2024-08-07T12:10:20-05:00 2023-09-30 Forvis Mazars LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2022-10-01 752717782 JPS Foundation % COURTNEY BOEDEKER JPSF 8177027310 1350 S Main Street Suite 4000 Fort Worth TX 76104 Rory McCrady Interim CFO TCHD 8177023869 2024-08-15 true Jeanette Verrelli P00742631 9727028262 2022 2024-08-08 14:25:15Z KAREN DUNCAN 1350 S MAIN STREET STE 4000 FORT WORTH TX 76104 3308685 false X WWW.JPSHEALTHNET.ORG/FOUNDATION X 1997 TX JPS FOUNDATION IS A NONPROFIT WHOSE PURPOSE IS TO PERFORM SERVICES ON BEHALF OF THE TARRANT COUNTY HOSPITAL DISTRICT, INCLUDING ... (CONTINUED ON SCHEDULE O) 4 3 0 3 0 0 2082653 2872879 69350 113730 113895 256845 37508 394 2303406 3243848 667632 1603047 0 0 0 0 0 0 25705 991293 1945913 1658925 3548960 644481 -305112 7046352 7270099 142343 245842 6904009 7024257 JPS FOUNDATION IS A PUBLIC/PRIVATE COLLABORATION DEDICATED TO ACTS OF SERVICE AND SUPPORT TO IMPROVE THE HEALTH STATUS OF FAMILIES RECEIVING HEALTH CARE VIA JPS HEALTH NETWORK. IT IS THE FOUNDATION FOR JPS HEALTH NETWORK. false false 3461709 1603047 114124 FOR THE YEAR ENDED SEPTEMBER 30, 2023, HEALTH AND HUMAN ASSISTANCE SERVICES WERE PROVIDED FOR PATIENTS AND EMPLOYEES OF THE TARRANT COUNTY HOSPITAL DISTRICT DBA JPS HEALTH NETWORK (TCHD) THROUGH PATIENT ASSISTANCE, DENTAL VOUCHERS, AND EMPLOYEE GIVING CAMPAIGN. JPS FOUNDATION ALSO PROVIDES SUPPORT FOR ACTIVITIES OF TCHD, THE SUPPORTED ORGANIZATION, INCLUDING CAPITAL PROJECTS AND OTHER PROGRAMS. 3461709 true true false false false true false false false true true false false false true false false true false false false false false false false false false true true true false false false false false false false false true false false false false true true true false false true 36 0 true 0 false false false false false false false false false false false false false false false X 4 3 false false false false false true false true true false false false true true true true true false false false X COURTNEY BOEDEKER 8177023869 1350 S MAIN STREET STE 4000 FORT WORTH TX 76104 KAREN DUNCAN PRESIDENT AND CEO TCHD 2.0 38.0 X 0 1315428 317476 CHERYL SUTTERFIELD JPSF PRESIDENT 40.0 0.0 X X 0 246852 36596 Teresa Yeargins Director of Development 40.0 0.0 X 0 115486 38299 AMANDA ARIZOLA JPS BOARD OF MANAGERS LIAISON 1.0 0.0 X 0 0 0 LARRY ANFIN Chair 1.0 0.0 X X 0 0 0 LAURA WHEAT Director 1.0 0.0 X 0 0 0 0 1677766 392371 0 false true false 0 775290 15094 2082495 876589 2872879 OTHER OPERATING REVENUE 624100 113730 113730 113730 246234 246234 0 0 0 0 0 75448 64837 10611 10611 10611 0 0 0 0 0 0 0 0 0 MISCELLANEOUS REVENUE 900099 394 394 394 3243848 114124 256845 X 876589 876589 726458 726458 0 0 0 0 0 0 0 0 0 1935 1935 0 0 0 24858 24858 697285 674112 4088 19085 0 217211 199475 11116 6620 22485 22485 0 38048 37424 624 44767 44767 0 44105 43166 939 0 0 0 0 COMMUNITY RELATIONS 89745 89745 TRAINING EXPENSES 197249 194472 2777 EQUIPMENT EXPENSES 523097 522594 503 DUES & SUBSCRIPTIONS 13067 1686 11381 32061 26801 5260 3548960 3461709 61546 25705 0 0 2711663 2418496 70000 0 0 47269 0 0 0 0 0 0 0 0 29201 9657 23829 23829 4217647 4747774 0 0 0 0 0 0 17841 46903 7046352 7270099 20618 8198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121725 237644 142343 245842 X 4141930 4518590 2762079 2505667 6904009 7024257 7046352 7270099 -305112 425360 X X false true X false false X 2175215 2672238 2431366 2082653 2872879 12234351 0 0 2175215 2672238 2431366 2082653 2872879 12234351 440799 11793552 58676 97758 63540 120004 246234 586212 0 28824 28824 12849387 634147 0.91783 0.88840 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 250000 377252 false false 509329 8500 43126 6267 554688 594430 5000 -83486 6615 509329 537531 10000 53510 6611 594430 512446 