2017-08-15T20:30:19-05:00 2016-09-30 BKD LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2015-10-01 750974351 Harrison County Hospital Association % NIKKI BENOIT HARR 9039276703 811 South Washington Ave Marshall TX 75670 MICHAEL CHEEK CFO 9039276703 2017-08-15 true Jeanette Verrelli P00742631 9727028262 2015 2021-01-29 14:40:06Z Good Shepherd Medical Center - Marsh RUSS COLLIER 811 SOUTH WASHINGTON AVE MARSHALL TX 75670 110533896 false X WWW.GSMCMARSHALL.ORG/ X 1954 TX TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION REGARDLESS OF RACE, SEX, CREED, NATIONAL ORIGIN, HANDICAP, (SEE SCHEDULE O)... 15 12 581 75 109487 0 0 92097973 109635284 27603 119899 710610 715605 92836186 110470788 225000 2788568 0 0 26870360 28184977 0 0 62596 62668290 76341652 89763650 107315197 3072536 3155591 36863188 39838169 41520670 41282557 -4657482 -1444388 X TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION REGARDLESS OF RACE, SEX, CREED, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. false false 95075412 2788568 109635284 GOOD SHEPHERD MEDICAL CENTER - MARSHALL EXISTS TO IDENTIFY AND DELIVER QUALITY HEALTHCARE SERVICES IN A SAFE & CARING ENVIRONMENT TO THE PEOPLE OF THIS REGION. GOOD SHEPHERD MEDICAL CENTER - MARSHALL IS A NON-FOR-PROFIT FACILITY LOCATED NORTHEAST TEXAS, APPROXIMATELY 150 MILES EAST OF DALLAS, TEXAS AND 35 MILES WEST OF SHREVEPORT, LOUISIANA. GOOD SHEPHERD MEDICAL CENTER - MARSHALL IS THE ONLY HOSPITAL LOCATED IN HARRISON AND MARION COUNTIES. ESTABLISHED IN 1954 BY SEVERAL HARRISON COUNTY PHYSICIANS, GOOD SHEPHERD MEDICAL CENTER - MARSHALL HAS GROWN TO A 149 BED FACILITY WITH AN INTENSIVE CARE UNIT AND A 24-HOUR LEVEL III TRAUMA CENTER. GOOD SHEPHERD MEDICAL CENTER - MARSHALL IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION FOR HEALTHCARE ORGANIZATIONS. 95075412 true false false true false false false false false false true true false true true false false false false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true true false false true 86 0 581 true false false false false false false false false false false X 15 12 false false false false true true true true true false false false true true true true true true true true false X NIKKI BENOIT 9033155177 700 E MARSHALL AVE LONGVIEW TX 75601 X CHASE PALMER BOARD TREASURER 1.0 0.0 X X 0 0 0 DEAN SEARLE BOARD SECRETARY 1.0 0.0 X X 0 0 0 R BLAIR ABNEY BOARD CHAIRMAN 1.0 0.0 X X 0 0 0 RUSSELL J COLLIER PRESIDENT/CEO 40.0 1.0 X X 0 315969 48178 STEVE ALTMILLER GSHS PRESIDENT/CEO 1.0 50.0 X X 0 650200 87557 LUIS BALBUENA MD MEDICAL STAFF REP TO BOARD 1.0 40.0 X X 0 444707 24732 ALBERTO SUMMERHALDERS MEDICAL STAFF VP 1.0 0.0 X X 0 0 0 JEFF BEATY MEDICAL STAFF PRESIDENT 1.0 0.0 X X 0 0 0 ALLEN STAGGERS DIRECTOR 1.0 0.0 X 0 0 0 BUCK BIRDSONG DESIGNATED SYSTEM REP 1.0 0.0 X 0 0 0 GEORGE MEISENHEIMER DIRECTOR 1.0 0.0 X 0 0 0 JULIE SIMMONS DIRECTOR 1.0 0.0 X 0 0 0 LEROY FISHER DIRECTOR 1.0 0.0 X 0 0 0 TED HUFFHINES BOARD VICE CHAIRMAN 1.0 0.0 X X 0 0 0 MITTIE HUTCHINS DIRECTOR 1.0 0.0 X 0 0 0 TIM PILEGGI INTERIM CFO 1.0 50.0 X 0 583683 0 OLUWOLE O PETERS PHARMICIST 40.0 0.0 X 144923 0 3914 THOMAS SMOLENSKI PHYSICIAN 40.0 0.0 X 167663 0 3679 JOYCE EGLI CHARGE NURSE 40.0 0.0 X 166607 0 12387 REMONA WATSON CHARGE NURSE 40.0 0.0 X 140086 0 6059 KEITH KIRBOW CHIEF NURSING OFFICER 40.0 0.0 X 148760 0 31297 RICKY PAUL FORMER PRES OF MEDICAL STAFF 0.0 40.0 X 0 556806 28866 JOHN MCDONALD DO FORMER MEDICAL STAFF 0.0 40.0 X 0 217294 13917 VALARIE ALLMAN MD FORMER VP MEDICAL STAFF 0.0 40.0 X 0 303415 22454 RAY DELK FORMER VP OPERATIONS 0.0 40.0 X 0 231767 37289 768039 3303841 320329 16 true true false MORRIS AND DICKSON CO LLC PO BOX 51367 SHREVEPORT LA 71135 PHARMACY MANAGEMENT 2291532 MEDEFIS INC 10826 OLD MILL RD SUITE 101 OMAHA NE 68154 MEDICAL SERVICES 515088 ALLEGIANCE HEALTH MANAGEMENT INC 504 TEXAS STREET SHREVEPORT LA 71101 MENTAL HEALTH 464725 EAST TEXAS PULMONARY ASSOCIATES 703 E MARSHALL AVE SUITE 3008 LONGVIEW TX 75601 MEDICAL SERVICES 334000 NUMED INC PO BOX 1098 DENTON TX 76202 MEDICAL SERVICES 264542 17 0 Net Patient Revenues 621110 99488976 99488976 Government Funds - 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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 