Verification File Descriptions

FY 2020 Statewide SDA Status Verification File: Information contained within this file must be

reviewed and verified to be true, accurate and correct by each provider. If an error is found, it

must be submitted through use of the FY 2020 SDA Add-on Status Verification Form and

certification statement. The file contains a list of the hospitals, their hospital specific identifying

information, and add-on status information.

ATTENTION RURAL HOSPITAL PROVIDERS:

No action is required for rural hospitals. Rural hospitals do not receive add-on

amounts to their SDAs. Rural hospitals are listed for informational purposes only.

Please do not submit verification forms for rural hospitals.

Below are descriptions of several key columns in the FY 2020 Statewide SDA Status Verification File.

Please be sure to verify the information in all columns in the file.

SDA Status Verification File

Column B - Texas Provider Identifier (TPI) - Please be sure the TPI in Column A is correct as it relates

to your facility currently or as of 9-1-2019.

Column M - CBSA Wage Index - contains the reclassified wage index for each applicable hospital.

Column N - Applicable Teaching Add-on (Medicare Operating IME%) - contains the Teaching SDA

add-on percentage from the Medicare operating IME percentage for each hospital.

Column O - DSH 2019 Qualified - Indicates that the hospital meets qualifications outlined in TAC

§355.8065.

Column P - 2019 Trauma Level - contains the FY 2019 trauma designation for each provider from the

Department of State Health Services.

Column Q - 2020 Trauma Level - contains the current trauma designation for each provider from the

Department of State Health Services.

Additional Supporting Files Descriptions

DSHS Trauma Hospital Listing: The Department of State Health Services list of the trauma hospitals

and designation used for the SDA trauma add-on at Texas Trauma Facilities.

Texas Health and Human Services CommissionFY 2020 Statewide SDA Status Verification File

Prepared by HHSC Hospital Rate Analysis Department Page 1 or 10 7/11/2019

Texas - FY 2012 Final Rule- IPPS Impact File PUF: The file contains the Texas in-state hospital

specific information from the impact file from the Medicare Final Rule for the Inpatient Prospective

Payment System (IPPS). The second tab contains a variable description for each row in tab one. This file

was used as the Medicare source data to determine the CBSA, reclassification, and the Applicable

Teaching Add-on (Medicare Operating IME%).

Prepared by HHSC Hospital Rate Analysis Department Page 2 or 10 7/11/2019

Texas

Provider

Identifier

National

Provider

Identifier

Medicare

NumberHospital Name

2019 SDA

(Current)

2020 Hospital

Type

Hospital Physical

Street Address

Hospital Physical

City

Hospital Physical

Zip CodeCounty CBSA Name

Texas CBSA after

Reclass

(from IPUF)

CBSA

Wage Index

Applicable Teaching

Add-on (Medicare

Operating IME%)

DSH 2019

Qualified

2019 Trauma

Level

2020 Trauma

Level 1

112705203 1851344162 450558 ABILENE REGIONAL MEDICAL CENTER 3,648.12$ Urban 6250 HWY 83/84 AT ANTILLEY ROAD Abilene 79606 Taylor ABILENE, TX 10180 0.8789 Yes IV IV

365048301 1669732178 670102 AD HOSPITAL EAST LLC 3,565.03$ Urban 12950 EAST FWY Houston 2472 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

121789503 1821009242 450272 ADVENTIST HEALTH SYSTEM SUNBELT INC-CENTRAL TEXASMEDICAL CENTER 3,864.94$ Urban 1301 WONDER WORLD DR San Marcos 78666 Hays AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 Yes IV IV

282322101 1407169196 670071 AMH CATH LABS, LLC-TEXAS HEALTH HEART & VASCULAR HOSPITAL ARLINGTON 3,435.11$ Urban 811 WRIGHT ST Arlington 76012 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

127298107 1174563779 450144 ANDREWS COUNTY HOSPITAL DISTRICT 12,008.98$ Rural 720 HOSPITAL DR Andrews 79714 Andrews RURAL Yes IV IV

364187001 1457393571 450078 ANSON HOSPITAL DISTRICT 5,509.68$ Rural 101 AVE J Anson 79501 Jones RURAL

334284201 1295173664 450871 ARISE HEALTHCARE SYSTEM LLC 3,449.03$ Urban 3003 BEE CAVES RD Austin 78746 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

365612601 1114340080 670093 ASPIRE HOSPITAL LLC 3,565.03$ Urban 2006 S LOOP 336 W STE 500 Conroe 77304 Montgomery HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

387515501 1417465824 450389 UT HEALTH EAST TEXAS ATHENS - ATHENS HOSPITAL LLC 3,766.55$ Urban 2000 S PALESTINE ST Athens 75751 Henderson DALLAS-PLANO-IRVING, TX 19124 0.9506 Yes IAP IV

282268601 1386882488 452114 ATRIUM MEDICAL CENTER LP 3,565.03$ Urban 11929 W AIRPORT BLVD STE 110 Stafford 77477 Fort Bend HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

094215302 1245292630 450808 AUSTIN CENTER FOR OUTPATIENT SURGERY LP-NORTHWEST HILLS SURGICAL HOSPITAL 3,449.03$ Urban 6818 AUSTIN CENTER BLVD STE 100 Austin 78731 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

130089906 1225038938 451310 BALLINGER MEMORIAL HOSPITAL 7,647.75$ Rural 608 AVENUE B Ballinger 76821 Runnels RURAL IV IV

094148602 1093744187 450346 BAPTIST HOSPITALS OF SOUTHEAST TEXAS-MEMORIAL HERMANN BAPTIST BEAUMONT HOSPITAL3,617.07$ Urban 3080 COLLEGE Beaumont 77704 Jefferson BEAUMONT-PORT ARTHUR, TX 13140 0.8605 Yes IV IV

020973601 1508810573 450788 BAY AREA HEALTHCARE GROUP, LTD-CORPUS CHRISTI MEDICAL CENTER 3,754.79$ Urban 7101 S PADRE ISLAND DR Corpus Christi 78412 Nueces CORPUS CHRISTI, TX 18580 0.8578 0.02418 Yes IV IV

135036506 1669472387 450137 BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER 3,898.14$ Urban 1400 8TH AVENUE BOX 31 Fort Worth 76104 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 Yes III III

138353107 1194893263 450586 BAYLOR COUNTY HOSPITAL DISTRICT-SEYMOUR HOSPITAL 7,394.62$ Rural 200 STADIUM DRIVE Seymour 76380 Baylor RURAL Yes IV IV

151691601 1609855139 450851 BAYLOR HEART AND VASCULAR CENTER 3,624.05$ Urban 621 N HALL ST Dallas 75226 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 0.04253

288563403 1285930891 673046 BAYLOR INSTITUTE FOR REHABILITATION AT FRISCO 3,496.73$ Urban 2990 LEGACY DR Frisco 75034 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650

127262703 1073511762 450563 BAYLOR SCOTT & WHITE MEDICAL CENTER - GRAPEVINE 4,006.21$ Urban 1650 W COLLEGE ST Grapevine 76051 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 II II

344925801 1952509465 450730 BAYLOR SCOTT & WHITE MEDICAL CENTER - CARROLLTON 3,496.73$ Urban 4343 N JOSEY LN Carrollton 75010 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

121776205 1992700983 450079 BAYLOR MEDICAL CENTER AT IRVING 3,496.73$ Urban 1901 N MACARTHUR BLVD Irving 75061 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

135223905 1265430177 450372 BAYLOR MEDICAL CENTER AT WAXAHACHIE 3,496.73$ Urban 2400 N INTERSTATE HIGHWAY 35 E Waxahachie 75165 Ellis DALLAS-PLANO-IRVING, TX 19124 0.9650 IV

314161601 1124305065 670082 BAYLOR SCOTT AND WHITE MEDICAL CENTER - MCKINNEY 3,589.34$ Urban 5252 W UNIVERSITY DR McKinney 75071 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650 III III

171848805 1649273434 450890 BAYLOR REGIONAL MEDICAL CENTER AT PLANO 3,496.73$ Urban 4700 ALLIANCE BLVD Plano 75093 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650

388217701 1801826839 450885 BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL 3,496.73$ Urban 12505 LEBANON RD Frisco 75035 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650

395486901 1346729159 670128 BAYLOR SCOTT & WHITE MEDICAL CENTER - PFLUGERVILLE 3,449.03$ Urban 2600 E PFLUGERVILLE PKWY STE 100 Pflugerville 78660 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

139485012 1447250253 450021 BAYLOR UNIVERSITY MEDICAL CENTER 4,820.78$ Urban 3500 GASTON AVENUE Dallas 75246 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 0.08073 Yes I I

020993401 1174522494 451320 BAYSIDE COMMUNITY HOSPITAL 12,968.04$ Rural 200 HOSPITAL DR Anahuac 77514 Chambers RURAL IV

083290905 1477857332 450253 BELLVILLE ST JOSEPH HEALTH CENTER-BELLVILLE GENERAL HOSPITAL 6,143.35$ Rural 44 N CUMMINGS Bellville 77418 Austin RURAL IV IV

136141205 1821011248 450213 BEXAR COUNTY HOSPITAL DISTRICT-UNIVERSITY HEALTH SYSTEM 5,373.84$ Urban 4502 MEDICAL DR San Antonio 78229 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978 0.30993 Yes I I

094224503 1356312243 451378 BIG BEND REGIONAL MEDICAL CENTER 9,511.97$ Rural 2600 N HIGHWAY 118 Alpine 79830 Brewster RURAL Yes IV IV

112721903 1538465901 453036 BIR JV LLP-BAYLOR INSTITUTE FOR REHABILITATION 3,496.73$ Urban 909 N WASHINGTON AVE Dallas 75246 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

094226002 1801817135 450834 BRAZOS VALLEY PHYSICIANS ORGANIZATION MSO LLC-THE PHYSICIANS CENTRE HOSPITAL 3,404.11$ Urban 3131 UNIVERSITY DR EAST Bryan 77802 Brazos COLLEGE STATION-BRYAN, TX 17780 0.9247

207311601 1114903523 450200 BRIM HEALTHCARE OF TEXAS LLC-WADLEY REGIONAL MEDICAL CENTER 3,566.68$ Urban 1000 PINE ST Texarkana 75501 Bowie TEXARKANA, TX-TEXARKANA, AR 45500 0.8068 0.01744 Yes III III

020930601 1679526982 450587 BROWNWOOD REGIONAL MEDICAL CENTER 6,214.15$ Rural 1501 BURNET Brownwood 76801 Brown RURAL Yes IV IV

322879301 1407191984 450231 BSA HOSPITAL LLC-BAPTIST ST ANTHONYS HEALTH SYSTEM 3,567.61$ Urban 1600 WALLACE BLVD Amarillo 79106 Potter AMARILLO, TX 11100 0.8559 0.01265 Yes IV IV

391575301 1083112023 450678 BAYLOR SCOTT & WHITE MEDICAL CENTER - WHITE ROCK 3,496.73$ Urban 9440 POPPY DRIVE Dallas 75218 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

112725003 1750377289 451305 BURLESON ST JOSEPH HEALTH CENTER-BURLESON ST. JOSEPH HEALTH CENTER 7,404.87$ Rural 1101 WOODSON DRIVE Caldwell 77836 Burleson RURAL IV IV

212060201 1205164928 451312 CAHRMC LLC-RICE MEDICAL CENTER 8,557.94$ Rural 600 S AUSTIN RD Eagle Lake 77434 Colorado RURAL Yes IV IV

387663301 1538667035 450210 CARTHAGE HOSPITAL LLC-UT HEALTH EAST TEXAS CARTHAGE HOSPITAL 9,756.36$ Rural 409 COTTAGE RD Carthage 75633 Panola RURAL Yes IAP IAP

136142011 1033118716 451350 CASTRO COUNTY HOSPITAL DISTRICT-PLAINS MEMORIAL HOSPITAL 8,689.08$ Rural 310 WEST HALSELL Dimmitt 79027 Castro RURAL IV IV

211970301 1013142553 670061 CBSH,LLC- 3,250.24$ Urban 6130 PARKWAY Corpus Christi 78414 Nueces CORPUS CHRISTI, TX 18580 0.8578

192622201 1376662296 670043 CEDAR PARK REGIONAL MEDICAL CENTER 3,508.57$ Urban 1401 MEDICAL PARKWAY Cedar Park 78613 Williamson AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 IV IV

190809701 1609091693 673027 CENTRAL TEXAS REHABILITATION HOSPITAL LLC-CENTRAL TEXAS REHABILITATION HOSPITAL 3,449.03$ Urban 700 W 45TH ST Austin 78751 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

020817501 1174576698 450097 CHCA BAYSHORE LP-HCA HOUSTON HEALTHCARE SOUTHEAST 3,974.73$ Urban 4000 SPENCER HWY Pasadena 77504 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 Yes III III

121807504 1063466035 450617 CHCA CLEAR LAKE LP-HCA HOUSTON HEALTHCARE CLEAR LAKE 4,395.14$ Urban 500 W MEDICAL CENTER BLVD Webster 77598 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 Yes II II

020841501 1962455816 450222 CHCA CONROE LP-HCA HOUSTON HEALTHCARE CONROE 4,221.48$ Urban 504 MEDICAL CENTER BLVD Conroe 77304 Montgomery HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.03808 II II

349366001 1609275585 670106 CHCA PEARLAND, LP-HCA HOUSTON HEALTHCARE PEARLAND 3,565.03$ Urban 11100 Shadowcreek Parkway Pearland 77584 Brazoria HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

094187402 1275580938 450644 CHCA WEST HOUSTON LP-HCA HOUSTON HEALTHCARE WEST 3,944.02$ Urban 12141 RICHMOND AVE Houston 77082 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.02295 Yes IV

112712802 1023065794 450674 CHCA WOMANS HOSPITAL LP-THE WOMANS HOSPITAL OF TEXAS 3,984.30$ Urban 7600 FANNIN STREET Houston 77054 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 Yes IV

356438701 1912395203 452034 CHG HOSPITAL AUSTIN LLC-CORNERSTONE HOSPITAL AUSTIN 3,449.03$ Urban 4207 BURNET ROAD Austin 78756 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

357216601 1073901476 452107 CHG HOSPITAL CONROE LLC-CHG HOSPITAL CONROE, LLC 3,679.03$ Urban 1500 GRAND LAKE DR Conroe 77304 Montgomery HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.03808

358588701 1457730426 452032 CHG HOSPITAL HOUSTON LLC-CORNERSTONE HOSPITAL HOUSTON-BELLAIRE 3,565.03$ Urban 709 W MEDICAL CENTER BLVD Webster 77598 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

355796901 1760870166 452095 CHG HOSPITAL MCALLEN LLC-SOLARA HOSPITAL MCALLEN 3,306.85$ Urban 301 W EXPRESSWAY 83 FL 8 McAllen 78503 Hidalgo MCALLEN-EDINBURG-MISSION, TX 32580 0.8824

357053301 1659761815 452055 CHG HOSPITAL MEDICAL CENTER LLC- 3,565.03$ Urban 2001 Hermann Dr Houston 77004 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

127300503 1184622847 450193 CHI ST LUKES HEALTH BAYLOR COLLEGE OF MEDICINE MED 3,797.67$ Urban 6720 BERTNER AVE Houston 77030 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.07771

138910807 1194743013 453302 CHILDRENS MEDICAL CENTER OF DALLAS-CHILDRENS MEDICAL CENTER 12,483.43$ Children's 1935 MEDICAL DISTRICT DR Dallas 75235 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 0.04099 Yes I I

354178101 1720480627 453316 CHILDRENS MEDICAL CENTER OF DALLAS-CHILDREN'S MEDICAL CENTER PLANO 12,434.55$ Children's 7601 PRESTON ROAD Plano 75204 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650 Yes IV

133250406 1326079534 450369 CHILDRESS COUNTY HOSPITAL DISTRICT-CHILDRESS REGIONAL MEDICAL CENTER 6,781.14$ Rural 901 US HIGHWAY 83 N Childress 79201 Childress RURAL Yes IV IV

154632701 1548269590 451326 CHILLICOTHE HOSPITAL DISTRICT 12,968.04$ Rural 303 AVENUE I Chillicothe 79225 Hardeman RURAL IV IV

