Form990
Click to see attachment
Department of the TreasuryInternal 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
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 07-01-2015 , and ending 06-30-2016
BCheck if applicable:
CName of organization
Memorial Hermann Community Benefits
Corporation
% ANTHONY FRANK
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
909 Frostwood Suite 2100
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Houston, TX77024
D Employer identification number

68-0511504
E Telephone number

G Gross receipts $ 12,150,379
F Name and address of principal officer:
Benjamin K Chu MD
909 Frostwood Suite 2100
Houston,TX77024
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
http://communitybenefit.memorialhermann.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: 2001
M State of legal domicile: TX
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Provision of programs to improve the utilization of preventive medical services by the underserved population of Harris County.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 3
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 0
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 114
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 10,593,168 12,150,379
9 Program service revenue (Part VIII, line 2g) ......... 0 0
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 0 0
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 10,593,168 12,150,379
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,338,399 1,326,558
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) 6,625,990 7,453,529
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet26,493    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,191,144 1,372,074
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 9,155,533 10,152,161
19 Revenue less expenses. Subtract line 18 from line 12....... 1,437,635 1,998,218
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 8,241,570 10,137,592
21 Total liabilities (Part X, line 26)............. 635,992 533,796
22 Net assets or fund balances. Subtract line 21 from line 20..... 7,605,578 9,603,796
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 (2015)
Form 990 (2015)
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: THE MISSION OF MEMORIAL HERMANN COMMUNITY BENEFIT CORPORATION (MHCBC) IS TO TEST AND MEASURE INNOVATIVE SOLUTIONS THAT REDUCE THE IMPACT OF THE LACK OF ACCESS TO CARE ON THE INDIVIDUAL, THE HEALTH SYSTEM AND THE COMMUNITY. NEW PROGRAMS ARE PILOTED, AND PROVEN PROGRAMS ARE REPLICATED IN THE COMMUNITY THAT INCLUDE INITIATIVES TO: REMOVE BARRIERS TO HEALTHCARE ACCESS; INCREASE AND STRENGTHEN THE PRIMARY AND SPECIALTY CARE INFRASTRUCTURE; PROVIDE EDUCATION AND INCREASE HEALTHCARE AWARENESS; AND IMPROVE THE USE OF PREVENTATIVE MEDICAL 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 $ 3,796,695 including grants of $   ) (Revenue $   )
4A. ADDRESSING THE NEED FOR A "MEDICAL HOME" FOR THE UNINSURED AND UNDERINSURED, MHCBC PARTNERS WITH FIVE SCHOOL DISTRICTS, HOUSTON--THE LARGEST IN TEXAS, PASADENA, LAMAR CONSOLIDATED, ALIEF AND ALDINE FOR ITS HEALTH CENTERS FOR SCHOOLS PROGRAM DESIGNED TO PROVIDE A "MEDICAL HOME" FOR UNINSURED CHILDREN AND A SECONDARY ACCESS POINT FOR INSURED CHILDREN, GRADES K-12TH. THE HEALTH CENTERS PROVIDE PRIMARY HEALTHCARE, MENTAL HEALTHCARE, NUTRITIONAL CARE AND DENTAL CARE TO MEDICALLY UNDERSERVED, AT-RISK CHILDREN. THE PROGRAM BEGAN IN 1996 WITH TWO SCHOOL-BASED HEALTH CENTERS SERVICING THREE SCHOOLS. TODAY, MEMORIAL HERMANN OPERATES HEALTH CENTERS ON-SITE AT TEN CAMPUSES IN THE GREATER HOUSTON AREA PROVIDING ACCESS TO HEALTHCARE FOR STUDENTS AT 72 SCHOOLS. "FEEDER" PATTERNS ARE ACCOMMODATED, MAKING IT POSSIBLE FOR A CHILD TO RECEIVE CONTINUITY OF CARE FROM PRE-KINDERGARTEN THROUGH TWELFTH GRADE. WHILE MEDICAID ELIGIBLE SERVICES ARE BILLED, ALL SERVICES ARE PROVIDED AT NO COST TO FAMILIES. THE HEALTH CENTERS FOR SCHOOLS OPERATE MONDAY THROUGH FRIDAY, 7:30 AM TO 4:00 PM, 12 MONTHS A YEAR. THE PRIMARY GOAL OF THE HEALTH CENTERS FOR SCHOOLS PROGRAM IS TO BRING INCREASED HEALTH CARE TO CHILDREN WHO WILL OTHERWISE NOT OBTAIN IT AND TO KEEP CHILDREN HEALTHY AND IN SCHOOL SO THEY CAN LEARN THE SKILLS THEY WILL NEED FOR A BRIGHTER FUTURE. 52% OF THE CHILDREN SERVED AT THE CLINICS DO NOT HAVE ANY TYPE OF HEALTHCARE COVERAGE. 32% HAVE SOME FORM OF MEDICAID. THE REMAINING 16% ARE CHILDREN WHO WILL NOT OBTAIN HEALTHCARE DUE TO TRANSPORTATION ISSUES, WORKING PARENTS UNABLE TO AFFORD A DAY OFF, HIGH PRIVATE INSURANCE DEDUCTIBLES OR SIMPLY A LACK OF PARENTAL INVOLVEMENT. MORE THAN 89% OF STUDENTS SERVED THROUGH THE PROGRAM ARE ON THE FREE/REDUCED LUNCH PROGRAM, AND 29% ARE MORE COMFORTABLE SPEAKING, READING AND WRITING IN A LANGUAGE OTHER THAN ENGLISH. THE SCOPE OF SERVICES OFFERED INCLUDES IMMUNIZATIONS, GENERAL AND SPORTS PHYSICALS, ACUTE, CHRONIC AND MINOR INJURY CARE, MENTAL HEALTH THERAPY, SOCIAL SERVICE COUNSELING AND REFERRALS, HEALTH EDUCATION, AND NUTRITIONAL GUIDANCE AS WELL AS OTHER SPECIFIC CARE TO MEET STUDENTS' NEEDS. STAFFING AT EACH CENTER CONSISTS OF A NURSE PRACTITIONER, LICENSED CLINICAL SOCIAL WORKER, LVN AND A RECEPTIONIST, WITH MEDICAL OVERSIGHT PROVIDED BY A FAMILY PRACTITIONER. TWO DIETITIAN AND CERTIFIED COMMUNITY HEALTH WORKERS ROTATE AMONG THE TEN CENTERS. THE DIETITIANS DELIVER THE HEALTHY EATING AND LIFESTYLES PROGRAM (HELP) DESIGNED TO EDUCATE HEALTH CENTERS FOR SCHOOLS' STUDENTS AND THEIR FAMILIES ON THE IMPORTANCE OF PROPER NUTRITION AND