2013-07-12T14:50:09-05:00 2012-08-31 990 2011-09-01 741161944 Hillcrest Baptist Medical Center HILL 2542159043 100 Hillcrest Medical Blvd Waco TX 76712 Richard Perkins 2542029416 2013-07-12 2011 2016-02-24 21:20:13Z Glenn Robinson 100 Hillcrest Medical Blvd Waco TX 76712 228671922 0 X www.hillcrest.net X 1916 TX Scott & White provides personalized, comprehensive, high quality health care services enhanced by medical education and research through 12 acute care hospital sites, two additional announced facilities, a 240,000+ 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 178 clinics at 65 clinic locations providing care in 46 medical specialties. Hillcrest Baptist Medical Center ("HBMC") is a subsidiary of Scott & White Memorial Hospital ("SWMH"). Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is the parent corporation of SWMH and 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 provided at cost approximately: $60 million in unreimbursed charity care. 12 6 2100 203 0 0 1901845 1940849 229101515 219837150 1717481 1758289 3704437 4285190 236425278 227821478 3634464 5101513 0 0 80802640 87165846 0 0 0 147666590 124895208 232103694 217162567 4321584 10658911 268864206 270710677 223596488 215066562 45267718 55644115 X Hillcrest's mission statement: "To personally provide the highest quality healthcare in a compassionate and Christian environment, enhanced by medical education and research." 0 0 208936231 1940849 221751365 Scott & White provides personalized, comprehensive, high quality health care services enhanced by medical education and research through 12 acute care hospital sites, two additional announced facilities, a 240,000+ 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 178 clinics at 65 clinic locations providing care in 46 medical specialties. Hillcrest Baptist Medical Center ("HBMC") is a subsidiary of Scott & White Memorial Hospital ("SWMH"). Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is the parent corporation of SWMH and 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 provided at cost approximately: $60 million in unreimbursed charity care, $46 million in unreimbursed Medicaid, $4.5 million in unreimbursed indigent care, $21 million in unreimbursed subsidized services, $63 million in unreimbursed health professions education, $13 million in unreimbursed research, $1 million in other community benefits, and had a Medicare shortfall of approximately $96 million in the fiscal year ending August 31, 2012.The Scott & White Healthcare System had more than 14,000 employees, including over 1,000 physicians and scientists and 300+ advanced practice professionals during the fiscal year ending August 31, 2012, and served over 537,000 patients accounting for 2.2 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. Hillcrest Baptist Medical Center is a 237 bed acute care hospital. HBMC had 13,211 admissions, 61,603 patient days, 2,716 newborn deliveries and 8,167 surgeries. HBMC is a major level II trauma center, with a level III neonatal intensive care unit and the most sophisticated CT diagnostic technology available.Scott & White System personnel strive to do more than merely meet the healthcare needs of patients. Employees go into the community to educate about living a healthier life. Targeted populations are provided information on specific needs. For example, physicians specializing in geriatric care hold regular seminars discussing subjects such as preventing injury from falls, questions patients should be asking their doctor, how to maintain a healthy lifestyle with limited mobility, and more. Health educational programs regarding prevention and treatment are offered free or at minimal cost to all community members in a variety of subject areas, such as weight loss, smoking cessation, education on coping with a diagnosis, support groups for families, child safety, heart disease education, diabetes education, sex education for teens, domestic violence prevention and many more. Staff and physicians attend health fairs in the community and provide regular community presentations about health issues for different populations. Clinics in the region offer healthy cooking classes led by a Scott & White dietician to instruct families in creating easy and cost effective healthy meals. As an integrated health care delivery system, Scott & White is able to leverage the Scott & White Health Plan to provide health education information to the community and is actively working to make that information more widely available.Scott & White uses various forms