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 private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 01-01-2014 , and ending 12-31-2014
BCheck if applicable:
CName of organization
TEXAS HEALTH HUGULEY INC
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
11801 S FREEWAY
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BURLESON, TX76028
D Employer identification number

45-2694620
E Telephone number

G Gross receipts $ 183,136,011
F Name and address of principal officer:
KENNETH FINCH
11801 S FREEWAY
BURLESON,TX76028
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.TEXASHEALTHHUGULEY.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 2011
M State of legal domicile: FL
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF A 223 BED HOSPITAL.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 10
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 5
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 150
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 413,276
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 33,113
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 32,899 104,535
9 Program service revenue (Part VIII, line 2g) ......... 172,459,086 181,554,677
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 505,865 371,897
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,107,256 1,100,491
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 174,105,106 183,131,600
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 90,500 34,930
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) 21,724 26,000
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 147,628,362 155,926,468
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 147,740,586 155,987,398
19 Revenue less expenses. Subtract line 18 from line 12....... 26,364,520 27,144,202
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 116,622,448 138,157,764
21 Total liabilities (Part X, line 26)............. 19,932,066 18,009,466
22 Net assets or fund balances. Subtract line 21 from line 20..... 96,690,382 120,148,298
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 Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: OUR MISSION IS TO EXTEND THE HEALING MINISTRY OF CHRIST BY IDENTIFYING AND MEETING THE HEALTH NEEDS OF OUR COMMUNITY, PROVIDING QUALITY, CUSTOMER ORIENTED AND COST EFFECTIVE SERVICES, AND ENSURING ACCESS TO THOSE SERVICES.
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 organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations 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 $ 149,141,461 including grants of $ 34,930 ) (Revenue $ 182,723,557 )
OPERATION OF ACUTE CARE HOSPITAL TOTALING 223 BEDS WITH 9,457 PATIENT ADMISSIONS, 39,251 PATIENT DAYS, AND 111,791 OUTPATIENT VISITS IN THE CURRENT YEAR.
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 expensesMediumBullet149,141,461
Form 990 (2014)
Form 990 (2014)
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 (see instructions)? 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, or have a section 501(h) election in effect during the tax year? 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
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which 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 for escrow or custodial account liability; 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 temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
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, line 10?
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 VIIClick 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 VIIIClick 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 IXClick 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 XClick 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 XClick 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 and XII Click to see attachment.................
12a
Yes
 
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 and XII is optional Click to see attachment
12b
 
No
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, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
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 (see instructions) ....
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
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
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
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I....
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...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
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 ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
.....................
28b
 
No
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 direct or indirect owner? If "Yes," complete Schedule L, Part IV...
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, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, 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
35b
Yes
 
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 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
212
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
0
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
 
 
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” to line 3b, 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, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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 as charitable contributions?...
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
 
 
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.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring 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.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
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 or note to any line 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
10
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
5
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
Yes
 
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
Yes
 
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
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
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
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete 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 this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did 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
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, 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," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take 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 made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletPENNY JOHNSON

11801 S FREEWAY
BURLESON,TX76028 (817) 551-2704
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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. 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) BARCLAY BERDAN........................................................................
CHAIRMAN
0.20
.......................50.00
X           0 1,755,695 120,756
(2) RICHARD REINER........................................................................
VICE CHAIRMAN
0.20
.......................0.00
X           0 0 0
(3) ERIC ANDERSON PHD........................................................................
DIRECTOR (END 06/14)
0.20
.......................0.00
X           0 0 0
(4) HAROLD BERENZWEIG MD........................................................................
DIRECTOR
0.20
.......................50.00
X           0 771,155 67,236
(5) HENRY CUNNINGHAM MD........................................................................
DIRECTOR (END 01/14)
0.00
.......................0.00
X           0 0 0
(6) BRENDA GAMMON........................................................................
DIRECTOR
0.20
.......................0.00
X           0 0 0
(7) RONALD LONG........................................................................
DIRECTOR
0.20
.......................50.00
X           0 1,095,629 291,996
(8) LARRY MOORE........................................................................
DIRECTOR
0.20
.......................0.00
X           0 0 0
(9) JOSEPH PROSSER MD........................................................................
DIRECTOR
0.20
.......................50.00
X           0 567,450 34,586
(10) MEHBOOB QASSAM MD........................................................................
DIRECTOR (12/14)
3.30
.......................0.00
X           26,000 0 0
(11) BAJAJ MD GURPREET........................................................................
DIRECTOR
0.20
.......................0.00
X           0 0 0
(12) PAUL RATHBUN........................................................................
DIRECTOR/TREASURER
0.20
.......................0.00
X           0 0 0
(13) KENNETH FINCH........................................................................
CEO
50.00
.......................0.00
    X       0 0 0
(14) PENNY JOHNSON........................................................................
CFO
50.00
.......................0.00
    X       0 0 0






Form 990 (2014)
Form 990 (2014)
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 (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 26,000 4,189,929 514,574
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet0
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. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCA

900 HOPE WAY
ALTAMONTE SPRINGS,FL32714
MANAGEMENT & IT SERVICES 7,051,162
TEXAS HEALTH RESOURCES

612 E LAMAR BLVD SUITE 600
ARLINGTON,TX76011
UPL/MGMT/PHYS SERVICES 4,893,069
NORTHSTAR ANESTHESIA PA

PO BOX 650252
DALLAS,TX75265
ANESTHESIA SERVICES 2,575,736
HCBECK LTD

1807 ROSS AVE SUITE 500
DALLAS,TX75201
PROFESSIONAL FEES FOR CONSTRUCTION OF NE 2,400,640
NURSEFINDERS INC

PO BOX 910738
DALLAS,TX75391
NURSING PERSONNEL 992,226
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet41
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
104,535
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 104,535
 Program Service RevenueAmt Business Code
2a NET PATIENT REVENUE 900099 176,129,897 176,129,897    
b MEDICAL OFFICE BLDG 531120 1,705,660 1,705,660    
c LAB REVENUE 621500 1,092,609 737,376 355,233  
d FITNESS CENTER 900099 1,076,187 1,076,187    
e CAFETERIA 900099 835,809 835,809    
f All other program service revenue . 714,515 656,472 58,043  
g Total. Add lines 2a–2f........MediumBullet 181,554,677
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 296,339     296,339
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 18,355  
b Less: rental expenses 0  
c Rental income or (loss) 18,355  
d Net rental income or (loss).......MediumBullet 18,355     18,355
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 79,969  
b Less: cost or other basis and sales expenses 0 4,411
c Gain or (loss) 79,969 -4,411
d Net gain or (loss)..........MediumBullet 75,558     75,558
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 EQUITY EARNINGS FROM RELATED ENT 900099 1,082,136 1,082,136    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 1,082,136
12 Total revenue. See Instructions......MediumBullet 183,131,600 182,223,537 413,276 390,252
Form 990 (2014)
Form 990 (2014)
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).Check if Schedule O contains a response or note to any line in this Part IX ...............
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 domestic organizations and domestic governments. See Part IV, line 21 .... 34,930 34,930
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ....    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............    
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees .... 26,000   26,000  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages ....        
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....        
9 Other employee benefits .......        
10 Payroll taxes ...........        
11 Fees for services (non-employees):        
a Management ...... 7,111,662 5,480,439 1,631,223  
b Legal ......... 49,221   49,221  
c Accounting ...........        
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 100,119,878 97,406,298 2,713,580  
12 Advertising and promotion .... 299,507   299,507  
13 Office expenses ....... 4,918,781 3,965,176 953,605  
14 Information technology ...... 636,823 636,823    
15 Royalties ..        
16 Occupancy ........... 3,335,365 3,335,365    
17 Travel ............ 314,155   314,155  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 20,109   20,109  
20 Interest ........... 1,730 1,730    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 6,714,931 6,714,931    
23 Insurance .............. 441,176 291,025 150,151  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 27,147,451 27,147,451    
b REPAIRS & MAINTENA 4,094,004 4,094,004    
c DUES & SUBSCRIPTIONS 226,939   226,939  
d
e All other expenses 494,736 33,289 461,447  
25 Total functional expenses. Add lines 1 through 24e 155,987,398 149,141,461 6,845,937 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 4,853 1 4,849
2 Savings and temporary cash investments ......... 21,309,425 2 32,277,763
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 22,073,907 4 20,321,546
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 4,097,391 8 4,091,782
9 Prepaid expenses and deferred charges .......... 668,717 9 924,944
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 76,952,801
b Less: accumulated depreciation ..... 10b 16,089,628 51,652,162 10c 60,863,173
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ............... 255,018 14 455,443
15 Other assets. See Part IV, line 11 ........... 16,560,975 15 19,218,264
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 116,622,448 16 138,157,764
Liabilities 17 Accounts payable and accrued expenses ......... 8,532,734 17 10,495,267
18 Grants payable .................   18  
19 Deferred revenue ................ 965,541 19 0
20 Tax-exempt bond liabilities .............   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other 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 ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 10,433,791 25 7,514,199
26 Total liabilities. Add lines 17 through 25......... 19,932,066 26 18,009,466
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 94,904,519 27 118,337,675
28 Temporarily restricted net assets ........... 372,836 28 397,596
29 Permanently restricted net assets ........... 1,413,027 29 1,413,027
Organizations that do not follow SFAS 117 (ASC 958), 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 ........... 96,690,382 33 120,148,298
34 Total liabilities and net assets/fund balances ........ 116,622,448 34 138,157,764
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
183,131,600
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
155,987,398
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
27,144,202
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
96,690,382
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-3,686,286
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
120,148,298
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
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 Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number

45-2694620
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
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
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 listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.)..            
11 Total support Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
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 ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.) ..            
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
 
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions
 
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2014
(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)
 
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)
 
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2015. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

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.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number

45-2694620
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 on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, 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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number

45-2694620
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number

45-2694620
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number

45-2694620
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. 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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(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) (2014)

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 Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
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) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number

45-2694620
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 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 function 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 Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2014

Schedule C (Form 990 or 990-EZ) 2014
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2014


Schedule C (Form 990 or 990-EZ) 2014
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)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(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? .......................
 
