Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2010 and ending 09-30-2011
BCheck if applicable:
CName of organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
811 SOUTH WASHINGTON AVE
 
Room/suite
City or town, state or country, and ZIP + 4
MARSHALL, TX75670
D Employer identification number

75-0974351
E Telephone number

G Gross receipts $ 102,898,978
F Name and address of principal officer:
PAT KEEL
700 E MARSHALL AVE
LONGVIEW,TX75601
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
HTTP://WWW.GSMCMARSHALL.ORG/
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1954
M State of legal domicile: TX
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION REGARDLESS OF RACE, SEX, CREED, NATIONAL ORIGIN, HADICAP, AGE, OR ABILITY TO PAY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 17
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 12
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 600
6 Total number of volunteers (estimate if necessary) .... 6 74
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 2,904
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -3,683
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 90,000
9 Program service revenue (Part VIII, line 2g) ......... 94,330,339 101,587,764
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 207,278 204,220
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 887,312 991,590
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 95,424,929 102,873,574
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 23,533,238 24,994,683
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet15,573    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 70,964,406 72,633,139
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 94,497,644 97,627,822
19 Revenue less expenses. Subtract line 18 from line 12...... 927,285 5,245,752
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 69,165,766 70,270,084
21 Total liabilities (Part X, line 26)............ 53,902,991 49,542,944
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 15,262,775 20,727,140
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION REGARDLESS OF RACE, SEX, CREED, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 83,431,513 including grants of $   ) (Revenue $ 101,587,764 )
GOOD SHEPHERD MEDICAL CENTER-MARSHALL EXISTS TO IDENTIFY AND DELIVER QUALITY HEALTHCARE SERVICES IN A SAFE & CARING ENVIRONMENT TO THE PEOPLE OF THIS REGION.GOOD SHEPHERD MEDICAL CENTER - MARSHALL IS A NOT-FOR-PROFIT FACILITY LOCATED IN NORTHEAST TEXAS, APPROXIMATELY 150 MILES EAST OF DALLAS, TEXAS AND 35 MILES WEST OF SHREVEPORT, LOUISIANA. GOOD SHEPHERD MEDICAL CENTER - MARSHALL IS THE ONLY HOSPITAL LOCATED IN HARRISON AND MARION COUNTIES. ESTABLISHED IN 1909 BY SEVERAL HARRISON COUNTY PHYSICIANS, GOOD SHEPHERD MEDICAL CENTER - MARSHALL HAS GROWN TO A 149 BED FACILITY WITH AN INTENSIVE CARE UNIT AND A 24-HOUR LEVEL III TRAUMA CENTER. GOOD SHEPHERD MEDICAL CENTER - MARSHALL IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION FOR HEALTHCARE ORGANIZATIONS.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 83,431,513
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
63
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
600
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
No
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
17
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
JANET ANDERSEN
700 E MARSHALL AVE
LONGVIEW,TX75601
(903) 315-5177
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) EDWARD D BANOS
PRESIDENT/CEO
 1.00 X   X       0 695,940 8,409
(2) BUCK BIRDSONG
BOARDMEMBER
 1.00 X           0 0 0
(3) R BLAIR ABNEY
BOARDMEMBER
 1.00 X           0 0 0
(4) DAVID BATES
BOARD TREASURER
 1.00 X   X       0 0 0
(5) GLEN BICKERDIKE
BOARD CHAIRMAN
 1.00 X   X       0 0 0
(6) BRENDA BROWN
BOARDMEMBER
 1.00 X           0 0 0
(7) RUSS COLLIER
PRESIDENT/CEO
 40.00 X   X       388,256 0 60,340
(8) LEROY FISHER
BOARDMEMBER
 1.00 X           0 0 0
(9) JOHN MCDONALD DO
VP OF MEDICAL STAFF
 1.00 X           0 186,200 20,173
(10) GEORGE MEISENHEIMER
BOARDMEMBER
 1.00 X           0 0 0
(11) CHASE PALMER
BOARDMEMBER
 1.00 X           0 0 0
(12) DEAN SEARLE
BOARD SECRETARY
 1.00 X   X       0 0 0
(13) JULIE SIMMONS
BOARDMEMEBER
 1.00 X           0 0 0
(14) ALLEN STAGGERS
BOARD VICE CHAIRMAN
 1.00 X   X       0 0 0
(15) ROBERT W PALMER
DIRECTOR
 1.00 X           0 0 0
(16) WILLIAM SIMPSON
VICE PRESIDENT
 1.00 X   X       0 547,214 35,444
(17) O IVAN WHITE JR
BOARDMEMBER
 1.00 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) DIANE JONES
BOARDMEMBER
 1.00 X           0 0 0
(19) RICKY PAUL MD
PRESIDENT OF MEDICAL STAFF
 1.00 X           0 425,474 37,583
(20) PAULA BRANDON
VICE PRESIDENT
 40.00     X       191,852 0 50,351
(21) GARLAND RAY DELK
VICE PRESIDENT
 40.00     X       167,391 0 29,093
(22) PAT KEEL
CFO
 1.00     X       0 346,520 4,153
(23) JOYCE EGLI
CHARGE NURSE
 40.00         X   102,017 0 1,445














