TY 2021 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) JOHNSON PENNY...................................................................... CEO	25.00 ................. 15.00		X			1,300,909	780,545	146,255
(2) KING JAMES KIRK...................................................................... DIRECTOR/VICE CHAIRMAN	0.20 ................. 50.00	X				0	1,201,569	149,837
(3) CRAFT BRIAN...................................................................... DIRECTOR	0.20 ................. 50.00	X				0	574,902	96,841
(4) JACKSON DAVID...................................................................... DIRECTOR	0.20 ................. 50.00	X				0	535,754	90,372
(5) TUCKER REBECCA...................................................................... DIRECTOR (BEG 01/21)	0.20 ................. 50.00	X				0	509,001	93,868
(6) LLOYD MD DAVID...................................................................... DIRECTOR (BEG 06/21)	0.20 ................. 50.00	X				0	511,730	87,235
(7) LAUE MD ED...................................................................... CMO (END 06/21)	35.00 ................. 15.00			X		344,438	147,616	66,198
(8) THORSBERRY MD MICHAEL...................................................................... DIRECTOR (END 06/21)	0.20 ................. 50.00	X				0	496,877	33,845
(9) SUTTON JESSE...................................................................... CFO	15.00 ................. 20.00		X			172,518	230,024	67,746
(10) FORD MD RONNY...................................................................... DIRECTOR(END06/21)/CMO(BEG06/21)	35.00 ................. 15.00	X				118,906	255,448	61,540
(11) PAI AJITH...................................................................... DIRECTOR	0.20 ................. 50.00	X				0	335,948	78,473
(12) FINCH KENNETH...................................................................... FORMER CEO	0.00 ................. 0.00				X	0	335,617	6,078
(13) ELLIS TAMMY...................................................................... CNO	30.00 ................. 10.00			X		204,363	68,122	42,483
(14) LEMON SEAN...................................................................... COO (BEG 08/21)	40.00 ................. 10.00			X		191,140	47,785	49,319
(15) HASLAM MD DENNIS...................................................................... DIRECTOR	0.20 ................. 0.00	X				0	34,450	0
(16) HAFFNER PHD RANDALL...................................................................... DIRECTOR/CHAIRMAN (END 02/21)	0.20 ................. 50.00	X				0	0	0
(17) SOLER EDDIE...................................................................... DIRECTOR (END 08/21)	0.20 ................. 50.00	X				0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
THE BECK GROUP 1601 ELM STREET DALLAS,TX75201	GENERAL CONTRACTOR	5,622,396
SOUND PHYSICIANS OF NEW MEXICO 1498 PACIFIC AVENUE SUITE 400 TACOMA,WA98402	HOSPITALIST STAFFING	3,958,371
MAXIM HEALTHCARE SERVICES INC 12558 COLLECTIONS CENTER DRIVE CHICAGO,IL60693	STAFFING SERVICES	1,124,071
HUGULEY PATHOLOGY CONSULTANTS PA PO BOX 879 BURLESON,TX76028	LABORATORY MEDICAL DIRECTOR/SUBSIDY SERV	1,077,496
NORTHSTAR ANESTHESIA PA 6225 STATE HIGHWAY 161 SUITE 200 IRVING,TX75038	ANESTHESIA SERVICES	985,611
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 69

- TIN:

SCHEDULE A
(Form 990)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

TEXAS HEALTH HUGULEY INC

Employer identification number

45-2694620

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2021

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 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

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2021

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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.)..

First 5 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

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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.

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.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c 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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

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.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on 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.

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

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) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

By reason of the relationship described in line 2 above, 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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

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.

Did the activities described on line 2a, above 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

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?If "Yes" or "No", provide details in Part VI.

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.

Schedule A (Form 990) 2021

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 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 0.035	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Name of the organization

TEXAS HEALTH HUGULEY INC

Employer identification number

45-2694620

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization TEXAS HEALTH HUGULEY INC

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization TEXAS HEALTH HUGULEY INC		Employer identification number 45-2694620

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization TEXAS HEALTH HUGULEY INC			Employer identification number 45-2694620
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

TEXAS HEALTH HUGULEY INC

Employer identification number

45-2694620

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2021

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

7,022

Total. Add lines 1c through 1i ....................................................................................................

7,022

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	AMERICAN HOSPITAL ASSOCIATION AND TEXAS HOSPITAL ASSOCIATION DUES.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

TEXAS HEALTH HUGULEY INC

Employer identification number

45-2694620

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" 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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	1,413,027	1,413,027	1,413,027	1,413,027	1,475,927
b	Contributions ...
c	Net investment earnings, gains, and losses	186,470	185,178	170,164		109,260
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	186,470	185,178	170,164		172,160
f	Administrative expenses ....
g	End of year balance ......	1,413,027	1,413,027	1,413,027	1,413,027	1,413,027

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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 .....	6,742,536		6,742,536
b	Buildings ....	118,614,894	32,551,767	86,063,127
c	Leasehold improvements
d	Equipment ....	78,963,528	43,546,600	35,416,928
e	Other .....	15,912,628	2,307,048	13,605,580
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				141,828,171

Schedule D (Form 990) 2021

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) INVESTMENT IN COMMUNITY HOSPICE OF TEXAS	14,943,021	C
(B) INVESTMENT IN THH SURGERY CENTER	3,691,898	C
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	18,634,919

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.)

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 RELATED				9,708,358
(2)OTHER RECEIVABLES				4,807,039
(3)RECEIVABLE FROM THIRD PARTIES				804,655
(4)DUE FROM AFFILIATED				9,108
(5)RIGHT OF USE ASSET-OPERATING LEASE				1,385,289
(6)OTHER ASSETS				1,525,227
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				18,239,676

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	5,949
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	12,004,635
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) 2021

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
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
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

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
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
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

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

PART V, LINE 4:

THE FILING ORGANIZATION'S ENDOWMENT CONSISTS OF TWO DONOR-RESTRICTED ENDOWMENT FUNDS ESTABLISHED TO SUPPORT A VARIETY OF PURPOSES INCLUDING THE ACQUISITION AND MAINTENANCE OF THE HOSPITAL'S EQUIPMENT, AND ASSISTANCE TO THE HELPING HAND FUND WHICH PROVIDES ASSISTANCE TO ORGANIZATIONS AND NEEDY INDIVIDUALS WITHIN THE COMMUNITY. AN ENDOWNMENT FUND TOTALING $1,313,027 HAS A DONOR-IMPOSED RESTRICTION ON THE INVESTMENT RETURN TO BE USED EXCLUSIVELY FOR CAPITAL IMPROVEMENTS AND MAINTENANCE OF THE HOSPITAL. THE REMAINING FUND HAS NO DONOR-IMPOSED RESTRICTION ON ITS INVESTMENT RETURN.

PART X, LINE 2:

THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR THE TWELVE-MONTH PERIOD ENDED 12/31/2021 INCLUDE THE FILING ORGANIZATION AND THREE OF ITS SUBSIDIARIES: HUGULEY MEDICAL ASSOCIATES (HMA), A NONPROFIT, TAX-EXEMPT PHYSICIAN GROUP, TEXAS HEALTH HUGULEY SURGERY CENTER, A FREESTANDING AMBULATORY SURGERY CENTER, AND TEXAS HEALTH HOSPITAL MANSFIELD, A NONPROFIT, TAX-EXEMPT HOSPITAL. THESE CONSOLIDATED AUDITED FINANCIAL STATEMENTS CONTAIN THE FOLLOWING FIN 48 FOOTNOTE: THE COMPANY IS EXEMPT FROM STATE AND FEDERAL INCOME TAXES. ACCORDINGLY, THE COMPANY AND ITS TAX-EXEMPT AFFILIATES ARE NOT SUBJECT TO FEDERAL, STATE OR LOCAL INCOME TAXES, EXCEPT FOR ANY NET UNRELATED BUSINESS TAXABLE INCOME. FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, UNRELATED BUSINESS INCOME ACTIVITIES CONDUCTED BY THE COMPANY AND ITS TAX-EXEMPT AFFILIATES DID NOT GENERATE A MATERIAL AMOUNT OF COMBINED FEDERAL, STATE OR LOCAL INCOME TAX.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

TEXAS HEALTH HUGULEY INC

Employer identification number

45-2694620

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	15,784,931		15,784,931	6.830 %
b	Medicaid (from Worksheet 3, column a) . . . . .	28,248,817	24,072,984	4,175,833	1.810 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	44,033,748	24,072,984	19,960,764	8.640 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	184,144		184,144	0.080 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	82,815		82,815	0.040 %
j	Total. Other Benefits . .	266,959		266,959	0.120 %
k	Total. Add lines 7d and 7j .	44,300,707	24,072,984	20,227,723	8.760 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

22,078,370

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

5,833,146

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

38,168,919

Enter Medicare allowable costs of care relating to payments on line 5.....

36,746,632

Subtract line 6 from line 5. This is the surplus (or shortfall)........

1,422,287

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2021

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH 11801 S FREEWAY BURLESON,TX76028 WWW.TEXASHEALTHHUGULEY.ORG 100157	X	X	X

Schedule H (Form 990) 2021

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, PAGE 8

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, PAGE 8

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, PAGE 8

The FAP application form was widely available on a website (list url):

