2013-11-15T13:35:56-06:00 2012-12-31 742900215 MAXWELL LOCKE & RITTER LLP 401 CONGRESS AVENUE SUITE 1100 AUSTIN TX 787019682 990 2012-01-01 742427148 GEORGETOWN HEALTHCARE SYSTEM GEOR 5129312221 2425 WILLIAMS DRIVE NO 101 GEORGETOWN TX 78628 SCOTT ALARCON 5129312221 2013-11-15 1 SEAN HOLCOMB P01249221 5123703200 2013-11-15 2012 2016-03-07 17:11:31Z X SCOTT ALARCON 2425 WILLIAMS DRIVE NO 101 GEORGETOWN TX 78628 4012747 0 X N/A X 1985 TX THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION, DEDICATED TO THE PROMOTION OF QUALITY, ACCESSIBLE HEALTH CARE FOR ALL PERSONS IN THE GEORGETOWN AND THE SURROUNDING AREA. AS A PARTNER IN ST. DAVID'S HEALTH CARE PARTNERSHIP, WE PROVIDE HEALTHCARE TO THE PUBLIC THROUGH THE OPERATION OF FOUR HOSPITALS IN THE CENTRAL TEXAS AREA. ADDITIONALLY, IN THE GEORGETOWN AREA, WE SERVE AS A CATALYST TO FACILITATE THE EXPANSION AND ENHANCEMENT OF HEALTH AND WELLNESS TO A DIVERSE AND GROWING POPULATION THROUGH EFFECTIVE COLLABORATION AND APPROPRIATE FINANCIAL SUPPORT FOR COMMUNITY PARTNERS WHO EXIST TO MEET THESE NEEDS. 14 14 26 147 0 0 0 196677 2849608 3044296 351750 672525 110547 66865 3311905 3980363 823450 788284 0 0 1387220 1459688 0 0 0 733910 647516 2944580 2895488 367325 1084875 34829409 36185439 503347 528177 34326062 35657262 TO PROMOTE AND FACILITATE THE ADVANCEMENT OF AFFORDABLE HEALTH CARE TO THE COMMUNITY OF GEORGETOWN AND THE SURROUNDING AREA. 0 0 1042795 982615 THE REPORTING ORGANIZATION OPERATES A HOME HEALTH AGENCY WHICH PROVIDED 6,888 PATIENT VISITS TO OVER 310 PATIENTS IN AND AROUND THE GEORGETOWN, TEXAS AREA IN THIS REPORTING PERIOD. THE PRIMARY PAYOR TYPE FOR THE AGENCY IS MEDICARE. 788284 788284 THE REPORTING ORGANIZATION PROVIDES GRANTS TO COMMUNITY ORGANIZATIONS THAT PROMOTE IMPROVED ACCESS TO, OR DIRECTLY PROVIDE HEALTHCARE TO THE CITIZENS OF THE GEORGETOWN, TEXAS AREA REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. 2128546 THE REPORTING ORGANIZATION IS A PARTNER IN THE ST. DAVID'S HEALTHCARE PARTNERSHIP, LP, LLP WHICH IS DEDICATED TO SERVING CENTRAL TEXAS UNDER THE COMMUNITY BENEFIT STANDARD. THE PARTNERSHIP INCLUDES FOUR ACUTE CARE HOSPITALS AND ONE REHABILITATION HOSPITAL. IN 2012, 65,018 PATIENTS WERE ADMITTED AND THERE WERE 302,588 EMERGENCY ROOM VISITS. 1831079 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 50 0 26 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X RICHARD SCHULTZ CFO 5129312221 2425 WILLIAMS DRIVE NO 101 GEORGETOWN TX 78628 BARBARA H BRIGHTWELL 2.00 X 0 0 0 DOAK FLING 1.50 X 0 0 0 STEPHEN D SCHAEFER OD 1.50 X 0 0 0 DALE ILLIG 1.50 X 0 0 0 KAREN COLE 1.50 X 0 0 0 ALMA GUZMAN 1.50 X 0 0 0 DARRICK MCGILL 1.50 X 0 0 0 AUSTIN BRYAN 1.00 X 0 0 0 KAREN CROSBY 1.00 X 0 0 0 LARRY J HEMENES 1.00 X 0 0 0 JOAN MAIER 1.00 X 0 0 0 LINDA MEIGS 1.00 X 0 0 0 RICHARD PEARCE MD 1.00 X 0 0 0 JAKE SCHRUM 1.00 X 0 0 0 M SCOTT ALARCON 40.00 X 227717 0 32472 RICHARD SCHULTZ 40.00 X 167217 0 21386 394934 0 53858 2 0 1 0 0 196327 350 196677 ST. DAVID'S HEALTHCARE 621990 2128546 2128546 GEORGETOWN HOME HEALTH 621610 915750 915750 3044296 271 271 8059 0 8059 8059 8059 672254 0 672254 672254 672254 58665 32384 26281 26281 OTHER INCOME 900099 28409 28409 AUXILIARY 900099 4116 4116 32525 3980363 3111161 0 672525 X 788284 788284 448792 448792 802969 582540 220429 32597 15955 16642 77048 59811 17237 98282 51006 47276 21835 21835 28653 28653 76370 76370 89215 67507 21708 3164 3164 86138 50567 35571 11192 3390 7802 136241 83957 52284 80990 46530 34460 65902 53161 12741 21036 11991 9045 SUPPLIES 12511 12511 MISCELLANEOUS EXPENSES 9617 620 8997 DUES & SUBSCRIPTIONS 4652 85 4567 2895488 1831079 1064409 0 722672 509560 89321 66824 23946 23437 10632 21731 3114215 710057 2439103 2404158 8782631 11254954 12571850 12571850 10189254 9332925 34829409 36185439 48530 179219 454817 348958 503347 528177 X 34326062 35657262 34326062 35657262 34829409 36185439 1084875 246325 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 18 0 1 1362 1380 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE SCHEDULE K-1 FROM ST. DAVID'S HEALTHCARE PARTNERSHIP, LP, LLP INCLUDED $1,362 OF LOBBYING EXPENDITURES WHICH CONSTITUTED THE PORTION OF THE ORGANIZATION'S ANNUAL ASSOCIATION DUES DEDICATED TO LOBBYING ACTIVITIES. PART IV, SUPPLEMENTAL INFORMATION: IN ADDITION TO AMOUNTS REPORTED ON THE ABOVE-MENTIONED SCHEDULE K-1, THE REPORTING ORGANIZATION PARTICIPATED IN DIRECT CONTACT WITH LOCAL LEGISLATORS. DAVID HUFFSTUTLER, CEO OF THE PARTNERSHIP, SPENT 1.5 HOURS ON LOBBYING ACTIVITIES DURING 2012. THE AMOUNT REPORTED ON LINE 1G ABOVE REFLECTS THE COSTS OF THESE ACTIVITIES BASED UPON HOURLY RATES OF COMPENSATION AND ALLOCABLE OVERHEAD FOR THE OFFICER INVOLVED. 