MAIN STREET COMMUNITY INITIATIVES: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
MAIN STREET COMMUNITY INITIATIVES (EIN 46-1392824)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-11
IRS object ID
202233159349304043
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-11T12:34:20-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1750 N St Paul Suite 850AddressLine1Txt
CityDallasCityNm
State AbbreviationTXStateAbbreviationCd
ZIP752013246ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN461392824EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Texas Children's Health Plan The CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlTEXABusinessNameControlTxt
Phone8009908247PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16330 West Loop South 8th Floor 800AddressLine1Txt
CityBELLAIRECityNm
State AbbreviationTXStateAbbreviationCd
ZIP77401ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWeldon GagePersonNm
Person TitleExecutive Vice President & CFOPersonTitleTxt
Phone8009908247PhoneNum
Signature2022-11-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstWeldonPersonFirstNm
Person LastGagePersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRACHEL SPURLOCKPreparerPersonNm
PTINP00520729PTIN
Phone2147775200PhoneNum
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Texas Children's Health Plan-The Center for Children and WomenBusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Weldon GageBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16330 WEST LOOP S 8TH FL STE 800AddressLine1Txt
CityBELLAIRECityNm
State AbbreviationTXStateAbbreviationCd
ZIP77401ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$140,709,226GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.JOINTHECENTER.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2008FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionTO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION, AND RESEARCH.ActivityOrMissionDesc
Voting Members Governing Body4VotingMembersGoverningBodyCnt
Voting Members Independent2VotingMembersIndependentCnt
Total Employee209TotalEmployeeCnt
Total Volunteers2TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$421,161PYContributionsGrantsAmt
CY Contributions Grants$2,097CYContributionsGrantsAmt
PY Program Service Revenue$122,515,213PYProgramServiceRevenueAmt
CY Program Service Revenue$140,707,129CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$28,275PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$122,964,649PYTotalRevenueAmt
CY Total Revenue$140,709,226CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,698,421PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,971,765CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$110,266,228PYOtherExpensesAmt
CY Other Expenses$125,737,461CYOtherExpensesAmt
PY Total Expenses$122,964,649PYTotalExpensesAmt
CY Total Expenses$140,709,226CYTotalExpensesAmt
PY Revenues Less Expenses$0PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$0CYRevenuesLessExpensesAmt
Total Assets BOY$39,249,119TotalAssetsBOYAmt
Total Assets EOY$56,669,032TotalAssetsEOYAmt
Total Liabilities BOY$12,760,827TotalLiabilitiesBOYAmt
Total Liabilities EOY$30,180,740TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$26,488,292NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$26,488,292NetAssetsOrFundBalancesEOYAmt
MissionTO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION, AND RESEARCH.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$129,642,497ExpenseAmt
Revenue$140,707,129RevenueAmt
DescTEXAS CHILDREN'S HEALTH PLAN - THE CENTER FOR CHILDREN AND WOMEN (CCW), IN FULFILLING ITS PURPOSE OF SUPPORTING TEXAS CHILDREN'S HEALTH PLAN, ESTABLISHES PATIENT AND FAMILY-CENTERED MEDICAL HOMES PROVIDING CARE TO PRIMARILY MEDICAID AND CHIP PATIENTS THAT ARE MEMBERS OF TEXAS CHILDREN'S HEALTH PLAN. THE MEDICAL HOMES ARE SPECIFICALLY IN SUPPORT OF TEXAS CHILDREN'S HEALTH PLAN'S MISSION TO PROVIDE CARE THAT IS ACCESSIBLE, COORDINATED, COMPREHENSIVE, CONTINUOUS, CULTURALLY SENSITIVE, COMMUNITY-BASED AND FAMILY-CENTERED.Desc
Total Program Service Expenses$129,642,497TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee209EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member2IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JESSICA ANDERSONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8328242918PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16330 WEST LOOP S 8TH FL STE 800AddressLine1Txt
