2015-05-14T13:38:59-05:00 2014-06-30 990 2013-07-01 751844139 Baylor Medical Center at Waxahachie BAYL 2148204135 2001 Bryan Street No 2200 Dallas TX 752013005 Cheryl McMullan VP Finance/CFO 2148204135 2015-05-14 2013 2016-03-07 17:11:31Z Chris York 1405 W Jefferson Waxahachie TX 75165 81986477 0 X www.BaylorHealth.com X 1982 TX Faith based acute care hospital providing exemplary patient care to Waxahachie, Texas and the surrounding communities. 6 5 434 163 0 0 732745 437168 65562439 71904968 3270795 2466022 0 213409 69565979 75021567 233430 349865 0 0 26206055 27955479 0 0 0 34155083 33069259 60594568 61374603 8971411 13646964 87145466 130933894 2927963 31495208 84217503 99438686 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 51689420 349865 71904968 See Schedule OBaylor Medical Center at Waxahachie (Baylor Waxahachie) is a faith-based, non-profit, 69 bed acute care hospital providing exemplary patient care services to the residents of Ellis County and the surrounding rural communities in North Texas. Baylor Waxahachie provides inpatient and outpatient medical services to treat individuals with diseases, illness and injuries of varying complexities including asthma care, cancer care, diabetes and endocrinology, fitness and wellness, heart and vascular, men's health, neuroscience, orthopedics, spine care, scoliosis care, sleep disturbances, pulmonology, palliative care, physical medicine, digestive diseases, metabolic diseases, emergency care, surgical services, intensive care services, urology, urogynecology, weight management and weight surgery, and women's services. See Schedule H for more information regarding these services and how Baylor Waxahachie promotes the health of the communities.Baylor Waxahachie 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.During the fiscal year, Baylor Waxahachie admitted 3,014 patients resulting in 10,765 days of care and received 40,786 emergency department visits. Additionally, Baylor Waxahachie provided community benefits (as reported to the Texas Department of State Health Services and in accordance with the State of Texas Statutory methodology) of $15,271,938 and provided community benefits (as reported on the IRS Form 990, Schedule H) of $8,790,848 during the tax year. The Texas Annual Statement of Community Benefit Standard includes approximately $5,556,883 of unreimbursed cost of Medicare that is not included in the IRS Form 990, Schedule H. Baylor Waxahachie also provided supervisory education programs for the training of future nurses in an effort to increase the supply of health care professionals nationwide. Assisting with the preparation of future nurses at entry levels of nursing is critical to establishing a workforce of qualified nurses. During the fiscal year, Baylor Waxahachie invested in the training of 275 undergraduate nurses. Total unreimbursed cost of this nursing education program is $1,040,798. 51689420 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 66 0 1 434 1 0 0 0 0 0 0 0 0 0 0 X 6 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Cheryl McMullan 9729238056 1405 West Jefferson Waxahachie TX 75165 Ron Carter Trustee 1.00 11.00 X 0 1086 0 Roy Lamkin Chairman 1.00 9.00 X 0 1534 0 Paul Madeley MD Trustee 1.00 40.00 X 0 569710 73035 George McCleskey Trustee 1.00 8.00 X 0 0 0 J Kent Newsome Trustee 1.00 8.00 X 0 0 0 Walker Harman Trustee 1.00 9.00 X 0 3305 0 Cindy Murray CNO/COO 40.00 X 221711 0 22656 Jay Fox President 40.00 X 471332 0 110954 William Boyd Secretary 1.00 40.00 X 0 1131925 237251 Cheryl McMullan VP Finance/CFO 40.00 X 184549 0 22360 Amy Yeager Secretary 1.00 40.00 X 0 310713 61715 Marva Goins Director Pharmacy 40.00 X 162677 0 24883 Sean Mahaney Director Health Care Impr 40.00 X 120773 8157 26089 Elizabeth Ortiz Director Acute Care 40.00 X 135924 0 24309 Laura Mobley Director Clinical Informat 40.00 X 131382 0 23804 Faye Collins Director Education 40.00 X 130148 0 22763 Stephen Roussel Former Officer 0.00 X 0 210902 23308 1558496 2237332 673127 39 1 1 0 Medco Construction LLC 2001 Bryan St Ste 2200 Dallas TX 75201 Construction 27606589 HealthTexas Provider Network 2001 Bryan St Ste 2200 Dallas TX 75201 Clinical/Administrative 2125542 Aramark Services Inc P O Box 651009 Charlotte NC 282651009 Engineering/Food Serv 1381306 Med Fusion LLC P O Box 222137 Dallas TX 75222 Lab Services 726193 Waxahachie Anesthesia Consultants Servic 107 Kiowa Waxahachie TX 75165 Physician Services 560887 19 429101 8067 437168 Patient Care 621990 69484726 69484726 EHR Incentive 900099 1269385 1269385 Rent 531120 926295 926295 Shared Savings-ACO 900099 200792 200792 Duplication Fees 900099 22455 22455 1315 1315 71904968 550071 550071 8358787 522074 6964910 0 1393877 522074 1915951 1915951 Cafeteria/Vending 722210 213409 213409 213409 75021567 71904968 0 2679431 X 349865 349865 1058839 1058839 21692264 21564652 127612 718319 711938 6381 2968820 2943298 25522 1517237 1517237 26517 26517 4483 4483 16206942 8009531 8197411 52073 5037 47036 702413 667202 35211 3507308 3507308 888246 888246 46304 24679 21625 44219 37753 6466 3262 3262 2783585 2783585 26661 26661 Medical Supplies 7851346 7851346 Non-Medical Supplies 667483 665408 2075 Special Functions 116320 43570 72750 Dues & Memberships 47771 32970 14801 94326 56016 38310 61374603 51689420 9685183 0 19596 28465 152968 153484 1234361 5298421 1204008 1393723 158091 26345 157364350 45212688 28950811 112151662 52380553 3938674 625000 1250000 620000 2420078 6073120 87145466 130933894 2103596 30778531 785854 716677 38513 0 2927963 31495208 X 81710717 95384453 2145390 3694064 361396 360169 84217503 99438686 87145466 130933894 X 13646964 1234898 339321 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 1368 1 16201 0 0 17569 0 Part II-B, Line 1: Statement Regarding Legislative Activity Health care policy is critical to all Americans, and Baylor Medical Center at Waxahachie ("Baylor") 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. Baylor has established relationships with persons and industry associations that often communicate Baylor's positions on major health care issues. These contacts may include direct contact, telephone conversations and/or letters. Also, Baylor may attempt to educate the local community on certain legislative initiatives that may impact Baylor'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. Baylor has not intervened in any political campaign. 547197 75 52299 56883 542688 491550 55647 547197 472536 19014 491550 416067 56469 472536 243743 172324 416067 0.00000 1.00000 0 1 1 1488589 1488589 125536866 26724470 98812396 30338895 18488218 11850677 112151662 X Part V, Line 4: The Baylor Health Care System Foundation endowments provide support for the activities and purposes of Baylor Health Care System and its affiliated entities (collectively, "BHCS"). They enable BHCS to advance its medical objective and mission, including sponsorship of patient care, research, and educational and training programs. Part X, Line 2: The filing organization does not have separate individual audited financial statements; however, the organization is included in Baylor Health Care System's combined audited financial statements (System). The System follows the provisions of ASC 740 "Income Taxes." As of June 30, 2014 and 2013, the System had no material gross unrecognized tax benefits. 