Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Accountants’ Report and Financial Statements 
September 30, 2011 and 2010 

 
Tarrant County Hospital District  
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
September 30, 2011 and 2010 
Contents 
Independent Accountants’ Report on Financial Statements and  
Supplementary Information ............................................................................................... 1 
Management’s Discussion and Analysis ............................................................................. 2 
Financial Statements 
Balance Sheets .................................................................................................................................... 8 
Statements of Revenues, Expenses and Changes in Net Assets ......................................................... 9 
Statements of Cash Flows ................................................................................................................ 10 
Notes to Financial Statements .......................................................................................................... 12 
Supplementary Information 
Balance Sheet Information ............................................................................................................... 34 
Statement of Revenues, Expenses and Change in Net Assets Information ...................................... 35 
Required Supplementary Information 
Schedule of Funding Progress – Pension Plan ................................................................................. 36 

 
Independent Accountants’ Report on Financial  
Statements and Supplementary Information 
Board of Managers 
Tarrant County Hospital District d/b/a JPS Health Network 
Fort Worth, Texas 
We have audited the accompanying balance sheet of Tarrant County Hospital District d/b/a JPS Health 
Network (the District), a component unit of Tarrant County, Texas, as of September 30, 2011, and the 
related statements of revenues, expenses and changes in net assets and cash flows for the year then ended.  
These financial statements are the responsibility of the District’s management.  Our responsibility is to 
express an opinion on these financial statements based on our audit.  The financial statements of the 
District as of and for the year ended September 30, 2010, were audited by other accountants whose report 
dated February 10, 2011, expressed an unqualified opinion on those statements. 
We conducted our audit in accordance with auditing standards generally accepted in the United States of 
America.  Those standards require that we plan and perform the audit to obtain reasonable assurance 
about whether the financial statements are free of material misstatement.  An audit includes examining, 
on a test basis, evidence supporting the amounts and disclosures in the financial statements.  An audit also 
includes assessing the accounting principles used and significant estimates made by management, as well 
as evaluating the overall financial statement presentation.  We believe that our audit provides a reasonable 
basis for our opinion.  
In our opinion, the 2011 financial statements referred to above present fairly, in all material respects, the 
financial position of the District as of September 30, 2011, and the changes in its financial position and its 
cash flows for the year then ended in conformity with accounting principles generally accepted in the 
United States of America. 
The accompanying management’s discussion and analysis is not a required part of the basic financial 
statements but is supplementary information required by the Governmental Accounting Standards Board.  
We have applied certain limited procedures, which consisted principally of inquiries of management 
regarding the methods of measurement and presentation of the required supplementary information.  
However, we did not audit the information and express no opinion on it. 
Our audit was conducted for the purpose of forming an opinion on the District’s basic financial 
statements.  The accompanying supplementary information as listed in the table of contents is presented 
for purposes of additional analysis of the basic financial statements rather than to present the financial 
position and results of operations of the individual entities, and is not a required part of the basic financial 
statements.  Such information has been subjected to the auditing procedures applied in the audit of the 
basic financial statements and, in our opinion, is fairly stated, in all material respects, in relation to the 
basic financial statements taken as a whole. 
January 25, 2012 

 
Tarrant County Hospital District  
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Management’s Discussion and Analysis 
Years Ended September 30, 2011 and 2010 
(In Thousands) 
Introduction
This management’s discussion and analysis of the financial performance of Tarrant County Hospital 
District d/b/a JPS Health Network (the District) provides an overview of the District’s financial activities 
for the years ended September 30, 2011 and 2010.  It should be read in conjunction with the 
accompanying financial statements of the District.  Unless otherwise indicated, amounts are in thousands. 
Financial Highlights



Cash, short-term investments and other noncurrent investments decreased in 2011 by $11,131 or 2.8 
percent and increased in 2010 by $23,265 or 6.2 percent.  
The District’s net assets increased in each of the past two years with a $3,165, or 0.5 percent increase 
in 2011, and a $12,590, or 2.0 percent increase in 2010. 
The District reported operating losses in both 2011 ($302,167) and 2010 ($303,200).  The operating 
loss in 2011 decreased by $1,033, or 0.3 percent, as compared to the operating loss reported in 2010.  
The operating loss in 2010 increased by $12,763, or 4.4 percent, from the operating loss reported in 
2009. 

Net nonoperating revenues decreased by $10,458, or 3.3 percent, in 2011 compared to 2010, and 
increased by $23,996, or 8.2 percent, in 2010 compared to 2009.  
Using This Annual Report
The District’s financial statements consist of three statements:  a balance sheet; a statement of revenues, 
expenses and changes in net assets; and a statement of cash flows.  These statements provide information 
about the activities of the District, including resources held by the District but restricted for specific 
purposes by creditors, contributors, grantors or enabling legislation.  The District is accounted for as a 
business-type activity and presents its financial statements using the economic resources measurement 
focus and the accrual basis of accounting. 
The Balance Sheet and Statement of Revenues, Expenses and Changes in Net Assets
One of the most important questions asked about any hospital’s finances is “Is the hospital as a whole 
better or worse off as a result of the year’s activities?”  The balance sheet and the statement of revenues, 
expenses and changes in net assets report information about the District’s resources and its activities in a 
way that helps answer this question.  These statements include all restricted and unrestricted assets and all 
liabilities using the accrual basis of accounting.  Using the accrual basis of accounting means that all of 
the current year’s revenues and expenses are taken into account regardless of when cash is received or 
paid.
2 

 
These two statements report the District’s net assets and changes in them.  The District’s total net assets - 
the difference between assets and liabilities - is one measure of the District’s financial health or financial 
position.  Over time, increases or decreases in the District’s net assets are an indicator of whether its 
financial health is improving or deteriorating.  Other nonfinancial factors, such as changes in the 
District’s patient base, changes in legislation and regulations, measures of the quantity and quality of 
services provided to its patients, and local economic factors should also be considered to assess the 
overall financial health of the District.  
The Statement of Cash Flows
The statement of cash flows reports cash receipts, cash payments, and net changes in cash and cash 
equivalents resulting from four defined types of activities.  It provides answers to such questions as where 
did cash come from, what was cash used for, and what was the change in cash and cash equivalents 
during the reporting period.  
The District’s Net Assets
The District’s net assets are the difference between its assets and liabilities reported in the balance sheets.  
The District’s net assets increased by $3,165 (0.5 percent) in 2011 over 2010, and by $12,590 
(2.0 percent) in 2010 over 2009, as shown in Table 1: 
Table 1:  Assets, Liabilities and Net Assets
2011
2010
2009
Assets
Cash and short-term investments
$
200,306
$
213,839
$
190,701
Patient accounts receivable, net 
Other current assets
53,821
45,200
55,626
52,177
44,217
61,903
Capital assets, net
Other noncurrent assets
303,918
179,037
293,555
176,886
302,578
176,447
Total assets
$
782,282
$
792,083
$
775,846
Liabilities
Long-term debt
Other current and noncurrent liabilities
$
56,352
71,802
$
58,593
82,527
$
66,823
70,650
Total liabilities
128,154
141,120
137,473
Net Assets
Invested in capital assets, net of related debt
Restricted expendable
Restricted nonexpendable
Unrestricted
248,344
2,308
250
232,867
8,997
250
238,290
10,377
250
403,226
408,849
389,456
Total net assets
654,128
782,282
650,963
792,083
638,373
775,846
Total liabilities and net assets
$
$
$
3 