No
 
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? ..........................
Yes
 
6,801
j
Total. Add lines 1c through 1i ...............................
6,801
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 carry over 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) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible 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
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: AMERICAN HOSPITAL ASSOCIATION AND TEXAS HOSPITAL ASSOCIATION DUES
Schedule C (Form 990 or 990EZ) 2014

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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number

45-2694620
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 value of contributions to (during year)    
3 Aggregate value of 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 can 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 through 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, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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 section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, 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 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), 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)
Revenue 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 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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 XIII 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, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 1,413,027 1,413,027 1,413,027    
b Contributions ........          
c Net investment earnings, gains, and losses 33,233 33,227 3,082    
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
33,233 33,227 3,082    
f Administrative expenses ....          
g End of year balance ...... 1,413,027 1,413,027 1,413,027    
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet0 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
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)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   6,888,354 6,888,354
b Buildings ................   34,235,447 6,759,871 27,475,576
c Leasehold improvements ............        
d Equipment ................   22,735,800 9,047,441 13,688,359
e Other .................   13,093,200 282,316 12,810,884
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 60,863,173
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) OTHER CURRENT RECEIVABLES 5,904,681
(2) DONOR RESTRICTED ASSETS 1,814,915
(3) INVESTMENT IN COMMUNITY HOSPICE OF 10,000,920
(4) OTHER NON-CURRENT ASSETS 15,120
(5) DUE FROM RELATED 731,000
(6) RECEIVABLE FROM THIRD PARTIES 751,628



Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 19,218,264
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
PAYABLE TO THIRD PARTIES 3,282,462
OTHER CURRENT LIABILITIES 307,748
LEASES PAYABLE 867,004
DUE TO RELATED 2,930,052
INTERCO ALLOC OF TE BOND PROCEEDS 126,933




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 7,514,199
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 193,356,161
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 10,565,993
e Add lines 2a through 2d ..................... 2e 10,565,993
3 Subtract line 2e from line 1..................... 3 182,790,168
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 XIII.) ........... 4b 341,432
c Add lines 4a and 4b....................... 4c 341,432
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 183,131,600
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 168,627,745
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 XIII.) ............ 2d 12,981,779
e Add lines 2a through 2d...................... 2e 12,981,779
3 Subtract line 2e from line 1..................... 3 155,645,966
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 XIII.) ............ 4b 341,432
c Add lines 4a and 4b....................... 4c 341,432
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 155,987,398
Part XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART V, LINE 4: THE FILING ORGANIZATION'S ENDOWMENT CONSISTS OF TWO DONOR-RESTRICTED ENDOWMENT FUNDS ESTABLISHED TO SUPPORT A VARIETY OF PURPOSES INCLUDING THE ACQUISITION AND MAINTENANCE OF THE HOSPITAL'S EQUIPMENT, AND ASSISTANCE TO THE HELPING HAND FUND WHICH PROVIDES ASSISTANCE TO ORGANIZATIONS AND NEEDY INDIVIDUALS WITHIN THE COMMUNITY. AN ENDOWNMENT FUND TOTALING $1,313,027 HAS A DONOR-IMPOSED RESTRICTION ON INVESTMENT RETURN TO BE USED EXCLUSIVELY FOR CAPITAL IMPROVEMENTS AND MAINTENANCE OF THE HOSPITAL. THE REMAING FUND HAS NO DONOR-IMPOSED RESTRICTION ON ITS INVESTMENT RETURN.
PART X, LINE 2: THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR THE TWELVE-MONTH PERIOD ENDED 12/31/14 INCLUDE THE FILING ORGANIZATION AND TWO OF ITS SUBSIDIARIES: HUGULEY MEDICAL ASSOCIATES (HMA), A TAXABLE NONPROFIT PHYSICIAN GROUP, AND JOHNSON COUNTY COMMUNITY CARE CORPORATION (JCCC), A TEXAS NONPROFIT, TAX-EXEMPT CORPORATION. THESE CONSOLIDATED AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING FIN 48 FOOTNOTE: THE COMPANY, OTHER THAN HMA, IS EXEMPT FROM STATE AND FEDERAL INCOME TAXES. ACCORDINGLY, THE COMPANY AND ITS TAX-EXEMPT AFFILIATES ARE NOT SUBJECT TO FEDERAL, STATE, OR LOCAL INCOME TAXES EXCEPT FOR ANY NET UNRELATED BUSINESS TAXABLE INCOME. FOR THE YEARS ENDED DECEMBER 31, 2014 AND 2013, UNRELATED BUSINESS INCOME ACTIVITIES CONDUCTED BY THE COMPANY AND ITS TAX-EXEMPT AFFILIATES DID NOT GENERATE A MATERIAL AMOUNT OF COMBINED FEDERAL, STATE AND LOCAL INCOME TAX. HMA IS A WHOLLY-OWNED, FOR-PROFIT SUBSIDIARY OF THE COMPANY. HMA IS SUBJECT TO FEDERAL AND STATE INCOME TAXES AND FILES A FEDERAL AND STATE INCOME TAX RETURN. FOR THE YEARS ENDED DECEMBER 31, 2014 AND 2013, HMA GENERATED A TAXABLE LOSS OF APPROXIMATELY $1,279,000 AND $2,394,000, RESPECTIVELY. ACCORDINGLY, THERE IS NO PROVISION FOR CURRENT FEDERAL OR STATE INCOME TAX FOR THE YEARS ENDED DECEMBER 31, 2014 OR 2013. HMA ALSO HAS CUMULATIVE TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $9,670,000 AND $7,855,000 AT DECEMBER 31, 2014 AND 2013, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2014, HMA HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $8,032,000 OF WHICH APPROXIMATELY $5,220,000 WILL EXPIRE IN 2034, WITH THE REMAINING $2,812,000 EXPIRING BEGINNING IN 2018 THROUGH 2031. SOME OF THESE NET OPERATING LOSSES ARE SUBJECT TO THE SEPARATE RETURN LIMITATION YEAR RULES. DEFERRED TAXES HAVE BEEN PROVIDED FOR THESE AMOUNTS, RESULTING IN A NET DEFERRED TAX ASSET OF APPROXIMATELY $3,288,000 AND $2,671,000 AT DECEMBER 31, 2014 AND 2013, RESPECTIVELY. A FULL VALUATION ALLOWANCE HAS BEEN PROVIDED AT DECEMBER 31, 2014 AND 2013, TO OFFSET THE DEFERRED TAX ASSET SINCE HMA HAS DETERMINED THAT IT IS MORE LIKELY THAN NOT THAT THE BENEFIT OF THE NET OPERATING LOSS CARRYFORWARDS WILL NOT BE REALIZED IN FUTURE YEARS. ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN, OR EXPECTED TO BE TAKEN, IN A TAX RETURN. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2014 OR 2013.
PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE FROM SUBSIDIARIES INCLUDED IN AUDIT 10,565,992. RECLASS LOSS ON SALE ROUNDING 1.
PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASS MANAGEMENT FEE REVENUE FROM EXPENSE 341,432. REVENUE AND EXPENSE AUDIT RECLASS
PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM SUBSIDIARIES INCLUDED IN AUDIT 12,981,779. RECLASS NET LOSS ON SALE ROUNDING
PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS MANAGEMENT FEE REVENUE 341,432. REVENUE AND EXPENSE AUDIT RECLASS ROUNDING
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number

45-2694620
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did 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
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance 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 Financial Assistance at cost
(from Worksheet 1) ..
    9,307,897   9,307,897 5.970 %
b Medicaid (from Worksheet 3,
column a) ....
    17,004,322 10,896,958 6,107,364 3.920 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
           
d Total Financial Assistance
and Means-Tested
Government Programs .
    26,312,219 10,896,958 15,415,261 9.890 %
Other Benefits
    141,799   141,799 0.090 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
           
g Subsidized health services
(from Worksheet 6) ..
           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
           
j Total. Other Benefits ..     141,799   141,799 0.090 %
k Total. Add lines 7d and 7j .     26,454,018 10,896,958 15,557,060 9.980 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(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
Did 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. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
14,435,355
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
2,451,087
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
39,721,713
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
39,700,837
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
20,876
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
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(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 %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 TEXAS HEALTH HUGULEY HOSPITAL
11801 S FREEWAY
FT WORTH,TX76028
WWW.TEXASHEALTHHUGULEY.ORG
100157
X X         X      
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
TEXAS HEALTH HUGULEY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