211454803 1548495740 452082 CHRISTUS CONTINUING CARE- 6,917.62$ Rural 820 CLARKSVILLE ST, 6th Floor Paris 75460 Lamar RURAL

094353202 1467453902 453065 CHRISTUS HEALTH ARK LA TEX-CHRISTUS ST MICHAEL REHABILITATION HOSPITAL 3,132.93$ Urban 2400 ST MICHAEL DR Texarkana 75503 Bowie TEXARKANA, TX-TEXARKANA, AR 45500 0.8068

020976902 1295736734 450801 CHRISTUS HEALTH ARK LATEX- 3,484.28$ Urban 2600 ST MICHAEL DR Texarkana 75503 Bowie TEXARKANA, TX-TEXARKANA, AR 45500 0.8068 0.00860 Yes III III

138296208 1679557888 450034 CHRISTUS HEALTH SOUTHEAST TEXAS-CHRISTUS HOSPITAL 3,564.49$ Urban 2830 CALDER ST Beaumont 77702 Jefferson BEAUMONT-PORT ARTHUR, TX 13140 0.8605 Yes III III

366812101 1033568621 450236 CHRISTUS HOPKINS HEALTH ALLIANCE-CHRISTUS MOTHER FRANCES HOSPITAL - SULPHUR SPRINGS6,770.36$ Rural 115 AIRPORT ROAD Sulphur Springs 75482 Hopkins RURAL Yes IV IV

112706003 1598749707 450573 CHRISTUS JASPER MEMORIAL HOSPITAL- 7,487.59$ Rural 1275 MARVIN HANCOCK DR Jasper 75951 Jasper RURAL Yes IV IV

020844903 1821004151 453315 CHRISTUS SANTA ROSA HEALTH CARE CORPORATION-CHRISTUS SANTA ROSA CHILDRENS 12,118.36$ Children's 333 N SANTA ROSA ST San Antonio 78207 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978 $440.52* Yes III III

020844901 1194787218 450237 CHRISTUS SANTA ROSA HEALTH CARE CORPORATION-CHRISTUS SANTA ROSA HOSPITAL 3,501.01$ Urban 2827 BABCOCK ROAD San Antonio 78207 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978 0.03319 IV IV

094222903 1003885641 450828 CHRISTUS SPOHN HEALTH SYSTEM CORPORATION- 5,773.94$ Rural 2500 E MAIN ST Alice 78332 Jim Wells RURAL Yes IV IV

020811801 1447228747 450082 CHRISTUS SPOHN HEALTH SYSTEM CORPORATION-CHRISTUS SPOHN HOSPITAL BEEVILLE 6,827.21$ Rural 1500 E HOUSTON ST Beeville 78102 Bee RURAL Yes IV IV

FY 2020 Statewide SDA Status Verification File

Texas Health and Human Services Commission

Texas

Provider

Identifier

National

Provider

Identifier

Medicare

NumberHospital Name

2019 SDA

(Current)

2020 Hospital

Type

Hospital Physical

Street Address

Hospital Physical

City

Hospital Physical

Zip CodeCounty CBSA Name

Texas CBSA after

Reclass

(from IPUF)

CBSA

Wage Index

Applicable Teaching

Add-on (Medicare

Operating IME%)

DSH 2019

Qualified

2019 Trauma

Level

2020 Trauma

Level 1

FY 2020 Statewide SDA Status Verification File

Texas Health and Human Services Commission

121775403 1689641680 450046 CHRISTUS SPOHN HEALTH SYSTEM CORPORATION-CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI4,109.58$ Urban 2606 HOSPITAL BLVD Corpus Christi 78405 Nueces CORPUS CHRISTI, TX 18580 0.8578 0.03023 Yes II II

136436606 1093783391 450163 CHRISTUS SPOHN HEALTH SYSTEM CORPORATION-CHRISTUS SPOHN HOSPITAL KLEBERG 5,488.00$ Rural 1311 E GENERAL CAVAZOS BLVD Kingsville 78363 Kleberg RURAL Yes IV IV

137907508 1124052162 450023 CITIZENS MEDICAL CENTER COUNTY OF VICTORIA-CITIZENS MEDICAL CENTER 3,514.65$ Urban 2701 HOSPITAL DRIVE Victoria 77901 Victoria VICTORIA, TX 47020 0.8166 Yes III III

094138703 1437156361 451362 CLAY COUNTY MEMORIAL HOSPITAL 8,020.83$ Rural 310 W SOUTH STREET Henrietta 76365 Clay RURAL

354076701 1861882532 673061 CLEAR LAKE INSTITUTE FOR REHABILITATION, LLC-PAM REHABILITATION HOSPITAL OF CLEAR LAKE3,565.03$ Urban 110 E MEDICAL CENTER BLVD Webster 77598 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

179322602 1972540417 453052 CLEAR LAKE REHABILITATION HOSPITAL LLC-KINDRED REHABILIT HOSPITAL CLEAR LAKE 3,565.03$ Urban 655 E MEDICAL CENTER BLVD Webster 77598 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

094349003 1689648339 453054 CMS REHAB OF WF LP-ENCOMPASS HEALTH REHABILITATION HOSPITAL OF WICHIT 3,663.59$ Urban 3901 ARMORY RD Wichita Falls 76302 Wichita WICHITA FALLS, TX 48660 1.0375

094152803 1942314448 451366 COCHRAN MEMORIAL HOSPITAL 8,003.33$ Rural 201 E GRANT AVE Morton 79346 Cochran RURAL

020860501 1467403477 450299 COLLEGE STATION MEDICAL CENTER 3,506.30$ Urban 1604 ROCK PRAIRIE RD College Station 77845 Brazos COLLEGE STATION-BRYAN, TX 17780 0.9247 0.00320 III III

020943901 1689628984 450647 COLUMBIA HOSPITAL MEDICAL CITY DALLAS, SUBSIDIARY-MEDICAL CITY DALLAS HOSPITAL 3,823.08$ Urban 7777 FOREST LANE Dallas 75230 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 0.00077 Yes IV IV

020950401 1134172406 450675 COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP-MEDICAL CENTER OF ARLINGTON 3,930.51$ Urban 3301 MATLOCK RD Arlington 76015 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 Yes III II

111905902 1306897277 450634 COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP-DENTON REGIONAL MEDICAL CENTER4,039.18$ Urban 3535 S INTERSTATE 35 E Denton 76210 Denton DALLAS-PLANO-IRVING, TX 19124 0.9650 II II

020979302 1902857766 450822 COLUMBIA MEDICAL CENTER OF LAS COLINAS, INC-LAS COLINAS MEDICAL CENTER 3,496.73$ Urban 6800 N MACARTHUR BLVD Irving 75039 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

112698903 1437102639 450403 COLUMBIA MEDICAL CENTER OF MCKINNEY SUBSIDIARY LP-MEDICAL CENTER OF MCKINNEY 3,589.34$ Urban 4500 MEDICAL CENTER DR McKinney 75069 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650 III III

127311205 1699726406 450651 COLUMBIA MEDICAL CENTER OF PLANO LP-MEDICAL CENTER OF PLANO 4,343.48$ Urban 3901 W 15TH ST Plano 75075 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650 I I

094105602 1518911833 450087 COLUMBIA NORTH HILLS HOSPITAL-COLUMBIA NORTH HILLS HOSPITA 3,556.37$ Urban 4401 BOOTH CALLOWAY ROAD North Richland Hills 76180 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 III III

094193202 1659323772 450672 COLUMBIA PLAZA MED CTR OF FT WORTH SUBSIDIARY LP-PLAZA MEDICAL CENTER OF FORT WORTH3,791.18$ Urban 900 8TH AVE Fort Worth 76104 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 0.10937

112716902 1619924719 450711 COLUMBIA RIO GRANDE HEALTHCARE LP-RIO GRANDE REGIONAL HOSPITAL 3,625.75$ Urban 101 E RIDGE RD McAllen 78503 Hidalgo MCALLEN-EDINBURG-MISSION, TX 32580 0.8824 Yes III III

020947001 1043267701 450662 COLUMBIA VALLEY HEALTHCARE SYSTEMS LP-VALLEY REGIONAL MEDICAL CENTER 3,832.66$ Urban 100A E ALTON GLOOR BLVD Brownsville 78526 Cameron BROWNSVILLE-HARLINGEN, TX 15180 0.9397 Yes III III

135033210 1740238641 450370 COLUMBUS COMMUNITY HOSPITAL- 7,357.27$ Rural 110 SHULT DRIVE Columbus 78934 Colorado RURAL Yes IV IV

281406304 1346544616 451382 COMANCHE COUNTY MEDICAL CENTER COMPANY-COMANCHE COUNTY MEDICAL CENTER 6,111.53$ Rural 10201 HIGHWAY 16 Comanche 76442 Comanche RURAL IV IV

112671602 1972581940 450072 COMMUNITY HOSPITAL OF BRAZOSPORT-BRAZOSPORT REGIONAL HEALTH SYSTEM 3,657.64$ Urban 100 MEDICAL DRIVE Lake Jackson 77566 Brazoria HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 III III

091770005 1326025701 451325 CONCHO COUNTY HOSPITAL 12,968.04$ Rural 614 EAKER ST Eden 76837 Concho RURAL Yes IV IV

178396101 1174524466 452091 CONTINUE CARE HOSPITAL OF TYLER INC-TYLER CONTINUE CARE HOSPITAL AT MOTHER FRANCES HOS3,211.26$ Urban 800 EAST DAWSON 4TH FLOOR Tyler 75701 Smith TYLER, TX 46340 0.8409

364396701 1992709661 452029 CONTINUECARE HOSPITAL AT HENDRICK MEDICAL CENTER-CONTINUE CARE HOSPITAL AT HENDRICK MEDICAL CENTER3,298.68$ Urban 1900 PINE Abilene 79601 Taylor ABILENE, TX 10180 0.8789

352064501 1588005888 452117 CONTINUECARE HOSPITAL OF MIDLAND INC- 3,627.40$ Urban 4214 ANDREWS HWY FL 3 Midland 79703 Midland MIDLAND, TX 33260 1.0218

021184901 1891765178 453300 COOK CHILDREN'S MEDICAL CENTER 11,965.86$ Children's 801 7TH AVE Fort Worth 76104 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 0.00029 Yes II II

196882804 1235299132 670045 COOK CHILDRENS NORTHEAST HOSPITAL, LLC 3,435.11$ Urban 6316 PRECINCT LINE RD Hurst 76054 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

130826407 1639176456 451331 COON MEMORIAL HOSPITAL 9,445.92$ Rural 1411 DENVER AVE Dalhart 79022 Dallam RURAL Yes IV IV

313347201 1235374612 452111 CORINTH INVESTOR HOLDINGS LLC 3,496.73$ Urban 2813 S MAYHILL RD Denton 76208 Denton DALLAS-PLANO-IRVING, TX 19124 0.9650

094221102 1386652527 450825 CORNERSTONE REGIONAL HOSPITAL 3,306.85$ Urban 2302 CORNERSTONE BLVD Edinburg 78539 Hidalgo MCALLEN-EDINBURG-MISSION, TX 32580 0.8824

344945603 1821439183 673053 CORPUS CHRISTI REHABILITATION HOSPITAL LLC 3,250.24$ Urban 5726 ESPLANADE DR Corpus Christi 78414 Nueces CORPUS CHRISTI, TX 18580 0.8578

134772611 1780823021 451379 CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY- 4,539.10$ Rural 1507 WEST MAIN STREET Gatesville 76528 Coryell RURAL IV IV

136331910 1720096019 451373 COUNTY OF WARD-WARD MEMORIAL HOSPITAL 7,748.19$ Rural 406 S GARY Monahans 79756 Ward RURAL IV IV

137227806 1790702371 451308 COUNTY OF YOAKUM - YOAKUM COUNTY HOSPITAL 11,159.44$ Rural 412 MUSTANG AVE Denver City 79323 Yoakum RURAL Yes IV IV

139461107 1972517365 450040 COVENANT HEALTH SYSTEM-COVENANT MEDICAL CENTER 4,091.17$ Urban 3615 19TH ST Lubbock 79410 Lubbock LUBBOCK, TX 31180 0.8799 0.00757 Yes II II

319209801 1013941780 452102 COVENANT LONG TERM CARE LP-COVENANT SPECIALTY HOSPITAL 3,301.10$ Urban 3815 20TH ST Lubbock 79410 Lubbock LUBBOCK, TX 31180 0.8799

358006003 1952784985 673063 COVENANT REHABILITATION HOSPITAL OF LUBBOCK LLC-TRUSTPOINT REHABILITATION HOSPITAL OF LUBBOCK3,301.10$ Urban 4302 PRINCETON ST Lubbock 79415 Lubbock LUBBOCK, TX 31180 0.8799

303478701 1407010622 670062 CR EMERGENCY ROOM LLC-BAYLOR SCOTT AND WHITE EMERGENCY HOSPITAL 3,496.73$ Urban 26791 HIGHWAY 380 Aubrey 76227 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9506

199602701 1316197767 451353 CRANE COUNTY HOSPITAL DISTRICT-CRANE MEMORIAL HOSPITAL 12,968.04$ Rural 1310 SOUTH ALFORD STREET Crane 79731 Crane RURAL

391576104 1114435260 670126 CROCKETT MEDICAL CENTER LLC - CROCKETT MEDICAL CENTER 8,003.33$ Rural 1100 E LOOP 304 Crockett 75835 Houston RURAL

094141105 1063500270 451345 CROSBYTON CLINIC HOSPITAL 6,255.67$ Rural 710 W MAIN ST Crosbyton 79322 Crosby RURAL

138911619 1437148020 450597 CUERO COMMUNITY HOSPITAL 7,233.25$ Rural 2550 N ESPLANADE Cuero 77954 Dewitt RURAL Yes IV IV

361949601 1568848059 670112 CUMBERLAND SURGICAL HOSPITAL OF SAN ANTONIO LLC- 3,342.11$ Urban 5330 N LOOP 1604 W San Antonio 78249 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

378029801 1164952685 450716 CY FAIR MEDICAL CENTER HOSPITAL LLC-HCA HOUSTON HEALTHCARE CYPRESS FAIRBANKS 3,981.15$ Urban 10655 STEEPLETOP DR Houston 77065 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 Yes III IAP

320384603 1356559991 452108 DALLAS LTACH LLC-KINDRED HOSPITAL DALLAS CENTRAL 3,496.73$ Urban 8050 MEADOW RD Dallas 75231 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

219336901 1861690364 450379 DALLAS MEDICAL CENTER LLC- 3,556.27$ Urban 7 MEDICAL PARKWAY Dallas 75234 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 IV

189947801 1134108053 450489 DAWSON COUNTY HOSPITAL DISTRICT-MEDICAL ARTS HOSPITAL 6,822.00$ Rural 2200 N BRYAN AVE Lamesa 79331 Dawson RURAL Yes IV IV

160709501 1053317362 450869 DAY SURGERY AT RENAISSANCE LLC-DOCTORS HOSPITAL AT RENAISSANCE LTD 3,691.54$ Urban 5501 S MCCOLL RD Edinburg 78539 Hidalgo MCALLEN-EDINBURG-MISSION, TX 32580 0.8824 0.01599 Yes III III

133544006 1568454403 450155 DEAF SMITH COUNTY HOSPITAL DISTRICT-HEREFORD REGIONAL MEDICAL CENTER 8,732.41$ Rural 540 W 15TH ST Hereford 79045 Deaf Smith RURAL Yes IV IV

364597001 1407229529 670116 DECATUR HOSPITAL AUTHORITY-WISE HEALTH SYSTEM 3,463.26$ Urban 609 MEDICAL CENTER DRIVE Decatur 76177 Wise DALLAS-PLANO-IRVING, TX 19124 0.9506

130606006 1124076401 450271 DECATUR HOSPITAL AUTHORITY-WISE HEALTH SYSTEM 11,594.78$ Rural 2000 S. FM 51 Decatur 76234 Wise RURAL IV IV

343108201 1033204342 452109 DENTON TRANSITIONAL LTCH LP-INTEGRITY TRANSITIONAL HOSPITAL 3,496.73$ Urban 2813 S MAYHILL RD Denton 76208 Denton DALLAS-PLANO-IRVING, TX 19124 0.9650