SEE PART V, PAGE 8

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH	PART V, SECTION B, LINE 5: TEXAS HEALTH HUGULEY, INC. (THH OR THE HOSPITAL) OPERATES A 327-BED ACUTE-CARE HOSPITAL FACILITY IN BURLESON, TEXAS IN THE FORT WORTH, TEXAS AREA. THE MEMBERSHIP OF THH IS HELD BY TEXAS HEALTH RESOURCES (51%) AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (49%), BOTH ORGANIZATIONS ARE EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3).BECAUSE THH'S SERVICE COVERS PORTIONS OF JOHNSON AND TARRANT COUNTIES, THH PARTICIPATED IN BOTH COLLABORATIVE REGIONAL CHNAS CONDUCTED BY TEXAS HEALTH RESOURCES' (THR'S) AFFILIATED HOSPITALS. THE DESCRIPTION OF BOTH CHNAS ARE PROVIDED BELOW. THE SOUTHERN REGION 2019 CHNA WAS A COLLABORATIVE PROCESS UTILIZING QUALITATIVE AND QUANTITATIVE METHODS TO ASSESS THE HEALTH NEEDS OF PERSONS WITHIN THE SERVICE AREAS CONSISTING OF ERATH, JOHNSON, ELLIS & KAUFMAN COUNTIES. THE 2019 CHNA WAS CONDUCTED AT THE REGIONAL LEVEL TO GENERATE COMMUNITY-DRIVEN SOLUTIONS FOR BETTER INTEGRATION IN ADDRESSING THE CLINICAL AND SOCIAL NEEDS OF INDIVIDUALS LIVING IN NORTH TEXAS. BETWEEN APRIL 2018 AND AUGUST 2018, THE COMMUNITIES' HEALTH NEEDS WERE ASSESSED THROUGH KEY INFORMANT INTERVIEWS, SECONDARY DATA ANALYSIS, A WINDSHIELD SURVEY SERVING TO ASSIST ASSET-MAPPING THROUGH COMMUNITY OBSERVATION, AND FOCUS GROUPS. KEY INFORMANTS AND FOCUS GROUP PARTICIPANTS INCLUDED, BUT WERE NOT LIMITED TO FAITH COMMUNITY REPRESENTATIVES, PUBLIC HEALTH OFFICIALS, LAY COMMUNITY MEMBERS, SCHOOL OFFICIALS AND CITY ADMINISTRATION. THE ORGANIZATION ENGAGED 138 COMMUNITY MEMBERS WITH INTERESTS SPECIFIC TO THE HEALTH OF INDIVIDUALS IN THE SOUTHERN REGION COUNTIES IN THE CHNA DEVELOPMENT PROCESS. ONE HUNDRED TWENTY-THREE OF THESE COMMUNITY MEMBERS WERE ENGAGED ACROSS SIX SEPARATE FOCUS GROUPS HELD IN ZIP-CODES THAT WERE IDENTIFIED AS UNDERSERVED AREAS. FIFTEEN SERVED AS KEY INFORMANTS, AND THE WINDSHIELD SURVEY WAS CONDUCTED BY TWO TEXAS HEALTH GRADUATE FELLOWS AND FOUR COMMUNITY HEALTH MANAGERS. TO GAIN A COMPREHENSIVE UNDERSTANDING OF THE HEALTH NEEDS AND PRIORITIES OF INDIVIDUALS IN THIS REGION, TEXAS HEALTH USED FOCUS GROUP SESSIONS AND KEY INFORMANT INTERVIEWS TO ENGAGE THE MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS ALONG WITH REPRESENTATIVES FROM THE FOLLOWING COMMUNITY ORGANIZATIONS: CAIN & ASSOCIATES; CITY OF CLEBURNE; COMPASSION COUNSELING CENTER; CORNERSTONE ASSEMBLY OF GOD; ELMO CRIME WATCH; ELMO WATER DEPARTMENT; H-E-B GROCERY; HOOD COUNTY COMMITTEE ON AGING; HOPE MEDICAL CLINIC; KAUFMAN CHAMBER OF COMMERCE; LIGHTHOUSE CENTER FOR LEARNING; OAKDALE & HANNIBAL UNITED METHODIST CHURCHES; RUTH'S PLACE; SENIOR CONNECT; SOUTHWEST ADVENTIST UNIVERSITY; SPECIALIZED FLEET SERVICES; TARLETON STATE UNIVERSITY; TEXAS DEPARTMENT OF STATE HEALTH SERVICES; TEXAS VETERANS COMMISSION; AND TRI COUNTY FORD.FINDINGS FROM ALL DATA SOURCES (SECONDARY DATA, INTERVIEWS AND FOCUS GROUPS, AND THE WINDSHIELD SURVEY/OBSERVATIONAL ASSET MAPPING) WERE COMPARED. RECURRING THEMES WERE PULLED AND ANALYZED TO STRATIFY THE TOP MEDICAL AND SOCIAL DETERMINANT OF HEALTH NEEDS. THE OUTLINED NEEDS/BARRIERS WILL INFORM THE DEVELOPMENT OF THE 2020 CHNA IMPLEMENTATION PLAN, WHICH WILL LEVERAGE INTEGRATED STRATEGIES ACROSS THR'S INTERNAL AND EXTERNAL STAKEHOLDERS TO ENHANCE ITS SERVICE AND PROGRAM DELIVERY IN THE TARGET COMMUNITIES.THE TARRANT/PARKER COUNTIES REGION 2019 CHNA WAS A COLLABORATIVE PROCESS UTILIZING QUALITATIVE AND QUANTITATIVE METHODS TO ASSESS THE HEALTH NEEDS OF PERSONS WITHIN THE SERVICE AREAS WITHIN THESE COUNTIES. THE 2019 CHNA WAS CONDUCTED AT THE TARRANT/PARKER COUNTIES REGIONAL LEVEL TO GENERATE COMMUNITY-DRIVEN SOLUTIONS FOR BETTER INTEGRATION IN ADDRESSING THE CLINICAL AND SOCIAL NEEDS OF INDIVIDUALS LIVING IN NORTH TEXAS. BETWEEN APRIL 2018 AND AUGUST 2018, THE COMMUNITIES' HEALTH NEEDS WERE ASSESSED THROUGH KEY INFORMANT INTERVIEWS, SECONDARY DATA ANALYSIS, A WINDSHIELD SURVEY SERVING TO ASSIST ASSET-MAPPING THROUGH COMMUNITY OBSERVATION, AND FOCUS GROUPS. KEY INFORMANTS AND FOCUS GROUP PARTICIPANTS INCLUDED, BUT WERE NOT LIMITED TO FAITH COMMUNITY REPRESENTATIVES, PUBLIC HEALTH OFFICIALS, LAY COMMUNITY MEMBERS, SCHOOL OFFICIALS AND CITY ADMINISTRATION. THE ORGANIZATION ENGAGED 159 COMMUNITY MEMBERS WITH INTERESTS SPECIFIC TO THE HEALTH OF INDIVIDUALS IN THE TARRANT/PARKER COUNTIES REGION IN THE CHNA DEVELOPMENT PROCESS. ONE HUNDRED FORTY-NINE OF THESE COMMUNITY MEMBERS WERE ENGAGED ACROSS ELEVEN SEPARATE FOCUS GROUPS HELD IN ZIP-CODES THAT WERE IDENTIFIED AS UNDERSERVED AREAS. TEN SERVED AS KEY INFORMANTS, AND THE WINDSHIELD SURVEY WAS CONDUCTED BY TWO TEXAS HEALTH GRADUATE FELLOWS AND FIVE COMMUNITY HEALTH MANAGERS. TO GAIN A COMPREHENSIVE UNDERSTANDING OF THE HEALTH NEEDS AND PRIORITIES OF INDIVIDUALS IN THIS REGION, TEXAS HEALTH USED FOCUS GROUP SESSIONS AND KEY INFORMANT INTERVIEWS TO ENGAGE THE MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS ALONG WITH REPRESENTATIVES FROM THE FOLLOWING COMMUNITY ORGANIZATIONS: AZLE ISD; BROADIE'S AIRCRAFT; CITY OF BEDFORD; EMERGENCY MEDICINE CONSULTANT LTD.; FT WORTH SOUTH, INC.; HIGGINBOTHAM INSURANCE AGENCY; HIGHER PRAISE FAMILY CHURCH; KPMG; PRIVATE WEALTH SOLUTIONS INC.; PARKER COUNTY HOSPITAL DISTRICT; TARRANT COUNTY COLLEGE; TARRANT TRANSIT ALLIANCE; THE ABBEY CHURCH; THOS. S. BYRNE, INC.; UNITED WAY OF TARRANT COUNTY; URBAN THEORY; AND Z'S CAFE & CATERING. FINDINGS FROM ALL DATA SOURCES (SECONDARY DATA, INTERVIEWS AND FOCUS GROUPS, AND THE WINDSHIELD SURVEY/OBSERVATIONAL ASSET MAPPING) WERE COMPARED. RECURRING THEMES WERE PULLED AND ANALYZED TO STRATIFY THE TOP MEDICAL AND SOCIAL DETERMINANT OF HEALTH NEEDS. THE OUTLINED NEEDS/BARRIERS WILL INFORM THE DEVELOPMENT OF THE 2020 CHNA IMPLEMENTATION PLAN, WHICH WILL LEVERAGE INTEGRATED STRATEGIES ACROSS THR'S INTERNAL AND EXTERNAL STAKEHOLDERS TO ENHANCE ITS SERVICE AND PROGRAM DELIVERY IN THE TARGET COMMUNITIES.
TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH	PART V, SECTION B, LINE 6A: THE 2019 CHNA FOR THE SOUTHERN REGION WAS DONE IN COLLABORATION WITH TEXAS HEALTH CLEBURNE (THC), TEXAS HEALTH STEPHENVILLE (THS), TEXAS HEALTH KAUFMAN (THK), AND TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH(THH).THE 2019 CHNA FOR THE TARRANT/PARKER COUNTIES REGION WAS CONDUCTED IN COLLABORATION WITH TEXAS HEALTH ALLIANCE (THAL), TEXAS HEALTH ARLINGTON MEMORIAL (THAM), TEXAS HEALTH FORT WORTH (THFW), TEXAS HEALTH SPECIALTY HOSPITAL (THSH), TEXAS HEALTH SOUTHWEST FORT WORTH (THSW), TEXAS HEALTH HEB (THHEB), TEXAS HEALTH AZLE (THAZ), AMH CATH LABS (AMHH), TEXAS HEALTH SOUTHLAKE (THSL), USMD AT ARLINGTON (USMD-ARL), USMD AT FORT WORTH (USMD-FW), AND TEXAS HEALTH HUGULEY (THH).
TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH	PART V, SECTION B, LINE 7D: THE HOSPITAL HAS ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS MUST BE POSTED ON THE HOSPITAL'S WEBSITE AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE WIDELY AVAILABLE ON ITS WEBSITE ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AND WITHOUT CHARGE, AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE AVAILABLE FOR PUBLIC INSPECTION ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.
TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH	PART V, SECTION B, LINE 11: TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH, D/B/A TEXAS HEALTH HUGULEY WILL BE REFERRED TO IN THIS DOCUMENT AS TEXAS HEALTH HUGULEY OR "THE HOSPITAL". TEXAS HEALTH HUGULEY IS PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH. THE DIVISION INCLUDES 17 HOSPITAL FACILITIES.THIS IS THE SECOND-YEAR UPDATE FOR TEXAS HEALTH HUGULEY'S 2020-2022 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. TEXAS HEALTH HUGULEY DEVELOPED THIS PLAN AND POSTED IT BY MAY 2020 AS PART OF ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS.FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, TEXAS HEALTH HUGULEY WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY AND UNDERSERVED POPULATIONS IN OUR SERVICE AREA. THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT USED PRIMARY DATA INTERVIEWS AND SURVEYS; SECONDARY DATA FROM LOCAL, REGIONAL AND NATIONAL HEALTH-RELATED SOURCES; AND HOSPITAL PREVALENCE DATA TO HELP THE HOSPITAL DETERMINE THE HEALTH NEEDS OF THE COMMUNITY WE SERVE. ONCE THE DATA WAS GATHERED, THE PRIMARY ISSUES IDENTIFIED IN THE NEEDS ASSESSMENT WERE PRIORITIZED BY COMMUNITY AND HOSPITAL STAKEHOLDERS, WHO THEN SELECTED KEY ISSUES FOR THE HOSPITAL TO ADDRESS IN ITS 2020-2022 COMMUNITY HEALTH PLAN. THE SECOND-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE ISSUES IDENTIFIED IN 2019 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE ISSUES. THERE IS ALSO A DESCRIPTION OF THE IDENTIFIED ISSUES THAT THE HOSPITAL DID NOT ADDRESS.TEXAS HEALTH HUGULEY CHOSE THREE PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. CHRONIC DISEASE PREVENTION AND MANAGEMENT2. BEHAVIORAL HEALTH 3. AWARENESS, HEALTH LITERACY, NAVIGATION PRIORITY 1: CHRONIC DISEASE PREVENTION AND MANAGEMENT 2019 DESCRIPTION OF THE ISSUE:CHRONIC DISEASES ARE THE MAJOR CAUSES OF ILLNESS, DISABILITY AND DEATH IN TEXAS AND ACCOUNT FOR OVER 50% OF ALL DEATHS PER YEAR. THERE IS EVIDENCE THAT THE SOCIAL CONTEXT OF A PERSON'S LIFE DETERMINES THEIR RISK OF EXPOSURE, DEGREE OF SUSCEPTIBILITY AND THE COURSE AND OUTCOME OF CHRONIC DISEASES. CHRONIC CONDITIONS ARE DEVASTATING FOR QUALITY OF LIFE AND ARE COSTLY CONDITIONS TO TREAT AND MANAGE. IN 2014, TEXAS REPORTED OVER $34 BILLION IN HOSPITAL CHARGES RELATED TO JUST THREE CHRONIC DISEASES: HEART DISEASE, CANCER AND STROKE. THERE IS MOUNTING EVIDENCE THAT FOCUSING INTERVENTIONS, POLICIES AND INVESTMENTS ON ADDRESSING STRUCTURAL INEQUITIES CAN IMPROVE THE HEALTH STATUS AND OUTCOMES OF VULNERABLE POPULATIONS, THEREBY REDUCING HEALTH DISPARITIES. TEXAS HEALTH HUGULEY BEGAN OFFERING THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM (CDSMP) IN COLLABORATION WITH LOCAL COMMUNITY PARTNERS IN 2013 TO ADDRESS THE CHRONIC DISEASE PRIORITY IDENTIFIED BY TEXAS HEALTH HUGULEY IN THE TEXAS HEALTH RESOURCES SYSTEM-WIDE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THIS NATIONALLY RECOGNIZED PROGRAM AIMS TO ENABLE INDIVIDUALS TO BUILD THE SELF-CONFIDENCE AND MOTIVATION THEY NEED TO MANAGE THE CHALLENGES OF LIVING WITH A CHRONIC DISEASE. PARTICIPANTS ARE ADULTS EXPERIENCING CHRONIC HEALTH CONDITIONS SUCH AS HYPERTENSION, ARTHRITIS, HEART DISEASE, STROKE, LUNG DISEASE AND DIABETES. THE PROGRAM PROVIDES EDUCATIONAL INFORMATION AND SKILL-BUILDING PRACTICE OVER SIX WEEKS. INITIALLY, THE PROGRAM WORKSHOPS WERE EXCLUSIVELY IN-PERSON.TEXAS HEALTH RESOURCES (THR) MISSION IS TO "IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES WE SERVE". THR TAKES ITS RESPONSIBILITY TO ITS COMMUNITIES VERY SERIOUSLY AND INVESTS CHARITABLE RESOURCES TO PROMOTE GOOD HEALTH AND PREVENT DISEASE. THR PROVIDES HEALTHCARE TO THOSE WHO DO NOT HAVE THE MEANS TO PAY. ITS HOSPITALS ALSO CONDUCT A VARIETY OF PROGRAMS DESIGNED TO IMPROVE HEALTH AND PREVENT ILLNESS IN THE COMMUNITY. THR'S COMMUNITY HEALTH IMPROVEMENT STRATEGIES ARE DRIVEN BY THE COMMUNITY HEALTH NEEDS AND ARE COMMUNITY-BASED.THE HOSPITAL COMMUNITY BENEFIT STRATEGY INCLUDES CONFRONTING HEALTH PROBLEMS AT ITS SOURCE AND EMPHASIZES HEALTH PROMOTION, DISEASE PREVENTION AND EARLY DETECTION AND TREATMENT OF ILLNESS. THE HOSPITAL PROVIDED FREE SCREENINGS AND SUPPORT CLASSES FOR CHRONIC CONDITIONS SUCH AS DIABETES AND CANCER TO IMPROVE THE CHANCES OF EARLY DETECTION AND TREATMENT OF THESE CONDITIONS. SPECIFICALLY, THE HOSPITAL PROVIDED 30 DIABETES SUPPORT CLASSES AND LOGGED EIGHT VOLUNTEER HOURS FOR DIABETES SCREENINGS. ADDITIONALLY, THE HOSPITAL PROVIDED 45 MAMMOGRAMS, THREE COLONOSCOPIES, EIGHT HOURS OF SERVICE AT COMMUNITY EVENTS AND SIX SUPPORT CLASSES FOR COMMUNITY MEMBERS. THR HOSPITALS ALSO PROVIDE FREE CHILDHOOD AND FLU IMMUNIZATIONS TO THE UNINSURED AND HIGH-RISK POPULATIONS, IN ADDITION TO CHILD AUTO PASSENGER SAFETY SEATS TO NEW PARENTS. 2021 UPDATE: WHEN THE CORONAVIRUS PANDEMIC IMPACTED TEXAS, TEXAS HEALTH HUGULEY TOOK PROACTIVE MEASURES TO MINIMIZE THE RISK OF EXPOSURE TO ITS PARTICIPANTS AND STAFF BY MOVING CLASSES AND WORKSHOPS TO A VIRTUAL FORMAT WITH THE COLLABORATING PARTNERS' SUPPORT. AS A RESULT, THR AND ITS COLLABORATING AGENCIES PROVIDED 15 CDSMP WORKSHOPS SERVING 25 INDIVIDUALS IN THE HOSPITAL'S SERVICE AREA IN 2021, OF WHICH 30% WERE RESIDENTS IN HIGH NEED ZIP CODES, AS IDENTIFIED IN THE 2019 CHNA. DESPITE THE CHALLENGES OF WORKING WITH THE DISTANCE LEARNING FORMATS, 80% OF THE PARTICIPANTS GRADUATED (ATTENDED FOUR OR MORE OF THE SIX SESSIONS), YIELDING A 20% INCREASE IN THE GRADUATION RATE FROM THE PRIOR YEAR.BEFORE THE ONSET OF COVID-19, TEXAS HEALTH HUGULEY PLANNED TO ADDRESS CHRONIC DISEASE PREVENTION AND MANAGEMENT THROUGH SEVERAL AVENUES. THESE AVENUES INCLUDE FREE COMMUNITY EDUCATION EVENTS (DIABETES, HEART ATTACK AND STROKE) AND COMMUNITY EDUCATION ON ANNUAL SCREENINGS FOR CANCER PREVENTION (BREAST, LUNG, COLON). MOREOVER, TEXAS HEALTH HUGULEY PLANNED FOR LOCAL SPEAKING ENGAGEMENTS WITH PHYSICIANS RELEVANT TO EACH AREA OF OPPORTUNITY (SCHOOLS, CHURCHES, CITY EVENTS, ETC.). THESE ENGAGEMENTS AND INITIATIVES CHANGED DUE TO THE CIRCUMSTANCES OF THE PANDEMIC. IN 2020, TEXAS HEALTH HUGULEY PIVOTED MANY OF ITS COMMUNITY PROGRAMMING AND RESOURCES TO FOCUS ON THE COVID-19 PANDEMIC. EFFORTS INCLUDED SAFETY GUIDANCE FOR COMMUNITY BUSINESSES, LOCAL SCHOOLS, SIGNAGE AND SUPPLY DONATIONS, FREE COVID-19 TESTING SITES, AND VACCINE CLINICS TO PREVENT THE SPREAD OF THE DISEASE. ADDITIONAL EFFORTS INCLUDED COVID-19 EDUCATION AND SPREADING VACCINATION AWARENESS THROUGHOUT THE HOSPITAL'S SERVICE AREAS. TEXAS HEALTH HUGULEY PARTNERED WITH THE CITY OF BURLESON AND BURLESON FIRE DEPARTMENT TO ADMINISTER OVER 15,000 COVID-19 TESTS. IN PARTNERSHIP WITH THE CITY OF BURLESON, TEXAS HEALTH HUGULEY OPENED A COMMUNITY VACCINATION CLINIC AND ADMINISTERED OVER 32,000 COVID-19 VACCINES. THE HOSPITAL SUPPLIED AN ESTIMATED 3,000 OF THE ADMINISTERED VACCINES. THE TEXAS HEALTH HUGULEY HOSPITAL COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE CHRONIC DISEASE PREVENTION AND MANAGEMENT PRIORITY. 1. INTEGRATE AND STRENGTHEN THE DELIVERY SYSTEMS MECHANISM TO DECREASE HEALTH DISPARITIES AND IMPROVE HEALTH OUTCOMES IN TARGET COMMUNITIESGOAL 1: INTEGRATE AND STRENGTHEN THE DELIVERY SYSTEMS MECHANISM TO DECREASE HEALTH DISPARITIES AND IMPROVE HEALTH OUTCOMES IN TARGET COMMUNITIESOBJECTIVE 1: THE FIRST OBJECTIVE ADDRESSES THE PRIORITY OF CHRONIC DISEASE MANAGEMENT TO INCREASE THE VISIBILITY OF THR'S COMMUNITY HEALTH IMPROVEMENT (CHI) INTERVENTIONS AMONG INTERNAL AND EXTERNAL STAKEHOLDERS TO CREATE OPPORTUNITIES FOR COLLABORATION AND INTEGRATION AT THE DEPARTMENTAL AND SYSTEM LEVELS. THE INITIATIVE IS CONDUCTED THROUGH THE HOSPITAL AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE INITIATIVE PROVIDES MORE VISIBILITY, WHICH WILL INCREASE THE ABILITY OF THE HOSPITAL TO PROVIDE SERVICES IN THE COMMUNITY. THE HOSPITAL MET ITS SET GOAL OF REACHING 300,000 COMMUNITY MEMBERS BY PROVIDING EDUCATION AND AWARENESS FOR CHRONIC DISEASE RESULTING IN ABOUT 320,000 COMMUNITY MEMBERS REACHED. THE SECOND GOAL FOR THE OBJECTIVE WAS MET BY INCREASING THE NUMBER OF PARTNERSHIPS AND COLLABORATIONS ESTABLISHED. TEXAS HEALTH HUGULEY WAS ABLE TO REACH THE 320,000 INDIVIDUALS WITHIN OUR SERVICE AREA THROUGH COLLABORATING WITH THE BELOW MENTIONED PARTNERS TO PROVIDE HEALTH EDUCATION ON SCREENINGS, HEART HEALTH, DIABETES AND OTHER CHRONIC DISEASE AREAS. THE HOSPITAL WAS ABLE TO ESTABLISH OR FURTHER RELATIONSHIPS WITH THE FOLLOWING ORGANIZATIONS: CITY OF BURLESON, BURLESON FIRE DEPARTMENT, AMERICAN CANCER SOCIETY, ATHENA SOCIETY OF BURLESON AND SOUTHWESTERN ADVENTIST UNIVERSITY. *** SEE CONTINUATION OF PART V, SECTION B, LINE 11
TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH	PART V, SECTION B, LINE 13H: EFFECTIVE MARCH 1, 2020, THE FILING ORGANIZATION'S HOSPITAL FACILITY (OR FACILITIES) AUGMENTED THEIR FINANCIAL ASSISTANCE POLICY WITH A COVID-19 FINANCIAL GRACE ADDENDUM. PURSUANT TO THE COVID-19 FINANCIAL GRACE ADDENDUM, UNINSURED PATIENTS TREATED FOR COVID-19 RELATED EVALUATIONS ARE TO RECEIVE FREE OR DISCOUNTED CARE DEPENDING ON THE PATIENT'S COOPERATION IN SUBMITTING NECESSARY FINANCIAL ASSISTANCE INFORMATION. INSURED PATIENTS TESTED FOR COVID-19 ARE NOT EXPECTED TO HAVE OUT-OF-POCKET EXPENSES BASED ON INSURANCE COMMUNITY RESPONSE TO WAIVE PATIENT FINANCIAL RESPONSIBILITY. IF A PAYER UNEXPECTEDLY FAILS TO WAIVE PATIENT RESPONSIBILITY FOR COVID-19 RELATED TESTING, THE FILING ORGANIZATION WILL NOT BALANCE BILL PATIENTS FOR ANY OUT-OF-POCKET EXPENSES RELATED TO COVID-19. IN ADDITION, PATIENTS WITH EXISTING PAYMENT PLANS ARE PROVIDED OPPORTUNITIES FOR REDUCING THEIR MONTHLY PAYMENTS.
PART V, SECTION B, LINES 7A AND 10A:	LINE 7A. HOSPITAL FACILITY CHNA WEBSITE:WWW.TEXASHEALTHHUGULEY.ORG/HOSPITAL-AND-EMERGENCY-ROOMS/TEXAS-HEALTH-HUGULEY-HOSPITAL-FORT-WORTH-SOUTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS LINE 10A. COMMUNITY HEALTH PLAN (IMPLEMENATION STRATEGIES):WWW.TEXASHEALTHHUGULEY.ORG/HOSPITAL-AND-EMERGENCY-ROOMS/TEXAS-HEALTH-HUGULEY-HOSPITAL-FORT-WORTH-SOUTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS
PART V, SECTION B, LINE 16A, 16B, AND 16C:	16A. FAP WEBSITE:WWW.TEXASHEALTHHUGULEY.ORG/HOSPITAL-AND-EMERGENCY-ROOMS/TEXAS-HEALTH-HUGULEY-HOSPITAL-FORT-WORTH-SOUTH/BILLING-AND-FINANCIAL-SERVICES 16B. FAP APPLICATION WEBSITE:WWW.TEXASHEALTHHUGULEY.ORG/HOSPITAL-AND-EMERGENCY-ROOMS/TEXAS-HEALTH-HUGULEY-HOSPITAL-FORT-WORTH-SOUTH/BILLING-AND-FINANCIAL-SERVICES 16C. PLAIN LANGUAGE SUMMARY OF FAP WEBSITE:WWW.TEXASHEALTHHUGULEY.ORG/HOSPITAL-AND-EMERGENCY-ROOMS/TEXAS-HEALTH-HUGULEY-HOSPITAL-FORT-WORTH-SOUTH/BILLING-AND-FINANCIAL-SERVICES