1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 849,516 2,201,348 246,991
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet4
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
GOOD SHEPHERD HOSPITAL INC
700 E MARSHALL AVE
LONGVIEW,TX75601 		MEDICAL SERVICES 2,434,776
GSHS ADMINISTRATIVE SERVICES ORG
700 E MARSHALL AVE
LONGVIEW,TX75601 		ADMINISTRATIVE SERVICES 1,576,089
MARSHALL HEALTH SERVICES INC
PO BOX 1325
MARSHALL,TX75671 		PROFESSIONAL FEES 1,230,770
TEXAS MEDICAID & HEALTHCARE
PO BOX 204270
AUSTIN,TX78720 		MEDICAID/MEDICARE ADMINISTRATION 1,128,389
COMPLETERX LTD
3100 S GESSNER SUITE 640
HOUSTON,TX77063 		PHARMACY MANAGEMENT SERVICES 905,954
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet37
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 50,000
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		40,000
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 90,000
Program Service Revenue Business Code
2a NET PATIENT REVENUES 621,110 97,749,138 97,749,138    
b DISPRO RECEIPTS 621,110 2,836,215 2,836,215    
c LIFE WELLNESS CENTER 624,200 578,116 578,116    
d GOVERNMENT FUNDS-TRAUM 624,200 47,888 47,888    
e
f All other program service revenue . 376,407 373,503 2,904  
g Total. Add lines 2a–2f........MediumBullet 101,587,764
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 194,573     194,573
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 594,550  
b Less: rental expenses 25,404  
c Rental income or (loss) 569,146  
d Net rental income or (loss).......MediumBullet 569,146     569,146
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   9,647
b Less: cost or other basis and sales expenses    
c Gain or (loss)   9,647
d Net gain or (loss)..........MediumBullet 9,647     9,647
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a CAFETERIA REVENUE 722,210 405,785 405,785    
b VENDING MACHINES 722,210 16,659 16,659    
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 422,444
12 Total revenue. See Instructions....MediumBullet 102,873,574 102,007,304 2,904 773,366
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 747,499 747,499    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 124,125 124,125    
7 Other salaries and wages 19,628,515 13,622,495 6,006,020  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 627,867 443,789 184,078  
9 Other employee benefits ....... 2,360,569 1,668,497 692,072  
10 Payroll taxes ........... 1,506,108 1,064,547 441,561  
11 Fees for services (non-employees):        
a Management ...... 623,051   623,051  
b Legal ......... 168,542 9,388 159,154  
c Accounting ........... 375,377   375,377  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 13,233,045 13,068,303 163,002 1,740
12 Advertising and promotion .... 41,095 11,000 29,063 1,032
13 Office expenses ....... 943,853 579,744 353,777 10,332
14 Information technology ...... 467,596   467,596  
15 Royalties ..        
16 Occupancy ........... 992,675 721,154 271,373 148
17 Travel ............ 159,066 107,714 51,352  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 2,154,538   2,154,538  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 3,407,273 2,555,455 851,818  
23 Insurance .............. 552,314 414,236 138,078  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a BAD DEBT 41,273,397 41,273,397    
b MEDICAL SUPPLIES AND EQ 6,724,716 6,385,952 338,764  
c DIETARY EXPENSES 845,099 272,854 569,924 2,321
d PLANT OPERATIONS AND MA 303,965 227,974 75,991  
e SETTLEMENT 192,000   192,000  
f All other expenses 175,537 133,390 42,147  
25 Total functional expenses. Add lines 1 through 24f 97,627,822 83,431,513 14,180,736 15,573
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1 2,413
2 Savings and temporary cash investments ....... 15,895,328 2 16,307,928
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 9,166,313 4 7,715,785
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7 0
8 Inventories for sale or use .............. 681,416 8 923,494
9 Prepaid expenses and deferred charges ............ 724,349 9 756,824
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 69,602,623
b Less: accumulated depreciation. ..... 10b 44,629,101 26,341,310 10c 24,973,522
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ...... 808,295 12 973,374
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ......... 1,478,774 14 1,450,048
15 Other assets. See Part IV, line 11 ........... 14,069,981 15 17,166,696
16 Total assets. Add lines 1 through 15 (must equal line 34)... 69,165,766 16 70,270,084
Liabilities 17 Accounts payable and accrued expenses . 7,093,704 17 4,203,809
18 Grants payable ..........   18  
19 Deferred revenue .......... 42,667 19  
20 Tax-exempt bond liabilities .......... 43,387,497 20 43,371,925
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 2,358,617 23 423,190
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 1,020,506 25 1,544,020
26 Total liabilities. Add lines 17 through 25..... 53,902,991 26 49,542,944
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 14,567,634 27 19,862,275
28 Temporarily restricted net assets ..... 695,141 28 864,865
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 15,262,775 33 20,727,140
34 Total liabilities and net assets/fund balances ..... 69,165,766 34 70,270,084
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
102,873,574
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
97,627,822
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
5,245,752
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
15,262,775
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
218,613
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
20,727,140
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL
Employer identification number

75-0974351
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL
Employer identification number

75-0974351
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL 		Employer identification number

75-0974351
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL 		Employer identification number

75-0974351
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL 		Employer identification number

75-0974351
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL
Employer identification number

75-0974351
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
2,885
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
 
No
 
j
Total. lines 1c through 1i ...................................
2,885
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL
Employer identification number

75-0974351
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   602,390 602,390
b Buildings ................   43,439,045 25,099,426 18,339,619
c Leasehold improvements ............   98,113 78,790 19,323
d Equipment ................   25,065,374 19,130,134 5,935,240
e Other .................   397,701 320,751 76,950
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 24,973,522
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) HEALTH INSURANCE AND RENT 1,260
(2) INTERCOMPANY 17,165,436







Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 17,166,696
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
INTERCOMPANY PAYABLES 701,015
BOND INTEREST PAYABLE 513,622
OTHER NON CURRENT LIABILITIES 329,383






Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 1,544,020
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 102,873,574
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 97,627,822
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 5,245,752
4 Net unrealized gains (losses) on investments .......................... 4 -36,467
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 255,080
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 218,613
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 5,464,365
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 61,433,581
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d 25,404
e Add lines 2a through 2d ..................... 2e 25,404
3 Subtract line 2e from line 1..................... 3 61,408,177
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b 41,465,397
c Add lines 4a and 4b....................... 4c 41,465,397
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 102,873,574
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 56,187,829
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d 25,404
e Add lines 2a through 2d...................... 2e 25,404
3 Subtract line 2e from line 1..................... 3 56,162,425
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b 41,465,397
c Add lines 4a and 4b....................... 4c 41,465,397
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 97,627,822
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE SYSTEM, GSHS ASO, THE MEDICAL CENTER, GSMC LINDEN, GSMC MARSHALL, THE GSMC FOUNDATION AND THE GSMC - LINDEN FOUNDATION ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. THESE ENTITIES ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. ENTERPRISES IS A TAXABLE CORPORATION. CSC IS TAXED AS A PARTNERSHIP. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR ENTERPRISES FOR THE TAX EFFECTS OF DIFFERENCES BETWEEN THE FINANCIAL STATEMENTS AND TAX BASES OF ASSETS AND LIABILITIES. A VALUATION ALLOWANCE IS ESTABLISHED TO REDUCE DEFERRED TAX ASSETS IF IT IS MORE LIKELY THAN NOT THAT A DEFERRED TAX ASSET WILL NOT BE REALIZED. THE SYSTEM FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. WITH A FEW EXCEPTIONS, THE SYSTEM IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2008.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   CHANGE IN INTEREST IN THE FOUNDATION 165,080. CONTRIBUTIONS 90,000.
PART XII, LINE 2D - OTHER ADJUSTMENTS:   RENTAL EXPENSES NETTED AGAINST REVENUE 25,404.
PART XII, LINE 4B - OTHER ADJUSTMENTS:   LAW SUIT SETTLEMENT 192,000. BAD DEBT EXPENSE 41,273,397.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:   RENTAL EXPENSES NETTED AGAINST REVENUE 25,404.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:   BAD DEBT EXPENSE 41,273,397. LAW SUIT SETTLEMENT 192,000.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL
Employer identification number

75-0974351
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    1,985,645   1,985,645 3.530 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    8,757,886 9,429,262 -671,376 0 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     779,769 469,527 310,242 0.550 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		    11,523,300 9,898,789 1,624,511 4.080 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    87,526   87,526 0.160 %
f Health professions education
(from Worksheet 5) .. 		    322,706   322,706 0.570 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		           
jTotal Other Benefits ...     410,232   410,232 0.730 %
kTotal. Add lines 7d and 7j. ..     11,933,532 9,898,789 2,034,743 4.810 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
8,696,305
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
 
