2014-07-14T16:24:47-05:00 2013-08-31 990 2012-09-01 202850920 Scott & White Continuing Care Hospital SCOT 2542159256 2401 S 31st Street Temple TX 76508 Kimberly Langston 2542159256 2014-07-09 2012 2015-11-30 17:44:51Z Kimberly Langston 2401 S 31st Street Temple TX 76508 21434305 0 X www.sw.org X 2005 TX See Schedule O Providing the most personalized, comprehensive, high quality health care services enhanced by medical education and research to Central Texas residents throughout a 29,000-square mile service area. 6 2 0 0 0 0 0 0 22893062 21420581 102 0 12274 13724 22905438 21434305 0 6375 0 0 9362373 9786878 0 0 0 13475946 10265759 22838319 20059012 67119 1375293 16976544 15404373 25625519 22678055 -8648975 -7273682 X To provide the most personalized, comprehensive and highest quality health care, enhanced by medical education and research. 0 0 16255192 6375 21434305 See Schedule OScott & White provides personalized, comprehensive, high quality health care services enhanced by medical education and research through 13 acute care hospital facilities, one additional announced facility, a 215,000+ member regional health plan serving residents in a 29,000-square mile service area, and one of the nation's largest multi-specialty group practices with more than 140 clinics at over 70 clinic locations providing care in 46 medical specialties. Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is parent corporation of the Scott & White Healthcare System (the "System"). The Scott & White Healthcare Foundation ("SWF")(EIN: 27-3513154), a subsidiary of SWHC, raises funds for the priority programs and services of the entire Scott & White System. The Scott & White Healthcare System had more than 14,000 employees, including over 1,200 physicians and scientists and 300+ advanced practice professionals during the fiscal year ending August 31, 2013, and served over 537,000 patients accounting for 2.5 million patient visits. Scott & White Memorial Hospital ("SWMH"), located in Temple, Texas, is the flagship hospital of the Scott & White Healthcare System and is the only Level I Trauma Center between Dallas and Austin, Texas. The McLane Children's Hospital Scott & White is the only stand-alone children's hospital between Dallas and Austin, Texas. Scott & White Continuing Care Hospital ("CCH") operates a 50 bed, all-private-room, free standing Long Term Acute Care Hospital ("LTAC") targeted to care for critically ill and medically complex patients. CCH is the only LTAC hospital in Central Texas. Scott & White identified a need for residents of Central Texas to be close to their friends and loved ones requiring long term acute care. CCH provides patients daily physician visits, ICU and Med-Surg level nursing, case management, social services, laboratory, radiology, pharmacy, telemetry, dialysis, ventilator management and weaning, special monitoring, respiratory therapy, physical, occupational, speech and nutritional therapy, pain management, and wound care. The goals are to move patients to the next level of care and avoid readmissions to a general acute care hospital. Unique services provided at CCH are onsite 24/7 ICU critical care provided by internal medicine physicians, a 6-bed dialysis suite, and an onsite CT scanner. Scott & White Continuing Care Hospital provided 12,642 patient observation days and 428 admissions during the fiscal year ending August 31, 2013. Scott & White Continuing Care Hospital reported community benefits (as reported to the Texas Department of State Health Services and in accordance with the State of Texas Statutory methodology) of $1,534,306. All hospitals in the Scott & White Healthcare System reported combined community benefits under this same methodology of $223,575,612. 16255192 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 X Jon Malone 2542159259 2401 S 31st Street Temple TX 76508 X Francis P Anderson 1.00 40.00 X X 0 332403 50518 James Guleke 1.00 X 0 0 0 Mack Purifoy 1.00 X X 0 0 0 Stephen Sibbitt MD 1.00 40.00 X X 0 536178 52358 Andrejs E Avots-Avotins MD 1.00 40.00 X 0 533290 53781 Patricia M Currie 1.00 40.00 X 0 735763 53682 Kimberly K Langston 40.00 X 0 222609 36627 James Carroll 1.00 40.00 X 0 511014 46414 Cynthia B Dunlap 1.00 40.00 X 0 308906 45842 Glen R Couchman MD 1.00 40.00 X 0 741071 53113 Robert W Pryor MD 1.00 40.00 X 0 1202973 52070 Dick L Dixon 1.00 40.00 X 0 641174 52540 Matthew L Chambers 1.00 40.00 X 0 536594 54371 Marc R Hallee 1.00 40.00 X 0 496688 46603 Stephen F Sullivan 1.00 40.00 X 0 272378 12785 Charlene Church 40.00 X 0 151597 17094 Nancy Flentge 40.00 X 0 120998 11994 Dacia O Longworth 40.00 X 129166 0 21561 Moira J Pyle 40.00 X 124297 0 9504 Hui Y Yun 40.00 X 115855 0 7095 Alfred B Knight MD 0.00 40.00 X 0 343534 51101 Peter S Brumleve 0.00 40.00 X 0 199976 14740 369318 7887146 743793 3 1 1 0 Scott & White Clinic 2401 S 31st Street Temple TX 76508 Physician Services 866587 Scott & White Healthcare 2401 S 31st Street Temple TX 76508 Corporate Services 727031 Nursefinders