true X false X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 REPRESENTATIVES FROM THE COMMUNITY: HARRISON COUNTY HOSPITAL ASSOCIATION (DBA, GOOD SHEPHERD MEDICAL CENTER - MARSHALL) RECEIVED INPUT FROM REPRESENTATIVES OF THE COMMUNITY WHICH INCLUDES THE FOLLOWING INDIVIDUALS WITH; A) SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH B) AFFILIATION WITH LOCAL GOVERNMENT, SCHOOL AND INDUSTRY C) INVOLVEMENT WITH UNDERSERVED AND MINORITY POPULATIONS. ALL INTERVIEWS WERE CONDUCTED USING A STANDARD QUESTIONAIRE DEVELOPED BY BKD, LLP, A NATIONAL CPA FIRM THAT PROVIDES TAX AND OTHER ADVISORY SERVICES. THE FOLLOWING INDIVIDUALS PARTICIPATED IN OUR KEY INFORMANT QUESTIONAIRE PROCESS: GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR OF EMERGENCY SERVICES - LONGVIEW GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR GOOD SHEPHERD MEDICAL ASSOCIATES, GASTROENTEROLOGIST GOOD SHEPHERD MEDICAL CENTER, PHARMACY DIRECTOR GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF REIMBURSEMENT GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR - MEDICAL/SURGICAL GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR OF PATIENT ACCESS GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR OF INFECTION CONTROL GOOD SHEPHERD HEALTH SYSTEM, CHIEF INFORMATION OFFICER GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF EMERGENCY SERVICES (KILGORE) GOOD SHEPHERD HEALTH SYSTEM, EDUCATIONAL SERVICES DIRECTOR GOOD SHEPHERD HEALTH SYSTEM, EMPLOYEE HEALTH DIRECTOR LONGVIEW CITY COUNCILMAN, DISTRICT 5 GOOD SHEPHERD MEDICAL ASSOCIATES, FAMILY NURSE PRACTITIONER GOOD SHEPHERD HEALTH SYSTEM, PHYSICIAN SERVICES DIRECTOR GOOD SHEPHERD MEDICAL CENTER, INTERNAL MEDICINE RESIDENCY PROGRAM DIRECTOR GREGG COUNTY HEALTH DEPARTMENT AIR LIFETEAM AIRE RESCUE GOOD SHEPHERD HEALTH SYSTEM, VICE PRESIDENT OF HUMAN RESOURCES COMMUNITY HEALTHCORE, EXECUTIVE DIRECTOR CITY OF LONGIVEW, FIRE CHIEF GOOD SHEPHERD MEDICAL CENTER, IMAGING SERVICES DIRECTOR GOOD SHEPHERD MEDICAL CENTER, LAB SUPERVISOR GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR OF MARKETING COMMUNITY HEALTHCORE, EMPLOYEE RUSK COUNTY HEALTH DISTRICT GOOD SHEPHERD MEDICAL CENTER, PHYSICIAN DIRECTOR OF EMERGENCY SERVICES GOOD SHEPHERD MEDICAL CENTER, INPATIENT REHAB SERVICES DIRECTOR GOOD SHEPHERD MEDICAL ASSOCIATES, PHYSICIAN DIRECTOR - INTERNAL MEDICINE CLINIC GOOD SHEPHERD MEDICAL ASSOCIATES, NURSE PRACTITIONER LONGVIEW CITY COUNCIL WOMAN, DISTRICT 3 GOOD SHEPHERD MEDICAL CENTER, VICE PRESIDENT - ANCILLARY SERVICES (MARSHALL) GOOD SHEPHERD MEDICAL CENTER, CHIEF NURSING OFFICER (MARSHALL) LONGVIEW CHAMBER OF COMMERCE, CHIEF EXECUTIVE OFFICER MARSHALL/HARRISON COUNTY HEALTH DISTRICT, EMPLOYEE GOOD SHEPHERD MEDICAL ASSOCIATES, PHYSICIAN LONGVIEW CITY COUNCIL WOMAN, DISTRICT 4 GOOD SHEPHERD MEDICAL ASSOCIATES, EXECUTIVE VICE PRESIDENT/COO GOOD SHEPHERD MEDICAL CENTER, COMPLIANCE SPECIALIST - QUALITY GOOD SHEPHERD HEALTH SYSTEM, EXECUTIVE DIRECTOR - HEALTH & PREVENTION COMMUNITY HEALTHCORE, EMPLOYEE GOOD SHEPHERD MEDICAL CENTER, CHIEF NURSING OFFICER (LONGVIEW) GOOD SHEPHERD MEDICAL CENTER, MEDICAL DIRECTOR - SURGICAL SERVICES COMMUNITY HEALTHCORE, EMPLOYEE GOOD SHEPHERD HEALTH SYSTEM, PATIENT EXPERIENCE DIRECTOR GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR - ORTHO/NEURO UNIT GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR - ONCOLOGY UNIT GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR - ANTEPARTUM/MOTHER-BABY UNIT HARRISON COUNTY UNITED WAY GOOD SHEPHERD HEALTH SYSTEM, SENIOR VICE PRESIDENT - INTEGRATION & BUSINESS DEVELOPMENT CUMBERLAND PRESBYTERIAN CHURCH OF MARSHALL, REVEREND COMMUNITY HEALTHCORE, EMPLOYEE GOOD SHEPHERD MEDICAL ASSOCIATES, PEDIATRICIAN GOOD SHEPHERD MEDICAL ASSOCIATES, CLINIC DIRECTOR OF OPERATIONS (PRIMARY CARE) GOOD SHEPHERD MEDICAL ASSOCIATES, GASTROENTEROLOGIST GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF EMERGENCY SERVICES (NORTHPARK) GOOD SHEPHERD MEDICAL CENTER, EMERGENCY MEDICINE PHYSICIAN GOOD SHEPHERD MEDICAL ASSOCIATES, CLINIC DIRECTOR OF OPERATIONS (SPECIALTY CARE) GOOD SHEPHERD MEDICAL CENTER, CLINICAL DIRECTOR - LABOR & DELIVERY PINE TREE SCHOOL DISTRICT, SUPERINTENDENT GOOD SHEPHERD