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ObjectId: 201723179349303402 - Submission: 2017-11-13
TIN: 75-1752253
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.
Attach to Form 990.
Information about Schedule R (Form 990) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
16
Open to Public Inspection
Name of the organization
Texas Health Harris Methodist Hospital
Stephenville
Employer identification number
75-1752253
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
Part II
Identification of Related Tax-Exempt Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
Johnson County Community Care Corp
612 E Lamar Blvd
Arlington
,
TX
76011
45-2793120
Support Org.
TX
501(c)(3)
12a
TH Cleburne
No
(2)
North Texas Healthy Communities
612 E Lamar Blvd
Arlington
,
TX
76011
46-4513182
Comm Support
TX
501(c)(3)
7
TH Resources
No
(3)
Southwestern Health Resources JOC
5323 Harry Hines Blvd
Dallas
,
TX
75390
81-1575989
Support Org.
TX
501(c)(3)
12b
TH Resources
No
(4)
Texas Health Arlington Memorial Hospital
800 West Randol Mill Rd
Arlington
,
TX
76011
75-0972805
Hospital
TX
501(c)(3)
3
TH Resources
No
(5)
Texas Health Back Care
9229 LBJ Freeway
Dallas
,
TX
75243
47-4724257
Phys. Clinic
TX
501(c)(3)
10
TH Phys Grou
No
(6)
TH Behavioral Health Hospital Corinth
612 E Lamar Blvd
Arlington
,
TX
76011
81-4317635
Hospital
TX
501(c)(3)
3
TH Resources
No
(7)
Texas Health Alliance
10864 Texas Health Trail
Fort Worth
,
TX
76244
45-1502252
Hospital
TX
501(c)(3)
3
TH Resources
No
(8)
Texas Health Azle
108 Denver Trail
Azle
,
TX
76020
75-1748586
Hospital
TX
501(c)(3)
3
TH Resources
No
(9)
Texas Health Cleburne
201 Walls Dr
Cleburne
,
TX
76033
75-1977850
Hospital
TX
501(c)(3)
3
TH Resources
No
(10)
Texas Health Fort Worth
1301 Pennsylvania Ave
Fort Worth
,
TX
76104
75-6001743
Hospital
TX
501(c)(3)
3
TH Resources
No
(11)
Texas Health Hurst-Euless-Bedford
1600 Hospital Parkway
Bedford
,
TX
76022
75-1438726
Hospital
TX
501(c)(3)
3
TH Resources
No
(12)
Texas Health Southwest Fort Worth
6100 Harris Parkway
Fort Worth
,
TX
76132
75-2678857
Hospital
TX
501(c)(3)
3
TH Resources
No
(13)
Texas Health Stephenville
411 Belknap
Stephenville
,
TX
76401
75-1752253
Hospital
TX
501(c)(3)
3
TH Resources
No
(14)
Texas Health Huguley Inc
11801 S Freeway
Burleson
,
TX
76028
45-2694620
Hospital
FL
501(c)(3)
3
TH Resources
No
(15)
Texas Health Medical Support
612 E Lamar Blvd
Arlington
,
TX
76011
81-2833150
Spec Drugs
TX
501(c)(3)
10
TH Resources
No
(16)
TX Health Outpatient Surg Ctr Alliance
10840 Texas Health Trail
Fort Worth
,
TX
76244
80-0800294
Hospital
TX
501(c)(3)
3
TH Alliance
No
(17)
Texas Health Physicians Group
9229 LBJ Freeway
Dallas
,
TX
75243
75-2613493
Phys. Clinic
TX
501(c)(3)
10
TH Resources
No
(18)
TH Recovery and Wellness Center
612 E Lamar Blvd
Arlington
,
TX
76011
81-2813227
Resd Trmt Ctr
TX
501(c)(3)
3
TH Resources
No
(19)
Texas Health Resources Foundation
612 E Lamar Blvd
Arlington
,
TX
76011
75-2022128
Fundraising
TX
501(c)(3)
7
TH Resources
No
(20)
Texas Health Allen
1105 Central Expressway N
Allen
,
TX
75013
75-2890358
Hospital
TX
501(c)(3)
3
TH Resources
No
(21)
Texas Health Dallas
8200 Walnut Hill Ln
Dallas
,
TX
75231
75-1047527
Hospital
TX
501(c)(3)
3
TH Resources
No
(22)
Texas Health Denton
3000 North Interstate 35
Denton
,
TX
76201
43-2008974
Hospital
TX
501(c)(3)
3
TH Resources
No
(23)
Texas Health Kaufman
850 Ed Hall Drive
Kaufman
,
TX
75142
75-2771437
Hospital
TX
501(c)(3)
3
TH Resources
No
(24)
Texas Health Plano
6200 W Parker Rd
Plano
,
TX
75093
75-2770738
Hospital
TX
501(c)(3)
3
TH Resources
No
(25)
TX Health Research & Education Institute
612 E Lamar Blvd
Arlington
,
TX
76011
75-2562191
Edu& Research
TX
501(c)(3)
4
TH Resources
No
(26)
Texas Health Resources
612 E Lamar Blvd
Arlington
,
TX
76011
75-2702388
Mgmt Supp Org
TX
501(c)(3)
12c
NA
No
(27)
TH Seay Behavioral Health Hospital
6110 W Parker Rd
Plano
,
TX
75093
81-2792484
Hospital
TX
501(c)(3)
3
TH Resources
No
(28)
TH Springwood Behavioral Health Hospital
2717 Tibbets Dr
Bedford
,
TX
76022
81-2798838
Hospital
TX
501(c)(3)
3
TH Resources
No
(29)
TH Specialty Hospital Fort Worth
1301 Pennsylvania Ave
Fort Worth
,
TX
76104
75-1648589
LT Hospital
TX
501(c)(3)
3
TH Resources
No
(30)
WW Ward Endowment Fund Trust
612 E Lamar Blvd
Arlington
,
TX
76011
75-6196065
Support Org.