PO Box 910738 Dallas TX 753910738 Staffing 372234 Scott & White Memorial Hospital 2401 S 31st Street Temple TX 76508 Corporate Services 134018 4 Net Patient Care Revenue 622110 21420581 21420581 21420581 Food Service 722210 13724 13724 13724 21434305 21434305 0 0 X 6375 6375 246288 246288 7797700 7165562 632138 1742890 1583839 159051 287 287 4699623 2221770 2477853 54501 48549 5952 57417 51147 6270 1087640 968867 118773 289994 258326 31668 5595 4984 611 1136640 1012516 124124 Medical Supplies 2884667 2884667 Dues & Subscriptions 31088 31088 Other Supplies 9676 9676 Outreach 1283 1283 7348 6543 805 20059012 16255192 3803820 0 3713839 3040328 200620 225014 18461765 6322734 13062085 12139031 16976544 15404373 138140 143306 25487379 22534749 25625519 22678055 X -8648975 -7273682 -8648975 -7273682 16976544 15404373 1375293 0 X 0 1 X 1 0 X 0 0 0 0 0 1 3560 0 0 0 3560 0 Part IV, Supplemental Information: Part II-B, Line 1(f): Scott & White Continuing Care Hospital ("CCH") maintains membership in the American Hospital Association and the Texas Hospital Association. A percentage of the dues paid to these organizations are attributed to lobbying activities and are reported as grants to other organizations for lobbying purposes. 16244293 5347235 10897058 2210632 970205 1240427 6840 5294 1546 12139031 Due to Related Organization 22534749 22534749 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: Fin 48 (ASC 740) Footnote: Scott & White evaluates its income tax positions in accordance with ASC 740, Income Taxes, regarding accounting for uncertainty in income taxes. ASC 740 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. There are no material uncertain income tax positions as of August 31, 2013 or 2012. 1 1 1 X 1 X 375.000000000000 1 1 1 0 1 1 444505 444505 0.02220 95511 14764 80747 0.00400 540016 14764 525252 0.02620 13505 13505 0.00070 13505 13505 0.00070 553521 14764 538757 0.02690 1 456922 0 12329940 12305532 24408 X 1 1 1 1 Scott & White Continuing Care Hospital

546 Kegley Rd Temple TX 76502

X Long Term Acute Care Scott & White Continuing Care Hospital 1 1 X X X X X X X X X 12 1 1 1 X X X X X X 1 0 1 1 100.000000000000 1 375.000000000000 1 X X X X X X 1 1 X X X 1 0 X X X X 1 X 0 0 Part I, Line 3c: Scott & White provides free or discounted care to uninsured patients who are considered Financially Indigent. In order to qualify for financial assistance a patient must live within the 31 county service area of the Scott & White Health Care System. To determine eligibility for free or discounted care, in addition to income and residency; net assets, other financial resources, credit report, and other relevant information are considered. The Scott & White financial assistance policy also provides for exceptional circumstances in which a patient with income over 375% FPG could qualify for financial assistance if the cost exceeds two times their annual household income. 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.sw.org. Part I, Line 7: The costing method used for Schedule H is the cost to charge ratio, as calculated in Schedule H, Worksheet 2. This method was applied to the costs reported on lines 7a and 7c. Part III, Line 4: Audited financial statement footnote Page 18: The presentation of the provision for bad debts as a reduction of patient service revenue is based on an entity-wide assessment of the significance of patient revenue that is recognized without assessing patients' ability to pay. As stated in the combined audited financial statements, the organization maintains allowances for uncollectible accounts for estimated losses resulting from a payers 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. However, the allowable costs in the Medicare cost report do not reflect the actual cost of providing care to patients since the Medicare cost report excludes many direct patient care costs that are essential to providing quality care to these patients. For example, certain coverage fees to physicians, cost of Medicare C and D, and other similar direct patient care expenses are specifically excluded as allowable cost in the cost reports. Using the same methodology to calculate the unreimbursed cost of providing charity care and Medicaid (using applicable Schedule H Worksheets) would result in a shortfall higher than the shortfall reported on Part III, Section B, Line 7. 