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MEMORIAL HEALTH SYSTEM OF EAST TEXAS: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MEMORIAL HEALTH SYSTEM OF EAST TEXAS (EIN 75-0755367)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-13
IRS object ID
201323179349301787
Schema version
2012v2.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-13T08:28:26-08:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Axley & Rode LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11307 S 1st StAddressLine1
CityLufkinCity
StateTXState
ZIP Code759014717ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN750755367EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Memorial Health System of East TexasBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMEMONameControl
Phone9366348111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O Box 1447AddressLine1
CityLufkinCity
StateTXState
ZIP Code75902ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGARY N LOOPERName
TitleCEOTitle
Date Signed2013-11-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJ LEON MANNING CPAName
PTINP00045819PTIN
Phone9366346621Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGARY N LOOPERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1156 MAGNOLIA BENDAddressLine1
CityLUFKINCity
StateTXState
ZIP Code75904ZIPCode
FieldValueIRS element (for citing)
Gross Receipts130312613GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1944YearFormation
State Legal DomicileTXStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION OPERATES AN ACUTE CARE HOSPITAL WITH 271 LICENSED BEDS, A CANCER CENTER, AN IMAGING CENTER, A REHABILITATION CENTER AND A DEDICATED HEART STROKE CARE FACILITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees1140TotalNbrEmployees
Total Nbr Volunteers66TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year2521664ContributionsGrantsPriorYear
Contributions Grants Current Year2159487ContributionsGrantsCurrentYear
Program Service Revenue Prior Year114103590ProgramServiceRevenuePriorYear
Program Service Revenue CY126520680ProgramServiceRevenueCY
Investment Income Prior Year2030790InvestmentIncomePriorYear
Investment Income Current Year479290InvestmentIncomeCurrentYear
Other Revenue Prior Year4212OtherRevenuePriorYear
Other Revenue Current Year22915OtherRevenueCurrentYear
Total Revenue Prior Year118660256TotalRevenuePriorYear
Total Revenue Current Year129182372TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year56814412SalariesEtcPriorYear
Salaries Etc Current Year57934959SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year73964166OtherExpensePriorYear
Other Expenses Current Year68868148OtherExpensesCurrentYear
Total Expenses Prior Year130778578TotalExpensesPriorYear
Total Expenses Current Year126803107TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-12118322RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2379265RevenuesLessExpensesCY
Total Assets BOY250955939TotalAssetsBOY
Total Assets EOY250660919TotalAssetsEOY
Total Liabilities BOY150079986TotalLiabilitiesBOY
Total Liabilities EOY151133986TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY100875953NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY99526933NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION IS TO SUPPORT, MANAGE & FURNISH FACILITIES TO PROVIDE QUALITY ACUTE HEALTHCARE SERVICES FOR THE CITIZENS OF ANGELINA, POLK, SAN AUGUSTINE & SURROUNDING COUNTIES REGARDLESS OF RACE, COLOR, GENDER, AGE, NATIONAL ORIGIN, OR, TO THE EXTENT OF ITS AVAILABLE RESOURCES, ABILITY TO PAY, & TO FACILITATE & ENCOURAGE EDUCATION & TRAINING ACTIVITIES TO PROMOTE THE HEALTH & WELFARE OF THOSE CITIZENS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense114483823Expense
Revenue125879655Revenue
DescriptionHOSPITAL SERVICES TO PATIENTS AND SERVICES TO THE COMMUNITY INCLUDE 35,995 PATIENT DAYS DURING THE YEAR. THIS ALSO INCLUDES 8,339 INPATIENT ADMISSIONS, 99,750 OUTPATIENT VISITS, 39,031 EMERGENCY ROOM VISITS AND 10,454 HOME HEALTH VISITS.Description
Total Program Service Expense114483823TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvesttrueReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096205NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1140NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonGARY N LOOPERNamePerson
Telephone Number9366348111TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11201 W Frank AvenueAddressLine1
CityLUFKINCity
StateTXState
ZIP Code75904ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (56 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MIKE SMITH
Trustee0.000.00X000
GEORGE FIDONE M D
Pres Elect M S0.000.00X000
DAVID TAMMINGA
Trustee0.000.00X000
DAVID GLENN M D
Director0.000.00X000
THOMAS MOORE
Trustee0.000.00X000
JERRY SUTTON
Trustee0.000.00X000
EDD TERRILL III
Trustee0.000.00X2160000
KEVIN SMITHHART
Trustee0.000.00X000
H J TROUT JR
Trustee0.000.00X000
MACK FRAZIER
Trustee0.000.00X000
ARTIE BEDARD
Trustee0.000.00X000
JOHN STRAIN
Trustee0.000.00X000
JACK GORDEN
Trustee0.000.00X000
DR THOMAS DUNCAN
Trustee0.000.00X000
DON DURAN
Trustee0.000.00X000
RONNIE ROBINSON
Trustee0.000.00X000
ROSS ELDER
Trustee0.000.00X000
BRUCE BRYANT
Trustee0.000.00X000
DON BRILEY
Trustee0.000.00X000
GREG WALLEY
Trustee0.000.00X000
JOHN MILLER
Trustee0.000.00X000
DR THOMAS MCLAURIN
Trustee0.000.00X000
DAVID PERKINS
Trustee0.000.00X000
JOHN ANDERSON
Trustee0.000.00X000
RONA FRIESEN
Director1.000.00X000
HE STRIEDEL
Director1.000.00X000
TED LANKFORD
Trustee0.000.00X000
SID ROBERTS MD
Director1.000.00X4200000
CARL RAY POLK
Director1.000.00X000
H J SHANDS III
IMM PAST CHAIR1.000.00X000
JACK SWEENY
Chairman1.000.00X000
SW HENDERSON III
Director1.000.00X000
GEORGE HENDERSON III
Director1.000.00X000
RANDY GEORGE
Director1.000.00X000
RAY BALDWIN
Director1.000.00X000
PATRICIA MCKENZIE EDD
Director1.000.00X000
RAVINDER BACHIREDDY M D
Director1.000.00X000
GIPSON FRIESEN
1ST V CHAIR1.000.00X000
AL MEYER
Trustee0.000.00X000
ROBERT TELFORD
Trustee0.000.00X000
DANIEL FUENTES D O
PRES MED STAFF1.000.00X000
JOHN F GLICK
2ND VCHAIR/SEC1.000.00X000
MIKE ARNOLD M D
Director1.000.00X000
HAROLD MAXWELL
Trustee0.000.00X000
GARY N LOOPER
President & CEO40.000.000050000X
DAVID HEARNE
GENERAL COUNSEL40.000.0017704408607X
KRISTI GAY
VP/CFO40.000.00165004019007X
MARIO B ESTRELLA
VP/PATIENT SVC40.000.001130100187X
