Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Independent Auditor’s Report and Financial Statements 
September 30, 2015 and 2014

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Years Ended September 30, 2015 and 2014
Contents
Independent Auditor’s Report ............................................................................................... 1 
Management’s Discussion and Analysis ............................................................................. 3 
Financial Statements 
Balance Sheets .................................................................................................................................... 9 
Statements of Revenues, Expenses and Changes in Net Position .................................................... 10 
Statements of Cash Flows ................................................................................................................ 11 
Notes to Financial Statements .......................................................................................................... 13 
Required Supplementary Information 
Schedule of Changes in District’s Net Pension Liability and Related Ratios .................................. 42 
Schedule of District Contributions ................................................................................................... 43 
Schedule of Funding Progress – Pension Plan ................................................................................. 44 
Other Information 
Balance Sheet Information ............................................................................................................... 45 
Statement of Revenues, Expenses and Changes in Net Position Information .................................. 46 

 
Independent Auditor’s Report 
Board of Managers 
Tarrant County Hospital District 
  d/b/a JPS Health Network 
Fort Worth, Texas 
We have audited the accompanying balance sheets of Tarrant County Hospital District d/b/a JPS Health 
Network (District), a component unit of Tarrant County, Texas, as of September 30, 2015 and 2014, and 
the related statements of revenues, expenses and changes in net position and cash flows for the years then 
ended, and the related notes to the financial statements, which collectively comprise the District’s basic 
financial statements. 
Management’s Responsibility for the Financial Statements 
Management is responsible for the preparation and fair presentation of these financial statements in 
accordance with accounting principles generally accepted in the United States of America; this includes 
the design, implementation and maintenance of internal control relevant to the preparation and fair 
presentation of financial statements that are free from material misstatement, whether due to fraud or 
error. 
Auditor’s Responsibility 
Our responsibility is to express an opinion on these financial statements based on our audits.  We 
conducted our audits 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 from material misstatement. 
An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in 
the financial statements.  The procedures selected depend on the auditor’s judgment, including the 
assessment of the risks of material misstatement of the financial statements, whether due to fraud or error.  
In making those risk assessments, the auditor considers internal control relevant to the entity’s preparation 
and fair presentation of the financial statements in order to design audit procedures that are appropriate in 
the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity’s 
internal control.  Accordingly, we express no such opinion.  An audit also includes evaluating the 
appropriateness of accounting policies used and the reasonableness of significant accounting estimates 
made by management, as well as evaluating the overall presentation of the financial statements.   
We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for 
our audit opinion. 

 
Board of Managers 
Tarrant County Hospital District 
  d/b/a JPS Health Network 
Page 2 
Opinion 
In our opinion, the financial statements referred to above present fairly, in all material respects, the 
financial position of the District as of September 30, 2015 and 2014, and the changes in its financial 
position and its cash flows for the years then ended in accordance with accounting principles generally 
accepted in the United States of America. 
Emphasis of Matter 
As discussed in Note 16, in 2015, the District changed its method of accounting for its defined benefit 
pension plans as a result of implementing Governmental Accounting Standards Board (GASB) Statement 
No. 68, Accounting and Financial Reporting for Pensions – an amendment of GASB Statement No. 27 
and GASB Statement No. 71, Pension Transition for Contributions Made Subsequent to the Measurement 
Date – an Amendment of GASB Statement No. 68.  Our opinion is not modified with respect to this 
matter. 
Other Matters 
Required Supplementary Information 
Accounting principles generally accepted in the United States of America require that the management’s 
discussion and analysis and pension information listed in the table of contents be presented to supplement 
the basic financial statements.  Such information, although not part of the basic financial statements, is 
required by the Governmental Accounting Standards Board, who considers it to be an essential part of 
financial reporting for placing the basic financial statements in an appropriate operational, economic or 
historical context.  We have applied certain limited procedures to the required supplementary information 
in accordance with auditing standards generally accepted in the United States of America, which 
consisted of inquiries of management about the methods of preparing the information and comparing the 
information for consistency with management’s responses to our inquiries, the basic financial statements 
and other knowledge we obtained during our audits of the basic financial statements.  We do not express 
an opinion or provide any assurance on the information because the limited procedures do not provide us 
with sufficient evidence to express an opinion or provide any assurance. 
Other Information 
Our audits were conducted for the purpose of forming an opinion on the basic financial statements as a 
whole. The other balance sheet and statement of revenues, expenses and changes in net position 
information listed in the table of contents is presented for purposes of additional analysis and is not a 
required part of the financial statements. Such information has not been subjected to the auditing 
procedures applied in the audit of the basic financial statements, and accordingly, we do not express an 
opinion or provide any assurance on it. 
Dallas, Texas 
February 2, 2016 

 
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, 2015 and 2014
(In Thousands) 
Introduction 
This management’s discussion and analysis of the financial performance of Tarrant County Hospital 
District d/b/a JPS Health Network (District) provides an overview of the District’s financial activities for 
the years ended September 30, 2015 and 2014.  It should be read in conjunction with the accompanying 
financial statements of the District.  Unless otherwise indicated, amounts are in thousands. 
As discussed in Note 16, the District adopted Governmental Accounting Standards Board (GASB) 
Statement No. 68, Accounting and Financial Reporting for Pensions – an Amendment of GASB Statement 
No. 27 and GASB Statement No. 71, Pension Transition for Contributions Made Subsequent to the 
Measurement Date – an Amendment of GASB Statement No. 68, during the year ended September 30, 
2015.  As part of the implementation of GASB Statement No. 68, management determined it was not 
practical to restate 2014 and prior years.  Therefore, the impact of the implementation of GASB Statement 
No. 68 was recognized through a restatement of fiscal year 2015 beginning net position.  
Financial Highlights 
•
•
•
Cash, short-term investments and other noncurrent investments increased in 2015 by $85,140 or 
20.1% and increased in 2014 by $34,039 or 8.8%. 
The District’s net position increased in each of the past two years with a $51,763 or 6.8% increase in 
2015 and a $28,371 or 3.9% increase in 2014. 
The District reported operating losses in both 2015 ($266,599) and 2014 ($274,530).  The loss in 
2015 decreased by $7,931 or 2.9%, as compared to the operating loss reported in 2014.  The operating 
loss in 2014 increased by $37,852 or 16.0%, from the operating loss reported in 2013. 
•
Net nonoperating revenues increased by $15,654 or 5.2% in 2015 compared to 2014 and increased by 
$5,598 or 1.9% in 2014 compared to 2013. 
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 position; 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 Position 
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 position 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. 
3

 
These two statements report the District’s net position and changes in them.  The District’s total net 
position—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 position 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 Position 
The District’s net position is the difference between its assets and liabilities reported in the balance sheets.  
The District’s net position increased by $51,763 (6.8%) in 2015 over 2014 and by $28,371 (3.9%) in 2014 
over 2013, as shown in Table 1: 
Table 1:  Assets, Deferred Outflows of Resources, Liabilities, Deferred Inflows of 
Resources and Net Position 
2015
2014
2013
Assets
Cash and short-term investments
$
320,053
$
235,148
$
202,938
Patient accounts receivable, net 
Other current assets
Capital assets, net
44,838
164,261
289,046
187,536
47,721
192,677
284,087
187,366
53,928
161,882
283,409
187,096
Other noncurrent assets
Total assets
1,005,734
17,646
946,999
-
889,253
-
Deferred Outflows  of Resources
Total assets and deferred 
ouflows of resources
$
1,023,380
$
946,999
$
889,253
Liabilities
Long-term debt
Net pension liability
Other current and noncurrent liabilities
$
43,307
9,545
152,495
$
46,045
-
141,687
$
48,742
-
109,615
Total liabilities
205,347
7,003
187,732
-
158,357
-
Deferred Inflows  of Resources
Net Position
Net investment in capital assets
Restricted expendable
Restricted nonexpendable
Unrestricted
239,983
1,646
315
233,599
1,735
315
232,625
1,434
315
569,086
523,618
496,522
Total net position
811,030
759,267
946,999
730,896
889,253
Total liabilities, deferred inflows of 
resources and net position
$
1,023,380
$
$
4