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 continue to increase, and rest on the shoulders of, nonprofit hospitals and/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 Scott & White Healthcare Financial Assistance Policy has a section for coordination with collection policies. It states: "notwithstanding any other provision of any other policy or provision at S&W regarding billing and collection matters, S&W will not engage in extraordinary collection actions before it makes reasonable efforts to determine whether an individual who has an unpaid billing from S&W is eligible for financial assistance under this Policy. "Reasonable efforts" includes notification to the patient by S&W of this Policy upon admission or discharge and in written and oral communications with the patient regarding the patient's billings, including invoices, telephone calls, and such other communications as may be set forth in future guidance from the U.S. Department of the Treasury or Internal Revenue Service." Scott & White Continuing Care Hospital Part V, Section B, Line 3: The Community Benefit Task Force identified methods, participants, questions, and procedures for gathering input from community members around issues of health in Bell County. It was critical that this report be developed with input from people representing the broad interest of the community and people with special knowledge or expertise in public health as well as those who understand the health needs of the medically underserved, low-income and minority population. Direct input from these sources in the form of community surveys and one-on-one interviews, strategically helped us to better understand how best to meet needs based on the community's readiness to change, ability to access, or willingness to access specific services and resources. This ensured that hospital resources would be put to the best use.Several specific locations and community populations were targeted based on the challenges they face acquiring healthcare and maintaining a healthy lifestyle due to lower income situations. For 3 weeks in February, Scott & White sought input from those that are medically underserved in an attempt to focus efforts reaching those who need it most. Clients at The Greater Killeen Free Clinic, located on the West side of the county, and the Temple Community Clinic, located on the East side, were surveyed. Clients seeking assistance at a local health and human service agency, the Bell County HELP Center, and a local food pantry, Helping Hands Ministry in Belton, also participated. To gain input from the broad community, surveys were completed at various health fairs, cultural activities and civic organization meetings across the county as well.Five key informants were selected and interviewed based on their special knowledge around local health issues or their service with medically underserved populations. Each key informant interview began with a description of the findings from the CHNA and an explanation of the needs that were identified as priorities in the community. During the interview, each was asked to comment on all of the needs to either verify or refute the issue as a major concern based on their experiences with serving community members. All 5 felt that the issues identified were indeed priority problems that needed to be addressed. Through their work in the community, they had first-hand knowledge of the impact these issues caused. Interviews were concluded by extending the discussion to learn what resources might currently be available in the community to address the identified needs.Marlene DiLillo has served as the Killeen Free Clinic's Executive Director for 17 years. She is a spokeswoman for the underserved population with health needs. Marlene helped to found the Texas State Association of Charitable Clinics and has served at, and mentored, several charity clinics around Texas. She has a Master's degree in Human Resources, and holds certificates in non-profit management and volunteer management. DiLillo has also has served on many health related boards including the regional Susan G. Komen board.Judy Morales currently serves as the District 2 representative on the City Council of Temple and was elected Mayor Pro-Tem in May 2013. She has a Master's degree in Education and has served as the Executive Director of the Bell County HELP Centers social service agency administrating, planning and implementing community based outreach services and programs since 1972. Judy also serves as the Vice Chair of LULAC Council #4971, and is a volunteer member of numerous community service organizations in the county including Work Force Solutions, the local NAACP Chapter, and Citizens for Progress, the Heart of Temple Angels Alliance and the EMBRACE (Embracing Mentoring Bridging Reaching Assimilating Caring and Educating) Task Force. She also serves on the Executive Boards of Catholic Charities, Family Promise, Hill Country Community Action Association, Central Texas Homeless Alliance, and the Committee for Persons with Disabilities.Dell Ingram-Walker has served as the Administrator of Pediatrics for McLane Children's Hospital and Clinics since 2012. For 5 years prior, she was the Director of Clinic Operations for the Children's Hospital. Ingram-Walker holds a Bachelor of Science Degree in Health Care Management. Through her experience with pulmonary physicians and understanding of medical operations, she was able to provide justification of the need to address pediatric asthma hospitalization rates as well as an overview of the resources and procedures Scott & White has to implement