENTAL 32511 29723 2788 REPAIRS & MAINTENANCE 20471 3835 16636 56433 42069 14364 9340010 7423495 1916515 0 1174831 1069337 0 0 0 0 1229461 1425712 0 0 0 0 5000 5000 232790 216524 99153 56167 3491630 1495066 2084359 1996564 0 0 0 0 0 0 0 0 1338777 197411 6164371 4966715 651919 492178 0 0 0 0 0 0 0 0 0 0 116476 161162 0 0 2102237 445275 2870632 1098615 X 3293739 3868100 0 0 0 0 3293739 3868100 6164371 4966715 574361 X false true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2525 2525 false SCHEDULE C, PART II-B, LINE 1I OTHER ACTIVITIES: Dues Paid % Lobbying Lobbying THA $2,364 22.00% $520 AHA $5,992 21.78% $1,305 TORCH $2,800 25.00% $700 ---------------------------------------------------- Total $11,156 $2,525 346553 45252 301301 2571362 1087138 1484224 573715 362676 211039 1996564 0 DUE TO HOSPITAL DISTRICT 328989 Due to 3rd Party payer 116286 445275 11352722 2368764 -930413 1438351 9914371 9914371 10778361 2368764 2368764 8409597 930413 930413 9340010 SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. Schedule D, Part XI, Line 2D RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: Bad Debt Expense $(930,413) Schedule D, Part XII, Line 4B Reconciliation of expense per audited financial statements with return: Bad Debt Expense $930,413 true true X true X true X true true true false true true 514615 514615 0.06120 764347 1059925 163962 163962 0.01950 1442924 1059925 678577 0.08070 111432 111432 0.01330 12004 12004 0.00140 123436 123436 0.01470 1566360 1059925 802013 0.09540 true 930413 4757413 3325807 1431606 X true true 1 1 SWISHER MEMORIAL HEALTHCARE SYSTEM 539 SE SECOND STREET TULIA TX 79088 WWW.SWISHERHOSPITAL.COM 100122 X X X 1 SWISHER MEMORIAL HEALTHCARE SYSTEM 1 false false true X X X X X X X X X 14 true false false true X SEE PART V, SECTION C X true 14 true See Part V, SEction C false true X 100 300. X X X true true 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 true X false false SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY: THE HOSPITAL COMPLETED INTERVIEWS AND FOCUS GROUPS WITH REPRESENTATIVES FROM VARIOUS AREAS OF THE COMMUNITY INCLUDING: BUSINESS LEADERS, HISPANIC COMMUNITY, ELECTED CITY OFFICIALS, HOSPITAL AUXILIARY EMPLOYEES, COMMUNITY VOLUNTEERS, THE CHAMBER OF COMMERCE, SCHOOL SUPERINTENDENTS AND SCHOOL NURSES, PUBLIC HEALTH NURSE FROM TEXAS DEPARTMENT OF STATE HEALTH SERVICES, AND BOARD MEMBERS OF THE DISTRICT. ADDITIONAL INTERVIEWS WITH THE HOSPITAL DIRECTORS, THE CEO AND THE CFO WERE CONDUCTED AS WELL. SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS IDENTIFIED IN CHNA: THE STRATEGY TO ADDRESS THE NEEDS IDENTIFIED IS INCLUDED IN THE CHNA WHICH IS POSTED ON THE HOSPITAL'S WEBSITE. THE HOSPITAL COMPLETED THE COMMUNITY HEALTH NEEDS ASSESSMENT IN OCTOBER 2014. IN THE 2014 CHNA, THE HOSPITAL IDENTIFIED FOUR NEEDS OF THE COMMUNITY: - AVAILABILITY OF LOCAL SPECIALISTS - CHRONIC DISEASE MANAGEMENT - COMMUNITY EDUCATION ON CHRONIC DISEASE, NUTRITION, AND HEALTHY LIFESTYLES - MARKETING OF THE HOSPITAL ALL NEEDS IDENTIFIED IN THE CHNA ARE BEING ADDRESSED BY THE HOSPITAL. SWISHER MEMORIAL HEALTHCARE SYSTEM HAS PARTNERED WITH COVENANT HEALTH PLAINVIEW TO PROVIDE SPECIALTY SERVICES MONTHLY IN OUR CLINIC INCLUDING A CARDIOLOGIST, OBSTETRICIAN, ORTHOPEDIST AND PODIATRIST. BEGINNING FEBRUARY 2017 SWISHER MEMORIAL WILL HAVE A CHIROPRACTOR COMING WEEKLY TO AIDE IN CHRONIC DISEASE MANAGEMENT. THE HOSPITAL EXPANDED OUTPATIENT INFUSION SERVICES TO OFFER