2016-05-13T15:14:47-05:00 2015-06-30 990 2014-07-01 742958277 Scott & White Clinic SCOT 2542159256 2401 S 31st Street Temple TX 76508 Alejandro Arroliga MD Chairman 2542159256 2016-05-13 2014 2016-08-17 19:52:53Z Alejandro Arroliga MD 2401 S 31st Street Temple TX 76508 475409114 0 X www.baylorscottandwhite.com X 2000 TX Faith based physician group providing exemplary patient care, medical education, medical research and community service to residents of the Central Texas region since 1904. 9 0 1603 0 0 0 3500000 19730359 337434358 455678755 0 -302 0 0 340934358 475408812 0 0 0 0 351956832 488774331 0 0 0 133707144 91181602 485663976 579955933 -144729618 -104547121 139776395 66246911 26525103 65915895 113251292 331016 X Baylor Scott & White Health exists to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. 0 0 501762615 455678755 See Schedule OScott & White Clinic (SWC) is a faith-based, nonprofit physician group providing exemplary patient care services to the residents of Bell County and the surrounding communities since 1904. SWC is a major patient care, research and medical education center of the Southwest and serves local, national and international patients.SWC is affiliated with Baylor Scott & White Health (BSWH), a faith based nationally acclaimed network of acute care hospitals and related health care entities providing quality patient care, medical education, medical research and other community services to the residents of North and Central Texas. BSWH is the largest not-for-profit health care system in Texas, and one of the largest in the United States. BSWH was formed from the 2013 combination of Baylor Health Care System and Scott & White Healthcare.SWC is the System's largest physician group and provides inpatient and outpatient medical services to treat individuals with diseases, illnesses and injuries of varying complexities. During the year, SWC employed more than 926 Physicians, 37 PhDs and scientists, and 343 non-physician providers providing primary and specialty health care services at 84 locations throughout the community. In addition to providing access to primary care, SWC has 124 specialty services to meet the health care needs of the community that include Cardiac, Specialty, Pediatric, Neuroscience, Orthopedic, Women's Health, Cancer, Surgical, Eye Care, Trauma, Radiology, Health Support, and Physical Medicine and Rehabilitation. SWC had more than 3.8 million patient encounters during the year. SWC is committed to offering access to quality health care including providing free or discounted health care to the indigent, the underserved population and persons covered by government sponsored indigent health care and other government sponsored programs. As part of its mission and charitable purpose, SWC develops implements and operates innovative strategies and programs that create access to health services, provide equitable care and improves health outcomes for the indigent and the medically underserved population. These activities include wellness programs, community education programs, special programs for the elderly, handicapped and medically underserved and a variety of broad community support activities. SWC physicians serve as faculty for the Texas A&M Health Science Center College of Medicine, training 309 undergraduate medical students. SWC staff physicians also provide training for 443 residents and fellows participating in 38 residency and fellowship programs sponsored by Scott & White Memorial Hospital (SWMH). SWC provides faculty, facilities and lab space for area high school programs focusing on research sciences education. Through these programs, high school students can gain exposure to healthcare professions while earning high school and college credits. 501762615 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1 1603 1 0 0 0 0 0 0 0 0 0 0 X 9 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Laurie Hengst 2542159259 2401 S 31st Street Temple TX 76508 Madhava R Beeram MD Director 40.00 2.00 X 498962 0 48594 L Gill Naul MD Director, Treasurer 40.00 4.00 X X 732702 0 53805 Michael D Reis MD Director 40.00 3.00 X 491228 0 49591 Robert A Probe MD Director, Chairman 40.00 2.00 X X 824329 0 55293 Michael L Middleton MD Director, Secretary 40.00 2.00 X X 388496 0 48798 Stephen Sibbitt MD Director 33.00 11.00 X 601963 131333 29426 William L Rayburn MD Director, Vice-Chairman 40.00 2.00 X X 602324 0 50199 Alejandro C Arroliga MD Director 40.00 3.00 X 596187 0 51654 Robin W Watson MD Director 40.00 6.00 X 522423 0 49080 