change.Rita Kelley has worked with indigent health care since 1986 serving up to 5 different counties. She has been in her current role with the Bell County Indigent Health Services for nearly 8 years. Her position involves interaction, coordination and planning with other community organizations to address health and human service infrastructure and safety net services. She also monitors state and federal health and human service trends, policy and legislations to assure the county is best represented and served when changes are being considered. Rita was instrumental in the completion of the 2010 community needs assessment for Bell County and has been involved in a multitude of health service organizations including working for Central Texas Council on Alcohol and Drug Abuse, MHMR and the Bell County Human Services-Killeen HELP Center.Bonnie Scurzi has been a Registered Nurse and a Woman's Health Nurse Practitioner with the Bell County Public Health District for more than 20 years. She also has a degree in Nursing Administration and served as the Nursing Director for the BCHD for over 12 years before becoming the District Director in the fall of 2012. She oversees the BCHD medical and nursing facilities that provide a variety of clinical, health counseling, and health educational services, focusing on treating and preventing disease and promoting healthy lifestyles. Scott & White Continuing Care Hospital Part V, Section B, Line 4: Scott & White Memorial Hospital and Mclane's Children's Hospital. Scott & White Continuing Care Hospital Part V, Section B, Line 7: Although the Hospital recognizes the importance of all needs identified by the community, the Hospital will not directly address the following needs identified in the CHNA at this time:Sexually Transmitted Diseases Breast Cancer Death RateAge Adjusted Hospitalization Rate due to Pediatric AsthmaLinguistic IsolationThese priorities did not meet the defined evaluation criteria1.Severity or prevalence of the issue2.Notable health disparities in specific populations3.Feasibility of possible interventions to affect change4.Community population readiness to change5.Ability to evaluate outcomes6.Resources available to impact the needIt was determined internally that the Scott & White Continuing Care Hospital does not have the ability to directly affect change within these needs nor are there resources available to influence change. It was also determined there are other hospitals within the Scott & White Healthcare System that are better positioned to address certain needs. Strategies to address Sexually Transmitted Diseases, the Breast Cancer Death Rate, and Linguistic Isolation are outlined in the implementation plan for Scott & White Memorial Hospital and the Pediatric Asthma Hospitalization Rate will be addressed by McLane Children's Hospital Scott & White. Scott & White Continuing Care Hospital Part V, Section B, Line 12h: The Scott & White Healthcare Patient Financial Assistance Policy ("PFAP") requires patients to be a Permanent Resident of the Scott & White Provider Service Area. Permanent Resident is defined as "an individual who has established and maintained residency within a Scott & White Provider Service Area for a period of at least six (6) months immediately prior to submitting an application for financial assistance." The Scott & White Provider Service Area as defined in the PFAP "is the geographic area, defined by Texas counties and determined by Scott & White, in which a patient must be a Permanent Resident in order to be eligible to receive financial assistance under this Policy." Schedule A of the PFAP lists the 31 Texas Counties that Scott & White has defined as their service area to meet the residency requirement. Scott & White Continuing Care Hospital Part V, Section B, Line 14g: 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. Scott & White Continuing Care Hospital Part V, Section B, Line 20d: The organization's financial assistance policy is developed to provide discounted care to those qualifying for financial assistance to where the amount charged under this policy will always be equal to or lower than the Medicare rates. However, for those qualifying as medically indigent and whose income level is over 375% of the federal poverty level shall not be billed more than 2 times their annual household income, which is generally lower than the methodology listed above and the three methods listed in Schedule H Part V, Line a-c. Part VI, Line 2: Data collection is critical to understanding and meeting community health needs. Scott & White continually monitors local health trends, reviews hospitalization inpatient and outpatient records, and takes feedback from community leaders and public health officials as to what the current needs are. S&W staff members participate regularly in exchanges with government, education, and human service organizations to learn what other issues are in the community that are perhaps underlying causes of healthcare