*** CONTINUATION OF PART V, SECTION B, LINE 11:	THE CITY OF BURLESON IS A LOCAL GOVERNING BODY THAT COLLABORATES WITH THE BURLESON FIRE DEPARTMENT, WHICH HAS A MISSION TO IMPROVE THE QUALITY OF LIFE AND SAFETY OF THE CITIZENS THROUGH FIRE PREVENTION AND EMERGENCY RESPONSE. THE AMERICAN CANCER SOCIETY IS A NON-PROFIT ORGANIZATION THAT PROMOTES A HEALTHY LIFESTYLE TO HELP PREVENT CANCER. THE ATHENA SOCIETY OF BURLESON IS A NON-PROFIT ORGANIZATION COMPRISED OF WOMEN WITH A MISSION TO CONTRIBUTE TO THEIR COMMUNITY TO IMPROVE THE QUALITY OF LIFE FOR OTHERS. THE SOUTHWESTERN ADVENTIST UNIVERSITY HAS A MISSION TO INSPIRE KNOWLEDGE, FAITH AND SERVICE CENTERED THROUGH CHRIST-CENTERED EDUCATION. OBJECTIVE 2: THE SECOND OBJECTIVE, WHICH ADDRESSES THE PRIORITY OF CHRONIC DISEASE MANAGEMENT, IS TO FINALIZE SUSTAINABILITY PLANS AND COLLECTIVELY SUPPORT STRATEGIES THAT INCREASE RESOURCES, FUNDING AND COLLABORATION OPPORTUNITIES THAT STRENGTHEN THR'S COMMUNITY HEALTH IMPROVEMENT INTERVENTIONS. THE INITIATIVE IS FUNDED AND DEPLOYED THROUGH THE HOSPITAL AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE INITIATIVE PROVIDES RESOURCES, AWARENESS, MONETARY DONATIONS AND EDUCATION TO COMMUNITY ORGANIZATIONS THAT PRESENT OPPORTUNITIES FOR HEALTH IMPROVEMENTS. THE HOSPITAL MET ITS SET GOAL OF DONATING FUNDS IN THE FORM OF SPONSORSHIPS TO OVER 30 COMMUNITY ORGANIZATIONS. TEXAS HEALTH HUGULEY PROVIDED $85,750 TO ORGANIZATIONS LIKE MEALS ON WHEELS ($2,750), CRAZY8 MINISTRIES ($4,000), HARVEST HOUSE ($500), AMERICAN CANCER SOCIETY ($1,000), CASA OF JOHNSON COUNTY ($2,000), COMMUNITY HOSPICE OF TEXAS ($2,500), ONE SAFE PLACE ($500), NEXT STEP WOMEN'S CENTER ($2,500) AND OTHER NON-PROFIT ORGANIZATIONS THAT TOTAL THE AMOUNT OF $70,000. THESE DONATIONS WERE GIVEN TO EACH OF THE ABOVE ORGANIZATIONS TO SUPPORT SPECIFIC EVENTS OR INITIATIVES THAT RELATED TO THE PRIORITY CHRONIC DISEASE PREVENTION. THE HOSPITAL ALSO COLLABORATED WITH 15 OF THE 30 NON-PROFIT ORGANIZATIONS TO PROVIDE FOOD, MEDICAL SCREENINGS (CANCER, DIABETES, HEART HEALTH, BEHAVIORAL HEALTH), VOLUNTEER HOURS AND HEALTH EDUCATION MATERIALS (PRINT COLLATERAL, PROMOTIONAL ITEMS AND SPEAKING ENGAGEMENTS) TO AID THESE ORGANIZATIONS IN IMPROVING THE HEALTH OF THE COMMUNITY AND MANAGING OR PREVENTING CHRONIC DISEASE. OBJECTIVE 3:THE THIRD OBJECTIVE, WHICH ADDRESSES THE PRIORITY OF CHRONIC DISEASE MANAGEMENT, IS TO DEMONSTRATE INNOVATION AT THE DEPARTMENTAL OR SYSTEM-LEVEL FOCUSED ON IMPROVING THE DELIVERY OF HEALTH SERVICES TO OUR TARGET POPULATION/COMMUNITIES. THE INITIATIVE IS CONDUCTED THROUGH THE HOSPITAL AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE INITIATIVE USES THE TEXAS HEALTH HUGULEY'S MOBILE HEALTH BUS TO PROVIDE SERVICES TO THOSE UNABLE TO ACCESS HEALTHCARE DUE TO A LACK OF TRANSPORTATION OR ADEQUATE FINANCIAL RESOURCES. SERVICES INCLUDE IMMUNIZATIONS, WELL WOMEN EXAMS, REGULAR AND SPORTS PHYSICALS, EKG, TB TESTING, FLU SHOTS, SKIN CANCER SCREENING, HEPATITIS A & B VACCINES, BLOOD PRESSURE SCREENINGS AND LAB WORK. THE HOSPITAL MET ITS SET GOAL OF DELIVERING ACCESS TO POPULATIONS IN NINE UNDERPRIVILEGED ZIP CODES OF FAMILIES WHICH INCLUDE ADULTS AND CHILDREN THAT WERE REACHED. DURING THE COURSE OF 2021, 50,000+ COVID VACCINES WERE ADMINISTERED IN OUR COMMUNITY. FROM MAY - OCTOBER OF 2021 THE MOBILE HEALTH BUS WAS ENGAGING IN ITS REGULAR SCHEDULE, VISITING TARGETED ZIP CODES WITHIN OUR PSA TO PROVIDE IMMUNIZATIONS, WELL WOMEN EXAMS, REGULAR AND SPORTS PHYSICALS, EKG, TB TESTING, FLU SHOTS, SKIN CANCER SCREENING, HEPATITIS A & B VACCINES, BLOOD PRESSURE SCREENINGS, LAB WORK , MEDICATIONS AND TREATMENT OPTIONS FOR ADULTS AND CHILDREN RESIDING IN THESE AREAS. DURING THIS TIME THE BUS WAS AVAILABLE 59 TIMES, SERVING 708 PATIENTS. DUE TO MECHANICAL ISSUES WITH THE BUS, ADDITIONAL COMMUNITY OUTREACH WAS ENGAGED IN BY THE STAFF DURING NOVEMBER AND DECEMBER. ACTIVITY INCLUDED SCREENINGS AND IMMUNIZATIONS FOR 300 FAMILIES AT THE CROWLEY HOUSE OF HOPE'S BACK TO SCHOOL FAIR; FOUR SEPARATE FLU CLINICS WHERE 630 FLU SHOTS WERE ADMINISTERED; 9 COMMUNITY CPR CLASSES EDUCATING 35 INDIVIDUALS.PRIORITY 2: BEHAVIORAL HEALTH 2019 DESCRIPTION OF THE ISSUE:BEHAVIORAL HEALTH CONDITIONS AFFECT NEARLY ONE IN FIVE AMERICANS AND OFTEN GOES UNDETECTED AND UNTREATED DUE TO THE FRAGMENTED BEHAVIORAL AND PHYSICAL HEALTH SYSTEMS. IF LEFT UNTREATED, UNCONTROLLED BEHAVIORAL HEALTH CAN LEAD TO HIGH UTILIZATION OF PREVENTABLE HOSPITALIZATION, WHICH IN TURN LEADS TO HIGH HEALTH EXPENSES FOR MANY PATIENTS AND HEALTH CARE SYSTEMS. ACCORDING TO THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA), THE COST OF CARE IS 75 PERCENT HIGHER FOR PEOPLE WITH CO-MORBID BEHAVIORAL AND PHYSICAL HEALTH CONDITIONS. LIMITED HEALTH CARE ACCESS AND UNSAFE ENVIRONMENTS ARE POTENTIAL RISK FACTORS FOR BEHAVIORAL HEALTH DISORDERS. ALSO, EXPOSURES TO VIOLENCE, SOCIAL ISOLATION AND DISCRIMINATION ARE SOURCES OF TOXIC STRESS THAT SIGNIFICANTLY CONTRIBUTE TO THE DEVELOPMENT AND EXACERBATION OF BEHAVIORAL HEALTH DISORDERS. IT IS IMPORTANT TO EMPOWER INDIVIDUALS WITH THE SKILLS AND RESOURCES TO ACCESS AND UTILIZE APPROPRIATE BEHAVIORAL HEALTH SERVICES.2021 UPDATE: IN SEPTEMBER 2020, TEXAS HEALTH HUGULEY LAUNCHED AN ADOLESCENT BEHAVIORAL HEALTH PROGRAM TO MEET THE NEEDS OF YOUTH IN JOHNSON/TARRANT COUNTY SUFFERING FROM MENTAL HEALTH DISABILITIES. THE TIMING OF THE COVID-19 OUTBREAK ALLOWED TEXAS HEALTH HUGULEY TO BECOME A "HUB" FOR ADOLESCENTS STRUGGLING AS THEIR FAMILIES NAVIGATED THE CHALLENGES OF THE PANDEMIC INCLUDING THE TRANSITION TO VIRTUAL LEARNING, INCREASES IN DOMESTIC VIOLENCE, ETC. THE "HUB" FOR THESE SERVICES ENTAILED PROVIDING FREE WALK-IN OR VIRTUAL ASSESSMENT FOR THOSE WHO ARE CLINICALLY IDENTIFIED AS MENTALLY OR EMOTIONALLY UNSTABLE. THIS WOULD ALSO INCLUDE PROVIDING FREE OF COST THERAPY OR TREATMENT TO THOSE WHO NEED ADDITIONAL RESOURCES TO COPE WITH THE BEHAVIORAL HEALTH ISSUES THAT HAVE BEEN IDENTIFIED FOR EACH INDIVIDUAL. THE "HUB" ALSO ENTAILS PROVIDING COUNSELING AND GUIDANCE FREE OF CHARGE TO PARENTS AND FAMILY MEMBERS ON HOW TO ADDRESS THE ISSUES AT HOME. WHILE LAUNCHING THIS PROGRAM, TEXAS HEALTH HUGULEY'S BEHAVIORAL HEALTH DEPARTMENT WAS ABLE TO OFFER FREE SERVICES IN SUPPORT OF COMMUNITY BENEFIT AND MEET THE MENTAL HEALTH NEEDS OF ADULTS IN BOTH AN INPATIENT AND OUTPATIENT SETTING. THE TEXAS HEALTH HUGULEY, COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENTS UNDER THE BEHAVIORAL HEALTH PRIORITY. 1. INTEGRATE AND STRENGTHEN THE DELIVERY SYSTEMS MECHANISM TO DECREASE HEALTH DISPARITIES AND IMPROVE HEALTH OUTCOMES IN TARGET COMMUNITIESGOAL 1: INTEGRATE AND STRENGTHEN THE DELIVERY SYSTEMS MECHANISM TO DECREASE HEALTH DISPARITIES AND IMPROVE HEALTH OUTCOMES IN TARGET COMMUNITIESOBJECTIVE 1: THE FIRST OBJECTIVE, WHICH ADDRESSES THE PRIORITY OF BEHAVIORAL HEALTH, IS TO INCREASE THE VISIBILITY OF THR'S COMMUNITY HEALTH IMPROVEMENT (CHI) INTERVENTIONS AMONG INTERNAL AND EXTERNAL STAKEHOLDERS TO CREATE OPPORTUNITIES FOR COLLABORATION AND INTEGRATION AT THE DEPARTMENTAL AND SYSTEM LEVELS. THE INITIATIVE IS CONDUCTED THROUGH THE HOSPITAL AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. INTERNAL STAKEHOLDERS FROM OUR BEHAVIORAL HEALTH DEPARTMENT WORKED WITH SCHOOL COUNSELORS TO OFFER FREE THERAPY CLASSES AND ASSESSMENTS TO SCHOOL-AGED ADOLESCENTS. THESE SERVICES WERE ALSO OFFERED FREE OF CHARGE TO BEHAVIORAL-HEALTH RELATED NETWORKING GROUPS (BURLESON INDEPENDENT SCHOOL DISTRICT, UNITED WAY, PRIVATE PRACTICES, ADULT AND ADOLESCENT THERAPISTS). THERE WERE 103 ADOLESCENTS SERVED THROUGH THIS EFFORT IN 2021. IN ADDITION, 390 ADULTS WERE PROVIDED WITH FREE MENTAL HEALTH ASSESSMENT SERVICES.OBJECTIVE 2: THE SECOND OBJECTIVE, WHICH ADDRESSES THE PRIORITY OF BEHAVIORAL HEALTH, IS TO FINALIZE SUSTAINABILITY PLANS AND COLLECTIVELY SUPPORT STRATEGIES THAT INCREASE RESOURCES, FUNDING AND COLLABORATION OPPORTUNITIES THAT STRENGTHEN THR'S COMMUNITY HEALTH IMPROVEMENT INTERVENTIONS. THE INITIATIVE IS FUNDED AND DEPLOYED THROUGH TEXAS HEALTH RESOURCES AND THE REPORTING HOSPITAL. THE HOSPITAL MET ITS SET GOAL FOR THE ABOVE OBJECTIVE THROUGH TEXAS HEALTH RESOURCES SYSTEM INVOLVEMENT TOUCHING OUR PRIMARY SERVICE AREA ZIP CODES IN JOHNSON AND SOUTHWEST TARRANT COUNTIES. WITH THE LAUNCH OF THE ADOLESCENT BEHAVIORAL HEALTH PROGRAM IN SEPTEMBER 2020, THE HOSPITAL HAS HAD THE OPPORTUNITY TO GREATLY EXPAND BEHAVIORAL SERVICES FOR THIS POPULATION. IN 2021, 300 ADOLESCENTS WERE SERVED IN THE PROGRAM. THE TEXAS HEALTH HUGULEY BEHAVIORAL HEALTH PROGRAM HAS ALSO CREATED PARTNERSHIPS WITH LOCAL ORGANIZATIONS LIKE UNITED WAY, CENTER FOR AUTISTIC SPECTRUM DISORDER (ASD) AND LOCAL INDEPENDENT SCHOOL DISTRICTS (ISDS) TO OFFER SERVICES AND SPREAD AWARENESS. AN ADDITIONAL 1,929 ADULTS WERE PROVIDED WITH MENTAL HEALTH ASSESSMENT AND TREATMENT DURING 2021. *** SEE CONTINUATION OF PART V, SECTION B, LINE 11
*** CONTINUATION OF PART V, SECTION B, LINE 11:	TEXAS HEALTH HUGULEY AWARDED $125,000 FROM THE HOSPITAL SYSTEM BUDGET TO THE FOLLOWING COMMUNITY ORGANIZATIONS: BURLESON OPPORTUNITY FUND, CASA OF JOHNSON COUNTY, CRAZY 8 MINISTRIES, HARVEST HOUSE, MEALS ON WHEELS, NEXT STEP WOMEN'S CENTER AND ONE SAFE PLACE. THE AIM OF THIS INITIATIVE WAS TO ADVANCE THE PREVENTION AND MANAGEMENT OF SOCIAL, PHYSICAL, AND BEHAVIORAL HEALTH IN UNDERSERVED COMMUNITIES, WITH THE GOAL OF REDUCING HEALTH DISPARITIES AND IMPROVING HEALTH EQUITY. THE INITIATIVE CALLS ON AGENCIES FROM DIFFERENT SECTORS EDUCATION, HEALTH CARE, GOVERNMENT, GRASSROOTS ORGANIZATIONS, AND OTHERS TO UNITE AGAINST IDENTIFIED ISSUES.PRIORITY 3: AWARENESS, HEALTH LITERACY, NAVIGATION 2019 DESCRIPTION OF THE ISSUE:APPROXIMATELY 80 MILLION ADULTS IN THE UNITED STATES HAVE LIMITED HEALTH LITERACY, WHICH ADVERSELY AFFECTS THE QUALITY AND COST OF HEALTHCARE. EVIDENCE SHOWS THAT POOR HEALTH LITERACY IS ASSOCIATED WITH HIGHER HOSPITALIZATIONS, GREATER USE OF EMERGENCY CARE, LOWER RECEIPTS OF SCREENINGS AND VACCINES, REDUCED ABILITY TO DEMONSTRATE MEDICATION ADHERENCE AND POOR OVERALL HEALTH STATUS AND HIGHER MORTALITY RATES. INDIVIDUALS OR GROUPS THAT LACK ECONOMIC RESOURCES, RESIDE IN NEIGHBORHOODS WITH HIGH CONDITIONS OF CRIME, HAVE LIMITED GREEN SPACE AND GROCERY STORES ARE AT RISK FOR ADVERSE HEALTH OUTCOMES. THERE IS EVIDENCE THAT A PERSON'S ZIP CODE HAS POWERFUL INFLUENCES ON THEIR HEALTH STATUS, ACCESS TO RESOURCES, AND THE ABILITY TO NAVIGATE THOSE RESOURCES.2021 UPDATE: IN 2021, TEXAS HEALTH HUGULEY WAS ABLE TO ADDRESS THIS ISSUE OF AWARENESS, HEALTH LITERACY AND NAVIGATION THROUGH SEVERAL DIFFERENT AVENUES. TEXAS HEALTH HUGULEY'S COMMUNITY CARE CLINIC WAS ABLE TO PROVIDE POST-ACUTE PRIMARY CARE FOLLOW UP FOR UNINSURED INDIVIDUALS UPON BEING DISCHARGED FROM OUR EMERGENCY DEPARTMENT OR AT THE CONCLUSION OF AN INPATIENT STAY. SERVICES INCLUDE OFFICE VISITS, MEDICATION MANAGEMENT, MONETARY ASSISTANCE FOR MEDICATION, HELP WITH NEEDED DME AND GLUCOSE MONITORING DEVICES. CARE CLINIC ASSISTANCE PROVIDED RESOURCES (FUNDING, MEDICATION, REFERRALS) FOR THOSE WITH HIGH BLOOD PRESSURE, DIABETES, HEART DISEASE AND MANY OTHER CHRONIC HEALTH ISSUES. ASSISTANCE RESULTED IN A MONETARY PROVISION OF OVER $1,500 IN PRESCRIPTION MEDICATIONS PLUS ADDITIONAL LAB, X-RAY OR RADIOLOGY SERVICES FOR EACH PATIENT BASED ON INCOME, EMPLOYMENT, INSURANCE STATUS AND OTHER CRITERIA. TEXAS HEALTH HUGULEY'S MOBILE HEALTH BUS WAS ABLE TO AID SURROUNDING JOHNSON/TARRANT COUNTY RESIDENTS THROUGH GIVING VACCINATIONS, PHYSICAL EXAMS, PAP SMEARS, PASSING OUT FREE MAMMOGRAM VOUCHERS AND MEETING MANY OTHER MEDICAL NEEDS. SERVICE AREAS FOCUSED ON THE TOWNS OF EVERMAN, CROWLEY, BURLESON, JOSHUA, GODLEY AND SOUTH FORT WORTH. TO ALLOW PATIENTS TO BETTER NAVIGATE HEALTH ISSUES, TEXAS HEALTH HUGULEY HAS ADDED SEVERAL CLINICAL NAVIGATOR ROLES TO SERVICES INCLUDING ONCOLOGY, ORTHOPEDICS AND SPINE. THESE ROLES ARE NOT ONLY USED TO NAVIGATE PATIENTS WITHIN THE SERVICE LINES BUT ARE REQUIRED TO PARTICIPATE IN FINDING OUTSIDE COMMUNITY BENEFIT OPPORTUNITIES TO SERVICE THOSE WHO NEED ACCESS TO THESE SERVICES BUT CANNOT AFFORD THEM. ADDITIONAL EDUCATOR ROLES HAVE BEEN ADDED TO DEPARTMENTS LIKE WOMEN'S SERVICES AND CRITICAL CARE TO MAKE EACH PATIENT'S JOURNEY AS STREAMLINED AS POSSIBLE AND PROVIDE ADDITIONAL EDUCATION NEEDED FREE OF CHARGE.THE HOSPITAL IS A PART OF SEVERAL COMMUNITY COLLABORATIONS THAT WORKED ON CONTRIBUTING TO THIS PRIORITY, INCLUDING: CRAZY 8 MINISTRIES, PARTNERSHIPS WITH LOCALS ISDS, NEXT STEP WOMEN'S CENTER, ONE SAFE PLACE AND THE BURLESON AREA CHAMBER OF COMMERCE. THE EFFORTS DESCRIBED ARE FOR THE INDIVIDUAL FACILITY, TEXAS HEALTH HUGULEY, TO ADDRESS THIS ISSUE IS PROVIDING CONSISTENT EDUCATIONAL OPPORTUNITIES, AS WELL AS STAFFING AND MATERIALS FOR THE MOBILE HEALTH BUS AND OFFERING COMMUNITY EDUCATION AND SUPPORT CLASSES DURING A PANDEMIC.THE COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENTS UNDER THE AWARENESS, HEALTH LITERACY, NAVIGATION PRIORITY. 1. INTEGRATE AND STRENGTHEN THE DELIVERY SYSTEMS MECHANISM TO DECREASE HEALTH DISPARITIES AND IMPROVE HEALTH OUTCOMES IN TARGET GOAL 1: INTEGRATE AND STRENGTHEN THE DELIVERY SYSTEMS MECHANISM TO DECREASE HEALTH DISPARITIES AND IMPROVE HEALTH OUTCOMES IN TARGET OBJECTIVE 1: THE FIRST OBJECTIVE WHICH ADDRESSES THE PRIORITY OF AWARENESS, HEALTH LITERACY AND NAVIGATION, IS TO INCREASE THE VISIBILITY OF THR'S COMMUNITY HEALTH IMPROVEMENT (CHI) INTERVENTIONS AMONG INTERNAL AND EXTERNAL STAKEHOLDERS TO CREATE OPPORTUNITIES FOR COLLABORATION AND INTEGRATION AT THE DEPARTMENTAL AND SYSTEM LEVELS. THE INITIATIVE IS CONDUCTED THROUGH TEXAS HEALTH HUGULEY AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE WILL AIM TO PROVIDE WAYS TO MAKE IT EASIER FOR THE TARGET POPULATION TO ACCESS HEALTH EDUCATION, SUPPLIES AND SERVICES THEY NEED TO CARE FOR THEMSELVES AND THEIR FAMILIES. THE HOSPITAL MET ITS SET GOAL OF REACHING INDIVIDUALS IN PRIMARY SERVICE AREA ZIP CODES (76133, 76123, 76140, 76036 TARRANT, 76028, 76058, 76059, 76031, 76009 JOHNSON) THROUGH EDUCATION PROGRAMS SUCH AS DIABETES EDUCATION PROGRAM, COLLABORATIONS WITH ORGANIZATIONS, SPEAKING ENGAGEMENTS AND DISTRIBUTING MATERIALS AT COMMUNITY EVENTS. SPECIFICALLY, THE HOSPITAL PROVIDED A MOBILE HEALTH SERVICES CLINIC, COMMUNITY CARE CLINIC, BEHAVIORAL HEALTH PROGRAM, PARTNERSHIPS AND COLLABORATIONS WITH VARIOUS ORGANIZATIONS AND STAKEHOLDERS THAT AID IN ACCESS AND LITERACY AND AWARENESS (I.E. MEALS ON WHEELS, HARVEST HOUSE, ETC.).OBJECTIVE 2: THE SECOND OBJECTIVE WHICH ADDRESSES THE PRIORITY OF AWARENESS, HEALTH LITERACY AND NAVIGATION, IS TO FINALIZE SUSTAINABILITY PLANS AND COLLECTIVELY SUPPORT STRATEGIES THAT INCREASE RESOURCES, FUNDING AND COLLABORATION OPPORTUNITIES THAT STRENGTHEN THR'S COMMUNITY HEALTH IMPROVEMENT INTERVENTIONS.THE INITIATIVE IS CONDUCTED THROUGH TEXAS HEALTH HUGULEY AND TEXAS HEALTH RESOURCES AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE INITIATIVE TO FINALIZE SUSTAINABILITY AND STRATEGY PLANS IS TO CONTINUE TO OFFER SERVICES IN OUR AREA THAT PROVIDE EDUCATION, AWARENESS, LITERACY AND ACCESS TO HEALTH SERVICES AND SUPPLIES FOR THE TARGET POPULATIONS. THIS WILL BE ACCOMPLISHED THROUGH COLLABORATING WITH COMMUNITY STAKEHOLDERS AND LOCAL ORGANIZATIONS TO ATTEND COMMUNITY EVENTS, OFFER EDUCATION THROUGH SPEAKING ENGAGEMENTS AND CONTINUE DISTRIBUTING MATERIALS.THE HOSPITAL MET IT'S SET METRIC OF REACHING 330,000 INDIVIDUALS IN THE HOSPITAL'S SERVICE AREA THAT BENEFITED FROM EDUCATION, SUPPLIES OR SERVICES THAT TEXAS HEALTH HUGULEY WAS ABLE TO OFFER. THIS WAS DONE THROUGH COMMUNITY ENGAGEMENTS AND EVENTS, CLINICIAN EDUCATION SESSIONS AND SPEAKING EVENTS AS WELL AS NON-PAID SOCIAL AND EMAIL CAMPAIGNS TO EDUCATE INDIVIDUALS. ADDITIONALLY, THE HOSPITAL CONTINUED TO WORK WITH INTERNAL DEPARTMENTS TO CREATE STRATEGIES AND PLANS TO FURTHER REACH OUR COMMUNITY TO MEET THIS NEED. FOUR EXAMPLES OF THIS INCLUDE OUR FAITH COMMUNITY COMMITTEE IN COLLABORATION WITH BEHAVIORAL HEALTH, COMMUNITY STRATEGY COMMITTEE IN PARTNERSHIP WITH KEY STAKEHOLDERS IN OUR COMMUNITY, AND NEW INITIATIVES WITH BOTH OUR BEHAVIORAL HEALTH AND PASTORAL CARE DEPARTMENTS THAT OFFER EDUCATION AND SERVICES ON GRIEF AND MENTAL HEALTH. OBJECTIVE 3:THE THIRD OBJECTIVE WHICH ADDRESSES THE PRIORITY OF AWARENESS, HEALTH LITERACY AND NAVIGATION, IS TO DEMONSTRATE INNOVATION AT THE DEPARTMENTAL OR SYSTEM-LEVEL FOCUSED ON IMPROVING THE DELIVERY OF HEALTH SERVICES TO OUR TARGET POPULATION/COMMUNITIES. THE INITIATIVE IS CONDUCTED THROUGH TEXAS HEALTH RESOURCES AND TEXAS HEALTH HUGULEY AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE INITIATIVE PROVIDES ACCESS TO HEALTH CARE AND THE KNOWLEDGE OF HEALTH CARE THROUGH STRATEGIC PLANNING AND INNOVATION TO REACH TARGETED AUDIENCES. THE HOSPITAL MET ITS SET METRIC OF CREATING TWO NEW, INNOVATIVE WAYS TO STRATEGICALLY DECIDE HOW TO MEET THE NEEDS OF OUR POPULATION. THIS METRIC WAS MET BY IMPLEMENTING THE COMMUNITY STRATEGY COMMITTEE AND FAITH COMMUNITY COMMITTEE. THESE COMMITTEES INCLUDE DEPARTMENT REPRESENTATIVES, EXECUTIVES AND KEY STAKEHOLDERS IN THE COMMUNITY THAT GET TOGETHER MONTHLY TO ASSESS AND PLAN WHERE HOSPITAL STAFF TIME AND EFFORTS ARE BEING SPENT AND SHOULD BE FOCUSED. IN THESE MEETINGS, INDIVIDUALS ARE TASKED WITH RELATIONSHIP BUILDING AND FINDING WAYS FOR THE HOSPITAL TO PROMOTE HEALTH SERVICES AND EDUCATE THE COMMUNITY BETTER. *** SEE CONTINUATION OF PART V, SECTION B, LINE 11
*** CONTINUATION OF PART V, SECTION B, LINE 11:	COMMUNITY NEEDS NOT CHOSEN BY TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH:THE PRIMARY AND SECONDARY DATA IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MULTIPLE COMMUNITY ISSUES. THE HOSPITAL AND COMMUNITY STAKEHOLDERS USED THE FOLLOWING CRITERIA TO NARROW THE LARGER LIST TO THE PRIORITY AREAS NOTED ABOVE:1. HOW ACUTE IS THE NEED? (BASED ON DATA AND COMMUNITY CONCERN)2. WHAT IS THE TREND? IS THE NEED GETTING WORSE?3. DOES THE HOSPITAL PROVIDE SERVICES THAT RELATE TO THE PRIORITY? 4. IS SOMEONE ELSE - OR MULTIPLE GROUPS - IN THE COMMUNITY ALREADY WORKING ON THIS ISSUE? 5. IF THE HOSPITAL WERE TO ADDRESS THIS ISSUE, ARE THERE OPPORTUNITIES TO WORK WITH COMMUNITY PARTNERS? BASED ON THIS PRIORITIZATION PROCESS, THE HOSPITAL DID NOT CHOOSE THE FOLLOWING COMMUNITY ISSUES:1. TRANSPORTATION: A POOR TRANSPORTATION SYSTEM PREVENTS THOSE WHO DO NOT OWN A CAR OR HAVE RELIABLE TRANSPORTATION FROM ACCESSING HEALTH CARE. TRANSPORTATION BARRIERS LEAD TO RESCHEDULED OR MISSED APPOINTMENTS, DELAYED CARE AND MISSED OR DELAYED MEDICATION USE. 2. HEART DISEASE & STROKE: THOUGH NOT A PRIORITIZED AREA, THE HOSPITAL HAS CERTIFICATIONS IN STROKE AND CHEST PAIN. THE HOSPITAL WILL PROMOTE HEART HEALTH EDUCATION IN THE COMMUNITY ON EACH TOPIC AND PARTNER WITH COMMUNITY ORGANIZATIONS AS NECESSARY.3. CANCER: CANCER IS THE SECOND LEADING CAUSE OF DEATH IN THE U.S. WITH OVER 100 TYPES. MANY ARE PREVENTABLE AND RESEARCH ADVANCES IN DETECTION AND TREATMENT HAVE GREATLY IMPROVED SURVIVAL RATES. THE HOSPITAL WILL CONTINUE TO PARTICIPATE BY SUPPORTING REFERRALS FROM SUSAN G. KOMEN FOUNDATION AND MONCRIEF CANCER INSTITUTE TO PROVIDE MAMMOGRAPHY, CLINICAL BREAST EXAMINATIONS AND PAP SMEARS.