 
A significant change in the District’s assets in 2015 is the increase cash and investments.  Cash and 
investments increased by $85,140 or 20.1% in 2015 over 2014.  This is primarily due to a lower operating 
loss and increased property tax revenue.  In addition, the District adopted GASB Statement No. 68 in 
2015 which resulted in the recognition of a net pension liability and related deferred outflows and 
deferred inflows of resources.  This is more fully described in Note 13. 
The most significant change in the District’s assets in 2014 is the increase in amounts due from the state 
of Texas under supplemental funding programs. Supplemental funding payments from the Medicaid 
Disproportionate Share Program and the Medicaid section 1115(a) demonstration (Waiver) funding pools, 
discussed more fully in Note 3, were delayed and the related receivable increased by $28,377 or 21.3% in 
2014 as compared to 2013. 
The District’s cash and investments and other noncurrent investments increased by $34,039 or 8.8% in 
2014 as compared to 2013, and the District’s accounts receivable decreased by $6,207 or 11.5% in 2014 
as compared to 2013. The increase in cash and investments is attributable to the excess of revenues over 
expenses and a decrease in patient accounts receivable. The decrease in accounts receivable is primarily 
attributable to continued process improvement resulting in increased cash collections. 
Operating Results and Changes in the District’s Net Position 
In 2015, the District’s net position increased by $51,656 or 6.8%, as shown in Table 2.  This increase is 
made up of several components and represents an increase of 82.5% compared with the increase in net 
position for 2014 of $28,371.  The District’s change in net position decreased from $60,260 in 2013 to 
$28,371 in 2014. 
Table 2:  Operating Results and Changes in Net Position 
2015
2014
2013
Operating Revenues
Net patient service  revenue
Supplemental Medicaid  funding
Other operating revenue
$
337,394
191,360
37,589
$
299,019
185,143
42,396
$
261,427
211,628
51,384
Total operating revenues
566,343
526,558
524,439
Operating Expenses
Salaries and wages and  employee benefits
Purchased services  and professional fees
Supplies
Depreciation and  amortization
Other operating expenses
442,891
186,971
126,017
38,817
408,976
189,390
124,201
40,084
372,709
187,917
121,011
42,491
38,246
38,437
36,989
Total operating  expenses
832,942
801,088
761,117
Operating Loss
(266,599)
(274,530)
(236,678)
Nonoperating Revenues  (Expenses)
Property taxes
Contributed services
307,019
11,296
(145)
291,013
9,185
2,318
283,766
12,427
725
Investment return, interest  expense and other
Total nonoperating  revenues (expenses)
318,170
302,516
296,918
Excess of Revenues  Over Expenses
Before Capital  Grants
51,571
85
27,986
385
60,240
20
Capital Grants
Increase in Net Position
$
51,656
$
28,371
$
60,260
5

 
Operating Losses 
The first component of the overall change in the District’s net position 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 2015 decreased by $7,931or 2.9% as compared to 2014.  The primary components 
of the change are: 
•
•
•
•
An increase in net patient service revenue of $38,375 or 12.8% 
An increase in Medicaid supplemental funding of $6,217 or 3.4% 
A decrease in other operating revenue of $4,807 or 11.3% 
An increase in salary and related expenses of $33,915 or 8.3% 
The increase in net patient service revenue is primarily attributable to changes in payer mix and the 
increase in Medicaid supplemental funding revenue is primarily due to shifts in funding allocations. 
The decrease in other operating revenue is due in large part to a decrease in funding from the Medicare 
and Medicaid Electronic Health Records Incentive Program discussed more fully in Note 1.   
The increase in salary and related expenses is due to wage increases resulting from the District’s retention 
efforts and to the addition of full time equivalent employees. 
The operating loss for 2014 of $274,530 was $37,852 more than the operating loss of $236,678 
recognized in 2013.  The District had an increase in net patient service revenue of $37,592 and a decrease 
in Texas Medicaid supplemental funding of $26,485.  Net patient service revenue increased as a result of 
patient volumes and changes in payer mix. The decrease in Medicaid Supplemental Funding is due to the 
impact of the overall planned decrease in Waiver funding pools for 2014 and changes in funding 
allocation methodology.  Salaries and wages increased in 2014 by $36,267 or 9.7%, as compared to 2013 
due to retention efforts and the addition of full time equivalent employees.  Other operating revenue 
decreased in 2014 by $8,988 or 17.5% as compared to 2013, due to a decrease in funding from the 
Medicare and Medicaid Electronic Health Records Incentive Program as discussed above.   
Nonoperating Revenues and Expenses 
Nonoperating revenues and expenses consist primarily of property taxes levied by the District, 
contributions and investment income and interest expense.  The District held property tax rates steady in 
2015, but an increase in overall property values as well as changes in estimated uncollectible property 
taxes resulted in a net increase in property tax revenue of $16,006 or 5.5% from 2014 to 2015.  
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 increased by $2,111 or 22.98% in 2015 as compared to 2014.  Contributed services 
fluctuate each year based on the costs associated with the physician services provided to the District’s 
indigent patients.   
Interest expense decreased by $123 or 8.43% in 2015 as compared to 2014 due to the District paying 
down outstanding debt in 2015 and an increase in the amount of interest capitalized in 2015 as compared 
to 2014.  
6

 
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 2015, 2014 and 2013, discussed earlier. 
Capital Asset and Debt Administration 
Capital Assets
At the end of 2015, the District had $289,046 invested in capital assets, net of accumulated depreciation, 
as detailed in Note 7 to the financial statements.  In 2015, the District purchased new capital assets costing 
$43,942.
At the end of 2014, the District had $284,087 invested in capital assets, net of accumulated depreciation.  
In 2014, the District purchased new capital assets costing $40,868. 
Debt
At September 30, 2015, the District had $45,035 in revenue bonds and certificates of obligations 
outstanding.  The District issued no new debt in 2015.  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 District’s outlook was updated from negative to stable in 2014, by 
Moody’s and Standard & Poor’s.  The District has a current Aa3 rating from Moody’s and a current AA- 
rating from Standard & Poor’s. 
Other Economic Factors 
The District is the Anchor facility for the Region 10 Regional Healthcare Partnership (RHP) DSRIP 
program under the Medicaid Section 1115(a) demonstration.  The Region 10 RHP is the result of a
shared commitment by the region’s providers to a community-oriented, regional health care delivery
model focused on the triple aims of improving the experience of care for patients and their families,
improving the health of the region, and reducing the cost of care without compromising quality.
Region 10 RHP’s DSRIP plan is the essential blueprint for improved individual and population
health at a lower cost, delivered more efficiently.
The District is anticipating a small increase in volumes in fiscal year 2016 from growth in the county.  
Based on the recommendation of the District’s Board of Managers (Board), the Tarrant County 
Commissioners Court set the property tax rate for fiscal year 2016 to $0.227897 per $100 valuation, 
which is consistent with the property tax rate for fiscal year 2015. 
The Board and management continue to monitor and consider many factors that have direct or indirect 
impact on future operations.  These include: 
•
The Medicaid Section 1115(a) demonstration project which could have a material impact on the 
District’s funding for providing uncompensated care and provides funding for improvements in the 
design of the health care delivery system and associated outcomes, specifically shifting 
reimbursement systems from fee for service to value based payments 
•
•
The reimbursement impact of the Patient Protection and Affordable Care Act, Texas Medicaid DSH 
and other federal legislation 
Tarrant County’s population growth, as well as continued growth in the number of uninsured, 
working poor and medically indigent 
7

 
•
•
•
Shifting of care trend from inpatient to outpatient settings 
Continued growth in medical and pharmaceutical costs, as well as advances in therapies 
Continued advances in health care medical equipment and computing technology 
Significant Financial Practices 
The District maintains several financial practices designed to maintain its credit-worthiness 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. 
Operating Practices
•
The District’s adoption of LEAN and Six Sigma methodologies to improve efficiency and reduce 
outcome variation 
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. 
8

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Balance Sheets
September 30, 2015 and 2014
(In Thousands) 
Assets and Deferred Outflows of Resources
2015
2014
Current Assets
Cash and cash equivalents
$
205,072
$
144,248
Short-term investments
Patient accounts receivable, net
Property taxes receivable, net
Supplemental Medicaid funding receivable
Restricted pledges receivable, net
Internally designated for self-insurance, current portion
Supplies inventory
114,981
44,838
4,535
137,082
-
255
8,287
14,102
90,900
47,721
4,075
165,105
10
190
9,640
13,657
Prepaid expenses and other assets
Total current assets
529,152
475,546
Noncurrent Cash and Investments
Internally designated for debt service
Internally designated for self-insurance
Restricted by donors for capital acquisitions and
specific operating activities
419
11,587
333
11,502
1,991
173,539
187,536
289,046
1,005,734
2,069
173,462
187,366
284,087
946,999
Internally designated for capital acquisitions and 
operating activities
Total noncurrent cash and investments
Capital Assets, Net
Total assets
Deferred Outflows of Resources
17,646
-
$
1,023,380
$
946,999
Total assets and deferred outflows of resources
See Notes to Financial Statements