CityBELLAIRECityNm
State AbbreviationTXStateAbbreviationCd
ZIP77401ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ERIC WILLIAMS MD
SCHEDULE O1.03.0Yes (X)Yes (X)$0$0$0
JAMES VERSALOVIC MD PHD
BOARD MEMBER / CHAIR1.02.0Yes (X)Yes (X)$0$149,100$0
LISA HOLLIER MD
SCHEDULE O1.01.0Yes (X)Yes (X)$0$0$0
MICHAEL A BELFORT MD PHD
BOARD MEMBER / VICE CHAIR1.03.0Yes (X)Yes (X)$0$184,200$0
ANNA MATEJA
SCHEDULE O1.039.0Yes (X)$0$945,034$4,373
LANCE LIGHTFOOT
SENIOR VICE PRESIDENT AND BOARD SECRETARY1.039.0Yes (X)$0$1,570,769$351,598
MARK MULLARKEY
TREASURER1.039.0Yes (X)$0$1,995,786$403,207
SUSAN (RICHELLE) MONTGOMERY
PRESIDENT1.039.0Yes (X)$0$1,059,727$332,374
IVETT SHAH
Senior VICE PRESIDENT1.040.0$0$920,577$85,396Yes (X)
IJEOMA BURNS
ASSISTAND DIRECTOR BUSINESS OPERATIONS40.00$121,282$0$26,732Yes (X)
JENNIFER DALTON
ASSISTANT CLIN DIRECTOR NURSING36.04.0$129,428$14,815$49,566Yes (X)
JODI HARRIS
DIRECTOR40.00$224,216$0$26,519Yes (X)
RODNEY DAVID
ASSISTANT DIRECTOR40.00$138,491$0$46,526Yes (X)
TONJA NEELY
PRACTICE LEADER40.00$128,976$0$36,039Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$742,393TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,840,008TotReportableCompRltdOrgAmt
Total Other Compensation$1,362,330TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K24IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2Txt
LANGUAGE LINE SERVICES INC
1 LOWER RAGSDALE DRIVE BUILDING 2MONTEREYCA93940INTERPRETING SERVICES$267,260
PHYSICIAN RESOURCES INC
1818 MEMORIAL DRIVEHOUSTONTX77007STAFFING SERVICES$152,152STE 200
UNIVERSITY OF TX HEALTH SCIENCE CTR HOU
6431 FANNIN STHOUSTONTX77030HEALTHCARE SERVICES$116,536MSB 2106
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$0RelatedOrganizationsAmt
Government Grants$2,097GovernmentGrantsAmt
All Other Contributions$0AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$2,097TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
Premium Revenue900099$139,520,340$139,520,340$0$0
Net Patient Service Revenue622310$1,009,676$1,009,676$0$0
Program Service Rental900099$177,113$177,113$0$0
$0$0$0
$0$0$0$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$140,707,129TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$0ContriRptFundraisingEventAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

Total Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
$0$0$0$0
$0$0$0$0
$0$0$0$0

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$140,709,226TotalRevenueColumnAmt
Related Or Exempt Func Income$140,707,129RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,760,194TotalAmt
Program Services$9,545,059ProgramServicesAmt
Management And General$2,215,135ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$574,622TotalAmt
Program Services$568,575ProgramServicesAmt
Management And General$6,047ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,759,183TotalAmt
Program Services$1,613,676ProgramServicesAmt
Management And General$145,507ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$877,766TotalAmt
Program Services$777,886ProgramServicesAmt
Management And General$99,880ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$5,425TotalAmt
Management And General$5,425ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$11,479,528TotalAmt
Program Services$10,038,037ProgramServicesAmt
Management And General$1,441,491ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$102,076TotalAmt
Program Services$31,156ProgramServicesAmt
Management And General$70,920ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$54,475TotalAmt
Program Services$47,875ProgramServicesAmt
Management And General$6,600ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,750,655TotalAmt
Program Services$1,544,291ProgramServicesAmt
Management And General$206,364ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$8,782TotalAmt
Program Services$7,747ProgramServicesAmt
Management And General$1,035ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,964TotalAmt
Program Services$2,861ProgramServicesAmt
Management And General$103ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,971,121TotalAmt
Program Services$1,775,801ProgramServicesAmt
Management And General$195,320ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$243,200TotalAmt
Program Services$214,532ProgramServicesAmt
Management And General$28,668ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Premium Taxes$101,898,576$101,898,576
Vended Services from TCH$6,612,398$6,612,398