Schedule H (Form 990) 2021

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?4
Name and address		Type of Facility (describe)
1	1 - TEXAS HEALTH HUGULEY IMAGING CENTER 12001 S FREEWAY SUITE 100 BURLESON,TX76028	OUTPATIENT IMAGING
2	2 - CENTER FOR WOUND CARE & HYPERBARIC MED 12001 S FREEWAY SUITE 301 BURLESON,TX76028	OUTPATIENT WOUND CARE
3	3 - OUTPATIENT REHABILITATION 215 OLD HIGHWAY 1187 BURLESON,TX76028	OUTPATIENT REHAB THERAPY
4	4 - OUTPATIENT MRI 215 OLD HIGHWAY 1187 BURLESON,TX76028	OUTPATIENT MRI
5
6
7
8
9
10

Schedule H (Form 990) 2021

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 7:	THE AMOUNTS OF COSTS REPORTED IN THE TABLE IN LINE 7 OF PART I OF SCHEDULE H WERE DETERMINED BY UTILIZING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, CONTAINED IN THE SCHEDULE H INSTRUCTIONS.
PART III, LINE 2:	THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE.
PART III, LINE 3:	METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY:SELF-PAY PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM). IF AN INDIVIDUAL DOES NOT SUBMIT A COMPLETE FAA FORM WITHIN 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL, AN INDIVIDUAL MAY BE CONSIDERED FOR PRESUMPTIVE ELIGIBILITY BASED UPON A SCORING TOOL THAT IS DESIGNED TO CLASSIFY PATIENTS INTO GROUPS OF VARYING ECONOMIC MEANS. THE SCORING TOOL USES ALGORITHMS THAT INCORPORATE DATA FROM CREDIT BUREAUS, DEMOGRAPHIC DATABASES, AND HOSPITAL SPECIFIC DATA TO INFER AND CLASSIFY PATIENTS INTO RESPECTIVE ECONOMIC MEANS CATEGORIES. INDIVIDUALS WHO EARN A CERTAIN SCORE ON THE SCORING TOOL ARE CONSIDERED TO QUALIFY AS ELIGIBLE FOR THE MOST GENEROUS FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. AS DETERMINED BY THE FILING ORGANIZATION, A NOMINAL AMOUNT OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORING TOOL IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION CANNOT BE MADE BASED UPON INFORMATION SUPPLIED BY THE INDIVIDUAL. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY.
PART III, LINE 4:	FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 6 THROUGH 8.
PART III, LINE 8:	COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.RATIONALE FOR INCLUDING A MEDICARE SHORTFALL AS COMMUNITY BENEFIT:AS A 501(C)(3) ORGANIZATION, THE FILING ORGANIZATION PROVIDES EMERGENCY AND NON-ELECTIVE CARE TO ALL REGARDLESS OF ABILITY TO PAY. ALL HOSPITAL SERVICES ARE PROVIDED IN A NON-DISCRIMINATORY MANNER TO PATIENTS WHO ARE COVERED BENEFICIARIES UNDER THE MEDICARE PROGRAM. AS A PUBLIC INSURANCE PROGRAM, MEDICARE PROVIDES A PRE-ESTABLISHED REIMBURSEMENT RATE/AMOUNT TO HEALTH CARE PROVIDERS FOR THE SERVICES THEY PROVIDE TO PATIENTS. IN SOME CASES, THE REIMBURSEMENT AMOUNT PROVIDED TO A HOSPITAL MAY EXCEED ITS COSTS OF PROVIDING A PARTICULAR SERVICE OR SERVICES TO A PATIENT. IN OTHER CASES, THE MEDICARE REIMBURSEMENT AMOUNT MAY RESULT IN THE HOSPITAL EXPERIENCING A SHORTFALL OF REIMBURSEMENT RECEIVED OVER COSTS INCURRED. IN THOSE CASES WHERE AN OVERALL SHORTFALL IS GENERATED FOR PROVIDING SERVICES TO ALL MEDICARE PATIENTS, THE SHORTFALL AMOUNT SHOULD BE CONSIDERED AS A BENEFIT TO THE COMMUNITY. TAX-EXEMPT HOSPITALS ARE REQUIRED TO ACCEPT ALL MEDICARE PATIENTS REGARDLESS OF THE PROFITABILITY, OR LACK THEREOF, WITH RESPECT TO THE SERVICES THEY PROVIDE TO MEDICARE PATIENTS. THE POPULATION OF INDIVIDUALS COVERED UNDER THE MEDICARE PROGRAM IS SUFFICIENTLY LARGE SO THAT THE PROVISION OF SERVICES TO THE POPULATION IS A BENEFIT TO THE COMMUNITY AND RELIEVES THE BURDENS OF GOVERNMENT. IN THOSE SITUATIONS WHERE THE PROVISION OF SERVICES TO THE TOTAL MEDICARE PATIENT POPULATION OF A TAX-EXEMPT HOSPITAL DURING ANY YEAR RESULTS IN A SHORTFALL OF REIMBURSEMENT RECEIVED OVER THE COST OF PROVIDING CARE, THE TAX-EXEMPT HOSPITAL HAS PROVIDED A BENEFIT TO A CLASS OF PERSONS BROAD ENOUGH TO BE CONSIDERED A BENEFIT TO THE COMMUNITY. DESPITE A FINANCIAL SHORTFALL, A TAX-EXEMPT HOSPITAL MUST AND WILL CONTINUE TO ACCEPT AND CARE FOR MEDICARE PATIENTS. TYPICALLY, TAX-EXEMPT HOSPITALS PROVIDE HEALTH CARE SERVICES BASED UPON AN ASSESSMENT OF THE HEALTH CARE NEEDS OF THEIR COMMUNITY AS OPPOSED TO THEIR TAXABLE COUNTERPARTS WHERE PROFITABILITY OFTEN DRIVES DECISIONS ABOUT PATIENT CARE SERVICES THAT ARE OFFERED. PATIENT CARE PROVIDED BY TAX-EXEMPT HOSPITALS THAT RESULTS IN MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS PROVIDING A BENEFIT TO THE COMMUNITY AND RELIEVING THE BURDENS OF GOVERNMENT.
PART III, LINE 9B:	THE HOSPITAL FILING ORGANIZATION'S COLLECTION PRACTICES ARE IN CONFORMITY WITH THE REQUIREMENTS SET FORTH IN THE 2014 FINAL REGULATIONS REGARDING THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(R)(4) - (R)(6). NO EXTRAORDINARY COLLECTION ACTIONS (ECA'S) ARE INITIATED BY THE HOSPITAL FILING ORGANIZATION IN THE 120-DAY PERIOD FOLLOWING THE DATE AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL (OR, IF LATER, THE SPECIFIED DEADLINE GIVEN IN A WRITTEN NOTICE OF ACTIONS THAT MAY BE TAKEN, AS DESCRIBED BELOW). INDIVIDUALS ARE PROVIDED WITH AT LEAST ONE WRITTEN NOTICE (NOTICE OF ACTIONS THAT MAY BE TAKEN) AND A COPY OF THE FILING ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY THAT INFORMS THE INDIVIDUAL THAT THE HOSPITAL FILING ORGANIZATION MAY TAKE ACTIONS TO REPORT ADVERSE INFORMATION TO CREDIT REPORTING AGENCIES/BUREAUS IF THE INDIVIDUAL DOES NOT SUBMIT A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM) OR PAY THE AMOUNT DUE BY A SPECIFIED DEADLINE. THE SPECIFIED DEADLINE IS NOT EARLIER THAN 120 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL AND IS AT LEAST 30 DAYS AFTER THE NOTICE IS PROVIDED. A REASONABLE ATTEMPT IS ALSO MADE TO ORALLY NOTIFY AN INDIVIDUAL ABOUT THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AND HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FAA FORM DURING THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST POST-DISCHARGE BILLING STATEMENT WAS SENT TO THE INDIVIDUAL, THE HOSPITAL FILING ORGANIZATION SUSPENDS ANY REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS (OR CEASES ANY OTHER ECA'S) AND PROVIDES A WRITTEN NOTICE TO THE INDIVIDUAL DESCRIBING WHAT ADDITIONAL INFORMATION OR DOCUMENTATION IS NEEDED TO COMPLETE THE FAA FORM. THIS WRITTEN NOTICE CONTAINS CONTACT INFORMATION INCLUDING THE TELEPHONE NUMBER AND PHYSICAL LOCATION OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY, AS WELL AS CONTACT INFORMATION OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS OR, ALTERNATIVELY, A NONPROFIT ORGANIZATION OR GOVERNMENTAL AGENCY THAT CAN PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS IF THE HOSPITAL FACILITY IS UNABLE TO DO SO. IF AN INDIVIDUAL SUBMITS A COMPLETE FAA FORM WITHIN A REASONABLE TIME-PERIOD AS SET FORTH IN THE NOTICE DESCRIBED ABOVE, THE HOSPITAL FILING ORGANIZATION WILL SUSPEND ANY ADVERSE REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS UNTIL A FINANCIAL ASSISTANCE POLICY ELIGIBILITY DETERMINATION CAN BE MADE.
SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B, LINE 8	RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE CONSIDERED A COMMUNITY BENEFIT TO THE ELDERLY AND ARE COMBINED INTO AN ANNUAL COMMUNITY BENEFIT STATEMENT PREPARED BY ADVENTHEALTH.THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS AS REPORTED IN THE AHS COMMUNITY BENEFIT REPORT ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ 1,422,287- DIFFERENCE IN COSTING METHODOLOGY: (2,000,821)- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (11,095,412) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITY BENEFIT REPORTING: $(11,673,946) AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S PORTION OF THE COMPANY'S ANNUAL COMMUNITY BENEFIT STATEMENT IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION.
PART VI, LINE 2:	THE HOSPITAL CONDUCTS COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) EVERY THREE YEARS. ITS 2019 CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2019, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S 2019 CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN FINAL REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY.
PART VI, LINE 3:	THE FINANCIAL ASSISTANCE POLICY (FAP), FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM), AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS) OF THE FILING ORGANIZATION'S HOSPITAL FACILITY ARE TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, FAA FORM, PLS, AND CONTACT INFORMATION FOR THE HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITE. THE WEBSITE INDICATES THAT A COPY OF THE FAP, FAA FORM, AND PLS IS AVAILABLE AND HOW TO OBTAIN SUCH COPIES IN THE PRIMARY LANGUAGES OF ANY POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY (REFERRED TO BELOW AS LEP DEFINED POPULATIONS). SIGNAGE IS DISPLAYED IN PUBLIC LOCATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITY, INCLUDING AT ALL POINTS OF ADMISSION AND REGISTRATION AND THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS THE HOSPITAL FACILITY'S WEBSITE ADDRESS WHERE THE FAP, FAA FORM, AND PLS CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT TO OBTAIN COPIES OF THE FAP, FAA FORM AND PLS OR TO OBTAIN MORE INFORMATION ABOUT THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS. PAPER COPIES OF THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN THE HOSPITAL FACILITY AND BY MAIL. PAPER COPIES ARE MADE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGES OF ANY LEP DEFINED POPULATIONS. THE FILING ORGANIZATION'S HOSPITAL FACILITY'S FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A PAPER COPY OF THE HOSPITAL FACILITY'S PLS WILL BE OFFERED TO EVERY PATIENT AS A PART OF THE INTAKE OR DISCHARGE PROCESS. A CONSPICUOUS WRITTEN NOTICE IS INCLUDED ON ALL BILLING STATEMENTS SENT TO PATIENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, INCLUDING THE FOLLOWING: 1) THE TELEPHONE NUMBER OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FAP AND THE FAA FORM; AND 2) THE WEBSITE ADDRESS WHERE COPIES OF THE FAP, FAA FORM AND PLS MAY BE OBTAINED. REASONABLE ATTEMPTS ARE MADE TO INFORM INDIVIDUALS ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE. COPIES OF THE PLS ARE DISTRIBUTED TO MEMBERS OF THE COMMUNITY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE.
PART VI, LINE 4:	THE FILING ORGANIZATION CURRENTLY OPERATES TEXAS HEALTH HUGULEY (THH) A 327-BED ACUTE-CARE HOSPITAL IN BURLESON, TEXAS. BURLESON, TEXAS IS LOCATED IN JOHNSON COUNTY AND THH SERVES THE SOUTH FORT WORTH AREA. THE HOSPITAL INCLUDES A MEDICAL INTENSIVE CARE UNIT, A CARDIOVASCULAR CRITICAL CARE UNIT, A PROGRESSIVE CARE UNIT, OPEN HEART SURGERY CENTER AND BEHAVIORAL HEALTH. THH ALSO HAS AN ACCREDITED BONE AND JOINT PROGRAM, AN ACCREDITED CHEST PAIN CENTER, AND AN AWARD WINNING EMERGENCY DEPARTMENT AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK. MORE THAN 400 PRIMARY CARE AND SPECIALTY PHYSICIANS PROVIDE A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES. PART OF THH'S PRIMARY SERVICE AREA INCLUDES A NUMBER OF SMALLER COMMUNITIES WITH LIMITED ACCESS TO HEALTHCARE SERVICES. TO MEET THE NEEDS OF THESE RESIDENTS, THH HAS A SUBSIDIARY THAT OPERATES MULTIPLE PRIMARY CARE CLINICS THROUGHOUT ITS PRIMARY SERVICE AREA. IN ADDITION, THE MOBILE HEALTH SERVICES BUS PROVIDES HEALTH SCREENINGS AND WELLNESS EDUCATION SERVICES THROUGHOUT TARRANT AND JOHNSON COUNTIES. DURING 2021, THE HOSPITAL'S PATIENT PERCENTAGE POPULATION WAS MADE UP OF THE BELOW PAYORS WITH THE REMAINING PERCENTAGE OF THE PATIENTS BEING COVERED UNDER COMMERCIAL INSURANCE. IN 2021, ABOUT 71.90% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 47.5% - MEDICAID PATIENTS 11.1% - SELF-PAY PATIENTS 8.0% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S COMMUNITY IS AS FOLLOWS: - POPULATION (APPROXIMATELY) 300,000 - POVERTY (BELOW 100% FPL) 14.6% - UNEMPLOYMENT RATE 6.3% - VIOLENT CRIME RATE (PER 100,000 POP.) 334.6 - POP. AGE 25+ WITH NO HIGH SCHOOL DIPLOMA 16.7% - UNINSURED ADULTS 21.6% - UNINSURED CHILDREN 10.8% - FOOD INSECURITY RATE 15.2% - POP. WITH LOW FOOD ACCESS 32.4%
PART VI, LINE 5:	THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO TEXAS HEALTH HUGULEY'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE FILING ORGANIZATION IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE FIING ORGANIZATION'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE FILING ORGANIZATION COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT AND COMMUNITY BUILDING INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, THE FILING ORGANIZATION PROVIDED $456,714 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY. THE FILING ORGANIZATION ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE FILING ORGANIZATION EXPENDED $26,401,036 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE FILING ORGANIZATION IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY.
PART VI, LINE 6:	AS EXPLAINED IN OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 6, TEXAS HEALTH HUGULEY, INC. (THH OR THE HOSPITAL) HAS TWO MEMBERS. THE MEMBERS ARE TEXAS HEALTH RESOURCES AND ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI). AHSSI IS A WHOLLY-OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION. THH IS ABLE TO DRAW UPON THE EXPERTISE AND LEADERSHIP OF BOTH ITS HEALTH SYSTEM MEMBERS IN ITS EFFORT TO CREATE EXCELLENT PATIENT EXPERIENCES AND OFFER A BROAD SPECTRUM OF HEALTH SERVICES NEEDED IN ITS COMMUNITY.DURING ITS CURRENT TAX YEAR, THH WAS MANAGED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 48 HOSPITALS THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 10 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. PURSUANT TO A MANAGEMENT SERVICES AGREEMENT, AHSSHC PROVIDES MANAGEMENT AND CERTAIN CONSULTING SERVICES TO TEXAS HEALTH HUGULEY. MANAGEMENT AND CONSULTING SERVICES INCLUDE PERSONNEL ADMINISTRATION, PROCUREMENT, HEALTH INFORMATION MANAGEMENT, MAINTENANCE AND SECURITY, CONTRACTS, FINANCIAL ACCOUNTING SYSTEMS AND BUDGET DEVELOPMENT.THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION IN A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITAL AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. EACH ADVENTHEALTH SUBSIDIARY PAYS A MANAGEMENT FEE TO AHSSHC FOR THE INTERNAL SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY AN ADVENTHEALTH SUBSIDIARY ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF ADVENTHEALTH AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEB-SITE OF ADVENTHEALTH AT WWW.ADVENTHEALTH.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF ADVENTHEALTH.
PART VI, LINE 7, REPORTS FILED WITH STATES	TX

