2017-07-10T10:35:56-05:00 2016-08-31 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2015-09-01 752660403 HENDRICK PROVIDER NETWORK % JEREMY WALKER HEND 3256702000 PO BOX 3117 ABILENE TX 79604 JEREMY WALKER CFO 7134994600 2017-06-15 true Amanda Maya P01067777 7134994600 2015 2021-01-29 14:40:06Z TIM LANCASTER 1242 N 19TH ST ABILENE TX 79604 32128561 false X WWW.EHENDRICK.ORG X 1995 TX TO PROVIDE MEDICAL CARE TO THE COMMUNITY OF ABILENE AND SURROUNDING AREAS. MANY PATIENTS ARE ON MEDICAID. SERVICES ARE PROVIDED REGARDLESS OF ABILITY TO PAY. 6 0 390 0 0 0 0 0 26914964 31409824 -5654 -43315 1323568 718521 28232878 32085030 0 0 0 0 34942860 40717644 0 0 0 9995027 11484047 44937887 52201691 -16705009 -20116661 17447468 18243720 16545540 15892172 901928 2351548 TO PROVIDE MEDICAL CARE TO THE COMMUNITY OF ABILENE AND SURROUNDING AREAS. MANY PATIENTS ARE ON MEDICAID. SERVICES ARE PROVIDED TO PROMOTE BEST HEALTH PRACTICES REGARDLESS OF ABILITY TO PAY. false false 47286392 31275922 HENDRICK PROVIDER NETWORK OPERATES A PRENATAL CLINIC AND ALSO PROVIDES WOMEN'S HEALTH SERVICES, ONCOLOGY, CARDIOLOGY, CARDIOVASCULAR, FAMILY MEDICINE, RHEUMATOLOGY, PLASTIC SURGERY, GENERAL SURGERY, NEUROLOGY, ENDOCRINOLOGY, UROLOGY, OPHTHALMOLOGY, SLEEP MEDICINE AND INTERNAL MEDICINE SERVICES FOR PATIENTS IN THE ABILENE AND SURROUNDING AREA, MANY OF WHOM ARE UNINSURED OR ARE ON MEDICAID. THESE SERVICES ARE PROVIDED BY PHYSICIANS EMPLOYED BY THE COMPANY. 902 HENDRICK PROVIDER NETWORK SUBLEASES THE BUILDING FOR THE ABILENE BRANCH OF TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER SCHOOL OF NURSING AND SCHOOL OF PHARMACY. 47286392 true false false true false false false false false false true false false true false true false true false false false false false false false false false false false true false false false false false false false false false false false false true true true false false false true 31 0 true 390 true false false false false false false false false false false X 6 0 false false false false true true true true true false false true true true true true true true false false X JEREMY WALKER 3256702000 1900 PINE STREET ABILENE TX 79601 X Whitney Mascorro DIRECTOR 40.0 0.0 X 763655 0 33505 Min Gao director 40.0 2.0 X 615301 0 42210 Henry Fosah DIRECTOR 40.0 2.0 X 388715 0 28525 Jose Vega director 40.0 2.0 X 395678 0 31109 Ren Zhang director 40.0 0.0 X 638973 0 11700 Larry Lin DIRECTOR 40.0 0.0 X 683079 0 38241 Rhett Lohman chair 40.0 2.0 X X 454865 0 38065 Tim Lancaster PRESIDENT 2.0 44.0 X 0 900598 109298 Joe Pearson VICE PRESIDENT 2.0 45.0 X 0 377680 71700 David Stephenson ASST VP 38.0 4.0 X 174683 0 37367 Jeremy Walker VICE CHAIRMAN/CFO 2.0 44.0 X 0 250991 39690 Harvinder Arora PHYSICIAN 40.0 0.0 X 1244888 0 25976 Joji Varghese PHYSICIAN 40.0 0.0 X 1108005 0 34813 Nageswari Daggubati PHYSICIAN 40.0 0.0 X 782307 0 17419 David Carlson PHYSICIAN 40.0 0.0 X 982319 0 30966 Scott Crocker Physician 40.0 0.0 X 914203 0 41764 9146671 