 
The most significant change in the District’s assets in 2011 is the decrease in cash and investments of 
$11,131 or 2.8 percent, which was offset by an increase in the District’s capital assets of $10,363 or 3.5 
percent.  Capital assets purchased during 2011 were $24,342 higher than assets purchased in 2010, which 
relates primarily to the District’s implementation of electronic health records.  Total assets were also 
impacted by amounts due from the State of Texas under the Texas disproportionate share program (DSH).  
Due to the timing of payments and the maximum DSH reimbursement the District was eligible for in the 
last quarter of the State’s 2011 fiscal year, that receivable decreased by $6,984 or 36.9 percent from 2010 
to 2011.    
The most significant change in the District’s financial position in 2010 was an increase in cash and 
investments of $23,265 or 6.2 percent, offset by a decrease in the DSH receivable of $10,377 or 54.8 
percent.  As in 2011, the decrease in the DSH receivable in 2010 is a product of the timing of payments 
and the maximum DSH reimbursement the District was eligible for in the last quarter of the fiscal year. 
Operating Results and Changes in the District’s Net Assets
In 2011, the District’s net assets increased by $3,165, or 0.5 percent, as shown in Table 2.  This increase 
is made up of several different components and represents a decline of 74.9 percent compared with the 
increase in net assets for 2010 of $12,590.  The District’s change in net assets increased from $1,357 in 
2009 to $12,590 in 2010. 
Table 2:  Operating Results and Changes in Net Assets
2011
2010
2009
Operating Revenues
Net patient service revenue
$
264,448
$
267,358
$
228,057
Texas disproportionate share and UPL program
Other operating revenues
103,309
52,450
91,780
52,306
103,311
47,268
Total operating revenues
420,207
411,444
378,636
Operating Expenses
Salaries and wages and employee benefits
Purchased services and professional fees
Supplies
Depreciation and amortization
Other operating expenses
354,123
174,237
131,964
40,454
342,987
178,633
134,577
38,308
325,863
156,995
129,201
36,248
21,596
20,139
20,766
Total operating expenses
722,374
714,644
669,073
Operating loss
(302,167)
(303,200)
(290,437)
Nonoperating Revenues (Expenses)
Property taxes
Contributed services
275,345
26,509
3,478
284,028
27,150
4,612
279,091
2,331
10,372
Investment return, interest expense and other
Total nonoperating revenues (expenses)
305,332
3,165
315,790
12,590
291,794
1,357
Increase in Net Assets
$
$
$
4 

 
Operating Losses
The first component of the overall change in the District’s net assets is its operating income or loss—
generally, the difference between net patient service and other operating revenues and the expenses 
incurred to perform those services.  In each of the past three years, the District has reported an operating 
loss.  This is consistent with the District’s recent operating history as the District was formed and is 
operated primarily to serve lower income residents of Tarrant County.  The District levies property taxes 
to provide sufficient resources to enable the facility to serve lower income and other residents. 
The operating loss for 2011 decreased by $1,033, or 0.3 percent, as compared to 2010.  The primary 
components of the increased operating loss are: 





An decrease in net patient service revenue of $2,910, or 1.1 percent 
An increase in Texas disproportionate share and UPL program revenue of $11,529 or 12.6 percent 
An decrease in professional fees and purchased services of $4,396 or 2.5 percent 
A decrease in supply and drug costs of $2,613 or 1.9 percent and 
An increase in salaries and wages of $11,136, or 3.2 percent. 
While patient days increased by 3,659 from 2010 to 2011, net patient service revenue decreased primarily 
due to a change in the District’s payer mix and higher uninsured utilization.  Revenue from the Texas 
disproportionate share and upper payment limit programs increased by $11,529 from 2010 to 2011 as a 
result of increased Medicaid volumes and uncompensated patients, coupled with fluctuations in various 
other factors impacting the amount of revenue the District is eligible for under this program.   
Professional fees and purchased services decreased as a result of changes to the District’s estimate of 
amounts due to various physician groups for providing services to indigent patients served by the District 
as a result of the settlement in the UPL program as of September 30, 2011.   
Expenditures for supplies and prescription drugs are a major component of the District’s costs.  In 2011, 
supplies and prescription drug costs totaled $131,964, or 18.3 percent, of total operating expenses.  In 
2010, they totaled $134,577, or 18.8 percent, of total operating expenses, an increase of $5,376, or 
4.2 percent, over 2009.  The primary factor contributing to the current year decrease in supply and drug 
costs is a decline in drug costs resulting from enhanced management of the supply chain distribution and 
department efficiencies.  A contract with Maxor to manage the outpatient pharmacies was implemented in 
2011 that provided outpatient pharmacy efficiencies.  
Employee salaries and wages and benefits increased in 2011 in connection with the growth in volume as 
well as the District’s retention and recruitment efforts. 
The District’s other operating revenue also increased by $824 due to implementation of a flat parking 
garage fee, additional Tobacco Settlement revenue and increased vendor rebates.   
The operating loss for 2010 of $303,200 was $12,763 more than the operating loss of $290,437 
recognized in 2009.  The increase in net patient service revenue of $39,301 was offset by a decline in 
Texas disproportionate share and UPL program revenue of $11,531 as well as increased operating costs.  
The District’s increase in overall operating expenses was approximately 6.8 percent.
5 

 
Nonoperating Revenues and Expenses
Nonoperating revenues and expenses consist primarily of property taxes levied by the District and 
investment income and interest expense, all of which declined in 2011 as compared to 2010.  The District 
held property tax rates constant in 2011, but a decline in overall property values as well as changes in 
estimated uncollectible property taxes resulted in a net decrease in property tax revenue of $8,683 or 3.1 
percent from 2010 to 2011.  Investment return declined in 2011 compared to 2010, resulting primarily 
from a decrease in total cash and investments and changes in interest rates on certificates of deposit and 
debt securities.  Contributed services represent the difference between the value of services provided to 
the District’s indigent patients by area physicians and the amount the District ultimately paid for those 
services.  Contributed services decreased by $641 in 2011 as compared to 2010. 
Interest expense decreased by $784 or 28.1 percent due to a decrease in long-term debt, but primarily due 
to more interest being capitalized in conjunction with the District’s electronic medical records project.   
The District’s Cash Flows
Changes in the District’s cash flows are consistent with changes in operating losses and nonoperating 
revenues and expenses for 2011, 2010 and 2009, discussed earlier.  As discussed below, capital asset 
purchases were significantly higher in 2011 due to the electronic medical records project. 
Capital Asset and Debt Administration
Capital Assets
At the end of 2011, the District had $303,918 invested in capital assets, net of accumulated depreciation, 
as detailed in Note 6 to the financial statements.  In 2011, the District purchased new equipment costing 
$26,066.  In addition, approximately $22,047 was spent to develop a new electronic medical record 
system.  The total capital cost of this project is estimated to be $81,378 and is expected to be completed in 
the third quarter of fiscal year 2012.   
Debt
At September 30, 2011, the District had $58,565 in revenue bonds and certificates of obligation   
outstanding.  The District issued no new debt in 2011 or 2010.  The District’s formal debt issuances, 
revenue bonds, are subject to limitations imposed by state law.  There have been no changes in the 
District’s debt ratings in the past three years, but the outlook changed from stable to negative on the 2006 
bonds given the dependence of the District on federal funding. 
Other Economic Factors
The District is anticipating that volumes will continue to increase in fiscal year 2012 from growth in the 
county and with the addition of new physicians to the District’s medical staff.  Based on the 
recommendation of the District’s Board of Managers (the Board), the Tarrant County Commissioners 
Court (the Court) set the property tax rate for fiscal year 2012 to $0.227897 per $100 valuation. 
6 

 
The Board and management continue to monitor and consider many factors that have direct or indirect 
impact on future operations.  These include: 

Tarrant County’s population growth, as well as continued growth in the number of uninsured and 
working poor, 

Workforce shortages, particularly in the areas of nursing, physical, occupational and speech 
therapists, and medical technologists, 



Continued growth in medical and pharmaceutical costs, as well as advances in therapies, 
Continued advances in health care medical equipment and computing technology and 
Access to funds for capital expansion 
Significant Financial Practices
The District maintains several financial practices designed to maintain its creditworthiness and to position 
the District to carry out its defined mission of providing health care to the residents of Tarrant County, as 
well as its fiduciary responsibility to the taxpayers of Tarrant County.  Those practices are as follows: 
Investments Internally Designated for Capital Acquisition and Operating Activities
The Board sets aside funds for both long-term stability and capital improvements. 
Monthly Financial Reporting
The Board meets monthly and reviews the financial statements from the prior month.  This 
information is presented to show actual monthly and year-to-date revenues and expenses 
compared to budget and the prior year.  Management provides explanation for significant 
variances. 
Pay-As-You-Go Capital Funding
The District has maintained the practice to fund routine capital items under a pay-as-you-go basis.  
This has been done to minimize borrowing costs as well as maintain financial flexibility. 
Budget Process
The operating and capital budgets are proposed by the District’s management and endorsed by the 
Board.  Final approval is obtained from the Court.  The budget remains in effect for the entire 
fiscal year. 
Contacting the District’s Financial Management
This financial report is designed to provide our readers with a general overview of the District’s finances 
and to show the District’s accountability for the money it receives.  Questions about this report and 
requests for additional financial information should be directed to the District’s Financial Offices at 1350 
South Main Street, Suite 4000, Fort Worth, Texas 76104. 
7 