 
Liabilities, Deferred Inflows of Resources and Net Position
2015
2014
Current Liabilities
Accounts payable
$
80,186
$
89,178
Accrued expenses
57,259
4,257
5,481
2,470
38,784
3,434
5,357
2,405
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
149,653
139,158
1,422
43,307
9,545
1,370
46,045
-
Net Pension Liability
Other Long-term Liabilities
Total liabilities
1,420
1,159
187,732
205,347
Deferred Inflows of Resources
7,003
-
Net Position
Net investment in capital assets
Restricted expendable
Restricted nonexpendable
Unrestricted
239,983
1,646
315
233,599
1,735
315
569,086
523,618
Total net position
811,030
759,267
946,999
Total liabilities, deferred inflows of resources
and net position
$
1,023,380
$
9

 
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 Position
Years Ended September 30, 2015 and 2014
(In Thousands) 
2015
2014
Operating Revenues
Net patient service revenue, net of provision for 
uncollectible accounts; 2015 – $240,669; 2014 – $349,306
Supplemental Medicaid funding
$
337,394
191,360
37,589
$
299,019
185,143
42,396
Other operating revenue
Total operating revenues
566,343
526,558
Operating Expenses
Salaries and related expenses
Professional fees and purchased services
Supplies
Depreciation and amortization
Other
442,891
186,971
126,017
38,817
408,976
189,390
124,201
40,084
38,246
38,437
Total operating expenses
832,942
801,088
Operating Loss
(266,599)
(274,530)
Nonoperating Revenues (Expenses)
Property tax revenue
Contributed services
Contribution revenue
Contribution expense
307,019
11,296
1,064
(2,500)
(1,336)
2,627
291,013
9,185
1,306
-
(1,459)
2,471
Interest expense
Investment return and other
Total nonoperating revenues (expenses)
Excess of Revenues Over Expenses Before Capital Grants
Capital Grants and Gifts
318,170
51,571
85
302,516
27,986
385
Increase in Net Position
51,656
759,267
107
28,371
730,896
-
Net Position, as Previously Reported
Change in Accounting Principle
Net Position, Beginning of Year, as Restated
Net Position, End of Year
759,374
811,030
730,896
759,267
$
$
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
Years Ended September 30, 2015 and 2014
(In Thousands) 
2015
2014
Operating Activities
Receipts from and on behalf of patients
Receipts from Texas Medicaid supplemental
funding programs
Payments to suppliers and contractors
Payments to employees
$
346,608
$
302,178
219,383
(358,380)
(425,261)
37,962
156,766
(315,302)
(405,910)
41,965
Other receipts, net
Net cash used in operating activities
(179,688)
(220,303)
Noncapital Financing Activities
Noncapital grants and gifts
1,064
1,306
Property taxes supporting operations
304,410
289,179
Net cash provided by noncapital financing activities
305,474
290,485
Capital and Related Financing Activities
Principal paid on long-term debt
Interest paid on long-term debt
Property taxes supporting debt service
Capital grants and gifts
(2,405)
(1,960)
2,149
(2,340)
(2,038)
2,101
918
2,051
Proceeds from sale of capital assets
Purchase of capital assets
198
(42,260)
80
(38,548)
Net cash used in capital and related financing activities
(43,360)
(38,694)
Investing Activities
Purchase of investments
(248,207)
(286,783)
Proceeds from the sale and maturities of
  short-term investments
Interest income and other
221,426
3,330
300,715
3,257
Net cash provided by (used in) investing activities
(23,451)
58,975
17,189
48,677
99,257
147,934
Increase in Cash and Cash Equivalents
Cash and Cash Equivalents, Beginning of Year
Cash and Cash Equivalents, End of Year
147,934
206,909
$
$
See Notes to Financial Statements
11

 
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, 2015 and 2014
(In Thousands) 
2015
2014
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
$
$
205,072
1,837
$
$
144,248
3,686
206,909
147,934
Reconciliation of Net Operating Revenues (Expenses) to 
   Net Cash Used in Operating Activities
Operating loss
Depreciation and amortization
Gain on disposal of assets
$
(266,599)
38,817
(33)
$
(274,530)
40,084
(324)
Provision for uncollectible accounts
Contributed services expense
240,669
11,296
349,306
9,185
Changes in operating assets and liabilities
Patient accounts receivable
Texas Medicaid supplemental funding receivable
Estimated amounts due from and to third-party payers
Accounts payable and accrued expenses
Other assets and liabilities
(237,786)
28,023
823
5,658
(556)
(343,099)
(28,377)
(3,478)
32,648
(1,718)
Net cash used in operating activities
$
(179,688)
$
(220,303)
Supplemental Cash Flows Information
Capital asset acquisitions included in accounts payable
Contributed services revenue (Note 14  )
Amounts pledged to other entities included in accounts payable
$
$
$
3,705
11,296
2,500
$
$
$
2,371
9,185
-
See Notes to Financial Statements
12

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(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 (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, 20 school-based clinics and 
dental services at seven 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 (Court) and is governed by an 11 member Board of Managers 
(Board) appointed by the Court.  For this reason, the District is considered to be a component unit 
of Tarrant County, Texas (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.  Separate financial 
statements of JPSPG can be obtained by contacting the District’s management. 
JPS Foundation (Foundation) was formed on August 4, 1997, solely to support and benefit 
scientific, educational and charitable activities conducted by the District.  The Foundation 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.  Because the Foundation operates primarily for 
the exclusive benefit of the District, it is also presented as a blended component unit of the District.  
Separate financial statements of the Foundation can be obtained by contacting the District’s 
management. 
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 accompanying 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.
13

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(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 position when an expense or outlay is 
incurred for purposes for which both restricted and unrestricted net position is available. 
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, 2015 and 2014, cash equivalents consisted primarily of money 
market accounts with brokers and state investment pools described more fully in Note 5. 
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. 
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.
14

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
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 – 10 years
Computer software
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: 
2015
2014
Interest costs capitalized
Interest costs charged to expense
$
$
348
1,336
$
$
279
1,459
Total interest incurred
1,684
1,738
15

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
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 benefits are earned whether the employee is expected to realize the 
benefit as time off or in cash.  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. 
Defined Benefit Pension Plan 
The District sponsors a defined benefit pension plan (Plan) as more fully described in Note 13. For 
purposes of measuring the net pension liability, deferred outflows of resources and deferred 
inflows of resources related to pensions, and pension expense, information about the fiduciary net 
position of the Plan and additions to and deductions from the Plan’s fiduciary net position have 
been determined on the same basis as they are reported by the Plan.  For this purpose, benefit 
payments (including refunds of employee contributions) are recognized when due and payable in 
accordance with the benefit terms.  Investments are reported at fair value. 
Deferred Outflows/Inflows of Resources 
Transactions not meeting the definition of an asset or liability that result in the consumption or 
acquisition of net position in one period that are applicable to future periods are reported as 
deferred outflows of resources and deferred inflows of resources.  As of September 30, 2015, the 
District’s deferred outflows and deferred inflows of resources were related to the District’s defined 
benefit pension plan as described more fully in Note 13. 
Net Position 
Net position of the District is classified in four components.  Net investment in capital assets 
consists 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 position is made up of 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 position consists of noncapital assets that are required to be 
maintained in perpetuity as specified by parties external to the District, such as permanent 
endowments.  Unrestricted net position is the remaining assets less remaining liabilities that do not 
meet the definition of net invested in capital assets or restricted net 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, 2015 and 2014
(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 $5,773 and $5,485 in revenue from this settlement for the years 
ended September 30, 2015 and 2014, respectively.  This revenue is recognized as a component of 
other operating revenue in the accompanying statements of revenues, expenses and changes in net 
position. 
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 (IRC) and a similar 
provision of state law.  The District and the Foundation also carry an exemption from income taxes 
under IRC Section 501(c)(3).  JPSPG is exempt from income taxes under Section 501(a) of the 
IRC.  The District, the Foundation and JPSPG are all subject to federal income tax on any unrelated 
business taxable income. 
17

