Methodist Hospital Group

“John bookout iii, board director/officer of houston methodist academic institute, is the son of john bookout, who is also a director of the same entity.”

“-houston methodist hospital is the sole corporate member of tmh health care group and houston methodist academic institute. -tmh health care group is the sole corporate member of diagnostic center hospital corp. Of texas, methodist health centers, houston methodist baytown hospital, houston methodist specialty physician group, tmh medical office buildings and houston methodist coordinated care. -houston methodist specialty physician group is the sole corporate member of methodist pathology associates, pllc, methodist radiology associates, pllc, tmh physician associates, pllc, tmh physicians and surgeons, pllc, and lone star pathology pllc. -methodist health centers is the sole corporate member of hmcl, hmcch and hmstc real property. -houston methodist academic institute is the sole corporate member of houston methodist research institute.”

“Except as noted below, the subsidiary organizations' sole corporate member or the ultimate parent company, hmh, have the authority to appoint, remove or replace the members of their respective boards of directors. The following entities are controlled solely by their member, spg, and do not have a separate governing body: tmh physician associates, pllc methodist pathology associates, pllc methodist radiology associates, pllc tmh physicians and surgeons, pllc lone star pathology, pllc”

“The subsidiary organizations' sole corporate member or ultimate parent company, hmh, reserve the following powers: -authority to appoint or remove, with or without cause, the directors of the organization; -authority to establish the mission, strategy, and policy of the organization; -approval authority of all guarantees of debt by the organization; -approval authority of the annual operating and capital budget of the organization; -approval authority of all acquisitions, dissolution, sales of capital assets, partnerships, and joint ventures of the organization; -authority to direct the organization in its actions as the corporate member or shareholder of the other organizations; -authority to amend the certificate and the bylaws and comparable governing documents of the organization.”

“Management, including certain officers, works diligently to complete the form 990 and attached schedules (return) in a thorough manner. The return is reviewed by a paid preparer. Prior to filing the return, a copy of the form 990 is made available to board members (including required schedules) and management team members are available to answer any board members' questions.”

“Individuals serving in a significant decision making capacity complete a conflict of interest (coi) questionnaire annually. A comprehensive evaluation and thorough review of disclosures is performed by a 6-member coi committee comprised of executives, management, and staff. The results of the coi disclosures are summarized and reported to the parent corporation, houston methodist hospital's board audit & compliance committee, including certain actions being taken to protect the integrity of houston methodist decision-making. In addition, certain disclosure results are also communicated to management and to affected committee chairs to promote transparency, protect decision-making integrity, and to ensure restrictions are imposed where appropriate. Conflicted individuals may not vote or exert self-serving influence on the disclosed matter.”

“Houston methodist hospital (hmh) (sole corporate member of the subsidiaries) follows irs regulations as it relates to establishing a rebuttable presumption of reasonableness related to total compensation of the ceo of the organizations as well as other key employees and compensated officers of the organizations listed below. It has established a process that includes the following elements: a separate committee (the board committee) comprised of independent directors meets at least annually to review, deliberate and make recommendations to houston methodist hospital's board of directors as it relates to any changes in total compensation including base pay, bonus awards from incentive programs or benefits and perquisites of the ceo. For 2022, the board committee reviewed and recommended compensation packages for the following positions: - president/ceo, officer and director (houston methodist hospital); director and officer president & ceo (methodist health centers); director and officer (houston methodist research institute); director & officer-chairperson (houston methodist baytown hospital); director and officer-president/ceo (tmh health care group); director and officer-chairperson (tmh medical office buildings); director & officer-chairperson (diagnostic center hospital corporation of texas); director (houston methodist clear lake hospital); director, chairperson, president & ceo (houston methodist continuing care hospital); director, chairperson, president & ceo (houston methodist st. Catherine real property); director, ceo, hm (houston methodist academic institute) - evp, chief financial officer/chief business officer, officer-assistant secretary & treasurer (houston methodist hospital) who serves as officer-assistant secretary (houston methodist research institute); officer-assistant secretary (methodist health centers); officer-assistant secretary (houston methodist baytown hospital); officer-secretary (tmh health care group); director and officer, vice chairperson, secretary and treasurer (diagnostic center hospital); director and officer, secretary & treasurer (tmh medical office buildings); director and officer, secretary & treasurer (houston methodist st. Catherine real property); director and officer, secretary/chairperson (houston methodist clear lake hospital); director and officer, secretary & treasurer (houston methodist continuing care hospital); officer, vice president & secretary (houston methodist coordinated care); officer, assistant secretary (houston methodist academic institute) - evp, chief legal officer (houston methodist hospital) who serves as director and officer, vice president (houston methodist continuing care hospital); director (houston methodist clear lake hospital); director and officer, vice president (houston methodist st. Catherine real property) - evp & chief physician executive (houston methodist hospital) who serves as director and officer, chief medical officer (methodist health centers) - evp, houston methodist hospital who serves as director (tmh medical office buildings); director and officer, president & ceo (diagnostic center hospital corp. Of texas) - evp, president, institute for academic medicine & chief academic officer; director and officer, secretary/treasurer (houston methodist research institute) - svp, institutional advancement & president & ceo hmh foundation - svp, chief human resources officer - svp, director and president & ceo (hm research institute); director and officer, president & ceo (houston methodist academic institute) - regional svp, houston methodist health centers (hmb and hmcl) who serves as ceo of houston methodist sugar land hospital - regional svp, houston methodist health centers (hmw and hmwb) who serves as ceo of houston methodist the woodlands hospital the board committee establishes that no member has any conflict of interest with regard to the executive compensation arrangements being approved. The board committee reviews and considers informat”

