2016-05-16T14:55:23-05:00 2015-06-30 BKD LLP 14241 DALLAS PKWY STE 1100 DALLAS TX 75254 990 2014-07-01 750818167 Mother Frances Hospital Regional Health Care Center % CHRISSY RAMSEY MOTH 9036065639 1315 Doctors Drive Tyler TX 75701 ELIZABETH PULLIAM VICE PRESIDENT 9036065783 2016-05-16 true Jeanette Verrelli P00742631 9727028262 2014 2016-08-17 19:52:53Z JOHN MCGREEVY 800 E DAWSON STREET TYLER TX 75701 753412476 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. 10 4 3863 204 2078105 1536021 2831335 567303149 620936007 5632580 12071903 8348799 8447895 582820549 644287140 16569076 23095342 0 0 175628692 183265791 0 0 0 341567068 354692309 533764836 561053442 49055713 83233698 744985551 807350395 341239077 348205022 403746474 459145373 TO PROVIDE THE COMMUNITY WITH A FULL RANGE OF COMPREHENSIVE HEALTHCARE SERVICES WITHOUT REGARD TO RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. false false 467012199 23095342 621299785 THE HOSPITAL'S OPERATING PLAN INCORPORATES PROVISIONS FOR INDIVIDUALS WHO DO NOT POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. OUR COMMITMENT TO OUR COMMUNITY 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. 467012199 true true false true false false false false false true true false false true true false false true false true true false false false false false true true true false true true false false false false false false false false true false false false false false false true true true false false true 150 0 true 3863 true true true true CJ false false false false false false false false X 10 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 X RAY THOMPSON SYS EXEC VP/DIRECTOR/ASST SEC 11.0 29.0 X X 495276 1305729 30207 BEN FITZGERALD CHAIRMAN 1.0 0.0 X X 0 0 0 FAGG SANFORD MD DIRECTOR 1.0 39.0 X 0 878349 13473 SISTER MALGORZATA MAJSZCZYK DIRECTOR 1.0 0.0 X 0 0 0 SISTER IRENE ASZTEMBORSKA SECRETARY/TREASURER 1.0 1.0 X X 0 0 0 ANDY KIRKPATRICK MD DIRECTOR 1.0 39.0 X 0 684190 19717 PATRICK THOMAS MD DIRECTOR 1.0 1.0 X 49596 0 0 CC BAKER VICE CHAIR 1.0 0.0 X X 0 0 0 JOHN MCGREEVY SR. VP/CEO OF MFH 39.0 1.0 X X 458571 0 29432 NOAH ISRAEL MD DIRECTOR 1.0 0.0 X 0 0 0 J LINDSEY BRADLEY JR SYSTEM PRESIDENT 9.0 31.0 X 455098 1567561 30207 JOYCE HESTER SR. VICE PRESIDENT/CFO 10.0 30.0 X 120750 362249 27706 ROBERT ROSE SR. VP, PATIENT CARE SERVICES 40.0 0.0 X 300111 0 15848 TODD HANCOCK SR. VP/COO 40.0 0.0 X 302221 0 18056 LEE PORTWOOD VP 40.0 0.0 X 267178 0 13882 PATRICK SIMONSON VP 40.0 0.0 X 139144 0 2044 JASON PROCTOR VP 40.0 0.0 X 119893 0 4023 ELIZABETH PULLIAM CFO OF MFH REGIONAL 15.0 25.0 X 104735 174559 11020 SCOTT FOSSEY VP 20.0 20.0 X 97910 0 7982 CHRISTY BUSH NIGHT ADMINISTRATOR 40.0 0.0 X 157225 0 5047 WILLIAM SANDBERG CRNA 40.0 0.0 X 299520 0 12030 ROBERT BIENERT CRNA 40.0 0.0 X 372445 0 8415 TAWONDA FELTON CRNA 40.0 0.0 X 440931 0 10847 TIMOTHY CLARK CRNA 40.0 0.0 X 264082 0 14833 JODY KING ANESTHESIOLOGIST 40.0 0.0 X 267637 0 14231 CHRIS GLENNEY VP OPERATIONS 0.0 40.0 X 0 374470 28468 4712323 5347107 317468 122 true true false SODEXO INC AND AFFILIATES PO BOX 536922 ATLANTA GA 30353 HOUSEKEEPING/DIETARY 2588530 HEALTH CAROUSEL LLC PO BOX 44743 MIDDLETOWN OH 45044 EMPLOYMENT SERVICES 2588305 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 55480 LAB SERVICES 1734569 TYLER NEUROSURGICAL ASSOCIATES PA 700 OLYMPIC PLAZA CIRCLE TYLER TX 75701 PHYSICIAN SERVICES 1440500 CAPSTONE PERSONNEL SERVICES INC PO BOX 8744 TYLER TX 75711 EMPLOYMENT SERVICES 1116665 72 X 2378616 452719 2831335 NET PATIENT SERVICE REVENUE 621110 578897675 578897675 UPL MEDICAID 900099 15477427 15477427 EHR INCENTIVE REVENUE 900099 101959 101959 OTHER OPERATING REVENUE 900099 26458946 26458946 620936007 6065766 6065766 0 0 3773832 3773832 0 3773832 280390 3493442 114819068 11410 108780569 43772 6038499 -32362 6006137 6006137 0 0 678220 300995 377225 363778 13447 CAFETERIA REVENUE 722514 2368848 2368848 FITNESS CENTERS 713940 1784268 1784268 Vending Machine Revenue 722514 143722 143722 4296838 644287140 621299785 2078105 18077915 X 23095342 23095342 0 0 0 2144976 1949052 195924 81576 74551 7025 150789882 137253969 13535913 6284694 5173193 1111501 13026481 13026481 0 10938182 9448656 1489526 983091 302496 680595 0 0 0 0 500 500 127648058 57521057 70127001 40911 40561 350 2477873 2105100 