East Texas Medical Center Regional Healthcare System in Tyler, Texas (TX)

East Texas Medical Center Regional Healthcare System
Employer Identification Number (EIN)	751803327
Name of Organization	East Texas Medical Center Regional Healthcare System
Address	1000 S Beckham Ave, Tyler, TX 75701-1908
Activities	Other health services, Community health planning
Subsection	Charitable Organization
Ruling Date	04/2010
Deductibility	Contributions are deductible
Foundation	Organizations operated solely for the benefit of and in conjunction with organizations described in 10 through 16 above
Organization	Corporation
Exempt Organization Status	Unconditional Exemption
Tax Period	10/2013
Assets	$50,000,000 to greater
Income	$50,000,000 to greater
Filing Requirement	990 (all other) or 990EZ return
Asset Amount	$521,354,070
Amount of Income	$83,927,182
Form 990 Revenue Amount	$83,716,847
National Taxonomy of Exempt Entities (NTEE)	Health - General and Rehabilitative: Community Health Systems

Non-representatives - add comments:

Amount of income in 2013: $83,927,182

This organization:	$83,927,182
Other organizations performing similar types of work:	$6,791,313

Assets in 2013: $521,354,070

This organization:	$521,354,070
Other organizations performing similar types of work:	$5,000,000

Expenses in 2013: $84,245,241

This organization:	$84,245,241
Other organizations performing similar types of work:	$5,603,496

Income to expenses ratio in 2013: 1.0

East Texas Medical Center Regional Healthcare System:	1.0
Other organizations performing similar types of work:	1.1

Expenses allocated to program services in 2007: 79.5%

East Texas Medical Center Regional Healthcare System:	79.5%
Other organizations performing similar types of work:	86.4%

Grants share in income in 2013: 0.0%

This organization:	0.0%
Other organizations performing similar types of work:	0.5%

Financial snapshot ($)

Revenue for 2013

Assets at the end of 2013

Functional expenses for 2013

	2012	2013
Checklist
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?	No	No
Is the organization required to complete Schedule B, Schedule of Contributors?	No	No
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office?	No	No
Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year?	No	No
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19?	No	No
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts?	No	No
Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures?	No	No
Did the organization maintain collections of works of art, historical treasures, or other similar assets?	No	No
Did the organization report an amount for escrow or custodial account liability; serve as a custodian or provide credit counseling, debt management, credit repair, or debt negotiation services?	No	No
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments?	No	No
Did the organization report an amount for land, buildings, and equipment?	Yes	Yes
Did the organization report an amount for investments-other securities that is 5% or more of its total assets?	No	No
Did the organization report an amount for investments-program related that is 5% or more of its total assets?	No	No
Did the organization report an amount for other assets that is 5% or more of its total assets?	Yes	Yes
Did the organization report an amount for other liabilities?	Yes	Yes
Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)?	No	No
Did the organization obtain separate, independent audited financial statements for the tax year?	No	No
Was the organization included in consolidated, independent audited financial statements for the tax year?	Yes	Yes
Is the organization a school described in section 170(b)(1)(A)(ii)?	No	No
Did the organization maintain an office, employees, or agents outside of the United States?	No	No
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more?	No	No
Did the organization report more than $5,000 of grants or other assistance to or for any foreign organization?	No	No
Did the organization report more than $5,000 of aggregate grants or other assistance to or for foreign individuals?	No	No
Did the organization report a total of more than $15,000 of expenses for professional fundraising services?	No	No
Did the organization report more than $15,000 total of fundraising event gross income and contributions?	No	No
Did the organization report more than $15,000 of gross income from gaming activities?	No	No
Did the organization operate one or more hospital facilities?	No	No
Did the organization attach a copy of its audited financial statements?	No	No
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government?	Yes	Yes
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals?	No	No
Did the organization answer 'Yes' about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees?	Yes	Yes
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002?	Yes	Yes
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?	No	No
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?	No	No
Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year?	No	No
Did the organization engage in an excess benefit transaction with a disqualified person during the year?	No	No
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?	No	No
Did the organization report any amount for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?	No	No
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons?	No	No
Was the organization a party to a business transaction with one of the following parties
A current or former officer, director, trustee, or key employee?	Yes	Yes
A family member of a current or former officer, director, trustee, or key employee?	Yes	Yes
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner?	Yes	Yes
Did the organization receive more than $25,000 in non-cash contributions?	No	No
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions?	No	No
Did the organization liquidate, terminate, or dissolve and cease operations?	No	No
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?	No	No
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3?	No	No
Was the organization related to any tax-exempt or taxable entity?	Yes	Yes
Did the organization have a controlled entity within the meaning of section 512(b)(13)?	Yes	Yes
Did the organization make any transfers to an exempt non-charitable related organization?	No	No
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes?	No	No