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
19,610,701
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
17,834,636
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
1,776,065
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
11 LHC GROUP INC
  		HOME HEALTH CARE IN MARSHALL 33.330 %    
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 HARRISON COUNTY HOSPITAL ASSOCIATION
811 SOUTH WASHINGTON ST
MARSHALL,TX75670 		X X         X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:NOT REQUIRED
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?  
Name and address Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 3C: POLICY THE FOLLOWING MUST BE MET:(1) A RATIO IS DEVELOPED BY DIVIDING THE PATIENT'S INCOME BY THE FEDERAL POVERTY GUIDELINES.(2) THIS RATIO IS MATCHED TO THE FOLLOWING CHART TO DETERMINE AMOUNT ELIGIBLE FOR FINANCIAL ASSISTANCE.RATIO ASSISTANCE0% - 100% 100%101%-200% 80%201%-300% 60%301%-400% 40%401%-500% 20%501%-1000% 0%
    PART I, L7 COL(F): BAD DEBT EXPENSE IN THE AMOUNT OF $41,273,397 WAS NOT INCLUDED IN TOTAL EXPENSE USED TO COMPUTE THE PERCENTAGE REPORTED IN PART I, LINE 7, COL(F).
    PART II: THE COMMUNITY BUILDING ACTIVITIES INCLUDE OUR WELLNESS CENTER AND THE PROGRAMS WE OFFER IN AN ATTEMPT TO KEEP OUR COMMUNITY HEALTHY. THE WELLNESS CENTER IS THE HUB OF OUR PROGRAM OFFERING FITNESS AND WELLNESS PROGRAMS FOR INDIVIDUALS, FAMILIES AND BUSINESSES IN OUR COMMUNITY, INCLUDING OUR OWN EMPLOYEES AND THEIR FAMILIES. WE ALSO OFFER A VARIETY OF WATER AEROBICS, ADULT AEROBIC CLASSES, SENIOR EXERCISE CLASSES, SPECIALTY CLASSES, SUCH AS ZUMBA CARDIAC REHAB CLASSES, ETC. WE ALSO OFFER ACUTE, CHRONIC, AND PREVENTATIVE EDUCATIONAL PROGRAMS TO OUR COMMUNITY. WE ARE INVOLVED IN THE SCHOOLS WITH PRENATAL CLASSES FOR PREGNANT TEENS AT THE SCHOOL AND HAVE WORKED WITH THE SCHOOLS ON OBESITY PROGRAMS. IN ADDITION, WE PROVIDE COMMUNITY EDUCATIONAL SERVICES AND PROGRAMS, SUCH AS CPR, CERTIFIED DIABETIC EDUCATION PROGRAMS, WOUND CARE EDUCATION AND PREVENTION, SEATBELT AWARENESS, HARD HATS FOR LITTLE HEADS BICYCLE RODEO PROGRAMS, AND SHOPPING CLASSES FOR THOSE TRYING TO MODIFY THEIR DIET FOR CARDIAC REASONS OR WEIGHT LOSS. WE ALSO OFFER HEALTH FAIRS THROUGHOUT THE YEAR, PROVIDING BASIC SCREENING EXAMS AT NO COST TO OUR COMMUNITY. OUR CASE MANAGEMENT AND SOCIAL SERVICES PROGRAM OFFER THE AVAILABILITY OF EXTERNAL RESOURCES AND PROGRAMS TO ASSIST PATIENTS AND THEIR FAMILIES, SUCH AS WIC AND OTHER GOVERNMENT AND PRIVATE PROGRAMS. THESE ARE JUST SOME EXAMPLES OF THE MANY EDUCATIONAL AND DEVELOPMENTAL PROGRAMS WE HAVE PROVIDED TO OUR COMMUNITY.
    PART III, LINE 4: PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE STATED AT NET REALIZED AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS AND OTHERS FOR SERVICES RENDERED. THE MEDICAL CENTER PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS,WHICH IS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. PATIENTS ACCOUNT RECEIVABLES ARE ORDINARILY DUE 30 DAYS AFTER THE ISSUANCE OF THE BILL.BALANCES PAST DUE MORE THAN 120 DAYS ARE CONSIDERED DELINQUENT. DELINQUENT RECEIVABLES ARE WRITTEN OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT OR THIRD-PARTY PAYER.PART III, LINE 2: IS BAD DEBT FROM OUR AUDITED FINANCIAL STATEMENTS MULTIPLIED BY THE COMPUTED COST TO CHARGE RATIO (21.07%). WE DID NOT INCLUDE ANY BAD DEBT AMOUNTS IN COMMUNITY BENEFIT. SEE BAD DEBT NARRATIVE AND FOOTNOTES TO AUDITED FINANCIAL STATEMENTS.
    PART III, LINE 8: PT III, LINE 6 - MEDICARE ALLOWABLE COSTS WERE DERIVED FROM FYE 9/30/2011 FILED COST REPORT FOR FINANCIAL AND STATISTICAL DATA TO DEVELOP PER DIEMS AND COST TO CHARGE RATIOS FOR ALLOWABLE COST AND REIMBURSEMENT.PART III, LINE 8: SOURCE OF INFORMATION ON LINE 6 IS THE FYE 09/30/11 MEDICARE COST REPORT. THE SUM OF MEDICARE PART A ALLOWABLE COSTS REPORTED ON WORKSHEET D-1, PART II (FOR BOTH INPATIENT ACUTE PPS AND INPATIENT REHAB FACILITY)AND WORKSHEET DV, COLUMN 9 FOR MEDICARE OUTPATIENT PPS SERVICES. SINCE ALLOWABLE COSTS ARE NOT DETERMINED FOR SERVICES RENDERED TO MEDICARE PATIENTS ENROLLED IN MEDICARE ADVANTAGE (MEDICARE PART C) OR FOR PHYSICIAN SERVICES (SUCH AS EMERGENCY ROOM DOCTORS) BILLED UNDER MEDICARE PART B, NEITHER THE REVENUES OR COSTS RELATED TO THESE SERVICES HAVE BEEN INCLUDED ON LINES 5 OR 6.
    PART III, LINE 9B: PART III, LINE 9B:ALL PATIENTS WHO ARE UNDERINSURED OR UNINSURED WILL BE EVALUATED FOR GOVERNMENT PROGRAMS,PAYMENT PLANS, AND FINANCIAL ASSISTANCE. IF ALL ATTEMPTS FAIL, WE WILL CONSIDER EACH ACCOUNT MEETING CERTAIN CRITERIA FOR FINANCIAL ASSISTANCE. ANY ACCOUNT THAT HAS A BALANCE GREATERTHAN $10,000 AND HAS NOT QUALIFIED FOR MEDICAID OR COUNTY PROGRAMS WILL BE REVIEWED ON A CASE BY CASE BASIS FOR CHARITY CONSIDERATION. CREDIT REPORTS WILL BE RUN AND SUBMITTED FOR REVIEW. IF THE PATIENT HAS A CREDIT SCORE BELOW 650, AND THE BALANCE IS COMPLETELY OWED BY THE GUARANTOR/PATIENT ON ANY ONE ACCOUNT, CHARITY WILL BE CONSIDERED AT 100%. WRITE-OFFS WILL BE MONITORED THROUGH A SPECIFIC CODE, TO MONITOR AND EVALUATE AS NEEDED FOR CHANGES OR UPDATES. IF AT ANYTIME RECOVERIES ARE OBTAINED AFTER WRITE-OFF, THE CHARITY ADJUSTMENT WILL BE REVERSED AND ADDITIONAL REVIEW OF THE ACCOUNT WILL BE REQUIRED.
    PART VI, LINE 2: THE BOARD OF DIRECTORS IS A NON-PAID COMMUNITY BASED BOARD WHO REPRESENTS A BROAD SPECTRUM OF OUR COMMUNITY. THEY GUIDE THE DIRECTION OF THE ORGANIZATION BASED ON THE INFORMATION THEY RECEIVE FROM THEIR CONSTITUENTS, THE PROGRAM CAPABILITIES OF THE ORGANIZATION, AVAILIBILITY OF PHYSICIANS AND THE PERFORMANCE OUTCOMES OF THE ORGANIZATION. IN ADDITION, THE GOOD SHEPHERD MEDICAL CENTER, MARSHALL EXECUTIVES AND MID-LEVEL MANAGERS LIVE AND WORK IN THIS COMMUNITY, SURROUNDING COMMUNITIES AND ALL THREE COUNTIES WHICH WE SERVE, AS WELL AS PARTICIPATE IN COMMUNITY ORGANIZATION AT ALL LEVELS. GOOD SHEPHERD MEDICAL CENTER, MARSHALL HAS A GROUP OF OVER 1,100 SENIORS WHO ARE A PART OF OUR EXTRA STEPS PROGRAM WHO PROVIDE US FEEDBACK MONTHLY AT THEIR MEETING WHERE MORE THAN 500 SENIORS ATTEND. IN ADDITION, GOOD SHEPHERD MEDICAL CENTER, MARSHALL HAS A WELLNESS CENTER SERVING 2,900 MEMBERS CALLED THE LIFECENTER WHERE POPULATIONS OF ALL AGES COME TO WORK OUT AND PARTICIPATE IN WELLNESS PROGRAMS. THE CENTER HAS A BOX FOR IDEAS REGARDING IMPROVEMENTS, PROGRAMS, AND SUGGESTIONS. IN ADDITION, LOCAL AND INDIVIDUAL MEETINGS ARE HELD WITH LOCAL BUSINESSES WHERE WE HAVE AN OPEN FORUM/FOCUS GROUP THAT SHARES INFORMATION REGARDING IMPROVEMENT AND PROGRAMS THEY WOULD LIKETO SEE OUR ORGANIZATION OFFER TO ASSIST IN MEETING THEIR EMPLOYEE'S HEALTHCARE NEEDS. THE CEO PARTICIPATES IN A TASK FORCE TO POTENTIATE GROWTH AND DEVELOPMENT OF OUR COMMUNITY AND THE ASSOCIATED NEEDS REQUIRED TO OBTAIN SUCH GROWTH AND DEVELOPMENT. WE TYPICALLY CONDUCT A FORMAL COMMUNITY ASSESSMENT THROUGH OUR MARKETING DEPARTMENT EVERY 2 YEARS.
    PART VI, LINE 3: ANY PATIENT WITH A BALANCE OWED IS PROVIDED A FINANCIAL ASSISTANCE APPLICATION WITH INSTRUCTIONS WHICH LIST THE DOCUMENTS REQUIRED TO PROCESS THE FINANCIAL ASSISTANCE APPLICATION. A CONTACT PERSON IS LISTED FOR ANY QUESTIONS OR CONCERNS AND A FINANCIAL COUNSELOR IS AVAILABLE IF NEEDED. THE FINANCIAL COUNSELOR ALSO GOES TO PATIENT ROOMS TO PERSONALLY ASSIST WHO HAVE BEEN INDENTIFIED AS HAVING NO METHOD OF PAYMENT OR HARDSHIP FOR THE PURPOSE OF ASSISTING PATIENTS WITH THEIR FINANCIAL NEEDS.
    PART VI, LINE 4: GOOD SHEPHERD MEDICAL CENTER, MARSHALL IS LOCATED IN THE PINEY WOODS OF EAST TEXAS AND SERVES A RURAL AREA WHICH INCLUDES HARRISON, NORTHERN PANOLA, AND SOUTHERN MARION COUNTIES. THE POPULATION IN EACH OF THESE COUNTIES IS DIVERSE IN INCOME AND ETHNICITY AS INDICATED BELOW. HARRISON COUNTY IS LOCATED IN NORTHEASTERN TEXAS ALONG THE LOUISIANA BORDER. MARSHALL, THE COUNTY SEAT, IS 152 MILES EAST OF DALLAS AND 39 MILES WEST OF SHREVEPORT. THE COUNTY SEAT IS MARSHALL, TEXAS. HARRISON COUNY WAS OFFICIALLY ESTABLISHED IN 1839 AND COMPRISES 984 SQUARE MILES. BASED ON THE 2009 ESTIMATED CENSUS THERE IS A POPULATION OF 64,795 WITH THE FOLLOWING DISTRIBUTION OF AGE BASED ON 2008 NUMBERS: 6.8% UNDER 5 YEARS OF AGE, 24.3% UNDER AGE 18 AND 12.9% OVER THE AGE OF 65. THE 2008 ETHNICITY DISTRIBUTION OF HARRISON COUNTY IS AS FOLLOWS: 75% OF THE POPULATION IS WHITE, 22.4% IS BLACK, 8.8% HISPANIC OR LATINO, WHITE, NOT, HISPANIC IS 67.1% AND THE REMAINDERS ARE AMERICAN INDIAN, ASIAN, NATIVE HAWAIIAN/PACIFIC ISLANDER OR MORE THAN TWO RACES. THE AVERAGE HOUSEHOLD INCOME IN HARRISON COUNTY IN 2010 WAS $44,425. 15.2% OF POPULATION WAS BELOW THE POVERTY LEVEL IN 2010. MARION COUNTY IS NORTH OF HARRISON COUNTY WITH JEFFERSON, TEXAS AS THE COUNTY SEAT. THE POPULATION OF MARION COUNTY IS ESTIMATED IN 2010 TO BE 10,546 AND 23.2% OF ITS RESIDENTS LIVE IN POVERTY. 11.2% OF THE POPULATION HAS A COLLEGE EDUCATION. MARION COUNTY HAS A MEDIAN HOUSEHOLD INCOME OF $29,943 AND 23.2% OF RESIDENTS LIVE IN POVERTY. THE 2008 ETHNICITY DISTRIBUTION OF MARION COUNTY IS WHITE 75.7%, BLACK 21.3%, 3.2% IS HISPANIC OR LATINO, WHITE, NOT HISPANIC IS 72.9% AND THE REMAINDER ARE AMERICAN INDIAN, ASIAN, NATIVE HAWAIIAN/PACIFIC ISLANDER OR MORE THAN TWO RACES. THE AVERAGE HOUSEHOLD INCOME IN 2008 WAS $31,510 WITH 21.6% BELOW POVERTY LEVEL. PANOLA COUNTY IS DUE SOUTH OF HARRISON COUNTY WITH CARTHAGE AS THE COUNTY SEAT. THE POPULATION OF PANOLA COUNTY IS 23,310 BASED ON THE 2009 ESTIMATES. ACCORDING TO THE 2008 STATISTICS, 6.6% ARE UNDER THE AGE OF 5 YEARS OF AGE, 23.2% ARE UNDER THE AGE OF 18 AND 15.7% ARE OVER 65 YEARS OF AGE. THE 2008 ETHNICITY DISTRIBUTION OF PANOLA COUNTY IS 80.4% WHITE, 17.8% BLACK, 6.1% HISPANIC OR LATINO, 74.5% ARE WHITE PERSONS NOT HISPANIC AND THE REMAINDERS ARE AMERICAN INDIAN, ASIAN, NATIVE HAWAIIAN/PACIFIC ISLANDER OR MORE THAN TWO RACES. THE AVERAGE HOUSEHOLD INCOME IN 2008 WAS $42,917 WITH 13.9% BELOW POVERTY LEVEL.
    PART VI, LINE 7: WE ARE A PART OF GOOD SHEPHERD HEALTH SYSTEMS WHICH HAS ALLOWED US TO BETTER OUTREACH AND SERVE OUR CATCHMENT AREA. ONE OF THE AFFILIATED HOSPITALS IN OUR SYSTEMS IS A CRITICAL ACCESS HOSPITAL LOCATED IN LINDEN, TEXAS WHICH IS THE COUNTY SEAT OF CASS COUNTY AND MEDICALLY SERVES THE NORTHERN PART OF MARION COUNTY AND CASS COUNTY. THE AREA IS QUITE REMOTE AND RURAL. IT IS ALSO DIFFICULT TO RECRUIT PHYSICIANS TO THIS COMMUNITY AND AREA. SINCE OUR AFFILIATION, SEVERAL OF OUR PHYSICIANS PROVIDE OUTPATIENT CLINICS AND PERFORM SERVICES/PROCEDURES OR ACCEPT TRANSFERS TO RENDER COMPREHENSIVE CARE TO THE NORTHERN PART OF MARION COUNTY AND CASS COUNTY POPULATION.
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL
Employer identification number