Biral T Patel MD Physician 40.00 X 844027 0 51821 Christopher J Burnett MD Physician 40.00 X 1032968 0 55903 Laurie W Lazott MD Physician 40.00 X 869098 0 51777 Benjamin P Lowry MD Physician 40.00 X 887587 0 55660 Jason H Huang MD Physician 40.00 X 938503 0 20256 Wade L Knight MD Former Officer 40.00 X 534862 0 49272 Andrejs E Avots-Avotins MD Former Officer 40.00 2.00 X 454352 0 48039 Glen R Couchman MD Former Officer 1.00 42.00 X 0 977426 32465 10820011 1108759 801633 1213 1 1 0 Smart Physician Recruiting LLC S73 W16485 Janesville Rd Ste 101 Muskego WI 531508960 Medical Staffing 774476 Weatherby Locums Inc PO Box 973633 Dallas TX 753972633 Medical Staffing 465384 Staff Care Inc PO Box 281923 Atlanta GA 303841923 Medical Staffing 460299 ECG Consultants Inc 1111 Third Ace Ste 2700 Seattle WA 98101 Consulting 399540 Berger Transfer & Storage PO Box 1450 Minneapolis MN 554857215 Moving Services 246903 6 19730359 19730359 Patient Care 621110 455673457 455673457 5298 5298 455678755 302 -302 -302 -302 475408812 455678755 0 -302 X 6570931 2812152 3758779 376849 376849 414905650 413961007 944643 15245254 15226160 19094 36580920 36193152 387768 15094727 15082089 12638 150912 150912 73599848 4163095 69436753 95654 94682 972 202219 202192 27 2006359 35085 1971274 2193485 2193485 2274770 2192071 82699 113502 40120 73382 490015 484988 5027 Medical Supplies 5904750 5904750 Dues & Memberships 1603384 1578191 25193 Non - Medical Supplies 971278 964865 6413 Recruiting 292500 254267 38233 1282926 3415 1279511 579955933 501762615 78193318 0 1799 8337 57610950 63157848 3180861 1759530 104040 128407 1074074 485747 479705 588327 78399040 604462 139776395 66246911 26525103 41470733 23021 0 24422141 26525103 65915895 X 112581497 -273446 669795 604462 113251292 331016 139776395 66246911 X -104547121 -8373155 X 0 1 X 1 0 X 111120605 5000000 3500000 19730359 139350964 429913747 458462955 388674386 337434759 432347214 2046833061 429913747 569583560 393674386 340934759 452077573 2186184025 0 0 0 2186184025 429913747 569583560 393674386 340934759 452077573 2186184025 1.00000 1.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 16968 1 150912 0 0 167880 0 Part II-B, Line 1: Statement Regarding Legislative Activity: Health care policy is critical to all Americans, and the Organization believes that health care providers must participate in forming health care policy by interacting with national, state and local representatives and their staff members to help them better understand the complexities and ramifications of key health care policies including, without limitation, those related to uninsured and indigent patient needs as well as the legislative and regulatory needs to assure the delivery of cost-efficient, quality health care. The Organization has established relationships with persons and industry associations that often communicate the Organization's positions on major health care issues. These contacts may include direct contact, telephone conversations and/or letters. Also, the Organization may attempt to educate the local community on certain legislative initiatives that may impact the Organization's ability to provide quality health care services to the community through direct mailings, media advertising or broadcast statements. The amount of resources (time and money) involved in these activities is insubstantial. The Organization has not intervened in any political campaign. 1074074 485747 588327 588327 Due to Related Organizations 24422141 24422141 X Part X, Line 2: The filing organization does not have separate individual audited financial statements; however, the organization is included in BSW Holdings' combined audited financial statements (System). The System follows the provisions of ASC 740 "Income Taxes". As of June 30, 2015 and 2014, the System had no material gross unrecognized tax benefits. Central America and the Caribbean - Antigua & Barbuda, Aruba, Bahamas, 0 0 Program Services Medical Education 19000 Europe (Including Iceland & Greenland) - Albania, Andorra, Austria, Belgium 0 0 Program Services Medical Education 41000 North America - Canada and Mexico, but but not the United States 0 0 Program Services Medical Education 26000 Antarctica 0 0 Program Services Medical Education 3000 East Asia and the Pacific 0 0 Program Services Medical Education 7000 South Asia 0 0 Program Services Medical Education 3000 Sub-Saharan Africa 0 0 Program Services Medical Education 5000 0 0 0 0 0 0 104000 0 104000 0 0 0 0 0 0 Part I, line 3: Accrual X X X 1 1 X X X X 0 0 0 0 