SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
Medium right arrow Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow Attach to Form 990.
Medium right arrow Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
Texas Health Harris Methodist Hospital
Stephenville
Employer identification number

75-1752253
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    3,848,116 181,636 3,666,480 5.990 %
b Medicaid (from Worksheet 3, column a) . . . . .     8,244,276 10,667,082 0 0 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     127,070 197,973 0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     12,219,462 11,046,691 3,666,480 5.990 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     400,515   400,515 0.650 %
f Health professions education (from Worksheet 5) . . .     177,457   177,457 0.290 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     17,135   17,135 0.030 %
j Total. Other Benefits . .     595,107   595,107 0.970 %
k Total. Add lines 7d and 7j .     12,814,569 11,046,691 4,261,587 6.960 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
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     2,737   2,737 0 %
3 Community support     3,635   3,635 0.010 %
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building     13,156   13,156 0.020 %
7 Community health improvement advocacy     6,568   6,568 0.010 %
8 Workforce development            
9 Other            
10 Total     26,096   26,096 0.040 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
8,710,597
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
12,395,607
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
14,063,683
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-1,668,076
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
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)
Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Texas Health Stephenville
411 Belknap
Stephenville,TX76401
www.texashealth.org
TDH #000265
X X         X      
Schedule H (Form 990) 2023
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Schedule H (Form 990) 2023
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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 Stephenville
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 22
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
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.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 23
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): See Section C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2023
Page 5
Schedule H (Form 990) 2023
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Texas Health Stephenville
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
See Section C
b
See Section C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2023
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Schedule H (Form 990) 2023
Page 6
Part VFacility Information (continued)

Billing and Collections
Texas Health Stephenville
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2023
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Schedule H (Form 990) 2023
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Texas Health Stephenville
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2023
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Schedule H (Form 990) 2023
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
Part V, Section B Part V. Section B, Line 3e The significant health needs of the community are in line with the significant health needs that have been prioritized and identified in the current CHNA. Part V. Section B, Line 5 Texas Health Cleburne's (THC) 2022 CHNA was a collaborative process utilizing qualitative and quantitative methods to assess the health needs of persons within the service areas in the Southern Region, consisting of Erath, Johnson, Ellis & Kaufman Counties. The 2022 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 June 2021 and May 2022, the community's health needs were assessed through key informant interviews, secondary data analysis, focus groups and an asset-map. 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 sixty-seven community members with interests specific to the health of individuals in the Southern Region Counties in the CHNA development process. Fifty-seven of these community members were engaged across seven separate focus groups held in zip-codes that were identified as underserved areas. Ten served as key informants. Listening sessions were additionally held to understand opportunities for strengthening community collaborations. Through focus groups, key informant interviews and listening sessions, a community asset map was developed to provide an inventory of resources. 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: Christian Help Center, City of Ennis, Cleburne Fire Department, Cross Timbers Family Services, Erath County Extension, Johnson County Family Crisis Center, North Texas Behavioral Health Authority, Paluxy River Children's Advocacy Center, Senior Connect and Texas Department of State Health Services. Findings from all data sources (secondary data, interviews and focus groups, and asset mapping) were compared. Recurring themes were pulled and analyzed to stratify the top social determinant of health needs. The outlined needs/barriers informed the development of the 2023-2025 CHNA implementation strategy, which will leverage integrated strategies across THR's internal and external stakeholders to enhance its service and program delivery in the target communities. Part V. Section B, Line 6a The 2022 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. Part V. Section B, Lines 7a and 10a The most recently adopted implementation strategy and the CHNA is widely available on the following website at: https://www.texashealth.org/Community-Health/Community-Health-Needs-Assess ment Part V. Section B, Ln 11 The 2023 - 2025 implementation strategy focuses on reforming the delivery of our services in the target communities. The hospital is part of the Texas Health Resources (THR) healthcare system, which developed a system-wide community benefit strategy to increase its hospitals' ability to impact the community health needs of the target areas with a higher focus on three health priorities. Through the prioritization process these three health priorities from the 2022 CHNA were determined to be ongoing issues that THR hospitals needed to address: 1. Behavioral Health 2. Chronic Disease Prevention & Management 3. Access to Health Services and Healthcare Navigation & Literacy In 2023, Texas Health Stephenville addressed significant health needs identified in the 2022 CHNA using the following approaches: 1. Behavioral Health 1a. Texas Health Community Impact 1a1. Through a request for proposal (RFP) process by Texas Health Resources through its Texas Health Community Impact (THCI) Initiative, in the Southern region, one agency, CNM, was awarded a grant to address depression, anxiety, and food insecurity among underserved individuals in specific zip-codes in the hospital's region. 