2017-02-08T08:05:54-06:00 2016-06-30 721396621 CARR RIGGS & INGRAM LLC TWO RIVERWAY FLOOR 15 HOUSTON TX 77056 990 2015-07-01 760500960 HMH PHYSICIAN ORGANIZATION HMHP 9362913411 110 MEMORIAL HOSPITAL DRIVE HUNTSVILLE TX 77340 SHANNON BROWN CEO PRESIDENT 9364352230 2017-02-08 1 DAVID DONNELLY P00956426 7136218090 2017-02-03 2015 2021-01-29 14:40:06Z SHANNON L BROWN 110 MEMORIAL HOSPITAL DRIVE HUNTSVILLE TX 77340 3185721 0 X N/A X 1994 TX SEE SCHEDULE OALLOWS PATIENTS TO REMAIN IN THE HUNTSVILLE COMMUNITY TO RECEIVE TREATMENT AND FOLLOW UP FOR MEDICAL CONDITIONS WHICH GREATLY IMPROVES WALKER COUNTY HOSPITAL CORP'S ABILITY TO PROVIDE MEDICAL SERVICES. 5 1 44 5 0 0 3304 983 2416853 3121425 0 0 53416 63313 2473573 3185721 0 0 0 0 3107445 5077929 0 0 0 1523480 2089404 4630925 7167333 -2157352 -3981612 1543522 1651578 3655044 584168 -2111522 1067410 X SEE SCHEDULE OHMH PHYSICIANS ORGANIZATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY TO CARRY OUT ANY AND ALL OF THE FOLLOWING PURPOSES: (A) THE CARRYING OUT OF SCIENTIFIC RESEARCH AND RESEARCH PROJECTS IN THE PUBLIC INTEREST IN THE FIELDS OF MEDICAL SCIENCES, MEDICAL ECONOMICS, PUBLIC HEALTH, SOCIOLOGY AND RELATED FIELDS; (B) THE SUPPORTING OF MEDICAL EDUCATION IN MEDICAL SCHOOLS THROUGH GRANTS AND SCHOLARSHIPS; (C)THE IMPROVING AND DEVELOPING OF THE CAPABILITIES OF INDIVIDUALS AND INSTITUTIONS STUDYING, TEACHING AND PRACTICING MEDICINE; (D) THE DELIVERY OF HEALTH CARE TO THE PUBLIC; (E) THE ENGAGING IN THE INSTRUCTION OF THE GENERAL PUBLIC IN THE AREAS OF MEDICAL SCIENCE, PUBLIC HEATH, AND HYGIENE AND RELATED INSTRUCTION USEFUL TO THE INDIVIDUAL AND BENEFICIAL TO THE COMMUNITY; AND (F) OTHER ACTIVITIES USEFUL OR APPROPRIATE TO THE ACCOMPLISHMENT OF THE FOREGOING PURPOSES. 0 0 1556 5267 THE ORGANIZATION EXPANDED IN 2014 WITH THE ADDITION OF A NEUROLOGIST, RHEUMATOLOGIST AND WOUND CARE PHYSICIANS. INCREASED PATIENT VOLUME FOR NEPHROLOGY, RHEUMATOLOGY AND WOUND CARE SERVICES HAVE ALLOWED HUNTSVILLE MEMORIAL HOSPITAL TO NOW OFFER INPATIENT ACUTE DIALYSIS SERVICES. THIS ADDITION OF SERVICES FURTHER DECREASED THE AMOUNT OF PATIENT TRANSFERS FOR THOSE PATIENTS WITH CHRONIC ILLNESSES WHO ALSO REQUIRED DIALYSIS SERVICES WHILE IN A HOSPITAL SETTING. THE ORGANIZATION ADDED AN OB/GYN IN NOVEMBER OF 2015. A NEW CLINIC WAS ALSO OPENED IN WILLIS AND LIVINGSTON IN 2015. INPATIENT VISITS 2,435, OFFICE VISITS 20,434. 6939397 3116077 THE ORGANIZATION EXPANDED IN 2011 WITH THE ADDITION OF TWO ORTHOPEDIC SURGEONS. THE ADDITION OF THE ORTHOPEDICS AND PHYSICIAN ASSISTANT HAS ALLOWED HUNTSVILLE MEMORIAL HOSPITAL TO INCREASE SPORTS MEDICINE SERVICES AVAILABLE TO THE COMMUNITY. THROUGH THEIR INVOLVEMENT, THE HOSPITAL HAS INCREASED THEIR PRESENCE IN VARIOUS COMMUNITIES FOR ATHLETIC TRAINING SERVICES AND NOW SERVES AS THE OFFICIAL HEALTHCARE PROVIDER FOR BEARKAT ATHLETICS THROUGH SAM HOUSTON STATE UNIVERSITY. INPATIENT VISITS 126, OFFICE VISITS 4,769. 