TX
501(c)(3)
12a
TH Foundatio
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2016
Page 2
Schedule R (Form 990) 2016
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
AMH Cath Labs LLC
811 Wright St
Arlington
,
TX
76012
20-3003947
Hospital
TX
NA
N/A
(2)
Arlington Surgery Ctr LLC
918 N Davis Dr
Arlington
,
TX
76012
75-2055800
Amb Surg Ctr
TX
NA
N/A
(3)
Cleburne Imaging LLC
PO Box 820519
Dallas
,
TX
75382
46-0767278
Medical Imaging
TX
NA
N/A
(4)
Cleburne Surgical Ctr LLC
2010 W Katherine P Raines Blvd St
Cleburne
,
TX
76033
20-3742012
Amb Surg Ctr
TX
NA
N/A
(5)
Denton Surgery Ctr LLC
207 North Bonnie Brea
Denton
,
TX
76201
47-0926556
Amb Surg Ctr
TX
NA
N/A
(6)
Flower Mound Hospital Ptrs LLC
4400 Long Prairie Rd
Flower Mound
,
TX
75028
26-0684968
Hospital
TX
NA
N/A
(7)
Fort Worth Endoscopy Ctr LLC
900 W Magnolia Ave 101
Fort Worth
,
TX
76104
77-0368346
Endoscopy Ctr
TX
NA
N/A
(8)
FTH DFW Partners LLC
1401 E trinity Mills Rd
Carrollton
,
TX
75006
47-3426036
Hospital/ER
TX
NA
N/A
(9)
Greenville Surgery Ctr LLC
7150 Greenville Ave Ste 200
Dallas
,
TX
75231
74-2411643
Amb Surg Ctr
TX
NA
N/A
(10)
Health Imaging Ptrs LLC
8610 Explorer Drive Ste 300
Colorado Springs
,
CO
80920
27-1385885
Medical Imaging
TX
NA
N/A
(11)
North Dallas Surgical Ctr LLC
17980 Dallas Parkway Ste 100
Dallas
,
TX
75287
27-2248103
Amb Surg Ctr
TX
NA
N/A
(12)
Ophthalmology Surgery Ctr of Dallas LLC
10740 N Central Expressway Ste 400
Dallas
,
TX
75231
26-1914835
Amb Surg Ctr
TX
NA
N/A
(13)
Physician Medical Ctr LLC
6020 W Parker Rd
Plano
,
TX
75093
48-1281376
Hospital
TX
NA
N/A
(14)
Presbyterian Cancer Ctr-Dallas LLC
PO Box 819607
Dallas
,
TX
75381
26-0422749
Cancer Ctr
TX
NA
N/A
(15)
Rockwall Regional Hospital LLC
3150 Horizon Rd
Rockwall
,
TX
75032
20-2848116
Hospital
TX
NA
N/A
(16)
Southlake Specialty Hospital LLC
1545 E Southlake Blvd
Southlake
,
TX
76092
02-0555370
Hospital
TX
NA
N/A
(17)
Surgical Caregivers of Fort Worth LLC
2001 W Rosedale Street
Fort Worth
,
TX
76104
75-1925497
Amb Surg Ctr
TX
NA
N/A
(18)
Texas Health Craig Ranch Surgery Ctr LLC
8080 State Hwy 121 Ste 100
McKinney
,
TX
75070
38-3897811
Amb Surg Ctr
TX
NA
N/A
(19)
Texas Health Flower Mound Orthopedic Sur
5000 Long Prairie Road
Flower Mound
,
TX
75028
80-0866449
Amb Surg Ctr
TX
NA
N/A
(20)
TH Medsynergies LLC
909 Hidden Ridge Ste 300
Irving
,
TX
75038
80-0272951
Mgmt Services
TX
NA
N/A
(21)
TH Spine Center Arlington
1545 E Southlake Blvd Ste 100
Southlake
,
TX
76092
46-4143686
Amb Surg Ctr
TX
NA
N/A
(22)
TH Surgery Ctr Preston Plaza LLC
17950 Preston Road Ste 75
Dallas
,
TX
75252
20-3991622
Amb Surg Ctr
TX
NA
N/A
(23)
TH Surgery Ctr Rockwall LLC
569 Brookwood Village Ste 901
Birmingham
,
AL
35209
47-4425996
Inactive
TX
NA
N/A
(24)
Texas Institute for Surgery LLP
7715 Greenville Ave Ste 100
Dallas
,
TX
75231
77-0628004
Hospital
TX
NA
N/A
(25)
THR-STT Rockwall ASC LLC
1545 E Southlake Blvd
Southlake
,
TX
76092
26-2429878
Amb Surg Ctr
TX
NA
N/A
(26)
THR-STT Southlake ASC LLC
1545 E Southlake Blvd
Southlake
,
TX
76092
20-1728912
Amb Surg Ctr
TX
NA
N/A
(27)
USMD Hospital at Arlington LP
801 I -20 West
Arlington
,
TX
76017
73-1662763
Hospital
TX
NA
N/A
(28)
USMD Hospital at Fort Worth LP
5900 Altamesa Blvd
Fort Worth
,
TX
76132
20-3571243
Hospital
TX
NA
N/A
(29)
Wilson Creek Surigcal Ctr LLC
8855 Synergy Dr
McKinney
,
TX
75070
27-4816583
Amb Surg Ctr
TX
NA
N/A
(30)
Women's Specialty Surgery Ctr
8230 Walnut Hill Ln Ste 101
Dallas
,
TX
75231
26-2310072
Amb Surg Ctr
TX
NA
N/A
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
Huguley Medical Associates Inc
11801 South Freeway
Burleson
,
TX
76028
75-2547668
Phys Clinics
TX
NA
C Corp
No
(2)
Magnum Health Holdings Inc