EXERCISE. THE PROGRAM IS INTENSIVE AND INDIVIDUAL, MEETING THE STUDENT AND FAMILY WHERE THEY ARE ON THE "STAGE OF CHANGE" CONTINUUM. THE THREE MOBILE DENTAL CLINIC VANS ROTATE AMONG THE HEALTH CENTERS FOR SCHOOLS AND ARE STAFFED BY A DENTIST AND ONE TO TWO DENTAL ASSISTANTS. THE VANS PROVIDE SERVICES THAT INCLUDE PERIODIC ORAL EXAMINATIONS, DIAGNOSTIC X-RAYS, PROPHYLAXIS, FLUORIDE TREATMENTS, ORAL HYGIENE INSTRUCTIONS, SEALANTS, COMPOSITE FILLINGS, EXTRACTIONS, STAINLESS STEEL CROWNS, AND PULPOTOMIES. THIS PROGRAM HAS SERVED AS A "DENTAL HOME" TO UNINSURED STUDENTS SINCE 2000. THE MEMORIAL HERMANN HEALTH CENTERS FOR SCHOOLS PROGRAM IS CONTINUALLY EVOLVING AND IN FY 15-16 TWO PROGRAM COMPONENTS WERE ADDED: FOOD INSECURITY AND BOOT CAMPS. THE CENTERS SCREEN ALL PARENTS USING THE 2-ITEM USDA FOOD INSECURITY SCREENER IN ENGLISH/SPANISH. FOOD INSECURE FAMILIES ARE PROVIDED WITH ASSISTANCE IN SIGNING UP FOR SNAP AND GIVEN LOCAL PANTRY INFORMATION. TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH IN ADDITION TO HUNGER, FAMILIES IN NEED OF OTHER BASIC SERVICES ARE NAVIGATED TO APPROPRIATE SOCIAL SERVICE AGENCIES. FOOD INSECURITY CONTRIBUTES TO UNHEALTHY EATING HABITS AND OBESITY. TO COMPLEMENT THE DIETITIANS HEALTHY EATING AND LIFESTYLE PROGRAM (HELP), IN THE SUMMER OF 2015, THE HAPPY (HEALTHY ATTITUDES PROMOTING POSITIVE YOUTH) BOOT CAMP FOR STUDENTS MEETING BMI REQUIREMENTS WAS PILOTED. EACH CAMP DAY INCLUDED A MEDICAL EVALUATION WITH THE LVN AND MID-LEVEL PROVIDER, 1-HOUR OF EXERCISE WITH A CERTIFIED FITNESS INSTRUCTOR, A 45 MINUTE NUTRITION CONSULTATION WITH A REGISTERED DIETITIAN AND A 45 MINUTE GROUP COUNSELING SESSION WITH A LICENSED CLINICAL SOCIAL WORKER. THE CURRICULUM IS DESIGNED TO PROMOTE A HEALTHY LIFESTYLE THROUGH GUIDED PRACTICE. DATA COLLECTION HAS BEEN REFINED TO INCLUDE PRE/POST KNOWLEDGE; HABITS AND SELF-ESTEEM THROUGH POSITIVE ASSERTIVENESS SURVEYS. AN EVIDENCED-BASED PROGRAM, BENCHMARKS ARE DERIVED FROM THE NATIONAL ASSOCIATION OF SCHOOL BASED HEALTH CENTERS, PRE/POST DATA, AND HEALTHY PEOPLE 2020. OUTCOMES IN 2016 INCLUDE: 3.6% OF HEALTH CENTER STUDENTS USED AN ER FOR PRIMARY CARE PURPOSES VERSUS 10.5% OF THE GENERAL PRIMARY CARE PEDIATRIC COMMUNITY. ASTHMA EXACERBATIONS, EMERGENCY ROOM VISITS AND HOSPITALIZATIONS WERE REDUCED BY 83%. 89% OF STUDENTS RETURNED TO THEIR CLASSROOM ON THE SAME DAY. STUDENTS WHO RECEIVED THERAPY FROM LICENSED CLINICAL SOCIAL WORKERS IMPROVED GPAS, REDUCED DAYS ABSENT, AND REDUCED DETENTION/SUSPENSION INCIDENTS. 95% OF STUDENTS WITH 3+ CLINIC VISITS FOR ACUTE OR CHRONIC REASONS RECEIVE A BI-ANNUAL PHYSICAL. 4.7% OF STUDENTS AGE 4-11 AND 4.9% OF STUDENTS AGE 12+ EXPERIENCED CARIES AT RECALL. HEALTHY PEOPLE 2020 CALLS FOR THE PROPORTION OF CHILDREN WITH ONE OR MLORE CARIES TO BE NO MORE THAN 49% AND 48%, RESPECTIVELY. 85.4% OF STUDENTS AGE 6-9 AND 80.4% OF STUDENTS AGE 13 TO 15 RECEIVED SEALANTS. HEALTHY PEOPLE 2020 REQUIRES SEALANTS PLACEMENT TO BE 28.1%, RESPECTIVELY.
4b (Code:   ) (Expenses $ 3,484,780 including grants of $   ) (Revenue $   )
4B. COMPOUNDED BY TEXAS LACK OF MEDICAID EXPANSION, ARE PEOPLE WHO CANNOT AFFORD PRIVATE INSURANCE; WHO ARE ELIGIBLE BUT NOT ENROLLED IN GOVERNMENT SPONSORED PROGRAMS, AND WHO ARE RECENT OR UNDOCUMENTED IMMIGRANTS. A GROWING NUMBER OBTAIN THEIR HEALTH CARE IN ERS. A HOUSTON STUDY CONDUCTED BY THE UNIVERSITY OF TX SCHOOL OF PUBLIC HEALTH INDICATES THAT ROUGHLY 46% OF ER VISITS ARE USED FOR NON ER CONDITIONS. IN NOVEMBER, 2008, WHEN UNINSURED RATES FOR THE NATION AND THE HOUSTON AREA WERE 15% AND 32%, RESPECTIVELY, THE MEMORIAL HERMANN COMMUNITY BENEFIT CORPORATION LAUNCHED A PATIENT NAVIGATION PROGRAM TO ADDRESS PRIMARY CARE RELATED ER USE AT MEMORIAL HERMANN SOUTHWEST HOSPITAL. OVERALL OBJECTIVES WERE AND CONTINUE TO BE: (1) TO CONNECT PATIENTS WITH MEDICAL HOMES THAT ARE THE RIGHT LOCATION, THE RIGHT COST, THE RIGHT HOURS OF OPERATION, AND THE CORRECT SERVICES FOR EACH INDIVIDUAL; (2) TO REDUCE PRIMARY CARE RELATED ER USE; AND (3) TO REDUCE PRIMARY CARE RELATED COSTS, AT LEAST TO THE POINT OF COVERING THE COST OF THE PROGRAM. TODAY, ER NAVIGATORS ARE LOCATED IN TMC, SOUTHWEST, GREATER HEIGHTS, SOUTHEAST, NORTHEAST, MEMORIAL CITY, KATY, SUGAR LAND AND PEARLAND ERS. THE TARGET POPULATION CONSISTS OF UNINSURED INDIVIDUALS BETWEEN 18 MONTHS AND 64 YEARS, WHO UTILIZE THE ER FOR PRIMARY CARE RELATED REASONS. THE STUDY DESIGN IS BASED ON PRE/POST DATA; AND THE INTERVENTION INCLUDES PATIENT NAVIGATION, CONDUCTED BY BI-LINGUAL, STATE CERTIFIED COMMUNITY HEALTH WORKERS (CHWS) TRAINED IN PEER-TO-PEER COUNSELING. DURING THE ER VISIT CHWS MEET WITH PATIENTS TO: EXPLORE ALL ACCESS ISSUES; ACCESS IS MORE THAN HAVING HEALTH INSURANCE COACH ON HOW TO ACCESS HEALTHCARE AND COMMUNITY RESOURCES EDUCATE ON THE IMPORTANCE OF FINDING AND MAINTAINING A MEDICAL HOME ALL PATIENTS LEAVE THE ER WITH SOME SORT OF FOLLOW-UP INSTRUCTIONS FROM THE MEDICAL TEAM--THE CHWS MAKE SURE THEY HAVE A PLACE TO GO. AFTER THE ER VISIT CHWS: FOLLOW UP WITH PATIENTS; USUALLY WITHIN ONE WEEK MONITOR/REVIEW/RESOLVE ONGOING PATIENT NEEDS CONTINUE TO FOLLOW-UP UNTIL THE CASE IS CLOSED ESSENTIAL TO THE PROCESS; CONTINUING TO BUILD RELATIONSHIPS WITH HOSPITAL STAFF AND COMMUNITY BASED ORGANIZATIONS IN PARTNERSHIP WITH MEMORIAL HERMANN ER BUSINESS, CLINICAL AND CARE MANAGEMENT TEAMS, THE PROGRAM ANNUALLY NAVIGATES 16,200 PATIENTS AND INCURS MORE THAN 30,000 ENCOUNTERS. A 12-MONTH, PRE-POST ANALYSIS OF NAVIGATED PATIENTS RESULTED IN A 67% DECLINE IN ER VISITS. THE