TEXAS HEALTH HUGULEY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

TEXAS HEALTH HUGULEY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
TEXAS HEALTH HUGULEY HOSPITAL PART V, SECTION B, LINE 5: TEXAS HEALTH HUGULEY, INC. (THH OR THE HOSPITAL) OPERATES A 223-BED ACUTE-CARE HOSPITAL FACILITY IN BURLESON, TEXAS IN THE FORT WORTH, TEXAS AREA. THH'S COMMUNITY CONSISTS OF 13 ZIP CODES LOCATED IN JOHNSON AND TARRANT COUNTY, TEXAS AND IS POPULATED BY APPROXIMATELY 355,000 RESIDENTS. APPROXIMATELY 11% OF THE COMMUNITY'S RESIDENTS ARE ABOVE THE AGE OF 65 AND APPROXIMATELY 28% ARE LESS THAN AGE 18. WHITE, NON-HISPANIC INDIVIDUALS COMPRISE APPROXIMATELY 51% OF THE POPULATION, THE HISPANIC POPULATION PERCENTAGE IS APPROXIMATELY 27%, AND THE BLACK NON-HISPANIC POPULATION CONSTITUTES APPROXIMATELY 19% OF THE HOSPITAL'S COMMUNITY. ON AVERAGE, 33% OF THE HOSPITAL'S COMMUNITY LIVES BELOW 200% OF THE FEDERAL POVERTY LEVEL. UNINSURED INDIVIDUALS COMPRISE APPROXIMATELY 23% OF THE HOSPITAL'S COMMUNITY. THE MEMBERSHIP OF THH IS HELD BY TEXAS HEALTH RESOURCES (51%) AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (49%), BOTH ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3).THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED BY THE HOSPITAL WAS A COLLABORATIVE PROCESS, LED BY TEXAS HEALTH'S COMMUNITY HEALTH IMPROVEMENT DEPARTMENT AND ENTITY COMMUNITY ADVOCATES WITH SIGNIFICANT INPUT FROM TEXAS HEALTH'S COMMUNITY HEALTH ADVISORY COUNCIL. VAST AMOUNTS OF QUALITATIVE AND QUANTITATIVE DATA WERE COLLECTED, REFINED, AND ANALYZED. APPROXIMATELY 200 COMMUNITY MEMBERS PROVIDED INVALUABLE INFORMATION, DATA, AND FEEDBACK THROUGH INTERVIEWS. INFORMATION AND DATA WERE GATHERED FROM OPEN-ENDED DISCUSSIONS AIMED AT SOLICITING INPUT FROM INTERVIEW PARTICIPANTS, INCLUDING THOSE REPRESENTING THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS IN THE HOSPITAL'S COMMUNITY, AND FROM A SURVEY INSTRUMENT. COMMUNITY REPRESENTATIVES INCLUDED, AMONG OTHERS, THE FOLLOWING ORGANIZATIONS/GOVERNMENT AGENCIES: THE CITY OF BURLESON, THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES, THE BURLESON POLICE DEPARTMENT, AND THE SHORT FAMILY MEDICAL CENTER.
TEXAS HEALTH HUGULEY HOSPITAL PART V, SECTION B, LINE 7D: THE HOSPITAL HAS ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT MUST BE POSTED ON THE HOSPITAL'S WEBSITE BY THE END OF THE YEAR IN WHICH IT IS CONDUCTED. THE HOSPITAL WILL MAKE A COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE UPON REQUEST. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION AT THE HOSPITAL FACILITY.
TEXAS HEALTH HUGULEY HOSPITAL PART V, SECTION B, LINE 11: PRIORITIES SELECTED SECONDARY DATA USED THROUGHOUT THIS ANALYSIS WAS OBTAINED FROM MORE THAN 30 SOURCES. AT ITS MOST BASIC LEVEL, THE NEEDS ASSESSMENT MODEL OUTLINES ALL IDENTIFIED HEALTH ISSUES AND MARKS EACH ENTITY IMPACTED BY THAT SPECIFIC ISSUE. THE SPECIFIC ISSUES WERE ALSO GROUPED INTO HEALTH CATEGORIES ADAPTED FROM THE HEALTHY PEOPLE 2020 CATEGORIES. INTERVENTIONS RELATED TO BOTH PRIORITIES INCLUDE THE DEVELOPMENT OF A TRACKING SYSTEM THAT INCLUDES A COMMUNITY BENEFIT SECTION.PRIORITY 1: CHRONIC DISEASE THE NATIONAL COUNCIL ON AGING NOTES THAT NEARLY HALF OF ALL ADULTS HAVE ONE OR MORE CHRONIC CONDITIONS. APPROPRIATE MANAGEMENT OF THESE CONDITIONS CAN IMPROVE AND EXTEND LIFE WHILE RESULTS IN LOWER MORTALITY AND FEWER PREVENTABLE READMISSIONS. IN 2011, THE HUGULEY COMMUNITY'S OVERALL MORTALITY RATE WAS 731.4 PER 100,000. THE READMISSION RATE FOR CHRONIC DISEASES WAS 1139.03 PER 100,000.INTERVENTIONS INCLUDE: - IMPLEMENT BETTER CHOICES, BETTER HEALTH PROGRAM, AN EVIDENCE-BASED CHRONIC DISEASE SELF-MANAGEMENT PROGRAM ACROSS HUGULEY AND THE REST OF THE THR SYSTEM. PROGRAMS TO BE OFFERED ONSITE OR ON-LINE. - MAINTAIN ENTITY-BASED CHRONIC DISEASE PROGRAMS, INCLUDING DISEASE SELF-MANAGEMENT AND NUTRITION THROUGH THE DIABETES MANAGEMENT CENTER PROGRAMS AT HUGULEY. - SPONSOR COLLABORATIVES WORKING ON CHRONIC DISEASE, INCLUDING THE KOMEN FOUNDATION, CAREITY FOUNDATION AND MONCRIEF CANCER CENTER TO ENSURE THAT IN-KIND DONATIONS AND SPONSORSHIPS ALIGN WITH HUGULEY'S STRATEGIC FOCUSPRIORITY 2: AWARENESS, LITERACY AND NAVIGATION OF HEALTH SERVICES FOR LOW-INCOME AND OTHER POPULATIONS A COMMUNITY'S HEALTH IS IMPACTED BY LACK OF AWARENESS, LIMITED UNDERSTANDING OF CARE PROCESSES, AND DIFFICULTY NAVIGATING THE HEALTH CARE SYSTEM. THIS CAN RESULT IN INAPPROPRIATE USE OF HEALTH SERVICES AND LESS-THAN-DESIRABLE HEALTH OUTCOMES. IN 2011, THE COMMUNITY'S PREVENTABLE INPATIENT ADMISSIONS WERE 1716.21 PER 100,000.INTERVENTIONS INCLUDE: - DEVELOPMENT AND DISSEMINATION OF AN AREA RESOURCE GUIDE THAT IDENTIFIES HEALTH SERVICES AVAILABLE TO THE COMMUNITY THEY GUIDE WILL BE IN PRINT AND USED BY THE TEXAS HEALTH CALL CENTER STAFF. - MAINTAIN ENTITY-BASED AWARENESS, LITERACY AND NAVIGATION PROGRAMS -- HUGULEY PLUS FITNESS CENTER -- LADIES FIRST WELLNESS PROGRAM -- "IN THE LOOP" HEALTH MAGAZINE -- CONTINUE COMMUNITY CALENDAR -- SPONSOR AND PARTICIPATE IN AREA COLLABORATIVES ON AWARENESS, LITERACY AND NAVIGATION: COMMUNITY HEALTH COUNCIL, CITY OF BURLESON, HEB GROCERY CHAIN, CHAMBER OF COMMERCE AND LOCAL SCHOOL DISTRICT - CONTINUE USE OF THE MOBILE HEALTH UNIT TO PROVIDE HEALTH SCREENINGS AND REFERRALS TO APPROPRIATE COMMUNITY AGENCIES PRIORITIES CONSIDERED BUT NOT SELECTED A. ADEQUATE HEALTH RESOURCES AND COST OF CARE FOR THE INDIGENT (LOW-INCOME) AND OTHER VULNERABLE POPULATIONS THE SUPPLY (NUMBER, TYPE OF PROVIDERS) IS A BARRIER TO ACCESS IN THIS COMMUNITY. TEXAS HEALTH HUGULEY DOES NOT HAVE THE RESOURCES FOR EFFECTIVE INTERVENTIONS ON THIS ISSUE, BUT HAS SET OUT TO UNDERSTAND THE RESOURCES THAT ARE AVAILABLE, AND RAISE AWARENESS AROUND THEM. HUGULEY WILL CONTINUE TO PROVIDE SUPPORT TO THESE ENTITIES. B. TRANSPORTATION IS A BARRIER TO ACCESS IN THIS COMMUNITY, BUT IS A SOCIAL DETERMINANT RATHER THAN A HEALTH CONDITION. THE HOSPITAL CANNOT DIRECTLY PROVIDE PUBLIC TRANSPORTATION, BUT THE MOBILE MEDICAL UNIT PROVIDES SERVICES IN UNDERSERVED COMMUNITIES. C. CANCERHUGULEY BELIEVES THERE ARE ADEQUATE RESOURCES FOR CANCER PATIENTS IN ITS COMMUNITY. HUGULEY WILL CONTINUE TO PROVIDE SUPPORT TO THESE ENTITIES. D. INJURY AND VIOLENCE HUGULEY HOSPITAL DOES NOT HAVE EXPERTISE IN THIS AREA AND THE NEED IS BEING ADDRESSED BY OTHERS IN THE COMMUNITY. HUGULEY WILL CONTINUE TO PROVIDE SUPPORT TO THESE ENTITIES. E. MATERNAL AND CHILD HEALTH THIS COMMUNITY CONCERN IS BEING ADDRESSED BY OTHERS IN THE COMMUNITY. HUGULEY WILL CONTINUE TO PROVIDE SUPPORT TO THESE ENTITIES. F. MENTAL HEALTH THE HOSPITAL DOES NOT PROVIDE THE SERVICES NEEDED TO ADDRESS THIS ISSUE BUT WILL CONTINUE TO SUPPORT COMMUNITY ENTITIES THAT DO PROVIDE SERVICES. G. ORAL HEALTH THE HOSPITAL DOES NOT HAVE EXPERTISE IN DENTAL SERVICES.H. PREVENTION AND WELLNESSTHIS NEED IS BEING ADDRESSED IN THE CHRONIC CARE AND AWARENESS/NAVIGATION PART OF THIS IMPLEMENTATION STRATEGY. THE HOSPITAL CONTINUES TO SUPPORT OTHER COMMUNITY ENTITIES WHO ARE WORKING ON THIS ISSUE.I. TOBACCO OTHER COMMUNITY AGENCIES OFFER SMOKING CESSATION PROGRAMS.