“The governing documents (except the articles of incorporation, which are on file with the secretary of the state of texas), conflict of interest policy and financial statements of the organizations are not made available to the general public.”

“The following list of officers, directors, trustees, key employees and highest compensated employees provide entity level details to support the information reported in part vii since many of the group's reportable individuals serve more than one entity included in this group return. In addition, pursuant to treasury regulation section 1.6033-2(d)(5), houston methodist hospital, which is the central organization of the group, elected to report information about its current and former officers, directors, trustees, key employees, and current highest compensated employees in this group return. Each person listed below held the following position(s) with the central organization and/or entities included in this group return:”

“Houston methodist baytown and held the following position: houston methodist baytown hospital- key employee, vice president & chief operating officer (average hours per week-50). Alecia rister received her part vii compensation from houston methodist academic institute and held the following positions: houston methodist research institute- key employee, vice president-finance (average hours per week-25) and houston methodist academic institute- key employee, vice president-finance (average hours per week-25). Amy l. Waer, md is an uncompensated director and held the following position: houston methodist academic institute- director (average hours per week-2). Andrea harrow received her part vii compensation from houston methodist clear lake hospital and held the following position: houston methodist clear lake hospital- key employee, vice president & chief nursing officer (average hours per week-50). Ann snyder, phd is an uncompensated director and held the following position: methodist health centers- director (average hours per week-2). Antonio gotto, md, dphil is an uncompensated director and held the following position: houston methodist academic institute- director (average hours per week-2). Augustine m. K. Choi, md is an uncompensated director and held the following position: houston methodist academic institute- director (average hours per week-2). Bishop scott jones is an uncompensated director and held the following position: houston methodist hospital- director (average hours per week-2). Brent allmon, md is an uncompensated director and held the following position: houston methodist coordinated care- director (average hours per week-2). Carl t. Little received his part vii compensation from methodist health centers and held the following position: methodist health centers- key employee, vice president & chief operating officer-houston methodist willowbrook hospital (average hours per week-50). Carlton e. Baucum is an uncompensated director and held the following positions: houston methodist hospital- director & officer, vice chairperson (average hours per week-2) and tmh health care group- director (average hours per week-2). Carole hackett received her part vii compensation from houston methodist hospital and held the following position: houston methodist hospital- key employee, senior vice president chief human resources officer (average hours per week-50). Cathy l. Easter received her part vii compensation from houston methodist hospital and held the following position: houston methodist hospital- highest compensated employee, senior vice president/chief executive officer global health care services (average hours per week-50). Chris siebenaler received his part vii compensation from methodist health centers and held the following positions: methodist health centers- key employee, regional senior vice president of houston methodist clear lake hospital and houston methodist baytown hospital, and chief executive officer of houston methodist sugar land hospital (average hours per week-50). Christopher p. Robben, md received his part vii compensation from a related organization and held the following positions: houston methodist coordinated care- director & officer, medical director (average hours per week-2) and 48 hours with related organization. Clint nichols received his part vii compensation from methodist health centers and held the following position: methodist health centers- key employee, vice president-finance of houston methodist the woodlands hospital (average hours per week-50). Connie dyer is an uncompensated director and held the following positions: methodist health centers- director (average hours per week-2), houston methodist coordinated care- director (average hours per week-2), and houston methodist continuing care hospital- director (average hours per week-2). Constance m. Mobley, md, phd received her part vii compensation from a related organization and held the following positions: houston me”