094118902 1851343909 450147 DETAR HOSPITAL-DETAR HOSPITAL NAVARRO 3,644.24$ Urban 506 E SAN ANTONIO ST Victoria 77901 Victoria CORPUS CHRISTI, TX 18580 0.8578 Yes III IV

217884004 1326134255 451390 DIMMIT REGIONAL HOSPITAL 7,248.48$ Rural 704 HOSPITAL DR Carrizo Springs 78834 Dimmit RURAL Yes IV IV

112727605 1891741468 450803 DOCTORS HOSPITAL 1997 LP-UNITED MEMORIAL MEDICAL CENTER 3,624.57$ Urban 510 W TIDWELL RD Houston 77091 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 IV IV

132812205 1548286172 453301 DRISCOLL CHILDRENS HOSPITAL 11,270.50$ Children's 3533 SOUTH ALAMEDA Corpus Christi 78411 Nueces CORPUS CHRISTI, TX 18580 0.8578 0.00840 Yes III III

199210901 1669655601 450877 EAST EL PASO PHYSICIANS MEDICAL CENTER LLC-FOUNDATION SURGICAL HOSPITAL OF EL PASO3,243.18$ Urban 1416 GEORGE DIETER DR El Paso 79936 El Paso EL PASO, TX 21340 0.8548

121817401 1821063553 450749 EAST TEXAS MEDICAL CENTER TRINITY 9,705.69$ Rural 317 PROSPECT DRIVE Trinity 75862 Trinity RURAL

137074409 1689650921 450411 EASTLAND MEMORIAL HOSPITAL DISTRICT-EASTLAND MEMORIAL HOSPITAL 4,533.08$ Rural 304 S DAUGHERTY AVE Eastland 76448 Eastland RURAL IV IV

348928801 1679903967 670107 EBD BEMC BURLESON, LLC-BAYLOR SCOTT AND WHITE EMERGENCY HOSPITAL MANSFIEL 3,463.76$ Urban 12500 SOUTH FWY STE 100 Burleson 76028 Johnson DALLAS-PLANO-IRVING, TX 19124 0.9506

343799801 1952732653 670097 EBD BEMC ROCKWALL, LLC-BAYLOR EMERGENCY MEDICAL CENTER 3,496.73$ Urban 1975 ALPHA DR STE 100 Rockwall 75087 Rockwall DALLAS-PLANO-IRVING, TX 19124 0.9650

135235306 1740273994 450132 ECTOR COUNTY HOSPITAL DISTRICT-MEDICAL CENTER HOSPITAL 4,513.22$ Urban 500 W 4TH ST Odessa 79761 Ector ODESSA, TX 36220 0.9690 0.07064 Yes II II

311054601 1003192311 450694 EL CAMPO MEMORIAL HOSPITAL 4,533.08$ Rural 303 SANDY CORNER RD El Campo 77437 Wharton RURAL Yes IV IV

291854201 1558659714 453313 EL PASO CHILDRENS HOSPITAL 11,194.89$ Children's 4845 ALAMEDA AVE El Paso 79905 El Paso EL PASO, TX 21340 0.8548 $2.79* Yes

138951211 1316936990 450024 EL PASO COUNTY HOSPITAL DISTRICT-UNIVERSITY MEDICAL CENTER OF EL PASO 5,103.72$ Urban 4815 ALAMEDA El Paso 79905 El Paso EL PASO, TX 21340 0.8548 0.26325 Yes I I

094109802 1770536120 450107 EL PASO HEALTHCARE SYSTEM LTD-LAS PALMAS MEDICAL CENTER 4,056.74$ Urban 1801 N OREGON El Paso 79902 El Paso EL PASO, TX 21340 0.8548 Yes II II

148322401 1366427130 450845 EL PASO SPECIALTY HOSPITAL LTD-SURGICAL INSTITUTE OF EL PASO 3,243.18$ Urban 1755 CURIE STE A El Paso 79902 El Paso EL PASO, TX 21340 0.8548

135034009 1871583153 451343 ELECTRA HOSPITAL DISTRICT-ELECTRA MEMORIAL HOSPITAL 7,028.27$ Rural 1207 S BAILEY ST Electra 76360 Wichita RURAL IV IV

363070901 1992172019 670115 EMERGENCY HOSPITAL SYSTEMS LLC-CLEVELAND EMERGENCY HOSPITAL 3,565.03$ Urban 1017 S TRAVIS AVE Cleveland 77327 Liberty HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

Texas

Provider

Identifier

National

Provider

Identifier

Medicare

NumberHospital Name

2019 SDA

(Current)

2020 Hospital

Type

Hospital Physical

Street Address

Hospital Physical

City

Hospital Physical

Zip CodeCounty CBSA Name

Texas CBSA after

Reclass

(from IPUF)

CBSA

Wage Index

Applicable Teaching

Add-on (Medicare

Operating IME%)

DSH 2019

Qualified

2019 Trauma

Level

2020 Trauma

Level 1

FY 2020 Statewide SDA Status Verification File

Texas Health and Human Services Commission

309798201 1669752234 670078 EMERUS BHS SA THOUSAND OAKS LLC-BAPTIST EMERGENCY HOSPITAL SHAVANO PARK 3,342.11$ Urban 16088 SAN PEDRO AVE San Antonio 78232 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

163111101 1063411767 450196 ESSENT PRMC LP-PARIS REGIONAL MEDICAL CENTER 6,917.62$ Rural 865 DeShong Drive Paris 75460 Lamar RURAL Yes III

325449201 1144566316 670087 ESWCT CEDAR PARK, LLC-BAYLOR SCOTT & WHITE EMERGENCY MEDICAL CTR AT CEDA 3,449.03$ Urban 900 E WHITESTONE BLVD Cedar Park 78613 Williamson AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

376537203 1235685892 450658 FAIRFIELD HOSPITAL DISTRICT-FREESTONE MEDICAL CENTER 4,533.08$ Rural 125 NEWMAN ST Fairfield 75840 Freestone RURAL IV

133367602 1841294246 450348 FALLS COMMUNITY HOSPITAL AND CLINIC 6,738.79$ Rural 322 COLEMAN ST Marlin 76661 Falls RURAL IV

330811601 1760417646 451370 FANNIN COUNTY HOSPITAL AUTHORITY-TMC BONHAM HOSPITAL 5,752.19$ Rural 504 LIPSCOMB ST Bonham 75418 Fannin RURAL IAP IV

354160901 1336533595 670110 FIRST TEXAS HOSPITAL CARROLLTON LLC- 3,496.73$ Urban 1401 E TRINITY MILLS RD Carrollton 75006 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

365480801 1821450255 670118 FIRST TEXAS HOSPITAL CY-FAIR, LLC-FIRST TEXAS HOSPITAL 3,565.03$ Urban 9922 LOUETTA RD Houston 77070 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

112692202 1598746703 451313 FISHER COUNTY HOSPITAL 9,914.02$ Rural 774 STATE HWY 70 NORTH Rotan 79546 Fisher RURAL Yes IV IV

217744601 1902047376 670068 FLOWER MOUND HOSPITAL PARTNERS LLC-TEXAS HEALTH PRESBYTERIAN HOSPITAL FLOWER MOUND3,496.73$ Urban 4400 LONG PRAIRIE RD Flower Mound 75028 Denton DALLAS-PLANO-IRVING, TX 19124 0.9650

110803703 1770579591 450092 FORT DUNCAN REGIONAL MEDICAL CENTER LP-FORT DUNCAN REGIONAL MEDICAL CENTER 7,523.52$ Rural 3333 N FOSTER MALDONADO BLVD Eagle Pass 78852 Maverick RURAL Yes IV IV

112688004 1447574819 451391 FRIO HOSPITAL-FRIO REGIONAL SWING BED 7,403.94$ Rural 200 S I H 35 Pearsall 78061 Frio RURAL Yes IV IV

157144001 1922002674 450853 FRISCO MEDICAL CENTER-BAYLOR SCOTT & WHITE MEDICAL CENTER - FRISCO 3,496.73$ Urban 5601 WARREN PARKWAY Frisco 75034 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650

167364201 1871599183 450880 FT WORTH SURGICARE PARTNERS, LTD-BAYLOR SURGICAL HOSPITAL AT FT WORTH 3,463.76$ Urban 1800 PARK PLACE AVENUE Fort Worth 76110 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9650

121777003 1922009331 450090 GAINESVILLE HOSPITAL DISTRICT-NORTH TEXAS MEDICAL CENTER 9,143.46$ Rural 1900 HOSPITAL BLVD Gainesville 76240 Cooke RURAL Yes IV IAP

112728403 1083619712 451307 GENERAL HOSPITAL-IRAAN GENERAL HOSPITAL 12,968.04$ Rural 600 HWY 349 NORTH Iraan 79744 Pecos RURAL IV IV

312476002 1396902540 673035 GLOBALREHAB FORT WORTH, LP- 3,496.73$ Urban 6601 HARRIS PKWY Fort Worth 76132 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

310164401 1306011929 673033 GLOBALREHAB LP- 3,496.73$ Urban 1340 EMPIRE CENTRAL DR Dallas 75247 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

349912101 1568695146 673040 GLOBALREHAB SAN ANTONIO LP-SELECT REHABILITATION HOSPITAL OF SAN ANTONIO 3,342.11$ Urban 19126 STONEHUE San Antonio 78258 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

121785303 1932108214 450235 GONZALES HEALTHCARE SYSTEMS-MEMORIAL HOSPITAL 7,712.06$ Rural 1110 SARAH DEWITT DR Gonzales 78629 Gonzales RURAL Yes IV IV

137075116 1962455832 451385 GOODALL WITCHER HOSPITAL- 11,716.90$ Rural 101 POSEY AVE Clifton 76634 Bosque RURAL Yes IV IV

197063401 1841497153 451369 GPCH LLC-GOLDEN PLAINS COMMUNITY HOSPITAL 8,322.88$ Rural 100 MEDICAL DR Borger 79007 Hutchinson RURAL Yes IV IV

346945401 1881691061 450085 GRAHAM HOSPITAL DISTRICT- 7,705.35$ Rural 1301 MONTGOMERY RD Graham 76450 Young RURAL IV IV

147918003 1154317774 451322 GRIMES ST JOSEPH HEALTH CENTER 8,853.64$ Rural 210 S. JUDSON Navasota 77868 Grimes RURAL IV IV

138411709 1720088123 450104 GUADALUPE COUNTY HOSPITAL BOARD-GUADALUPE REGIONAL MEDICAL CENTER 3,401.65$ Urban 1215 EAST COURT Seguin 78155 Guadalupe SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978 IV IV

007068203 1326037607 451392 HAMILTON COUNTY HOSPITAL DISTRICT-HAMILTON GENERAL HOSPITAL 4,533.08$ Rural 400 N BROWN Hamilton 76531 Hamilton RURAL IV IV

110856504 1134137466 451354 HAMILTON HOSPITAL 5,528.81$ Rural 901 W HAMILTON Olney 76374 Young RURAL Yes IV IV

094131202 1396739710 450243 HAMLIN HOSPITAL DISTRICT-HAMLIN MEMORIAL HOSPITAL 8,376.86$ Rural 632 NW SECOND Hamlin 79520 Jones RURAL IV

094117105 1992707780 451344 HANSFORD COUNTY HOSPITAL DISTRICT-HANSFORD COUNTY HOSPITAL 10,685.26$ Rural 707 SOUTH ROLAND ST Spearman 79081 Hansford RURAL IV IV

121692107 1861510521 451352 HARDEMAN COUNTY MEMORIAL HOSPITAL 7,975.02$ Rural 402 MERCER ST Quanah 79252 Hardeman RURAL Yes IV IV

154504801 1881688976 450855 HARLINGEN MEDICAL CENTER LP 3,723.15$ Urban 5501 S EXPRESSWAY 77 Harlingen 78550 Cameron BROWNSVILLE-HARLINGEN, TX 15180 0.9397 IV IV

133355104 1205900370 450289 HARRIS COUNTY HOSPITAL DISTRICT 5,586.25$ Urban 1504 TAUB LOOP Houston 77030 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.31066 Yes I I

112667403 1124092036 450032 HARRISON COUNTY HOSPITAL ASSOCIATION-CHRISTUS GOOD SHEPHERD MEDICAL CENTER MARSHALL3,798.67$ Urban 811 S WASHINGTON AVE Marshall 75670 Harrison LONGVIEW, TX 30980 0.8689 0.05823 Yes III III

112702904 1184607897 451341 HASKELL MEMORIAL HOSPITAL 4,533.08$ Rural 1 NORTH AVE N Haskell 79521 Haskell RURAL

380473401 1003344334 670124 HCN EP HORIZON CITY LLC-THE HOSPITALS OF PROVIDENCE HORIZON CITY CAMPUS 3,243.18$ Urban 13600 HORIZON BLVD Horizon City 79928 El Paso EL PASO, TX 21340 0.8548

199329702 1699749341 453042 HEALTH SOUTH CITY VIEW REHABILITATION HOSPITAL-ENCOMPASS HEALTH REHABILITATION HOSPITAL OF CITY V3,435.11$ Urban 6701 OAKMONT BLVD Fort Worth 76132 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

337018101 1366871600 453029 HEALTH SOUTH REHABILITATION HOSPITAL OF HUMBLE- 3,565.03$ Urban 19002 MCKAY DR Humble 77338 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

021185601 1013968726 453309 HEALTHBRIDGE CHILDRENS HOSPITAL- HOUSTON LTD-HEALTHBRIDGE CHILDRENS HOSPITAL 13,227.19$ Children's 2929 WOODLAND PARK DRIVE Houston 77082 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 Yes

094347402 1144294893 453047 HEALTHSOUTH PLANO REHABILITATION HOSPITAL LLC-HEALTHSOUTH PLANO REHABILITATION HOSPITAL3,496.73$ Urban 2800 W 15TH ST Plano 75075 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650

309446801 1548546088 673054 HEALTHSOUTH REHAB HOSPITAL OF SOUTH AUSTIN LLC-HEALTHSOUTH REHABILITATION HOSPITAL OF AUSTIN3,449.03$ Urban 330 E BEN WHITE BLVD Austin 78704 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

288662403 1427374222 673044 HEALTHSOUTH REHAB HOSPITAL OF THE MID-CITIES LLC-RELIANT REHABILITATION HOSPITAL MID CITIES3,463.76$ Urban 2304 HIGHWAY 121 Bedford 76021 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

021168201 1548233265 453031 HEALTHSOUTH REHAB INSTITUTUE OF SAN ANTONIO RIOSA-ENCOMPASS HEALTH REHABILITATION HOSPITAL OF SAN AN3,342.11$ Urban 9119 CINNAMON HL San Antonio 78240 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

021173202 1821062050 453040 HEALTHSOUTH REHABILIATION HOSPITAL OF ARLINGTON 3,435.11$ Urban 3200 MATLOCK RD Arlington 76015 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

094352403 1194798801 453059 HEALTHSOUTH REHABILITATION HOSPITAL THE WOODLANDS-ENCOMPASS HEALTH REHABILITATION HOSPITAL OF THE W3,565.03$ Urban 18550 IH 45S Conroe 77384 Montgomery HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

209804801 1477731156 673034 HEALTHSOUTH REHABILITATION HOSPITAL NORTH HOUSTON-ENCOMPASS HEALTH REHABILITATION HOSPITAL VISION PA3,565.03$ Urban 117 VISION PARK BLVD Shenandoah 77384 Montgomery HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

313188001 1659539567 673039 HEALTHSOUTH REHABILITATION HOSPITAL OF ABILENE LLC-HEALTHSOUTH REHABILITATION HOSPITAL OF ABILENE3,298.68$ Urban 6401 DIRECTORS PKWY Abilene 79606 Taylor ABILENE, TX 10180 0.8789

301006801 1275813610 673050 HEALTHSOUTH REHABILITATION HOSPITAL OF CYPRESS LLC- 3,565.03$ Urban 13031 WORTHAM CENTER DR Houston 77065 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

314562501 1982920773 673043 HEALTHSOUTH REHABILITATION HOSPITAL OF DALLAS LLC-HEALTHSOUTH REHABILITATION HOSPITAL OF DALLAS3,496.73$ Urban 7930 NORTHAVEN RD Dallas 75230 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

094343303 1851364558 453041 HEALTHSOUTH REHABILITATION HOSPITAL OF FORT WORTH- 3,435.11$ Urban 1212 W LANCASTER Fort Worth 76102 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