of media to promote health in the community. The System website, blogs, social media, printed flyers, and newspaper and magazine articles written by staff and physicians throughout the year provide information that community members can use to enhance personal health. A specific website has been created to instruct on wellness initiatives (wellness.sw.org). Also, Scott & White staff dedicate many hours serving on community boards and collaborative groups whose missions are to improve the overall health of the community. In addition to these efforts, the System has designated specific funds to be used to enhance healthy initiatives occurring in each community. For example, Scott & White provides substantial financial and in-kind support for multiple free clinics to assist in providing better access and more affordable healthcare to the medically underserved. Scott & White is one of sixteen major U.S. health systems to be part of the National High Value Healthcare Collaborative ("HVHC"). This partnership is designed to improve healthcare, lower costs and make best practices available to the national provider community. The Dartmouth Institute for Health Policy and Clinical Practice leads the collaborative which is studying nine prevalent condition/disease specific areas that have been shown to have wide variation nationally in rates, costs and outcomes. Additional high variation, high cost conditions that affect diverse populations will be added over time. The healthcare systems in this group are responsible for 50 million patients and are using private dollars and research and grant funds to identify ways to get the most out of every healthcare dollar. In June of 2012 the HVHC received a $26 million grant from the Center for Medicare and Medicaid Innovation ("CMMI"). CMMI projects the service improvements funded by this grant will save $64 million over three years, largely due to reduced utilization and costs that have been shown to occur when patients are engaged and empowered to make health care decisions based on their own values and preferences.Scott & White strives to better serve patients while decreasing costs to the healthcare system. One way this is accomplished is through better communication between specialists and primary care physicians creating coordinated and integrated care. Scott & White's electronic medical records (EMR) system allows specialists to review a patient's medical history and lab results and make recommendations to a primary care physician possibly eliminating an office visit. If the specialist needs to see a patient the specialist has access to all tests and lab work prior to the office visit which can prevent a second or third specialty follow-up visit. Scott & White is also using the EMR system to practice active rather than passive medicine. The new EMR system allows Scott & White to automatically remind physicians that patients are due for preventive tests such as mammograms or cholesterol checks. The system allows doctors and nurses to use e-mail to provide patients with test results or to answer questions that previously would have required an office visit.The Scott & White Healthcare System has received numerous awards and accreditations. Scott & White Memorial Hospital was ranked for the eighth time as one of the Top 100 Hospitals by Thomson Reuters. For the second consecutive year, SWMH was named one of the nation's Best Regional Hospitals according to U.S. News & World Report.Hillcrest Baptist Medical Center serves patients qualifying for federal Medicare and state Medicaid programs and other federal and state means tested assistance programs. Services for indigent, uninsured and underinsured patients are provided according to provisions of the Scott & White Healthcare Financial Assistance Policy, which provides financial assistance to patients up to 375% of the Federal Poverty Guidelines. 