39 81 THE ORGANIZATION PROVIDES OTHER VALUABLE HEALTH SERVICES FOR THE COMMUNITY. 6940992 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 57 0 1 44 1 0 0 0 0 0 0 0 0 0 0 X 5 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X SHANNON L BROWN 9364352230 110 MEMORIAL HOSPITAL DRIVE HUNTSVILLE TX 77340 DALTON D HEATH MD DIRECTOR/CHAIRMAN 40.00 X X 547613 0 35408 NHU T BRUCE MD PHYSICIAN/BOARD 40.00 X 411272 0 33817 DAVE KHURANA MD PHYSICIAN/BOARD 1.00 X 0 0 0 LAWRENCE BOYLE MD PHYSICIAN/BOARD 40.00 1.00 X 258469 0 15757 TEMITOPE EKWO MD PHYSICIAN/BOARD 40.00 1.00 X 116761 0 4665 SHANNON BROWN PRESIDENT/CEO 1.00 40.00 X 0 475456 15125 ANDREA HARRIS SECRETARY 40.00 X 67825 0 25775 JESSE WARD PHYSICIAN 40.00 X 517412 0 31739 ANIL WARRIER MD PHYSICIAN 40.00 X 320862 0 24352 ELIDA CERVANTES MD PHYSICIAN 40.00 X 171109 0 10664 MELISSA TUCK-WHITE MD PHYSICIAN 40.00 X 199813 0 19486 JOHN TANKSLEY MD PHYSICIAN 40.00 X 166678 0 8679 2777814 475456 225467 9 0 1 0 GENZYME CORPORATION 55 CAMBRIDGE PARKWAY CAMBRIDGE MA 02142 MEDICAL SUPPLIES 150451 MEDICAL OFFICE PARK - HUNTSVILLE LP 100 MEDICAL CENTER BLVD SUITE 200 CONROE TX 77304 BUILDING LEASE 110081 2 983 983 OUTPATIENT REVENUE 621990 3121425 3121425 3121425 59281 0 59281 59281 59281 OTHER REVENUE 900099 4032 4032 4032 3185721 3121425 0 63313 4443134 4372243 70891 50097 49298 799 341777 336324 5453 242921 239045 3876 90681 90681 1324 1275 49 427907 412176 15731 526922 507551 19371 16323 15723 600 75207 75207 91998 90445 1553 PURCHASED SERVICES 540166 461706 78460 OTHER FEES 147327 122487 24840 PHYSICIAN RECRUITMENT 67177 64707 2470 DUES AND SUBSCRIPTIONS 37768 37041 727 66604 65083 1521 7167333 6940992 226341 0 68242 101852 460505 650319 9418 14460 1006567 137200 999784 869367 5573 15580 1543522 1651578 407372 584168 3247672 0 3655044 584168 X -2111522 1067410 -2111522 1067410 1543522 1651578 X -3981612 7160544 X 0 1 X 1 0 X 908578 1052984 1893810 3304 983 3859659 1854648 1535475 2669416 2416853 3121425 11597817 2763226 2588459 4563226 2420157 3122408 15457476 1889475 1889475 880700 1026388 1907088 880700 1026388 1889475 3796563 11660913 24462 50942 54566 53025 59281 242276 24462 50942 54566 53025 59281 242276 150 432 7026 391 4032 12031 2787838 2639833 4624818 2473573 3185721 15711783 0.74220 0.68690 0.01540 0.01340 X 717102 58273 658829 255433 67760 187673 34032 11167 22865 869367 3185721 0 3185721 0 3185721 7167333 0 7167333 0 7167333 X X X X X 0 0 0 0 0 0 0 0 0 DALTON D HEATH MD DIRECTOR/CHAIRMAN 428083 0 119530 0 0 0 7311 0 28097 0 583021 0 0 0 NHU T BRUCE MD PHYSICIAN/BOARD 289559 0 121713 0 0 0 8287 0 25530 0 445089 0 0 0 LAWRENCE BOYLE