TEXAS HEALTH HUGULEY HOSPITAL PART V, SECTION B, LINE 22D: IN DETERMINING THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FINANCIAL ASSISTANCE POLICY-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, THE HOSPITAL USED THE FOLLOWING METHODOLOGY IN 2014:THE HOSPITAL IDENTIFIED ALL COMMERCIAL PAYORS THAT HAD ANY ACTIVITY WITH THE HOSPITAL DURING THE TAXABLE YEAR. FOR THOSE IDENTIFIED COMMERCIAL PAYORS, AN AVERAGE OF THE NEGOTIATED COMMERCIAL INSURANCE RATES WAS DETERMINED. THE AVERAGE OF ALL OF THE NEGOTIATED COMMERCIAL INSURANCE RATES FOR THOSE IDENTIFIED COMMERCIAL PAYORS DETERMINED THE MAXIMUM AMOUNT THAT COULD BE CHARGED TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.
SCH H, PART V, SECTION B, LINES 7A AND 10A. LINE 7A. HOSPITAL FACILITY CHNA WEBSITE:HTTP://WWW.TEXASHEALTHHUGULEY.ORG/PORTALS/9/DOCS/COMMUNITY%20BENEFITS/TEXAS%20HEALTH%20HUGULEY%202013%20CHNA.PDFLINE 10. LINE B. COMMUNITY HEALTH PLAN.HTTP://WWW.TEXASHEALTHHUGULEY.ORG/PORTALS/9/DOCS/COMMUNITY%20BENEFITS/TEXAS%20HEALTH%20HUGULEY%202014-16%20COMMUNITY%20HEALTH%20PLAN.PDF
SCH H, PART V, SECTION B, LINE 16A, 16B, AND 16C 16A. FAP WEBSITEHTTPS://WWW.TEXASHEALTHHUGULEY.ORG/PATIENTS-VISITORS/AFTER-MY-STAY/FINANCIAL-ASSISTANCE16B. FAP APPLICATION WEBSITE:HTTPS://WWW.TEXASHEALTHHUGULEY.ORG/PATIENTS-VISITORS/AFTER-MY-STAY/FINANCIAL-ASSISTANCE16C. PLAIN LANGUAGE SUMMARY OF FAP WEBSITE:HTTPS://WWW.TEXASHEALTHHUGULEY.ORG/PATIENTS-VISITORS/AFTER-MY-STAY/FINANCIAL-ASSISTANCE
PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
TEXAS HEALTH HUGULEY HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: SEE PART V, SECTION C
TEXAS HEALTH HUGULEY HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: SEE PART V, SECTION C
TEXAS HEALTH HUGULEY HOSPITAL PART V, SECTION B, LINE 16C WEBSITE: SEE PART V, SECTION C
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?5
Name and address Type of Facility (describe)
1 HUGULEY SURGICAL CENTER
12001 S FWY SUITE 101
BURLESON,TX76028
OUTPATIENT SURGICAL CENTER
2 OUTPATIENT IMAGING CENTER
12001 S FWY SUITE 100
BURLESON,TX76028
OUTPATIENT IMAGING
3 WOUND CARE
12001 S FWY SUITE 301
BURLESON,TX76028
OUTPATIENT WOUND CARE
4 OUTPATIENT MRI
215 OLD HWY 1187
BURLESON,TX76028
OUTPATIENT MRI
5 OUTPATIENT REHABILITATION
215 OLD HWY 1187
BURLESON,TX76028
OUTPATIENT REHAB THERAPY
6
7
8
9
10
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
PART I, LINE 7: THE AMOUNTS OF COSTS REPORTED IN THE TABLE IN LINE 7 OF PART I OF SCHEDULE H WERE DETERMINED BY UTILIZING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, CONTAINED IN THE SCHEDULE H INSTRUCTIONS.
PART III, LINE 2: THE AMOUNT OF BAD DEBT EXPENSE, REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE.
PART III, LINE 3: METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY:SELF-PAY PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM). IF AN INDIVIDUAL DOES NOT SUBMIT A COMPLETE FAA FORM WITHIN 240 DAYS AFTER THE FIRST BILLING STATEMENT IS SENT TO THE INDIVIDUAL, AN INDIVIDUAL MAY BE CONSIDERED FOR PRESUMPTIVE ELIGIBILITY BASED UPON A SCORING TOOL THAT IS DESIGNED TO CLASSIFY PATIENTS INTO GROUPS OF VARYING ECONOMIC MEANS. THE SCORING TOOL USES ALGORITHMS THAT INCORPORATE DATA FROM CREDIT BUREAUS, DEMOGRAPHIC DATABASES, AND HOSPITAL SPECIFIC DATA TO INFER AND CLASSIFY PATIENTS INTO RESPECTIVE ECONOMIC MEANS CATEGORIES. INDIVIDUALS WHO EARN A CERTAIN SCORE ON THE SCORING TOOL ARE CONSIDERED TO QUALIFY AS NON-STATE CHARITY PATIENTS. AN AMOUNT UP TO $1,000 OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED TO BE NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORING TOOL IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION CANNOT BE MADE BASED UPON INFORMATION SUPPLIED BY THE INDIVIDUAL. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY.
PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGE 7.
PART III, LINE 8: COSTING METHODOLOGY:MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.
PART III, LINE 9B: THE HOSPITAL FILING ORGANIZATION'S COLLECTION PRACTICES ARE IN CONFORMITY WITH THE REQUIREMENTS SET FORTH IN THE 2012 PROPOSED REGULATIONS REGARDING THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(R)(4) - (R)(6). NO EXTRAORDINARY COLLECTION ACTIONS (ECA'S) ARE INITIATED BY THE HOSPITAL FILING ORGANIZATION IN THE 120-DAY PERIOD FOLLOWING THE DATE AFTER THE FIRST BILLING STATEMENT IS SENT TO THE INDIVIDUAL (OR, IF LATER, THE SPECIFIED DEADLINE GIVEN IN A WRITTEN NOTICE OF ACTIONS THAT MAY BE TAKEN, AS DESCRIBED BELOW). INDIVIDUALS ARE PROVIDED WITH AT LEAST ONE WRITTEN NOTICE (NOTICE OF ACTIONS THAT MAY BE TAKEN) THAT INFORMS THE INDIVIDUAL THAT THE HOSPITAL FILING ORGANIZATION MAY TAKE ACTIONS TO REPORT ADVERSE INFORMATION TO CREDIT REPORTING AGENCIES/BUREAUS IF THE INDIVIDUAL DOES NOT SUBMIT A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM) OR PAY THE AMOUNT DUE BY A SPECIFIED DEADLINE. THE SPECIFIED DEADLINE IS NOT EARLIER THAT 120 DAYS AFTER THE FIRST BILLING STATEMENT IS SENT TO THE INDIVIDUAL AND IS AT LEAST 30 DAYS AFTER THE NOTICE IS PROVIDED. IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FAA FORM DURING THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST BILLING STATEMENT WAS SENT TO THE INDIVIDUAL, THE HOSPITAL FILING ORGANIZATION SUSPENDS ANY REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS AND PROVIDES A WRITTEN NOTICE TO THE INDIVIDUAL DESCRIBING WHAT ADDITIONAL INFORMATION OR DOCUMENTATION IS NEEDED TO COMPETE THE FAA FORM. THIS WRITTEN NOTICE INCLUDES A COPY OF THE HOSPITAL FILING ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS) AND INFORMS THE INDIVIDUAL THAT THE HOSPITAL FILING ORGANIZATION MAY ENGAGE IN ADVERSE REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS IF THE FAA FORM IS NOT COMPLETED BY A SPECIFIED DEADLINE WHICH IS NO EARLIER THAN THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST BILLING STATEMENT WAS SENT TO THE INDIVIDUAL OR, IF LATER, 30 DAYS AFTER THE WRITTEN NOTICE IS PROVIDED. IF AN INDIVIDUAL SUBMITS A COMPETE FAA FORM WITHIN THE 240-DAY PERIOD AFTER THE FIRST BILLING STATEMENT IS SENT, THE HOSPITAL FILING ORGANIZATION WILL SUSPEND ANY ADVERSE REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS UNTIL A FINANCIAL ASSISTANCE POLICY ELIGIBILITY DETERMINATION CAN BE MADE.
SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE REPORTED AS A COMMUNITY BENEFIT TO THE ELDERLY. THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ 20,876- DIFFERENCE IN COSTING METHODOLOGY: 862,665- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (5,920,749) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS: $(5,037,208) AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S DETERMINATION OF UNREIMBURSED COSTS REPORTED AS A BENEFIT TO THE ELDERLY IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION.