75-0974351
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) EDWARD D BANOS (i)
(ii)		 0
495,128 		0
200,812 		0
0 		0
6,125 		0
2,284 		0
704,349 		0
0
(2) RUSS COLLIER (i)
(ii)		 322,506
0 		65,750
0 		0
0 		53,200
0 		7,140
0 		448,596
0 		0
0
(3) JOHN MCDONALD DO (i)
(ii)		 0
184,700 		0
1,500 		0
0 		0
16,500 		0
3,673 		0
206,373 		0
0
(4) WILLIAM SIMPSON (i)
(ii)		 0
547,214 		0
0 		0
0 		0
32,644 		0
2,800 		0
582,658 		0
0
(5) RICKY PAUL MD (i)
(ii)		 0
365,035 		0
60,439 		0
0 		0
32,618 		0
4,965 		0
463,057 		0
0
(6) PAULA BRANDON (i)
(ii)		 169,852
0 		22,000
0 		0
0 		43,898
0 		6,453
0 		242,203
0 		0
0
(7) GARLAND RAY DELK (i)
(ii)		 145,391
0 		22,000
0 		0
0 		26,414
0 		2,679
0 		196,484
0 		0
0
(8) PAT KEEL (i)
(ii)		 0
311,519 		0
35,001 		0
0 		0
0 		0
4,153 		0
350,673 		0
0








Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
SUPPLEMENTAL INFORMATION PART III EDWARD D BANOS 40 HOURS RELATED ORGANIZATION JOHN MCDONALD 40 HOURS RELATED ORGANIZATION RICKY PAUL 40 HOURS RELATED ORGANIZATION PAT KEEL 40 HOURS RELATED ORGANIZATION WILLIAM SIMPSON 40 HOURS RELATED ORGANIZATION
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL
Employer identification number
75-0974351
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A HARRISON COUNTY HEALTH FACILITIES DEVELOPMENT CORPORATION
  		75-2740093 415221AW0 09-22-2010 43,980,049 REFUND ESCROWS, CAPITAL PROJECTS AND IMPROVEMENTS   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 43,980,049      
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . .        
4 Gross proceeds in reserve funds . . 3,077,293      
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 879,601      
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . .        
11 Other spent proceeds . .        
12 Other unspent proceeds. . .        
13 Year of substantial completion . . .
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X              
15 Were the bonds issued as part of an advance refunding issue?   X            
16 Has the final allocation of proceeds been made? . .   X            
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X              
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X            
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X            
b Are there any research agreements that may result in private business use of bond-financed property? . .   X            
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X              
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet        
6 Total of lines 4 and 5 . . .. . . . . .        
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X            
2 Is the bond issue a variable rate issue?   X            
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X            
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X            
b Name of provider .  
  		 
  		 
  		 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X            
6 Did the bond issue qualify for an exception to rebate? . . .   X            
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL
Employer identification number

75-0974351
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) DEBORAH BATES DIR-BATES IS SPOUSE 43,328 SALARIES/WAGES   No
(2) TARA COLLIER DIR-COLLIER IS FAMILY 13,941 SALARIES/WAGES   No
(3) THREASA COLLIER DIR-COLLIER IS FAMILY 66,856 SALARIES/WAGES   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL
Employer identification number