382091201 1144756578 673066 HEALTHSOUTH REHABILITATION HOSPITAL OF PEARLAND LL - HEALTHSOUTH REHABILITATION OF HOSPITAL OF PEARLAND3,565.03$ Urban 2121 BUSINESS CENTER DR Pearland 77584 Brazoria HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

199238002 1720279342 673029 HEALTHSOUTH REHABILITATION HOSPITAL OF RICHARDSON 3,565.03$ Urban 3351 WATERVIEW PKWY Richardson 77080 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

209190201 1245422567 673032 HEALTHSOUTH REHABILITATION HOSPITAL OF ROUND ROCK 3,449.03$ Urban 1400 HESTERS CROSSING RD Round Rock 78681 Williamson AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

219907701 1518287721 673042 HEALTHSOUTH REHABILITATION HOSPITAL OF SUGAR LAND-HEALTHSOUTH SUGAR LAND REHABILITATION HOSPITAL3,565.03$ Urban 1325 HIGHWAY 6 Sugar Land 77478 Fort Bend HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

315341301 1376829812 673052 HEALTHSOUTH REHABILITATION HOSPITAL OF VINTAGE PAR-HEALTHSOUTH REHABILITATION HOSPITAL THE VINTAGE3,565.03$ Urban 20180 CHASEWOOD PARK DR Houston 77070 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

021175701 1649243353 453053 HEALTHSOUTH REHABILITATION OF TEXARKANA INC-ENCOMPASS HEALTH REHABILITATION HOSPITAL OF TEXARK3,132.93$ Urban 515 W 12TH ST Texarkana 75501 Bowie TEXARKANA, TX-TEXARKANA, AR 45500 0.8068

094351601 1821061532 453057 HEALTHSOUTH REHABILITATION-ENCOMPASS HEALTH REHABILITATION HOSPITAL OF MIDLA 3,627.40$ Urban 1800 HERITAGE BLVD Midland 79707 Midland MIDLAND, TX 33260 1.0218

322916301 1558349399 451348 HEART OF TEXAS HEALTHCARE SYSTEM- 7,174.06$ Rural 2008 NINE RD Brady 76825 McCulloch RURAL IV IV

109588703 1558354241 450578 HEMPHILL COUNTY HOSPITAL 12,968.04$ Rural 1020 S FOURTH ST Canadian 79014 Hemphill RURAL IV IV

387377001 1326546797 450475 HENDERSON HOSPITAL LLC-UT HEALTH EAST TEXAS HENDERSON HOSPITAL 9,559.60$ Rural 300 WILSON ST Henderson 75652 Rusk RURAL Yes IAP IV

138644310 1528064649 450229 HENDRICK MEDICAL CENTER 3,606.98$ Urban 1900 PINE Abilene 79601 Taylor ABILENE, TX 10180 0.8789 Yes III III

361699701 1235510090 670076 HERITAGE PARK SURGICAL HOSPITAL, LLC-BAYLOR SCOTT & WHITE SURGICAL HOSPITAL AT SHERMAN3,463.76$ Urban 3601 N CALAIS ST Sherman 75090 Grayson DALLAS-PLANO-IRVING, TX 19124 0.9506

312239201 1841562709 670080 HH KILLEEN HEALTH SYSTEM LLC-SETON MEDICAL CENTER HARKER HEIGHTS 3,518.78$ Urban 850 W CENTRAL TEXAS EXPY Harker Heights 76548 Bell KILLEEN-TEMPLE-FORT HOOD, TX 28660 0.9487 IV IV

136430906 1497726343 450604 HILL COUNTRY MEMORIAL HOSPITAL-HILL COUNTRY MEMORIAL HOSP 8,255.55$ Rural 1020 SOUTH STATE HWY 16 Fredericksburg 78624 Gillespie RURAL IV IV

138962907 1891882833 450101 HILLCREST BAPTIST MEDICAL CENTER-BAYLOR SCOTT AND WHITE MEDICAL CENTER HILLCREST 4,211.49$ Urban 100 HILLCREST MEDICAL BLVD Waco 76712 McLennan WACO, TX 47380 0.8721 0.03813 Yes II II

365213301 1265808232 670072 HOPEBRIDGE HOSPITAL HOUSTON, LLC-HOPEBRIDGE HOSPITAL 3,565.03$ Urban 5556 GASMER DR Houston 77035 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

360991901 450580 HOUSTON COUNTY HOSPITAL DISTRICT 4,780.15$ Rural 1100 E LOOP 304 Crockett 75835 Houston RURAL

342897103 1306268321 452118 HOUSTON METHODIST ST CATHERINE HOSPITAL-HOUSTON METHODIST CONTINUING CARE HOSPITAL3,565.03$ Urban 701 S FRY RD Katy 77450 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

336478801 1952723967 450709 HOUSTON METHODIST ST JOHN HOSPITAL-HOUSTON METHODIST CLEAR LAKE HOSPITAL 3,565.03$ Urban 18300 SAINT JOHN DR Nassau Bay 77058 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

193867201 1740450121 450638 HOUSTON NORTHWEST OPERATING COMPANY LLC-HOUSTON NORTHWEST MEDICAL CENTER 3,990.20$ Urban 710 CYPRESS CREEK PKWY Houston 77090 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.00322 Yes III III

378943001 1073043592 450659 HOUSTON PPH LLC-HCA HOUSTON HEALTHCARE MEDICAL CENTER 3,568.79$ Urban 1313 HERMANN DRIVE Houston 77004 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.00126

Texas

Provider

Identifier

National

Provider

Identifier

Medicare

NumberHospital Name

2019 SDA

(Current)

2020 Hospital

Type

Hospital Physical

Street Address

Hospital Physical

City

Hospital Physical

Zip CodeCounty CBSA Name

Texas CBSA after

Reclass

(from IPUF)

CBSA

Wage Index

Applicable Teaching

Add-on (Medicare

Operating IME%)

DSH 2019

Qualified

2019 Trauma

Level

2020 Trauma

Level 1

FY 2020 Statewide SDA Status Verification File

Texas Health and Human Services Commission

131038504 1598750721 450352 HUNT MEMORIAL HOSPITAL DISTRICT-HUNT REGIONAL MEDICAL CENTER 3,874.67$ Urban 4215 JOE RAMSEY BLVD Greenville 75401 Hunt DALLAS-PLANO-IRVING, TX 19124 0.9650 0.01249 Yes IV IV

163936101 1669569984 450874 IRVING COPPELL SURGICAL HOSPITAL LLP-IRVING-COPPELL SURGICAL HOSPITAL LLP 3,496.73$ Urban 400 W INTERSTATE 635 STE 101 Irving 75063 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

119874904 1790777696 450241 JACK COUNTY HOSPITAL DISTRICT-FAITH COMMUNITY HOSPITAL 4,533.08$ Rural 717 MAGNOLIA ST Jacksboro 76458 Jack RURAL Yes IV IV

121808305 1124061882 451363 JACKSON COUNTY HOSPITAL DISTRICT-JACKSON HEALTHCARE CENTER 8,228.00$ Rural 1013 S WELLS ST Edna 77957 Jackson RURAL Yes IV IV

387381201 1730697350 450194 JACKSONVILLE HOSPITAL LLC-UT HEALTH EAST TEXAS JACKSONVILLE HOSPITAL 7,693.44$ Rural 501 S RAGSDALE ST Jacksonville 75766 Cherokee RURAL Yes IAP IV

136412710 1699772541 451364 KARNES COUNTY HOSPITAL DISTRICT-OTTO KAISER MEMORIAL HOSPITAL 6,753.13$ Rural 3349 S HWY 181 Kenedy 78119 Karnes RURAL IV IV

168648701 1669480323 450827 KELL WEST REGIONAL HOSPITAL LLC-KELL WEST REGIONAL HOSPITAL 3,663.59$ Urban 5420 KELL WEST BOULEVARD Wichita Falls 76310 Wichita WICHITA FALLS, TX 48660 1.0375

021004901 1922177997 452019 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPITAL - MANSFIELD 3,435.11$ Urban 1802 HWY 157 NORTH Mansfield 76063 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

021001501 1699844654 452015 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPITAL- DALLAS 3,496.73$ Urban 9525 GREENVILLE AVE Dallas 75243 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

164466801 1598834566 452088 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPITAL-FORT WORTH 3,435.11$ Urban 815 EIGHTH AVENUE Fort Worth 76104 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

021002301 1558430520 452016 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPITALS SAN ANTONIO 3,342.11$ Urban 3636 MEDICAL DRIVE San Antonio 78229 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

149633301 1821167818 452071 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPITAL-WHITE ROCK 3,496.73$ Urban 9440 POPPY DR -5TH FLOOR SOUTH Dallas 75218 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

021008001 1942379912 452023 KINDRED HOSPITALS LIMITED PARTNERSHIP-KINDRED HOSPTIAL HOUSTON MEDICAL CENTER 3,565.03$ Urban 6441 MAIN STREET Houston 77030 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

112724302 1811942238 450775 KINGWOOD PLAZA HOSPITAL-HCA HOUSTON HEALTHCARE KINGWOOD 3,613.38$ Urban 22999 HIGHWAY 59 NORTH Kingwood 77339 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.01615 Yes

135035706 1861488579 450128 KNAPP MEDICAL CENTER 3,632.02$ Urban 1401 E 8TH ST Weslaco 78596 Hidalgo MCALLEN-EDINBURG-MISSION, TX 32580 0.8824 Yes III III

366222301 1558721365 452073 KND DEVELOPMENT 68, LLC-KINDRED HOSPITAL - SAN ANTONIO CENTRAL 3,342.11$ Urban 111 DALLAS ST FL 4 San Antonio 78205 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

121053602 1487639175 450746 KNOX COUNTY HOSPITAL 7,020.50$ Rural 701 S. FIFTH Knox City 79529 Knox RURAL Yes IV IV

094178302 1114998911 450596 LAKE GRANBURY MEDICAL CENTER 7,521.30$ Rural 1310 PALUXY ROAD Granbury 76048 Hood RURAL IV IV

020966001 1205018439 450742 LAKE POINTE MEDICAL CENTER-BAYLOR SCOTT & WHITE MEDICAL CENTER LAKE POINTE 3,945.62$ Urban 6800 SCENIC DR Rowlett 75088 Rockwall DALLAS-PLANO-IRVING, TX 19124 0.9650 Yes III III

310443201 1831471291 670079 LAKEWAY REGIONAL MEDICAL CENTER LLC- 3,508.57$ Urban 100 MEDICAL PKWY Austin 78738 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 IV

127313803 1700854288 450698 LAMB HEALTHCARE CENTER 8,817.23$ Rural 1500 S SUNSET Littlefield 79339 Lamb RURAL Yes IV IV

331242301 1851632616 670090 LANCASTER REGIONAL HOSPITAL LP- 3,496.73$ Urban 2600 W PLEASANT RUN RD Lancaster 75146 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

162033801 1548232044 450029 LAREDO MEDICAL CENTER 3,523.88$ Urban 1700 E SAUNDERS ST Laredo 78041 Webb LAREDO, TX 29700 0.8068 Yes III III

094186602 1396731105 450643 LAREDO REGIONAL MEDICAL CENTER LP-DOCTORS HOSPITAL OF LAREDO 3,518.86$ Urban 10700 MCPHERSON RD Laredo 78045 Webb LAREDO, TX 29700 0.8068 Yes III III

350658601 1710389929 673059 LAREDO REHABILITATION HOSPITAL LLC- 3,132.93$ Urban 2005A E BUSTAMANTE ST Laredo 78041 Webb LAREDO, TX 29700 0.8068

185051301 1316992878 452096 LAREDO SPECIALTY HOSPITAL 3,132.93$ Urban 2005 BUSTAMANTE ST Laredo 78041 Webb LAREDO, TX 29700 0.8068

135233809 1992767511 451376 LAVACA MEDICAL CENTER HBP-LAVACA MEDICAL CENTER 8,523.79$ Rural 1400 N TEXANA Hallettsville 77964 Lavaca RURAL IV IV

388218501 1922522606 452042 LHCG CXXI, LLC-CHRISTUS DUBUIS HOSPITAL OF BEAUMONT 3,256.36$ Urban 2830 CALDER ST FL 4 Beaumont 77702 Jefferson BEAUMONT-PORT ARTHUR, TX 13140 0.8605

284333604 1154324952 451375 LIBERTY COUNTY HOSPITAL DISTRICT NO 1-LIBERTY DAYTON REGIONAL MEDICAL CENTER 8,630.53$ Rural 1353 N TRAVIS ST Liberty 77575 Liberty RURAL

121781205 1831140979 451324 LILLIAN M HUDSPETH MEMORIAL ER PHYS-LILLIAN M HUDSPETH MEMORIAL HOSPITAL 10,994.85$ Rural 308 HUDSPETH AVE Sonora 76950 Sutton RURAL Yes IV IV

140714001 1861487779 451303 LIMESTONE MEDICAL CENTER 6,845.00$ Rural 701 MCCLINTIC Groesbeck 76642 Limestone RURAL Yes IV IV

342027501 1619303641 670094 LITTLE RIVER HEALTHCARE CAMERON HOSPITAL- 8,003.33$ Rural 806 N CROCKETT AVE Cameron 76520 Milam RURAL

110839103 1528026267 450702 LONGVIEW MEDICAL CENTER LP-LONGVIEW REGIONAL MEDICAL CENTER 3,633.43$ Urban 2901 N 4TH ST Longview 75605 Gregg LONGVIEW, TX 30980 0.8689 Yes III III

163219201 1922001775 450876 LUBBOCK HEART HOSPITAL LLC-LUBBOCK HEART HOSPITAL 3,301.10$ Urban 4810 N LOOP 289 Lubbock 79416 Lubbock LUBBOCK, TX 31180 0.8799

281514401 1225289499 450162 LUBBOCK HERITAGE HOSPITAL LLC-GRACE MEDICAL CENTER 3,301.10$ Urban 2412 50TH STREET Lubbock 79412 Lubbock LUBBOCK, TX 31180 0.8799

094180903 1821066820 451351 LYNN COUNTY HOSPITAL-LYNN COUNTY HOSPITAL DISTRICT 6,185.63$ Rural 2600 LOCKWOOD ST Tahoka 79373 Lynn RURAL IV IV

020990001 1780731737 451316 MADISON ST JOSEPH HEALTH CENTER 8,194.36$ Rural 100 W CROSS ST Madisonville 77864 Madison RURAL IV IV

136145310 1679560866 451333 MARTIN COUNTY HOSPITAL DISTRICT 12,968.04$ Rural 600 EAST I 20 Stanton 79782 Martin RURAL

130959304 1679678767 450465 MATAGORDA COUNTY HOSPITAL DISTRICT-MATAGORDA REGIONAL MEDICAL CENTER 8,927.36$ Rural 104 7TH ST Bay City 77414 Matagorda RURAL Yes IV IV

283280001 1871898478 670010 MAYHILL BEHAVIORAL HEALTH LLC- 3,496.73$ Urban 2809 S MAYHILL RD Denton 76208 Denton DALLAS-PLANO-IRVING, TX 19124 0.9650

094172602 1023013935 451309 MCCAMEY HOSPITAL 12,968.04$ Rural 2500 S HWY 305 McCamey 79752 Upton RURAL

094192402 1255384533 450669 MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP-MEDICAL CENTER OF LEWISVILLE 3,589.34$ Urban 500 WEST MAIN Lewisville 75057 Denton DALLAS-PLANO-IRVING, TX 19124 0.9650 III III

212140201 1427048453 451330 MEDINA COUNTY HOSPITAL DISTRICT-MEDINA HEALTHCARE SYSTEM,MEDINA REGIONAL HOSPITAL,8,615.98$ Rural 3100 AVENUE E Hondo 78861 Medina RURAL Yes IV IV

384108201 1831629674 670058 MEMORIAL HERMANN FIRST COLONY HOSPITAL 3,565.03$ Urban 16000 SOUTHWEST FWY STE 100 Sugar Land 77479 Fort Bend HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

020834001 1730132234 450184 MEMORIAL HERMANN HEALTH SYSTEM-MHHS THE WOODLANDS HOSPITAL 4,428.67$ Urban 9250 Pinecroft Dr. The Woodlands 77380 Montgomery HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.01942 Yes II III