1 1 X 1 X 1 X 500.000000000000 1 1 0 1 1 6045490 883475 5162015 0.08410 4113440 2433533 1679907 0.02740 33133 0 33133 0.00050 10192063 3317008 6875055 0.11200 436741 0 436741 0.00710 1040798 1040798 0.01700 438255 0 438255 0.00720 1915794 1915794 0.03130 12107857 3317008 8790849 0.14330 1 12091039 0 18026346 21519689 -3493343 X 1 1 1 1 Baylor Medical Center at Waxahachie 2400 North I-35E Waxahachie TX 75165 www.baylorhealth.com 100275 X X X Baylor Medical Center at Waxahachie 1 1 X X X X X X X X 12 1 1 1 X www.baylorhealth.com/about/community/ X X X X X X X 1 0 1 1 200.000000000000 1 500.000000000000 1 X X X X X X 1 1 X X X 1 0 X X X 1 X 0 0 Baylor Medical Center at Waxahachie Part V, Section B, Line 3: Creating healthy communities requires a high level of mutual understanding and collaboration with community individuals and partner groups. The development of the community health needs assessment brought together information from community health leaders and providers along with local residents for the purposes of researching, prioritizing and documenting the community health needs for the geographies served by the hospital facility.As an affiliate of Baylor Health Care System (BHCS), the hospital facility conducted its community health needs assessment with the assistance and direction of BHCS and the guidance of the BHCS Community Benefit Committee. The mission and role of the BHCS Community Benefit Committee is to assist the BHCS Board of Trustees in setting direction, identifying priorities, and monitoring performance in mission and vision integration into community benefits across the BHCS hospital system. The Committee is comprised of trustees (current System and community board members) and other community representatives appointed by the BHCS board of trustees. The hospital facilitys community health needs assessment brings together information from a variety of sources. This assessment consolidates information from recent community health needs assessments conducted for the Texas Regional Healthcare Partnerships, the Dallas County Community Health Needs Assessment and the Consumer Health Report conducted by the National Research Corporation (NRC) for the hospital facility. Members from Baylor Health Care System participated in the development of these reports with other health care providers, community groups and others throughout the Dallas/Fort Worth Metroplex. These reports used a variety of methods to gather and assess the community including, but not limited to, surveys, meetings, and interviews. The hospital has also fostered continued community participation and outreach activities through membership in the Dallas Fort Worth Hospital Council. They have used data from this collaboration of health care providers, including data that served as the basis for this CHNA. This datadrawn from a variety of local, state and federal sourcesrepresents the most recent evaluation of Dallas/Fort Worth residents health status and the assets available to the community for improving health.In addition, data was drawn from the Healthy North Texas website (www.healthytexas.org), which was created under the direction of the Dallas Fort Worth Hospital Council Foundations Community Health Collaborative. The website features data regarding overall population health. It boasts more than 100 local health indicators that can be compared across other Texas regions and the nation. The information can be used to expose crucial health concerns in North Texas, including incidents of diabetes, breast cancer and suicide. The site also has a database of information detailing ways to combat these health ailments. Sponsors of the site include Blue Cross Blue Shield of Texas, Communities Foundation of Texas, HCA North Texas, JPS Health Network, Methodist Health System, Texas Health Resources, University of North Texas Health Science Center and Baylor Health Care System.More detailed information can be found in the hospital community health needs assessment and community benefit plan located at the following website: http://www.baylorhealth.com/About/Community/Assessments/Pages/Default.aspx Baylor Medical Center at Waxahachie Part V, Section B, Line 4: As an affiliate of Baylor Health Care System, the hospital facility conducted its community health needs assessment with other related hospital facilities and with the assistance and direction of Baylor Health Care System. These related hospital facilities included the following: Baylor University Medical Center, Baylor All Saints Medical Center, Baylor Medical Center at Garland, Baylor Regional Medical Center at Grapevine, Baylor Regional Medical Center at Plano, Baylor Medical Center at Waxahachie, Baylor Medical Center at McKinney, Baylor Medical Center at Irving, Baylor Medical Center at Carrollton, Baylor Specialty Hospital, Our Childrens House at Baylor, Baylor Heart and Vascular Hospital, The Heart Hospital Baylor Plano, Baylor Medical Center at Frisco, Baylor Medical Center at Uptown, Irving/Coppell Surgical Hospital, Baylor Orthopedic and Spine Hospital at Arlington, Baylor Surgical Hospital at Fort Worth, Baylor Medical Center at Trophy Club, North Central Surgical Center, Baylor Institute for Rehabilitation at Dallas, Baylor Institute for Rehabilitation at Frisco, Baylor Institute for Rehabilitation at Northwest Dallas, Baylor Institute for Rehabilitation at Fort Worth, and Baylor Emergency Medical Center at Aubrey. Additionally, Baylor Health Care System also participated in numerous workgroups and studies used for other community health needs assessments conducted throughout the twelve county North Texas Region. The data and results of these various community health needs assessments were used by Baylor Health Care System and its affiliated hospital facilities to conduct their own community health needs assessments. Other hospital facilities in the community including county hospitals such as Parkland Memorial Hospital, John Peter Smith Hospital and other hospitals participated in these other community health needs assessments. Baylor Medical Center at Waxahachie Part V, Section B, Line 11: In addition to providing free care to financially indigent patients at 200% of the federal poverty guidelines (FPG), the organization provides discounted care to the medically indigent which is based on both the FPG (up to 500%) and the percentage of the patient's total bills from all providers in relation to the patient's annual income. Pursuant to the charity care policy, a patient's total balance due will not exceed 10% of total annual income if the patient qualifies as medically indigent. The organization also provides discounted care to those individuals whose amount of total