75-0974351
Identifier Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6   GOOD SHEPHERD HEALTH SYSTEM, INC. IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A   AS THE SOLE MEMBER, GOOD SHEPHERD HEALTH SYSTEM, INC. HAS THE POWER TO APPOINT ONE MEMBER TO THE CORPORATION'S BOARD OF DIRECTORS AND THE POWER TO APPROVE THE REMAINING DIRECTORS NOMINATED TO THE BOARD.
FORM 990, PART VI, SECTION A, LINE 7B   A NUMBER OF DECISIONS OF THE ORGANIZATION ARE SUBJECT TO APPROVAL OF THE MEMBER OF THE ORGANIZATION. THESE RESERVED POWERS ARE STATED BELOW: A) THE APPOINTMENT OF ONE MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, AND THE APPROVAL OF THE REMAINING DIRECTORS FOLLOWING THE NOMINATION PROCESS AND SUBJECT TO THE PROVISIONS GOVERNING STAFF DIRECTORS; B) THE REMOVAL OF A MEMBER OF THE ORGANIZATION'S BOARD AND ALSO THE APPROVAL OF REMOVAL AND APPOINTMENTS TO FILL VACANCIES ON THE BOARD AND SET SIZE OF BOARD; C) APPROVE ELECTION AND REMOVAL OF OFFICES OF THE ORGANIZATION AND ESTABLISH, TERMINATE, AND/OR REVISE ALL EMPLOYMENT CONTRACTS, COMPENSATION, AND BENEFIT PACKAGES OF THE OFFICERS OF THE ORGANIZATION REGARDLESS OF WHICH ENTITY ACTUALLY PAYS SUCH COMPENSATION OR BENEFITS; D) DESIGNATE THE FISCAL YEAR; E) APPROVE THE SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, OUTSIDE GENERAL LEGAL COUNSEL, AND OUTSIDE INVESTMENT ADVISORS; F) AMEND THE ARTICLES OF INCORPORATION; G) APPROVE ALL MERGERS ACQUISITIONS, CONSOLIDATIONS, OR AFFILIATIONS WITH OHTER ENTITIES, THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION, OR THE SALE, MORTGAGE, OR ENCUMBRANCE OF ANY PROPERTY OWNED BY THE ORGANIZATION; H) APPROVE THE DISSOLUTION OR LIQUIDATION OF THE ORGANIZATION; I) APPROVE CAPITAL PLANS, STRATEGIC PLANS, AND ANNUAL OPERATING AND CAPITAL BUDGETS; J) APPROVE ANY EXCEPTION TO THE CAPITAL BUDGET FOR A SINGLE ITEM OR RELATED ITEM THAT EXCEEDS $100,000 AND/OR APPROVE ANY AGGREGATE ANNUAL EXPENDITURES THAT EXCEED THE BUDGET BY $50,000; K) SELECT OFFICIAL DEPOSITORIES FOR THE ORGANIZATION'S FUNDS; L) CREATE OR INVEST IN ANY SUBSIDIARY ENTITY OR ENTER INTO ANY PARTNERSHIP OR JOINT VENTURE; M) AUTHORIZE ANY LOANS, GUARANTEES, OR INCURRENCE OF DEBT; N) AUTHORIZE THE COMMENCEMENT OF ANY LITIGATION OR OTHER LEGAL PROCEEDING, OR THE SETTLEMENT, DISPOSITION, OR TERMINATION OF ANY SUCH LITIGATION OR OTHER LEGAL PROCEEDING OR OF ANY CLAIM OR THREAT OF LITIGATION OR OTHER LEGAL PROCEEDING NOT FULLY COVERED BY INSURANCE; AND O) APPROVE THE ADMISSION OF ADDITIONAL MEMBERS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11   THE ORGANIZATION HAS AN EXTERNAL ACCOUNTING FIRM AUDIT ON A CONSOLIATED BASIS. INTERNAL ACCOUNTING PREPARES THE 990. THE 990 IS REVIEWED BY AN EXTERNAL ACCOUNTING FIRM. THE RETURN IS THEN REVIEWED BY INTERNAL ACCOUNTANTS AND EXECUTIVES. THE RETURNS ARE SENT TO THE BOARD FOR FINAL APPROVAL BEFORE FILING.
  FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURES ARE OBTAINED ANNUALLY. THE BOARD REVIEWS AND APPROVES THE BOARD MEMBERS' DISCLOSURES, AND THE CEO REVIEWS AND APPROVES THE EMPLOYEES' DISCLOSURES. BOARD MINUTES REFLECT WHEN A BOARD MEMBER DECLARES A CONFLICT AND DOES NOT VOTE.
  FORM 990, PART VI, SECTION B, LINE 15 A COMPENSATION SUBCOMMITTEE OF THE BOARD NEGOTIATES CONTRACTS WITH EXECUTIVES THROUGH HAY GROUP. THIS SUBCOMMITTEE OF THE BOARD REVIEWS AND APPROVES COMPENSATION AND BONUSES.
  FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -36,467. CHANGE IN INTEREST IN THE FOUNDATION 165,080. CONTRIBUTIONS 90,000. TOTAL TO FORM 990, PART XI, LINE 5: 218,613.
COMMUNITY BENEFITS - CONT'D FORM 990, PART III, LINE 4A RECRUITMENT OF ADDITIONAL PHYSICIANS IN THE COMMUNITIES SERVED BY THE HOSPITAL CONTINUES TO BE A HIGH PRIORITY. SPECIFIC AREAS TARGETED FOR PRIORITY IN PHYSICIAN RECRUITMENT INCLUDE: INTERNAL MEDICINE, FAMILY PRACTICE, OBSTETRICS AND GYNECOLOGY, ORTHOPEDICS, AND HOSPITALIST. IN THE PAST YEAR, GOOD SHEPHERD MARSHALL HAS ADDED THE FOLLOWING SPECIALTIES TO THE AREA: RHEUMATOLOGY, ENDOCRINOLOGY, AND NEUROSURGERY. A GENERAL SURGEON AND A PODIATRIST WERE ALSO RECRUITED. THE HOSPITAL CURRENTLY HAS A RETAINED SEARCH FOR AN OB/GYN. THE HOSPITAL CONTRACTS WITH ONLY BOARD CERTIFIED EMERGENCY MEDICINE PHYSICIANS, RADIOLOGISTS, AND HOSPITALISTS. RECRUITMENT EFFORTS IN THE AREA OF MID-LEVEL PRACTITIONERS ALSO CONTINUE TO BE A HIGH PRIORITY. BEING ABLE TO STAFF PHYSICIAN OFFICES AND RURAL HEALTH CLINICS WITH MID-LEVEL PRACTITIONERS ALLOWS EASIER ACCESS TO PATIENTS WITH NON-EMERGENT ROUTINE MEDICAL CONDITIONS. THIS, IN TURN, ALLOWS FOR MORE APPROPRIATE AND BENEFICIAL ACCESS TO PHYSICIANS FOR PATIENTS WITH EMERGENT CASES. TWO ADDITIONAL MID-LEVEL PRACTITIONERS WERE ADDED IN AREA CLINICS AND ONE IN THE HOSPITAL. SURVEY RESULTS AND COMMUNITY INTEREST HAVE SHOWN THE NEED FOR IMPROVED FACILITIES AND TECHNOLOGY IN THE HOSPITAL. FOLLOWING A CAREFUL AND INTENTIONAL LONG-RANGE PLAN, DURING THE LAST 10 YEARS EACH AREA OF PATIENT CARE HAS UNDERGONE EXTENSIVE RENOVATION AND UPGRADING. IN ONE PHASE OF CONSTRUCTION, A STATE-OF-THE-ART EMERGENCY DEPARTMENT WAS CONSTRUCTED AND AN OUTPATIENT SURGERY CENTER WAS ADDED. THE HOSPITAL ALSO NOW CONTAINS A G.I. LAB WITH DIGITAL ENDOSCOPY EQUIPMENT AND AN ACUTE REHAB FACILITY. THE OPERATING AREA WAS EXPANDED TO INCLUDE SEVEN OPERATING SUITES; THE ICU WAS ENLARGED AND UPDATED WITH NEWER TECHNOLOGY. ALL ROOMS CAN BE MONITORED CONTINUOUSLY AS WELL. EVERY ROOM ON THE PATIENT CARE FLOORS HAS BEEN REFURBISHED TO ENHANCE PATIENT SATISFACTION AND THE CARE THEY RECEIVE. THE HOSPITAL OPERATES TWO PEDIATRIC RURAL HEALTH CLINICS. THESE HAVE PROVEN TO BE VERY SUCCESSFUL ENDEAVORS IN REACHING CHILDREN IN UNDERSERVED AREAS OF THE COUNTIES SERVED. LAST YEAR COMBINED, THESE TWO CLINICS BROUGHT NEEDED PEDIATRIC SERVICES TO 18,424 PATIENTS. A FAMILY HEALTH CLINIC IS LOCATED IN MARSHALL DIRECTLY BEHIND THE HOSPITALS EMERGENCY DEPARTMENT. STAFFED BY MID-LEVEL PRACTITIONERS AND PHYSICIANS, IT HELPS