337433201 1710985098 453025 MEMORIAL HERMANN HEALTH SYSTEM-TIRR MEMORIAL HERMANN 3,781.78$ Urban 1333 MOURSUND ST Houston 77030 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.07240

137805107 1982666111 450068 MEMORIAL HERMANN HOSPITAL SYSTEM-MHHS HERMANN HOSPITAL 5,353.98$ Urban 6411 Fannin Street Houston 77024 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.23434 Yes I I

146509801 1932152337 450847 MEMORIAL HERMANN HOSPITAL SYSTEM-MHHS KATY HOSPITAL 3,624.57$ Urban 23900 Katy Freeway Katy 77494 Fort Bend HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 IV IV

020934801 1740233782 450610 MEMORIAL HERMANN HOSPITAL SYSTEM-MHHS MEMORIAL CITY HOSPITAL 3,565.03$ Urban 921 Gessner Rd Houston 77024 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

192751901 1295843787 450684 MEMORIAL HERMANN HOSPITAL SYSTEM-MHHS NORTHEAST HOSPITAL 3,565.03$ Urban 18951 Memorial North Humble 77338 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

146021401 1295788735 450848 MEMORIAL HERMANN HOSPITAL SYSTEM-MHHS SUGAR LAND HOSPITAL 3,624.57$ Urban 17500 West Grand Parkway Sugar Land 77479 Fort Bend HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 IV IV

220238402 1043457583 673038 MEMORIAL HERMANN REHABILITATION HOSPITAL KATY- 3,565.03$ Urban 21720 KINGSLAND BLVD STE 102 Katy 77450 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

202351701 1366532228 670005 MEMORIAL HERMANN SPECIALTY HOSPITAL KINGWOOD LLC 3,565.03$ Urban 300 KINGWOOD MEDICAL DR Kingwood 77339 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

201645301 1033114608 450860 MEMORIAL HERMANN SUGAR LAND SURGICAL HOSPITAL LLP-SUGAR LAND SURGICAL HOSPITAL3,565.03$ Urban 1211 HIGHWAY 6 STE 70 Sugar Land 77478 Fort Bend HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

112697102 1689650616 450395 MEMORIAL HOSP OF POLK COUNTY-MEMORIAL MEDICAL CENTER LIVINGSTON 11,711.24$ Rural 1717 HIGHWAY 59 BYPASS Livingston 77351 Polk RURAL Yes IV IV

094121303 1821025990 451358 MEMORIAL HOSPITAL 10,373.95$ Rural 209 NW 8TH STREET Seminole 79360 Gaines RURAL Yes IV IV

137909111 1689630865 451356 MEMORIAL MEDICAL CENTER 10,021.21$ Rural 815 NORTH VIRGINIA ST Port Lavaca 77979 Calhoun RURAL Yes III IV

139172412 1396746129 450211 MEMORIAL MEDICAL CENTER OF EAST TEXAS-MEMORIAL MED CTR OF EAST TX 8,007.82$ Rural 1201 W FRANK AVE Lufkin 75904 Angelina RURAL Yes IV IV

130734007 1578547345 451360 MEMORIAL MEDICAL CENTER SAN AUGUSTINE 5,835.96$ Rural 511 E HOSPITAL ST San Augustine 75972 San Augustine RURAL

353570001 1285028951 452035 MESA HILLS SPECIALTY HOSPITAL OPERATOR, LLC-MESA HILLS SPECIALTY HOSPITAL 3,243.18$ Urban 2311 N OREGON El Paso 79902 El Paso EL PASO, TX 21340 0.8548

218319601 1831146331 452100 MESQUITE SPECIALTY HOSPITAL LP 3,496.73$ Urban 1024 N GALLOWAY AVE Mesquite 75149 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

376837601 1184179194 670122 METHODIST HEALTH CENTERS-HOUSTON METHODIST THE WOODLANDS HOSPITAL 3,565.03$ Urban 17201 I-45 The Woodlands 77385 Montgomery HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

281028501 1083937593 670077 METHODIST HEALTH CENTERS-HOUSTON METHODIST WEST HOSPITAL 3,565.03$ Urban 18500 KATY FWY Houston 77094 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

121820803 1871560003 450780 METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP-METHODIST AMBULATORY SURGERY3,342.11$ Urban 9150 HUEBNER RD #100 San Antonio 78240 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

379200401 1376071530 450165 METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP-METHODIST HOSPITAL SOUTH 6,673.04$ Rural 1905 HIGHWAY 97 EAST Jourdanton 78026 Atascosa RURAL IAP

204254101 1659525236 670055 METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP-METHODIST STONE OAK HOSPITAL3,342.11$ Urban 1139 E SONTERRA BLVD San Antonio 78258 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

094154402 1124074273 450388 METHODIST HOSPITAL 3,747.16$ Urban 7700 FLOYD CURL DR San Antonio 78229 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978 0.00344 Yes III III

133258705 1225146400 450755 METHODIST HOSPITAL LEVELLAND-COVENANT HOSPITAL LEVELLAND 7,160.68$ Rural 1900 COLLEGE AVE Levelland 79336 Hockley RURAL Yes IV IV

126679303 1275592131 450723 METHODIST HOSPITAL OF DALLAS-METHODIST CHARLTON MEDICAL CENTER 3,670.95$ Urban 3500 WHEATLAND ROAD Dallas 75237 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 0.02726 III

186221101 1689629941 670023 METHODIST HOSPITAL OF DALLAS-METHODIST MANSFIELD MEDICAL CENTER 3,463.76$ Urban 2700 E BROAD ST Mansfield 76063 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 III

Texas

Provider

Identifier

National

Provider

Identifier

Medicare

NumberHospital Name

2019 SDA

(Current)

2020 Hospital

Type

Hospital Physical

Street Address

Hospital Physical

City

Hospital Physical

Zip CodeCounty CBSA Name

Texas CBSA after

Reclass

(from IPUF)

CBSA

Wage Index

Applicable Teaching

Add-on (Medicare

Operating IME%)

DSH 2019

Qualified

2019 Trauma

Level

2020 Trauma

Level 1

FY 2020 Statewide SDA Status Verification File

Texas Health and Human Services Commission

127263503 1073580726 450539 METHODIST HOSPITAL PLAINVIEW-COVENANT HOSPITAL PLAINVIEW 5,138.23$ Rural 2601 DIMMITT RD Plainview 79072 Hale RURAL Yes IV IV

135032405 1528027786 450051 METHODIST HOSPITALS OF DALLAS-METHODIST DALLAS MEDICAL CENTER 4,816.57$ Urban 1441 NORTH BECKLEY Dallas 75265 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 0.05442 Yes I I

209345201 1033165501 450537 METHODIST HOSPITALS OF DALLAS-METHODIST RICHARDSON MEDICAL CENTER 3,496.73$ Urban 401 W CAMPBELL RD Richardson 75080 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

328934001 1952538431 670069 METHODIST MCKINNEY HOSPITAL LLC- 3,496.73$ Urban 8000 ELDORADO PKWY McKinney 75070 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650

094219503 1497871628 450820 METHODIST SUGAR LAND HOSPITAL-HOUSTON METHODIST SUGAR LAND HOSPITAL 3,565.03$ Urban 16655 SOUTHWEST FWY Sugar Land 77479 Fort Bend HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

140713201 1871619254 450844 METHODIST WILLOWBROOK-HOUSTON METHODIST WILLOWBROOK HOSPITAL 3,565.03$ Urban 18220 TOMBALL PKY Houston 77070 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

127319504 1437171568 453306 METHODISTS CHILDRENS HOSPITAL-COVENANT CHILDRENS HOSPITAL 11,454.37$ Children's 4015 22ND PL Lubbock 79410 Lubbock LUBBOCK, TX 31180 0.8799 0.00396 Yes II II

094119702 1629089966 450152 METROPLEX ADVENTIST HOSPITAL INC-METROPLEX HOSPITAL 3,822.07$ Urban 2201 SOUTH CLEAR CREEK RD Killeen 76549 Bell KILLEEN-TEMPLE-FORT HOOD, TX 28660 0.9487 Yes IV IV

149073203 1750392916 451323 METROPLEX ADVENTIST HOSPITAL INC-ROLLINS BROOK COMMUNITY HOSPITAL 7,422.45$ Rural 608 N KEY AVE Lampasas 76550 Lampasas RURAL IV IV

379968601 1376073114 670095 MH EMERUS TOMBALL, LLC-MEMORIAL HERMANN TOMBALL 3,565.03$ Urban 24429 STATE HIGHWAY 249 Tomball 77375 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

357475801 1346630316 452083 MID JEFFERSON EXTENDED CARE HOSPITAL- 3,256.36$ Urban 2600 HIGHWAY 365 Nederland 77627 Jefferson BEAUMONT-PORT ARTHUR, TX 13140 0.8605

136143806 1255325817 450133 MIDLAND COUNTY HOSPITAL DISTRCT-MIDLAND MEMORIAL HOSPITAL 4,102.17$ Urban 400 ROSALIND REDFERN GROVER PARKWAY Midland 79701 Midland MIDLAND, TX 33260 1.0218 0.02460 Yes III III

112679902 1205833985 450176 MISSION HOSPITAL INC-MISSION REGIONAL MEDICAL CENTER 3,643.25$ Urban 900 SOUTH BRYAN ROAD Mission 78572 Hidalgo MCALLEN-EDINBURG-MISSION, TX 32580 0.8824 Yes IV IV

136325111 1184631673 451342 MITCHELL COUNTY HOSPITAL DISTRICT-MITCHELL COUNTY HOSPITAL 5,694.47$ Rural 997 WEST I-20 Colorado City 79512 Mitchell RURAL IV IV

094129604 1700991700 451386 MOORE COUNTY HOSPITAL 11,316.07$ Rural 224 E 2ND ST Dumas 79029 Moore RURAL Yes IV IV

141858401 1952306672 451319 MOTHER FRANCES HOSPITAL JACKSONVILLE 5,789.32$ Rural 2026 S JACKSON ST Jacksonville 75766 Cherokee RURAL IV IV

094108002 1679578439 450102 MOTHER FRANCES HOSPITAL REGIONAL HEALTHCARE CENTER-MOTHER FRANCES HOSPITAL 4,008.38$ Urban 800 E DAWSON ST Tyler 75701 Smith TYLER, TX 46340 0.8409 0.00382 Yes II II

127301306 1659308948 451381 MOTHER FRANCES HOSPITAL WINNSBORO 6,809.61$ Rural 719 W COKE RD Winnsboro 75494 Wood RURAL IV IV

094159302 1386647717 450422 MSH PARTNERS LLC-BAYLOR MEDICAL CENTER AT UPTOWN 3,496.73$ Urban 2727 E LEMMON AVE Dallas 75204 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

120745806 1699770149 451335 MUENSTER HOSPITAL DISTRICT-MUENSTER MEMORIAL HOSPITAL 6,343.55$ Rural 605 N MAPLE ST Muenster 76252 Cooke RURAL IV IV

131030203 1801831748 450508 NACOGDOCHES COUNTY HOSPITAL DISTRICT-MEMORIAL HOSPITAL 6,884.44$ Rural 1204 NORTH MOUND ST Nacogdoches 75961 Nacogdoches RURAL Yes III III

130605205 1700885076 450656 NACOGDOCHES MEDICAL CENTER 7,365.56$ Rural 4920 NE STALLINGS DR Nacogdoches 75965 Nacogdoches RURAL Yes IV

112701102 1144274226 450447 NAVARRO REGIONAL HOSPITAL 5,928.34$ Rural 3201 WEST HIGHWAY 22 Corsicana 75110 Navarro RURAL Yes IV IV

147227603 1760482939 452038 NEURO INSTITUTE OF AUSTIN LP-TEXAS NEUROREHAB CENTER 3,449.03$ Urban 1106 W DITTMAR RD Austin 78745 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

291429301 1801191853 673049 NEW BRAUNFELS REG REHAB HOSP INC- 3,342.11$ Urban 2041 SUNDANCE PKWY New Braunfels 78130 Comal SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

331172201 1023451077 452044 NEW LIFECARE HOSPITALS OF NORTH TEXAS LLC- 3,496.73$ Urban 1950 RECORD CROSSING RD Dallas 75235 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

330847001 1679916530 452063 NEW LIFECARE HOSPITALS OF SOUTH TEXAS LLC- 3,306.85$ Urban 2001 S M ST McAllen 78503 Hidalgo MCALLEN-EDINBURG-MISSION, TX 32580 0.8824

329623801 1942643804 452059 NEW SAN ANTONIO SPECIALTY HOSPITAL LLC-LIFE CARE HOSPITALS OF SAN ANTONIO 3,342.11$ Urban 8902 FLOYD CURL DR San Antonio 78240 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

133252005 1093786204 450192 NHCI OF HILLSBORO INC-HILL REGIONAL HOSPITAL 7,941.75$ Rural 101 CIRCLE DRIVE Hillsboro 76645 Hill RURAL Yes IV IV

297342201 1801168190 450130 NIX HOSPITALS SYSTEM LLC- 3,847.55$ Urban 414 NAVARRO ST STE 600 San Antonio 78205 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978 Yes IV IV

127310404 1689655912 450641 NOCONA HOSPITAL DISTRICT-NOCONA GENERAL HOSPITAL 4,533.08$ Rural 100 PARK RD Nocona 76255 Montague RURAL IV IV

121845505 1245315647 450605 NORTH BAY GENERAL HOSPITAL INC 3,250.24$ Urban 1711 W WHEELER AVE Aransas Pass 78336 San Patricio CORPUS CHRISTI, TX 18580 0.8578

185964702 1548236524 670049 NORTH CENTRAL SURGICAL CENTER LLP 3,496.73$ Urban 9301 N CENTRAL EXPY STE 100 Dallas 75231 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

189049301 1285681064 670024 NORTH CYPRESS MEDICAL CENTER OPERATION COMPANY LTD-NORTH CYPRESS MEDICAL CENTER3,565.03$ Urban 21214 NORTHWEST FREEWAY Cypress 77429 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

377705402 1750819025 450670 NORTH HOUSTON TRMC LLC-HCA HOUSTON HEALTHCARE TOMBALL 3,570.75$ Urban 605 HOLDERRIETH BLVD Tomball 77375 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.00191

020989201 1205837770 451315 NORTH RUNNELS COUNTY HOSPITAL- 9,938.89$ Rural 7821 STATE HIGHWAY 153 Winters 79567 Runnels RURAL

350857401 1871911016 670103 NORTH TEXAS - MCA, LLC-MEDICAL CENTER OF ALLIANCE 3,463.26$ Urban 3101 N. TARRANT PARKWAY Fort Worth 76177 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

121787905 1396748471 451334 NORTH WHEELER COUNTY HOSTPIAL DISTRICT-PARKVIEW HOSPITAL 8,145.46$ Rural 901 SWEETWATER Wheeler 79096 Wheeler RURAL Yes IV IV

137245009 1467442418 450209 NORTHWEST TEXAS HEALTH CARE SYSTEM INC-NORTHWEST TEXAS HOSPITAL 3,816.38$ Urban 1501 S COULTER ST Amarillo 79106 Potter AMARILLO, TX 11100 0.8559 0.06754 Yes III III

127303903 1700883196 450330 OAK BEND MEDICAL CENTER-OAKBEND MEDICAL CENTER 3,665.33$ Urban 1705 JACKSON ST Richmond 77469 Fort Bend HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.00257 III IV

358963201 1255708715 453308 OCH HOLDINGS-OUR CHILDRENS HOUSE 12,399.37$ Children's 1340 EMPIRE CENTRAL DR Dallas 75204 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 Yes

112704504 1245237593 451359 OCHILTREE GENERAL HOSPITAL 9,349.49$ Rural 3101 GARRETT DR Perryton 79070 Ochiltree RURAL Yes IV IV

112711003 1801852736 450661 ODESSA REGIONAL HOSPITAL LP-ODESSA REGIONAL MEDICAL CENTER 3,884.60$ Urban 520 E 6TH ST Odessa 79760 Ector ODESSA, TX 36220 0.9690 Yes IV IV

285368102 1881915304 670109 OPREX SURGERY BAYTOWN LP-ALTAS BAYTOWN HOSPICE 3,565.03$ Urban 1455 MANOR DRIVE STE 200 Baytown 77521 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

