2012-08-15T15:10:46-05:00 2011-09-30 BKD LLP 2800 POST OAK BLVD STE 3200 HOUSTON TX 77056 990 2010-10-01 861132471 GSHS ADMINISTRATIVE SERVICES ORGANIZATIO GSHS 9033152000 700 E MARSHALL AVENUE LONGVIEW TX 75601 PAT KEEL 9033152000 2012-08-15 1 PAIGE GERICH 7134994600 2010 2016-02-24 21:20:13Z PAT KEEL 700 E MARSHALL AVENUE LONGVIEW TX 75601 36543732 0 X N/A X 2005 TX PROVIDES ADMINISTRATIVE, MANAGERIAL, AND SUPPORT SERVICES FOR RELATED ENTITIES THAT PROVIDE HEALTHCARE SERVICES AND SERVICES RELATED THERETO AS A BENEVOLENT, CHARITABLE, AND EDUCATIONAL INSTITUTION. 3 2 391 2 0 0 0 0 46090260 36541287 231 1123 -2688 0 46087803 36542410 0 0 0 0 21685434 18297665 0 0 0 18951016 13798802 40636450 32096467 5451353 4445943 17688938 15743951 4911739 4520809 12777199 11223142 X PROVIDES ADMINISTRATIVE, MANAGERIAL, AND SUPPORT SERVICES FOR RELATED ENTITIES THAT PROVIDE HEALTHCARE SERVICES AND SERVICES RELATED THERETO AS A BENEVOLENT, CHARITABLE, AND EDUCATIONAL INSTITUTION. 0 0 28779796 36541287 GSHS ADMINISTRATIVE SERVICES ORGANIZATION IS A NOT-FOR-PROFIT, TAX-EXEMPT CORPORATION FORMED IN 2005 TO PROVIDE ADMINISTRATIVE AND OTHER SERVICES TO VARIOUS ENTITIES WITH THE GOOD SHEPHERD HEALTH SYSTEM. GSHS IS THE SOLE MEMBER OF GSHS ADMINISTRATIVE SERVICES ORGANIZATION, INC. THE CORPORATION'S BOARD OF DIRECTORS IS COMPRISED OF THE PRESIDENT OF THE CORPORATION, OR A VICE PRESIDENT DESIGNATED BY THE PRESIDENT, AND SUCH ADDITIONAL PERSONS AS ARE APPOINTED BY GSHS.THE GSHS ADMINISTRATIVE SERVICES ORGANIZATION IS COMPRISED OF SERVICES THAT PROVIDE SUPPORT TO THE OTHER ENTITIES OF THE ORGANIZATION. SOME OF THESE SERVICES INCLUDE ACCOUNTING, HUMAN RESOURCES, INFORMATION SYSTEMS, CARE MANAGEMENT, HEALTH INFORMATION MANAGEMENT, EDUCATION, MATERIALS MANAGEMENT, MANAGED CARE, INFECTION CONTROL, HOUSEKEEPING, SECURITY, AND PLANT OPERATIONS.OUR ACTIVITIES INCLUDE ADVOCACY, POLICY DEVELOPMENT, EDUCATION AND RESEARCH. WE WORK IN PARTNERSHIP WITH THE GSMC HEALTH NETWORKS ON A WIDE VARIETY OF ISSUES. WE PROVIDE EDUCATIONAL AND RESEARCH SERVICES.GSHS ADMINISTRATIVE SERVICES ORGANIZATION PROVIDES SERVICES TO THREE HOSPITALS, GOOD SHEPHERD MEDICAL CENTER, GOOD SHEPHERD MEDICAL CENTER-LINDEN, AND GOOD SHEPHERD MEDICAL CENTER-MARSHALL. THESE THREE HOSPITALS ARE 501(C)(3) ORGANIZATIONS, NOT-FOR-PROFIT COMMUNITY BASED HOSPITALS. THE HOSPITALS TOGETHER PROVIDE HEALTH SERVICES TO THE UNDERSERVED COMMUNITIES OF LONGVIEW AND NORTHEAST TEXAS, CASS, MORRIS AND MARION COUNTIES, AND HARRISON AND MARION COUNTIES, RESPECTIVELY.GSHS ADMINISTRATIVE SERVICES ORGANIZATION EXISTS FOR THE SOLE PURPOSE OF SUPPORTING OTHER NOT-FOR-PROFIT 501(C)(3) ORGANIZATIONS. 