2013-05-14T19:47:21-05:00 2012-06-30 990 2011-07-01 751037591 Baylor Medical Centers at Garland and McKinney BAYL 2148204135 2001 Bryan Street No 2200 Dallas TX 752013005 Bob Knowlton 2148204135 2013-05-08 2011 2016-02-24 21:20:13Z Tom Trenary 2300 Marie Curie Garland TX 75042 215170906 0 X www.BaylorHealth.com X 1958 TX Faith based acute care hospital providing exemplary patient care and medical education to Garland, Texas and the surrounding communities since 1964. 6 5 1386 250 0 0 775347 963917 205704874 205539133 1770919 1058232 0 0 208251140 207561282 2588836 3914353 0 0 85249841 86466300 0 0 0 127831156 130922559 215669833 221303212 -7418693 -13741930 125453326 142137630 18825334 50205195 106627992 91932435 X Founded as a Christian ministry of healing, Baylor Medical Center at Garland exists to serve all people through exemplary health care, education, research and community service. 0 0 190798857 3914353 205545355 See Schedule OBaylor Medical Center at Garland (Baylor Garland) is a faith-based, non-profit, 240-bed acute care hospital providing exemplary patient care and medical education to residents of Garland, Texas and surrounding communities since 1964. Baylor Garland is an affiliate of Baylor Health Care System (BHCS), a nationally acclaimed network of acute care hospitals and related health care entities providing quality patient care, medical education, medical research and other community services to the North Texas region. Baylor Garland provides inpatient and outpatient medical services to treat individuals with diseases, illnesses and injuries of varying complexities. Services include all of the comprehensive health care services typical of a quality teaching and acute care hospital with multidisciplinary interaction among physicians, providing patients with innovative methods of prevention, diagnosis, treatment, education and support. These services include comprehensive care for all stages of illness through all stages of life. Some of these clinical services are provided despite a financial loss to Baylor Garland. During the fiscal year ended June 30, 2012, Baylor Garland admitted 19,653 inpatients resulting in a total of 88,278 days of care, treated 64,444 outpatients, delivered 1,255 babies and had 57,699 emergency department visits.Baylor Garland's 4,300-square-foot expanded and renovated emergency department (ED) offers a dedicated ambulance entrance, eight medical screening exam rooms, new lobby, check-in and waiting areas, 20 treatment rooms and seven critical care rooms. Laboratory and pharmacy services, as well as expanded radiology capabilities, have been added, including a dedicated radiology room and a 16-slice CT scanner. As a result of the expansion, Baylor Garland has cut the arrival to treatment time in half through use of the "parallel processes". The goal was to change linear processes such as registration, information gathering, medical testing and the initial physician contact into parallel processes happening simultaneously. Among the more than thirty specialties and services offered by Baylor Garland, diabetes self-management training programs help individuals of all ages learn how to successfully manage diabetes. These services are for both type 2 diabetes and type 1 diabetes. Team members include a registered dietitian and registered nurse. Classes empower participants to plan meals, make better food choices and learn how to monitor glucose levels and interpret results. Othere aspects of the program include pre-diabetes education, diabetes during pregnancy, medical nutrition therapy, diabetes type 2 for adolescents and an insulin pump program.The newly updated Women's Center at the hospital provides for the unique needs of women through every stage of life. The Women's Center features medically advanced facilities that provide family-centered maternity care and gynecological services, including digital mammography screening and diagnostics through our Baylor Breast Center, and osteoporosis detection through bone densitometry testing. The hospital is now offering gynecologic robotic surgery. The da Vinci Si robotic surgery system for certain gynecologic surgical procedures, such as hysterectomy and myomectomy, are now available. Baylor Breast Center and Baylor Diagnostic Imaging Center at Mesquite offer screening and diagnostic digital mammography services, along with additional testing, including ultrasound. Bone densitometry testing to detect osteoporosis is also available.The hospital provides family-centered maternity care and gynecological care through the Baylor Women's Center. Perinatologists are available for high-risk mothers. Supplemental newborn testing, which screens for more than 30 inherited metabolic diseases, is offered to all infants, as well as hearing screenings. Genetic counseling/screenings are also available. The Baylor Women's Center offers a variety of educational programs and classes, including preparation for childbirth, Caesarean birth, breastfeeding and a class for siblings.The hospital has received the Get With The Guidelines-Stroke Silver Plus Quality Achievement Award from the American Heart Association. The award recognizes the hospital's commitment and success in implementing a higher standard of care by ensuring stroke patients receive treatment according to nationally accepted guidelines. Get With The Guidelines-Stroke helps Baylor Garland's staff develop and implement acute and secondary prevention guideline processes to improve patient care and outcomes. The Joint Commission certified the hospital as a Primary Stroke Center, which recognizes a demonstrated ability to provide the complete continuum of care shown to improve outcomes for people who suffer strokes. Procedures are in place in the emergency department for quickly evaluating stroke victims for treatment options, which may include the use of drug therapy for dissolving clots. Drug therapy within the first three hours after the start of stroke symptoms can significantly reduce the effects of stroke and reduce permanent disability. The Hospital's Cardiovascular Rehabilitation Program has been accredited by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). Certified AACVPR programs are recognized as leaders in the field of cardiovascular and pulmonary rehabilitation because they offer the most advanced practices available. The Hospital's Cardiac Rehab department was recognized for its commitment to improving