2026-05-13T12:00:20+00:00 2025-06-30 346565596 ERNST & YOUNG US LLP 425 HOUSTON ST FORT WORTH TX 76102 990 2024-07-01 200991990 ContinueCare Hospital of Tyler Inc CONT 9729436400 7950 LEGACY DRIVE 1000 PLANO TX 75024 STEPHANIE HYDE PRESIDENT 9729436400 2026-05-13 true Jodi Rosser P01255710 8173351900 2026-05-11 2024 2025-03-06 01:10:19Z See Schedule O STEPHANIE HYDE 7950 LEGACY DRIVE 1000 PLANO TX 75024 30554169 false X HTTPS://LONGVIEW.CONTINUECARE.ORG/ X 2004 DE IT IS THE MISSION OF LONGVIEW CONTINUECARE HOSPITAL AND CONTINUECARE HOSPITAL OF TYLER, INC. TO ENHANCE COMMUNITY HEALTH THROUGH SERVICE WITH COMPASSION, CARE, ACCOUNTABILITY, RESPECT AND EMPATHY. 5 3 216 0 0 2500 0 21308212 30533538 -22601 8126 152 107 21288263 30541771 0 0 0 0 10128674 16861384 0 0 0 10120662 15740342 20249336 32601726 1038927 -2059955 8666242 10330188 4449494 8173395 4216748 2156793 IT IS THE MISSION OF LONGVIEW CONTINUECARE HOSPITAL AND CONTINUECARE HOSPITAL OF TYLER, INC. TO ENHANCE COMMUNITY HEALTH THROUGH SERVICE WITH COMPASSION, CARE, ACCOUNTABILITY, RESPECT AND EMPATHY. false false 28468280 0 30533538 ContinueCare Hospital of Tyler Inc operates Longview Continuecare Hospital and Tyler ContinueCare Hospital, which are Long Term Acute Care Hospitals (LTACH) that serve the needs of patients with medically complex conditions, especially those suffering from multisystem complications and needing extended recovery times - a hospital stay that is often 25 days or more. A patient is usually admitted after a short-term, acute-care hospital stay. After care in an LTACH, many patients are then able to transition from the LTACH to acute rehab, skilled nursing or go home. As an LTACH, the ContinueCARE Hospitals develop a continuum of care between the acute and long term phases of a patient's illness. Our innovative and distinctive physician-driven approach allows us to bring new meaning to the "hospital-within-a-hospital" model. As a separate, fully licensed and staffed hospital, we are able to provide intensive and complex medical treatment to patients requiring longer lengths of stay for acute-care. We have specialty programs designed to meet the needs of long term, acutely ill patients with conditions including ventilator dependence, respiratory failure, chronic pulmonary problems, complex and severe wounds, and infections requiring long term antibiotic therapy. LTACH facilities also provide physical, occupational, and nutritional therapies. DURING THE FISCAL YEAR ENDED JUNE 30, 2025, TYLER CONTINUECARE HOSPITAL'S TOTAL PATIENTS ADMITTED WERE 638 AND THE TOTAL NUMBER OF PATIENT CARE DAYS PROVIDED WAS 19,269. THE AVERAGE DAILY CENSUS WAS 52.8 PATIENTS AND THE AVERAGE LENGTH OF STAY OF THE DISCHARGED PATIENTS WAS 30.3 DAYS. As of September 1, 2025, the tyler continuecare hospital location consolidated services to the longview continuecare hospital location. 28468280 true false false true false false false false false false true false false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false false false true false false false false true 10 0 true 216 true false false false false false false false false false false false false X 5 3 false true false false true true true true false false false false true true true true true true false false false false X MIKE MURRAY 9729431225 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 CRAIG CHESLEY DIRECTOR 1.0 1.0 X 0 42050 0 DAN HARDIMAN DIRECTOR 1.0 0 X 0 0 0 Jeff Warr DIRECTOR 1.0 0 X 0 0 0 JIM KENDRICK DIRECTOR 0.2 39.8 X 0 1910049 470298 Mark Anderson MD DIRECTOR 1.0 0 X 0 0 0 JAMES HILL TREASURER 0.4 39.6 X 0 451879 60342 LINDA MOORE SECRETARY 0.1 39.9 X 0 482307 52098 STEPHANIE HYDE CEO/PRESIDENT 40.0 0.0 X 0 288240 42097 Dawn Stiles LVN 40.0 0 X 138849 0 22585 Jennifer Minchew Registered Nurse 40.0 0 X 151441 0 4749 Kent Andries CNO ContinueCare Tyler (until 1/2025) 40.0 0.0 X 0 187869 50020 LADUANDA HILL RN CHARGE NURSE 40.0 0 X 202638 0 19594 Ty'Eesha Dawkins Registered Nurse 40.0 0 X 136761 0 14476 629689 3362394 736259 19 false true false NATHAN JACKSON PLLC 6760 OLD JACKSONVILLE HWY STE 101 TYLER TX 75703 CONTRACT PT/OT 528135 Tyler Physician Services PO BOX 677979 DALLAS TX 75267 Contract Physicians 385897 HHS ENVIRONMENTAL SERVICES PO Box 734367 Dallas TX 75373 Contract Cleaning 307917 CHRISTUS TRINITY CLINIC 919 Hidden Ridge 5th Fl Irving TX 75038 CONTRACT PHYSICIANS 124456 4 0 INPATIENT REVENUE 623000 30533538 30533538 0 0 0 0 30533538 11941 11941 0 0 8583 12398 0 -3815 -3815 -3815 MEDICAL RECORDS 900099 107 107 0 0 0 0 107 30541771 30533538 0 8233 X 0 0 14036485 12492472 1544013 242292 215640 26652 1596259 1420671 175588 986348 877850 108498 1702800 1702800 523 523 120495 120495 27421 27421 8027884 8024163 3721 0 13017 13017 57172 57172 1768251 1768251 63258 63258 3541 3541 222170 222170 314168 314168 MEDICAL SUPPLIES 2250754 2250754 EQUIPMENT LEASE 775688 775688 REPAIRS & MAINTENANCE 289812 289812 LICENSES & PERMITS 55461 55461 47927 47927 0 0 32601726 28468280 4133446 0 1080849 269501 5164690 5459745 0 0 0 0 188229 314390 357430 522304 9180632 5416384 1783794 3764248 0 0 0 0 91250 0 8666242 10330188 2270291 4152010 0 0 0 0 2179203 4021385 4449494 8173395 X 4216748 2156793 4216748 2156793 8666242 10330188 -2059955 0 X false true true false X false false false false false false false false true 27421 27421 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY IN FISCAL YEAR 2025 Tyler ContinueCare Hospital PAID: $12,145 TO THE NATIONAL ASSOCIATION OF LONG TERM HOSPITALS (NALTH) $3,765 TO THE TEXAS HOSPITAL ASSOCIATION (THA) $10,841 TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) $36,000 TO THE PICARD GROUP THE PORTION OF DUES THAT WERE REPORTED FOR LOBBYING PURPOSES WERE: NALTH: 13.12% THA: 0% AHA: 39% PICARD GROUP: 60% TOTAL DUES PAID AND REPORTED FOR LOBBYING ACTIVITIES WERE: NALTH: $12,145 * 13.12% = $1,593 THA: $3,765 * 0% = $0 AHA: $10,841 * 39% = $4,228 PICARD GROUP: $36,000 * 60.0% = $21,600 0 0 0 0 166642 166642 0 0 0 0 0 0 3111842 2645909 465933 0 5902148 2603833 3298315 3764248 Federal Income Taxes Short Term Lease Obligations 870588 Optum Advance Funding Long Term Lease Obligations 2454034 INTERCOMPANY- CCC 395440 Long Term Debt Escheat Accounts 211 INTERCOMPANY- Paducah INTERCOMPANY- CHC 301112 4021385 0 0 0 0 0 0 0 0 0 0 0 0 true true X true X true X 168361 -399925 568286 0.01743 0 0.0 0 0.0 0 0 168361 -399925 568286 0.01743 0 0.0 241395 241395 0.00740 0 0.0 0 0.0 8196 8196 0.00025 0 0 249591 0 249591 0.00766 0 0 417952 -399925 817877 0.02509 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 14067434 14862554 -795120 X true true 2 1 CONTINUECARE HOSPITAL OF TYLER 800 E DAWSON 4TH FLOOR TYLER TX 75701 HTTPS://TYLER.CONTINUECARE.ORG 008065 X X A 2 LONGVIEW CONTINUECARE HOSPITAL 700 E MARSHALL AVE 1ST FLOOR WING LONGVIEW TX 75601 HTTPS://LONGVIEW.CONTINUECARE.ORG 008065 X X A A 2 false false true X X X X X X X X X 24 true false false true X HTTPS://LONGVIEW.CONTINUECARE.ORG/CHNA/ X true 24 true HTTPS://LONGVIEW.CONTINUECARE.ORG/CHNA/ false true X 200.0 400.0 X X X true true X X X true X HTTPS://LONGVIEW.CONTINUECARE.ORG/FOR-FAMILIES/FINANCIAL-ASSISTANCE/ X HTTPS://LONGVIEW.CONTINUECARE.ORG/FOR-FAMILIES/FINANCIAL-ASSISTANCE/ X HTTPS://LONGVIEW.CONTINUECARE.ORG/FOR-FAMILIES/FINANCIAL-ASSISTANCE/ X X X X X X true X false X false X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED IN THE CHNA OF CONTINUECARE HOSPITAL OF TYLER (TYLER CCH) AND CONTINUECARE HOSPITAL OF LONGVIEW (LONGVIEW CCH) ARE PRESENTED AS A PRIORITIZED DESCRIPTION. Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - Facility Reporting Group A. DURING THE 2025 CHNA PROCESS, TYLER CONTINUECARE HOSPITAL (TYLER CCH) OPENED UP A SATELLITE LOCATION, LONGVIEW CONTINUECARE HOSPITAL (LONGVIEW CCH), IN GREGG COUNTY. IN THE CHNA REPORT, BOTH HOSPITALS ARE LISTED SEPARATELY BY NAME BUT THEY ARE UNDER ONE HOSPITAL LICENSE. ADDITIONALLY, AT THAT TIME OF THE 2025 CHNA STUDY, THERE WERE 2 FACILITY LOCATIONS - TYLER CCH IN TYLER, TX AND THE SATELLITE HOSPITAL LOCATION, LONGVIEW CCH, IN LONGVIEW. TEXAS. AS OF SEPTEMBER 1, 2025, THE TYLER CCH LOCATION HAS CONSOLIDATED SERVICES TO THE LONGVIEW CCH LOCATION. TYLER CCH HOSPITAL OPERATES A 51-BED LONG-TERM ACUTE CARE HOSPITAL (LTACH) LOCATED ON THE FOURTH FLOOR OF THE HOST HOSPITAL, CHRISTUS MOTHER FRANCES HOSPITAL - TYLER IN TYLER, TEXAS. AS A "HOSPITAL WITHIN A HOSPITAL". TYLER CCH HAS EXPANDED ITS SERVICE EXCELLENCE TO LONGVIEW, TEXAS. LONGVIEW CCH, A 32-BED SATELLITE OF TYLER CCH, OPENED ON SEPTEMBER 10, 2024, WITHIN CHRISTUS GOOD SHEPHERD MEDICAL CENTER - LONGVIEW, LOCATED IN LONGVIEW, TEXAS. BOTH TYLER CCH AND LONGVIEW CCH ARE LICENSED ACUTE-CARE HOSPITALS WITH THE ABILITY TO PROVIDE CARE TO CRITICALLY ILL AND MEDICALLY COMPLEX PATIENTS REQUIRING LONGER ACUTE-CARE STAYS THAN REGULAR HOSPITALS. AS LTACHS, TYLER CONTINUECARE HOSPITAL AND LONGVIEW CONTINUECARE HOSPITAL DEVELOP A CONTINUUM OF CARE BETWEEN THE ACUTE AND LONG-TERM PHASES OF A PATIENT'S ILLNESS. A PATIENT IS USUALLY ADMITTED AFTER A SHORT-TERM, ACUTE-CARE HOSPITAL STAY. AFTER CARE IN AN LTACH, MANY PATIENTS ARE THEN ABLE TO TRANSITION FROM THE LTACH TO ACUTE REHAB, SKILLED NURSING OR GO HOME. HOSPICE CARE IS ALSO A POST-ACUTE TREATMENT OPTION FOR PATIENTS WITH A TERMINAL DISEASE WHO HAVE A LIFE EXPECTANCY OF SIX MONTHS OR LESS. THE TYLER FACILITY HAS SERVED PATIENTS FOR 20 YEARS WHILE EARNING HIGH PATIENT SATISFACTION SCORES AND MULTIPLE INDUSTRY AWARDS. THIS SAME LEVEL OF HIGH-QUALITY CARE HAS EXTENDED TO LONGVIEW AND THE EAST TEXAS COMMUNITY. TYLER CCH AND LONGVIEW CCH ARE DESIGNED TO MEET THE NEEDS OF LONG-TERM, ACUTELY ILL PATIENTS WITH CONDITIONS INCLUDING VENTILATOR DEPENDENCE, CHRONIC PULMONARY PROBLEMS, COMPLEX AND SEVERE WOUNDS, INFECTIOUS DISEASE AND POST COVID RECOVERY. LTACH FACILITIES ALSO PROVIDE PHYSICAL, OCCUPATIONAL, AND NUTRITIONAL THERAPIES, AS WELL AS INFECTION CONTROL AND PATIENT AND FAMILY EDUCATION. BOTH HOSPITALS ARE LED BY A CLOSE- KNIT TEAM OF PROFESSIONALS WHO SHARE A PHILOSOPHY TO PROVIDE COMPASSIONATE, HIGH-QUALITY HEALTH CARE SERVICES AND ARE DEDICATED TO RESTORING QUALITY OF LIFE TO THEIR PATIENTS. THE DEFINED SERVICE AREA OF TYLER CCH AND LONGVIEW CCH IS SMITH COUNTY AND GREGG COUNTY, RESPECTIVELY, IN THE STATE OF TEXAS. SMITH AND GREGG COUNTIES TOGETHER COMPRISE 34.7% OF SY2025 INPATIENT DISCHARGES (SMITH AT 20% AND GREGG AT 14.6%). THE POPULATION OF SMITH COUNTY IS EXPECTED TO INCREASE BY 0.5% FROM 2024 (245,423) TO 2029 (255,823) AND THE POPULATION OF GREGG COUNTY IS EXPECTED TO INCREASE BY 4.2% FROM 2024 (125,606) TO 2029 (126,260). THIS IS BELOW THE 5.6% EXPECTED GROWTH FOR THE STATE OF TEXAS FROM 2024 (30,857,478) TO 2029 (32,581,174). AS OF 2024, THE RACIAL/ETHNIC BREAKOUT OF SMITH COUNTY WAS 60.6% WHITE, 16.4% BLACK, 1.9% ASIAN, 0.8% AMERICAN INDIAN AND 20.3% ALL OTHERS. IN GREGG COUNTY, AS OF 2024, THE RACIAL/ETHNIC BREAKOUT WAS 57.8% WHITE, 20.2% BLACK, 1.4% ASIAN, 0.6% AMERICAN INDIAN AND 19.9% ALL OTHERS. HISPANIC IS CLASSIFIED AS AN ETHNICITY AND THEREFORE IS CATEGORIZED SEPARATELY FROM WHITE, BLACK, ASIAN, AMERICAN INDIAN AND ALL OTHERS. BY 2029, THE WHITE POPULATION IN SMITH COUNTY IS EXPECTED TO INCREASE BY 0.9% AND THE BLACK POPULATION IS EXPECTED TO INCREASE BY 5.3%. BY 2029, THE ASIAN POPULATION IS EXPECTED TO INCREASE BY 11.1% AND THE AMERICAN INDIAN POPULATION IN SMITH COUNTY IS EXPECTED TO INCREASE BY 6.4%, WITH ALL OTHER GROUPS EXPECTED TO INCREASE BY 12.6%. BY 2029, THE HISPANIC ETHNIC POPULATION IN SMITH COUNTY IS EXPECTED TO INCREASE BY 13.2%. BY 2029, IN GREGG COUNTY, THE WHITE POPULATION IS EXPECTED TO DECREASE BY 2.7% AND THE BLACK POPULATION IS EXPECTED TO INCREASE BY 1.3%. THE ASIAN POPULATION IS EXPECTED TO INCREASE BY 7.2% AND THE AMERICAN INDIAN POPULATION IN GREGG COUNTY IS EXPECTED TO INCREASE BY 1.0%, WITH ALL OTHER GROUPS EXPECTED TO INCREASE BY 8.6%. THE HISPANIC ETHNIC POPULATION IN GREGG COUNTY IS EXPECTED TO INCREASE BY 9.6%. BETWEEN 2014 AND 2022, THE PERCENT OF FOREIGN-BORN RESIDENTS INCREASED IN SMITH COUNTY, THE STATE AND THE NATION AND DECREASED IN GREGG COUNTY. IN 2018-2022, GREGG COUNTY (8.5%) HAD THE LOWEST PERCENT OF FOREIGN-BORN RESIDENTS AS COMPARED TO SMITH COUNTY (8.7%), THE STATE (17.1%) AND THE NATION (13.7%). GREGG COUNTY (38.1 YEARS) AND SMITH COUNTY (38.1 YEARS) HAVE AN OLDER MEDIAN AGE THAN TEXAS (36.3 YEARS) (2024). THE MEDIAN AGES IN BOTH GREGG AND SMITH COUNTIES AND THE STATE ARE EXPECTED TO INCREASE OVER THE NEXT FIVE YEARS (2024-2029). THE MEDIAN HOUSEHOLD INCOME IN BOTH GREGG AND SMITH COUNTIES AND THE STATE ARE EXPECTED TO INCREASE OVER THE NEXT FIVE YEARS (2024-2029). GREGG COUNTY ($63,171) HAD A LOWER MEDIAN HOUSEHOLD INCOME WHEN COMPARED TO SMITH COUNTY ($70,652) AND THE STATE ($77,169) (2024). BOTH GREGG COUNTY (25.2%) AND SMITH COUNTY (30.4%) HAD A LOWER PERCENT OF RESIDENTS WITH A BACHELOR OR ADVANCED DEGREE THAN THE STATE (35.7%) (2024). IN 2018-2022, 15.2% OF THE NATION LIVED IN A DISTRESSED COMMUNITY, AS COMPARED TO 24.9% OF THE NATION THAT LIVED IN A PROSPEROUS COMMUNITY. IN 2018-2022, 22.8% OF THE POPULATION IN TEXAS LIVED IN A DISTRESSED COMMUNITY, AS COMPARED TO 27.6% OF THE POPULATION WHO LIVED IN A PROSPEROUS COMMUNITY. IN 2018-2022, SMITH COUNTY IS MID-TIER WITH A DISTRESS SCORE OF 42.0 AND RANKS 64 OUT OF 251 COUNTIES IN TEXAS AND GREGG COUNTY IS AT RISK WITH A DISTRESS SCORE OF 58.9 AND RANKS 103 OUT OF 251 COUNTIES IN TEXAS. WITH RESPECT TO UNEMPLOYMENT, RATES IN BOTH GREGG AND SMITH COUNTIES AND THE STATE DECREASED BETWEEN 2021 AND 2023. IN 2023, SMITH COUNTY (3.6) HAD A LOWER UNEMPLOYMENT RATE THAN GREGG COUNTY (4.2) AND THE STATE (3.9). OVER THE MOST RECENT 12-MONTH TIME PERIOD, GREGG COUNTY MAINTAINED A HIGHER MONTHLY UNEMPLOYMENT RATE THAN SMITH COUNTY. OVER THE MOST RECENT 12-MONTH