28779796 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 74 0 1 391 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JANET ANDERSEN 9033155177 700 E MARSHALL AVE LONGVIEW TX 75601 RICHARD DIAL 1.00 X 0 0 0 EDWARD BANOS 40.00 X X 695940 0 8409 TOM MOBLEY 1.00 X 0 0 0 MARION BENSON 40.00 X 199754 0 8834 KENNETH CUNNINGHAM 40.00 X 262724 0 16074 PAT KEEL 40.00 X 346520 0 4153 LEORA WILLIAMS 34.00 X 91111 0 5829 CONNIE HEIDBREDER 34.00 X 47115 0 1120 RUBY BREWER 40.00 X 204432 0 16444 SANDY FERRIGNO 40.00 X 128087 0 1301 RONALD DEAN SHORT III 40.00 X 176315 0 13005 TROY THIBODEAUX 40.00 X 327812 0 6125 KAREN WATTS 40.00 X 308153 0 5337 BETH CHRISMER 40.00 X 146281 0 7434 LEON KOEHN 40.00 X 101789 0 1559 CHERYL HERBERT 40.00 X 108547 0 1595 JAMES AYERS 40.00 X 123056 0 4153 CHRISSY RAMSEY 40.00 X 121854 0 875 3389490 0 102247 14 1 1 0 THE SHAMS GROUP TSG 1304 WEST WALNUT HILL LANE IRVING TX 75038 SOFTWARE SUPPORT 552185 INGRAM AND ASSOCIATES 2771 MOMENTUM PLACE CHICAGO IL 60689 COLLECTIONS 483810 DELL MARKETING LP 9505 ARBORETUM AUSTIN TX 78759 SOFTWARE INSTALL/SUPPORT 424781 PNC BANK 995 DALTON AVE CINCINNATI OH 45203 FINANCIAL SERVICES 307947 CCA FINANCIAL LLC PO BOX 17190 RICHMOND VA 23226 FINANCIAL SERVICES 295777 5 MANAGEMENT SERVICES 541610 36541287 36541287 36541287 670 670 1775 1322 453 453 453 36542410 36541287 0 1123 2851472 2851472 10569973 8882569 1687404 57048 57048 3929817 3929817 889355 768252 121103 1231702 1231702 366609 366609 29726 29726 2930196 2930196 824368 801746 22622 2730507 2730507 153107 150895 2212 55894 55894 2092172 2092172 76644 76644 BILLINGS AND COLLECTION 1264938 1264938 LEASE AND RENTAL 1020988 804875 216113 PLANT OPERATIONS 769178 769178 RECRUITING EXPENSE 142234 142234 MISCELLANEOUS EXPENSES 71938 70910 1028 38601 37350 1251 32096467 28779796 3316671 0 6127053 3620285 235883 69577 76201 76453 1237699 1509849 29148584 23326175 5509672 5822409 4502430 4645378 17688938 15743951 3846139 3480791 360031 638229 705569 401789 4911739 4520809 X 12777199 11223142 12777199 11223142 17688938 15743951 X 4445943 -6000000 X 0 1 1 X 0 X X X 0 0 0 THE GOOD SHEPHERD HOSPITAL INC 751041154 3 1 1 1 0 GOOD SHEPHERD MEDICAL CENTER-LINDEN 010829282 3 1 1 1 0 2 0 33134 28227 4907 5567 1775 3792 29109883 23296173 5813710 5822409 DUE FROM AFFILIATES 4645378 4645378 DUE TO AFFILIATES 401789 401789 36542410 32096467 4445943 -6000000 -6000000 -1554057 36542410 0 36542410 0 36542410 32096467 0 32096467 0 32096467 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE SYSTEM, GSHS ASO, THE MEDICAL CENTER, GSMC LINDEN, GSMC MARSHALL, THE GSMC FOUNDATION AND THE GSMC LINDEN FOUNDATION ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. THESE ENTITIES ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. ENTERPRISES IS A TAXABLE CORPORATION. CSC IS TAXED AS A PARTNERSHIP. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR ENTERPRISES FOR THE TAX EFFECTS OF DIFFERENCES BETWEEN THE FINANCIAL STATEMENTS AND TAX BASES OF ASSETS AND LIABILITIES. A VALUATION ALLOWANCE IS ESTABLISHED TO REDUCE DEFERRED TAX ASSETS IF IT IS MORE LIKELY THAN NOT THAT A DEFERRED TAX ASSET WILL NOT BE REALIZED. THE SYSTEM FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. WITH A FEW EXCEPTIONS, THE SYSTEM IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2007. PART XI, LINE 8 - OTHER ADJUSTMENTS: TRANSFERS TO AFFILIATES -6,000,000. TRANSFERS TO AFFILIATES (6,000,000) X X 0 0 0 0 0 0 0 0 0 EDWARD BANOS 495128 0 200812 0 0 0 6125 0 2284 0 704349 0 0 0 MARION BENSON 155354 0 44400 0 0 0 7696 0 1138 0 208588 0 0 0 KENNETH CUNNINGHAM 202922 0 59802 0 0 0 7853 0 8221 0 278798 0 0 0 PAT KEEL 311519 0 35001 0 0 0 0 0 4153 0 350673 0 0 0 RUBY BREWER 164052 0 40380 0 0 0 8484 0 7960 0 220876 0 0 0 RONALD DEAN SHORT III 141315 0 35000 0 0 0 7284 0 5721 0 189320 0 0 0 TROY THIBODEAUX 265312 0 62500 0 0 0 6125 0 0 0 333937 0 0 0 KAREN WATTS 237610 0 70543 0 0 0 4546 0 791 0 313490 0 0 0 BETH CHRISMER 119656 0 26625 0 0 0 6023 0 1411 0 153715 0 0 0 JAMES AYERS 82055 0 1009 0 39992 0 0 0 4153 0 127209 0 0 0 CHRISSY RAMSEY 120543 0 1311 0 0 0 0 0 875 0 122729 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS GOOD SHEPHERD HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER, GOOD SHEPHERD HEALTH SYSTEM, INC. HAS THE POWER TO APPROVE MEMBERS TO THE ORGANIZATION'S BOARD. FORM 990, PART VI, SECTION A, LINE 7B A NUMBER OF DECISIONS OF THE ORGANIZATION ARE SUBJECT TO APPROVAL OF THE MEMBER OF THE ORGANIZATION. THESE RESERVED POWERS ARE STATED BELOW: A) APPROVE THE MEMBERS OF THE BOARD; B) APPROVE REMOVAL AND APPOINTMENTS TO FILL VACANCIES ON THE BOARD AND SET SIZE OF BOARD; C) APPROVE ELECTION AND REMOVAL OF OFFICERS OF THE CORPORATION AND ESTABLISH, TERMINATE AND/OR REVISE ALL EMPLOYMENT CONTRACTS, COMPENSATION AND BENEFITS PACKAGES OF THE OFFICERS OF THE CORPORATION REGARDLESS OF WHICH ENTITY ACTUALLY PAYS SUCH COMPENSATION OR BENEFITS; D) DESIGNATE THE FISCAL YEAR; E) APPROVE THE SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, OUTSIDE GENERAL LEGAL COUNSEL, AND OUTSIDE INVESTMENT ADVISORS; F) AMEND THE ARTICLES OF INCORPORATION; G) AMEND OR REPEAL THE BYLAWS; H) APPROVAL OF ALL MERGERS, ACQUISITIONS, CONSOLIDATIONS, OR AFFILIATIONS WITH OTHER ENTITIES, THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE SALE, MORTGAGE, OR ENCUMBRANCE OF ANY REAL PROPERTY OWNED BY THE CORPORATION; I) APPROVE THE DISSOLUTION OR LIQUIDATION OF THE CORPORATION; J) APPROVE CAPITAL PLANS, STRATEGIC PLANS, AND ANNUAL OPERATING AND CAPITAL BUDGETS; K) APPROVE ANY EXCEPTION TO THE CAPITAL BUDGET FOR A SINGLE ITEM OR RELATED ITEM THAT EXCEEDS $100,000 AND/OR APPROVE ANY AGGREGATE ANNUAL OPERATING EXPENDITURES THAT EXCEED THE BUDGET BY $50,000; L) SELECT OFFICIAL DEPOSITORIES FOR THE CORPORATION'S FUNDS; M) CREATE OR INVEST IN ANY SUBSIDIARY ENTITY OR ENTER INTO ANY PARTNERSHIP OR JOINT VENTURE; N) AUTHORIZE ANY LOANS, GUARANTEES, OR INCURRENCE OF DEBT; O) COMMENCE ANY LITIGATION OR OTHER LEGAL PROCEEDING, OR SETTLE, DISPOSE, OR TERMINATE OF ANY SUCH LITIGATION OR OTHER LEGAL PROCEEDING OR OF ANY CLAIM OR THREAT OF LITIGATION OR OTHER LEGAL PROCEEDING NOT FULLY COVERED BY INSURANCE; AND P) APPROVAL OF THE ADMISSION OF ADDITIONAL MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION PREPARES THE 990 INTERNALLY AND ENGAGES AN OUTSIDE ACCOUNTING FIRM TO REVIEW THE FORM 990. ONCE PREPARED AND REVIEWED, THE FORM IS REVIEWED BY INTERNAL ACCOUNTANTS AND BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURES ARE OBTAINED ANNUALLY. THE BOARD REVIEWS AND APPROVES BOARD DISCLOSURES, AND THE CEO REVIEWS AND APPROVES EMPLOYEE DISCLOSURES. BOARD MINUTES NOTE WHEN A BOARD MEMBER DECLARES A CONFLICT AND DOES NOT VOTE. FORM 990, PART VI, SECTION B, LINE 15 A COMPENSATION SUBCOMMITTE OF THE BOARD NEGOTIATES CONTRACTS WITH EXECUTIVES THROUGH HAY GROUP. THIS SUBCOMMITTEE OF THE BOARD REVIEWS AND APPROVES COMPENSATION AND BONUSES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: TRANSFERS TO AFFILIATES -6,000,000. TOTAL TO FORM 990, PART XI, LINE 5: -6,000,000. GOOD SHEPHERD MEDICAL CENTER-LINDEN 404 N KAUFMAN STREET LINDEN TX 75563 010829282 HEALTHCARE TX 501(C)(3) LINE 3 GOOD SHEPHERD HEALTH SYSTEM INC 0 GOOD SHEPHERD HEALTH SYSTEM INC 700 E MARSHALL AVE LONGVIEW TX 75601 752027157 SUPPORT GSMC TX 501(C)(3) LINE 11B, II N/A 0 GOOD SHEPHERD MEDICAL CENTER-MARSHALL 811 