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.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CHC Community Care LLC
Employer identification number
37-1485773
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
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(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)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(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
(1)
ContinueCare Hospital of Tyler Inc
200991990
03
Yes
Yes
Yes
525,324
(2)
ContinueCare Hopital of SE Texas Inc
201150480
03
Yes
Yes
Yes
0
Total
525,324
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
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
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
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
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:
-
TIN:
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.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CHC Community Care LLC
Employer identification number
37-1485773
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION STATEMENT
FORM 990, PART III, LINE 1
CHC COMMUNITY CARE LLC (CCC) WAS ORGANIZED FOR THE PURPOSE OF OWNING AND OPERATING LONG-TERM ACUTE CARE HOSPITALS (LTACHS). CCC'S LONG-TERM MISSION IS TO PROVIDE EFFECTIVE, VALUE-ADDED POST-ACUTE CARE SERVICES THAT COMPLEMENT THE CONTINUUM OF PATIENT CARE PROVIDED BY NON-FOR-PROFIT AND PUBLICLY GOVERNED HOSPITALS IN THE U.S. DURING THE YEAR, CCC OWNED AND OPERATED TWO HOSPITALS: CONTINUECARE HOSPITAL OF TYLER, A 51-BED LTACH IN TYLER, TEXAS AND CONTINUECARE HOSPITAL OF CARSON TAHOE, A 29 BED LTACH IN CARSON CITY, NEVADA. CCC DISPOSED OF ITS INTEREST IN CONTINUECARE HOSPITAL OF CARSON TAHOE ON NOVEMBER 1, 2010. CCC ALSO PROVIDED MANAGEMENT SERVICES TO CONTINUECARE HOSPITAL OF TYLER. LTACHS PROVIDE A VENUE OF CARE FOR PATIENTS THAT REQUIRE EXTENDED LENGTHS OF STAY IN AN ACUTE CARE SETTING. TYPICALLY, LENGTHS OF STAY WILL AVERAGE 25 DAYS OR LONGER. CONDITIONS APPROPRIATE FOR THE TREATMENT IN AN LTACH INCLUDE THE FOLLOWING: MEDICALLY COMPLEX, RESPIRATORY DISORDERS INCLUDING TRACHEOTOMY, VENTILATORS DEPENDENT, CARDIAC/CARDIOVASCULAR CONDITIONS, RENAL DISEASE, ONCOLOGY AND WOUND CARE.
CESSATION OF SERVICES
FORM 990, PART III, LINE 3
CCC DISPOSED OF ITS INTEREST IN CONTINUECARE HOSPITAL OF CARSON TAHOE ON NOVEMBER 1, 2010.
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS
FORM 990, PART III, LINE 4A
CONTINUECARE HOSPITAL OF TYLER, A 51-BED LTACH IN TYLER, TEXAS. LTACHS PROVIDE A VENUE OF CARE FOR PATIENTS THAT REQUIRE EXTENDED LENGTHS OF STAY IN AN ACUTE CARE SETTING. TYPICALLY, LENGTHS OF STAY WILL AVERAGE 25 DAYS OR LONGER. CONDITIONS APPROPRIATE FOR THE TREATMENT IN AN LTACH INCLUDE THE FOLLOWING: MEDICALLY COMPLEX, RESPIRATORY DISORDERS INCLUDING TRACHEOTOMY, VENTILATORS DEPENDENT, CARDIAC/CARDIOVASCULAR CONDITIONS, RENAL DISEASE, ONCOLOGY AND WOUND CARE. DURING THE FISCAL YEAR ENDED JUNE 30, 2011 THE TYLER LTACH ADMITTED 672 PATIENTS AND PROVIDED 17,737 DAYS OF PATIENT CARE.
DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS
FORM 990, PART VI, QUESTION 6
THE COMPANY SHALL HAVE FIVE (5) CLASSES OF MEMBERS, DESIGNATED AS CLASS A, CLASS B, CLASS C, CLASS D, AND CLASS E AS SET FORTH IN THE ARTICLES OF INCORPORATION AS FOLLOWS: (A) THE SOLE CLASS A MEMBER OF THE COMPANY IS COMMUNITY LTACH, LLC. EXCEPT AS OTHERWISE PROVIDED IN THE CERTIFICATE OR THIS AGREEMENT, THE CLASS A MEMBER SHALL BE THE SOLE VOTING MEMBER OF THE COMPANY. (B) THE SOLE CLASS B MEMBER OF THE COMPANY IS TRINITY MOTHER FRANCES HEALTH SYSTEM, A TEXAS NOT-FOR-PROFIT CORPORATION. IN THE EVENT THAT TRINITY MOTHER FRANCES HEALTH SYSTEM, A TEXAS NOT-FOR-PROFIT CORPORATION CEASES TO BE A CLASS B MEMBER OF THE COMPANY, THERE SHALL NO LONGER BE A CLASS B MEMBER OF THE COMPANY. (C) THERE SHALL BE NO MORE THAN ONE CLASS C MEMBER. IT SHALL BE AN ORGANIZATION THAT SATISFIES THE REQUIREMENTS FOR MEMBERSHIP SET FORTH IN THE CERTIFICATE AND THIS AGREEMENT. FROM THE DATE THAT THE FIRST CLASS C MEMBER (WHENEVER DESIGNATED BY THE MANAGERS AND SET FORTH ON EXHIBIT A) CEASES TO BE A CLASS C MEMBER OF THE COMPANY, THERE SHALL NO LONGER BE A CLASS C MEMBER OF THE COMPANY. (D) THERE SHALL BE NO MORE THAN ONE CLASS D MEMBER. IT SHALL BE AN ORGANIZATION THAT SATISFIES THE REQUIREMENTS FOR MEMBERSHIP SET FORTH IN THE CERTIFICATE AND THIS AGREEMENT. FROM THE DATE THAT THE FIRST CLASS D MEMBER (WHENEVER DESIGNATED BY THE MANAGERS AND SET FORTH ON EXHIBIT A). CARSON TAHOE REGIONAL HEALTHCARE WAS A CLASS D MEMBER UNTIL NOVEMBER 1, 2010, WHEN CCC CONTRIBUTED ITS MEMBERSHIP OF CONTINUECARE HOSPITAL AT CARSON TAHOE TO CARSON TAHOE REGIONAL HEALTHCARE. AS OF JUNE 30, 2011 THERE WERE NO CLASS D MEMBERS. (E) EACH AND EVERY CLASS E MEMBER (WHENEVER DESIGNATED BY THE MANAGERS AND SET FORTH ON EXHIBIT A) SHALL BE ANY ORGANIZATION THAT SATISFIES THE REQUIREMENTS FOR MEMBERSHIP SET FORTH IN THE CERTIFICATE AND THIS AGREEMENT.
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS
FORM 990, PART VI, QUESTION 7A
NO MEMBER, OTHER THAN CLASS A MEMBER, SHALL HAVE ANY VOTING, VETO, APPROVAL OR CONSENT RIGHTS.
DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS
FORM 990, PART VI, QUESTION 7B
THE FOLLOWING ACTIONS BY THE ORGANIZATION WILL REQUIRE THE PRIOR WRITTEN CONSENT OF ALL OF THE MEMBERS: A) MERGER OR CONSOLIDATION OF THE ORGANIZATION WITH ANY ENTITY B) VOLUNTARY PETITION IN BANKRUPTCY, DISSOLUTION OR LIQUIDATION OF THE ORGANIZATION C) ANY INTENTIONAL CHANGE IN THE TAX EXEMPTION STATUS OF THE ORGANIZATION D) ANY CHANGE IN THE MEMBERSHIP OF THE ORGANIZATION, EXCEPT AS OTHERWISE PERMITTED BY THE LIMITED LIABILITY AGREEMENT.
DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990
FORM 990, PART VI, QUESTION 11A
THE DETAILED REVIEW OF THE FORM 990 IS CONDUCTED BY THE MANAGEMENT FOLLOWING THE PREPARATION AND REVIEW OF THE RETURN BY THE ORGANIZATION'S PAID PREPARER. AN ELECTRONIC COPY OF THE FINAL FORM 990 IS EMAILED TO EACH BOARD MEMBER PRIOR TO FILING WITH THE IRS.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST
FORM 990, PART VI, QUESTION 12C
PROCEDURES: 1. ACTUAL OR POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED BY THE INTERESTED PARTY TO THE APPROPRIATE GOVERNING BODY OR A COMMITTEE OF THE SAID THE ORGANIZATION BEING CONSIDERED BY THE GOVERNING BODY OR COMMITTEE OR IF AN INTERESTED PERSON BECOMES AWARE OF A POTENTIAL CONFLICT BEFORE THE MATTER IS UNDER CONSIDERATION BY THE GOVERNING BODY OR THE COMMITTEE, THEN THE INTERESTED PERSON MAY DISCLOSE THE POTENTIAL CONFLICT OF INTEREST TO THE ORGANIZATION'S APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICER, GENERAL COUNSEL OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY (OR IF NONE, THE CHAIRMAN OF THE BOARD). 2. AN INTERESTED PERSON MAY MAKE A PRESENTATION AND ANSWER QUESTIONS POSED AT THE GOVERNING BODY OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POTENTIAL CONFLICT OF INTEREST. 3. THE CHAIRPERSON OF THE ORGANIZATION'S GOVERNING BODY OR COMMITTEE SHALL, IF HE/SHE DEEMS APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT OR OTHER RESOLUTION OF A POTENTIAL CONFLICT OF INTEREST. 4. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BODY OR COMMITTEE SHALL DETERMINE WHETHER THE ORGANIZATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. 5. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CHC COMMUNITY CARE ORGANIZATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO OR CONTINUE THE TRANSACTION OR ARRANGEMENT. 6. EMPLOYEES AND OTHERS ENGAGED BY THE ORGANIZATION MUST SEEK GUIDANCE AND APPROVAL FROM APPROPRIATE MANAGEMENT PERSONNEL PRIOR TO PURSUING ANY BUSINESS OR PERSONAL ACTIVITY THAT MIGHT CONSTITUTE A CONFLICT OF INTEREST. 7. THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER WORKING WITH THE CHIEF FINANCIAL OFFICER WILL BE RESPONSIBLE TO ENSURE THOSE CONDUCTING AUDITING AND MONITORING REVIEWS OF INTERNAL CONTROLS ARE FREE FROM ANY CONFLICTS OF INTEREST OR OTHER INFLUENCES THAT WOULD IMPAIR THEIR ABILITY TO OBJECTIVELY CARRY OUT THEIR WORK WITHOUT BIAS. 8. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE A BOARD/COMMITTEE MEMBER OR EMPLOYEE HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, THE MEMBER OR EMPLOYEE WILL BE INFORMED OF THE BASIS FOR SUCH BELIEF AND AFFORDED AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. 9. IF AFTER HEARING A MEMBER'S OR EMPLOYEE'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, IT IS DETERMINED THAT THERE WAS A FAILURE TO DISCLOSE, THERE WILL BE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION, WHICH COULD INCLUDE, WITHOUT LIMITATION, TERMINATION OF THE PERSON'S MEMBERSHIP, EMPLOYMENT OR CONTRACT. RECORDS: MINUTES OF THE GOVERNING BOARD AND ALL COMMITTEES OF THE ORGANIZATIONS WITH BOARD DELEGATED POWERS SHALL CONTAIN: A. THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS OR IS PRESENT, AND THE GOVERNING BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED OR EXISTS. B. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION WITH THE PROCEEDINGS. C. RECORDS OF EMPLOYEE CONFLICT OF INTEREST WILL BE MAINTAINED ACCORDING TO THE COMPLIANCE PROGRAM RECORDS MANAGEMENT POLICY. ANNUAL STATEMENTS: ANNUALLY THE GOVERNING BOARD AND EMPLOYEES OF A THE ORGANIZATION WILL SIGN A STATEMENT WHICH AFFIRMS EACH PERSON: A. HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, B. HAS READ AND UNDERSTANDS THE POLICY, C. HAS AGREED TO COMPLY WITH THE POLICY, AND D. UNDERSTANDS THE ORGANIZATION IS CHARITABLE AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. PERIODIC REVIEWS: TO ENSURE THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED. PERIODIC REVIEWS WILL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: A. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION AND THE RESULT OF ARM'S LENGTH BARGAINING. B. WHETHER ACQUISITIONS OF PHYSICIAN PRACTICE AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. C. WHETHER PARTNERSHIPS, JOINT VENTURES, AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS CONFORM TO THE ORGANIZATION'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENTS FOR GOODS AND SERVICES, FURTHER CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT OR IN AN EXCESS BENEFIT TRANSACTION. D. WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD-PARTY PAYORS FURTHER THE ORGANIZATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN
FORM 990, PART VI, QUESTIONS 15A & 15B
THE ORGANIZATION FOLLOWS THE COMPENSATION POLICY OF ITS SOLE MEMBER, COMMUNITY LTACH LLC WHICH FOLLOWS THE POLICY OF VHA SOUTHWEST HEALTH CORPORATION (CHC). THE ORGANIZATION'S BOARD FORMALLY ADOPTED CHC'S COMPENSATION POLICY FOR YEAR ENDED JUNE 30, 2011. CHC ENGAGED SULLIVAN COTTER TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITIES AND CURRENT INCUMBENTS' COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPENTENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THE ORGANIZATION FOLLOWED THE PROCESS FOR THE YEAR ENDED 6/30/11 FOR ITS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES AND OTHER MANAGEMENT OFFICIALS. THIS PROCESS IS PERFORMED EACH YEAR PRIOR TO THE ANNUAL EMPLOYEE EVALUATION PROCESS, WHICH ENDS ON JULY 1ST OF EACH YEAR.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC
FORM 990, PART VI, QUESTION 19
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE AT ITS BUSINESS OFFICE UPON REQUEST.
AVERAGE RELATED HOURS DISCLOSURE
FORM 990, PART VII, SECTION A, COLUMN B
ESTIMATED HOURS WORKED BY OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES AT RELATED ENTITIES: DAVID BUTLER: BAPTIST HOSPITALS OF SE TEXAS - 1 HOUR CONTINUECARE HOSPITAL OF TYLER - 1 HOUR VHASW COMMUNITY HEALTH CORPORATION - 38 HOURS YOAKUM COMMUNITY HOSPITAL - 1 HOUR COMMUNITY HOSPITAL CONSULTING, INC. - 1 HOUR SOUTHWEST COMMUNITY HOSPITAL - 0.01 HOURS ARTESIA GENERAL HOSPITAL - 1 HOUR JAMES HILL: VHASW COMMUNITY HEALTH CORPORATION - 39 HOURS COMMUNITY HOSPITAL CONSULTING, INC. - 1 HOUR SOUTHWEST COMMUNITY HOSPITAL - 0.01 HOURS JASON BOOTZ: COMMUNITY HOSPITAL CONSULTING, INC. - 20 HOURS MICHAEL D. WILLIAMS: BAPTIST HOSPITALS OF SE TEXAS - 1 HOUR CONTINUECARE HOSPITAL OF TYLER - 1 HOUR VHASW COMMUNITY HEALTH CORPORATION - 30 HOURS YOAKUM COMMUNITY HOSPITAL - 1 HOUR COMMUNITY HOSPITAL CONSULTING, INC. - 6 HOUR SOUTHWEST COMMUNITY HOSPITAL - 0.01 HOUR STEPHANIE HYDE: CONTINUECARE HOSPITAL OF TYLER - 40 HOURS
OVERSIGHT OR SELECTION PROCESS
FORM 990, PART XI, QUESTION 2C
THE AUDIT COMMITTEE OF VHA SOUTHWEST COMMUNITY HEALTH CORPORATION, WHICH IS THE PARENT ORGANIZATION IS RESPONSIBLE FOR OVERSEEING THE EXTERNAL AUDIT OF THE CONSOLIDATED FINANCIALS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.