Membership Incentives$1,445,451$1,445,451
Professional dues$37,228$37,228

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$125,582TotalAmt
Program Services$93,746ProgramServicesAmt
Management And General$31,836ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$140,709,226TotalAmt
Program Services$129,642,497ProgramServicesAmt
Management And General$11,066,729ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$13,543,460BOYAmt
EOY$47,984,257EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$4,264,485BOYAmt
EOY$3,201,397EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$25,247,260LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$20,034,652LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,996,386BOYAmt
EOY$5,212,608EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$14,444,788BOYAmt
EOY$270,770EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$39,249,119BOYAmt
EOY$56,669,032EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,692,982BOYAmt
EOY$10,182,122EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$37,970BOYAmt
EOY$30,275EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,029,875BOYAmt
EOY$19,968,343EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,760,827BOYAmt
EOY$30,180,740EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$26,488,292BOYAmt
EOY$26,488,292EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$26,488,292BOYAmt
EOY$26,488,292EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$39,249,119BOYAmt
EOY$56,669,032EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$0ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1TEXAS CHILDREN'S HEALTH PLANBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN760486264EIN
Organization Type9OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$129,642,497SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$129,642,497SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Book Value$0BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$0BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$18,563,440OtherCostOrOtherBasisAmt
Depreciation$13,690,197DepreciationAmt
Book Value$4,873,243BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$6,683,820OtherCostOrOtherBasisAmt
Depreciation$6,344,455DepreciationAmt
Book Value$339,365BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,212,608TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
DEFERRED RENT
DUE TO AFFILIATES
FICA TAX DEFERRED
DUE TO AFFILIATES$19,968,343
FieldValueIRS element (for citing)
Total Liability$19,968,343TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$140,709,226TotalRevEtcAuditedFinclStmtAmt
Other Revenue$0OtherRevenueAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$140,709,226RevenueSubtotalAmt
Other Revenues Not Included$0OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$140,709,226TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$140,709,226TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$140,709,226ExpensesSubtotalAmt
Other Expenses Not Included$0OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$140,709,226TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationMANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION ON THE ACCOMPANYING BALANCE SHEETS AS OF DECEMBER 31, 2021 AND 2020.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MICHAEL A BELFORT MD PHD
BOARD MEMBER / VICE CHAIR$0$184,200$0$0$0$0$0$0$0$0$0$184,200$0$0
LANCE LIGHTFOOT
SENIOR VICE PRESIDENT AND BOARD SECRETARY$0$598,669$0$829,300$0$142,800$0$316,282$0$35,316$0$1,922,367$0$408,819
SUSAN (RICHELLE) MONTGOMERY
PRESIDENT$0$442,153$0$588,200$0$29,374$0$309,457$0$22,917$0$1,392,101$0$0
MARK MULLARKEY
TREASURER$0$678,185$0$1,094,400$0$223,201$0$361,391$0$41,816$0$2,398,993$0$541,094
ANNA MATEJA
SCHEDULE O$0$179,948$0$0$0$765,086$0$1,364$0$3,009$0$949,407$0$38,420
IVETT SHAH
Senior VICE PRESIDENT$0$368,050$0$508,100$0$44,427$0$75,250$0$10,146$0$1,005,973$0$226,069
JODI HARRIS
DIRECTOR$196,555$0$27,250$0$411$0$12,944$0$13,575$0$250,735$0$0$0
RODNEY DAVID
ASSISTANT DIRECTOR$130,007$0$4,366$0$4,118$0$13,438$0$33,088$0$185,017$0$0$0
JENNIFER DALTON
ASSISTANT CLIN DIRECTOR NURSING$124,660$14,797$4,611$0$157$18$13,675$10,186$22,751$2,954$165,854$27,955$0$0
TONJA NEELY
PRACTICE LEADER$119,873$0$5,148$0$3,955$0$11,365$0$24,674$0$165,015$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 4a Severance or change-of-control paymentANNA MATEJA RECEIVED SEVERANCE IN THE AMOUNT OF $348,853.