 
Tarrant County Hospital District  
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Balance Sheets 
September 30, 2011 and 2010 
(In Thousands) 
Assets
2011
2010
Current Assets
Cash and cash equivalents
Short-term investments
$
90,030
110,276
53,821
5,209
11,941
279
$
72,801
141,038
55,626
4,219
18,925
436
Patient accounts receivable, net
Property taxes receivable, net
Texas disproportionate share program receivable
Restricted pledges receivable, net
Held by trustee for self insurance, current portion
Due from third-party payers
5,501
2,200
5,493
679
Supplies inventory
Prepaid expenses and other assets
10,011
10,059
10,462
11,963
Total current assets
299,327
321,642
Noncurrent Cash and Investments
Held by trustee for debt service
2,958
2,976
Held by trustee for self insurance
Restricted by donors for capital acquisitions and
specific operating activities
Internally designated for capital acquisitions and 
operating activities
13,243
12,676
2,623
160,120
178,944
93
5,092
155,806
176,550
336
Total noncurrent assets
Pledges Receivable
Capital Assets - Net
Total assets
303,918
782,282
293,555
792,083
$
$
See Notes to Financial Statements 

 
Liabilities and Net Assets
2011
2010
Current Liabilities
Accounts payable
$
32,847
$
46,935
Accrued expenses
28,171
150
5,501
2,180
24,646
168
5,493
2,095
Due to third-party payers
Current portion of self-insurance costs
Current maturities of long-term debt
Total current liabilities
Estimated Self-insurance Costs
Long-term Debt
68,849
1,674
79,337
2,069
56,352
1,279
58,593
1,121
Other Long-term Liabilities
Total liabilities
128,154
141,120
Net Assets
Invested in capital assets - net of related debt
Restricted expendable
Restricted nonexpendable
Unrestricted
248,344
2,308
250
232,867
8,997
250
403,226
408,849
Total net assets
654,128
782,282
650,963
792,083
$
$
Total liabilities and net assets
8 

 
Tarrant County Hospital District  
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Statements of Revenues, Expenses and Changes in Net Assets 
Years Ended September 30, 2011 and 2010 
(In Thousands) 
2011
2010
Operating Revenues
Net patient service revenue, net of provision for 
     uncollectible accounts; 2011 - $285,867; 2010 - $265,502
Texas disproportionate share and upper payment 
limit program revenue 
$
264,448
$
267,358
103,309
819
91,780
1,499
Contributions
Other operating revenue
51,631
50,807
Total operating revenues
420,207
411,444
Operating Expenses
Salaries and related expenses
Professional fees and purchased services
Supplies
Depreciation and amortization
Other
354,123
174,237
131,964
40,454
342,987
178,633
134,577
38,308
21,596
20,139
Total operating expenses
722,374
714,644
Operating Loss
(302,167)
(303,200)
Nonoperating Revenues (Expenses)
Property tax revenue
Contributed services
Interest expense
Investment return and other
275,345
26,509
(2,009)
5,487
284,028
27,150
(2,793)
7,405
Total nonoperating revenues (expenses)
Increase in Net Assets
305,332
3,165
315,790
12,590
Net Assets, Beginning of Year
Net Assets, End of Year
650,963
654,128
638,373
650,963
$
$
See Notes to Financial Statements 
9

 
Tarrant County Hospital District  
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Statements of Cash Flows 
Years Ended September 30, 2011 and 2010 
(In Thousands) 
2011
2010
Operating Activities
Receipts from and on behalf of patients
Receipts from Texas disproportionate share and 
   upper payment limit programs 
Payments to suppliers and contractors
Payments to employees
$
264,714
$
255,949
110,293
(309,600)
(350,756)
53,008
102,157
(301,361)
(340,446)
52,306
Other receipts, net
Net cash used in operating activities
(232,341)
(231,395)
Noncapital Financing Activities
Property taxes supporting operations
Other
272,449
-
279,514
111
Net cash provided by noncapital financing activities
272,449
279,625
Capital and Related Financing Activities
Principal paid on long-term debt
Interest paid on long-term debt
Property taxes supporting debt service
Purchase of capital assets
(2,095)
(2,910)
1,906
(4,684)
(2,920)
1,974
(53,627)
(29,285)
Net cash used in capital and related financing activities
(56,726)
(34,915)
Investing Activities
Purchase of investments
(218,326)
(181,576)
Proceeds from the sale and maturities of
  short-term investments
Interest income and other
246,690
5,487
103,829
9,621
Net cash provided by (used in) investing activities
Increase (Decrease) in Cash and Cash Equivalents
Cash and Cash Equivalents, Beginning of Year
Cash and Cash Equivalents, End of Year
33,851
17,233
76,454
93,687
(68,126)
(54,811)
131,265
76,454
$
$
  
