2024-05-02T12:01:05+00:00 2023-06-30 346565596 ERNST & YOUNG US LLP 425 HOUSTON ST FORT WORTH TX 76102 990 2022-07-01 831683025 Gainesville Community Hospital Inc GAIN 9406651751 1900 HOSPITAL BLVD GAINESVILLE TX 76240 THOMAS SLEDGE Chief Executive Officer 9406128616 2024-05-02 true JAMES HILL 999009999 Melva Scott P01207335 8173351900 2024-04-30 2022 2023-04-26 12:10:37Z NORTH TEXAS MEDICAL CENTER THOMAS SLEDGE 1900 HOSPITAL BLVD GAINESVILLE TX 76240 43911930 false X WWW.NTMCONLINE.NET X 2018 TX THE MISSION OF GAINESVILLE COMMUNITY HOSPITAL IS TO PROVIDE EXCEPTIONAL PATIENT CENTERED CARE. 3 0 418 36 0 0 1297000 853582 43409694 42634731 0 0 537587 244219 45244281 43732532 0 0 0 0 21634651 23332855 0 0 0 22187708 21583393 43822359 44916248 1421922 -1183716 17103108 15857179 10456488 10377197 6646620 5479982 NONE false false 29855821 42855331 SEE SCHEDULE O 29855821 true false false true false false false false false true false false false true false true 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 true false true false true 28 0 true 418 true false false false false false false false false false false false false X 3 0 false true false false true true true true true false false true true true true true true false false false X THOMAS SLEDGE 9406128616 1900 HOSPITAL BLVD GAINESVILLE TX 76240 JOE THOMASON Director/President 1.0 39.0 X X 0 472603 52506 JIM KENDRICK Director 0.2 39.8 X 0 1521874 138727 Shane Lee Director 1.0 0 X 0 0 0 JAMES HILL Treasurer 0.4 39.6 X 0 394083 38701 LINDA MOORE Secretary 0.1 39.9 X 0 424165 33792 SHELLE DIEHM CFO (Until 12/22) 40.0 0 X 0 217761 52265 Tania LeMons CFO (Start 12/22) 40.0 0 X 0 14111 795 THOMAS SLEDGE CEO 40.0 0 X 0 312889 52265 Bonnie Hess CNO 40.0 0 X 0 143941 10002 BHUPINDER KHAIRA MD GENERAL SURGEON 40.0 0 X 676891 0 0 Cedric L Buckley DO Internal Med. Physician 40.0 0 X 241410 0 0 CHRISTIAN VISSERS MD ORTHOPEDIC SURGEON 40.0 0 X 635215 0 0 Elizabeth S Newman DO OB/GYN Physician 40.0 0 X 305564 0 0 ZAIRA JORAI-KHAN DO OB/GYN PHYSICIAN 40.0 0 X 365984 0 0 2225064 3501428 379054 15 false true false MEDICAL SOLUTIONS LLC PO BOX 310737 DES MOINES IA 50331 contract clinical labor 1152740 FARAHAT AND ASSOCIATES PLLC 8831 CEDAR RIDGE LANTANA TX 76226 hospitalist group 663900 NOBLE ASSET MANAGEMENT LLC 2501 Scripture St Ste 300 Denton TX 76201 Contracted Physician 127321 3 0 0 0 0 853582 0 0 853582 PATIENT SERVICE REVENUE 622110 38614577 38614577 0 0 SUPPLEMENTAL STATE FUNDING 622110 4020154 4020154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42634731 0 0 0 0 0 0 0 0 0 0 0 0 203017 179398 23619 0 23619 0 0 23619 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 Outsourced Pharmacy Staffing 622110 60425 60425 TOBACCO FUND REVENUE 622110 113773 113773 Trauma Fund Revenue 622110 21525 21525 24877 24877 0 0 220600 43732532 42855331 0 23619 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18779200 15398944 3380256 375714 90171 285543 2877814 690675 2187139 1300127 312030 988097 509883 509883 41682 41682 191458 191458 769 769 8758491 5603515 3154976 0 119800 119800 1183762 1183762 1514120 1029602 484518 160682 160682 352401 352401 323657 220087 103570 362935 225020 137915 MEDICAL SUPPLIES 3892745 3892745 REPAIRS & MAINT/CONTRACT 847497 432222 415275 LEASES/EQUIPMENT RENTAL 1182672 650470 532202 Legal Settlement 215000 215000 1925839 1309571 616268 0 44916248 29855821 15060427 0 4297483 754091 0 0 0 0 4075330 7876575 0 0 0 0 0 0 773627 728032 761926 642100 7356758 1500377 6764536 5856381 0 0 0 0 0 0 430206 0 17103108 15857179 3747649 5295676 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6708839 5081521 10456488 10377197 X 5612667 5196017 1033953 283965 0 0 0 0 0 0 6646620 5479982 17103108 15857179 X -1183716 17078 X false true X true false X false false false false false false false false true 769 769 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY IN FISCAL YEAR 2023 Gainesville Community Hospital PAID $4,483 TO TEXAS HOSPITAL ASSOCIATION, (THA). THE PORTION OF DUES THAT WERE REPORTED FOR LOBBYING PURPOSES BY THA WERE 17.16% TOTAL DUES PAID AND REPORTED FOR LOBBYING ACTIVITIES WERE: THA: $4,484* 17.16%= $769 399267 177982 221285 2481523 1322395 1159128 4475968 0 4475968 5856381 DUE TO THIRD PARTY PAYERS 295223 LIMITED PAYBACK TO GAINESVILLE HOSP Current Lease Liability - Operating 1061646 long term lease liablity - operating 3366908 related party payables 357744 5081521 43911930 0 0 43911930 -179398 -179398 43732532 45095646 0 0 45095646 -179398 -179398 44916248 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements RENTAL EXPENSE - -179398 Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements RENTAL EXPENSE - -179398 true true X true X true X true true true false true true 2943039 175 2942864 0.0655 4413993 4353095 60898 0.0014 0 0.0 0 0 7357032 4353270 3003762 0.0669 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 0 0 7357032 4353270 3003762 0.0669 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 12931505 17515144 -4583639 X true true 1 1 NORTH TEXAS MEDICAL CENTER 1900 HOSPITAL BLVD GAINESVILLE TX 76240 HTTPS://NTMCONLINE.NET 100453 X X X NORTH TEXAS MEDICAL CENTER 1 false false true X X X X X X X X X 22 true false false true X https://ntmconline.net/your-hospital/community-health-needs-assessment/ X true 22 true https://ntmconline.net/your-hospital/community-health-needs-assessment/ false true X 200.0 400.0 X X X true true X X X true X https://ntmconline.net/YOUR-HOSPITAL/FINANCIAL-ASSISTANCE/ X https://ntmconline.net/YOUR-HOSPITAL/FINANCIAL-ASSISTANCE/ X https://ntmconline.net/YOUR-HOSPITAL/FINANCIAL-ASSISTANCE/ X X X X X X false X false X true X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED IN THE CHNA ARE PRESENTED AS A PRIORITIZED DESCRIPTION. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - NORTH TEXAS MEDICAL CENTER. NORTH TEXAS MEDICAL CENTER, (NTMC), IS AN ACUTE CARE HOSPITAL LOCATED IN GAINESVILLE, TEXAS AND SERVES THE RESIDENTS OF COOKE, EASTERN MONTAGUE, WESTERN GRAYSON AND NORTHERN DENTON COUNTIES IN TEXAS AND SOUTHERN LOVE COUNTY, OKLAHOMA. NTMC IS OPERATED BY COMMUNITY HOSPITAL CORPORATION AND OWNED BY GAINESVILLE HOSPITAL DISTRICT. THE 125,000-SQUARE-FOOT MEDICAL CENTER HOUSES 42 MEDICAL/SURGICAL BEDS, A 6-BED INTENSIVE CARE UNIT, AND A 12-BED WOMEN'S CENTER WITH A DEDICATED C-SECTION OPERATING SUITE. THE HOSPITAL FEATURES AN 11-BED EMERGENCY ROOM WITH 3 TRAUMA ROOMS, 4 OPERATING ROOMS, 2 PROCEDURE ROOMS, 2 INPATIENT SLEEP STUDY ROOMS AND 3 WOUND CARE TREATMENT AREAS. ADDITIONALLY, NTMC OFFERS THERAPY, LABORATORY AND MOST MEDICAL IMAGING SERVICES. THE DEFINED SERVICE AREA OF NTMC IS COOKE COUNTY. COOKE COUNTY COMPRISED 78% OF FY2022 INPATIENT DISCHARGES. THE POPULATION OF COOKE COUNTY IS EXPECTED TO INCREASE BY 2.1% FROM 2022 (42,275) TO 2027 (43,158), WHICH IS BELOW THE 4.5% EXPECTED GROWTH FOR THE STATE OF