	2011	2012	2013
Statements Regarding Other IRS Filings and Tax Compliance
The number reported in Box 3 of Form 1096		155	146
The number of Forms W-2G		0	0
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?		Yes	Yes
The number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return		0	0
Did the organization file all required federal employment tax returns?		No	No
Did the organization have unrelated business gross income of $1,000 or more during the year?	Yes	Yes	Yes
Has it filed a Form 990-T for this year?		Yes	No
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?		No	No
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?		No	No
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?		No	No
Did the organization file Form 8886-T?		No	No
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?		No	No
Did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?		No	No
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?		No	No
Did the organization notify the donor of the value of the goods or services provided?		No	No
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?		No	No
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?		No	No
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?		No	No
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?		No	No
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?		No	No
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?		No	No
Did the sponsoring organization make any taxable distributions under section 4966?		No	No
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?		No	No
Initiation fees and capital contributions	$0	$0	$0
Gross receipts for public use of club facilities	$0	$0	$0
Gross income from members or shareholders	$0	$0	$0
Gross income from other sources	$0	$0	$0
Is the organization filing Form 990 in lieu of Form 1041?		No	No
The amount of tax-exempt interest received or accrued during the year		$0	$0
Is the organization licensed to issue qualified health plans in more than one state?		No	No
The amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans		$0	$0
The amount of reserves on hand		$0	$0
Did the organization receive any payments for indoor tanning services during the tax year?		No	No
Has it filed a Form 720 to report these payments?		No	No

	2012	2013
Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
Total reportable compensation from the organization	$5,492,661	$4,005,990
Total reportable compensation from related organizations	$819,453	$1,086,514
Total estimated amount of other compensation from the organization and related organizations	$301,612	$253,729
Total number of individuals who received more than $100,000 of reportable compensation from the organization	34	36
Total number of independent contractors who received more than $100,000 of compensation from the organization	15	14

	2011	2012	2013
Statement of Revenue
Total revenue	$86,785,324	$75,283,057	$83,716,847
Contributions, Gifts, Grants and Other Similar Amounts	$3,938,478	$0	$0
Program Service Revenue	$82,030,910	$74,332,238	$74,526,428
0		$21,566,958	$21,954,741
0		$632,890	$48,156,205
0		$48,512,704	$468,313
0		$551,509	$3,110,763
0		$3,068,177	$574,106
All other program service revenue		$0	$262,300
Other Revenue
Investment income (including dividends, interest, and other similar amounts)	$659,444	$895,180	$1,018,864
Income from investment of tax-exempt bond proceeds	$0	$0	$0
Royalties	$0	$0	$0
Net rental income	$0	$0	$0
Net gain/loss from sales of assets other than inventory	$156,492	$-49,849	$106,251
Gross amount from sales of assets other than inventory (Securities / Other)	$58,841 / $1,776,359	$0 / $1,104,589	$25,242 / $291,344
Less: cost or other basis and sales expenses (Securities / Other)	$0 / $1,678,708	$0 / $1,154,438	$0 / $210,335
Gain or (loss) (Securities / Other)	$58,841 / $97,651	$0 / $-49,849	$25,242 / $81,009
Net income/loss from fundraising events	$0	$0	$0
Net income/loss from gaming activities	$0	$0	$0
Net income/loss from sales of inventory	$0	$0	$0
Miscellaneous Revenue	$0	$105,488	$8,065,304
All other revenue		$0	$0

	2011	2012	2013
Statement of Functional Expenses
Total functional expenses	$88,218,553	$81,135,709	$84,245,241
Grants and other assistance to domestic organizations and domestic governments		$3,494,208	$29,094
Grants and other assistance to domestic individuals		$0	$0
Grants and other assistance to foreign organizations, foreign governments, and foreign individuals		$0	$0
Benefits paid to or for members		$0	$0
Compensation of current officers, directors, trustees, and key employees	$4,183,381	$4,061,177	$4,375,150
Compensation not included above, to disqualified persons		$0	$0
Other salaries and wages	$21,110,940	$21,025,277	$20,329,602
Pension plan accruals and contributions		$1,432,494	$467,250
Other employee benefits		$2,832,672	$2,413,373
Payroll taxes	$1,696,326	$1,646,199	$1,664,362
Fees for services (non-employees)
Management		$1,222,554	$1,273,695
Legal		$-1,250,544	$2,703,830
Accounting		$795,541	$859,921
Lobbying		$0	$0
Professional fundraising services	$0	$0	$0
Investment management fees		$0	$0
Other		$0	$0
Advertising and promotion		$2,425,019	$2,180,274
Office expenses		$482,800	$437,973
Information technology		$156,829	$25,591
Royalties		$0	$0
Occupancy		$1,294,560	$1,280,256
Travel		$155,874	$147,681
Payments of travel or entertainment expenses for any federal, state, or local public officials		$0	$0
Conferences, conventions, and meetings		$19,299	$31,587
Interest		$5,315,896	$5,176,794
Payments to affiliates		$0	$4,056,399
Depreciation, depletion, and amortization		$16,859,608	$19,768,307
Insurance		$2,672,716	$361,926
Other expenses		$1,702,696	$1,677,975
Other expenses		$1,992,753	$2,267,378
Other expenses		$2,720,121	$2,628,928
Other expenses		$3,677,712	$3,738,401
Other expenses		$6,400,248	$6,349,494