2. Chronic Disease Prevention & Management 2a. Healthy Education Lifestyle Program (HELP) 2a1. The Healthy Education Lifestyle Program (HELP) is an innovative way of delivering diabetes and hypertension management to uninsured populations. Every HELP visit is comprised of three key components: an individual visit with a mid-level practitioner, including necessary lab testing; an education session by the nurse to increase health literacy; and a support group facilitated by a nurse, which is crucial for establishing and ensuring accountability for improved health outcomes. The goal of HELP is to increase the percentage of diabetic patients whose A1c levels were improved, and the percentage of patients whose blood pressure were controlled based in the management/treatment guidelines. The implementation of the HELP virtual clinic at THC increased their ability to serve eligible patients and report clinical outcomes of improved A1c levels and blood pressure. 2b. Mobile Health 2b1. The Mobile Health program aims to improve access to quality preventive care services to adults 18+ years across Texas Health's service areas. Patients are seen across the several service types offered, including Mammograms, Wellness for Life (WFL), and Healthy Education Lifestyles Program (HELP). The WFL program provides colon cancer screenings, well female and well man exams, including cervical cancer screenings, and blood work to test for diabetes and cholesterol. The Mammogram service type provides mammograms and breast cancer screening services for women. The HELP program provides chronic disease management services to uninsured patients. 3. Access, Literacy, and Navigation (ALN) 3a. Health Workshops 3a1. Child Automobile Safety Initiative (CASI) is a program focused on protecting children from injury in motor vehicle collisions by providing free car seat safety checks and community-based education. 3a2. Flu vaccination clinics were offered to local parishes and city residents by the Faith Community Nurses. 3b. Faith Community Nursing 3b1. Faith Community Nursing is a system-wide program offered by Texas Health to link faith communities with health-related resources that focus on holistic care for the body, mind, and spirit. Emphasis is placed on equipping faith-based communities with the tools and resources to offer prevention and wellness support to care for the people they serve. The Texas Health Faith Community Nursing program offers classes and trainings in a variety of topics. These courses are taught to community partners/stakeholders, faith leaders, FCNs, HPs, and Texas Health Resources staff. 3b2. Flu vaccine clinics provided by the Texas Health Resource Faith Community Nurses focus on serving people and communities who would otherwise not have access to vaccines. Fulfilling our Mission to meet our consumers' needs where they work, live, play and pray is exemplified in the care provided in communities of faith and faith-based organizations across our service areas. Faith Community Nursing organizes clinics with the primary focus of serving people who do not have access to flu vaccines. Services are aligned with food pantries, congregations in CHNA zip codes, senior community members, and outreach ministries to underserved communities. Each site is open to the community. Through these efforts, thousands of individuals receive flu shots who otherwise would not have had access to one. All the priority health needs identified are being addressed by the hospital in the category listed above. Part V. Section B, Line 13 h Although a patient may have been notified of the Financial Assistance Policy, there are times when the patient chooses not to complete the Financial Assistance Application. Texas Health routinely screens uninsured patients using an independent third party for financial assistance eligibility. Part V. Section B, Lines 16 a, b & c The FAP, FAP Application and the Plain Language Summary of the FAP were widely available at this website: https://www.texashealth.org/Costs-and-Billing/Financial-Assistance
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2023
Page 9
Schedule H (Form 990) 2023
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?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2023
Page 10
Schedule H (Form 990) 2023
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 VI Supplemental Information Part I, Line 3c - Patient Eligibility Patients with family income at or below 200% of applicable Federal Poverty Guidelines (FPG) may be eligible for free care if the patient lacks sufficient funds and assets to pay the out-of-pocket portion of their hospital bill. Patients with a family income above 200% of applicable FPG who have unpaid medical bills exceeding a specified percentage of the patient's annual gross income, as determined on a sliding scale based on FPG, may be deemed medically indigent and eligible for charity care. The patient may be eligible for a charity adjustment up to 100% of the unpaid balance of their hospital bill in excess of a specified patient responsible amount if the patient has insufficient funds/assets to pay his hospital bill without incurring an undue financial hardship. The patient responsible amount is based on a percentage of the patient's annual income in relation to FPG. A determination as to whether or not a patient has insufficient funds and/or assets to pay for purposes of determining both financial and medical indigence is made at the time a patient's financial assistance application is reviewed. Assets considered when determining eligibility include cash, stocks, bonds and other financial assets that can be readily converted to cash. An additional process to screen for charity patients using publicly available financial information is also in place for patients not submitting a financial assistance application. Part I, Line 7 - Cost-to-Charge Ratio A cost-to-charge ratio is used to compute the amounts reported on Lines 7a-7c. The cost-to-charge ratio is derived from Worksheet 2 - Ratio of Patient Care Cost-to-Charges, as found in the Schedule H Instructions. The amounts reported on Lines 7e-7i were computed using direct costs, as determined by a cash outlay. Part II - Community Building The organization participates in community building activities that aim to address the disparities in the social determinants of health factors that influence the overall health and wellbeing of individuals in the communities Texas Health serves. As identified in the community health needs assessment, there are areas of need that are not aligned with the