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Electronic Health Records Incentive Program 
The Electronic Health Records Incentive Program, enacted as part of the American Recovery and 
Reinvestment Act of 2009, provides for one time incentive payments under both the Medicare and 
Medicaid programs to eligible hospitals that demonstrate meaningful use of certified electronic 
health records technology (EHR).  Payments under the Medicare program are generally made for 
up to four years based on a statutory formula.  Payments under the Medicaid program are generally 
made for up to four years based upon a statutory formula, as determined by the state, which is 
approved by the Centers for Medicare and Medicaid Services (CMS).  Payments under both 
programs are contingent on the District continuing to meet escalating meaningful use criteria and 
any other specific requirements that are applicable for the reporting period.  The final amount for 
any payment year is determined based upon an audit by the administrative contractor.  JPSPG may 
also receive incentive payments of up to $44 per eligible physician over five years for Medicare 
and $64 per eligible physician over six years for Medicaid.  Events could occur that would cause 
the final amounts to differ materially from the initial payments under the program. 
The District recognizes revenue under the grant accounting model using the cliff recognition 
approach.  Under this approach, revenue is recognized once meaningful use status has been met for 
the full reporting period. 
In 2015 and 2014, the District recorded revenue from the Medicare program of approximately 
$1,046 and $1,447, respectively.  In 2015 and 2014, the District recorded revenue from the 
Medicaid program of approximately $400 and $860 in 2015 and 2014, respectively.  The revenue 
earned from these programs is included as a component of other operating revenue in the 
accompanying statements of revenue, expenses and changes in net position. 
Reclassifications 
Certain reclassifications have been made to the 2014 financial statements to conform to the 2015 
financial statement presentation.  The reclassifications had no effect on the changes in financial 
position. 
18

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(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, 2011. 
Medicaid.   Inpatient services rendered to Medicaid program beneficiaries are reimbursed under a 
prospective payment system.  Inpatient reimbursement is inclusive of an add-on for trauma care 
that is based on the Medicaid Standards Dollar Amount.  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, 2009. 
Approximately 77% and 82% of net patient service revenue is from participation in the Medicare 
and state-sponsored Medicaid programs for both the years ended September 30, 2015 and 2014.  
Settlements under reimbursement agreements with Medicare and Medicaid programs are estimated 
and recorded in the period the related services are rendered, and are adjusted in future periods as 
adjustments become known or as the service years are no longer subject to audit, review or 
investigation.  Annual cost reports required under the Medicare and Medicaid programs are subject 
to routine audits, which may result in adjustments to the amounts ultimately determined to be due 
under the reimbursement programs.  These audits often require several years to reach their financial 
determination of amounts earned under the programs.  As a result, it is reasonably possible that 
recorded estimates will change materially in the near term.  Net patient service revenue decreased 
in 2015 by approximately $460 and increased in 2014 by approximately $2,633, due to changes in 
previous estimates. 
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. 
19

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Note 3:     Supplemental Medicaid Funding Revenue
Supplemental Medicaid funding revenue included in the statement of revenues, expenses and 
changes in net position includes revenue received from the Medicaid Disproportionate Share 
Program (DSH) of approximately $30,721 and $39,191 for the years ended September 30, 2015 
and 2014, respectively.  The amounts the District may expect to receive from this program in future 
years could be impacted by the Medicaid section 1115(a) demonstration program discussed below.   
On December 12, 2011, the United States Department of Health and Human Services approved a 
new Medicaid section 1115(a) demonstration entitled “Texas Health Transformation and Quality 
Improvement Program” (Waiver).  The Waiver expanded existing Medicaid managed care 
programs and established two funding pools that assists providers with uncompensated care costs 
(UC Pool) and promotes health system transformation (DSRIP Pool). The Waiver is effective from 
December 12, 2011 to September 30, 2016.  The revenue from the two funding pools is recognized 
as earned throughout the related demonstration year.  During 2015, the District recognized 
approximately $105,369 and $55,270 from the UC Pool and DSRIP Pool, respectively. During 
2014, the District recognized approximately $102,072 and $43,880 from the UC Pool and DSRIP 
Pool, respectively.  The funding the District has received is subject to audit and is not 
representative of funding to be received in future years. 
The programs described above are subject to review and scrutiny by both the Texas Legislature and
the CMS, and the programs could be modified or terminated based on new legislation or regulation 
in future periods.  The Waiver is scheduled to expire in September 2016.  Management expects the 
Waiver to be extended or renewed in some form, but it is possible the Waiver will expire with no 
replacement funding source.  This outcome would have a material adverse impact on the District’s 
operating results.  
Note 4:     Property Tax Revenue
The District received approximately 35% and 36% of its support from property taxes in the years 
ended September 30, 2015 and 2014, respectively.  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 $9,341 and $8,877 at September 30, 2015 and 2014, respectively. 
20

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
The District’s property tax rate was $0.226300 and $0.226253 per $100 valuation for 2015 and 
2014, respectively, for the maintenance and operation fund and property tax revenue for this fund 
was $304,867 and $288,914 for 2015 and 2014, respectively.  The District’s property tax rate was 
$0.001597 and $0.001644 per $100 valuation for 2015 and 2014, respectively, for the interest and 
sinking fund and property tax revenue for this fund was $2,152 and $2,099 for 2015 and 2014, 
respectively. 
Note 5:     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, 2015 and 2014, the District’s deposits were either insured 
or collateralized in accordance with state law. 
At September 30, 2015, the Foundation’s cash accounts exceeded federally insured limits by 
$2,009. 
Investments 
The District may legally invest 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, 2015 and 2014, the District had the following investments and maturities as: 
September  30, 2015
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
$
37
110,841
716
45,540
5,674
29,944
$
$
37
110,841
-
7,982
102
29,944
$
$
-
-
716
37,558
5,572
-
$
$
-
-
-
-
-
-
$
$
-
-
-
-
-
-
Commercial paper
148,906
43,846
-
-
Mutual funds
528
$
193,280
21

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
September  30, 2014
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
$
43
64,714
1,223
29,927
5,714
$
$
43
64,714
507
2,840
102
$
-
-
716
27,087
5,612
$
$
-
-
-
-
-
$
$
-
-
-
-
-
68,206
$
33,415
-
-
Mutual funds
531
$
102,152
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’s investments in municipal bonds were rated AA2 to AA3 by Moody’s rating 
agency.  The District also invests in State Investment Pools (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’s investments in commercial 
paper was rated A- to AA- by Standard & Poor’s rating agency. 
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. 
22

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
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. 
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 5% 
of total investments: 
2015
2014
Federal Home Loan Bank
3.7%
8.8%
Federal Farm Credit Bank
5.3%
2.8%
10.4%
7.8%
7.7%
10.5%
5.4%
1.5%
0.0%
0.0%
Federal Agricultural Mortgage Corporation
Federal Home Loan Mortgage Association
Toyota Motor Credit Commercial Paper
JP Morgan Securities Commercial Paper
Summary of Carrying Values 
The carrying values of deposits and investments shown previously are included in the balance 
sheets as follows: 
2015
2014
Carrying value
Deposits
Investments
$
$
314,564
193,280
$
$
320,552
102,152
507,844
422,704
Included in the following balance sheet captions
Cash and cash equivalents
Short-term investments
Internally designated for self-insurance, current portion
Noncurrent cash and investments
$
$
205,072
114,981
255
$
$
144,248
90,900
190
187,536
187,366
507,844
422,704
23

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Investment Income 
Investment income for the years ended September 30, consisted of: 
2015
2014
Interest and dividend income
Net decrease in fair value of investments
$
$
2,994
(616)
$
$
2,816
(706)
2,378
2,110
Note 6:     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: 
2015
2014
Medicare
Medicaid
Other third-party payers
Patients
$
$
12,833
16,119
31,345
93,750
154,047
109,209
$
$
10,758
20,846
25,803
125,949
183,356
135,635
Less allowance for uncollectible accounts
44,838
47,721
24