SAVINGS ASSOCIATED WITH REDUCING PRIMARY CARE RELATED ER VISITS ARE GREATER THAN THE COSTS TO IMPLEMENT THE ER NAVIGATION PROGRAM. RESEARCH DATA INDICATES THAT SOCIAL DETERMINANTS OF HEALTH (SDOH) HAVE A PROFOUND IMPACT ON THE HEALTH STATUS OF INDIVIDUALS, AND IN ORDER TO IMPROVE POPULATION HEALTH, HEALTH CARE SYSTEMS WILL NEED TO CONSIDER ADDRESSING SDOH. THE ER NAVIGATION PROGRAM BEGAN ADDRESSING SDOH IN FY 16 INCORPORATING FOOD INSECURITY SCREENING INTO THE NAVIGATION INTERVENTION PROCESS AND LEARNED THAT NEARLY 20% OF PATIENTS SCREENED WERE FOUND TO HAVE FOOD INSECURITIES. WITH LARGE NUMBERS OF MEMORIAL HERMANN PATIENTS SUBSEQUENTLY REFERRED TO AREA FOOD PANTRIES, THE PROGRAM IS GIVING BACK TO THE FOOD PANTRIES THROUGH COMMUNITY HEALTH AND OUTREACH INITIATIVES. COLLABORATING WITH THE FOOD PANTRIES PRESENTS AN OPPORTUNITY FOR THE ER NAVIGATION PROGRAM TO ALIGN EFFORTS OF ADDRESSING SOCIAL DETERMINANT ISSUES AND INCREASES THE OPPORTUNITY FOR OUR PROGRAM TO BUILD BRIDGES TO HEALTH CARE AND COMMUNITY RESOURCES IN EFFORTS OF IMPROVING ACCESS AND WELLNESS. THROUGH EIGHT YEARS OF PLANNING, IMPLEMENTING AND ANALYSIS, DETERMINED NEXT STEPS ARE FOR NAVIGATION SERVICES TO BE ENHANCED TO INCLUDE THE DEVELOPMENT AND IMPLEMENTATION OF COMMUNITY-BASED CARE COORDINATION SERVICES. THESE SERVICES WILL INCLUDE ASSISTANCE AND ALIGNMENT INTERVENTIONS WITH A FOCUS ON SCREENING, REFERRALS, COMMUNITY SERVICE NAVIGATION, AND COMMUNITY PARTNER ALIGNMENT FOR SDOH NEEDS FALLING IN ONE OF FOUR CATEGORIES: FOOD INSECURITY, HOUSING, TRANSPORTATION AND UTILITIES. THESE SERVICES WILL BE PROVIDED TO PATIENTS THAT FALL IN THE HIGH END SPECTRUM OF CARE; UNINSURED, UNDERINSURED AND MEDICAID PATIENTS WHO PRESENT WITH SIX OR MORE ER VISITS WITHIN A 12 MONTH PERIOD AND IDENTIFIED WITH HAVING TWO OR MORE SDOH ISSUES. BOTH OF THESE INITIATIVES, COMMUNITY OUTREACH AND CARE COORDINATION PROVIDE INNOVATION OPPORTUNITIES WHILE ALSO ENHANCING POPULATION HEALTH.
4c (Code:   ) (Expenses $ 1,854,286 including grants of $ 872,722 ) (Revenue $   )
4C. ACCORDING TO AN EMERGENCY DEPARTMENT USE STUDY, PUBLISHED IN JUNE 2013 AND CONDUCTED BY THE UNIVERSITY OF TEXAS SCHOOL OF PUBLIC HEALTH, 46% OF ALL PATIENTS TREATED AND RELEASED FROM EMERGENCY ROOMS IN HOUSTON WERE TREATED FOR PRIMARY CARE RELATED ILLNESSES OR INJURIES. BASED ON THIS DATA WHICH REPRESENTS A CONSISTENT TREND, THE MEMORIAL HERMANN HEALTH SYSTEM NURSE TRIAGE CENTER DBA THE NURSE HEALTH LINE WAS ESTABLISHED AND DESIGNED TO IMPROVE ACCESS TO CARE AND ENSURE MORE EFFICIENT USE OF THE EMERGENCY ROOMS IN HARRIS AND THE SURROUNDING COUNTIES. THE STUDY HIGHLIGHTS THE NEED FOR PATIENT EDUCATION ABOUT APPROPRIATE EMERGENCY DEPARTMENT USE. HEALTHCARE CONSUMERS ARE UNCERTAIN ABOUT WHERE AND WHEN TO GO FOR TREATMENT. THE 1115 MEDICAID WAIVER DSRIP PROGRAM ALLOWED MEMORIAL HERMANN TO LAUNCH AND OPERATE A REGION-WIDE 24-HOUR NURSE TRIAGE CALL CENTER TO ASSIST PATIENTS WITH THEIR LEVEL OF CARE DECISIONS. THE GOAL OF THE PROGRAM IS TO BE A REGIONAL RESOURCE THAT CITIZENS CAN CALL TO DISCUSS THEIR HEALTH CONCERNS, RECEIVE RECOMMENDATIONS ON THE APPROPRIATE SETTING FOR CARE, AND GET CONNECTED TO APPROPRIATE RESOURCES. THE CALL CENTER IS STAFFED WITH REGISTERED NURSES AND COMMUNITY HEALTH WORKERS 24/7 AND AVAILABLE TO CALLERS, FREE OF CHARGE, REGARDLESS OF INSURANCE STATUS, LANGUAGE, PHYSICIAN ALIGNMENT, OR HOSPITAL AFFILIATION. CALLERS WITH QUESTIONS OR CONCERNS REGARDING MEDICAL CONDITIONS ARE ENCOURAGED TO CALL AND GET HELP FROM A REGISTERED NURSE WHO PROVIDES NURSE TRIAGE AND HEALTH EDUCATION/INFORMATION. REGISTERED NURSES PROVIDE SUGGESTIONS ON THE URGENCY OF THE NEED FOR TREATMENT AND THE APPROPRIATE LEVEL OF CARE. COMMUNITY HEALTH WORKERS PROVIDE REFERRALS TO RESOURCES SUCH AS CLINICS AND PHARMACIES. 2016 DATA SHOWS THAT: 72% OF THE TRIAGE LINE CALLERS THAT WOULD HAVE SOUGHT CARE IN AN ED SETTING WERE REDIRECTED TO PRIMARY CARE; AND IN FOLLOW-UP CALLS IT WAS FOUND THAT 97% OF CALLERS FOLLOWED THE ADVICE OF THE NURSE. THE CALL CENTER IS A CREDIBLE AND AVAILABLE RESOURCE FOR ASSISTANCE WITH MEDICAL CONCERNS AND QUESTIONS. THE ACTUAL CALL VOLUME FOR 2016 WAS 72,627. THE NURSE HEALTH LINE CONTINUES TO ENHANCE LINKAGES BETWEEN PRIMARY CARE, URGENT CARE, AND EMERGENCY DEPARTMENTS IN ORDER TO INCREASE COMMUNICATION AND IMPROVE CARE TRANSITIONS FOR PATIENTS. PATIENTS ARE OFTEN GIVEN DISCHARGE INSTRUCTIONS TO CONTACT THE NURSE TRIAGE LINE FOR ASSISTANCE WITH MEDICAL CONCERNS POST-DISCHARGE. CONVERSELY, PATIENTS ARE REFERRED TO EDS, URGENT CARE CENTERS, CLINICS, OR THEIR PCP FOR FOLLOW UP IN ACCORDANCE WITH THE APPROPRIATE TREATMENT SETTING NEEDED. CALLS ARE RECEIVED FROM PATIENTS BEING DISCHARGED FROM HOSPITALS, CLINICS, SURGERY CENTERS, AND DOCTORS' OFFICES. PATIENTS ARE REFERRED TO PHARMACIES, POISON CONTROL HOTLINES, DENTIST, MENTAL HEALTH HOTLINES/FACILITIES AND AT-HOME TREATMENT.
(Code:   ) (Expenses $ 199,704 including grants of $ 198,000 ) (Revenue $   )
Physicians of Sugar Creek
(Code:   ) (Expenses $ 255,836 including grants of $ 255,836 ) (Revenue $   )
Support of Community Health Centers
4d Other program services (Describe in Schedule O.)
(Expenses $ 455,540 including grants of $ 453,836 ) (Revenue $   )
4e Total program service expensesMediumBullet9,591,301
Form 990 (2015)
Form 990 (2015)
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 I.............
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 II..............
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III.................
5
 