020977701 1134166192 450804 ORTHOPEDIC HOSPITAL LTD-TEXAS ORTHOPEDIC HOSPITAL 3,565.03$ Urban 7401 S MAIN ST Houston 77030 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

158914501 1295890093 450856 ORTHOPEDIC AND SPINE SURGICAL HOSPITAL OF S TX LP-SOUTH TEXAS SPINE AND SURGICAL HOSPITAL LP3,342.11$ Urban 18600 N HARDY OAK BLVD San Antonio 78258 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

152686501 1780786699 451332 PALACIOS COMMUNITY MEDICAL CENTER 10,834.96$ Rural 311 GREEN AVE Palacios 77465 Matagorda RURAL

121816602 1164510673 450747 PALESTINE PRINCIPAL HEALTHCARE LIMITED PARTNERSHIP-PALESTINE REGIONAL MEDICAL CENTER6,488.99$ Rural 2900 S LOOP 256 Palestine 75801 Anderson RURAL Yes III III

138950412 1972590602 450565 PALO PINTO GENERAL HOSPITAL 7,583.29$ Rural 400 SW 25TH AVE Mineral Wells 76067 Palo Pinto RURAL Yes IV IV

395270701 1427506385 673069 PAM REHABILITATION HOSPITAL OF ROUND ROCK LLC-PAM REHABILITATION HOSPITAL OF ROUND ROCK3,449.03$ Urban 351 SETON PKWY Round Rock 78665 Williamson AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

393491101 1083104004 452031 PAM SPECIALTY HOSPITAL OF LUFKIN, LLC 3,132.93$ Urban 1201 W FRANK AVE Lufkin 75904 Angelina LUFKIN, TX 30980 0.8689

367514201 1831550680 453048 PAM SQUARED AT BEAUMONT, LLC- 3,256.36$ Urban 3340 PLAZA 10 DR Beaumont 77707 Jefferson BEAUMONT-PORT ARTHUR, TX 13140 0.8605

346300201 1467853051 452086 PAM SQUARED AT CORPUS CHRISTI LLC-PAM SPECIALTY HOSPITAL AT CORPUS CHRISTI NORTH3,250.24$ Urban 600 ELIZABETH ST FL 3 Corpus Christi 78404 Nueces CORPUS CHRISTI, TX 18580 0.8578

346138602 1225439821 452061 PAM SQUARED AT TEXARKANA, LLC- 3,132.93$ Urban 2400 ST MICHAEL DR FLOOR 2 Texarkana 75503 Bowie TEXARKANA, TX-TEXARKANA, AR 45500 0.8068

127295703 1932123247 450015 PARKLAND MEMORIAL HOSPITAL 5,563.25$ Urban 5200 HARRY HINES BLVD Dallas 75235 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 0.30236 Yes I I

111915801 1497708929 450400 PARKVIEW REGIONAL HOSPITAL 8,879.85$ Rural 600 SOUTH BONHAM STREET Mexia 76667 Limestone RURAL IV IV

137343308 1861475626 451300 PARMER COUNTY COMMUNITY HOSPITAL 12,968.04$ Rural 1307 CLEVELAND AVE Friona 79035 Parmer RURAL

130616909 1760598692 451389 PECOS COUNTY MEMORIAL HOSPITAL- 8,511.53$ Rural 387 WEST I-10 Fort Stockton 79735 Pecos RURAL Yes IV IV

174662001 1316933609 450891 PHYSICIANS MEDICAL CENTER LLC-TEXAS HEALTH CENTER FOR DIAGNOSTICS AND SURGERY PL3,496.73$ Urban 6020 WEST PARKER ROAD Plano 75093 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650

165305701 1912948845 450875 PHYSICIANS SURGICAL HOSPITALS LLC-QUAIL CREEK SURGICAL HOSPITAL 3,245.78$ Urban 6819 PLUM CREEK DR Amarillo 79124 Potter AMARILLO, TX 11100 0.8559

343467201 1659374585 450894 PINE CREEK MEDICAL CENTER, LLC- 3,496.73$ Urban 9032 HARRY HINES BLVD Dallas 75235 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

361849801 1184089054 452043 PINE VALLEY SPECIALTY HOSPITAL OPERATOR, LLC-PINE VALLEY SPECIALTY HOSPITAL 3,565.03$ Urban 6160 SOUTH LOOP E Houston 77087 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

353871201 1689068355 452054 PLANO SPECIALTY HOSPITAL OPERATOR LLC-PLANO SPECIALTY HOSPITAL 3,496.73$ Urban 1621 COIT RD Plano 75075 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650

352444901 1851785521 452066 PLUM CREEK SPECIALTY HOSPITAL OPERATOR LLC-PLUM CREEK SPECIALTY HOSPITAL 3,245.78$ Urban 5601 PLUM CREEK DR Amarillo 79124 Potter AMARILLO, TX 11100 0.8559

325177904 1043552177 673025 POST ACUTE MEDICAL AT ALLEN LLC DBA WARM SPRINGS-WARM SPRINGS REHABILITATION HOSPITAL OF ALLEN3,496.73$ Urban 1001 RAINTREE CIRCLE Allen 75013 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650

199191101 1114962842 452062 POST ACUTE MEDICAL AT LULING LLC-WARM SPRINGS SPECIALTY HOSPITAL OF LULING LLC 8,003.33$ Rural 200 MEMORIAL DR Luling 78648 Caldwell RURAL

199478201 1376588228 453035 POST ACUTE MEDICAL AT SAN ANTONIO LLC-WARM SPRINGS REHABILITATION HOSPITAL OF SAN ANTONI3,417.25$ Urban 5101 MEDICAL DR San Antonio 78229 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978 0.02510

199183801 1659316115 452094 POST ACUTE MEDICAL AT VICTORIA LLC-PAM SPECIALTY HOSPITAL OF VICTORIA NORTH 3,155.39$ Urban 102 MEDICAL DR Victoria 77904 Victoria VICTORIA, TX 47020 0.8166

317151401 1689795098 452106 POST ACUTE MEDICAL OF NEW BRAUNFELS LLC-WARM SPRINGS SPECIALTY HOSPITAL OF NEW BRAUNFELS3,342.11$ Urban 1445 HANZ DR New Braunfels 78130 Comal SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

386625301 1003340639 673067 POST ACUTE MEDICAL REHABILITATION HOSPITAL OF CORP-PAM REHABILITATION HOSPITAL OF CORPUS CHRISTI3,250.24$ Urban 345 S WATER ST Corpus Christi 78401 Nueces CORPUS CHRISTI, TX 18580 0.8578

Texas

Provider

Identifier

National

Provider

Identifier

Medicare

NumberHospital Name

2019 SDA

(Current)

2020 Hospital

Type

Hospital Physical

Street Address

Hospital Physical

City

Hospital Physical

Zip CodeCounty CBSA Name

Texas CBSA after

Reclass

(from IPUF)

CBSA

Wage Index

Applicable Teaching

Add-on (Medicare

Operating IME%)

DSH 2019

Qualified

2019 Trauma

Level

2020 Trauma

Level 1

FY 2020 Statewide SDA Status Verification File

Texas Health and Human Services Commission

329971101 1366874620 452092 POST ACUTE SPECIALTY HOSPITAL OF CORPUS CHRISTI LL- 3,250.24$ Urban 6226 SARATOGA BLVD Corpus Christi 78414 Nueces CORPUS CHRISTI, TX 18580 0.8578

331384301 1417389784 452056 POST ACUTE SPECIALTY HOSPITAL OF VICTORIA LLC DBA-PAM SPECIALTY HOSPITAL OF VICTORIA SOUTH3,155.39$ Urban 506 E SAN ANTONIO ST FL 3 Victoria 77901 Victoria VICTORIA, TX 47020 0.8166

316360201 1407121189 451347 PREFERRED HOSPITAL LEASING COLEMAN INC-COLEMAN COUNTY MEDICAL CENTER COMPANY7,547.08$ Rural 310 S PECOS ST Coleman 76834 Coleman RURAL Yes IV IV

179272301 1295764553 451304 PREFERRED HOSPITAL LEASING ELDORADO INC-SCHLEICHER COUNTY MEDICAL CENTER 9,510.08$ Rural 102 N US HIGHWAY 277 Eldorado 76936 Schleicher RURAL IV IV

200683501 1932379856 451361 PREFERRED HOSPITAL LEASING HEMPHILL INC-SABINE COUNTY HOSPITAL 9,795.44$ Rural 2301 HIGHWAY 83 WEST Hemphill 75948 Sabine RURAL IV IV

126840107 1477594299 451355 PREFERRED HOSPITAL LEASING INC-COLLINGSWORTH GENERAL HOSPITAL 9,107.59$ Rural 1013 15TH STREET Wellington 79095 Collingsworth RURAL IV IV

206083201 1164688495 451306 PREFERRED HOSPITAL LEASING JUNCTION INC-KIMBLE HOSPITAL 7,687.72$ Rural 349 REID RD Junction 76849 Kimble RURAL IV IV

350190001 1619368339 451372 PREFERRED HOSPITAL LEASING MULESHOE INC-MULESHOE AREA MEDICAL CENTER 5,448.98$ Rural 708 SOUTH FIRST STREET Muleshoe 79347 Bailey RURAL

176354201 1013970862 451338 PREFERRED HOSPITAL LEASING VAN HORN INC-CULBERSON HOSPITAL 12,968.04$ Rural EISENHOWER AND FM 2185 Van Horn 79855 Culberson RURAL IV IV

121822403 1700805678 450833 PRHC ENNIS LP-ENNIS REGIONAL MEDICAL CENTER 3,556.27$ Urban 2201 WEST LAMPASAS STREET Ennis 75119 Ellis DALLAS-PLANO-IRVING, TX 19124 0.9650 IV IV

354018901 1790174860 450688 PRIME HEALTHCARE SERVICES MESQUITE LLC-DALLAS REGIONAL MEDICAL CENTER 3,556.27$ Urban 1011 N GALLOWAY AVE Mesquite 75149 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 IV IV

308032701 1386902138 450099 PRIME HEALTHCARE SERVICES PAMPA LLC-PAMPA REGIONAL MEDICAL CENTER 9,590.22$ Rural 1 Medical Plaza Pampa 79065 Gray RURAL IV IV

340716501 1902237431 452067 PROMISE HOSPITAL OF DALLAS INC 3,496.73$ Urban 7955 HARRY HINES BLVD BLD Dallas 75235 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

339884401 1346671849 452068 PROMISE HOSPITAL OF WICHITA FALLS INC 3,663.59$ Urban 1103 GRACE ST Wichita Falls 76301 Wichita WICHITA FALLS, TX 48660 1.0375

111829102 1093708679 450042 PROVIDENCE HEALTH SERVICES OF WACO-PROVIDENCE HEALTHCARE NETWORK 3,332.58$ Urban 6901 MEDICAL PKWY Waco 76712 McLennan WACO, TX 47380 0.8721 0.01653 Yes

370663201 1467836841 670119 PROVIDENCE HOSPITAL OF NORTH HOUSTON LLC 3,565.03$ Urban 16750 RED OAK DR Houston 77090 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

388701003 1477061885 451380 QUITMAN HOSPITAL LLC-UT HEALTH EAST TEXAS 4,873.14$ Rural 117 N WINNSBORO ST Quitman 75783 Wood RURAL IAP IV

121799406 1295739258 451329 RANKIN COUNTY HOSPITAL DISTRICT 8,003.33$ Rural 1611 SPUR 576 Rankin 79778 Upton RURAL

121806703 1881697316 451301 REAGAN HOSPITAL DISTRICT-REAGAN MEMORIAL HOSPITAL 12,968.04$ Rural 805 NORTH MAIN Big Lake 76932 Reagan RURAL IV

112684904 1831170273 451377 REEVES COUNTY HOSPITAL DISTRICT 8,963.45$ Rural 2323 TEXAS ST Pecos 79772 Reeves RURAL Yes IV IV

020991801 1942240189 451317 REFUGIO COUNTY MEMORIAL HOSPITAL DISTRICT 12,500.51$ Rural 107 SWIFT STREET Refugio 78377 Refugio RURAL Yes IV IV

212203801 1770740359 673036 REHABILIATION INSTITUTE OF DENTON LLC-SELELCT REHABILITATIOIN HOSPITAL OF DENTON 3,496.73$ Urban 2620 SCRIPTURE ST Denton 76201 Denton DALLAS-PLANO-IRVING, TX 19124 0.9650

218868201 1922321447 673045 REHABILITATION HOSPITAL OF MESQUITE LLC-MESQUITE REHABILITATION INSTITUTE 3,496.73$ Urban 1023 N BELT LINE RD Mesquite 75149 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

343723801 1427472463 670098 RESOLUTE HOSPITAL COMPANY LLC- 3,342.11$ Urban 555 CREEKSIDE CROSSING New Braunfels 78130 Comal SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

183086102 1306933692 451357 ROCKDALE BLACKHAWK LLC-LITTLE RIVER HEALTHCARE 9,029.90$ Rural 1700 BRAZOS STREET Rockdale 76567 Milam RURAL IV

193399601 1629138029 670044 ROCKWALL REGIONAL HOSPITAL LLC-TEXAS HEALTH PRESBYTERIAN HOSPITAL ROCKWALL 3,496.73$ Urban 3150 HORIZON RD Rockwall 75032 Rockwall DALLAS-PLANO-IRVING, TX 19124 0.9650

133244705 1275581852 450055 ROLLING PLAINS MEMORIAL HOSPITAL 8,322.73$ Rural 200 E ARIZONA Sweetwater 79556 Nolan RURAL Yes IV IV

127267603 1942294939 450011 SAINT JOSEPH REGIONAL HEALTH CENTER 4,302.44$ Urban 2801 FRANCISCAN DRIVE Bryan 77802 Brazos COLLEGE STATION-BRYAN, TX 17780 0.9247 0.04665 Yes II II

112693002 1194776104 450340 SAN ANGELO COMMUNITY MEDICAL CENTER 3,609.23$ Urban 3501 KNICKERBOCKER RD San Angelo 76904 Tom Green SAN ANGELO, TX 41660 0.8367 Yes III III

395673201 1528559713 452040 SAN ANTONIO AMG SPECIALTY HOSPITAL, LLC (formerly ACUITY HOSPITAL OF SOUTH TEXAS) 3,342.11$ Urban 718 LEXINGTON AVE San Antonio 78212 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

137962006 1891789772 450424 SAN JACINTO METHODIST HOSPITAL-HOUSTON METHODIST BAYTOWN HOSPITAL 3,735.49$ Urban 4401 GARTH RD Baytown 77521 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.05694

150967102 1013993559 452079 SCCI HOSPITAL EL PASO LLC-KINDRED HOSPITAL EL PASO 3,243.18$ Urban 1740 CURIE DR El Paso 79902 El Paso EL PASO, TX 21340 0.8548

131043506 1831160423 450653 SCENIC MOUNTAIN MEDICAL CENTER 8,767.93$ Rural 1601 WEST 11TH PLACE Big Spring 79720 Howard RURAL Yes IV

135226205 1154315307 450187 SCOTT & WHITE HOSPITAL BRENHAM-BAYLOR SCOTT AND WHITE MEDICAL CENTER BRENHAM11,209.38$ Rural 700 MEDICAL PARKWAY Brenham 77833 Washington RURAL Yes IV IV

388635001 1013085083 452105 SCOTT & WHITE CONTINUING CARE HOSPITAL-BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL3,459.24$ Urban 546 N KEGLEY RD Temple 76502 Bell KILLEEN-TEMPLE-FORT HOOD, TX 28660 0.9487

353712801 1396138970 670108 SCOTT & WHITE HOSPITAL-MARBLE FALLS-BAYLOR SCOTT & WHITE MEDICAL CENTER-MARBLE FALLS8,003.33$ Rural 810 WEST HIGHWAY 71 Marble Falls 78654 Burnet RURAL

220798701 1326349986 450219 SCOTT AND WHITE HOSPITAL - LLANO-BAYLOR SCOTT AND WHITE MEDICAL CENTER - LLANO 9,280.29$ Rural 200 W OLLIE ST Llano 78643 Llano RURAL IV IV

326725404 1265772362 670088 SCOTT AND WHITE HOSPITAL COLLEGE STATION-BAYLOR SCOTT & WHITE MEDICAL CENTER COLLEGE STATIO3,496.72$ Urban 700 SCOTT AND WHITE BLVD College Station 77840 Brazos COLLEGE STATION-BRYAN, TX 17780 0.9247 III III