Schedule J, Part I, Line 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATIONCOMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS ESTABLISHED BY TEXAS CHILDREN'S AND TEXAS CHILDREN'S HOSPITAL, USING THE FOLLOWING METHODS: *COMPENSATION COMMITTEE *INDEPENDENT COMPENSATION CONSULTANT *COMPENSATION SURVEY OR STUDY *APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
Schedule J, Part I, Line 4b SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN457 (F) PLAN: PAID/DEFERRED ANNA MATEJA 343,112 / 0 MARK MULLARKEY 218,883 / 123,460 LANCE LIGHTFOOT 118,966 / 96,611 IVETT SHAH 20,840 / 48,868 SUSAN (RICHELLE) MONTGOMERY 0 / 64,000 THE 457(F) PLAN IS A NON-QUALIFIED DEFERRED COMPENSATION PLAN THAT ALLOWS ELIGIBLE EXECUTIVES, FROM THE ASSISTANT VICE PRESIDENT LEVEL TO CHIEF EXECUTIVE OFFICER, TO RECEIVE SUPPLEMENT EXECUTIVE RETIREMENT INCOME. FUNDS MAY BE CREDITED INTO THIS ACCOUNT FROM AN EMPLOYER CONTRIBUTION, CALCULATED BASED ON AN INDIVIDUAL'S TITLE AND BASE SALARY AS OF JANUARY 1. THESE EMPLOYER FUNDED CONTRIBUTIONS VEST THE EARLIER OF FIVE YEARS, OR THE ATTAINMENT OF AGE 60 AND 75-POINTS DETERMINED AS OF THEIR AGE AND YEARS OF SERVICE. THE 457(F) PLAN ALSO CONTAINS RESIDUAL LONG-TERM INCENTIVE PLAN CONTRIBUTIONS AND CAPITAL ACUMULATION CONTRIBUTIONS FROM A FLEXILBE BENEFIT ACCOUNT SURPLUS. THE LONG-TERM INCENTIVE CONTRIBUTIONS VEST AFTER THREE YEARS AND THE CAPITAL ACCUMULATION CONRIBUTIONS VEST AFTER 5 YEARS IN THE PLAN.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 6 Classes of members or stockholdersTEXAS CHILDREN'S HEALTH PLAN IS THE SOLE CORPORATE MEMBER OF TEXAS CHILDREN'S HEALTH PLAN - THE CENTER.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyTEXAS CHILDREN'S HEALTH PLAN, AS THE SOLE MEMBER CORPORATION, HAS THE AUTHORITY TO ELECT THE BOARD OF DIRECTORS OF THE ORGANIZATION.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersPER THE ORGANIZATION'S BYLAWS THE MEMBER HAS CERTAIN RESERVED POWERS: -APPROVE, INTERPRET OR CHANGE THE PURPOSE OF THE CORPORATION. -FIX THE NUMBER OF DIRECTORS AND APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY DIRECTOR OF THE CORPORATION. -APPROVE THE MERGER, DISSOLUTION OR CONSOLIDATION, OR REORGANIZATION OF THE CORPORATION. -APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF PROPERTY OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATION'S BUSINESS, WHEN SUCH ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION IS ABOVE SPECIFIED FINANCIAL LEVELS SET IN ACCORDANCE WITH POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBER. -APPROVE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. -ADOPTION OR AMENDMENT OF SALARIES OR OTHER COMPENSATION (INCLUDING THE AWARDING OF ANY INCENTIVE COMPENSATION) OF THE OFFICERS OF THE CORPORATION, PHYSICIAN EMPLOYEES OF THE CORPORATION, IF ANY, AND PHYSICIANS WHO ARE INDEPENDENT CONTRACTORS TO THE CORPORATION, IF ANY. -APPROVE DEBT INCURRED BY THE CORPORATION, WHICH IS IN EXCESS OF SUCH LIMITS AS ARE ESTABLISHED BY THE MEMBER. -APPROVE THE DISPOSITION OF ASSETS OF THE CORPORATION AT THE TIME OF ITS DISSOLUTION. -APPROVE ANY LONG-RANGE FINANCIAL AND STRATEGIC PLANS FOR THE CORPORATION. -SELECTION OF THE CORPORATION'S AUDITORS AND LEGAL COUNSEL. -CREATION OR SALE OF ANY SUBSIDIARIES OF THE CORPORATION. -ANY AFFILIATION, JOINT VENTURE, CONTRACT, EMPLOYMENT, RETENTION, INDEMNIFICATION, OR