bills, after all payments from third parties, exceeds 50% of the patient's annual income (regardless of the level of income) if the patient is unable to pay the remaining bill. Baylor Medical Center at Waxahachie Part V, Section B, Line 12i: Baylor Medical Center at Waxahachie has had a financial assistance policy written in accordance with Texas Health and Safety Code Chapter 311. In general that regulation defines charity care as providing, funding or otherwise financially supporting health care services to a person cliassifed by the hospital as financially or medically indigent; or providing funding or otherwise financially supporting health care services provided to financially indigent persons through other nonporfot or public clinics, hospital or hospital organizations. To determine if a patient meets the definition of financially or medically indigent in the statute, the number in the household is required. Additionally, although assets and other resources are not included in the calculation to determine whether a patient is financially or medically indigent, the organization's policy reserves the right to allow the patient's assets or other resources to be considered when determining if financial assistance will be granted. Baylor Medical Center at Waxahachie Part V, Section B, Line 14g: Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the charity care policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's charity care program in the local newspapers: 3) information regarding financial assistance, including the organization's charity care policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization provides free financial counselors to help patients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's charity care program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital will automatically receive help from a financial counselor. These services are provided in writing and through interpretation services in the primary language of the patient requesting assistance. Though the most often needed alternate language is Spanish, the organization can accommodate multiple languages including American Sign Language. Baylor Medical Center at Waxahachie Part V, Section B, Line 20d: The organizations financial assistance policy is developed to provide discounted care to those qualifying for financial assistance to where the amount charged under the policy will always be equal to or lower than the average of the three largest (by volume) negotiated commercial insurance rates. However, for those qualifying as medically indigent and whose income level is from 200% to 500% of the federal poverty level shall not be billed more than 10% of their annual income which is generally lower than the methodology listed above and the three methods listed in Question Part V, Line 20ac. 3 Baylor Imaging & Diag Ctr at Red Oak 305 E Ovilla Rd Red Oak TX 75154 Radiology Sleep Center at Baylor Waxahachie 1510 W Jefferson Waxahachie TX 75165 Sleep Center Baylorworx Waxahachie 507 N Hwy 77 Waxahachie TX 75165 Diabetes, Bariatrics Part I, Line 3c: and Line 3b: In addition to providing free care to financially indigent patients at 200% of the federal poverty guidelines ("FPG"), the organization provides discounted care to the medically indigent which is based on both the FPG (up to 500%) and the percentage of the patient's total bills from all providers in relation to the patient's annual income. Pursuant to the charity care policy, a patient's total balance due will not exceed 10% of total annual income if the patient qualifies as medically indigent. The organization also provides discounted care to those individuals whose amount of total bills, after all payments from third parties, exceeds 50% of the patient's annual income (regardless of the level of income) if the patient is unable to pay the remaining bill. Part I, Line 6a: The organization prepares and files an Annual Report of Community Benefit Plan with the Texas Department of State Health Services. These reports are made available through the organization's website at www.baylorhealth.com. Part I, Line 7: A ratio of patient care cost to charges, as determined in Worksheet 2, was used to report the amounts in Part I, Lines 7a - 7d. For amounts reported on lines 7e - 7k, actual expenses for each community benefit activity are tracked and reported using both community benefit software and/or the organization's cost accounting system.Part I, Line 7b, column (d): Includes payments from the State 1115 Medicaid Waiver Program for uncompensated care, which funds are to be used to expand indigent care.Part I, Line 7i, Column (c): Includes charity care payments of $348,720 that are made directly to or on the behalf of a local public hospital and/or other nonprofit organizations for the treatment of indigent patients of those organizations. Part I, Ln 7 Col(f): The amount of bad debt expense included on Form 990, Part IX, line 25, but removed for Schedule H, Part I, Line 7, Column (f) totaled $0. Part III, Line 4: As stated in the combined audited financial statements, the organization maintains allowances for uncollectible accounts for estimated losses resulting from a payor's inability to make payments on accounts. The organization assesses the reasonableness of the allowance account based on the historical write-offs, cash collections, the aging of the accounts and other economic factors. Accounts are written off when collection efforts have been exhausted. Management continually monitors and adjusts its allowance associated with its receivable. Bad debt does not include amounts for patients who are known to qualify under the organizations charity care policy. The amount of bad debt attributable to patient's accounts is net of contractual allowance, payments received and recoveries of bad debt previously written off. The Organization has entered zero on Schedule H, Part III, Line 3; however, based on prior experience and certain demographics and other information obtained during admission, the organization believes a portion of the bad debt expenses (estimated to range from 1-5%) would be attributable to patients that would otherwise qualify for charity care. Despite all of the effort and ways the organization educates patients about qualifying for its charity care program as demonstrated in Part VI, question 3 below, many uninsured patients either refuse or fail to complete a charity care application or provide sufficient information at the time of admission, during their stay or after being discharged to qualify for assistance under the organization's charity care policy. Part III, Line 8: The amount reported on Part III, Section B, line 7 was calculated in accordance with the Schedule H instructions utilizing the organization's allowable cost reported in the Medicare cost report based on a cost to charge ratio. The organization believes that all of the shortfall should be considered as a community benefit for the following reasons. First, the IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health benefits, including for example Medicare, is an indication that the hospital operates for the promotion of health in the community. Second, the organization provides care to Medicare patients regardless of this shortfall, i.e., loss, and thereby relieves the state and federal government of the burden of paying the full cost for the care of Medicare beneficiaries. Medicare does not provide sufficient reimbursement to cover the entire cost of providing care to these patients causing the organization to use other surplus funds to cover the shortfall. It is expected that reimbursement under the Medicare program will continue to decline and therefore may further limit access to care due to the anticipated reduction of participating Medicare providers in the community. As a result, the care for these patients will likely increase at, and rest on the shoulders of, nonprofit hospitals or county hospital districts. Third, many of the Medicare participants have low fixed incomes and therefore would qualify for charity care or other means tested government programs absent being enrolled in the Medicare program. Fourth, Texas nonprofit hospitals must provide a minimum level of community benefit in order to obtain exemption from state and local taxes. According to the current Texas Health and Safety Code, the unreimbursed cost of Medicare is considered to be a community benefit in determining these state statutory requirements as it helps relieve a governmental burden of providing this care that would otherwise be provided through the county hospital system in Texas. Part III, Line 9b: The organization's debt collection policy and procedures prohibit any collection efforts for the portion of the patient account balance that qualifies for financial assistance under the organization's charity care policy. For any remaining balances due, the same collection policy and procedures are applied equally to all patient types. Part VI, Line 2: During the fiscal year ending June 30, 2013, the Organization conducted a Community Health Needs Assessment (CHNA) to assess the health care needs of the community for each of its licensed hospital facilities and developed an implementation strategy to address the needs identified in the CHNAs. The CHNAs were conducted in accordance with state and federal guidelines including Internal Revenue Code Section 501(r) and the Texas Health and Safety Code Section 311. These CHNAs and implementation strategies have been made widely available to the public and are located on the Organizations website at the following address: www.BaylorHealth.com/Community. Part VI, Line 3: The organization is committed to promoting health in the community including providing or finding financial assistance programs to assist patients. Patients who may qualify for financial assistance through the organization's charity care program or other federal, state and local government programs are informed and educated about their eligibility in several ways including, but not limited to, the following: 1) posting signs and notices regarding the charity care policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's charity care program in the local newspapers: 3) information regarding financial assistance, including the organization's charity care policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization provides free financial counselors to help patients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's charity care program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital will automatically receive help from a financial counselor. These services are provided in writing and through interpretation services in the primary language of the patient requesting assistance. Though the most often needed alternate language is Spanish, the organization can accommodate multiple languages including American Sign Language. Part VI, Line 4: The hospitals community is defined and summarized below. Additional information regarding the community can also be found in the hospitals community health needs assessment and implementation strategy located on the organizations website at www.BaylorHealth.com/Community.Baylor Medical Center at Waxahachie (Baylor Waxahachie) is located in Ellis County and its total service area includes zip codes primarily from the suburban areas of Ellis County covering more than 162,000 residents. The average household income is $69,386 with 9.3 percent living below the federal poverty level. Additionally, 8.1 percent is uninsured and 11.9 percent of the population is enrolled in Medicaid. The vast majority of Ellis County is designated as underserved by the Texas Department of State Health Services except for the Midlothian community. In addition to Baylor Waxahachie, there is one other hospital providing hospital care to the service area. Part VI, Line 5: With the oversight of an independent volunteer community board and Baylor Scott & White Holdings, the organization's parent, the organization has promoted health and benefited the community by providing exemplary health care, medical education, research and other community services. The organization's governing body is comprised of volunteer community representatives that provide leadership and governance for the organization. The members of the governing body contribute their wisdom, insights, and expertise to ensure the organization is fulfilling its mission and charitable purpose while providing efficient administrative support services and direction for the System. The members are well respected residents and/or own businesses in the organization's primary or secondary service area and understand the needs of the community. The medical staff of the organization is open to all physicians in the community who meet membership and clinical privileges requirements. Surplus funds are continuously utilized to maintain access to limited patient services or expand access points of care to patients throughout the community including, but not limited to, the following: The organization operates an emergency department accepting all patients without the regard for the ability to pay. In order to keep up with the growth of the community and the need for emergency services, the organization recently expanded the emergency department in FY 2010 by adding 9 beds and new equipment. This included the addition of the minor emergency E-clinic that provides patients quick access to minor emergency care with a private waiting area resulting in an average patient turnaround time just over one hour. The Organization provides financial assistance in the form of charity care to patients who are indigent and satisfy certain requirements. Additionally, the Organization is committed to treating patients who are eligible for means tested government programs such as Medicaid and other government sponsored programs including Medicare, which is provided regardless of the reimbursement shortfall, and thereby relieves the state and