SERVE THE NEEDS FOR THOSE WHO DO NOT HAVE A PRIMARY CARE PHYSICIAN AND TO OFFER HEALTHCARE FOR THE NON-EMERGENT CASES THAT ARRIVE AT THE HOSPITALS EMERGENCY DEPARTMENT. LAST YEAR THE CLINIC TREATED 15,412 PATIENTS. FOR MAXIMUM BENEFIT FOR THE PUBLIC, THE FAMILY HEALTH CLINIC IS A JOINT VENTURE WITH HARRISON COUNTY AND HOUSES THE HOSPITALS FAMILY CLINIC AS WELL AS THE HARRISON COUNTY HEALTH DEPARTMENT. THE COMBINING OF THESE EFFORTS AND FACILITIES AND LOCATING BOTH IN CLOSE PROXIMITY TO THE EMERGENCY DEPARTMENT HAS BEEN A VERY PRACTICAL AND BENEFICIAL STREAMLINING OF SERVICE TO OUR PUBLIC IN CARING FOR THEIR MEDICAL NEEDS. THE HOSPITALS EMERGENCY DEPARTMENT SAW 23,852 PATIENTS LAST YEAR. SINCE MANY OF THESE PATIENTS COME TO THE EMERGENCY ROOM FOR TREATMENT OF ROUTINE MEDICAL CONDITIONS, AFTER A THOROUGH TRIAGE, MORE OF THE NON-EMERGENT CASES ARE BEING REFERRED TO THE FAMILY CLINIC. THIS PLACES THE APPROPRIATE TREATMENT IN THE APPROPRIATE SETTING AND ALLOWS THE EMERGENCY DEPARTMENT TO MORE READILY TREAT THE TRULY EMERGENT CASES AND SPEED THE CARE NEEDED. IN 2006 THE HOSPITAL OPENED A WOUND CARE CENTER. THIS HAD BEEN IDENTIFIED AS A NEED IN THE STRATEGIC PLANNING PROCESS PARTICULARLY FOR THE LARGE NUMBER OF DIABETIC AND ELDERLY PATIENTS IN OUR AREA. THIS CENTER ASSISTS THOSE WHO HAVE WOUNDS THAT ARE SLOW TO HEAL. THESE OCCUR MORE COMMONLY IN THE ELDERLY WHO HAVE, FOR EXAMPLE, DIABETES OR OTHER CONTRIBUTING CAUSES, AND THE CENTER FEATURES SUCH TREATMENT OPTIONS AS A HYPERBARIC CHAMBER. THE WOUND CARE CENTER PROVIDES LOCAL CARE AND TREATMENT FOR PROBLEMS THAT PREVIOUSLY WENT UNCARED FOR OR THAT PATIENTS HAD TO TRAVEL GREATER DISTANCES TO RECEIVE. THE HOSPITAL WILL PLAY A MAJOR ROLE IN THE WELLNESS/PREVENTION ASPECT OF HEALTH CARE FOR THE COMMUNITY IN THE COMING YEAR. DIABETIC EDUCATION CLASSES ARE CONDUCTED ON AN ONGOING BASIS, AND THE HOSPITALS DIABETIC EDUCATOR ATTENDS LOCAL HEALTH FAIRS AND PUBLIC EVENTS. A DIABETES SUPPORT GROUP MEETING IS ALSO HELD ONCE PER QUARTER. A CAREGIVER AND STROKE CLUB MEETS EACH MONTH TO PROVIDE EDUCATION AND SUPPORT FOR LOCAL RESIDENTS WHO ARE CARING FOR A LOVED ONE OR WHO HAVE HAD A STROKE. EACH FEBRUARY A STRONG EMPHASIS IS PLACED ON HEART DISEASE IN WOMEN AND THE MARSHALL HOSPITAL FOUNDATION HOSTS A SERIES OF EVENTS TO PROVIDE EDUCATION ABOUT THE SIGNS AND SYMPTOMS OF HEART DISEASE ALONG WITH TIPS ON HOW TO LOWER CONTROLLABLE RISK FACTORS. GOOD SHEPHERD MARSHALL IS A LEVEL III TRAUMA CENTER AND PROVIDES EDUCATION FOR INJURY PREVENTION THROUGHOUT THE YEAR. IN 2011, THE HOSPITAL OFFERED THREE OUTREACH EVENTS INCLUDING THE FOLLOWING TOPICS: BICYCLE SAFETY, WATER SAFETY, AND HUNTING SAFETY. THE SAFETY SPOKES BICYCLE EVENT WAS FREE TO PUBLIC AND OVER 80 HELMETS WERE DISTRIBUTED TO CHILDREN IN ATTENDANCE. THE ANNUAL CAMO EXPO OFFERS A WIDE-RANGE OF SAFETY INFORMATION INCLUDING GUN SAFETY, WILDERNESS SAFETY, HUNTING SAFETY, AND OTHER TOPICS RELEVANT TO THE OUTDOORS. THERE WERE MORE THAN 400 IN ATTENDANCE AT CAMO EXPO. IN APRIL 2010, GOOD SHEPHERD - MARSHALL PARTNERED WITH TEXAS PARKS AND WILDLIFE GAME WARDENS TO PROVIDE A WATER SAFETY EVENT PROMOTING SAFETY AROUND POOLS, LAKES, AND WATER WILDLIFE. THIS WAS LATER TRANSITIONED TO THE CAMO EXPO EVENT. HEALTH SCREENINGS TAKE PLACE AT THE WORK SITES FOR VARIOUS LOCAL MAJOR EMPLOYERS. IN COOPERATION WITH EMPLOYERS, THESE CLINICS HAVE PROVIDED COLLECTION OF INFORMATION OF BASIC HEALTH INDICATORS WHICH ASSIST WITH POSSIBLE EARLY DETECTION OF ILLNESS. ESPECIALLY FOR THOSE WHO DO NOT HAVE A PRIMARY CARE PHYSICIAN, THESE WORKPLACE CLINICS HAVE ALLOWED LOCAL RESIDENTS TO DETECT CERTAIN RISK FACTORS THAT THEY DID NOT KNOW THEY EXHIBITED. IMMEDIATE INTERVENTION HAS BEEN NECESSARY FOR SOME WHICH HAS SAVED LIVES AND IMPROVED HEALTH AND WELLNESS OF LOCAL RESIDENTS AND A HEALTHIER, MORE PRODUCTIVE WORKFORCE. GOOD SHEPHERD MARSHALL ALSO PROVIDES ON-SITE FLU SHOT CLINICS FOR MORE THAN 20 EMPLOYERS. THE HOSPITAL CONTINUES TO OFFER SERVICES TO AREA CITIZENS OVER THE AGE OF 55 THROUGH ITS EXTRA STEPS PROGRAM. THROUGH THIS PROGRAM MEMBERS HAVE ACCESS TO MONTHLY EDUCATION PROGRAMS ON TOPICS THAT ARE RELEVANT AND OF INTEREST TO SENIORS, FREE CONSULTATIONS AND ASSISTANCE WITH MEDICARE CLAIMS AND HOSPITAL BILLS, AND NUMEROUS WELLNESS OPPORTUNITIES THROUGH THE MARSHALL LIFE CENTER AT FREE OR SIGNIFICANTLY DISCOUNTED RATES. IN ADDITION THE PROGRAM ORGANIZES SOCIAL ACTIVITIES THROUGHOUT THE YEAR. FUNCTIONS RANGE FROM DAY TRIPS TO NEARBY URBAN CITIES ARTS, CULTURAL, AND RECREATIONAL OPPORTUNITIES, TO INTERNATIONAL EXCURSIONS TO EUROPE OR THE FAR EAST. HARRISON, MARION AND PANOLA COUNTIES ARE HOME TO A LARGE POPULATION WITH UNDERSERVED MEDICAL AND HEALTH CARE NEEDS. A LARGE NUMBER ARE ELDERLY AND A HIGH PERCENTAGE OF THE POPULATION LIVE BELOW THE POVERTY LEVEL, WHICH MAKES RECEIVING ADEQUATE HEALTH CARE EVEN MORE DIFFICULT TO OBTAIN. TO SERVE THE EXISTING NEEDS, THE HOSPITAL CONTINUES TO TAKE A PRO-ACTIVE APPROACH WITH RECRUITMENT OF ADDITIONAL DOCTORS, MID-LEVEL EXTENDERS, AND EXPANSION OF EXISTING HOSPITAL SERVICES. COST CONTAINMENT MEASURES PLAY A MAJOR ROLE IN THE SUCCESS OF ITS ENDEAVORS. IN AN EFFORT TO BETTER SERVE THE COMMUNITY THE HOSPITAL BECAME A PART OF THE GOOD SHEPHERD HEALTH SYSTEM IN NOVEMBER OF 2007. THIS NOT ONLY ALLOWS FOR THE EXPANSION OF SERVICES PROVIDED TO THE MEMBERS OF THE COMMUNITY, BUT IT ALSO ALLOWS ACCESS TO THE RESOURCES OF THE GOOD SHEPHERD HEALTH SYSTEM ESPECIALLY IN THE AREA OF PHYSICIAN RECRUITMENT. FURTHER EXPANSION OF COOPERATIVE EFFORTS WITH OTHER HEALTH CARE SERVICES AND PROFESSIONALS WILL BE NEEDED FOR BOTH COST CONTAINMENT AND GREATER EFFECTIVENESS. DISPROPORTIONATE FUNDS ARE CURRENTLY BEING UTILIZED TO PROVIDE PRIMARY CARE SERVICES TO PERSONS WHO MIGHT NOT OTHERWISE BE ABLE TO RECEIVE THEM.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HARRISON COUNTY HOSPITAL ASSOCIATION
GOOD SHEPHERD MEDICAL CENTER-MARSHALL
Employer identification number