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Note 7:     Capital Assets
Capital assets activity for the years ended September 30, was: 
2015
Beginning
Balance
Transfers
and Other
Ending
Balance
Additions
Disposals
Land and improvements
Buildings and improvements
Equipment
$
52,618
$
1,892
$
-
$
-
10,635
21,165
$
54,510
241,353
395,687
8,496
325
16,396
25,329
(4,775)
(2,608)
-
247,538
430,640
2,025
Construction in progress
(31,800)
698,154
414,067
284,087
43,942
38,817
5,125
(7,383)
(7,217)
(166)
-
-
-
734,713
445,667
289,046
Less accumulated 
  depreciation
Capital assets, net
$
$
$
$
$
2014
Beginning
Balance
Transfers
and Other
Ending
Balance
Additions
Disposals
Land and improvements
Buildings and improvements
Equipment
$
51,835
237,015
366,069
7,358
$
301
1,055
17,423
22,089
$
-
-
(4,991)
-
$
482
3,283
17,186
$
52,618
241,353
395,687
8,496
Construction in progress
(20,951)
662,277
378,868
283,409
40,868
40,084
784
(4,991)
(4,885)
(106)
-
-
-
698,154
414,067
284,087
Less accumulated 
  depreciation
Capital assets, net
$
$
$
$
$
25

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Note 8:     Accounts Payable and Accrued Expenses
Accounts payable and accrued expenses included in current liabilities at September 30, consisted 
of: 
2015
2014
Payable to suppliers and contractors
Payable to employees (including payroll taxes 
and benefits)
Payable to TCICC  (Note 14)
Payable to the Plan (Note 13  )
Patient credit balances
$
37,733
$
40,665
44,709
34,736
12,313
7,681
273
38,534
46,336
-
2,173
254
Other accrued liabilities
$
137,445
$
127,962
Note 9:     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. 
Activity in the District’s accrued medical malpractice claims liability during 2015 and 2014 is 
summarized as follows: 
2015
2014
Balance, beginning of year
$
$
485
$
$
665
Current year claims incurred and changes in 
estimates for claims incurred in prior years
Claims and expenses paid
254
(149)
(61)
(119)
Balance, end of year
590
485
26

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
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 2015 and 2014 is 
summarized as follows: 
2015
2014
Balance, beginning of year
$
$
4,260
$
$
2,970
Current year claims incurred and changes in 
estimates for claims incurred in prior years
Claims and expenses paid
38,434
(38,644)
32,533
(31,243)
Balance, end of year
4,050
4,260
Workers’ Compensation Claims 
The District is self-insured for workers’ compensation claims.  A provision is accrued for 
self-insured worker’s compensation 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 workers’ compensation claims liability during 2015 and 2014 is 
summarized as follows: 
2015
2014
Balance, beginning of year
$
$
1,982
$
$
1,883
Current year claims incurred and changes in 
estimates for claims incurred in prior years
Claims and expenses paid
2,027
(1,746)
1,446
(1,347)
Balance, end of year
2,263
1,982
27

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Note 10:   Long-term Debt
A summary of long-term debt is as follows: 
2015
2014
Revenue bonds, Series 2012
$
21,595
$
23,015
Certificates of obligation, Series 2006
23,440
45,035
742
24,425
47,440
1,010
Bond premium (discount), net
$           45,777 
$           48,450 
Revenue Bonds – Series 2012 
The Series 2012 revenue bonds consist of Tarrant County Hospital District Senior Lien Revenue 
Refunding Bonds, Series 2012 (Series 2012 Bonds) in the original amount of $25,890 dated 
September 1, 2012, which bear interest at 3.0% to 5.0%.  The Series 2012 Bonds are payable in 
annual installments of $1,445 to $2,205 through August 15, 2027.  The Series 2012 Bonds are 
secured by revenues of the District, exclusive of ad valorem tax revenue.  All of the Series 2012 
Bonds still outstanding may be redeemed at the District’s option on or after August 15, 2023, at par 
value plus accrued interest.  The proceeds from the Series 2012 Bonds were used to advance 
refund the Series 2002 Bonds.   
Certificates of Obligation – Series 2006 
The Series 2006 certificates of obligation consist of Tarrant County Hospital District Certificates of 
Obligation, Series 2006 (Certificates) in the original amount of $30,330 dated March 1, 2006, 
which bear interest at 4.0% to 5.0%.  The Certificates are payable in remaining annual installments 
of $1,025 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 Certificates are secured by the net revenues of the District, including property tax revenue. 
Subsequent to September 30, 2015, the Certificates were refunded with the issuance of the General 
Obligation Refunding Bonds, Series 2016 (Series 2016 Bonds) issued in the amount of $22,415.  
The present value of cash flow savings from this refunding is approximately $3,960. 
The indenture agreements require the District to comply with certain restrictive covenants 
including minimum insurance coverage and days cash on hand. 
The District has a current Aa3 rating from Moody’s and a current AA- rating from Standard & 
Poor’s.  
28

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
The following is a summary of long-term debt transactions for the District for the years ended 
September 30: 
2015
Beginning
Balance
Ending
Balance
Current
Portion
Additions
Deductions
Long-term debt
Revenue bonds,  Series 2012
Certificates  of obligation, Series  2006
$
$
23,015
24,425
$
$
-
-
$
1,420
985
$
$
21,595
23,440
$
$
1,445
1,025
Total long-term  debt
47,440
-
$
2,405
45,035
2,470
2014
Beginning
Ending
Current
Balance
Additions
Deductions
Balance
Portion
Long-term debt
Revenue bonds,  Series 2012
Certificates  of obligation, Series  2006
$
$
24,405
25,375
$
$
-
-
$
1,390
950
$
$
23,015
24,425
$
$
1,420
985
Total long-term  debt
49,780
-
$
2,340
47,440
2,405
The debt service requirements as of September 30, 2015, are as follows: 
Year Ending
September 30, 2015
Principal
Interest
Total
2016
2017
2018
2019
2020
2021 – 2025
2026 – 2030
2031
$
2,470
$
1,877
$
4,347
2,555
2,650
2,735
2,865
16,565
13,170
2,025
1,792
1,702
1,608
1,480
5,161
1,745
47
4,347
4,352
4,343
4,345
21,726
14,915
2,072
$
45,035
$
15,412
$
60,447
29

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
The revised debt service requirements after issuance of the Series 2016 Bonds is as follows: 
Year Ending
September 30, 2015
Principal
Interest
Total
2016
2017
2018
2019
2020
$
$
1,525
2,985
3,070
3,140
3,255
$
$
1,133
$
$
2,658
4,255
4,262
4,251
4,252
1,270
1,192
1,111
997
3,137
554
2021 – 2025
2026 – 2029
18,120
11,915
21,257
12,469
44,010
9,394
53,404
Note 11:   Restricted and Designated Net Position
At September 30, 2015 and 2014, $1,646 and $1,735, respectively, of net position were restricted 
by donors for capital and operating activities. 
At September 30, 2015 and 2014, $173,541 and $173,462, respectively, of unrestricted net position 
has been designated by the Board for future operating needs and capital acquisitions.  Designated 
assets remain under the control of the Board, which may, at its discretion, later use these assets for 
other purposes. 
At September 30, 2015 and 2014, the District had $315 of restricted nonexpendable net position 
which is a general endowment for the Foundation.  
Note 12:   Uncompensated 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.  The costs of charity care provided under the 
District’s charity care policy were $126,033 and $141,587 for 2015 and 2014, respectively.  The 
cost of charity care is estimated by applying the ratio of cost to gross charges to the gross charity 
care charges.  The decrease in uncompensated care cost in 2015 as compared to 2014 is primarily 
attributable to more of the District’s patients obtaining health insurance coverage through the 
federal health insurance exchange. 
30

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Note 13:   Pension Plan
Plan Description 
The District sponsors an agent multiple-employer 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 1108 Lavaca, Suite 700, Austin, Texas  78701. 
Benefits Provided  
The Plan provides retirement, disability, and death benefits.  Retirement benefits for eligible 
employees are calculated as 1.4% of the employee’s final 5-year average compensation plus 0.7% 
of the employee’s final 5-year average compensation, if any, that exceeds $75,000, with the sum 
multiplied times the employee’s years of service.     
Participants with 5 years of participation service are eligible to retire at age 65.  Participants may 
retire at any age after 55 if they have 10 years or vesting service.  Disability retirement benefits are 
determined in the same manner as retirement benefits but are payable immediately with an 
actuarial reduction.  Death benefits are determined in the same manner as retirement benefits but 
are payable immediately with an actuarial reduction.  An employee who leaves the employer’s 
service may withdraw his or her contributions, plus any accumulated interest. 
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, made plan participation voluntary for employees hired after that date. 
The employees covered by the Plan at October 1, 2014 and 2013(measurement date), are: 
2014
2013
Inactive employees or beneficiaries currently
receiving benefits
246
221
Inactive employees entitled to but not yet
receiving benefits
Active employees
930
2,950
4,126
833
3,050
4,104
31