PEGGY MORTENSON
COO/VP CLINICAL40.000.00000X
BRYANT H KRENEK
FORMER CEO40.000.0088252108099X
SUZANNE FRAPPIER
DIR OF SURGERY40.000.00152590010266X
THOMAS A BROSE
ASST DIR - PHARM40.000.00137927023156X
LESLIE LEACH
ASST COO40.000.00144359019823X
LOU A CHESSER
PHARMACIST42.000.0012459509487X
SANYUDE SANYUDE
PHARMACIST41.000.00125327019605X
KATHY GRIFFIN
DIR - PHARMACY42.000.00145446011005X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2231423TotalReportableCompFromOrg
Total Other Compensation179242TotalOtherCompensation
Number Individuals GT100 K26NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcestrueCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SODEXO SERVICES
P O BOX 536992ATLANTAGA30353DIETARY/ENVIROMENTAL5382735
WILLIAM BASSUKCLINICAL ENG
1606 DOE CRESTSAN ANTONIOTX78248EQUIPMENT MAINTENANC2892322
MCKESSON TECHNOLOGIES INC
P O BOX 98347CHICAGOIL60693TECHNOLOGY SERVICES9193797
HB ANESTHESIOLOGY GROUP PA
P O BOX 4502LONGVIEWTX75606ANESTHESIOLOGY4850925
COMMUNITY HOSPITAL CONSULTING INC
5801 TYNNYSON PARKWAYPLANOTX75024MANAGEMENT & OTHER3040000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Government Grants164627GovernmentGrants
All Other Contributions1994860AllOtherContributions
Total Contributions2159487TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
RENTAL INCOME - AFFILIATE621990228720228720
PATIENT SERVICE REVENUE621990124627438124627438
OTHER HOSPITAL SERVICES621990319916319916
ELECTRONIC HEALTH RECORDS621990548930548930
CAFETERIA REVENUE621990517938$517,938

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column277738TotalRevenueColumn
Related Or Exempt Function Income154650RelatedOrExemptFunctionIncome
Exclusion$123,088ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue126520680TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1063318TotalRevenueColumn
Exclusion$1,063,318ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real63941Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real41027Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real22914Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column22914TotalRevenueColumn
Exclusion$22,914ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other330208Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other914236Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-584028Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-584028TotalRevenueColumn
Exclusion-$584,028ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory174979GrossSalesOfInventory
Cost Of Goods Sold174978CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1TotalRevenueColumn
Exclusion$1ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column129182372TotalRevenueColumn
Related Or Exempt Function Income125879654RelatedOrExemptFunctionIncome
Exclusion$1,143,231ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total889605Total
Program Services155220ProgramServices
Management And General734385ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total42132867Total
Program Services37691100ProgramServices
Management And General4441767ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1015266Total
Program Services895175ProgramServices
Management And General120091ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total10799036Total
Program Services9377414ProgramServices
Management And General1421622ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3098185Total
Program Services2731717ProgramServices
Management And General366468ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2679408Total
Management And General2679408ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total535019Total
Program Services295533ProgramServices
Management And General239486ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total126880Total
Management And General126880ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total36200Total
Management And General36200ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total25142520Total
Program Services22283881ProgramServices
Management And General2858639ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total336654Total
Program Services43302ProgramServices
Management And General293352ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total733038Total
Program Services202012ProgramServices
Management And General531026ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total893254Total
Management And General893254ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2526141Total
Program Services2513262ProgramServices
Management And General12879ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total325359Total
Program Services227059ProgramServices
Management And General98300ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total4845029Total
Program Services4845029ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total10362335Total
Program Services10362335ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1113960Total
Program Services647819ProgramServices
Management And General466141ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
OTHER OPERATING EXPENSES783675456394327281
RENTS & LEASES - EQUIP14697601049851419909
REPAIRS & MAINTENANCE24702786652661805012
PATIENT CARE SUPPLIES2031473720314737

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total-5826099Total
Program Services-273283ProgramServices
Management And General-5552816ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total126803107Total
Program Services114483823ProgramServices
Management And General12319284ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1494808BOY
EOY1985433EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY58317617BOY
EOY57068263EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY13626347BOY
EOY14746621EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2223759BOY
EOY2107083EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1161092BOY
EOY838914EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis193228165LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec116473063LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY77606679BOY
EOY76755102EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY389216BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY15766869BOY
EOY15495514EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY80369552BOY