“Certain officers/directors of the organizations of the methodist hospital group (group) are employees of houston methodist hospital and related organizations, houston specialty physician group (a subordinate organization within the group but filing a separate return), houston methodist hospital foundation (a subordinate organization within the group but filing a separate return) or its non-group affiliates. The officers and directors who are employed by these organizations work a total of 50 hours per week on behalf of these organizations and other organizations of houston methodist. The compensation shown on part vii and schedule j reflects the total compensation earned for the officer/director for the combined hours spent working for all the organizations in the system.”

“The amounts reported on part vii, section b, are for both services and materials. These amounts could not be separated.”

“Affiliated organizations not included in group return (total of 2 entities): (1) tmh physician organization (d/b/a houston methodist specialty physician group), ein 57-1201170, 6565 fannin, houston, tx 77030 (2) methodist hospital foundation (d/b/a houston methodist hospital foundation), ein 76-0094743, 6565 fannin, houston, tx 77030.”

“The organizations in methodist hospital group (group) (see statement 1) are part of the methodist hospital, doing business as houston methodist hospital, whose mission is: to provide high quality, cost-effective health care that delivers the best value to the people we serve in a spiritual environment of caring in association with internationally recognized teaching and research.”

“The entities in methodist hospital group (see statement 1) included in this return perform different activities. The program service accomplishments for the activities are described below. 1. Methodist health centers does business as houston methodist sugar land hospital (hmsl), houston methodist willowbrook hospital (hmwb), houston methodist west hospital (hmw), and houston methodist the woodlands hospital (hmtw). 1a. Hmsl is located in sugar land, texas, which is approximately 21 miles southwest of downtown houston, texas. As of december 31, 2022, hmsl's licensed bed capacity was 350. With 1,240 affiliated physicians and 2,676 employees, hmsl offers access to the most innovative care available, including comprehensive cancer care; neuroscience and spine care; orthopedics and sports medicine; heart and vascular care; women's services; bariatric and digestive care; and advanced imaging. Hmsl has earned quality-based hospital accreditation through det norske veritas (dnv), chest pain accreditation through the society of cardiovascular patient care, and accreditation with the commendation by the american college of surgeons-commission on cancer. Hmsl recorded 337,208 visits during 2022, which were comprised of 248,304 outpatient visits, 69,526 emergency visits, and 19,378 inpatient admissions. 1b. Hmwb is located in northwest harris county, approximately 25 miles northwest of downtown houston, texas. As of december 31, 2022, hmwb's operating bed capacity was 358. Principal medical services provided by hmwb include inpatient and outpatient medical and surgical care, surgery suites, endoscopy suites, a cardiac catheterization lab, a 24-hour emergency department, three freestanding emergency care centers, a childbirth center with a neonatal intensive care unit, an intensive care unit, a breast care center, one freestanding breast imaging center, infusion services, wound care, general and diagnostic radiology, nuclear medicine, laboratory, radiation therapy, orthopedics and sports medicine, neurology and neurosurgery, physical therapy, two freestanding physical therapy and rehabilitation services locations, and 24-hour coverage in the obstetrics emergency department and intensive care unit. In addition, hmwb operated two emergency care centers - one located in cypress, tx and the other located in spring, tx. Hmwb recorded 183,298 outpatient visits, 22,816 admissions and 93,965 emergency room visits for a total of 300,079 visits in 2022. 1c. Hmw is located in the western part of harris county, approximately 21 miles west of downtown houston, texas. On december 17, 2010, hmw opened its emergency center, operating rooms, icu, surgery center and all ancillary support services. The hospital also opened with one 6 story professional office building and has since added a second office building as well as two parking garages. Other areas that have been developed and/or expanded since opening include additional specialty & outpatient areas including a cancer center, birthing center, breast center, wound care, operating rooms, cath labs and cardiac imaging and a physical therapy area. During 2022, hmw had 137,536 outpatient visits, 65,897 emergency room visits and 15,643 inpatient admissions for a total of 219,076 visits. As of december 31, 2022, hmw had 271 licensed beds. The campus master plan includes expansion space to increase the inpatient capacity to approximately 400 beds and to accommodate two additional professional buildings. 1d. Hmtw is located in southern montgomery county, approximately 35 miles north of downtown houston, texas. As of december 31, 2022, hmtw had 293 licensed beds. Principal medical services provided by hmtw include inpatient and outpatient medical and surgical care, surgery suites, endoscopy suites, cardiac catheterization labs, sleep lab, 24-hour emergency care center, birthing center, level iii nicu, intensive care unit, general and diagnostic radiology, nuclear medicine, laboratory, radiation therapy, sports”