OTHER ARRANGEMENTS BETWEEN THE CORPORATION AND ANY INSURER, HEALTH MAINTENANCE ORGANIZATION, PREFERRED PROVIDER ORGANIZATION, MEDICAL SCHOOL, HOSPITAL, CLINIC, PHARMACY, PHYSICIAN, TEXAS CHILDREN'S HEALTH PLAN AFFILIATE, OR OTHER PROVIDER OF HEALTH OR RELATED SERVICES, INCLUDING, WITHOUT LIMITATION, ALL SERVICE TERMS AND COMPENSATION ARRANGEMENTS. -ESTABLISHMENT BY THE CORPORATION OF ANY TRAINING OR RESIDENCY PROGRAM. -THE GIVING, SEEKING, OR RECEIVING OF GRANTS. -ADOPTION OR AMENDMENT OF ANY INDEMNIFICATION RIGHTS, OBLIGATIONS, OR AGREEMENTS AFFECTING THE CORPORATION. -PURCHASE, ADOPTION, AMENDMENT, CANCELLATION, OR REPLACEMENT OF ANY INSURANCE COVERAGE FOR THE CORPORATION OR ITS DIRECTORS, OFFICERS AND AGENTS, AS WELL AS COPIES OF ANY NOTICES OF CANCELLATION RECEIVED BY THE CORPORATION. -THE COMMENCEMENT OF LITIGATION OR THE SETTLEMENT OF LITIGATION OR OTHER CLAIMS. -APPROVAL OF THE ADOPTION OR AMENDMENT OF FEE SCHEDULES RELATING TO PATIENT SERVICES. -DESIGNATION OF ADDITIONAL OR SUCCESSOR MEMBER(S). -TAKE ANY ACTION WHICH WOULD BE CONSISTENT WITH THE GOVERNING DOCUMENTS OR POLICIES OF THE MEMBER.
Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing bodyNO SUCH COMMITTEES EXIST.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyPER A RESOLUTION APPROVED BY THE MEMBER'S BOARD OF TRUSTEES, THE MEMBER BOARD'S AUDIT & COMPLIANCE COMMITTEE HAS DELEGATED AUTHORITY TO REVIEW THE ORGANIZATION'S COMPLETED FORM 990 PRIOR TO FILING. FOLLOWING THE COMMITTEE'S REViEW, THE COMPLETED FORM 990 IS DISTRIBUTED TO THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
Form 990, Part VI, Line 12c Conflict of interest policyTHE ORGANIZATION CONSISTENTLY MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY THROUGH TWO SEPARATE PROCESSES, ONE THAT APPLIES TO THE BOARD MEMBERS, AND A SECOND THAT APPLIES TO OFFICERS AND KEY EMPLOYEES. 1) BOARD MEMBERS: PER THE ORGANIZATION'S BOARD-APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE MEMBER'S BOARD LEADERSHIP AND PRESENTED TO THE MEMBER'S AUDIT & COMPLIANCE COMMITTEE. IF THE COMMITTEE DEEMS THERE ARE ANY SIGNIFICANT ISSUES, THE RESPONSES ARE THEN REVIEWED BY THE MEMBER BOARD'S EXECUTIVE COMMITTEE AND ANY REQUIRED ACTION (RECUSEMENT FROM BOARD DELIBERATIONS RELATED TO THE CONFLICT, ETC.) IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT. 2) OFFICERS / KEY EMPLOYEES: PER THE ORGANIZATION'S BOARD APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE COMPLIANCE SERVICES DEPARTMENT. IF THE DEPARTMENT DEEMS THERE ARE ANY SIGNIFICANT ISSUES, REQUIRED ACTION IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT AND THE BOARD IS NOTIFIED OF SUCH ACTIONS.
Form 990, Part VI, Line 15a Process to establish compensation of top management officialTHE ANNUAL PROCESS FOR DETERMINING COMPENSATION INCLUDES: - REVIEW AND APPROVAL BY GOVERNING BODY AND COMPENSATION COMMITTEE, PROVIDED THAT PERSONS WITH A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE WERE NOT INVOLVED. - COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. - CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING TOTAL COMPENSATION.
Form 990, Part VI, Line 15b Process to establish compensation of other employeesPlease refer to process described in Part VI, Line 15a.
Form 990, Part VI, Line 19 Required documents available to the publicTHE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST.
