2025-05-14T16:50:18+00:00 2024-06-30 346565596 ERNST & YOUNG US LLP 425 HOUSTON ST FORT WORTH TX 76102 990 2023-07-01 200991990 ContinueCare Hospital of Tyler Inc CONT 9729436400 7950 LEGACY DRIVE 1000 PLANO TX 75024 STEPHANIE HYDE PRESIDENT 9729436400 2025-05-14 true Jodi Rosser P01255710 8173351900 2025-05-14 2023 2025-03-06 01:10:19Z See Schedule O STEPHANIE HYDE 7950 LEGACY DRIVE 1000 PLANO TX 75024 21319751 false X HTTPS://TYLER.CONTINUECARE.ORG/ X 2004 DE AS A "HOSPITAL WITH-IN A HOSPITAL", IT IS THE MISSION OF CONTINUECARE HOSPITAL OF TYLER, INC. TO PROVIDE HIGH QUALITY, COST-EFFECTIVE HEALTHCARE IN A LTACH ENVIRONMENT. 5 3 140 0 0 0 0 2500 19464358 21308212 23238 -22601 186 152 19487782 21288263 0 0 0 0 9715606 10128674 0 0 11194643 10120662 20910249 20249336 -1422467 1038927 4584897 8666242 1407076 4449494 3177821 4216748 AS A "HOSPITAL WITH-IN A HOSPITAL," IT IS THE MISSION OF CONTINUECARE HOSPITAL OF TYLER, INC. (TYLER CONTINUECARE HOSPITAL) TO ENHANCE COMMUNITY HEALTH THROUGH SERVICE WITH COMPASSION, CARING, ACCOUNTABILITY, RESPECT, AND EMPATHY. false false 17697617 0 21308212 TYLER CONTINUECARE HOSPITAL IS A LONG-TERM ACUTE CARE HOSPITAL (LTACH) OPERATING AS A "HOSPITAL WITHIN A HOSPITAL" AT CHRISTUS MOTHER FRANCES HOSPITAL IN TYLER, TEXAS. TYLER CONTINUECARE HOSPITAL OBTAINED A LICENSE TO OPERATE AN ACUTE CARE HOSPITAL ON MAY 14, 2004, AND BECAME CERTIFIED AS A LONG-TERM ACUTE CARE HOSPITAL ON JANUARY 1, 2005. AS AN LTACH, TYLER CONTINUECARE HOSPITAL PROVIDES AN AVENUE OF CARE FOR PATIENTS THAT REQUIRE EXTENDED LENGTHS OF STAY IN AN ACUTE CARE SETTING. TYPICALLY, LENGTHS OF STAY WILL AVERAGE 25 DAYS OR LONGER. CONDITIONS APPROPRIATE FOR TREATMENT IN AN LTACH INCLUDE THE FOLLOWING: MEDICALLY COMPLEX RESPIRATORY DISORDERS INCLUDING TRACHEOTOMY, VENTILATOR DEPENDENT CARDIAC/CARDIOVASCULAR CONDITIONS, RENAL DISEASE, ONCOLOGY, AND WOUND CARE. DURING THE FISCAL YEAR ENDED JUNE 30, 2024, TYLER CONTINUECARE HOSPITAL'S TOTAL PATIENTS ADMITTED WERE 447 AND THE TOTAL NUMBER OF PATIENT CARE DAYS PROVIDED WAS 12,169. THE AVERAGE DAILY CENSUS WAS 33.2 PATIENTS AND THE AVERAGE LENGTH OF STAY OF THE DISCHARGED PATIENTS WAS 27.7 DAYS. 17697617 true false false true false false false false false true false false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 8 0 true 140 true false false false false false false false false false false false false X 5 3 false true false false true true true true false false false true true true true true true false false false X MIKE MURRAY 9729431225 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 CHRIS GLENNEY DIRECTOR (until 5/2024) 1.0 0 X 0 0 0 CRAIG CHESLEY DIRECTOR 1.0 1.0 X 0 40300 0 DAN HARDIMAN DIRECTOR 1.0 0 X 0 0 0 Jeff Warr DIRECTOR 1.0 0 X 0 0 0 JIM KENDRICK DIRECTOR 0.2 39.8 X 0 1577721 335427 Mark Anderson MD DIRECTOR (start 5/2024) 1.0 0 X 0 0 0 JAMES HILL TREASURER 0.4 39.6 X 0 414920 55174 LINDA MOORE SECRETARY 0.1 39.9 X 0 451065 69908 STEPHANIE HYDE CEO/PRESIDENT 40.0 0.0 X 0 216500 42036 Davey Hamilton Registered Nurse 40.0 0 X 118197 0 4537 Dawn Stiles LVN 40.0 0 X 124030 0 21595 Kent Andries CNO ContinueCare Tyler 40.0 0.0 X 0 150609 47936 LADUANDA HILL RN CHARGE NURSE 40.0 0 X 129043 0 15464 Lisa Williams Registered Nurse 40.0 0 X 126307 0 34013 497577 2851115 626090 13 false true false NATHAN JACKSON PLLC PO BOX 6336 TYLER TX 75711 CONTRACT PT/OT 504951 CHRISTUS TRINITY CLINIC 1001 E Southeast loop 323 ste 260 Tyler TX 75701 CONTRACT PHYSICIANS 439567 HHS ENVIRONMENTAL SERVICES PO Box 734367 Dallas TX 75373 Contract Cleaning 283124 3 2500 2500 INPATIENT REVENUE 623000 21308212 21308212 0 0 0 0 21308212 8887 8887 0 0 31488 0 -31488 -31488 -31488 MEDICAL RECORDS 900099 152 152 0 0 0 0 152 21288263 21308212 0 -22449 X 0 0 8473516 7541429 932087 143771 127956 15815 927445 825426 102019 583942 519708 64234 996000 996000 5168 5168 132588 132588 15625 15625 5228615 5226011 2604 0 4333 4333 39064 39064 475 475 1105548 1105548 47871 47871 4213 4213 2503 2503 182572 182572 202745 202745 MEDICAL SUPPLIES 1597324 1597324 EQUIPMENT LEASE 297122 297122 REPAIRS & MAINTENANCE 120675 120675 LICENSES & PERMITS 47082 47082 91139 91139 0 0 20249336 17697617 2551719 0 535407 1080849 2723650 5164690 0 0 0 0 196056 188229 318681 357430 5481165 3697371 811103 1783794 0 0 0 0 0 91250 4584897 8666242 1312398 2270291 0 0 0 0 94678 2179203 1407076 4449494 X 3177821 4216748 3177821 4216748 4584897 8666242 1038927 0 X false true X true false X false false false false false false false false true 15625 15625 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY IN FISCAL YEAR 2024 Tyler ContinueCare Hospital PAID: $15,248 TO THE NATIONAL ASSOCIATION OF LONG TERM HOSPITALS (NALTH) $4,399 TO THE TEXAS HOSPITAL ASSOCIATION (THA) $10,790 TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) $16,000 TO THE PICARD GROUP THE PORTION OF DUES THAT WERE REPORTED FOR LOBBYING PURPOSES WERE: NALTH: 14.35% THA: 8.74% AHA: 32% PICARD GROUP: 60% TOTAL DUES PAID AND REPORTED FOR LOBBYING ACTIVITIES WERE: NALTH: $15,248 * 14.35% = $2,188 THA: $4,399 * 8.74% = $384 AHA: $10,790 * 32% = $3,453 PICARD GROUP: $16,000 * 60.0% = $9,600 166642 166642 0 2880144 2425374 454770 2434379 1105355 1329024 1783794 Short Term Lease Obligations 1083468 Optum Advance Funding 929000 Long Term Lease Obligations 245556 INTERCOMPANY- CCC 12172 Long Term Debt Escheat Accounts 211 INTERCOMPANY- Paducah -3426 INTERCOMPANY- CHC -87778 2179203 true true X true X true X true true false true true 287570 -171000 458570 0.0226 0 0.0 0 0.0 0 0 287570 -171000 458570 0.0226 0 0.0 196263 196263 0.0097 0 0.0 0 0.0 5917 5917 0.0003 0 0 202180 0 202180 0.0100 0 0 489750 -171000 660750 0.0326 0 0.0 0 0.0 6 3 505 505 0.0000 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 6 3 505 0 505 0.0000 true 9399067 8361146 1037921 X true true 1 1 CONTINUECARE HOSPITAL OF TYLER 800 E DAWSON 4TH FLOOR TYLER TX 75701 HTTPS://TYLER.CONTINUECARE.ORG 008065 X X CONTINUECARE HOSPITAL OF TYLER 1 false false true X X X X X X X X X 21 true false false true X HTTPS://TYLER.CONTINUECARE.ORG/CHNA/ X true 21 true HTTPS://TYLER.CONTINUECARE.ORG/CHNA/ false true X 200.0 400.0 X X X true true X X X true X https://tyler.continuecare.org/for-families/financial-assistance/ X https://tyler.continuecare.org/for-families/financial-assistance/ X https://tyler.continuecare.org/for-families/financial-assistance/ X X X X X X true X false X false X X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED IN THE CHNA OF CONTINUECARE HOSPITAL OF TYLER (TYLER CONTINUECARE HOSPITAL) ARE PRESENTED AS A PRIORITIZED DESCRIPTION. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - CONTINUECARE HOSPITAL OF TYLER, INC.. TYLER CONTINUECARE HOSPITAL OPERATES A 51-BED LONG-TERM ACUTE CARE HOSPITAL (LTACH) LOCATED ON THE FOURTH FLOOR OF THE HOST HOSPITAL, CHRISTUS MOTHER FRANCES HOSPITAL - TYLER IN TYLER, TEXAS. AS A "HOSPITAL WITHIN A HOSPITAL", TYLER CONTINUECARE HOSPITAL IS A SEPARATE YET FULLY LICENSED ACUTE-CARE HOSPITAL WITH THE ABILITY TO PROVIDE CARE TO CRITICALLY ILL AND MEDICALLY COMPLEX PATIENTS REQUIRING LONGER ACUTE-CARE STAYS THAN REGULAR HOSPITALS. AS AN LTACH, TYLER CONTINUECARE HOSPITAL DEVELOPS A CONTINUUM OF CARE BETWEEN THE ACUTE AND LONG-TERM PHASES OF A PATIENT'S ILLNESS. A PATIENT IS USUALLY ADMITTED AFTER A SHORT-TERM, ACUTE-CARE HOSPITAL STAY. AFTER CARE IN AN LTACH, MANY PATIENTS ARE THEN ABLE TO TRANSITION FROM THE LTACH TO ACUTE REHAB, SKILLED NURSING OR GO HOME. HOSPICE CARE IS ALSO A POST-ACUTE TREATMENT OPTION FOR PATIENTS WITH A TERMINAL DISEASE WHO HAVE A LIFE EXPECTANCY OF SIX MONTHS OR LESS. TYLER CONTINUECARE HOSPITAL IS DESIGNED TO MEET THE NEEDS OF LONG-TERM, ACUTELY ILL PATIENTS WITH CONDITIONS INCLUDING VENTILATOR DEPENDENCE, CHRONIC PULMONARY PROBLEMS, COMPLEX AND SEVERE WOUNDS, INFECTIOUS DISEASE AND POST COVID RECOVERY. LTACH FACILITIES ALSO PROVIDE PHYSICAL, OCCUPATIONAL, AND NUTRITIONAL THERAPIES, AS WELL AS INFECTION CONTROL AND PATIENT AND FAMILY EDUCATION. TYLER CONTINUECARE HOSPITAL IS LED BY A CLOSE-KNIT TEAM OF PROFESSIONALS WHO SHARE A PHILOSOPHY TO PROVIDE COMPASSIONATE, HIGH-QUALITY HEALTH CARE SERVICES. OUR MULTIDISCIPLINARY TEAM CONSISTS OF PHYSICIANS, NURSES, THERAPISTS, DIETITIANS, SOCIAL WORKERS, CASE MANAGERS, PHARMACISTS AND OTHER PROFESSIONALS WHO WORK TOGETHER ON EVERY ASPECT OF PATIENT CARE. THE DEFINED SERVICE AREA OF TYLER CONTINUECARE HOSPITAL IS SMITH COUNTY IN TEXAS. SMITH COUNTY COMPRISES 36.9% OF STUDY YEAR 2021 INPATIENT DISCHARGES. THE POPULATION OF SMITH COUNTY IS EXPECTED TO INCREASE BY 5.3% FROM 2021 (238,813) TO 2026 (251,488), WHICH IS BELOW THE 7.9% EXPECTED GROWTH FOR THE STATE OF TEXAS FROM 2021 (29,969,514) TO 2026 (32,346,738). AS OF 2021, THE RACIAL/ETHNIC BREAKOUT OF SMITH COUNTY WAS 68.0% WHITE, 17.4% BLACK, 1.6% ASIAN, 0.5% AMERICAN INDIAN AND 12.5% ALL OTHERS. HISPANIC IS CLASSIFIED AS AN ETHNICITY AND THEREFORE IS CATEGORIZED SEPARATELY FROM WHITE, BLACK, ASIAN, AMERICAN INDIAN AND ALL OTHERS. BY 2026, THE WHITE POPULATION IN SMITH COUNTY IS EXPECTED TO INCREASE BY 3.6% AND THE BLACK POPULATION IS EXPECTED TO INCREASE BY 2.7%. BY 2026, THE ASIAN POPULATION IS EXPECTED TO INCREASE BY 21.2% AND THE AMERICAN INDIAN POPULATION IN SMITH COUNTY IS EXPECTED TO INCREASE BY 7.5% WITH ALL OTHER GROUPS EXPECTED TO INCREASE BY 16.1% BY 2026. THE HISPANIC ETHNIC POPULATION IN SMITH COUNTY IS EXPECTED TO INCREASE BY 16.3%. BETWEEN 2015 AND 2019, THE PERCENT OF FOREIGN-BORN RESIDENTS INCREASED IN SMITH COUNTY, THE STATE AND THE NATION. IN 2019, SMITH COUNTY (8.4%) HAD A LOWER PERCENT OF FOREIGN-BORN RESIDENTS THAN THE STATE (17.1%) AND THE NATION (13.7%). SMITH COUNTY (37.2 YEARS) HAS AN OLDER MEDIAN AGE THAN THE STATE OF TEXAS (35.3 YEARS) (2021). THE MEDIAN AGES FOR SMITH COUNTY AND THE STATE ARE EXPECTED TO INCREASE OVER THE NEXT FIVE YEARS (2021-2026). SMITH COUNTY ($58,291) HAS A LOWER MEDIAN HOUSEHOLD INCOME THAN THE STATE OF TEXAS ($63,524) (2021). THE MEDIAN HOUSEHOLD INCOME IN SMITH COUNTY AND THE STATE IS EXPECTED TO INCREASE OVER THE NEXT FIVE YEARS (2021-2026). SMITH COUNTY (27.7%) HAS A LOWER PERCENTAGE OF RESIDENTS WITH A BACHELOR OR ADVANCED DEGREE THAN THE STATE (31.3%) (2021). IN 2014-2018, 16.0% OF THE NATION LIVED IN A DISTRESSED COMMUNITY, AS COMPARED TO 26.0% OF THE NATION THAT LIVED IN A PROSPEROUS COMMUNITY. IN 2014-2018, 24.5% OF THE POPULATION IN TEXAS LIVED IN A DISTRESSED COMMUNITY, AS COMPARED TO 26.2% OF THE POPULATION THAT LIVED IN A PROSPEROUS COMMUNITY. IN 2014-2018, THE DISTRESS SCORE IN SMITH COUNTY WAS 55.2 WHICH IS MORE PROSPEROUS AS COMPARED TO OTHER COUNTIES IN THE STATE. WITH RESPECT TO UNEMPLOYMENT, RATES IN SMITH COUNTY AND THE STATE INCREASED BETWEEN 2018 AND 2020. IN 2020, SMITH COUNTY (6.8) HAD A LOWER UNEMPLOYMENT RATE THAN THE STATE (7.6). OVER THE MOST RECENT 12-MONTH TIME PERIOD, MONTHLY UNEMPLOYMENT RATES IN SMITH COUNTY OVERALL DECREASED. MAY 2021 HAD THE LOWEST UNEMPLOYMENT RATE (5.2) AS COMPARED TO JUNE 2020 WITH THE HIGHEST RATE (9.1). AS OF 2019, THE MAJORITY OF EMPLOYED PERSONS IN SMITH COUNTY ARE WITHIN SALES AND RELATED OCCUPATIONS (11.6%). THE MOST COMMON EMPLOYED GROUPINGS ARE OFFICE AND SALES AND RELATED OCCUPATIONS, (11.6%); ADMINISTRATIVE SUPPORT OCCUPATIONS, (10.6%); MANAGEMENT OCCUPATIONS, (8.9%); CONSTRUCTION AND EXTRACTION OCCUPATIONS, (6.8%); AND FOOD PREPARATION AND SERVING RELATED OCCUPATIONS, (6.5%). IN 2015-2019, DRIVING ALONE WAS THE MOST FREQUENT MEANS OF TRANSPORTATION TO WORK FOR BOTH SMITH COUNTY AND THE STATE. IN 2015-2019, SMITH COUNTY (7.0%) HAD A HIGHER PERCENT OF PEOPLE WORKING AT HOME THAN THE STATE (6.0%). SMITH COUNTY (25.9 MINUTES) HAD A SHORTER MEAN TRAVEL TIME TO WORK THAN THE STATE (27.2 MINUTES) (2015-2019). THERE IS A HIGHER PERCENTAGE OF FAMILIES LIVING BELOW POVERTY IN SMITH COUNTY (19.8%) AS COMPARED TO THE STATE OF TEXAS (18.0%) (2021). BETWEEN 2015 AND 2019, THE PERCENT OF CHILDREN (UNDER 18 YEARS) LIVING BELOW POVERTY IN SMITH COUNTY AND THE STATE DECREASED. SMITH COUNTY (17.8%) HAD A LOWER PERCENTAGE OF CHILDREN (UNDER 18 YEARS) LIVING BELOW POVERTY THAN TEXAS (19.2%) (2019). ACCORDING TO FEEDING AMERICA, AN ESTIMATED 14.8% OF SMITH COUNTY RESIDENTS ARE FOOD INSECURE