federal government of the burden of paying the full cost of care for these patients. Often, patients are unaware of the federal, state and local programs open to them for financial assistance, or they are unable to access them due to the cumbersome enrollment process required to receive these benefits. The Organization offers assistance in enrollment to these government programs or extends financial assistance in the form of charity care through the Organization's Financial Assistance Policy which can be located on the Organization's website at BaylorHealth.com/FinancialAssistance.The organization is committed to promoting an environment of wellness in its community and coaches residents to intentionally adopt healthier lifestyles to reduce the number of deaths associated with chronic disease. Throughout the year the organization offers free preventive health services to the community such as health screenings, health fairs, immunizations and community education. These efforts are targeted to meet the community health needs identified in the community health needs assessment conducted by the hospital. In addition, the organization has committed significant funding to aid the operation of the Hope Clinic, a local community health clinic serving the medically underserved population. The Hope Clinic, operates as a community need driven, primary care clinic providing diagnostic laboratory & radiologic services, preventive health services, dental services, transportation assistance, pharmaceutical services, mental health and substance abuse services, patient case management services, health education and outreach. The clinic began with the identification of access to care needs for uninsured and indigent residents of Ellis County. In March 2009, Hope Clinic became a Federally Qualified Health Service Center for the provision of primary health care services in underserved and rural communities. Ellis County is one of the fastest growing areas in North Central Texas. Keeping its commitment to meet the health needs of a growing community, the Organization recently purchased 83 acres at the northwest corner of the intersection of I-35 and Hwy 287 for future expansion. Providing more than thirty services and specialties, the planned growth will bring new and expanded services to Waxahachie and the surrounding communities. The Organization is currently building a new $175.5 million hospital facility on the site. The new campus will also be the home to Baylor Charles A. Sammons Cancer Center at Waxahachie, along with expanded facilities to increase services for women. The new facility also will provide additional inpatient beds, operating rooms, and emergency and intensive care unit (ICU). The new hospital is expected to open in December 2014, the Organization's 100th anniversary.The Organization is also committed to assisting with the preparation of future nurses at entry and advanced levels of the profession to establish a workforce of qualified nurses. Through BHCS relationships with fifteen North Texas schools of nursing, the Organization maintains strong affiliations with schools of nursing. In the fiscal year ending June 30, 2014, the Organization invested in training 275 nurses. Total unreimbursed cost of these programs was $1,040,798. Nursing graduates trained at a BHCS entity are not obligated to join the staff although many remain in the North Texas area to provide top quality nursing services to many health care institutions. Part VI, Line 6: The organization is affiliated with Baylor Scott & White Health, 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 communities of North and Central Texas. Baylor Scott & White Health is the largest not-for-profit health care system in Texas, and one of the largest in the United States. Baylor Scott & White Health was formed from the 2013 combination of Baylor Health Care System and Scott & White Healthcare. Known for exceptional patient care for more than a century, the two organizations serve adjacent regions of Texas and operate on a foundation of complementary values and similar missions. Baylor Scott & White Health includes 43 hospitals, more than 500 patient care sites, more than 6,000 affiliated physicians, 35,000 employees and the Scott & White Health Plan.The System exists to serve all people through exemplary health care, education, research and community service. Community benefits are provided through the provision of charity care, governmental sponsored programs (such as Medicaid and Medicare), medical research, medical education, community health improvement services, donations to other nonprofit health care providers, and many other community service activities. During the year, the affiliated nonprofit hospitals reported community benefits (as reported to the Texas Department of State Health Services, and in accordance with the State of Texas Statutory methodology) in excess of $701,800,000. The System's nonprofit hospitals provided community benefits (as reported on the IRS Form 990, Schedule H) in excess of $357,480,000 during the tax year. The Texas Annual Statement of Community Benefit Standard includes approximately $274,860,000 of unreimbursed cost of Medicare that is not included in the IRS Form 990, Schedule H. The System is comprised of separate legal entities including philanthropic foundations, a research institute, a physician network, acute care hospitals, short-stay hospitals, specialty hospitals, ambulatory surgery centers, a health plan and other health care providers all which fall under the common control of Baylor Scott & White Holdings. Under the guidance of an independent community board, the System follows one single mission, vision and values focusing on quality patient centered care while meeting the demands of health care reform, the changing needs of patients and extraordinary recent advances in clinical care.As part of the System, certain affiliates make grants and/or contributions to other related nonprofit affiliates to help financially support and/or fund worthy community benefits activities. The System has also established a patient transfer system among the affiliated hospitals allowing patients needing a particular level of care to be transferred as needed to a related hospital that can provide that service in an efficient and effective manner. As part of the System, all hospitals and other affiliated health care providers are required to adhere to high standards for medical quality, patient safety and patient satisfaction. These standards are set forth by Baylor Scott & White Holdings, the organization's parent, which helps ensures consistency across the System. Part VI, Line 7, Reports Filed With States TX 1 Ellis County Indigent Care Corporation 1405 W Jefferson Waxahachie TX 75165 455449299 N/A 349865 N/A N/A Indigent Care 1 0 Part I, Line 2: Monitoring Grants & Other Assistance As part of its mission, the organization provides grants and other assistance to related organizations and/or unrelated not-for-profit