0 0 0 1 0 Madhava R Beeram MD Director 458372 0 27342 0 13248 0 33800 0 14794 0 547556 0 0 0 L Gill Naul MD Director, Treasurer 679102 0 40288 0 13312 0 33800 0 20005 0 786507 0 0 0 Michael D Reis MD Director 435194 0 51116 0 4918 0 33800 0 15791 0 540819 0 0 0 Robert A Probe MD Director, Chairman 766964 0 45485 0 11880 0 33800 0 21493 0 879622 0 0 0 Michael L Middleton MD Director, Secretary 385009 0 55 0 3432 0 33800 0 14998 0 437294 0 0 0 Stephen Sibbitt MD Director 387108 84457 213677 46619 1178 257 10672 2328 13484 2942 626119 136603 0 0 William L Rayburn MD Director, Vice-Chairman 526367 0 63244 0 12713 0 32659 0 17540 0 652523 0 0 0 Alejandro C Arroliga MD Director 550757 0 32814 0 12616 0 33800 0 17854 0 647841 0 0 0 Robin W Watson MD Director 465036 0 54655 0 2732 0 32816 0 16264 0 571503 0 0 0 Biral T Patel MD Physician 833342 0 7 0 10678 0 33800 0 18021 0 895848 0 0 0 Christopher J Burnett MD Physician 1022331 0 0 0 10637 0 33800 0 22103 0 1088871 0 0 0 Laurie W Lazott MD Physician 858310 0 75 0 10713 0 33800 0 17977 0 920875 0 0 0 Benjamin P Lowry MD Physician 886798 0 7 0 782 0 33800 0 21860 0 943247 0 0 0 Jason H Huang MD Physician 868521 0 50007 0 19975 0 0 0 20256 0 958759 0 0 0 Wade L Knight MD Former Officer 518579 0 7 0 16276 0 33800 0 15472 0 584134 0 0 0 Andrejs E Avots-Avotins MD Former Officer 398492 0 43643 0 12217 0 32935 0 15104 0 502391 0 0 0 Glen R Couchman MD Former Officer 0 558912 0 391859 0 26655 0 15763 0 16702 0 1009891 0 0 Part I, Line 1a Tax indemnification and gross up payments - The organization provides tax indemnification where an authorized member of management determines there is justification to reimburse an individual for the tax impact on certain taxable, non-cash benefits provided to them. All tax indemnification payments provided are treated as taxable compensation. Sixteen of the persons listed in the Form 990, Part VII, Section A, received this benefit during the tax year. Part I, Line 1a The organization provides temporary housing to eligible employees under the organization's moving and relocation reimbursement policy. All temporary housing provided to any employee is treated as taxable compensation. One person listed in the Form 990, Part VII, Section A, received this benefit during the tax year. Part I, Line 1a Travel for companions-The organization reimburses eligible employees and board members certain reasonable travel expenses associated with spousal travel where the spouse's presence is important to the event. These events may include, for example, board meetings, business meetings, and award ceremonies approved by the BSW Holdings' CEO, COO or CFO. All spousal travel reimbursements are treated as taxable compensation. Two people listed in the Form 990, Part VII, Section A, received this benefit during the tax year. Part I, Line 3 Process for determining compensation: The organization, a controlled affiliate of BSW Holdings, recognizes that those chosen to lead the organization are vital to its ongoing success and growth. Thus, it must attract, retain and engage the highest quality officers and key employees to lead the organization and help the organization maintain its national reputation for achieving high targets for medical quality, patient safety, and patient satisfaction. A significant portion of the organization's officers and key employees' total compensation is based on significant performance achievements. This strategy, known as the Annual Incentive Plan, places a greater emphasis on the importance of the organization achieving targeted improvements in the areas of people, quality, patient satisfaction and financial stewardship, annually. Total executive compensation is part of an integrated talent management strategy developed by the BSW Holdings' Board of Trustees and its Compensation and Governance Committee (C&G Committee) to attract, motivate, and retain the best leadership resources for the organization. Executive compensation is determined pursuant to guidelines outlined in the intermediate sanction rules under IRC Section 4958 including taking steps to meet the rebuttable presumption standard of reasonableness under Treasury Regulation 53.4958-6, as summarized below. When making compensation decisions, the organization compares itself to similar-sized, and structured businesses including other integrated health care service systems and other similar-sized organizations, both locally and nationally. The BSW Holdings' Board of Trustees and C&G Committee, on behalf of the organization, work