EOY81663989EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY250955939BOY
EOY250660919EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY17367087BOY
EOY16219112EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY110985000BOY
EOY109085000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY21727899BOY
EOY25829874EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY150079986BOY
EOY151133986EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY82445660BOY
EOY80247728EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY18430293BOY
EOY19279205EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY100875953BOY
EOY99526933EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY250955939BOY
EOY250660919EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2379265ReconcilationRevenueExpenses
Reconcilation Other Changes-3728285ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2613815OtherCostOrOtherBasis
Book Value2613815BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis91256146OtherCostOrOtherBasis
Depreciation42183460Depreciation
Book Value49072686BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis93043007OtherCostOrOtherBasis
Depreciation72235618Depreciation
Book Value20807389BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6315197OtherCostOrOtherBasis
Depreciation2053985Depreciation
Book Value4261212BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings76755102TotalOfBookValueLandBuildings
Total Of Book Value Program Related15495514TotalOfBookValueProgramRelated

Other Assets OtherAssets (13 entries)

DescriptionDescriptionBook ValueBookValue
PREPAID BOND ISSUANCE COST691504
PHYSICIAN CONTRACT RECEIVABLE1565656
OTHER ASSETS
Miscellaneous Receivables37911
INVESTMENT IN PREMIER345569
INSURANCE RECOVERIES - LONG TERM645840
HELD IN TRUST ACCOUNTS19192910
GRANT RECEIVABLE194152
DUE TO MEMORIAL SPECIALTY HOSPITAL-25882211
DUE FROM PINEYWOODS MED DEV CO17754932
Due from AFFILIATES66171959
DEFFERED CHARGE
BOND DISCOUNTS945767
FieldValueIRS element (for citing)
Total Book Value Other Assets81663989TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
THIRD PARTY SETTLEMENTS$4,316,823
PENSION PLAN PAYABLE$10,314,332
LEASES PAYABLE$56,286
Insurance Reserve Payable$1,940,920
EXECUTIVE RETIREMENT BENEFIT PAYABLE$75,033
CHANGE IN FAIR VALUE OF SWAP$10,217,828
BOND ISSUE DISCOUNT-$1,119,507
2007 BOND ORIGINAL ISSUE DISCOUNT$28,159
FieldValueIRS element (for citing)
Total Of Amounts25829874TotalOfAmounts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense6248446TotalCommunityBenefitExpense
Net Community Benefit Expense6248446NetCommunityBenefitExpense
Percent Of Total Expense0.04990PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense12968092TotalCommunityBenefitExpense
Direct Offsetting Revenue12092926DirectOffsettingRevenue
Net Community Benefit Expense875166NetCommunityBenefitExpense
Percent Of Total Expense0.00700PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense19216538TotalCommunityBenefitExpense
Direct Offsetting Revenue12092926DirectOffsettingRevenue
Net Community Benefit Expense7123612NetCommunityBenefitExpense
Percent Of Total Expense0.05690PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense215495TotalCommunityBenefitExpense
Net Community Benefit Expense215495NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense215495TotalCommunityBenefitExpense
Net Community Benefit Expense215495NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense19432033TotalCommunityBenefitExpense
Direct Offsetting Revenue12092926DirectOffsettingRevenue
Net Community Benefit Expense7339107NetCommunityBenefitExpense
Percent Of Total Expense0.05860PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$10,303,484BadDebtExpenseAmount
Amount Attributable To1030348AmountAttributableTo
Amount Reimbursed By Medicare40961762AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare47262335CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-6300573MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HEALTH SYSTEM OF E TBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11201 W FRANK AVEAddressLine1
CityLUFKINCity
StateTXState
ZIP Code75904ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HEALTH SYSTEM OF E TBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
File Form4720 Report Excise TaxfalseFileForm4720ReportExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.0000FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent250.0000FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Uninsured DiscountXUninsuredDiscount
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymentfalseActionsOnNonpayment
Collection ActivitiestrueCollectionActivities
Other ActionsXOtherActions
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - Additional InformationPART I, LINE 7 - THE HOSPITAL USED A COST-TO-CHARGE RATIO TO CALCULATE THE AMOUNTS REPORTED IN THIS TABLE. THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2- "RATIO OF PATIENT CARE COST-TO-CHARGES".PART I, LINE 7, COLUMN (F):IN ACCORDANCE WITH THE INSTRUCTIONS,COMMUNITY BENEFITS EXPENSE TOTALING $215,495 INCLUDED IN PART IX, LINE 25, COLUMN A AND $1,298,095 IN REVENUE FROM NON PATIENT CARE ACTIVITIES INCLUDED IN PART VIII, LINE 12, COLUMN A HAVE BEEN REMOVED FROM THE DENOMINATOR IN THE CALCULATION OF THE PERCENTAGES SHOWN IN COLUMN (F) FOR LINES 7 (A) THRU 7 (K). AS THE RESULT OF THE FOREGOING, THE CALCULATION OF THE DENOMINATOR AMOUNT IS SHOWN BELOW: TOTAL FUNCTIONAL EXPENSES FROM PART IX, LINE 25, COLUMN A $126,803,107 LESS: COMMUNITY BENEFITS EXPENSE ( 215,495) CAFETERIA REVENUE ( 517,938) COPY REVENUE - MEDICAL RECORDS ( 76,870) RENTAL INCOME ( 383,370) OTHER REVENUE ( 319,917) ADJUSTED PATIENT CARE COSTS $125,289,517
Part VI - States Where Community Benefit Report FiledTX
Part VI - Affilated Health Care System Roles and PromotionIN ADDITION TO THE CUSTOMIZED OUTREACH IN EACH INDIVIDUAL COMMUNITY THE CORPORATE STRUCTURE PROVIDES EACH HOSPITAL IN ANGELINA, POLK AND SAN AUGUSTINE COUNTIES WITH IMPROVED MEDICAL TECHNOLOGY THROUGH A COMMON COMPUTER SYSTEM, COMMUNICATION TO ALL COMMUNITIES THROUGH THE CORPORATE MARKETING DEPARTMENT, AND COORDINATION OF MEDICAL TRAINING FOR ALL CLINICAL EMPLOYEES. MEMORIAL HEALTH SYSTEM OF EAST TEXAS IS ABLE TO ACCEPT TRANSFERS OF MORE MEDICALLY COMPLEX CASES FROM OTHER AFFILIATED HOSPITALS.