190123303 1265568638 670034 SCOTT AND WHITE HOSPITAL ROUND ROCK-BAYLOR SCOTT & WHITE MEDICAL CENTER - ROUND ROCK3,508.57$ Urban 300 UNIVERSITY BLVD Round Rock 78665 Williamson AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 IV IV

136327710 1962497800 451374 SCOTT AND WHITE HOSPITAL TAYLOR-BAYLOR SCOTT AND WHITE MEDICAL CENTER TAYLOR 5,825.75$ Rural 305 MALLARD LN Taylor 76574 Williamson RURAL IV IV

137249208 1477516466 450054 SCOTT AND WHITE MEMORIAL HOSPITAL-SCOTT AND WHITE MEDICAL CENTER TEMPLE 5,016.65$ Urban 2401 SOUTH 31ST STREET Temple 76508 Bell KILLEEN-TEMPLE-FORT HOOD, TX 28660 0.9487 0.17007 Yes I II

136330112 1578588463 451384 SCURRY COUNTY HOSPITAL DISTRICT-D.M. COGDELL MEMORIAL HOSPITAL 10,136.82$ Rural 1700 COGDELL BLVD Snyder 79549 Scurry RURAL Yes IV IV

358597801 1184029811 452119 SELECT SPECIALITY HOSPITAL-DALLAS, INC- 3,496.73$ Urban 3500 GASTON AVE Dallas 75246 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

194036301 1063411239 452022 SELECT SPECIALTY HOSPITAL DALLAS INC-DALLAS SPECIALTY HOSPITAL DALLAS INC 3,496.73$ Urban 2329 PARKER RD Carrollton 75010 Denton DALLAS-PLANO-IRVING, TX 19124 0.9650

197824901 1861492670 452087 SELECT SPECIALTY HOSPITAL LONGVIEW INC-SELECT SPECIALTY HOSPITAL LONGVIEW 3,275.66$ Urban 700 E MARSHALL AVE - GROUND FLOOR Longview 75601 Gregg LONGVIEW, TX 30980 0.8689

361697101 1790189942 452120 SELECT SPECIALTY HOSPITAL-DALLAS, INC 3,496.73$ Urban 2300 MARIE CURIE DR Garland 75042 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

137265806 1093810327 450124 SETON FAMILY OF HOSPITALS-DELL SETON MEDICAL CENTER AT THE UNIVERSITY OF TEX 4,920.98$ Urban 1500 Red River Austin 78701 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 0.14511 Yes I I

094153604 1356446686 451371 SETON FAMILY OF HOSPITALS-SETON EDGAR B DAVIS HOSPITAL 6,319.52$ Rural 130 HAYS STREET Luling 78648 Caldwell RURAL IV IV

094151004 1003833013 451365 SETON FAMILY OF HOSPITALS-SETON HIGHLAND LAKES 6,197.23$ Rural 3201 S WATER ST Burnet 78611 Burnet RURAL IV IV

135225404 1164526786 450056 SETON FAMILY OF HOSPITALS-SETON MEDICAL CENTER AUSTIN 3,839.57$ Urban 1201 W 38TH ST Austin 78705 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 IV IV

208013701 1619115383 670056 SETON FAMILY OF HOSPITALS-SETON MEDICAL CENTER HAYS 3,790.53$ Urban 6001 Kyle Parkway Kyle 78640 Hays AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 III III

194106401 1578780870 670041 SETON FAMILY OF HOSPITALS-SETON MEDICAL CENTER WILLIAMSON 3,991.48$ Urban 201 SETON PKWY Round Rock 78665 Williamson AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 II II

158980601 1124137054 450867 SETON FAMILY OF HOSPITALS-SETON NORTHWEST HOSPITAL 3,508.57$ Urban 11113 RESEARCH BLVD Austin 78759 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 IV IV

286326801 1154612638 450143 SETON FAMILY OF HOSPITALS-SETON SMITHVILLE REGIONAL HOSPITAL 3,449.03$ Urban 800 HIGHWAY 71 E Smithville 78957 Bastrop AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

158977201 1750499273 450865 SETON FAMILY OF HOSPITALS-SETON SOUTHWEST HOSPITAL 3,508.57$ Urban 7900 FM 1826 Austin 78737 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 IV IV

186599001 1447355771 453310 SETON HEALTHCARE-DELL CHILDRENS MEDICAL CENTER OF CENTRAL TEXAS 11,881.97$ Children's 4900 MUELLER BLVD Austin 78723 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 Yes I I

121193005 1538150370 451340 SHAMROCK GENERAL HOSPITAL 12,968.04$ Rural 1000 S MAIN ST Shamrock 79079 Wheeler RURAL IV IV

137226005 1992707228 450571 SHANNON MEDICAL CENTER 3,523.64$ Urban 120 E HARRIS AVE San Angelo 76903 Tom Green SAN ANGELO, TX 41660 0.8367 Yes III III

220351501 1013957836 450469 SHERMAN GRAYSON HOSPITAL LLC-WILSON N JONES REGIONAL MEMORIAL CENTER 3,793.08$ Urban 500 N HIGHLAND AVE Sherman 75092 Grayson DALLAS-PLANO-IRVING, TX 19124 0.9506 Yes III III

298213401 1518000306 453312 SHRINERS HOSPITAL FOR CHILDREN- 12,104.57$ Children's 6977 MAIN ST Houston 77030 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 $2.79*

293388901 1669513941 453311 SHRINERS HOSPITALS FOR CHILDREN- 12,104.57$ Children's 815 MARKET ST Galveston 77550 Galveston HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 $2.79*

127294003 1790782704 450007 SID PETERSON MEMORIAL HOSPITAL-PETERSON REGIONAL MEDICAL CENTER 7,888.45$ Rural 551 HILL COUNTRY DR Kerrville 78028 Kerr RURAL

133245406 1215969787 450668 SIERRA MEDICAL CENTER-THE HOSPITAL OF PROVIDENCE SIERRA CAMPUS 3,302.72$ Urban 1625 MEDICAL CENTER DR El Paso 79902 El Paso EL PASO, TX 21340 0.8548 IV IV

181706601 1154361475 450035 SJ MEDICAL CENTER LLC-ST JOSEPH MEDICAL CENTER 4,199.18$ Urban 1401 ST JOSEPH PKWY Houston 77002 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.07393 Yes III III

190895601 1598710592 452101 SOLARA HOSPITAL HARLINGEN 3,438.63$ Urban 508 VICTORIA LN Harlingen 78550 Cameron BROWNSVILLE-HARLINGEN, TX 15180 0.9397

216719901 1700826575 450451 SOMERVELL COUNTY HOSPITAL DISTRICT-GLEN ROSE MEDICAL CENTER 5,036.71$ Rural 1021 HOLDEN ST Glen Rose 76043 Somervell RURAL

094113001 1770573586 450119 SOUTH TEXAS HEALTH SYSTEM 3,698.12$ Urban 1102 WEST TRENTON RD Edinburg 78539 Hidalgo MCALLEN-EDINBURG-MISSION, TX 32580 0.8824 0.00903 Yes III IV

173995503 1093712697 453092 SOUTH TEXAS REHABILITATION HOSPITAL LP- 3,438.63$ Urban 425 EAST ALTON GLOOR Brownsville 78526 Cameron BROWNSVILLE-HARLINGEN, TX 15180 0.9397

171461001 1629064928 450888 SOUTHLAKE SPECIALTY HOSPITAL LLC-TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHLAKE3,463.76$ Urban 1545 SOUTHLAKE BLVD Southlake 76092 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

136491104 1912906298 450697 SOUTHWEST GENERAL HOSPITAL LP-SOUTHWEST GENERAL HOSPITAL 3,767.50$ Urban 7400 BARLITE San Antonio 78224 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978 Yes IV IV

Texas

Provider

Identifier

National

Provider

Identifier

Medicare

NumberHospital Name

2019 SDA

(Current)

2020 Hospital

Type

Hospital Physical

Street Address

Hospital Physical

City

Hospital Physical

Zip CodeCounty CBSA Name

Texas CBSA after

Reclass

(from IPUF)

CBSA

Wage Index

Applicable Teaching

Add-on (Medicare

Operating IME%)

DSH 2019

Qualified

2019 Trauma

Level

2020 Trauma

Level 1

FY 2020 Statewide SDA Status Verification File

Texas Health and Human Services Commission

094160103 1720033947 450431 ST DAVIDS COMMUNITY HOSPITAL-ST DAVIDS MEDICAL CENTER 3,869.63$ Urban 919 EAST 32ND ST Austin 78741 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 Yes IV IV

020957901 1649223645 450718 ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP-ROUND ROCK MEDICAL CENTER 3,991.48$ Urban 2400 ROUND ROCK AVE Round Rock 78681 Williamson AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 II II

112717702 1679528889 450713 ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP-SOUTH AUSTIN HOSPITAL 3,991.48$ Urban 901 W. BEN WHITE BLVD Austin 78704 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 II II

094216103 1629021845 450809 ST DAVID'S HEALTHCARE PARTNERSHIP LP LLP-ST DAVID'S NORTH AUSTIN MEDICAL CENTER 3,900.57$ Urban 12221 N MO PAC EXPY Austin 78758 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442 Yes IV IV

368423501 1932573417 673065 ST JOSEPH HEALTHSOUTH REHABILITATION HOSPITAL LLC-CHI ST JOSEPH REHABILITATION HOSPITAL3,404.11$ Urban 1600 JOSEPH DR Bryan 77802 Brazos COLLEGE STATION-BRYAN, TX 17780 0.9247

160630301 1942208616 450862 ST LUKES COMMUNITY HEALTH SERVICES-ST LUKES THE WOODLANDS HOSPITAL 3,565.03$ Urban 17200 ST LUKE'S WAY The Woodlands 77384 Montgomery HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

339153401 1710314141 670075 ST LUKES HOSPITAL AT THE VINTAGE- 3,565.03$ Urban 20171 CHASEWOOD PARK DR Houston 77070 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

210274101 1184868879 670059 ST LUKES LAKESIDE HOSPITAL LLC-ST LUKES LAKESIDE HOSPITAL 3,565.03$ Urban 17400 ST LUKES WAY The Woodlands 77384 Montgomery HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

281219001 1407990088 670031 ST LUKES PATIENTS MEDICAL CENTER- 3,565.03$ Urban 4600 E SAM HOUSTON PKWY S Pasadena 77505 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

176692501 1659362630 670004 ST MARKS MEDICAL CENTER 10,623.85$ Rural ONE ST MARK'S PLACE La Grange 78945 Fayette RURAL

298019501 1659559573 670053 ST. LUKE'S COMMUNITY DEVELOPMENT CORPORATION-SUGAR-ST. LUKE'S SUGAR LAND HOSPITAL3,565.03$ Urban 1317 LAKE POINTE PKWY Sugar Land 77478 Fort Bend HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

126842708 1649224825 450306 STAMFORD MEMORIAL HOSPITAL- 8,110.46$ Rural 1601 COLUMBIA ST Stamford 79553 Jones RURAL

136332705 1760567085 450654 STARR COUNTY MEMORIAL HOSPITAL 9,277.02$ Rural 128 N FM 3167 Rio Grande City 78582 Starr RURAL Yes IV IV

337991901 1285065623 450498 STEPHENS MEMORIAL HOSPITAL- 4,553.08$ Rural 200 S GENEVA ST Breckenridge 76424 Stephens RURAL IV IV

020992601 1083612121 451318 STONEWALL MEMORIAL HOSPITAL DISTRICT-STONEWALL MEMORIAL HOSPITAL 10,294.33$ Rural 821 N BROADWAY Aspermont 79502 Stonewall RURAL Yes IV IV

020988401 1023011657 451311 SWEENY COMMUNITY HOSPITAL 10,423.49$ Rural 305 N MCKINNEY Sweeny 77480 Brazoria RURAL IV IV

316076401 1518253194 451349 SWISHER MEMORIAL HEALTHCARE SYSTEM-SWISHER MEMORIAL HOSPITAL 5,184.47$ Rural 539 SE 2ND ST Tulia 79088 Swisher RURAL IV IV

126675104 1992753222 450039 TARRANT COUNTY HOSPITAL DISTRICT-JPS HEALTH NETWORK 5,006.89$ Urban 1500 S MAIN ST Fort Worth 76104 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 0.14863 Yes I I

196829901 1972709970 670047 TENET HOSPITALS LIMITED-THE HOSPITALS OF PROVIDENCE EAST CAMPUS 3,302.72$ Urban 3280 JOE BATTLE BLVD El Paso 79938 El Paso EL PASO, TX 21340 0.8548 IV III

130601104 1700801909 450002 TENET HOSPITALS LIMITED-THE HOSPITALS OF PROVIDENCE MEMORIAL CAMPUS 3,599.20$ Urban 2001 NORTH OREGON El Paso 79902 El Paso EL PASO, TX 21340 0.8548 0.00327 Yes IV IV

369162801 1538522412 670120 TENET HOSPITALS LIMITED-THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS 3,243.18$ Urban 2000 TRANS MOUNTAIN RD El Paso 79911 El Paso EL PASO, TX 21340 0.8548 IV

130618504 1811916901 450399 TERRY MEMORIAL HOSPITAL DISTRICT-BROWNFIELD REGIONAL MEDICAL CENTER 6,181.93$ Rural 705 E FELT Brownfield 79316 Terry RURAL Yes IV IV

133257904 1841354677 452033 TEXAS CENTER FOR INFECTIOUS 3,342.11$ Urban 2303 SE Military Drive San Antonio 78223 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

139135109 1477643690 453304 TEXAS CHILDRENS HOSPITAL 12,809.26$ Children's 6621 FANNIN ST Houston 77030 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.04634 Yes I I

318137201 1245523372 670083 TEXAS GENERAL HOSPITAL 3,496.73$ Urban 2709 HOSPITAL BLVD Grand Prairie 75051 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

371495801 1720474919 670117 TEXAS GENERAL HOSPITAL - VZRMC LP- 8,003.33$ Rural 707 N WALDRIP ST Grand Saline 75140 Van Zandt Rural

130614405 1174533343 450064 TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL- 3,523.30$ Urban 800 WEST RANDOL MILL ROAD Arlington 76012 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 IV IV

316296801 1215296884 670085 TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE- 3,523.30$ Urban 10864 TEXAS HEALTH TRL Fort Worth 76244 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 IV IV

127304703 1508899204 450419 TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE- 3,523.30$ Urban 108 DENVER TRAIL Azle 76020 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 IV IV

131036903 1396778064 450148 TEXAS HEALTH HARRIS METHODIST HOSPITAL CLEBURNE- 3,523.30$ Urban 201 WALLS DRIVE Cleburne 76031 Johnson DALLAS-PLANO-IRVING, TX 19124 0.9506 IV IV

112677302 1336172105 450135 TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH- 4,284.89$ Urban 1301 PENNSYLVANIA AVE Fort Worth 76104 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 0.00224 Yes II II

136326908 1104845015 450639 TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST EULES- 3,556.37$ Urban 1600 HOSPITAL PARKWAY Bedford 76022 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506 III III

120726804 1417980202 450779 TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST F- 3,463.76$ Urban 6100 HARRIS PKWY Fort Worth 76132 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

121794503 1922031541 450351 TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILL- 7,677.37$ Rural 411 N BELKNAP Stephenville 76401 Erath RURAL Yes IV IV

314080801 1033120423 450677 TEXAS HEALTH HUGULEY INC-TEXAS HEALTH HUGULEY FORT WORTH SOUTH 3,523.30$ Urban 11801 SOUTH FWY Burleson 76028 Johnson DALLAS-PLANO-IRVING, TX 19124 0.9506 IV IV

020982701 1548291883 450840 TEXAS HEALTH PRESBYTERIAN HOSPITAL ALLEN- 3,556.27$ Urban 1105 CENTRAL EXPY N STE 140 Allen 75013 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650 IV

020967802 1003883158 450743 TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON- 3,496.73$ Urban 3000 I 35 NORTH Denton 76201 Denton DALLAS-PLANO-IRVING, TX 19124 0.9650