A WIDE VARIETY OF NEEDS THE COMMUNITY WOULD OTHERWISE HAVE TO TRAVEL FOR. THE HOSPITAL IS IN THE PROCESS OF SEARCHING FOR FUNDING FOR A NEW ASSISTED LIVING FACILITY THAT WILL BE A 12-SUITE RESIDENCE WITH A LARGE COMMON ROOM AND KITCHEN. WE HAVE DRAWINGS AND BLUEPRINTS FOR THE NEW ASSISTED LIVING CENTER. WE ALSO HAVE BLUEPRINTS FOR AN INDOOR THERAPY POOL FOR PHYSICAL THERAPY AND FOR OUR WELLNESS MEMBERS TO EXPAND OUR EXISTING WELLNESS CENTER. SINCE THE CHNA IN OCTOBER 2014, SWISHER MEMORIAL HEALTHCARE SYSTEM HAS HOSTED COMMUNITY WIDE HEALTH FAIRS AND HAD GREAT PARTICIPATION FROM THE COMMUNITY. THE HEALTH FAIRS EACH BROUGHT IN OVER 30 BOOTHS AND OVER 100 COMMUNITY MEMBERS IN ATTENDANCE. WE HAD A WIDE RANGE OF BOOTHS FROM A DIETICIAN, TO RESOURCES FOR A FREE MEDICAL ADVICE LINE PROVIDED BY THE HOSPITAL, ADMINISTERED INFLUENZA VACCINATIONS, PROVIDED A BOOTH FOR SAFE MEDICATION DISPOSAL AND MUCH MORE. WE HAVE ALSO HAD HOSPITAL STAFF SPEAK AT LOCAL CHURCHES, GROUPS AND CIVIC ORGANIZATION MEETINGS OVER EXPANDED AND NEW SERVICES AVAILABLE TO THE COMMUNITY. SWISHER MEMORIAL HEALTHCARE SYSTEM HAS EXPANDED ITS MARKETING AREA BY EXPANDING TO THE USE OF SOCIAL MEDIA WITH A FACE BOOK PAGE WHERE INFORMATION IS POSTED AND SHARED REGARDING SERVICES AVAILABLE, RESOURCES AND HAPPENINGS AT SMHS. THE FACE BOOK PAGE HOSTS A WEEKLY SPOTLIGHT ON A MEDICAL PROVIDER AND/OR DEPARTMENT DIRECTOR AND KEEPS THE COMMUNITY UP TO DATE ON UPCOMING EVENTS. SWISHER HOSPITAL IS UTILIZING THE LOCAL NEWSPAPER FOR ADVERTISING AND EDUCATING THE COMMUNITY, AS WELL AS, IN A LOCAL E-NEWSLETTER. SMHS PROMOTED ITS MEDICAL ADVICE LINE WITH A BILLBOARD ADVERTISEMENT ON THE EDGE OF TOWN. Schedule H, Part V, Section B, Line 7a & 10 CHNA & Implementation Strategy MADE AVAILABLE: THE HOSPITAL'S MOST RECENT CHNA and implementation strategy CAN BE FOUND AT THE FOLLOWING WEBSITE: http://www.swisherhospital.com/getpage.php?name=Community_Health_Needs_Ass essment&sub=Community+Health+Needs+Assessment. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16C Availability of Financial Assistance Information: The Hospital's financial assistance policy, application and plain language summary can be found at the following site: http://www.swisherhospital.com/getpage.php?name=Financial_Assistance&sub=F inancial+Assistance SCHEDULE H, PART V, SECTION B Compliance with 501r: Swisher Memorial Healthcare System identified a couple areas where it was not yet fully compliant with the final 501r regulations. The hospital realized the most recent implementation strategy was not on the hospitals website. Once this was identified, the hospital uploaded the document on November 8, 2017. The hospital also identified that the financial assistance policy was not compliant with the final 501r regulations. Swisher engaged an outside accounting firm to consult on the billing and collections language needed to be added to the policy to meet the requirements of the final 501r regulations. The updated policy was uploaded to the website on November 8, 2017. Finally, the financial assistance application and plain language summary were not on the website in a downloadable format. Swisher maintained good faith by having the policy on the website and showing information about the availability of financial assistance on the face of the web page. The hospital uploaded the plain language summary and application to the website on November 8, 2017. Swisher Memorial Healthcare System personnel are working diligently to maintain compliance and will correct any additional failures to comply as they are identified. Top management will monitor the website quarterly to confirm the hospital continues to stay compliant with the widely publicized requirements under 501r. 