PART VI, LINE 2: AS REPORTED IN SCHEDULE H, PART V, SECTION B, LINES 1-8, THE HOSPITAL CONDUCTED ITS INITIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING 2013. ITS INITIAL CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2013, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S INITIAL CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN PROPOSED REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY.
PART VI, LINE 3: THE FINANCIAL ASSISTANCE POLICY (FAP) OF THE FILING ORGANIZATION'S HOSPITAL FACILITY IS TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, THE FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM), THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS), AND CONTACT INFORMATION FOR THE HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITE. SIGNAGE IS DISPLAYED IN THE FILING ORGANIZATION'S HOSPITAL FACILITY AT ALL POINTS OF ADMISSION AND REGISTRATION, INCLUDING THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS THE HOSPITAL FACILITY'S WEBSITE ADDRESS WHERE THE FAP AND THE FAA FORM CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT WITH ANY QUESTIONS ABOUT THE FAP OR THE APPLICATION PROCESS. PAPER COPIES OF THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN THE HOSPITAL FACILITY AND BY MAIL. THE FILING ORGANIZATION'S HOSPITAL FACILITY'S FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A COPY OF THE HOSPITAL FACILITY'S PLS AND FAA FORM IS DISTRIBUTED TO EVERY INDIVIDUAL BEFORE DISCHARGE FROM THE HOSPITAL FACILITY. ADDITIONALLY, A COPY OF THE PLS IS INCLUDED WITH AT LEAST THREE BILLING STATEMENTS THAT ARE SENT TO THE INDIVIDUAL DURING THE 120-DAY PERIOD AFTER THE FIRST BILLING STATEMENT IS SENT. INDIVIDUALS ARE INFORMED ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE.
PART VI, LINE 4: THE FILING ORGANIZATION CURRENTLY OPERATES TEXAS HEALTH HUGULEY (THH) A 223-BED ACUTE-CARE HOSPITAL IN BURLESON, TEXAS. THE HOSPITAL HOUSES TWO INTENSIVE CARE UNITS, A PROGRESSIVE CARE UNIT, AN OPEN-HEART SURGERY DEPARTMENT, A BEHAVIORAL HEALTH CENTER AND A 24/7 EMERGENCY DEPARTMENT. THH HAS A 16-BED INTENSIVE CARE UNIT FOR PATIENTS WITH MEDICAL CARE AND RESPIRATORY NEEDS AND A 12-BED INTENSIVE CARE UNIT CONCENTRATING ON CARDIOVASCULAR PATIENTS. A 4-BED DIALYSIS CENTER IS AVAILABLE FOR RENAL PATIENTS WITH CRITICAL NEEDS. ADDITIONALLY, THERE IS A 33-BED PROGRESSIVE CARE UNIT DESIGNED TO BRIDGE THE GAP BETWEEN THE INTENSIVE CARE UNIT AND THE MEDICAL-SURGICAL UNITS. PART OF THH'S PRIMARY SERVICE AREA INCLUDES A NUMBER OF SMALLER COMMUNITIES WITH LIMITED ACCESS TO HEALTHCARE SERVICES. TO MEET THE NEEDS OF THESE RESIDENTS, THH HAS A SUBSIDIARY THAT OPERATES MULTIPLE PRIMARY CARE CLINICS THROUGHOUT ITS PRIMARY SERVICE AREA. IN ADDITION, THE MOBILE HEALTH SERVICES BUS PROVIDES HEALTH SCREENINGS AND WELLNESS EDUCATION SERVICES THROUGHOUT TARRANT AND JOHNSON COUNTIES. BURLESON, TEXAS IS LOCATED IN JOHNSON COUNTY AND SERVES THE SOUTH FORT WORTH AREA. THE HOSPITAL'S COMMUNITY HAS A POPULATION OF APPROXIMATELY 355,000, WITH AN ESTIMATED 11% OVER THE AGE OF 65. THE MEDIAN HOUSEHOLD INCOME, BASED ON POPULATION, IN THE COMMUNITY IS APPROXIMATELY $49,000. HIGH SCHOOL GRADUATES ACCOUNT FOR APPROXIMATELY 82% OF JOHNSON COUNTY, WITH AN ESTIMATED 16% HAVING A BACHELOR'S DEGREE OR HIGHER. IT IS ESTIMATED THAT 11% OF THE INDIVIDUALS RESIDING IN JOHNSON COUNTY LIVE BELOW THE POVERTY LEVEL AND THE UNEMPLOYMENT RATE IS ABOUT 8%. APPROXIMATELY 50% OF THE HOSPITAL'S PATIENTS DURING 2014 WERE MEDICARE PATIENTS, ABOUT 12.2% WERE MEDICAID PATIENTS, ABOUT 9.9% WERE SELF-PAY PATIENTS AND THE REMAINING PERCENTAGE WERE PATIENTS COVERED UNDER COMMERCIAL INSURANCE. IN 2014, ABOUT 67% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT.
PART VI, LINE 5: THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO TEXAS HEALTH HUGULEY'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE FILING ORGANIZATION IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST" AND EMBODIES THE FIING ORGANIZATION'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE FILING ORGANIZATION COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, THE FILING ORGANIZATION PROVIDED $192,915 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY. THE FILING ORGANIZATION ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE FILING ORGANIZATION EXPENDED $16,665,773 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE FILING ORGANIZATION IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY.
PART VI, LINE 6: AS EXPLAINED IN OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 6, TEXAS HEALTH HUGULEY, INC. (THH OR THE HOSPITAL) HAS TWO MEMBERS. THE MEMBERS ARE TEXAS HEALTH RESOURCES AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AHSSI IS A WHOLLY-OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION. THH IS ABLE TO DRAW UPON THE EXPERTISE AND LEADERSHIP OF BOTH ITS HEALTH SYSTEM MEMBERS IN ITS EFFORT TO CREATE EXCELLENT PATIENT EXPERIENCES AND OFFER A BROAD SPECTRUM OF HEALTH SERVICES NEEDED IN ITS COMMUNITY.DURING ITS CURRENT TAX YEAR, THH WAS MANAGED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 44 HOSPITALS IN 10 STATES THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 16 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. PURSUANT TO A MANAGEMENT SERVICES AGREEMENT, AHSSHC PROVIDES MANAGEMENT AND CERTAIN CONSULTING SERVICES TO TEXAS HEALTH HUGULEY. MANAGEMENT AND CONSULTING SERVICES INCLUDE PERSONNEL ADMINISTRATION, PROCUREMENT, HEALTH INFORMATION MANAGEMENT, MAINTENANCE AND SECURITY, CONTRACTS, FINANCIAL ACCOUNTING SYSTEMS AND BUDGET DEVELOPMENT.THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS MANAGEMENT BY AHSSHC. THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO ITS AFFILIATION WITH AHSSHC, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. TEXAS HEALTH HUGULEY PAYS A MANAGEMENT FEE TO AHSSHC FOR THE MANAGEMENT SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY TEXAS HEALTH HUGULEY MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL WITH NO SUCH AFFILIATION. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE.
PART VI, LINE 7, REPORTS FILED WITH STATES TX
Schedule H (Form 990) 2014
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number
45-2694620
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) SOUTHWESTERN ADVENTIST UNIVERSITY
100 W HILLCREST
KEENE,TX76059
75-0891465 501(C)(3) 14,000       GENERAL SUPPORT- GOLF TOURNAMENT/CONCERT/GALA SPONSORSHIPS
(2) SOUTHWESTERN UNION CONFERENCE OF SDA
777 S BURLESON BLVD
BURLESON,TX76028
75-0904016 501(C)(3) 10,000       GENERAL SUPPORT - CHURCH MININSTERIES CONVENTION
(3) BURLESON AREA CHAMBER OF COMMERCE
1044 SW WILSHIRE BLVD
BURLESON,TX76028
75-1228140 501(C)(6) 10,930       GENERAL SUPPORT - SPONSORSHIPS FOR LUNCHEONS/AWARDS


