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeTHE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY THROUGH PARTICIPATION IN DIABETIC, CARDIOVASCULAR AND STROKE, ORTHOPEDIC, CANCER THERAPY AND NUTRITION EDUCATION. THE HOSPITAL PARTICIPATES IN HEALTH FAIRS AT THE HOSPITAL, DIABETES EXPO, SENIOR LIFESTYLE EXPO, WOMEN'S LIFESTYLE EXPO, AND AT MANY LOCAL BUSINESSES. ADDITIONALLY, THE HOSPITAL IS ACTIVE WITH THE ANGELINA COUNTY BUSINESS COALITION THAT PROMOTES A DRUG FREE WORKPLACE AND EDUCATES THE COMMUNITY ON HOW TO LEAD A HEALTHIER LIFE. WE ALSO PROVIDE SPEAKERS TO COMMUNITY GROUPS AS REQUESTED. THE HOSPITAL PARTNERS WITH THE FOLLOWING COMMUNITY GROUPS: CANCER SUPPORT GROUPS, DIABETES SUPPORT GROUP, RELAY FOR LIFE, RED CROSS, ANGELINA COUNTY HEART ASSOCIATION, BLOOD CENTER OF EAST TEXAS, ANGELINA COLLEGE, STEPHEN F. AUSTIN STATE UNIVERSITY, AND TYLER COUNTY NURSING PROGRAMS, AND WITH AREA HIGH SCHOOLS' HEALTH CAREERS PROGRAMS WHICH ALLOW HIGH SCHOOL STUDENTS TO PARTICIPATE IN CLINICAL STUDIES AT THE HOSPITAL. WE HOST A MONTHLY WOMEN'S POWER LUNCH TO PROVIDE MEDICAL EDUCATION TO THE COMMUNITY AND HOST THE ANNUAL POWER OF PINK BANQUET TO EDUCATE WOMEN AND TO CELEBRATE CANCER SURVIVORS. HOSPICE IN THE PINES, WHICH IS A NOT-FOR-PROFIT ORGANIZATION, HAS AN INPATIENT FACILITY IN OUR HOSPITAL. WE HAVE A CLOSE PARTNERSHIP WITH THE ANGELINA COUNTY AND CITIES HEALTH DISTRICT WHICH MEETS THE MEDICAL NEEDS OF UNDERSERVED PEOPLE IN OUR COMMUNITY AND PROVIDE FUNDING FOR THE DIRECTOR'S SALARY. THE HOSPITAL IS A MEMBER OF THE ANGELINA COUNTY EMERGENCY PLANNING COMMITTEE IN ORDER TO PLAN FOR MEETING MEDICAL NEEDS IN COMMUNITY EMERGENCIES. WE ALSO FILM HEALTHY COOKING CLASSES WHICH AIR ON A LOCAL TV CHANNEL AND PROVIDE HEART EDUCATION CLASSES. THE HOSPITAL'S WEB SITE OFFERS A MEDICAL LIBRARY TO VISITORS AND A HOST OF VIDEOS THAT DETAIL MEDICAL PROCEDURES. THE HOSPITAL OFFERS EDUCATION TO THE PUBLIC THROUGH SOCIAL NETWORKS SUCH AS YOU TUBE, FACEBOOK AND TWITTER.
Part VI - Community InformationANGELINA COUNTY HAS AN APPROXIMATE POPULATION OF 87,597 AS OF 2012 AND IS A FEDERALLY DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA. THE POPULATION MEDIAN INCOME PER HOUSEHOLD, AS OF 2011, IS $39,325; AS OF 2011, 18.4% OF PERSONS IN ANGELINA COUNTY ARE BELOW THE POVERTY LEVEL. APPROXIMATELY 11% OF OUR PATIENT BASE IS UNINSURED, APPROXIMATELY 18% OF OUR PATIENT BASE IS MEDICAID RECIPIENTS, AND APPROXIMATELY 50% OF OUR PATIENT BASE IS MEDICARE RECIPIENTS. THE HOSPITAL IS ONE OF TWO ACUTE CARE FACILITIES IN ANGELINA COUNTY, AND IS THE ONLY NOT-FOR-PROFIT HOSPITAL WHICH DIRECTLY SERVES OUR COMMUNITY.WITH THE CITY OF LUFKIN BEING THE COUNTY SEAT, WE SERVE AS THE MEDICAL AND RETAIL HUB OF ANGELINA AND SURROUNDING COUNTIES. WITH PROXIMITY TO TWO NATIONAL FORESTS AND LAKE SAM RAYBURN, WHICH IS THE LARGEST LAKE COMPLETELY IN TEXAS, THE HOSPITAL SERVES A LARGE POPULATION OF RETIREES AND RECREATIONAL LAND USERS. ANGELINA COUNTY IS HOME TO ANGELINA COLLEGE, A VETERAN'S ADMININSTRATION HEALTH CLINIC, THREE MUSEUMS, AND A ZOO.
Part VI - Patient Education of Eligibility for AssistanceTHE HOSPITAL INFORMS AND EDUCATES PATIENTS BY PROVIDING PATIENT HANDBOOKS TO INPATIENT AND DAY SURGERY PATIENTS THAT CONTAIN INFORMATION FOR UNINSURED PATIENTS AS WELL AS FINANCIAL COUNSELOR INFORMATION. PATIENT BILLS HAVE INFORMATION AND WORDING IN THEM WHICH INSTRUCTS THE PATIENT TO CALL THE BUSINESS OFFICE FOR POSSIBLE DISCOUNTS FOR UNINSURED PATIENTS. WE ALSO PROVIDE LITERATURE FOR THE PUBLIC TITLED, "NEED HELP WITH HOSPITAL BILLS?" THAT LISTS POSSIBLE PROGRAMS AND FINANCIAL COUNSELOR HOURS OF OPERATION.THE HOSPITAL HAS SIGNS IN THE EMERGENCY DEPARTMENT AND ALL OUTPATIENT REGISTRATION AREAS NOTIFYING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND GIVES INSTRUCTIONS FOR CONTACTING FINANCIAL COUNSELORS.WE ALSO HAVE A THIRD PARTY ELIGIBILITY CONTRACTOR WHOSE ROLE IS TO SCREEN SELF PAY PATIENTS AND QUALIFY THEM FOR GOVERNMENT PROGRAMS AND TO FORWARD POTENTIAL CHARITY PATIENTS TO OUR FINANCIAL COUNSELORS. THE HOSPITAL HAS AN ON-SITE MEDICAID ELIGIBILITY SPECIALIST TO HELP PATIENTS COMPLETE PAPERWORK AND EXPEDITE APPLICATION PROCESSING.
Part VI - Needs AssessmentIN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT REQUIRED BY LAW, THE HOSPITAL HAS A BOARD OF DIRECTORS MADE UP OF COMMUNITY MEMBERS WHO PROVIDE INPUT ABOUT NEEDS IN THE COMMUNITY. OUR PHYSICIANS HAVE NUMEROUS COMMITTEES AT THE HOSPITAL, IN PART TO KEEP US INFORMED ABOUT COMMUNITY MEDICAL NEEDS.