Schedule H (Form 990) 2021

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
TEXAS HEALTH HUGULEY INC

Employer identification number
45-2694620

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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	(h) Purpose of grant or assistance
(1) YOUR HARVEST HOUSE 349 NW RENFRO STREET BURLESON,TX76028	75-1985674	501(C)(3)	7,100	GENERAL SUPPORT
(2) SOUTHWESTERN ADVENTIST UNIVERSITY 100 W HILLCREST STREET KEENE,TX76059	75-0891465	501(C)(3)	17,500	GENERAL SUPPORT
(3) BURLESON AREA CHAMBER OF COMMERCE 124 S MAIN STREET SUITE 226 BURLESON,TX76028	75-1228140	501(C)(6)	11,500	GENERAL SUPPORT
(4) BURLESON ISD 1160 SW WILSHIRE BOULEVARD BURLESON,TX76028	75-6000295	501(C)(3)	12,750	GENERAL SUPPORT
(5) CITY OF BURLESON 141 W RENFRO STREET BURLESON,TX76028	75-6000475	GOVT	9,985	GENERAL SUPPORT
(6) KEENE CHAMBER OF COMMERCE 110 S OLD BETSY ROAD KEENE,TX76059	75-2505148	501(C)(6)	6,000	GENERAL SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2021

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash 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

PART I, LINE 2:

GRANTS ARE GENERALLY MADE ONLY TO RELATED ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3), OR TO OTHER LOCAL CHARITABLE COMMUNITY ORGANIZATIONS, OR TO OTHER 501(C)(3) ORGANIZATIONS THAT ARE A PART OF THE GROUP EXEMPTION RULING ISSUED TO THE GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS. ACCORDINGLY, THE FILING ORGANIZATION HAS NOT ESTABLISHED SPECIFIC PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES AS THE FILING ORGANIZATION DOES NOT HAVE A GRANT MAKING PROGRAM THAT WOULD NECESSITATE SUCH PROCEDURES.

Schedule I (Form 990) 2021

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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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

TEXAS HEALTH HUGULEY INC

Employer identification number

45-2694620

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .....

Yes

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 on Line 1a? ....