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Contributions 
The District’s Board has the sole authority to establish and amend the contribution requirements of 
the active employees.  The District’s contributions are based on an actuarially determined rate 
recommended by an independent actuary.  The actuarial determined rate is the established amount 
necessary to finance the costs of benefits earned by employees during the year, with an additional 
amount to finance any unfunded accrued liability.  The District is required to contribute the 
difference between the actuarially determined rate and the contribution rate of employees.  For the 
District’s fiscal year ended September 30, 2015, the average active employee contribution rate (for 
the period between the two most recent measurement dates) was 1.0% of annual pay, and the 
District’s average contribution rate was 6.5% of annual payroll.   
The District’s contribution is set to be 6.75% of participant payroll effective October 1, 2014, and 
will remain at that level as long as the amount thus determined is sufficient to pay the Employer 
Normal Cost and amortize the Unfunded Actuarial Liability (Net Pension Liability) over a period 
of not more than 25 years.    
The employer contributions were 6.75% of estimated participant compensation for the year ended 
September 30, 2015.  The costs of administering the plan are paid by the plan and are considered in 
the determination of the employer contribution rate. 
Net Pension Liability 
The District’s net pension liability was measured as of October 1, 2014, and the total pension 
liability used to calculate the net pension liability was determined by an actuarial valuation as of 
that date. 
The total pension liability in the October 1, 2014, actuarial valuation was determined using the 
following actuarial assumptions, applied to all periods included in the measurement: 
Inflation
3%
Salary increases
Ad hoc   cost of living adjustments
Investment rate of return
5.0%, average, including inflation
Not included
7.75%, net of pension plan
investment expense, including inflations
Mortality rates were based on the Society of Actuaries RP-2014 Mortality Table with Projection 
Scale MP-2014. 
The actuarial assumptions used in the October 1, 2014, valuation were based on the results of an 
actuarial experience study for the period 2005-2013.   
32

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
The long-term expected rate of return on pension plan investments was determined using a 
building-block method in which expected future real rates of return (expected returns, net of 
pension plan investment expense and inflation) are developed for each major asset class.  These 
components are combined to produce the long-term expected rate of return by weighting the 
expected future real rates of return by the target asset allocation percentage and by adding expected 
inflation (3.00%).  In addition, the final 7.75% assumption reflected a reduction of 0.10% for 
adverse deviation. 
The target allocation and best estimates of rates of return for each major asset class are summarized 
in the following table: 
Long-Term
Target
Allocation
Expected Real
Rate of Return
Asset Class
Domestic equity
International equity
Fixed income
65%
10%
25%
5.8%
6.2%
1.7%
Total
100%
Discount Rate
The discount rate used to measure the total pension liability was 7.75% at October 1, 2014.  The 
projection of cash flows used to determine the discount rate assumed that employee contributions 
will be made at the current contribution rate and that employer contributions will be made at rates 
equal to the difference between actuarially determined contribution rates and the employee rate.  
Based on those assumptions, the pension plan’s fiduciary net position was projected to be available 
to make all projected future benefit payments of current active and inactive employees.  Therefore, 
the long-term expected rate of return on pension plan investments was applied to all periods of 
projected benefit payments to determine the total pension liability. 
33

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Changes in the total pension liability, plan fiduciary net position and the net pension liability for 
the year ended September 30, 2015, are: 
Total
Pension
Liability
(a)
Plan
Fiduciary
Net Position
(b)
Net
Pension
Liability (Asset)
(a) - (b)
Balances at September 30,  2014
$
170,583
$
158,554
$
12,029
Changes for the year:
Service cost
11,556
12,953
-
-
11,556
12,953
Interest on total pension liability
Differences between expected
and actual experience
Contributions - employee
Contributions - employer
Net investment income
Benefit payments, including refunds
of employee contributions
Administrative expenses
Assumption changes
(717)
-
1,574
11,625
20,134
(717)
(1,574)
(11,625)
(20,134)
-
-
-
(7,021)
-
6,650
(7,021)
(407)
-
-
407
6,650
Net changes
23,421
25,905
(2,484)
9,545
Balances at September 30,  2015
$
194,004
$
184,459
$
The net pension liability of the District has been calculated using a discount rate of 7.75%.  The 
following presents the net pension (asset) liability using a discount rate 1% higher and 1% lower 
than the current rate. 
Current Discount
1% Decrease
6.75 %
Rate
1% Increase
8.75 %
7.75 %
District's net pension (asset) liability
$
35,635
$
9,545
$
(11,931)
34

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Pension Expense and Deferred Outflows of Resources and Deferred Inflows of 
Resources Related to Pensions 
For the year ended September 30, 2015, the District recognized pension expense of $10,810.  At 
September 30, 2015, the District reported deferred outflows of resources and deferred inflows of 
resources related to pensions from the following sources: 
2015
Deferred
Deferred
Outflows  of
Inflows  of
Resources
Resources
Differences  between  expected and  actual experience
Employer  contributions  subsequent  to the measurement  date
Changes  of assumptions
Net difference  between  projected  and
actual earnings  on plan  investments
$
$
-
12,313
5,333
$
$
575
-
-
17,646
6,428
7,003
At September 30, 2015, the District reported $12,313 as deferred outflows of resources related to 
pensions resulting from District contributions subsequent to the measurement date that will be 
recognized as a reduction of the net pension liability at September 30, 2016.  Other amounts 
reported as deferred outflows of resources and deferred inflows of resources at September 30, 
2015, related to pensions will be recognized in pension expense as follows: 
Year ending September 30:
2016
2017
2018
2019
2020
$
(432)
(432)
(432)
(432)
58
$
(1,670)
Pension Plan Fiduciary Net Position 
Detailed information about the Plan’s fiduciary net position is available in the separately issued 
financial report of THA for the year ended December 31, 2014. 
35

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Funding Status and Funding Progress 
Prior to adoption of GASB 68, and as of October 1, 2013, the plan was 85.2% funded.  The 
actuarial accrued liability for benefits was $170,583 and the actuarial value of assets was $145,400 
resulting in an unfunded actuarial accrued liability (UAAL) of $25,183.  The covered payroll 
(annual payroll of active employees covered by the plan) was $178,847, and the ratio of the UAAL 
to the covered payroll was 14.1% for the year ended September 30, 2014. 
Annual Pension Cost 
For the year ended September 30, 2014, the District’s annual pension cost was $11,625, which is 
equal to the annual required contributions as determined in the actuarial valuations dated October 
1, 2013.   
The required contributions for the plan year ended September 30, 2014, were based on the results 
of the actuarial valuation as of October 1, 2013, using the entry age normal 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) 
7.75% investment rate of return (net of administrative expenses) and (b) projected salary increases 
of 4.5% to 8.0%, per year, varying by attained age.  Both (a) and (b) included an inflation 
component of 4.0%.  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. 
Three-year Trend Information 
Annual
Pension Cost
(APC)
Percentage
of APC
Contributed
Net Pension
Obligation
Fiscal Year Ended
2012
2013
2014
$
12,051
12,380
11,625
100%
100%
100%
$
-
-
-
Other Benefit Plans 
The District has an IRC Section 401(a) plan that includes an employer match calculated as 50% of 
an employee’s contribution to the IRC Section 403(b) plan discussed below, up to 4% of pay.  The 
contributions for the employer match on the plan were approximately $3,925 and $3,963 for the 
years ended September 30, 2015 and 2014, respectively.
36

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
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 accompanying 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.  Employee contributions were $10,162 and $9,070 for the 
years ended September 30, 2015 and 2014, respectively. 
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 IRC.  Contributions to this 
plan are included in noncurrent cash and investments and the plan liability is recorded in other 
long-term liabilities in the balance sheets.  As of September 30, 2015 and 2014, $345 and $0, 
respectively, in contributions are included in noncurrent cash and investments and $477 and $345, 
respectively, was due under this plan.  Approximately $150 of benefit expense was recognized in 
2015. 
Note 14:   Related Party Transactions
The District is party to 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 was 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).  During 2012, 
funding through the UPL program was largely replaced with funding from the Waiver.  This 
program allows for continued funding under the current TCICC agreement. 
Under this program, the District contributes certain government funds to the state of Texas, limited 
to the amount allowed based on aggregate statewide funding caps.  TCICC uses the 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. 
37