MD PHYSICIAN/BOARD 258469 0 0 0 0 0 5096 0 10661 0 274226 0 0 0 SHANNON BROWN PRESIDENT/CEO 0 365966 0 109490 0 0 0 8121 0 7004 0 490581 0 0 JESSE WARD PHYSICIAN 427674 0 89738 0 0 0 9701 0 22038 0 549151 0 0 0 ANIL WARRIER MD PHYSICIAN 274095 0 46767 0 0 0 3332 0 21020 0 345214 0 0 0 ELIDA CERVANTES MD PHYSICIAN 171109 0 0 0 0 0 4039 0 6625 0 181773 0 0 0 MELISSA TUCK-WHITE MD PHYSICIAN 199813 0 0 0 0 0 3846 0 15640 0 219299 0 0 0 JOHN TANKSLEY MD PHYSICIAN 166678 0 0 0 0 0 3281 0 5398 0 175357 0 0 0 FORM 990, PART V, LINE 3A THE TAXPAYER HAS DETERMINED IN GOOD FAITH THAT THE TAXPAYER DOES NOT HAVE ANY ACTIVITIES GENERATING UNRELATED BUSINESS TAXABLE INCOME (AS DEFINED IN IRC 152 (A)) IN THE CURRENT YEAR. THEREFORE, THE TAXPAYER IS NOT REQUIRED TO FILE ANY RETURN OTHER THAN FORM 990. FORM 990, PART VI, SECTION A, LINE 6 WALKER COUNTY HOSPITAL DBA HUNTSVILLE MEMORIAL HOSPITAL IS THE SOLE MEMBER OF THE HMH PHYSICIANS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A WALKER COUNTY HOSPITAL CORPORATION DBA HUNTSVILLE MEMORIAL HOSPITAL AS THE SOLE MEMBER MAY APPROVE OR REMOVE AT ANY TIME ANY TRUSTEE FROM THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B WALKER COUNTY HOSPITAL CORPORATION DBA HUNTSVILLE MEMORIAL HOSPITAL AS THE SOLE MEMBER HAS THE POWER TO ALTER, AMEND OR REPEAL THE ARTICLES OF INCORPORATION, AND BYLAWS. THE FOLLOWING MATTERS SHALL REQUIRE THE APPROVAL OF THE MEMBER FOLLOWING CONSULTATION WITH THE BOARD OF TRUSTEES: - ANNUAL OPERATING AND CAPITAL BUDGETS; - MATERIAL ($500) DEVIATIONS FROM ANNUAL OPERATIONS AND CAPITAL BUDGETS; - THE PURCHASE OR ACQUISITION OF ANY PROPERTY, REAL, PERSONAL, OR MIXED, BY THE CORPORATION EXCEEDING $500; - THE SALE, GIFT OR OTHER DISPOSITION OF ANY PROPERTY, REAL, PERSONAL, OR MIXED, BY THE CORPORATION EXCEEDING $500; - THE MORTGAGE OR OTHER ENCUMBRANCE OF ANY PROPERTY, REAL, PERSONAL, OR MIXED BY THE CORPORATION EXCEEDING $500; - THE MERGER, ACQUISITION, LIQUIDATION, DISSOLUTION OR CONSOLIDATION OF THE CORPORATION; - THE CREATION OF OR INVESTMENT IN ANY SUBSIDIARY ENTITY; - THE SETTLEMENT OF CLAIMS OR LITIGATION; AND - THE APPROVAL AND ADOPTION OF THE SALARIES, COMPENSATION AND OTHER BENEFITS TO BE PAID TO PHYSICIANS EMPLOYED BY THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 THE DETAILED REVIEW OF THE FORM 990 IS CONDUCTED BY THE ORGANIZATION FOLLOWING THE PREPARATION AND REVIEW OF THE RETURN BY THE ORGANIZATION'S PAID PREPARER. AN ELECTRONIC COPY OF THE FINAL FORM 990 IS EMAILED TO EACH BOARD MEMBER PRIOR TO THE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS OF ITS PARENT, WALKER COUNTY HOSPITAL CORPORATION DBA HUNTSVILLE MEMORIAL HOSPITAL, WHICH REQUIRES ALL OFFICERS, DIRECTORS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES AND OTHER MANAGEMENT OFFICIALS ("COVERED PERSONS") TO DISCLOSE POTENTIAL CONFLICTS PURSUANT TO THE POLICY, A DISCLOSURE STATEMENT IS CIRCULATED ANNUALLY TO COVERED PERSONS IN WHICH THE INDIVIDUAL MUST DISCLOSE TRANSACTIONS THAT MAY RESULT IN A CONFLICT. COVERED PERSONS ARE ALSO ENCOURAGED TO NOTIFY THE BOARD, APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICE, GENERAL COUNSEL, OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. WHEN NECESSARY, THE BOARD CHAIR OR APPROPRIATE BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON(S) OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND RECOMMEND ALTERNATIVES TO THE APPLICABLE TRANSACTION OF ARRANGEMENT OR OTHERWISE DETERMINE IF THE CONFLICT CAN BE RESOLVED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE MAKES THE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. ANY MEMBER OF THE BOARD OPERATING UNDER A CONFLICT IS NOT PERMITTED TO BE PRESENT OR OTHERWISE PARTICIPATE IN THE VOTE ON ANY MATTER TO WHICH THE CONFLICT RELATES. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND AFTER INVESTIGATION THE BOARD OR COMMITTEE DETERMINES THAT THE COVERED PERSON FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE ORGANIZATION TAKES APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION, WHICH MAY INCLUDE TERMINATION OF THE INDIVIDUAL'S MEMBERSHIP, EMPLOYMENT, OR CONTRACT. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION FOLLOWS THE COMPENSATION POLICY OF WALKER COUNTY HOSPITAL CORPORATION DBA HUNTSVILLE MEMORIAL HOSPITAL, ITS SOLE MEMBER. HMH ALSO UTILIZES SALARY REVIEWS AND SURVEYS FOR COMPARISON WHEN DETERMINING COMPENSATION OF HIGHLY COMPENSATED EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE AT ITS ADMINISTRATION OFFICE UPON REQUEST. FORM 990, PART XI, LINE 9: INTERNAL TRANSFER FROM HUNTSVILLE MEMORIAL HOSPITAL 7,160,544. WALKER COUNTY HOSPITAL CORPORATION PO BOX 4001 HUNTSVILLE TX 77342 203069241 HOSPITAL TX 501(C)(3) LINE 3 N/A 0 HUNTSVILLE HEART & VASCULAR CENTER LLC (CLOSED FEBRUARY 15 2016) 110 MEMORIAL HOSPITAL DRIVE HUNTSVILLE TX 77340 463408635 HEALTHCARE TX N/A N/A 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 SCHEDULE R, PART V, LINE 1C HMH PHYSICIAN ORGANIZATION IS 100% OWNED BY HUNTSVILLE MEMORIAL HOSPITAL ( HEREINAFTER REFERRED TO AS " THE HOSPITAL") AND IS A CONTROLLED ENTITY OF THE HOSPITAL. DURING THE TAX YEAR ENDED 6.30.2016, THE HOSPITAL RECLASSIFIED $7,160,544 NET INTERCOMPANY TRANSACTION BALANCES, WHICH INCLUDED $3,247,672 BALANCES FROM THE YEAR ENDED 6.30.2015 AND THE REMAINING FROM THE YEAR ENDED 6.30.2016, TO THE FUND BALANCE TRANSFERS FROM THE HOSPITAL TO HMH PHYSICIAN ORGANIZATION FOR THE BOOK PURPOSES. ALL THE AFOREMENTIONED INTERCOMPANY TRANSACTIONS WERE TO FURTHER THE EXEMPT FUNCTIONS OF BOTH THE HOSPITAL AND HMH PHYSICIAN ORGANIZATION.