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
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, 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
 
No
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
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, 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....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2015)
Form 990 (2015)
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
Yes
 
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
 
No
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 ...
35b
 
 
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 (2015)
Form 990 (2015)
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
7
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
114
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
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
 
 
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 (2015)
Form 990 (2015)
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
3
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
0
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
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
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
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:
MediumBulletANTHONY FRANK909 FROSTWOOD SUITE 2100   Houston,TX77024 (713) 338-4643
Form 990 (2015)
Form 990 (2015)
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) GORDON DEBORAH......................................................................
Director; CLO & Secr/Treas
 1.0
.................
50.0 		X   X       0 821,026 136,148
(2) LARAWAY DENNIS L......................................................................
Director; CFO
 1.0
.................
50.0 		X           0 1,470,986 234,017
(3) SHABOT MICHAEL......................................................................
Chief Clinical Officer
 1.0
.................
50.0 		X   X       0 1,309,915 164,631
(4) CHU BENJAMIN K......................................................................
Ex Officio
 1.0
.................
50.0 		X   X       0 0 0
(5) WOLTERMAN DAN J......................................................................
Director; President & CEO
 1.0
.................
50.0 		    X       0 3,238,155 2,119,983
(6) PARET CAROL J......................................................................
SVP Chief Community Officer
 0.0
.................
50.0 		      X     0 551,898 90,195
(7) CHALAJOUR MAHASTI......................................................................
Dentist
 50.0
.................
0.0 		        X   183,845 0 20,036
(8) STEPHENS CHRISCILDA S......................................................................
Dentist
 50.0
.................
0.0 		        X   173,822 0 22,463
(9) KIMMEY-WALKER LISA L......................................................................
NP/PA Manager
 50.0
.................
0.0 		        X   154,917 0 18,794
(10) GRAVES DESHAUNDA T......................................................................
Dentist
 50.0
.................
0.0 		        X   149,170 0 11,331
(11) FURTADO ALBERT......................................................................
Dentist
 50.0
.................
0.0 		        X   143,090 0 20,890
(12) REIMER RENEE......................................................................
Former Officer
 0.0
.................
50.0 		          X 0 817,144 66,817
(13) STOKES CHARLES D......................................................................
Former Officer
 0.0
.................
50.0 		          X 0 1,740,614 229,733
(14) GARMAN JAMES......................................................................
Former Key Employee
 0.0
.................
50.0 		          X 0 1,054,018 158,061






Form 990 (2015)
Form 990 (2015)
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 804,844 11,003,756 3,293,099
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet12
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
Yes
 
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
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet0
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 6,512,812
e Government grants (contributions)1e 5,558,401
f All other contributions, gifts, grants, and similar amounts not included above1f 79,166
g Noncash contributions included in lines 1a-1f:$  
h Total.Add lines 1a-1f.......MediumBullet 12,150,379
Program Service RevenueAmt Business Code
2a
b
c
d
e
f All other program service revenue.        
g Total.Add lines 2a–2f.....MediumBullet 0
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 0      
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss) 0 0
d Net rental income or (loss)......MediumBullet 0      
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss).....MediumBullet 0      
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 0    
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 0      
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 0      
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 0
12 Total revenue. See Instructions......MediumBullet 12,150,379      
Form 990 (2015)
Form 990 (2015)
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 1,326,558 1,326,558
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 0      
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 6,111,342 5,706,043 381,301 23,998
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 293,952 274,458 18,340 1,154
9 Other employee benefits ....... 634,981 645,474 -9,872 -621
10 Payroll taxes ........... 413,254 385,847 25,784 1,623
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 0      
c Accounting ........... 0      
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 0      
12 Advertising and promotion .... 27,192 27,192    
13 Office expenses ....... 142,616 138,421 4,195  
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 170,070 169,840   230
17 Travel ............ 41,471 38,002 3,360 109
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 11,309 10,659 650  
20 Interest ........... 0      
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 415,059 387,465 27,594  
23 Insurance ... 5,421 5,421    
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 PROFESSIONAL FEES 196,592 168,582 28,010  
b MEDICAL SUPPLIES 129,069 129,069    
c EQUIPMENT RENTAL & MAINT. 143,411 140,039 3,372  
d RECUITMENT AND OTHER MISC EXP 85,150 33,517 51,633  
e All other expenses 4,714 4,714    
25 Total functional expenses. Add lines 1 through 24e 10,152,161 9,591,301 534,367 26,493
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 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 0 1 0
2 Savings and temporary cash investments ......... 0 2 0
3 Pledges and grants receivable, net ...... 126,511 3 88,794
4 Accounts receivable, net ............. 0 4 0
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
0 5 0
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
0 6 0
7 Notes and loans receivable, net .... 0 7 0
8 Inventories for sale or use ........ 0 8 0
9 Prepaid expenses and deferred charges ...... 0 9 0
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 3,553,005
b Less: accumulated depreciation 10b 1,079,075 2,668,880 10c 2,473,930
11 Investments—publicly traded securities . 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 5,446,179 15 7,574,868
16 Total assets. Add lines 1 through 15 (must equal line 34)... 8,241,570 16 10,137,592
Liabilities 17 Accounts payable and accrued expenses ..... 635,992 17 533,796
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 0 19 0
20 Tax-exempt bond liabilities ......... 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
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.. 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
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 0 25 0
26 Total liabilities. Add lines 17 through 25.. 635,992 26 533,796
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 7,605,578 27 9,603,796
28 Temporarily restricted net assets ........... 0 28 0
29 Permanently restricted net assets 0 29 0
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 ........... 7,605,578 33 9,603,796
34 Total liabilities and net assets/fund balances ........ 8,241,570 34 10,137,592
Form 990 (2015)
Form 990 (2015)
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
12,150,379
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
10,152,161
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
1,998,218
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
7,605,578
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
 