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JOHNSON PENNY CEO	(i) (ii)	328,481 ------------- 197,088	137,817 ------------- 82,690	834,611 ------------- 500,767	64,356 ------------- 38,614	27,053 ------------- 16,232	1,392,318 ------------- 835,391	40,012 ------------- 24,007
2KING JAMES KIRK DIRECTOR/VICE CHAIRMAN	(i) (ii)	0 ------------- 656,358	0 ------------- 307,624	0 ------------- 237,587	0 ------------- 101,868	0 ------------- 47,969	0 ------------- 1,351,406	0 ------------- 48,503
3CRAFT BRIAN DIRECTOR	(i) (ii)	0 ------------- 345,243	0 ------------- 124,202	0 ------------- 105,457	0 ------------- 48,567	0 ------------- 48,274	0 ------------- 671,743	0 ------------- 13,982
4JACKSON DAVID DIRECTOR	(i) (ii)	0 ------------- 325,186	0 ------------- 111,884	0 ------------- 98,684	0 ------------- 53,076	0 ------------- 37,296	0 ------------- 626,126	0 ------------- 11,705
5TUCKER REBECCA DIRECTOR (BEG 01/21)	(i) (ii)	0 ------------- 327,103	0 ------------- 100,286	0 ------------- 81,612	0 ------------- 46,527	0 ------------- 47,341	0 ------------- 602,869	0 ------------- 6,532
6LLOYD MD DAVID DIRECTOR (BEG 06/21)	(i) (ii)	0 ------------- 307,602	0 ------------- 96,842	0 ------------- 107,286	0 ------------- 39,229	0 ------------- 48,006	0 ------------- 598,965	0 ------------- 8,587
7LAUE MD ED CMO (END 06/21)	(i) (ii)	241,938 ------------- 103,688	52,722 ------------- 22,595	49,778 ------------- 21,333	28,537 ------------- 12,231	17,801 ------------- 7,629	390,776 ------------- 167,476	12,993 ------------- 5,569
8THORSBERRY MD MICHAEL DIRECTOR (END 06/21)	(i) (ii)	0 ------------- 155,308	0 ------------- 131,492	0 ------------- 210,077	0 ------------- 12,904	0 ------------- 20,941	0 ------------- 530,722	0 ------------- 0
9SUTTON JESSE CFO	(i) (ii)	115,270 ------------- 153,693	40,601 ------------- 54,135	16,647 ------------- 22,196	17,721 ------------- 23,628	11,313 ------------- 15,084	201,552 ------------- 268,736	10,068 ------------- 13,424
10FORD MD RONNY DIRECTOR(END06/21)/CMO(BEG06/21)	(i) (ii)	114,067 ------------- 253,374	0 ------------- 0	4,839 ------------- 2,074	21,527 ------------- 9,226	13,173 ------------- 17,614	153,606 ------------- 282,288	0 ------------- 0
11PAI AJITH DIRECTOR	(i) (ii)	0 ------------- 202,802	0 ------------- 63,921	0 ------------- 69,225	0 ------------- 30,924	0 ------------- 47,549	0 ------------- 414,421	0 ------------- 4,506
12FINCH KENNETH FORMER CEO	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 335,617	0 ------------- 0	0 ------------- 6,078	0 ------------- 341,695	0 ------------- 0
13ELLIS TAMMY CNO	(i) (ii)	164,897 ------------- 54,966	28,826 ------------- 9,609	10,640 ------------- 3,547	9,329 ------------- 3,110	22,533 ------------- 7,511	236,225 ------------- 78,743	0 ------------- 0
14LEMON SEAN COO (BEG 08/21)	(i) (ii)	162,775 ------------- 40,694	20,352 ------------- 5,088	8,013 ------------- 2,003	9,494 ------------- 2,373	29,962 ------------- 7,490	230,596 ------------- 57,648	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 1A	AS DISCLOSED IN OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 3, INDIVIDUALS WHO SERVE AS OFFICERS OF THE FILING ORGANIZATION IN THE ROLES OF CEO, CFO, COO, CMO, AND CNO ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE FILING ORGANIZATION REIMBURSES AHSSHC FOR THE SALARY AND BENEFIT COST OF THOSE EXECUTIVES ON THE PAYROLL OF AHSSHC. AT THE DIRECTION OF AHSSHC, AND IN ACCORDANCE WITH THE RESERVED POWERS IN THE FILING ORGANIZATION'S GOVERNING DOCUMENTS, THE EXECUTIVE TEAM LISTED ON PART VII PROVIDES SERVICES TO THE FILING ORGANIZATION. FIRST-CLASS OR CHARTER TRAVEL: PURSUANT TO THE ADVENTHEALTH SYSTEM-WIDE GENERAL POLICY REGARDING BUSINESS TRAVEL, NO REIMBURSEMENT WILL BE PROVIDED FOR ANY ADDITIONAL COST INCURRED WITH RESPECT TO FIRST-CLASS OR CHARTER AIR TRAVEL BEYOND THE COST OF A REGULAR COACH AIRFARE. AS A MEANS OF PROVIDING ADDITIONAL BUSINESS TRAVEL REIMBURSEMENT FOR THOSE MEMBERS OF THE AHSSHC SENIOR EXECUTIVE MANAGEMENT TEAM THAT TRAVEL FREQUENTLY ON BEHALF OF ADVENTHEALTH, A SPECIAL ANNUAL TRAVEL ALLOWANCE IS PROVIDED FOR THOSE EXECUTIVES. AS ADVENTHEALTH OPERATES 48 HOSPITALS IN 9 STATES, THE SENIOR LEADERSHIP OF AHSSHC TRAVEL EXTENSIVELY AND OFTEN VISIT MULTIPLE HOSPITAL LOCATIONS IN DIFFERENT STATES AS A PART OF A SINGLE BUSINESS TRIP. THE SPECIAL TRAVEL ALLOWANCE CAN PROVIDE REIMBURSEMENTS TO THE EXECUTIVE FOR SUCH ITEMS AS THE PURCHASE OF AIR TRAVEL UPGRADE COUPONS, TO COVER THE COST DIFFERENTIAL BETWEEN COACH AND FIRST-CLASS TRAVEL, OR TO COVER THE COST OF A CHARTER FLIGHT. THE SPECIAL TRAVEL ALLOWANCE BENEFIT WAS ORIGINALLY AUTHORIZED BY AND CODIFIED INTO A POLICY BY THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE), AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS, WHO ALSO APPROVES THE ANNUAL CAP ON THE AMOUNT OF THE ALLOWANCE. THE SPECIAL TRAVEL ALLOWANCE HAS AN ANNUAL CAP OF $24,000 FOR MEMBERS OF THE LEADERSHIP EXECUTIVE TEAM (ADVENTHEALTH CABINET - 13 MEMBERS) AND $15,000 FOR ADVENTHEALTH CORPORATE OFFICE SENIOR VICE PRESIDENTS, REGIONAL CEO'S, AND DIVISION CHIEF OFFICERS (GENERALLY 20-35 INDIVIDUAL EXECUTIVES). TWO INDIVIDUALS WHO SERVED IN 2021 AS REGIONAL CEOS FOR ADVENTHEALTH ARE MEMBERS OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. THE REGIONAL CEOS ARE CONSIDERED COMMON LAW EMPLOYEES AND ARE ON THE PAYROLL OF AHSSHC. WHILE THE SPECIAL TRAVEL ALLOWANCE BENEFIT IS AN AHSSHC COMPENSATION POLICY AND PRACTICE, THE COST OF PROVIDING THIS BENEFIT IS ALLOCATED TO AND EITHER WHOLLY OR PARTIALLY REIMBURSED BY THE FILING ORGANIZATION. ACCORDINGLY, THE FILING ORGANIZATION HAS CHECKED THE BOX IN SCHEDULE J, PART I, LINE 1A FOR FIRST-CLASS OR CHARTER TRAVEL SINCE IT HAS WHOLLY OR PARTIALLY PAID FOR THE COST OF PROVIDING THIS BENEFIT. THOSE EXECUTIVES WHO RECEIVE THE SPECIAL TRAVEL ALLOWANCE ARE RESPONSIBLE FOR TRACKING THE EXPENSES REIMBURSABLE UNDER THE SPECIAL TRAVEL ALLOWANCE AND MUST SUBMIT SUCH EXPENSES ON THEIR ACCOUNTABLE PLAN EXPENSE REPORT. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES UNDER THE SPECIAL TRAVEL ALLOWANCE ARRANGEMENT ARE TREATED AS TAXABLE COMPENSATION TO THE EXECUTIVE. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING AHSSHC EXECUTIVE TO HAVE HIS OR HER SPOUSE ACCOMPANY THE EXECUTIVE ON CERTAIN BUSINESS TRIPS EACH YEAR. TYPICALLY, REIMBURSEMENT IS ONLY PROVIDED TO CERTAIN EXECUTIVE LEADERS AND IS USUALLY LIMITED TO ONE BUSINESS TRIP PER YEAR BEYOND THE ANNUAL ADVENTHEALTH PRESIDENT'S COUNCIL BUSINESS MEETING AND OTHER MEETINGS WHERE THE SPOUSE IS SPECIFICALLY INVITED. THE AHSSHC CORPORATE EXECUTIVE SPOUSAL TRAVEL POLICY WAS ORIGINALLY APPROVED AND REVIEWED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. ALL SPOUSAL TRAVEL COSTS REIMBURSED TO THE EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: ADVENTHEALTH HAS A SYSTEM-WIDE POLICY ADDRESSING GROSS-UP PAYMENTS PROVIDED IN CONNECTION WITH EMPLOYER-PROVIDED BENEFITS/OTHER TAXABLE ITEMS. UNDER THE POLICY, CERTAIN TAXABLE BUSINESS-RELATED REIMBURSEMENTS (I.E. TAXABLE BUSINESS-RELATED MOVING EXPENSES, TAXABLE ITEMS PROVIDED IN CONNECTION WITH EMPLOYMENT) PROVIDED TO ANY EMPLOYEE MAY BE GROSSED-UP AT A 25% RATE UPON APPROVAL BY THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: OCCASIONAL DISCRETIONARY SPENDING AMOUNTS ARE PERIODICALLY PROVIDED TO ELIGIBLE EXECUTIVES WHO ATTEND ANNUAL BUSINESS MEETINGS SUCH AS THE ADVENTHEALTH PRESIDENT'S COUNCIL, CFO CONFERENCE OR THE CMO/CNO BUSINESS MEETING. PAYMENTS PROVIDED TO EACH EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES BUSINESS DEVELOPMENT EXPENDITURES. UNDER THIS POLICY, TO ENCOURAGE EXECUTIVES TO ESTABLISH AND CULTIVATE STRONG WORKING RELATIONSHIPS WITH THE MEDICAL COMMUNITY AND OTHER LEADERS IN THE COMMUNITY AND INDUSTRY, CERTAIN ADVENTHEALTH EXECUTIVES MAY BE REIMBURSED FOR MEMBER DUES AND USAGE CHARGES FOR A COUNTRY CLUB OR OTHER SOCIAL CLUB UPON AUTHORIZATION. CLUB MEMBERSHIPS MUST BE APPROVED BY THE ADVENTHEALTH PRESIDENT/CEO INITIALLY AS WELL AS ON AN ANNUAL BASIS. EACH ADVENTHEALTH EXECUTIVE WHO IS APPROVED FOR A CLUB MEMBERSHIP MUST SUBMIT AN ANNUAL REPORT DESCRIBING HOW THEY USED THE MEMBERSHIP TO BENEFIT THEIR ORGANIZATION DURING THE PRECEDING YEAR SO THAT THE ADVENTHEALTH PRESIDENT/CEO CAN MAKE A DETERMINATION IF CONTINUANCE OF THE CLUB MEMBERSHIP FURTHERS THE BUSINESS INTERESTS OF ADVENTHEALTH. IN THE CURRENT YEAR, FOR THIS FILING ORGANIZATION, ONE EXECUTIVE LISTED IN PART VII RECEIVED REIMBURSEMENT FOR CLUB FEES. WHILE THE CLUB DUES MEMBERSHIP IS AN AHSSHC COMPENSATION POLICY AND PRACTICE, THE COST OF PROVIDING THIS BENEFIT IS ALLOCATED TO AND REIMBURSED IN WHOLE OR IN PART BY THE FILING ORGANIZATION. ACCORDINGLY, THE FILING ORGANIZATION HAS CHECKED THE BOX IN SCHEDULE J, PART I, LINE 1A FOR HEALTH OR SOCIAL CLUB DUES SINCE IT HAS WHOLLY OR PARTIALLY PAID FOR THE COST OF PROVIDING THIS BENEFIT.
PART I, LINE 3	THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), AN UNRELATED ENTITY AS DISCLOSED IN OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 3, FOR THAT INDIVIDUAL'S ROLE IN SERVING AS THE CEO PURSUANT TO THE MANAGEMENT SERVICES AGREEMENT BETWEEN THE FILING ORGANIZATION AND AHSSHC. COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF AHSSHC THAT ARE DESIGNED TO ENSURE COMPLIANCE WITH THE INTERMEDIATE SANCTIONS LAWS AS SET FORTH IN IRC SECTION 4958. AHSSHC HAS TAKEN STEPS TO ENSURE THAT PROCESSES ARE IN PLACE TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS STANDARD AS SET FORTH IN TREASURY REGULATION 53.4958-6 WITH RESPECT TO ITS ACTIVE EXECUTIVE-LEVEL POSITIONS. THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE) SERVES AS THE GOVERNING BODY FOR ALL EXECUTIVE COMPENSATION MATTERS. THE COMMITTEE IS COMPOSED OF CERTAIN MEMBERS OF THE BOARD OF DIRECTORS (THE BOARD) OF AHSSHC. VOTING MEMBERS OF THE COMMITTEE INCLUDE ONLY INDIVIDUALS WHO SERVE ON THE BOARD AS INDEPENDENT REPRESENTATIVES, WHO HOLD NO EMPLOYMENT POSITIONS WITH AHSSHC AND WHO DO NOT HAVE RELATIONSHIPS WITH ANY OF THE INDIVIDUALS WHOSE COMPENSATION IS UNDER THEIR REVIEW THAT IMPACTS THEIR BEST INDEPENDENT JUDGMENT AS FIDUCIARIES OF AHSSHC. THE COMMITTEE'S ROLE IS TO REVIEW AND APPROVE ALL COMPONENTS OF THE EXECUTIVE COMPENSATION PLAN OF AHSSHC. AS AN INDEPENDENT GOVERNING BODY WITH RESPECT TO EXECUTIVE COMPENSATION, IT SHOULD BE NOTED THAT THE COMMITTEE WILL OFTEN CONFER IN EXECUTIVE SESSIONS ON MATTERS OF COMPENSATION POLICY AND POLICY CHANGES. IN SUCH EXECUTIVE SESSIONS, NO MEMBERS OF MANAGEMENT OF AHSSHC ARE PRESENT, OTHER THAN THE CHIEF PEOPLE OFFICER, WHO REMAINS AT THE REQUEST OF THE CHAIRMAN/COMMITTEE TO PROVIDE ASSISTANCE/INFORMATION AS NEEDED. THE COMMITTEE IS ADVISED BY AN INDEPENDENT THIRD-PARTY COMPENSATION ADVISOR. THIS ADVISOR PREPARES ALL THE BENCHMARK STUDIES FOR THE COMMITTEE. COMPENSATION LEVELS ARE BENCHMARKED WITH A NATIONAL PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS OF SIMILAR SIZE AND COMPLEXITY TO ADVENTHEALTH AND EACH OF ITS AFFILIATED ENTITIES. THE FOLLOWING PRINCIPLES GUIDE THE ESTABLISHMENT OF INDIVIDUAL EXECUTIVE COMPENSATION: - THE SALARY OF THE PRESIDENT/CEO OF ADVENTHEALTH WILL NOT EXCEED THE 50TH PERCENTILE OF COMPARABLE SALARIES PAID BY SIMILARLY SITUATED ORGANIZATIONS; AND - OTHER EXECUTIVE SALARIES SHALL BE ESTABLISHED USING MARKET MEDIANS. THE COMPENSATION PHILOSOPHY, POLICIES, AND PRACTICES OF AHSSHC ARE CONSISTENT WITH THE ORGANIZATION'S FAITH-BASED MISSION AND CONFORM TO APPLICABLE LAWS, REGULATIONS, AND BUSINESS PRACTICES. AS A FAITH-BASED ORGANIZATION SPONSORED BY THE SEVENTH-DAY ADVENTIST CHURCH (THE CHURCH), AHSSHC'S PHILOSOPHY AND PRINCIPLES WITH RESPECT TO ITS EXECUTIVE COMPENSATION PRACTICES REFLECT THE CONSERVATIVE APPROACH OF THE CHURCH'S MISSION OF SERVICE AND WERE DEVELOPED IN COUNSEL WITH THE CHURCH'S LEADERSHIP.
PART I, LINES 4A-B	PART I, LINE 4A: DURING THE YEAR ENDING DECEMBER 31, 2021, KENNETH FINCH RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $329,608 FROM ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE COPORATION (AHSSHC), AN UNRELATED ENTITY, FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. PURSUANT TO THE AHSSHC CORPORATE EXECUTIVE POLICY GOVERNING EXECUTIVE SEVERANCE, SEVERANCE AGREEMENTS FOR EXECUTIVES OPERATING AT THE VICE PRESIDENT LEVEL AND ABOVE ARE ENTERED INTO UPON ELIGIBILITY TO FACILITATE THE TRANSITION TO SUBSEQUENT EMPLOYMENT FOLLOWING AN INVOLUNTARY SEPARATION FROM EMPLOYMENT WITH ADVENTHEALTH. PART I, LINE 4B: NONQUALIFIED RETIREMENT PLAN - TEXAS HEALTH RESOURCES: CERTAIN OF THE BOARD MEMBERS ARE COMPENSATED BY TEXAS HEALTH RESOURCES (THR), A RELATED ENTITY TO THE FILING ORGANIZATION, AND ARE COVERED BY A NONQUALIFIED RETIREMENT PLAN. PARTICIPATION IN THE PLAN IS MADE AVAILABLE TO A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES, AS DETERMINED BY THE THR BOARD OF TRUSTEES, WHO ARE PROVIDING SERVICES IN KEY POSITIONS OF MANAGEMENT AND RESPONSIBILITY. FOR THE ACTIVE RESTORATION ACCOUNT (ACCOUNT BALANCES AFTER 12/31/2009), SERP BENEFITS VEST WHILE THE PARTICIPANT IS EMPLOYED IF THE PARTICIPANT: * REACHES AGE 65, * BECOMES DISABLED OR DIES, * REACHES THE FOLLOWING YEARS OF SERVICE: 2 YEARS - 25%; 3 YEARS -50%; 4 YEARS - 75%; AND 5 OR MORE - 100%. PARTICIPANTS MUST BE EMPLOYED ON DECEMBER 1 TO QUALIFY FOR THE CURRENT YEAR'S SERP BENEFIT UNLESS SEPARATION IS DUE TO DEATH, DISABILITY, RETIREMENT (AGE 65) OR EARLY RETIREMENT (SEPARATION FROM SERVICE AT OR AFTER AGE 55 WITH 75 YEARS OF COMBINED AGE AND CONTINUOUS SERVICE WITH THE SYSTEM). SERP BENEFITS ARE CALCULATED EACH DECEMBER 1. VESTED BALANCES ARE TAXED TO THE EMPLOYEE AND THE NET BALANCES BEGIN ACCRUING EARNINGS. VESTED BALANCES ARE PAID IN A CASH LUMP SUM WITHIN A 90 DAY PERIOD COMMENCING ON THE EARLIER OF DEATH, DISABILITY, OR SEPARATION FROM SERVICE. THE DEFERRED PORTION IS INCLUDED IN SCHEDULE J, PART II, COLUMN C. IN FROZEN RESTORATION ACCOUNTS (ACCOUNT BALANCES PRIOR TO 1/1/2010), THE PARTICIPANT OR BENEFICIARY SHALL BE TAXED ON HIS OR HER VESTED SERP BENEFITS UPON THE EARLIEST OF: * CONTINUED EMPLOYMENT IN THR UNTIL AGE 68 * TERMINATION OF EMPLOYMENT FOR DISABILITY OR DEATH * INVOLUNTARY TERMINATION OF EMPLOYMENT WITHOUT REASONABLE CAUSE; OR * SATISFYING A 24 MONTH NON-COMPETE PERIOD FOLLOWING HIS/HER TERMINATION OF EMPLOYMENT. PAYMENT FOLLOWS THE BEFORE MENTIONED EVENTS, EXCEPT IN THE CASE OF INVOLUNTARY SEPARATIONS FOR WHICH THE PARTICIPANT MUST WAIT 24 MONTHS TO RECEIVE THE PREVIOUSLY TAXED BENEFIT. PAYOUTS TO THE FOLLOWING EMPLOYEES WERE MADE DURING THE YEAR. THE AMOUNTS BELOW ARE INCLUDED IN THE AMOUNT REPORTED ON SCH J, PART II, COLUMN B(III) AND COLUMN (F). CRAFT, BRIAN 13,982 KING, JAMES K. 48,503 THORNSBERRY, MICHAEL D. 41,133 JACKSON, DAVID 11,705 PAI, AJITH 4,506 LLOYD, DAVID 8,587 TUCKER, REBECCA 6,532 NONQUALIFIED RETIREMENT PLAN - ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION KENNETH FINCH, PENNY JOHNSON, JESSE SUTTON, ED LAUE, MD, RONNY FORD, MD, SEAN LEMON, AND TAMMY ELLIS RECEIVED COMPENSATION FROM ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE TOP-TIER PARENT OF THE THE 49% OWNER OF THE FILING ORGANIZATION AND THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH PROVIDES SUPPLEMENTAL EXECUTIVE BENEFIT PLANS TO ELIGIBLE EXECUTIVES. IN 2020, ADVENTHEALTH RESTRUCTURED ITS EXECUTIVE SUPPLEMENTAL RETIREMENT AND BENEFIT PLANS TO REDUCE COMPLEXITY, TO INCREASE PREDICTABILITY OF BENEFITS AND TO CONSOLIDATE MULTIPLE SUPPLEMENTAL EXECUTIVE BENEFIT PLANS INTO ONE PLAN. EFFECTIVE 1/1/2020, A NEW SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP III) WAS ADOPTED AND THE THREE EXISTING PLANS, DESCRIBED BELOW, WERE AMENDED AND RESTATED. THE NEWLY ADOPTED SERP III PLAN, AS WELL AS THE AMENDED AND RESTATED PLANS, WERE REVIEWED AND APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. SERP III PLAN (EFFECTIVE 1/1/2020): TO RECOGNIZE THE CONTRIBUTION EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH AND TO RECOGNIZE THE LIMITATIONS AVAILABLE TO EXECUTIVES IN QUALIFIED RETIREMENT PLANS DUE TO COMPENSATION LIMITS SET ON SUCH PLANS, ADVENTHEALTH ADOPTED A NEW SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP III) IN 2020. THE SERP III PLAN EFFECTIVELY REPLACES THE PRIOR SERP II PLAN, THE EXECUTIVE FLEX BENEFIT PROGRAM PLAN, AND THE SENIOR EXECUTIVE DEATH BENEFIT PLAN FOR QUALIFIED EXECUTIVES EXCEPT FOR CERTAIN GRANDFATHERED EXECUTIVE EMPLOYEES. THE SERP III PLAN PROVIDES ELIGIBLE EXECUTIVES A PERCENTAGE OF THEIR BASE PAY, WHICH IS CREDITED TO A DEFERRED COMPENSATION ACCOUNT. THE PLAN ALSO PROVIDES FOR COMPENSATION DEFERRAL AND SELECTION OF LIFE INSURANCE COVERAGE AND LONG-TERM CARE INSURANCE. TO BE ELIGIBLE TO PARTICIPATE IN THE SERP III PLAN, EXECUTIVES MUST BE ON THE AHSSHC CORPORATE PAYROLL AND BE EITHER A CEO OF AN ADVENTHEALTH ENTITY, AN AHSSHC VICE PRESIDENT (VP) OR VP OF AN ADVENTHEALTH ENTITY WITH A BASE SALARY OF AT LEAST $290,000 IN 2021 (ADJUSTED ANNUALLY BY THE SAME PERCENTAGE AS IRC SECTION 401(A)(17) LIMIT INCREASES), OR OTHER LEADER SPECIFICALLY APPROVED BY THE ADVENTHEALTH PRESIDENT. ELIGIBLE EXECUTIVES DO NOT INCLUDE GRANDFATHERED EXECUTIVES, MEANING THOSE EXECUTIVES WHO WOULD SATISFY ALL THE ELIGIBILITY REQUIREMENTS OF THE SERP II PLAN PRIOR TO DEC 31, 2027, HAD THE PLAN NOT BEEN AMENDED AND RESTATED AS OF JAN. 1, 2020. CONTRIBUTION CREDITS WILL BE ESTABLISHED AND MAINTAINED BY CLASS YEAR ACCOUNTS FOR EACH PARTICIPANT USING TIERED CONTRIBUTION CREDIT PERCENTAGES OF ANNUAL BASE COMPENSATION. CONTRIBUTION CREDIT PERCENTAGES RANGE BETWEEN 15% AND 19% OF BASE COMPENSATION. CONTRIBUTION CREDITS WILL BE MADE EACH QUARTER IN 25% INCREMENTS WITH REDUCTIONS IN CONTRIBUTIONS IF THE EXECUTIVE IS ALSO A GRANDFATHERED FLEX PARTICIPANT (SEE BELOW). SERP III PROVIDES FOR A CLASS YEAR VESTING AND PAYMENT SCHEDULE (7 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S DEFERRED COMPENSATION ACCOUNT. UPON ATTAINMENT OF A NORMAL RETIREMENT AGE (AGE 62), OR UPON CERTAIN OTHER CIRCUMSTANCES AS DEFINED IN THE SERP III PLAN DOCUMENT, ALL DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT. FOR ANY EXECUTIVES WORKING BEYOND THE NORMAL RETIREMENT AGE, FUTURE EMPLOYER CONTRIBUTIONS WILL BE MADE QUARTERLY FROM SERP III DIRECTLY TO THE PARTICIPANT AS A TAXABLE CASH BONUS. SERP II PLAN (AMENDED AND RESTATED IN 2020): IN 2020, THE SERP II PLAN WAS AMENDED AND RESTATED TO PROVIDE THAT ELIGIBLE EMPLOYEES ARE RESTRICTED TO THOSE EXECUTIVES WHO, AS OF JANUARY 1, 2020, SATISFIED, OR IF EMPLOYMENT CONTINUES, WILL SATISFY THE ELIGIBILITY REQUIREMENTS OF SERP II PRIOR TO DECEMBER 31, 2027. THE SERP II PLAN IS A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO ADVENTHEALTH AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITALS OR HEALTH CARE INSTITUTIONS. UNDER THE PROVISIONS OF THE SERP II PLAN, BENEFITS ARE PROVIDED TO QUALIFYING EXECUTIVE PARTICIPANTS ON A PRO-RATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF ADVENTHEALTH AND/OR ANOTHER HOSPITAL OR HEALTH CARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP II) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE, FIVE OR SEVEN HIGHEST YEARS OF BASE SALARY FROM ADVENTHEALTH ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. THE NUMBER OF YEARS INCLUDED IN HIGHEST AVERAGE COMPENSATION IS DETERMINED BY THE INDIVIDUAL'S YEAR OF ENTRY TO SERP II AND BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM.
PART I, LINE 4B CONT'D:	FLEX PLAN (AMENDED AND RESTATED IN 2020): IN 2020, THE FLEX PLAN WAS AMENDED AND RESTATED TO EXCLUDE EMPLOYED EXECUTIVES WHO ARE HIRED OR PROMOTED AFTER A CERTAIN DATE FROM BEING ELIGIBLE TO PARTICIPATE IN THE FLEX PLAN EXCEPT FOR CERTAIN INSURANCE COVERAGE FEATURES OF THE PLAN. ADDITIONALLY, A PROVISION WAS ADDED TO PLACE A MAXIMUM LIMIT ON THE AMOUNT OF A PARTICIPANT'S ANNUAL FLEX ALLOWANCE TO NOT BE GREATER THAN A MAXIMUM DOLLAR AMOUNT OR PERCENTAGE OF COMPENSATION AS ESTABLISHED BY THE ADVENTHEALTH BENEFITS ADMINISTRATION COMMITTEE. THE FLEX PLAN WAS ORIGINALLY DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES AN OPPORTUNITY TO SELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING A SPLIT DOLLAR LIFE INSURANCE POLICY AND LONG-TERM CARE INSURANCE, TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. THE FLEX PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS IS DEDUCTED. THE BENEFITS ALLOWANCE CREDIT PERCENTAGE IS DETERMINED BY THE ADVENTHEALTH BENEFITS ADMINISTRATION COMMITTEE. FOR GRANDFATHERED ELIGIBLE EMPLOYEES, THE ANNUAL PRE-DETERMINED FLEX ALLOWANCE IS CONTRIBUTED AND ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED ARE, AT THE EMPLOYEE'S OPTION, CONTRIBUTED TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT WILL BE FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. WITH RESPECT TO GRANDFATHERED PARTICIPANTS, THE FLEX PLAN DOCUMENTS DEFINE ELIGIBLE EMPLOYEES TO INCLUDE THE CHIEF EXECUTIVE OFFICERS OF ADVENTHEALTH ENTITIES AND VICE PRESIDENTS OF ALL ADVENTHEALTH ENTITIES WHOSE BASE SALARY WAS AT LEAST EQUAL TO THE INTERNAL REVENUE CODE SECTION 401(A)(17) COMPENSATION LIMIT EACH YEAR. SENIOR EXECUTIVE DEATH BENEFIT PLAN (SEDB) (AMENDED AND RESTATED IN 2020): THE SEDB PLAN WAS ORIGINALLY DESIGNED TO PROVIDE A BENEFIT IN AN AMOUNT EQUAL TO THE AMOUNT THE EXECUTIVE'S BENEFIT WOULD HAVE BEEN UNDER THE SERP II PLAN ASSUMING THAT, ON THE DATE OF THE EXECUTIVE'S DEATH (AND NOT BEFORE), THE EXECUTIVE SATISFIED THE LAST OF THE ELIGIBILITY REQUIREMENTS OF THE SERP II PLAN WITH PRESENT VALUE RECOGNIZING AN EARLY BENEFIT COMMENCEMENT. IN CONJUNCTION WITH THE AMENDMENT AND RESTATEMENT OF THE SERP II PLAN, THE SEDB WAS SIMILARLY AMENDED IN 2020 TO LIMIT ELIGIBLE EMPLOYEES TO ONLY THOSE WHO EITHER SATISFY THE ELIGIBILITY REQUIREMENTS OF SERP II AS OF JANUARY 1 2020, OR REMAIN IN ACTIVE EMPLOYMENT AND WILL SATISFY THOSE REQUIREMENTS PRIOR TO DECEMBER 31, 2027. AN ELIGIBLE EXECUTIVE BECOMES A PARTICIPANT IN THE SEDB PLAN IF THE EXECUTIVE DIES PRIOR TO TERMINATION OF EMPLOYMENT, PROVIDED THE EXECUTIVE HAS NOT SATISFIED ALL THE ELIGIBILITY REQUIREMENTS OF SERP II AS OF THE EXECUTIVE'S DATE OF DEATH BUT WOULD HAVE SATISFIED ALL THOSE REQUIREMENTS WITHIN FIVE (5) YEARS FOLLOWING DEATH HAD THE EXECUTIVE LIVED AND CONTINUED EMPLOYMENT. THE SEDB PLAN WILL TERMINATE AUTOMATICALLY AFTER DECEMBER 31, 2027. FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. JOHNSON,PENNY $ 90,531 $ 77,160 $ 1,239,962 $ 0 SUTTON,JESSE $ 30,466 $ 27,784 $ 0 $ 0 LAUE,MD,ED $ 44,721 $ 21,755 $ 0 $ 0 FORD,MD,RONNY $ 0 $ 0 $ 0 $ 23,192 * INCLUDING INVESTMENT EARNINGS
FORM 990, PART VII, SECTION A, LINE 5:	KENNETH FINCH, FORMER CEO, PENNY JOHNSON, CEO, JESSE SUTTON, CFO, SEAN LEMON, COO, ED LAUE, MD, FORMER CMO, RONNY FORD, MD, CMO, AND TAMMY ELLIS, CNO, WERE COMPENSATED BY AHSSHC IN 2021 FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. PLEASE SEE OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 3 FOR A DISCUSSION CONCERNING THE FILING ORGANIZATIONS AFFILIATION WITH AHSSHC. COMPENSATION FOR KENNETH FINCH, PENNY JOHNSON, JESSE SUTTON, SEAN LEMON, ED LAUE, MD, RONNY FORD, MD, AND TAMMY ELLIS IS DISCLOSED IN SCHEDULE J, PART II. COMPENSATION FOR PENNY JOHNSON, JESSE SUTTON, AND TAMMY ELLIS REFLECTS COMPENSATION FOR SERVICES PROVIDED TO THE FILING ORGANIZATION AND RELATED ENTITIES. THESE EXECUTIVES ALSO PROVIDE SERVICES TO AHHSSHC AFFILIATES, WHICH ARE UNRELATED, AND ARE NOT REFLECTED IN THIS RETURN.