	2011	2012	2013
Balance Sheet
Total assets	$559,029,443	$567,484,708	$521,354,070
Cash - non-interest-bearing		$-181,608,238	$-196,654,091
Savings and temporary cash investments		$185,459,281	$200,640,908
Pledges and grants receivable, net		$0	$0
Accounts receivable, net		$123	$806
Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees		$0	$0
Loans and other receivables from other disqualified persons, persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations		$0	$0
Notes and loans receivable, net		$0	$0
Inventories for sale or use		$0	$0
Prepaid expenses and deferred charges		$1,576,323	$3,582,704
Land, buildings, and equipment: cost or other basis		$251,754,886	$216,605,036
Investments - publicly traded securities		$1,407	$0
Investments - other securities		$0	$0
Investments - program-related		$0	$0
Intangible assets		$0	$0
Other assets		$310,300,926	$297,178,707
Total liabilities	$642,097,864	$670,569,387	$619,623,764
Accounts payable and accrued expenses		$24,488,686	$19,277,446
Grants payable		$0	$0
Deferred revenue		$0	$0
Tax-exempt bond liabilities	$270,780,000	$265,960,000	$260,900,000
Escrow or custodial account liability		$0	$0
Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons		$0	$0
Secured mortgages and notes payable to unrelated third parties	$35,814,827	$30,411,072	$29,014,362
Unsecured notes and loans payable to unrelated third parties	$0	$0	$0
Other liabilities (including federal income tax, payables to related third parties, and other liabilities)		$349,709,629	$310,431,956
Total net assets or fund balances	$-83,068,421	$-103,084,679	$-98,269,694
Unrestricted net assets		$-103,084,679	$-98,269,694
Temporarily restricted net assets		$0	$0
Permanently restricted net assets		$0	$0
Capital stock or trust principal, or current funds		$0	$0
Paid-in or capital surplus, or land, building, or equipment fund		$0	$0
Retained earnings, endowment, accumulated income, or other funds	$0	$0	$0

Reason for Public Charity Status (for 2013)
The organization is not a private foundation because it is:	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)
Number of organizations supported	22
Sum of amounts of support	$65,432,775

	2000	2001	2002	2003	2004	2005	2006	2007
Revenue, Expenses, and Changes in Net Assets or Fund Balances
Total revenue	$29,746,812	$34,087,416	$47,201,054	$56,759,348	$69,068,184	$75,646,916	$70,147,952	$70,914,794
Contributions, gifts, grants, and similar amounts received	$0	$0	$614,621	$250,000	$283,262	$0	$86,933	$265,100
Contributions to donor advised funds							$0	$0
Direct public support	$0	$0	$614,621	$250,000	$0	$0	$0	$260,000
Indirect public support	$0	$0	$0	$0	$283,262	$0	$86,933	$5,100
Government contributions (grants)	$0	$0	$0	$0	$0	$0	$0	$0
Program service revenue including government fees and contracts	$26,624,605	$31,113,752	$43,411,171	$53,381,973	$62,954,370	$66,575,861	$60,509,869	$62,170,025
Membership dues and assessments	$0	$0	$0	$0	$0	$0	$0	$0
Interest on savings and temporary cash investments	$0	$0	$0	$0	$0	$0	$0	$0
Dividends and interest from securities	$3,038,019	$2,975,454	$3,109,677	$3,132,614	$5,840,507	$9,061,927	$9,786,266	$7,644,885
Net rental income or (loss)	$0	$0	$0	$0	$0	$0	$0	$0
Gross rents	$0	$0	$0	$0	$0	$0	$0	$0
Less: rental expenses	$0	$0	$0	$0	$0	$0	$0	$0
Other investment income	$0	$0	$0	$0	$0	$0	$0	$0
Gain or (loss) from sales of assets other than inventory	$84,188	$-1,790	$65,585	$-5,239	$-9,955	$9,128	$-235,116	$834,784
Gross amount from sales of assets other than inventory	$898,315	$81,690	$348,798	$38,000	$17,000	$253,862	$488,392	$2,424,901
Less: cost or other basis and sales expenses	$814,127	$83,480	$283,213	$43,239	$26,955	$244,734	$723,508	$1,590,117
Net income or (loss) from special events and activities	$0	$0	$0	$0	$0	$0	$0	$0
Gross revenue	$0	$0	$0	$0	$0	$0	$0	$0
Less: direct expenses other than fundraising expenses	$0	$0	$0	$0	$0	$0	$0	$0
Gross profit or (loss) from sales of inventory	$0	$0	$0	$0	$0	$0	$0	$0
Gross sales of inventory, less returns and allowances	$0	$0	$0	$0	$0	$0	$0	$0
Less: cost of goods sold	$0	$0	$0	$0	$0	$0	$0	$0
Other revenue	$0	$0	$0	$0	$0	$0	$0	$0
Total expenses	$45,818,141	$50,157,926	$61,057,202	$70,814,176	$87,347,127	$79,296,507	$79,132,676	$92,918,513
Program services	$36,661,556	$40,320,451	$48,953,791	$56,685,061	$68,822,073	$61,590,017	$62,365,472	$73,871,448
Management and general	$9,156,585	$9,837,475	$12,103,411	$14,129,115	$18,525,054	$17,706,490	$16,767,204	$19,047,065
Fundraising	$0	$0	$0	$0	$0	$0	$0	$0
Payments to affiliates	$0	$0	$0	$0	$0	$0	$0	$0
Net assets or fund balances at end of year	$-55,431,960	$-64,469,908	$-69,807,970	$-85,870,871	$-99,094,823	$-90,032,165	$-92,303,550	$-119,198,825
Excess or (deficit) for the year	$-16,071,329	$-16,070,510	$-13,856,148	$-14,054,828	$-18,278,943	$-3,649,591	$-8,984,724	$-22,003,719
Net assets or fund balances at beginning of year	$-42,765,905	$-55,431,960	$-64,469,908	$-69,807,970	$-85,870,871	$-99,094,823	$-90,032,165	$-92,303,550
Other changes in net assets or fund balances	$3,405,274	$7,032,562	$8,518,086	$-2,008,073	$5,054,991	$12,712,249	$6,713,339	$-4,891,556