Form 990, Part VII, Section A INCENTIVE COMPENSATIONDRS. BELFORT AND VERSALOVIC, WHILE EMPLOYED BY BAYLOR COLLEGE OF MEDICINE, SERVES AS IN-CHIEFS DIRECTING PATIENT CARE AT TEXAS CHILDREN'S HOSPITAL. DUE TO THEIR SENIOR LEADERSHIP ROLES, THEY ARE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON THEIR CONTRIBUTIONS TO ACHIEVING THE ORGANIZATION'S STRATEGIC GOALS. ALL COMPENSATION IS EARNED IN THEIR CAPACITY AS PHYSICIAN LEADERS.
Form 990, Part VII, Section A TITLESANNA MATEJA WAS CHIEF FINANCIAL OFFICER THROUGH 1/26/2021. ERIC WILLIAMS, M.D. CHIEF MEDICAL OFFICER AS OF 07/28/2021 AND BOARD MEMBER ALL YEAR. LISA HOLLIER, M.D. CHIEF MEDICAL OFFICER OF OBSTETRICS, CHIEF MEDICAL DIRECTOR, AND BOARD MEMBER THROUGH 07/28/2021.
SCHEDULE O FORM 5471 DISCLOSURE STATEMENTUNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT: -TEXAS CHILDREN'S HOSPITAL FOUNDATION EIN:20-2380599 6621 FANNIN ST HOUSTON, TX 77030 -TEXAS CHILDREN'S EIN: 76-0461578 1919 S. BRAESWOOD BLVD, 4TH FL HOUSTON, TX 77030

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndAddress Line2USAddress/AddressLine2Txt
TEXAS CHILDREN'S
1919 S BRAESWOOD BLVD 4TH FLOORHOUSTONTX77030760461578PARENTTX501(c)(3)Type IINAfalse
TEXAS CHILDREN'S PHYSICIAN GROUP
6621 FANNIN STREETHOUSTONTX77030260834681HEALTH CARETX501(c)(3)10TEXAS CHILDREN'Sfalse
TEXAS CHILDREN'S WOMEN'S SPECIALISTS
PO BOX 300630HOUSTONTX77230261482195HEALTH CARETX501(c)(3)Type IITEXAS CHILDREN'Sfalse
TEXAS CHILDREN'S HOSPITAL
6621 FANNIN STREETHOUSTONTX77030741100555HOSPITALTX501(c)(3)3TEXAS CHILDREN'Sfalse
TEXAS CHILDREN'S HOSPITAL FOUNDATION
6621 FANNIN STREETHOUSTONTX77030202380599SUPPORTING ORGTX501(c)(3)Type IITEXAS CHILDREN'Sfalse
TCH PEDIATRIC ASSOCIATES INC
PO BOX 300630HOUSTONTX77230760460242HEALTH CARETX501(c)(3)10TEXAS CHILDREN'Sfalse
TEXAS CHILDREN'S HEALTH PLAN
6330 WEST LOOP SOUTH SUITE 800HOUSTONTX77401760486264HEALTH CARETX501(c)(3)10TEXAS CHILDREN'Sfalse8TH FLOOR
TEXAS CHILDREN'S URGENT CARE
1919 S BRAESWOOD BLVD 4TH FLOORHOUSTONTX77030472029489HEALTH CARETX501(c)(3)10TCH PEDIATRIC ASSOCIATES INCfalse
THE GORDON AND MARY CAIN PEDIATRIC NEUROLOGY RESEARCH FOUNDATION
9 GREENWAY PLAZAHOUSTONTX77046760246858SUPPORTING ORGTX501(c)(3)Type ITEXAS CHILDREN'S HOSPITALfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CORDILLERA PRIMARY WAVE CO-INVESTMENT FUND LPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13000 SAND HILL RDAddressLine1Txt
Address Line2BLDG 3 STE 100AddressLine2Txt
CityMENLO PARKCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94025ZIPCd
FieldValueIRS element (for citing)
EIN821568240EIN
Primary ActivitiesINVESTMENTPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeTypeTxt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1ForeignAddress/AddressLine1TxtProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
TCH INSURANCE COMPANY LTD
23 LIME BAY AVENUEGRAND CAYMANCJKY11102980176652INSURANCECJNAC Corporationfalse
CVI GVF HOLDINGS 3 LTD
981078282INVESTMENTCJNAC Corporationfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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