HEALTH SYSTEM, CHIEF FINANCIAL OFFICER GOOD SHEPHERD HEALTH SYSTEM, DIRECTOR - GOVERNMENT & COMMUNITY RELATIONS GOOD SHEPHERD MEDICAL CENTER, DIRECTOR OF EMERGENCY SERVICES (LONGVIEW) RUSK COUNTY UNITED WAY GOOD SHEPHERD MEDICAL ASSOCIATES, PEDIATRICIAN THE FOLLOWING COMMUNITY NEEDS WERE IDENTIFIED: 1) LACK OF MENTAL HEALTH PROVIDERS/SERVICES 2) OBESITY, DIABETES, HEART DISEASE AND OTHER CHRONIC DISEASES 3) AFFORDABLE PRIMARY AND PREVENTATIVE CARE OPTIONS 4) UNEMPLOYMENT AND DECREASE IN INCOME IN THE COMMUNITY DUE TO ECONOMIC DOWNTURN 5) HEALTHY BEHAVIORS/LIFESTYLE CHOICES 6) SUBSTANCE ABUSE 7) LACK OF HEALTH KNOWLEDGE/EDUCATION 8) LACK OF COMMUNITY RESOURCES TO PROMOTE HEALTH (FACILITIES, OUTDOOR SPACES) 9) POOR NUTRITION/LIMITED ACCESS TO HEALTHY FOOD OPTIONS 10) UNINSURED/LIMITED INSURANCE DUE TO LACK OF MEDICAID EXPANSION OR HIGH DEDUCTIBLE PLANS 11) ADULT SMOKING/TOBACCO USE 12) CRIME AND VIOLENCE SCHEDULE H, PART V, SECTION B, LINE 22D DETERMINATION OF AMOUNTS BILLED: THE FINANCIAL ASSISTANCE ELIGIBILITY DISCOUNT GUIDELINES IN PLACE DURING TAX YEAR 2015 STATED, "ALL UNINSURED PATIENTS WHO QUALIFY FOR LESS THAN 68% FINANCIAL ASSISTANCE AND COMPLETE THE NECESSARY APPLICATION PROCESS, WILL RECEIVE THE DISCOUNT UNDER THE UNINSURED ADJUSTMENT. THIS AMOUNT IS BASED ON AN AVERAGE OF GSHS MANAGED CARE CONTRACTS DEEPEST DISCOUNTS." (BEGINNING IN TAX YEAR 2016, THE HOSPITAL CHANGED TO USING MEDICARE RATES TO CALCULATE MAXIMUM AMOUNTS THAT CAN BE CHARGED.) SCHEDULE H, PART V, SECTION B, LINE 11 IDENTIFIED NEEDS ADDRESSED AND NOT ADDRESSED: IN RESPONSE TO THE RESULTS OF THE 2016 CHNA, THE HOSPITAL'S BOARD OF DIRECTORS AND MANAGEMENT TEAM DEVELOPED A CHNA IMPLEMENTATION PLAN IN ORDER TO PRIORITIZE AND ADDRESS THE MAJOR COMMUNITY NEEDS. IN REGARDS TO THE #1 COMMUNITY NEED IDENTIFIED IN THE CHNA (LACK OF MENTAL HEALTH PROVIDERS/SERVICES), WE TOOK SEVERAL ACTIONS DURING THE TAX YEAR AND PLAN TO CONTINUE BUILDING UPON THESE STEPS IN THE FUTURE. THESE ACTIONS ARE PRIMARILY TO ADDRESS THE ONGOING ISSUE OF TREATING BEHAVIORAL HEALTH PATIENTS IN OUR EMERGENCY DEPARTMENT AND REFERRING THESE PATIENTS TO OTHER PSYCHIATRIC PROVIDERS. OUR GOAL IS TO BOTH IMPROVE CARE AND PROVIDE SERVICES IN A MORE APPROPRIATE TREATMENT SETTING. ACTIONS TAKEN TOWARDS ADDRESSING THE #1 NEED INCLUDED: - ENGAGED A TELE-PSYCHIATRY PROVIDER TO PROVIDE BEHAVIORAL HEALTH SCREENINGS AND EVALUATIONS. - PROVIDED SAMA DE-ESCALATION TRAINING TO HEALP PREVENT PSYCHIATRIC PATIENT AGGRESSION FROM BEING PHYSICALLY HARMFUL. - WORKED WITH COMMUNITY HEALTHCORE, THE REGIONAL MENTAL HEALTH AUTHORITY, TO IMPROVE PSYCHIATRIC PATIENT SCREENING AND DISPOSITION PROCESSES, INCLUDING USE OF TELEMEDICINE. - EVALUATING AND PLANNING FOR REMODELING THE EMERGENCY DEPARTMENT TO INCLUDE PATIENT CARE DESIGNED SPECIFICALLY FOR PSYCHIATRIC PATIENTS. THE AFOREMENTIONED ACTIONS WILL ALSO ADDRESS COMMUNITY NEED #6 (SUBSTANCE ABUSE) AND INDIRECTLY CONTRIBUTE TO A REDUCTION IN NEED #12 (CRIME AND VIOLENCE) DUE TO HIGH CRIME AND VIOLENCE RECIDIVISM OF UNTREATED PSYCHIATRIC AND SUBSTANCE ABUSE PATIENTS. IN REGARDS TO THE REMAINING COMMUNITY NEEDS, THE HOSPITAL WILL CONTINUE TO OFFER A WIDE RANGE OF SERVICES, PROGRAMS, EDUCATION AND TRAINING TO ADDRESS NEED #'S 2,5,7, AND 11. ISSUE #8 IS PARTIALLY ADDRESSED THROUGH THE HOSPITAL FITNESS CENTER FACILITIES AND PROGRAMS. NEED #'S 3 AND 10 ARE ADDRESSED BY SPECIAL IN-HOUSE PROGRAMS TO ASSIST THE UNINSURED, INCLUDING PAYMENT DISCOUNT PROGRAMS, CERTIFIED APPLICATION COUNSELORS TO ASSIST PATIENTS WITH ACCESS TO THE FEDERAL HEALTH INSURANCE MARKETPLACE, CHARITY POLICIES AND REFERRALS TO LOCAL FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS). MORE DETAILS REGARDING OUR CHNA IMPLEMENATION STRATEGY MAY BE FOUND AT WWW.GSMC.ORG/MARSHALL/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. COMMUNITY NEEDS NOT ADDRESSED: AREAS OF NEED NOT SPECIFICALLY ADDRESSED BY THE HOSPITAL INCLUDE NEED #4 (UNEMPLOYMENT AND DECREASE IN INCOME DUE TO ECONOMIC DOWNTURN), #9 (POOR NUTRITION/LIMITED ACCESS TO HEALTHY FOODS) AND DIRECT ACTION TO MEET #12 (CRIME AND VIOLENCE). WHILE MEMBERS OF HOSPITAL MANAGEMENT PARTICIPATE IN LOCAL GROUPS AND COMMITTEES FORMED TO PROMOTE ECONOMIC