organizations which are religious, charitable, scientific, or educational in nature, within the meaning of Internal Revenue Code Section 501(c)(3), when the use will further one or more tenets of the organization's charitable mission and one of the following criteria for use of these funds is met: (1) Fulfills a need identified by a community needs assessment conducted by the organization and/or outlined in an implementation strategy, (2) Serves an under-served community or group of people through medical mission work to improve their health status (3) promotes health in the community, (4) supports community buildings activities that protect or improves the community's health or safety and/or (5) provides positive visibility and good community relations with other organization serving the health needs of the community . For related organizations, all grants and other assistance are subject to the policies and procedures set forth by BSWH which ensures all funds are used in accordance with the guidelines set forth above and in accordance with the related organization's exempt purpose. Grants and other assistance provided to unrelated organizations are typically monitored by personal inspection. Examples include providing assistance to entities where the filing organization's employee serves as a Board Member for the recipient organization or through attendance at community events where the filing organization employees work as volunteers or to help coordinate these events. X X 1 1 X X X X 0 1 0 0 0 0 0 1 0 Paul Madeley MD Trustee 0 395604 0 0 0 174106 0 56437 0 16598 0 642745 0 147205 Cindy Murray CNO/COO 185669 0 36042 0 0 0 9356 0 13300 0 244367 0 0 0 Jay Fox President 283835 0 128643 0 58854 0 94698 0 16256 0 582286 0 46575 0 William Boyd Secretary 0 582787 0 298107 0 251031 0 215925 0 21326 0 1369176 0 225260 Cheryl McMullan VP Finance/CFO 156050 0 28499 0 0 0 7934 0 14426 0 206909 0 0 0 Amy Yeager Secretary 0 257801 0 51803 0 1109 0 39156 0 22559 0 372428 0 0 Marva Goins Director Pharmacy 143999 0 18494 0 184 0 1505 0 23378 0 187560 0 0 0 Sean Mahaney Director Health Care Impr 109017 8157 10492 0 1264 0 5224 441 18779 1645 144776 10243 0 0 Elizabeth Ortiz Director Acute Care 121383 0 14526 0 15 0 6145 0 18164 0 160233 0 0 0 Laura Mobley Director Clinical Informat 115799 0 15433 0 150 0 5998 0 17806 0 155186 0 0 0 Faye Collins Director Education 115849 0 14074 0 225 0 5954 0 16809 0 152911 0 0 0 Stephen Roussel Former Officer 0 182319 0 27877 0 706 0 9227 0 14081 0 234210 0 0 Part I, Line 1a Discretionary spending account - The organization provides eligible employees who travel frequently in their personal vehicle an auto expense allowance in lieu of reimbursement for business mileage under the organization's business travel and expense reimbursement policy. All auto expense allowances are 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 Health or social club dues or initiation fees-The organization may reimburse eligible employees for dues for a health club and/or a social club where there is a bona fide business need for the membership. For example, as part of the organization's promotion of health, the organization will cover a portion of any employees' fitness center club membership dues paid to an affiliated entity that owns and operates a fitness center. All employees are eligible for this benefit. Such reimbursements are treated as taxable compensation to the extent any part of the membership is used for personal use. One person listed in the Form 990, Part VII, Section A, received this benefit during the tax year. Part I, Line 4b In order to recruit and retain key talent, Baylor Health Care System ("BHCS") offers a supplemental non qualified retirement plan to eligible employees. The plan provides an annual benefit (based on a percentage of compensation) to the employee that is paid to the employee on a future date upon vesting in the plan. The following individual(s) participated in and/or received payments (noted in parenthesis) from BHCS' supplemental non qualified retirement plan during the tax year: Jay Fox, Paul Madeley, M.D. ($147,205), and William Boyd ($329,530). Also, certain officers, as designated by BHCS's governing body, are eligible to participate in a Long Term Incentive Plan that is designed to recognize the key senior leaders value and contribution to BHCS as well as align their compensation to the long term strategy of the BHCS. Performance targets are based upon a percentage of the participants base salary and are developed by independent third party expert(s) using market competitive data within the guides of reasonableness. The plan is based on BHCS's three-year performance against its peers, determined based on peer rankings or percentile rankings in quality, patient satisfaction and financial performance. At the end of three years, awards are determined by BHCS's governing body for participants. Payouts are partially made in cash and the remainder vests over an additional two year period. The following individuals participated in and/or received payments (noted in parenthesis) from this plan during the tax year: Jay Fox ($98,267) and William Boyd ($245,151). Part I, Line 7 The organization has adopted and implemented BHCS's, the organization's sole member, Performance Award 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 BHCS's 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 financal stewardship. BHCS's governing body may approve modifications to annual incentive awards provided under the program consistent with market comparability data. Schedule J, Part III Supplemental Information: Governing body compensation The members of the governing body serve on a voluntary basis and receive no cash compensation from the organization for these duties as a member of the governing body. Some, but not all, members have received modest benefits incident to their service on the board and/or multiple board committees or received compensation as an employee of a related organization. These benefits include reimbursement for certain reasonable expenses paid on behalf of the member's spouse while accompanying the member on business travel on behalf of the related organization and/or a wellness physical. All such benefits are treated as taxable compensation to the extent required by law and are reported in the Form 990 where applicable. Form 990, Part VI, Section A, line 6 Members or stockholders: The organization is a Texas nonprofit membership organization in which Baylor Health Care System, 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: As disclosed in Part VI, Line 4, Baylor Scott & White Holdings, a Texas nonprofit corporation, is currently the sole member of Baylor Health Care System (BHCS) and BHCS is the sole member of the organization. Prior to October 1, 2013, BHCS had control and substantial reserved powers over the organization, including those to elect and remove the governing body of the organization. Effective October 1, 2013, BHCS transferred control and