1529269 632348 55 false true false TEXAS TECH UNIVERSITY HEALTH SCIENC 3601 4TH STREET STOP 6225 LUBBOCK TX 79424 UROLOGY SERVICES 866667 ALLSCRIPTS HEALTHCARE LLC 26430 NETWORK PLACE CHICAGO IL 606731246 SOFTWARE SUPPORT 313361 ZIRMED INC 1311 SOLUTIONS CENTER CHICAGO IL 606771311 ACH SVC/SOFTWARE SUP 165569 HAYES MANAGEMENT CONSULTING 1320 CENTRE STREET SUITE 402 NEWTON CENTER MA 02459 CONSULTING SERVICES 137716 4 0 NET PATIENT FEES 621500 31275922 31275922 RELATED NMTC RENTAL REVENUE 531120 133902 133902 31409824 216 216 0 0 1659 1659 0 1659 1659 43531 -43531 -43531 -43531 0 0 0 MISCELLANEOUS REVENUE 900099 716862 716862 716862 32085030 31411483 673547 0 0 0 0 4375670 4044901 330769 0 32295068 30027293 2267775 544041 486339 57702 1998697 1639307 359390 1504168 1295464 208704 89893 89893 91903 47465 44438 18252 18252 0 0 0 1370680 512716 857964 0 183521 152765 30756 444518 310496 134022 716720 700488 16232 0 1850903 1736118 114785 48298 41616 6682 0 0 0 0 552675 348157 204518 342352 270237 72115 BAD DEBT EXPENSE 4108919 4108919 MEDICAL SUPPLIES 860398 860398 MINOR EQUIPMENT 217925 186501 31424 DUES & SUBSCRIPTIONS 139057 128456 10601 448033 298863 149170 52201691 47286392 4915299 0 2525 3075 89908 118543 0 0 2163878 2627437 0 0 0 0 0 0 462345 560033 136276 334315 4579277 2873668 1562871 1705609 0 0 0 0 0 0 0 0 13029665 12894708 17447468 18243720 3665540 3012172 0 0 0 0 0 0 0 0 0 0 12880000 12880000 0 0 0 0 16545540 15892172 X 901928 2351548 0 0 0 0 901928 2351548 17447468 18243720 X -20116661 21566281 X false true X true false X 0 0 0 0 0 0 13263041 16458805 22172927 26914964 31411483 110221220 0 0 0 13263041 16458805 22172927 26914964 31411483 110221220 0 0 0 110221220 1811 1191 1404 134875 139281 0 1811 1191 1404 134875 139281 0 45912 363139 522353 1322164 716862 2970430 13310764 16821944 22696471 28238532 32263220 113330931 0.97256 0.97438 0.00123 0.00008 X false false false false false true 14000 false false false 14000 false PART II-B, QUESTION 1F Amount reported in Part II-B, Question 1F represents portion of dues paid to trade associations that is attributable to lobbying activities. 14667 4483 10184 38478 23728 14750 4458536 2845457 1613079 67596 67596 1705609 OTHER ASSET 215466 DUE FROM HMC 12261450 NMTC RESERVE 417792 12894708 0 0 X 27886642 -4108919 -4108919 31995561 89469 89469 32085030 48003524 -89248 -89248 48092772 4108919 4108919 52201691 SCHEDULE D, PART X, LINE 2 FIN 48 FINANCIAL STATEMENTS FOOTNOTE IN ACCORDANCE WITH ASC 740-10 FASB INTERPRETATION (FIN 48), ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, MANAGEMENT EVALUATED HENDRICK'S TAX POSITIONS AND CONCLUDED THAT HENDRICK HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRED ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. WITH A FEW EXCEPTIONS, HENDRICK IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2013. SCHEDULE D, PART XI, LINES 2D & 4B RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 REVENUE ON BOOKS, NOT ON RETURN: BAD DEBT