TEXAS FROM 2022 (30,157,100) TO 2027 (31,502,395). AS OF 2022, THE RACIAL/ETHNIC BREAKOUT OF COOKE COUNTY WAS 75.1% WHITE NON HISPANIC, 3.0% BLACK, 0.8% ASIAN, 1.3% AMERICAN INDIAN AND 19.8% ALL OTHERS. HISPANIC IS CLASSIFIED AS AN ETHNICITY AND THEREFORE, IS CATEGORIZED SEPARATELY FROM WHITE, BLACK, ASIAN, AMERICAN INDIAN AND ALL OTHERS. BY 2027 THE WHITE NON-HISPANIC POPULATION IN COOKE COUNTY IS EXPECTED TO DECREASE BY 0.5% AND THE BLACK POPULATION IS EXPECTED TO INCREASE BY 6.1%. BY 2027, THE ASIAN POPULATION IN COOKE COUNTY IS EXPECTED TO INCREASE BY 4.7% AND THE AMERICAN INDIAN POPULATION IS EXPECTED TO INCREASE BY 6.1%. BY 2027, ALL OTHER RACIAL ETHNIC GROUPS IN COOKE COUNTY ARE EXPECTED TO INCREASE BY 11.0%. THE HISPANIC POPULATION OF 8,893 IS EXPECTED TO INCREASE TO 9,593, BY 2027. AS OF 2022, COOKE COUNTY (41.0 YEARS) HAD AN OLDER MEDIAN AGE THAN THE STATE OF TEXAS (35.4 YEARS). THE MEDIAN AGE IN BOTH COOKE COUNTY AND THE STATE IS EXPECTED TO SLIGHTLY INCREASE OVER THE NEXT FIVE YEARS (2022-2027). COOKE COUNTY ($68,352) HAS A LOWER MEDIAN HOUSEHOLD INCOME THAN THE STATE OF TEXAS ($70,834) (2022). THE MEDIAN HOUSEHOLD INCOME IN BOTH COOKE COUNTY AND THE STATE IS EXPECTED TO INCREASE OVER THE NEXT FIVE YEARS (2022-2027). COOKE COUNTY (23.4%) HAS A LOWER PERCENTAGE OF RESIDENTS WITH A BACHELORS OR ADVANCED DEGREE THAN THE STATE OF TEXAS (33.4%) (2022). IN 2016-2020, 14.8% OF THE NATION LIVED IN A DISTRESSED COMMUNITY, AS COMPARED TO 25.6% OF THE NATION THAT LIVED IN A PROSPEROUS COMMUNITY. IN 2016-2020, 21.2% OF THE POPULATION IN TEXAS LIVED IN A DISTRESSED COMMUNITY, AS COMPARED TO 27.0% OF THE POPULATION THAT LIVED IN A PROSPEROUS COMMUNITY. IN 2016-2020, THE DISTRESS SCORE IN COOKE COUNTY WAS 18, WHICH FALLS WITHIN THE PROSPEROUS ECONOMIC CATEGORY AND IS MORE PROSPEROUS COMPARED TO OTHER COUNTIES IN THE STATE. WITH RESPECT TO UNEMPLOYMENT, RATES IN COOKE COUNTY AND THE STATE OF TEXAS FLUCTUATED BETWEEN 2019 AND 2021. IN 2021, COOKE COUNTY (5.0) HAD A LOWER UNEMPLOYMENT RATE THAN THE STATE (5.7). OVER THE MOST RECENT 12-MONTH TIME PERIOD, MONTHLY UNEMPLOYMENT RATES IN COOKE COUNTY OVERALL DECREASED. AS OF 2020, THE MAJORITY OF EMPLOYED PERSONS IN COOKE COUNTY WERE WITHIN OFFICE & ADMINISTRATION SUPPORT OCCUPATIONS. THE MOST COMMON EMPLOYED GROUPINGS WERE WITHIN OFFICE & ADMINISTRATION SUPPORT OCCUPATIONS (10.9%); PRODUCTION OCCUPATIONS (10.4%); MANAGEMENT OCCUPATIONS (10.1%); SALES & RELATED OCCUPATIONS (7.2%); & CONSTRUCTION AND EXTRACTION OCCUPATIONS (7.1%). COOKE COUNTY (13.0%) HAS A LOWER PERCENTAGE OF FAMILIES LIVING BELOW POVERTY THAN THE STATE OF TEXAS (15.5%) (2022). BETWEEN 2017 AND 2021, THE PERCENTAGE OF CHILDREN (UNDER 18 YEARS) LIVING BELOW POVERTY IN COOKE COUNTY AND THE STATE DECREASED. IN 2022, COOKE COUNTY (19.3%) HAD A LOWER PERCENTAGE OF CHILDREN LIVING BELOW POVERTY THAN THE STATE (19.5%). ACCORDING TO FEEDING AMERICA, AN ESTIMATED 14.8% OF COOKE COUNTY RESIDENTS ARE FOOD INSECURE AS COMPARED TO 14.0% IN TEXAS (2020). ADDITIONALLY, 21.1 % OF THE YOUTH POPULATION (UNDER 18 YEARS OF AGE) IN COOKE COUNTY IS FOOD INSECURE AS COMPARED TO 18.9% IN TEXAS (2020). THE AVERAGE MEAL COST FOR A COOKE COUNTY RESIDENT IS $3.12 AS COMPARED TO $2.76 IN TEXAS (2020). BETWEEN 2015 AND 2019, COOKE COUNTY MAINTAINED A LOWER PERCENTAGE OF RECIPIENTS WHO QUALIFIED FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) BENEFITS THAN THE STATE OF TEXAS. IN 2019, COOKE COUNTY (10.2%) HAD A LOWER PERCENTAGE OF RECIPIENTS WHO QUALIFIED FOR SNAP BENEFITS THAN THE STATE (11.8%). IN 2020-2021, COOKE COUNTY (53.2%) HAS A LOWER PERCENTAGE OF PUBLIC SCHOOL STUDENTS THAT ARE ELIGIBLE FOR FREE/REDUCED PRICE LUNCH THAN THE STATE (60.2%) AND A COMPARABLE RATE TO THE NATION (53.2%). COOKE COUNTY (94.1%) HAS A HIGHER HIGH SCHOOL GRADUATION RATE THAN THE STATE (91.4%) AND THE NATION (87.7%) (2018-2019). HEART DISEASE IS THE LEADING CAUSE OF DEATH IN BOTH COOKE COUNTY AND THE STATE OF TEXAS (2016-2020). BETWEEN 2016 AND 2020, HEART DISEASE MORTALITY RATES IN COOKE COUNTY DECREASED WHILE RATES IN THE STATE REMAINED FLAT. THE HEART DISEASE MORTALITY RATE IN COOKE COUNTY (164.9 PER 100,000) WAS LOWER THAN THE STATE (169.1 PER 100,000). CANCER IS THE SECOND LEADING CAUSE OF DEATH OVERALL IN BOTH COOKE COUNTY AND THE STATE (2016-2020). BETWEEN 2016 AND 2020, CANCER MORTALITY RATES IN COOKE COUNTY INCREASED WHILE RATES IN THE STATE DECREASED. IN 2018-2020, THE CANCER MORTALITY RATE IN COOKE COUNTY (181.5 PER 100,000) WAS HIGHER THAN THE STATE RATE (141.4 PER 100,000). CEREBROVASCULAR DISEASES ARE THE THIRD LEADING CAUSE OF DEATH IN COOKE COUNTY AND IN THE STATE (2016-2020). BETWEEN 2016 AND 2020, CEREBROVASCULAR DISEASE MORTALITY RATE IN COOKE COUNTY INCREASED, AND THE RATE IN THE STATE DECREASED SLIGHTLY. IN 2018-2020, THE CEREBROVASCULAR DISEASE MORTALITY RATE IN COOKE COUNTY (58.7 PER 100,000) WAS HIGHER THAN THE STATE RATE (40.1 PER 100,000). CHRONIC LOWER RESPIRATORY DISEASES (CLRD) ARE THE FOURTH LEADING CAUSE OF DEATH IN COOKE COUNTY AND THE SIXTH LEADING CAUSE OF DEATH IN THE STATE (2016-2020). BETWEEN 2016 AND 2020, CLRD MORTALITY RATES IN COOKE COUNTY INCREASED AND IN THE STATE SLIGHTLY DECREASED. THE CLRD MORTALITY RATE IN COOKE COUNTY (54.1 PER 100,000) WAS HIGHER THAN THE RATE IN THE STATE (38.1 PER 100,000). ALZHEIMER'S DISEASE IS THE FIFTH LEADING CAUSE OF DEATH IN COOKE COUNTY AND IN THE STATE OF TEXAS (2016-2020). BETWEEN 2016 AND 2020, ALZHEIMER'S MORTALITY RATES IN COOKE COUNTY AND THE STATE INCREASED.THE ALZHEIMER'S DISEASE MORTALITY RATE IN COOKE COUNTY (52.3 PER 100,000) WAS HIGHER THAN THE STATE RATE (40.6 PER 100,000). FATAL ACCIDENTS, INTENTIONAL SELF-HARM (SUICIDE), NEPHRITIS, NEPHROTIC SYNDROME AND NEPHROSIS, DIABETES MELLITUS, AND COVID-19 ARE ALSO LEADING CAUSES OF DEATH IN COOKE COUNTY. AS OF 2023, COOKE COUNTY (23.6 PER 100,000) HAS A LOWER RATE OF COVID-19 CASES THAN THE STATE (36.0 PER 100,000). AS OF DECEMBER 8, 2022, COOKE COUNTY HAD A LOWER PERCENT OF ITS POPULATION THAT IS FULLY VACCINATED (40.5%) AS COMPARED TO THE STATE OF TEXAS (58.0%). IN 2019, COOKE COUNTY (21.5%) HAD A LOWER PERCENTAGE OF ADULTS (AGE 20+) WHO REPORTED HAVING A BODY MASS INDEX (BMI) GREATER THAN 30.0 (OBESE) THAN THE STATE RATE (29.8%) AND THE NATION (29.0%). IN 2019, THE PERCENT OF ADULTS (AGE 20+) EVER DIAGNOSED WITH DIABETES BY A DOCTOR IN COOKE COUNTY (7.2%) WAS LOWER THAN THE STATE (9.4%) AND THE NATION (9.0%). IN 2018, THE PERCENT OF MEDICARE BENEFICIARIES WITH DIABETES IN COOKE COUNTY (24.9%) WAS LOWER THAN THE STATE (28.8%) AND THE NATION (27.0%). COOKE COUNTY (60.4%) HAS A HIGHER RATE OF MEDICARE BENEFICIARIES WITH HYPERTENSION THAN THE STATE (59.9%) AND THE NATION (57.2%) (2018). IN 2019-2021, COOKE, WISE, AND GRAYSON COUNTIES (20.6%) HAD A HIGHER PERCENTAGE OF ADULTS (AGE 18+) EVER DIAGNOSED WITH A DEPRESSIVE DISORDER THAN THE STATE (17.8%). IN 2019-2021, THE PERCENT OF ADULTS (AGE 18+) THAT HAD A DISABILITY IN COOKE, WISE, AND GRAYSON COUNTIES (29.0%) WAS HIGHER THAN THE STATE (27.5%). AS OF 2020, COOKE COUNTY (22.6%) HAD A HIGHER RATE OF UNINSURED ADULTS (AGE 18-64) AS COMPARED TO THE STATE OF TEXAS (19.9%). THE PERCENTAGE OF UNINSURED ADULTS (AGE 18-64) IN COOKE COUNTY AND THE STATE INCREASED BETWEEN 2016 AND 2020. A COMPREHENSIVE, SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED FOR NORTH TEXAS MEDICAL CENTER (NTMC), BY COMMUNITY HOSPITAL CORPORATION (CHC). THIS CHNA UTILIZES RELEVANT HEALTH DATA AND STAKEHOLDER INPUT TO IDENTIFY THE SIGNIFICANT COMMUNITY HEALTH NEEDS IN COOKE COUNTY, TEXAS. COMMUNITY INPUT WAS RECEIVED DURING INTERVIEWS CONDUCTED BY CHC FROM NOVEMBER 17, 2022 - DECEMBER 15, 2022. Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - NORTH TEXAS MEDICAL CENTER (CONTINUED). 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 NTMC BOARD REVIEWED AND ADOPTED THE 2023 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN ON MAY 16, 2023. INTERVIEW METHODOLOGY: NTMC WORKED WITH COMMUNITY HOSPITAL CORPORATION, (CHC), IN THE DEVELOPMENT OF ITS CHNA. NTMC 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. THE STUDY AREA FOR NTMC IS BASED ON HOSPITAL INPATIENT DISCHARGE DATA FROM JULY 1, 2021 - JUNE 30, 2022 AND DISCUSSIONS WITH HOSPITAL STAFF. HEALTH DATA WAS ALSO COLLECTED FROM A VARIETY OF SOURCES, INCLUDING BUT NOT LIMITED TO, THE ROBERT WOOD JOHNSON FOUNDATION, TEXAS STATE DEPARTMENT OF HEALTH AND HUMAN SERVICES, SPARKMAP, THE UNITED STATES CENSUS BUREAU, AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). BACKGROUND INFORMATION ABOUT NTMC INCLUDING THE MISSION, VISION, VALUES, AND HOSPITAL SERVICES WERE PROVIDED BY THE HOSPITAL OR TAKEN FROM ITS WEBSITE. POPULATION DEMOGRAPHICS INCLUDE POPULATION CHANGE BY RACE, ETHNICITY, AGE, MEDIAN INCOME ANALYSIS, UNEMPLOYMENT AND ECONOMIC STATISTICS IN THE STUDY AREA. DEMOGRAPHIC DATA SOURCES INCLUDE, BUT ARE NOT LIMITED TO, STRATASAN, THE U.S. CENSUS BUREAU AND THE UNITED STATES BUREAU OF LABOR STATISTICS. NTMC PROVIDED CHC WITH A LIST OF PERSONS WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN COOKE COUNTY AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. FROM THAT LIST, THIRTEEN IN DEPTH INTERVIEWS WERE CONDUCTED, USING A STRUCTURED INTERVIEW GUIDE, WITH THE TWO GROUPS OUTLINED IN 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 61.5% 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. 7.7% OF THOSE PROVIDING INPUT WORK FOR A STATE, LOCAL, TRIBAL OR REGIONAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENT WITH KNOWLEDGE, INFORMATION OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY AND 30.8% OF THOSE PROVIDING INPUT ARE COMMUNITY LEADERS. INTERVIEWEES INCLUDED: -MEGAN ANDERLE: MARKETING DIRECTOR, RENAISSANCE CENTER OF GAINESVILLE -WADE BROWER: MINISTER, HILLCREST CHURCH OF CHRIST -DARA IRWIN: EXECUTIVE DIRECTOR, CASA OF NORTH TEXAS -CHERYL GOMEZ: DIRECTOR, WORKFORCE SOLUTIONS TEXOMA -GINGER JOHNSON: EXECUTIVE DIRECTOR, ABIGAIL'S ARMS COOKE COUNTY FAMILY CRISIS CENTER -EMILY LEWIS, RN: BOARD MEMBER, NORTH TEXAS MEDICAL CENTER; INSTRUCTOR OF NURSING DEPARTMENT, NORTH CENTRAL TEXAS COLLEGE -TOMMY MOORE: MAYOR, CITY OF GAINESVILLE -WILLIAM MYERS: EXECUTIVE DIRECTOR, GAINESVILLE ECONOMIC DEVELOPMENT CORPORATION; BOARD MEMBER, NORTH TEXAS MEDICAL CENTER FOUNDATION -ALEX RUCKER: DIRECTOR, BOYS AND GIRLS CLUB OF COOKE COUNTY -JENNIFER SHUMATE: EXECUTIVE DIRECTOR, GAINESVILLE AREA CHAMBER OF COMMERCE -RONDA SILMON: NURSE SUPERVISOR, TEXAS DEPARTMENT OF STATE HEALTH SERVICES -STEVE STARNES: COUNTY JUDGE, COOKE COUNTY -DES STEWART: SUPERINTENDENT, GAINESVILLE INDEPENDENT SCHOOL DISTRICT EXTENSIVE NOTES WERE TAKEN DURING EACH INTERVIEW AND THEN QUANTIFIED BASED ON RESPONSES, COMMUNITIES AND POPULATIONS (MINORITY, ELDERLY, UN/UNDERINSURED, ETC.) SERVED, AND PRIORITIES IDENTIFIED BY RESPONDENTS. QUALITATIVE DATA FROM THE INTERVIEWS WAS ALSO ANALYZED AND REPORTED. AN EVALUATION OF THE HOSPITAL'S IMPACT WAS ALSO ASSESSED USING A DESCRIPTION OF THE PROGRESS AND/OR COMPLETION OF COMMUNITY BENEFIT ACTIVITIES DOCUMENTED IN THE PREVIOUS IMPLEMENTATION PLAN AND FROM A REPORT PROVIDED TO COMMUNITY HOSPITAL CORPORATION (CHC) BY NTMC OF COMMUNITY BENEFIT ACTIVITY PROGRESS SINCE THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT. POPULATIONS THAT WERE IDENTIFIED AS THE MOST AT RISK FOR INADEQUATE CARE IN THE COMMUNITY BY INTERVIEWEES WERE: YOUTH, ELDERLY, OBSTETRIC POPULATION, LOW INCOME/WORKING POOR, RACIAL/ETHNIC GROUPS, UNDOCUMENTED, VETERANS AND HOMELESS. THESE UNDERSERVED GROUPS WERE IDENTIFIED AS MOST AT RISK FOR INADEQUATE CARE DUE TO THE FOLLOWING: YOUTH - MENTAL HEALTH CONCERNS - LACK OF PREVENTIVE CARE - NEED FOR MORE VISION CARE - SEXUALLY TRANSMITTED INFECTIONS (STIS) - INCREASING SUICIDE RATE - VAPING - LACK OF ENTERTAINMENT, RECREATIONAL ACTIVITIES ELDERLY - TRANSPORTATION BARRIERS - DIFFICULTY USING TELEHEALTH SERVICES - NEED FOR ADDITIONAL COMMUNITY OUTREACH - COST BARRIER TO CARE (MEDICATIONS, DENTAL SERVICES) - LACK OF LOCAL SPECIALIZED SERVICES (GERIATRICIANS) OBSTETRIC POPULATION - LIMITED ACCESS TO LOCAL RESOURCES LOW INCOME/WORKING POOR - ACCESS TO AFFORDABLE CARE -LIMITED COMPUTER SKILLS - LACK OF LOCAL MEAL SERVICES - HIGH RATE OF UNINSURED - INAPPROPRIATE USE OF THE EMERGENCY ROOM RACIAL/ETHNIC - LANGUAGE BARRIERS (NON-ENGLISH SPEAKING) - INCREASING POPULATION (HISPANIC) - LIMITED NUMBER OF BILINGUAL PROVIDERS - LACK OF PREVENTIVE CARE UNDOCUMENTED -TUBERCULOSIS - FOREGOING CARE - LANGUAGE BARRIERS VETERANS - LACK OF ACCESS TO LOCAL CARE - LACK OF AWARENESS OF LOCAL SERVICES HOMELESS - CONFLICTING PERCEPTIONS ON ISSUE OF HOMELESSNESS - LACK OF PROGRAMS - LACK OF AWARENESS OF TRUE NUMBER OF HOMELESS PERSONS - MENTAL HEALTH CONCERNS Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - NORTH TEXAS MEDICAL CENTER, (NTMC). THE MOST RECENTLY CONDUCTED CHNA IDENTIFIED FIVE SIGNIFICANT NEEDS IN THE COMMUNITY SERVED BY NORTH TEXAS MEDICAL CENTER (NTMC), WHICH WERE DETERMINED BY ASSESSING THE PREVALENCE OF THE ISSUES IDENTIFIED FROM THE HEALTH DATA FINDINGS, COMBINED WITH THE FREQUENCY AND SEVERITY OF MENTIONS IN COMMUNITY INPUT. NTMC LEADERSHIP PRIORITIZED THOSE NEEDS 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. THE LIST OF PRIORITIZED NEEDS, IN ORDER OF IMPORTANCE, IS AS FOLLOWS: 1. PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES 2. CONTINUED EMPHASIS ON PROVIDER RECRUITMENT AND RETENTION 3. ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS 4. ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS 5. CONTINUED FOCUS ON COMMUNITY INFRASTRUCTURE ONCE THIS PROCESS WAS COMPLETE, HOSPITAL LEADERSHIP DISCUSSED THE RESULTS AND DECIDED TO ADDRESS FOUR OF THE FIVE HEALTH 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. NTMC WILL CONTINUE TO HOST AND/OR PARTICIPATE IN LOCAL HEALTH-RELATED EVENTS TO PROMOTE HOSPITAL SERVICES, OFFER A VARIETY OF HEALTH SCREENINGS TO THE COMMUNITY, AND/OR SUPPORT OR PARTNER WITH LOCAL ORGANIZATIONS THAT PROVIDE SERVICES TO VULNERABLE POPULATIONS. 