directly with an independent compensation expert(s) to identify reasonable and competitive market rates as well as provide an annual review of the total compensation of the organization's top management officials and key employees. The C&G Committee is made up of members of the BSW Holdings' Board of Trustees, who are independent, community volunteers Guided by the information provided by the independent compensation expert(s), the C&G Committee approves and recommends to the BSW Holdings' Board of Trustees salary increases, earned incentives, and benefit offerings for the organization's President, other officers and/or key employees to be comparable to similar organizations for similar services and/or positions. Furthermore, the C&G Committee is charged with the responsibility of reviewing annually the major elements of the executive compensation program to assure designs remain consistent with the business needs, market practices, and compensation philosophy. As part of the decision making process, the C&G Committee will often meet in executive session to discuss and review recommendations made by the independent compensation expert(s). During the executive session no officer or key employee whose compensation is being reviewed is present during these discussions. All decisions are contemporaneously documented in the C&G Committee minutes which are timely reviewed and approved by the C&G Committee. Part I, Line 7 The organization has adopted and implemented BSW Holdings', the organization's ultimate parent, Annual Incentive Program to provide a market competitive total cash compensation incentive program that is designed to attract and retain key leaders and establish greater individual accountability and alignment to business performance. Payout targets are based upon a percentage of base pay and are developed by independent third party expert(s) using comparable market competitive data within the bounds of reasonableness and that are reviewed and approved by BSW Holdings' governing body. Payout levels are based upon a combination of system, entity, and individual performance using various metrics related to quality, patient satisfaction, employee retention, and financial stewardship. BSW Holdings' governing body may approve modifications to annual incentive awards provided under the program consistent with market comparability data. Barbara Weiss MD Family member of Michael L. Middleton, M.D., Officer 125971 Employee Compensation 0 Darla Lowe MD Family member of Robert A. Probe, M.D., Officer 151125 Employee Compensation 0 Mercedes Arroliga MD Family member of Alejandro C. Arroliga, M.D., Director 99753 Employee Compensation 0 Part I, Lines 3 & 4 & Part VI, Lines 1a & 1b: Number of Independent Board Members: The organization is operated under chapter 162.001(b) of the Texas Occupations Code (formerly 5.01(a) in the Medical Practice Act), for the public interest, such as research, education or public health, and must be incorporated and directed by physicians licensed by the Texas Medical Board and actively engaged in the practice of medicine. The administrative side of the corporation may be handled by non-physician officers, but all medical decisions and the overall medical policies of the organization must be made by physicians. The organization's board members are employees of the organization who are nominated by vote of the Senior Staff and recommended by the organization's board, subject to final approval by Baylor Scott & White Holdings (BSW Holdings) in the exercise of a power reserved to the member of the organization. As employees of the organization, the organization's board members would not be considered independent according the Form 990 instructions. However, to the fullest extent allowed by state law, BSW Holdings, has certain reserved powers over the organization that include, without limitation, financial decisions, compensation (including physicians) matters, approval of the organization's articles of incorporation and bylaws, and amendments thereto, removal of the members of the governing body under certain conditions, and approval of dissolutions and mergers, over the organization. BSW Holdings' governing body is comprised of a majority of independent community representatives that provide leadership and governance to BSW Holdings and its affiliated tax exempt entities, including the filing organization, to ensure it is meeting its charitable purpose. Form 990, Part V, Line 1a The Organization does not file Forms 1096 or 1099. All