problems. S&W executives assist with strategic planning processes for other organizations that provide healthcare services for the medically underserved. In an effort to get regular feedback from the community, Scott & White created a new department to actively engage the patients and community in continuous dialogue to provide an opportunity for them to share what their unmet needs are when they seek medical care. We believe this platform will allow the opportunity to view shortcomings from the community perspective. Additionally a strategic plan for conducting lengthy assessments on a 3 year cyclical basis has been made for upcoming years. Data pertaining to the changing demographics, hospitalization rates for the top 15 conditions, and 100 health and quality of life indicators will be collected, monitored and reported on a regular basis on the hospital's website. The data will show how counties within the Scott & White service area stand in relation to other Texas Counties, U.S. Counties and Healthy People 2020 goals for the indicators. Also, gaps in information in the current collection of data will be identified and targeted for future exploration in the form of surveys, key informant interviews and focus groups. The 2013 community health needs assessment and corresponding implementation strategy to address identified health needs was presented to and adopted by the Hospital Board of Directors. The CHNA was posted onto the Scott & White website: http://assets.thehcn.net/content/sites/sw/FINAL_2013_CHNA_CCH.pdf. The Implementation Strategy was posted onto the Scott & White website: http://assets.thehcn.net/content/sites/sw/FINAL_2013_IMPLEMENTATION _STRATEGY_CCH.pdf 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. Part VI, Line 4: Bell County encompasses 16 zip codes in 11 cities which include Belton, Fort Hood, Harker Heights, Killeen, Moody, Morgans Point Resort, Nolanville, Rogers, Salado, Temple and Troy. The most recent census data shows that nearly 321,000 people live in Bell County which is nearly a 3.5% growth over the last 3 years. The gender split is nearly even with 49.48% male and 50.52% female.Bell County's demographics are slightly altered as a result of the large military presence in Fort Hood. The base itself is fairly self-contained both as a community and in terms of healthcare services received. The base inflates the 25-34 age group which is the largest in Bell counting accounting for nearly 17% of the population.More than 60% of the residents living in the county are White. 21.63% are Black/African American, and just fewer than 23% of the population in Bell County claim to have Hispanic/Latino ethnicity. The zip codes with the highest Hispanic population (more than 28%) are 76501, 76504 in Temple, and 76541 in Killeen. More than 12% of the county's population speaks Spanish at home including nearly 20% of the households in the 76504 and 76541 zip codes.The median household income in the county is $49,736 and the average household income is $61,315. Nearly one-third of the population has at least an Associate Degree.The census reported that 9,341 families in Bell County live in poverty and of those, approximately 89% have children living with them.77.4 % of Adults and 90.4% of Children in Bell County have some form of health insurance coverage. Medical costs in the United States are extremely high, and many people without health insurance likely cannot afford medical treatment or prescription drugs. They are also less likely to get routine checkups and screenings, so if they do become ill they are less likely to seek treatment until the condition is more advanced and therefore more difficult and costly to treat. Part VI, Line 5: All Scott & White Healthcare System facilities are operated in a manner that furthers exempt purposes. Scott & White Healthcare officers and executives plan and direct the activities of all System facilities under the direction and oversight of the Scott & White Healthcare Board of Trustees. The Scott & White Continuing Care Hospital ("CCH") Board of Directors is comprised of persons residing in the service area. As explained in response to Form 990 Part VI, Section A, Question 7b, the CCH Board of Directors does not consist of a majority of independent directors because CCH relies on the Scott & White Healthcare Board of Trustees, which is controlled by a majority of community trustees, to meet community board standards. Surplus funds are reinvested in facilities, equipment and programs to further CCH's exempt purposes. CCH is operated for the benefit of the public and no part of income inures to any private individual or serves a private interest. Surplus funds are used to improve the quality of patient care, expand facilities, advance medical training and education and fund research. Scott & White Healthcare has a Financial Assistance Policy that all hospitals in the Scott & White Healthcare System, including CCH, follow, which provides assistance to individuals with incomes up to 375% of the Federal Poverty Guidelines. Part VI, Line 6: Scott & White provides personalized, comprehensive, high quality health care services enhanced by medical education and research through 13 acute care hospital facilities, one additional announced facility, a 215,000+ member regional health plan serving residents in a 29,000-square mile service area, and one of the nation's largest multi-specialty group practices with more than 140 clinics at over 70 clinic locations providing care in 46 medical specialties. Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is parent corporation of the Scott & White Healthcare System (the "System"). The Scott & White Healthcare Foundation ("SWF")(EIN: 27-3513154), a subsidiary of SWHC, raises funds for the priority programs and services of the entire Scott & White System. The Scott & White Healthcare System had more than 14,000 employees, including over 1,200 physicians and scientists and 300+ advanced practice professionals during the fiscal year ending August 31, 2013, and served over 537,000 patients accounting for 2.5 million patient visits. Scott & White Memorial Hospital ("SWMH"), located in Temple, Texas, is the flagship hospital of the Scott & White Healthcare System and is the only Level I Trauma Center between Dallas and Austin, Texas. The McLane Children's Hospital Scott & White is the only stand-alone children's hospital between Dallas and Austin, Texas. Scott & White Continuing Care Hospital operates a 50 bed, all-private-room, free standing Long Term Acute Care Hospital ("LTAC") targeted to care for critically ill and medically complex patients. CCH is the only LTAC hospital in Central Texas. Scott & White identified a need for residents of Central Texas to be close to their friends and loved ones requiring long term acute care. CCH provides patients daily physician visits, ICU and Med-Surg level nursing, case management, social services, laboratory, radiology, pharmacy, telemetry, dialysis, ventilator management and weaning, special monitoring, respiratory therapy, physical, occupational, speech and nutritional therapy, pain management, and wound care. The goals are to move patients to the next level of care and avoid readmissions to a general acute care hospital. Unique services provided at CCH are onsite 24/7 ICU critical care provided by internal medicine physicians, a 6-bed dialysis suite, and an onsite CT scanner. Scott & White Continuing Care Hospital provided 12,642 patient observation days and 428 admissions during the fiscal year ending August 31, 2013. Scott & White Continuing Care Hospital reported community benefits (as reported to the Texas Department of State Health Services and in accordance with the State of Texas Statutory methodology) of $1,534,306. The combined hospital reported community benefits of the entire Scott & White Healthcare System under this same methodology was $223,575,612. Reports Filed With States Part VI, Line 7 TX 0 0 0 0 0 0 0 1 0 Francis P Anderson 0 263244 0 67750 0 1409 0 32500 0 18018 0 382921 0 0 Stephen Sibbitt MD 0 435416 0 100000 0 762 0 32500 0 19858 0 588536 0 0 Andrejs E Avots-Avotins MD 0 521642 0 8980 0 2668 0 32500 0 21281 0 587071 0 0 Patricia M Currie 0 540415 0 192500 0 2848 0 32500 0 21182 0 789445 0 0 Kimberly K Langston 0 184584 0 37608 0 417 0 29073 0 7554 0 259236 0 0 James Carroll 0 375213 0 132300 0 3501 0 32500 0 13914 0 557428 0 0 Cynthia B Dunlap 0 245315 0 62750 0 841 0 32500 0 13342 0 354748 0 0 Glen R Couchman MD 0 545222 0 192500 0 3349 0 32500 0 20613 0 794184 0 0 Robert W Pryor MD 0 895623 0 300000 0 7350 0 32500 0 19570 0 1255043 0 0 Dick L Dixon 0 431778 0 207750 0 1646 0 32500 0 20040 0 693714 0 0 Matthew L Chambers 0 392598 0 140000 0 3996 0 32500 0 21871 0 590965 0 0 Marc R Hallee 0 366554 0 129750 0 384 0 32500 0 14103 0 543291 0 0 Stephen F Sullivan 0 230513 0 40833 0 1032 0 0 0 12785 0 285163 0 0 Charlene Church 0 148677 0 2018 0 902 0 12915 0 4179 0 168691 0 0 Alfred B Knight MD 0 242623 0 87500 0 13411 0 32500 0 18601 0 394635 0 0 Peter S Brumleve 0 118744 0 0 0 81232 0 10219 0 4521 0 214716 0 0 Part I, Line 3 The compensation review process is performed annually. All physician compensation is reviewed including pay, production data and total compensation. The physician compensation is then benchmarked against industry standards using data from ten different industry surveys. This review is performed by an independent consultant and presented to the Scott & White Healthcare Board of Trustees Compensation Committee. Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is the parent corporation of the Scott & White Healthcare System (the "System"). System Officers along with regional Chief Executive Officers and Chief Medical Officers are reviewed annually. An independent consultant compares total compensation to benchmark surveys. The Scott & White Healthcare Board of Trustees Compensation Committee reviews the compensation and comparability data annually. Part I, Line 7 Discretionary bonuses are an element of various Scott & White Healthcare System (the "System") compensation plans. The Scott & White Healthcare Board of Trustees, which is the governing body of the Scott & White Healthcare System and the Board Compensation Committee have approved plans designed to measure performance based on differing job functions. The Board of Trustees approves the bonus pools reserved for the various plans. The Board of Trustees determines and approves the bonus, if any, for the System's Chief Executive Officers and other executive level personnel. Form 990, Part V, Line 1a: Scott & White Continuing Care Hospital ("CCH") does not file Forms 1096 or 1099. All expenditures for goods and services are made by Scott & White Memorial Hospital, which has filed all required reporting forms. Form 990, Part V, Line 2a: Employees of the Scott & White Healthcare System are employed by Scott & White Memorial Hospital ("SWMH")(EIN: 74-1166904) or Scott & White Clinic ("SWC")(EIN: 74-2958277). This is done to achieve parity and consistency in compensation and benefits offered to employees and to reduce administrative costs. Consistent with this practice, employee Form W-2's are filed by Scott & White Memorial Hospital or Scott & White Clinic. For financial reporting purposes, compensation, benefits and other employee costs are assigned to the Scott & White 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 Scott & White entity to which such employees are assigned. All required employment forms have been filed by Scott & White Memorial Hospital and Scott & White Clinic. Form 990, Part VI, Section A, line 6 Scott & White Healthcare ("SWHC")(EIN: 26-4532547), an organization exempt from tax under IRC section 501(c)(3) and a public charity under IRC section 509(a)(3) is the sole member. Form 990, Part VI, Section A, line 7a Scott & White Healthcare ("SWHC")(EIN: 26-4532547), an organization exempt from tax under IRC section 501(c)(3) and a public charity under IRC section 509(a)(3) is the sole member. Election of the Hospital Board of Directors requires the approval of the Scott & White Healthcare Board of Trustees, by majority vote. The majority of the Scott & White Healthcare Board of Trustees is comprised of individuals who are representative of the community. Form 990, Part VI, Section A, line 7b Scott & White Healthcare ("SWHC")(EIN: 26-4532547), an organization exempt from tax under IRC section 501(c)(3) and a public charity under IRC section 509(a)(3) is the sole member. Actions taken by the Hospitals Board of Directors are subject to oversight and approval of the Scott & White Healthcare Board of Trustees. The majority of the Scott & White Healthcare Board of Trustees is comprised of individuals who are representative of the community. Form 990, Part VI, Section B, line 11 The Form 990 is prepared and reviewed by Scott & White Healthcare's ("SWHC") 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. 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 Persons with an actual or perceived ability to influence the organization have a 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. Scott & White Healthcare ("SWHC")Board of Trustees Audit and Compliance Committee and the SWHC Corporate Compliance Committee reviewed 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 The compensation review process is performed annually. All physician compensation is reviewed including; pay, production data, and total compensation. The physician compensation is then benchmarked against industry standards using data from ten different industry surveys. This review is performed by an independent consultant and presented to the Scott & White Healthcare Board of Trustees Compensation Committee. Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is the parent corporation of the Scott & White Healthcare System (the "System"). System Officers along with regional Chief Executive Officers and Chief Medical Officers are reviewed annually. An independent consultant compares total compensation to benchmark surveys. The Scott & White Healthcare Board of Trustees Compensation Committee reviews the compensation and comparability data annually. Form 990, Part VI, Section C, line 19 The Scott & White governing documents and Conflict of Interest Policy (Tax) are available to the public upon request. This entity does not have separately audited financial statements. The audited financial statements of the Scott & White Healthcare System are available at http://www.dacbond.com and upon request. Part VI, Line 14: While not formally adopted as of the organization's tax year end, written policies and procedures have been drafted by the organization that address the procedures followed with respect to written document retention and destruction compliance. The organization anticipates these procedures will be adopted within the next fiscal year. Form 990, Part VII: Average hours per week recorded in column B for the Officers, Directors, Key