1.B. NTMC WILL CONTINUE TO INCREASE EDUCATIONAL OPPORTUNITIES FOR THE PUBLIC CONCERNING WELLNESS TOPICS AND HEALTH RISK CONCERNS. 1.C. NTMC PERSONNEL WILL CONTINUE TO SERVE IN LEADERSHIP ROLES AND AS VOLUNTEERS WITH MANY AGENCIES AND COMMITTEES IN THE COMMUNITY. ADDITIONALLY, NTMC WILL CONTINUE TO PROVIDE STAFF REPRESENTATION AT VARIOUS CONFERENCES AND IN LOCAL CONSORTIUMS FOCUSED AROUND ITS PATIENT POPULATION'S NEEDS. 1.D. NTMC WILL CONTINUE TO INCREASE AWARENESS OF ITS SERVICE OFFERINGS IN THE COMMUNITY THROUGH LOCAL MEDIA OUTLETS, SUCH AS THE RADIO, BILLBOARDS, DIRECT MAIL, FACEBOOK AND ADVERTISEMENTS, UPDATING THE HOSPITAL'S WEBSITE. 1.E. NTMC WILL CONTINUE TO PROVIDE MEDICATION MANAGEMENT RESOURCES TO PATIENTS UPON DISCHARGE AS NEEDED. PRIORITY #2: CONTINUED EMPHASIS ON PROVIDER RECRUITMENT AND RETENTION OBJECTIVE: CONTINUE TO PRIORITIZE PROVIDER RECRUITMENT AND RETENTION BASED ON COMMUNITY NEED 2.A. NTMC WILL CONTINUE TO CONSULT ITS MEDICAL STAFF DEVELOPMENT PLAN REPORT TO DETERMINE THE PHYSICIAN NEEDS OF THE COUNTY AND CONSIDER THE RECRUITMENT OF PROVIDERS ACCORDINGLY. 2.B. NTMC WILL CONTINUE TO STRENGTHEN THE CONTINUUM OF CARE BY INCREASING HEALTH INFORMATION EXCHANGE OPPORTUNITIES, SUCH AS ELECTRONICALLY EXCHANGING PATIENT SUMMARIES OF CARE WITH OTHER PHYSICIANS TO RECONCILE ANY MEDICATION CONCERNS. 2.C. NTMC WILL CONTINUE TO SERVE AS A CLINICAL SITE FOR HEALTH CARE STUDENTS FROM SEVERAL LOCAL ACADEMIC INSTITUTIONS TO ROTATE THROUGH THE FACILITY. 2.D. NTMC WILL CONTINUE TO HOST AREA HIGH SCHOOL STUDENTS DURING THE SUMMER TIME SO THAT THEY MAY OBSERVE DIFFERENT AREAS OF THE HOSPITAL. 2. E. NTMC WILL CONTINUE TO PROVIDE A VARIETY OF PRIMARY AND SPECIALTY CARE SERVICES IN ORDER TO INCREASE ACCESS TO LOCAL CARE FOR RESIDENTS. PRIORITY #3: ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS OBJECTIVE: PROVIDE A POINT OF ACCESS FOR MENTAL HEALTH SERVICES IN THE COMMUNITY 3.A. NTMC IS EVALUATING THE STAFFING OF A LICENSED SOCIAL WORKER IN THE PEDIATRIC CLINIC. 3.B. NTMC WILL CONTINUE TO EVALUATE AND TRANSFER ANY PATIENTS THAT PRESENT TO THE EMERGENCY ROOM WITH A MENTAL OR BEHAVIORAL HEALTH ISSUE TO APPLICABLE FACILITIES AS APPROPRIATE. ADDITIONALLY, A CASE MANAGER WILL PROVIDE A BROCHURE OF COMMUNITY RESOURCES TO APPLICABLE PATIENTS, AND WILL WORK TO UPDATE THE INFORMATION BASED ON NEW AGENCIES IN THE AREA. 3.C. NTMC WILL CONTINUE TO PROVIDE SEXUAL ASSAULT NURSE EXAMINER (SANE) SERVICES IN THE HOSPITAL FOR APPROPRIATE PATIENTS, AND COLLABORATE WITH LOCAL ORGANIZATIONS TO PROVIDE SUPPORT FOR VICTIM ADVOCACY. PRIORITY #4: 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 4.A. NTMC WILL CONTINUE TO HOST AND/OR PARTICIPATE IN FUNDRAISING EVENTS AND DONATION DRIVES TO BENEFIT UNDERSERVED ORGANIZATIONS IN THE COMMUNITY, AS WELL AS EDUCATIONAL EVENTS. 4.B. NTMC WILL CONTINUE STRENGTHENING ITS PARTNERSHIPS WITH LOCAL NURSING HOMES TO PROVIDE LAB AND IMAGING SERVICES. 4.C. NTMC WILL CONTINUE TO WORK WITH SELF PAY PATIENTS ON PAYMENT PLANS AND/OR INSURANCE COVERAGE THROUGH FINANCIAL COUNSELING. 4.D. NTMC WILL CONTINUE TO PROVIDE TRANSLATION SERVICES AND RESOURCES IN MULTIPLE LANGUAGES, INCLUDING FOR THOSE WHO MAY BE VISION AND/OR HEARING IMPAIRED. 4.E. NTMC WILL CONTINUE TO PARTICIPATE IN PROGRAMS TO CONNECT PATIENTS TO AFFORDABLE RESOURCES WHEN AVAILABLE, SUCH AS DISCOUNT PHARMACY PRICING THROUGH THE 340B PHARMACY PROGRAM. 4.F. NTMC PROVIDES THE MD SAVE PROGRAM FOR SELF-PAY AND THOSE WITH HIGH DEDUCTIBLES IN ORDER TO OFFER CERTAIN SERVICES AT A DISCOUNTED RATE TO ASSIST THE COMMUNITY WITH THEIR HIGH DEDUCTIBLE PLANS OR INDIVIDUALS SERVICES WHO ARE UNINSURED. PRIORITIES NOT ADDRESSED: NTMC DECIDED NOT TO SPECIFICALLY ADDRESS "CONTINUED FOCUS ON COMMUNITY INFRASTRUCTURE." BASED ON NTMC'S STATUS AS AN ACUTE CARE FACILITY, THE HOSPITAL HAS FOCUSED ITS CAPABILITIES ON ADDRESSING THE NEEDS OF THIS PARTICULAR MARKET. THEREFORE, "CONTINUED FOCUS ON COMMUNITY INFRASTRUCTURE" ARE NOT DIRECTLY ADDRESSED IN THE HOSPITAL'S IMPLEMENTATION PLAN. WHILE NTMC ACKNOWLEDGES THAT THIS IS A SIGNIFICANT NEED IN THE COMMUNITY, THE HOSPITAL WILL CLOSELY MONITOR POPULATION GROWTH AND RESPOND ACCORDINGLY AND WITHIN ITS CAPABILITIES. NTMC WILL CONTINUE TO SUPPORT LOCAL ORGANIZATIONS AND EFFORTS TO ADDRESS THIS NEED IN THE COMMUNITY. Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - NORTH TEXAS MEDICAL CENTER. GAINESVILLE COMMUNITY HOSPITAL, INC. (NORTH TEXAS MEDICAL CENTER) DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTION ON ANY OUTSTANDING PATIENT ACCOUNTS. 7 COOKE COUNTY MEDICAL CENTER 1902 HOSPITAL BOULEVARD GAINESVILLE TX 76240 RURAL HEALTH CLINIC NTMC ORTHOPEDICS CLINIC 1615 HOSPITAL BLVD GAINESVILLE TX 76240 ORTHOPEDICS CLINIC SURGICAL SPECIALISTS OF NORTH TEXAS 1627 N GRAND AVE GAINESVILLE TX 76240 SURGICAL SERVICES CLINIC ADVANCED SURGERY & BARIATRICS 2024 US-82 GAINESVILLE TX 76240 BARIATRICS SURGERY AND CLINIC PEDIATRIC & ADULT SLEEP WELLNESS CENTER 1900 HOSPITAL BLVD GAINESVILLE TX 76240 SLEEP STUDY CLINIC Schedule H, Part I, Line 6a SCHEDULE H, PART I, LINE 6A THE COMMUNITY BENEFIT REPORT FOR FISCAL YEAR ENDED JUNE 30, 2023 WAS PREPARED BY OUR CORPORATE OFFICE, COMMUNITY HOSPITAL CORPORATION. Schedule H, Part V, Section B, Line 22 SCHEDULE H, PART V, SECTION B, LINE 22 DURING THE FISCAL YEAR ENDED JUNE 30, 2023 NTMC USED A COMBINATION OF THE LOOKBACK METHOD AND THE PRESUMPTIVE MEDICARE AND MEDICAID METHOD IN DETERMINING THE MAXIMUM AMOUNTS TO BE CHARGED TO FAPS ELIGIBLE INDIVIDUALS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE. LOOKING BACK AT WHAT MEDICARE AND MEDICAID REIMBURSEMENT / CONTRACTUALS WERE BEING CALCULATED AT OVER THE PRIOR 12 MONTH PERIOD, A WEIGHTED AVERAGE WAS THEN TAKEN. THIS RESULT LED TO THE APPLICATION OF A 75% DISCOUNT FOR ALL SELF-PAY PATIENTS. Schedule H, Part III, Line 4 BAD DEBT EXPENSE FOOTNOTE PATIENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING BALANCE SHEETS AT NET REALIZABLE VALUE BASED ON CERTAIN ASSUMPTIONS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE NET REALIZABLE VALUE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE NET REALIZABLE VALUE IS BASED ON THE ESTIMATED CONTRACTUAL REIMBURSEMENT PERCENTAGES, WHICH IS BASED ON CURRENT CONTRACT PRICES OR HISTORICAL CLAIMS PAID DATA BY PAYOR. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE NET REALIZABLE VALUE IS DETERMINED USING ESTIMATES OF HISTORICAL COLLECTION EXPERIENCE. THESE ESTIMATES ARE ADJUSTED FOR RECOVERIES AND ANY ANTICIPATED CHANGES IN TRENDS, INCLUDING SIGNIFICANT CHANGES IN PAYOR MIX, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE. Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEM GAINESVILLE COMMUNITY HOSPITAL (D/B/A NORTH TEXAS MEDICAL CENTER) IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Based off of 2022 cost report and a cost to charge ratio of 27.1596% Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Bad debt accounts are written off after they are returned from our final collectors at MDS with no collections recovered after 365 days. All discounts and payments are subtracted from the original balance before the account is expensed. 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 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 ALL PATIENTS WITHOUT INSURANCE, AND OR AFTER INSURANCE IS BILLED AND COLLECTED, ARE SENT A LETTER FROM OUR EARLY OUT VENDOR FOR THEIR PATIENT BALANCE. ALL STATEMENTS SENT INDICATE NTMC HAS A FINANCIAL ASSISTANCE POLICY AND THAT PATIENTS THINK IT APPLIES TO THEM TO CALL THE NUMBER INDICATED. ALL EMERGENT SERVICES ARE PROVIDED WITHOUT ASKING FOR MONEY AND PATIENT IS BILLED AFTER THE SERVICES ARE PROVIDED. THE ONLY DIFFERENCE ON PATIENTS WITH FINANCIAL ASSISTANCE IS RELATED TO ELECTIVE (NON-EMERGENT) SERVICES. THOSE HAVE TO BE APPROVED PRIOR TO PROVIDING / SCHEDULING THE SERVICE. IF PATIENTS HAVE ALREADY QUALIFIED FOR FINANCIAL ASSISTANCE, THE SELF-PAY PERCENT (IS APPLIED FIRST IF TRUE SELF PAY) THEN IF THEY QUALIFY FOR FINANCIAL ASSISTANCE THE APPLICABLE PERCENT IS APPLIED AND ANY REMAINING BALANCE (IF LESS THAN 100% FA) IS THEN BILLED TO THE PATIENT. ONLY THE PART THEY ARE RESPONSIBLE FOR IS BILLED TO THEM. Schedule H, Part V, Section B, Line 16a FAP website - NORTH TEXAS MEDICAL CENTER: Line 16a URL: https://ntmconline.net/YOUR-HOSPITAL/FINANCIAL-ASSISTANCE/; Schedule H, Part V, Section B, Line 16b FAP Application website - NORTH TEXAS MEDICAL CENTER: Line 16b URL: https://ntmconline.net/YOUR-HOSPITAL/FINANCIAL-ASSISTANCE/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - NORTH TEXAS MEDICAL CENTER: Line 16c URL: https://ntmconline.net/YOUR-HOSPITAL/FINANCIAL-ASSISTANCE/; Schedule H, Part VI, Line 2 Needs assessment GAINESVILLE COMMUNITY HOSPITAL (A/K/A NORTH TEXAS MEDICAL CENTER) WAS FORMED ON AUGUST 10, 2018 AS AN ACUTE CARE HOSPITAL LOCATED IN GAINESVILLE, TX TO SERVE THE RESIDENTS OF COOKE COUNTY AND SURROUNDING AREAS IN TEXAS. AS REPORTED IN SCHEDULE H, PART V, SECTION B, THE HOSPITAL CONDUCTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE FISCAL YEAR ENDED JUNE 30, 2023. THE HOSPITAL'S CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN THE FINAL REGULATIONS RELEASED DECEMBER 29, 2014. THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE HAS BEEN ABLE TO IDENTIFY AND PRIORITIZE THE HEALTH NEEDS OF ITS COMMUNITY THROUGH A REVIEW OF COUNTY LEVEL HEALTH DATA GATHERED FROM THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) AND STATE AND COUNTY AREA INFORMATION, PROVIDED BY THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES. ADDITIONALLY, THE COMMITTEE REVIEWED MULTIPLE NATIONAL HEALTH DATA PLATFORMS AND RESOURCES AND CONDUCTED INTERVIEWS WITH PERSONS HAVING SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN COOKE COUNTY, INCLUDING PUBLIC HEALTH REPRESENTATIVES, NOT-FOR-PROFIT ORGANIZATION PROFESSIONALS, CHARITIES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. HOSPITAL LEADERSHIP DEVELOPED AN IMPLEMENTATION PLAN TO IDENTIFY SPECIFIC ACTIVITIES AND SERVICES WHICH DIRECTLY ADDRESS THE IDENTIFIED PRIORITIES. THE OBJECTIVES WERE IDENTIFIED BY STUDYING THE PRIORITIZED HEALTH NEEDS, WITHIN THE CONTEXT OF THE HOSPITAL'S OVERALL STRATEGIC PLAN AND THE AVAILABILITY OF FINITE RESOURCES. THE PLAN INCLUDES A RATIONALE FOR EACH PRIORITY, FOLLOWED BY OBJECTIVES, SPECIFIC IMPLEMENTATION ACTIVITIES, RESPONSIBLE LEADERS, ANNUAL STATUS, AND PROGRESS UPDATES (AS APPROPRIATE). THE NTMC BOARD REVIEWED AND ADOPTED THE 2023 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN ON MAY 16, 2023. IN ADDITION TO THE CHNA AND IMPLEMENTATION PLAN DISCUSSED ABOVE, THE HOSPITAL WILL CONTINUE TO WORK WITH OTHER COMMUNITY RESOURCES TO ENSURE IT IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES ARE INFORMED UPON ADMISSION TO THE HOSPITAL BY A FACE TO FACE VISIT WITH THE HOSPITAL/ADMISSIONS STAFF. THE PATIENT FINANCIAL OBLIGATION IS DISCUSSED WITH THE RESPONSIBLE PARTY. THE HOSPITAL CHARITY CARE POLICY IS DISCUSSED WITH EACH RESPONSIBLE PARTY AND IF IT IS FELT THAT THE PATIENT WOULD QUALIFY FOR THE CHARITY PROGRAM THEN THE NECESSARY DOCUMENTS WOULD BE PRESENTED BY THE RESPONSIBLE PARTY TO THE BUSINESS OFFICE ASSOCIATE FOR REVIEW. THE CHARITY CARE POLICY IS ALSO POSTED IN THE ADMISSIONS OFFICE AND ON ITS WEBSITE. Schedule H, Part VI, Line 4 Community information NORTH TEXAS MEDICAL CENTER, (NTMC), IS AN ACUTE CARE HOSPITAL LOCATED IN GAINESVILLE, TEXAS AND SERVES THE RESIDENTS OF COOKE, EASTERN MONTAGUE, WESTERN GRAYSON AND NORTHERN DENTON COUNTIES IN TEXAS AND SOUTHERN LOVE COUNTY, OKLAHOMA. GAINESVILLE, TEXAS IS PART OF THE TEXOMA REGION. LAKE TEXOMA IS SITUATED ON THE BORDER BETWEEN OKLAHOMA AND TEXAS AND INCLUDES GRAYSON AND COOKE COUNTIES ON THE TEXAS SIDE. THE LAKE IS ONE OF THE LARGEST RESERVOIRS IN THE COUNTRY AND DRAWS MILLIONS OF VISITORS EACH YEAR DUE TO THE DIVERSE RECREATIONAL ACTIVITIES AVAILABLE. NTMC IS OPERATED BY COMMUNITY HOSPITAL CORPORATION AND OWNED BY GAINESVILLE HOSPITAL DISTRICT. THE 125,000-SQUARE-FOOT MEDICAL CENTER HOUSES 42 MEDICAL/SURGICAL BEDS, A 6-BED INTENSIVE CARE UNIT, AND A 12-BED WOMEN'S CENTER WITH A DEDICATED C-SECTION OPERATING SUITE. THE HOSPITAL FEATURES AN 11-BED EMERGENCY ROOM WITH 3 TRAUMA ROOMS, 4 OPERATING ROOMS, 2 PROCEDURE ROOMS, 2 INPATIENT SLEEP STUDY ROOMS AND 3 WOUND CARE TREATMENT AREAS. ADDITIONALLY, NTMC OFFERS THERAPY, LABORATORY AND MOST MEDICAL IMAGING SERVICES. AS OF 2022, THERE WERE 42,275 RESIDENTS IN COOKE COUNTY AND THE POPULATION IS EXPECTED TO INCREASE 2.1% BY 2027. THE MAJORITY OF RESIDENTS IN COOKE COUNTY IDENTIFY AS WHITE (NON HISPANIC) AT 75.1% (2022) BY 2027, THE WHITE POPULATION IS EXPECTED TO DECREASE 0.5% AND THE BLACK POPULATION IS EXPECTED TO INCREASE BY 6.1%. THE ASIAN AND AMERICAN INDIAN POPULATION ARE EXPECTED TO INCREASE BY 4.7% AND 6.1%, RESPECTIVELY, BY 2027. ALL OTHER RACES ARE EXPECTED TO INCREASE 11.0% BY 2027. THE MAJORITY OF RESIDENTS IN COOKE COUNTY WERE BETWEEN THE AGES OF 18-44 YEARS OLD (2022). COOKE COUNTY (41.0 YEARS) HAD AN OLDER MEDIAN AGE THAN THE STATE OF TEXAS (35.4 YEARS) IN 2022. THE MEDIAN HOUSEHOLD INCOME IN COOKE COUNTY IN 2022 WAS $68,352, WHICH WAS LOWER THAN THE MEDIAN HOUSEHOLD INCOME IN TEXAS OF $70,834. COOKE COUNTY HAS LOWER EDUCATIONAL ATTAINMENT RATES THAN THOSE OF THE STATE OF TEXAS (2022). ADDITIONALLY, COOKE COUNTY (13.0%) HAS A LOWER PERCENTAGE OF FAMILIES LIVING BELOW POVERTY THAN THE STATE OF TEXAS (15.5%) (2022).IN COOKE COUNTY AN ESTIMATED 14.8% OF RESIDENTS ARE FOOD INSECURE AS COMPARED TO 14.0% IN