GROWTH AND JOBS, THE HOSPITAL DOES NOT CHOOSE TO DIRECTLY ADDRESS ECONOMIC MATTERS OF THE COMMUNITY DUE TO OUR FINANCIAL LIMITATIONS. ALSO, WHILE THE HOSPITAL PROVIDES SOME EDUCATION TO PATIENTS REGARDING PROPER DIET, WE DO NOT HAVE THE RESOURCES OR ABILITY TO ENSURE THAT IMPOVERISHED POPULATIONS ENJOY NUTRITIONAL AND VARIED FOOD OPTIONS DELIVERED TO FOOD DESERTS. FINALLY, IT IS NOT CONSIDERED A HOSPITAL ROLE TO CONFRONT RISING CRIME AND VIOLENCE THROUGH DIRECT ENFORCEMENT ACTIONS. SCHEDULE H, PART V, SECTION B, LINES 7 & 10A CHNA & IMPLEMENTATION STRATEGY: THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: WWW.GSMC.ORG/MARSHALL/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 16A, 16B & 16C FAP DOCUMENTS AVAILABLE TO THE PUBLIC: THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: www.gsmc.org/patients-visitors/financial-assistance-2 4 MARSHALL HEALTH CINIC 805 LINDSEY DRIVE MARSHALL TX 75670 HEALTH CLINIC EAST TEXAS PEDIATRICS 618 S GROVE STREET STE 100 MARSHALL TX 75670 HEALTH CLINIC MARSHALL PEDIATRIC CLINIC 707 S GROVE STREET MARSHALL TX 75670 HEALTH CLINIC FIRST IN PEDIATRICS 304 UNIVERSITY SUITE 105 MARSHALL TX 75670 HEALTH CLINIC SCHEDULE H, PART I, LINES 7A & 7B ALLOCATION OF MEDICAID SUPPLEMENTAL PAYMENTS: DURING THE CURRENT REPORTING PERIOD, THE STATE OF TEXAS PARTICIPATED IN A SPECIAL 1115 MEDICAID WAIVER WITH THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). VARIOUS SUPPLEMENTAL PAYMENTS UNDER THE WAIVER ARE INTENDED TO HELP HOSPITALS OFFSET MEDICAID AND UNINSURED LOSSES AND/OR CREATE NEW PROGRAMS DESIGNED TO IMPROVE THE PATIENT CARE EXPERIENCE, ENHANCE HEALTH OUTCOMES AND REDUCE COSTS FOR THESE SAME PATIENT POPULATIONS. SUPPLEMENTAL PAYMENTS ARE CAPPED BY MEDICAID AND UNINSURED LOSSES DETERMINED FROM A SPECIAL UNCOMPENSATED CARE (UC) TOOL DESIGNED BY THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION (HHSC). IN FISCAL YEAR 2016, THE HOSPITAL RECOGNIZED $6,374,714 OF SUPPLEMENTAL PAYMENT INCOME UNDER THE MEDICAID WAIVER. FOR PURPOSES OF IRS FORM 990 SCHEDULE H REPORTING, MEDICAID SUPPLEMENTAL PAYMENTS AND TAX ASSESSMENTS HAVE BEEN ALLOCATED BETWEEN FINACIAL ASSISTANCE (CHARITY), MEDICAID AND BAD DEBT USING RATIOS DERIVED FROM THE UC TOOL AND OTHER INTERNAL DOCUMENTS USED FOR PURPOSES OF PREPARING MEDICARE COST REPORT WORKSHEET S-10 "HOSPITAL UNCOMPENSATED AND INDIGENT CARE DATA". MORE INFORMATION ON THE MEDICAID WAIVER MAY BE FOUND AT HTTP://WWW.HHSC.STATE.TX.US/1115WAIVER-SHTML. SCHEDULE H, PART III, LINE 2 & 3 BAD DEBT EXPENSE: THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24(A) OF $41,145,508 HAS BEEN REDUCED BY ALLOCATED MEDICAID SUPPLEMENTAL PAYMENTS OF $3,353,751. WE DID NOT INCLUDE ANY BAD DEBT AMOUNTS IN COMMUNITY BENEFITS. SCHEDULE H, PART III, LINE 4 BAD DEBT FOOTNOTE: THE INFORMATION IS PROVIDED IN THE ATTACHED AUDITED FINANCIAL STATEMENT ON PAGES 10 AND 11 TITLED "PATIENT ACCOUNTS RECEIVABLE". SCHEDULE H, PART III, LINE 8 COSTING METHODOLOGY: SOURCE OF INFORMATION ON LINE 6 IS THE FYE 09/30/16 MEDICARE COST REPORT. THE SUM OF MEDICARE PART A ALLOWABLE COSTS REPORTED ON WORKSHEET D-1 PART II (FOR BOTH INPATIENT ACUTE PPS AND INPATIENT REHAB FACILITY) AND WORKSHEET DV, COLUMN 9.01 FOR MEDICARE OUTPATIENT PPS SERVICES. SINCE ALLOWABLE COSTS ARE NOT DETERMINED FOR SERVICES RENDERED TO MEDICARE PATIENTS ENROLLED IN MEDICARE ADVANTAGE (MEDICARE PART C) OR FOR PHYSICIAN SERVICES BILLED UNDER MEDICARE PART B, NEITHER THE REVENUES OR COSTS RELATED TO THESE SERVICES HAVE BEEN INCLUDED ON LINES 5 OR 6. MEDICARE ALLOWABLE COSTS WERE DERIVED FROM THE FYE 09/30/16 MEDICARE COST REPORT. THE COST REPORT USES FINANCIAL AND STATISTICAL DATA TO DEVELOP PER DIEMS AND COST TO CHARGE RATIOS THAT ULTIMATELY DETERMINE ALLOWABLE MEDICARE INPATIENT AND OUTPATIENT COSTS. SCHEDULE H, PART III, LINE 9B PROVISIONS ON COLLECTION PRACTICES: ALL PATIENTS WHO ARE UNDERINSURED OR UNINSURED WILL BE EVALUATED FOR GOVERNMENT PROGRAMS, PAYMENT PLANS AND FINANCIAL ASSISTANCE. IF ALL ATTEMPTS FAIL, WE WILL CONSIDER EACH ACCOUNT MEETING CERTAIN CRITERIA FOR FINANCIAL ASSISTANCE. ANY ACCOUNT THAT HAS A BALANCE GREATER THAN $10,000 AND HAS NOT QUALIFIED FOR MEDICAID OR COUNTY CHARITY PROGRAMS WILL BE REVIEWED ON A CASE BY CASE BASIS FOR CHARITY CONSIDERATION. CREDIT REPORTS MAY BE RUN AND SUBMITTED FOR REVIEW. WRITE OFFS WILL BE MONITORED THROUGH A SPECIFIC CODE, TO MONITOR AND EVALUATE, AS NEEDED, FOR CHANGES OR UPDATES. IF AT ANYTIME RECOVERIES OBTAINED AFTER WRITE-OFF, THE CHARITY ADJUSTMENT WILL BE REVERSED AND ADDITIONAL REVIEW OF THE ACCOUNT WILL BE REQUIRED. GOOD SHEPHERD MEDICAL CENTER - MARSHALL DOES NOT CONDUCT, OR PERMIT COLLECTION AGENCIES TO CONDUCT ON ITS BEHALF, EXTRAORDINARY COLLECTION ACTIONS, AGAINST INDIVIDUALS BEFORE REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR THE FINANCIAL ASSISTANCE PROGRAM. IF AT ANY TIME IT IS DETERMINED THAT AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE, ALL COLLECTION ATTEMPTS ARE STOPPED. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: THE BOARD OF DIRECTORS IS A NON-PAID COMMUNITY BASED BOARD WHO REPRESENT A BROAD SPECTRUM OF OUR COMMUNITY. THEY GUIDE THE DIRECTION OF THE ORGANIZATION BASED ON THE INFORMATION THEY RECEIVE FROM THEIR CONSTITUENTS, THE PROGRAM CAPABILITIES OF THE ORGANIZATION, AVAILABILITY OF PHYSICIANS AND THE PERFORMANCE OUTCOMES OF THE ORGANIZATION. IN ADDITION, THE HOSPITAL EXECUTIVES AND MID-LEVEL MANAGERS LIVE AND WORK IN THIS COMMUNITY, SURROUNDING COMMUNITIES AND ALL THREE COUNTIES WHICH WE SERVE, AS WELL AS PARTICIPATE IN COMMUNITY EDUCATION AT ALL LEVELS. GOOD SHEPHERD MEDICAL CENTER - MARSHALL EXECUTIVES AND MID-LEVEL MANAGERS LIVE AND WORK IN THIS COMMUNITY, SURROUNDING COMMUNITIES AND ALL THREE COUNTIES WHICH WE SERVE, AS WELL AS, PARTICIPATE IN COMMUNITY ORGANIZATIONS. GOOD SHEPHERD MEDICAL CENTER - MARSHALL HAS A GROUP OF OVER 1,100 SENIORS WHO ARE A PART OF OUR EXTRA STEPS PROGRAM WHICH PROVIDE US FEEDBACK AT MONTHLY MEETINGS ATTENDED BY OVER 500 SENIORS. IN ADDITION, GOOD SHEPHERD MEDICAL CENTER - MARSHALL HAS A FITNESS/WELLNESS CENTER THAT SERVES 2,300 MEMBERS OF ALL AGES. THE CENTER HAS A SUGGESTION BOX FOR IDEAS REGARDING IMPROVEMENTS AND PROGRAMS. IN ADDITION, LOCAL AND INDIVIDUAL MEETINGS ARE HELD WITH LOCAL BUSINESSES WITH AN OPEN FORUM/FOCUS GROUP THAT SHARES INFORMATION REGARDING IMPROVEMENTS AND PROGRAMS THEY WOULD LIKE THE ORGANIZATION TO OFFER FOR PURPOSES OF MEETING THEIR EMPLOYEE'S HEALTH NEEDS. THE CEO ALSO PARTICPATES IN A TASK FORCE TO ENCOURAGE GROWTH AND DEVELOPMENT OF OUR COMMUNITY. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: AS PATIENTS ENTER OUR FACILITY, SIGNAGE IS POSTED IN DESIGNATED AREAS WHICH STATE OUR POLICY TO PROVIDE CHARITY CARE TO THOSE PATIENTS WHO MEET ELIGIBILITY REQUIREMENTS. BUSINESS OFFICE AND REGISTRATION STAFF DISCUSS PAYMENT OPTIONS AND FINANCIAL ASSITANCE AVAILABLE TO PATIENTS USING VERBAL AND WRITTEN COMMUNICATION. PATIENTS ARE CONTACTED PRIOR TO SERVICES WITH AN ESTIMATED COST AND OUT OF POCKET EXPENSES. CASH PRICES AND PAYMENT OPTIONS ARE DISCUSSED AND A FINANCIAL ASSISTANCE SCREENING IS AVAILABLE UPON REQUEST. GOOD SHEPHERD MEDICAL CENTER EVALUATES PATIENT APPLICATIONS AND UTILIZES A SLIDING SCALE TO QUALIFY PATIENTS BASED ON GOVERNMENT POVERTY GUIDELINES. ADDITIONALLY, OUR ELIGIBILITY VENDOR SCREENS FOR GOVERNMENT AGENCY PROGRAMS AND OFFERS FINANCIAL ASSISTANCE APPLICATIONS TO THOSE WHO DO NOT QUALIFY FOR GOVERNMENT PROGRAMS. BUSINESS OFFICE AND REGISTRATION PERSONNEL ARE AVAILABLE TO ANSWER ANY FINANCIAL QUESTIONS AND ASSIST THE PUBLIC WITH THEIR FINANCIAL OBLIGATIONS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: GOOD SHEPHERD MEDICAL CENTER - MARSHALL IS LOCATED IN THE PINEY WOODS OF EAST TEXAS AND SERVICES A RURAL COMMUNITY WHICH INCLUDES HARRISON, NORTHERN PANALO AND SOUTHERN MARION COUNTIES. THE POPULATION IN EACH OF THESE COUNTIES IS DIVERSE IN INCOME AND ETHNICITY. HARRISON COUNTY, ESTABLISHED IN 1839, IS LOCATED IN NORTHEASTERN TEXAS ALONG THE LOUISIANA BORDER AND COMPRISES 984 SQUARE MILES. MARSHALL, THE COUNTY SEAT, 152 MILES EAST OF DALLAS AND 39 MILES WEST OF SHREVEPORT. ACCORDING TO THE 2016 CENSUS ESTIMATES, 18.5% OF HARRISON COUNTY POPULATION LIVES IN POVERTY. 15.9% OF HARRISON COUNTY RESIDENTS ARE AGE 65 OR OLDER. THE CENSUS BUREAU REPORTS THAT ONLY 19.1% OF ADULTS HOLD A COLLEGE DEGREE OR HIGHER LEVEL OF EDUCATION. EDUCATION LEVEL IMPACTS THE TYPES OF AVAILABLE JOBS AND BENEFIT LEVELS, INCLUDING HEALTHCARE COVERAGE. IN OTHER SERVICE LOCATIONS, MARION COUNTY HAS A MEDIAN ANNUAL INCOME OF $34,175 AND 23.4% OF ITS RESIDENTS LIVE IN POVERTY. PANOLA COUNTY HAS A MEDIAN ANNUAL HOUSEHOLD INCOME OF $50,119 AND 15.1% OF ITS RESIDENTS LIVE IN POVERTY. UNEMPLOYMENT IN HARRISON, PANOLA AND MARION COUNTIES IS CURRENTLY BETWEEN 6.1% TO 7.4%. IT IS CLEAR THAT WITHIN THE AREA SERVED THERE ARE MANY OBSTACLES TO OVERCOME REGARDING HEALTH CARE COVERAGE. MANY FIND IT DIFFICULT TO AFFORD THE COST OF HEALTHCARE BOTH IN BASIC PREVENTION AND IN TREATMENT OF EXISTING CONDITIONS. (SOURCE: U.S. CENSUS BUREAU) SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: THE COMMUNITY BUILDING ACTIVITIES INCLUDE OUR WELLNESS CENTER AND THE PROGRAMS WE OFFER IN AN ATTEMPT TO KEEP OUR COMMUNITY HEALTHY. THE WELLNESS CENTER IS THE HUB OF OUR PROGRAM OFFERING FITNESS AND WELLNESS PROGRAMS FOR INDIVIDUALS, FAMILIES AND BUSINESSES IN OUR COMMUNITY, INCLUDING HOSPITAL EMPLOYEES AND THEIR FAMILIES. WE ALSO OFFER A VARIETY OF WATER AEROBICS, ADULT AEROBIC CLASSES, SENIOR EXERCISE CLASSES, SPECIALTY CLASSES SUCH AS ZUMBA, CARDIAC REHAB, ETC. WE ALSO OFFER ACUTE, CHRONIC AND PREVENTATIVE EDUCATIONAL PROGRAMS TO OUR COMMUNITY. WE ARE INVOLVED IN THE SCHOOLS WITH PRENATAL CLASSES FOR PREGNANT TEENS AND ALSO WORK WITH THE SCHOOLS ON OBESITY PROGRAMS. IN ADDITION, WE PROVIDE COMMUNITY EDUCATIONAL SERVICES AND PROGRAMS, SUCH AS CPR, CERTIFIED DIABETIC EDUCATION PROGRAMS, WOUND CARE EDUCATION AND PREVENTION, SEATBELT AWARENESS, HARD HATS FOR LITTLE HEADS BICYCLE RODEO AND SHOPPING CLASSES FOR PERSONS TRYING TO MODIFY DIET FOR CARDIAC REASONS OR WEIGHT LOSS. FURTHERMORE, WE OFFER HEALTH FAIRS THAT PROVIDE BASIC SCREENING EXAMS AT NO COST TO OUR COMMUNITY. OUR CASE MANAGEMENT AND SOCIAL SERVICES PROGRAM OFFERS THE AVAILABILITY OF EXTERNAL SOURCES AND PROGRAMS TO ASSIST PATIENTS AND THEIR FAMILIES, SUCH AS WIC AND OTHER GOVERNMENT AND PRIVATE PROGRAMS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE HOSPITAL IS PART OF GOOD SHEPHERD HEALTH SYSTEM WHICH ALLOWS US TO BETTER REACH OUT AND SERVE OUR CATCHMENT AREA. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: TEXAS SCHEDULE H, PART I, LINE 3B PROCESS FOR DETERMINING ELIGIBILITY FOR DISCOUNTED CARE: POLICY IN TAX YEAR 2015 ALLOWED FOR FINANCIAL ASSISTANCE FOR PERSONS UP TO 500% OF FEDERAL POVERTY GUIDELINES (FPG). BEGINNING IN TAX YEAR 2016, THE QUALIFICATION THRESHOLD WAS LOWERED TO 400% OF FPG. SCHEDULE H, PART I, LINE 3C FACTORS TO DETERMINE FREE OR DISCOUNTED CARE: TO QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY THE FOLLOWING MUST BE MET: (1) A RATIO IS DEVELOPED BY DIVIDING THE PATIENT'S INCOME BY THE FEDERAL POVERTY GUIDELINES. (2) THIS RATIO IS MATCHED TO THE FOLLOWING CHART TO DETERMINE AMOUNT ELIGIBLE FOR FINANCIAL ASSISTANCE. RATIO ASSISTANCE 0% - 100% 100% 101% - 200% 80% 201% - 300% 60% 301% - 400% 40% 401% - 500% 20% 501% - 1000% 0% FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: - ASSET LEVEL - MEDICAL INDIGENCY - INSURANCE STATUS - UNDERINSURANCE STATUS SCHEDULE H, PART I, LINE 7, COL(F) BAD DEBT EXPENSE: BAD DEBT EXPENSE IN THE AMOUNT OF $41,145,508, WAS NOT INCLUDED IN TOTAL EXPENSE USED TO COMPUTE THE PERCENTAGE REPORTED IN PART I, LINE 7, COL(F). true SERVICE ORGANIZATION OF GOOD SHEPHERD 2950 50TH STREET LUBBOCK TX 79413 383914883 501(C)(3) 2788568 0 HEALTHCARE SERVICES 1 SCHEDULE I, PART I, LINE 2 AFTER A NEED IS DETERMINED FOR ASSISTANCE, A REQUEST FROM THE SERVICE ORGANIZATION OF GOOD SHEPHERD IS SUBMITTED, IDENTIFYING THE FUNDS NEEDED FOR THE PROGRAM AND/OR PATIENT. THE REQUEST IS REVIEWED AND APPROVED BY THE CFO BEFORE FUNDS ARE TRANSFERRED. A SERVICE LOG IS SUBMITTED TO THE CFO TO DOCUMENT HOURS INCURRED ON PROJECTS AND SUPPORT USE OF FUNDS. X X false true false false false false false false false RUSSELL J COLLIER PRESIDENT/CEO 0 315969 0 0 0 0 0 34484 0 13694 0 364147 STEVE ALTMILLER GSHS PRESIDENT/CEO 0 650200 0 0 0 0 0 75600 0 11957 0 737757 LUIS BALBUENA MD MEDICAL STAFF REP TO BOARD 0 429959 0 14748 0 0 0 10600 0 14132 0 469439 TIM PILEGGI INTERIM CFO 0 583683 0 0 0 0 0 0 0 0 0 583683 THOMAS SMOLENSKI PHYSICIAN 165163 0 2500 0 0 0 0 0 3679 0 171342 0 JOYCE EGLI CHARGE NURSE 166607 0 0 0 0 0 6715 0 5672 0 178994 0 KEITH KIRBOW CHIEF NURSING OFFICER 148760 0 0 0 0 0 13377 0 17920 0 180057 0 RICKY PAUL FORMER PRES OF MEDICAL STAFF 0 556806 0 0 0 0 0 10600 0 18266 0 585672 JOHN MCDONALD DO FORMER MEDICAL STAFF 0 205162 0 12132 0 0 0 8825 0 5092 0 231211 VALARIE ALLMAN MD FORMER VP MEDICAL STAFF 0 303082 0 333 0 0 0 10600 0 11854 0 325869 RAY DELK FORMER VP OPERATIONS 0 231767 0 0 0 0 0 23735 0 13554 0 269056 SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DESCRIBED IN 457(F): INDIVIDUALS: PAYMENT IN W-2: DEFERRED COMPENSATION: STEVE ALTMILLER NONE $ 65,000 RUSSELL J COLLIER NONE $ 23,884 KEITH KIRBOW NONE $ 7,285 RAY DELK NONE $ 14,375 A HARRISON COUNTY HEALTH FACILITIES DEVELOPMENT 752740093 415221AW0 2010-09-22 43980049 REFUND ESCROWS, CAPITAL PROJECTS false false false A 2005000 0 43980049 3077293 0 31331629 879600 0 0 8691527 0 0 2013 true false false true A false false false false 0 false false false false A false false false true false false 0 false 0 false false A false SCHEDULE K, PART I, BOND ISSUES: (A) THE ISSUER NAME: HARRISON COUNTY HEALTH FACILITIES DEVELOPMENT CORPORATION (F) DESCRIPTION OF PURPOSE: REFUND ESCROWS, CAPITAL PROJECTS AND IMPROVEMENTS SCHEDULE K, PART IV, ARBITRAGE, LINE 2C: (A) ISSUER NAME: HARRISON COUNTY HEALTH FACILITIES DEVELOPMENT CORPORATION DATE THE REBATE COMPUTATION WAS PERFORMED: 08/01/2015 FORM 990, PART VI, SECTION A, LINE 1A DELEGATION OF AUTHORITY: THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS BETWEEN MEETINGS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE ORGANIZATION: GSHS, INC. IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF MEMBERS AND THE BOARD OF DIRECTORS: AS THE SOLE MEMBER, GSHS, INC. HAS THE POWER TO APPOINT ONE MEMBER TO THE CORPORATION'S BOARD OF DIRECTORS AND THE POWER TO APPROVE THE REMAINING DIRECTORS NOMINATED TO THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B GOVERNING DECISIONS OF THE ORGANIZATION: A NUMBER OF DECISIONS OF THE ORGANIZATION ARE SUBJECT TO APPROVAL OF THE MEMBER OF THE ORGANIZATION. THESE RESERVED POWERS ARE STATED BELOW: A) THE APPOINTMENT OF ONE MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, AND THE APPROVAL OF THE REMAINING DIRECTORS FOLLOWING THE NOMINATION PROCESS AND SUBJECT TO THE PROVISIONS GOVERNING STAFF DIRECTORS; B) THE REMOVAL OF A MEMBER OF THE ORGANIZATION'S BOARD AND ALSO THE APPROVAL OF REMOVAL AND APPOINTMENTS TO FILL VACANCIES ON THE BOARD AND SET THE SIZE OF THE BOARD; C) APPROVE ELECTION AND REMOVAL OF OFFICERS OF THE ORGANIZATION AND ESTABLISH, TERMINATE, AND/OR REVISE ALL EMPLOYMENT CONTRACTS, COMPENSATION, AND BENEFIT PACKAGES OF THE OFFICERS OF THE ORGANIZATION REGARDLESS OF WHICH ENTITY ACTUALLY PAYS SUCH COMPENSATION OR BENEFITS; D) DESIGNATE THE FISCAL YEAR; E) APPROVE THE SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, OUTSIDE GENERAL LEGAL COUNSEL, AND OUTSIDE INVESTMENT ADVISORS; F) AMEND THE ARTICLES OF INCORPORATION; G) APPROVE ALL MERGERS, ACQUISITIONS, CONSOLIDATIONS, OR AFFILIATIONS WITH OTHER ENTITIES, THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION, OR THE SALE, MORTGAGE, OR ENCUMBRANCE OF ANY PROPERTY OWNED BY THE ORGANIZATION; H) APPROVE THE DISSOLUTION OR LIQUIDATION OF THE ORGANIZATION; I) APPROVE CAPITAL PLANS, STRATEGIC PLANS, AND ANNUAL OPERATING AND CAPITAL BUDGETS; J) APPROVE ANY EXCEPTION TO THE CAPITAL BUDGET FOR A SINGLE ITEM OR RELATED ITEM THAT EXCEEDS $100,000 AND/OR APPROVE ANY AGGREGATE ANNUAL EXPENDITURES THAT EXCEED THE BUDGET BY $50,000; K) SELECT OFFICIAL DEPOSITORIES FOR THE ORGANIZATION'S FUNDS; L) CREATE OR INVEST IN ANY SUBSIDIARY ENTITY OR ENTER INTO ANY PARTNERSHIP OR JOINT VENTURE; M) AUTHORIZE ANY LOANS, GUARANTEES, OR INCURRENCE OF DEBT; N) AUTHORIZE THE COMMENCEMENT OF ANY LITIGATION OR OTHER LEGAL PROCEEDING, OR THE SETTLEMENT, DISPOSITION, OR TERMINATION OF ANY SUCH LITIGATION OR OTHER LEGAL PROCEEDING OR OF ANY CLAIM OR THREAT OF LITIGATION OR OTHER LEGAL PROCEEDING NOT FULLY COVERED BY INSURANCE; AND O) APPROVE THE ADMISSION OF ADDITIONAL MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B PROCESS OF REVIEWING FORM 990: THE