EXPENSE IN AUDIT REVENUE (4,108,919) ------------ (4,108,919) REVENUE ON RETURN, NOT ON BOOKS: RENT INCOME INCLUDED IN AUDIT EXPENSE 133,000 LOSS ON ASSET DISPOSAL IN AUDIT EXPENSE (43,531) --------- 89,469 SCHEDULE D, PART XII, LINES 2D & 4B RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS TO FORM 990 EXPENSE ON BOOKS, NOT ON RETURN: RENT INCOME INCLUDED IN AUDIT EXPENSE (133,000) LOSS ON ASSET DISPOSAL IN AUDIT EXPENSE 43,531 OTHER DIFFERENCES 221 ---------- (89,248) EXPENSE ON RETURN, NOT ON BOOKS: BAD DEBT EXPENSE IN AUDIT REVENUE 4,108,919 ----------- 4,108,919 X X X X X false true false false false false false false false Whitney Mascorro DIRECTOR 432842 0 312254 0 18559 0 7950 0 25555 0 797160 0 0 0 Tim Lancaster PRESIDENT 0 681236 0 60357 0 159005 0 93019 0 16279 0 1009896 0 120828 Min Gao director 501628 0 93803 0 19870 0 7950 0 34260 0 657511 0 0 0 Henry Fosah DIRECTOR 200045 0 188402 0 268 0 5987 0 22538 0 417240 0 0 0 Jose Vega director 351202 0 43952 0 524 0 7950 0 23159 0 426787 0 0 0 Ren Zhang director 468722 0 151534 0 18717 0 7950 0 3750 0 650673 0 0 0 Harvinder Arora PHYSICIAN 541729 0 684636 0 18523 0 7950 0 18026 0 1270864 0 0 0 Larry Lin DIRECTOR 480787 0 183451 0 18841 0 7950 0 30291 0 721320 0 0 0 Joji Varghese PHYSICIAN 511434 0 576449 0 20122 0 6497 0 28316 0 1142818 0 0 0 Rhett Lohman chair 446860 0 7500 0 505 0 7950 0 30115 0 492930 0 0 0 Joe Pearson VICE PRESIDENT 0 287981 0 23372 0 66327 0 52864 0 18836 0 449380 0 44599 David Stephenson ASST VP 148466 0 9841 0 16376 0 14993 0 22374 0 212050 0 15245 0 Jeremy Walker VICE CHAIRMAN/CFO 0 204048 0 19667 0 27276 0 22399 0 17291 0 290681 0 10947 Nageswari Daggubati PHYSICIAN 608707 0 166478 0 7122 0 7950 0 9469 0 799726 0 0 0 David Carlson PHYSICIAN 650666 0 327952 0 3701 0 7950 0 23016 0 1013285 0 0 0 Scott Crocker Physician 640788 0 269714 0 3701 0 7950 0 33814 0 955967 0 0 0 PART I, QUESTION 4B PARTICIPATION IN OR PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPANTS IN 457(F) REPORTED W-2 DEFERRED COMP. PAID BY ---------------------- ------------ -------------- ------- TIM LANCASTER 120,828 85,069 HMC JEREMY WALKER 10,947 15,734 HMC JOE PEARSON 44,599 44,914 HMC DAVID STEPHENSON 15,245 10,376 HPN FORM 990, PART VI, SECTION A, LINE 6 DESCRIBE THE CLASSES OF MEMBERS OR STOCKHOLDERS: HENDRICK MEDICAL CENTER IS THE SOLE MEMBER OF HENDRICK PROVIDER NETWORK. FORM 990, PART VI, SECTION A, LINE 7A PERSONS WHO MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY: THE MEMBER, HENDRICK MEDICAL CENTER, SHALL ELECT THE SUCCESSORS OF THE INITIAL DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY OTHER PERSONS: ARTICLE VII OF THE RESTATED ARTICLES OF INCORPORATION PROVIDES, IN PART, THAT AN AMENDMENT TO ARTICLE II RELATING TO THE PURPOSE OF THE CORPORATION AND ARTICLE VI RELATING TO THE NUMBER AND METHOD OF THE ELECTION OR APPOINTMENT OF THE BOARD OF TRUSTEES SHALL OCCUR ONLY WITH THE CONSENT OF THE BAPTIST GENERAL CONVENTION OF TEXAS OR ITS EXECUTIVE