TEXAS (2020). COOKE COUNTY HAS HIGHER RATES OF CHILD FOOD INSECURITY AS WELL AS A HIGHER AVERAGE MEAL COST THAN THE STATE OF TEXAS (2020). IN 2021. COOKE COUNTY (5.0) HAD A LOWER UNEMPLOYMENT RATE THAN THE STATE (5.7). OVER THE MOST RECENT 12-MONTH TIME PERIOD, MONTHLY UNEMPLOYMENT RATES IN COOKE COUNTY OVERALL DECREASED. AS OF 2020, THE MAJORITY OF EMPLOYED PERSONS WERE WITHIN OFFICE & ADMINISTRATION SUPPORT OCCUPATIONS. AS OF 2020, COOKE COUNTY (22.6%) HAD A HIGHER RATE OF UNINSURED ADULTS (AGE 18-64) AS COMPARED TO THE STATE OF TEXAS (19.9%). THE PERCENTAGE OF UNINSURED ADULTS (AGE 18-64) IN COOKE COUNTY AND THE STATE INCREASED BETWEEN 2016 AND 2020. HEART DISEASE AND CANCER ARE THE TWO LEADING CAUSES OF DEATH IN COOKE COUNTY AND THE STATE OF TEXAS (2016-2020). OVERALL MORTALITY RATES IN COOKE COUNTY REMAINED HIGHER THAN THE STATE BETWEEN 2016 AND 2020. ADDITIONALLY, OVERALL MORTALITY RATES IN COOKE COUNTY AND THE STATE INCREASED BETWEEN 2016 AND 2020. COOKE COUNTY HAS LOWER PREVALENCE RATES OF CHRONIC CONDITIONS SUCH AS OBESITY AND DIABETES THAN THE STATE AND A HIGHER PREVALENCE RATE OF HYPERTENSION AMONG MEDICARE BENEFICIARIES THAN THE STATE OF TEXAS. AS OF 2019, THE PERCENTAGE OF ADULTS (AGE 20+) WHO SELF-REPORTED NO LEISURE TIME FOR PHYSICAL ACTIVITY OUTSIDE OF WORK IN COOKE COUNTY WAS APPROXIMATELY 3.3% LOWER THAN THE STATE RATE AND 3.4% LOWER THAN THE NATIONAL RATE. AS OF DECEMBER 8, 2022, COOKE COUNTY HAD A LOWER PERCENT OF ITS POPULATION THAT IS FULLY VACCINATED FOR COVID-19 (40.5%) AS COMPARED TO THE STATE OF TEXAS (58.0%). WITH REGARDS TO MATERNAL AND CHILD HEALTH, BETWEEN 2016-2019, THE PERCENTAGE OF TEEN BIRTHS (AGES 15-19 YEARS) IN COOKE COUNTY WAS HIGHER THAN THE STATE OF TEXAS. BETWEEN 2016-2019 COOKE COUNTY HAD HIGHER RATES OF MOTHERS SMOKING DURING PREGNANCY THAN THE STATE OF TEXAS. Schedule H, Part VI, Line 5 Promotion of community health NORTH TEXAS MEDICAL CENTER (NTMC) PARTICIPATES IN A NUMBER OF ACTIVITIES IN ORDER TO PROMOTE AND IMPROVE THE HEALTH AND WELLNESS OF OUR COMMUNITY. BELOW ARE SOME OF THOSE ACTIVITIES NTMC PARTICIPATED IN DURING FISCAL YEAR 2023 WITH ONGOING PLANS TO CONTINUE AS OPPORTUNITIES ARISE. NTMC WILL CONTINUE TO HOST AND/OR PARTICIPATE IN FUNDRAISING EVENTS AND DONATION DRIVES TO BENEFIT UNDERSERVED ORGANIZATIONS IN THE COMMUNITY, AS WELL AS EDUCATIONAL EVENTS. EXAMPLES INCLUDED: HOSTED 4 BLOOD DRIVES; ACTIVE MEMBER OF TEAMS; GAINESVILLE CHAMBER OF COMMERCE GOLF TOURNAMENT SPONSOR; COOKE COUNTY UNITED WAY; CNO SPEAKING TO AREA SCHOOLS; GUEST SPEAKERS AT KIWANIS CLUB, LIONS CLUB, RETIRED TEACHERS MEETING. PRESENTING PROGRAMS AT CIVIC ORGANIZATIONS AND SCHOOLS ALLOWS NTMC TO EDUCATE THE COMMUNITY ON HEALTH ISSUES AFFECTING THEM AND THEIR FAMILIES. NTMC WILL CONTINUE STRENGTHENING ITS PARTNERSHIPS WITH LOCAL NURSING HOMES TO PROVIDE LAB AND IMAGING SERVICES. THE HOSPITAL WILL CONTINUE TO WORK WITH NURSING HOMES TO MAKE THEIR PATIENTS VISITS QUICK AND SEEMLESS TO AVOID TAKING THE PATIENT OUT OF THEIR NORMAL SURROUNDINGS FOR TOO LONG. PATIENTS FROM NURSING HOMES TEND TO GET DISORIENTED SO PROVIDING A PROCESS TO GET IN AND OUT OF THE HOSPITAL AS QUICKLY AS POSSIBLE AND BACK INTO THEIR FAMILIAR SURROUNDINGS IS A BENEFIT TO THE PATIENT. NTMC WILL CONTINUE TO HOST AND/OR PARTICIPATE IN LOCAL HEALTH-RELATED EVENTS TO PROMOTE HOSPITAL SERVICES, OFFER A VARIETY OF HEALTH SCREENINGS TO THE COMMUNITY, AND/OR SUPPORT OR PARTNER WITH LOCAL ORGANIZATIONS THAT PROVIDE SERVICES TO VULNERABLE POPULATIONS. EXAMPLES INCLUDED: THE SPRING FLING; FREE PHYSICALS FOR GISD ATHLETES; CHEER AND BAND; BACK TO SCHOOL WELLNESS EVENT; BLOOD DRIVES INTRODUCED THE HOSPITAL AND OUR PROVIDERS TO MEMBERS OF THE COMMUNITY WHO MAY NOT HAVE OTHERWISE KNOWN ABOUT NTMC'S SERVICES. NTMC WILL CONTINUE TO CONNECT PATIENTS TO AFFORDABLE RESOURCES, SUCH AS DISCOUNT PHARMACY SERVICES WHEN AVAILABLE. NTMC CONTINUALLY GIVES OUT RESOURCES THAT ARE AVAILABLE IN THE COMMUNITY. THESE RESOURCES HAVE INCLUDED DISCOUNT CARDS, PRESCRIPTION ASSISTANCE PROGRAMS, AND COMMUNITY RESOURCES SUCH AS 2-1-1, VISTO, VETERAN'S SERVICES, ETC. NTMC WILL CONTINUE TO INCREASE EDUCATIONAL OPPORTUNITIES FOR THE PUBLIC CONCERNING WELLNESS TOPICS AND HEALTH RISK CONCERNS. EXAMPLES INCLUDED PROVIDING GUEST SPEAKERS, INCLUDING THE DIETICIAN AND THERAPY SERVICES DIRECTOR ON THE KGAF DAILY RADIO SEGMENT "TO YOUR HEALTH" WHICH SPECIFICALLY FOCUSES ON HEATH TOPICS. MONTHLY INTERVIEW ON KGAF MORNING SHOW; PRESS RELEASES SENT TO AREA NEWSPAPERS AND RADIO STATIONS. NTMC ALSO PROVIDED GUEST SPEAKERS TO KIWANIS CLUB, LIONS CLUB AND RETIRED TEACHERS ASSOCIATION. NTMC PERSONNEL WILL CONTINUE TO SERVE IN LEADERSHIP ROLES AND AS VOLUNTEERS WITH MANY AGENCIES AND COMMITTEES IN THE COMMUNITY. ADDITIONALLY, NTMC WILL CONTINUE TO PROVIDE STAFF REPRESENTATION AT VARIOUS CONFERENCES AND IN LOCAL CONSORTIUMS FOCUSED AROUND ITS PATIENT POPULATION'S NEEDS. NTMC STAFF SERVE ON BOARDS AT UNITED WAY, GAINESVILLE ECONOMIC DEVELOPMENT CORPORATION AND BUTTERFIELD STAGE. TWO MEMBERS OF NTMC STAFF SERVED ON UNITED WAY ALLOCATIONS COMMITTEE DURING THE FISCAL YEAR. ADDITIONALLY, STAFF ARE MEMBERS OF KIWANIS CLUB. NTMC WILL CONTINUE TO INCREASE AWARENESS OF ITS SERVICE OFFERINGS IN THE COMMUNITY THROUGH LOCAL MEDIA OUTLETS, SUCH AS THE RADIO, BILLBOARDS, DIRECT MAIL ADVERTISEMENTS, FACEBOOK AND UPDATING THE HOSPITAL'S WEBSITE. EXAMPLES HAVE INCLUDED UTILIZING SOCIAL MEDIA - INCLUDING FACEBOOK, TWITTER, AND YOUTUBE. FOUR BILLBOARD ADS WERE ALSO UTILIZED IN THE GAINESVILLE AREA AS WELL AS NEWSPAPER ADS IN SEVEN PAPERS. ADDITIONALLY, THERE WERE COMMERCIALS ON TWO RADIO STATIONS. NTMC WILL CONTINUE TO PROVIDE MEDICATION MANAGEMENT RESOURCES TO PATIENTS UPON DISCHARGE AS NEEDED. DURING THE FISCAL YEAR, IMPROVEMENTS WERE MADE TO PATIENT DISCHARGE PACKETS. Schedule H, Part VI, Line 7 State filing of community benefit report TX X X false true false false false false false true false JOE THOMASON Director/President 0 380712 0 57907 0 33984 0 12788 0 39718 0 525109 0 11817 JIM KENDRICK Director 0 976164 0 437586 0 108124 0 99909 0 38818 0 1660601 0 38242 JAMES HILL Treasurer 0 323943 0 49687 0 20453 0 9150 0 29551 0 432784 0 0 LINDA MOORE Secretary 0 338309 0 50550 0 35306 0 12304 0 21488 0 457957 0 5208 SHELLE DIEHM CFO (Until 12/22) 0 186435 0 27409 0 3917 0 21862 0 30403 0 270026 0 0 THOMAS SLEDGE CEO 0 264622 0 45361 0 2906 0 21862 0 30403 0 365155 0 0 Bonnie Hess CNO 0 126191 0 16699 0 1052 0 10002 0 0 0 153944 0 0 BHUPINDER KHAIRA MD GENERAL SURGEON 676891 0 0 0 0 0 0 0 0 0 676891 0 0 0 CHRISTIAN VISSERS MD ORTHOPEDIC SURGEON 635215 0 0 0 0 0 0 0 0 0 635215 0 0 0 ZAIRA JORAI-KHAN DO OB/GYN PHYSICIAN 365984 0 0 0 0 0 0 0 0 0 365984 0 0 0 Elizabeth S Newman DO OB/GYN Physician 305564 0 0 0 0 0 0 0 0 0 305564 0 0 0 Cedric L Buckley DO Internal Med. Physician 241410 0 0 0 0 0 0 0 0 0 241410 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation GAINESVILLE COMMUNITY HOSPITAL, INC. (GCH) DOES NOT COMPENSATE THE PRESIDENT OF THE ORGANIZATION. COMMUNITY HOSPITAL CONSULTING COMPENSATES THE GCH PRESIDENT. COMMUNITY HOSPITAL CONSULTING 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 6/30/2023 FOR ITS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES AND OTHER MANAGEMENT OFFICIALS. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan NONQUALIFIED RETIREMENT PLAN PARTICIPATION WAS PAID TO: JIM KENDRICK - $186,178 LINDA MOORE - $20,980 JAMES HILL - $15,502 JOE THOMASON - $30,005 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 III, Line 4a PROGRAM SERVICE DESCRIPTION GCH IS A COMMUNITY HEALTH PROVIDER THAT SERVES THE COMMUNITY REGARDLESS OF ANY INDIVIDUAL'S RACE, CREED, NATIONALITY, OR ABILITY TO PAY FOR SERVICES INCLUDING INPATIENT, OUTPATIENT, AND EMERGENCY CARE IN SUPPORT OF THE HOSPITAL'S HEALTHCARE MISSION. DURING THE YEAR ENDED JUNE 30, 2023, WE HAD 1,539 ADMISSIONS, 6,470 PATIENT DAYS, 18,037 ER VISITS, 223 INPATIENT SURGERIES AND 1,122 OUTPATIENT SURGERIES. THE AVERAGE DAILY CENSUS WAS 17.7 PATIENTS AND THE AVERAGE LENGTH OF STAY WAS 4.2 DAYS. GCH UTILIZES THE MOST ADVANCED TECHNOLOGIES RIVALING THOSE OF MAJOR CITIES IN A COMFORTABLE ENVIRONMENT CLOSE TO HOME. WE OFFER INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES WITH COMPASSIONATE CARE, FOCUSING ON RESPECT AND CARE FOR THE WHOLE PERSON. AT GCH, WE ARE DETERMINED TO BUILD AN UNRIVALED REPUTATION FOR OUR OUTSTANDING SERVICE AND DELIVERY OF CARE. WE OFFER ADVANCED SERVICES AND PROGRAMS INCLUDING A SERENE BIRTHING CENTER, SPECIALTY CLINICS, COMPREHENSIVE PUBLIC HEALTH SERVICES AND SPECIALIZED NUTRITION PROGRAMS FOR WOMEN, INFANTS AND CHILDREN. WORKING TOGETHER, OUR GOAL IS TO PROVIDE MEMBERS OF THE COMMUNITY WITH 'ADVANCED HOMETOWN WORKING TOGETHER, OUR GOAL IS TO PROVIDE MEMBERS OF THE COMMUNITY WITH "ADVANCED HOMETOWN HEALTHCARE." Form 990, Part VI, Line 15 OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN THE ORGANIZATION EXECUTIVES ARE EMPLOYED BY THE PARENT ORGANIZATION, CHC, AND THEREFORE FOLLOW THE COMPENSATION POLICY OF CHC. CHC ENGAGED SULLIVAN COTTER TO CONDUCT A 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 RESPONSIBILITY, 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 PROCESS IS PERFORMED EACH YEAR PRIOR TO THE ANNUAL EMPLOYEE EVALUATION PROCESS, WHICH ENDS ON JULY 1ST OF EACH YEAR. Form 990, Part VI, Line 3 Delegation of management duties COMMUNITY HOSPITAL CORPORATION (CHC) PROVIDES CERTAIN FINANCIAL, TECHNICAL AND MANAGERIAL SUPPORT SERVICES TO THE HOSPITAL. Form 990, Part VI, Line 6 Classes of members or stockholders CHC, A TEXAS NON-PROFIT CORPORATION IS THE CLASS A MEMBER AND GAINESVILLE HOSPITAL DISTRICT IS THE CLASS B MEMBER OF GCH. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body CHC, AS THE CLASS A MEMBER OF GCH, SHALL APPOINT TWO OF THE THREE MEMBERS OF THE BOARD OF DIRECTORS. GAINESVILLE HOSPITAL DISTRICT SHALL APPOINT ONE MEMBER OF THE BOARD OF DIRECTORS AS THE CLASS B MEMBER OF GCH. ANY DIRECTOR MAY BE REMOVED, WITH OR WITHOUT CAUSE, BY THE MEMBER WHICH APPOINTED THE DIRECTOR. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders CLASS A AND CLASS B APPROVALS. THE APPROVAL OF THE CLASS A MEMBER AND THE CLASS B MEMBER OF THE CORPORATION SHALL BE NECESSARY FOR EACH OF THE FOLLOWING MATTERS: 1. THE ESTABLISHMENT OF OR ANY CHANGE IN THE MISSION OR PURPOSE OF THE CORPORATION AS SET BY THE MEMBERS, INCLUDING BUT NOT LIMITED TO THE PROVISION OF INDIGENT CARE. 2. ANY AMENDMENTS OR REVISIONS TO THE CERTIFICATE OF FORMATION OR BYLAWS OF CORPORATION. 3. ANY AMENDMENTS OR REVISIONS OF THE CERTIFICATE OF FORMATION OR BYLAWS OF ANY SUBSIDIARY CORPORATION OF CORPORATION. 4. THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY, PARTNERSHIP OR VENTURE. 5. ANY AMENDMENT, REVISION OR TERMINATION OF THE PARTNERSHIP AGREEMENT OF ANY PARTNERSHIP OR REGULATIONS OF ANY LIMITED LIABILITY COMPANY, TO WHICH CORPORATION IS A PARTY. 6. THE MERGER, DISSOLUTION, OR CONSOLIDATION OF CORPORATION OR SUBSIDIARY ENTITY. 7. THE APPROVAL OF MAJOR (IN EXCESS OF $3,000,000.00) DEVELOPMENT CAMPAIGNS AND FUND-RAISING. 8. THE ENTRY INTO ANY AGREEMENT WHICH WOULD HAVE A MATERIALLY NEGATIVE EFFECT ON THE DISTRICT TO MEET ITS STATUTORY OR CONSTITUTIONAL OBLIGATIONS WITH REGARD TO INDIGENT CARE. 9. THE ENTRY INTO ANY AGREEMENT WHICH WOULD HAVE A MATERIALLY NEGATIVE EFFECT ON THE DISTRICT'S BOND RATING OR ABILITY TO MEET ITS OBLIGATIONS UNDER ANY BONDS. CLASS A APPROVALS. THE APPROVAL OF THE CLASS A MEMBER OF THE CORPORATION SHALL BE NECESSARY FOR EACH OF THE FOLLOWING MATTERS: 1. THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION. 2. ALL MATERIAL EXPENDITURE DEVIATIONS (GREATER THAN $25,000 IN ANY SINGLE OR SERIES OF TRANSACTIONS) FROM THE ANNUAL OPERATING BUDGET. 3. ALL EXPENDITURE DEVIATIONS FROM THE ANNUAL CAPITAL BUDGET. 4. THE PURCHASE OR ACQUISITION OF ANY REAL, PERSONAL, OR MIXED PROPERTY BY THE CORPORATION IN EXCESS OF $100,000.00 THAT IS NOT PROVIDED FOR IN THE CORPORATION'S ANNUAL OPERATING OR CAPITAL BUDGETS. 5. THE SALE, MORTGAGE, ENCUMBRANCE, TRANSFER, LEASE, GIFT, OR OTHER DISPOSITION OF ANY REAL PROPERTY OF THE CORPORATION. 6. ANY SALE, GIFT, EXCHANGE, LEASE, MORTGAGE OR OTHER TRANSFER OR ENCUMBRANCE (COLLECTIVELY, "TRANSFER") OF THE PERSONAL PROPERTY OF CORPORATION (TANGIBLE OR INTANGIBLE) IF THE SUM OF SUCH TRANSFER AND THE SUM OF ALL PRIOR TRANSFERS, PER FISCAL YEAR, EXCEEDS $100,000.00. 7. ANY DEBT OR FINANCING ARRANGEMENT OF CORPORATION, EXCEPT USUAL AND CUSTOMARY TRADE DEBT WHICH IS INCURRED IN THE ORDINARY COURSE OF BUSINESS OF THE CORPORATION. 8. SETTLEMENT OF ANY CLAIMS OR LITIGATION INVOLVING THE CORPORATION IN EXCESS OF $100,000.00. 9. THE EXECUTION, REVISION, AMENDMENT, EXTENSION, NON-RENEWAL OR TERMINATION OF ANY MANAGEMENT, EMPLOYMENT, LEASE, OR SERVICE CONTRACT, WITH AN ANNUAL COMPENSATION IN EXCESS: OF $50,000.00 OR AN AGGREGATE COMPENSATION IN EXCESS OF $100,000.00. 10. ANY DEBTS, LOANS, GUARANTIES, OR GRANTS NOT CONTEMPLATED BY AND APPROVED AS PART OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS IN EXCESS OF $100,000.00; PROVIDED, HOWEVER, THAT NO DEBT IN EXCESS OF $100,000 SHALL BE APPROVED BY THE CLASS A MEMBER OR INCURRED BY THE CORPORATION WITHOUT UNANIMOUS WRITTEN APPROVAL OF THE BOARD OF DIRECTORS OF THE CORPORATION. 