its reserved powers over the organization to Baylor Scott & White Health, LLC and subsequently to Baylor Scott & White Holdings on March 1, 2014. The Baylor Scott & White Holdings Board of Trustees is comprised of a majority of independent community representatives that provide leadership and governance to Baylor Scott & White 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: Prior to October 1, 2013, all rights and powers were reserved to the sole member, Baylor Health Care System (BHCS), 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, the member's 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. Effective October 1, 2013, BHCS transferred control and its reserved powers over the organization to Baylor Scott & White Health, LLC and subsequently to Baylor Scott & White Holdings on March 1, 2014. Form 990, Part VI, Section B, line 11 Process used to review the Form 990: The Form 990 is prepared and reviewed by BSWH's 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 BHCS, 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 BHCS 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 Performance Award Program, 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 BHCS 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 BHCS 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 BHCS 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 BHCS 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. 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 BHCS 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 IX, line 11g Contract Labor : Program service expenses 2,230,850. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,230,850. Other Purchased Services : Program service expenses 3,134,326. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,134,326. Repairs & Maintenance: Program service expenses 1,146,907. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,146,907. Professional Fees : Program service expenses 776,477. Management and general expenses 0. Fundraising expenses 0. Total expenses 776,477. Lab Fees : Program service expenses 720,971. Management and general expenses 0. Fundraising expenses 0. Total expenses 720,971. Other Purchased Services : Program service expenses 0. Management and general expenses 182,384. Fundraising expenses 0. Total expenses 182,384. Professional Fees : Program service expenses 0. Management and general expenses 3,855. Fundraising expenses 0. Total expenses 3,855. Corporate Overhead : Program service expenses 0. Management and general expenses 8,011,172. Fundraising expenses 0. Total expenses 8,011,172. Form 990, Part XI, line 9: Transfers Between Entities Under Common Control -796,470. Changes in Net Assets of Related Foundation 1,548,748. Transfer to/from BHCS-Liability Reserve -412,957. Part XII, Line 2c, Audit & Compliance Committee: As a result of the changes in the governance structure described in Part VI, Line 4, the oversight and selection process of the organization's audit and compilation of its financial statements including the selection of the independent accountant was transferred to the Audit and Compliance Committee of Baylor Scott & White Health LLC effective October 1, 2013 and subsequently transferred to Baylor Scott & White Holdings on March 1, 2014. 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 Scott & White Assurance Ltd and Health Care Insurance Company of Texas, Ltd. These filing requirements are or will be satisfied through the filing of Forms 5471 for these CFCs by other U.S. taxpayers identified below who have the same filing requirement. Taxpayer Name: Scott & White Memorial Hospital Taxpayer Address: 2401 S. 31st Street Temple, TX 76508 Taxpayer Identification Number of U.S. tax return with which the Forms 5471 were or will be filed: 74-1166904 IRS Service Center where U.S. tax return was or will be filed: Ogden Taxpayer Name: Baylor Health Care System 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: 75-1812652 IRS Service Center where U.S. tax return was or will be filed: Ogden Part VI, Line 4, Changes to Organizational Documents: The organization did not make any changes to its governing documents during the tax year, however, effective October 1, 2013, Baylor Health Care System, a Texas nonprofit corporation (BHCS), and Scott & White Healthcare ("SWHC"), a Texas nonprofit corporation, consummated their affiliation pursuant to an Affiliation Agreement (the "Agreement") dated June 19, 2013. BHCS and SWHC formed Baylor Scott & White Holdings (BSW Holdings), a Texas nonprofit corporation. While the receipt of the Internal Revenue Service (IRS) tax-exempt and public charity determination letter for BSW Holdings was pending, BHCS and SWHC formed a Texas limited liability company, Baylor Scott & White Health LLC (BSW Holdings LLC). On December 31, 2013, BSW Holdings received a favorable determination letter from the IRS regarding their tax-exempt and public charity status. Effective March 1, 2014, BSW Holdings LLC was merged into BSW Holdings. BSW Holdings is now the sole member of BHCS and SWHC and has control and substantial reserved powers over all BHCS and SWHC material affiliates including the organization, as more fully described in the exemption application filed with the Internal Revenue Service for BSW Holdings. 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) Line 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 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 Clinic 2401 S 31st Street Temple TX 76508 742958277 Physician Services TX 501(c)(3) Line 9 Scott & White Healthcare 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) Scott & White Healthcare 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) Line 9 Scott & White Healthcare 1 Scott & White Memorial Hospital 2401 S 31st Street Temple TX 76508 741166904 Acute Care Hospital TX 501(c)(3) Line 3 Scott & White Healthcare 1 Scott & White Memorial Hospital Employee Welfare Benfit Trust 2401 S 31st Street Temple TX 76508 742939712 VEBA TX 501(c)(9) Line 9 Scott & White Healthcare 1 Southern Sector Health Initiative 2001 Bryan Street Suite 2200 Dallas TX 75201 263087442 Diabetes Health & Wellness Center TX 501(c)(3) Line 11a, I Baylor University Medical Center 1 Arlington Ortho & Spine Hospital LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 261578178 Short Stay Hospital TX N/A Arlington Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752748040 Ambulatory Surgery Center TX N/A Baylor Affiliated Services LLC 2001 Bryan Street Suite 2200 Dallas TX 75201 260614730 Benefit Plans TX N/A Baylor Heart and Vascular Center LLP 2001 Bryan Street Suite 2200 Dallas TX 75201 752834135 Specialty Hospital TX N/A Baylor Scott & White Health LLC 4005 Crutcher Suite 310 Dallas TX 75246 463748258 Parent TX N/A Baylor Surgicare at Ennis LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 274202856 Ambulatory Surgery Center TX N/A Baylor Surgicare at Granbury LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 263896477 Ambulatory