See Notes to Financial Statements 
10 

 
Tarrant County Hospital District  
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Statements of Cash Flows (Continued) 
Years Ended September 30, 2011 and 2010 
(In Thousands) 
2011
2010
Reconciliation of Cash and Cash Equivalents to the Balance Sheets
Cash and cash equivalents in current assets
Cash and cash equivalents in noncurrent cash and investments
$
$
90,030
3,657
$
$
72,801
3,653
93,687
76,454
Reconciliation of Net Operating Revenues (Expenses) to 
    Net Cash Used in Operating Activities
Operating loss
Depreciation and amortization
Loss (gain) on disposal of assets
$
(302,167)
40,454
1,245
$
(303,200)
38,308
(46)
Contributed services expense
26,509
27,150
Changes in operating assets and liabilities:
Patient accounts receivable
Texas disproporationate share program receivable
Estimated amounts due from and to third-party payers
Accounts payable and accrued expenses
Other assets and liabilities
1,805
6,984
(1,539)
(8,158)
2,526
(11,409)
10,377
175
10,235
(2,985)
Net cash used in operating activities
$
(232,341)
$
(231,395)
Supplemental Cash Flows Information
Capital asset acquisitions included in accounts payable
Contributed services revenue (Note 13  )
$
$
506
26,509
$
$
2,881
27,150
See Notes to Financial Statements 
11 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Note 1: 
Nature of Operations and Summary of Significant Accounting Policies 
Nature of Operations and Reporting Entity 
Tarrant County Hospital District d/b/a JPS Health Network (the District) is a political subdivision 
of the state of Texas and operates a hospital, a psychiatric inpatient facility, a skilled nursing unit, 
24 ambulatory health centers, a psychiatric emergency center, an emergency department and a 
designated Level 1 trauma center, three health centers for women, 19 school-based clinics and 
dental services at six locations.  Additionally, it manages medical care services at the Tarrant 
County correctional system’s three locations.  The District is under the supervision of the Tarrant 
County Commissioners Court (the Court) and is governed by an 11 member Board of Managers 
(the Board) appointed by the Court.  For this reason, the District is considered to be a component 
unit of Tarrant County, Texas (the County) and is included as a discretely presented component 
unit in the basic financial statements of the County. 
JPS Physician Group (JPSPG) began operations in July 2003, primarily for the purpose of 
providing physician services to District patients.  The District is the sole corporate member of 
JPSPG and has the authority to exercise significant control over the financial operations of JPSPG.  
As such, JPSPG is presented as a blended component unit of the District. 
Partners Together for Health (Partners) was formed on August 4, 1997, solely to support and 
benefit scientific, educational and charitable activities conducted by the District.  Partners is a non-
profit organization whose purpose is to perform services on behalf of the District, including 
organizing fundraising activities, providing patient assistance programs, participating in recruiting 
functions and conducting administrative services.  Partners is also presented as a blended 
component unit of the District. 
The District’s financial statements include the activities as set forth above.  All material 
intercompany accounts and transactions have been eliminated in the financial statements.
Basis of Accounting and Presentation 
The financial statements of the District have been prepared on the accrual basis of accounting using 
the economic resources measurement focus.  Revenues, expenses, gains, losses, assets and 
liabilities from exchange and exchange-like transactions are recognized when the exchange 
transaction takes place, while those from government-mandated nonexchange transactions 
(principally federal and state grants) are recognized when all applicable eligibility requirements are 
met.  Operating revenues and expenses include exchange transactions and program-specific, 
government-mandated nonexchange transactions.
12 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Government-mandated nonexchange transactions that are not program specific, property taxes, 
investment income and interest on capital assets-related debt are included in nonoperating revenues 
and expenses.  The District first applies restricted net assets when an expense or outlay is incurred 
for purposes for which both restricted and unrestricted net assets are available. 
The District prepares its financial statements as a business-type activity in conformity with 
applicable pronouncements of the Governmental Accounting Standards Board (GASB).  Pursuant 
to GASB Statement No. 20, the District has elected to apply the provisions of all relevant 
pronouncements of the Financial Accounting Standards Board (FASB) that were issued on or 
before November 30, 1989, and do not conflict with or contradict GASB pronouncements. 
Use of Estimates 
The preparation of financial statements in conformity with accounting principles generally 
accepted in the United States of America requires management to make estimates and assumptions 
that affect the reported amounts of assets and liabilities and disclosure of contingent assets and 
liabilities at the date of the financial statements and the reported amounts of revenues and expenses 
during the reporting period.  Actual results could differ from those estimates. 
Cash and Cash Equivalents 
The District considers all liquid investments with original maturities of three months or less to be 
cash equivalents.  At September 30, 2011 and 2010, cash equivalents consisted primarily of money 
market accounts with brokers.   
Risk Management 
The District is exposed to various risks of loss from torts; theft of, damage to and destruction of 
assets; business interruption; errors and omissions; employee injuries and illnesses; natural 
disasters; medical malpractice; and employee health, dental and accident benefits.  Commercial 
insurance coverage is purchased for claims arising from such matters other than medical 
malpractice, employee health and workers’ compensation claims.  Settled claims have not 
exceeded this commercial coverage in any of the three preceding years. 
The District is self-insured for a portion of its exposure to risk of loss from medical malpractice, 
employee health and workers’ compensation claims.  Annual estimated provisions are accrued for 
the self-insured portion of these risks and include an estimate of the ultimate costs for both reported 
claims and claims incurred but not yet reported.
13 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Investments and Investment Income 
Investments in U.S. Treasury, agency and instrumentality obligations with a remaining maturity of 
one year or less at time of acquisition and in nonnegotiable certificates of deposit are carried at 
amortized cost.  All other investments are carried at fair value.  Fair value is determined using 
quoted market prices. 
Investment income includes dividend and interest income, realized gains and losses on investments 
carried at other than fair value and the net change for the year in the fair value of investments 
carried at fair value. 
Patient Accounts Receivable 
The District reports patient accounts receivable for services rendered at net realizable amounts 
from third-party payers, patients and others.  The District provides an allowance for uncollectible 
accounts based upon a review of outstanding receivables, historical collection information and 
existing economic conditions.  
Supplies 
Supply inventories are stated at the lower of cost, determined using the first-in, first-out method or 
market. 
Capital Assets 
Capital assets are recorded at cost at the date of acquisition, or fair value at the date of donation if 
acquired by gift.  Depreciation is computed using the straight-line method over the estimated useful 
life of each asset.  Assets under capital lease obligations and leasehold improvements are 
depreciated over the shorter of the lease term or their respective estimated useful lives.  The 
following estimated useful lives are being used by the District: 
Land improvements
Buildings and improvements
Equipment
10–20 years
10–40 years
3–20 years
3–5 years
Computer software
14 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
The District capitalizes interest costs as a component of construction in progress, based on the 
weighted-average rates paid for long-term borrowing.  Total interest incurred was: 
2011
2010
Interest costs capitalized
Interest costs charged to expense
$
$
830
2,009
$
$
246
2,793
Total interest incurred
2,839
3,039
Deferred Financing Costs 
Deferred financing costs represent costs incurred in connection with the issuance of long-term debt.  
Such costs are being amortized over the term of the respective debt using the effective interest 
method. 
Compensated Absences 
District policies permit most employees to accumulate vacation and sick leave benefits that may be 
realized as paid time off or, in limited circumstances, as a cash payment.  Expense and the related 
liability are recognized as vacation benefits are earned whether the employee is expected to realize 
the benefit as time off or in cash.  Expense and the related liability for sick leave benefits are 
recognized when earned to the extent the employee is expected to realize the benefit in cash 
determined using the termination payment method.  Sick leave benefits expected to be realized as 
paid time off are recognized as expense when the time off occurs and no liability is accrued for 
such benefits employees have earned but not yet realized.  Compensated absence liabilities are 
computed using the regular pay and termination pay rates in effect at the balance sheet date, plus an 
additional amount for compensation-related payments such as social security and Medicare taxes 
computed using rates in effect at that date. 
Net Assets 
Net assets of the District are classified in four components.  Net assets invested in capital assets, 
net of related debt, consist of capital assets net of accumulated depreciation and reduced by the 
outstanding balances of borrowings used to finance the purchase or construction of those assets.  
Restricted expendable net assets are noncapital assets that must be used for a particular purpose, as 
specified by creditors, grantors or donors external to the District, including amounts deposited with 
trustees as required by bond indentures, reduced by the outstanding balances of any related 
borrowings.  Restricted nonexpendable net assets are noncapital assets that are required to be 
maintained in perpetuity as specified by parties external to the Hospital, such as permanent 
endowments.  Unrestricted net assets are remaining assets less remaining liabilities that do not meet 
the definition of invested in capital assets, net of related debt or restricted.
15 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Net Patient Service Revenue 
The District has agreements with third-party payers that provide for payments to the District at 
amounts different from its established rates.  Net patient service revenue is reported at the 
estimated net realizable amounts from patients, third-party payers and others for services rendered 
and includes estimated retroactive revenue adjustments and a provision for uncollectible accounts.  
Retroactive adjustments are considered in the recognition of revenue on an estimated basis in the 
period the related services are rendered and such estimated amounts are revised in future periods as 
adjustments become known. 
Tobacco Settlement Revenue 
The District receives revenue that is the result of a settlement between various counties and 
hospital districts in Texas and the tobacco industry for tobacco-related health care costs.  The 
District received approximately $5,664 and $5,388 in revenue from this settlement for the years 
ended September 30, 2011 and 2010, respectively.  This revenue is recognized as a component of 
other operating revenue in the statements of revenues, expenses and changes in net assets. 
Charity Care 
The District provides care without charge or at amounts less than its established rates to patients 
meeting certain criteria under its charity care policy.  Because the District does not pursue 
collection of amounts determined to qualify as charity care, these amounts are not reported as net 
patient service revenue. 
Income Taxes 
As an essential government function of the County, the District is generally exempt from federal 
and state income taxes under Section 115 of the Internal Revenue Code and a similar provision of 
state law.  The District and Partners also carry an exemption from income taxes under Internal 
Revenue Code Section 501(c)(3).  JPSPG is exempt from income taxes under Section 501(a) of the 
Internal Revenue Code.  The District, Partners and JPSPG are all subject to federal income tax on 
any unrelated business taxable income. 
Reclassifications 
Certain reclassifications have been made to the 2011 financial statements to conform to the 
2010 financial statement presentation.  The reclassifications had no effect on the changes in 
financial position. 
16 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Note 2: 
Net Patient Service Revenue 
The District has agreements with third-party payers that provide for payments to the District at 
amounts different from its established rates.  These payment arrangements include: 

Medicare – Inpatient acute care services and substantially all outpatient services rendered to 
Medicare program beneficiaries are paid at prospectively determined rates.  These rates vary 
according to a patient classification system that is based on clinical, diagnostic and other 
factors.  Certain inpatient nonacute services and defined medical education costs are paid based 
on a cost reimbursement methodology.  The District is reimbursed for certain services at 
tentative rates with final settlement determined after submission of annual cost reports by the 
District and audits thereof by the Medicare administrative contractor.  The District’s Medicare 
cost reports have been audited by the Medicare administrative contractor through September 
30, 2007. 