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Services provided by TCICC were valued at approximately $45,308 and $36,124 for the years 
ended September 30, 2015 and 2014, respectively.  As part of the affiliation agreement, the District 
provided $34,012 and $26,939 in funding to the program for the years ended September 30, 2015 
and 2014, 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 $11,296 and $9,185 for 2015 and 2014, 
respectively. 
Should TCICC cease providing these services, the District has entered a standby agreement with 
physicians participating in this program under which the District would assume the payment 
obligations of TCICC.  
Note 15:   Condensed Combining Information
The following tables include condensed combining balance sheet information for the District and 
its blended component units as of September 30, 2015 and 2014: 
September  30, 2015
Hospital
JPSPG
Foundation
Eliminations
Total
Assets and Deferred Outflows of Resources
Current assets
Due from affiliates
Noncurrent cash and investments
Capital assets, net
Total assets
$        499,808 
889
185,377
287,773
973,847
$         30,266 
2,225
-
1,271
33,762
$              529 
 $         (1,451)
(3,139)
-
-
(4,590)
$            529,152 
-
187,536
289,046
1,005,734
25
2,159
2
2,715
Deferred outflows of resources
17,646
-
-
-
17,646
Total assets and deferred outflows
of resources
$
991,493
$
33,762
$
2,715
$
(4,590)
$
1,023,380
Liabilities, Deferred Inflows of Resources and Net Position
Current liabilities
$        145,381 
$           5,687 
$                36 
 $         (1,451)
$            149,653 
Due to affiliates
Estimated self-insurance costs
Long-term debt
Net pension liability
Other long-term liabilities
Total liabilities
2,250
1,422
43,307
9,545
483
202,388
855
-
-
-
937
7,479
34
-
-
-
-
(3,139)
-
-
-
-
-
1,422
43,307
9,545
1,420
205,347
70
(4,590)
Deferred inflows of resources
Net Position
7,003
-
-
-
7,003
Net investment in capital assets
Restricted expendable
Restricted nonexpendable
Unrestricted
238,710
-
-
543,392
782,102
1,271
-
-
25,012
26,283
2
1,646
315
682
2,645
-
-
-
-
-
239,983
1,646
315
569,086
811,030
Total net position
Total liabilities, deferred inflows of
resources and net position
$
991,493
$
33,762
$
2,715
$
(4,590)
$
1,023,380
38

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
September  30, 2014
Hospital
JPSPG
Foundation
Eliminations
Total
Assets
Current assets
Due from affiliates
Noncurrent cash and investments
Capital assets, net
$        452,113 
865
185,297
282,621
$         24,769 
245
-
$              443 
$
(1,779)
(1,121)
-
-
$            475,546 
11
2,069
2
-
187,366
284,087
1,464
Total assets
$
920,896
$
26,478
$
2,525
$
$
(2,900)
$
946,999
Liabilities and Net Position
Current liabilities
Due to affiliates
Estimated self-insurance costs
Long-term debt
Other long-term liabilities
$        135,560 
273
$           5,367 
$                10 
(1,779)
(1,121)
-
-
-
$            139,158 
805
-
-
43
-
-
-
1,370
46,045
1,159
1,370
46,045
345
814
-
Total liabilities
Net Position
183,593
6,986
53
(2,900)
187,732
Net investment in capital assets
Restricted expendable
Restricted nonexpendable
Unrestricted
232,133
-
-
1,464
-
-
2
1,735
315
-
-
-
-
233,599
1,735
315
505,170
18,028
420
523,618
Total net position
737,303
19,492
2,472
-
759,267
Total liabilities and net position
$
920,896
$
26,478
$
2,525
$
(2,900)
$
946,999
The following tables include condensed combining statements of revenues, expenses and changes 
in net position information for the District and its blended component units for the years ended 
September 30, 2015 and 2014. 
September  30, 2015
Hospital
JPSPG
Foundation
Eliminations
Total
Operating revenues
Operating expenses
$        535,774 
808,330
$         49,627 
42,894
$              161 
2,394
 $       (19,219)
(20,676)
$            566,343 
832,942
Operating income (loss)
Nonoperating revenues (expenses)
Capital grants
(272,556)
317,163
85
6,733
58
-
(2,233)
2,406
-
1,457
(1,457)
-
(266,599)
318,170
85
Increase (decrease) in net position
44,692
6,791
173
-
51,656
Net position, as previously reported
Change in accounting principle
737,303
107
19,492
-
2,472
-
-
-
759,267
107
Net position, beginning of year, as restated
Net position, end of year
737,410
19,492
2,472
-
759,374
$
782,102
$
26,283
$
2,645
$
-
$
811,030
39

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
September  30, 2014
Hospital
JPSPG
Foundation
Eliminations
Total
Operating revenues
Operating expenses
$
504,984
778,243
$
42,438
43,109
$
108
825
$
(20,972)
(21,089)
$            526,558 
801,088
Operating income (loss)
Nonoperating revenues (expenses)
Capital grants
(273,259)
301,212
385
(671)
59
-
(717)
1,362
-
117
(117)
-
-
(274,530)
302,516
385
Increase (decrease) in net position
28,338
(612)
645
28,371
Net position, beginning of year
Net position, end of year
708,965
737,303
20,104
19,492
1,827
2,472
-
-
730,896
$
$
$
$
$
759,267
The following tables include condensed combining statements of cash flows information for the 
District and its blended component units for the years ended September 30, 2015 and 2014. 
September  30, 2015
Hospital
JPSPG
Foundation
Eliminations
Total
Net cash provided by (used in):
Operating activities
Noncapital financing activities
Capital and related financing activities
Investing activities
$       (181,174)
305,474
(43,360)
(23,519)
57,421
$           1,312 
-
-
58
1,370
$              174 
-
-
10
184
 $                   - 
$           (179,688)
305,474
(43,360)
(23,451)
58,975
-
-
-
-
Increase in cash and cash equivalents
Cash and cash equivalents, beginning of year
Cash and cash equivalents, end of year
127,548
18,305
2,081
-
147,934
$
184,969
$
19,675
$
2,265
$
-
$
206,909
September  30, 2014
Foundation
Hospital
JPSPG
Eliminations
Total
Net cash provided by (used in):
Operating activities
Noncapital financing activities
Capital and related financing activities
Investing activities
$       (224,636)
290,485
(38,531)
17,116
$           3,743 
$              590 
-
-
14
604
$
-
-
-
-
-
$           (220,303)
290,485
(38,694)
17,189
48,677
-
(163)
59
Increase in cash and cash equivalents
44,434
3,639
Cash and cash equivalents, beginning of year
Cash and cash equivalents, end of year
83,114
14,666
1,477
-
-
99,257
$
127,548
$
18,305
$
2,081
$
$
147,934
40

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Notes to Financial Statements
September 30, 2015 and 2014
(In Thousands) 
Note 16:   Change in Accounting Principle
In June 2012, the Governmental Accounting Standards Board (GASB) issued GASB Statement No. 
68, Accounting and Financial Reporting for Pensions – an amendment of GASB Statement No. 
27(GASB 68), which was amended by GASB Statement No. 71, Pension Transition for 
Contributions Made Subsequent to the Measurement Date, issued in November 2013.  In addition 
to making changes to how annual pension expense is to be calculated for defined benefit pension 
plans, the standard also requires that governmental entities record an asset or liability in their 
financial statements that is equal to the net pension asset or liability.  Historically, governmental 
entities have only been required to record a liability, if any, for the difference between annual 
pension cost (APC) and the amount of APC contributed to the plan.  Restatement of the 2014 
financial statements is not practical because prior year information calculated under the provisions 
of GASB 68 is not available, accordingly, the District has reported the cumulative effect of 
applying GASB 68 as a restatement of net position as of October 1, 2014.  This restatement 
increased previously reported net position by $107 to recognize net pension liabilities of $12,029 
and deferred outflows of $12,136. 
41

 
Required Supplementary Information

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Schedule of Changes in District's Net Position Liability and Related Ratios
Year Ending September 30,
(In Thousands) 
2015
Total pension liability
Service cost
Interest on total pension liability
Changes of benefit terms
$
11,556
12,953
- 
Differences between expected and actual experiend
Changes of assumptions
Benefit payments, including refunds of employee contributions
(717)
6,650
(7,021)
Net change in total pension liability
Total pension liability—beginning
23,421
170,583
194,004
Total pension liability—ending (a)
  
Plan fiduciary net position 
Contributions—employer
$
$
11,625
1,574
Contributions—employee
Net investment income
Benefit payments, including refunds of employee contributions
Administrative expense
20,134
(7,021)
(407)
Net change in plan fiduciary net position
Plan fiduciary net position—beginning
Plan fiduciary net position—ending (b)
25,905
158,554
184,459
$
$
District's net pension liability—ending (a) – (b)
9,545
Plan fiduciary net position as a percentage of the total pension liability 
Covered-employee payroll 
District's net pension liability as a percentage of covered-employee payroll
95.08%
178,847
5.34%
$
Notes to Schedule:
Changes of assumptions:  
1) Mortality updated to new table published by Society of Actuaries (November 2014)
2) Future wage increases above age 40 adjusted to reflect recent experience
This schedule is presented as of October 1, 2014, which is the measurement date.
This schedule is presented to illustrate the requirement to show information for 10 years.  However, until a full 10-year 
trend is compiled, the District will present information for those years for which information is available.  All amounts 
are in thousands, unless otherwise indicated.
42

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Schedule of District Contributions
Year Ending September 30,
(In Thousands) 
Contributions
as a
percentage of
covered-
employee
payroll
Contributions
in relation to
the actuarially
determined
Actuarially
determined
contribution
Contribution
deficiency
(excess)
Covered-
employee
payroll
Year Ending
September 30,
contribution
2015
$
12,313
$
12,313
$
-
$
182,418
6.75%
Notes to Schedule:
Valuation date:
October 1, 2014
Actuarially determined contribution rates are calculated as of October 1, 2014, which is the most recent valuation date prior to 
the end of the fiscal year in which contributions are reported.
Methods and assumptions used to determine contribution rates:
Actuarial cost method
Entry age
Amortization method
Level percentage of payroll, open
Remaining amortization period
20 years at October 1, 2014; recalculated annually; employer contribution rate
constant unless amortization period > 25 years or ≤ 0 years
5-year smoothed market
Asset valuation method
Inflation
3.0%
Salary increases
Investment rate of return
Retirement age
Mortality
5.0%, average, including inflation
7.75%, net of pension plan investment expense, including inflation
60
RP-2014 Total Employee Mortality Table, Projected with Scale MP-2014 
mortality improvement scale
This schedule is presented to illustrate the requirement to show information for 10 years.  However, until a full 10-year trend is 
compiled, the District will present information for those years for which information is available.  All amounts are in thousands 
unless otherwise indicated.
43

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Schedule of Funding Progress
September 30, 2014
Plan Assets
Less Than
AAL as a
Percent of
Covered
Acturial
Valuation
Date
Acturial
Value of Plan
Assets
Acturial
Accrued
Liability (AAL)
Plan Assets
Less
than AAL
Funded
Ratio
Covered
Payroll
Payroll
10/1/2011
10/1/2012
10/1/2013
$113,033,130           $144,578,735
$
(31,545,605)
(34,571,085)
(25,182,895)
78.2%
78.4%
85.2%
$185,406,171
190,463,939
178,847,385
(17.0%)
(18.2%)
(14.1%)
125,180,815
145,400,069
159,751,900
170,582,964

 
Other Information

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Balance Sheet Information
September 30, 2015
(In Thousands) 
Assets and Deferred Outflow of Resources
Hospital
JPSPG
Foundation
Eliminations
Total
Current Assets
Cash and cash equivalents
Short-term investments
$
184,934
$
19,675
-
2,321
-
7,153
-
-
-
1,117
$
463
-
-
-
-
-
-
-
66
$
-
-
(1,451)
-
-
-
-
-
-
$
205,072
114,981
44,838
4,535
137,082
-
255
8,287
14,102
114,981
43,968
4,535
129,929
-
255
8,287
12,919
Patient accounts receivable, net
Property taxes receivable, net
Supplemental Medicaid funding receivable
Restricted pledges receivable, net
Internally designated for self-insurance, current portion
Supplies inventory
Prepaid expenses and other assets
Total current assets
499,808
889
30,266
2,225
529
25
(1,451)
(3,139)
529,152
-
Due from Affiliates
Noncurrent Cash and Investments
Internally designated for debt service
Internally designated for self-insurance
Restricted by donors for capital acquisitions and
specific operating activities
419
11,587
-
-
-
-
-
-
419
11,587
-
173,371
185,377
287,773
973,847
17,646
-
1,991
168
2,159
2
-
1,991
173,539
187,536
289,046
1,005,734
17,646
Internally designated for capital acquisitions and
operating activities
-
-
Total noncurrent cash and investments
Capital Assets, Net
-
1,271
33,762
-
-
-
(4,590)
-
Total assets
2,715
-
Deferred Outflows of Resources
Total assets and deferred
outflows of resources
$
991,493
$
33,762
$
2,715
$
(4,590)
$
1,023,380

 
Liabilities, Deferred Inflows of Resources
and Net Position
Hospital
JPSPG
Foundation
Eliminations
Total
Current Liabilities
Accounts payable
Accrued expenses
Due to third-party payers
Current portion of self-insurance costs
Current maturities of long-term debt
$
81,363
$
238
5,449
-
-
-
$
36
-
-
-
-
$
(1,451)
$
80,186
51,810
4,257
5,481
2,470
-
-
-
-
57,259
4,257
5,481
2,470
Total current liabilities
Due to Affiliates
145,381
2,250
1,422
43,307
9,545
483
5,687
36
34
-
(1,451)
149,653
-
855
(3,139)
Estimated Self-insurance Costs
Long-term Debt
-
-
-
-
-
-
1,422
43,307
9,545
1,420
-
Net Pension Liability
-
-
Other Long-term Liabilities
937
-
Total liabilities
202,388
7,003
7,479
-
70
-
(4,590)
-
205,347
7,003
Deferred Inflows of Resources
Net Position
Net investment in capital assets
Restricted expendable
Restricted nonexpendable
Unrestricted
238,710
-
-
1,271
-
-
2
1,646
315
-
-
-
-
239,983
1,646
315
543,392
25,012
682
569,086
Total net position
782,102
991,493
26,283
33,762
2,645
2,715
-
811,030
Total liabilities, deferred inflows of
resources and net position
$
$
$
$
(4,590)
$
1,023,380
45

 
Tarrant County Hospital District
d/b/a JPS Health Network
A Component Unit of Tarrant County, Texas
Statement of Revenues, Expenses and
Changes in Net Position Information
Year Ended September 30, 2015
(In Thousands) 
Hospital
JPSPG
Foundation
Eliminations
Total
Operating Revenues
Net patient service revenue
Supplemental Medicaid funding
Other operating revenue
$
318,192
181,618
35,964
$
30,268
9,742
9,617
$
-
-
161
$
(11,066)
-
(8,153)
$
337,394
191,360
37,589
Total operating revenues
535,774
49,627
161
(19,219)
566,343
Operating Expenses
Salaries and related expenses
Professional fees and purchased services
Supplies
Depreciation and amortization
Other
402,988
205,088
125,826
38,624
39,843
1,993
72
193
793
60
461
165
-
-
(20,571)
(46)
-
(59)
442,891
186,971
126,017
38,817
35,804
1,708
38,246
Total operating expenses
808,330
42,894
6,733
2,394
(20,676)
1,457
832,942
Operating Income (Loss)
(272,556)
(2,233)
(266,599)
Nonoperating Revenues (Expenses)
Property tax revenue
Contributed services
307,019
11,296
64
-
-
-
-
-
2,405
-
-
(1,405)
307,019
11,296
1,064
Contribution revenue
Contribution expense
Interest expense
Investment return and other
(2,500)
(1,336)
2,620
-
-
58
-
-
1
-
-
(52)
(2,500)
(1,336)
2,627
Total nonoperating revenues (expenses)
317,163
58
2,406
(1,457)
318,170
Excess of Revenues Over Expenses Before Capital
Grants and Gifts
44,607
85
6,791
-
173
-
-
-
51,571
85
Capital Grants and Gifts
Increase in Net Position
44,692
737,303
107
6,791
19,492
-
173
2,472
-
-
-
-
-
-
51,656
759,267
107
Net Position, as Previously Reported
Change in Accounting Principle
Net Position, Beginning of Year, as Restated
Net Position, End of Year
737,410
782,102
19,492
26,283
2,472
2,645
759,374
811,030
$
$
$
$
$
46