1662191 1662191 1374880 664683 710197 77144 45374 31770 2404158 ST DAVIDS PARTNERSHIP LP 12571850 C 12571850 INVESTMENTS HELD FOR DEFERRED EMPLOYEE BENEFITS 293096 DUE FROM AFFILIATED ENTITIES (NET) 8843502 OTHER LONG TERM ASSETS - CSV 196327 9332925 DEFERRED EMPLOYEE BENEFITS 293096 GEORGETOWN HOME HEALTH 55862 348958 THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT FOR ANY UNRELATED BUSINESS ACTIVITIES. NO EXPENSE HAS BEEN PROVIDED FOR INCOME TAX IN THE ACCOMPANYING FINANCIAL STATEMENTS; HOWEVER, THERE MAY BE IMMATERIAL TAXES DUE TO DEBT FINANCED PRIVATE PURPOSE ACTIVITIES THAT MANAGEMENT HAS ELECTED NOT TO RECORD AS A LIABILITY. 1 1 X 1 X 1 X 500.000000000000 1 1 1 0 1 1 631590 7197 624393 0.04420 1136879 1274160 -137281 0.00000 1768469 1281357 487112 0.04420 114815 0 114815 0.00810 47826 0 47826 0.00340 764880 764880 0.05410 927521 927521 0.06560 2695990 1281357 1414633 0.10980 154270 3859 150411 0.01060 154270 3859 150411 0.01060 0 134170 0 3919191 3776584 142607 X 1 1 1 ST DAVID'S THE ORGANIZATION OWNS A 0.01000 0.00000 0.00000 2 HEALTHCARE 1% PARTNERSHIP INTEREST 3 PARTNERSHIP LP LLP IN ST DAVID'S HEALTHCARE 4 PARTNERSHIP WHICH 5 OPERATES FOUR ACUTE 6 CARE HOSPITALS 7 IN CENTRAL TEXAS. 4 1 ST DAVID'S MEDICAL CENTER

919 E 32ND STREET AUSTIN TX 78705

X X X A 2 ST DAVID'S NORTH AUSTIN MEDICAL CENTER

12221 N MOPAC EXPWY AUSTIN TX 78758

X X X A 3 ST DAVID'S SOUTH AUSTIN MEDICAL CENTER

901 W BEN WHITE BLVD AUSTIN TX 78704

X X X A 4 ST DAVID'S ROUND ROCK MEDICAL CENTER

2400 ROUND ROCK AVE ROUND ROCK TX 78681

X X X A FACILITY REPORTING GROUP - A 1 1 200.000000000000 1 500.000000000000 1 X X X X X X X X 1 1 X X X X X 1 0 X X X X 1 X 0 0 3 GEORGETOWN HOME HEALTH

2120 SCENIC DRIVE GEORGETOWN TX 78626

HOME HEALTH CARE AGENCY BAILEY SQUARE SURGERY CENTER

1111 W 34TH ST 400 AUSTIN TX 78705

AMBULATORY SURGERY CENTER SOUTH AUSTIN SURGERY CENTER

4207 JAMES CASEY ST 203 AUSTIN TX 78745

AMBULATORY SURGERY CENTER PART I, LINE 3C: IN COMPLIANCE WITH IRC SECTION 501(R), THE HOSPITALS PROVIDE 100% FINANCIAL ASSISTANCE (CHARITY CARE) FOR ELIGIBLE PATIENTS WITH INCOME EQUAL TO OR LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES (FPG). FOR ELIGIBLE PATIENTS WITH INCOME OVER 200% FPG AND EQUAL TO 500% OR LESS THAN FPG, DISCOUNTS ARE PROVIDED ON A SLIDING SCALE. ELIGIBILITY IS DETERMINED USING VARIOUS SOURCES OF DOCUMENTATION AND INCOME VERIFICATION. THE ACCOUNTS FOR INDIVIDUALS WITHOUT ANY HEALTH INSURANCE WHO LIVE IN LOW INCOME ZIP CODES AND WHO FAIL TO RESPOND TO COLLECTION EFFORTS ARE REMOVED FROM ACCOUNTS RECEIVABLE AND TREATED AS CHARITY CARE. ALL COLLECTIONS EFFORTS CEASE ON THESE ACCOUNTS ONCE THEY ARE CLASSIFIED AS CHARITY CARE. PART I, LINE 7: THE HOSPITALS UTILIZE THE COST TO CHARGE RATIO FROM THE AUDITED FINANCIAL STATEMENTS.PART I, LINE 7 COL(F): BAD DEBTS ARE EXCLUDED FROM THE CALCULATION OF TOTAL EXPENSES.PART II: ALL OF THE HOSPITALS ARE ACTIVE IN THE COMMUNITY PROMOTING HEALTH OF CENTRAL TEXANS. THE ORGANIZATION ALSO PROVIDES A BUILDING WITH OFFICE SPACE TO MISSION ALIGNED LOCAL CHARITABLE ORGANIZATIONS AT A SUBSTANTIALLY DISCOUNTED RATE. THE GOAL IS TO PROMOTE COLLABORATION AMONG THE TENANT AGENCIES PROVIDING SERVICES TO THE LOCAL COMMUNITY.PART III, LINE 4: THE ORGANIZATION'S PROPORTIONATE SHARE OF BAD DEBT EXPENSE FROM ITS OWNERSHIP INTEREST IN ST. DAVID'S HEALTHCARE PARTNERSHIP, LP, LLP (THE "PARTNERSHIP") IS REPORTED ON SCHEDULE H, PART III, LINE 2. FOLLOWING IS THE FOOTNOTE TO THE PARTNERSHIP'S AUDITED FINANCIAL STATEMENTS WHICH DESCRIBES BAD DEBT EXPENSE:"ESTIMATED PROVISIONS FOR DOUBTFUL ACCOUNTS ARE RECORDED TO THE EXTENT IT IS PROBABLE THAT A PORTION OR ALL OF A PARTICULAR ACCOUNT WILL NOT BE COLLECTED. THE PARTNERSHIP CONSIDERS A NUMBER OF FACTORS IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE INCLUDING THE AGE OF THE ACCOUNTS, CHANGES IN COLLECTION PATTERNS AND OTHER CURRENT CONDITIONS, AND THE COMPOSITION OF PATIENT ACCOUNTS BY PAYOR TYPE."PART III, LINE 8: THE ORGANIZATION HAS USED THE HOSPITALS' PROPORTIONATE SHARE OF THE SHORTFALL ON MEDICARE USING THE MEDICARE COST REPORTS. PART III, LINE 9B: THE ORGANIZATION WRITES OFF ALL CHARITY CARE AND IN COMPLIANCE WITH IRC SECTION 501(R) DOES NOT PURSUE COLLECTION ON THOSE THAT QUALIFY FOR