Medicaid – Inpatient services rendered to Medicaid program beneficiaries are reimbursed 
under a prospective payment system.  Outpatient and physician services are reimbursed under a 
mixture of fee schedules and cost reimbursement.  The District is reimbursed for cost 
reimbursable services at tentative rates with final settlement determined after submission of 
annual cost reports by the District and audits thereof by the Medicaid administrative contractor.  
The District’s Medicaid cost reports have been audited by the Medicaid administrative 
contractor through September 30, 2007. 
In response to the growing number of uninsured patients and the rising cost of health care, the 
Texas Legislature established a Texas Medicaid Disproportionate Share Program (DSH) that was 
designed to assist those facilities serving the majority of the indigent patients by providing funds 
supporting increased access to health care within the community.  This program allows the Texas 
Department of Human Services to levy assessments from certain hospitals, use the assessed funds 
to obtain federal matching funds, and then redistribute the total funds to those facilities serving a 
disproportionate share of indigent patients in the state of Texas.  The District receives additional 
reimbursement from this program as well as the Texas Medicaid Upper Payment Limit Program 
(UPL) to assist in serving the indigent population of Tarrant County.  The District received 
approximately $103,309 and $91,780 during 2011 and 2010, respectively, from these programs, 
primarily DSH.  On December 12, 2011, the United States Department of Health & Human 
Services approved a new Medicaid section 1115(a) demonstration entitled “Texas Health 
Transformation and Quality Improvement Program”.  This demonstration will expand existing 
Medicaid managed care programs and establish two funding pools that will assist providers with 
uncompensated care costs and promote health system transformation.  The demonstration is 
effective from December 12, 2011 to September 30, 2016, and may have a material impact on the 
District’s future Medicaid funding.  Management is not currently able to estimate the impact of the 
1115(a) waiver on future funding.
17 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Approximately 50 percent of net patient service revenue is from participation in the Medicare and 
state-sponsored Medicaid programs for both the years ended September 30, 2011 and 2010, 
respectively.  Laws and regulations governing the Medicare and Medicaid programs are complex 
and subject to interpretation and change.  As a result, it is reasonably possible that recorded 
estimates will change materially in the near term. 
The District has also entered into payment agreements with certain commercial insurance carriers, 
HMOs and preferred provider organizations.  The basis for payment to the District under these 
agreements includes prospectively determined rates per discharge, discounts from established 
charges and prospectively determined daily rates. 
Note 3: 
Property Tax Revenue 
The District received approximately 40 percent of its support from property taxes in both the years 
ended September 30, 2011 and 2010.  Property taxes are levied by the District on October 1 of each 
year based on the preceding January 1 assessed property values.  To secure payment, an 
enforceable lien attaches to the property on January 1, when the value is assessed.  Property taxes 
become due and payable when levied on October 1.  This is the date on which an enforceable legal 
claim arises and the District records a receivable for the property tax assessment, less an allowance 
for uncollectible taxes.  Property taxes are considered delinquent after January 31 of the following 
year.  The District recorded an allowance for uncollectible property taxes of approximately $7,891 
and $9,051 at September 30, 2011 and 2010, respectively. 
The District’s property tax rate was $0.226255 per $100 valuation for 2011 and 2010 for the 
maintenance and operation fund and property tax revenue for this fund was approximately 
$273,432 and $282,054 for 2011 and 2010, respectively.  The District’s property tax rate was 
$0.001583 per $100 valuation for 2011 and 2010 for the interest and sinking fund and property tax 
revenue for this fund was approximately $1,913 and $1,974 for 2011 and 2010, respectively. 
Note 4: 
Deposits, Investments and Investment Income 
Deposits 
Custodial credit risk is the risk that in the event of a bank failure, a government’s deposits may not 
be returned to it.  The District’s deposit policy for custodial credit risk requires compliance with the 
provisions of state law.  
State law requires collateralization of all deposits with federal depository insurance or other 
qualified investments.  At September 30, 2011 and 2010, the District’s deposits were either insured 
or collateralized in accordance with state law.
18 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Investments 
The District may legally invest in direct obligations of and other obligations guaranteed as to 
principal by the U.S. Treasury and U.S. agencies and instrumentalities and in bank repurchase 
agreements.  It may also invest to a limited extent in corporate bonds and equity securities. 
At September 30, 2011 and 2010, the District had the following investments and maturities as: 
September 30, 2011
Maturities in Years
Less
More
Type
Fair Value
Than 1
1-5
6-10
Than 10
Money market mutual funds
Investment pools
U.S. Treasury obligations
U.S. agencies obligations
Municipal bonds
$
3,244
$
$
3,244
45,298
-
21,548
101
$
-
-
521
20,777
582
$
-
-
727
17,829
-
$
$
-
-
-
-
-
45,298
1,248
60,154
683
70,191
$
21,880
$
18,556
-
Mutual funds
199
$
$
110,826
September 30, 2010
Maturities in Years
Less
More
Type
Fair Value
Than 1
1-5
6-10
Than 10
Money market mutual funds
Investment pools
U.S. Treasury obligations
U.S. agencies obligations
Corporate bonds
3,291
22,972
1,211
79,995
718
$
$
3,291
22,972
-
23,836
403
$
-
-
$
-
-
699
$
-
-
-
-
-
512
32,947
315
-
23,212
-
-
Municipal bonds
100
-
100
50,502
$
33,774
$
23,911
$
100
Mutual funds
475
$
108,762
19 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 

Interest Rate Risk – As a means of limiting its exposure to fair value losses arising from rising 
interest rates, the District investment policy requires that total investments have a weighted-
average maturity of five years or less.  The District’s investments in U.S. Treasury and agency 
obligations include fixed-rate notes and bonds with a weighted average maturity of three years.  
The longer the maturity of a fixed-rate obligation, the greater the impact a change in interest 
rates will have on its fair value.  As interest rates increase, the fair value of the obligations 
decrease.  Likewise, when interest rates decrease, the fair value of the obligations increase.  The 
money market mutual funds are presented as an investment with a maturity of less than one 
year because they are redeemable in full immediately. 

Credit Risk – Credit risk is the risk that the issuer or other counterparty to an investment will 
not fulfill its obligations.  It is the District's policy to limit its investments to U.S. Treasury and 
agency obligations or otherwise follow the restriction of the Texas Public Funds Investment 
Act.  The District’s investment in U.S. Treasury obligations carry the explicit guarantee of the 
U.S. government.  The debt securities of the U.S. agencies are rated AA+ by Standard & Poor’s 
rating agency.  The District also invests in State Investment Pools (the Pools), which are 
considered investments for financial reporting.  The District has an undivided beneficial interest 
in the pool of assets held by the Pools.  Authorized investments include obligations of the 
United States or its agencies, direct obligation of the State of Texas or its agencies, certificates 
of deposit, and repurchase agreements.  The fair value of the position in these pools is the same 
as the value of the shares in each pool.  The Pools, as well as the money market mutual funds 
invested in by the District, are rated as AAAm by Standard & Poor’s. 
The District also invests in certificates of deposit, which are classified as deposits for financial 
reporting purposes.  These certificates of deposit are fully collateralized by the various financial 
institutions. 