75-0974351
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) GOOD SHEPHERD HEALTH SYSTEM INC

700 E MARSHALL AVE

LONGVIEW,TX75601
75-2027157 		SUPPORT GSMC TX 501(C)(3) LINE 11B, II N/A
 
No
(2) MARSHALL HEALTH SERVICES INC

811 SOUTH WASHINGTON AVE

MARSHALL,TX75670
75-2580686 		HEALTHCARE TX 501(C)(3) LINE 3 HARRISON COUNTY HOSPITAL ASSOCIATION
 
Yes
 
(3) MARSHALL HOSPITAL FOUNDATION INC

811 SOUTH WASHINGTON AVE

MARSHALL,TX75670
75-2605699 		SUPPORT TX 501(C)(3) LINE 7 GOOD SHEPHERD HEALTH SYSTEM INC
 
 
No
(4) GOOD SHEPHERD MEDICAL CENTER

700 E MARSHALL AVE

LONGVIEW,TX75601
75-1041154 		HEALTHCARE TX 501(C)(3) LINE 3 GOOD SHEPHERD HEALTH SYSTEM INC
 
 
No
(5) GSHS ADMINISTRATIVE SERVICES ORG INC

700 E MARSHALL AVE

LONGVIEW,TX75601
86-1132471 		ADMIN SUPPORT TX 501(C)(3) LINE 11A, I GOOD SHEPHERD HEALTH SYSTEM INC
 
 
No
(6) GOOD SHEPHERD MEDICAL CENTER - LINDEN

404 N KAUFMAN STREET

LINDEN,TX75563
01-0829282 		HEALTHCARE TX 501(C)(3) LINE 3 GOOD SHEPHERD HEALTH SYSTEM INC
 
 
No
(7) GSMC - LINDEN FOUNDATION INC

404 N KAUFMAN STREET

LINDEN,TX75563
20-0845127 		SUPPORT TX 501(C)(3) LINE 11A, I GOOD SHEPHERD MEDICAL CENTER - LINDEN INC
 
 
No
(8) GOOD SHEPHERD HOSPITAL AUXILIARY

700 E MARSHALL AVE

LONGVIEW,TX75601
23-7203364 		SUPPORT TX 501(C)(3) LINE 9 GOOD SHEPHERD HOSPITAL INC
 
 
No
(9) GOOD SHEPHERD FOUNDATION INC

700 E MARSHALL AVE

LONGVIEW,TX75601
75-2056700 		SUPPORT TX 501(C)(3) LINE 11A, I GOOD SHEPHERD HEALTH SYSTEM INC
 
 
No
(10) CHAMPION EMS

2201 S MOBBERLY AVE

LONGVIEW,TX75604
75-2747708 		MED TRANSPORT TX 501(C)(3) LINE 11B, II GOOD SHEPHERD MEDICAL CENTER
 
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) GOOD SHEPHERD AMBULATORY SURGICAL

700 E MARSHALL AVE
LONGVIEW,TX75601
 SURGERY TX GSHS ENTERPRISES OPERATING #2
  		RELATED       No     No 0 %












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) GSHS ENTERPRISES INC
700 E MARSHALL AVE
LONGVIEW,TX75601
75-2027162 		HEALTHCARE TX GOOD SHEPHERD HEALTH SYSTEM INC
  		C      
(2) GOOD SHEPHERD HEALTH NETWORK
700 E MARSHALL AVE
LONGVIEW,TX75601
75-2554695 		INACTIVE TX GOOD SHEPHERD HOSPTIAL INC
  		C      
(3) NORTHEAST TEXAS PHYSICIAN SE
700 E MARSHALL AVE
LONGVIEW,TX75601
75-2712245 		MGMT SERVICES TX GSHS ENTERPRISES INC
  		C      
(4) GS PHYSICIAN SERVICE INC
700 E MARSHALL AVE
LONGVIEW,TX75601
75-2762417 		MEDICAL SERVICES TX GSHS ENTERPRISES INC
  		C      
(5) GSHS ENTERPRISES HOLDING INC
700 E MARSHALL AVE
LONGVIEW,TX75601
51-0412465 		HOLDING COMPANY DE GSHS ENTERPRISES INC
  		C      
(6) GSHS ENTERPRISES OPERATING 1
700 E MARSHALL AVE
LONGVIEW,TX75601
75-2954772 		HEALTHCARE DE GSHS ENTERPRISES INC
  		C      
(7) GSHS ENTERPRISES OPERATING 2
700 E MARSHALL AVE
LONGVIEW,TX75601
75-2954777 		HEALTHCARE DE GSHS ENTERPRISES INC
  		C      
(8) GSHS ENTERPRISES OPERATING 3
700 E MARSHALL AVE
LONGVIEW,TX75601
71-0896512 		HEALTHCARE DE GSHS ENTERPRISES INC
  		C      
(9) GSHS MEDICAL PLAZA LTD
700 E MARSHALL AVE
LONGVIEW,TX75601
75-2955157 		HEALTHCARE TX GSHS ENTERPRISES INC
  		C      
(10) GSHS MEDICAL PLAZA III LTD
700 E MARSHALL AVE
LONGVIEW,TX75601
73-1654263 		HEALTHCARE TX GSHS ENTERPRISES INC
  		C      
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) MARSHALL HEALTH SERVICES

 N 72,709 CASH PAID
(2) MARSHALL HEALTH SERVICES

 P 2,697,223 CASH PAID
(3) MARSHALL HEALTH SERVICES

 O 2,773,474 CASH PAID
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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