expenditures for goods and services are made by SWMH, which has filed all required reporting forms. Form 990, Part V, Line 2a Employees of certain BSWH affiliates located in Central Texas are employed by SWMH (EIN: 74-1166904) or SWC. This is done to achieve parity and consistency in compensation and benefits offered to employees and to reduce administration costs. Consistent with this practice, employee Forms W-2 are filed by SWMH or SWC. For financial reporting purposes, compensation, benefits and other employee costs are assigned to the BSWH entity for which services are rendered. Oversight of and responsibility for the activities of employees are vested in the board of directors and management of the BSWH entity to which such employees are assigned. All required employment forms have been filed by SWMH and SWC. Form 990, Part VI, Section A, line 1 Number of Independent Board Members: The organization is operated under chapter 162.001(b) of the Texas Occupations Code (formerly 5.01(a) in the Medical Practice Act), for the public interest, such as research, education or public health, and must be incorporated and directed by physicians licensed by the Texas Medical Board and actively engaged in the practice of medicine. The administrative side of the corporation may be handled by non-physician officers, but all medical decisions and the overall medical policies of the organization must be made by physicians. The organization's board members are employees of the organization who are nominated by vote of the Senior Staff and recommended by the organization's board, subject to final approval by Baylor Scott & White Holdings (BSW Holdings) in the exercise of a power reserved to the member of the organization. As employees of the organization, the organization's board members would not be considered independent according the Form 990 instructions. However, to the fullest extent allowed by state law, BSW Holdings, has certain reserved powers over the organization that include, without limitation, financial decisions, compensation (including physicians) matters, approval of the organization's articles of incorporation and bylaws, and amendments thereto, removal of the members of the governing body under certain conditions, and approval of dissolutions and mergers, over the organization. BSW Holdings' governing body is comprised of a majority of independent community representatives that provide leadership and governance to BSW Holdings and its affiliated tax exempt entities, including the filing organization, to ensure it is meeting its charitable purpose. Form 990, Part VI, Section A, line 6 Members or stockholders: The organization is a Texas nonprofit membership organization in which Scott & White Healthcare, a tax exempt, Texas nonprofit corporation, is the sole member. Form 990, Part VI, Section A, line 7a Election of members of governing body by members, stockholders, or other persons: Baylor Scott & White Holdings (BSW Holdings), a tax exempt, Texas nonprofit corporation is the ultimate parent entity of the organization. BSW Holdings has control and substantial reserved powers over the organization, including those to elect and remove the governing body of the organization. The BSW Holdings' Board of Trustees is comprised of a majority of independent community representatives that provide leadership and governance to BSW Holdings and its affiliated tax exempt entities, including the filing organization, to ensure it is meeting its charitable purpose. Form 990, Part VI, Section A, line 7b Governing body decisions subject to approval: All rights and powers were reserved to the organization's ultimate parent, BSW Holdings, except only those rights and powers expressly set forth in the bylaws, required by state or federal law, or to meet the requirements and standards promulgated by joint commission. For example, BSW Holdings' substantial reserved rights and powers include, without limitation, approval of the organization's articles of incorporation and bylaws and amendments thereto, appointment and removal of members of the organization's governing body, approval of dissolutions and mergers, and other similar decisions over the organization. The BSW Holdings' Board of Trustees is comprised of a majority of independent community representatives that provide leadership and governance to BSW Holdings and its affiliated tax exempt entities, including the filing organization, to ensure it is meeting its charitable purpose. Form 990, Part VI, Section B, line 11 Process used