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
9,603,796
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 (2015)
Form 990 (2015)
Additional Data


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

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
Memorial Hermann Community Benefits
Corporation
Employer identification number

68-0511504
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
6
7
8
9
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 (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 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . 5,188,659 5,676,593 6,818,519 10,593,168 12,150,379 40,427,318
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......           0
3 Gross receipts from activities that are not an unrelated trade or business under section 513...           0
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...           0
5 The value of services or facilities furnished by a governmental unit to the organization without charge..           0
6 Total. Add lines 1 through 5. 5,188,659 5,676,593 6,818,519 10,593,168 12,150,379 40,427,318
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...           0
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.           0
c Add lines 7a and 7b..           0
8 Public support. (Subtract line 7c from line 6.) 40,427,318
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
9 Amounts from line 6... 5,188,659 5,676,593 6,818,519 10,593,168 12,150,379 40,427,318
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..           0
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.           0
c Add lines 10a and 10b.           0
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.           0
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..           0
13 Total support. (Add lines 9, 10c, 11, and 12.).. 5,188,659 5,676,593 6,818,519 10,593,168 12,150,379 40,427,318
14
Section C. Computation of Public Support Percentage
15
15
100.000 %
16
16
100.000 %
Section D. Computation of Investment Income Percentage
17
17
0 %
18
18
0 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
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 I of Schedule L (Form 990 or 990-EZ).
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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
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
 
 
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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
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 2015 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-2015 		(iii)
Distributable
Amount for 2015
1 Distributable amount for 2015 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......  
e From 2014.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2015 distributable amount  
i Carryover from 2010 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2015 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2015 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2015, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2015. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2016. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
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) 2015


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
2015
Name of the organization
Memorial Hermann Community Benefits
Corporation
Employer identification number

68-0511504
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
Memorial Hermann Community Benefits
Corporation 		Employer identification number
68-0511504
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
Name of organization
Memorial Hermann Community Benefits
Corporation 		Employer identification number

68-0511504
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 4
Name of organization
Memorial Hermann Community Benefits
Corporation 		Employer identification number

68-0511504
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) (2015)

Additional Data


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SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on 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
2015
Open to Public Inspection
Name of the organization
Memorial Hermann Community Benefits
Corporation
Employer identification number

68-0511504
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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 on 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 on 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) 2015

Schedule D (Form 990) 2015
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" on 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" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on 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)
 
 
(ii) related organizations .................
3a(ii)
 
 
b
If "Yes" on 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' on 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 ...      
b Buildings   1,723,954 523,578 1,200,376
c Leasehold improvements   224,956 68,321 156,635
d Equipment ...   1,604,095 487,176 1,116,919
e Other ...        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 2,473,930
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on 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    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
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' on 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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DUE FROM AFFILIATES 7,574,868
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 7,574,868
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 0
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) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 12,150,379
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  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3 12,150,379
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  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 12,150,379
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 10,152,161
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  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3 10,152,161
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  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 10,152,161

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
Form 990 Schedule D Part X Line 2 The Community Benefits Corporation does have an annual financial audit conducted although the financial accounts of the Community Benefits are also included in the financial statements that are audited by an independent public accounting firm of the consolidated Memorial Hermann Health System entities and its related affiliates. The paragraph included in the last issued audited financial statements of the Community Benefits was: Income Taxes - The Community Benefit is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code (Code) and did not conduct unrelated business activities during the years ended June 30, 2016 and 2015. Therefore, the Community Benefit has made no provisions for federal income taxes in the accompanying financial statements. The Community Benefit applies the provisions of FASB ASC Topic 740, Income Taxes, which prescribes a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. FASB ASC Topic 740 also provides guidance on de-recognition, classification, interest and penalties, accounting in interim periods, disclosure, and transition. The Community Benefit believes that it has appropriate support for any tax positions taken, and as such, does not have any uncertain tax positions that are material to the financial statements. disclosure, and transition. The Community Benefit believes that it has appropriate support for any tax positions taken, and as such, does not have any uncertain tax positions that are material to the financial statements.
Schedule D (Form 990) 2015


Additional Data


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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," on 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
2015
Open to Public
Inspection
Name of the organization
Memorial Hermann Community Benefits
Corporation
Employer identification number
68-0511504
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" on 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) Spring Branch Community Clinic
1615 Hillendahl 100
Houston,TX77055 		76-0360533 501(C)(3) 20,000       Funding of healthcare services
(2) South County Community Clinic
101 Pine Manor Dr
Oak Ridge North,TX77385 		75-2634623 501(c)(3) 75,000       Funding of Healthcare Services
(3) Houston Ear Research Foundation
7737 SW Fry Suite 630
Houston,TX77074 		76-0645238 501(c)(3) 50,000       Funding of healthcare services
(4) Tomagwa Healthcare Ministries
455 School Suite 30
Tomball,TX77375 		76-0280324 501(c)(3) 20,000       Funding of healthcare services
(5) Memorial Hermann Health System
909 Frostwood Suite 2100
Houston,TX77024 		74-1152597 501(C)(3) 1,070,722       Funding of healthcare services
(6) Gateway to Care
3611 Ennis
Houston,TX77004 		20-3946677 501(C)(3) 75,000       Funding of healthcare services
(7) Project Fit America
PO Box 308
Boyes Hot Springs,CA95416 		36-3730823 501(C)(3) 15,836       Funding of healthcare services
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
7
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
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
Monitoring the use of Grants and Awards Funding Community agencies can request funds from Memorial Hermann by completing a Propsal Submission Packet which details the agency's mission, services, existing collaborators, and realized and proposed goals. Missions and goals that support Memorial Hermann's community benefit mission of increasing and strengthening the primary and specialty care infrastructure for the uninsured and underinsured community receive high priority. Often a site visit is performed by Memorial Hermann Community Benefit Corporation staff and recommendations are made to the President,CEO and the community relations committee for the ultimate decision.
Schedule I (Form 990) 2015



Additional Data


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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" on 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
2015
Open to Public Inspection
Name of the organization
Memorial Hermann Community Benefits
Corporation
Employer identification number

68-0511504
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 on 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 on 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 on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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," on line 6a or 6b, describe in Part III.
7
For persons listed on 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 on 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" on 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) 2015

Schedule J (Form 990) 2015
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 on 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 on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1GORDON DEBORAHDirector; CLO & Secr/Treas (i)

(ii)		 0
-------------
491,046 		0
-------------
328,257 		0
-------------
1,723 		0
-------------
126,368 		0
-------------
9,780 		0
-------------
957,174 		0
-------------
0
2LARAWAY DENNIS LDirector; CFO (i)

(ii)		 0
-------------
748,951 		0
-------------
667,411 		0
-------------
54,624 		0
-------------
221,219 		0
-------------
12,798 		0
-------------
1,705,003 		0
-------------
52,691
3SHABOT MICHAELChief Clinical Officer (i)

(ii)		 0
-------------
611,864 		0
-------------
517,274 		0
-------------
180,777 		0
-------------
154,658 		0
-------------
9,973 		0
-------------
1,474,546 		0
-------------
105,696
4WOLTERMAN DAN JDirector; President & CEO (i)

(ii)		 0
-------------
1,259,919 		0
-------------
1,531,815 		0
-------------
446,421 		0
-------------
2,112,552 		0
-------------
7,431 		0
-------------
5,358,138 		0
-------------
283,638
5PARET CAROL JSVP Chief Community Officer (i)