1025 30036 5976 537531 417876 62173 38333 5936 512446 0.73720 0.26280 false false 23829 23829 0 0 0 DUE TO AFFILIATES 237644 237644 4650479 425360 1006129 1431489 3218990 24858 24858 3243848 4530231 1006129 1006129 3524102 24858 24858 3548960 SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. Schedule D, Part V, Line 4 INTENDED USE OF ENDOWMENT FUNDS: THE PERMANENTLY RESTRICTED NET ASSETS OF JPS FOUNDATION REPRESENT FUNDS RESTRICTED BY THE DONOR TO ESTABLISH A PERMANENT ENDOWMENT. THE INCOME FROM THE ALCON OPHTHALMOLOGY ENDOWMENT IS FOR THE OPHTHALMOLOGY TEACHING PROGRAM AT JPS. THE INCOME FROM THE HEALING WINGS ENDOWMENT WAS ESTABLISHED FOR THE ONGOING PRESERVATION OF THE HEALING WINGS UNIT. THE MEDICAL LIBRARY ENDOWMENT MAY BE SPENT ON EQUIPMENT AND MATERIALS TO IMPROVE THE MEDICAL LIBRARY. THE INCOME FROM THE JPS HEALTH NETWORK ENDOWMENT FOR PODIATRIC RESIDENCY IS ALLOCATED 25% TO UNRESTRICTED FUNDS TO SUPPORT THE OVERALL MISSION OF THE FOUNDATION AND 75% TO SUPPORT THE JPS PODIATRIC RESIDENCY PROGRAM. true Tarrant County Hospital District 1500 S Main Street Fort Worth TX 76104 756000439 501(C)(3) 876589 Improve Health Status of Community 1 PATIENT ASSISTANCE 1230 107177 EMPLOYEE ASSISTANCE 69 51557 PATIENT TRANSPORTATION 2867 11615 ACA CONNECTION SUPPLEMENTAL TO INSURANCE 2798 556109 MONITORING USE OF GRANT FUNDS IN THE UNITED STATES MONITORING USE OF GRANT FUNDS IN THE UNITED STATES: Patient assistance for medical treatment, transportation, rent payments, utilities, and supplies - requests for distributions from these funds are submitted from the social services department to the JPS foundation. Upon receipt, the requests are reviewed and approved by the management at JPS Foundation for check disbursement. A log of gas cards and bus passes is reviewed monthly. Employee emergency assistance - for a JPS employee to submit an application for emergency assistance, they must meet the criteria of (1) full time employment at JPS for at least six months or part time for one year, (2) no disciplinary actions within the last twelve months or currently under investigation with any major area of concern, and (3) situation must be a naturally occurring emergency or catastrophe (fire, flood, tornado, etc). applications for emergency assistance are submitted to the JPS Employee Assistance Department and forwarded to a review committee and a majority decision vote is made to approve or reject the application. Approved applications are forwarded to the accountant for payment of emergency expenses from the fund. Assistance is done by paying bills directly. It is intended to help with life sustaining or essential expenses. Typically, life sustaining or essential includes utilities, car payment, house payment, apartment rent, travel (to attend funeral or reach bedside of terminally ill family member), food, etc. Direct payments to the employee typically are not made. The maximum amount of assistance per employee in an eighteen-month period is $1,500. The JPS health network will donate funds to the foundation to cover eligible patient expenses. The network established the JPS connection program to assist individuals who need medical assistance but are without the financial means to afford necessary medical services. The network will identify a portion of the network's eligible JPS connection population who are eligible for enrollment and/or may enroll in the future in a qualified health plan or stand-alone dental plan and lack the financial resources for payment of the required insurance premiums and other eligible patient expenses. Only the patients' needs and not their health status is considered. Assistance, where applicable, must cover the entire policy year, be provided in amounts that are consistent