to review the Form 990: The Form 990 is prepared and reviewed by the BSWH tax department. During the return preparation process the tax department works with other functional areas including finance, accounting, treasury, legal, human resources, and corporate compliance for advice, information and assistance to prepare a complete and accurate return. Upon completion, the Form 990 is reviewed by the organization's President, financial officer and/or other key officers. A complete final copy of the return is provided to the organization's governing body prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Process used to monitor and enforce compliance with the organization's conflict of interest policy: Persons with an actual or perceived ability to influence the organization have the duty to disclose annually and otherwise promptly as potential conflicts are identified, any familial, professional or financial relationships with entities or individuals that do, or seek to do business with the organization or that compete with the organization. These individuals include the organization's officers, governing body, management, physicians with administrative services agreements and other key personnel who interact with outside organizations or businesses on behalf of the organization. The BSW Holdings' Board of Trustees Audit and Compliance Committee and the BSW Holdings' Corporate Compliance Committee review all relevant disclosures submitted by these individuals to determine whether a conflict of interest exists and to determine an appropriate resolution, if necessary any individual with a perceived or potential conflict is prohibited from voting or participating in the decision making process regarding such transaction with that individual. Form 990, Part VI, Section B, line 15 Process for determining compensation: The organization, a controlled affiliate of BSW Holdings, recognizes that those chosen to lead the organization are vital to its ongoing success and growth. Thus, it must attract, retain and engage the highest quality officers and key employees to lead the organization and help the organization maintain its national reputation for achieving high targets for medical quality, patient safety, and patient satisfaction. A significant portion of the organization's officers and key employees' total compensation is based on significant performance achievements. This strategy places a greater emphasis on the importance of the organization achieving targeted improvements in the areas of people, quality, patient satisfaction and financial stewardship, annually. Total executive compensation is part of an integrated talent management strategy developed by the BSW Holdings' Board of Trustees and its Compensation and Governance Committee (C&G Committee) to attract, motivate, and retain the best leadership resources for the organization. Executive compensation is determined pursuant to guidelines outlined in the intermediate sanction rules under IRC Section 4958 including taking steps to meet the rebuttable presumption standard of reasonableness under Treasury Regulation 53.4958-6, as summarized below. When making compensation decisions, the organization compares itself to similar-sized, and structured businesses including other integrated health care service systems and other similar-sized organizations, both locally and nationally. The BSW Holdings' Board of Trustees and C&G Committee, on behalf of the organization, works directly with an independent compensation expert(s) to identify reasonable and competitive market rates as well as provide an annual review of the total compensation of the system's top management officials and key employees. For the organization's officers or key employees that don't meet the threshold for annual review by the C&G Committee of the new combined BSWH System have been through a similar process by the one of the legacy parent board's (BHCS or SWHC) compensation committees in a prior year. The C&G Committee is made up of members of the BSW Holdings' Board of Trustees, who are independent, community volunteers guided by the information provided by the independent compensation expert(s), the C&G Committee approves and recommends to the BSW Holdings' Board of Trustees salary increases, earned incentives, and/or benefit offerings for the organization's President, other officers and/or key employees to be comparable to similar organizations for similar services and/or positions. Furthermore, the C&G Committee is charged with the responsibility