Schedule J (Form 990) 2021

Additional Data

Software ID:
Software Version:

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SCHEDULE O
(Form 990)

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.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

TEXAS HEALTH HUGULEY INC

Employer identification number

45-2694620

Return Reference	Explanation
PART V, LINE 1A:	EFFECTIVE JANUARY 1, 2012, TEXAS HEALTH HUGULEY, INC. (THE FILING ORGANIZATION) ENTERED INTO A MANAGEMENT SERVICES AGREEMENT WITH ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). A 501(C)(3) SUBSIDIARY HOSPITAL ORGANIZATION OF AHSSHC, ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI), OWNS A 49% MEMBER INTEREST IN THE FILING ORGANIZATION. AHSSHC HAS ESTABLISHED A SHARED SERVICE CENTER TO CENTRALIZE THE ACCOUNTS PAYABLE (A/P) FUNCTION FOR ALL AHSSHC SUBSIDIARY ORGANIZATIONS. THE FILING ORGANIZATION HAS ENTERED "0" IN PART V, LINE 1A BECAUSE THE FILING ORGANIZATION NO LONGER ISSUES FORM 1099 RETURNS, RATHER, ALL SUCH RETURNS ARE FILED BY AND UNDER THE NAME AND EIN OF AHSSHC AS THE PAYOR SUBJECT TO THE INFORMATION REPORTING REQUIREMENTS OF SECTION 6041. THE FACTS AND CIRCUMSTANCES SUPPORT A POSITION THAT AHSSHC, AS A PAYOR ON BEHALF OF ITS SUBSIDIARY ORGANIZATIONS IN A SHARED SERVICE ENVIRONMENT, WILL HAVE SUFFICIENT MANAGEMENT AND OVERSIGHT IN CONNECTION WITH THE SUBSIDIARY ORGANIZATIONS' PAYMENTS TO MEET THE STANDARD SET FORTH IN TREAS. REG. SECTION 1.6041-1(E). AHSSHC WILL NOT MERELY BE MAKING PAYMENTS AT THE DIRECTION OF ITS SUBSIDIARY ORGANIZATIONS. ACCORDINGLY, AHSSHC IS CONSIDERED THE PAYOR SUBJECT TO THE INFORMATION REPORTING REQUIREMENTS OF SECTION 6041.
FORM 990, PART VI, SECTION A, LINE 1A	THE MEMBERS OF THE BOARD OF DIRECTORS LISTED ON PART VII OF THIS FORM 990 INCLUDE THE FILING ORGANIZATION'S GOVERNING BOARD AND THE MEMBERS OF THE FILING ORGANIZATION'S HOSPITAL BOARD. THE HOSPITAL BOARD IS PRIMARILY RESPONSIBLE FOR MATTERS OF THE HOSPITAL INVOLVING THE OVERSIGHT OF MEDICAL STAFF (INCLUDING THE REVIEW AND APPROVAL OF MEDICAL STAFF BYLAWS, AND APPROVAL OF APPOINTMENTS TO AND DISMISSALS FROM THE MEDICAL STAFF), CARE OF PATIENTS, IMPROVEMENTS TO LAND, BUILDINGS AND EQUIPMENT, QUALITY ASSESSMENT AND IMPROVEMENT PROGRAMS IMPLEMENTED AT THE HOSPITAL AND RISK MANAGEMENT FUNCTIONS.
FORM 990, PART VI, SECTION A, LINE 3	EFFECTIVE JANUARY 1, 2012, TEXAS HEALTH HUGULEY, INC. (THE FILING ORGANIZATION) ENTERED INTO A MANAGEMENT SERVICES AGREEMENT WITH ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 30 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND A NUMBER OF OTHER HEALTH CARE FACILITIES THAT OPERATED IN 10 STATES WITHIN THE U.S. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). A 501(C)(3) SUBSIDIARY HOSPITAL ORGANIZATION OF AHSSHC, ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI), OWNS A 49% MEMBER INTEREST IN THE FILING ORGANIZATION. UNDER THE MANAGEMENT SERVICES AGREEMENT (THE AGREEMENT), AHSSHC MUST FOLLOW THE POLICIES OF THE FILING ORGANIZATION'S BOARD OF DIRECTORS. MANAGERIAL SERVICES PROVIDED BY AHSSHC INCLUDED OVERSIGHT AND DAY TO DAY MANAGEMENT OF THE FILING ORGANIZATION'S HOSPITAL, INCLUDING THE FOLLOWING FUNCTIONS: PERSONNEL ADMINISTRATION, INCLUDING RECRUITMENT, HIRING, TRAINING, PROMOTING, DIRECTING AND TERMINATING PERSONNEL; PROCUREMENT, INCLUDING THE ACQUISITION OF FOOD AND BEVERAGE ITEMS, SUPPLIES, DEVICES, FURNITURE, AND MEDICAL EQUIPMENT; HEALTH INFORMATION MANAGEMENT; MAINTENANCE AND SECURITY; CONTRACTING FOR SERVICES AND CONSULTING SERVICES; FINANCIAL ACCOUNTING SYSTEMS; DEVELOPMENT OF OPERATIONAL AND CAPITAL BUDGETS; BILLING AND COLLECTION OF RECEIVABLES AND REMITTANCES OF PAYABLES; PATIENT SAFETY AND QUALITY SYSTEMS; MARKETING; REGULATORY COMPLIANCE; ADMINISTRATION - POLICIES AND PROCEDURES, INCLUDING APPOINTMENT OF THE CFO, COO, AND CNO. THE INDIVIDUALS WHO SERVE AS OFFICERS OF THE FILING ORGANIZATION IN THE ROLES OF CEO, CFO, COO, CMO, AND CNO ARE LISTED IN PART VII, SECTION A. IN 2021, THESE INDIVIDUALS WERE COMPENSATED BY AND ON THE PAYROLL OF AHSSHC FOR SERVICES RENDERED TO THE FILING ORGANIZATION. THEIR COMPENSATION HAS BEEN REPORTED ON PART VII AND SCHEDULE J IN ACCORDANCE WITH THE INSTRUCTIONS FOR PART VII, SECTION A, LINE 5.
FORM 990, PART VI, SECTION A, LINE 6	THE ARTICLES OF INCORPORATION OF THE FILING ORGANIZATION PROVIDE THAT 51% OF THE MEMBERSHIP IN THE FILING ORGANIZATION SHALL BE HELD BY TEXAS HEALTH RESOURCES, THE SOLE CLASS A MEMBER, AND 49% OF THE MEMBERSHIP IN THE FILING ORGANIZATION SHALL BE HELD BY ADVENTIST HEALTH SYSTEM/SUNBELT, INC. (AHSSI), THE SOLE CLASS B MEMBER. BOTH AHSSI AND THR ARE EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN THH.
FORM 990, PART VI, SECTION A, LINE 7A	THE MEMBERS OF THE BOARD OF DIRECTORS (GOVERNING BOARD) OF THE FILING ORGANIZATION ARE APPOINTED BY THR (MAJORITY MEMBER) AND AHSSI (MINORITY MEMBER). THE MAJORITY MEMBER IS ENTITLED TO ELECT THREE DIRECTORS TO THE BOARD OF THE FILING ORGANIZATION AND THE MINORITY MEMBER IS ENTITLED TO ELECT TWO DIRECTORS TO THE BOARD. IN ADDITION, THE MEMBERSHIP SHALL APPOINT FOR THE HOSPITAL A COMMUNITY HOSPITAL BOARD TO OVERSEE THE OPERATIONS OF THE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B	CERTAIN GOVERNANCE POWERS ARE RESERVED TO THE MEMBERS OF THE FILING ORGANIZATION. THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION DESCRIBE THOSE MATTERS REQUIRING ONLY AN AFFIRMITIVE VOTE OF THE CLASS A MEMBER (THR), THOSE MATTERS REQUIRING ONLY AN AFFIRMATIVE VOTE OF THE CLASS B MEMBER (AHSSI) AND THOSE MATTERS REQUIRING A SUPERMAJORITY VOTE OF THE MEMBERS. A SUPERMAJORITY VOTE REQUIRES AN AFFIRMATIVE VOTE OF NOT LESS THAN 52% OF THE OUTSTANDING MEMBERSHIP INTERESTS. THE RESERVED POWERS REQUIRING AN AFFIRMATIVE VOTE OF ONLY THE CLASS A MEMBER, THR, INCLUDE THE FOLLOWING: 1) TO APPROVE OR AMEND MANAGED CARE CONTRACTS TO WHICH THE FILING ORGANIZATION IS A PARTICIPATING PROVIDER; 2) TO APPROVE THE STRATEGIC PLANS OF THE FILING ORGANIZATION; 3) TO APPROVE THE ANNUAL OPERATING PLANS AND OPERATING AND CAPITAL BUDGET OF THE FILING ORGANIZATION; AND 4) TO APPROVE THE SELECTION, REMOVAL AND/OR MODIFICATION OF THE AUTHORITY AND RESPONSIBILITIES OF LAWYERS, ACCOUNTANTS AND OTHER ADVISORS AND CONSULTANTS TO THE FILING ORGANIZATION THAT ARE NOT OTHERWISE IDENTIFIED IN THE APPROVED ANNUAL OPERATING BUDGET. THE RESERVED POWERS REQUIRING AN AFFIRMATIVE VOTE OF ONLY THE CLASS B MEMBER, AHSSI, INCLUDE THE FOLLOWING: 1) TO APPROVE CHANGES TO THE MISSION, VISION, OR VALUES OF THE HOSPITAL; 2) TO APPROVE CHANGES TO RELIGIOUS AFFILIATION OF HOSPITAL; AND 3) TO APPROVE CHANGES TO OPERATIONAL POLICIES, PLANS, PROCEDURES THAT ARE SPECIFICALLY RELATED TO THE HOSPITAL'S RELIGIOUS AFFILIATION WITH THE SEVENTH-DAY ADVENTIST CHURCH. BOTH THR, THE MAJORITY MEMBER, AND AHSSI, THE MINORITY MEMBER HAVE THE RESERVED POWER TO TERMINATE THE APPOINTMENT OF THE INDIVIDUAL HOLDING THE OFFICE OF PRESIDENT/CEO. THE FOLLOWING MATTERS REQUIRE A SUPERMAJORITY VOTE OF THE MEMBERSHIP: 1) TO AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; 2) TO CHANGE THE NAME OF THE HOSPITAL; 3) TO ADD NEW CORPORATE MEMBERS OF THE FILING ORGANIZATION; 4) TO APPOINT AND REMOVE THE HOSPITAL BOARD; 5) TO APPROVE DISTRIBUTIONS OF CASH AND OTHER PROPERTY; 6) TO APPROVE THE BORROWING OF MONEY OR OTHERWISE COMMITTING THE CREDIT OF THE FILING ORGANIZATION FOR CORPORATE ACTIVITIES, AND THE VOLUNTARY PREPAYMENT OR EXTENSION OF DEBT IN EXCESS OF $200,000; 7) TO ADOPT AND THEREAFTER AMEND QUALITY AND/OR RISK MANAGEMENT PLANS; 8) TO APPROVE THE TRANSFER OF CORPORATE PROPERTY HAVING A VALUE IN EXCESS OF $500,000; 9) TO APPROVE ANY SALE, LEASE, TRANSFER, MERGER OR CONSOLIDATION OF THE FILING ORGANIZATION WITH A THIRD PARTY; 10) TO DISSOLVE THE FILING ORGANIZATION; 11) TO APPROVE THE FORMATION OF ANY SUBSIDIARY OF THE FILING ORGANIZATION OR APPROVE THE FILING ORGANIZATION ENTERING INTO ANY AFFILIATION OR JOINT VENTURE AGREEMENT; AND 12) TO APPROVE ANY SINGLE CAPITAL BUDGET ITEM OF $1,000,000 (OR MORE).
FORM 990, PART VI, SECTION B, LINE 11B	THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE CEO, CFO, AND BOARD CHAIRMAN PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THESE INDIVIDUALS DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990, BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES.
FORM 990, PART VI, SECTION B, LINE 12C	THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR ANY PRINCIPAL OFFICER OF THE FILING ORGANIZATION (I.E. INTERESTED PERSONS) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTERESTS POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES.
FORM 990, PART VI, SECTION C, LINE 19	THE FINANCIAL STATEMENTS OF THE FILING ORGANIZATION, ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT GENERALLY MADE AVAILABLE TO THE PUBLIC AS A WHOLE.
PART VII, SECTION A, COLUMN (B)	FOR THOSE BOARD OF DIRECTOR MEMBERS WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN COLUMN (B) ON PAGE 7 OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) ON PAGE 7 WERE PROVIDED IN CONJUNCTION WITH THAT PERSON'S RESPONSIBILITIES AND ROLES IN SERVING IN AN EXECUTIVE LEADERSHIP POSITION WITHIN THR. PHYSICIAN MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS AS A RESULT OF PROVIDING VARIOUS MEDICAL SERVICES TO THOSE RELATED ENTITIES. ADDITIONALLY, COMPENSATION FOR PENNY JOHNSON, JESSE SUTTON, AND TAMMY ELLIS DOES NOT REFLECT SERVICES PROVIDED TO AFFFILIATES OF AHSSHC, WHICH ARE NOT RELATED TO THE TAXPAYER.
PART VIII, LINES 7A, B AND C:	THE AMOUNT SHOWN IN PART VIII, LINE 7C(I) OF THE FORM 990 REPRESENTS AN ALLOCATED SHARE OF CAPITAL GAIN/(LOSS) FROM A SYSTEM WIDE, CORPORATE ADMINISTERED, INVESTMENT PROGRAM.
FORM 990, PART IX, LINE 11G	PAYMENTS TO HEALTHCARE PROFESSIONALS: PROGRAM SERVICE EXPENSES 15,594,315. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,594,315. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,448,578. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,448,578. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 3,140,769. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,140,769. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 1,404,078. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,404,078. TRANSCRIPTION SERVICES: PROGRAM SERVICE EXPENSES 46,829. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 46,829. RECRUITING: PROGRAM SERVICE EXPENSES 470,538. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 470,538. LEASED PERSONNEL COSTS: PROGRAM SERVICE EXPENSES 109,796,342. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 109,796,342. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,797,371. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,797,371. ADVENTHEALTH MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,833,719. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,833,719. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,166,018. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,166,018. ADVENTHEALTH SHARED SERVICE FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,653,825. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,653,825. LEASED PERSONNEL COSTS MGMT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,904,572. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,904,572.
PART X, LINE 2	THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER PARENT. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE.
FORM 990, PART XI, LINE 9:	TRANSFER FROM RELATED AND AFFILIATED ENTITIES 4,171,165. RESTRICTED GIFTS 28,081. OTHER -16,573. ROUNDING -1.
FORM 990, PART XII, LINE 3B:	FOR THE 2020 FISCAL YEAR ENDING DECEMBER 31, 2020, TEXAS HEALTH HUGULEY, INC. WAS SUBJECT TO THE SINGLE AUDIT REQUIREMENTS, AS SET FORTH IN THE REGULATIONS AT 2 CFR PART 200, SUBPART F. AS A CALENDAR YEAR TAXPAYER, THE DEADLINE TO COMPLETE AND SUBMIT THE SINGLE AUDIT REPORTING PACKAGE TO THE FEDERAL AUDIT CLEARINGHOUSE, AS REQUIRED UNDER SUBPART F OF 2 CFR 200.501, IS SEPTEMBER 30, 2021. HOWEVER, ON MARCH 19TH, 2021, THE OFFICE OF MANAGEMENT AND BUDGET (OMB) ISSUED MEMORANDUM M21-20, WHICH OUTLINED THE OMB'S EFFORTS TO SUPPLEMENT THE SUPPORT IN THE AMERICAN RESCUE PLAN ACT OF 2021 (ARP), PROMOTE PUBLIC TRUST IN THE FEDERAL GOVERNMENT'S STEWARDSHIP OF TAXPAYER RESOURCES, AND ALLEVIATE SOME OF THE ADMINISTRATIVE CHALLENGES RELATED TO THE CORONAVIRUS PANDEMIC. AS PART OF THE ADMINISTRATIVE RELIEF INCLUDED IN MEMORANDUM M21-20, THE OMB PROVIDED A SIX-MONTH EXTENSION OF TIME TO COMPLETE AND SUBMIT THE SINGLE AUDIT REPORTING PACKAGE. THE EXTENDED REPORTING DEADLINE FOR CALENDAR YEAR TAXPAYERS IS MARCH 31, 2022.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