TIME PERIOD, MONTHLY UNEMPLOYMENT RATES IN BOTH GREGG AND SMITH COUNTY OVERALL INCREASED. APRIL 2024 HAD THE LOWEST UNEMPLOYMENT RATE FOR GREGG COUNTY (3.9) AND DECEMBER 2023 HAD THE LOWEST UNEMPLOYMENT RATE FOR SMITH COUNTY (3.2). AS OF 2022, THE MAJORITY OF EMPLOYED PERSONS IN BOTH GREGG AND SMITH COUNTIES ARE WITHIN OFFICE & ADMINISTRATIVE SUPPORT OCCUPATIONS. THE MOST COMMON EMPLOYED GROUPINGS IN GREGG AND SMITH COUNTIES, RESPECTIVELY, ARE OFFICE & ADMINISTRATIVE SUPPORT OCCUPATIONS (12.2% AND 11.3%); SALES & RELATED OCCUPATIONS (10.6% AND 11.2%); MANAGEMENT OCCUPATIONS (9.0% AND 9.1%); PRODUCTION OCCUPATIONS (8.4% AND 6.7%); CONSTRUCTION & EXTRACTION OCCUPATIONS (6.0% AND 6.8%). IN 2018-2022, DRIVING ALONE WAS THE MOST FREQUENT MEANS OF TRANSPORTATION TO WORK FOR BOTH GREGG AND SMITH COUNTIES AND THE STATE. IN 2018-2022, SMITH COUNTY (7.0%) HAD A HIGHER PERCENT OF PEOPLE WORKING AT HOME THAN GREGG COUNTY (4.6%) BUT LOWER THAN THE STATE (9.7%). GREGG COUNTY (21.3 MINUTES) HAD A SHORTER MEAN TRAVEL TIME TO WORK THAN SMITH COUNTY (23.2 MINUTES) AND THE STATE (26.6 MINUTES) (2018-2022). IN 2024, GREGG COUNTY (18.0%) HAD A HIGHER PERCENT OF FAMILIES LIVING BELOW POVERTY AS COMPARED TO SMITH COUNTY (15.1%) AND THE STATE (14.4%). BETWEEN 2017 AND 2021, PERCENT OF CHILDREN ( <18 YEARS) LIVING IN POVERTY IN BOTH GREGG AND SMITH COUNTIES AND THE STATE DECREASED. SMITH COUNTY (17.8%) HAS A LOWER PERCENT OF CHILDREN ( <18 YEARS) LIVING IN POVERTY THAN GREGG COUNTY (21.6%) AND TEXAS (19.5%) (2021). ACCORDING TO FEEDING AMERICA, GREGG COUNTY (16.7%) HAD THE HIGHEST ESTIMATED PERCENT OF RESIDENTS WHO ARE FOOD INSECURE AS COMPARED TO SMITH COUNTY (14. 9%) AND THE STATE (16.4%) (2022). ADDITIONALLY, 26.7% OF CHILDREN (UNDER 18 YEARS OF AGE) IN GREGG COUNTY ARE FOOD INSECURE, AS COMPARED TO 22.7% IN SMITH COUNTY AND 22.8% IN TEXAS (2022). SMITH COUNTY HAD THE HIGHEST AVERAGE MEAL COST OF $3.86, AS COMPARED TO $3.72 IN GREGG COUNTY AND $3.45 IN TEXAS (2022). BETWEEN 2017 AND 2021, SMITH COUNTY MAINTAINED A LOWER PERCENT OF SNAP BENEFIT RECIPIENTS THAN GREGG COUNTY AND THE STATE. ADDITIONALLY, THE PERCENT OF SNAP BENEFIT RECIPIENTS IN BOTH GREGG AND SMITH COUNTIES AND THE STATE OVERALL DECREASED BETWEEN 2017 AND 2021. IN 2021, SMITH COUNTY (10.4%) HAD A LOWER PERCENT OF SNAP PARTICIPANTS THAN GREGG COUNTY (14.4%) AND THE STATE (10.7%). Schedule H, Part V, Section B, Line 5 Facility A, 2 Facility A, 2 - Facility Reporting Group A (CONTINUED). THE PERCENT OF PUBLIC SCHOOL STUDENTS THAT ARE ELIGIBLE FOR FREE/REDUCED PRICE LUNCH IN BOTH GREGG COUNTY (70.0%) AND SMITH COUNTY (64.9%) IS HIGHER THAN THE STATE (61.3%) AND THE NATIONAL (53.5%) RATES (2022-2023). IN 2020-2021, THE PERCENT OF STUDENTS RECEIVING THEIR HIGH SCHOOL DIPLOMA WITHIN FOUR YEARS IN GREGG COUNTY (97.5%) AND SMITH COUNTY (94.1%) WAS HIGHER THAN THE STATE (91.2%) AND THE NATION (81.1%). AS OF JANUARY 2024, THE COST OF LIVING FOR A TWO-PARENT, TWO-CHILD FAMILY IN GREGG COUNTY WAS $82,219 PER YEAR OR $6,852 PER MONTH AND SMITH COUNTY WAS $90,082 PER YEAR OR $7,507. TRANSPORTATION IS ESTIMATED TO BE THE HIGHEST MONTHLY COST FOR GREGG AND SMITH COUNTIES WITH TAXES ESTIMATED TO BE THE LOWEST MONTHLY COST, AS OF JANUARY 2024. OVERALL MORTALITY RATES IN BOTH GREGG AND SMITH COUNTIES REMAINED HIGHER THAN THE STATE RATES BETWEEN 2020 AND 2022. BETWEEN 2020 AND 2022, OVERALL MORTALITY RATES IN BOTH GREGG AND SMITH COUNTIES AND THE STATE DECREASED. IN 2022, THE OVERALL MORTALITY RATE IN GREGG COUNTY (1,086.5 PER 100,000) WAS HIGHER THAN SMITH COUNTY (889.5) AND THE STATE (678.7 PER 100,000). HEART DISEASE IS THE LEADING CAUSE OF DEATH IN BOTH GREGG AND SMITH COUNTIES AND THE STATE (2020-2022). BETWEEN 2020 AND 2022, HEART DISEASE MORTALITY RATES IN BOTH GREGG AND SMITH COUNTIES AND THE STATE DECREASED. IN 2022, THE HEART DISEASE MORTALITY RATE IN GREGG COUNTY (300.5 PER 100,000) WAS HIGHER THAN SMITH COUNTY (260.0 PER 100,000) AND THE STATE (168.7 PER 100,000). CANCER IS THE SECOND LEADING CAUSE OF DEATH IN BOTH GREGG AND SMITH COUNTIES AND THE STATE (2020-2022). BETWEEN 2020 AND 2022, CANCER MORTALITY RATES IN BOTH GREGG AND SMITH COUNTIES DECREASED, WHILE RATES IN THE STATE INCREASED. IN 2022, THE CANCER MORTALITY RATE IN GREGG COUNTY (196.9 PER 100,000) WAS HIGHER THAN SMITH COUNTY (185.6 PER 100,000) AND THE STATE (144.5 PER 100,000). COVID-19 IS THE THIRD LEADING CAUSE OF DEATH IN BOTH GREGG AND SMITH COUNTIES AND THE STATE (2020-2022). BETWEEN 2020 AND 2022, COVID-19 MORTALITY RATES IN BOTH GREGG AND SMITH COUNTIES AND THE STATE DECREASED. IN 2022, THE COVID-19 MORTALITY RATE IN GREGG COUNTY (92.5 PER 100,000) WAS HIGHER THAN SMITH COUNTY (61.6 PER 100,000) AND THE STATE (48.5 PER 100,000). CEREBROVASCULAR DISEASES ARE THE FOURTH LEADING CAUSE OF DEATH IN SMITH COUNTY, THE SIXTH LEADING CAUSE OF DEATH IN GREGG COUNTY, AND THE FIFTH LEADING CAUSE OF DEATH IN THE STATE (2020-2022). BETWEEN 2020 AND 2022, CEREBROVASCULAR DISEASE MORTALITY RATES IN BOTH GREGG AND SMITH COUNTIES AND THE STATE INCREASED. IN 2022, THE CEREBROVASCULAR DISEASE MORTALITY RATE IN SMITH COUNTY (62.8 PER 100,000) WAS HIGHER THAN GREGG COUNTY (59.0 PER 100,000) AND THE STATE (40.7 PER 100,000).CHRONIC LOWER RESPIRATORY DISEASES (CLRD) ARE THE FIFTH LEADING CAUSE OF DEATH IN SMITH COUNTY, THE FOURTH LEADING CAUSE OF DEATH IN GREGG COUNTY AND THE SEVENTH LEADING CAUSE OF DEATH IN THE STATE (2020- 2022). BETWEEN 2020 AND 2022, CLRD MORTALITY RATES IN GREGG COUNTY INCREASED, WHILE RATES IN SMITH COUNTY AND THE STATE DECREASED. IN 2022, THE CLRD MORTALITY RATE IN GREGG COUNTY (101.2 PER 100,000) WAS HIGHER THAN SMITH COUNTY (54.6 PER 100,000) AND THE STATE (33.3 PER 100,000). FATAL ACCIDENTS (FROM MOTOR VEHICLES), DIABETES MELLITUS, ALZHEIMER'S DISEASE, NEPHRITIS, NEPHROTIC SYNDROME AND NEPHROSIS ARE ALSO LEADING CAUSES OF DEATH IN SMITH AND GREGG COUNTIES. ADDITIONALLY, INTENTIONAL SELF-HARM (SUICIDE) IS LEADING CAUSE OF DEATH IN SMITH COUNTY. BETWEEN 2020 AND 2022, THE PERCENT OF ADULTS (AGE 18+) WHO WERE OBESE OVERALL INCREASED IN BOTH GREGG AND SMITH COUNTIES, WHILE THE PERCENT IN THE STATE SLIGHTLY DECREASED. IN 2022 GREGG COUNTY (39.9%) HAD THE HIGHEST PERCENT OF ADULTS (AGE 18+) WHO WERE OBESE WHEN COMPARED TO SMITH COUNTY (39.7%) AND THE STATE (35.7%). BETWEEN 2020 AND 2022, THE PERCENT OF MEDICARE BENEFICIARIES WITH HYPERTENSION INCREASED IN BOTH GREGG AND SMITH COUNTIES AND THE STATE. IN 2022, THE PERCENT OF MEDICARE BENEFICIARIES WITH HYPERTENSION IN GREGG COUNTY (71.0%) WAS HIGHEST WHEN COMPARED TO SMITH COUNTY (70.0%) AND THE STATE (64.0%). BETWEEN 2020 AND 2022, THE PERCENT OF ADULTS (AGE 18+) WITH ASTHMA INCREASED IN BOTH GREGG AND SMITH COUNTIES AND DECREASED IN THE STATE. GREGG COUNTY (10.6%) HAD THE HIGHEST PERCENT OF ADULTS (AGE 18+) WITH ASTHMA WHEN COMPARED TO SMITH COUNTY (10.5%) AND THE STATE (7.9%) (2022). IN 2022, THE PERCENT OF