208936231 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 227 0 1 2100 1 0 0 0 0 0 0 0 0 0 0 X 12 6 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Richard Perkins 2542029416 3000 Herring St Waco TX 76708 X Terry Maness 1.00 X 0 0 0 Billy H Davis Jr 1.00 X 0 0 0 David G Hoffman MD 1.00 X 0 0 0 Lyndon L Olson Jr 1.00 X 0 0 0 G Michael Reitmeier 1.00 X 0 0 0 J Mark Rister MD 1.00 X 0 0 0 Carey Hobbs 1.00 X 0 0 0 John Speckmiear MD 40.00 X 0 403501 53327 Glenn A Robinson 40.00 X 619432 0 41894 Patricia M Currie 40.00 X 0 480343 46740 Glen R Couchman MD 40.00 X 0 573830 53381 Michael D Reis MD 1.00 X 0 432640 48214 Richard W Perkins 40.00 X 0 264260 51214 James Morrison MD 40.00 X 0 342843 48214 David Blackwell 40.00 X 0 162044 37689 Brad Crye 40.00 X 0 180322 42814 Robert W Pryor MD 40.00 X 0 866989 46463 Cynthia B Dunlap 40.00 X 0 202857 38845 Dennis Laraway 40.00 X 0 444702 42397 Dick L Dixon 40.00 X 0 313365 48214 Matthew L Chambers 40.00 X 0 188235 6084 Marc R Hallee 40.00 X 0 450015 6951 Bill Willis 40.00 X 221137 0 20537 Richard Warren 40.00 X 164867 0 32193 Robert Brace 40.00 X 146807 0 31506 David Gentsch 40.00 X 148953 0 22933 Debra Wallace 40.00 X 142262 0 27681 Jason Jennings 40.00 X 0 263745 50047 1443458 5569691 797338 35 1 1 1 Community Hospital Consulting 5801 Tennyson Pkwy Ste 550 Plano TX 75024 Consulting Services 1090598 Total Trauma Care PLLC 50 Hillcrest Medical Blvd Ste 102 Waco TX 76712 Physician Services 955081 North Texas Healthcare Laundry PO Box 535849 Grand Prairie TX 75053 Laundry Services 658620 Hillcrest Surgical Associates PA 3000 Herring Waco TX 76708 Physician Services 646800 Central Texas Pathology Lab PO Box 21509 Waco TX 767021509 Laboratory Services 504706 31 1267368 473516 199965 1940849 Net Patient Care Reven 621990 219837150 219837150 219837150 1490800 1490800 21 21 1296670 786355 510315 510315 510315 331578 64089 267489 267489 267489 Meaningful Use 900099 1914215 1914215 Food Service 900099 1533309 1533309 Gift Shop 900099 327330 327330 3774854 227821478 221751365 0 4129264 5100000 5100000 1513 1513 2814634 1262729 1551905 69520900 69520900 14830312 14562407 267905 38242 38242 279306 279306 278394 278394 16532162 13538328 2993834 37699 37699 1789485 1757162 32323 1918473 1918473 8903527 8742704 160823 871669 855924 15745 3656 3656 13300389 13300389 11417732 11417732 Patient Care 34034735 34034735 Bad Debt 29124765 29124765 Repairs/Maintenance 3246397 3246397 Miscellaneous 2473643 510718 1962925 644934 644934 217162567 208936231 8226336 0 13928877 2404586 500000 14486567 21683349 24012104 120862 91011 3805568 3427516 3618885 2226643 171581530 39365350 142640401 132216180 73969625 80308544 6243988 2320726 2352651 9216800 268864206 270710677 20592587 16632957 250441 368344 176746555 192374716 19962712 0 6044193 5690545 223596488 215066562 X 39080732 48643535 4616875 5433392 1570111 1567188 45267718 55644115 268864206 270710677 X 10658911 -282514 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 5792 0 0 0 5792 0 Explanation of Lobbying Activities: Part II-B, Line 1: Part II-B, Line 1(f): Hillcrest Baptist Medical Center ("HBMC") maintains memberships in the American Hospital Association, Texas Hospital Association and other national and state medical associations. A percentage of the dues paid to those organization is attributed to lobbying activites and is reported as grant to other organizations for lobbying purposes. Periodically, officers or employees of the organization make contact with legislators or government officials. These contacts are generally by letter, with occasional contact in person or by phone. The contacts are for the purpose of informing the legislator or official of the impact of proposed legislation or regulation and its ability to carry out its purpose. 1570111 356 1513 1764 1567190 1561185 8926 1570111 1546959 12438 1788 1561185 1542197 4738 24 1546959 1.00000 0 0 14641678 14641678 110794487 18559541 92234946 42435714 19890049 22545665 3709651 915760 2793891 132216180 Wells Fargo 80308544 F 80308544 Other 4374849 Capital Lease 461195 Intercompany 854501 5690545 Description of Uncertain Tax Positions Under FIN 48: Part X: FIN 48 Footnote: Scott & White evaluates its income tax positions in accordance with ASC 740-10, Income Taxes - Overall, regarding accounting for uncertainty in income taxes. ASC 740-10 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken in a tax return. There are no material uncertain tax positions as of August 31, 2012 or 2011. 1 1 X 1 X 1 X 375.000000000000 1 1 1 0 0 14809142 26540 14782602 0.07860 30677522 20850268 9827254 0.05230 881290 747590 133700 0.00070 46367954 21624398 24743556 0.13160 381917 381917 0.00200 2478026 517616 1960410 0.01040 17803356 14639390 3163966 0.01680 20663299 15157006 5506293 0.02920 67031253 36781404 30249849 0.16080 1 7252827 0 41991981 58624924 -16632943 X 1 1 1 1 Hillcrest Baptist Medical Center

100 Hillcrest Medical Blvd Waco TX 76712