with applicable fair market value, and be consistent with applicable network policies and procedures. payments are then wired weekly from the JPS foundation to various physician networks that provide services to these patients. false true false false false false false false false KAREN DUNCAN PRESIDENT AND CEO TCHD 0 812712 0 408184 0 94532 0 306359 0 11117 0 1632904 Teresa Yeargins Director of Development 0 99512 0 13021 0 2953 0 4209 0 34090 0 153785 CHERYL SUTTERFIELD JPSF PRESIDENT 0 194722 0 19554 0 32576 0 23175 0 13421 0 283448 SCHEDULE J, PART I, LINE 3 EXECUTIVE COMPENSATION: THE TARRANT COUNTY HOSPITAL DISTRICT, A RELATED ORGANIZATION, DETERMINES COMPENSATION OF THE FOUNDATION'S EXECUTIVE DIRECTOR THROUGH THE USE OF THE FOLLOWING: - COMPENSATION SURVEYS OR STUDIES - COMPENSATION CONSULTANTS - APPROVAL BY THE EXECUTIVE ADMINISTRATOR OVER THE DEPARTMENT Schedule J, Part I, Line 4b Supplemental Nonqualified Retirement Plan: JPS Health Network offers a Long-Term Incentive Plan (LTIP) to executive leadership employees. The deferred compensation plan is in compliance with the IRC section 457(f), ineligible deferred compensation plan sponsored by a tax exempt organization. The following participated in the plan during FY23. Participant W-2 Deferred Comp ------------- --------- --------------- Karen Duncan $319,103 $259,609 Cheryl Sutterfield None $14,607 X 360 FMV X 873726 FMV X 6 2503 FMV false true false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTIONS OR ITEMS RECEIVED: THE AMOUNTS REPORTED IN THIS COLUMN ARE THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS WHO CAN ELECT MEMBERS OF THE GOVERNING BODY: AT ALL TIMES THE JPS FOUNDATION BOARD WILL CONSIST OF MEMBERS OF THE TCHD BOARD, THE TCHD CEO AND PERSONS SELECTED BY THE TCHD CEO. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR, CONTROLLER AT TARRANT COUNTY HOSPITAL DISTRICT AND JPS FOUNDATION PRESIDENT PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: MEMBERS ARE ASKED TO DISCLOSE, ANNUALLY, ANY BUSINESS RELATIONSHIPS THAT POTENTIALLY GIVE RISE TO CONFLICTS. ANY CONFLICTS THAT ARISE ARE RESOLVED AT THE BOARD LEVEL. IN THE EVENT OF A CONFLICT, THE BOARD MEMBER ABSTAINS FROM VOTING AND DISCUSSION OF THE RELATED MATTER. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO AVAILABLE ON THE JPS HEALTH NETWORK WEBSITE. FORM 990, PART VI, SECTION B, LINE 15A REVIEW OF CEO OF TOP MGMT OFFICIAL COMPENSATION: NO COMPENSATION IS PAID BY JPS FOUNDATION. COMPENSATION IS PAID THROUGH TARRANT COUNTY HOSPITAL DISTRICT WHICH REVIEWS, APPROVES, AND SETS ALL SALARIES. FORM 990, PART I, LINE 1 ORGANIZATION'S MISSION: CONTINUED FROM FORM 990, PART I... ORGANIZING FUNDRAISING ACTIVITIES, PROVIDING PATIENT ASSISTANCE PROGRAMS, PARTICIPATING IN RECRUITING FUNCTIONS AND CONDUCTING ADMINISTRATIVE SERVICES. FORM 990, PART XII, LINE 2C: COMMITTEE RESPONSIBLE OVER THE AUDIT: TARRANT COUNTY HOSPITAL DISTRICT, A RELATED ORGANIZATION, ALONG WITH ITS BOARD OF MANAGERS, HAVE THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:376984 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:282171 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTATION FEES TOTAL FEES:24503 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:13627 TARRANT COUNTY HOSPITAL DISTRICT 1500 SOUTH MAIN STREET FORT WORTH TX 76104 756000439 HEALTHCARE TX 501(C)(3) 6 NA false ACCLAIM PHYSICIAN GROUP 200 W MAGNOLIA AVE SUITE 20 FORT WORTH TX 761047644 352526373 HEALTHCARE TX 501(C)(3) 3 TCHD true TCHD PUBLIC FACILITY CORPORATION 1500 SOUTH MAIN STREET FORT WORTH TX 76104 384224168 PUBLIC FACILITY TX TCHD C CORPORATION true false true true false true false false false false false false true false true true true true true false Acclaim Physician Group E 430939 FMV