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. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
METHODIST HOSPITALS OF DALLAS
Employer identification number
75-0800661
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 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
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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
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—2012.
If the organization did not check a 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—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013
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.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
METHODIST HOSPITALS OF DALLAS
Employer identification number
75-0800661
Return Reference
Explanation
FORM 990, PART I, LINE'S 9 & 17
CONSISTENT WITH FASB ACCOUNTING STANDARD UPDATE (ASU) 2011-07 MHS REPORTS BAD DEBTS AND COST OF CHARITY CARE AS A REDUCTION IN NET PATIENT REVENUE. LIKEWISE FUNCTIONAL EXPENSES DO NOT INCLUDE ANY PROVISION FOR BAD DEBTS OR CHARITY CARE.
FORM 990, PART III, LINE 4 A
MHS SERVICE AREAS HAVE: (I) HIGH PERCENTAGES OF HOUSEHOLDS IN POVERTY, (II) LOW MEDIAN HOUSEHOLD INCOME, (III) HIGH PERCENTAGES OF ADULTS WITH LESS THAN A HIGH SCHOOL EDUCATION, (IV) HIGH PERCENTAGES OF BLUE COLLAR WORKERS, AND (V) LOW PERCENTAGES OF MANAGERIAL AND PROFESSIONAL WORKERS (VI) HIGH UNEMPLOYMENT (VII) A HIGH RATE OF BIRTHS TO TEENAGERS (VIII), HIGH PREMATURE BIRTHS AND INFANT MORTALITY AND (IX) HIGH PERCENTAGES OF CHILDREN. CONSEQUENTLY, IN FISCAL YEAR 2014 MHS PROVIDED A SUBSTANTIAL AMOUNT OF CHARITY CARE AND GOVERNMENT-SPONSORED INDIGENT HEALTHCARE, AS WELL AS A NUMBER OF OTHER COMMUNITY BENEFITS IN ACCOMPLISHING ITS EXEMPT PURPOSE. WHETHER FINANCIALLY OR MEDICALLY INDIGENT, THERE IS NO QUESTION THAT THE DEMAND FOR HEALTHCARE FOR THE INDIGENT POPULATION IS GREAT AND THE COUNTY SUPPORTED PARKLAND HOSPITAL IS NOT CARING FOR, AND LIKELY CANNOT CARE FOR, ALL OF THOSE WHO QUALIFY. AS A RESULT, THE MAJOR HOSPITALS SERVICING DALLAS COUNTY HAVE COLLABORATED IN THE DEVELOPMENT OF THE DALLAS COUNTY INDIGENT CARE PLAN WHICH IS PART OF THE UPL PROGRAM APPROVED BY THE STATE AND FEDERAL GOVERNMENTS. THE DSRIP (DELIVERY SYSTEM REFORM INCENTIVE PAYMENT) POOL PROVIDES PAYMENTS TO HOSPITALS AND OTHER PROVIDERS UPON THEIR ACHIEVING CERTAIN GOALS THAT ARE INTENDED TO IMPROVE THE QUALITY AND LOWER THE COST OF CARE. DSRIP IS PART OF THE FEDERALLY APPROVED 1115 WAIVER THAT PRESERVES UPPER PAYMENT LIMIT (UPL) FUNDING UNDER A NEW METHODOLOGY, BUT ALLOWS FOR MANAGED CARE EXPANSION TO ADDITIONAL AREAS OF THE STATE. THE PROGRAM, WHICH MDMC HAS PARTICIPATED IN SINCE IT BEGAN, HELPS FUND EFFORTS TARGETED TOWARD CHARITY CLINICS IN THE DALLAS AREA. NOW IN ITS FOURTH YEAR, ACCOMPLISHMENTS INCLUDE: (1) DURING FY14 METHODIST DALLAS AND BROTHER BILL'S HELPING HAND CLINIC HAVE CONTINUED TO WORK ON PROVIDING COORDINATED CARE FOR LOW INCOME MEDICAL HOME PATIENTS. SUCCESSES INCLUDE THE ADDITION OF FREE RADIOLOGIST SERVICES FROM THE METHODIST-AFFILIATED RADIOLOGY GROUP AND A DONATION OF PILL ORGANIZERS FROM WALGREEN'S PHARMACY TO ASSIST MEDICAL HOME PATIENTS WITH MEDICATION MANAGEMENT. ALL BROTHER BILL CLINIC PATIENTS ARE FROM SPECIFIC DFW ZIP CODES WHERE 62 PERCENT OF HOUSEHOLDS HAVE INCOMES LESS THAN $35,000. ALL CLINIC PATIENTS ARE ALSO UNINSURED PER MEDICAL HOME CRITERIA.