of reviewing annually the major elements of the executive compensation program to assure designs remain consistent with the business needs, market practices, and compensation philosophy. As part of the decision making process, the C&G Committee will often meet in executive session to discuss and review recommendations made by the independent compensation expert(s). During the executive session no officer or key employee whose compensation is being reviewed is present during these discussions. All decisions are contemporaneously documented in the C&G Committee minutes which are timely reviewed and approved by the C&G Committee. Form 990, Part VI, Section C, line 19 Process for making governing documents, conflict of interest policy, & financial statements available to the public: The organization's articles of incorporation and amendments thereto are made available to the public by the filing of those documents with the Texas Secretary of State. Also, the organization is included within the combined financial statements of BSW Holdings that are made available to the public by the posting of those documents through DAC Bond and are attached to this return. The organization's other governing documents and conflicts of interest policy are not made available to the public. Form 990, Part VI, Line 14 The BSW Holdings' Board of Trustees approved a System wide Business Record Retention and Destruction Policy. While BSW Holdings' Board of Trustees does have certain rights and powers over the organization, it is not the official governing body of the organization. The organization does follow the Baylor Scott & White Business Record Retention and Destruction Policy, and we expect the governing body of the organization to formally adopt the policy within the next fiscal year. Form 990, Part IX, line 11g Other Purchased Services : Program service expenses 36,551. Management and general expenses 497,784. Fundraising expenses 0. Total expenses 534,335. Contract Labor: Program service expenses 3,094,440. Management and general expenses 41,013. Fundraising expenses 0. Total expenses 3,135,453. Laboratory : Program service expenses 465,545. Management and general expenses 0. Fundraising expenses 0. Total expenses 465,545. Repairs & Maintenance : Program service expenses 529,295. Management and general expenses 0. Fundraising expenses 0. Total expenses 529,295. Patient Care : Program service expenses 37,264. Management and general expenses 0. Fundraising expenses 0. Total expenses 37,264. Corporate Overhead : Program service expenses 0. Management and general expenses 68,897,956. Fundraising expenses 0. Total expenses 68,897,956. Form 990, Part XI, line 9: Self-Insurance Liability Reserve -8,307,822. Change in Net Assets of Related Foundation -65,333. Supplemental Information: IRC Section 6038 Statement: Disclosure Statement Related to Forms 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations, Filed on Behalf of the Taxpayer: In accordance with IRC Section 6038 and the constructive ownership rules of IRC Sections 958(a) and (b), the taxpayer is required to file Forms 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations, with respect to certain controlled foreign corporations (CFCs) including Baylor Scott & White Assurance SPC. These filing requirements are or will be satisfied through the filing of Forms 5471 for this CFCs by the U.S. taxpayer identified below who has the same filing requirement. Taxpayer Name: Baylor University Medical Center Taxpayer Address: 2001 Bryan Street Suite 2200 Dallas, TX 75201 Taxpayer Identification Number of U.S. tax return with which the Forms 5471 were or will be filed: 75-1837454 IRS Service Center where U.S. tax return was or will be filed: Ogden Accountable Care Network of Texas LLC 2401 S 31st Street Temple TX 76508 900856905 Inactive DE 0 0 Scott & White Clinic All Saints Health Foundation 2001 Bryan Street Suite 2200 Dallas TX 75201 751947007 Fundraising TX 501(c)(3) Line 7 Baylor All Saints Medical Center 1 Baylor All Saints Medical Center 2001 Bryan Street Suite 2200 Dallas TX 75201 751008430 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Health Care System 2001 Bryan Street Suite 2200 Dallas TX 75201 751812652 Management Services TX 501(c)(3) Line 11b, II Baylor Scott & White Holdings 1 Baylor Health Care System Employee Benefit Trust 2001 Bryan Street Suite 2200 Dallas TX 75201 751848557 VEBA TX 501(c)(9) Baylor Health Care System 1 Baylor Health Care System Foundation 2001 Bryan Street Suite 2200 Dallas TX 