	Total	Program services	Management and general	Fundraising
Statement of Functional Expenses (for 2007)
Total functional expenses	$92,918,513	$73,871,448	$19,047,065	$0
Grants paid from donor advised funds		$0
Other grants and allocations		$3,332,873
Specific assistance to individuals		$0
Benefits paid to or for members		$0
Compensation of current officers, directors, key employees, etc.	$2,031,194	$0	$2,031,194	$0
Compensation of former officers, directors, key employees, etc.	$0	$0	$0	$0
Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)	$0	$0	$0	$0
Salaries and wages of employees not included above	$20,574,237	$17,800,518	$2,773,719	$0
Pension plan contributions not included above	$2,914,754	$2,328,227	$586,527	$0
Employee benefits not included above	$2,881,112	$2,264,669	$616,443	$0
Payroll taxes	$1,351,963	$1,060,911	$291,052	$0
Professional fundraising fees	$0	$0	$0	$0
Accounting fees	$883,230	$706,584	$176,646	$0
Legal fees	$6,204,940	$4,963,952	$1,240,988	$0
Supplies	$719,283	$578,217	$141,066	$0
Telephone	$288,886	$238,837	$50,049	$0
Postage and shipping	$238,743	$200,355	$38,388	$0
Occupancy	$5,962,827	$4,797,180	$1,165,647	$0
Equipment rental and maintenance	$3,586,582	$2,874,970	$711,612	$0
Printing and publications	$92,491	$76,364	$16,127	$0
Travel	$419,185	$324,606	$94,579	$0
Conferences, conventions, and meetings	$102,830	$78,111	$24,719	$0
Interest	$10,349,982	$8,279,986	$2,069,996	$0
Depreciation, depletion, etc.	$16,233,062	$13,146,124	$3,086,938	$0
Other expenses not covered above	$14,750,339	$10,818,964	$3,931,375	$0

	2000	2001	2002	2003	2004	2005	2006	2007
Balance Sheets
Total assets	$336,629,348	$347,803,299	$365,548,651	$421,914,024	$372,609,583	$432,004,512	$510,780,552	$630,246,246
Cash - non-interest-bearing	$2,291,497	$3,343,758	$0	$0	$0	$23,813,179	$6,870,268	$5,492,577
Savings and temporary cash investments	$0	$0	$0	$0	$0	$0	$78,192,963	$161,464,561
Accounts receivable less allowance for doubtful accounts	$108,240	$116,217	$8,593	$61,595	$34,788	$13,890	$25,808	$12,654
Pledges receivable less allowance for doubtful accounts	$0	$0	$0	$0	$0	$0	$0	$0
Grants receivable	$0	$0	$0	$0	$0	$0	$0	$0
Receivables from current and former officers, directors, trustees, and key employees	$0	$0	$0	$0	$0	$0	$0	$0
Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)							$0	$0
Other notes and loans receivable less allowance for doubtful accounts	$25,776,390	$29,457,122	$30,368,193	$38,516,699	$39,986,582	$19,314,194	$15,789,957	$16,276,258
Inventories for sale or use	$0	$0	$0	$0	$0	$0	$0	$0
Prepaid expenses and deferred charges	$9,342,588	$8,525,648	$8,104,073	$8,301,905	$7,252,371	$6,963,548	$13,730,591	$4,561,923
Investments - publicly-traded securities							$1,407	$1,407
Investments - other securities	$13,452	$1,407	$1,407	$1,407	$1,407	$1,407	$0	$0
Investments - land, buildings, and equipment less accumulated depreciation	$0	$5,469,988	$8,657,645	$10,053,770	$0	$0	$0	$0
Investments - other	$0	$0	$1,136	$0	$0	$0	$0	$0
Land, buildings, and equipment less accumulated depreciation	$161,166,555	$144,880,266	$160,307,904	$172,298,185	$168,967,388	$163,690,389	$162,328,585	$185,933,539
Other assets, including program-related investments	$137,930,626	$156,008,893	$158,099,700	$192,680,463	$156,367,047	$218,207,905	$233,840,973	$256,503,327
Total liabilities	$392,061,308	$412,273,207	$435,356,621	$507,784,895	$471,704,406	$522,036,677	$603,084,102	$749,445,071
Accounts payable and accrued expenses	$12,242,020	$16,882,731	$18,890,974	$16,158,111	$21,237,952	$21,124,334	$20,870,697	$32,532,916
Grants payable	$0	$0	$0	$0	$0	$0	$0	$0
Deferred revenue	$0	$0	$0	$0	$0	$0	$0	$0
Loans from officers, directors, trustees, and key employees	$0	$0	$0	$0	$0	$0	$0	$0
Tax-exempt bond liabilities	$0	$0	$0	$0	$0	$209,670,000	$193,450,000	$283,865,000
Mortgages and other notes payable	$249,458,331	$249,013,193	$248,619,824	$255,648,516	$249,687,552	$39,702,759	$35,422,801	$28,844,823
Other liabilities	$130,360,957	$146,377,283	$167,845,823	$235,978,268	$200,778,902	$251,539,584	$353,340,604	$404,202,332
Total liabilities and net assets/fund balances	$336,629,348	$347,803,299	$365,548,651	$421,914,024	$372,609,583	$432,004,512	$510,780,552	$630,246,246
Total net assets or fund balances	$-55,431,960	$-64,469,908	$-69,807,970	$-85,870,871	$-99,094,823	$-90,032,165	$-92,303,550	$-119,198,825