X X X X Hillcrest Baptist Medical Center 1 0 1 1 100.000000000000 1 375.000000000000 1 X 1 1 X X X X X 1 0 1 X 0 0 Part I, Line 6a: Hillcrest Baptist Medical Center ("HBMC") did not prepare a community benefit report for the fiscal year ending August 31, 2012. HBMC is located in McLennan County Texas, and McLennan County completes a county needs assessment annually. The assessment is being used to reassess the current programs and services to better serve the community. 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, 7b, 7c and 7g. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 29124765. Part III, Line 4: In the Hillcrest Baptist Medical Center's ("HBMC") accounting system, bad debt is recorded as the cost of forgone charges. To calculate the cost of bad debt for purposes of Schedule H, Part III, line 2, the cost to charge ratio calculated in Worksheet 2 of the Schedule H Instructions was applied. Due to patient screenings which occur prior to recording bad debt charges, bad debt expense should not contain community benefit expenditures.Audited financial statement footnote: 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. Hillcrest has experienced an increase in write-off trends related to bad debt and charity across the system driven by changes in insurance plan structures shifting financial responsibility away from the health plan to individuals and general economic conditions. There have been no significant changes to the charity care policies for the year ended August 31, 2012. Part III, Line 8: Hillcrest Baptist Medical Center ("HBMC") is a nonprofit hospital that voluntarily participates in the Medicare program. Medicare payments received do not cover the costs incurred to provide services to Medicare patients. In reporting the community benefit portion of the American Hospital Association/Texas Hospital Association survey, the Medicare short-fall is included in community benefit reporting.Costing methodology/source: The Medicare revenue and costs are from the Medicare Cost Report which has a year-end August 31, 2012. All payments to providers of services must be based on the reasonable cost of services covered under title XVIII of the Social Security Act. Reasonable cost includes all necessary and proper costs incurred in rendering the services. Reasonable cost takes into account both direct and indirect costs of providers of services, including normal standby costs. The general services or overhead cost is stepped down and allocated through statistical data to equitably allocate the expenses to the hospital service departments. Part III, Line 9b: The Scott & White Healthcare Sysytem's Financial Assistance Policy, which includes Hillcrest Baptist Medical Center, has a section for coordination with collection policies. It states: "not withstanding 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." Hillcrest Baptist Medical Center Part V, Section B, Line 13g: In addition to the methods of publication listed in question 13, Hillcrest Baptist Medical Center ("HBMC") annually posts a notice in the principal newspaper of its service area. Part VI, Line 2: Hillcrest Baptist Medical Center ("HBMC") utilizes multiple sources in order to identify, define, develop and provide services to our community based on the demographic, economic status and health of those living within HBMC's service area. Once every three years HBMC in cooperation with McLennan County's Health District and other prominent health care provider organizations conduct a Community Needs Assessment. In analyzing the results, HBMC is able to glean the community's overall health status as well as identify community members who are medically underserved as a result of economic conditions, limited access or unattended chronic health problems. From the analysis a listing of prioritized health needs is developed along with an implementation strategy that describes how HBMC plans to meet the health needs. During the period between assessments, HBMC monitors the plan's effectiveness and seeks input from members of the community, physicians, public health leaders and our patients. Recommendations to continue, modify or alter the plan are generated from this input and as well as other contributing factors such as a changing population with respect to health risk factors; incidence of health issues; provider access; and service availability. Part VI, Line 3: Hillcrest Baptist Medical Center ("HBMC") provides patients with information regarding eligibility for financial assistance in a number of ways. Patients are notified of the Financial Assistance Policy upon admission or discharge and in written and oral communications with the patient regarding patient billing statements including phone contact information for patients seeking information regarding billings, invoices and