Employees and Highly Compensated Employees represent total hours worked for the entire Scott & White Healthcare System. Other Fees Form 990, Part IX, line 11g Corporate Services: Program service expenses 0. Management and general expenses 2,205,487. Fundraising expenses 0. Total expenses 2,205,487. Repairs: Program service expenses 175,962. Management and general expenses 21,571. Fundraising expenses 0. Total expenses 197,533. Contract Labor: Program service expenses 146,010. Management and general expenses 17,899. Fundraising expenses 0. Total expenses 163,909. Other Purchased Services: Program service expenses 1,899,798. Management and general expenses 232,896. Fundraising expenses 0. Total expenses 2,132,694. Form 5471 Disclosure Statement Related to Forms 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations, Filed on Behalf of the Taxpayer: Under 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, as a Category 5 filer with respect to certain controlled foreign corporations (CFCs). 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: efile Scott & White Healthcare 2401 S 31st Street Temple TX 76508 264532547 Operational Support TX 501 (c) (3) Line 11a, I N/A 0 Scott & White Memorial Hospital 2401 S 31st Street Temple TX 76508 741166904 Hospital Services TX 501 (c) (3) Line 3 Scott & White Healthcare 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 Hospital-Round Rock 2401 S 31st Street Temple TX 76508 203749695 Hospital Services TX 501 (c) (3) Line 3 Scott & White Healthcare 1 Scott & White EMS Inc 2401 S 31st Street Temple TX 76508 753242749 Emergency Transportation TX 501 (c) (3) Line 9 Scott & White Memorial Hospital 1 Hillcrest Baptist Medical Center 100 Hillcrest Medical Blvd Waco TX 76712 741161944 Hospital Services TX 501 (c) (3) Line 3 Scott & White Memorial Hospital 1 Scott & White Hospital-Brenham 2401 S 31st Street Temple TX 76508 742519752 Hospital Services TX 501 (c) (3) Line 3 Scott & White Healthcare 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 Health Plan 2401 S 31st Street Temple TX 76508 742052197 HMO/Insurance TX 501 (c) (4) Scott & White Healthcare 1 Scott & White Hospital-Taylor 2401 S 31st Street Temple TX 76508 741595711 Hospital Services TX 501 (c) (3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-Llano 2401 S 31st Street Temple TX 76508 273026151 Hospital Services TX 501 (c) (3) Line 3 Scott & White Healthcare 1 Scott & White Hospital-College Station 2401 S 31st Street Temple TX 76508 274434451 Hospital Services TX 501 (c) (3) Line 3 Scott & White Healthcare 1 Brenham Hospital Services Corporation 2401 S 31st Street Temple TX 76508 742605157 Operational Support TX 501 (c) (3) Line 11a, I Scott & White Healthcare 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 Brenham Care Center 2401 S 31st Street Temple TX 76508 742663229 Healthcare TX 501 (c) (3) Line 9 Scott & White Hospital-Brenham 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 Scott & White Hospital-Marble Falls 2401 S 31st Street Temple TX 76508 464007700 Hospital Services TX Applied for 501 (c) Applied for Line 3 Scott & White Healthcare 1 ESWCT LLC 10077 Grogans Mill Rd Ste 100 The Woodlands TX 77380 900899017 Investment TX N/A 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 Scott & White Assurance Ltd 23 Lime Tree Bay Grand Cayman CJ 980589956 Investment CJ N/A C 1 Hillcrest Healthcare Holdings Inc 3000 Herring St Waco TX 76708 742793367 Operational Support TX N/A C 1 Atumida Inc 2401 S 31st Street Temple TX 76508 270583030 Research TX N/A C 1 Insurance Company of Scott & White 2401 S 31st Street Temple TX 76508 743092083 Insurance TX N/A C 1 Charitable Remainder Trust #1 PO Box 6101 Temple TX 765036101 526854329 Investment TX N/A T 1 Charitable Remainder Trust #2 PO Box 6101 Temple TX 765036101 206463694 Investment TX N/A T 1 Charitable Remainder Trust #3 PO Box 6101 Temple TX 765036101 416504860 Investment TX N/A T 1 Charitable Remainder Trust #4 PO Box 6101 Temple TX 765036101 742751167 Investment TX N/A T 1 Charitable Remainder Trust #5 PO Box 6101 Temple TX 765036101 746391353 Investment TX N/A T 1 Charitable Remainder Trust #6 PO Box 6101 Temple TX 765036101 746397360 Investment TX N/A T 1 Charitable Remainder Trust #7 PO Box 6101 Temple TX 765036101 742751168 Investment TX N/A T 1 Charitable Remainder Trust #8 PO Box 6101 Temple TX 765036101 746423552 Investment TX N/A T 1 Charitable Remainder Trust #9 PO Box 6101 Temple TX 765036101 456783659 Investment TX N/A T 1 Phil and June Hivnor Charitable 2401 S 31st Street Temple TX 76508 900850773 Investment TX N/A T 1 Nelda I Staller Charitable Remainder Unitrust No 1 2401 S 31st Street Temple TX 76508 326224724 Investment TX N/A T 1 Scott & White Lake of the Hills Regional Medical Center 2401 S 31st Street Temple TX 76508 451608264 Hospital Services TX N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 Scott & White Memorial Hospital P 7963580 Cost Scott & White Healthcare P 8543878 Cost Scott & White Clinic P 1007573 Cost