094140302 1457382798 450292 TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN- 3,556.27$ Urban 850 ED HALL DR Kaufman 75142 Kaufman DALLAS-PLANO-IRVING, TX 19124 0.9650 IV

094207002 1770514077 450771 TEXAS HEALTH PRESBYTERIAN HOSPTAL PLANO- 4,039.18$ Urban 6200 W PARKER RD Plano 75093 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650 II II

094205403 1730278417 452018 TEXAS HEALTH SPECIALTY HOSPITAL FORT WORTH- 3,435.11$ Urban 1301 PENNSYLVANIA AVE Fort Worth 76104 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

185556101 1962504340 670025 TEXAS HEART HOSPITAL OF THE SOUTHWEST LLP-BAYLOR SCOTT & WHITE THE HEART HOSPITAL PLANO3,496.73$ Urban 1100 ALLIED DRIVE Plano 75093 Collin DALLAS-PLANO-IRVING, TX 19124 0.9650

173574801 1245201656 450889 TEXAS INSTITUTE FOR SURGERY LLP-TEXAS INSTITUTE FOR SURGERY AT TEXAS HEALTH PRESBY 3,496.73$ Urban 7115 GREENVILLE AVENUE STE 100 Dallas 75231 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

020908201 1396779948 450462 TEXAS PRESBYTERIAN HOSPITAL OF DALLAS 4,469.97$ Urban 8200 WALNUT HILL LN Dallas 75231 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 0.03028 Yes II II

209719801 1255579389 670060 TEXAS REGIONAL MEDICAL CENTER LTD-TEXAS REGIONAL MEDICAL CENTER AT SUNNYVALE 3,496.73$ Urban 231 S COLLINS RD Sunnyvale 75182 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

315440301 1760628184 453314 TEXAS SCOTTISH RITE HOSPITAL FOR CRIPPLED CHILDREN- 12,514.59$ Children's 2222 WELBORN ST Dallas 75219 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 $440.52* Yes

162459501 1942292255 450864 TEXAS SPINE AND JOINT HOSPITAL LTD 3,211.26$ Urban 1814 ROSELAND BLVD Tyler 75701 Smith TYLER, TX 46340 0.8409

021017102 1700955796 452039 THC HOUSTON LLC- 3,565.03$ Urban 4801 E Sam Houston Pkwy S Pasadena 77505 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

021017101 1043389034 452039 THC HOUSTON LLC-KINDRED HOSPITAL HOUSTON NORTHWEST 3,565.03$ Urban 11297 FALLBROOK DR Houston 77065 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

178795401 1043328198 670006 THE HOSPITAL AT WESTLAKE MEDICAL CENTER 3,449.03$ Urban 5656 BEE CAVES RD STE M302 Austin 78746 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

163925401 1861467573 450518 THE MEDICAL CENTER OF SOUTHEAST TEXAS LP- 3,650.27$ Urban 2555 JIMMY JOHNSON BLVD Port Arthur 77640 Jefferson BEAUMONT-PORT ARTHUR, TX 13140 0.8605 Yes IV IV

137949705 1548387418 450358 THE METHODIST HOSPITAL 3,903.26$ Urban 6565 FANNIN Houston 77030 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 0.11298

330388501 1194753590 450893 THHBP MANAGEMENT COMPANY LLC-BAYLOR SCOTT AND WHITE THE HEART HOSPITAL DENTON3,496.73$ Urban 2801 S MAYHILL RD Denton 76208 Denton DALLAS-PLANO-IRVING, TX 19124 0.9650

088189803 1356418974 451339 THROCKMORTON COUNTY MEMORIAL HOSPITAL- 8,003.33$ Rural 802 N MINTER AVE Throckmorton 76483 Throckmorton RURAL IV IV

138913209 1174526529 450080 TITUS COUNTY MEM HOSP DIST-TITUS REGIONAL MEDICAL CENTER 6,887.45$ Rural 2001 N JEFFERSON Mt Pleasant 75455 Titus RURAL Yes III III

094208803 1144203662 450774 TOPS SPECIALTY HOSPITAL, LTD- 3,565.03$ Urban 17080 RED OAK DR Houston 77090 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

021011402 1174692156 452028 TRANSITIONAL HOSPITALS CORPORATION OF TEXAS LLC-KINDRED HOSPITAL - TARRANT COUNTY3,435.11$ Urban 7800 OAKMONT BLVD Fort Worth 76132 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

021011401 1659440634 452028 TRANSITIONAL HOSPITALS CORPORATION OF TEXAS LLC-KINDRED HOSPITAL- TARRANT COUNTY3,435.11$ Urban 1000 N Cooper St Arlington 76011 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

184505902 1316911068 453056 TRINITY MOTHER FRANCES REHABILITATION HOSPITAL-CHRISTUS TRINITY MOTHER FRANCES REHABILITATION HOS3,211.26$ Urban 3131 TROUP HIGHWAY Tyler 75701 Smith TYLER, TX 46340 0.8409

149047601 1609876309 452075 TRIUMPH HOSPITAL OF EAST HOUSTON LP-KINDRED HOSPITAL CLEAR LAKE 3,565.03$ Urban 350 BLOSSOM ST Webster 77598 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

094354003 1285626028 452074 TRIUMPH HOSPITAL OF NORTH HOUSTON LP-KINDRED HOSPITAL TOMBALL 3,565.03$ Urban 505 GRAHAM DRIVE Tomball 77375 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

322878502 1417225434 673051 TRIUMPH REHABILIATION HOSPITAL OF NORTHEAST HOUSTO-KINDRED REHABILITATION HOSPITAL NORTHEAST HOUSTON3,565.03$ Urban 18839 MCKAY DR Humble 77338 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

157203401 1720088412 452080 TRIUMPH SOUTHWEST LP-KINDRED HOSPITAL SUGAR LAND 3,565.03$ Urban 1550 First Colony Blvd. Sugar Land 77043 Fort Bend HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

172620001 1982609558 450883 TROPHY CLUB MEDICAL CENTER LP 3,496.73$ Urban 2850 E STATE HWY 114 Trophy Club 76262 Denton DALLAS-PLANO-IRVING, TX 19124 0.9650

136381405 1447259627 450460 TYLER COUNTY HOSPITAL 6,407.07$ Rural 1100 W BLUFF ST Woodville 75979 Tyler RURAL Yes IV IV

194997601 1851390967 450324 UHS OF TEXOMA INC-TEXOMA MEDICAL CENTER 3,821.83$ Urban 5016 S US HIGHWAY 75 Denison 75020 Grayson DALLAS-PLANO-IRVING, TX 19124 0.9506 Yes III III

135237906 1023013448 450010 UNITED REGIONAL HEALTHCARE 4,443.47$ Urban 1600 11TH STREET Wichita Falls 76301 Wichita WICHITA FALLS, TX 48660 1.0375 Yes II II

137999206 1821087164 450686 UNIVERSITY MEDICAL CENTER 4,938.56$ Urban 602 INDIANA AVE Lubbock 79415 Lubbock LUBBOCK, TX 31180 0.8799 0.18711 Yes I I

175287501 1285798918 450044 UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT-UNIVERSITY OF TEXAS SOUTHWESTERN UNIVERSITY HOSPTI3,713.65$ Urban 5323 HARRY HINES BLVD Dallas 75390 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 0.07246

175289101 1417010653 450766 UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT-UTSOUTHWESTERN UNIVERSITY HOSPITAL ZALE LIPSHY3,951.51$ Urban 5151 HARRY HINES BLVD Dallas 75235 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650 0.15191

094212002 1538117452 450797 US PAIN AND SPINE HOSPITAL LP- 3,565.03$ Urban 5445 LA BRANCH ST Houston 77004 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

Texas

Provider

Identifier

National

Provider

Identifier

Medicare

NumberHospital Name

2019 SDA

(Current)

2020 Hospital

Type

Hospital Physical

Street Address

Hospital Physical

City

Hospital Physical

Zip CodeCounty CBSA Name

Texas CBSA after

Reclass

(from IPUF)

CBSA

Wage Index

Applicable Teaching

Add-on (Medicare

Operating IME%)

DSH 2019

Qualified

2019 Trauma

Level

2020 Trauma

Level 1

FY 2020 Statewide SDA Status Verification File

Texas Health and Human Services Commission

162965101 1659352987 450872 USMD HOSPITAL AT ARLINGTON LP 3,463.76$ Urban 801 WEST I-20 Arlington 76017 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

198248001 1568656502 670046 USMD HOSPITAL AT FORT WORTH LP 3,463.76$ Urban 5900 DIRKS RD Fort Worth 76132 Tarrant DALLAS-PLANO-IRVING, TX 19124 0.9506

388696201 1184132524 451367 UT HEALTH EAST TEXAS PITTSBURG HOSPITAL 7,196.94$ Rural 2701 US HIGHWAY 271 N Pittsburg 75686 Camp RURAL IAP IV

389645801 1174021695 453072 UT HEALTH EAST TEXAS REHABILITATION HOSPITAL 3,211.26$ Urban 701 OLYMPIC PLAZA CIR Tyler 75701 Smith TYLER, TX 46340 0.8409

388758001 1962900472 452051 UT HEALTH EAST TEXAS SPECIALTY HOSPITAL 3,211.26$ Urban 1000 S BECKHAM 5TH FLOOR Tyler 75701 Smith TYLER, TX 46340 0.8409

388347201 1407364847 450083 UT HEALTH EAST TEXAS TYLER REGIONAL HOSPITAL 4,280.70$ Urban 1000 S. Beckham Avenue Tyler 75701 Smith TYLER, TX 46340 0.8409 Yes IAP I

121782009 1740288505 451387 UVALDE COUNTY HOSPITAL AUTHORITY-UVALDE MEMORIAL HOSPITAL 12,968.04$ Rural 1025 GARNER FIELD RD Uvalde 78801 Uvalde RURAL Yes IV IV

119877204 1104830900 450154 VAL VERDE HOSPITAL CORPORATION-VAL VERDE REGIONAL MEDICAL CENTER 6,589.68$ Rural 801 N BEDELL AVE Del Rio 78840 Val Verde RURAL Yes IV IV

294543801 1184911877 450028 VHS BROWNSVILLE HOSPITAL COMPANY LLC-VALLEY BAPTIST MEDICAL CENTER BROWNSVILLE 3,796.18$ Urban 1040 W JEFFERSON ST Brownsville 78520 Cameron BROWNSVILLE-HARLINGEN, TX 15180 0.9397 Yes III III

292096901 1154618742 450033 VHS HARLINGEN HOSPITAL COMPANY LLC- 4,268.79$ Urban 2101 PEASE ST Harlingen 78550 Cameron BROWNSVILLE-HARLINGEN, TX 15180 0.9397 0.02316 Yes II II

159156201 1598744856 450058 VHS SAN ANTONIO PARTNERS LLC-BAPTIST MEDICAL CENTER 3,734.77$ Urban 111 DALLAS STREET San Antonio 78205 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978 Yes III IV

334801301 1063844306 452060 VIBRA HOSPITAL OF AMARILLO LLC-VIBRA HOSPITAL OF AMARILLO 3,245.78$ Urban 7501 WALLACE BLVD Amarillo 79124 Potter AMARILLO, TX 11100 0.8559

334224803 1750713012 453096 VIBRA REHABILITATION HOSPITAL OF AMARILLO LLC-VIBRA REHABILITATION HOSPITAL OF AMARILLO3,245.78$ Urban 7200 SW 9TH AVE Amarillo 79106 Potter AMARILLO, TX 11100 0.8559

357697701 1740693316 453086 VIBRA REHABILITATION HOSPITAL OF EL PASO, LLC-HIGHLANDS REHABILITATION HOSPITAL 3,243.18$ Urban 1395 GEORGE DIETER DR El Paso 79936 El Paso EL PASO, TX 21340 0.8548

347495902 1194137364 673058 VIBRA REHABILITATION HOSPITAL OF LAKE TRAVIS 3,449.03$ Urban 2000 MEDICAL DR Lakeway 78734 Travis AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

197976701 1477507432 452097 VIBRA SPECIALTY HOSPITAL OF DALLAS LLC- 3,496.73$ Urban 2700 WALKER WAY Desoto 75115 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

197976703 1053778860 452097 VIBRA SPECIALTY HOSPITAL OF DALLAS LLC-VIBRA HOSPITAL OF RICHARDSON 3,496.73$ Urban 401 W. Campbell Rd Ste 300 Richardson 75080 Dallas DALLAS-PLANO-IRVING, TX 19124 0.9650

020981901 1891718789 450831 VISTA COMMUNITY MEDICAL CENTER HOSPITAL LLP-SURGERY SPECIALTY HOSPITAL OF AMERICA SE HOUSTON3,565.03$ Urban 4301 VISTA RD Pasadena 77504 Harris HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947

126667806 1104842475 451337 W J MANGOLD MEMORIAL HOSPITAL 7,299.93$ Rural 320 N MAIN Lockney 79241 Floyd RURAL Yes IV IV

189791001 1144225699 450347 WALKER COUNTY HOSPITAL CORPORATION-HUNTSVILLE MEMORIAL HOSPITAL 3,624.75$ Urban 110 MEMORIAL HOSPITAL DR Huntsville 77342 Walker HOUSTON-SUGAR LAND-BAYTOWN, TX 26420 0.9947 IV IV

347731701 1861818809 673057 WARM SPRINGS REHABILITATION HOSPITAL OF KYLE LLC- 3,449.03$ Urban 5980 Kyle Parkway Kyle 78640 Hays AUSTIN-ROUND ROCK-SAN MARCOS, TX 12420 0.9442

350452401 1073952339 673056 WARM SPRINGS REHABILITATION HOSPITAL OF VICTORIA L-PAM REHABILITATION HOSPITAL OF VICTORIA3,155.39$ Urban 101 JAMES COLEMAN DR Victoria 77904 Victoria VICTORIA, TX 47020 0.8166

326690001 1629037163 452090 WARM SPRINGS SPECIALTY HOSPITAL OF SAN ANTONIO LLC-PAM SPECIALTY HOSPITAL OF SAN ANTONIO3,342.11$ Urban 7400 BARLITE BLVD FL 2ND San Antonio 78224 Bexar SAN ANTONIO-NEW BRAUNFELS, TX 41700 0.8978

385345901 1417471467 450203 WEATHERFORD HEALTH SERVICES, LLC- 3,685.23$ Urban 713 E ANDERSON STREET Weatherford 76086 Parker FT WORTH-ARLINGTON, TX 23104 0.9382 0.06366 IV IV

359190101 1720407935 670114 WEIMAR MEDICAL CENTER 4,533.08$ Rural 400 YOUENS DR Weimar 78962 Colorado RURAL

350453201 1538551791 453091 WESLACO REGIONAL REHABILITATION HOSPITAL, LLC- 3,306.85$ Urban 906 SOUTH JAMES STREET Weslaco 78596 Hidalgo MCALLEN-EDINBURG-MISSION, TX 32580 0.8824

112707808 1316931835 450584 WILBARGER COUNTY HOSPITAL DISTRICT-WILBARGER GENERAL HOSPITAL 5,442.05$ Rural 920 HILLCREST DRIVE Vernon 76384 Wilbarger RURAL IV IV

135151206 1871599829 450108 WILSON COUNTY MEMORIAL HOSPITAL DISTRICT-CONNALLY MEMORIAL MEDICAL CENTER 7,470.55$ Rural 499 10TH STREET Floresville 78114 Wilson RURAL Yes IV IV

094204703 1730183658 451314 WINKLER COUNTY MEMORIAL HOSP 5,959.51$ Rural 821 JEFFEE DR Kermit 79745 Winkler RURAL

148698701 1295781227 451328 WINNIE COMMUNITY HOSPITAL LLC 5,532.97$ Rural 538 BROADWAY Winnie 77665 Chambers RURAL

094164302 1487607792 450484 WOODLAND HEIGHTS MEDICAL CENTER 6,329.83$ Rural 505 S JOHN REDDITT DR Lufkin 75904 Angelina RURAL Yes IV

112673204 1881697878 451346 YOAKUM COMMUNITY HOSPITAL 10,963.69$ Rural 1200 CARL RAMBERT DR Yoakum 77995 Lavaca RURAL Yes IV IV

Notes:

1. Hospitals with IAP in the 2020 Trauma Level field are "in active pursuit" of a specific trauma designation, but have not yet been officially designated by the Department of State Health Services.