Part V, Line 22 - Charge Patients Amount Equal Gross Charge for ServicesALL PATIENTS ARE EQUALLY CHARGED. PATIENTS WHO FILE AN APPLICATION FOR FINANCIAL ASSISTANCE ARE NOT BILLED UNLESS IT IS LATER DETERMINED THAT THEY DO NOT QUALIFY FOR ASSISTANCE.Number of Hospital Faciltiy - 1
Part V, Line 20d - Other Billing Determination of Individuals Without InsurancePATIENTS WITHOUT INSURANCE ARE BILLED USING THE SAME RATES FOR SERVICES AS ALL OTHER PATIENTS.Number of Hospital Faciltiy - 1
Part V, Line 17e - Other Collection Actions by Facility or Third Party EngagedACCIDENT LIABILITY CASE LIENS FILED AGAINST FUTURE SETTLEMENT IN CASES INVOLVING THIRD-PARTY LIABILITY.Number of Hospital Faciltiy - 1
Part V, Line 7 - Explanation of Needs Not Addressed and Reasons WhyFollowing the completion of thorough process designed to comply with the requirements of Patient Protection and Affordable Care Act, including research, individual interviews with stakeholders, and receipt of the survey results, a Community Health Needs Assessment Team consisting of hospital representatives and the Executive Director of the local Health District reviewed all results identified and prioritized eight (8) specific health needs. Working with the consultants from Community Hospital Consulting, the team identified actions to address those needs and developed implementation plans FOR Seven (7) of the eight (8) needs identified. The eighth identified need, increasing access to affordable dental care, was not addressed as it was deemed not a core business function of the health system.Number of Hospital Faciltiy - 1
Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs AssessmentThe Community Health Needs Assessment was conducted to include all four (4) facilities which comprise Memorial Health System of East Texas: (1) Memorial Medical Center of East Texas (Lufkin), (2) Memorial Medical Center Livingston, (3) Memorial Medical Center San Augustine, and (4) Memorial Specialty Hospital.Number of Hospital Faciltiy - 1
Part V, Line 3 - Account Input from Person Who Represent the CommunityInterview Methodology- Memorial Health System of East Texas provided CHC Consulting with a list of people with special knowledge of Angelina, Polk and San Augustine Counties including public health representatives, not-for-profit organization professionals, charities and other individuals who focus specifically on underrepresented groups.- From that list, 21 in depth interviews were conducted using a structured interview guide. In order to further quantify the data, a follow up survey was sent to the list of 21 with the option to forward the survey on to others.- Extensive notes were taken during each interview and then quantified based on responses, communities and populations (minority, elderly, un/underinsured, etc.)served, and priorities identified by respondents. Qualitative data from the interviews was also analyzed and reported. Survey Construction, Distribution, and Collection- An electronic survey was constructed using Survey Monkey(TM) software in order to gather opinions and input of those with special knowledge regarding the health needs and priorities of the study area.- The survey was restricted so that respondents could only complete the survey once per computer to protect the integrity of the data.- The survey was initially distributed to the 21 interviewees. Recipients were allowed to forward the survey to other stakeholders in the community. The survey remained open for approximately one month.- Responses were quantified and analyzed for reporting purposes, including any free-form comments. Interviewee list- Tina Battise, Deputy Administrator, Alabama-Coushatta Tribe- Deborah Walters, RN, Director, Case Management and Social Work, MHSET- Marilyn Kegler, Director of Nurses, Lufkin ISD- Marshall McMillan, Member, MMC-San Augustine Board of Directors, Chair, Boys and Girls Club of San Augustine- John L. Brink, RN, Nurse Manager, Cardiac Cath Lab/Cardiac Rehab, MHSET/Member of the Angelina County Heart Alliance- Dr. Sid Roberts, Radiation Oncologist- Jean Hines, SAN Augustine County Hospital District Board member- Carla Hight, Director, United Way - Angelina County- Judge Sammye Johnson, San Augustine County Judge- Brittney Johnson, Project Manager, San Augustine County- Sharon Shaw, Administrator, Angelina County and Cities Health District- Dr. Robert Fayle, Neurologist- Jerry Hathorne, Chairman, Polk County Advisory Committee- Susan Rushing, CEO, Burke Center- Letha Tullos, Regional Vice President for the East Texas Region, American Cancer Society- Carrie Yocum, Administrator, Twin Lakes Rehabilitation and Care Center- Ray Polk, Diabetes Activist and former Board Member, Memorial Medical Center- Lufkin- Phyllis Grandgeorge, Executive Director, Alcohol and Drug Abuse Council- Heather Kartye, Executive Director, Family Crisis Center of East Texas- Minerva Palomino, Social Worker, MHSET- Judge John Thompson, Judge, Polk CountyNumber of Hospital Faciltiy - 1
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsAS SOON AS SUFFICIENT INFORMATION IS AVAILABLE CONCERNING THE PATIENT'S FINANCIAL RESOURCES AND ELIGIBILITY FOR GOVERNMENT ASSISTANCE, A DETERMINATION IS MADE CONCERNING THE PATIENT'S ELIGIBILITY FOR CHARITY. NO COLLECTION EFFORTS ARE PURSUED ON A CHARITY ACCOUNT AFTER SUCH DETERMINATION IS MADE.
Part III, Line 8 - Explanation Of Shortfall As Community BenefitTHE HOSPITAL BELIEVES THAT THE SHORTFALL SHOWN ON LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT. IN THE HOSPITAL'S ANNUAL COMMUNITY BENEFIT REPORT FILED WITH THE STATE OF TEXAS, THE UNREIMBURSED COST APPLICABLE TO MEDICARE PATIENTS IS A PART OF THE DETERMINATION THAT A HOSPITAL MEETS THE STATE'S REQUIREMENT THAT THE COST OF PROVIDING CHARITY CARE IS EQUAL TO AT LEAST 5% OF NET PATIENT SERVICE REVENUE. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NON-PROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.THE SHORTFALL AMOUNT WAS DETERMINED BY USING THE COST INFORMATION SHOWN ON THE 2012 "COST REPORT" FILED WITH THE CENTERS OF MEDICARE AND MEDICAID SERVICES (CMS).
Part III, Line 4 - Bad Debt ExpenseTHE HOSPITAL DOES NOT REPORT BAD DEBT EXPENSE (UNCOLLECTIBLE ACCOUNTS) IN ACCORDANCE WITH HFMA STATEMENT NO. 15. THE HOSPITAL ACCOUNTS FOR ANY LOSSES ON ACCOUNTS RECEIVABLE USING THE ALLOWANCE METHOD. THE HOSPITAL IS A MEMBER OF A SYSTEM WITH CONSOLIDATED FINANCIAL STATEMENTS AUDITED BY BDK, LLP. THE CONSOLIDATED FINANCIAL STATEMENTS FOOTNOTE TO PATIENT ACCOUNTS RECEIVABLE INCLUDES THE FOLLOWING:"ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTILBE ACCOUNTS."
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community BenefitTHE AMOUNT SHOWN ON LINE 3 IS BASED ON THE HOSPITAL'S ESTIMATE THAT 10% OF THE ACCOUNTS RECORDED AS BAD DEBT EXPENSE WOULD HAVE BEEN CLASSIFIED AS CHARITY (COMMUNITY BENEFIT) HAD THE APPROPRIATE INFORMATION BEEN OBTAINED. THIS ESTIMATE IS PRIMARILY BASED ON THE FACT THAT THE MEDIAN INCOME PER HOUSEHOLD OF THE COMMUNITY IS $39,325, THAT 18.4% OF COMMUNITY RESIDENTS HAD INCOME BELOW THE POVERTY LIMIT AND THAT 51.47% OF GROSS PATIENT REVENUE WAS FROM OUTPATIENTS. REASONS WHY ADEQUATE INFORMATION WAS NOT OBTAINED INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: LANGUAGE BARRIERS WITH THE SPANISH SPEAKING POPULATION A PATIENT'S LACK OF UNDERSTANDING ABOUT THE PROCESS AND WHERE TO FIND THE INFORMATION REQUESTED SOME PATIENTS ARE UNABLE OR UNWILLING TO SUPPLY SUPPORTING DOCUMENTATION, SUCH AS INCOME TAX RETURN DATA LACK OF UNDERSTANDING ON THE PATIENT'S PART ABOUT HOW A CHARITY CLASSIFICATION RATHER THAN A BAD DEBT CLASSIFICATION MAY BENEFIT THEM
Part III, Line 2 - Methodology Used To Estimate Bad Debt ExpenseTHE AMOUNT SHOWN ON LINE 2 WAS DETERMINED BY USING THE COSTING METHODOLOGY DERIVED FROM WORKSHEET 2 - "RATIO OF PATIENT CARE COST-TO-CHARGES". THE HOSPITAL ACCOUNTS FOR DISCOUNTS AS A DEDUCTION FROM GROSS PATIENT REVENUE AND WHERE APPLICABLE, PAYMENTS ON PATIENTS' ACCOUNTS AS DEDUCTIONS FROM UNCOLLECTIBLE (BAD DEBTS EXPENSE) ACCOUNTS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
THOMAS A BROSE
ASST DIR - PHARM137428499305620100161083
SUZANNE FRAPPIER
DIR OF SURGERY15200258815308736162856
LESLIE LEACH
ASST COO143968391328916534164182
KRISTI GAY
VP/CFO164750254158917418184011
KATHY GRIFFIN
DIR - PHARMACY14493651030947911156451
GARY N LOOPER
President & CEO5000050000
DAVID HEARNE
GENERAL COUNSEL1765494958607185651
BRYANT H KRENEK
FORMER CEO15006473245749523147890620675160

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 1aIdentifier
Return ReferencePart I, Line 1a: Relevant information in regards to selections on 1a.ReturnReference
ExplanationTHE ORGANIZATION PAID MONTHLY COUNTRY CLUB DUES FOR THE CURRENT CEO AND FORMER CEO. IN 2012, THE AMOUNT OF DUES WAS $7,070.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
LUFKIN HEALTH FACILITIES DEVELOPMENT CORPORATION
B521441564549802BY12009-11-1970186034REFUND 2005A & 2005B BONDS/HOSP BLDGS/EQUIPfalsefalsefalse
LUFKIN HEALTH FACILITIES
A521441564549802BN52007-10-1742372303HOSPITAL BUILDINGS & EQUIPMENT, BOND RESERVE FUNDfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
B318000070186034593640613639165004694578810182010truefalsetruetrue
A1640000423723034100766638477376330602009falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrsChange In Use Bond Financed PropChangeInUseBondFinancedProp
Bfalsefalsefalsefalsefalsefalse
Afalsefalsefalsefalsefalsefalsefalse

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsNo Rebate DueNoRebateDue
Bfalsetruefalsefalsefalsefalse
Afalsefalsefalsefalsefalsetrue

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
Bfalse
Afalse

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSupplemental InformationIdentifier
Return ReferencePart VIReturnReference
ExplanationA PORTION ($57,881,018) OF THE BONDS ISSUED ON 11/19/2009 WERE USED TO RETIRE SERIES 2005 AND 2005A VARIABLE RATE DEMAND REVENUE BONDS. THE ORGANIZATION HAD ENTERED INTO TWO INTEREST RATE SWAPS IN CONJUNCTION WITH THE ISSUANCE OF THE SERIES 2005 AND 2005A REVENUE BONDS. THESE SWAPS WERE ORIGINALLY DESIGNATED AS CASH FLOW HEDGES. THE SWAPS FAILED TO QUALIFY AS CASH FLOW HEDGES UPON REPAYMENT OF THE 2005 AND 2005A REVENUE BONDS DURING 2009. CONSEQUENTLY, ALL PRIOR CHANGES IN THE SWAPS' FAIR VALUE THAT HAD BEEN DEEMED EFFECTIVE, TOTALING $8,499,134, WERE RECLASSIFIED INTO DEFICIENCY OF REVENUES OVER EXPENSES FOR 2009. THE SWAPS REMAIN IN EFFECT SUBSEQUENT TO THE RETIREMENT OF 2005 AND 2005A BONDS. AT DECEMBER 31, 2012 THE FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS TOTALING $10,217,828 IS INCLUDED IN LIABILITIES ON THE ORGANIZATION'S BALANCE SHEET.PART III - PRIVATE BUSINESS USE, LINE 9 - BOND ISSUES A & B:THE ORGANIZATION IS IN THE PROCESS OF ESTABLISHING WRITTEN PROCEDURES TO ENSURE THAT NONQUALIFIED BONDS OF THE ISSUE, IF THERE ARE ANY, ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. PART IV - ARBITRAGE - LINE 2C - BOND ISSUE A:THE DATE THE REBATE COMPUTATION WAS PERFORMED - NOVEMBER 26, 2012PART IV - ARBITRAGE - LINE 9 - BOND ISSUES A & B: THE ORGANIZATION IS IN THE PROCESS OF ESTABLISHING WRITTEN PROCEDURES TO MONITOR THE REQUIREMENTS OF SECTION 148.PART V - PROCEDURES TO UNDERTAKE CORRECTIVE ACTION - BOND ISSUES A & B:THE ORGANIZATION IS IN THE PROCESS OF ESTABLISHING WRITTEN PROCEDURES TO ENSURE THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION IS NOT AVAILABLE UNDER APPLICABLE REGULATIONS.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
SID ROBERTS M D
DIRECTOR343331MEDICAL SERVICESfalse
DANIEL FUENTES D O
DIRECTOR365853MEDICAL SERVICESfalse
EDD TERRILL III
TRUSTEE315900SECURITY SERVICESfalse
MERLINA ESTRELLA
SPOUSE/OFFICER116390SALARY/BENEFITSfalse
RAY BALDWIN
DIRECTOR665910COMMERCIAL INS BROKERfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
ExplanationRAY BALDWIN HAS AN OWNERSHIP INTEREST IN SWAIN AND BALDWIN INSURANCE TO WHICH THE ORGANIZATION PAID $665,910 FOR INSURANCE COVERAGE.MERLINA ESTRELLA, AN EMPLOYEE, IS THE SPOUSE OF AN INDIVIDUAL WHO SERVED AS AN OFFICER OF THE ORGANIZATION FOR PART OF 2012EDD TERRILL, III HAS AN OWNERSIP INTEREST IN SECURITY SERVICES OF LUFKIN TO WHICH THE ORGANIZATION PAID $315,900 FOR SECURITY SERVICES.DANIEL FUENTES, D. O. HAS A PARTNERSHIP INTEREST IN TEXAS SPECIALIST CENTER, PLLC TO WHICH THE ORGANIZATION PAID $365,853 FOR MEDICAL SERVICESSID ROBERTS, M. D. HAS AN OWNERSHIP INTEREST IN ANGELINA RADIATION ONCOLOGY ASSOCIATES TO WHICH THE ORGANIZATION PAID $343,331 FOR MEDICAL SERVICESExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (16 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PATIENT SERVICE REVENUE RECONCILIATION:PATIENT SERVICE REVENUE SHOWN ON FORM 990, PART VIII, LINE 2A WAS DETERMINED AS FOLLOWS: GROSS CHARGES TO PATIENTS $760,429,642 LESS: MEDICARE CONTRACTUAL ADJUSTMENTS (311.709,818) MEDICAID CONTRACTUAL ADJUSTMENTS ( 46,916,738) INSURED/MANAGE CARE ADJUSTMENTS (158,854,421) OTHER DISCOUNTS ( 17,884,755)UNCOLLECTIBLE ACCOUNTS ( 62,521,142) CHARITY DEDUCTIONS ( 37,915,330) PATIENT SERVICE REVENUE 124,627,438
Other Changes In Net Assets Or Fund Balances - Other DecreasesNET RESTRICTED FUND ASSETS RELEASED FROM RESTRICTIONS = -$1818013Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other IncreasesNET INCREASE IN BENEFICIAL INTEREST IN TRUST = $2573254Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other IncreasesINTEREST INCOME - RESTRICTED FUND = $421Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other IncreasesCONTRIBUTIONS RECEIVED - RESTRICTED FUND = $93251Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other DecreasesCHANGE IN DEFINED BENEFIT PLAN GAINS AND LOSSES = -$4704103Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other IncreasesASSETS RELEASED FROM RESTRICTIONS USED FOR PURCHASE OF P & E = $126905Form 990, Part XI, Line 9
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableORGANIZATIONAL DOCUMENTS, APPLICATIONS FOR EXEMPTION AND FINANCIAL STATEMENTS OF THE CORPORATION ARE AVAILABLE FOR INSPECTION AND COPYING IN THE OFFICE OF THE CHIEF FINANCIAL OFFICER LOCATED AT 1201 W. FRANK AVENUE, LUFKIN, TX 75904 ON ORAL OR WRITTEN REQUEST DURING REGULAR BUSINESS HOURS, OR SUCH OTHER TIMES AS ARE SCHEDULED DIRECTLY WITH THE CHIEF FINANCIAL OFFICER.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe Executive Committee of the Board of Directors is responsible for establishing compensation for Executives and key management employees of corporation. As a part of the management services provided corporation pursuant to the Management Agreement referenced in response to Part VI, Line 3, Community Hospital Consulting, Inc. (CHC) assists the Executive Committee in its review and evaluation of compensation for its Executives, and its key management employees, some of which are employees of CHC seated with corporation. To set compensation for the Chief Executive Officer, CHC establishes an appropriate salary using its internal compensation policy and then engages an independent nationally known compensation consultant to perform a competitive market analysis considering the job description, scope of responsibility and current compensation of the Chief Executive Officer. The consultant recommends appropriate comparison data, and using data from four major compensation surveys, provides the data and makes recommendations based on the articulated compensation policy. Those recommendations and the market data on which they are based are then forwarded to the Executive Committee of the Board which establishes an appropriate compensation level for the Chief Executive Officer. Other key employees compensation is set in much the same manner using information related to their positions and data developed with the assistance of CHC from major compensation surveys, passed on to the Chief Executive Officer and the Executive Committee of the Board, which establishes compensation levels as appropriate.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsANNUALLY, EACH MEMBER OF THE BOARD AND OFFICER OF THE CORPORATION IS PROVIDED A COPY OF THE CONFLICTS OF INTEREST POLICY, A STATEMENT ACKNOWLEDGING ITS RECEIPT, AND DISCLOSURE OF OUTSIDE INTERESTS AND ACTIVITIES FORM. THE POLICY IS DISCUSSED WITH THE BOARD AND EACH OFFICER. EACH BOARD MEMBER AND OFFICER COMPLETES THE DISCLOSURE OF OUTSIDE INTERESTS AND ACTIVITIES FORM AND RETURNS THEM TO THE CHIEF EXECUTIVE OFFICER (CEO). THE CEO AND THE SYSTEM'S GENERAL COUNSEL REVIEW EACH STATEMENT ACKNOWLEDGING RECEIPT OF THE POLICY AND THE DISCLOSURES TO FAMILIARIZE THEMSELVES WITH POTENTIAL CONFLICTS.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11b: Form 990 Review ProcessTHE BOARD OF DIRECTORS, BY RESOLUTION, DETERMINES WHETHER THE FORM 990 WILL BE REVIEWED BY ALL DIRECTORS, AN EXISTING COMMITTEE, OR A SPECIAL COMMITTEE APPOINTED FOR SUCH PURPOSE PRIOR TO FILING. ONCE THE RETURN IS COMPLETED, IT IS PROVIDED TO THE DIRECTORS OF THE COMMITTEE RESPONSIBLE FOR REVIEWING, EITHER INDIVIDUALLY OR IN A JOINT SESSION. EMPLOYEES OF THE CORPORATION RESPONSIBLE FOR FILING ARE AVAILABLE TO RESPOND TO QUESTIONS OR PROVIDE BACKGROUND AS NEEDED. ONCE THE DIRECTORS RESPONSIBLE FOR REVIEWING THE FORM 990 ARE SATISFIED IT IS COMPLETE, THE RETURN IS FILED. SUBSEQUENTLY, THE RETURN IS MADE AVAILABLE TO ALL DIRECTORS FOR THEIR REVIEW.Form 990, Part VI, Line 11b
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersThe Board of Trustees has authority to amend the Articles of Incorporation, to elect new and additional Directors, and to approve the ultimate disposition of assets of the corporation on dissolution in accordance with the provisions of the Articles of Incorporation.Form 990, Part VI, Line 7b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyNominations for election to the Board of Trustees may be made by any Member, the Board of Directors, or by any Trustee. Nominations for election to the Board of Trustees may be made by the Board of Directors or by any Trustee. In each case, nominations other than those made on behalf of the Board of Directors must be in writing and mailed or delivered to the Chair of the Board of Directors not less than10 days, nor more than 30 days, prior to any meeting called for election of Directors or Trustees.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 4: Description of Significant Changes to Organizational DocumentsThe Bylaws of the corporation were amended in 2012 to:1. Delegate transactional authority from the Trustees to the Board of Directors,2. Increase the size of the Board from 16 to 18,3. Create a separate class of members for six (6) Physicians to include the two (2) Medical Staff officer members ex officio with vote (already members) and four (4) new at-large physician positions,4. Establish term limits for all positions,5. Remove requirements for prescribed percent of Directors from Trustees,6. Create certain standing committees of the Board, and7. Extend terms of all current Directors for one (1) additional year.Form 990, Part VI, Line 4
Form 990, Part VI, Line 3: Description of Delegated Duties to Management CompanyIN AUGUST 2011, THE SYSTEM ENGAGED COMMUNITY HOSPITAL CONSULTING, INC. (CHC) FOR CERTAIN MANAGEMENT SERVICES INCLUDING RESPONSIBILITY FOR OVERSIGHT AND MANAGEMENT OF DAY-TO-DAY OPERATIONS OF THE SYSTEM AND ITS HOSPITALS, AND TO MEMORIAL SPECIALTY HOSPITAL TO WHICH IT PROVIDES ADMINISTRATIVE OVERSIGHT AND SERVICES BY CONTRACT. THE CONTRACT AUTHORIZES PLACEMENT OF COMMUNITY HOSPITAL CONSULTING EMPLOYEES OR CONTRACTORS AS SUCH OF THE SENIOR AND OTHER MANAGEMENT PERSONNEL AS COMMUNITY HOSPITAL CONSULTING, INC. DEEMS APPROPRIATE SUBJECT TO THE OVERSIGHT OF THE SYSTEM BOARD OF DIRECTORS. IN 2012, THE FOLLOWING SENIOR PERSONNEL WERE EMPLOYEES OF CHC: CHIEF EXECUTIVE OFFICER CHIEF OPERATING OFFICER/VP CLINICAL OPERATIONSForm 990, Part VI, Line 3
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtBOARD MEMBER RELATIONSHIPS: GEORGE H. HENDERSON, III AND H.J. SHANDS, III - BUSINESS RELATIONSHIP CARL RAY POLK AND GEORGE H. HENDERSON, III - BUSINESS RELATIONSHIP GIBSON FRIESEN AND RONA FRIESEN - FAMILY RELATIONSHIPForm 990, Part VI, Line 2

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
MEMORIAL MULTISPECIALTY ASSOCIATES
1201 W FRANK AVELUFKINTX75904752721155PHYSICIAN OFFICESTX501(C)(3)11 - TYPE IIIMEMORIAL HEALTH SYSTEM OF EAST TEXASfalse
LUFKIN VISION ACQUISITIONS
1201 W FRANK AVELUFKINTX75904820563768PROVIDES OFFICE SPACE FOR HEALTH CARE PROFESSIONALSTX501(C)(3)11CMEMORIAL HEALTH SYSTEM OF EAST TEXASfalse
MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
511 HOSPITAL STSAN AUGUSTINETX75972752663904LICENSED HOSPITALTX501(C)(3)(3) HOSPITALMEMORIAL HEALTH SYSTEM OF EAST TEXASfalse
MEMORIAL MEDICAL CENTER - LIVINGSTON
1717 HWY 59 BYPASSLIVINGSTONTX77351760436439LICENSED HOSPITALTX501(C)(3)(3) HOSPITALMEMORIAL HEALTH SYSTEM OF EAST TEXASfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MEMORIAL MULTISPECIALTY ASSOCIATES
q1027024COST
MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
q526433COST
MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
l47636COST
MEMORIAL MEDICAL CENTER - SAN AUGUSTINE
k15120COST
MEMORIAL MEDICAL CENTER - LIVINGSTON
q4006871COST
MEMORIAL MEDICAL CENTER - LIVINGSTON
l230706COST
MEMORIAL MEDICAL CENTER - LIVINGSTON
j6498AMOUNT CHARGED