telephone calls. Hillcrest personnel attempt to screen uninsured patients for eligibility for financial assistance, as well as alternative funding sources, prior to providing services. When screening prior to services is not possible, Hillcrest personnel attempt to screen uninsured patients prior to billing. Hillcrest financial counselors contacting patients regarding outstanding accounts attempt to screen patients for eligibility for financial assistance and opportunities for alternative funding sources. Part VI, Line 4: The Scott & White Healthcare System provides care for patients in 35 counties in the state of Texas covering 29,000+ square miles. Eighty-five percent of the patients come from the primary service area including the counties of Bell, Brazos, Coryell, Falls, Lampasas, McLennan, Milam, and Williamson. Eight percent of patients come from the secondary service area including Blanco, Bosque, Brown, Burleson, Burnet, Comanche, Grimes, Hamilton, Hays, Hill, Hood, Johnson, Lee, Leon, Limestone, Llano, Madison, Mills, Robertson, San Saba, Somervell, Travis and Washington counties.In Scott & White's primary service area, the total population is 1,268,822 and the median household income is $46,930. Twenty-seven percent of the population is under the age of 17; 42% is between the ages of 18 and 44; 21% is between the ages of 45 and 64; and 10% of the population is over 65. The top three ethnicities in the primary service area are Caucasion Non-Hispanic with 61.08% of the population; 20.67% are Hispanic and 12% are African American. Part VI, Line 5: Hillcrest Baptist Medical Center ("HBMC") is operated in a manner that furthers exempt purposes. The HBMC Board of Directors is comprised of persons residing in the service area. Surplus funds are reinvested in facilities, equipment and programs to further HBMC's exempt purposes. HBMC maintains an emergency room following EMTALA requirements and has an open medical staff. HBMC 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 follow, including HBMC, 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 12 acute care hospital sites, two additional announced facilities, a 240,000+ 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 178 clinics at 65 clinic locations providing care in 46 medical specialties. Hillcrest Baptist Medical Center ("HBMC") is a subsidiary of Scott & White Memorial Hospital ("SWMH"). Scott & White Healthcare ("SWHC")(EIN: 26-4532547) is the parent corporation of SWMH and 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 provided at cost approximately: $60 million in unreimbursed charity care, $46 million in unreimbursed Medicaid, $4.5 million in unreimbursed indigent care, $21 million in unreimbursed subsidized services, $63 million in unreimbursed health professions education, $13 million in unreimbursed research, $1 million in other community benefits, and had a Medicare shortfall of approximately $96 million in the fiscal year ending August 31, 2012. The Scott & White Healthcare System employs over 1,000 physicians and scientists and 300+ advanced practice professionals. The System has more than 14,000 employees and in the fiscal year ending August 31, 2012 served over 537,000 unique patients accounting for 2.2 million patient visits. Scott & White Memorial Hospital, 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. Hillcrest Baptist Medical Center had 64,503 patient observation days (excluding newborns), 8,167 surgical cases, 13,211 admissions and 54,326 emergency room visits for the fiscal year ending August 31, 2012. Hillcrest Baptist Medical Center serves the community by offering free wellness screenings and health fairs. Most of these health fairs are offered at local schools and at various times throughout the year. HBMC also sponsors the Waco stroke support group, the Jingle Bell Run/Walk for Arthritis and the Waco Heart Walk. Scott & White strives to do more than merely meet the healthcare needs of patients. Employees go into the community to educate about living a healthier life. Targeted populations are provided information on their specific needs. For example, physicians specializing in geriatric care hold regular seminars discussing subjects such as preventing injury from falls, questions patients should be asking their doctor, how to maintain a healthy lifestyle with limited mobility, and more. Health educational programs regarding prevention and treatment are offered free or at minimal cost to all community members in a variety of subject areas, such as weight loss, smoking cessation, education