“Program and infrastructure that enable faculty across the system to bring new scientific discoveries to patients as rapidly as possible through the full cycle of a cure from conceptual bench research, to prototyping and development, to clinical trials and fda approval. The institute supports more than 1,430 clinical research protocols and $87.6 million in extramurally funded translational research programs. Hmri's research departments, programs, and core facilities provide platform technology in support of clinical research programs throughout houston methodist. Its research goals are closely aligned with houston methodist's six centers of excellence. Hmri serves as a focal point for physicians and scientists with diverse interests and backgrounds to come together and share ideas. Hmri comprises 19 interdisciplinary departments: anesthesiology and critical care; cardiology; cardiovascular sciences; cardiovascular surgery; medicine; nanomedicine; stanley h. Appel department of neurology; neurosurgery; obstetrics and gynecology; ophthalmology; oral and maxillofacial surgery; orthopedic surgery; otolaryngology; pathology and genomic medicine; psychiatry and behavioral health; radiation oncology; radiology; surgery and urology. There are also 22 research centers and programs: ann kimball and john w. Johnson center for cellular therapeutics; blanton eye institute; bioenergetics; cardiovascular regeneration; critical care; health & nature; health data science and analytics; human performance; institute for robotics, imaging and navigation; houston methodist institute for technology, innovation & education (mitie); immunobiology & transplant science; immunology; infectious diseases; kenneth r. Peak brain & pituitary treatment center; musculoskeletal regeneration; nantz national alzheimer center; neuroregeneration; nursing research, education and practice; rapid device translation; rna therapeutics; sherrie and alan conover center for liver disease & transplantation; translational neural prosthetics and interfaces. The research institute also provides 20 core facilities for access to pioneering technology and data analysis, including: advanced cellular and tissue microscopy; biorepository; biostatistics and bioinformatics; clinical research services; comparative medicine; digital solutions; electron microscopy; event services; flow cytometry; high performance computing; immunomonitoring; intravital microscopy; machine shop; magnetic stimulation devices; nanoengineering; preclinical catheterization lab; research pathology; rnacore; translational imaging; and translational production and quality. 8. Houston methodist coordinated care (hmcc) accountable care organization (aco) is a non-profit corporation that was formed on june 7, 2016 to benefit houston methodist hospitals in collaboration with a high value primary care network of physicians. Its purpose is to manage, coordinate patient care and promote accountability for the quality, patient safety, cost and overall care of houston methodist's medicare fee-for-service patients by following them through their healthcare journey, providing preventive care and patient education as well as to decrease health care costs to medicare and the patients hmcc serves. Houston methodist coordinated care establishes, reports, and ensures provider compliance with health care quality criteria, including performance standards, care protocols and efficiency measure. 9. The houston methodist academic institute is a cornerstone of houston methodist's position as a nationally recognized academic medical center. The academic institute oversees the research institute and education institute, including 793 faculty and 56,260 learners. The academic institute aligns our research and education initiatives in service to the clinical mission, providing solutions that answer the call for new technologies and skills our clinicians need for patient care.”