	2000	2001	2002	2003	2004	2005	2006	2007
Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
Total revenue	$29,746,812	$34,087,416	$47,201,054	$56,759,348	$69,068,184	$75,646,916	$70,147,952	$70,914,794
Total revenue, gains, and other support per audited financial statements	$29,746,812	$34,087,416	$47,201,054	$56,759,348	$69,028,132	$75,661,499	$69,431,184	$60,239,633
Other expenses	$0	$0	$0	$0	$-40,052	$14,583	$-716,768	$-10,675,161
Net unrealized gains on investments	$0	$0	$0	$0	$-40,052	$14,583	$8,184	$-170,902
Donated services and use of facilities	$0	$0	$0	$0	$0	$0	$0	$0
Recoveries of prior year grants	$0	$0	$0	$0	$0	$0	$0	$0
Other	$0	$0	$0	$0	$0	$0	$-724,952	$-10,504,259
Other revenue	$0	$0	$0	$0	$0	$0	$0	$0
Investment expenses	$0	$0	$0	$0	$0	$0	$0	$0
Other	$0	$0	$0	$0	$0	$0	$0	$0

	2000	2001	2002	2003	2004	2005	2006	2007
Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
Total expenses	$45,818,141	$50,157,926	$61,057,202	$70,814,176	$87,347,127	$79,296,507	$79,132,676	$92,918,513
Total expenses and losses per audited financial statements	$45,818,141	$50,157,926	$61,057,202	$70,814,176	$87,347,127	$79,296,507	$79,132,676	$92,918,513
Other revenue	$0	$0	$0	$0	$0	$0	$0	$0
Donated services and use of facilities	$0	$0	$0	$0	$0	$0	$0	$0
Prior year adjustments	$0	$0	$0	$0	$0	$0	$0	$0
Losses	$0	$0	$0	$0	$0	$0	$0	$0
Other	$0	$0	$0	$0	$0	$0	$0	$0
Other expenses	$0	$0	$0	$0	$0	$0	$0	$0
Investment expenses	$0	$0	$0	$0	$0	$0	$0	$0
Other	$0	$0	$0	$0	$0	$0	$0	$0

Average hours per week devoted to position	Compensation	Contributions to employee benefit plans & deferred compensation plans	Expense account and other allowances
Current Officers, Directors, Trustees, and Key Employees
40	$1,575,424	$42,425	$12,000
40	$455,770	$205,111	$5,244

Total number of officers, directors, and trustees permitted to vote on organization business at board meetings	8
Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, related to each other through family or business relationships?	No
Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization?	Yes
Does the organization have a written conflict of interest policy?	Yes

Other Information
Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return, and has it filed a tax return on Form 990-T for this year?	Yes
Was there a liquidation, dissolution, termination, or substantial contraction during the year?	No
Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization?	Yes
Direct and indirect political expenditures	$0
Did the organization file Form 1120-POL for this year?	No
Were substantially all dues nondeductible by members?
Did the organization make only in-house lobbying expenditures of $2,000 or less?
Dues, assessments, and similar amounts from members	$0
Section 162(e) lobbying and political expenditures	$0
Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices	$0
Taxable amount of lobbying and political expenditures	$0
Does the organization elect to pay the section 6033(e) tax on the amount above?
If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount above to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?
Initiation fees and capital contributions	$0
Gross receipts for public use of club facilities	$0
At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)?	No
Amount of tax imposed on the organization during the year under: section 4911	$0
Amount of tax imposed on the organization during the year under: section 4912	$0
Amount of tax imposed on the organization during the year under: section 4955	$0
Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year?	No
Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958	$0
Amount of tax above, reimbursed by the organization	$0
At any time during the tax year, was the organization a party to a prohibited tax shelter transaction?	No
Did the organization acquire a direct or indirect interest in any applicable insurance contract?	No
Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year?	No
Number of employees employed in the pay period that includes March 12, 2006	0

