Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(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. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(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 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| 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 | ||||
| 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. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | DELEGATION OF CONTROL OVER MANAGEMENT DUTIES: METHODIST HEALTH SYSTEMS PROVIDES CERTAIN FINANCIAL, TECHNICAL, AND MANAGERIAL SUPPORT SERVICES TO THE HOSPITAL. THE CONTRACT BEGAN IN JUNE 2015. PER IRS GUIDANCE, NO COMPENSATION IS SHOWN ON FORM 990, PART VII, FOR THE 2015 CALENDAR YEAR FOR THIS INDIVIDUAL: XOCHY HURTADO $ 119,789 |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS OR STOCKHOLDERS: VAL VERDE COUNTY HOSPITAL DISTRICT IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ELECTION OF GOVERNING BODY: THE MEMBER, VAL VERDE COUNTY HOSPITAL DISTRICT, SHALL APPOINT CLASS A DIRECTORS FROM ITS OWN BOARD ANNUALLY. THE MEMBER SHALL APPOINT TWO CLASS B DIRECTORS INITIALLY AND THEN SHALL APPOINT ONE CLASS B DIRECTOR ANNUALLY THEREAFTER. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS OF THE GOVERNING BODY: FOLLOWING AMENDED BYLAWS ENACTED IN JULY 2010, THE BOARD SHALL REQUIRE APPROVAL BY THE NEW MEMBER VAL VERDE COUNTY HOSPITAL DISTRICT, FOR THE FOLLOWING DECISIONS: A. THE ESTABLISHMENT OF OR ANY CHANGES IN THE ACTIVITIES, PHILOSOPHY, MISSION OR PURPOSE OF THE CORPORATION AS SET BY A MEMBER. B. ANY AMENDMENTS OR REVISIONS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION. C. ANY AMENDMENTS OR REVISIONS OF THE ARTICLES OF INCORPORATION OR BYLAWS OF ANY SUBSIDIARY CORPORATION OF THE CORPORATION. D. THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY, PARTNERSHIP OR VENTURE. E. ANY AMENDMENT, REVISION OR TERMINATION OF THE PARTNERSHIP AGREEMENT OF ANY PARTNERSHIP OR REGULATIONS OF ANY LIMITED LIABILITY COMPANY, TO WHICH THE CORPORATION IS A PARTY. F. THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION. G. ALL MATERIAL EXPENDITURE DEVIATIONS, WHICH IS DEFINED AS $100,000 IN ANY SINGLE OR SERIES OF TRANSACTIONS, FROM THE ANNUAL OPERATING BUDGET. H. ALL EXPENDITURE DEVIATIONS FROM THE ANNUAL CAPITAL BUDGET. I. THE PURCHASE OR ACQUISITION OF ANY REAL PROPERTY BY THE CORPORATION. J. ANY DEBT OR FINANCING ARRANGEMENT OF THIS CORPORATION FOR AN AMOUNT THAT EXCEEDS $100,000 THAT IS NOT PROVIDED FOR IN THE CORPORATION'S ANNUAL OPERATING OR CAPITAL BUDGETS. K. THE MERGER, DISSOLUTION, OR CONSOLIDATION OF THE CORPORATION OR SUBSIDIARY CORPORATION. L. THE SELECTION OF THE MEMBERS OF THE BOARD OF DIRECTORS OR THE REMOVAL OF SAID BOARD MEMBERS, WHETHER WITH OR WITHOUT CAUSE. |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW FORM 990: THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED THE ORGANIZATION'S INTERNAL ACCOUNTANTS AND CFO PERFORM A REVIEW OF THE RETURN PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROCESS TO MONITOR COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THROUGH FEBRUARY 2010, THE ORGANIZATION FOLLOWED THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADMINISTERED BY ITS FORMER PARENT, VHA SOUTHWEST COMMUNITY HEALTH CORPORATION (CHC), WHICH REQUIRES ALL OFFICERS, DIRECTORS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES AND OTHER MANAGEMENT OFFICIALS (COVERED PERSONS) TO DISCLOSE POTENTIAL CONFLICTS. PURSUANT TO THE POLICY, A DISCLOSURE STATEMENT IS CIRCULATED ANNUALLY TO COVERED PERSONS IN WHICH THE INDIVIDUAL MUST DISCLOSE TRANSACTIONS