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2: GRANTS ARE GENERALLY MADE ONLY TO AFFILIATED ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER 501(C)(3) AND TO OTHER LOCAL CHARITABLE ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER 501(C)(3). ACCORDINGLY, THE FILING ORGANIZATION HAS NOT ESTABLISHED SPECIFIC PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES AS THE FILING ORGANIZATION DOES NOT HAVE A GRANT MAKING PROGRAM THAT WOULD NECESSITATE SUCH PROCEDURES.
Schedule I (Form 990) 2014


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, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number

45-2694620
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 or provision of all of 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
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
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
Yes
 
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), 501(c)(4), and 501(c)(29) organizations 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 Regulations 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (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 in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1BARCLAY BERDANCHAIRMAN (i)
(ii)
0
...............................
757,467
0
...............................
575,693
0
...............................
422,535
0
...............................
99,214
0
...............................
21,542
0
...............................
1,876,451
0
...............................
201,768
2HAROLD BERENZWEIG MDDIRECTOR (i)
(ii)
0
...............................
447,865
0
...............................
213,429
0
...............................
109,861
0
...............................
51,676
0
...............................
15,560
0
...............................
838,391
0
...............................
58,261
3RONALD LONGDIRECTOR (i)
(ii)
0
...............................
593,819
0
...............................
268,781
0
...............................
233,029
0
...............................
275,359
0
...............................
16,637
0
...............................
1,387,625
0
...............................
150,230
4JOSEPH PROSSER MDDIRECTOR (i)
(ii)
0
...............................
371,088
0
...............................
117,973
0
...............................
78,389
0
...............................
19,500
0
...............................
15,086
0
...............................
602,036
0
...............................
36,249
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 3 THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) FOR THAT INDIVIDUAL'S ROLE IN SERVING AS THE CEO PURSUANT TO THE MANAGEMENT SERVICES AGREEMENT BETWEEN THE FILING ORGANIZATION AND AHSSHC. COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF AHSSHC THAT ARE DESIGNED TO ENSURE COMPLIANCE WITH THE INTERMEDIATE SANCTIONS LAWS AS SET FORTH IN IRC SECTION 4958. AHSSHC HAS TAKEN STEPS TO ENSURE THAT PROCESSES ARE IN PLACE TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS STANDARD AS SET FORTH IN TREASURY REGULATION 53.4958-6 WITH RESPECT TO ITS ACTIVE EXECUTIVE-LEVEL POSITIONS. THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE) SERVES AS THE GOVERNING BODY FOR ALL EXECUTIVE COMPENSATION MATTERS. THE COMMITTEE IS COMPOSED OF CERTAIN MEMBERS OF THE BOARD OF DIRECTORS (THE BOARD) OF AHSSHC. VOTING MEMBERS OF THE COMMITTEE INCLUDE ONLY INDIVIDUALS WHO SERVE ON THE BOARD AS INDEPENDENT REPRESENTATIVES OF THE COMMUNITY, WHO HOLD NO EMPLOYMENT POSITIONS WITH AHSSHC AND WHO DO NOT HAVE RELATIONSHIPS WITH ANY OF THE INDIVIDUALS WHOSE COMPENSATION IS UNDER THEIR REVIEW THAT IMPACTS THEIR BEST INDEPENDENT JUDGMENT AS FIDUCIARIES OF AHSSHC. THE COMMITTEE'S ROLE IS TO REVIEW AND APPROVE ALL COMPONENTS OF THE EXECUTIVE COMPENSATION PLAN OF AHSSHC. AS AN INDEPENDENT GOVERNING BODY WITH RESPECT TO EXECUTIVE COMPENSATION, IT SHOULD BE NOTED THAT THE COMMITTEE WILL OFTEN CONFER IN EXECUTIVE SESSIONS ON MATTERS OF COMPENSATION POLICY AND POLICY CHANGES. IN SUCH EXECUTIVE SESSIONS, NO MEMBERS OF MANAGEMENT OF AHSSHC ARE PRESENT. THE COMMITTEE IS ADVISED BY AN INDEPENDENT THIRD PARTY COMPENSATION ADVISOR. THIS ADVISOR PREPARES ALL THE BENCHMARK STUDIES FOR THE COMMITTEE. COMPENSATION LEVELS ARE BENCHMARKED WITH A NATIONAL PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS OF SIMILAR SIZE AND COMPLEXITY TO AHS AND EACH OF ITS AFFILIATED ENTITIES. THE FOLLOWING PRINCIPLES GUIDE THE ESTABLISHMENT OF INDIVIDUAL EXECUTIVE COMPENSATION: - THE SALARY OF THE PRESIDENT/CEO OF AHS WILL NOT EXCEED THE 40TH PERCENTILE OF COMPARABLE SALARIES PAID BY SIMILARLY SITUATED ORGANIZATIONS; AND - OTHER EXECUTIVE SALARIES SHALL BE ESTABLISHED USING MARKET MEDIANS. THE COMPENSATION PHILOSOPHY, POLICIES, AND PRACTICES OF AHSSHC ARE CONSISTENT WITH THE ORGANIZATION'S FAITH-BASED MISSION AND CONFORM TO APPLICABLE LAWS, REGULATIONS, AND BUSINESS PRACTICES. AS A FAITH-BASED ORGANIZATION SPONSORED BY THE SEVENTH-DAY ADVENTIST CHURCH (THE CHURCH), AHSSHC'S PHILOSOPHY AND PRINCIPLES WITH RESPECT TO ITS EXECUTIVE COMPENSATION PRACTICES REFLECT THE CONSERVATIVE APPROACH OF THE CHURCH'S MISSION OF SERVICE AND WERE DEVELOPED IN COUNSEL WITH THE CHURCH'S LEADERSHIP.
PART I, LINE 4B THE FILING ORGANIZATION IS 51% OWNED BY TEXAS HEALTH RESOURCES (THR). FOUR OF THE INDIVIDUALS LISTED ON PART VII AS BOARD MEMBERS (BARCLAY BERDAN, RONALD LONG, HAROLD BERENZWEIG, AND JOSEPH PROSSER) HOLD EXECUTIVE POSITIONS AND ARE ON THE PAYROLL OF THR. PARTICIPATION IN THE PLAN IS MADE AVAILABLE TO A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES, AS DETERMINED BY THE THR BOARD OF TRUSTEES, WHO ARE PROVIDING SERVICES TO AN EMPLOYER IN KEY POSITIONS OF MANAGEMENT AND RESPONSIBILITY. BENEFITS ARE CALCULATED FOR ELIGIBLE EMPLOYEES WHEN BASE PAY AND INCENTIVES EXCEED THE IRS QUALIFIED PLAN COMPENSATION LIMIT. SERP BENEFITS VEST WHILE THE PARTICIPANT IS EMPLOYED IF THE PARTICIPANT: REACHES AGE 65, BECOMES DISABLED, DIES, OR REACHES THE FOLLOWING YEARS OF SERVICE: 2 YEARS - 25%; 3 YEARS -50%; 4 YEARS - 75%; AND 5 OR MORE - 100%. FOR FROZEN RESTORATION ACCOUNTS (ACCOUNT BALANCES PRIOR TO 1/1/2010), THE PARTICIPANT OR BENEFICIARY SHALL BE TAXED ON HIS OR HER VESTED SERP BENEFITS UPON THE EARLIEST OF: * REMAINING EMPLOYED BY THR TO AGE 68 * TERMINATION OF EMPLOYMENT FOR DISABILITY OR DEATH * INVOLUNTARY TERMINATION OF EMPLOYMENT WITHOUT REASONABLE CAUSE; OR * SATISFYING A 24 MONTH NON-COMPETE PERIOD FOLLOWING HIS OR HER TERMINATION OF EMPLOYMENT. PAYMENT IS MADE FOLLOWING THE BEFORE MENTIONED EVENTS, EXCEPT IN THE CASE OF INVOLUNTARY SEPARATIONS FOR WHICH THE PARTICIPANT MUST WAIT UNTIL AFTER 24 MONTHS TO RECEIVE THE PREVIOUSLY TAXED BENEFIT. FOR THE ACTIVE RESTORATION ACCOUNT (ACCOUNT BALANCES AFTER 12/31/2009)PARTICIPANTS MUST BE EMPLOYED ON DEC 1 TO QUALIFY FOR THE CURRENT YEAR'S SERP AMOUNT UNLESS SEPARATION IS DUE TO DEATH, DISABILITY, RETIREMENT (AGE 65) OR EARLY RETIREMENT ( SEPARATION FROM SERVICE AT OR AFTER AGE 55 WITH 75 YEARS OF COMBINED AGE AND CONTINUOUS SERVICE WITH THE SYSTEM). SERP AMOUNTS ARE CALCULATED EACH DEC 1; VESTED BALANCES ARE TAXED; AND THE NET BALANCES CAN BEGIN ACCRUING EARNINGS. VESTED BALANCES ARE PAID IN CASH LUMP SUMS WITHIN THE 90 DAY PERIOD COMMENCING UPON THE EARLIER OF DEATH, DISABILITY, OR SEPARATION FROM SERVICE. THR OWNS ANY INVESTMENTS PURCHASED IN CONNECTION WITH ITS OBLIGATIONS UNDER THE SERP PLAN. IF THR BECOMES INSOLVENT, EXECUTIVES ARE UNSECURED CREDITORS AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. PAYOUTS TO THE FOLLOWING EMPLOYEES WERE MADE DURING THE YEAR. THE AMOUNTS BELOW ARE INCLUDED IN THE AMOUNT REPORTED ON SCH J, PART II, COLUMN B(III) AND COLUMN (F). BARCLAY E. BERDAN $159,033 HAROLD BERENZWEIG $ 34,124 RON LONG $112,502 JOSEPH PROSSER $ 32,599
Schedule J (Form 990) 2014

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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number