	Unrelated business income		Excluded by section 512, 513, or 514		Related or exempt function income
Analysis of Income-Producing Activities (for 2007)
	Business code	Amount	Exclusion code	Amount	Related or exempt function income
Total		$2,584,471		$7,423,564	$60,641,659
Program service revenue
Program service revenue 1	000000	$0	00	$0	$31,097,268
Program service revenue 2	Passive income activities with controlled organizations	$304,242	00	$0	$21,295,599
Program service revenue 3	Administrative and support services	$857,340	00	$0	$4,784,822
Program service revenue 4	Medical and diagnostic laboratories	$44,926	00	$0	$2,368,846
Program service revenue 5	Administrative and support services	$321,858	00	$0	$1,095,124
		$0		$0	$31,097,268
	Passive income activities with controlled organizations	$304,242		$0	$21,295,599
	Offices of physicians	$139,052		$0	$0
	Administrative and support services	$857,340		$0	$4,784,822
		$0		$0	$705,436
		$0		$0	$33,497
		$0		$0	$352,991
		$0		$0	$3,200
	Medical and diagnostic laboratories	$44,926		$0	$2,368,846
	Administrative and support services	$182,806		$0	$0
Medicare/Medicaid payments	000000	$0	00	$0	$0
Fees and contracts from government agencies	000000	$0	00	$0	$0
Membership dues and assessments	000000	$0	00	$0	$0
Interest on savings and temporary cash investments	000000	$0	00	$0	$0
Dividends and interest from securities	Passive income activities with controlled organizations	$1,056,105	Dividends, interest, payments with respect to securities loans, annuities, income from notional principal contracts, loan commitment fees, and other substantially similar income from ordinary and routine investments excluded by section 512(b)(1)	$6,588,780	$0
Net rental income or (loss) from real estate
debt-financed property	000000	$0	00	$0	$0
not debt-financed property	000000	$0	00	$0	$0
Net rental income or (loss) from personal property	000000	$0	00	$0	$0
Other investment income	000000	$0	00	$0	$0
Gain or (loss) from sales of assets other than inventory	000000	$0	Gain (or loss, to the extent allowed) from the sale of investments and other non-inventory property and from certain property acquired from financial institutions that are in conservatorship or receivership (sections 512(b)(5) and 512(b)(16)(A))	$834,784	$0
Net income or (loss) from special events	000000	$0	00	$0	$0
Gross profit or (loss) from sales of inventory	000000	$0	00	$0	$0
Other revenue	000000	$0	00	$0	$0

EIN of corporation, partnership, or disregarded entity	Percentage of ownership interest	Total income	End-of-year assets
Information Regarding Taxable Subsidiaries and Disregarded Entities (for 2007)
751925036	100%	$90,395,480	$30,773,730
000000000	0%	$0	$0
000000000	0%	$0	$0
000000000	0%	$0	$0

Compensation	Contributions to employee benefit plans & deferred compensation	Expense account and other allowances
Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (for 2007)
$419,084	$201,371	$7,200
$367,169	$185,587	$2,862
$296,000	$61,244	$0
$295,192	$61,485	$0
$285,577	$59,395	$7,200

Total number of other employees paid over $50,000	166

Total number of other employees paid over $50,000

166

Statements About Activities (for 2007)
Expenses paid or incurred in connection with the lobbying activities	$0
Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures?	No
Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services?	No
Did the organization maintain any donor advised funds?	No
Did the organization make any taxable distributions under section 4966?	No
Did the organization make a distribution to a donor, donor advisor, or related person?	No
The total number of donor advised funds owned at the end of the tax year	$0
The aggregate value of assets held in all donor advised funds owned at the end of the tax year	$0
The total number of separate funds or accounts owned at the end of the tax year (excluding donor advised funds included above) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts	$0
The aggregate value of assets held in all funds or accounts included above at the end of the tax year	$0

Reason for Non-Private Foundation Status
The organization is not a private foundation because it is	Not controlled by disqualified persons/supports non private foundation
Type of supporting organization	Type II

Employer identification number (EIN)	Name of organization	Is the supported organization listed in the supporting organization's governing documents?	Amount of support
Information about the supported organizations
751803325	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Tyler	Yes	$0
751803329	East Texas Medical Center Regional Healthcare System, E Tx Medical Cntr Cancer Institute	Yes	$0
752599215	East Texas Medical Center Regional Healthcare System, E Tx Medical Center Rehabilitation	Yes	$0
752503960	East Texas Medical Center Regional Healthcare System, East Texas Medical Ctr Home Service	Yes	$0
752627236	First Choice Cooperative	Yes	$0
752547158	East Texas Medical Center Regional Healthcare System, East Texas Specialty Hospital	Yes	$0
752605821	East Texas Medical Center Regional Healthcare System, E Tx Medical Ctr Healthcare Assoc	Yes	$0
751854562	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Athens	Yes	$0
752735077	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Carthage	Yes	$0
752638020	East Texas Medical Center Regional Healthcare System, East Texas Medical Cntr Clarksville	Yes	$0
752602621	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Crockett	Yes	$0
752753454	East Texas Medical Center Regional Healthcare System, Est Texas Medical Center Fairfield	Yes	$0
200079162	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Gilmer	Yes	$0
752715084	East Texas Medical Center Regional Healthcare System, Etmc Jacksonville	Yes	$0
752250730	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Mt Vernon	Yes	$0
752715898	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Trinity	Yes	$0
751919624	East Texas Medical Center Regional Healthcare System, Easttexas Medical Center Pittsburg	Yes	$0
752766160	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Quitman	Yes	$0
Total			$86,410,361