(ii)		 0
-------------
281,501 		0
-------------
215,432 		0
-------------
54,965 		0
-------------
75,983 		0
-------------
14,212 		0
-------------
642,093 		0
-------------
30,471
6CHALAJOUR MAHASTIDentist (i)

(ii)		 160,915
-------------
0 		22,614
-------------
0 		316
-------------
0 		8,627
-------------
0 		11,409
-------------
0 		203,881
-------------
0 		0
-------------
0
7STEPHENS CHRISCILDA SDentist (i)

(ii)		 136,855
-------------
0 		36,506
-------------
0 		461
-------------
0 		13,363
-------------
0 		9,100
-------------
0 		196,285
-------------
0 		0
-------------
0
8KIMMEY-WALKER LISA LNP/PA Manager (i)

(ii)		 128,824
-------------
0 		18,013
-------------
0 		8,080
-------------
0 		14,173
-------------
0 		4,621
-------------
0 		173,711
-------------
0 		0
-------------
0
9GRAVES DESHAUNDA TDentist (i)

(ii)		 132,975
-------------
0 		16,090
-------------
0 		105
-------------
0 		5,341
-------------
0 		5,990
-------------
0 		160,501
-------------
0 		0
-------------
0
10FURTADO ALBERTDentist (i)

(ii)		 120,178
-------------
0 		19,903
-------------
0 		3,009
-------------
0 		10,907
-------------
0 		9,983
-------------
0 		163,980
-------------
0 		0
-------------
0
11REIMER RENEEFormer Officer (i)

(ii)		 0
-------------
302,316 		0
-------------
314,687 		0
-------------
200,141 		0
-------------
60,892 		0
-------------
5,925 		0
-------------
883,961 		0
-------------
186,160
12STOKES CHARLES DFormer Officer (i)

(ii)		 0
-------------
779,720 		0
-------------
710,343 		0
-------------
250,551 		0
-------------
221,397 		0
-------------
8,336 		0
-------------
1,970,347 		0
-------------
182,589
13GARMAN JAMESFormer Key Employee (i)

(ii)		 0
-------------
551,867 		0
-------------
440,623 		0
-------------
61,528 		0
-------------
148,088 		0
-------------
9,973 		0
-------------
1,212,079 		0
-------------
56,626
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
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
Form 990 Schedule J Line 3 See Schedule O narrative specific to Part VI, Line 15 for details of the compensation determination and approval process.
Form 990 Schedule J Line 4B Memorial Hermann Health System (of which this filer is a part) sponsors two nonqualified retirement plans - Memorial Hermann Supplemental Executive Retirement Plan (SERP) and Executive Deferred Compensation Plan (EDCP). Applicable SERP and EDCP amounts accrued per person: EDCP SERP LARAWAY DENNIS L. 52,690.95 0.00 SHABOT MICHAEL 105,696.10 48,894.48 PARET CAROL J 30,470.91 19,771.01 REIMER RENEE 186,160.46 12,582.45 STOKES CHARLES D 182,588.75 58,069.39 WOLTERMAN DAN J. 283,638.09 157,880.69 GARMAN JAMES 56,626.00 0.00
Form 990 Schedule J Line 7 Memorial Hermann Health System (of which this filer is a part) provides variable compensation opportunity through an annual management incentive plan. Paid as a percentage of base salary, the potential bonus payout is based upon the performance of the individual meeting particular goals for their area of responsibility as determined by their immediate supervisor.
Schedule J (Form 990) 2015
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
2015
Open to Public
Inspection
Name of the organization
Memorial Hermann Community Benefits
Corporation
Employer identification number