Surgery Center TX N/A Baylor Surgicare at Mansfield LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 271835675 Ambulatory Surgery Center TX N/A Baylor Surgicare at Plano Parkway LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 274282604 Ambulatory Surgery Center TX N/A Baylor Surgicare at Plano LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 260308454 Ambulatory Surgery Center TX N/A Bellaire Outpatient Surgery Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 562297308 Ambulatory Surgery Center TX N/A BIR JV LLP 4714 Gettysburg Rd Mechanicsburg PA 17055 274586141 Rehabilitation Hospitals TX N/A BTDI JV LLP 5214 Maryland Way Suite 200 Brentwood TN 37207 462908086 Imaging Centers TX N/A Dallas Surgical Partners LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 722183815 Ambulatory Surgery Center TX N/A Denton Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752708579 Ambulatory Surgery Center TX N/A Desoto Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752592508 Ambulatory Surgery Center TX N/A EBD JV LLP 10077 Grogans Mill Rd Suite 100 The Woodlands TX 77380 455434614 Free Standing Emergency Hospitals TX N/A ESWCT LLC 10077 Grogans Mill Rd Ste 100 The Woodlands TX 77380 900899017 Free Standing Emergency Hospitals TX N/A Frisco Medical Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 752865177 Short Stay Hospital TX N/A Ft Worth Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752658178 Short Stay Hospital TX N/A Garland Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752764855 Ambulatory Surgery Center TX N/A GlobalRehab LP 4714 Gettysburg Rd Mechanicsburg PA 17055 288077072 Rehabilitation Hospitals TX N/A GlobalRehab-Fort Worth LP 4714 Gettysburg Rd Mechanicsburg PA 17055 205558682 Rehabilitation Hospitals TX N/A Grapevine Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752854711 Ambulatory Surgery Center TX N/A HealthTexas Provider Network-Gastro Serv LLP 2001 Bryan St Ste 2200 Dallas TX 75201 731697736 Physician Services TX N/A Irving Coppell Surgical Hospital LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 542086863 Short Stay Hospital TX N/A Lewisville Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752862263 Ambulatory Surgery Center TX N/A Lone Star Endoscopy Center LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 273635726 Ambulatory Surgery Center TX N/A MEDCO Construction LLC 2001 Bryan Street Suite 2200 Dallas TX 75201 205965871 Construction TX N/A Metrocrest Surgery Center LP 15305 Dallas Parkway Suite 1600 Addison TX 75001 030380493 Ambulatory Surgery Center TX N/A Metroplex Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752567179 Ambulatory Surgery Center TX N/A MSH Partners LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 752829613 Short Stay Hospital TX N/A North Central Surgical Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 201508140 Short Stay Hospital TX N/A North Garland Surgery Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 562399993 Ambulatory Surgery Center TX N/A Park Cities Surgery Center LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 562357079 Ambulatory Surgery Center TX N/A Physicians Surgical Center of Ft Worth LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 208303422 Ambulatory Surgery Center TX N/A Rockwall Ambulatory Surgery Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 205506447 Ambulatory Surgery Center TX N/A RockwallHeath Surgery Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 200334166 Ambulatory Surgery Center TX N/A SeniorCare Associates LP 4714 Gettysburg Rd Mechanicsburg PA 17055 201937212 Rehabilitation Hospitals TX N/A Specialty Surgery Center of Fort Worth LP 15305 Dallas Parkway Suite 1600 Addison TX 75001 201942281 Ambulatory Surgery Center TX N/A Surgery Center of Richardson Phys Pship LP 15305 Dallas Parkway Suite 1600 Addison TX 75001 200606781 Ambulatory Surgery Center TX N/A Texas Endoscopy Center LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 470985876 Ambulatory Surgery Center TX N/A Texas Health Venture Group LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 752696845 Holds interests in ASCs/ Short Stay Hospitals TX N/A Texas Heart Hospital of the Southwest LLP 2001 Bryan Street Suite 2200 Dallas TX 75201 412101361 Specialty Hospital TX N/A THVG Bariatric LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 383894636 Holds interests in Ambulatory Surgery Centers TX N/A Trophy Club Medical Center LLP 15305 Dallas Parkway Suite 1600 Addison TX 75001 481260190 Short Stay Hospital TX N/A Tuscan Surgery Center at Las Colinas LLC 15305 Dallas Parkway Suite 1600 Addison TX 75001 273578014 Ambulatory Surgery Center TX N/A University Surgical Partners of Dallas LLP 15305 Dallas Pkwy Suite 1600 Addison TX 75001 550823809 Ambulatory Surgery Center TX N/A Valley View Surgicare Partners Ltd 15305 Dallas Parkway Suite 1600 Addison TX 75001 752900902 Ambulatory Surgery Center TX N/A Baylor All Saints Med Cntr at Ft Worth Condo Owners Association Inc 2001 Bryan Street Suite 2200 Dallas TX 75201 261661900 Condo Association TX N/A C 1 Baylor Health Enterprises LP 2001 Bryan Street Suite 2200 Dallas TX 75201 751997378 Fitness Center/Pharmacy/ Hotel TX N/A C 1 Baylor Health Network Inc 2001 Bryan Street Suite 2200 Dallas TX 75201 752463251 Billing/Collection TX N/A C 1 Baylor Med Ctr at Grapevine Condo Owners Association Inc 2001 Bryan Street Suite 2200 Dallas TX 75201 752747555 Condo Association TX N/A C 1 Baylor Quality Health Care Alliance LLC 2001 Bryan Street Suite 2200 Dallas TX 75201 454015863 ACO TX N/A C 1320740 755414 0.12500 1 BMP Incorporated 2001 Bryan Street Suite 2200 Dallas TX 75201 751436779 Post Office TX N/A C 1 BUMCRoberts Condominium Owners Association Inc 2001 Bryan Street Suite 2200 Dallas TX 75201 752897806 Condo Association TX N/A C 1 Charitable Remainder Trusts (63) Investment TX N/A 1 Charitable Lead Trusts (2) Investment TX N/A 1 Health Care Insurance Company of Texas Ltd PO Box GT 720 W Bay Rd Grand Cayman CJ 980403182 Investment CJ N/A C 1 Hillcrest Health Holdings Inc 3000 Herring St Waco TX 76708 742793367 Management Services TX N/A C 1 Insurance Company of Scott & White 2401 S 31st Street Temple TX 76508 743092083 Insurance TX N/A C 1 Scott & White Assurance Ltd 23 Lime Tree Bay Grand Cayman CJ 980589956 Investment CJ N/A C 1 Scott & White Properties Holdings Inc 2401 S 31st Street Temple TX 76508 452920596 Investment TX N/A C 1 Scott & White Properties Inc 2401 S 31st Street Temple TX 76508 742497061 Hotel Services TX N/A C 1 Ellis County Indigent Care Corporation 2400 North I-35E Waxahachie TX 75165 455449299 Indigent Care TX N/A C 349865 0.50000 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 HealthTexas Provider Network A 457870 GAAP Baylor Health Care System Foundation C 429101 GAAP Baylor Health Care System M 12863559 GAAP Baylor University Medical Center M 147468 GAAP HealthTexas Provider Network M 2105226 GAAP MEDCO Construction LLC M 71699515 GAAP 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