CHARITY CARE.PART I, LINE 7B, COLUMN (D): OFFSETTING REVENUE IN COLUMN (D) REFLECTS THE DIFFERENCE BETWEEN MEDICARE AND MEDICAID REIMBURSEMENT RATES. EVEN THE HIGHER MEDICARE REIMBURSEMENT RATE DOES NOT COVER THE COST OF SERVICES.PART I, LINE 7B, COLUMN (F): IN ACCORDANCE WITH FORM 990 INSTRUCTIONS, THE PERCENT OF TOTAL EXPENSE FOR LINE 7B, UNREIMBURSED MEDICAID, IS REPORTED AS ZERO. THE ACTUAL AMOUNT OF LINE 7B, COLUMN (F) IS -1.14%. LINES 7D AND 7K, COLUMN (F), WOULD BE 3.28% AND 9.84%, RESPECTIVELY. PARTS I AND II: THE TOTAL COMMUNITY BENEFIT FOR THE REPORTING ORGANIZATION IS $1,565,044, AND THE COMBINED PERCENTAGE IS 10.90%, WHICH IS THE SUM OF PART I, LINE 7K, COLUMN (F) PERCENTAGE OF 9.84% (AS ADJUSTED FOR UNREIMBURSED MEDICAID AS FURTHER EXPLAINED ABOVE) AND THE PART II, LINE 10, COLUMN (F) PERCENTAGE OF 1.06%.PART III, LINE 1: HOSPITALS CONTROLLED BY THE ORGANIZATION DETERMINE BAD DEBT AND CHARITY CARE IN ACCORDANCE WITH GAAP AND WITH IRC SECTION 501(R). WHETHER BAD DEBT IS DETERMINED IN ACCORDANCE WITH STATEMENT 15 REQUIREMENTS IS A MORE DIFFICULT ISSUE.STATEMENT 15 REQUIRES HOSPITALS TO RECOGNIZE REVENUE ONLY WHEN COLLECTIONS ARE REASONABLY ASSURED AND FOR AN AMOUNT THAT IS DETERMINABLE. MOST HOSPITALS, INCLUDING THOSE CONTROLLED BY THE ORGANIZATION, USE MATHEMATICAL MODELS BASED ON PRIOR HISTORY TO DETERMINE THE PERCENTAGE OF PATIENT BILLINGS THAT IS LIKELY TO RESULT IN BAD DEBT.FOR THIS REASON, AND OUT OF AN ABUNDANCE OF CAUTION, THE ORGANIZATION HAS ANSWERED "NO" TO WHETHER STATEMENT 15 IS FOLLOWED. DESPITE THE BEST EFFORTS OF HMFA TO ASSIST HOSPITALS IN DETERMINING THE DIFFERENCE BETWEEN PATIENTS WHO HAVE THE CAPACITY TO PAY FOR THEIR CARE BUT WON'T PAY AND PATIENTS WHO LACK THE CAPACITY TO PAY, THE DETERMINATION ALWAYS INVOLVES JUDGMENT. HOWEVER, THE HOSPITALS CONTROLLED BY THE ORGANIZATION DETERMINE CHARITY CARE ON THE CORE PRINCIPLES SET FORTH IN STATEMENT 15, INCLUDING SPECIFIC CRITERIA FOR CHARITY CARE, A SPECIFIC TIME OF DETERMINATION, RECORD KEEPING, DISCLOSURE OF THE CHARITY CARE POLICY AND VALUATION OF CHARITY CARE AT COST. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 56. FORM 990, SCHEDULE H, PART VI: LINE 2: THE HOSPITAL PARTNERSHIP STRATEGIC PLANNING PROCESS CONTINUALLY ASSESSES AND ADDRESSES THE NEEDS OF THE COMMUNITY. THE ORGANIZATION ITSELF ASSESSES THE NEEDS OF THE COMMUNITY OF GEORGETOWN AND THE SURROUNDING COMMUNITY MORE SPECIFICALLY THROUGH ITS GRANT MAKING PROCESS.PART VI, LINE 3: EACH HOSPITAL POSTS A SUMMARY OF ITS CHARITY CARE POLICY IN ADMISSION AREAS, EMERGENCY ROOMS, AND OTHER AREAS WHERE ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. THE HOSPITALS CONDITION OF ADMISSION CONSENT INFORMS THE PATIENTS THAT THEY MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE OR CHARITY CARE AND THEY MAY REQUEST INFORMATION ABOUT THESE PROGRAMS. A SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM IS PROVIDED TO THE PATIENT DURING THE INTAKE AND DISCHARGE PROCESSES. PATIENTS ARE INFORMED, WHERE APPLICABLE, OF AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID, AND ASSISTS THE PATIENTS WITH THE QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE.PART VI, LINE 4: THE HOSPITALS ARE LOCATED IN TRAVIS AND WILLIAMSON COUNTIES. THE PATIENTS ARE PREDOMINATELY FROM TRAVIS, WILLIAMSON AND HAYS COUNTIES. THE ORGANIZATION'S GRANT RECIPIENTS ALIGN WITH DEMOGRAPHICS SERVED AT THE HOSPITALS.PART VI, LINE 5: THE HOSPITALS IN ST. DAVID'S HEALTHCARE PARTNERSHIP OPERATE AS EXEMPT HOSPITALS. THEY EACH HAVE OPEN EMERGENCY ROOMS AND AN OPEN MEDICAL STAFF. THE REPORTING ORGANIZATION USES ITS SHARE OF EARNINGS FROM THE HOSPITALS FOR PROGRAMS IN THE LOCAL COMMUNITY THAT INCREASE ACCESS TO HEALTHCARE.PART VI, LINE 6: THE REPORTING ORGANIZATION IS A PARTNER IN ST. DAVID'S HEALTHCARE, A HOSPITAL SYSTEM THAT MEETS THE COMMUNITY BENEFIT STANDARD AND THE REQUIREMENTS OF THE AFFORDABLE CARE ACT IN DELIVERING HOSPITAL CARE TO CENTRAL TEXAS. IN ADDITION, THE REPORTING ORGANIZATION HAS ASSESSED THE UNMET HEALTHCARE NEEDS OF GEORGETOWN, TEXAS AND THE SURROUNDING COMMUNITIES AND USES ITS FUNDS TO COLLABORATE WITH SEVERAL TAX EXEMPT ORGANIZATIONS TO INCREASE ACCESS TO CARE FOR THE INDIGENT POPULATION.PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: TX PART V, LINE 8 FACILITY REPORTING GROUP A SEE BELOW FACILITY 1 -- ST. DAVID'S MEDICAL CENTER PART V, SECTION B, LINE 10: IN COMPLIANCE WITH IRC SECTION 501(R), THE HOSPITALS PROVIDE 100% FINANCIAL ASSISTANCE (CHARITY CARE) FOR ELIGIBLE PATIENTS WITH INCOME EQUAL TO OR LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES (FPG). ELIGIBILITY IS DETERMINED USING VARIOUS SOURCES OF DOCUMENTATION AND INCOME VERIFICATION. THE ACCOUNTS FOR INDIVIDUALS WITHOUT ANY HEALTH INSURANCE WHO LIVE IN LOW INCOME ZIP CODES AND WHO FAIL TO RESPOND TO COLLECTIONS EFFORTS ARE REMOVED FROM ACCOUNTS RECEIVABLE AND TREATED AS CHARITY CARE. ALL COLLECTIONS EFFORTS CEASE ON THESE ACCOUNTS ONCE CLASSIFIED AS CHARITY CARE. FACILITY 1 -- ST. DAVID'S MEDICAL CENTER PART V, SECTION B, LINE 11: FOR ELIGIBLE PATIENTS WITH INCOME OVER 200% FPG AND EQUAL TO 500% OR LESS THAN FPG, DISCOUNTS ARE PROVIDED ON A SLIDING SCALE. ELIGIBILITY IS DETERMINED USING VARIOUS SOURCES OF DOCUMENTATION AND INCOME VERIFICATION. FACILITY 1 -- ST. DAVID'S MEDICAL CENTER PART V, SECTION B, LINE 12H: THE FOLLOWING IS A SUMMARY OF THE CHARITY CARE POLICY ADOPTED BY ST. DAVID'S MEDICAL CENTER:ST. DAVID'S MEDICAL CENTER ACTIVELY SEEKS COMPLETION OF ANAPPLICATION, WHICH FACILITATES COLLECTION OF APPROPRIATE INFORMATION,INCLUDING:*VERIFICATION OF FAMILY MEMBERS IN THE HOUSEHOLD - FOR ADULT PATIENTS,PATIENT SPOUSE AND ANY DEPENDENTS; FOR MINORS, MOTHER AND FATHER, ANDDEPENDENTS OF BOTH.*INCOME CALCULATION - FOR ADULTS, SUM OF THE TOTAL YEARLY GROSS INCOME OFTHE PATIENT AND THE PATIENT'S SPOUSE; FOR MINORS, TOTAL YEARLY GROSSINCOME OF THE PATIENT, AND THE PATIENT'S MOTHER AND FATHER.*DOCUMENTATION - VARIOUS OFFICIAL INCOME REPORTING DOCUMENTATION IS SOUGHT(E.G. W-2, WAGE AND TAX STATEMENT, PAY CHECK REMITTANCE AND OTHERS).DOCUMENTATION ASSOCIATED WITH THE PARTICIPATION IN A PUBLIC BENEFITPROGRAM CAN BE PROVIDED IN LIEU OF INCOME DOCUMENTATION (PROOF OFPARTICIPATION INDICATES THE PATIENT HAS BEEN DEEMED FINANCIALLY INDIGENTAND THEREFORE IS NOT REQUIRED TO PROVIDE INCOME INFORMATION). THERE ISALSO A VERIFICATION PROCESS IN PLACE FOR PATIENTS THAT DO NOT HAVEAPPROPRIATE DOCUMENTATION.*CHARITY ELIGIBILITY CLASSIFICATIONS - FOR FINANCIALLY INDIGENT PATIENTS,THE AMOUNT OWED BY THE PATIENT AFTER PAYMENT BY ALL THIRD-PARTY PAYORSMUST EXCEED TEN PERCENT OF THE PATIENT'S YEARLY INCOME AND THE PATIENTMUST BE UNABLE TO PAY THE REMAINING BILL. ACCEPTANCE BY ST. DAVID'S SOUTHAUSTIN MEDICAL CENTER IS BASED ON MEETING ONE OF TWO CRITERIA. YEARLYINCOME MUST BE GREATER THAN 200%, BUT LESS THAN OR EQUAL TO 500% OF THEFEDERAL POVERTY GUIDELINES. FACILITY 1 -- ST. DAVID'S MEDICAL CENTER PART V, SECTION B, LINE 19D: FACILITY 1 -- ST. DAVID'S MEDICAL CENTER PART V, SECTION B, LINE 20D: THE HOSPITAL UTILIZED A SLIDING FEE SCALE FOR PATIENTS BETWEEN 200% AND 500% OF FEDERAL POVERTY GUIDELINES THAT IS LOWER THAN THE AVERAGE OF THE THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES. FACILITY 2 -- ST. DAVID'S NORTH AUSTIN MEDICAL CENTER PART V, SECTION B, LINE 11: FACILITY 2 -- ST. DAVID'S NORTH AUSTIN MEDICAL CENTER PART V, SECTION B, LINE 12H: THE FOLLOWING IS A SUMMARY OF THE CHARITY CARE POLICY ADOPTED BY ST. DAVID'S NORTH AUSTIN MEDICAL CENTER:ST. DAVID'S NORTH AUSTIN MEDICAL CENTER ACTIVELY SEEKS COMPLETION OF ANAPPLICATION, WHICH FACILITATES COLLECTION OF APPROPRIATE INFORMATION,INCLUDING:*VERIFICATION OF FAMILY MEMBERS IN THE HOUSEHOLD - FOR ADULT PATIENTS,PATIENT SPOUSE AND ANY DEPENDENTS; FOR MINORS, MOTHER AND FATHER, ANDDEPENDENTS OF BOTH.*INCOME CALCULATION - FOR ADULTS, SUM OF THE TOTAL YEARLY GROSS INCOME OFTHE PATIENT AND THE PATIENT'S SPOUSE; FOR MINORS, TOTAL YEARLY GROSSINCOME OF THE PATIENT, AND THE PATIENT'S MOTHER AND FATHER.*DOCUMENTATION - VARIOUS OFFICIAL INCOME REPORTING DOCUMENTATION IS SOUGHT(E.G. W-2, WAGE AND TAX STATEMENT, PAY CHECK REMITTANCE AND OTHERS).DOCUMENTATION ASSOCIATED WITH THE PARTICIPATION IN A PUBLIC BENEFITPROGRAM CAN BE PROVIDED IN LIEU OF INCOME DOCUMENTATION (PROOF OFPARTICIPATION INDICATES THE PATIENT HAS BEEN DEEMED FINANCIALLY INDIGENTAND THEREFORE IS NOT REQUIRED TO PROVIDE INCOME INFORMATION). THERE ISALSO A VERIFICATION PROCESS IN PLACE FOR PATIENTS THAT DO NOT HAVEAPPROPRIATE DOCUMENTATION.