68-0511504
Return Reference Explanation
Form 990 Part III Line 1 IN THE GREATER HOUSTON AREA WHERE ALMOST ONE IN FOUR RESIDENTS ARE UNINSURED, MEMORIAL HERMANN, THROUGH ITS SUBSIDIARY, THE MEMORIAL HERMANN COMMUNITY BENEFIT CORPORATION (MHCBC), IMPLEMENTS PROGRAMS TO WORK WITH OTHER HEALTHCARE PROVIDERS, GOVERNMENT AGENCIES, BUSINESS LEADERS AND COMMUNITY STAKEHOLDERS TO ENSURE THAT ALL RESIDENTS OF THE GREATER HOUSTON AREA HAVE ACCESS TO THE SERVICES THEY NEED TO IMPROVE THEIR QUALITY OF LIFE AND THE OVERALL HEALTH OF THE COMMUNITY. PRIMARY PROGRAM FOCII INCLUDE EDUCATION ON, ACCESS TO, AND PROVISION OF PRIMARY MEDICAL, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICE SUPPORT TO UNDERSERVED POPULATIONS; FOOD AS HEALTH; AND, EXERCISE AS MEDICINE. NEW PROGRAMS ARE PILOTED, AND PROVEN PROGRAMS ARE REPLICATED IN THE COMMUNITY. THE MISSION OF MEMORIAL HERMANN COMMUNITY BENEFIT CORPORATION IS TO TEST AND MEASURE INNOVATIVE SOLUTIONS THAT PROMOTE GOOD HEALTH FOR THE INDIVIDUAL, THE HEALTH SYSTEM AND THE COMMUNITY. COMMUNITY BENEFIT CORPORATION FUNDING TENENTS INCLUDE: PROVISION OF PRIMARY AND/OR SPECIALTY CARE FOR THE UNINSURED AND UNDERINSURED; CONTRIBUTION TO THE EXISTING INFRASTRUCTURE OF NON-PROFIT CLINICS AND FQHC'S; PROGRAMS, PRACTICES, AND POLICIES THAT AFFECT THE HEALTH OF INDIVIDUALS, FAMILIES, AND COMMUNITIES; COMMITMENT TO MEASUREMENT; EXISTENCE OF COLLABORATIVE PARTNERS; PROGRAMMATIC INCLUSION OF HEALTH EDUCATION AND LITERACY; STRIVE TOWARDS SUSTAINABILITY. AS REQUIRED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT-SECTION 501(R)(3)-REQUIREMENT OF THE ACA, MEMORIAL HERMANN COMMUNITY BENEFIT CORPORATION SUPPORTS THE MEMORIAL HERMANN HEALTH SYSTEM 13 LICENSED ACUTE, REHAB, AND SURGICAL HOSPITALS IN CONDUCTING COMMUNITY NEEDS ASSESSMENTS. THE CORRESPONDING IMPLEMENTATION STRATEGIES BALANCE THE INDIVIDUALITY OF THE DIFFERENT HOSPITALS WITH THE STSTEM STRATEGY OF COLLECTIVELY SUPPORTING COMMUNITY OBJECTIVES TO ACHIEVE THE NECESSARY ALIGNMENT AND LEVERAGE TO IMPACT TRUE COMMUNITY CHANGE.
Form 990 Part III Line 1 cont. COMMITTED TO MAKING THE GREATER HOUSTON AREA A HEALTHIER AND MORE VITAL PLACE TO LIVE, MHCBC COLLABORATES WITH OTHERS AS WELL AS CREATES SIGNATURE, EVIDENCE-BASED WAYS TO IMPROVE THE COMMUNITIES WHERE PEOPLE LIVE, WORK, LEARN AND PLAY. MHCBC SUPPORTS THE FOLLOWING INITIATIVES AS WELL AS THOSE STATED AS PROGRAM SERVICE ACTIVITIES #1, #2, AND #3: E.C.H.0. (EPIPHANY COMMUNITY HEALTH OUTREACH) - SUPPORT OF OPERATIONS THAT PROVIDE HEALTH AND SOCIAL SERVICES TO THE NEW IMMIGRANTS AND REFUGEES, PRIMARILY LIVING IN THE SOUTHWEST AREA. _ GATEWAY TO CARE SUPPORT FOR THE DEVELOPMENT OF A SATURDAY SURGICAL DAY PROGRAM AND NAVIGATION SERVICE THAT WILL PROVIDE PRO-BONO SPECIALTY CARE SERVICES TO QUALIFIED UNINSURED RESIDENTS OF HARRIS COUNTY AND SURROUNDING AREA THROUGH A VOLUNTEER NETWORK OF PROVIDERS. HOUSTON EAR RESEARCH FOUNDATION SUPPORT FOR COCHLEAR IMPLANT SERVICES, HELPING DEAF CHILDREN AND ADULTS LEARN TO LISTEN AND SPEAK. THE SERVICE IS UNIQUE TO THE HOUSTON COMMUNITY. INTERFAITH COMMUNITY CLINIC - OPERATIONAL FUNDING FOR THIS PRIVATE NOT-FOR-PROFIT VOLUNTEER BASED HEALTH CARE CLINIC. ITS MISSION IS TO PROVIDE SHORT-TERM MEDICAL CARE, DENTAL CARE, AND SOCIAL SERVICE REFERRALS FOR INDIGENT PERSONS WHO DO NOT HAVE PRIVATE HEALTH INSURANCE AND ARE NOT ELIGIBLE FOR MEDICAID. OPENED IN 1966, THE CLINIC SPECIFICALLY CONCENTRATES ON PROVIDING SERVICES TO MONTGOMERY COUNTY RESIDENTS WHO ARE NOT ELIGIBLE FOR OTHER PROGRAMS AND HAVE NOWHERE ELSE TO TURN. MEMORIAL HERMANN HAS SUPPORTED THE CLINIC SINCE INCEPTION, WITH MEMORIAL HERMANN-THE WOODLANDS PROVIDING ADDITIONAL SUPPORT IN ANCILLARY SERVICES. MEMORIAL HERMANN NEIGHBORHOOD HEALTH CENTERS - OPERATIONAL SUPPORT FOR TWO LOW-COST CLINICS OPEN EXTENDED HOURS AND STRATEGICALLY LOCATED NEAR BUSY EMERGENCY CENTERS. DESIGNED TO SERVE AS A "MEDICAL HOME" TO UNINSURED WORKING FAMILIES WHO DO NOT QUALIFY FOR OTHER PROGRAMS, THE CENTERS ACCEPT CASH, MEDICARE AND MEDICAID. THE GOAL IS TO PROVIDE THIS POPULATION WITH A MEDICAL HOME FOR ROUTINE AS WELL AS CHRONIC CARE, AND PREVENT THESE CASES FROM ESCALATING TO EMERGENCIES AND POOR HEATLHCARE OUTCOMES. PHYSICIANS OF SUGAR CREEK - FUNDING OF THE DIFFERENCE BETWEEN COSTS AND SLIDING FEE SCALE PAYMENTS OF CARE PROVIDED BY THIS MEMORIAL FAMILY PRACTICE RESIDENCY TRAINING SITE TO THE WORKING POOR OF THE AREA. PROJECT FIT AMERICA - THIS PROGRAM IS ONE OF OUR COLLABORATIVE PROGRAMS DESIGNED TO ENHANCE SCHOOLS PHYSICAL ACTIVITY PROGRAMMING. PFA FACILITATES THE INSTALLATION OF EXERCISE EQUIPMENT ON SCHOOL CAMPUSES AND PROVIDES A CURRICULUM DESIGNED TO HELP THE PHYSICAL EDUCATION (PE) TEACHERS CREATE EXERCISE ROUTINES THAT TEACH STUDENTS HOW TO HAVE FUN WITH EXERCISE AS WELL AS MAINTAIN AND IMPROVE THEIR PERSONAL FITNESS LEVELS. SPRING BRANCH COMMUNITY HEALTH CENTER SUPPORT OF THIS FEDERALLY QUALIFIED HEALTH CENTER THAT SERVES THE UNINSURED AND UNDERINSURED POPULATIONS IN SPRING BRANCH AND WEST HOUSTON AREAS. USING THE PRIMARY CARE MODEL, SBCHC OFFERS AN INTEGRATED AND COMPREHENSIVE SERVICE DELIVERY SYSTEM, SERVING AS A MEDICAL HOME FOR ALL WHO SEEK IT. TOMAGWA MINISTRIES, INC - SUPPORT OF PRIMARY CARE AND EDUCATION TO THE WORKING POOR NOT QUALIFYING FOR PUBLIC ASSISTANCE AND NOT EARNING ENOUGH TO PAY FOR DOCTOR VISITS IN THE TOMBALL, MAGNOLIA, AND WALLER AREAS.
Form 990 Part V Line 2B The employees of Memorial Hermann Community Benefits are record-kept and paid through the payroll system of Memorial Hermann Health System and reported under the Memorial Hermann Community Benefits EIN for Form 941 and Form W-2 purposes. All costs of the compensation and benefits of the Community Benefits employees are reimbursed to the Health System. Corporate officers are employees of Memorial Hermann Health System and their salaries and benefits are not allocated amongst the various corporate entities for which they conduct employment activities.
Form 990 Part VI Section A Line 6 Memorial Hermann Community Benefits has as its sole member Memorial Hermann Health System, both of which are 501(c)(3) non-profit entities.
Form 990 Part VI Section A Line 7A The member has the authority to annually elect the board members of the organization and to terminate and replace them at its discretion.
Form 990 Part VI Section A Line 7B The member has approval authority over the decisions of the board for amendments to the bylaws and articles of incorporation, annual operating and capital budget, the purchase or sale of substantial assets, and the merger or dissolution of the organization.
Form 990 Part VI Section B Line 11B Memorial Hermann Community Benefits PROVIDES A COPY OF THE FORM 990 TO ALL MEMBERS OF THE GOVERNING BODY VIA A WEBSITE SET UP SPECIFICALLY FOR BOARD MEMBERS TO ACCESS VARIOUS BOARD MEMBER DOCUMENTS. THE FORM 990 IS REVIEWED BY MEMORIAL HERMANN FINANCIAL ACCOUNTING STAFF, BY SPECIFIC DEPARTMENTS INVOLVED IN RELATED SECTIONS OF THE RETURN, BY THE MEMORIAL HERMANN CHIEF ACCOUNTING OFFICER, PRIOR TO ITS FILING.
Form 990 Part VI Section B Line 12C Memorial Hermann Community Benefits utilizes a conflict of interest survey and has codified its procedure in a policy. The policy is monitored by our Corporate Compliance Department through annual surveys of board members, corporate officers, management level employees, and other selected employees, physicians and vendors for all of its entities and related affiliates. In addition to responding to the survey, each recipient affirms that they have received a copy of the policy, has read and understood it, has agreed to comply with it, and understands that Memorial Hermann is a charitable organization that must engage in primarily tax-exempt purpose activities. The Corporate Compliance Department, Chief Legal Officer and the Corporate Audit Committee, consisting of independent board members, receive a report of all items disclosed. The Audit Committee Chair reports the existence of any conflicts to the Corporate Board of Directors. Memorial Hermann Community Benefits conflicts of interest policy requires that Board members excuse themselves from discussions in which they have a conflict of interest. The policy also subjects Board members to disciplinary action if they are found to have violated the policy.
Form 990 Part VI Section B Line 13 Memorial Hermann Community Benefits Corp (MHCBC) is committed to complying with all applicable laws and regulations. We support the efforts of federal and state authorities in identifying incidents of fraud and/or abuse and we have the necessary policies and procedures in place to prevent, detect, report and correct incidents of fraud and/or abuse in accordance with contractual, regulatory and statutory requirements. Recognizing the complexity of the various federal, state, and local laws regulating health care, MHCBC has adopted a Corporate Compliance Program. This Program is designed to assist the Board, the Health System and its employees, medical staff members, and independent contractors to maintain compliance through responsive educational programs, internal monitoring and reporting mechanisms, and compliance Standards of Conduct. Corporate Compliance is "Doing the Right Thing by following government regulations and the law." The MHCBC Compliance Program includes these 7 elements: A Compliance Officer and Committee; to oversee and advise the Compliance Program Compliance Policies and Procedures; to provide written guidance to help you do your job and demonstrate our commitment to compliance, Compliance Training and Education; to ensure appropriate education on areas of legal and regulatory compliance Auditing and Monitoring; to conduct periodic and ongoing auditing and monitoring of high-risk areas and adherence to policies and procedures Corrective Action; to develop plans to resolve identified issues, prevent them from happening again and avoid the risk of the same or similar issues occurring in other areas, departments or facilities Disciplinary Guidelines: may be necessary to encourage prompt reporting of Compliance concerns; to ensure non-retaliation for reporting concerns and to encourage cooperation with compliance investigations Open Lines of Communication: to establish an open environment for reporting compliance concerns - a hotline is available to all employees to call to report compliance concerns and non-retaliation for reporting a compliance concern in good faith Available 24 hours a day, 7 days a week Anonymous and Confidential Callers making reports in good faith are protected from any form of retaliation or adverse action.
Form 990, Part VI, Section B Line 15a & 15b Compensation Determination The process for determining compensation for the Organization's CEO and disqualified persons is modeled after the requirements in IRC Section 4958 to establish the presumption of reasonable compensation. Compensation was reviewed and approved in advance of being paid by a Compensation Committee of the Board of Memorial Hermann Health System. The Committee is comprised of individuals who have no conflicts of interest. The Compensation Committee engages an independent third-party executive compensation consultant who provides comparable market data from published surveys and/or Form 990s of similar organizations. The compensation for each disqualified person is determined based on the market data. The Compensation Committee conducted a review of the comparability data and documented its discussion and decisions in minutes that are retained with the Organization's other governance materials. Disqualified persons of the organization undergo a review and Compensation Committee approval (as outlined above) on an annual-basis, and such approval is recorded in minutes. The executive compensation philosophy drives the strategy and design of Memorial Hermann's compensation package. The executive compensation philosophy is established and maintained by the Compensation Committee. The philosophy is as follows: Executive compensation should be tied to our long-term and short-term business strategies of each dimension of our business including, but not limited to: Quality & Safety, Service & Satisfaction, Operational Excellence, and Growth & People. Compensation should reflect the competitive marketplace so the Company can attract, retain and motivate talented executives. Compensation should be tied to our individual and business unit performance. Compensation programs and pay levels should be "Reasonable" within the definition of IRC Section 4958. We should balance any potential strategic, financial, operational and reputational risk with our pay-for-performance philosophy. Based on the above philosophy, Memorial Hermann's executive total compensation package includes a mix of fixed compensation and variable compensation. The following components are included in the executive total compensation package: base salary, annual incentive plan, long term incentive plan and deferred compensation plan. In addition to the compensation components listed above, the former CEO and President, Mr. Wolterman, has been provided with a retention agreement. Per the terms of this agreement, he will receive a lump sum payment in July 2016. This lump sum payment is being accrued over the life of the retention agreement (July 2009 to July 2016). The 2015 accrual is included in Column C of Part II on the attached Form 990 Schedule J. If Mr. Wolterman voluntarily leaves prior to July 2016, he does not receive any portion of this lump sum payment. Under certain circumstances (e.g., death or disability), Mr. Wolterman, or his beneficiary, would be entitled to a prorated portion of this lump sum payment.
Form 990 Part VI Section C Line 19 The articles of incorporation, corporate bylaws, conflict of interest policy and financial statements of Memorial Hermann Health System and its affiliates are generally not made available to the public. If the inquirer provided a valid reason for desiring a copy of the documents that are related to the business interests of any of the Memorial Hermann Health System corporate entities, we would consider doing so.
Form 990 Part XII Line 2C Memorial Hermann Health System has independent committees for audits, governance, and compensation which perform their respective functions on a consolidated basis for all corporate entities. The audit committee hires the independent accountants and oversees all audits that are conducted within all affiliated entities for financial information, grants and awards, and qualified plans.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