Custodial Credit Risk – For an investment, custodial credit risk is the risk that, in the event of 
the failure of the counterparty, the District will not be able to recover the value of its investment 
or collateral securities that are in the possession of an outside party.  All of the District’s 
investments are held in safekeeping or trust accounts.
20 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 

Concentration of Credit Risk – The District places no limit on the amount that may be 
invested in any one issuer as long as the restrictions of the Texas Public Funds Investment Act 
are followed.  The following table reflects the District’s investments in single issuers that 
represent more than five percent of total investments: 
2011
2010
Federal Home Loan Bank
Federal National Mortgage Association
Federal Farm Credit Bank
Federal Home Loan Mortgage Association
Federal Agricultural Mortgage Corporation
19.2%
32.5%
12.7%
12.9%
9.4%
8.8%
11.7%
9.3%
5.3%
5.2%
Summary of Carrying Values 
The carrying values of deposits and investments shown above are included in the balance sheets as 
follows: 
2011
2010
Carrying value
Deposits
Investments
$
$
273,925
110,826
$
$
287,120
108,762
384,751
395,882
Included in the following balance sheets captions
Cash and cash equivalents
Short-term investments
Restricted cash and investments, current
Noncurrent cash and investments
$
$
90,030
110,276
5,501
$
$
72,801
141,038
5,493
178,944
176,550
384,751
395,882
21 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Investment Income 
Investment income for the years ended September 30 consisted of: 
2011
2010
Interest and dividend income
Net decrease in fair value of investments
$
$
6,112
(713)
$
$
7,233
(218)
5,399
7,015
Note 5: 
Patient Accounts Receivable 
The District grants credit without collateral to its patients, many of whom are area residents and are 
insured under third-party payer agreements.  Patient accounts receivable at September 30 consisted 
of: 
2011
2010
Medicare
Medicaid
Other third-party payers
Patients
$
$
10,803
25,813
6,746
$
$
11,496
18,050
21,226
151,805
143,336
195,167
141,346
194,108
138,482
Less allowance for uncollectible accounts
53,821
55,626
22 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Note 6: 
Capital Assets 
Capital assets activity for the years ended September 30 was: 
2011
Beginning
Balance
Ending
Balance
Additions
Disposals
Transfers
Land and improvements
Buildings and improvements
Equipment
$
46,898
$
176
$
-
$
826
1,267
10,801
$
47,900
230,176
328,873
5,029
349
15,287
36,270
231,792
338,074
28,405
(16,887)
-
Construction in progress
(12,894)
610,976
317,421
293,555
52,082
40,565
11,517
(16,887)
(15,733)
(1,154)
-
-
-
646,171
342,253
303,918
Less accumulated
depreciation
Capital assets, net
$
$
$
$
$
$
$
$
$
$
2010
Beginning
Balance
Ending
Balance
Additions
Disposals
Transfers
Land and improvements
Buildings and improvements
Equipment
45,788
224,182
305,161
8,393
1,044
42
13,513
15,567
-
66
6,112
12,753
(18,931)
46,898
(160)
(2,554)
-
230,176
328,873
5,029
Construction in progress
583,524
280,946
302,578
30,166
38,409
(8,243)
(2,714)
(1,934)
(780)
-
-
-
610,976
317,421
293,555
Less accumulated
depreciation
Capital assets, net
$
$
$
$
$
23 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
In 2010, the District began implementing an electronic medical record system.  This project is 
expected to be completed in 2012 and the total estimated remaining cost at September 30, 2011, is 
$94,122, of which $81,378 is expected to be capital related. 
Note 7: 
Accounts Payable and Accrued Expenses 
Accounts payable and accrued expenses included in current liabilities at September 30 consisted of: 
2011
2010
Payable to suppliers and contractors
Payable to employees (including payroll taxes 
      and benefits)
Pollution remediation liability
Patient credit balances
$
26,650
$
40,655
27,818
2,837
1,968
1,745
24,285
3,464
2,948
229
Other accrued liabilities
$
61,018
$
71,581
Note 8: 
Risk Management 
Medical Malpractice and General Liability Risks 
The District is self-insured for medical malpractice and general liability claims.  The District’s 
maximum liability for professional and general liability claims as a governmental unit under the 
Tort Claims Act is generally $100,000 per individual and $300,000 per occurrence. 
Losses from asserted and unasserted claims identified under the District’s incident reporting system 
are accrued based on estimates that incorporate the District’s past experience, as well as other 
considerations, including the nature of each claim or incident and relevant trend factors.  It is 
reasonably possible that the District’s estimate of losses will change by a material amount in the 
near term.
24 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Activity in the District’s accrued medical malpractice claims liability during 2011 and 2010 is 
summarized as follows: 
2011
2010
Balance, beginning of year
$
$
1,211
$
$
1,333
Current year claims incurred and changes in 
estimates for claims incurred in prior years
Claims and expenses paid
(54)
(51)
(14)
(108)
Balance, end of year
1,106
1,211
Employee Health Claims 
Substantially all of the District’s employees and their dependents are eligible to participate in the 
District's employee health insurance plan.  Commercial stop-loss insurance coverage is purchased 
for claims in excess of $500,000.  A provision is accrued for self-insured employee health claims 
including both claims reported and claims incurred but not yet reported.  The accrual is estimated 
based on consideration of prior claims experience, recently settled claims, frequency of claims, and 
other economic and social factors.  It is reasonably possible that the District’s estimate will change 
by a material amount in the near term. 
Activity in the District’s accrued employee health claims liability during 2011 and 2010 is 
summarized as follows: 
2011
2010
Balance, beginning of year
$
$
4,250
$
$
4,870
Current year claims incurred and changes in 
estimates for claims incurred in prior years
Claims and expenses paid
35,273
(35,223)
37,224
(37,844)
Balance, end of year
4,300
4,250
Workers’ Compensation Claims 
The District is self-insured for workers’ compensation claims.  A provision is accrued for 
self-insured employee health claims including both claims reported and claims incurred but not yet 
reported.  The accrual is estimated based on consideration of prior claims experience, recently 
settled claims, frequency of claims, and other economic and social factors.  It is reasonably 
possible that the District’s estimate will change by a material amount in the near term.
25 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Activity in the District’s accrued workers’ compensation claims liability during 2011 and 2010 is 
summarized as follows: 
2011
2010
Balance, beginning of year
$
$
2,101
$
$
3,110
Current year claims incurred and changes in 
estimates for claims incurred in prior years
Claims and expenses paid
537
(869)
321
(1,330)
Balance, end of year
1,769
2,101
Note 9: 
Long-term Debt 
A summary of long-term debt follows: 
2011
2010
Revenue bonds, Series 2002
$
31,405
27,160
$
32,660
28,000
Certificates of obligation, Series 2006
58,565
(33)
60,660
28
Bond premium (discount)
$           58,532 
$           60,688 
Revenue Bonds - Series 2002 
The Series 2002 revenue bonds consist of Tarrant County Hospital District Revenue Bonds, Series 
2002 (the Bonds) in the original amount of $40,940 dated June 1, 2002, which bear interest at 
2.0 percent to 5.5 percent.  The Bonds are payable in remaining annual installments of $1,305 to 
$2,790 through August 15, 2027.  All of the Bonds still outstanding may be redeemed at the 
District’s option on or after August 15, 2012, at par value plus accrued interest.  The Bonds are 
secured by the net revenues of the District, excluding property tax revenue.  
26 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Certificates of Obligation - Series 2006 
The Series 2006 certificates of obligation consist of Tarrant County Hospital District Certificates of 
Obligation, Series 2006 (the Certificates) in the original amount of $30,330 dated March 1, 2006, 
which bear interest at 4.0 percent to 5.0 percent.  The Certificates are payable in remaining annual 
installments of $875 to $2,025 through February 15, 2031.  All of the Certificates still outstanding 
may be redeemed at the District’s option on or after February 15, 2016, at par value plus accrued 
interest.  The Bonds are secured by the net revenues of the District, including property tax revenue.  
The indenture agreements require that certain funds be established with the trustee.  Accordingly, 
these funds are included as assets held by trustee for debt service in the balance sheets.  The 
indenture agreements also require the District to comply with certain restrictive covenants 
including minimum insurance coverage and days cash on hand. 
The following is a summary of long-term debt transactions for the District for the years ended 
September 30: 
2011
Beginning 
Balance
Ending 
Balance
Additions
Deductions
Current Portion
Long-term debt
Revenue bonds, Series 2002
Certificates of obligation, Series 2006
$
$
32,660
28,000
$
$
-
-
$
1,255
840
$
$
31,405
27,160
$
$
1,305
875
Total long-term debt
60,660
-
$
2,095
58,565
2,180
2010
Beginning 
Balance
Ending 
Balance
Additions
Deductions
Current Portion
Long-term debt
Revenue bonds, Series 2002
Certificates of obligation, Series 2006
Capital lease obligations
$
$
33,870
28,810
2,664
$
$
-
-
-
$
1,210
810
2,664
$
$
32,660
28,000
-
$
$
1,255
840
-
Total long-term debt
65,344
-
$
4,684
60,660
2,095
27 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
The debt service requirements as of September 30, 2011, are as follows: 
Year Ending
September 30,
Principal
Interest
Total
2012
2013
2014
2015
2016
2017 - 2021
2022 - 2026
2027 - 2031
$
2,180
2,265
2,385
2,500
2,620
15,195
19,380
12,040
$
2,826
$
5,006
5,002
5,010
5,007
5,004
25,020
25,014
13,298
2,737
2,625
2,507
2,384
9,825
5,634
1,258
$
58,565
$
29,796
$
88,361
Note 10:   Restricted and Designated Net Assets 
At September 30, 2011 and 2010, $2,308 and $4,664, respectively, of net assets were restricted by 
donors for capital and operating activities.  
At September 30, 2011 and 2010, $160,120 and $155,806, respectively, of unrestricted net assets 
has been designated by the Board for future operating needs and capital acquisitions.  Designated 
net assets remain under the control of the Board, which may, at its discretion, later use these net 
assets for other purposes. 
At September 30, 2011 and 2010, the District had $250 of restricted nonexpendable net assets 
which is a general endowment for Partners.
28 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Note 11:   Charity Care 
In support of its mission, the District voluntarily provides free care to patients who lack financial 
resources and are deemed to be medically indigent.  Because the District does not pursue collection 
of amounts determined to qualify as charity care, they are not reported in net patient service 
revenue.  In addition, the District provides services to other medically indigent patients under 
certain government-reimbursed public aid programs.  Such programs pay providers amounts which 
are less than established charges for the services provided to the recipients and many times the 
payments are less than the cost of rendering the services provided. 
Uncompensated charges relating to these services are as follows: 
2011
2010
Charity allowances
State Medicaid and other public aid programs
$
$
654,576
206,152
$
$
655,881
199,274
860,728
855,155
In addition to uncompensated charges, the District also commits significant time and resources to 
endeavors and critical services, which meet otherwise unfilled community needs.  Many of these 
activities are sponsored with the knowledge that they will not be self-supporting or financially 
viable. 
Note 12:   Pension Plan 
Plan Description 
The District sponsors a defined benefit pension plan for eligible employees within a multiemployer 
retirement program sponsored for member hospitals by the Texas Hospital Association (THA).  
HealthShare/THA, a wholly owned subsidiary of THA, is the plan administrator of the pension 
plan.  The plan’s assets are invested as a portion of the THA’s master pension trust fund.  The plan 
provides retirement, death and disability benefits.  Amendments to the plan are made only with the 
authority of the District’s Board.   
The plan does not issue a stand-alone financial report.  However, an annual actuarial valuation 
report is available from the District or HealthShare/THA.  That report may be obtained by writing 
HealthShare/THA at Post Office Box 679010, Austin, Texas 78768-9010.
29 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Funding Policy 
The Board has the sole authority to establish or amend the obligations to contribute to the plan by 
participants or the employer.  The District is not subject to any explicit legal or contractual 
contribution rate.  Plan members are required to annually contribute 1 percent of their 
compensation.  Effective October 1, 2006, participation in the pension plan became mandatory for 
full-time employees completing one year of service on or after October 1, 2006.  An amendment 
effective October 1, 2011 will make plan participation voluntary for employees hired after that 
date. 
The District makes annual contributions, which are actuarially determined as a level percentage of 
total participant compensation less projected employee contributions in accordance with the Entry 
Age Normal (EAN) actuarial funding method.  Under the EAN method, the District contribution 
rate is set equal to 6.5 percent of total participant compensation beginning with the current fiscal 
year until a future actuarial valuation shows that:  (a) actuarial value of assets equals or exceeds the 
EAN accrued liability, which will cause a reduction to the employer contribution rate or (b) the 
implicit amortization period of the unfunded EAN accrued liability at the current contribution rate 
exceeds 30 years, which would be remediated by an increase in the employer contribution rate.  
The employer contributions were 6.5 percent of estimated participant compensation for both the 
years ended September 30, 2011 and 2010.  The costs of administering the plan are paid by the 
plan and are considered in the determination of the employer contribution rate. 
Annual Pension Cost 
The District’s annual pension cost was $12,652 and $11,206 for the years ended September 30, 
2011 and 2010, respectively.  These costs were equal to the annual required contributions as 
determined in the actuarial valuations dated October 1, 2010 and 2009, respectively.  There is no 
existing net pension obligation. 
The required contributions for the plan year ended September 30, 2011, were based on the results 
of the actuarial valuation as of October 1, 2010, using the EAN actuarial funding method and were 
in compliance with the GASB Statement No. 27, Accounting for Pensions by State and Local 
Governmental Employers, parameters.  The actuarial assumptions included:  (a) an 8 percent 
investment rate of return (net of administrative expenses) and (b) projected salary increases of 4.5 
percent to 8.0 percent, per year, varying by attained age.  Both (a) and (b) included an inflation 
component of 4.0 percent.  The assumptions did not include any postretirement benefit increases.  
The actuarial value of plan assets was determined using a five-year smoothed market value method.  
30 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Three-Year Trend Information 
Annual
Pension Cost
(APC)
Percentage of
APC
Contributed
Net Pension
Obligation
Fiscal Year Ended
2009
2010
2011
$
9,646,748
11,205,667
12,652,413
100%
100%
100%
$
-
-
-
  