AS COMPARED TO 14.1% IN TEXAS. ADDITIONALLY, 21.0% OF THE YOUTH POPULATION (UNDER 18 YEARS OF AGE) IN SMITH COUNTY ARE FOOD INSECURE, AS COMPARED TO 19.6% IN TEXAS (2019). THE AVERAGE MEAL COST FOR A SMITH COUNTY RESIDENT IS $2.95, AS COMPARED TO $2.68 IN TEXAS (2019). BETWEEN 2014 AND 2018, SMITH COUNTY MAINTAINED A LOWER PERCENTAGE OF RECIPIENTS WHO QUALIFIED FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) BENEFITS THAN THE STATE. IN 2018, SMITH COUNTY (11.1%) HAD A LOWER PERCENTAGE OF RECIPIENTS WHO QUALIFIED FOR SNAP BENEFITS THAN THE STATE (12.2%). THE PERCENT OF PUBLIC SCHOOL STUDENTS THAT ARE ELIGIBLE FOR FREE/REDUCED PRICE LUNCH IN SMITH COUNTY (64.3%) IS HIGHER THAN THE STATE RATE (60.5%) AND THE NATIONAL RATE (49.5%) (2018-2019). IN 2018-2019, THE PERCENT OF STUDENTS RECEIVING THEIR HIGH SCHOOL DIPLOMA WITHIN FOUR YEARS IN SMITH COUNTY (92.8%) WAS HIGHER THAN THE STATE (91.4%) AND NATIONAL (87.7%) RATES. Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - CONTINUECARE HOSPITAL OF TYLER, INC. (continued). HEART DISEASE IS THE LEADING CAUSE OF DEATH IN BOTH SMITH COUNTY AND THE STATE (2017-2019). HEART DISEASE MORTALITY RATES IN BOTH SMITH COUNTY AND THE STATE DECREASED BETWEEN 2017 AND 2019. IN 2019, THE HEART DISEASE MORTALITY RATE IN SMITH COUNTY (189.7 PER 100,000) WAS HIGHER THAN THE STATE (163.4 PER 100,000). CANCER IS THE SECOND LEADING CAUSE OF DEATH IN BOTH SMITH COUNTY AND THE STATE (2017- 2019). BETWEEN 2017 AND 2019, CANCER MORTALITY RATES IN SMITH COUNTY INCREASED, WHILE RATES IN THE STATE OF TEXAS DECREASED. IN 2019, THE CANCER MORTALITY RATE IN SMITH COUNTY (157.5 PER 100,000) WAS HIGHER THAN THE STATE (141.4 PER 100,000). CHRONIC LOWER RESPIRATORY DISEASE (CLRD) IS THE THIRD LEADING CAUSE OF DEATH IN SMITH COUNTY, AND THE FOURTH LEADING CAUSE OF DEATH IN THE STATE (2017-2019). BETWEEN 2017 AND 2019, CLRD MORTALITY RATES IN BOTH SMITH COUNTY AND THE STATE DECREASED. IN 2019, THE CLRD MORTALITY RATE IN SMITH COUNTY(44.8 PER 100,000) WAS HIGHER THAN THE STATE (38.6 PER 100,000). FATAL ACCIDENTS IS THE FOURTH LEADING CAUSE OF DEATH IN SMITH COUNTY AND THE FIFTH LEADING CAUSE OF DEATH IN THE STATE (2017-2019). BETWEEN 2017 AND 2019, ACCIDENT MORTALITY RATES IN BOTH SMITH COUNTY AND THE STATE OF TEXAS INCREASED. IN 2019, THE ACCIDENT MORTALITY RATE IN SMITH COUNTY (44.1 PER 100,000) WAS HIGHER THAN THE STATE (39.7 PER 100,000). IN 2019, THE LEADING CAUSE OF FATAL ACCIDENTS IN SMITH COUNTY WAS DUE TO MOTOR VEHICLE ACCIDENTS. CEREBROVASCULAR DISEASES ARE THE FIFTH LEADING CAUSE OF DEATH IN SMITH COUNTY AND THE THIRD LEADING CAUSE OF DEATH IN THE STATE (2017-2019). BETWEEN 2017 AND 2019, CEREBROVASCULAR DISEASE MORTALITY RATES IN SMITH COUNTY INCREASED, WHILE RATES IN THE STATE DECREASED. IN 2019, THE CEREBROVASCULAR DISEASE MORTALITY RATE IN SMITH COUNTY (40.1 PER 100,000) WAS SLIGHTLY HIGHER THAN THE STATE (39.0 PER 100,000). DIABETES MELLITUS, INTENTIONAL SELF-HARM (SUICIDE), ALZHEIMER'S DISEASE, NEPHRITIS, NEPHROTIC SYNDROME AND NEPHROSIS AND CHRONIC LIVER DISEASE AND CIRRHOSIS ARE ALSO LEADING CAUSES OF DEATH IN SMITH COUNTY. AS OF SEPTEMBER 11, 2021, SMITH COUNTY (72.5 PER 1,000) HAS A LOWER RATE OF TOTAL COVID-19 CASES THAN THE STATE (106.4 PER 1,000). AS OF NOVEMBER 17, 2021, THE PERCENT OF THE POPULATION (AGE 5+) THAT IS FULLY VACCINATED IN SMITH COUNTY (46.7%) IS LOWER THAN THE STATE (60.2%). BETWEEN 2014 AND 2020, OBESITY PREVALENCE RATES IN ADULTS (AGE 18+) IN SMITH COUNTY AND THE STATE INCREASED. IN 2016-2020, SMITH COUNTY (34.2%) HAD A CONSISTENT PERCENTAGE OF OBESE ADULTS (AGE 18 +) AS THE STATE (34.2%). SMITH COUNTY (63.6%) HAS A HIGHER RATE OF MEDICARE FEEFORSERVICE RESIDENTS WITH HYPERTENSION THAN THE STATE (59.9%) AND THE NATION (57.2%) (2018). BETWEEN 2014 AND 2020, ASTHMA PREVALENCE RATES IN ADULTS (AGE 18+) IN THE STATE SLIGHTLY INCREASED. IN 2015-2019, THE PREVALENCE RATE OF ADULTS (AGE 18+) EVER DIAGNOSED WITH ASTHMA IN SMITH COUNTY (10.0%) WAS LOWER THAN THE STATE (12.6%). BETWEEN 2014 AND 2020, ARTHRITIS PREVALENCE RATES IN ADULTS (AGE 18+) IN SMITH COUNTY AND THE STATE INCREASED. IN 2016-2020, SMITH COUNTY (24.2%) HAD A HIGHER PERCENT OF ADULTS (AGE 18+) EVER DIAGNOSED WITH ARTHRITIS THAN THE STATE (21.2%). BETWEEN 2014 AND 2020, THE RATE OF ADULTS (AGE 18+) IN SMITH COUNTY THAT HAVE BEEN DIAGNOSED WITH A DEPRESSIVE DISORDER STAYED CONSISTENT, WHILE THE RATES IN THE STATE OF TEXAS INCREASED. IN 2016-2020, THE PERCENT OF ADULTS (AGE 18+) EVER DIAGNOSED WITH A DEPRESSIVE DISORDER IN SMITH COUNTY (12.1%) WAS LOWER THAN THE STATE (16.1%). BETWEEN 2014 AND 2020, ADULTS (AGE 18+) WHO SELF-REPORTED THAT THEY HAD A DISABILITY IN SMITH COUNTY AND THE STATE INCREASED. THE PERCENT OF ADULTS (AGE 18+) WHO SELF-REPORTED THAT THEY HAD A DISABILITY IN SMITH COUNTY (24.9%) WAS LOWER THAN THE STATE (26.3%) (2016-2020). AS OF 2019, SMITH COUNTY (25.1%) HAD A SLIGHTLY HIGHER RATE OF UNINSURED ADULTS (AGE 18-64) AS COMPARED TO THE STATE (24.3%). BOTH SMITH COUNTY AND THE STATE EXPERIENCED SLIGHT INCREASES IN THE PERCENTAGE OF UNINSURED ADULTS (AGE 18-64) BETWEEN 2015 AND 2019. A COMPREHENSIVE, SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") WAS CONDUCTED FOR TYLER CONTINUECARE HOSPITAL BY CHC CONTINUECARE. THIS CHNA UTILIZES RELEVANT HEALTH DATA AND STAKEHOLDER INPUT TO IDENTIFY THE SIGNIFICANT COMMUNITY HEALTH NEEDS IN SMITH COUNTY, TEXAS. COMMUNITY INPUT WAS RECEIVED DURING INTERVIEWS CONDUCTED BY CHC CONTINUECARE FROM OCTOBER 12, 2021-NOVEMBER 2, 2021. THE CHNA IS DESIGNED IN ACCORDANCE WITH CHNA REQUIREMENTS IDENTIFIED IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND FURTHER ADDRESSED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS RELEASED ON DECEMBER 29, 2014. THE TYLER CONTINUECARE HOSPITAL BOARD REVIEWED AND ADOPTED THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN ON MAY 5, 2022. INTERVIEW METHODOLOGY: TYLER CONTINUECARE HOSPITAL WORKED WITH CHC CONTINUECARE IN THE DEVELOPMENT OF ITS CHNA. TYLER CONTINUECARE HOSPITAL PROVIDED ESSENTIAL DATA AND RESOURCES NECESSARY TO INITIATE AND COMPLETE THE PROCESS, INCLUDING THE