TEXAS HEALTH HUGULEY INC

Employer identification number

45-2694620

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(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	Yes	No
(1)HUGULEY MEDICAL ASSOCIATES 11801 SOUTH FREEWAY BURLESON,TX76028 75-2547668	PHYS. CLINIC	TX	501(C)(3)	LINE 3	TH HUGULEY	Yes
(2)NORTH TEXAS HEALTHY COMMUNITIES 612 E LAMAR BLVD ARLINGTON,TX76011 46-4513182	COMM SUPPORT	TX	501(C)(3)	LINE 7	TH RESOURCES		No
(3)SOUTHWESTERN HEALTH RESOURCES JOC 5323 HARRY HINES BLVD DALLAS,TX75390 81-1575989	MANAGEMENT ORG.	TX	501(C)(3)	LINE 12B	TH RESOURCES		No
(4)TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL 800 WEST RANDOL MILL RD ARLINGTON,TX76012 75-0972805	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(5)TEXAS HEALTH BACK CARE 9250 AMBERTON PKWY DALLAS,TX75243 47-4724257	PHYS. CLINIC	TX	501(C)(3)	LINE 10	TH PHYS GROUP		No
(6)TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE 10864 TEXAS HEALTH TRAIL FORT WORTH,TX76244 45-1502252	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(7)TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE 108 DENVER TRAIL AZLE,TX76020 75-1748586	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(8)TEXAS HEALTH HARRIS METHODIST HOSPITAL CLEBURNE 201 WALLS DR CLEBURNE,TX76033 75-1977850	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(9)TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH 1301 PENNSYLVANIA AVE FORT WORTH,TX76104 75-6001743	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(10)TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD 1600 HOSPITAL PARKWAY BEDFORD,TX76022 75-1438726	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(11)TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH 6100 HARRIS PARKWAY FORT WORTH,TX76132 75-2678857	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(12)TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE 411 BELKNAP STREET STEPHENVILLE,TX76401 75-1752253	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(13)TEXAS HEALTH HOSPITAL FRISCO 12400 DALLAS PKWY FRISCO,TX75033 83-1954982	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(14)TEXAS HEALTH HOSPITAL MANSFIELD 2300 LONE STAR RD MANSFIELD,TX76063 83-1869297	HOSPITAL	TX	501(C)(3)	LINE 3	TH HUGULEY	Yes
(15)TEXAS HEALTH HUGULEY INC 11801 S FREEWAY BURLESON,TX76028 45-2694620	HOSPITAL	FL	501(C)(3)	LINE 3	TH RESOURCES		No
(16)TEXAS HEALTH MEDICAL SUPPORT 612 E LAMAR BLVD ARLINGTON,TX76011 81-2833150	SPEC DRUGS	TX	501(C)(3)	LINE 10	TH RESOURCES		No
(17)TEXAS HEALTH PHYSICIANS GROUP 9250 AMBERTON PKWY DALLAS,TX75243 75-2613493	PHYS. CLINIC	TX	501(C)(3)	LINE 10	TH RESOURCES		No
(18)TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN 1105 CENTRAL EXPRESSWAY N ALLEN,TX75013 75-2890358	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(19)TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS 8200 WALNUT HILL LN DALLAS,TX75231 75-1047527	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(20)TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON 3000 NORTH INTERSTATE 35 DENTON,TX76201 43-2008974	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(21)TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN 850 ED HALL DRIVE KAUFMAN,TX75142 75-2771437	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(22)TEXAS HEALTH PRESBYTERIAN HOSPITAL PLANO 6200 W PARKER RD PLANO,TX75093 75-2770738	HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(23)TEXAS HEALTH RECOVERY AND WELLNESS CENTER 240 MILLER ROAD MANSFIELD,TX76063 81-2813227	RESD TRMT CTR	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(24)TEXAS HEALTH RESEARCH & EDUCATION INSTITUTE 612 E LAMAR BLVD ARLINGTON,TX76011 75-2562191	EDUC & RESEARCH	TX	501(C)(3)	LINE 4	TH RESOURCES		No
(25)TEXAS HEALTH RESOURCES 612 E LAMAR BLVD ARLINGTON,TX76011 75-2702388	SYSTEM MANAGEMENT	TX	501(C)(3)	LINE 12C	N/A		No
(26)TEXAS HEALTH RESOURCES FOUNDATION 612 E LAMAR BLVD ARLINGTON,TX76011 75-2022128	FUNDRAISING	TX	501(C)(3)	LINE 7	TH RESOURCES		No
(27)TEXAS HEALTH SPECIALTY HOSPITAL FORT WORTH 1301 PENNSYLVANIA AVE FORT WORTH,TX76104 75-1648589	LT HOSPITAL	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(28)TEXAS HEALTH URGENT CARE 3805 W UNIVERSITY PARK 100 MCKINNEY,TX75071 81-4317635	URGENT CARE CTR	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(29)TEXAS HEALTH VIRTUAL CARE 612 E LAMAR BLVD ARLINGTON,TX76011 87-3611585	VIRTUAL CARE	TX	501(C)(3)	LINE 3	TH RESOURCES		No
(30)WW WARD ENDOWMENT FUND TRUST 612 E LAMAR BLVD ARLINGTON,TX76011 75-6196065	NURSING GRANTS	TX	501(C)(3)	LINE 12A	TH FOUNDATION		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

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	(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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) AMH CATH LABS LLC 811 WRIGHT STREET ARLINGTON,TX76012 20-3003947	HOSPITAL	TX	N/A				No			No
(2) ARLINGTON SURGERY CENTER LLC 918 N DAVIS DRIVE ARLINGTON,TX76012 75-2055800	AMB SURG CTR	TX	N/A				No			No
(3) CLEBURNE SURGICAL CENTER LLC 2010 W KATHERINE P RAINES BLVD STE CLEBURNE,TX76033 20-3742012	AMB SURG CTR	TX	N/A				No			No
(4) CROSS TIMBERS SURGERY CENTER LLC 1001 N WALDROP DRIVE STE 705 ARLINGTON,TX76102 75-2862780	AMB SURG CTR	TX	N/A				No			No
(5) DENTON SURGERY CENTER LLC 207 NORTH BONNIE BRAE STREET DENTON,TX76201 47-0926556	AMB SURG CTR	TX	N/A				No			No
(6) FLOWER MOUND HOSPITAL PRTS LLC 4400 LONG PRAIRIE ROAD FLOWER MOUND,TX75028 26-0684968	HOSPITAL	TX	N/A				No			No
(7) FORT WORTH ENDOSCOPY CENTER LLC 900 W MAGNOLIA AVENUE 101 FORT WORTH,TX76104 77-0368346	ENDOSCOPY CENTER	TX	N/A				No			No
(8) GREENVILLE SURGERY CENTER LLC 7150 GREENVILLE AVENUE STE 200 DALLAS,TX75231 74-2411643	AMB SURG CTR	TX	N/A				No			No
(9) HEALTH IMAGING PARTNERS LLC 8610 EXPLORER DRIVE STE 300 COLORADO SPRINGS,CO80920 27-1385885	MEDICAL IMAGING	TX	N/A				No			No
(10) MANSFIELD ENDOSCOPY CENTER LLC 647 N MILLER ROAD MANSFIELD,TX76063 86-1354607	ENDOSCOPY CENTER	TX	N/A				No			No
(11) NORTH DALLAS SURGICAL CENTER LLC 17980 DALLAS PARKWAY STE 100 DALLAS,TX75287 27-2248103	AMB SURG CTR	TX	N/A				No			No
(12) OPTHALMOLOGY SURGERY CENTER OF DALLAS 10740 N CENTRAL EXPY DALLAS,TX75231 26-1914835	AMB SURG CTR	TX	N/A				No			No
(13) PARK HILL SURGERY CENTER LLC 3455 LOCKE AVENUE FORT WORTH,TX76107 45-1484375	AMB SURG CTR	TX	N/A				No			No
(14) PHYSICIAN MEDICAL CENTER LLC 6020 W PARKER ROAD PLANO,TX75093 48-1281376	HOSPITAL	TX	N/A				No			No
(15) PRESBYTERIAN CANCER CENTER-DALLAS LLC PO BOX 819067 DALLAS,TX75381 26-0422749	CANCER CTR	TX	N/A				No			No
(16) ROCKWALL REGIONAL HOSPITAL LLC 3150 HORIZON ROAD ROCKWALL,TX75032 20-2848116	HOSPITAL	TX	N/A				No			No
(17) SOUTH ARLINGTON SURGICAL PROVIDERS LLC 350 E INTERSTATE 20 STE 200 ARLINGTON,TX76018 75-2723958	AMB SURG CTR	TX	N/A				No			No
(18) SOUTHLAKE SPECIALTY HOSPITAL LLC 1545 E SOUTHLAKE BLVD SOUTHLAKE,TX76092 02-0555370	HOSPITAL	TX	N/A				No			No
(19) SURGICAL CAREGIVERS OF FORT WORTH LLC 2001 W ROSEDALE STREET FORT WORTH,TX76104 75-1925497	AMB SURG CTR	TX	N/A				No			No
(20) TEXAS HEALTH CRAIG RANCH SURGERY CENTER LLC 8080 STATE HWY 121 STE 100 MCKINNEY,TX75070 38-3897811	AMB SURG CTR	TX	N/A				No			No
(21) TEXAS HEALTH HUGULEY SURGERY CENTER LLC 12001 S FREEWAY BURLESON,TX76028 82-1289045	AMB SURG CTR	TX	N/A				No			No
(22) TEXAS HEALTH ORTHOPEDIC SURGERY CENTER ALLIANCE LLC 9848 N BEACH STREET FORT WORTH,TX76244 81-4977249	AMB SURG CTR	TX	N/A				No			No
(23) TEXAS HEALTH SPINE SURGERY CENTER ALLEN LLC 1120 RAINTREE CIRCLE STE 100 ALLEN,TX75013 30-0957868	AMB SURG CTR	TX	N/A				No			No
(24) TEXAS HEALTH SUPPLY CHAIN SERVICES LLC 612 E LAMAR BLVD STE 600 ARLINGTON,TX76011 84-1833532	PURCHASING CO	TX	N/A				No			No
(25) TEXAS HEALTH SURGERY CENTER ALLIANCE LLC 10840 TEXAS HEALTH TRAIL STE 100 FORT WORTH,TX76244 82-2296081	AMB SURG CTR	TX	N/A				No			No
(26) TEXAS HEALTH SURGERY CENTER BEDFORD LLC 1605 AIRPORT FREEWAY STE 100 BEDFORD,TX76021 82-1307876	AMB SURG CTR	TX	N/A				No			No
(27) TEXAS HEALTH SURGERY CENTER IRVING LLC 2120 N MACARTHUR BLVD STE 200 IRVING,TX75061 83-1085415	AMB SURG CTR	TX	N/A				No			No
(28) TEXAS HEALTH SURGERY CENTER WAXAHACHIE LLC 1434 US HWY 287 BYPASS STE 100 WAXAHACHIE,TX75165 83-1464243	AMB SURG CTR	TX	N/A				No			No
(29) TEXAS HEALTH SURGERY CENTER WILLOW PARK LLC 612 E LAMAR BLVD STE 600 ARLINGTON,TX76011 84-1953918	INACTIVE	TX	N/A				No			No
(30) TEXAS HLTH SPINE SURGERY CENTER ALLIANCE LLC 1545 E SOUTHLAKE BLVD STE 100 SOUTHLAKE,TX76092 32-0571301	AMB SURG CTR	TX	N/A				No			No
(31) TEXAS INSTITUTE FOR SURGERY LLP 7115 GREENVILLE AVENUE STE 100 DALLAS,TX75231 77-0628004	HOSPITAL	TX	N/A				No			No
(32) TH FLOWER MOUND ORTHOPEDIC SURGERY CENTER LLC 5000 LONG PRAIRIE ROAD FLOWER MOUND,TX75028 80-0866449	AMB SURG CTR	TX	N/A				No			No
(33) TH SURGERY CENTER CHISHOLM TRAIL LLC 5900 ALTAMESA BLVD FORT WORTH,TX76132 85-1225852	AMB SURG CTR	TX	N/A				No			No
(34) TH SURGERY CENTER PRESTON PLAZA LLC 17950 PRESTON ROAD STE 75 DALLAS,TX75252 20-3991622	AMB SURG CTR	TX	N/A				No			No
(35) TH SURGERY CENTER ROCKWALL LLC 3144 HORIZON ROAD STE 120 ROCKWALL,TX75032 47-4425996	AMB SURG CTR	TX	N/A				No			No
(36) TH SURGERY CENTER SW FORT WORTH LLC 6317 HARRIS PARKWAY STE 200 FORT WORTH,TX76132 84-3814490	AMB SURG CTR	TX	N/A				No			No
(37) THR-STT ROCKWALL ASC LLC 1545 E SOUTHLAKE BLVD SOUTHLAKE,TX76092 26-2429878	AMB SURG CTR	TX	N/A				No			No
(38) THR-STT SOUTHLAKE ASC LLC 1545 E SOUTHLAKE BLVD SOUTHLAKE,TX76092 20-1728912	AMB SURG CTR	TX	N/A				No			No
(39) USMD HOSPITAL AT ARLINGTON LP 801 I -20 WEST ARLINGTON,TX76017 73-1662763	HOSPITAL	TX	N/A				No			No
(40) USMD HOSPITAL AT FORT WORTH LP 5900 ALTAMESA BLVD FORT WORTH,TX76132 20-3571243	HOSPITAL CLOSED	TX	N/A				No			No
(41) WALNUT HILL SURGERY CENTER LLC 5494 GLEN LAKES DRIVE DALLAS,TX75231 36-4499777	AMB SURG CTR	TX	N/A				No			No
(42) WILSON CREEK SURIGCAL CENTER LLC 8855 SYNERGY DRIVE MCKINNEY,TX75070 27-4816583	AMB SURG CTR	TX	N/A				No			No
(43) WOMEN'S SPECIALTY SURGERY CENTER OF DALLAS LLC 8230 WALNUT HILL LANE STE 101 DALLAS,TX75231 26-2310072	AMB SURG CTR	TX	N/A				No			No

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?
(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	Yes	No
(1) GRACE INDEMNITY COMPANY SPC LTD 1159 CARIBBEAN PLAZA GRAND CAYMAN CJ 98-1209573	CAPTIVE INSURANCE	CJ	N/A	C					No
(2) TEXAS HEALTH BIOMEDICAL ADVANCEMENT CENTER INC 612 E LAMAR BLVD ARLINGTON,TX76011 75-2636884	RESEARCH	TX	N/A	C					No

Schedule R (Form 990) 2021

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

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 .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) HUGULEY MEDICAL ASSOCIATES	A	642,163	FMV RENT
(2) HUGULEY MEDICAL ASSOCIATES	Q	1,852,605	COST
(3) HUGULEY MEDICAL ASSOCIATES	R	5,442,365	ACTUAL AMOUNT TRANSFERRED
(4) HUGULEY MEDICAL ASSOCIATES	L	60,000	ACTUAL AMOUNT RECEIVED
(5) TEXAS HEALTH RESOURCES	S	1,822,500	ACTUAL AMOUNT RECEIVED
(6) TEXAS HEALTH HOSPITAL MANSFIELD	Q	1,929,825	COST
(7) TEXAS HEALTH HOSPITAL MANSFIELD	D	8,000,000	ACTUAL AMOUNT TRANSFERRED
(8) TEXAS HEALTH HOSPITAL MANSFIELD	S	6,530,207	ACTUAL AMOUNT RECEIVED
(9) TEXAS HEALTH HUGULEY SURGERY CENTER LLC	L	691,776	ACTUAL AMOUNT RECEIVED
(10) TEXAS HEALTH HUGULEY SURGERY CENTER LLC	Q	6,159,047	COST
(11) TEXAS HEALTH HUGULEY SURGERY CENTER LLC	R	104,733	ACTUAL AMOUNT TRANSFERRED
(12) TEXAS HEALTH HUGULEY SURGERY CENTER LLC	S	661,323	ACTUAL AMOUNT RECEIVED

Schedule R (Form 990) 2021

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE PROVISION OF MEDICAL CARE TO THE COMMUNITY THROUGH THE OPERATION OF A 327 BED HOSPITAL.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	58
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,143,493
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	350,519

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	5,124,103	4,898,439
9	Program service revenue (Part VIII, line 2g) .........	233,807,365	265,508,812
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,772,350	4,764,919
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,663,184	5,003,920
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	242,367,002	280,176,090
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	167,000	80,585
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)	2,421,478	2,255,955
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	204,233,339	228,782,174
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	206,821,817	231,118,714
19	Revenue less expenses. Subtract line 18 from line 12.......	35,545,185	49,057,376
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	261,729,508	308,074,574
21	Total liabilities (Part X, line 26).............	44,504,327	35,835,345
22	Net assets or fund balances. Subtract line 21 from line 20.....	217,225,181	272,239,229

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 216,179,794 including grants of $ 80,585 ) (Revenue $ 269,353,435 )
	OPERATION OF AN ACUTE CARE HOSPITAL TOTALING 327 BEDS WITH 11,582 PATIENT ADMISSIONS, 54,381 PATIENT DAYS, AND 124,891 OUTPATIENT VISITS IN THE CURRENT YEAR.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses216,179,794

(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/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) BACON KENNETH........................................................................ DIRECTOR/CHAIRMAN (BEG 03/21)	0.20 .......................50.00	X	0	0	0
(19) RANDOLPH KARSTEN........................................................................ DIRECTOR (BEG 08/21)	0.20 .......................50.00	X	0	0	0
(20) SHAW EDD KENNETH........................................................................ DIRECTOR (END 05/21)	0.20 .......................0.00	X	0	0	0
(21) CRAIG CARLOS........................................................................ DIRECTOR (BEG 05/21)	0.20 .......................0.00	X	0	0	0
(22) PATTERSON ANA........................................................................ DIRECTOR (BEG 07/21)	0.20 .......................0.00	X	0	0	0
(23) MOORE LARRY........................................................................ DIRECTOR (END 05/21)	0.20 .......................0.00	X	0	0	0
(24) SECHRIST SHERRI........................................................................ DIRECTOR	0.20 .......................0.00	X	0	0	0
(25) BOND JUSTIN........................................................................ DIRECTOR (BEG 01/21)	0.20 .......................0.00	X	0	0	0
(26) OWEN DALLAS........................................................................ DIRECTOR (BEG 01/21)	0.20 .......................0.00	X	0	0	0
(27) PAGE JOHN........................................................................ DIRECTOR (BEG 01/21)	0.20 .......................0.00	X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,332,274	6,065,388	1,070,090

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	4,873,110

f	All other contributions, gifts, grants, and similar amounts not included above		1f	25,329

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		4,898,439

		Business Code
2a	NET PATIENT REVENUE	622110	259,070,054	259,070,054
b	MEDICAL OFFICE BUILDING	622110	1,478,139	1,478,139
c	MANAGEMENT FEE REVENUE	622110	1,339,313	1,280,341	58,972
d	LAB REVENUE	622110	1,076,341		1,076,341
e	CAFETERIA REVENUE	622110	974,485	966,305	8,180
f	All other program service revenue.		1,570,480	1,570,480
g	Total. Add lines 2a–2f .....		265,508,812

3 Investment income (including dividends, interest, and othersimilar amounts) ......			2,276,553			2,276,553
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		15,804	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		15,804	6c
d	Net rental income or (loss).......			15,804			15,804
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	6,522	2,485,995	7a
b	Less: cost or other basis and sales expenses	4,151	0	7b
c	Gain or (loss)	2,371	2,485,995	7c
d	Net gain or (loss).........			2,488,366			2,488,366
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	EQUITY EARNINGS FROM RELATED ENTI		622110	4,988,116	4,988,116
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			4,988,116
12	Total revenue. See instructions.....			280,176,090	269,353,435	1,143,493	4,780,723

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	80,585	80,585
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,255,955		2,255,955
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	96,503		96,503
c	Accounting ...........	180,000		180,000
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	194,695		194,695
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	144,256,954	134,698,820	9,558,134
12	Advertising and promotion ....	241,794		241,794
13	Office expenses .......	3,736,603	2,615,757	1,120,846
14	Information technology ......	10,170,016	9,667,333	502,683
15	Royalties ..
16	Occupancy ...........	6,624,682	6,624,682
17	Travel ............	154,527		154,527
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	438,262		438,262
20	Interest ...........	3,023	3,023
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	10,891,923	10,891,923
23	Insurance ...	404,463	236,619	167,844
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	41,343,996	41,343,996
b	REPAIRS & MAINTENANCE	5,959,847	5,959,847
c	STATE TAX INDIGENT ASSE	3,928,106	3,928,106
d	UBI TAXES	-123,112		-123,112
e	All other expenses	279,892	129,103	150,789
25	Total functional expenses. Add lines 1 through 24e	231,118,714	216,179,794	14,938,920	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			5,902	1	5,899
2	Savings and temporary cash investments .........			67,265,618	2	78,624,995
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			33,953,004	4	34,398,478
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			5,993,295	8	6,667,846
9	Prepaid expenses and deferred charges ......			2,738,055	9	9,634,261
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	220,233,586
b	Less: accumulated depreciation	10b	78,405,415	127,508,881	10c	141,828,171
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			13,664,931	12	18,634,919
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			257,280	14	40,329
15	Other assets. See Part IV, line 11 ...........			10,342,542	15	18,239,676
16	Total assets. Add lines 1 through 15 (must equal line 33)...			261,729,508	16	308,074,574

17	Accounts payable and accrued expenses .....	9,491,617	17	7,162,487
18	Grants payable ...		18
19	Deferred revenue .........	24,652,107	19	16,668,223
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	10,360,603	25	12,004,635
26	Total liabilities. Add lines 17 through 25..	44,504,327	26	35,835,345

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	215,475,423	27	270,470,464
28	Net assets with donor restrictions ...........	1,749,758	28	1,768,765
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	217,225,181	32	272,239,229
33	Total liabilities and net assets/fund balances ........	261,729,508	33	308,074,574