*CHARITY ELIGIBILITY CLASSIFICATIONS - FOR FINANCIALLY INDIGENT PATIENTS,THE AMOUNT OWED BY THE PATIENT AFTER PAYMENT BY ALL THIRD-PARTY PAYORSMUST EXCEED TEN PERCENT OF THE PATIENT'S YEARLY INCOME AND THE PATIENTMUST BE UNABLE TO PAY THE REMAINING BILL. ACCEPTANCE BY ST. DAVID'S NORTHAUSTIN MEDICAL CENTER IS BASED ON MEETING ONE OF TWO CRITERIA. YEARLYINCOME MUST BE GREATER THAN 200%, BUT LESS THAN OR EQUAL TO 500% OF THEFEDERAL POVERTY GUIDELINES. FACILITY 2 -- ST. DAVID'S NORTH AUSTIN MEDICAL CENTER PART V, SECTION B, LINE 19D: FACILITY 2 -- ST. DAVID'S NORTH AUSTIN MEDICAL CENTER PART V, SECTION B, LINE 20D: THE HOSPITAL UTILIZED A SLIDING FEE SCALE FOR PATIENTS BETWEEN 200% AND 500% OF FEDERAL POVERTY GUIDELINES THAT IS LOWER THAN THE AVERAGE OF THE THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES. FACILITY 3 -- ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER PART V, SECTION B, LINE 11: FACILITY 3 -- ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER PART V, SECTION B, LINE 12H: THE FOLLOWING IS A SUMMARY OF THE CHARITY CARE POLICY ADOPTED BY ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER:ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER ACTIVELY SEEKS COMPLETION OF ANAPPLICATION, WHICH FACILITATES COLLECTION OF APPROPRIATE INFORMATION,INCLUDING:*VERIFICATION OF FAMILY MEMBERS IN THE HOUSEHOLD - FOR ADULT PATIENTS,PATIENT SPOUSE AND ANY DEPENDENTS; FOR MINORS, MOTHER AND FATHER, ANDDEPENDENTS OF BOTH.*INCOME CALCULATION - FOR ADULTS, SUM OF THE TOTAL YEARLY GROSS INCOME OFTHE PATIENT AND THE PATIENT'S SPOUSE; FOR MINORS, TOTAL YEARLY GROSSINCOME OF THE PATIENT, AND THE PATIENT'S MOTHER AND FATHER.*DOCUMENTATION - VARIOUS OFFICIAL INCOME REPORTING DOCUMENTATION IS SOUGHT(E.G. W-2, WAGE AND TAX STATEMENT, PAY CHECK REMITTANCE AND OTHERS).DOCUMENTATION ASSOCIATED WITH THE PARTICIPATION IN A PUBLIC BENEFITPROGRAM CAN BE PROVIDED IN LIEU OF INCOME DOCUMENTATION (PROOF OFPARTICIPATION INDICATES THE PATIENT HAS BEEN DEEMED FINANCIALLY INDIGENTAND THEREFORE IS NOT REQUIRED TO PROVIDE INCOME INFORMATION). THERE ISALSO A VERIFICATION PROCESS IN PLACE FOR PATIENTS THAT DO NOT HAVEAPPROPRIATE DOCUMENTATION.*CHARITY ELIGIBILITY CLASSIFICATIONS - FOR FINANCIALLY INDIGENT PATIENTS,THE AMOUNT OWED BY THE PATIENT AFTER PAYMENT BY ALL THIRD-PARTY PAYORSMUST EXCEED TEN PERCENT OF THE PATIENT'S YEARLY INCOME AND THE PATIENTMUST BE UNABLE TO PAY THE REMAINING BILL. ACCEPTANCE BY ST. DAVID'S ROUNDROCK MEDICAL CENTER IS BASED ON MEETING ONE OF TWO CRITERIA. YEARLY INCOMEMUST BE GREATER THAN 200%, BUT LESS THAN OR EQUAL TO 500% OF THE FEDERALPOVERTY GUIDELINES. FACILITY 3 -- ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER PART V, SECTION B, LINE 19D: FACILITY 3 -- ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER PART V, SECTION B, LINE 20D: THE HOSPITAL UTILIZED A SLIDING FEE SCALE FOR PATIENTS BETWEEN 200% AND 500% OF FEDERAL POVERTY GUIDELINES THAT IS LOWER THAN THE AVERAGE OF THE THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES. FACILITY 4 -- ST. DAVID'S ROUND ROCK MEDICAL CENTER PART V, SECTION B, LINE 12H: THE FOLLOWING IS A SUMMARY OF THE CHARITY CARE POLICY ADOPTED BY ST. DAVID'S ROUND ROCK MEDICAL CENTER:ST. DAVID'S ROUND ROCK MEDICAL CENTER ACTIVELY SEEKS COMPLETION OF AN APPLICATION, WHICH FACILITATES COLLECTION OF APPROPRIATE INFORMATION, INCLUDING:*VERIFICATION OF FAMILY MEMBERS IN THE HOUSEHOLD - FOR ADULT PATIENTS,PATIENT SPOUSE AND ANY DEPENDENTS; FOR MINORS, MOTHER AND FATHER, AND DEPENDENTS OF BOTH.*INCOME CALCULATION - FOR ADULTS, SUM OF THE TOTAL YEARLY GROSS INCOME OF THE PATIENT AND THE PATIENT'S SPOUSE; FOR MINORS, TOTAL YEARLY GROSS INCOME OF THE PATIENT, AND THE PATIENT'S MOTHER AND FATHER.*DOCUMENTATION - VARIOUS OFFICIAL INCOME REPORTING DOCUMENTATION IS SOUGHT (E.G. W-2, WAGE AND TAX STATEMENT, PAY CHECK REMITTANCE AND OTHERS). DOCUMENTATION ASSOCIATED WITH THE PARTICIPATION IN A PUBLIC BENEFIT PROGRAM CAN BE PROVIDED IN LIEU OF INCOME DOCUMENTATION (PROOF OF PARTICIPATION INDICATES THE PATIENT HAS BEEN DEEMED FINANCIALLY INDIGENTAND THEREFORE IS NOT REQUIRED TO PROVIDE INCOME INFORMATION). THERE IS ALSO A VERIFICATION PROCESS IN PLACE FOR PATIENTS THAT DO NOT HAVE APPROPRIATE DOCUMENTATION.