“The following positions: houston methodist hospital- director (average hours per week-2), methodist health centers- director & officer, vice chairperson (average hours per week-2) and 2 hours with related organization. Ernie d. Cockrell, ii is an uncompensated director and held the following position: houston methodist academic institute- director (average hours per week-2). Evan katz is an uncompensated director and held the following position: houston methodist academic institute- director (average hours per week-2). Ewing werlein, jr. Is an uncompensated director and held the following positions: houston methodist hospital- director & officer, senior chairperson (average hours per week-2), methodist health centers- director & officer, senior chair (average hours per week-2), tmh health care group- director & officer, senior chair (average hours per week-2), houston methodist academic institute- director (average hours per week-2) and 2 hours with related organization. Gail vozzella received her part vii compensation from houston methodist hospital and held the following position: houston methodist hospital- key employee, senior vice president & chief nursing executive (average hours per week-50). Gary w. Edwards is an uncompensated director and held the following position: houston methodist hospital- director (average hours per week-2). Gary kempf received his part vii compensation from houston methodist continuing care and held the following position: houston methodist continuing care- officer, board president (average hours per week-50). Gilbert santana is an uncompensated director and held the following position: houston methodist baytown hospital- director & officer, vice chairperson (average hours per week-2). Gregory terry, md received his part vii compensation from a related organization and held the following positions: houston methodist coordinated care- director (average hours per week-2) and 48 hours with related organization. Gregory v. Nelson is an uncompensated director and held the following positions: houston methodist hospital- director & officer, chair (average hours per week-2), houston methodist research institute- director (average hours per week-2), methodist health centers- director (average hours per week-2), tmh health care group- director & officer, chairperson (average hours per week-2), houston methodist academic institute- director (average hours per week-2) and 2 hours with related organization. H. Dirk sostman, md received his part vii compensation from houston methodist academic institute and held the following positions: houston methodist research institute- director & officer, secretary/treasurer (average hours per week-2) and houston methodist academic institute- director and vice president & chief academic officer (average hours per week-48). Heidi reigel received her part vii compensation from houston methodist clear lake hospital and held the following position: houston methodist clear lake hospital- key employee, vice president & chief operating officer (average hours per week-50). Janet leatherwood received her part vii compensation from methodist health centers and held the following position: methodist health centers- key employee, vice president & chief nursing officer-houston methodist sugar land hospital (average hours per week-50). Jeff carr received his part vii compensation from a related organization and held the following positions: houston methodist coordinated care- officer, treasurer (average hours per week-2) and 48 hours with related organizations. Joe bob perkins is an uncompensated director and held the following positions: houston methodist hospital- director & officer, assistant treasurer (average hours per week-2) and houston methodist academic institute- director (average hours per week-2). John f. Bookout is an uncompensated director and held the following positions: houston methodist hospital- director (average hours per week-2), methodist health centers- direct”

“The following position: houston methodist academic institute- director (average hours per week-2). Kimberly sims, md received her part vii compensation from a related organization and held the following positions: houston methodist coordinated care- director (average hours per week-2) and 48 hours with related organization. Krystle riley received her part vii compensation from methodist health centers and held the following position: methodist health centers- key employee, vice president & chief operating officer of houston methodist the woodlands hospital (average hours per week-50). Kyle r. Stanzel received his part vii compensation from methodist health centers and held the following position: methodist health centers- key employee, vice president & chief operating officer houston methodist west hospital (average hours per week-50). Leslie doggett is an uncompensated director and held the following position: houston methodist academic institute- director (average hours per week-2). Lynn schroth is an uncompensated director and held the following position: houston methodist continuing care hospital- director (average hours per week-2). Marc l. Boom, m.d. Received his part vii compensation from houston methodist hospital and held the following positions: houston methodist hospital- director & officer, president & ceo (average hours per week of 28), diagnostic center hospital corp. Of texas- director & officer, chairperson (average hours per week-2), tmh medical office buildings- director & officer, chairperson (average hours per week-2), houston methodist baytown hospital- director & officer, chairperson (average hours per week-2), methodist health centers- director & officer, president & ceo (average hours per week-2), houston methodist research institute- director & officer, chairperson (average hours per week-2), tmh health care group- director & officer, president & ceo (average hours per week-2), houston methodist clear lake hospital- director (average hours per week-2), houston methodist continuing care hospital- director (average hours per week-2), houston methodist st. Catherine real property- director & officer, chair, president & ceo (average hours per week-2), houston methodist academic institute- director (average hours per week-2) and 2 hours with related organization. Mark a. Houser is an uncompensated director and held the following position: houston methodist hospital- director (average hours per week-2). Martha s. Debusk is an uncompensated director and held the following positions: houston methodist hospital- director (average hours per week-2), houston methodist research institute- director (average hours per week-2) and houston methodist academic institute- director & officer, chair (average hours per week-2). Martha walton is an uncompensated director and held the following position: houston methodist academic institute- director (average hours per week-2). Martin craighead is an uncompensated director and held the following position: houston methodist academic institute- director (average hours per week-2). Mary a. Daffin is an uncompensated director and held the following positions: houston methodist hospital- director & officer, vice chair (average hours per week-2) and tmh health care group- director & officer, vice chair (average hours per week-2). Mary eliza shaper is an uncompensated director and held the following position: houston methodist academic institute- director (average hours per week-2). Maya patel, md is an uncompensated director and held the following position: houston methodist coordinated care- director (average hours per week-2). Michael l. Garcia received his part vii compensation from houston methodist hospital and held the following position: houston methodist hospital- key employee, senior vice president & chief operating officer (average hours per week-50). Natalie j. Dryden, md received her part vii compensation from a related organization and held the following positions: hou”