on coping with a diagnosis, support groups for families, child safety, heart disease education, diabetes education, sex education for teens, domestic violence prevention and many more. Staff and physicians attend health fairs in the community and provide regular community presentations about health issues for different populations. Clinics in the region offer healthy cooking classes led by a Scott & White dietician to instruct families in creating easy and cost effective healthy meals. As an integrated health care delivery system, Scott & White is able to leverage the Scott & White Health Plan to provide health education information to the community and is actively working to make that information more widely available. Scott & White uses various forms of media to promote health in the community. The System website, blogs, social media, printed flyers, and newspaper and magazine articles written by staff and physicians throughout the year provide information that community members can use to enhance personal health. A specific website has been created specifically to instruct on wellness initiatives (wellness.sw.org). Also, Scott & White staff dedicate many hours of service serving on community boards and collaborative groups whose missions are to improve the overall health of the community. In addition to these efforts, the hospital has designated specific funds to be used to enhance healthy initiatives occurring in each community. For example, Scott & White provides substantial financial and in-kind support for multiple free clinics to assist in providing better access and more affordable healthcare to the medically underserved. Scott & White is one of sixteen major U.S. health systems to be part of the National High Value Healthcare Collaborative ("HVHC"). This partnership is designed to improve healthcare, lower costs and move best practices out to the national provider community. The Dartmouth Institute for Health Policy and Clinical Practice leads the collaborative which is studying nine prevalent condition/disease specific areas that have been shown to have wide variation in rates, costs and outcomes nationally. Additional high variation, high cost conditions that affect diverse populations will be added over time. The healthcare systems in this group are responsible for 50 million patients and are using private dollars and research and grant funds to identify ways to get the most out of every healthcare dollar. In June of 2012 the HVHC received a $26 million grant from the Center for Medicare and Medicaid Innovation ("CMMI"). CMMI projects the project funded by this grant will save $64 million over three years, largely due to reduced utilization and costs that have been shown to occur when patients are engaged and empowered to make health care decisions based on their own values and preferences.The entire Scott & White Healthcare System serves patients qualifying for federal Medicare and state Medicaid programs and other federal and state means tested assistance programs. Services for indigent patients and uninsured and underinsured patients are provided according to provisions of the Scott & White Healthcare Financial Assistance Policy, which provides assistance to individuals with incomes up to 375% of the Federal Poverty Guidelines. Scott & White also serves private pay patients and contracts with health plans and insurance companies to provide medical services for their participants. 0 Hillcrest Physician Services 100 Hillcrest Medical Blvd Waco TX 76712 742967081 501 (c) (3) 4500000 To fund medical services Hillcrest Family Health Center 100 Hillcrest Medical Blvd Waco TX 76712 742730350 501 (c) (3) 600000 To fund medical services 2 Scholarships 3 1513 Cost X 0 1 X X X X 0 0 0 0 0 0 0 0 0 John Speckmiear MD 0 269064 0 92767 0 41670 0 34811 0 18516 0 456828 0 0 Glenn A Robinson 479412 0 0 0 140020 0 17150 0 24744 0 661326 0 0 0 Patricia M Currie 0 479377 0 0 0 966 0 31850 0 14890 0 527083 0 0 Glen R Couchman MD 0 572024 0 0 0 1806 0 31850 0 21531 0 627211 0 0 Michael D Reis MD 0 429184 0 0 0 3456 0 31850 0 16364 0 480854 0 0 Richard W Perkins 0 262454 0 0 0 1806 0 31850 0 19364 0 315474 0 0 James Morrison MD 0 341877 0 0 0 966 0 31850 0 16364 0 391057 0 0 David Blackwell 0 159272 0 0 0 2772 0 21699 0 15990 0 199733 0 0 Brad Crye 0 179692 0 0 0 630 0 24497 0 18317 0 223136 0 0 Robert W Pryor MD 0 864217 0 0 0 2772 0 31850 0 14613 0 913452 0 0 Cynthia B Dunlap 0 201891 0 0 0 966 0 26914 0 11931 0 241702 0 0 Dennis Laraway 0 444256 0 0 0 446 0 31850 0 10547 0 487099 