	1999	2000	2001	2002	2003	2004	2005	2006
Support Schedule
Total	$0	$0	$0	$0	$0	$0	$0	$0
Gifts, grants, and contributions received	$0	$0	$0	$0	$0	$0	$0	$0
Membership fees received	$0	$0	$0	$0	$0	$0	$0	$0
Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc., purpose	$0	$0	$0	$0	$0	$0	$0	$0
Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30, 1975	$0	$0	$0	$0	$0	$0	$0	$0
Net income from unrelated business activities not included above	$0	$0	$0	$0	$0	$0	$0	$0
Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf	$0	$0	$0	$0	$0	$0	$0	$0
The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge	$0	$0	$0	$0	$0	$0	$0	$0
Other income	$0	$0	$0	$0	$0	$0	$0	$0

Lobbying Expenditures by Electing Public Charities (for 2007)
Total exempt purpose expenditures	$0
Total lobbying expenditures	$0
Total lobbying expenditures to influence public opinion (grassroots lobbying)	$0
Total lobbying expenditures to influence a legislative body (direct lobbying)	$0
Other exempt purpose expenditures	$0
Lobbying nontaxable amount	$0
Grassroots nontaxable amount	$0

	Income	Expenses	Net
Unrelated Trade or Business Income (for 2008)
Total	$2,584,471	$1,461,016	$1,123,455
Gross receipts or sales less returns and allowances	$183,978	$0	$0
Cost of goods sold	$0	$0	$0
Gross profit	$183,978	$0	$183,978
Capital gain net income	$0	$0	$0
Net gain	$0	$0	$0
Capital loss deduction for trusts	$0	$0	$0
Income (loss) from partnerships and S corporations	$0	$0	$0
Rent income	$0	$0	$0
Unrelated debt-financed income	$0	$0	$0
Interest, annuities, royalties, and rents from controlled organizations	$1,360,347	$1,461,016	$-100,669
Investment income of a section 501(c)(7), (9), or (17) organization	$0	$0	$0
Exploited exempt activity income	$0	$0	$0
Advertising income	$0	$0	$0
Other income	$1,040,146	$0	$1,040,146

Deductions Not Taken Elsewhere (for 2008)
Total deductions	$1,250,414
Compensation of officers, directors, and trustees	$0
Salaries and wages	$135,064
Repairs and maintenance	$0
Bad debts	$0
Interest	$0
Taxes and licenses	$0
Charitable contributions	$0
Depreciation	$10,339
Depletion	$0
Contributions to deferred compensation plans	$0
Employee benefit programs	$23,106
Excess exempt expenses	$0
Excess readership costs	$0
Other deductions	$1,081,905
Unrelated business taxable income	$0
Unrelated business taxable income before net operating loss deduction	$-126,959
Net operating loss deduction	$0
Unrelated business taxable income before specific deduction	$-126,959
Specific deduction	$1,000

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Id	Name	Address	State	Established	Total Income
Organizations performing similar types of work
1	East Texas Medical Center Regional Healthcare System, Group Return	1000 S Beckham Ave, Tyler, TX 75701-1908	TX	2010-04	$847,739,247
2	Walker County Hospital Corporation	PO BOX 4001, Huntsville, TX 77342-4001	TX	2006-02	$95,080,234
3	St Joseph Physician Associates	2801 Franciscan Dr, Bryan, TX 77802-2544	TX	2007-02	$39,248,638
4	Texas Bay Area Clinical Services Inc	3315 S Alameda St, Crp Christi, TX 78411-1820	TX	2015-03	$32,938,214
5	Tri-County Practice Association Aka Seton Family Of Physicians, Tri-County Practice Association	1345 Philomena St, Austin, TX 78723-3210	TX	2009-05	$22,965,765
6	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Henderson	300 Wilson St, Henderson, TX 75652-5956	TX	2010-04	$16,199,147
7	St Lukes Community Developmentcorporation	6624 Fannin St, Houston, TX 77030-2312	TX	2010-06	$13,199,125
8	Seton Healthcare, Seton Family Of Pediatric Surgeons	1345 Philomena St, Austin, TX 78723-3210	TX	2009-05	$7,683,899
9	St Lukes Hospital At The Vintage	6624 Fannin, Houston, TX 77030-2312	TX	2012-03	$5,223,188
10	Institute Of Reconstructive Plastic Surgery Of Central Texas, Institute Of Reconstructive Plastic	1345 Philomena St, Austin, TX 78723-3210	TX	2009-05	$5,058,089
11	Tomball Health Coalition	PO BOX 608, Tomball, TX 77377-0608	TX	2014-07	$3,031,571
12	Seton Healthcare, Seton Ent	1345 Philomena St, Austin, TX 78723-3210	TX	2009-05	$2,911,438
13	Seton Healthcare, Seton Hays Foundation	1345 Philomena Street, Austin, TX 78723-3210	TX	2009-05	$959,741
14	Southwest Texas Network Inc	201 South Evans, Uvalde, TX 78801	TX	2003-03	$838,502
15	The Arthur Nagel Community Clinic Inc	PO BOX 519, Bandera, TX 78003-0519	TX	2008-01	$476,106
16	South Central Area Health Education Center Inc, South Central Ahec	7411 One Technology Center Ste 1050, San Antonio, TX 78229	TX	1998-02	$118,168
17	Complex Care Medical Services Corporation	1935 Medical District Drive, Dallas, TX 75235	TX	2015-03	$32,162
18	Mcamericas Holdings Inc	201 E Main Dr Ste 1514, El Paso, TX 79901-1335	TX	2013-08	$10,358
19	Baylor Scott & White Health	2001 Bryan St Ste 2200, Dallas, TX 75201-3024	TX	2013-12	$0
20	Baylor Scott & White Holdings	2001 Bryan St Ste 2200, Dallas, TX 75201-3024	TX	2013-12	$0