MEDICARE BENEFICIARIES WITH ASTHMA IN GREGG COUNTY (8.0%) WAS COMPARABLE TO SMITH COUNTY (8.0%) AND WAS HIGHER THAN THE STATE (7.0%). BETWEEN 2020 AND 2022, THE PERCENT OF ADULTS (AGE 18+) WITH ARTHRITIS INCREASED IN BOTH GREGG AND SMITH COUNTIES. GREGG COUNTY (25.1%) HAD A HIGHER PERCENT OF ADULTS (AGE 18+) WITH ARTHRITIS THAN SMITH COUNTY (24.2%) AND THE STATE (21.4%) (2022). THE PERCENT OF THE TOTAL CIVILIAN NON-INSTITUTIONALIZED POPULATION WITH A DISABILITY IN GREGG COUNTY (13.1%) IS HIGHER THAN SMITH COUNTY (12.4%), THE STATE (11.7%) AND THE NATION (12.9%) (2018-2022). BOTH GREGG AND SMITH COUNTIES AND THE STATE EXPERIENCED A DECREASE IN UNINSURED RATES BETWEEN 2018 AND 2022. AS OF 2022, SMITH COUNTY (18.6%) HAD A LOWER PERCENT OF UNINSURED ADULTS (AGE18-64) AS COMPARED TO GREGG COUNTY (19.9%) AND THE STATE (18.8%). A COMPREHENSIVE, SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") WAS CONDUCTED FOR TYLER CCH AND LONGBVIEW CCH BY CHC CONTINUECARE. THIS CHNA UTILIZES RELEVANT HEALTH DATA AND STAKEHOLDER INPUT TO IDENTIFY THE SIGNIFICANT COMMUNITY HEALTH NEEDS IN SMITH AND GREGG COUNTIES IN TEXAS. COMMUNITY INPUT WAS RECEIVED DURING INTERVIEWS CONDUCTED BY CHC CONTINUECARE FROM OCTOBER 14, 2024 - OCTOBER 31, 2024. THE CHNA IS DESIGNED IN ACCORDANCE WITH CHNA REQUIREMENTS IDENTIFIED IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND FURTHER ADDRESSED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS RELEASED ON DECEMBER 29, 2014. THE TYLER CCH AND LONGVIEW CCH BOARD REVIEWED AND ADOPTED THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN ON MAY 14, 2025. INTERVIEW METHODOLOGY: TYLER CCH AND LONGVIEW CCH WORKED WITH CHC CONTINUECARE IN THE DEVELOPMENT OF ITS CHNA BOTH HOSPITALS PROVIDED ESSENTIAL DATA AND RESOURCES NECESSARY TO INITIATE AND COMPLETE THE PROCESS, INCLUDING THE DEFINITION OF THE HOSPITAL'S STUDY AREA AND THE IDENTIFICATION OF KEY COMMUNITY STAKEHOLDERS TO BE INTERVIEWED. BACKGROUND INFORMATION ABOUT TYLER CCH AND LONGIVEW CCH, INCLUDING THE MISSION, VISION, VALUES, AND HOSPITAL SERVICES WAS PROVIDED BY THE HOSPITAL FACILITY OR TAKEN FROM ITS WEBSITE. POPULATION DEMOGRAPHICS INFORMATION WAS COLLECTED BY CHC CONTINUECARE USING SOURCES WHICH INCLUDED, BUT NOT LIMITED TO, SYNTELLIS, THE U.S. CENSUS BUREAU AND THE UNITED STATES BUREAU OF LABOR STATISTICS AND INCLUDED INFORMATION REGARDING POPULATION CHANGE BY RACE, ETHNICITY, AGE, MEDIAN HOUSEHOLD INCOME, UNEMPLOYMENT AND ECONOMIC STATISTICS IN THE STUDY AREA. HEALTH DATA WAS ALSO COLLECTED FROM A VARIETY OF SOURCES, INCLUDING BUT NOT LIMITED TO, THE ROBERT WOOD JOHNSON FOUNDATION, THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE, SPARKMAP, THE TEXAS DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE TEXAS CENTRAL CANCER REGISTRY, SMALL AREA HEALTH INSURANCE ESTIMATES (SAHIE), AND THE U.S. CENSUS BUREAU. TYLER CCH AND LONGVIEW CCH PROVIDED CHC CONTINUECARE WITH A LIST OF PERSONS WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN THE SMITH AND GREGG COUNTIES, INCLUDING PUBLIC HEALTH REPRESENTATIVES, NOT-FOR-PROFIT ORGANIZATION PROFESSIONALS, CHARITIES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. FROM THAT LIST, ELEVEN IN DEPTH INTERVIEWS WERE CONDUCTED USING A STRUCTURED INTERVIEW GUIDE, WITH THE TWO GROUPS OUTLINED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS ISSUED DECEMBER 29, 2014. DISCUSSED WERE THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. WITH RESPECT TO INDIVIDUALS PROVIDING INPUT, IT WAS NOTED IN THE CHNA THAT 81.8% OF THOSE PROVIDING INPUT ARE MEMBERS OF A MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATION IN THE COMMUNITY, OR INDIVIDUALS OR ORGANIZATIONS SERVING OR REPRESENTING THE INTERESTS OF SUCH POPULATIONS.18.2% OF THOSE PROVIDING INPUT WORK FOR A STATE, LOCAL, TRIBAL OR REGIONAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENT (OR EQUIVALENT DEPARTMENT OR AGENCY) WITH KNOWLEDGE, INFORMATION OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. Schedule H, Part V, Section B, Line 5 Facility A, 3 Facility A, 3 - Facility Reporting Group A (CONTINUED). INTERVIEWEES INCLUDED: - LEROY BIGGERS: BOARD MEMBER, TYLER FAMILY CIRCLE OF CARE - CRAIG CHESLEY: BOARD MEMBER, TYLER CONTINUECARE HOSPITAL; BOARD MEMBER, LONGVIEW CONTINUECARE HOSPITAL; BOARD MEMBER, COMMUNITY HOSPITAL CORPORATION - MELLODY DANIELS: SENIOR DIRECTOR OF PROGRAMS, EAST TEXAS CRISIS CENTER - JOHN ENGLISH, MD: CHIEF EXECUTIVE OFFICER, BETHESDA HEALTH CLINIC - DAN HARDIMAN: OWNER, THE HARDIMAN AGENCY; BOARD PRESIDENT, TYLER CONTINUECARE HOSPITAL; BOARD PRESIDENT, LONGVIEW CONTINUECARE HOSPITAL - ABDAL HARRIS, MPH: HEALTH ADMINISTRATOR, GREGG COUNTY PUBLIC HEALTH DEPARTMENT - KATHY HARRY: CHIEF EXECUTIVE OFFICER, CATHOLIC CHARITIES - NICHOLE HENRY: CHIEF EXECUTIVE OFFICER, EAST TEXAS CRISIS CENTER - SAMANTHA KAUFFMAN: CLINICAL SERVICES COORDINATOR, EAST TEXAS CRISIS CENTER - GEORGE ROBERTS, JR., FACHE: CHIEF EXECUTIVE OFFICER, NORTH EAST TEXAS PUBLIC HEALTH DISTRICT - JEFF WARR: OWNER, WARR INTERESTS - REAL ESTATE; BOARD MEMBER, TYLER CONTINUECARE HOSPITAL; BOARD MEMBER, LONGVIEW CONTINUECARE HOSPITAL POPULATIONS THAT WERE IDENTIFIED AS THE MOST AT RISK FOR INADEQUATE CARE IN THE COMMUNITY BY INTERVIEWEES WERE: RACIAL/ETHNIC GROUPS, LOW INCOME, WOMEN/CHILDREN, HOMELESS, VETERANS. ELDERLY, DISABLED AND YOUTH. THESE UNDERSERVED GROUPS WERE IDENTIFIED AS MOST AT RISK FOR INADEQUATE CARE DUE TO THE FOLLOWING: RACIAL/ETHNIC - LANGUAGE BARRIERS - LACK OF TRUST USING THE HEALTHCARE SYSTEM - CULTURAL CHALLENGES - FEAR OF DEPORTATION - NEED FOR DIVERSITY OF PROVIDERS FOR CULTURAL COMFORT LOW INCOME - TRANSPORTATION BARRIERS - LACK OF AFFORDABLE MEDICAL CARE AND MEDICATIONS - HOURLY SHIFT LIMITATION - LACK OF AFFORDABLE HOUSING - LACK OF AWARENESS AND UNDERSTANDING OF EXISTING HEALTHCARE SERVICES WOMEN/CHILDREN - DOMESTIC VIOLENCE HOMELESS - MENTAL HEALTH CONCERNS - LIMITED AVAILABILITY OF SHELTERS (NUMBER, VACANCY, ORGANIZATIONAL GUIDELINES) - OVERUSE OF THE EMERGENCY ROOM VETERANS - LACK OF AWARENESS OF EXISTING HEALTHCARE SERVICES - LONG WAIT TIME AT VA FACILITIES - LACK OF MENTAL AND BEHAVIORAL HEALTH CARE - TRANSPORTATION BARRIERS - PERCEIVED LACK OF LOCAL VA HOSPITAL - LIMITED ACCESS TO HEALTHCARE DUE TO VA INSURANCE ELDERLY - AFFORDABLE MEDICATIONS - TRANSPORTATION BARRIERS - ACCESS TO DENTAL CARE - EDUCATION ON TELEMEDICINE AND COMPUTER USE - ALZHEIMER'S/DEMENTIA DISABLED - HANDICAP COMPLIANT HOMES YOUTH - LIMITED ACCESS TO PEDIATRIC SPECIALTIES - MENTAL AND BEHAVIORAL HEALTH ISSUES (SOCIAL MEDIA, DEPRESSION, ANXIETY, SUICIDE) - DRUG ABUSE (MARIJUANA, VAPING) - TRANSPORTATION BARRIERS Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - Facility Reporting Group A. THE MOST RECENTLY CONDUCTED CHNA IDENTIFIED FIVE SIGNIFICANT NEEDS IN THE COMMUNITY SERVED BY TYLER CONTINUECARE HOSPITAL (TYLER CCH) AND LONGVIEW CONTINUECARE HOSPITAL (LONGVIEW CCH). THE NEEDS WERE IDENTIFIED BY ASSESSING THE PREVALENCE OF THE ISSUES FOUND WITHIN THE HEALTH DATA FINDINGS, COMBINED WITH THE FREQUENCY AND SEVERITY OF MENTIONS IN COMMUNITY INPUT. THE CHNA TEAM, CONSISTING OF LEADERSHIP FROM TYLER CCH AND LONGVIEW CCH MET WITH CHC CONTINUECARE TO REVIEW THE RESEARCH FINDINGS AND PRIORITIZE THE COMMUNITY HEALTH NEEDS IN GREGG AND SMITH COUNTIES, TEXAS. THE FINAL LIST OF PRIORITIZED NEEDS IS AS FOLLOWS: 1. PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES 2. ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS 3. ACCESS TO PRIMARY CARE AND SPECIALTY CARE SERVICES AND PROVIDERS 4. ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS 5. CONTINUED FOCUS ON COMMUNITY CONCERNS THE CHNA TEAM PARTICIPATED IN A PRIORITIZATION PROCESS USING A STRUCTURED MATRIX TO RANK THE COMMUNITY HEALTH NEEDS BASED ON THREE CHARACTERISTICS: SIZE AND PREVALENCE OF THE ISSUE, EFFECTIVENESS OF INTERVENTIONS AND THE HOSPITAL'S CAPACITY TO ADDRESS THE NEED. ONCE THIS PRIORITIZATION PROCESS WAS COMPLETE, HOSPITAL LEADERSHIP DISCUSSED THE RESULTS AND DECIDED TO ADDRESS ALL OF THE FIVE PRIORITIZED NEEDS IN VARIOUS CAPACITIES THROUGH A HOSPITAL SPECIFIC IMPLEMENTATION PLAN. PRIORITY #1: PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES OBJECTIVE: IMPLEMENT PROGRAMS AND PROVIDE EDUCATIONAL OPPORTUNITIES THAT SEEK TO ADDRESS UNHEALTHY LIFESTYLES AND BEHAVIORS IN THE COMMUNITY 1.A. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL CONTINUE TO MAINTAIN A SMOKE FREE CAMPUS AND PROVIDES EDUCATIONAL LITERATURE ON SMOKING CESSATION AS REQUESTED. 1.B. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL CONTINUE TO REACH OUT TO THE COMMUNITY BY OFFERING SPEAKERS AND OTHER INFORMATIVE ACTIVITIES. HOSPITAL PERSONNEL ARE MADE AVAILABLE AS SPEAKERS FOR CIVIC GROUPS, INDUSTRIAL PARTNERS, AND MEDIA APPEARANCES AND HEALTH FAIRS TO ADDRESS HEALTH TOPICS OF PARTICULAR CONCERN TO THE PUBLIC. 1.C. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL PARTICIPATE IN BLOOD DRIVES TARGETED AT THE EMPLOYEES OF THE HOSPITAL AND CLINIC MULTIPLE TIMES A YEAR. PRIORITY #2: ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS OBJECTIVE: IMPLEMENT AND OFFER PROGRAMS THAT AIM TO REDUCE HEALTH DISPARITIES BY TARGETING SPECIFIC POPULATIONS 2.A. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL CONTINUE TO PROVIDE SERVICES TO ELIGIBLE UNINSURED AND UNDERINSURED INDIVIDUALS AS OUTLINED IN THEIR CHARITY CARE POLICY, WHICH IS AVAILABLE TO EVERY PATIENT ON ADMISSION. THIS ALLOWS PATIENTS AND/OR FAMILIES TO KNOW THE DETAILS OF HOW THEY MAY QUALIFY FOR REDUCTION OR ELIMINATION OF ANY BALANCE OWED BY THEM FOR SERVICES WE PROVIDE 2.B. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL CONTINUE TO OFFER FINANCIAL ASSISTANCE AND PAYMENT PLAN EDUCATION TO PATIENTS WHO HAVE AN ECONOMIC NEED AND MEET THE QUALIFICATIONS OF THE FINANCIAL ASSISTANCE POLICY. IF FINANCIAL ASSISTANCE IS NEEDED, TYLER & LONGVIEW CONTINUECARE HOSPITAL ENCOURAGES PATIENTS TO COMPLETE AN APPLICATION TO SEE IF THEY QUALIFY. 2.C. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL CONTINUE TO IMPLEMENT A VARIETY OF AWARENESS, EDUCATION AND SCREENING PROGRAMS FOCUSED ON AGING AND ON RISK FACTORS, PREVENTION AND TREATMENT OF HEART DISEASE AND RESPIRATORY DISEASE, INCLUDING PARTICIPATING IN ELDER CONFERENCES HELD IN TYLER & LONGVIEW AND LONGVIEW AND IN LOCAL HEALTH FAIRS AND OFFER BLOOD PRESSURE HEALTH SCREENINGS AS OPPORTUNITIES ARISE. 2.D. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL HELP PROVIDE COMMUNITY MEMBERS WITH BASIC NEEDS BY ASSISTING THE LOCAL FOOD PANTRY WITH REGULARLY SCHEDULED FOOD DRIVES AND SCHOOL SUPPLY DRIVE AS OPPORTUNITIES ARISE. 2.E. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL COLLABORATE WITH VARIOUS ORGANIZATIONS THAT PROVIDE SERVICES TO VULNERABLE POPULATIONS AS OPPORTUNITIES ARISE. 2.F. TYLER & LONGVIEW CONTINUECARE HOSPITALS PROVIDE ACCESS TO A TELEPHONE LANGUAGE LINE AND A VIDEO LANGUAGE LINE FOR TRANSLATION SERVICES, AND FLAT SCREEN TELEVISIONS ARE INSTALLED THROUGHOUT THE FACILITY TO AID HEARING IMPAIRED PATIENTS AS APPROPRIATE. 2.G. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL SHARE THE COMMUNITY RESOURCE LIST OF AVAILABLE LOCAL SERVICES FOR APPLICABLE SITUATIONS. 2.H. IN CONJUNCTION WITH THE HOST, TYLER CONTINUECARE HOSPITAL PARTICIPATES IN THE LOCAL PROVIDER PARTICIPATION FUNDS PROGRAM THAT FUNDS SMITH COUNTY'S DELIVERY OF INDIGENT CARE. PRIORITY #3: ACCESS TO PRIMARY CARE AND SPECIALTY CARE SERVICES AND PROVIDERS OBJECTIVE: PROVIDE ACCESS TO PRIMARY CARE AND SPECIALTY CARE SERVICES IN THE COMMUNITY 3.A. THE EMPLOYEES OF TYLER & LONGVIEW CONTINUECARE HOSPITALS ARE DEDICATED TO ENHANCING COMMUNITY WELLNESS BY SUPPORTING LOCAL NURSING SCHOOLS, RESPIRATORY, DPT AND PT ASSISTANT SCHOOLS BY PRESENTING TO STUDENTS ENROLLED IN THESE PROGRAMS AND DONATING EQUIPMENT TO THE FACILITIES. ADDITIONALLY, TYLER CONTINUECARE HOSPITAL HAS AFFILIATION AGREEMENTS WHICH ALLOW FOR CLINICAL ROTATIONS IN THE HOSPITAL WITHIN THE NURSING, PHARMACY AND RESPIRATORY AREAS. 3.B. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL CONTINUE ITS STRONG REFERRAL RELATIONSHIP WITH SURROUNDING ACUTE CARE FACILITIES TO PROVIDE SPECIALTY SERVICES TO PATIENTS REQUIRING THAT LEVEL OF CARE FROM THE LTACH. 3.C. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL CONTINUE TO MAINTAIN AND PROVIDE A LIST OF REFERRAL SERVICES TO PATIENTS WHO ARE REQUIRING SPECIALTY CARE. PRIORITY #4: ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS OBJECTIVE: PROVIDE A POINT OF ACCESS FOR MENTAL HEALTH SERVICES IN THE COMMUNITY 4.A. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL CONTINUE TO OFFER THE EMPLOYEE ASSISTANCE PROGRAM (EAP) THROUGH OPTUM TO HELP EMPLOYEES NAVIGATE VARIOUS LIFE CHALLENGES 4.B. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO SHARE AVAILABLE LOCAL COUNSELING RESOURCES WITH MENTAL AND BEHAVIORAL HEALTH RELATED PATIENTS AS NEEDED. THROUGH ITS ESTABLISHED RELATIONSHIP WITH ALETHIA, TYLER CONTINUECARE HOSPITAL IS ABLE TO PROVIDE INPATIENT COUNSELING FOR APPLICABLE PATIENTS. 4.C. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL CONTINUE TO ADDRESS MENTAL HEALTH CONDITIONS AMONG ITS PATIENTS THROUGH MEDICATION MANAGEMENT. PRIMARY CARE PHYSICIANS ARE ABLE TO PROMOTE MEDICATION 4.D. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL CONTINUE TO OFFER CHAPLAIN SERVICES TO SUPPORT PATIENTS AND THEIR FAMILIES. PRIORITY #5. CONTINUED FOCUS ON COMMUNITY CONCERNS OBJECTIVE: ASSESS AND ADDRESS COMMUNITY CONCERNS THROUGH COLLABORATION WITH STAKEHOLDERS AND EVIDENCE-BASED INITIATIVES THAT IMPROVE ACCESS AND WELL-BEING 5.A. TYLER & LONGVIEW CONTINUECARE HOSPITALS WILL PARTICIPATE IN EVENTS TO SUPPORT LOCAL NONPROFIT ORGANIZATIONS AS THEY ARISE. 