45-2694620
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 1 THE MEMBERS OF THE BOARD OF DIRECTORS LISTED ON PART VII OF THIS FORM 990 INCLUDE THE FILING ORGANIZATION'S GOVERNING BOARD AND THE MEMBERS OF THE FILING ORGANIZATION'S HOSPITAL BOARD. THE HOSPITAL BOARD IS PRIMARILY RESPONSIBLE FOR MATTERS OF THE HOSPITAL INVOLVING THE OVERSIGHT OF MEDICAL STAFF (INCLUDING THE REVIEW AND APPROVAL OF MEDICAL STAFF BYLAWS, AND APPROVAL OF APPOINTMENTS TO AND DISMISSALS FROM THE MEDICAL STAFF), CARE OF PATIENTS, IMPROVEMENTS TO LAND, BUILDINGS AND EQUIPMENT, QUALITY ASSESSMENT AND IMPROVEMENT PROGRAMS IMPLEMENTED AT THE HOSPITAL AND RISK MANAGEMENT FUNCTIONS.
FORM 990, PART VI, SECTION A, LINE 2 RON LONG AND BARCLAY BERDAN - BUSINESS RELATIONSHIP RON LONG AND JOE PROSSER, MD - BUSINESS RELATIONSHIP RON LONG AND HAROLD BERENZWEIG, MD - BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 3 EFFECTIVE JANUARY 1, 2012, TEXAS HEALTH HUGULEY, INC. (THE FILING ORGANIZATION) ENTERED INTO A MANAGEMENT SERVICES AGREEMENT WITH ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS THE PARENT ORGANIZATION OF A SYSTEM OF TAX-EXEMPT HOSPITALS AND OTHER HEALTH CARE PROVIDER ORGANIZATIONS THAT OPERATE 44 HOSPITALS IN 10 STATES. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). A 501(C)(3) SUBSIDIARY HOSPITAL ORGANIZATION OF AHSSHC, ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI), OWNS A 49% MEMBER INTEREST IN THE FILING ORGANIZATION. UNDER THE MANAGEMENT SERVICES AGREEMENT (THE AGREEMENT), AHSSHC MUST FOLLOW THE POLICIES OF THE FILING ORGANIZATION'S BOARD OF DIRECTORS. MANAGERIAL SERVICES PROVIDED BY AHSSHC INCLUDED OVERSIGHT AND DAY TO DAY MANAGEMENT OF THE FILING ORGANIZATION'S HOSPITAL, INCLUDING THE FOLLOWING FUNCTIONS: PERSONNEL ADMINISTRATION, INCLUDING RECRUITMENT, HIRING, TRAINING, PROMOTING, DIRECTING AND TERMINATING PERSONNEL; PROCUREMENT, INCLUDING THE ACQUISITION OF FOOD AND BEVERAGE ITEMS, SUPPLIES, DEVICES, FURNITURE, AND MEDICAL EQUIPMENT; HEALTH INFORMATION MANAGEMENT; MAINTENANCE AND SECURITY; CONTRACTING FOR SERVICES AND CONSULTING SERVICES; FINANCIAL ACCOUNTING SYSTEMS; DEVELOPMENT OF OPERATIONAL AND CAPITAL BUDGETS; BILLING AND COLLECTION OF RECEIVABLES AND REMITTANCES OF PAYABLES; PATIENT SAFETY AND QUALITY SYSTEMS; MARKETING; REGULATORY COMPLIANCE; ADMINISTRATION POLICIES AND PROCEDURES, INCLUDING APPOINTMENT OF THE CFO, COO, AND CNO. THE INDIVIDUALS WHO SERVE AS OFFICERS OF THE FILING ORGANIZATION IN THE ROLES OF CEO AND CFO ARE LISTED IN PART VII, SECTION A. IN 2014, THESE INDIVIDUALS WERE COMPENSATED BY AND ON THE PAYROLL OF AHSSHC FOR SERVICES RENDERED TO THE FILING ORGANIZATION. THE 2014 REPORTABLE AND OTHER COMPENSATION OF THESE TWO INDIVIDUALS IS AS FOLLOWS: KENNETH FINCH: 2014 REPORTABLE COMPENSATION - $763,130 2014 OTHER COMPENSATION - $120,058 PENNY JOHNSON: 2014 REPORTABLE COMPENSATION - $389,684 2014 OTHER COMPENSATION - $79,315.
FORM 990, PART VI, SECTION A, LINE 6 THE ARTICLES OF INCORPORATION OF THE FILING ORGANIZATION PROVIDE THAT 51% OF THE MEMBERSHIP IN THE FILING ORGANIZATION SHALL BE HELD BY TEXAS HEALTH RESOURCES, THE SOLE CLASS A MEMBER, AND 49% OF THE MEMBERSHIP IN THE FILING ORGANIZATION SHALL BE HELD BY ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI), THE SOLE CLASS B MEMBER. BOTH AHSSI AND THR ARE EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN THH.
FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE BOARD OF DIRECTORS (GOVERNING BOARD) OF THE FILING ORGANIZATION ARE APPOINTED BY THR (MAJORITY MEMBER) AND AHSSI (MINORITY MEMBER). THE MAJORITY MEMBER IS ENTITLED TO ELECT THREE DIRECTORS TO THE BOARD OF THE FILING ORGANIZATION AND THE MINORITY MEMBER IS ENTITLED TO ELECT TWO DIRECTORS TO THE BOARD. IN ADDITION, THE MEMBERSHIP SHALL APPOINT FOR THE HOSPITAL A COMMUNITY HOSPITAL BOARD TO OVERSEE THE OPERATIONS OF THE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B CERTAIN GOVERNANCE POWERS ARE RESERVED TO THE MEMBERS OF THE FILING ORGANIZATION. THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION DESCRIBE THOSE MATTERS REQUIRING ONLY AN AFFIRMITIVE VOTE OF THE CLASS A MEMBER (THR), THOSE MATTERS REQUIRING ONLY AN AFFIRMATIVE VOTE OF THE CLASS B MEMBER (AHSSI) AND THOSE MATTERS REQUIRING A SUPERMAJORITY VOTE OF THE MEMBERS. A SUPERMAJORITY VOTE REQUIRES AN AFFIRMATIVE VOTE OF NOT LESS THAN 52% OF THE OUTSTANDING MEMBERSHIP INTERESTS. THE RESERVED POWERS REQUIRING AN AFFIRMATIVE VOTE OF ONLY THE CLASS A MEMBER, THR, INCLUDE THE FOLLOWING: 1) TO APPROVE OR AMEND MANAGED CARE CONTRACTS TO WHICH THE FILING ORGANIZATION IS A PARTICIPATING PROVIDER; 2) TO APPROVE THE STRATEGIC PLANS OF THE FILING ORGANIZATION; 3) TO APPROVE THE ANNUAL OPERATING PLANS AND OPERATING AND CAPITAL BUDGET OF THE FILING ORGANIZATION; AND 4) TO APPROVE THE SELECTION, REMOVAL AND/OR MODIFICATION OF THE AUTHORITY AND RESPONSIBILITIES OF LAWYERS, ACCOUNTANTS AND OTHER ADVISORS AND CONSULTANTS TO THE FILING ORGANIZATION THAT ARE NOT OTHERWISE IDENTIFIED IN THE APPROVED ANNUAL OPERATING BUDGET. THE RESERVED POWERS REQUIRING AN AFFIRMATIVE VOTE OF ONLY THE CLASS B MEMBER, AHSSI, INCLUDE THE FOLLOWING: 1) TO APPROVE CHANGES TO THE MISSION, VISION, OR VALUES OF THE HOSPITAL; 2) TO APPROVE CHANGES TO RELIGIOUS AFFILIATION OF HOSPITAL; AND 3) TO APPROVE CHANGES TO OPERATIONAL POLICIES, PLANS, PROCEDURES THAT ARE SPECIFICALLY RELATED TO THE HOSPITAL'S RELIGIOUS AFFILIATION WITH THE SEVENTH-DAY ADVENTIST CHURCH. BOTH THR, THE MAJORITY MEMBER, AND AHSSI, THE MINORITY MEMBER HAVE THE RESERVED POWER TO TERMINATE THE APPOINTMENT OF THE INDIVIDUAL HOLDING THE OFFICE OF PRESIDENT/CEO. THE FOLLOWING MATTERS REQUIRE A SUPERMAJORITY VOTE OF THE MEMBERSHIP: 1) TO AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) TO CHANGE THE NAME OF THE HOSPITAL; 3) TO ADD NEW CORPORATE MEMBERS OF THE FILING ORGANIZATION; 4) TO APPOINT AND REMOVE THE HOSPITAL BOARD; 5) TO APPROVE DISTRIBUTIONS OF CASH AND OTHER PROPERTY; 6) TO APPROVE THE BORROWING OF MONEY OR OTHERWISE COMMITTING THE CREDIT OF THE FILING ORGANIZATION FOR CORPORATE ACTIVITIES, AND THE VOLUNTARY PREPAYMENT OR EXTENSION OF DEBT IN EXCESS OF $200,000; 7) TO ADOPT AND THEREAFTER AMEND QUALITY AND/OR RISK MANAGEMENT PLANS; 8) TO APPROVE THE TRANSFER OF CORPORATE PROPERTY HAVING A VALUE IN EXCESS OF $500,000; 9) TO APPROVE ANY SALE, LEASE, TRANSFER, MERGER OR CONSOLIDATION OF THE FILING ORGANIZATION WITH A THIRD PARTY; 10) TO DISSOLVE THE FILING ORGANIZATION; 11) TO APPROVE THE FORMATION OF ANY SUBSIDIARY OF THE FILING ORGANIZATION OR APPROVE THE FILING ORGANIZATION ENTERING INTO ANY AFFILIATION OR JOINT VENTURE AGREEMENT; AND 12) TO APPROVE ANY SINGLE CAPITAL BUDGET ITEM OF $1,000,000 (OR MORE).
FORM 990, PART VI, SECTION B, LINE 11 THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE CEO, CFO, BOARD VICE CHAIRMAN, AND TREASURER PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THESE INDIVIDUALS DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990, BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES.
FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTERESTS, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR ANY PRINCIPAL OFFICER OF THE FILING ORGANIZATION (I.E. INTERESTED PERSONS) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTERESTS POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES.
FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION, ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT GENERALLY MADE AVAILABLE TO THE PUBLIC AS A WHOLE.
PART VII, SECTION A, COLUMN (B) FOR THOSE BOARD OF DIRECTOR MEMBERS WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN COLUMN (B) ON PAGE 7 OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) ON PAGE 7 WERE PROVIDED IN CONJUNCTION WITH THAT PERSON'S RESPONSIBILITIES AND ROLES IN SERVING IN AN EXECUTIVE LEADERSHIP POSITION WITHIN THR.
FORM 990, PART IX, LINE 11G PAYMENTS TO HEALTHCARE PROFESSIONAL : PROGRAM SERVICE EXPENSES 7,241,686. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,241,686. PROFESSIONAL FEES : PROGRAM SERVICE EXPENSES 929,928. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 929,928. PURCHASED MEDICAL SERVICES : PROGRAM SERVICE EXPENSES 2,638,223. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,638,223. ENVIRONMENTAL SERVICES : PROGRAM SERVICE EXPENSES 1,132,808. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,132,808. TRANSCRIPTION SERVICES : PROGRAM SERVICE EXPENSES 225,449. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 225,449. RECRUITING : PROGRAM SERVICE EXPENSES 280,328. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 280,328. MISCELLANEOUS PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 6,384,514. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,384,514. LEASED PERSONNEL : PROGRAM SERVICE EXPENSES 78,573,362. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 78,573,362. BILLING & COLLECTION SERVICES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 827,807. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 827,807. LEASED PERSONNEL : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,885,773. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,885,773.
FORM 990, PART XI, LINE 9: CONTRIBUTION TO SUBSIDIARY -3,711,046. RESTRICTED GIFTS AND GRANTS 131,507. INVESTMENT INCOME - RESTRICTED FUNDS 33,233. TRANSFER FROM RESTRICTED TO OPERATING -139,979. ROUNDING -1.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
TEXAS HEALTH HUGULEY INC
 
Employer identification number

45-2694620
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) 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 entity?
Yes No
(1) HARRIS METHODIST HEALTH SYSTEM
612 E LAMAR BLVD

ARLINGTON,TX76011
75-1823547
SUPPORT ORG. TX 501(C)(3) LINE 11A, I N/A
 
No
(2) JOHNSON COUNTY COMMUNITY CARE CORPORATION
612 E LAMAR BLVD

ARLINGTON,TX76011
45-2793120
SUPPORT ORG. TX 501(C)(3) LINE 11A, I TH CLEBURNE
 
 
No
(3) NORTH TEXAS HEALTHY COMMUNITIES
612 E LAMAR BLVD

ARLINGTON,TX76012
46-4513182
COMM SUPPORT TX 501(C)(3) LINE 7 TH RESOURCES
 
 
No
(4) PRESBYTERIAN HEALTHCARE RESOURCES
612 E LAMAR BLVD

ARLINGTON,TX76011
51-0190395
SUPPORT ORG. TX 501(C)(3) LINE 11C, III-FI N/A
 
No
(5) TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL
800 WEST RANDOL MILL RD

ARLINGTON,TX76012
75-0972805
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(6) TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE
10864 TEXAS HEALTH TRAIL

FORT WORTH,TX76244
45-1502252
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(7) TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE
108 DENVER TRAIL

AZLE,TX76020
75-1748586
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(8) TEXAS HEALTH HARRIS METHODIST HOSPITAL CLEBURNE
201 WALLS DR

CLEBURNE,TX76033
75-1977850
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(9) TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH
1301 PENNSYLVANIA AVE

FORT WORTH,TX76104
75-6001743
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(10) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD
1600 HOSPITAL PARKWAY

BEDFORD,TX76022
75-1438726
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(11) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH
6100 HARRIS PARKWAY

FORT WORTH,TX76132
75-2678857
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(12) TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE
411 BELKNAP

STEPHENVILLE,TX76401
75-1752253
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(13) TEXAS HEALTH HUGULEY INC
11801 S FREEWAY

BURLESON,TX76028
45-2694620
HOSPITAL FL 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(14) TEXAS HEALTH OUTPATIENT SURGERY CENTER ALLIANCE
10840 TEXAS HEALTH TRAIL

FORT WORTH,TX76244
80-0800294
HOSPITAL TX 501(C)(3) LINE 3 TH ALLIANCE
 
 
No
(15) TEXAS HEALTH PHYSICIANS GROUP
9229 LBJ FREEWAY

DALLAS,TX75243
75-2613493
PHYS. CLINIC TX 501(C)(3) LINE 9 TH RESOURCES
 
 
No
(16) TEXAS HEALTH RESOURCES FOUNDATION
612 E LAMAR BLVD

ARLINGTON,TX76011
75-2022128
FUNDRAISING TX 501(C)(3) LINE 7 TH RESOURCES
 
 
No
(17) TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN
1105 CENTRAL EXPRESSWAY N