11. THE APPROVAL OF THE EMPLOYEE POLICIES AND BENEFITS PROGRAMS OF THE CORPORATION. Form 990, Part VI, Line 11b Review of form 990 by governing body THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS PRIOR TO FILING. ELECTRONIC COPIES ARE PROVIDED TO EACH BOARD MEMBER VIA EMAIL UPON COMPLETION OF THE FORM PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy CONFLICT OF INTEREST STATEMENTS ARE FILED OUT BY GOVERNING BOARD MEMBERS, ADMINISTRATIVE TEAM, AND OTHER KEY EMPLOYEES ON A YEARLY BASIS. IF A CONFLICT OF INTEREST IS DISCLOSED, IT IS REVIEWED BY MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICER, GENERAL COUNSEL, OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. THE INTERESTED PERSON IS ALLOWED TO MAKE A PRESENTATION, AND ANSWER QUESTIONS POSED BY THE GOVERNING BODY AT THE COMMITTEE MEETING BUT MUST LEAVE AFTER THE RESENTATION, DURING THE DISCUSSION OF AND VOTE ON THE TRANSACTION OR ARRANGEMENT INVOLVING THE POTENTIAL CONFLICT OF INTEREST. IF DEEMED NECESSARY, A DISINTERESTED PERSON CAN BE APPOINTED TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND THE ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT. IF A MORE ADVANTAGEOUS TRANSACTION/ARRANGEMENT IS NOT REASONABLE, THE GOVERNING BODY SHALL DETERMINE BY A MAJORITY VOTE OF THE ISINTERESTED DIRECTORS WHETHER THE TRANSACTION/ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION. THE COMPLIANCE OFFICER ALONG WITH THE CHIEF FINANCIAL OFFICER IS RESPONSIBLE FOR CONDUCTING AUDITS AND MONITORING REVIEWS OF INTERNAL CONTROLS TO MAKE SURE THEY ARE FREE FROM ANY CONFLICTS OF INTEREST/INFLUENCES THAT WOULD IMPAIR THEIR ABILITY TO OBJECTIVELY CARRY OUT THEIR WORK WITHOUT BIAS. IF FOR ANY REASON THERE IS BELIEF THAT A BOARD/COMMITTEE MEMBER/EMPLOYEE FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, THE MEMBER/EMPLOYEE WILL BE INFORMED AND GIVEN AN OPPORTUNITY TO EXPLAIN THE FAILURE TO DISCLOSE. IF AFTER HEARING THE RESPONSE AND MAKING FURTHER INVESTIGATION IT IS DETERMINED THERE WAS FAILURE TO DISCLOSE, THEN APPROPRIATE DISCIPLINARY ACTION IS TAKEN WHICH CAN INCLUDE WITHOUT LIMITATION, TERMINATION OF THE PERSON'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 VIII, Line 11d Other Miscellaneous Revenue Other Misc. Revenue - Total Revenue: 24877, Related or Exempt Function Revenue: 24877, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees MEDICAL SVCS (CONTRACT LABOR) - Total Expense: 2411044, Program Service Expense: 2316727, Management and General Expenses: 94317, Fundraising Expenses: ; HOME HEALTH - Total Expense: 0, Program Service Expense: 0, Management and General Expenses: 0, Fundraising Expenses: 0; ANESTHESIA - Total Expense: 1275519, Program Service Expense: 956639, Management and General Expenses: 318880, Fundraising Expenses: ; PHYSICIAN SVCS - Total Expense: 672000, Program Service Expense: 504000, Management and General Expenses: 168000, Fundraising Expenses: ; DIETARY - Total Expense: 602889, Program Service Expense: 482311, Management and General Expenses: 120578, Fundraising Expenses: ; COVID - Total Expense: 1097, Program Service Expense: 1097, Management and General Expenses: , Fundraising Expenses: ; EVS - Total Expense: 357415, Program Service Expense: 268061, Management and General Expenses: 89354, Fundraising Expenses: ; FACILITIES - Total Expense: 231789, Program Service Expense: 173842, Management and General Expenses: 57947, Fundraising Expenses: ; MEDICAL IMAGING - Total Expense: 193362, Program Service Expense: 193362, Management and General Expenses: , Fundraising Expenses: ; TRANSCRI/CODING/3M - Total Expense: 289146, Program Service Expense: , Management and General Expenses: 289146, Fundraising Expenses: ; ADMIN PURCHASED SERVICES - Total Expense: 195584, Program Service Expense: , Management and General Expenses: 195584, Fundraising Expenses: ; PHARMACY - Total Expense: 34847, Program Service Expense: 34847, Management and General Expenses: , Fundraising Expenses: ; LAB - Total Expense: 516898, Program Service Expense: 516898, Management and General Expenses: , Fundraising Expenses: ; THERAPY - Total Expense: 59282, Program Service Expense: 59282, Management and General Expenses: , Fundraising Expenses: ; PT REGIS REGISTRATION - Total Expense: 46895, Program Service Expense: , Management and General Expenses: 46895, Fundraising Expenses: ; HR - Total Expense: 22533, Program Service Expense: , Management and General Expenses: 22533, Fundraising Expenses: ; MOB - Total Expense: 2561, Program Service Expense: , Management and General Expenses: 2561, Fundraising Expenses: ; MED STAFF - Total Expense: 36383, Program Service Expense: , Management and General Expenses: 36383, Fundraising Expenses: ; CLINIC - Total Expense: 268887, Program Service Expense: 45295, Management and General Expenses: 223592, Fundraising Expenses: ; EDUCATION - Total Expense: 16168, Program Service Expense: , Management and General Expenses: 16168, Fundraising Expenses: ; SLEEP - Total Expense: 21924, Program Service Expense: 21924, Management and General Expenses: , Fundraising Expenses: ; MATERIAL MGT - Total Expense: 12652, Program Service Expense: , Management and General Expenses: 12652, Fundraising Expenses: ; LAUNDRY - Total Expense: 14343, Program Service Expense: , Management and General Expenses: 14343, Fundraising Expenses: ; IT SERVICES - Total Expense: 279456, Program Service Expense: , Management and General Expenses: 279456, Fundraising Expenses: ; COLLECTIONS - Total Expense: 1166587, Program Service Expense: , Management and General Expenses: 1166587, Fundraising Expenses: ; RESPIRATORY - Total Expense: 29230, Program Service Expense: 29230, Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Contributions from members - 17078; 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 CONTINUECARE HOSPITAL OF TYLER INC 800 E DAWSON ST TYLER TX 75701 200991990 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 HMH PHYSICIAN ORGANIZATION 110 MEMORIAL HOSPITAL DRIVE HUNTSVILLE TX 77340 760500960 PUBLIC CHARI. TX 501(c)(3) 10 HUNTSVILLE false HUNTSVILLE COMMUNITY HOSPITAL INC 110 MEMORIAL HOSPITAL DRIVE HUNTSVILLE TX 77340 843654542 HOSPITAL TX 501(c)(3) 3 CHC false MERCY RESTORATIVE CARE HOSPITAL INC 10648 PARK ROAD CHARLOTTE NC 26210 753054855 HOSPITAL NC 501(c)(3) 3 CAR CC false RURAL AND COMMUNITY HEALTHCARE COLLABORA 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 814337246 SUPPORT ORG TX 501(c)(3) 7 CHC false SOUTHWEST COMMUNITY HOSPITAL INC 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 752725353 SUPPORT ORG TX 501(c)(3) Type III-FI CHC false ST MARK'S MEDICAL CENTER ONE ST MARKS PLACE LA GRANGE TX 78945 743019849 HOSPITAL TX 501(c)(3) 3 CHC false YOAKUM COMMUNITY HOSPITAL 1200 CARL RAMERT DRIVE YOAKUM TX 77995 742323822 HOSPITAL TX 501(c)(3) 3 CHC false YOAKUM COMMUNITY HOSPITAL FOUNDATION 1200 CARL RAMERT DRIVE YOAKUM TX 77995 453609830 SUPPORT ORG TX 501(c)(3) Type I YCH false COMMUNITY HEALTH ASSURANCE SPC LTD POB 69GT GRAND CAYMAN CJ CAPTIVE INSURANCE CJ CHC C Corporation false COMMUNITY HOSPITAL CONSULTING INC 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 204710183 MGMT CONSULTING TX CHC C Corporation false false false false false false false false false false false false false false false false true false false false COMMUNITY HOSPITAL CORPORATION P 6136106 COST