Schedule of Funding Progress 
Plan Assets 
Less Than 
AAL as a 
Percent of 
Covered 
Actuarial 
Value of Plan 
Assets
Actuarial 
Actuarial 
Accrued 
Plan Assets Less 
than AAL
Covered 
Payroll
Valuation Date
Liability (AAL)
Funded Ratio
Payroll
10/1/2008
10/1/2009
10/1/2010
$
79,788
89,497
101,345
$
97,125
113,781
134,597
$
(17,337)
(24,284)
(33,252)
82.1%
78.7%
75.3%
$
139,484
172,395
194,653
-12.4%
-14.1%
-17.1%
Other Benefit Plans 
The District has an Internal Revenue Code (IRC) Section 401(a) plan that includes an employer 
match calculated as 50% of an employee’s contribution up to 4 percent of pay.  The contributions 
for the employer match on the plan were approximately $3,831 and $3,516 for the years ended 
September 30, 2011 and 2010, respectively. 
In addition, the District offers its employees a tax-deferred annuity plan created in accordance with 
IRC Section 457.  The plan, available to all District employees, permits them to defer a portion of 
their salary until future years.  All amounts of compensation deferred under the plan and income 
attributable to those amounts are solely the property of the employee.  Thus, the plan amounts are 
not reported in the financial statements. 
The District also offers its employees a tax-deferred annuity plan created in accordance with IRC 
Section 403(b).  The plan, available to all District employees, permits them to defer a portion of 
their salary until future years.  All amounts of compensation deferred under the plan and income 
attributable to those amounts are solely the property of the employee.  Thus, the plan amounts are 
not reported in the financial statements.
31 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
The District has a Governmental Excess Benefit Arrangement Plan for executives approved by the 
Board.  This plan is to provide participants in the defined benefit plan that portion of the 
participant’s benefits that would otherwise be payable under the terms of the defined benefit plan, 
except for the limitations on benefits imposed by Section 415(b) of the IRS.  As of September 30, 
2011 and 2010, there were no benefits due under this plan. 
Note 13:   Related Party Transactions 
During 2010, the District entered an indigent care affiliation agreement with the Tarrant County 
Indigent Care Corporation (TCICC), a non-profit corporation comprised of affiliated Tarrant 
County hospitals.  This agreement is intended to increase funding for the Medicaid population and 
to access federal funding for the indigent population of Tarrant County through the Texas Medicaid 
Supplemental Payment Program also known as the Private Upper Payment Limit Program (UPL). 
Under this program, the District contributes certain government funds to the State of Texas, limited 
to the amount allowed based on aggregate state-wide funding caps.  TCICC uses the UPL funds 
received for medical direction and indigent care for services to the Tarrant County indigent care 
population provided at the District’s facilities.  Prior to this agreement, the medical direction and 
indigent care services were funded by the District. 
Services provided by TCICC were valued at approximately $83,100 and $73,490 for the years 
ended September 30, 2011 and 2010, respectively.  As part of the affiliation agreement, the District 
provided $56,591 and $46,340 in funding to the program for the years ended September 30, 2011 
and 2010, respectively.  The District recognizes revenue from contributed services equal to the 
difference in the value of the services provided by TCICC and the program funding provided by 
the District.  Contributed services revenue was $26,509 and $27,150 for 2011 and 2010, 
respectively. 
Should TCICC cease providing these services, the District has entered a stand-by agreement with 
physicians participating in this program under which the District would assume the payment 
obligations of TCICC.  
The funding for services for the indigent population of Tarrant County through the UPL program 
will be replaced by the Medicaid section 1115(a) Demonstration program, titled “Texas Healthcare 
Transformation and Quality Improvement Program” that was approved on December 12, 2011, by 
the Department of Health & Human Services.  This program allows for continued funding under 
the current TCICC agreement for the initial transition year.
32 