Number of organizations performing similar types of work

Alabama	6
Arkansas	5
Arizona	2
California	34
Colorado	11
Connecticut	6
District of Columbia	3
Delaware	2
Florida	20
Georgia	23
Hawaii	9
Iowa	2
Idaho	5
Illinois	23
Indiana	10
Kansas	8
Kentucky	8
Louisiana	5
Massachusetts	67
Maryland	7
Maine	6
Michigan	36
Minnesota	39
Missouri	15
Mississippi	4
Montana	3

North Carolina	27
North Dakota	14
Nebraska	4
New Hampshire	3
New Jersey	33
New Mexico	3
Nevada	2
New York	45
Ohio	26
Oklahoma	7
Oregon	6
Pennsylvania	46
Rhode Island	5
South Carolina	2
South Dakota	10
Tennessee	7
Texas	62
Utah	3
Virginia	29
Vermont	2
Washington	8
Wisconsin	25
West Virginia	8
Wyoming	1
International	1

Total

738

Affiliation	Name	Address	State	Established	Total Income
20 biggest affiliated organizations
Central	East Texas Medical Center Regional Healthcare System	1000 S Beckham Ave, Tyler, TX 75701-1908	TX	2010-04	$83,927,182
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Tyler	1000 S Beckham Ave, Tyler, TX 75701-1908	TX	2010-04	$404,666,609
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Athens	2000 S Palestine St, Athens, TX 75751-5610	TX	2010-04	$91,025,423
Subordinate	East Texas Medical Center Regional Healthcare System, E Tx Medical Ctr Healthcare Assoc	PO BOX 6720, Tyler, TX 75711-6720	TX	2010-04	$89,806,457
Subordinate	East Texas Medical Center Regional Healthcare System, Etmc Jacksonville	501 S Ragsdale St, Jacksonville, TX 75766-2434	TX	2010-04	$34,442,148
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Medical Ctr Home Service	PO BOX 6400, Tyler, TX 75711-6400	TX	2010-04	$12,008,973
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Medical Cntr Foundation	1000 S Beckham Ave, Tyler, TX 75701-1908	TX	2010-04	$660,190
Subordinate	East Texas Medical Center Regional Healthcare System, Group Return	1000 S Beckham Ave, Tyler, TX 75701-1908	TX	2010-04	$847,739,247
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Henderson	300 Wilson St, Henderson, TX 75652-5956	TX	2010-04	$16,199,147
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Self Insuranc Trust	1000 S Beckham Ave, Tyler, TX 75701-1908	TX	2010-04	$7,996,089
Subordinate	East Texas Medical Center Regional Healthcare System, E Tx Medical Cntr Cancer Institute	1000 S Beckham Ave, Tyler, TX 75701-1908	TX	2010-04	$0
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Carthage	409 Cottage Rd, Carthage, TX 75633-1466	TX	2010-04	$0
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Medical Cntr Clarksville	PO BOX 1270, Clarksville, TX 75426-1270	TX	2010-04	$0
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Crockett	PO BOX 1129, Crockett, TX 75835-1129	TX	2010-04	$0
Subordinate	East Texas Medical Center Regional Healthcare System, Est Texas Medical Center Fairfield	PO BOX 1090, Fairfield, TX 75840-0021	TX	2010-04	$0
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Gilmer	615 Us Highway 271 N, Gilmer, TX 75644-5569	TX	2010-04	$0
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Mt Vernon	PO BOX 477, Mt Vernon, TX 75457-0477	TX	2010-04	$0
Subordinate	East Texas Medical Center Regional Healthcare System, Easttexas Medical Center Pittsburg	2701 Us Highway 271 N, Pittsburg, TX 75686-4289	TX	2010-04	$0
Subordinate	East Texas Medical Center Regional Healthcare System, East Texas Medical Center Quitman	PO BOX 1000, Quitman, TX 75783-1000	TX	2010-04	$0
Subordinate	East Texas Medical Center Regional Healthcare System, E Tx Medical Center Rehabilitation	701 Olympic Plaza Cir, Tyler, TX 75701-1950	TX	2010-04	$0

Number of affiliated organizations

Texas