quality of life by enhancing standards of care.U.S. News & World Report's annual Best Hospitals Metro Area rankings listed Baylor Garland as Number 10 among area hospitals. The report gives consumers information about "high performing" regional hospitals in the U.S. The hospital is high performing in both orthopedics and urology.Baylor Garland also has been granted a three-year/full accreditation designation by the National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons. Accreditation by the NAPBC is only given to those centers that have voluntarily committed to provide the highest level of quality breast care and that undergo a rigorous evaluation process and review of their performance. A breast center that achieves NAPBC accreditation has demonstrated a firm commitment to offering its patients every significant advantage in their battle against breast disease.As part of its charitable mission, Baylor Garland is committed to providing free and/or subsidized care to both financially and medically indigent patients in the community. During the year, Baylor Garland reported community benefits (as reported to the Texas Department of State Health Services and in accordance with the State of Texas Statutory methodology) of $62,761,500. Baylor Garland provided community benefits (as reported on the IRS Form 990, Schedule H) of $22,934,279 during the tax year. The Texas Annual Statement of Community Benefit Standard includes approximately $31,878,713 of unreimbursed cost of Medicare that is not included in the IRS Form 990, Schedule H. As part of its Christian ministry of healing, community service is a cornerstone of Baylor Garland's mission. At the hospital itself, a new conference center and community resource center provide an ongoing forum for speakers and community education. Baylor Garland provided community education and outreach activities with particular emphasis on the prevention and treatment of cancer, heart and vascular diseases, diabetes, injury prevention and other health challenge. Baylor Garland also provided in-kind support of other non-profit organizations that uphold similar missions, visions and values. One such organization is the New Beginnings Center, whose mission is to foster an environment of safety, support and respect for families affected by domestic violence. Their mission is accomplished through crisis intervention, counseling, shelter, education, advocacy and diverse community partnership. During the year, these community benefit programs served over 7,000 people at an unreimbursed cost of $644,122. 2824043 901650 See Schedule OBaylor Garland provided a medical residency program for the training of future physicians, nurses and other health professionals in an effort to increase the supply of health care professionals nationwide. During the year, Baylor Garland provided a medical residency for 18 medical students. Assisting with the preparation of future nurses at entry and advanced levels of nursing is critical to establishing a supply of qualified nurses. Baylor Garland strengthened and increased the number of affiliations with schools of nursing through their work with six Dallas County nursing schools. During the year, Baylor Garland invested 6,243 hours in the training of 213 undergraduate nurses. Total unreimbursed cost of providing these physician and nursing education programs is $1,922,393. 193622900 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 192 0 1 1386 1 0 0 0 0 0 0 0 0 0 0 X 6 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Robert Knowlton 9724875358 2300 Marie Curie Blvd Garland TX 75042 X Paul Madeley MD 1.00 X 0 505380 79610 George McCleskey 1.00 X 0 0 0 Ron Carter 1.00 X 0 583 0 Roy Lamkin 1.00 X 0 1729 0 Timothy Owens 1.00 X 0 547 0 Walker Harman 1.00 X 0 5919 0 James Winter 40.00 X 346932 0 12971 Janice Walker 40.00 X 238986 0 31445 Robert Knowlton 40.00 X 53451 117768 22965 Tom Trenary 40.00 X 524427 0 131138 William Boyd 1.00 X 0 860104 239979 Melissa Winter 40.00 X 0 218720 28954 Scott Peek 40.00 X 0 423627 100228 Steve Roussel 40.00 X 0 204950 25105 Beverly Foulkrod 55.00 X 156478 0 23261 John Foster 40.00 X 50532 143598 31723 Julie Allen 40.00 X 147179 0 26574 Karen Schelfhout 40.00 X 147608 0 25103 Margaret Nguyen 44.00 X 151897 0 20988 James Thaxton 0.00 X 0 116512 52736 Karen Stubbs 0.00 X 0 209573 31061 1817490 2809010 883841 126 1 1 0 Baylor Health Care System 2001 Bryan St Ste 2200 Dallas TX 75201 Management Services 29469124 HealthTexas Provider Network 2001 Bryan St Ste 2200 Dallas TX 75201 Clinical/Admin Services 5179109 Aramark Services Inc P O Box 651009 Charlotte NC 282651009 Engineering/Food Services 3818966 BIR JV LLP P O Box 677466 Dallas TX 75267 Staffing/Mgmt Services 2905497 Med Fusion LLC P O Box 222137 Dallas TX 75222 Lab Services 2152835 23 786915 127695 49307 963917 Patient Care Revenue 621990 203886876 203886876 Rent 531120 1102064 1102064 Cafeteria 565593 498969 498969 Unclaimed Property 900099 45886 45886 Education 611600 18072 18072 -12734 -40492 27758 205539133 499776 6222 493554 8149231 18849 7609624 0 539607 18849 558456 558456 207561282 205018628 0 1578737 3914353 3914353 1826878 1826878 67757360 66298658 1458702 2204775 2108053 96722 9617161 9349207 267954 5060126 4902327 157799 245738 245738 40285 40285 46783963 25268707 21515256 1516007 21917 1494090 4057197 3772959 284238 6954147 6954147 6539279 6435241 104038 100360 67269 33091 72654 57110 15544 8977736 8977736 45917 45917 Bad Debt 28831564 28831564 Medical Supplies 25850175 25850175 Ambulance Expense 219704 219704 Dues & Memberships 122559 57425 65134 565274 290610 274664 221303212 193622900 27680312 0 4136 2906 14268668 18332309 163463 3410508 4265575 125742 25024 207366620 99065776 68556337 108300844 30859246 0 625000 1979159 1993097 6249530 8429412 125453326 142137630 10362798 47918931 2618695 1426638 5843841 859626 18825334 50205195 X 100378462 84362649 1407003 2722264 4842527 4847522 106627992 91932435 125453326 142137630 X -13741930 -953627 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 5509 1 52350 0 0 57859 0 Part IV, Supplemental Information: Statement Regarding Legislative Activity Health care policy is critical to all Americans, and Baylor Medical Centers at Garland and McKinney ("BMCG") believes that health care providers must participate in forming health care policy by interacting with national, state and local representatives and their staff members to help them better understand the complexities and ramifications of key health care policies including, without limitation, those related to uninsured and indigent patient needs as well as the legislative and regulatory needs to assure the delivery of cost-efficient, quality health care. BMCG has established relationships with persons and industry associations that often communicate BMCG's positions on major health care issues. These contacts may include direct contact, telephone conversations and/or letters. Also, BMCG may attempt to educate the local community on certain legislative initiatives that may impact BMCG's ability to provide quality health care services to the community through direct mailings, media advertising or broadcast statements. The amount of resources (time and money) involved in these activities is insubstantial. BMCG has not intervened in any political campaign. 