BOARD. FORM 990, PART VI, SECTION B, LINE 11B DESCRIBE REVIEW PROCESS OF FORM 990: THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C DESCRIBE THE ORGANIZATION'S PRACTICE FOR MONITORING COMPLIANCE WITH POLICY: THE ORGANIZATION CONDUCTS, AT A MINIMUM, ANNUAL REVIEWS OF THE POSSIBLE CONFLICTS OF INTEREST AND OTHER FINANCIAL RELATIONSHIPS IDENTIFIED UNDER THIS CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15A PROCESS FOR DETERMINING COMPENSATION OF CEO, DIRECTORS, OR TOP OFFICIALS: A COMPREHENSIVE REVIEW OF COMPENSATION IS CONDUCTED BY AN INDEPENDENT PARTY AT LEAST EVERY THREE YEARS. THIS REPORT PRESENTS THE RESULTS OF THE ANALYSIS OF SALARY, INCENTIVE, TOTAL CASH COMPENSATION (SALARY PLUS INCENTIVE), BENEFITS, AND TOTAL COMPENSATION (TOTAL CASH AND BENEFITS). INTEGRATED HEALTHCARE STRATEGIES (IHS) WORKS WITH THE PERSONNEL COMMITTEE TO FORMALLY DEFINE AN EXECUTIVE TOTAL COMPENSATION PHILOSOPHY. HENDRICK HEALTH SYSTEM'S CURRENT PHILOSOPHY IS TO USE RANGES BUILT AROUND THE MEDIAN OF THE MARKET WITH A 50% SPREAD FROM MINIMUM TO MAXIMUM. INCENTIVE OPPORTUNITY LEVELS ARE COMPETITIVE WITH PRACTICES OF PEER GROUPS AND BENEFITS WILL BE DELIVERED AT MARKET COMPETITIVE LEVELS. SEVERANCE AND PERQUISITES REFLECT A CONSERVATIVE PHILOSOPHY. THE COMMITTEE DETERMINED THAT THE PEER GROUP WOULD BE PRIMARILY REGIONAL NOT-FOR-PROFIT HOSPITALS OF SIMILAR SIZE AND COMPLEXITY. NATIONAL PEER GROUP WILL BE USED FOR REFERENCE PURPOSES WHERE APPROPRIATE. THE HENDRICK HEALTH SYSTEM PERSONNEL COMMITTEE IS DELEGATED THE RESPONSIBILITY FOR THE EXECUTIVE COMPENSATION PROGRAM BY THE BOARD OF TRUSTEES. THE COMMITTEE: SETS THE OVERALL EXECUTIVE COMPENSATION PHILOSOPHY TO BE IMPLEMENTED BY HENDRICK HEALTH SYSTEM; SETS COMPENSATION COMPONENTS FOR THE PRESIDENT & CEO; REVIEWS, DISCUSSES AND MAKES DECISIONS BASED ON THE PRESIDENT & CEO'S RECOMMENDATIONS FOR HIS DIRECT REPORTS; REPORTS A SUMMARY OF THE PROCESS BACK TO THE BOARD OF TRUSTEES ALONG WITH THE ACTUAL COMPENSATION APPROVED FOR THE PRESIDENT AND CEO; AND APPROVES ALL INCENTIVE GOALS AND AWARDS. FORM 990, PART VI, SECTION C, LINE 19 DESCRIBE WHETHER THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE TO PUBLIC: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: EQUITY CONTRIBUTIONS $21,566,281 HPN RO BILLING SERVICES LLC 1900 PINE ST ABILENE TX 79601 813892121 BILLING SRVCS TX 0 0 HPN HPN PHYSICIAN BILLING LLC 1900 PINE ST ABILENE TX 79601 815158335 BILLING SRVCS TX 0 0 HPN HENDRICK MEDICAL CENTER PO BOX 3117 ABILENE TX 79604 750827446 HOSPITAL TX 501(C)(3) 3 NA false HENDRICK ANESTHESIA NETWORK PO BOX 3117 ABILENE TX 79604 752728889 ANESTHESIA TX 501(C)(3) 9 HMC true HENDRICK MEDICAL CENTER FOUNDATION PO BOX 3117 ABILENE TX 79604 237413284 FUNDRAISING TX 501(C)(3) 11A HMC true HENDRICK HEALTH NETWORK PO BOX 3117 ABILENE TX 79604 721619011 HEALTH INSURA TX HMC C-CORPORATION 0 0 true false false false false false false false false false false true false false false false false false false false