“The following position: houston methodist coordinated care- director (average hours per week-2). Roberta l. Schwartz, phd received her part vii compensation from houston methodist hospital and held the following positions: houston methodist hospital- key employee, executive vice president chief innovation officer (average hours per week-46), tmh medical office buildings- director (average hours per week-2), and diagnostic center hospital corp. Of texas- director & officer, president & chief executive officer (average hours per week-2). Ryane jackson received her part vii compensation from houston methodist hospital and held the following positions: houston methodist hospital- vp community benefits (average hours per week-48) and houston methodist coordinated care- director (average hours per week-2). Sarah norene pletcher received her part vii compensation from houston methodist hospital and a related organization and held the following position: houston methodist hospital- highest compensated employee, vice president virtual medicine (average hours per week-50). Scott b. Ulrich received his part vii compensation from houston methodist hospital and held the following position: houston methodist hospital- key employee, vice president finance and operations (average hours per week-50). Sean a. Menogan received his part vii compensation from houston methodist hospital and held the following position: tmh medical office buildings- director & officer, president & chief executive officer (average hours per week-50). Seva papageorge, md received her part vii compensation from a related organization and held the following position: houston methodist coordinated care- director (average hours per week-2) and 48 hours with related organization. Shawn tittle, md received his part vii compensation from a related organization and held the following position: houston methodist baytown hospital- former key employee, chief quality officer (average hours per week-0) and 50 hours with related organization. Sidney j. Sanders received his part vii compensation from houston methodist hospital and held the following position: tmh medical office buildings- former director & officer, president & chief executive officer (average hours per week-0). Spencer tillman is an uncompensated director and held the following position: houston methodist hospital- director (average hours per week-2). Stephen chazen is an uncompensated director and held the following position: houston methodist academic institute- director & officer, secretary, part year (average hours per week-2). Stephen t. Wong received his part vii compensation from houston methodist research institute and held the following position: houston methodist research institute- highest compensated employee, acm dept chair/center dir mri (average hours per week-50). Steven birdwell is an uncompensated director and held the following position: houston methodist academic institute- director (average hours per week-2). Steven s. Looke is an uncompensated director and held the following position: houston methodist academic institute- director (average hours per week-2). Stuart l. Solomon, md received his part vii compensation from houston methodist hospital and held the following position: houston methodist hospital- director (average hours per week-2) and 2 hours with related organization. Susan h. Coulter received her part vii compensation from houston methodist hospital and held the following positions: houston methodist hospital- highest compensated employee, senior vice president, president & ceo foundation administration (average hours per week-25) and 25 hours with related organization. Susan miller, md received her part vii compensation from a related organization and held the following position: houston methodist coordinated care- director (average hours per week-2) and 48 hours with related organization. Suzanne smith is an uncompensated director and held the following position: houston methodist”

“Diagnostic center hospital (dch) of the methodist hospital group does not follow asc 958. Due to software limitations, the section could not be presented properly and therefore diagnostic center hospital's amount of retained earnings and common stock are included on line 27 instead of lines 29 and 31. Line 29 - capital stock or trust principal, etc. - $37,482,581 line 31 - retained earnings, endowment, etc. - $15,829,493”

“Income from subs 332,124,071. Transfers from donor restricted funds 872,871. Upl net adjustments -33,559,271.”

“The a-133 audit referred to on lines 3a & 3b was obtained by houston methodist research institute.”