 
Tarrant County Hospital District 
d/b/a JPS Health Network 
A Component Unit of Tarrant County, Texas 
Notes to Financial Statements 
September 30, 2011 and 2010 
(In Thousands) 
Note 14:   Pollution Remediation Obligations 
The District owns a building containing asbestos and other potential environmental issues that meet 
the criteria for “obligating events” and disclosure under GASB Statement No. 49, Accounting and 
Financial Reporting for Pollution Remediation Obligations.  This vacant property was acquired by 
the District for the purpose of eventually constructing new facility space and the District believes it 
has obligated itself to remediate the environmental hazards and, therefore, has incurred pollution 
remediation obligations (PRO). 
Changes in the District’s PRO liability are capitalized as a component of capital assets.  The 
District’s PRO liability is measured based on the current cost of expected remediation activities 
and is adjusted as changes in the cost of remediation occur. 
The following table summarizes the change in the District’s PRO during the years ended 
September 30, 2011 and 2010: 
2011
2010
PRO, beginning of year
Changes in estimated remediation costs
$
$
3,464
(627)
$
$
3,551
(87)
PRO, end of year
2,837
3,464
33 

 
Supplementary Information 

 
JPS Health Network 
A Component Unit of Tarrant County 
Balance Sheet Information 
September 30, 2011 
(In Thousands) 
Assets
Hospital
JPSPG
Partners
Eliminations
Total
Current Assets
Cash and cash equivalents
$
75,905
$
13,756
$
365
$
4
$
90,030
Short-term investments
Patient accounts receivable, net
Property taxes receivable, net
Texas disproportionate share program receivable
Restricted pledges receivable, net
Held by trustee for self insurance, current portion
Due from third-party payers
110,276
47,033
5,209
11,941
-
5,501
2,200
10,011
8,698
-
6,788
-
-
-
-
-
-
1,955
-
-
-
-
279
-
-
-
-
-
-
-
-
-
-
-
(635)
110,276
53,821
5,209
11,941
279
5,501
2,200
10,011
10,059
Supplies inventory
Prepaid expenses and other assets
41
Total current assets
276,774
2,095
22,499
551
685
5
(631)
299,327
-
Due from Affiliates
(2,651)
Noncurrent Cash and Investments
Held by trustee for debt service
Held by trustee for self insurance
Restricted by donors for capital acquisitions and
specific operating activities
2,958
13,243
-
-
-
-
-
-
2,958
13,243
-
160,120
176,321
-
-
2,623
-
-
2,623
160,120
178,944
93
Internally designated for capital acquisitions and
operating activities
-
-
Total noncurrent assets
Pledges Receivable
-
2,623
93
-
-
-
-
-
Capital Assets - Net
Total assets
303,913
759,103
5
303,918
782,282
$
$
23,050
$
3,411
$
(3,282)
$

 
Liabilities and Net Assets
Hospital
JPSPG
Partners
Eliminations
Total
Current Liabilities
Accounts payable
$
33,109
$
320
$
49
$
(631)
$
32,847
Accrued expenses
22,383
150
5,501
2,180
5,783
5
-
-
-
-
-
-
28,171
150
5,501
2,180
Due to third-party payers
Current portion of self-insurance costs
Current maturities of long-term debt
-
-
-
-
Total current liabilities
Due to Affiliates
63,323
560
6,103
1,687
-
54
404
-
(631)
68,849
-
(2,651)
Estimated Self-insurance Costs
Long-term Debt
1,674
56,352
-
-
-
-
1,674
56,352
1,279
-
-
Other Long-term Liabilities
1,269
10
Total liabilities
121,909
9,059
468
(3,282)
128,154
Net Assets
Invested in capital assets - net of related debt
Restricted expendable
Restricted non-expendable
Unrestricted
248,339
-
-
-
-
-
5
2,308
250
-
-
-
-
248,344
2,308
250
388,855
13,991
380
403,226
Total net assets
637,194
759,103
13,991
23,050
2,943
3,411
-
654,128
782,282
Total liabilities and net assets
$
$
$
$
(3,282)
$
34 

 
JPS Health Network 
A Component Unit of Tarrant County 
Statement of Revenues, Expenses and  
Changes in Net Assets Information 
Year Ended September 30, 2011 
(In Thousands) 
Hospital
JPSPG
Partners
Eliminations
Total
Operating Revenues
Net patient service revenue
Texas disproportionate share program revenue
Contributions
$
229,036
100,274
-
$
35,471
3,035
-
$
-
-
858
499
$
(59)
-
(39)
$
264,448
103,309
819
Other operating revenue
44,901
8,979
(2,748)
51,631
Total operating revenues
374,211
47,485
1,357
(2,846)
420,207
Operating Expenses
Salaries and related expenses
Professional fees and purchased services
Supplies
Depreciation and amortization
Other
311,145
175,109
131,705
40,452
42,931
1,527
189
-
570
47
828
102
2
-
(3,227)
(32)
-
(2,590)
354,123
174,237
131,964
40,454
20,510
3,106
21,596
Total operating expenses
678,921
45,217
2,268
4,085
(5,849)
3,003
722,374
Operating Income (Loss)
(304,710)
(2,728)
(302,167)
Nonoperating Revenues (Expenses)
Property tax revenue
Contributed services
Interest expense
Investment return and other
275,345
26,509
(2,009)
7,457
-
-
-
-
-
-
-
-
-
275,345
26,509
(2,009)
5,487
41
635
(2,646)
Total nonoperating revenues (expenses)
307,302
41
635
(2,646)
305,332
Excess of Revenues Over Expenses Before Capital
Grants and Gifts
2,592
(402)
2,309
(2,093)
760
357
3,165
-
Capital Grants and Gifts
(1)
(357)
Increase (Decrease) in Net Assets
Net Assets, Beginning of Year
Net Assets, End of Year
2,190
2,308
11,683
13,991
(1,333)
4,276
2,943
-
-
-
3,165
650,963
654,128
635,004
637,194
$
$
$
$
$
35 

 
Required Supplementary Information 

 
JPS Health Network 
A Component Unit of Tarrant County 
Schedule of Funding Progress – Pension Plan 
September 30, 2011 
Plan Assets 
Less Than 
AAL as a 
Percent of 
Covered 
Actuarial 
Value of Plan 
Assets
Actuarial 
Accrued 
Liability (AAL)
Actuarial 
Valuation Date
Plan Assets Less 
than AAL
Covered 
Payroll
Funded Ratio
Payroll
10/1/2008
10/1/2009
10/1/2010
$   79,787,987         $   97,125,493
$
(17,337,506)
(24,283,194)
(33,251,628)
82.1%
78.7%
75.3%
$ 139,484,491
172,394,878
194,652,507
-12.4%
-14.1%
-17.1%
89,497,413
113,780,607
134,596,522
101,344,894
36