traditional operations of a hospital system. Our volunteerism, collaborations and partnership opportunities with various community-based organizations and coalitions foster our ability to address the social and environmental needs for the purpose of providing for the whole person beyond the clinical services. Part III, Lines 2, 3 & 4 - Bad Debts Bad debt expense is not included for purposes of reporting community benefits. Each patient qualifying for charity care is treated as a charity patient and no charges related to that patient are included in bad debt expense. The hospital is part of a consolidated system of hospitals which operate under the name Texas Health Resources (THR). THR's annual audit is conducted on a system-wide basis with a single consolidated audit report issued for THR and its affiliates. On pages 13-14 of the attached audited financial statements of THR, which includes the activity of the organization, is a footnote regarding Accounts Receivable and Net Patient Service Revenue. Part III, Line 8 - Medicare Shortfall The state of Texas treats any Medicare shortfall as a community benefit for meeting the state statutory requirements for charity care & community benefit. For state purposes, the shortfall is computed by comparing actual Medicare reimbursements with the estimated cost the hospital incurs in providing these services to Medicare patients. Cost is determined by applying a cost-to-charge ratio (with costs determined in accordance with generally accepted accounting principles) to billed charges. The shortfall amount reported to the state of Texas for 2023 is $9,499,787. Sch H requires a different method to calculate the Medicare shortfall shown on Part III, Lines 5-7. Part III, Line 9b - Debt Collection During the year, standard collection procedures were in place and uniformly applicable to all patient accounts. Except to the extent a patient receives a recovery from any third party or other source, no attempts are made to collect unpaid charges from patient accounts approved for adjustment under the Financial Assistance Policy. Part VI, Line 2 - Needs Assessment In 2022, Texas Health Resources (Texas Health) completed a community health needs assessment (CHNA) for 27 facilities across 5 regions using the following steps: - Demographic analysis by region - Secondary data analysis of health indicators to identify zip codes of highest-needs within each region and prioritize zip codes for the community impact initiative - Primary data collection via key informant interviews, focus groups, and a windshield survey - Synthesis of secondary and primary data to identify the most pressing health needs by region - Prioritization of health needs that Texas Health would focus on within the current CHNA cycle, resulting in the identification of these health needs: Behavioral health; Chronic disease prevention and management; and access, navigation, and health literacy. In addition to the CHNA, a community readiness assessment was conducted in 2023 to identify zip codes/communities that were ready to address the health and social needs in their communities within the next 3 years. Though this assessment key informant interviews were conducted across five regions. The interviews were then compiled, scored and analyzed to determine strengths and barriers within communities. To assess hospital utilization and health outcomes, a diagnosis code and hospital utilization dashboard was created. This dashboard compiles data from all major hospitals within the Dallas-Fort Worth region. The dashboard allows us to analyze demographics, insurance status, charge data and diagnoses codes by patient zip codes. Though this analysis, we have been able to assess which populations have a higher hospital utilization as well as determining which populations have a higher prevalence of certain diagnoses. The dashboard was recently used to determine zip codes where stroke education should be prioritized based on overall prevalence of stroke cases along with the percentage of patients that were self-pay. Through the CHNA report, transportation was identified for further assessment given that community members reported transportation as a barrier to healthcare access and other health-related issues. In 2023, an analysis of the availability of household transportation and the access to the public transportation system was completed to better understand transportation needs in our communities. This analysis has been compiled into a report that is being disseminated to various stakeholders to build appropriate action plans. Part VI, Line 3 - Patient Education A description of the Financial Assistance Policy (FAP), the Plain Language Summary of the FAP (PLS) and the FAP application are available on the THR website at www.TexasHealth.org in English and other languages. Financial assistance information is included in the patient's admission packets. Signs alerting patients of financial assistance and related contact information are posted in various areas of the hospital including admissions & registration and the emergency room. Additionally, financial assistance information is provided verbally and in writing to self-pay patients by financial counselors. As part of the financial counseling meeting, patients are screened for potential eligibility in other governmental assistance programs. If it is determined that the patient is potentially eligible for governmental assistance, the counselor will assist the patient in completing forms necessary to apply for the assistance. At the same time, patients are provided with a financial assistance application. The patient is informed that the hospital is offering financial assistance to patients deemed medically or financially indigent. The PLS is included on the back of our patient bills. The patient is informed of how to qualify for financial assistance, how to ask for help, necessary documentation, and THR's collection process. The onsite financial counselors may assist the patient in completing the application and obtain available verification information. The counselors will continue to contact the patient to ensure all forms and verifications needed to file an application for governmental assistance and financial assistance have been provided. In certain cases, self-pay patients who are discharged before seeing a financial counselor receive both a phone call and a letter to alert them to the existence of the FAP. Each bill sent for hospital services also contains contact information alerting patients that Texas Health has a FAP. Part VI, Line 4 - Community Information Texas Health Stephenville (THS) is located in a rural area with a population of more than 21,000 . The race and ethnicity composition of Erath County has 73.
Schedule H (Form 990) 2023
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