(2)UTILIZE A GAP ANALYSIS TO ASSESS AND/OR MEASURE HOSPITAL AFFILIATED AND/OR PRIMARY CARE PHYSICIAN'S (PCP'S) NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) PATIENT CENTERED MEDICAL HOME (PCMH) READINESS. COMPLETED NCQA PCMH READINESS IN DSRIP YEAR 1 AND DSRIP YEAR 2.(3)CONDUCT FEASIBILITY STUDIES TO DETERMINE NECESSARY STEPS TO ACHIEVE NCQA PCMH STATUS. COMPLETED NCQA PCMH FEASIBILITY STUDIES IN DSRIP YEAR 1 AND DSRIP YEAR 2.(4)CONDUCT EDUCATIONAL SESSIONS FOR PRIMARY CARE PHYSICIAN PRACTICE OFFICES, HOSPITAL BOARDS OF DIRECTORS, MEDICAL STAFF AND SENIOR LEADERSHIP ON THE ELEMENTS OF PCMH, ITS RATIONALE AND VISION. COMPLETED IN DSRIP YEAR 1, DSRIP YEAR 2 AND DSRIP YEAR 3. (5)CONDUCT QUALITY IMPROVEMENT FOR PROJECT USING METHODS SUCH AS RAPID CYCLE IMPROVEMENT. ACTIVITIES MAY INCLUDE, BUT ARE NOT LIMITED TO, IDENTIFYING PROJECT IMPACTS, IDENTIFYING "LESSONS LEARNED," OPPORTUNITIES TO SCALE ALL OR PART OF THE PROJECT TO A BROADER PATIENT POPULATION, AND IDENTIFYING KEY CHALLENGES ASSOCIATED WITH EXPANSION OF THE PROJECT, INCLUDING SPECIAL CONSIDERATIONS FOR SAFETY NET POPULATIONS. ONGOING; THE TEAM PLANS TO USE PDSA (PLAN, DO, STUDY, ACT) CYCLES TO TEST AND IMPLEMENT QUALITY IMPROVEMENT MEASURES FOR THIS PROJECT. WE WILL ALSO CONTINUE TO EXPLORE THE REPORTING ABILITY AND FUNCTIONALITY OF THE CLINIC'S NEW EMR AND INCORPORATE THIS DATA INTO TRENDING AND TRACKING THE IMPACT OF THE PROJECT. DALLAS COUNTY'S TRAUMA RATES TYPICALLY ARE HIGHER THAN STATE AND NATIONAL TRAUMA RATES. HISTORICALLY, THE COUNTY HAS RELIED ALMOST EXCLUSIVELY ON PARKLAND MEMORIAL HOSPITAL (PARKLAND), MDMC AND BAYLOR UNIVERSITY MEDICAL CENTER (BAYLOR) TO HANDLE MAJOR TRAUMA. PARKLAND CURRENTLY OPERATES AS THE COUNTY'S PRIMARY TRAUMA FACILITY, SUPPORTED BY MDMC AND BAYLOR. MDMC'S COMMITMENT TO PROVIDE OUTSTANDING TRAUMA SERVICES TO DALLAS AND SURROUNDING COUNTIES IS DEMONSTRATED BY THE IMPROVEMENTS THAT MDMC HAS MADE WITHIN ITS OWN TRAUMA PROGRAM. MDMC IS DESIGNATED BY THE TEXAS DEPARTMENT OF HEALTH AS A LEVEL I MAJOR TRAUMA CENTER AND INCURS APPROXIMATELY $8 MILLION A YEAR IN EXPENSES RELATED TO RETAINING ON-CALL SURGEONS AND OTHER TRAUMA PERSONNEL, AS WELL AS PAYING A FEE TO SUB-SPECIALISTS FOR TREATMENT OF NON-FUNDED PATIENTS. MDMC DOES A GREAT DEAL TO FULFILL THE COMMUNITY NEED FOR EMERGENCY SERVICES. MHS RECENTLY COMPLETED A MORE THAN $108 MILLION EXPANSION TO THE MDMC EMERGENCY ROOM, CRITICAL CARE, AND SURGERY DEPARTMENTS WITH A NEW SIX-STORY TRAUMA AND CRITICAL CARE CENTER. THE 248,000 SQ-FT TRAUMA AND CRITICAL CARE CENTER INCLUDES 58 NEW EMERGENCY ROOM BEDS;6 TRAUMA SUITES,8 SURGICAL SUITES, A 36 BED CRITICAL CARE UNIT AND THE ABILITY TO EXPAND TO 11 STORIES FOR FUTURE GROWTH. THE MCMC EMERGENCY ROOM INCURS APPROXIMATELY $1.3 MILLION A YEAR IN EXPENSES RELATED TO FEES PAID TO ON-CALL PHYSICIANS AS WELL AS TREATMENT OF NON-FUNDED PATIENTS. MHS,ALONG WITH TWO OTHER NON-PROFIT HOSPITALS IN DALLAS, JOINTLY SPONSORS A REGIONAL HELICOPTER, FIXED WING, AND GROUND AMBULANCE SERVICE CALLED CAREFLITE. MDMC MAINTAINS HELIPADS FOR THE HELICOPTER SERVICE.