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
2015
Open to Public Inspection
Name of the organization
Memorial Hermann Community Benefits
Corporation
Employer identification number

68-0511504
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)Memorial Hermann Foundation
909 Frostwood Suite 2100

Houston,TX77024
74-1653640 		Fund raising TX 501(c)3 11a I MHHS
 
 
No
(2)Memorial Hermann Health System
909 Frostwood Suite 2100

Houston,TX77024
74-1152597 		Healthcare TX 501(c)3 3 na
 
 
No
(3)Memorial Hermann Medical Group
909 Frostwood Suite 2100

Houston,TX77024
20-4923281 		Healthcare TX 501(c)3 3 MHHS
 
 
No
(4)MHS Physicians of Texas
909 Frostwood Suite 2100

Houston,TX77024
76-0385980 		Healthcare TX 501(c)3 3 MHHS
 
 
No
(5)Memorial Hermann Information Exchange
909 Frostwood Suite 2100

Houston,TX77024
02-0684202 		Healthcare TX 501(c)3 3 MHHS
 
 
No
(6)Memorial Hermann Accountable Care Org
909 Frostwood Suite 2100

Houston,TX77024
80-0778181 		Healthcare TX 501(c)(3) 3 MHHS
 
 
No


For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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) The Woodlands POB III LP

909 Frostwood Suite 2100
Houston,TX77024
20-2184543 		Managed Med Build TX na
  		n/a                
(2) MHUSP Surgery Ctr III LLP

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
20-0707543 		Surgery Center TX na
  		n/a                
(3) Memorial Hermann Surgery Center Katy LLP

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
20-3360737 		Surgery Center TX na
  		n/a                
(4) MH Katy Rehab Hospital LLC

909 Frostwood suite 2100
houston,TX77024
26-3896057 		medical service TX na
  		n/a                
(5) MHUSP Surgery Centers IV LLP

15305 Dallas Pkwy Ste 1600 LB 28
Addison,TX75001
20-8575266 		Surgery Center TX na
  		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) MHMD

909 Frostwood Suite 2100
Houston,TX77024
76-0074819 		Healthcare TX NA
  		C Corp         No
(2) Memorial Hermann Health Solutions

909 Frostwood suite 2100
Houston,TX77024
26-4419989 		Insurance TX NA
  		C Corp         No
(3) Memorial Hermann Health Insurance

909 Frostwood Suite 2100
Houston,TX77024
76-0646301 		Insurance TX NA
  		C Corp         No
(4) The Health Professionals Ins Company LTD

Barclays House 3rd Floor
Grand Cayman    
CJ
Insurance CJ NA
  		Foreign         No
(5) Memorial Hermann Health Plan Inc

909 Frostwood Suite 2100
Houston,TX77024
46-2707092 		Insurance TX na
  		C corp         No




Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
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
 
 
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
Yes
 
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
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
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
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
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) NA

      





Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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) 2015
Schedule R (Form 990) 2015
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) 2015

Additional Data


Software ID:  
Software Version: