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In 2011 McCulloch County Hospital District leased their property at 2008 Nine Road to Heart of Texas Healthcare System, a tax-exempt private corporation for $150,000 per month (later raised to $250,000 per month). Healthcare System assumed all responsibility for operation, including staffing, payroll, accounting, debt collection, insurance, utilities, maintenance, regulatory compliance, supplies, and all other things required to operate a healthcare facility.

This agreement obligates Healthcare Systems to provide care for indigents but requires the Hospital District to pay for it. The details are in the Indigent Care Agreement (Exhibit A, which starts on page 49 of the attached reference document).

Part 4.a of the Indigent Care Agreement (ICA) states that the District will pay the Provider "those payments listed in Exhibit B". However, Exhibit B does not list any payments. It is blank.

On November 24, 2013, the Indigent Care Agreement was retroactively suspended effective April 1, 2012. The suspension is indefinite with no reinstatement date. It is interesting to note that the ICA was suspended indefinitely rather than terminated. Termination would have invalidated the entire lease agreement under Part 30.2.

During the suspension, neither the Hospital District nor Healthcare System have any rights or obligations under the ICA. It is unclear who is responsible for providing and paying for indigent care while the ICA is suspended.


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