*CHARITY ELIGIBILITY CLASSIFICATIONS - FOR FINANCIALLY INDIGENT PATIENTS, THE AMOUNT OWED BY THE PATIENT AFTER PAYMENT BY ALL THIRD-PARTY PAYORS MUST EXCEED TEN PERCENT OF THE PATIENT'S YEARLY INCOME AND THE PATIENTMUST BE UNABLE TO PAY THE REMAINING BILL. ACCEPTANCE BY ST. DAVID'S MEDICAL CENTER IS BASED ON MEETING ONE OF TWO CRITERIA. YEARLY INCOME MUST BE GREATER THAN 200%, BUT LESS THAN OR EQUAL TO 500% OF THE FEDERAL POVERTY GUIDELINES. FACILITY 4 -- ST. DAVID'S ROUND ROCK MEDICAL CENTER PART V, SECTION B, LINE 20D: THE HOSPITAL UTILIZED A SLIDING FEE SCALE FOR PATIENTS BETWEEN 200% AND 500% OF FEDERAL POVERTY GUIDELINES THAT IS LOWER THAN THE AVERAGE OF THE THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES. 1 LONE STAR CIRCLE OF CARE 1500 W UNIVERSITY GEORGETOWN TX 78628 743001674 501(C)(3) 524000 PROVIDE FUNDING FOR INDIGENT CARE AND INCREASING HEALTHCARE ACCESS. BOYS & GIRLS CLUB OF GEORGETOWN 210 W 18TH STREET BLDG B GEORGETOWN TX 78626 262916822 501(C)(3) 51000 TO BENEFIT THE CHILDREN OF GEORGETOWN THE CARING PLACE PO BOX 1215 GEORGETOWN TX 78627 742386902 501(C)(3) 37600 EXPAND HEALTH SERVICES. THE GEORGETOWN PROJECT PO BOX 957 GEORGETOWN TX 78628 742807713 501(C)(3) 35000 HEALTH INITIATIVES GRANT. CAPITAL INVESTING IN DEVELOPMENT AND EMPLOYMENT OF ADULTS INC PO BOX 1784 AUSTIN TX 78767 742893041 501(C)(3) 25000 EXPAND HEALTH SERVICES. WILLIAMSON COUNTY CHILDREN'S ADVOCACY CENTER 406 W UNIVERSITY GEORGETOWN TX 78626 742834639 501(C)(3) 25000 TO BENEFIT THE CHILDREN OF GEORGETOWN. CHISHOLM TRAIL COMMUNITIES FOUND DBA THE GEORGETOWN AREA COMMUNITY FOUND 116 WEST 8TH STREET GEORGETOWN TX 78626 742786718 501(C)(3) 21000 EXPAND HEALTH SERVICES. ST DAVID'S COMMUNITY HEALTH FOUNDATION LEADERSHIP 811 BARTON SPRINGS RD STE 600 AUSTIN TX 78704 742898888 501(C)(3) 8000 EXPAND HEALTH SERVICES. RIDE ON CENTER FOR KIDS PO BOX 2422 GEORGETOWN TX 78627 742917659 501(C)(3) 7000 TO BENEFIT THE CHILDREN OF GEORGETOWN. GEORGETOWN PARTNERS IN EDUCATION FOUNDATION 2211 NORTH AUSTIN AVE GEORGETOWN TX 78626 742843114 501(C)(3) 5000 SUPPORT FOR COMMUNITY HEALTH AWARENESS. AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 5000 EXPAND HEALTH SERVICES. WILLIAMSON BURNET COUNTY OPPORTUNITIES INC 604 HIGH TECH DRIVE GEORGETOWN TX 78626 746075213 501(C)(3) 5000 TO FUND A PORTION OF MEALS ON WHEELS PROGRAM. GEORGETOWN COMMUNITY RESOURCE CENTER 805 W UNIVERSITY GEORGETOWN TX 78626 010717158 501(C)(3) 154270 FMV LEASE ASSISTANCE EXPAND HEALTH SERVICES. 13 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION MONITORS THE USE OF GRANT FUNDS BY REQUIRING ANY GRANTEES RECEIVING IN EXCESS OF $10,000 TO PROVIDE QUARTERLY REPORTS, WITHIN 30 DAYS OF THE CLOSE OF THE CALENDAR QUARTER, WHICH IDENTIFY PROGRAM GOALS AND OUTCOME MEASUREMENTS, AND CLIENT SATISFACTION SURVEYS. GRANTEES RECEIVING IN EXCESS OF $10,000 ARE FURTHER REQUIRED TO SUBMIT ANNUAL REPORTS WITHIN 90 DAYS OF THE CLOSE OF THEIR FISCAL YEARS, WHICH PROVIDE AGGREGATED RESULTS OF THE MOST RECENT 4 QUARTERS OF DATA, ALONG WITH THE ENTITY FINANCIAL STATEMENTS. X X X X X X 0 0 0 0 0 0 0 0 0 M SCOTT ALARCON 227717 0 0 0 0 0 9109 0 23363 0 260189 0 0 0 RICHARD SCHULTZ 167217 0 0 0 0 0 6689 0 14697 0 188603 0 0 0 FORM 990, PART I, LINE 5, NUMBER OF EMPLOYEES - USE OF PEO: THE ORGANIZATION'S EMPLOYEES ARE CONTRACTED THROUGH A PROFESSIONAL EMPLOYMENT ORGANIZATION (PEO). THERE ARE APPROXIMATELY 26 EMPLOYEES, INCLUDING OFFICERS LISTED IN PART VII, SECTION A AND SCHEDULE J, FOR WHICH THE PEO HANDLES THE PAYROLL DUTIES, INCLUDING THE REQUIRED FEDERAL AND STATE REPORTING AND WITHHOLDING OBLIGATIONS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S TAX RETURN IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. AN INITIAL DRAFT OF THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS, MANAGEMENT, AND A THIRD PARTY TAX CONSULTANT PRIOR TO FINALIZATION. AFTER ANY CHANGES RESULTING FROM REVIEW BY THE BOARD HAVE BEEN MADE, THE FINAL VERSION OF FORM 990 IS FILED AND A COPY OF THE FILED FORM IS DISTRIBUTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S BOARD OF DIRECTORS AND KEY EMPLOYEES REVIEW THE CONFLICT OF INTEREST POLICY ANNUALLY. EACH INDIVIDUAL IS REQUIRED TO COMPLETE AND SIGN A DOCUMENT PROVIDED BY THE ORGANIZATION DISCLOSING ANY INTEREST THEY MAY HAVE WHICH COULD GIVE RISE TO A CONFLICT OF INTEREST. THE ORGANIZATION COMPILES A LIST OF ALL DISCLOSURES AND REPORTS IT TO ALL MEMBERS OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE BOARD DRAFTED AN EXECUTIVE COMPENSATION PHILOSOPHY TO BE USED WHEN DETERMINING EXECUTIVE COMPENSATION FOR THE ORGANIZATION. THIS PHILOSOPHY WILL BE UTILIZED TO DETERMINE THE ANNUAL COMPENSATION OF THE CHIEF EXECUTIVE OFFICER (CEO) AND THE CHIEF FINANCIAL OFFICER (CFO). AS PART OF THIS PROCESS, THE COMPENSATION COMMITTEE CONTRACTED WITH RODEGHERO AND ASSOCIATES TO ASSIST IN THE DEVELOPMENT OF FAIR MARKET VALUE EXECUTIVE COMPENSATION. DR. JAMES RODEGHERO, A COMPENSATION AND BENEFIT EXPERT, CREATED AN EXECUTIVE COMPENSATION GUIDELINE FOR THE CEO AND CFO USING COMPARISON DATA FROM MULTIPLE PUBLIC INFORMATION SECTORS. THOSE SOURCES INCLUDED: ERI: FOUNDATIONS (ASSETS) BASE, ERI: COMMUNITY FOUNDATIONS (FTE'S) BASE, ERI: COMMUNITY FOUNDATIONS (BUDGET) BASE, CHRONICLE OF PHILANTHROPY (REGRESSED TO THE ORGANIZATION ASSETS) BASE, CHRONICLE OF PHILANTHROPY (NORMS; ALL) (ASSETS) BASE; ERI PROPERTY MANAGEMENT (REVENUE) BASE, AS WELL AS PUBLICLY AVAILABLE 990 FILINGS FOR NONPROFIT ORGANIZATIONS OF A SIMILAR SIZE AND TYPE. MARKET SALARY AVERAGES FOR BOTH THE CEO AND CFO WERE ESTABLISHED USING THIS DATA. THE COMPENSATION COMMITTEE'S RECOMMENDATIONS FOR THE CEO AND CFO WERE RATIFIED BY THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE REPORTING ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION INCURS THE MAJORITY OF THE MANAGEMENT AND GENERAL EXPENSES FORM 990, PART IX, COLUMN (C) MANAGEMENT AND GENERAL EXPENSES: FOR ITS RELATED ORGANIZATIONS LISTED ON SCHEDULE R, PART II OF THIS FORM. AS A RESULT, ITS MANAGEMENT AND GENERAL EXPENSES, AS A PERCENTAGE OF TOTAL EXPENSES, ARE HIGHER THAN WOULD OTHERWISE BE THE CASE. STATEMENTS WERE AUDITED BY AN INDEPENDENT ACCOUTING FIRM AS PART OF CONSOLIDATED FINANCIAL STATEMENTS. THE CONSOLIDATED FINANCIAL STATEMENTS INCLUDED GEORGETOWN HEALTHCARE SYSTEM, GEORGETOWN HEALTHCARE COMMUNITY SERVICES, GEORGETOWN HEALTHCARE FOUNDATION AND GEORGETOWN HEALTHCARE SPECIAL ASSET FOUNDATION. ITS PROCESS FOR SELECTION OF AN INDEPENDENT ACCOUNTANT DID NOT CHANGE FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S OVERSIGHT PROCESS AND DURING THE TAX YEAR. COMMUNITY BENEFIT REPORT 2012 GEORGETOWN HEALTHCARE SYSTEM, THROUGH ITS GOVERNANCE AND PARTICIPATION IN THE ST. DAVID'S HEALTHCARE PARTNERSHIP, WILL ENSURE THAT HOSPITAL AND HEALTHCARE SERVICES ARE AVAILABLE IN THE GEORGETOWN AREA, REGARDLESS OF THE ABILITY OF THE PATIENT TO PAY FOR SUCH SERVICES. ADDITIONALLY, GEORGETOWN HEALTHCARE SYSTEM'S CURRENT ACTIVITIES INCLUDE INVOLVEMENT WITH OTHER COMMUNITY NON-PROFIT ORGANIZATIONS THAT OPERATE COMMUNITY HEALTH CENTERS AND OTHER FACILITIES THAT BENEFIT THE PUBLIC, AND MEET THE HEALTH RELATED NEEDS OF THE GEORGETOWN TEXAS COMMUNITY AND THE RESIDENTS OF CENTRAL TEXAS. HOSPITAL SERVICES THE ST. DAVID'S HEALTHCARE PARTNERSHIP PROVIDES A SUBSTANTIAL AMOUNT OF CHARITY CARE TO THE ELDERLY, INDIGENT, AND ECONOMICALLY DISADVANTAGED IN CENTRAL TEXAS. ALL PATIENTS ARE ADMITTED TO EMERGENCY ROOMS REGARDLESS OF THEIR ABILITY TO PAY. IF FURTHER ACUTE INPATIENT CARE IS REQUIRED, PATIENTS FROM THE EMERGENCY DEPARTMENT ARE ADMITTED TO THE HOSPITAL, ALSO WITHOUT REGARD TO THEIR ABILITY TO PAY. THE PARTNERSHIP PROVIDED FOR THE CARE OF THOUSANDS OF CENTRAL TEXANS IN 2012 IN MANY DIFFERENT WAYS. SOME OF THOSE WERE IN THE FORM OF: HOSPITAL ADMISSIONS - 65,018 EMERGENCY ROOM VISITS - 302,588 THE REPORTING ORGANIZATION ALSO PROVIDES THE FOLLOWING DIRECT HEALTHCARE SERVICES: HOME HEALTH SERVICES GEORGETOWN HEALTHCARE SYSTEM (GHS) OPERATES GEORGETOWN HOME HEALTH (GHH), A LOCAL HOME HEALTH AGENCY. GEORGETOWN HOME HEALTH ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. DURING 2012, GHH PROVIDED 6,888 HOME HEALTH VISITS TO 310 PATIENTS IN AND AROUND THE GEORGETOWN, TX AREA. THE PRIMARY PATIENT TYPE FOR THE AGENCY IS MEDICARE. ALCOHOL AND DRUG REHABILITATION GHS THROUGH ITS AFFILIATE GEORGETOWN HEALTHCARE COMMUNITY SERVICES (GHCS), OPERATES AN INPATIENT SUBSTANCE ABUSE FACILITY IN COORDINATION WITH THE RUSK COUNTY TEXAS DEPARTMENT OF CRIMINAL JUSTICE. THE PROGRAM IS A DIVERSION PROGRAM FOR NON-VIOLENT SUBSTANCE ABUSERS REFERRED THROUGH THE CRIMINAL JUSTICE SYSTEM. THE CENTER PROVIDED 24,463 PATIENT DAYS OF CARE. ITS AVERAGE DAILY CENSUS WAS JUST OVER 67 PATIENTS PER DAY. COMMUNITY COLLABORATIONS GEORGETOWN HEALTHCARE SYSTEM (GHS) INVESTS ITS SHARE OF THE EARNINGS FROM THE ST. DAVID'S HEALTHCARE PARTNERSHIP INTO PROGRAMS AND SERVICES THAT PROVIDE A BENEFIT TO THE LOCAL COMMUNITY. DURING 2012, GHS PROVIDED DIRECT FINANCIAL SUPPORT OR IN-KIND DONATIONS TO THE FOLLOWING NOT-FOR-PROFIT ORGANIZATIONS AND/OR FUNCTIONS : LONE STAR CIRCLE OF CARE LONE STAR CIRCLE OF CARE (LSCC) IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) BASED IN GEORGETOWN, TX THAT PROVIDES HEALTHCARE SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN 2012, LSCC PROVIDED OVER 339,000 VISITS TO 84,211 PATIENTS. IT PROVIDED OVER $14,000,000 IN UNCOMPENSATED CARE (STATED AT COST). GHS PROVIDED BOTH DIRECT AND INDIRECT FINANCIAL SUPPORT TO LSCC DURING THIS REPORTING PERIOD. DURING THIS REPORTING PERIOD, GHS CONTRIBUTED $524,000 TO HELP OFFSET LONE STAR'S UNCOMPENSATED