THAT MAY RESULT IN A CONFLICT. COVERED PERSONS ARE ALSO ENCOURAGED TO NOTIFY THE BOARD, APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICE, GENERAL COUNSEL, OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. WHEN NECESSARY, THE BOARD CHAIR OR APPROPRIATE BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON(S) OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND RECOMMEND ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT OR OTHERWISE DETERMINE IF THE CONFLICT CAN BE RESOLVED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, FOR ITS OWN BENEFIT, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE MAKES THE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. ANY MEMBER OF THE BOARD OPERATING UNDER A CONFLICT IS NOT PERMITTED TO BE PRESENT OR OTHERWISE PARTICIPATE IN THE VOTE ON ANY MATTER TO WHICH THE CONFLICT RELATES. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND AFTER INVESTIGATION THE BOARD OR COMMITTEE DETERMINES THAT THE COVERED PERSON FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE ORGANIZATION TAKES APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION, WHICH MAY INCLUDE, TERMINATION OF THE INDIVIDUAL'S MEMBERSHIP, EMPLOYMENT, OR CONTRACT. THE ORGANIZATION HAS CONTINUED TO FOLLOW A SIMILAR PROCESS AFTER FEBRUARY 2010 UNDER THE CURRENT PARENT, VAL VERDE COUNTY HOSPITAL DISTRICT. THE FACILITY OR DIVISION ECO OR THE SVP AND CHIEF ETHICS AND COMPLIANCE OFFICER WILL REVIEW DISCLOSURES WITH SUPERVISORS AND DETERMINE WHICH REQUIRE FURTHER ACTION. SUPERVISORS WILL DISCUSS NECESSARY ACTION WITH THE AFFECTED INDIVIDUAL. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | PROCESS FOR DETERMINING COMPENSATION: THE ORGANIZATION HAS ESTABLISHED AN INTERNAL PROCESS TO DETERMINE COMPENSATION. HUMAN RESOURCES ANNUALLY USES MARKET SURVEYS FOR BASE PAY, PRIMARILY TSHHRAE SURVEY TOOL WHICH INCLUDES 125 HOSPITALS IN TEXAS WITH 42 IN VVRMC'S REGION. PAY RANGES ARE ESTABLISHED BY HUMAN RESOURCES AND APPROVED BY SENIOR DIRECTORS FOR EACH PAY GRADE BASED ON THE MARKET SURVEYS. HUMAN RESOURCES WILL MAKE RECOMMENDATIONS TO THE SENIOR LEADERSHIP TEAM ANNUALLY TO DETERMINE COMPENSATION PHILOSOPHY, LEVEL OF ENTERPRISE PAY, EXPENSE TO BUDGET, EE ADJUSTMENTS FOR MERIT/MARKET RECOGNITION AND NEW HIRES INCENTIVES. AFTER HUMAN RESOURCE'S ANALYSIS OF THE CEO'S COMPENSATION, THE FINDINGS ARE PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. DOCUMENTATION OF THE PRESENTATION AND APPROVAL ARE DOCUMENTED IN THE BOARD MINUTES. THE MOST RECENT REVIEW WAS CONDUCTED IN 2016. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABILITY OF DOCUMENTS: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART IV, LINE 12 & PART XII, LINE 2 | AUDITED FINANCIAL STATEMENTS: THE ORGANIZATION HAS ANSWERED "NO" TO THE QUESTIONS REGARDING AN AUDIT IN PART XII AND PART IV, LINE 12B. THE ORGANIZATION IS IN THE PROCESS OF AN AUDIT OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2016. HOWEVER, AT THE TIME OF FILING THIS RETURN, THE AUDIT IS NOT YET COMPLETE. THE ORGANIZATION HAS ATTACHED A COPY OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2013 AND JUNE 30, 2014 TO THE 990 AND ANSWERED YES TO PART IV, LINE 20B. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:COLLECTION FEES TOTAL FEES:746309 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:8173887 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT LABOR TOTAL FEES:3539829 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:4572433 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTANT FEES TOTAL FEES:15820 |
| Software ID: | |
| Software Version: |