372773 1938726 83394 1855332 0 6493242 5974529 518713 86776 81238 5538 0 300728 229227 71501 8173948 8173948 0 23499831 22375458 1124373 1167673 1167673 MEDICAL SUPPLIES 110071700 109245898 825802 BAD DEBT EXPENSE 51124172 51124172 REPAIRS AND MAINTENANCE 8088852 7664225 424627 FOOD 3357697 3350708 6989 9238531 8718444 520087 561053442 467012199 94041243 0 73485852 89168491 5528758 6831700 0 0 54159296 60336428 0 0 0 0 0 0 6883909 6362520 2827494 3498209 599413366 296753179 318886412 302660187 194316861 237769064 3375713 3527805 0 0 0 2679974 85521256 94516017 744985551 807350395 66658256 68656758 0 0 104694 81960 190368073 188120099 0 0 0 0 521179 434872 0 0 83586875 90911333 341239077 348205022 X 403746474 459145373 0 0 0 0 403746474 459145373 744985551 807350395 X 83233698 -5346941 -22487858 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 9446 false false false 9446 false SCHEDULE C, PART II-B, LINE 1F GRANTS FOR LOBBYING PURPOSES: 22.8% OF AHA DUES WERE EXPENDED FOR SPECIFIC LOBBYING PURPOSES BASED ON MEDICARE DEFINITION OF UNALLOWABLE EXPENSES. 2762072 124881 1000 2885953 2414694 360569 13191 2762072 2408876 163752 157934 2414694 2350337 30875 27664 2408876 2209013 50 141274 2350337 0.71342 0.28658 false true true 0 26862351 26862351 0 228342516 89592705 138749811 0 109059835 60883151 48176684 0 231330721 146277323 85053398 0 3817943 0 3817943 302660187 DUE FROM AFFILIATES 93081696 DEFERRED FINANCING COSTS 1434321 94516017 0 PENSION LIABILITY 54748451 ESTIMATED SELF INSURANCE COSTS 5686590 DUE TO AFFILIATES 26949173 EST AMTS TO 3RD PARTY PAYERS 3527119 90911333 X 590855077 -5346941 -45739368 -51086309 641941386 500 2345254 2345754 644287140 509291404 -667045 -667045 509958449 500 51094493 51094993 561053442 SCHEDULE D, PART V, LINE 4 INTENDED USE OF THE ORGANIZATION'S 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 XI, LINE 2D RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT EXPENSE $(51,124,172) EQUITY IN EARNINGS OF AFFILIATE 5,355,125 OTHER CLASSIFICATION DIFFERENCES 29,679 --------------- TOTAL $(45,739,368) SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: LOSS ON ASSET DISPOSAL $(33,362) CONTRIBUTIONS IN NET ASSETS 2,378,616 ------------- TOTAL $2,345,254 SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: LOSS ON ASSET DISPOSAL $33,362 CHANGE IN FAIR VALUE INT RATE SWAP (736,720) EQUITY IN INCOME OF CONSOLIDATED SUB 36,313 ---------- TOTAL $(667,045) SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF EXPENSE PER AUDITED FINANCIAL STATEMENTS WITH RETURN: BAD DEBT EXPENSE $51,124,172 OTHER CLASSIFICATION DIFFERENCES (29,679) ------------- TOTAL $51,094,493 SCHEDULE D, PART X, LINE 2 LIABILITY FOR UNCERTAIN TAX POSITIONS: The System, the Hospital, RMSA, the Clinic, Jacksonville and Winnsboro have been recognized as exempt from income taxes under Section 501 of the Internal Revenue Code (IRC) and a similar provision of state law. However, these entities are subject to federal income tax on any unrelated business taxable income. APET will be applying for tax-exempt status. THFIC is not considered to be engaged in a United States trade or business and, therefore, is not subject to United States income taxes. If THFIC were to be considered engaged in a United States trade or business, it could be subject to federal income tax. THFIC is currently exempt from income taxes in the Cayman Islands. Accordingly, no provision for taxes has been made. With a few exceptions, the Health System is no longer subject to U.S. federal examinations by tax authorities for years before 2011. Central America and the Caribbean 1 Program Services INSURANCE 36313 Central America and the Caribbean Investments 16680479 1 1 16716792 16716792 true false true true false false true true X true X true X true true true false true true 18944669 18944669 0.04300 39537072 51566963 11223535 7818207 3405328 0.00670 69705276 59385170 22349997 0.04970 408469 408469 0.00080 175609 175609 0.00030 1092748 1092748 0.00220 76062 76062 0.00010 22894010 22894010 0.04490 24646898 24646898 0.04830 94352174 59385170 46996895 0.09800 true 51124172 178358411 157503681 20854730 X true true 2 1 MOTHER FRANCES HOSPITAL REG HC CENTER 1315 DOCTORS DRIVE TYLER TX 75701 WWW.TMFHC.ORG 000286 X X X 2 TYLER REHAB ASSOCIATES LP 3131 Troup Highway Tyler TX 75701 www.tmfrehabhospital.com 000692 X MOTHER FRANCES HOSPITAL REG HC CENTER 1 false false true X X X X X X X X X 12 true true false true X SEE PART V, SECTION C X true 12 true SEE PART V, SECTION C false 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 X X true X false X X X true X false false TYLER REHAB ASSOCIATES LP 2 false false true X X X X X X X X X 12 true true false true X SEE PART V, SECTION C true 12 true SEE PART V, SECTION C false false true X 200. 400. true true X true X X X true X false X X X false X X false false SCHEDULE H, PART V, SECTION B, FACILITIES 1 & 2, LINE 5 REPRESENTATIVES FROM THE COMMUNITY: MOTHER FRANCES HOSPITAL - TYLER CONDUCTED 17 INTERVIEWS WITH THE THREE GROUPS OUTLINED IN IRS NOTICE 2011-52. THE HOSPITAL CONSULTED INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS: BETHESDA CLINIC, LITERACY COUNCIL OF TYLER, BETHESDA HEALTH CLINIC, TISD HEAD START PROGRAM, BEN AND MAYTEE FISCH FOUNDATION, TYLER TODAY MAGAZINE, JUNIOR LEAGUE OF TYLER, RAMEY AND FLOCK PC, SAMARITAN COUNSELING CENTER, CATHOLIC CHARITIES OF EAST TEXAS, TEXAS DEPARTMENT OF STATE HEALTH SERVICES, ETCOG AREA AGENCY ON AGING, UNITED WAY OF SMITH COUNTY, EAST TEXAS CRISIS CENTER, MEALS ON WHEELS EAST TEXAS, NORTH EAST TEXAS PUBLIC HEALTH DISTRICT, AND MOTHER FRANCES HOSPITAL - TYLER. SCHEDULE H, PART V, SECTION B, FACILITIES 1 & 2, LINES 7A & 10A CHNA AVAILABLE TO THE PUBLIC: THE CHNA AND IMPLEMENTATION STRATEGY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: HTTP://WWW.TMFHC.ORG/COMPREHENSIVE-COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, FACILITIES 1 & 2, LINE 11 NEEDS IDENTIFIED IN CHNA ADDRESSED AND NOT ADDRESSED: MOTHER FRANCES HOSPITAL - TYLER IDENTIFIED AND ADDRESSED THE FOLLOWING PRIORITIES THROUGH ITS IMPLEMENTATION PLAN: - FRAGMENTED CONTINUUM OF CARE - ACCESS TO HEALTH SERVICES FOR SPECIFIC POPULATIONS - ACCESS TO SPECIALTY PROVIDERS AND SERVICES - IMPROVE PREVENTION, EDUCATION, AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC CONDITIONS AND UNHEALTHY LIFESTYLES - ACCESS TO MENTAL HEALTH SERVICES - SUPPORT MULTIPLE SYSTEM OBJECTIVES PROPOSED COMMUNITY PROGRAMS INCLUDE: - Support development and implementation in Region 1 of the Medicaid Waiver Program - Literacy Council, Alzheimer's, Diabetes, American Heart Association, Cancer Foundation For Life, American Cancer Society, Hospice of East Texas, Health Fitness Programs - Partner with Tyler Family Circle of Care for Women's Services - Partner with Tyler Family Circle of Care for Primary Care Services - Partner with Trinity Clinic for a 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 - Support of a new behavioral health community project - Participation in the Episcopal Foundation Community Health Collaboration Forums See Part VI, Line 5 for more information MOTHER FRANCES HOSPITAL - TYLER DECIDED NOT TO SPECIFICALLY ADDRESS THE NEED FOR "ACCESS TO DENTAL SERVICES" LARGELY DUE TO ITS POSITION (LAST) ON THE PRIORITIZED LIST AND THE HOSPITAL'S CAPACITY TO ADDRESS THAT NEED. SCHEDULE H, PART V, SECTION B, FACILITIES 1 & 2, LINES 17, 18, & 19 BILLING AND COLLECTIONS: NEITHER MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER, NOR THIRD PARTIES AUTHORIZED BY MFH-REGIONAL HEALTH CARE CENTER, TAKE ANY ACTIONS UPON NON-PAYMENT FROM A PATIENT BEFORE MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR THE FACILITY'S FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART V, SECTION B, FACILITY 1, LINE 22D DETERMINATION OF FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE: FOR SELFPAY PATIENTS THAT SHOW TO BE FAP ELIGIBLE, WE DISCOUNT BASED UPON THEIR PROVEN FPL PERCENTAGE (100%, 75% OR 50%). THESE AMOUNTS COMBINED WITH THE AUTO-SELFPAY DISCOUNT OF 45% GETS US TO A RATE COMPARABLE TO LOWEST MANAGED CARE OR MEDICARE RATES. SCHEDULE H, PART V, SECTION B, FACILITY 1, LINE 16B FAP APPLICATION FORM AVAILABLE TO THE PUBLIC: THE HOSPITAL'S FAP APPLICATION FORM IS AVAILABLE AT THE FOLLOWING WEBSITE: HTTP://WWW.TMFHC.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, FACILITY 1, LINE 13B INCOME LEVEL USED FOR FAP ELIGIBILITY: MFH REGIONAL PROVIDES CHARITY FOR PATIENTS ABOVE 400% UNDER THE CATASTROPHIC CAP PROVISION. THIS PROVISION ALLOWS MFH REGIONAL TO DISCOUNT THE CARE RECEIVED TO NO MORE THAN 30% OF THE PATIENT'S YEARLY INCOME. SCHEDULE H, PART V, SECTION B, FACILITY 2, LINE 22D Determination of FAP-Eligible Individuals for Emergency And Other Medically Necessary Care: The hospital does not provide emergency medical care. For patients that have income equal to 0% to 200% of the Federal Poverty Guidelines, the hospital does not charge the patient. For patients that have income equal to 201% to 300% of the Federal Poverty Guidelines, the hospital charges the patient 25% of the total charges for the patient's stay. For patients that have income equal to 301% to 400% of the Federal Poverty Guidelines, the hospital charges the patient 50% of the total charges for the patient's stay. SCHEDULE H, SECTION B, FACILITIES 1 & 2, LINE 6A CHNA CONDUCTED WITH ONE OR MORE HOSPITAL FACILITIES: THE CHNA WAS CONDUCTED WITH THE FACILITIES LISTED ON SCHEDULE H, PART V, SECTION A. 1 MFH OUTPATIENT SURGERY CENTER 415 SOUTH FLEISHEL TYLER TX 75702 AMBULATORY SURGICAL CENTER 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, SECTION A, LINE 4 FOOTNOTE TO THE FINANCIAL STATEMENTS DESCRIBING BAD DEBT: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL 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). THE HOSPITAL RECORDS AN AUTOMATIC DISCOUNT OF ITS STANDARD CHARGES FOR UNINSURED PATIENTS. FOR THE REMAINING 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 HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. THIS 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 REDUCED 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 DOUBTFUL ACCOUNTS. THE HEALTH SYSTEM'S ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS APPROXIMATELY 98% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2015 AND 2014. THE CURRENT YEAR DECREASE IN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS PRIMARILY THE RESULT OF THE CHANGES IN THE AGE AND PAYER MIX OF ACCOUNTS RECEIVABLE AT JUNE 30, 2015, AS COMPARED TO 2014. 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 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 ORGANIZATION'S CHARITY CARE POLICY. 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: MOTHER FRANCES HOSPITAL-TYLER PROMOTES HEALTHCARE AND WELLNESS EDUCATION BY OFFERING OUTREACH PROGRAMS AND SPECIAL INITIATIVES THAT IMPROVE THE QUALITY OF LIFE AND HEALTH IN THE COMMUNITIES SERVED. COMMUNITY BENEFIT IS PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS TO THE COMMUNITY. THESE SERVICES ARE ESSENTIAL TO PROVIDE COMPLETE HEALTHCARE TO THE COMMUNITIES SERVED. SOME OF THESE PROGRAMS INCLUDE THE FOLLOWING: Tyler Family Circle of Care - Women's Services - The clinic offers prenatal services to all Medicaid patients, self-pay, underinsured, and anyone who presents for prenatal services. Patient education is an integral part of patient care offering classes in English and Spanish. In addition to regular prenatal education, car seat education, and nutritional counseling to non-diabetic patients is also offered. This program receives TMF support for these services. 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. Additionally, case management and diabetic counseling, as well as, nutrition counseling to non-diabetic patients is also provided. Tyler Family Circle of Care - Children's Services - The Center serves the largest number of Medicaid and CHIP patients in the area. This patient population has a high percentage of at-risk ethnic groups. It is the largest provider of services to Medicaid and CHIP services for children in east Texas. A special reach out and read program with book distribution and mentors is also provided. This program receives financial and in-kind from TMF for these services. 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 - Women's Service and for the medically underserved children of east Texas. Tyler Family Circle of Care - Family Medicine - This clinic provides medical care services to all ages of patients. The clinic sees Medicaid, Medicare, CHIP/CHIP Perinate, self-pay, uninsured/underserved, and serving those without the ability to pay regardless of their county of residence. The goal is to ensure that all patients have a primary care home and do not have to use the emergency department for non-urgent issues. The long-term goal is to have all the clinics receive their medical home status. Trinity Clinic Special Needs Program - The Special Needs Program believes that all children should have access to health care services; a medical home: which are continuous, comprehensive, coordinated, compassionate and culturally competent. Medical and social services are provided to children with special needs. The purpose is to provide health care services to over 604 patients ranging from neonates to 21 years serving 35 communities encompassing a 12 county area. Services offered without charge include MOMS support group, Respite Care Program support, Annual Special Needs Children's Celebration for families, and other local community activities. Sickle Cell Clinic - The Tyler Family Circle of Care - Pediatric Clinic provides the facility and support for patients with Sickle Cell. Joining forces with UT Southwestern Medical Center through a grant, a registered nurse works as the liaison between pediatricians and the Sickle Cell Clinic in Dallas to coordinate the care of patients. Additionally, a hematologist specializing in the care of sickle cell patients conducts a clinic four times a year on site. TMFHC joins with TFCC and serves as the site in collaboration with UT Southwestern Medical Center in Dallas to provide care for Sickle Cell patients in the Smith and surrounding counties. This program eliminates the need for families to travel to Dallas to receive care. It provides frontline information to parents and families on the disease and the need for medical care. Emergency Education - 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. Over 551 people were trained. The purpose is to improve the ability of people to respond to an emergency situation regardless of where it occurs. The benefit to the public includes more rapid response by a trained person which should increase the potential for positive outcomes. TeleCare Plus-Your Health Information Resource - TeleCare Plus is a medical call center available for FREE to the public 24 hours a day. Registered nurses provide callers with answers to health questions over the telephone, can send health information via the mail, provide physician referrals, give information on community and hospital resources and do symptom based triage. Examples of the types of calls in 2014 would be: Tyler Family Circle of Care - Pediatrics/ Obstetrics, cardiac, neuro, endocrinology, geriatric, education calls, and general information and health care questions or nurse triage. TeleCare Plus is designed to provide a central, confidential resource for the community to turn to for health information and assist callers in seeking out the appropriate level of medical resources at the appropriate time. Bethesda Clinic Support - 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. The purpose is to provide a site for patients where they can receive acute medical care. Services are paid for on a sliding scale as determined by their board of directors. This provides another access point for vulnerable populations and has bilingual staff. Trinity Mother Frances Health System Website - The TMFHS website at www.tmfhc.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. The website is designed as an access point to TMFHS resources. Using the web people can access information about the many services TMFHS provides, find information about physicians, register for classes or upcoming events, find a job and more. The health information module provides a vast amount of information regarding diseases, medications, labs, tests and also links to disease communities or support groups and resources. Lifeline-Personal Emergency Response System - Lifeline provides independence to patients needing quick access to emergency assistance in their home. Customers wear a waterproof button on their wrist or around their neck that they can press to activate the Lifeline Call Center in case of incapacitating event such as a fall or stroke. The Lifeline Call Center will attempt to speak to the patient via the Lifeline speakerphone or send out a predetermined contact such as a friend or neighbor or activate emergency personnel to assist the caller. The Lifeline program allows some people to stay at home that might otherwise need to be in an assisted living facility. Scholarships are provided to a number of patients as requested to meet the needs of those who cannot afford the service and request financial support. Community Partnerships - Assistance was provided both financially and with staffing for groups and organizations to provide collaborative programs, services, and health information. Projects included over 75 opportunities, including school-based programs, youth programs, and general public events. The purpose is 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, Bethesda Health Clinic, Boy Scouts, Children's Advocacy Center, nursing programs, and public and private schools. United Way - TMFHS and our employees provided financial support of over $116,240.75. The purpose is 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. Share the Spirit - This is an annual fund raising campaign within the health system for designated programs by the employees. It is organized and implemented by employees with all proceeds going to help with health related programs. The amount raised was 175,964.81. The goal is to assist with the funding for the following projects: Heart care, Cancer care, Children's Miracle Network, diabetes education and services, and the employee CrisisCare Fund. Anyone is eligible to receive assistance based on need or program needs. Children's Miracle Network - This is a designation for hospitals that focus on children's care and the SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: MOTHER FRANCES HOSPITAL-TYLER IS PART OF AN AFFILIATED HEALTH CARE SYSTEM CALLED TRINITY MOTHER FRANCES HEALTH SYSTEM. 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 STATE FILING OF COMMUNITY BENEFIT REPORT: TEXAS SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE, TOTALING $51,124,172. SCHEDULE H, PART I, LINE 3C FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING FACTORS IN ITS DETERMINATON: - ASSET LEVEL - MEDICARE INDIGENCY - INSURANCE STATUS - UNDERINSURANCE STATUS - GREATER THAN 400% UNDER - RESIDENCY THE CATASTROPHIC CAP PROVISION true TRINITY MOTHER FRANCES HEALTH SYSTEM FDN 1315 DOCTORS DRIVE TYLER TX 75701 752028241 501(c)(3) 75000 SPONSORSHIP SERVICE ORGANIZATION OF PINEY WOODS 2950 50TH ST LUBBOCK TX 79314 300630886 501(C)(3) 16061400 COMMUNITY HEALTHCARE SERVICE ORGANIZATION OF NORTH EAST TEXAS 2950 50TH STREET LUBBOCK TX 79314 260468622 501(C)(3) 6832610 COMMUNITY HEALTHCARE 3 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: GRANT RECIPIENTS ARE REQUIRED TO ACKNOWLEDGE PRIOR TO THE ISSUANCE 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 X X X X false true false false false false false false false RAY THOMPSON SYS EXEC VP/DIRECTOR/ASST SEC 210668 555398 284608 750331 0 0 3009 7929 5299 13970 503584 1327628 0 0 FAGG SANFORD MD DIRECTOR 0 858527 0 0 0 19822 0 8450 0 5023 0 891822 0 0 ANDY KIRKPATRICK MD DIRECTOR 0 630633 0 0 0 53557 0 11050 0 8667 0 703907 0 32117 J LINDSEY BRADLEY JR SYSTEM PRESIDENT 204596 704719 250502 862842 0 0 2461 8477 4336 14933 461895 1590971 0 0 JOYCE HESTER SR. VICE PRESIDENT/CFO 84597 253791 36153 108458 0 0 2734 8203 4192 12577 127676 383029 0 0 ROBERT ROSE SR. VP, PATIENT CARE SERVICES 240544 0 47882 0 11685 0 8024 0 7824 0 315959 0 0 0 WILLIAM SANDBERG CRNA 298266 0 0 0 1254 0 8086 0 3944 0 311550 0 0 0 ROBERT BIENERT CRNA 372185 0 0 0 260 0 6371 0 2044 0 380860 0 0 0 TAWONDA FELTON CRNA 440260 0 0 0 671 0 8305 0 2542 0 451778 0 0 0 JOHN MCGREEVY SR. VP/CEO OF MFH 359461 0 99110 0 0 0 10163 0 19269 0 488003 0 0 0 TODD HANCOCK SR. VP/COO 242490 0 48347 0 11384 0 8957 0 9099 0 320277 0 0 0 LEE PORTWOOD VP 221957 0 32151 0 13070 0 9527 0 4355 0 281060 0 0 0 CHRISTY BUSH NIGHT ADMINISTRATOR 122144 0 25900 0 9181 0 1561 0 3486 0 162272 0 0 0 TIMOTHY CLARK CRNA 263837 0 0 0 245 0 6677 0 8156 0 278915 0 0 0 CHRIS GLENNEY VP OPERATIONS 0 283222 0 91248 0 0 0 8661 0 19807 0 402938 0 0 ELIZABETH PULLIAM CFO OF MFH REGIONAL 83874 139791 16510 27517 4351 7251 2766 4610 1367 2277 108868 181446 0 0 JODY KING ANESTHESIOLOGIST 267417 0 0 0 220 0 6909 0 7322 0 281868 0 0 0 SCHEDULE J, PART I, LINE 4B PARTICIPATION IN OR PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PARTICIPANTS IN 457(F) REPORTED IN W-2 --------------------- --------------- ANDY KIRKPATRICK MD $32,117 A TYLER HEALTH FACILITIES DEVELOPMENT CORPORATION 521315814 902261HP4 2011-10-12 51735000 CAPITAL DEVELOPMENT false false false B TYLER HEALTH FACILITIES DEVELOPMENT CORPORATION 521315814 902261FP6 2003-05-08 60753954 CAPITAL DEVELOPMENT false false false C TYLER HEALTH FACILITIES DEVELOPMENT CORPORATION 521315814 902261GP5 2007-05-30 23053130 CAPITAL DEVELOPMENT false false false D TYLER HEALTH FACILITIES DEVELOPMENT CORPORATION 521315814 XXXXXXXXX 2012-10-19 57429494 REFINANCING 1992 & 1997B BONDS false false false A 0 0 51735000 5173500 0 45260090 873700 0 0 0 0 0 2013 false false true true B 25653954 0 60753954 669419 0 40532637 771361 0 0 18780537 0 0 2005 true false true true C 53130 0 23053130 2300000 0 0 386250 0 0 20366880 0 0 2012 false false true true D 43419395 0 57429494 0 0 57170774 258720 0 0 0 0 0 2001 true false true true A false true false false 0.02300 0.00600 0.02900 false false false true B false false false false 0 false false false true C false false false false 0 false false false true D false true false false 0.00647 0.00000 0.00647 false false false true A false true false false false false 0 false 0 false true B true false false 0 false 0 false true C true false false 0 false 0 false true D false true false false true false 0 false 0 false true A true B true C true D true A TYLER HEALTH FACILITIES DEVELOPMENT CORPORATION 521315814 902261GN0 2007-05-16 66789990 CAPITAL DEVELOPMENT false false false A 2514990 0 66789990 288280 0 64699862 1801848 0 0 0 0 0 2003 false true true true A false false false false 0 false false false true A true false false 0 false 0 false true A true SCHEDULE K, PART I REFINANCED BONDS: SERIES 1992 REVENUE BOND ISSUE DATE 05/27/1992 SERIES 1997B REVENUE BOND ISSUE DATE 12/01/1997 SERIES 2001 REVENUE BOND ISSUE DATE 10/30/2001 SERIES 2003 REVENUE BOND ISSUE DATE 05/08/2003 JIM BUSH HUSBAND OF KEY EMPLOYEE 81576 SALARIES/WAGES false FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS: TRINITY MOTHER FRANCES HEALTH SYSTEM IS THE SOLE MEMBER OF MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS WHO MAY ELECT MEMBERS OF THE GOVERNING BODY: THE SOLE MEMBER, TRINITY MOTHER FRANCES HEALTH SYSTEM, HAS THE POWER TO APPOINT ALL DIRECTORS AND THEIR SUCCESSORS TO THE GOVERNING BOARD. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL BY THE MEMBER: 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 TO REVIEW THE 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 AND A COPY IS PROVIDED TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR AND ENFORCE CONFLICT OF INTEREST POLICY: THE BOARD REVIEWS AND RESOLVES, IF NECESSARY, ANY TRANSACTIONS AS THEY ARISE THROUGHOUT THE YEAR IN ACCORDANCE WITH POLICY STANDARDS. FORM 990, PART VI, SECTION B, LINES 15A & 15B REVIEW OF COMPENSATION OF CEO, OFFICER, OR KEY EMPLOYEE: 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 2015 BY LAURA LOCKHART, TMFHS DIRECTOR OF TOTAL REWARDS, AND JARED SEIGER, TMFHS BENEFIT SPECIALIST. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A & SCHEDULE J, PART II COMPENSATION FROM RELATED ORGANIZATIONS: THE GOVERNING BOARD OF TRINITY MOTHER FRANCES HEALTH SYSTEM UPON ADVICE FROM NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS, WHO PERIODICALLY REVIEW ALL EXECUTIVE COMPENSATION, APPROVED A DEFERRED COMPENSATION PLAN THAT PROVIDES A 65% TOTAL RETIREMENT BENEFIT FOR SENIOR EXECUTIVES THAT SERVE 20 YEARS OR MORE. THIS PROGRAM HAS BOTH RETENTION AND NON-COMPETITION CLAUSES THAT CREATE A RISK OF FORFEITURE. DEFERRED COMPENSATION IS SUBJECT TO A RISK OF FORFEITURE BASED ON RETENTION, NON-COMPETITION AND OTHER CONTRACTUAL FACTORS. ACCRUALS OF DEFERRED COMPENSATION ARE NOT INCLUDIBLE IN W-2 COMPENSATION UNTIL PAID. OTHER EMPLOYEE BENEFITS INCLUDE QUALIFIED PENSION PLANS, HEALTH, DENTAL AND LIFE INSURANCE PLANS, DISABILITY INSURANCE, ETC. TAXABLE EXPENSES ARE INCLUDED IN THE W-2 PAID COMPENSATION SALARY AMOUNT. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: TRANSFER TO AFFILIATE $(16,957,801) CHANGE IN PENSION PLAN LIABILITY (11,586,594) EQUITY IN EARNINGS OF AFFILIATE 5,355,125 CHANGE IN FAIR VALUE OF INT RATE SWAP 736,720 EQUITY IN INCOME OF CONSOLIDATED SUBSIDIARY (36,313) OTHER CHANGE IN NET ASSETS 1,005 ---------------- TOTAL $(22,487,858) FORM 990 PART IX LINE 11G DESCRIPTION:CORPORATE EXPENSE TOTAL FEES:59996506 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:37680495 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:23537074 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:5578384 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING TOTAL FEES:361844 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN ADVISOR TOTAL FEES:49750 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSCRIPTION SERVICES TOTAL FEES:444005 MOTHER FRANCES HOSPITAL - WINNSBORO 1315 DOCTORS DRIVE TYLER TX 75701 752771569 HOSPITAL TX 501(C)(3) 3 TMFHS true TRINITY MOTHER FRANCES HEALTH SYSTEM FDN 1315 DOCTORS DRIVE TYLER TX 75701 752028241 SUPPORT TX 501(C)(3) 11, TYPE I TMFHS true REGIONAL MEDICAL SERVICES ASSOCIATION 1315 DOCTORS DRIVE TYLER TX 75701 752511459 HEALTHCARE TX 501(C)(3) 3 MFH REG true TRINITY MOTHER FRANCES HEALTH SYSTEM 1315 DOCTORS DRIVE TYLER TX 75701 752616975 SUPPORT TX 501(C)(3) 11, TYPE II NA false TRINITY CLINIC 1315 DOCTORS DRIVE TYLER TX 75701 752616977 HEALTHCARE TX 501(C)(3) 3 TMFHS true MOTHER FRANCES HOSPITAL - JACKSONVILLE 1315 DOCTORS DRIVE TYLER TX 75701 751976930 HOSPITAL TX 501(C)(3) 3 TMFHS true ALIGNED PROVIDERS OF EAST TEXAS 1315 DOCTORS DRIVE TYLER TX 75701 465720165 HEALTHCARE TX 501(C)(3) 3 MFH REG true CSFN MISSION & MINISTRY INC 4001 GRANT AVENUE PHILADELPHIA PA 19114 205728802 CHURCH PA 501(C)(3) 1 NA false TYLER RADIATION EQUIP LEASING 10101 WOODLOCH FOREST DRIVE THE WOODLANDS TX 77380 262554738 EQUIPMENT LEASING TX MFH REG UNRELATED 280390 742432 false 280390 false 0.51000 TRI-STATE FINANCIAL LLC 1315 DOCTORS DRIVE TYLER TX 75701 752728318 DORMANT TX TMFHS C-CORPORATION true TRINCARE INC 1315 DOCTORS DRIVE TYLER TX 75701 752161369 RETAIL HEALTH SVC TX TMFHS C-CORPORATION true HEALTHPLAN OF TEXAS INC 1315 DOCTORS DRIVE TYLER TX 75701 752636832 THIRD PARTY ADMIN TX TMFHS C-CORPORATION true THE REGIONAL HEALTHCARE ALLIANCE 1315 DOCTORS DRIVE TYLER TX 75701 752484109 PREFER PROVIDER TX TMFHS C-CORPORATION true CONCORDIUM HEALTH LLC 1315 DOCTORS DRIVE TYLER TX 75701 702811022 INACTIVE TX NA C-CORPORATION false TEXAS HEALTH FACILITIES INSUR CORP LTD PO BOX 1109 BWI GRAND CAYMAN CJ 980136025 INSURANCE CJ MFH REG C-CORPORATION -36313 118625 1.00000 true true true true false false false false false false true false true true true true true true true true REGIONAL MEDICAL SERVICES ASSOCIATION L 309950 CASH VALUE TRINITY MOTHER FRANCES HEALTH SYSTEM FDN B 75000 CASH VALUE TRINITY MOTHER FRANCES HEALTH SYSTEM FDN C 2378616 CASH VALUE MOTHER FRANCES HOSPITAL WINNSBORO P 6528667 CASH VALUE MOTHER FRANCES HOSPITAL WINNSBORO Q 201971 CASH VALUE MOTHER FRANCES HOSPITAL WINNSBORO R 21689438 CASH VALUE MOTHER FRANCES HOSPITAL WINNSBORO S 11773558 CASH VALUE TRINITY CLINIC P 9714701 CASH VALUE TRINITY CLINIC Q 31683709 CASH VALUE TRINITY CLINIC R 19927937 CASH VALUE TRINITY CLINIC S 36316356 CASH VALUE TRINITY MOTHER FRANCES HEALTH SYSTEM FDN R 656064 CASH VALUE TRINITY MOTHER FRANCES HEALTH SYSTEM FDN S 857083 CASH VALUE MOTHER FRANCES HOSPITAL JACKSONVILLE P 21585482 CASH VALUE MOTHER FRANCES HOSPITAL JACKSONVILLE Q 453462 CASH VALUE MOTHER FRANCES HOSPITAL JACKSONVILLE R 14429166 CASH VALUE MOTHER FRANCES HOSPITAL JACKSONVILLE S 28806206 CASH VALUE ALIGNED PROVIDERS OF EAST TEXAS P 462301 CASH VALUE ALIGNED PROVIDERS OF EAST TEXAS R 5177541 CASH VALUE ALIGNED PROVIDERS OF EAST TEXAS S 8568766 CASH VALUE REGIONAL MEDICAL SERVICES ASSOCIATION P 3342680 CASH VALUE REGIONAL MEDICAL SERVICES ASSOCIATION Q 178951 CASH VALUE REGIONAL MEDICAL SERVICES ASSOCIATION R 2853779 CASH VALUE TRINCARE INC P 2246873 CASH VALUE TRINCARE INC R 3504928 CASH VALUE TRINCARE INC S 714406 CASH VALUE MOTHER FRANCES HOSPITAL JACKSONVILLE a 1258319 CASH VALUE SCHEDULE R, PART II, COLUMN F & PART III, COLUMN D DIRECT CONTROLLING ENTITY: THE FOLLOWING RELATED ORGANIZATIONS REPORTABLE IN PART II ARE DIRECTLY CONTROLLED BY TRINITY MOTHER FRANCES HEALTH SYSTEM ("TMFHS"): MOTHER FRANCES HOSPITAL - JACKSONVILLE TRINITY MOTHER FRANCES HEALTH SYSTEM FOUNDATION TRINITY CLINIC MOTHER FRANCES HOSPITAL - WINNSBORO REGIONAL MEDICAL SERVICES ASSOCIATION, TYLER RADIATION EQUIPMENT LEASING, AND ALIGNED PROVIDERS OF EAST TEXAS ARE DIRECTLY CONTROLLED BY MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER ("MFH REG").