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 EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE POLICY: THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. BAD DEBT EXPENSE SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE THIS IS UNCOMPENSATED HEALTHCARE PROVIDED TO RESIDENTS OF THE COMMUNITY. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT FOOTNOTE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE SYSTEM'S ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOR SELF-PAY PATIENTS WAS APPROXIMATELY 96% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2016 AND 93% AT DECEMBER 31, 2015. THE SYSTEM'S WRITE-OFFS WERE APPROXIMATELY $1,295,000 AND $890,000 FOR THE YEARS ENDED DECEMBER 31, 2016 AND 2015, RESPECTIVELY. THE INCREASE IN WRITE-OFFS IS A RESULT OF NEGATIVE TRENDS EXPERIENCED IN COLLECTIONS OF AMOUNTS FROM SELF-PAY PATIENTS IN 2015 WITH ACTUAL WRITE-OFFS OCCURRING IN 2016 FOLLOWING THE CONVERSION TO THE NEW FINANCIAL REPORTING SYSTEM. SCHEDULE H, PART III, SECTION B, 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. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION PRACTICES: ONCE A PATIENT HAS QUALIFIED FOR OUR INDIGENT PROGRAM, NO ADDITIONAL COLLECTION EFFORTS ARE MADE ON THAT ACCOUNT. THERE ARE DIFFERENT LEVELS OF CHARITY THAT WE AWARD, MOST OF THE TIME 90%, AND WE DO TRY TO COLLECT ON THE REMAINING 10%. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: SWISHER MEMORIAL HEALTHCARE SYSTEM UTILIZES HCAHPS SURVEYS TO MEASURE THE PATIENTS' PERSPECTIVES AND SATISFACTION REGARDING HOSPITAL CARE. IN ADDITION, THE SYSTEM IS ACTIVE IN ALL OF ITS COMMUNITY SERVICE ORGANIZATIONS. THE CEO ATTENDS THESE SERVICE CLUB MEETINGS TO INVITE PATIENTS, THEIR FAMILIES, AND LOCAL CITIZENS TO SHARE THEIR CONCERNS ABOUT THE COMMUNITY'S NEEDS WITH THE ORGANIZATION. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY CAN BE FOUND ON THE SYSTEM'S WEBSITE IN BOTH ENGLISH AND SPANISH AND DISCUSSED AT SERVICE ORGANIZATION MEETINGS IN OUR COMMUNITY. IT IS ALSO SHARED WITH VARIOUS GOVERNMENT AGENCIES SUCH AS HEALTH AND HUMAN SERVICES. FINALLY, ALL UNINSURED PATIENTS WHO ARE SEEN IN THE SYSTEM'S CLINIC OR EMERGENCY DEPARTMENT ARE REFERRED TO OUR PATIENT ADVOCATE WHO INVESTIGATES ALL POTENTIAL SOURCES OF ASSISTANCE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: SWISHER MEMORIAL HEALTHCARE SYSTEM SERVES ALL OF SWISHER COUNTY, TX AS WELL AS SOUTHERN RANDALL COUNTY, WESTERN BRISCOE COUNTY, AND EASTERN CASTRO COUNTY. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: OUR HOSPITAL CEO MEETS WITH LOCAL AND COUNTY GOVERNMENT OFTEN TO DISCUSS ANY ACTIONS THE SYSTEM AND/OR DISTRICT MAY BE ABLE TO PARTICIPATE IN, PERFORM, OFFER, OR ENCOURAGE WITHIN OUR COMMUNITY. ALSO, OUR QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT/DISASTER PREPAREDNESS DIRECTOR AND EMS DIRECTOR ARE ACTIVE WITH THE REGIONAL ADVISORY COUNCIL AND OTHER COMMUNITY-PREPAREDNESS ACTIVITIES. WE STAY ABREAST TO SITUATIONS WITHIN OUR SCHOOL DISTRICT WITH UPDATING PROVIDED BY THE REGISTERED SCHOOL NURSE, WHO IS ALSO AN ACTIVE DISTRICT AND FOUNDATION BOARD MEMBER. OUR CLINIC OFFERS AN INFLUENZA VACCINATION CLINIC YEARLY, FOR A FLAT FEE, WITH THE OPTION TO BILL MEDICARE FOR MEDICARE PATIENTS. WE CONTINUE TO PROVIDE A MEDICAL ADVICE LINE TO OUR PATIENTS FREE OF CHARGE THROUGH THE 1115 WAIVER. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: ALTHOUGH THERE IS NOT A CONTROL OF GOVERNANCE, SWISHER MEMORIAL HEALTHCARE SYSTEM AND SWISHER MEMORIAL HOSPITAL DISTRICT DO COOPERATE IN PROVIDING HEALTH CARE TO THE COMMUNITY. AS HIGHLIGHTED IN THE SCHEDULE H, PART VI - PROMOTION OF COMMUNITY HEALTH, BOTH ENTITIES PARTICIPATE IN VARIOUS PROGRAMS AND CLINICS TO FURTHER THE HEALTH OF SWISHER COUNTY. SWISHER MEMORIAL HOSPITAL DISTRICT OPERATES A TRAINED AND CERTIFIED AMBULATORY UNIT TO THE WHOLE POPULATION OF SWISHER COUNTY. SWISHER MEMORIAL HEALTHCARE SYSTEM OFFERS A LEVEL 4 EMERGENCY DEPARTMENT, CRITICAL ACCESS HOSPITAL WITH TWENTY BEDS, AND TULIA RURAL HEALTH CLINIC THAT SERVICES THE MAJORITY OF SWISHER COUNTY. THE DISTRICT AND THE SYSTEM WORK TOGETHER COHESIVELY IN PROVIDING EXCELLENT CARE TO ALL PATIENTS THAT UTILIZE OUR SERVICES. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: TEXAS Schedule H, Part I, Line 3C FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING OTHER CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: - MEDICAL INDIGENCY - INSURANCE STATUS - UNDERINSURANCE STATUS SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: BAD DEBT EXPENSE OF $930,413 WAS INCLUDED IN TOTAL EXPENSE ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSE IN COLUMN (F). X X X false false false false false false false true false Ryan Barnard CEO 174198 0 73998 0 25143 0 0 0 24101 0 297440 0 Cynthia Archer Physician's Assistant 228286 0 443 0 0 11618 0 6157 0 246504 0 Scott Dyer Physical Therapist 151283 0 3087 0 9260 0 7969 0 12934 0 184533 0 Kelly Maxwell CNO 118498 0 19800 0 6277 0 6291 0 22086 0 172952 0 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: A PERCENTAGE OF INCENTIVE COMPENSATION REPORTED BY THE INDIVIDUALS LISTED ON PART VII, SECTION A IS CONTINGENT ON MEETING THE ANNUAL BUDGET. FORM 990, PART VI, SECTION A, LINE 8B DOCUMENTATION OF COMMITTEES ACTING ON BEHALF OF THE GOVERNING BODY: ANY ACTIONS OF THE COMMITTEES (MEDICAL STAFF, QAPI, NURSING) THAT ARE PART OF THE SYSTEM'S OPERATION ARE REPORTED BY THE CNO/CEO AT QUARTERLY BOARD MEETINGS. THERE ARE NO COMMITTEES OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE ORGANIZATION'S CEO AND CFO REVIEW THE RETURN PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: BOARD MEMBERS ARE POLLED ANNUALLY TO DETERMINE IF/WHERE CONFLICTS MAY OCCUR. DEBBIE GARZA OF THE HR DEPARMENT MONITORS COMPLIANCE, AND IF A MEMBER HAS A POSSIBLE CONFLICT THEY ABSTAIN FROM VOTING ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION REVIEW: ALL KEY POSITIONS ARE EVALUATED IN COMPARISON TO THE TORCH ANNUAL SURVEY OF HOSPITAL SALARIES AND OTHER SOURCES. EVALUATIONS ARE CONDUCTED EACH YEAR ON COMPENSATION. ONCE THEY HAVE BEEN REVIEWED, WE TAKE IT TO THE BOARD FOR FURTHER REVIEW AND APPROVAL. THIS IS USUALLY DONE IN OCTOBER AND PRESENTED TO THE BOARD AT THE OCTOBER BOARD MEETING. ALL OF THE COMPENSATION APPROVAL IS DOCUMENTED IN THE BOARD MEETING MINUTES. THE COMPENSATION REVIEW FOR 2016 WAS DONE IN 2015. THE HOSPITAL CEO CONDUCTED THE REVIEW FOR EMPLOYEES OF THE HOSPITAL AND PRESENTED TO THE HOSPITAL BOARD. THE HOSPITAL BOARD CONDUCTED THE REVIEW FOR THE HOSPITAL CEO. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST AT THE ORGANIZATION'S OFFICE.