0 0 Dick L Dixon 0 311559 0 0 0 1806 0 31850 0 16364 0 361579 0 0 Matthew L Chambers 0 172585 0 10000 0 5650 0 0 0 6084 0 194319 0 0 Marc R Hallee 0 346430 0 90000 0 13585 0 0 0 6951 0 456966 0 0 Bill Willis 81736 0 0 0 139401 0 4326 0 16211 0 241674 0 0 0 Richard Warren 163601 0 0 0 1266 0 11656 0 20537 0 197060 0 0 0 Robert Brace 140049 0 5686 0 1072 0 9945 0 21561 0 178313 0 0 0 David Gentsch 145925 0 2317 0 711 0 9787 0 13146 0 171886 0 0 0 Debra Wallace 122947 0 19256 0 59 0 8864 0 18817 0 169943 0 0 0 Jason Jennings 0 261170 0 0 0 2575 0 31850 0 18197 0 313792 0 0 Part I, Line 1a Health Club dues are paid for some officers and are reported as compensation to the officer. Any personal expenses are required to be reimbursed to the organization. Supplemental Information Part III Hillcrest Baptist Medical Center paid Community Hospital Corporation, a management company, $619,432 for the services of President, Glenn Robinson. Community Hospital Corporation is an unrelated organization. Waco Health Facilities Development Corporation 742267504 929836AN4 2006-12-28 215015134 Construction of replacment campus 0 0 0 215015134 15343934 11565969 3540558 5977757 178586916 2009 0 0 1 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 1 Natixis Funding Corp 28.600000000000 1 1 0 Billy H Davis Jr Director 297360 Lease of medical office building 0 Julie Couchman Family of Key Employee 35406 Employee of the Scott & White Healthcare System 0 Jarrod Pryor Family of Key Employee 67026 Employee of the Scott & White Healthcare System 0 Brett Dixon Family of Key Employee 14995 Employee of the Scott & White Healthcare System 0 Form 990, Part VI, Section A, line 3 The bylaws of Hillcrest Baptist Medical Center ("HBMC") allow for management to be delegated, provided the management company and all corporate powers be under the ultimate direction of the HBMC Board of Directors. The Chief Executive Officer, Glenn Robinson, is employed by Community Hospital Corporation ("CHC") the management company of HBMC. Form 990, Part VI, Section A, line 6 Hillcrest Baptist Medical Center's ("HBMC") members are Hillcrest Health Systems Inc. and Scott & White Memorial Hospital, organizations exempt from tax under IRC section 501(c)(3) and public charities under IRC section 509(a)(3). Form 990, Part VI, Section A, line 7a Hillcrest Health System, Inc. and Scott & White Memorial Hospital are the two members of Hillcrest Baptist Medicale Center. Half of the directors for Hillcrest Baptist Medical Center are elected by Scott & White Healthcare, the sole corporate member of Scott & White Memorial Hospital and parent corporation of the Scott & White Healthcare System, and the other half are elected by Hillcrest Health Systems, Inc. Form 990, Part VI, Section A, line 7b Hillcrest Baptist Medical Center's ("HBMC") members are Hillcrest Health Systems Inc. ("HHS") and Scott & White Memorial Hospital ("SWMH"), organizations exempt from tax under IRC section 501(c)(3) and public charities under IRC section 509(a)(3). Scott & White Healthcare ("SWHC") is the sole corporate member of SWMH, and the parent corporation of the Scott & White Healthcare System. Actions taken by the HBMC Board of Directors are subject to oversight and approval of both HHS and SWHC. Form 990, Part VI, Section B, line 11 A copy of Form 990 was provided to the Hillcrest Baptist Medical Center's ("HBMC") Board of Directors for review prior to filing with the IRS. A meeting was held to allow the Directors to ask questions and provide feedback with respect to the information presented in the Form 990. Form 990, Part VI, Section B, line 12c Annually, a written questionnaire is provided to all persons identified as being subject to the Scott & White Healthcare System Conflict of Interest Policy (Tax), requesting responses to questions designed to identify potential conflicts. Responses are monitored and reviewed by System personnel and follow-ups are initiated as required. The Conflict of Interest Policy (Tax) is reviewed before each board meeting or board committee meeting. Board members or persons having business with the Board are asked to identify conflicts which may arise with respect to business conducted by the Board or committee during the meeting. 