FORM 990, PART VI, SECTION A, LINE 2
DUNCAN FULTON,BUSINESS RELATIONSHIP WITH GEORGE SHAFER. JOHN COLLINS, BUSINESS RELATIONSHIP WITH STEVE MANSFIELD MICHAEL REDDEN, BUSINESS WITH PETE SCHENKEL
FORM 990, PART VI, SECTION B, LINE 11
THE FORM 990 IS PREPARED BY THE MHS TAX DEPARTMENT. DURING THE RETURN PREPARATION PROCESS THE TAX DEPARTMENT LOOKS TO OTHER FUNCTIONAL AREAS INCLUDING FINANCE, HUMAN RESOURCES, ACCOUNTING, LEGAL, CORPORATE COMPLIANCE, AND TREASURY FOR ASSISTANCE IN PREPARING A COMPLETE AND ACCURATE RETURN. UPON COMPLETION THE RETURN IS REVIEWED WITH THE REPORTING ORGANIZATIONS APPLICABLE SENIOR FINANCIAL OFFICER. FURTHER, AS PART OF THE ANNUAL FINANCIAL AUDIT OF MHS THE FORM 990 IS PROVIDED TO A NATIONAL ACCOUNTING FIRM FOR REVIEW. ADDITIONALLY,PRIOR TO FILING, A SPECIALLY APPOINTED COMMITTEE OF THE BOARD RECEIVES A DETAILED PRESENTATION OF THE FORM 990 FOR THEIR REVIEW. ONCE THIS COMMITTEE APPROVES THE FORM 990 TO BE FILED IT IS PROVIDED ELECTRONICALLY TO ALL MEMBERS OF THE BOARD FOR THEM TO REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C
ALL OFFICERS,DIRECTORS AND EMPLOYEES ARE REQUIRED TO FILE AN ANNUAL DISCLOSURE STATEMENT DETAILING ANY POTENTIAL CONFLICTS WHICH ARE THEN MONITORED BY THE MHS COMPLIANCE OFFICER.
FORM 990, PART VI, SECTION B, LINE 15
THE MANAGEMENT DEVELOPMENT AND COMPENSATION COMMITTEE OF THE BOARD REVIEWS AND DETERMINES THE ANNUAL COMPENSATION OF THE CEO. ALSO, ON AN ANNUAL BASIS, THE CEO PRESENTS PROPOSED MERIT AND BONUS/INCENTIVE COMPENSATION FOR SVP'S AND ABOVE TO THE COMMITTEE FOR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19
THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATMENTS ARE AVAILABLE UPON REQUEST AT THE CORPORATE OFFICES.
FORM 990, PART VI, SECTION B, LINE 16
THE ORGANIZATION HAS A POLICY ON PHYSICIAN JOINT VENTURES WHICH REQUIRES THE INVESTMENT TO BE REVIEWED BY MHS LEGAL AND FINANCE DIVISIONS. THIS PRACTICE IS FOLLOWED FOR ALL JOINT VENTURES. ALL JOINT VENTURE INVESTMENTS ARE APPROVED BY THE BOARD PRIOR TO THE INVESTMENT.
FORM 990, PART VIII, LINE 2
CONSISTENT WITH FASB ACCOUNTING STANDARD UPDATE (ASU) 2011-07 MHS REPORTS BAD DEBTS AND COST OF CHARITY CARE AS A REDUCTION IN NET PATIENT REVENUE. LIKEWISE FUNCTIONAL EXPENSES DO NOT INCLUDE ANY PROVISION FOR BAD DEBTS OR CHARITY CARE.
FORM 990, PART XI, LINE 9:
UNREALIZED GAIN ON PENSION INVESTMENT 242201. RELEASE OF REMAINING ASSETS IN RICHARDSON ACQUISTION 1627602.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.