SOUTH WASHINGTON AVENUE MARSHALL TX 75670 750974351 HEALTHCARE TX 501(C)(3) LINE 3 GOOD SHEPHERD HEALTH SYSTEM INC 0 GOOD SHEPHERD MEDICAL CENTER 700 E MARSHALL AVE LONGVIEW TX 75601 751041154 HEALTHCARE TX 501(C)(3) LINE 3 GOOD SHEPHERD HEALTH SYSTEM INC 0 GSMC-LINDEN FOUNDATION INC 404 N KAUFMAN STREET LINDEN TX 75563 200845127 SUPPORT TX 501(C)(3) LINE 11A, I GOOD SHEPHERD MEDICAL CENTER - LINDEN 0 GOOD SHEPHERD FOUNDATION INC 700 E MARSHALL AVE LONGVIEW TX 75601 200845127 SUPPORT TX 501(C)(3) LINE 11A, I GOOD SHEPHERD HEALTH SYSTEM INC 0 MARSHALL HOSPITAL FOUNDATION INC 811 SOUTH WASHINGTON AVENUE MARSHALL TX 75670 752605699 HEALTHCARE TX 501(C)(3) LINE 7 GOOD SHEPHERD HEALTH SYSTEM INC 0 MARSHALL HEALTH SERVICES INC 811 SOUTH WASHINGTON AVENUE MARSHALL TX 75670 752580686 HEALTHCARE TX 501(C)(3) LINE 3 GOOD SHEPHERD MEDICAL CENTER - MARSHALL 0 GOOD SHEPHERD HOSPITAL AUXILIARY 700 E MARSHALL AVE LONGVIEW TX 75601 237203364 SUPPORT TX 501(C)(3) LINE 9 GOOD SHEPHERD MEDICAL CENTER 0 CHAMPION EMS 2201 S MOBBERLY AVE LONGVIEW TX 75604 752747708 MED TRANSPORT TX 501(C)(3) LINE 11B, II GOOD SHEPHERD MEDICAL CENTER 0 GOOD SHEPHERD AMBULATORY SURGICAL CENTER 700 E MARSHALL AVE LONGVIEW TX 75601 900259782 AMBULATORY SURGERY TX GSHS ENTERPRISES OPERATING 32 INC RELATED 0 0 0.00000 GSHS ENTERPRISES INC 700 E MARSHALL AVE LONGVIEW TX 75601 752027162 HEALTHCARE TX GOOD SHEPHERD HEALTH SYSTEM INC C GOOD SHEPHERD HEALTH NETWORK 700 E MARSHALL AVE LONGVIEW TX 75601 752554695 INACTIVE TX GOOD SHEPHERD MEDICAL CENTER C NORTHEAST TEXAS PHYSICIAN SERVICES 700 E MARSHALL AVE LONGVIEW TX 75601 752712245 MGMT SERVICES TX GSHS ENTERPRISES INC C GS PHYSICIAN SERVICES INC 700 E MARSHALL AVE LONGVIEW TX 75601 752762417 MEDICAL SERVICES TX GSHS ENTERPRISES INC C GSHS ENTERPRISES HOLDING INC 700 E MARSHALL AVE LONGVIEW DE 75601 510412465 HOLDING COMPANY TX GSHS ENTERPRISES INC C GSHS ENTERPRISES OPERATING 1 700 E MARSHALL AVE LONGVIEW DE 75601 752954772 HEALTHCARE TX GSHS ENTERPRISES INC C GSHS ENTERPRISES OPERATING 2 700 E MARSHALL AVE LONGVIEW DE 75601 752954777 HEALTHCARE TX GSHS ENTERPRISES INC C GSHS ENTERPRISES OPERATING 3 700 E MARSHALL AVE LONGVIEW DE 75601 750896512 HEALTHCARE TX GSHS ENTERPRISES INC C GSHS MEDICAL PLAZA LTD 700 E MARSHALL AVE LONGVIEW TX 75601 752955157 HEALTHCARE TX GSHS ENTERPRISES OPERATING #1 INC C GSHS MEDICAL PLAZA III LTD 700 E MARSHALL AVE LONGVIEW TX 75601 731654263 HEALTHCARE TX GSHS ENTERPRISES OPERATING #3 INC C 0 1 0 0 1 0 0 0 1 0 1 0 0 1 1 1 1 0