ALLEN,TX75013
75-2890358
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(18) TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS
8200 WALNUT HILL LN

DALLAS,TX75231
75-1047527
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(19) TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON
3000 NORTH INTERSTATE 35

DENTON,TX76201
43-2008974
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(20) TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN
850 ED HALL DRIVE

KAUFMAN,TX75142
75-2771437
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(21) TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO
6200 W PARKER RD

PLANO,TX75093
75-2770738
HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(22) TEXAS HEALTH RESEARCH & EDUCATION INSTITUTE
612 E LAMAR BLVD

ARLINGTON,TX76011
75-2562191
EDU& RESEARCH TX 501(C)(3) LINE 4 TH RESOURCES
 
 
No
(23) TEXAS HEALTH RESOURCES
612 E LAMAR BLVD

ARLINGTON,TX76011
75-2702388
MGMT SUPP ORG. TX 501(C)(3) LINE 11C, III-FI N/A
 
No
(24) TEXAS HEALTH RESOURCES SELF-INSURANCE TRUST
612 E LAMAR BLVD

ARLINGTON,TX76011
75-6335901
INSUR TRUST TX 501(C)(3) LINE 11C, III-FI TH RESOURCES
 
 
No
(25) TEXAS HEALTH SPECIALTY HOSPITAL FORT WORTH
1301 PENNSYLVANIA AVE

FORT WORTH,TX76104
75-1648589
LT HOSPITAL TX 501(C)(3) LINE 3 TH RESOURCES
 
 
No
(26) WW WARD ENDOWMENT FUND TRUST
612 E LAMAR BLVD

ARLINGTON,TX76011
75-6196065
SUPPORT ORG. TX 501(C)(3) LINE 11A, I TH FT WORTH
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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) AMH CATH LABS LLC

811 WRIGHT ST
ARLINGTON,TX76012
20-3003947
HOSPITAL TX N/A
                 
(2) CLEBURNE IMAGING LLC

PO BOX 820519
DALLAS,TX75382
46-0767278
OUTPATIENT DIAGNOSTIC IMAGING CTR TX N/A
                 
(3) CLEBURNE SURGICAL CENTER LLC

2010 W KATHERINE P RAINES BLVD STE
CLEBURNE,TX76033
20-3742012
AMB SURG CTR TX N/A
                 
(4) DENTON SURGERY CENTER LLC

569 BROOKWOOD VILLAGE STE 901
BIRMINGHAM,AL35209
47-0926556
AMB SURG CTR TX N/A
                 
(5) FLOWER MOUND HOSPITAL PARTNERS LLC

612 E LAMAR BLVD STE 600
ARLINGTON,TX76011
26-0684968
HOSPITAL TX N/A
                 
(6) FORT WORTH ENDOSCOPY CENTERS LLC

900 W MAGNOLIA AVE 101
FORT WORTH,TX76104
77-0368346
ENDOCSOPY CENTER TX N/A
                 
(7) GREENVILLE SURGERY CENTER LLC

7150 GREENVILLE AVE STE 200
DALLAS,TX75231
74-2411643
AMB SURG CTR TX N/A
                 
(8) HEALTH IMAGING PARTNERS LLC

8610 EXPLORER DRIVE STE 300
COLORADO SPRINGS,CO80920
27-1385885
OUTPATIENT DIAGNOSTIC IMAGING CTR TX N/A
                 
(9) NORTH DALLAS SURGICAL CENTER LLC

17980 DALLAS PARKWAY STE 100
DALLAS,TX75287
27-2248103
AMB SURG CTR TX N/A
                 
(10) PHYSICIAN MEDICAL CENTER LLC

612 E LAMAR BLVD 6TH FLR
ARLINGTON,TX76011
48-1281376
HOSPITAL TX N/A
                 
(11) PRESBYTERIAN CANCER CENTER-DALLAS LLC

1220 SENLAC DRIVE 2ND FLR
CARROLLTON,TX75006
26-0422749
CANCER TREATMENT TX N/A
                 
(12) ROCKWALL REGIONAL HOSPITAL LLC

612 E LAMAR BLVD 6TH FLR
ARLINGTON,TX76011
20-2848116
HOSPITAL TX N/A
                 
(13) SHERMANGRAYSON HEALTHCARE SYSTEM LLC

2400 DALLAS PKWY
PLANO,TX75093
27-2025497
HOSPITAL TX N/A
                 
(14) SOUTHLAKE SPECIALTY HOSPITAL LLC

612 E LAMAR BLVD 6TH FLR
ARLINGTON,TX76011
02-0555370
HOSPITAL TX N/A
                 
(15) SURGICAL CAREGIVERS OF FORT WORTH LLC

569 BROOKWOOD VILLAGE STE 901
BIRMINGHAM,AL35209
75-1925497
AMB SURG CTR TX N/A
                 
(16) TEXAS HEALTH CRAIG RANCH SURGERY CENTER LLC

8080 STATE HWY 121 STE 100
MCKINNEY,TX75070
38-3897811
AMB SURG CTR TX N/A
                 
(17) TEXAS HEALTH FLOWER MOUND ORTHOPEDIC SURGERY CENTER LLC

5000 LONG PRAIRIE ROAD
FLOWER MOUND,TX75028
80-0866449
AMB SURG CTR TX N/A
                 
(18) TEXAS HEALTH MEDSYNERGIES LLC

909 HIDDEN RIDGE STE 300
IRVING,TX75038
80-0272951
MGMT SERVICES TX N/A
                 
(19) TEXAS HEALTH SPINE CENTER ARLINGTON

1545 E SOUTHLAKE BLVD STE 100
SOUTHLAKE,TX76092
46-4143686
INACTIVE TX N/A
                 
(20) TEXAS INSTITUTE FOR SURGERY LLP

7715 GREENVILLE AVE STE 100
DALLAS,TX75231
77-0628004
HOSPITAL TX N/A
                 
(21) THR-STT ROCKWALL ASC LLC

1545 E SOUTHLAKE BLVD
SOUTHLAKE,TX76092
26-2429878
AMB SURG CTR TX N/A
                 
(22) THR-STT SOUTHLAKE ASC LLC

1545 E SOUTHLAKE BLVD
SOUTHLAKE,TX76092
20-1728912
AMB SURG CTR TX N/A
                 
(23) USMD HOSPITAL AT ARLINGTON LP

801 I -20 WEST
ARLINGTON,TX76017
73-1662763
HOSPITAL TX N/A
                 
(24) USMD HOSPITAL AT FORT WORTH LP

6333 NORTH STATE HWY 161 STE 200
IRVING,TX75038
20-3571243
HOSPITAL TX N/A
                 
(25) WILSON CREEK SURIGCAL CENTER LLC

8855 SYNERGY DRIVE
MCKINNEY,TX75070
27-4816583
AMB SURG CTR TX N/A
                 
(26) WOMEN'S SPECIALTY SURGERY CENTER

8230 WALNUT HILL LN STE 101
DALLAS,TX75231
26-2310072
AMB SURG CTR TX N/A
                 
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
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) GRACE INDEMNITY COMPANY LTD

1159 CARIBBEAN PLAZA
  GRAND CAYMAN, KY1  
CJ
98-1209573
CAPTIVE INSURANCE CJ N/A
C         No
(2) TEXAS HEALTH BIOMEDICAL ADVANCEMENT CENTER INC

612 E LAMAR BLVD
ARLINGTON,TX76011
75-2636884
RESEARCH TX N/A
C         No
(3) TEXAS HEALTH RESOURCES CASUALTY COMPANY

612 E LAMAR BLVD
ARLINGTON,TX76011
03-0310676
INSURANCE VT N/A
C         No
(4) TEXAS HEALTH RESOURCES CARDIOVASCULAR SERVICES

612 E LAMAR BLVD
ARLINGTON,TX76011
46-5588632
INACTIVE TX N/A
C         No
(5) TEXAS HEALTH RESOURCES JOINT SERVICES

612 E LAMAR BLVD
ARLINGTON,TX76011
46-5365421
INACTIVE TX N/A
C         No
(6) TEXAS HEALTH RESOURCES SPINE SERVICES

612 E LAMAR BLVD
ARLINGTON,TX76011
46-5347751
INACTIVE TX N/A
C         No
(7) TEXAS HEALTH RESOURCES WOMEN'S SERVICES

612 E LAMAR BLVD
ARLINGTON,TX76011
46-5330487
INACTIVE TX N/A
C         No
(8) CHARITABLE REMAINDER TRUSTS (4)

612 E LAMAR BLVD
ARLINGTON,TX76011
CR TRUST TX N/A
T         No
(9) HUGULEY MEDICAL ASSOCIATES INC

11801 SOUTH FREEWAY
BURLESON,TX76028
75-2547668
PHYS CLINICS TX TEXAS HEALTH HUGULEY INC
 
C 13,582,139 1,364,937 100.000 % Yes  
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
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 related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) HUGULEY MEDICAL ASSOCIATES INC

A 638,760 FMV INTEREST RATE
(2) HUGULEY MEDICAL ASSOCIATES INC

P 1,048,877 COST
(3) HUGULEY MEDICAL ASSOCIATES INC

R 2,610,046 ACTUAL AMOUNT TRANSFERRED
(4) HUGULEY MEDICAL ASSOCIATES INC

O 72,900 COST
(5) TEXAS HEALTH RESOURCES

P 4,569,564 COST
(6) TEXAS HEALTH RESOURCES

N 11,197,764 COST
(7) TEXAS HEALTH RESOURCES

O 116,730 COST
(8) TEXAS HEALTH RESOURCES

M 206,775 COST
(9) HUGULEY MEDICAL ASSOCIATES INC

M 1,159,041 COST
(10) HUGULEY MEDICAL ASSOCIATES INC

O 119,656 COST
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(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 Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


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