DEFINITION OF THE HOSPITAL'S STUDY AREA AND THE IDENTIFICATION OF KEY COMMUNITY STAKEHOLDERS TO BE INTERVIEWED. BACKGROUND INFORMATION ABOUT TYLER CONTINUECARE HOSPITAL, INCLUDING THE MISSION, VISION, VALUES, AND HOSPITAL SERVICES WAS PROVIDED BY THE HOSPITAL OR TAKEN FROM ITS WEBSITE. POPULATION DEMOGRAPHICS INFORMATION WAS COLLECTED BY CHC CONTINUECARE USING SOURCES WHICH INCLUDED STRATASAN, THE U.S. CENSUS BUREAU AND THE UNITED STATES BUREAU OF LABOR STATISTICS AND INCLUDED INFORMATION REGARDING POPULATION CHANGE BY RACE, ETHNICITY, AGE, MEDIAN HOUSEHOLD INCOME, UNEMPLOYMENT AND ECONOMIC STATISTICS IN THE STUDY AREA. HEALTH DATA WAS ALSO COLLECTED FROM A VARIETY OF SOURCES, INCLUDING BUT NOT LIMITED TO, THE ROBERT WOOD JOHNSON FOUNDATION, THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE, SPARKMAP, THE TEXAS DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE TEXAS CANCER REGISTRY, SMALL AREA HEALTH INSURANCE ESTIMATES (SAHIE), AND THE U.S. CENSUS BUREAU. TYLER CONTINUECARE HOSPITAL PROVIDED CHC CONTINUECARE WITH A LIST OF PERSONS WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN THE SMITH COUNTY, INCLUDING PUBLIC HEALTH REPRESENTATIVES, NOT-FOR-PROFIT ORGANIZATION PROFESSIONALS, CHARITIES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. FROM THAT LIST, ELEVEN IN DEPTH INTERVIEWS WERE CONDUCTED USING A STRUCTURED INTERVIEW GUIDE, WITH THE TWO GROUPS OUTLINED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS ISSUED DECEMBER 29, 2014. DISCUSSED WERE THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. WITH RESPECT TO INDIVIDUALS PROVIDING INPUT, IT WAS NOTED IN THE CHNA THAT 90.9% 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. 9.1% OF THOSE PROVIDING INPUT WORK FOR A STATE, LOCAL, TRIBAL OR REGIONAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENT (OR EQUIVALENT DEPARTMENT OR AGENCY) WITH KNOWLEDGE, INFORMATION OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. Schedule H, Part V, Section B, Line 5 Facility , 3 Facility , 3 - CONTINUECARE HOSPITAL OF TYLER, INC. (continued). INTERVIEWEES INCLUDED: *LEROY BIGGERS: BOARD MEMBER, TYLER FAMILY CIRCLE OF CARE *CRAIG CHESLEY: RETIRED PRESIDENT, APPRAISAL ASSOCIATES; BOARD MEMBER, TYLER CONTINUECARE HOSPITAL; BOARD MEMBER, COMMUNITY HOSPITAL CORPORATION *GINA DAUGHTRY: CHIEF EXECUTIVE OFFICER, HEART TO HEART HOSPICE *JOHN ENGLISH, MD: CHIEF EXECUTIVE OFFICER, BETHESDA HEALTH CLINIC *DAWN FRANKS: OWNER, YOUR PHILANTHROPY *DAN HARDIMAN: OWNER, THE HARDIMAN AGENCY; BOARD PRESIDENT, TYLER CONTINUECARE HOSPITAL *KATHY HARRY: CHIEF EXECUTIVE OFFICER, CATHOLIC CHARITIES *PAUL MCGAHA, MD: ASSOCIATED PROFESSOR OF COMMUNITY HEALTH AND PREVENTATIVE MEDICINE, UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER *ROBERT OWENS: OWNER, TRADITIONS/CORNER BAKERY; BOARD MEMBER, TYLER CONTINUECARE HOSPITAL *GEORGE ROBERTS, JR.: CHIEF EXECUTIVE OFFICER, NORTHEAST TEXAS PUBLIC HEALTH DISTRICT *SHERRI SOCHASKI: DIRECTOR OF HOSPITAL CASE MANAGEMENT, CHRISTUS TRINITY MOTHER FRANCES HOSPITAL - TYLER POPULATIONS THAT WERE IDENTIFIED AS THE MOST AT RISK FOR INADEQUATE CARE IN THE COMMUNITY BY INTERVIEWEES WERE: RACIAL/ETHNIC GROUPS, LOW INCOME, HOMELESS, VETERANS. ELDERLY AND YOUTH. THESE UNDERSERVED GROUPS WERE IDENTIFIED AS MOST AT RISK FOR INADEQUATE CARE DUE TO THE FOLLOWING: RACIAL/ETHNIC - LANGUAGE BARRIERS - TRANSPORTATION BARRIERS - OVERUSE OF EMERGENCY ROOM LOW INCOME - TRANSPORTATION BARRIERS - OVERUSE OF EMERGENCY ROOM - LACK OF AFFORDABLE MEDICAL CARE AND MEDICATIONS - LACK OF ACCESS TO TECHNOLOGY TO ACCESS MEDICAL HEALTH RECORDS - LACK OF AWARENESS AND UNDERSTANDING OF EXISTING HEALTHCARE SERVICES - GENERATIONAL HABITS REGARDING SEEKING MEDICAL CARE HOMELESS - MENTAL HEALTH CONCERNS - OVERUSE OF THE EMERGENCY ROOM VETERANS - LONG WAIT TIME AT VA FACILITIES - TRANSPORTATION ISSUES ELDERLY - EDUCATION ON INSURANCE BENEFITS, SPECIFICALLY MEDICARE/MEDICAID - TRANSPORTATION BARRIERS - EDUCATION ON TELEMEDICINE AND COMPUTER USE - LACK OF ACCESS TO AFFORDABLE NURSING HOME/ASSISTED LIVING - AWARENESS OF SERVICES YOUTH - LIMITED ACCESS TO PEDIATRIC SPECIALTIES - SUPPORT FOR SPECIAL NEEDS (EX. FEEDING TUBES, NUTRITION SUPPLEMENTS) - TRANSPORTATION BARRIERS Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - CONTINUECARE HOSPITAL OF TYLER, INC.. THE MOST RECENTLY CONDUCTED CHNA IDENTIFIED FIVE SIGNIFICANT NEEDS IN THE COMMUNITY SERVED BY TYLER CONTINUECARE HOSPITAL. THE NEEDS WERE IDENTIFIED BY ASSESSING THE PREVALENCE OF THE ISSUES FOUND WITHIN THE HEALTH DATA FINDINGS, COMBINED WITH THE FREQUENCY AND SEVERITY OF MENTIONS IN COMMUNITY INPUT. THE CHNA TEAM, CONSISTING OF LEADERSHIP FROM TYLER CONTINUECARE HOSPITAL, MET WITH CHC CONTINUECARE TO REVIEW THE RESEARCH FINDINGS AND PRIORITIZE THE COMMUNITY HEALTH NEEDS. THE FINAL LIST OF PRIORITIZED NEEDS IS AS FOLLOWS: 1. ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS 2. ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS 3. CONTINUED FOCUS ON COVID-19 PREVENTION & RESPONSE 4. PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES 5. ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES AND PROVIDERS THE CHNA TEAM PARTICIPATED IN A PRIORITIZATION PROCESS USING A STRUCTURED MATRIX TO RANK THE COMMUNITY HEALTH NEEDS BASED ON THREE CHARACTERISTICS: SIZE AND PREVALENCE OF THE ISSUE, EFFECTIVENESS OF INTERVENTIONS AND THE HOSPITAL'S CAPACITY TO ADDRESS THE NEED. ONCE THIS PRIORITIZATION PROCESS WAS COMPLETE, HOSPITAL LEADERSHIP DISCUSSED THE RESULTS AND DECIDED TO ADDRESS FOUR OF THE FIVE PRIORITIZED NEEDS IN VARIOUS CAPACITIES THROUGH A HOSPITAL SPECIFIC IMPLEMENTATION PLAN. PRIORITY #1: ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS OBJECTIVE: PARTICIPATE IN INITIATIVES TO IMPROVE ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS 1.A. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO OFFER THE EMPLOYEE ASSISTANCE PROGRAM (EAP) THROUGH BEACON HEALTH OPTIONS TO HELP EMPLOYEES NAVIGATE VARIOUS LIFE CHALLENGES. 1.B. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO SHARE AVAILABLE LOCAL COUNSELING RESOURCES WITH MENTAL AND BEHAVIORAL HEALTH RELATED PATIENTS AS NEEDED. THROUGH ITS ESTABLISHED RELATIONSHIP WITH ALETHIA, TYLER CONTINUECARE HOSPITAL IS ABLE TO PROVIDE INPATIENT COUNSELING FOR APPLICABLE PATIENTS. 1.C. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO ADDRESS MENTAL HEALTH CONDITIONS AMONG ITS PATIENTS THROUGH MEDICATION MANAGEMENT. PRIMARY CARE PHYSICIANS ARE ABLE TO PROMOTE MEDICATION MANAGEMENT AND REFER PATIENTS TO THE APPROPRIATE MENTAL HEALTH SETTINGS UPON DISCHARGE. 1.D. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO OFFER CHAPLAIN SERVICES TO SUPPORT PATIENTS AND THEIR FAMILIES. PRIORITY #2: ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS OBJECTIVE: PROVIDE ACCESS TO HEALTHCARE AND SERVICES TO VULNERABLE POPULATIONS, SUCH AS THE ELDERLY AND THE INDIGENT 2.A. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO PROVIDE SERVICES TO ELIGIBLE UNINSURED AND UNDERINSURED INDIVIDUALS AS OUTLINED IN THEIR CHARITY CARE POLICY, WHICH IS AVAILABLE TO EVERY PATIENT ON ADMISSION. THIS ALLOWS PATIENTS AND/OR FAMILIES TO KNOW THE DETAILS OF HOW THEY MAY QUALIFY FOR REDUCTION OR ELIMINATION OF ANY BALANCE OWED BY THEM FOR SERVICES WE PROVIDE. 2.B. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO OFFER FINANCIAL ASSISTANCE AND PAYMENT PLAN EDUCATION TO PATIENTS WHO HAVE AN ECONOMIC NEED AND MEET THE QUALIFICATIONS OF THE FINANCIAL ASSISTANCE POLICY. IF FINANCIAL ASSISTANCE IS NEEDED, TYLER CONTINUECARE HOSPITAL ENCOURAGES PATIENTS TO COMPLETE AN APPLICATION TO SEE IF THEY QUALIFY. 2.C. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO IMPLEMENT A VARIETY OF AWARENESS, EDUCATION AND SCREENING PROGRAMS FOCUSED ON AGING AND ON RISK FACTORS, PREVENTION AND TREATMENT OF HEART DISEASE AND RESPIRATORY DISEASE, INCLUDING PARTICIPATING IN ELDER CONFERENCES HELD IN TYLER AND LONGVIEW AND IN LOCAL HEALTH FAIRS AND OFFER BLOOD PRESSURE HEALTH SCREENINGS AS OPPORTUNITIES ARISE. 2.D. TYLER CONTINUECARE HOSPITAL WILL HELP PROVIDE COMMUNITY MEMBERS WITH BASIC NEEDS BY ASSISTING THE LOCAL FOOD PANTRY WITH REGULARLY SCHEDULED FOOD DRIVES AND SCHOOL SUPPLY DRIVE AS OPPORTUNITIES ARISE. 2.E. TYLER CONTINUECARE HOSPITAL WILL COLLABORATE WITH VARIOUS ORGANIZATIONS THAT PROVIDE SERVICES TO VULNERABLE POPULATIONS AS OPPORTUNITIES ARISE. 2.F. TYLER CONTINUECARE HOSPITAL PROVIDES ACCESS TO A TELEPHONE LANGUAGE LINE AND A VIDEO LANGUAGE LINE FOR TRANSLATION SERVICES, AND FLAT SCREEN TELEVISIONS ARE INSTALLED THROUGHOUT THE FACILITY TO AID HEARING IMPAIRED PATIENTS AS APPROPRIATE. 2.G. TYLER CONTINUECARE HOSPITAL WILL SHARE THE RECENTLY DEVELOPED COMMUNITY RESOURCE LIST OF AVAILABLE LOCAL SERVICES FOR APPLICABLE SITUATIONS. 2.H. IN CONJUNCTION WITH THE HOST, TYLER CONTINUECARE HOSPITAL PARTICIPATES IN THE LOCAL PROVIDER PARTICIPATION FUNDS PROGRAM THAT FUNDS SMITH COUNTY'S DELIVERY OF INDIGENT CARE. PRIORITY #3: CONTINUED FOCUS ON COVID-19 PREVENTION & RESPONSE OBJECTIVE: IMPLEMENT AND OFFER PROGRAMS THAT AIM TO REDUCE THE IMPACT OF THE COVID-19 PANDEMIC 3.A. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO PROVIDE EDUCATION ON COVID-19 AS OPPORTUNITIES ARISE. 3.B. TYLER CONTINUECARE HOSPITAL CONTINUES FOLLOWING CDC GUIDELINES AND COMMUNITY STANDARDS TO CONTROL THE SPREAD AND REDUCE RISK OF COVID-19 INFECTION WHEN DISCHARGING PATIENTS TO A LOWER LEVEL OF CARE AND THEIR HOME ENVIRONMENT. 3.C. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO DONATE PPE (EX. MASKS, FACE SHIELDS, SURGICAL GOWNS, ETC.) TO LOCAL ORGANIZATIONS TO HELP CONTROL THE SPREAD AND REDUCE RISK OF COVID-19 INFECTION AS OPPORTUNITIES ARISE. 3.D. TYLER CONTINUECARE HOSPITAL CONTINUES TO REPORT COVID-19 TEST AND PATIENT ADMISSIONS DATA TO THE STATE AND CENTERS FOR DISEASE CONTROL (CDC) IN AN ONGOING EFFORT TO SHARE TIMELY INFORMATION AND RESEARCH REGARDING THE PANDEMIC. VACCINATION RATES AT THE HOSPITAL ARE ALSO PROVIDED. PRIORITY #4: PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES OBJECTIVE: PROVIDE A VARIETY OF EDUCATION AND AWARENESS OPPORTUNITIES THAT AIM TO PROMOTE COMMUNITY WELLNESS, PROVIDE SUPPORT TO COMMUNITY MEMBERS, AND ASSIST PATIENTS AND EMPLOYEES IN CHANGING UNHEALTHY LIFESTYLES 4.A. THE EMPLOYEES OF TYLER CONTINUECARE HOSPITAL ARE DEDICATED TO ENHANCING COMMUNITY WELLNESS BY SUPPORTING LOCAL NURSING SCHOOLS, RESPIRATORY, DPT AND PT ASSISTANT SCHOOLS BY PRESENTING TO STUDENTS ENROLLED IN THESE PROGRAMS AND DONATING EQUIPMENT TO THE FACILITIES. ADDITIONALLY, TYLER CONTINUECARE HOSPITAL HAS AFFILIATION AGREEMENTS WHICH ALLOW FOR CLINICAL ROTATIONS IN THE HOSPITAL WITHIN THE NURSING, PHARMACY AND RESPIRATORY AREAS. 4.B. TYLER CONTINUECARE HOSPITAL WILL ENGAGE IN A VARIETY OF EMPLOYEE WELLNESS INITIATIVES, INCLUDING: PROMOTING EMPLOYEE AND FAMILY WELLNESS VIA ASSET HEALTH; OFFERING NEED SPECIFIC SPECIAL PROGRAMS; ENCOURAGING PARTICIPATION IN QUARTERLY WELLNESS CHALLENGES; SMOKING CESSATION; COLLABORATING WITH HOSPITAL CAFETERIA PROVIDERS TO HIGHLIGHT HEALTHY FOOD OPTIONS; PROVIDING MENTAL HEALTH EDUCATION VIA THE EMPLOYEE ASSISTANCE PROGRAM THROUGH BEACON HEALTH OPTIONS; AND CONTINUING TO IMPLEMENT THE TOBACCO-FREE NEW HIRE POLICY. 4.C. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO MAINTAIN A SMOKE FREE CAMPUS AND PROVIDES EDUCATIONAL LITERATURE ON SMOKING CESSATION AS REQUESTED. 4.D. TYLER CONTINUECARE HOSPITAL WILL CONTINUE TO REACH OUT TO THE COMMUNITY BY OFFERING SPEAKERS AND OTHER INFORMATIVE ACTIVITIES. HOSPITAL PERSONNEL ARE MADE AVAILABLE AS SPEAKERS FOR CIVIC GROUPS, INDUSTRIAL PARTNERS, AND MEDIA APPEARANCES AND HEALTH FAIRS TO ADDRESS HEALTH TOPICS OF PARTICULAR CONCERN TO THE PUBLIC. PRIORITIES NOT ADDRESSED: TYLER CONTINUECARE HOSPITAL DECIDED NOT TO SPECIFICALLY ADDRESS "ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES AND PROVIDERS." BASED ON TYLER CONTINUECARE HOSPITAL'S STATUS AS A LONG-TERM ACUTE-CARE FACILITY, THE HOSPITAL HAS FOCUSED ITS CAPABILITIES ON ADDRESSING THE NEEDS OF THIS PARTICULAR MARKET. THEREFORE, "ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES AND PROVIDERS" IS NOT DIRECTLY ADDRESSED IN THE HOSPITAL'S IMPLEMENTATION PLAN. WHILE TYLER CONTINUECARE HOSPITAL ACKNOWLEDGES THAT THIS IS A SIGNIFICANT NEED IN THE COMMUNITY AND WILL WORK WITH LOCAL COMMUNITY ORGANIZATIONS TO SEE HOW THE FACILITY CAN ASSIST IN THIS AREA, THE IDENTIFIED PRIORITY WILL NOT BE ADDRESSED BY THE HOSPITAL SINCE IT IS NOT A CORE BUSINESS FUNCTION OF THE HOSPITAL AND THE LEADERSHIP TEAM FELT THAT RESOURCES AND EFFORTS WOULD BE BETTER SPENT ADDRESSING THE REMAINING FOUR PRIORITIZED NEEDS. Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - CONTINUECARE HOSPITAL OF TYLER, INC.. TYLER CONTINUECARE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTION ON ANY OUTSTANDING PATIENT ACCOUNTS. 0 Schedule H, Part I, Line 7f EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE SINCE TYLER CONTINUECARE HOSPITAL IS A LONG TERM ACUTE CARE HOSPITAL, IT WILL HAVE LOWER PERCENTAGES THAN AN ACUTE CARE HOSPITAL. Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT Texas Schedule H, Part I PAYMENT FOR CHARITY CARE PAYMENT FOR CHARITY CARE IN THE STATE OF TEXAS, IT IS PERMISSIBLE TO PAY ANOTHER HEALTH PROVIDER FOR CHARITY CARE TO SATISFY THE CHARITY REQUIREMENTS. TYLER CONTINUECARE HOSPITAL DID NOT PAY ANOTHER PROVIDER FOR THE PROVISION OF CHARITY CARE IN FISCAL YEAR 2024 Schedule H, Part II DESCRIBE HOW COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY THE ORGANIZATION PROVIDES VARIOUS CHARITABLE SERVICES TO THE LOCAL COMMUNITY. THESE CHARITABLE SERVICES INCLUDE PROVIDING COMMUNITY MEMBERS WITH BASIC NEEDS BY ASSISTING WITH LOCAL FOOD PANTRY WITH REGULARLY SCHEDULED FOOD DRIVES AND A ONCE A YEAR SCHOOL SUPPLY DRIVE. THE HOSPITAL ALSO COLLABORATED WITH VARIOUS ORGANIZATIONS THAT PROVIDED SERVICES TO VULNERABLE POPULATIONS, SUCH AS THE INDIGENT. THIS INCLUDES ST. PAUL'S CHILDREN'S FOUNDATION, WHICH OFFERS ADULT AND CHILDREN'S MEDICAL AND DENTAL CLINICS, AND EAST TEXAS CRISIS CENTER, WHICH SERVES BATTERED WOMEN IN THE COMMUNITY. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote PATIENTS ACCOUNTS RECEIVABLE CONSIST OF AMOUNTS DUE FOR THE PROVISION OF HEALTH CARE SERVICES WHICH ARE RECORDED AT AMORTIZED COST AT THE NET AMOUNT EXPECTED TO BE COLLECTED. IN EVALUATION OF THE COLLECTABILITY OF PATIENTS ACCOUNTS RECEIVABLE, MANAGEMENT REGULARLY REVIEWS DATA AND DEVELOPS A LOSS RATE TO DETERMINE EXPECTED CREDIT LOSSES BASED ON SEVERAL FACTORS INCLUDING WHETHER A PATIENT HAS THIRD PARTY PAYOR COVERAGE OR IS UNINSURED, THE AGING OF RECEIVABLES, HISTORICAL COLLECTIONS AND LOSS EXPERIENCE, CURRENT CONTRACT PRICES OR CLAIMS PAID DATA, AND TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE. THESE ESTIMATES ARE ADJUSTED FOR RECOVERIES OF ANY ANTICIPATED CHANGES IN TRENDS, INCLUDING SIGNIFICANT CHANGES IN PAYOR MIX, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENT HEALTH CARE COVERAGE. MANAGEMENT BELIEVES THE COMPOSITION OF RECEIVABLES AT YEAR-END IS CONSISTENT WITH HISTORICAL CONDITIONS AS CREDIT TERMS AND PRACTICES AND THE CUSTOMER BASE HAS NOT CHANGED SIGNIFICANTLY; THEREFORE, THE ORGANIZATION HAS MAINTAINED CONSISTENT METHODOLOGY IN ESTIMATE OF CREDIT LOSSES. MANAGEMENT HAS DETERMINED THE ESTIMATE OF EXPECTED CREDIT LOSSES IS NOT MATERIAL TO THE FINANCIAL STATMENTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE COSTING METHODOLOGY USED ON LINE 6 COMES FROM THE COST REPORT (INPATIENT PPS COST-TO-CHARGE RATIO COMPUTATION). ANY SHORTFALL IS A COMMUNITY BENEFIT AS IT IS THE COST OF PROVIDING CARE TO THE COMMUNITY THAT IS NOT REIMBURSED BY THE MEDICARE PROGRAM. BY PROVIDING CARE TO THESE INDIVIDUALS, THE HOSPITAL IS IMPROVING THE HEALTH OF THE COMMUNITY. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IF A PATIENT OF TYLER CONTINUECARE HOSPITAL QUALIFIES FOR ITS CHARITY CARE POLICY THE PATIENTS ACCOUNT IS ADJUSTED ACCORDINGLY. PATIENT ACCOUNTS WITH REMAINING BALANCES WILL BE REASSESSED TO DETERMINE THEIR ABILITY TO PAY AND WILL EITHER BE ELIGIBLE TO PARTICIPATE IN A PAYMENT PLAN OR THEIR ACCOUNT BALANCE WILL BE WRITTEN OFF. Schedule H, Part V, Section B, Line 16a FAP website - CONTINUECARE HOSPITAL OF TYLER: Line 16a URL: https://tyler.continuecare.org/for-families/financial-assistance/; Schedule H, Part V, Section B, Line 16b FAP Application website - CONTINUECARE HOSPITAL OF TYLER: Line 16b URL: https://tyler.continuecare.org/for-families/financial-assistance/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - CONTINUECARE HOSPITAL OF TYLER: Line 16c URL: https://tyler.continuecare.org/for-families/financial-assistance/; Schedule H, Part VI, Line 2 Needs assessment THE HEALTH CARE NEEDS FOR THE COMMUNITY SERVED ARE ASSESSED BY A REVIEW OF THE PRIMARY AND TERTIARY SERVICE AREAS FOR DISEASE SPECIFIC MORTALITY RATES. DISEASE STATISTICS ARE GATHERED FROM THE HEALTH PROMOTION UNIT OF TEXAS DEPARTMENT OF STATE HEALTH SERVICES. INTERVIEWS WITH LOCAL HEALTH CARE AND ELDERLY SERVICE PROVIDERS ARE CONDUCTED TO ASSESS THEIR PERCEIVED UNMET NEEDS IN THE COMMUNITY. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES ARE INFORMED OF THIS UPON ADMISSION TO TYLER CONTINUECARE HOSPITAL. A FACE-TO-FACE VISIT WITH HOSPITAL ADMINISTRATIVE PERSONNEL MAY OCCUR, IF CLINICALLY APPROPRIATE, AT THE TIME OF ADMISSION OR LATER DURING THE HOSPITAL STAY. AS FINANCIAL ISSUES ARE DISCUSSED, IF IT IS FELT THAT THE PATIENT MAY QUALIFY FOR ASSISTANCE THROUGH THE HOSPITALS FINANCIAL ASSISTANCE POLICY, THEN THE NECESSARY DOCUMENTS WOULD BE PRESENTED BY HOSPITAL PERSONNEL TO THE RESPONSIBLE PARTY FOR COMPLETION AND SUBMISSION FOR CONSIDERATION. Schedule H, Part VI, Line 4 Community information TYLER CONTINUECARE HOSPITAL SERVES SMITH COUNTY. THE POPULATION IN SMITH COUNTY IS 238,813 (2021) AND IS EXPECTED TO INCREASE BY 5.3% BY THE YEAR 2026. THE MAJORITY OF RESIDENTS IN SMITH COUNTY IDENTIFY AS WHITE-NON HISPANIC AT 68.0%. (2021). BECAUSE THE HISPANIC MEMBERS OF THE POPULATION ARE CONSIDERED AN ETHNICITY, THE NUMBERS ARE CALCULATED SEPARATELY FROM OTHER RACES. AS OF 2021, THE HISPANIC POPULATION HAD 49,508 RESIDENTS IN SMITH COUNTY AND IT IS EXPECTED TO INCREASE 16.3% BY 2026. THE FASTEST GROWING POPULATION IN SMITH COUNTY IS THE ASIAN POPULATION. BY 2026, THE ASIAN POPULATION IS EXPECTED TO INCREASE 21.2%. SMITH COUNTY (37.2 YEARS) HAS AN OLDER MEDIUM AGE THAT THE STATE OF TEXAS. (35.3 YEARS) 2021. THE MEDIUM AGES IN BOTH SMITH COUNTY AND THE STATE IS EXPECTED TO INCREASE OVER THE NEXT FIVE YEARS. IN 2020, SMITH COUNTY (6.8) HAD A LOWER UNEMPLOYMENT RATE THAN THE STATE (7.6). OVER THE MOST RECENT 12-MONTH TIME PERIOD, MONTHLY UNEMPLOYMENT RATES IN SMITH COUNTY OVERALL DECREASED. MAY 2021 HAD THE LOWEST UNEMPLOYMENT RATE (5.2) AS COMPARED TO JUNE 2020 WITH THE HIGHEST RATE (9.1). IN 2021, THE MEDIAN HOUSEHOLD INCOME IN SMITH COUNTY IS $58,291 WHICH IS LOWER THAN THE STATE OF TEXAS AT $63,524. SMITH COUNTY HAS LOWER EDUCATIONAL ATTAINMENT RATES THAN THE STATE. SMITH COUNTY ALSO HAS A HIGHER PERCENTAGE OF FAMILIES LIVING BELOW POVERTY THAN THE STATE. AS OF 2019, THERE WERE HIGHER RATES OF OVERALL FOOD INSECURITY, CHILD FOOD INSECURITY AND A HIGHER AVERAGE MEAL COST IN SMITH COUNTY THAN IN THE STATE. AS OF 2019, SMITH COUNTY (25.1%) HAS A SLIGHTLY HIGHER RATE OF UNINSURED ADULTS (AGE 18-64) THAN THE STATE (24.3%). HEART DISEASE AND CANCER ARE THE TWO LEADING CAUSES OF DEATH IN SMITH COUNTY. OVERALL MORTALITY RATES IN SMITH COUNTY REMAINED HIGHER THAN STATE RATES BETWEEN 2017 AND 2019. ADDITIONALLY, SMITH COUNTY HAS HIGHER PREVALENCE RATES OF CHRONIC CONDITIONS SUCH AS DIABETES, OBESITY, HIGH BLOOD PRESSURE FOR MEDICARE BENEFICIARIES AS WELL AS HIGHER PERCENTAGES OF ADULTS WITH ARTHRITIS THAN THE STATE. SEDENTARY LIFESTYLE AND CULTURAL FACTORS ARE ALL CONTRIBUTORS TO THESE CHRONIC HEALTH CONDITIONS. SMITH COUNTY ALSO HAS A LOWER PERCENTAGE OF ITS POPULATION (AGE 5+) WHO ARE FULLY VACCINATED WITH THE COVID-19 VACCINE (46.7%) AS COMPARED TO STATE (60.2%) (INFORMATION AS OF DECEMBER 17, 2021). THERE ARE HIGHER PERCENTAGES OF RESIDENTS PARTICIPATING IN UNHEALTHY LIFESTYLE BEHAVIORS SUCH AS TOBACCO USE IN SMITH COUNTY THAN THE STATE. WITH REGARD TO MATERNAL AND CHILD HEALTH, SMITH COUNTY HAS HIGHER RATES OF MOTHERS RECEIVING INADEQUATE PRENATAL CARE AND HIGHER TEEN (AGE 0-19 YEARS) BIRTH RATES THAN THE STATE. Schedule H, Part VI, Line 5 Promotion of community health THE HEALTH OF THE COMMUNITY IS PROMOTED BY PARTNERING WITH LOCAL HEALTH CARE PROVIDERS TO GIVE ASSISTANCE IN WHATEVER IS NECESSARY TO MEET THE NEEDS OF THEIR CONSTITUENTS. Tyler ContinueCare Hospital also participates in events to support local nonprofit organizations as they arise. Current examples include: Children's Miracle Network, Back to School Bash Family Circle of Care, Back to School Healthfair BNR, Dash & Dine Transitional Care American Heart Association raffle, and the Kyle Lake Foundation. Additionally, Tyler ContinueCare Hospital PARTICIPATES IN REGULAR FOOD DRIVES FOR A LOCAL FOOD PANTRY AND ASSISTS WITH GATHERING SUPPLIES FOR THEIR ANNUAL BACK TO SCHOOL DRIVE WHERE SCHOOL SUPPLIES ARE COLLECTED FOR FILLING BACKPACKS PRIOR TO GOING BACK TO SCHOOL. Current example includes: St. Paul's Children Foundation. THE HOSPITAL STAFF ALSO PARTICIPATES IN HEALTH FAIRS THAT PRESENT INFORMATION ON HEALTHY LIFESTYLES TO THE ELDERLY OR UNDERSERVED POPULATION. Current examples include: St. Paul's Children's Foundation, East Texas Crisis Center, Hangers for Hope, Bethesda Health Clinic. IN ORDER TO BETTER SERVE THE PATIENTS SEEKING CARE Tyler ContinueCare HOSPITAL PROMOTES AN OPEN MEDICAL STAFF and ALSO HAS A COMMUNITY BOARD STRUCTURE SO THAT THE HOSPITAL CAN BE GOVERNED BY THE COMMUNITY IN WHICH IT SERVES. Schedule H, Part VI, Line 6 Affiliated health care system TYLER CONTINUECARE HOSPITAL IS AN AFFILIATE OF CHRISTUS MOTHER FRANCES HEALTH SYSTEM IN TYLER, TEXAS. THE HEALTH PROMOTION ACTIVITIES FOR BOTH ORGANIZATIONS ARE COLLABORATIVE IN ORDER TO HAVE A FAR REACHING EFFECT ON THE COMMUNITY. EACH ORGANIZATION ASSESSES THE NEEDS OF THE COMMUNITY AND THEN WORKS IN WAYS THAT WOULD MEET ANY UNMET NEEDS WITHIN THE COMMUNITY. false true false false false false false false false JIM KENDRICK DIRECTOR 0 1057220 0 455090 0 65411 0 294497 0 40930 0 1913148 0 0 JAMES HILL TREASURER 0 339865 0 51674 0 23381 0 23940 0 31234 0 470094 0 0 STEPHANIE HYDE CEO/PRESIDENT 0 204223 0 0 0 12277 0 15040 0 26996 0 258536 0 0 LINDA MOORE SECRETARY 0 355018 0 52572 0 43475 0 26433 0 43475 0 520973 0 8363 Kent Andries CNO ContinueCare Tyler 0 149260 0 0 0 1349 0 11256 0 36680 0 198545 0 0 Lisa Williams Registered Nurse 124351 0 0 0 1956 0 2007 0 32006 0 160320 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation TYLER CONTINUECARE HOSPITAL DOES NOT COMPENSATE THE PRESIDENT OF THE ORGANIZATION. CHC COMMUNITY CARE (CCC) COMPENSATES THE TYLER CONTINUECARE HOSPITAL PRESIDENT. CCC FOLLOWS THE COMPENSATION POLICY OF COMMUNITY HOSPITAL CORPORATION (CHC). CHC ENGAGED SULLIVAN COTTER TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITIES AND CURRENT INCUMBENTS COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THE ORGANIZATION FOLLOWED THE PROCESS FOR THE YEAR ENDED 6/30/24 FOR ITS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES AND OTHER MANAGEMENT OFFICIALS. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan NON QUALIFIED RETIREMENT PLAN PARTICIPATION WAS PAID TO: JIM KENDRICK - $284,597 JAMES HILL - $16,258 LINDA MOORE - $24,895 Form 990, Part VI, Line 15 OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN THE ORGANIZATIONS EXECUTIVES ARE EMPLOYED BY CCC WHICH FOLLOWS THE COMPENSATION POLICY OF CHC. CHC ENGAGED SULLIVAN COTTER TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITIES AND CURRENT INCUMBENTS COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THE ORGANIZATION FOLLOWED THE PROCESS FOR THE YEAR ENDED JUNE 30, 2024 FOR ITS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES AND OTHER MANAGEMENT OFFICIALS. THIS PROCESS IS PERFORMED EACH YEAR PRIOR TO THE ANNUAL EMPLOYEE EVALUATION PROCESS, WHICH ENDS ON OCTOBER 1ST OF EACH YEAR. Form 990, Part VI, Line 3 Delegation of management duties CHC COMMUNITY CARE, LLC (CCC) PROVIDES CERTAIN FINANCIAL, TECHNICAL AND MANAGERIAL SUPPORT SERVICES TO THE HOSPITAL. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE SHAREHOLDER OF CONTINUECARE HOSPITAL OF TYLER, INC. (TYLER CONTINUECARE HOSPITAL) IS CCC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE SOLE MEMBER SHALL MAINTAIN A MINORITY VOTING INTEREST OF THE BOARD OF DIRECTORS. ANY DIRECTOR MAY BE REMOVED AT ANY TIME, WITH OR WITHOUT CAUSE BY THE SOLE MEMBER. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE BOARD OF DIRECTORS MAY RECOMMEND, BUT SHALL NOT, WITHOUT EXPRESS WRITTEN CONSENT OF THE SOLE MEMBER, HAVE THE POWER TO TAKE ANY OF THE FOLLOWING ACTIONS: 1. ANY FUNDAMENTAL CHANGE IN THE MISSION OF PHILOSOPHY OF THE HOSPITAL 2. THE INCURRANCE OF DEBT, INCLUDING WITHOUT LIMITATION, BORROWINGS, GUARANTEES, LOANS, ENCUMBRANCES, OPERATING LEASES, PURCHASE OF LEASE OF REAL ESTATE, AND CAPITAL LEASES 3. ANY MERGER OR CONSOLIDATION TO WHICH THE HOSPITAL IS A PARTY 4. THE SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE HOSPITAL 5. POLICY CHANGES PERTAINING TO CHARITY CARE 6. APPOINTMENT AND REMOVAL OF CORPORATE DIRECTORS 7. ANY RELEASE OR CANCELLATION OF INDIVIDUAL CLAIMS IN EXCESS OF $25,000. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body THERE WERE NO COMMITTEES OF THE GOVERNING BODY. Form 990, Part VI, Line 11b Review of form 990 by governing body THE DETAILED REVIEW OF THE FORM 990 IS CONDUCTED BY THE HOSPITAL'S MANAGEMENT FOLLOWING THE PREPARATION AND REVIEW OF THE RETURN BY THE ORGANIZATION'S PAID PREPARER. AN ELECTRONIC COPY OF THE FINAL FORM 990 IS EMAILED TO EACH BOARD MEMBER PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADOPTED BY ITS SOLE MEMBER, CCC, WHICH IN TURN FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADMINISTERED BY ITS PARENT, COMMUNITY HOSPITAL CORPORATION (CHC), WHICH REQUIRES ALL OFFICERS, DIRECTORS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES AND OTHER MANAGEMENT OFFICIALS ("COVERED PERSONS") TO DISCLOSE POTENTIAL CONFLICTS. THE ORGANIZATION'S BOARD FORMALLY ADOPTED CHC'S CONFLICT OF INTEREST POLICY FOR YEAR ENDED JUNE 30, 2011. PURSUANT TO THE POLICY, A DISCLOSURE STATEMENT IS CIRCULATED ANNUALLY TO COVERED PERSONS IN WHICH THE INDIVIDUAL MUST DISCLOSE TRANSACTIONS THAT MAY RESULT IN A CONFLICT. COVERED PERSONS ARE ALSO ENCOURAGED TO NOTIFY THE BOARD, APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICER, GENERAL COUNSEL OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. WHEN NECESSARY, THE BOARD CHAIR OR APPROPRIATE BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND RECOMMEND ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT OR OTHERWISE DETERMINE IF THE CONFLICT CAN BE RESOLVED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE MAKES THE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. ANY MEMBER OF THE BOARD OPERATING UNDER A CONFLICT IS NOT PERMITTED TO BE PRESENT OR OTHERWISE PARTICIPATE IN THE VOTE ON ANY MATTER TO WHICH THE CONFLICT RELATES. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND AFTER INVESTIGATION THE BOARD OR COMMITTEE DETERMINES THAT THE COVERED PERSON FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE ORGANIZATION TAKES APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION, WHICH MAY INCLUDE, TERMINATION OF THE INDIVIDUAL'S MEMBERSHIP, EMPLOYMENT OR CONTRACT. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE AT ITS BUSINESS OFFICE UPON REQUEST. Form 990, Part IX, Line 11g Other Fees PURCHASED SERVICES - MEDICAL - Total Expense: 4693144, Program Service Expense: 4693144, Management and General Expenses: , Fundraising Expenses: ; FEES - PHYSICIAN - Total Expense: 508320, Program Service Expense: 508320, Management and General Expenses: , Fundraising Expenses: ; FEES - OTHER SERVICES - Total Expense: 27151, Program Service Expense: 24547, Management and General Expenses: 2604, Fundraising Expenses: ; Form 990, Box C Doing Business As Tyler ContinueCare Hospital Tyler ContinueCare Hospital at Mother Frances Hospital BAPTIST HOSPITALS OF SOUTHEAST TEXAS PO BOX 1591 BEAUMONT TX 77704 741303720 HOSPITAL TX 501(c)(3) 3 SWCH INC false BAPTIST PHYSICIAN NETWORK 3080 COLLEGE ST BEAUMONT TX 77701 760453250 PRIMARY CARE TX 501(c)(3) 3 BHSET false BHSETX FOUNDATION 810 HOSPITAL DRIVE 235 BEAUMONT TX 77701 611557670 SUPPORT ORG TX 501(c)(3) 7 BHSET false CAROLINAS COMMUNITY CARE LLC 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 465590355 SUPPORT ORG DE 501(c)(3) Type II CHC false CHC COMMUNITY CARE LLC 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 371485773 SUPPORT ORG TX 501(c)(3) Type III-FI CHC false COMMUNITY HOSPITAL CORPORATION 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 752638469 SUPPORT ORG TX 501(c)(3) Type III-FI NA false CONTINUECARE HOSP AT BAPTIST HLT PADUCAH 2501 KENTUCKY AVENUE 5TH FL PADUCAH KY 42003 465032999 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSP AT HENDRICK MED CTR 1900 PINE ST 5TH FL ABILENE TX 79601 463607347 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSP BPTST HLT MADISONVILLE 900 HOSPITAL DRIVE 4TH FL MADISONVILLE KY 42431 465033192 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSPITAL AT BAPTIST HEALTH 1 TRILLIUM WAY CORBIN KY 40701 200925675 HOSPITAL KY 501(c)(3) 3 CCC false CONTINUECARE HOSPITAL AT ODESSA INC 500 W 4TH STREET ODESSA TX 79761 473539943 HOSPITAL DE 501(c)(3) 3 CCC false CONTINUECARE HOSPITAL AT PALMETTO HEALTH 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 813048423 HOSPITAL TX 501(c)(3) 3 CCC false CRAWLEY MEMORIAL HOSPITAL INC 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 560691100 HOSPITAL NC 501(c)(3) 3 CAR CC false GAINESVILLE COMMUNITY HOSPITAL INC 1900 HOSPITAL BLVD GAINESVILLE TX 76240 831683025 HOSPITAL TX 501(c)(3) 3 CHC false HMH PHYSICIAN ORGANIZATION 110 MEMORIAL HOSPITAL DRIVE HUNTSVILLE TX 77340 760500960 PUBLIC CHARI. TX 501(c)(3) 10 HCH 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 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 HUNTSVILLE COMMUNITY HOSPITAL INC FOUNDATION 110 MEMORIAL HOSPITAL DRIVE HUNTSVILLE TX 77340 320771710 SUPPORT ORG TX 501(c)(3) 7 HCH 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 true true false false false COMMUNITY HOSPITAL CORPORATION P 1644664 COST CHC COMMUNITY CARE LLC P 1205126 COST CHC COMMUNITY CARE LLC O 366573 COST