ORGANIZATION HAS AN EXTERNAL ACCOUNTING FIRM AUDIT ON A CONSOLIDATED BASIS. THE 990 IS PREPARED BY AN EXTERNAL ACCOUNTING FIRM. THE RETURN IS THEN REVIEWED BY INTERNAL ACCOUNTANTS AND EXECUTIVES PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C MONITOR AND ENFORCE COMPLIANCE WITH CONFLICT OF INTEREST POLICY: DISCLOSURES ARE OBTAINED ANNUALLY. THE BOARD REVIEWS AND APPROVES THE BOARD MEMBERS' DISCLOSURES, AND THE CEO REVIEWS AND APPROVES THE EMPLOYEES' DISCLOSURES. BOARD MINUTES REFLECT WHEN A BOARD MEMBER DECLARES A CONFLICT AND DOES NOT VOTE. FORM 990, PART VI, SECTION B, LINE 15 PROCESS OF DETERMINING COMPENSATION: A COMPENSATION SUBCOMMITTEE OF THE BOARD NEGOTIATES CONTRACTS WITH EXECUTIVES THROUGH LONGNECKER & ASSOCIATES. THIS SUBCOMMITTEE OF THE BOARD REVIEWS AND APPROVES COMPENSATION AND BONUSES ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART I, LINE 1 CONTINUATION OF THE ORGANIZATION'S MISSION STATEMENT: ...AGE, OR ABILITY TO PAY. FORM 990, PART I DOING BUSINESS AS: GOOD SHEPHERD MEDICAL CENTER - MARSHALL FORM 990, PART IV, LINE 12 & PART XII, LINE 2 AUDITED FINANCIAL STATEMENTS: THE ORGANIZATION HAS ANSWERED "NO" TO THE QUESTIONS REGARDING AN AUDIT IN PART IV, LINE 12 AND PART XII. THE ORGANIZATION ONLY RECEIVED AN AUDIT OF ITS BALANCE SHEET FOR THE YEAR ENDED SEPTEMBER 30, 2016. THEREFORE, SINCE THE ORGANIZATION DID NOT HAVE AN AUDITED INCOME STATEMENT FOR THE PERIOD COVERED BY THIS RETURN, THE ORGANIZATION DOES NOT HAVE AUDITED FINANCIAL STATEMENTS ACCORDING TO THE IRS INSTRUCTIONS. THE ORGANIZATION HAS ATTACHED A COPY OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2015 AND SEPTEMBER 30, 2014 TO THE FORM 990 AND ANSWERED "YES" TO PART IV, LINE 20B. GSHS INC 700 E MARSHALL AVE LONGVIEW TX 75601 752027157 SUPPORT GSMC TX 501(C)(3) 11, TYPE II NA false MARSHALL HEALTH SERVICES INC 811 SOUTH WASHINGTON AVE MARSHALL TX 75670 752580686 HEALTHCARE TX 501(C)(3) 3 GSMC MARSH true MARSHALL HOSPITAL FOUNDATION INC 811 SOUTH WASHINGTON AVE MARSHALL TX 75670 752605699 SUPPORT TX 501(C)(3) 7 GSMC MARSH true THE GOOD SHEPHERD HOSPITAL INC 700 E MARSHALL AVE LONGVIEW TX 75601 751041154 HEALTHCARE TX 501(C)(3) 3 GSHS INC true GSHS ADMINISTRATIVE SERVICES ORG INC 700 E MARSHALL AVE LONGVIEW TX 75601 861132471 ADMIN SUPPORT TX 501(C)(3) 11, TYPE I GSHS INC true GOOD SHEPHERD MEDICAL CENTER - LINDEN 404 N KAUFMAN ST LINDEN TX 75563 010829282 HEALTHCARE TX 501(C)(3) 3 GSHS INC true GSMC - LINDEN FOUNDATION INC 404 N KAUFMAN ST LINDEN TX 75563 200845127 SUPPORT TX 501(C)(3) 11, TYPE I GSMC LINDEN true GOOD SHEPHERD HOSPITAL AUXILIARY 700 E MARSHALL AVE LONGVIEW TX 75601 237203364 SUPPORT TX 501(C)(3) 9 GSMC true GOOD SHEPHERD FOUNDATION INC 700 E MARSHALL AVE LONGVIEW TX 75601 752056700 SUPPORT TX 501(C)(3) 11, TYPE I GSMC true MEMORIAL HOSPITAL AUXILIARY 811 S WASHINGTON AVE MARSHALL TX 75670 510151805 SUPPORT TX 501(C)(3) 3 GSMC MARSH true GOOD SHEPHERD AMBULATORY SURGICAL CENTER 700 E MARSHALL AVE LONGVIEW TX 75601 900259782 SURGERY TX NA N/A GSHS ENTERPRISES INC 700 E MARSHALL AVE LONGVIEW TX 75601 752027162 HEALTHCARE TX GSHS INC C CORP true GOOD SHEPHERD HEALTH NETWORK 700 E MARSHALL AVE LONGVIEW TX 75601 752554695 INACTIVE TX GSMC C CORP true NORTHEAST TEXAS PHYSICIAN SERVICES 700 E MARSHALL AVE LONGVIEW TX 75601 752712245 MGMT SERVICES TX GSHS ENTERPRISE C CORP true GOOD SHEPHERD PHYSICIAN SERVICES INC 700 E MARSHALL AVE LONGVIEW TX 75601 752762417 MEDICAL SERVICES TX GSHS ENTERPRISE C CORP true GSHS ENTERPRISES HOLDING INC 700 E MARSHALL AVE LONGVIEW TX 75601 510412465 HOLDING COMPANY DE GSHS ENTERPRISE C CORP true GSHS ENTERPRISES OPERATING 1 700 E MARSHALL AVE LONGVIEW TX 75601 752954772 HEALTHCARE DE GSHS ENTERPRISE C CORP true GSHS ENTERPRISES OPERATING 2 700 E MARSHALL AVE LONGVIEW TX 75601 752954777 HEALTHCARE DE GSHS ENTERPRISE C CORP true MARSHALL PHYSICIAN HOSPITAL ORGANIZATION 700 E MARSHALL AVE LONGVIEW TX 75601 752580689 INACTIVE TX GSMC MARSHALL C CORP 0 0 1.00000 true true false false true true false false false false true true false true false false true true true false MARSHALL HEALTH SERVICES M 884295 CASH PAID MARSHALL HEALTH SERVICES A 620911 CASH PAID MARSHALL HEALTH SERVICES K 308370 CASH PAID