CARE. GHS STAFF ALSO DONATED MANAGEMENT SERVICES ASSISTANCE TO LSCC TO FURTHER DEVELOP AND IMPLEMENT THEIR KEY INITIATIVES IN 2012. BOTH ORGANIZATIONS SHARE THE PURSUIT OF PROVIDING QUALITY, ACCESSIBLE AND SUSTAINABLE PRIMARY HEALTHCARE FOR WILLIAMSON COUNTY RESIDENTS, FOCUSING ON THE UNINSURED AND UNDERSERVED. BOYS & GIRLS CLUB OF GEORGETOWN THE BOYS AND GIRLS CLUB OF GEORGETOWN PROVIDES AFTER SCHOOL AND SUMMER PROGRAMS TO THE YOUTH OF THE COMMUNITY. NO CHILD IS EXCLUDED FROM MEMBERSHIP REGARDLESS OF THEIR ABILITY TO PAY MEMBERSHIP FEES. THEY OFFER CHILDREN AGES 6 - 18 PROGRAMS RANGING FROM CHARACTER & LEADERSHIP TRAINING, CAREER & EDUCATION COUNSELING, HEALTH & LIFE SKILLS, THE ARTS, AND SPORTS FITNESS & RECREATION. RIDE ON CENTER FOR KIDS RIDE ON CENTER FOR KIDS (ROCK) IS THE LARGEST PROVIDER OF EQUINE ASSISTED ACTIVITIES AND THERAPY IN CENTRAL TEXAS. THEY ARE A PREMIER ACCREDITED NARHA CENTER THAT PROVIDES PHYSICAL THERAPY AND OCCUPATIONAL THERAPY. THE REPORTING ORGANIZATIONS SUPPORT ENABLED ROCK TO CONTINUE TO DEVELOP AND EXPAND PROGRAMS ASSOCIATED WITH THEIR STRATEGIC PLAN. WILLIAMSON COUNTY CHILDREN'S ADVOCACY CENTER THE WILLIAMSON COUNTY CHILDREN'S ADVOCACY CENTER EXISTS AS A CHILD-FRIENDLY PLACE TO INTERVIEW ABUSED OR NEGLECTED CHILDREN AND TEENS, OR YOUTH WHO HAVE WITNESSED A VIOLENT CRIME. THE CENTER CONTAINS BOTH MEDICAL FORENSIC EXAMINATION ROOMS AND ROOMS FOR COUNSELING SERVICES. THE REPORTING ORGANIZATIONS SUPPORT ENABLED THE CENTER TO EXPAND THE COUNSELING SERVICES. THE GEORGETOWN PROJECT GHS PROVIDED DIRECT FINANCIAL SUPPORT AND ACTIVELY PARTICIPATED IN THE GEORGETOWN PROJECT (TGP) ACTIVITIES. TGP IS A LOCAL NON-PROFIT ORGANIZATION THAT DEVELOPS INITIATIVES DESIGNED TO IMPROVE THE LIVES OF GEORGETOWNS CHILDREN, YOUTH, AND FAMILIES. THE ORGANIZATION SPEARHEADS OTHER PROGRAMS SUCH AS BRIDGES TO GROWTH, THE AFTER SCHOOL ACTION PROGRAM, STARS (A DRUG AND ALCOHOL PREVENTION PROGRAM FOR MIDDLE SCHOOL STUDENTS AND THEIR FAMILIES), KID CITY, AND THE COMMUNITY INTERACTION PARTNERSHIP. GEORGETOWN PARTNERS IN EDUCATION (PIE) PIE IS A NON-PROFIT ORGANIZATION THAT SEEKS TO ENCOURAGE AND PREPARE GEORGETOWN'S STUDENTS FOR SUCCESS IN SCHOOL, IN THE WORKPLACE, IN THE COMMUNITY, AND IN THEIR PERSONAL LIVES. PIE IS A PARTNERSHIP BETWEEN GEORGETOWN INDEPENDENT SCHOOL DISTRICT, THE GEORGETOWN CHAMBER OF COMMERCE, SOUTHWESTERN UNIVERSITY, AND MOST IMPORTANTLY, THE GEORGETOWN COMMUNITY. SOME OF THE PROGRAMS AND SERVICES PROVIDED BY PIE ARE : PROJECT MENTOR, HELPING HAND TUTOR, BUSINESS LINK, SUN CITY PARTNERS IN EDUCATION, EDUCATION FOUNDATION, PARTNERSHIP CONTRIBUTIONS, AND TEACHER GRANTS. GEORGETOWN COMMUNITY RESOURCE CENTER THE GEORGETOWN COMMUNITY RESOURCE CENTER WORKS WITH COMMUNITY MEMBERS TO IDENTIFY GAPS IN COMMUNITY PROGRAMS AND SERVICES AND ATTEMPTS TO RECRUIT NON-PROFIT AGENCIES INTO THE COMMUNITY TO FILL THIS VOID. THE ORGANIZATION PROVIDES A BUILDING WITH OFFICE SPACE TO THE COMMUNITY RESOURCE CENTER WHICH IN TURN IS PROVIDED TO AGENCIES SERVING THE COMMUNITY. THE NON-CASH ASSISTANCE REPRESENTS THE DIFFERENCE BETWEEN THE MARKET VALUE OF THE SPACE PROVIDED AND THE ACTUAL RENT CHARGED. VOLUNTEER SERVICES GHS MAINTAINS AN ACTIVE VOLUNTEER SERVICES PROGRAM AT ST. DAVIDS GEORGETOWN HOSPITAL. THE PROGRAM IS COMPRISED OF APPROXIMATELY 147 COMMUNITY MEMBERS THAT SERVE IN VARIOUS VOLUNTEER ROLES THROUGHOUT THE HOSPITAL. IN 2012, THE VOLUNTEER SERVICES PROGRAM PROVIDED 17,461 HOURS OF VOLUNTEER SUPPORT TO THE HOSPITAL IN CAPACITIES RANGING FROM PATIENT AND FAMILY ASSISTANCE TO ADMINISTRATIVE/CLERICAL SUPPORT IN VARIOUS DEPARTMENTS OF THE HOSPITAL. A CONSERVATIVE ESTIMATED VALUE OF THIS SERVICE IS APPROXIMATELY $209,532. GEORGETOWN HEALTHCARE COMMUNITY SERVICES 2425 WILLIAMS DRIVE GEORGETOWN TX 78628 742865171 TO ASSIST GEORGETOWN HEALTHCARE SYSTEM. TX 501(C)(3) LINE 9 GEORGETOWN HEALTHCARE SYSTEM 0 GEORGETOWN HEALTHCARE FOUNDATION 2425 WILLIAMS DRIVE GEORGETOWN TX 78628 742626552 TO ASSIST GEORGETOWN HEALTHCARE SYSTEM. TX 501(C)(3) LINE 11A, I GEORGETOWN HEALTHCARE SYSTEM 0 GEORGETOWN HEALTHCARE SPECIAL ASSET FOUNDATION 2425 WILLIAMS DRIVE GEORGETOWN TX 78628 743023706 TO ASSIST GEORGETOWN HEALTHCARE SYSTEM. TX 501(C)(3) LINE 11B, II GEORGETOWN HEALTHCARE SYSTEM 0 0 0 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 ST DAVID'S HEALTHCARE PARTNERSHIP LP LLP 98 SAN JACINTO BLVD STE 1800 AUSTIN TX 78701 742781812 OPERATES HOSPITALS IN CENTRAL TEXAS. TX RELATED 0 2128546 12571850 0 0 0.01000