2359881 2359881 152851328 63032700 89818628 52155411 36033076 16122335 108300844 Interest in Assets at BHCS Fdn 7569786 Physician Guarantee Receivable 859626 8429412 Physician Guarantee Liability 859626 859626 Description of Uncertain Tax Positions Under FIN 48: Part X: Part X, Line 2: The filing organization does not have separate individual audited financial statements; however, the organization is included in Baylor Health Care System's combined audited financial statements (System). The System follows the provisions of ASC 740 "Income Taxes." As of June 30, 2012 and 2011, the System had no material gross unrecognized tax benefits. 1 1 X 1 X 1 X 500.000000000000 1 1 1 0 1 1 14963987 0 14963987 0.07770 17157761 16225234 932527 0.00480 0 0 0.00000 32121748 16225234 15896514 0.08250 472058 0 472058 0.00250 2824043 901650 1922393 0.01000 11667240 10845407 821833 0.00430 0 0 0.00000 3821481 0 3821481 0.01990 18784822 11747057 7037765 0.03670 50906570 27972291 22934279 0.11920 1 28831564 1556904 61237070 71353280 -10116210 X 1 1 1 1 Baylor Medical Center at Garland

2300 Marie Curie Garland TX 75042

X X X X Baylor Medical Center at Garland 1 1 1 200.000000000000 1 500.000000000000 1 X X X X X 1 1 X X X 1 0 1 X 0 0 6 Baylor Senior Health Center

800 N Shiloh Garland TX 75042

Senior Clinic Baylor Diag Imaging Ctr Mesquite

1660 Republic Pkwy Mesquite TX 75150

Radiology Center Baylor Center for Pain Mgmt

2520 N Central Exp Suite 400 Richardson TX 75080

Pain Center Baylor Garland Comprehensive Wound Ctr

777 Walter Reed Blvd Garland TX 75042

Wound Care Center Baylor Center for Pain Mgmt at Wylie

600 Cooper Drive Suite 110 Wylie TX 75098

Pain Center Baylor Garland Diabetes Center

900 N Shiloh Garland TX 75042

Diabetes Center Part I, Line 3c: and Line 3b: In addition to providing free care to financially indigent patients at 200% of the federal poverty guidelines ("FPG"), the organization provides discounted care to the medically indigent which is based on both the FPG (up to 500%) and the percentage of the patient's total bills from all providers in relation to the patient's annual income. Pursuant to the charity care policy, a patient's total balance due will not exceed 10% of total annual income if the patient qualifies as medically indigent. The organization also provides discounted care to those individuals whose amount of total bills, after all payments from third parties, exceeds 50% of the patient's annual income (regardless of the level of income) if the patient is unable to pay the remaining bill. Part I, Line 6a: The organization prepares and files an Annual Report of Community Benefit Plan with the Texas Department of State Health Services. This report is made available through the organization's website at www.baylorhealth.com. Part I, Line 7: A ratio of patient care cost to charges, as determined in Worksheet 2, was used to report the amounts in Part I, Lines 7a - 7d. For amounts reported on lines 7e - 7k, actual expenses for each community benefit activity are tracked and reported using both community benefit software and/or the organization's cost accounting system.Part I, Line 7b, Column (d): Includes payments from the State Medicaid Private Hospital Upper Payment Limit Program, which funds are to be used to expand indigent care.Part I, Line 7i, Column (c): Includes charity care payments of $3,597,004 that are made directly to or on the behalf of a local public hospital and/or other nonprofit organizations for the treatment of indigent patients of those organizations. Part I, Line 7g: The organization operates a senior health center despite a financial loss after removing the unreimbursed cost of providing charity care and Medicaid. These services are provided to meet an identified community need and otherwise may not be available if not provided by the organization in these underserved areas of the community. Part I, L7 Col(f): The amount of bad debt expense included on Form 990, Part IX, line 25, but removed for Schedule H, Part I, Line 7, Column (f) totaled $28,831,564. Part III, Line 4: As stated in the combined audited financial statements, the organization maintains allowances for uncollectible accounts for estimated losses resulting from a payor's inability to make payments on accounts. The organization assesses the reasonableness of the allowance account based on the historical write-offs, cash collections, the aging of the accounts and other economic factors. Accounts are written off when collection efforts have been exhausted. Management continually monitors and adjusts its allowance associated with its receivable. Bad debt does not include amounts for patients who are known to qualify under the organization's charity care policy. The amount of bad debt attributable to patient's accounts is net of contractual allowances, payments received and recoveries of bad debt previously written off. Based on prior experience and certain demographics and other information obtained during admission, the organization believes a portion of the bad debt expenses 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 IV, 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. The amount reported on Part III, Line 3 was estimated by reviewing the average acceptance rate for charity care applications received at certain facilities during the year multiplied by the number of denials that were attributable to those facilities due to insufficient information. Part III, Line 8: The amount reported on Part III, Section B, line 6 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 of $13,656,446, which is $3,540,236 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 increase at, and rest on the shoulders of, nonprofit hospitals or county hospital districts. Third, many of the Medicare participants have low fixed incomes and therefore would qualify for charity care or other means tested government programs absent being enrolled in the Medicare program. Fourth, Texas nonprofit hospitals must provide a minimum level of community benefit in order to obtain exemption from state and local taxes. According to the current Texas Health and Safety Code, the unreimbursed cost of Medicare is considered to be a community benefit in determining these state statutory requirements as it helps relieve a governmental burden of providing this care that would otherwise be provided through the county hospital system in Texas. Part III, Line 9b: The organization's debt collection policy and procedures prohibit any collection efforts for the portion of the patient account balance that qualifies for financial assistance under the organization's charity care policy. For any remaining balances due, the same collection policy and procedures are applied equally to all patient types. Baylor Medical Center at Garland Part V, Section B, Line 10: In addition to providing free care to financially indigent patients at 200% of the federal poverty guidelines (FPG), the organization provides discounted care to the medically indigent which is based on both the FPG (up to 500%) and the percentage of the patient's total bills from all providers in relation to the patient's annual income. Pursuant to the charity care policy, a patient's total balance due will not exceed 10% of total annual income if the patient qualifies as medically indigent. The organization also provides discounted care to those individuals whose amount of total bills, after all payments from third parties, exceeds 50% of the patient's annual income (regardless of the level of income) if the patient is unable to pay the remaining bill. Baylor Medical Center at Garland Part V, Section B, Line 11h: For almost 20 years, the hospital has adopted a financial assistance policy written in accordance with Texas Health and Safety Code Chapter 311. In general, that statute defines charity care as providing, funding or otherwise financially supporting health care services to a person classified by the hospital as financially or medically indigent; or providing funding or otherwise financially supporting health care services provided to financially indigent persons through other nonprofit or public clinics, hospitals or hospital organizations. To determine if a patient meets the definition of financially or medically indigent in the statute, the number in the household is required. Additionally, although assets and other resources are not included in the calculation to determine whether a patient is financially or medically indigent, the organization's policy reserves the right to allow the patient's assets or other resources to be considered when determining if financial assistance will be granted. Baylor Medical Center at Garland Part V, Section B, Line 13g: Measures to publicize the policy within the community served by the hospital facility, include but are not limited to, the following: 1) posting signs and notices regarding the charity care policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's charity care program in the local newspapers: 3) information regarding financial assistance, including the organization's charity care policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization provides free financial counselors to help patients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's charity care program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital will automatically receive help from a financial counselor. These services are provided in writing and through interpretation services in the primary language of the patient requesting assistance. Though the most often needed alternate language is Spanish, the organization can accommodate multiple languages including American Sign Language. Baylor Medical Center at Garland Part V, Section B, Line 19d: The organizations financial assistance policy is developed to provide discounted care to those qualifying for financial assistance to where the amount charged under the policy will always be equal to or lower than the average of the three largest (by volume) negotiated commercial insurance rates. However, for those qualifying as medically indigent and whose income level is from 200% to 500% of the federal poverty level shall not be billed more than 10% of their annual income which is generally lower than the methodology listed above and the three methods listed in Question Part V, Line 19ac. Part VI, Line 2: Prior to June 30, 2012, the organization has elected to base their service area needs on a report generated by the local county hospital district. The annual Our Community Health Checkup for the Dallas/Fort Worth Combined Metropolitan Statistical Area (Checkup) is a collaborative effort of member hospitals of the Dallas Fort Worth Hospital Council (DFWHC). The preparation (including support, research and analysis) of the report was provided by the staffs of the Strategic Planning and Population Medicine Department of the Parkland Health & Hospital System also known as the Dallas County Hospital District, Baylor Health Care System and other health care providers. The Checkup was developed to address issues relative to health pertaining to individuals, families, and communities for use by the residents of the community and the institutions serving them. The Checkup provides a framework by which health needs can be joined with the assets or investments made by the community in its social and physical infrastructure. During the tax year ending June 30, 2013, the organization will be conducting a community health needs assessment and developing a written implementation strategy in accordance with the requirements under the Internal Revenue Code Section 501(r) which will be made widely available to the public on or before June 30, 2013. Part VI, Line 3: The organization is committed to promoting health in the community including providing or finding financial assistance programs to assist patients. Patients who may qualify for financial assistance through the organization's charity care program or other federal, state and local government programs are informed and educated about their eligibility in several ways including, but not limited to, the following: 1) posting signs and notices regarding the charity care policy in the emergency departments, admitting areas and business offices located throughout the organization: 2) annual posting regarding the organization's charity care program in the local newspapers: 3) information regarding financial assistance, including the organization's charity care policy, is posted on the organization's website: 4) notices about the organization's financial assistance policies are posted on each bill sent to patients including providing a phone number to access the customer service unit dedicated to answering patients billing questions, as well as provide information regarding financial assistance: and 5) the organization provides free financial counselors to help patients determine how to meet their financial obligations for services provided. Specifically financial counselors assist patients in applying for government assistance programs such as Medicaid or the organization's charity care program. Any patient may request to speak to a financial counselor when being treated at the organization. Uninsured patients who are admitted to the hospital will automatically receive help from a financial counselor. These services are provided in writing and through interpretation services in the primary language of the patient requesting assistance. Though the most often needed alternate language is Spanish, the organization can accommodate multiple languages including American Sign Language. Part VI, Line 4: Located in Dallas County, the organization's service area includes parts of the urban/suburban North Texas area including Wylie, Rowlett, Sachse, Mesquite and Murphy. The population is estimated to be approximately 639,648. The average household income is $67,316 with 10.5 percent of the population having household incomes below the Federal Poverty Level (FPL). The population is made up of 45.3 percent white non-Hispanic, 29.5 percent Hispanic, 16.3 percent black non-Hispanic, 6.3 percent Asian and Pacific Islanders Non-Hispanic and 2.5 percent other. The organizations service area payer mix is comprised of 33.3 percent Managed Care, 20.6 percent Medicaid, 33.9 percent Medicare and 11.4 percent Self-pay/Charity and 0.8 percent other. There are approximately six other hospitals located within the organization service area. The organizations service area does not contain any medically underserved areas or populations. Part VI, Line 5: With the oversight of an independent volunteer community board and Baylor Health Care System, the organization's sole member, the organization has promoted health and benefited the community by providing access to more than 20 specialty centers designed to treat a range of medical conditions. The organization's governing body is comprised of volunteer community representatives that provide leadership and governance for the organization. The members of the governing body contribute their wisdom, insights, and expertise to ensure the organization is fulfilling its mission and charitable purpose while providing efficient administrative support services and direction for the System. The members are well respected residents and/or own businesses in the organization's primary or secondary service area and understand the needs of the community. The medical staff of the organization is open to all physicians in the community who meet membership and clinical privileges requirements. Surplus funds are continuously utilized to maintain access to limited patient services or expand access points of care to patients throughout the community including, but not limited to, the following: The Organizations expanded ED expanded access to care and reduced wait times. The ED now offers a dedicated ambulance entrance, eight medical screening exam rooms, new lobby, check-in and waiting areas, twenty treatment rooms and seven critical care rooms. Laboratory and pharmacy services, as well as expanded radiology capabilities, have been added including a dedicated radiology room and a 16-slice computed tomography scanner.The organization is committed to promoting the healthy well being of individuals and families beyond the healthy activities of traditional hospital or clinic settings through its community outreach programs. The organization provides free community health seminars throughout the year at local libraries and community centers and collaborates with the school districts by offering programs such as Project Power, a free diabetes program provided in both English and Spanish to those who have no health insurance. Other programs include library seminars on dementia, options for care, urological problems, and breast cancer awareness. The organization also provides free health screenings in the community specifically targeted to meet the needs identified in the community needs assessment. Through these programs, over 13,000 people were served. Since late 2009, the organization has been supporting Hope Clinic. Many physicians and nurses on the organizations medical staff, as well as Family Medicine residents from the organization medical education program staff this clinic. The clinic served the working poor who have no private health insurance and who are ineligible for Medicare, Medicaid or similar programs. In addition to urgent care needs and health screenings, Hope Clinic helps its clients manage chronic conditions such as diabetes, high blood pressure, COPD and heart failure. Medications for this population are made more accessible through the clinic's prescription assistance program.Medical education is a crucial part of the Organizations mission. Being one of the nation's largest private teaching hospitals, the System annually trains residents and fellows in eight specialties and 13 subspecialties. These quality teaching programs add many dimensions to the Systems ability to serve patients. Residents graduate with demonstrated competence in population health management, continuous quality improvement, and the importance of patient satisfaction. Residents work with physicians assistants and are active managers of the patient-centered medical home, often assuming leadership roles in clinic and hospital operations. To help address the states health care workforce shortage, the Texas A&M Health Science Center (TAMHSC) College of Medicine and the Organization have joined forces to establish a Clinical Training Program in Dallas for students to complete clinical rotations in surgery, internal medicine, family medicine, psychiatry, pediatrics, and obstetrics/gynecology at the Organization and other clinical affiliates over their last two years of residency. While residents and fellows of the Organization are not required to work for an affiliate of BHCS, most remain in North Texas upon completion of their program, providing a continuous supply of well-trained medical professionals for the region. In fiscal year ending in June 30, 2012, the Organization invested more than $2.3 million in training medical residents. Part VI, Line 6: The organization is part of a large faith based integrated health care delivery system ("System") serving the health care needs of the twelve county Dallas-Fort Worth metroplex area. The System exists to serve all people through exemplary health care, education, research and community service. Community benefits are provided through the provision of charity care, governmental sponsored programs (such as Medicaid and Medicare), medical research, medical education, community health improvement services, donations to other nonprofit health care providers, and many other community service activities. During the year, the affiliated nonprofit hospitals reported community benefits (as reported to the Texas Department of State Health Services, and in accordance with the State of Texas Statutory methodology) in excess of $539,700,000. The System's nonprofit hospitals provided community benefits (as reported on the IRS Form 990, Schedule H) in excess of $221,650,000 during the tax year. The Texas Annual Statement of Community Benefit Standard includes approximately $297,000,000 of unreimbursed cost of Medicare that is not included in the IRS Form 990, Schedule H. The System is comprised of separate legal entities including philanthropic foundations, a research institute, a physician network, acute care hospitals, short-stay hospitals, specialty hospitals, ambulatory surgery centers and other health care providers all which fall under the common control of Baylor Health Care System, the organization's sole member. As part of the System, certain affiliates make grants and/or contributions to other related nonprofit affiliates to help financially support and/or fund worthy community benefits activities. The System has also established a patient transfer system among the affiliated hospitals allowing patients needing a particular level of care to be transferred as needed to a related hospital that can provide that service in an efficient and effective manner. As part of the System, all hospitals and other affiliated health care providers are required to adhere to high standards for medical quality, patient safety and patient satisfaction. These standards are set forth by Baylor Health Care System, the organization's sole member, which helps ensures consistency across the System. Reports Filed With States Part VI, Line 7 TX 1 Dallas Academy of Medicine dba Project Access Dallas 140 E 12th Street Dallas TX 75203 750223610 501(c)(3) 130363 N/A N/A Indigent Care Dallas County Indigent Care Corporation PO Box 655999 Dallas TX 75265 260610562 501(c)(3) 3783990 N/A N/A Indigent Care 2 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Monitoring Grants & Other Assistance As part of its mission, the organization provides grants and other assistance to related organizations and/or unrelated not-for-profit organizations which are religious, charitable, scientific, or educational in nature, within the meaning of Internal Revenue Code Section 501(c)(3), when the use will further one or more tenets of Baylor's charitable mission and one of the following criteria for use of these funds is met: (1)Fulfills a need identified by a community needs assessment conducted by Baylor Health Care System (BHCS) or a third party (such as Community Health Check Up or by the United Way) and adopted as a priority by BHCS's Community Service Advisory Council, (2) Serves an under-served community or group of people through medical mission work to improve their health status. For related organizations, all grants and other assistance are subject to the policies and procedures set forth by BHCS which ensures all funds are used in accordance with the guidelines set forth above and in accordance with the related organization's exempt purpose. Grants and other assistance provided to unrelated organizations are typically monitored by personal inspection. Examples include providing assistance to entities where the filing organization's employee serves as a Board Member for the recipient organization or through attendance at community events where the filing organization employees work as volunteers or to help coordinate these events. X X X 1 1 X X X X 1 1 0 0 0 0 0 1 0 Paul Madeley MD 0 446493 0 0 0 58887 0 61035 0 18575 0 584990 0 42772 James Winter 135740 0 13505 0 197687 0 0 0 12971 0 359903 0 0 0 Janice Walker 198493 0 40183 0 310 0 10262 0 21183 0 270431 0 0 0 Robert Knowlton 25606 114789 27805 0 40 2979 1292 5805 9629 6239 64372 129812 0 0 Tom Trenary 337632 0 140028 0 46767 0 111045 0 20093 0 655565 0 28879 0 William Boyd 0 554997 0 277981 0 27126 0 212834 0 27145 0 1100083 0 0 Melissa Winter 0 169739 0 45869 0 3112 0 8777 0 20177 0 247674 0 0 Scott Peek 0 253199 0 104261 0 66167 0 75368 0 24860 0 523855 0 19598 Steve Roussel 0 173141 0 30001 0 1808 0 8755 0 16350 0 230055 0 0 Beverly Foulkrod 148583 0 4775 0 3120 0 4045 0 19216 0 179739 0 0 0 John Foster 23153 139192 27305 0 74 4406 1225 7332 3739 19427 55496 170357 0 0 Julie Allen 132150 0 14719 0 310 0 6877 0 19697 0 173753 0 0 0 Karen Schelfhout 130290 0 14422 0 2896 0 6719 0 18384 0 172711 0 0 0 Margaret Nguyen 149540 0 200 0 2157 0 5354 0 15634 0 172885 0 0 0 James Thaxton 0 52866 0 0 0 63646 0 49990 0 2746 0 169248 0 61232 Karen Stubbs 0 178489 0 30274 0 810 0 9293 0 21768 0 240634 0 0 Part I, Line 1a Tax indemnification and gross up payments - The organization provides tax indemnification where an authorized member of management determines there is justification to reimburse an individual for the tax impact on certain taxable, non-cash benefits provided to them. All tax indemnification payments provided are treated as taxable compensation. Three of the persons listed in the Form 990, Part VII, Section A, received this benefit during the tax year. Part I, Line 1a Discretionary spending account-The organization provides eligible employees who travel frequently in their personal vehicle an auto expense allowance in lieu of reimbursement for business mileage under the organization's business travel and expense reimbursement policy. All auto expense allowances are treated as taxable compensation. One of the persons listed in the Form 990, Part VII, Section A, received this benefit during the tax year. Part I, Line 1a Health or social club dues or initiation fees-The organization may reimburse eligible employees for dues for a health club and/or a social club where there is a bona fide business need for the membership. For example, as part of the organization's promotion of health, the organization will cover a portion of any employees' fitness center club membership dues paid to an affiliated entity that owns and operates a fitness center. All employees are eligible for this benefit. Such reimbursements are treated as taxable compensation to the extent any part of the membership is used for personal use. One of the persons listed in the Form 990, Part VII, Section A, received this benefit during the tax year. Part I, Lines 4a-b In order to recruit and retain key talent, Baylor Health Care System ("BHCS") offers a supplemental non qualified retirement plan to eligible employees. The plan provides an annual benefit (based on a percentage of compensation) to the employee that is paid to the employee on a future date upon vesting in the plan. The following individual(s) participated in and/or received payments (noted in parenthesis) from BHCS' supplemental non qualified retirement plan during the tax year: James Thaxton ($61,232), Tom Trenary ($28,879), Paul Madeley, M.D. ($42,772), Scott Peek ($19,598) and William Boyd. Also, select certain officers, as designated by BHCS's governing body, are eligible to participate in a Long Term Incentive Plan that is designed to recognize the key senior leaders value and contribution to BHCS as well as align their compensation to the long term strategy of BHCS. Performance targets are based upon a percentage of the participant's base salary and are developed by independent third party expert(s) using market competitive data within the guides of reasonableness. The plan is based on BHCS's three-year performance against its peers, determined based on peer rankings or percentile rankings in quality, patient satisfaction and financial performance. At the end of three years, awards are determined by BHCS's governing body for participants. Payouts are partially made in cash and the remainder vests over an additional two year period. The following individuals participated in and/or received payments (noted in parenthesis) from this plan during the tax year: Tom Trenary ($58,080), Scott Peek ($37,459) and William Boyd ($115,038). Part I, Lines 4a-b James Winter's employment with the organization terminated during the tax year and he received a severance payment of $186,329. Part I, Line 7 The organization has adopted and implemented BHCS's, the organization's sole member, Performance Award Program to provide a market competitive total cash compensation incentive program that is designed to attract and retain key leaders and establish greater individual accountability and alignment to business performance. Payout targets are based upon a percentage of base pay and are developed by independent third party expert(s) using comparable market competitive data within the bounds of reasonableness and that are reviewed and approved by BHCS's governing body. Payout levels are based upon a combination of system, entity, and individual performance using various metrics related to quality, patient satisfaction, employee retention, and financal stewardship. BHCS's governing body may approve modifications to annual incentive awards provided under the program consistent with market comparability data. Supplemental Information Part III Supplemental Information: Governing Body Compensation The members of the governing body serve on a voluntary basis and receive no cash compensation from the organization for these duties as a member of the governing body. Some, but not all, members have received modest benefits incident to their service on the board and/or multiple board committees or received compensation as an employee of a related organization. These benefits include reimbursement for certain reasonable expenses paid on behalf of the member's spouse while accompanying the member on business travel on behalf of the related organization and/or a wellness physical. All such benefits are treated as taxable compensation to the extent required by law and are reported in the Form 990 where applicable. Form 990, Part VI, Section A, line 6 Members or stockholders: The organization is a Texas nonprofit membership organization in which Baylor Health Care System ("BHCS"), a tax exempt, Texas nonprofit corporation, is the sole member. Form 990, Part VI, Section A, line 7a Election of members of governing body by members, stockholders, or other persons: The sole member, BHCS, elects and removes the members of the governing body. Form 990, Part VI, Section A, line 7b Governing body decisions subject to approval: All rights and powers are reserved to the sole member, BHCS, except only those rights and powers expressly set forth in the bylaws, required by state or federal law, or to meet the requirements and standards promulgated by Joint Commission. For example, the member's reserved rights and powers include, without limitation, approval of the organization's articles of incorporation and bylaws and amendments thereto, appointment and removal of members of the organization's governing body, approval of dissolutions and mergers, and other similar decisions over the organization. Form 990, Part VI, Section B, line 11 Process used to review the Form 990: The Form 990 is prepared and reviewed by BHCS's tax department. During the return preparation process the tax department works with other functional areas including finance, accounting, treasury, legal, human resources, and corporate compliance for advice, information and assistance to prepare a complete and accurate return. Upon completion, the Form 990 is reviewed by the organization's President, financial officer and/or other key officers. A complete final copy of the return is provided to the organization's governing body prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Process used to monitor and enforce compliance with the organization's conflict of interest policy: Persons with the actual or perceived ability to influence the organization have the duty to disclose annually and otherwise promptly as potential conflicts are identified, any familial, professional or financial relationships with entities or individuals that do, or seek to do business with the organization or that compete with the organization. These individuals include the organization's officers, governing body, management, physicians with administrative services agreements and other key personnel who interact with outside organizations or businesses on behalf of the organization. The BHCS Board of Trustees Audit and Compliance Committee and the BHCS Corporate Compliance Committee review all relevant disclosures submitted by these individuals to determine whether a conflict of interest exists and to determine an appropriate resolution, if necessary. Any individual with a perceived or potential conflict is prohibited from voting or participating in the decision making process regarding such transaction with that individual. Form 990, Part VI, Section B, line 15 Process for determining compensation: The organization, a controlled affiliate of BHCS, recognizes that those chosen to lead the organization are vital to its ongoing success and growth. Thus, it must attract, retain and engage the highest quality officers and key employees to lead the organization and help BHCS maintain its national reputation for achieving high targets for medical quality, patient safety, and patient satisfaction. A significant portion of the organization's officers' and key employees' total compensation is based on significant performance achievements. This strategy, known as the Performance Award Program, works to put a greater emphasis on the importance of the organization achieving targeted improvements in the areas of People, Quality, Patient Satisfaction and Financial Stewardship, annually. Total executive compensation is part of an integrated talent management strategy developed by the BHCS Board of Trustees and its Compensation and Governance Committee (Committee) to attract, motivate, and retain the best leadership resources for the organization. Executive compensation is determined pursuant to guidelines outlined in the intermediate sanction rules under IRC Section 4958 including taking steps to meet the rebuttable presumption standard of reasonableness under Treasury Regulation 53.4958-6, as summarized below. When making compensation decisions, the organization compares itself to similar-sized, and structured businesses including other integrated health care service systems and other similar-sized organizations, both locally and nationally. The BHCS Board of Trustees and Committee, on behalf of the organization, work directly with independent compensation expert(s) to identify reasonable and competitive market rates as well as provide an annual review of the total compensation of the organization's top management officials and key employees. The Committee is made up of members of the BHCS Board of Trustees, who are independent, community volunteers. Guided by the information provided by the independent compensation expert(s), the Committee approves and recommends to the BHCS Board of Trustees salary increases, earned incentives, and benefit offerings for the organization's President, other officers and/or key employees to be comparable to similar organizations for similar services and/or positions. Furthermore, the Committee is charged with the responsibility of reviewing annually the major elements of the executive compensation program to assure designs remain consistent with the business needs, market practices, and compensation philosophy. As part of the decision making process, the Committee will often meet in executive session to discuss and review recommendations made by the independent compensation expert(s). During the executive session no officer or key employee whose compensation is being reviewed is present during these discussions. All decisions are contemporaneously documented in the Committee minutes which are timely reviewed and approved by the Committee. Form 990, Part VI, Section C, line 19 Process for making governing documents, conflict of interest policy, & financial statements available to the public: The organization's articles of incorporation and amendments thereto are made available to the public by the filing of those documents with the Texas Secretary of State. Also, the organization is included within the combined financial statements of BHCS that are made available to the public by the posting of those documents through DAC Bond and are attached to this return. The organization's other governing documents and conflicts of interest policy are not made available to the public. Form 990, Part VII: Hours devoted to related organizations: The persons listed below also serve either as a voluntary member of the governing body, an employed officer, or an employee of a related organization. The average hours per week devoted to the related organizations are listed below: William Boyd (40 Hours) Ron Carter (10 Hours) Walker Harman (10 Hours) Roy Lamkin (10 Hours) Paul Madeley, M.D. (40 Hours) Tim Owens (10 Hours) James Thaxton (40 Hours) Karen Stubbs (40 Hours) John Foster, Melissa Winter, Robert Knowlton, Stephen Roussel and Scott Peek transferred from a related organization during the year. They all worked an average of 40 hours both before and after the transfer. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -1,008,725. Change in Net Assets Held at BHCS Foundation 1,320,256. Transfer to/from BHCS-Liability Reserve -1,265,158. Total to Form 990, Part XI, Line 5: -953,627. Supplemental Information: IRC Section 6038 Statement: Baylor Garland is controlled by BHCS, employer identification number 75-1812652. BHCS also owns Health Care Insurance Company of Texas, Ltd. (HCIC). HCIC is a controlled foreign corporation. BHCS furnishes all information required of Baylor Garland by IRC Section 6038 and the regulations thereunder with respect to HCIC. Therefore, pursuant to Treasury Regulation Sec. 1.6038-2(j)(2), Baylor Garland is excepted from providing such information. BHCS files its Return of Organization Exempt from Income Tax in Ogden, Utah. 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