612 E Lamar Blvd
Arlington
,
TX
76011
47-5486814
Inactive
TX
NA
C Corp
No
(3)
Texas Health Aetna Health Plan
612 E Lamar Blvd
Arlington
,
TX
76011
47-5548221
Inactive
TX
NA
C Corp
No
(4)
TH Biomedical Advancement Center Inc
612 E Lamar Blvd
Arlington
,
TX
76011
75-2636884
Research
TX
NA
C Corp
No
(5)
SWHR Specialty Programs Groups
612 E Lamar Blvd
Arlington
,
TX
76011
46-5588632
Inactive
TX
NA
C Corp
No
(6)
THR Primary Care Ext Physcian Network
612 E Lamar Blvd
Arlington
,
TX
76011
46-5365421
Inactive
TX
NA
C Corp
No
(7)
Texas Health Resources Spine Services
612 E Lamar Blvd
Arlington
,
TX
76011
46-5347751
Inactive
TX
NA
C Corp
No
(8)
Texas Health Resources Women's Services
612 E Lamar Blvd
Arlington
,
TX
76011
46-5330487
Inactive
TX
NA
C Corp
No
(9)
Charitable Remainder Trusts (4)
612 E Lamar Blvd
Arlington
,
TX
76011
46-5330487
CR Trust
TX
NA
Trust
No
(10)
Grace Indemnity Company Ltd
1159 Caribbean Plaza
Grand Cayman
KY 1-1102
CJ
98-1209573
Captive Insurance
CJ
NA
C Corp
No
Schedule R (Form 990) 2016
Page 3
Schedule R (Form 990) 2016
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
No
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
Yes
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
No
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
No
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
Yes
s
Other transfer of cash or property from related organization(s)
............................
1s
Yes
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
Schedule R (Form 990) 2016
Page 4
Schedule R (Form 990) 2016
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2016
Page 5
Schedule R (Form 990) 2016
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Related Transactions- Part V, Line 2
Texas Health Resources (THR) is the parent organization in a large healthcare system made up of both wholly owned entities as well as related controlled joint ventures as listed on Schedule R. THR's role is to plan, manage and coordinate the activities of the affiliated healthcare system in order to maximize opportunities to deliver cost effective quality medical care to residents of north central Texas. THR provides direction and oversight to its wholly owned affiliates through centralized services. They also provide oversight for the controlled joint ventures. As an integral part of providing centralized services to the affiliates, THR maintains intercompany receivable/payable accounts, most of which do not fall within the scope of IRC Section 512(b)(13). The range of centralized services provided by THR include information services, managed care contracting, Human resources, revenue cycle, billing and collections, patient access/admissions, legal, tax, compliance, supply chain, quality, business development, insurance, treasury, marketing, general accounting, real estate services, coding, transcription and strategic planning. In addition, THR does daily cash sweeps of all controlled tax exempt entity cash accounts. As a result, THR has numerous daily transactions with controlled tax exempt entities, none of which fall within the scope of IRC Section 512(b)(13). A management fee is charged for the centralized services and reported on Form 990, Part VII, Section B as a professional services fee. Transactions with related tax exempt organizations falling within the meaning of centralized services as described above, are not listed on Schedule R, Part V, Line 2.
Part II
Texas Health Behavioral Health Hospital Corinth has applied for tax exempt status. The application is currently pending.
Schedule R (Form 990) 2016
Additional Data
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