5.B. TYLER & LONGVIEW CONTINUECARE HOSPITALS EMPLOYEES WILL ASSIST IN SETTING UP NECESSARY RESOURCES (I.E., TRANSPORTATION, PRESCRIPTIONS, NECESSARY EQUIPMENT, DISCHARGE SUMMARIES) AS REQUESTED IN ORDER TO INCREASE COLLABORATION ACROSS THE CONTINUUM OF CARE. Schedule H, Part V, Section B, Line 20 Facility A, 1 Facility A, 1 - Facility Reporting Group A. TYLER CCH and longview cch DO NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTION ON ANY OUTSTANDING PATIENT ACCOUNTS. 0 Schedule H, Part I, Line 7f EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE SINCE TYLER CONTINUECARE HOSPITAL and longview continuecare hospital are LONG TERM ACUTE CARE HOSPITALS, they WILL HAVE LOWER PERCENTAGES THAN AN ACUTE CARE HOSPITAL. Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT Texas Schedule H, Part I PAYMENT FOR CHARITY CARE PAYMENT FOR CHARITY CARE IN THE STATE OF TEXAS, IT IS PERMISSIBLE TO PAY ANOTHER HEALTH PROVIDER FOR CHARITY CARE TO SATISFY THE CHARITY REQUIREMENTS. TYLER CONTINUECARE HOSPITAL and longview continuecare hospital DID NOT PAY ANOTHER PROVIDER FOR THE PROVISION OF CHARITY CARE IN FISCAL YEAR 2025. Schedule H, Part II DESCRIBE HOW COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY TYLER CONTINUECARE HOSPITAL AND LONGVIEW CONTINUECARE HOSPITAL PROVIDE VARIOUS CHARITABLE SERVICES TO THE LOCAL COMMUNITY. THESE CHARITABLE SERVICES INCLUDE PROVIDING COMMUNITY MEMBERS WITH BASIC NEEDS BY ASSISTING the LOCAL FOOD PANTRY WITH REGULARLY SCHEDULED FOOD DRIVES AND A ONCE A YEAR SCHOOL SUPPLY DRIVE. THE HOSPITALS ALSO COLLABORATED WITH VARIOUS ORGANIZATIONS THAT PROVIDED SERVICES TO VULNERABLE POPULATIONS. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote PATIENTS ACCOUNTS RECEIVABLE CONSIST OF AMOUNTS DUE FOR THE PROVISION OF HEALTH CARE SERVICES WHICH ARE RECORDED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS AT AMORTIZED COST AT THE NET AMOUNT EXPECTED TO BE COLLECTED. IN EVALUATION THE COLLECTABILITY OF PATIENTS ACCOUNTS RECEIVABLE, MANAGEMENT REGULARLY REVIEWS DATA AND DEVELOPS A LOSS RATE TO DETERMINE EXPECTED CREDIT LOSSES BASED ON SEVERAL FACTORS INCLUDING WHETHER A PATIENT HAS THIRD PARTY PAYOR COVERAGE OR IS UNINSURED, THE AGING OF RECEIVABLES, HISTORICAL COLLECTIONS AND LOSS EXPERIENCE, CURRENT CONTRACT PRICES OR CLAIMS PAID DATA, AND TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE. THESE ESTIMATES ARE ADJUSTED FOR RECOVERIES OF ANY ANTICIPATED CHANGES IN TRENDS, INCLUDING SIGNIFICANT CHANGES IN PAYOR MIX, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENT HEALTH CARE COVERAGE. MANAGEMENT BELIEVES THE COMPOSITION OF RECEIVABLES AT YEAR-END IS CONSISTENT WITH HISTORICAL CONDITIONS AS CREDIT TERMS AND PRACTICES AND THE CUSTOMER BASE HAS NOT CHANGED SIGNIFICANTLY; THEREFORE, THE ORGANIZATION HAS MAINTAINED CONSISTENT METHODOLOGY IN ESTIMATE OF CREDIT LOSSES. MANAGEMENT HAS DETERMINED THE ESTIMATE OF EXPECTED CREDIT LOSSES IS NOT MATERIAL TO THE FINANCIAL STATEMENTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE COSTING METHODOLOGY USED ON LINE 6 COMES FROM THE COST REPORT (INPATIENT PPS COST-TO- CHARGE RATIO COMPUTATION). ANY SHORTFALL IS A COMMUNITY BENEFIT AS IT IS THE COST OF PROVIDING CARE TO THE COMMUNITY THAT IS NOT REIMBURSED BY THE MEDICARE PROGRAM. BY PROVIDING CARE TO THESE INDIVIDUALS, THE HOSPITAL IS IMPROVING THE HEALTH OF THE COMMUNITY. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IF A PATIENT OF TYLER CONTINUECARE HOSPITAL and longview continuecare hospital QUALIFies FOR its CHARITY CARE POLICY, THE PATIENTS ACCOUNT IS ADJUSTED ACCORDINGLY. PATIENT ACCOUNTS WITH REMAINING BALANCES WILL BE REASSESSED TO DETERMINE THEIR ABILITY TO PAY AND WILL EITHER BE ELIGIBLE TO PARTICIPATE IN A PAYMENT PLAN OR THEIR ACCOUNT BALANCE WILL BE WRITTEN OFF. Schedule H, Part V, Section B, Line 16a FAP website A - CONTINUECARE HOSPITAL OF TYLER: Line 16a URL: HTTPS://LONGVIEW.CONTINUECARE.ORG/FOR-FAMILIES/FINANCIAL-ASSISTANCE/; Schedule H, Part V, Section B, Line 16b FAP Application website A - CONTINUECARE HOSPITAL OF TYLER: Line 16b URL: HTTPS://LONGVIEW.CONTINUECARE.ORG/FOR-FAMILIES/FINANCIAL-ASSISTANCE/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - CONTINUECARE HOSPITAL OF TYLER: Line 16c URL: HTTPS://LONGVIEW.CONTINUECARE.ORG/FOR-FAMILIES/FINANCIAL-ASSISTANCE/; Schedule H, Part VI, Line 2 Needs assessment THE HEALTH CARE NEEDS FOR THE COMMUNITY SERVED ARE ASSESSED BY A REVIEW OF THE PRIMARY AND TERTIARY SERVICE AREAS FOR DISEASE SPECIFIC MORTALITY RATES. DISEASE STATISTICS ARE GATHERED FROM THE HEALTH PROMOTION UNIT OF TEXAS DEPARTMENT OF STATE HEALTH SERVICES. INTERVIEWS WITH LOCAL HEALTH CARE AND ELDERLY SERVICE PROVIDERS ARE CONDUCTED TO ASSESS THEIR PERCEIVED UNMET NEEDS IN THE COMMUNITY. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES ARE INFORMED OF THIS UPON ADMISSION TO TYLER CONTINUECARE HOSPITAL. A FACE-TO-FACE VISIT WITH HOSPITAL ADMINISTRATIVE PERSONNEL MAY OCCUR, IF CLINICALLY APPROPRIATE, AT THE TIME OF ADMISSION OR LATER DURING THE HOSPITAL STAY. AS FINANCIAL ISSUES ARE DISCUSSED, IF IT IS FELT THAT THE PATIENT MAY QUALIFY FOR ASSISTANCE THROUGH THE HOSPITALS FINANCIAL ASSISTANCE POLICY, THEN THE NECESSARY DOCUMENTS WOULD BE PRESENTED BY HOSPITAL PERSONNEL TO THE RESPONSIBLE PARTY FOR COMPLETION AND SUBMISSION FOR CONSIDERATION. Schedule H, Part VI, Line 4 Community information TYLER CCH HOSPITAL OPERATES A 51-BED LONG-TERM ACUTE CARE HOSPITAL (LTACH) LOCATED ON THE FOURTH FLOOR OF THE HOST HOSPITAL, CHRISTUS MOTHER FRANCES HOSPITAL - TYLER IN TYLER, TEXAS. AS A "HOSPITAL WITHIN A HOSPITAL" TYLER CCH HAS EXPANDED ITS SERVICE EXCELLENCE TO LONGVIEW, TEXAS. LONGVIEW CCH, A 32-BED SATELLITE OF TYLER CCH, OPENED ON SEPTEMBER 10, 2024, WITHIN CHRISTUS GOOD SHEPHERD MEDICAL CENTER - LONGVIEW, LOCATED IN LONGVIEW, TEXAS. AS OF SEPTEMBER 1, 2025, THE TYLER CCH LOCATION HAS CONSOLIDATED SERVICES TO THE LONGVIEW CCH LOCATION. THE DEFINED SERVICE AREA OF TYLER CCH AND LONGVIEW CCH IS SMITH COUNTY AND GREGG COUNTY, RESPECTIVELY, IN THE STATE OF TEXAS. THE POPULATION OF SMITH COUNTY IS EXPECTED TO INCREASE BY 4.2% FROM 2024 (245,423) TO 2029 (255,823) AND THE POPULATION OF GREGG COUNTY IS EXPECTED TO INCREASE BY 0.5% FROM 2024 (125,606) TO 2029 (126,260). THIS IS BELOW THE 5.6% EXPECTED GROWTH FOR THE STATE OF TEXAS FROM 2024 (30,857,478) TO 2029 (32,581,174). AS OF 2024, THE MAJORITY OF THE RESIDENTS IN SMITH COUNTY, 60.6% IDENTIFY AS WHITE. IN GREGG COUNTY, THE MAJORITY OF THE RESIDENTS, 57.8% ALSO IDENTIFY AS WHITE. HISPANIC IS CLASSIFIED AS AN ETHNICITY AND THEREFORE IS CATEGORIZED SEPARATELY FROM WHITE, BLACK, ASIAN, AMERICAN INDIAN AND ALL OTHERS. AS OF 2024, THE HISPANIC POPULATION HAD 53,119 RESIDENTS IN SMITH COUNTY AND 26,203 RESIDENTS IN GREGG COUNTY. BY 2029, THE HISPANIC ETHNIC POPULATION IN SMITH COUNTY IS EXPECTED TO INCREASE BY 13.2% AND IN GREGG COUNTY THE HISPANIC POPULATION IS EXPECTED TO INCREASE BY 9.6%. IT IS THE FASTEST GROWING POPULATION IN BOTH COUNTIES. IN 2024, SMITH COUNTY (38.1 YEARS) AND GREGG COUNTY (38.1 YEARS) HAVE AN OLDER MEDIAN AGE THAN TEXAS (36.3 YEARS) (2024). THE MEDIAN AGES IN BOTH GREGG AND SMITH COUNTIES AND THE STATE ARE EXPECTED TO INCREASE OVER THE NEXT FIVE YEARS (2024-2029). IN 2023, SMITH COUNTY (3.6) HAD A LOWER UNEMPLOYMENT RATE THAN GREGG COUNTY (4.2) AND THE STATE (3.9). OVER THE MOST RECENT 12-MONTH TIME PERIOD, MONTHLY UNEMPLOYMENT RATES IN BOTH GREGG AND SMITH COUNTY OVERALL INCREASED. APRIL 2024 HAD THE LOWEST UNEMPLOYMENT RATE FOR GREGG COUNTY (3.9) AND DECEMBER 2023 HAD THE LOWEST UNEMPLOYMENT RATE FOR SMITH COUNTY (3.2). IN 2024, GREGG COUNTY ($63,171) HAD A LOWER MEDIAN HOUSEHOLD INCOME WHEN COMPARED TO SMITH COUNTY ($70,652) AND THE STATE ($77,169) (2024). THE MEDIAN HOUSEHOLD INCOME IN BOTH GREGG AND SMITH COUNTIES AND THE STATE ARE EXPECTED TO INCREASE OVER THE NEXT FIVE YEARS (2024-2029). IN 2024, BOTH GREGG COUNTY (25.2%) AND SMITH COUNTY (30.4%) HAD A LOWER PERCENTAGE OF RESIDENTS WITH A BACHELOR OR ADVANCED DEGREE THAN THE STATE (35.7%). IN 2024, GREGG COUNTY (18.0%) HAD A HIGHER PERCENT OF FAMILIES LIVING BELOW POVERTY AS COMPARED TO SMITH COUNTY (15.1%) AND THE STATE (14.4%). BETWEEN 2017 AND 2021, THE PERCENTAGE OF CHILDREN (<18 YEARS) LIVING IN POVERTY IN BOTH GREGG AND SMITH COUNTIES AND THE STATE DECREASED. SMITH COUNTY (17.8%) HAS A LOWER PERCENTAGE OF CHILDREN (<18 YEARS) LIVING IN POVERTY THAN GREGG COUNTY (21.6%) AND TEXAS (19.5%) (2021). IN 2022, GREGG COUNTY (16.7%) HAD THE HIGHEST ESTIMATED PERCENT OF RESIDENTS WHO ARE FOOD INSECURE AS COMPARED TO SMITH COUNTY (14. 9%) AND THE STATE (16.4%). SMITH COUNTY HAD THE HIGHEST AVERAGE MEAL COST OF $3.86, AS COMPARED TO $3.72 IN GREGG COUNTY AND $3.45 IN TEXAS (2022). AS OF 2022, SMITH COUNTY (18.6%) HAD A LOWER PERCENT OF UNINSURED ADULTS (AGEs 18-64) AS COMPARED TO GREGG COUNTY (19.9%) AND THE STATE (18.8%). HEART DISEASE AND CANCER ARE THE TWO LEADING CAUSES OF DEATH IN BOTH SMITH AND GREGG COUNTIES (2022). OVERALL MORTALITY RATES IN BOTH GREGG AND SMITH COUNTIES REMAINED HIGHER THAN THE STATE RATES BETWEEN 2020 AND 2022. IN 2022, THE OVERALL MORTALITY RATE IN GREGG COUNTY WAS HIGHER THAN SMITH COUNTY AND THE STATE. ADDITIONALLY, CHRONIC CONDITIONS SUCH AS DIABETES MELLITUS, ALZHEIMER'S DISEASE, NEPHRITIS, NEPHROTIC SYNDROME AND NEPHROSIS ARE ALSO LEADING CAUSES OF DEATH IN BOTH SMITH AND GREGG COUNTIES. IN 2022, THE PERCENTAGE OF ADULTS IN BOTH SMITH AND GREGG COUNTIES WITH CONDITIONS SUCH AS OBESITY AND ASTHMA WAS HIGHER THAN THE STATE. THE PERCENT OF THE TOTAL CIVILIAN NON-INSTITUTIONALIZED POPULATION WITH A DISABILITY IN GREGG COUNTY AND GREGG COUNTY IS HIGHER THAN THE STATE OF TEXAS (2022). Schedule H, Part VI, Line 5 Promotion of community health TYLER AND LONGVIEW CONTINUECARE HOSPITALS PROMOTE COMMUNITY HEALTH THROUGH PARTICIPATION IN COMMUITY OUTREACH BY CONTINUING TO IMPLEMENT A VARIETY OF AWARENESS, EDUCATIONAL AND SCREENING PROGRAMS FOCUSED ON AGING AND RISK FACTORS, PREVENTION AND TREATMENT OF HEART DISEASE AND RESPIRATORY DISEASE, INCLUDING PARTICIPATING IN ELDER CONFERENCES HELD IN TYLER AND LONGVIEW AND IN LOCAL HEALTH FAIRS, AS WELL AS OFFER BLOOD PRESSURE HEALTH SCREENINGS AS OPPORTUNITIES ARISE. ADDITIONALLY, TYLER AND LONGVIEW CONTINUECARE HOSPITALS WILL HELP PROVIDE COMMUNITY MEMBERS WITH BASIC NEEDS BY ASSISTING THE LOCAL FOOD PANTRY WITH REGULARLY SCHEDULED FOOD DRIVES AND SCHOOL SUPPLY DRIVE AS OPPORTUNITIES ARISE BOTH HOSPITALS WILL ALSO COLLABORATE WITH VARIOUS ORGANIZATIONS THAT PROVIDE SERVICES TO VULNERABLE POPULATIONS AS OPPORTUNITIES ARISE. EXAMPLES INCLUDE SUPPLIES FOR ETX CRISIS CENTER, SUPPLIES FOR CHRISTY'S SAFE HAVEN, AND AN ETX CRISIS CENTER FUNDRAISER. THE EMPLOYEES OF TYLER & LONGVIEW CONTINUECARE HOSPITALS ARE DEDICATED TO ENHANCING COMMUNITY WELLNESS BY SUPPORTING LOCAL NURSING SCHOOLS, RESPIRATORY, DPT AND PT ASSISTANT SCHOOLS BY PRESENTING TO STUDENTS ENROLLED IN THESE PROGRAMS AND DONATING EQUIPMENT TO THE FACILITIES. ADDITIONALLY, TYLER CONTINUECARE HOSPITAL HAS AFFILIATION AGREEMENTS WHICH ALLOW FOR CLINICAL ROTATIONS IN THE HOSPITAL WITHIN THE NURSING, PHARMACY AND RESPIRATORY AREAS. EXAMPLES INCLUDE TJC, UT TYLER, BAYLOR SCOTT & WHITE. TYLER AND LONGVIEW CONTINUECARE HOSPITALS WILL PARTICIPATE IN EVENTS TO SUPPORT LOCAL NONPROFIT ORGANIZATIONS AS THEY ARISE. CURRENT EXAMPLES INCLUDE KITS FOR PALESTINE HIGH SCHOOL, ANGEL TREE, HELPING HANDS, HABITAT FOR HUMANITY, MEN'S HOMELESS SHELTER, AND THE HEART ASSOCIATION. Lastly, a majority of the organization's governing body is comprised of persons who reside in the organization's primary service area, who are neither employees nor independent contractors of the organization, nor family members thereof. The organization applies surplus funds to improvements in facilities and equipment, patient care, medical training, and education. Schedule H, Part VI, Line 6 Affiliated health care system TYLER CONTINUECARE HOSPITAL IS AN AFFILIATE OF CHRISTUS MOTHER FRANCES HEALTH SYSTEM IN TYLER, TEXAS. LONGVIEW CONTINUECARE HOSPITAL, WHICH OPENED IN SEPTEMBER 2024, IS AN AFFILIATE OF CHRISTUS GOOD SHEPHERD MEDICAL CENTER IN LONGVIEW, TEXAS. THE HEALTH PROMOTION ACTIVITIES FOR BOTH THE HOSPITALS AND THEIR AFFILATE HOST HOSPITALS ARE COLLABORATIVE IN ORDER TO HAVE A FAR REACHING EFFECT ON THEIR COMMUNITIES. EACH ORGANIZATION ASSESSES THE NEEDS OF THE COMMUNITY AND THEN WORKS IN WAYS THAT WOULD MEET ANY UNMET NEEDS WITHIN THE COMMUNITY. false true false false false false false true false JIM KENDRICK DIRECTOR 0 1136361 0 615419 0 158269 0 426812 0 43486 0 2380347 0 74596 JAMES HILL TREASURER 0 345401 0 81611 0 24867 0 28012 0 32330 0 512221 0 0 STEPHANIE HYDE CEO/PRESIDENT 0 220256 0 60294 0 7690 0 18380 0 23717 0 330337 0 0 LINDA MOORE SECRETARY 0 370712 0 74202 0 37393 0 28381 0 23717 0 534405 0 0 Kent Andries CNO ContinueCare Tyler (until 1/2025) 0 154453 0 32032 0 1384 0 12784 0 37236 0 237889 0 0 Jennifer Minchew Registered Nurse 149182 0 2245 0 14 0 4549 0 200 0 156190 0 0 0 LADUANDA HILL RN CHARGE NURSE 191737 0 9924 0 977 0 1924 0 17670 0 222232 0 0 0 Dawn Stiles LVN 137074 0 1761 0 14 0 1439 0 21146 0 161434 0 0 0 Ty'Eesha Dawkins Registered Nurse 133250 0 2339 0 1172 0 3848 0 10628 0 151237 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation TYLER CONTINUECARE HOSPITAL DOES NOT COMPENSATE THE PRESIDENT OF THE ORGANIZATION. CHC COMMUNITY CARE (CCC) COMPENSATES THE TYLER CONTINUECARE HOSPITAL PRESIDENT. CCC FOLLOWS THE COMPENSATION POLICY OF COMMUNITY HOSPITAL CORPORATION (CHC). CHC ENGAGED SULLIVAN COTTER TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITIES AND CURRENT INCUMBENTS COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THE ORGANIZATION FOLLOWED THE PROCESS FOR THE YEAR ENDED 6/30/25 FOR ITS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES AND OTHER MANAGEMENT OFFICIALS. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan NON QUALIFIED RETIREMENT PLAN PARTICIPATION WAS PAID TO: JIM KENDRICK - $416,461 JAMES HILL - $17,662 LINDA MOORE - $18,031 Schedule J, Part I, Line 7 Non-fixed payments A PORTION OF THE DISCRETIONARY INCENTIVE COMPENSATION PROGRAM WAS BASED ON THE EBIDA OF THE ORGANIZATION. Form 990, Part VI, Line 15 OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN THE ORGANIZATIONS EXECUTIVES ARE EMPLOYED BY CCC WHICH FOLLOWS THE COMPENSATION POLICY OF CHC. CHC ENGAGED SULLIVAN COTTER TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITIES AND CURRENT INCUMBENTS COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THE ORGANIZATION FOLLOWED THE PROCESS FOR THE YEAR ENDED JUNE 30, 2025 FOR ITS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES AND OTHER MANAGEMENT OFFICIALS. THIS PROCESS IS PERFORMED EACH YEAR PRIOR TO THE ANNUAL EMPLOYEE EVALUATION PROCESS, WHICH ENDS ON OCTOBER 1ST OF EACH YEAR. Form 990, Part VI, Line 3 Delegation of management duties CHC COMMUNITY CARE, LLC (CCC) PROVIDES CERTAIN FINANCIAL, TECHNICAL AND MANAGERIAL SUPPORT SERVICES TO THE HOSPITAL. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE SHAREHOLDER OF CONTINUECARE HOSPITAL OF TYLER, INC. IS CCC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE SOLE MEMBER SHALL MAINTAIN A MINORITY VOTING INTEREST OF THE BOARD OF DIRECTORS. ANY DIRECTOR MAY BE REMOVED AT ANY TIME, WITH OR WITHOUT CAUSE BY THE SOLE MEMBER. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE BOARD OF DIRECTORS MAY RECOMMEND, BUT SHALL NOT, WITHOUT EXPRESS WRITTEN CONSENT OF THE SOLE MEMBER, HAVE THE POWER TO TAKE ANY OF THE FOLLOWING ACTIONS: 1. ANY FUNDAMENTAL CHANGE IN THE MISSION OF PHILOSOPHY OF THE HOSPITAL 2. THE INCURRANCE OF DEBT, INCLUDING WITHOUT LIMITATION, BORROWINGS, GUARANTEES, LOANS, ENCUMBRANCES, OPERATING LEASES, PURCHASE OF LEASE OF REAL ESTATE, AND CAPITAL LEASES 3. ANY MERGER OR CONSOLIDATION TO WHICH THE HOSPITAL IS A PARTY 4. THE SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE HOSPITAL 5. POLICY CHANGES PERTAINING TO CHARITY CARE 6. APPOINTMENT AND REMOVAL OF CORPORATE DIRECTORS 7. ANY RELEASE OR CANCELLATION OF INDIVIDUAL CLAIMS IN EXCESS OF $25,000. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body THERE WERE NO COMMITTEES OF THE GOVERNING BODY. Form 990, Part VI, Line 11b Review of form 990 by governing body THE DETAILED REVIEW OF THE FORM 990 IS CONDUCTED BY THE HOSPITAL'S MANAGEMENT FOLLOWING THE PREPARATION AND REVIEW OF THE RETURN BY THE ORGANIZATION'S PAID PREPARER. AN ELECTRONIC COPY OF THE FINAL FORM 990 IS EMAILED TO EACH BOARD MEMBER PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADOPTED BY ITS SOLE MEMBER, CCC, WHICH IN TURN FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADMINISTERED BY ITS PARENT, COMMUNITY HOSPITAL CORPORATION (CHC), WHICH REQUIRES ALL OFFICERS, DIRECTORS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES AND OTHER MANAGEMENT OFFICIALS ("COVERED PERSONS") TO DISCLOSE POTENTIAL CONFLICTS. THE ORGANIZATION'S BOARD FORMALLY ADOPTED CHC'S CONFLICT OF INTEREST POLICY FOR YEAR ENDED JUNE 30, 2011. PURSUANT TO THE POLICY, A DISCLOSURE STATEMENT IS CIRCULATED ANNUALLY TO COVERED PERSONS IN WHICH THE INDIVIDUAL MUST DISCLOSE TRANSACTIONS THAT MAY RESULT IN A CONFLICT. COVERED PERSONS ARE ALSO ENCOURAGED TO NOTIFY THE BOARD, APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICER, GENERAL COUNSEL OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. WHEN NECESSARY, THE BOARD CHAIR OR APPROPRIATE BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND RECOMMEND ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT OR OTHERWISE DETERMINE IF THE CONFLICT CAN BE RESOLVED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE MAKES THE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. ANY MEMBER OF THE BOARD OPERATING UNDER A CONFLICT IS NOT PERMITTED TO BE PRESENT OR OTHERWISE PARTICIPATE IN THE VOTE ON ANY MATTER TO WHICH THE CONFLICT RELATES. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND AFTER INVESTIGATION THE BOARD OR COMMITTEE DETERMINES THAT THE COVERED PERSON FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE ORGANIZATION TAKES APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION, WHICH MAY INCLUDE, TERMINATION OF THE INDIVIDUAL'S MEMBERSHIP, EMPLOYMENT OR CONTRACT. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE AT ITS BUSINESS OFFICE UPON REQUEST. Form 990, Part IX, Line 11g Other Fees PURCHASED SERVICES - MEDICAL - Total Expense: 6898804, Program Service Expense: 6898804, Management and General Expenses: , Fundraising Expenses: ; FEES - PHYSICIAN - Total Expense: 1090298, Program Service Expense: 1090298, Management and General Expenses: , Fundraising Expenses: ; FEES - OTHER SERVICES - Total Expense: 38782, Program Service Expense: 35061, Management and General Expenses: 3721, Fundraising Expenses: ; Form 990, Box C Doing Business As Tyler ContinueCare Hospital Tyler ContinueCare Hospital at Mother Frances Hospital Longview ContinueCARE Hospital BAPTIST HOSPITALS OF SOUTHEAST TEXAS PO BOX 1591 BEAUMONT TX 77704 741303720 HOSPITAL TX 501(c)(3) 3 SWCH INC false BAPTIST PHYSICIAN NETWORK 3080 COLLEGE ST BEAUMONT TX 77701 760453250 PRIMARY CARE TX 501(c)(3) 3 BHSET false BHSETX FOUNDATION 810 HOSPITAL DRIVE 235 BEAUMONT TX 77701 611557670 SUPPORT ORG TX 501(c)(3) 7 BHSET false CAROLINAS COMMUNITY CARE LLC 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 465590355 SUPPORT ORG DE 501(c)(3) Type II CHC false CHC COMMUNITY CARE LLC 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 371485773 SUPPORT ORG TX 501(c)(3) Type III-FI CHC false COMMUNITY HOSPITAL CORPORATION 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 752638469 SUPPORT ORG TX 501(c)(3) Type III-FI NA false CONTINUECARE HOSP AT BAPTIST HLT PADUCAH 2501 KENTUCKY AVENUE 5TH FL PADUCAH KY 42003 465032999 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSP AT HENDRICK MED CTR 1900 PINE ST 5TH FL ABILENE TX 79601 463607347 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSP BPTST HLT MADISONVILLE 900 HOSPITAL DRIVE 4TH FL MADISONVILLE KY 42431 465033192 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSPITAL AT BAPTIST HEALTH 1 TRILLIUM WAY CORBIN KY 40701 200925675 HOSPITAL KY 501(c)(3) 3 CCC false CONTINUECARE HOSPITAL AT ODESSA INC 500 W 4TH STREET ODESSA TX 79761 473539943 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSPITAL AT PALMETTO HEALTH 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 813048423 HOSPITAL TX 501(c)(3) 3 CCC false CRAWLEY MEMORIAL HOSPITAL INC 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 560691100 HOSPITAL NC 501(c)(3) 3 CAR CC false GAINESVILLE COMMUNITY HOSPITAL INC 1900 HOSPITAL BLVD GAINESVILLE TX 76240 831683025 HOSPITAL TX 501(c)(3) 3 CHC false HMH PHYSICIAN ORGANIZATION 110 MEMORIAL HOSPITAL DRIVE HUNTSVILLE TX 77340 760500960 PUBLIC CHARI. 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