75201 751606705 Fundraising TX 501(c)(3) Line 7 Baylor Health Care System 1 Baylor Health Services 2001 Bryan Street Suite 2200 Dallas TX 75201 751917311 Inactive TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Institute for Rehabilitation at Gaston Episcopal Hospital 2001 Bryan Street Suite 2200 Dallas TX 75201 751037226 Rehabilitation Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Medical Center at Carrollton 2001 Bryan Street Suite 2200 Dallas TX 75201 454510252 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Medical Center at Irving 2001 Bryan Street Suite 2200 Dallas TX 75201 752586857 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Medical Center at Waxahachie 2001 Bryan Street Suite 2200 Dallas TX 75201 751844139 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Medical Centers at Garland and McKinney 2001 Bryan Street Suite 2200 Dallas TX 75201 751037591 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Regional Medical Center at Grapevine 2001 Bryan Street Suite 2200 Dallas TX 75201 751777119 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Regional Medical Center at Plano 2001 Bryan Street Suite 2200 Dallas TX 75201 820551704 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor Research Institute 2001 Bryan Street Suite 2200 Dallas TX 75201 751921898 Research TX 501(c)(3) Line 4 Baylor Health Care System 1 Baylor Scott & White Health 2001 Bryan Street Suite 2200 Dallas TX 75201 463131350 Management Services TX 501(c)(3) Line 11b, II Baylor Scott & White Holdings 1 Baylor Scott & White Holdings 2001 Bryan Street Suite 2200 Dallas TX 75201 463130985 Parent TX 501(c)(3) Line 11b, II N/A 0 Baylor Specialty Health Centers 2001 Bryan Street Suite 2200 Dallas TX 75201 751765385 Long Term Acute Care Hospitals TX 501(c)(3) Line 3 Baylor Health Care System 1 Baylor University Medical Center 2001 Bryan Street Suite 2200 Dallas TX 75201 751837454 Acute Care Hospital TX 501(c)(3) Line 3 Baylor Health Care System 1 Brenham Care Center 2401 S 31st Street Temple TX 76508 742663229 Inactive TX 501(c)(3) Line 9 Scott & White Hospital-Brenham 1 HealthTexas Provider Network 2001 Bryan Street Suite 2200 Dallas TX 75201 752536818 Physician Services TX 501(c)(3) Line 3 Baylor Health Care System 1 Hillcrest Baptist Medical Center 100 Hillcrest Medical Blvd Waco TX 76712 741161944 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Memorial Hospital 1 Hillcrest Family Health Center 100 Hillcrest Medical Blvd Waco TX 76712 742730350 Physician Services TX 501(c)(3) Line 11a, I Hillcrest Baptist Medical Center 1 Hillcrest Physician Services 100 Hillcrest Medical Blvd Waco TX 76712 742967081 Physician Services TX 501(c)(3) Line 11a, I Hillcrest Baptist Medical Center 1 Irving Healthcare Foundation 2001 Bryan Street Suite 2200 Dallas TX 75201 751570933 Fundraising TX 501(c)(3) Line 3 Baylor Medical Center at Irving 1 Scott & White Continuing Care Hospital 2401 S 31st Street Temple TX 76508 202850920 Long Term Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White EMS Inc 2401 S 31st Street Temple TX 76508 753242749 Emergency Transport TX 501(c)(3) Line 9 Scott & White Memorial Hospital 1 Scott & White Foundation-Brenham 2401 S 31st Street Temple TX 76508 742460815 Fundraising TX 501(c)(3) Line 7 Scott & White Hospital-Brenham 1 Scott & White Health Plan 2401 S 31st Street Temple TX 76508 742052197 HMO/Insurance TX 501(c)(4) Baylor Scott & White Holdings 1 Scott & White Healthcare 2401 S 31st Street Temple TX 76508 264532547 Management Services TX 501(c)(3) Line 11a, I Baylor Scott & White Holdings 1 Scott & White Healthcare Foundation 2401 S 31st Street Temple TX 76508 273513154 Fundraising TX 501(c)(3) Line 7 Scott & White Healthcare 1 Scott & White Hospital-Brenham 2401 S 31st Street Temple TX 76508 742519752 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-College Station 2401 S 31st Street Temple TX 76508 274434451 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-Llano 2401 S 31st Street Temple TX 76508 273026151 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-Marble Falls 2401 S 31st Street Temple TX 76508 464007700 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-Round Rock 2401 S 31st Street Temple TX 76508 203749695 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-Taylor 2401 S 31st Street Temple TX 76508 741595711 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Medical Plan Trust 2401 S 31st Street Temple TX 76508 742866102 VEBA TX 501(c)(9) Scott & White 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