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 Scott & White Memorial Hospital Hospital ("SWMH"). SWMH is one of the two corporate members of HBMC. Compensation for the Scott and White Healthcare System (the "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 Hillcrest Baptist Medical Center's ("HBMC") governing documents and Conflict of Interest Policy (Tax) are available to the public upon request. HBMC does not have separately audited financial statements, but the consolidated audited financial statements of Hillcrest Baptist Medical Center are available at http://www.dacbond.com and upon request. Estimated Average Hours Worked Form 990, Part VII Column B 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. Compensation of Officers and Directors Form 990, Part VII Column D Officers and Directors are not compensated in their capacity as Directors and Officers of the Corporation. However, some of the directors provide medical or administrative services for the corporation pursuant to employment agreements, and compensation is paid to them in their capacity as medical or administrative personnel. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 103,723. Transfer to Captive -1,199,831. Investment in Supporting Foundation 813,594. Total to Form 990, Part XI, Line 5: -282,514. 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 Properties Opportunities LLC 2401 S 31st Street Temple TX 76508 452920812 Investment TX Scott & White Properties Holdings Inc Scott & White Properties Management LLC 2401 S 31st Street Temple TX 76508 452920980 Investment TX Scott & White Properties Opportunities LLC 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 Continuing Care Hospital 2401 S 31st Street Temple TX 76508 202850920 Hospital Services TX 501 (c) (3) Line 3 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 Hillcrest Family Health Center 100 Hillcrest Medical Blvd Waco TX 76712 742730350 Hospital Services TX 501 (c) (3) Line 3 Hillcrest Baptist Medical Center 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 Healthplan 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 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 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 Physician Services 100 Hillcrest Medical Blvd Waco TX 76712 742967081 Physician Services TX 501 (c) (3) Line 11c, III-FI Hillcrest Baptist Medical Center 1 Scott & White Lake of the Hills Regional Medical Center 2401 S 31st Street Temple TX 76508 451608264 Hospital Services TX 501 (c) (3) Line 3 Scott & White Healthcare 1 Hillcrest Health Foundation 100 Hillcrest Medical Blvd Waco TX 76712 311804708 Fundraising TX 501 (c) (3) Line 11a 0 Hillcrest Health System 100 Hillcrest Medical Blvd Waco TX 76712 742924512 Operational Support TX 501 (c) (3) Line 11a 0 Scott & White Properties Holdings Inc 2401 S 31st Street Temple TX 76508 452920596 Investment TX N/A C Scott & White Properties Inc 2401 S 31st Street Temple TX 76508 742497061 Hotel Services TX N/A C Scott & White Assurance Ltd 23 Lime Tree Bay Grand Cayman Grand Cayman CJ 980589956 Investment CJ N/A C Hillcrest Holdings Inc 3000 Herring St Waco TX 76708 742793367 Operational Support TX N/A C Atumida 2401 S 31st Street Temple TX 76508 270583030 Research TX N/A C Insurance Company of Scott & White 2401 S 31st Street Temple TX 76508 743092083 Investment TX N/A C Charitable Remainder Trust #1 PO Box 6101 Temple TX 765036101 526854329 Investment Trust TX N/A T Charitable Remainder Trust #2 PO Box 6101 Temple TX 765036101 206463694 Investment Trust TX N/A T Charitable Remainder Trust #3 PO Box 6101 Temple TX 765036101 416504860 Investment Trust TX N/A T Charitable Remainder Trust #4 PO Box 6101 Temple TX 765036101 742751167 Investment Trust TX N/A T Charitable Remainder Trust #5 PO Box 6101 Temple TX 765036101 746391353 Investment Trust TX N/A T Charitable Remainder Trust #6 PO Box 6101 Temple TX 765036101 746397360 Investment Trust TX N/A T Charitable Remainder Trust #7 PO Box 6101 Temple TX 765036101 742751168 Investment Trust TX N/A T Charitable Remainder Trust #8 PO Box 6101 Temple TX 765036101 746423552 Investment Trust TX N/A T Phil and June Hivnor Charitable 2401 S 31st Street Temple TX 765080001 900850773 Investment Trust TX N/A T Nelda I Staller Charitable Remainder Unitrust No 1 2401 S 31st Street Temple TX 765080001 326224724 Investment Trust TX N/A T 1 1 1 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 Scott & White Memorial Hospital O 11600817 Cost Hillcrest Health Systems Inc C 850000 Cost Hillcrest Family Health Center A 5899 Cost Hillcrest Family Health Center B 600000 Cost Hillcrest Physician Services B 4500000 Cost Hillcrest Family Health Center I 921304 Cost Hillcrest Physician Services I 645185 Cost Hillcrest Family Health Center N 5994998 Cost Hillcrest Physician Services N 1658564 Cost Hillcrest Family Health Center P 242660 Cost