DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN INC (EIN 81-0584868)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202233199349308018
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-15T10:34:47-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 N St Paul Suite 850 | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 752013246 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810584868 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dallas Physician Medical Services for Children Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DALL | BusinessNameControlTxt |
| Phone | 2144567000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1935 Medical District Drive | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75235 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Robert Fries | PersonNm |
| Person Title | Senior Vice President, Finance | PersonTitleTxt |
| Phone | 2144567000 | PhoneNum |
| Signature | 2022-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Robert | PersonFirstNm |
| Person Last | Fries | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Amy Bellanca | PreparerPersonNm |
| PTIN | P01572961 | PTIN |
| Phone | 2147775200 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dai H Chung | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1935 Medical District Drive | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75235 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $30,884,788 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE SERVICES TO PATIENTS AT SEVERAL HOSPITALS, INCLUDING CHILDREN'S MEDICAL CENTER DALLAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 654 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $738,325 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,030,146 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $69,736,127 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $28,854,642 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $70,474,452 | PYTotalRevenueAmt |
| CY Total Revenue | $30,884,788 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $80,686,969 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $37,797,122 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $42,243,782 | PYOtherExpensesAmt |
| CY Other Expenses | $29,535,607 | CYOtherExpensesAmt |
| PY Total Expenses | $122,930,751 | PYTotalExpensesAmt |
| CY Total Expenses | $67,332,729 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$52,456,299 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$36,447,941 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $21,977,207 | TotalAssetsBOYAmt |
| Total Assets EOY | $33,121,247 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $106,373,020 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $153,965,001 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$84,395,813 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$120,843,754 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE DENTAL, GENERAL PEDIATRIC, AND PEDIATRIC SUB-SPECIALTY SERVICES, INCLUDING, BUT NOT LIMITED TO EMERGENCY DEPARTMENT COVERAGE, INPATIENT COVERAGE, ORTHOPEDIC SURGERY, AND CRANIOFACIAL ORTHODONTICS REGARDLESS OF PAYOR SOURCE OR FINANCIAL STATUS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $35,662,803 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $28,854,642 | RevenueAmt |
| Desc | PROVIDE PHYSICIAN SERVICES TO PATIENTS TREATED BY CHILDREN'S HEALTH CLINICAL OPERATIONS. THESE SERVICES ARE PROVIDED WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY. | Desc |
| Total Program Service Expenses | $35,662,803 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 93 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 654 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Amy Yeager | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2144567000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1935 MEDICAL DISTRICT DRIVE | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75235 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Dawn Johnson MD | |||||||||
| Director and Medical Director (Effec. 01/01/2021) | 40.0 | 0 | Yes (X) | $348,936 | $0 | $27,354 | |||
| Dustin Loveland MD | |||||||||
| Director and Medical Director (Effec. 01/01/2021) | 40.0 | 0 | Yes (X) | $917,593 | $0 | $50,674 | |||
| Michael B Tate MD | |||||||||
| Director and Medical Director | 40.0 | 0.0 | Yes (X) | $0 | $463,065 | $108,099 | |||
| Michael Day MD | |||||||||
| Director and Medical Director | 40.0 | 0.0 | Yes (X) | $534,804 | $0 | $50,144 | |||
| Dai H Chung MD | |||||||||
| President (Effec. 01/01/2021) | 1.0 | 54.0 | $16,667 | $900,000 | $0 | Yes (X) | |||
| Lisa M Frenkel | |||||||||
| Secretary | 1.0 | 53.0 | $0 | $457,901 | $65,168 | Yes (X) | |||
| Peter C Perialas Jr | |||||||||
| Vice President | 1.0 | 54.0 | $0 | $1,548,349 | $327,607 | Yes (X) | |||
| Amit Verma MD | |||||||||
| Medical Director | 40.0 | 0 | $549,891 | $0 | $60,857 | Yes (X) | |||
| Christopher Redman MD | |||||||||
| Physician | 40.0 | 0 | $813,715 | $0 | $51,739 | Yes (X) | |||
| Clarisa Garcia MD | |||||||||
| Medical Director | 40.0 | 0 | $423,703 | $0 | $52,978 | Yes (X) | |||
| Kathryn Bauer MD | |||||||||
| Physician | 40.0 | 0 | $456,625 | $0 | $14,716 | Yes (X) | |||
| William Laird MD | |||||||||
| Medical Director | 40.0 | 0 | $468,642 | $0 | $61,500 | Yes (X) | |||
| David T Berry | |||||||||
| Former Officer | 0.0 | 55.0 | $0 | $1,220,782 | $261,802 | Yes (X) | |||
| Ray Tsai MD | |||||||||
| Former Officer | 0.0 | 40.0 | $0 | $1,464,945 | $56,596 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,530,576 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,055,042 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,189,234 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 78 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (true) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| MEADOWS MENTAL HEALTH POLICY | ||||||
| 2800 Swiss Ave | Dallas | TX | 75204 | Mental Heath care | $720,000 | |
| TCN PEDIATRIC NEUROLOGY PLLC | ||||||
| 4032 McDermott Road | Plano | TX | 75024 | Physician Services | $676,250 | Suite 100 |
| UTSW | ||||||
| HI 108 5323 Harry Hines Blvd | Dallas | TX | 753908886 | Phys & Medical Services | $456,936 | |
| TYTOCARE INC | ||||||
| 215W 40th Street | New York | NY | 10018 | Telemedicine equipment | $350,246 | |
| WRITERGIRL COMMUNICATIONS INC | ||||||
| 10539 Cinderella Dr | Montgomery | OH | 45242 | Writing & Mentoring Svcs | $250,000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $2,030,146 | RelatedOrganizationsAmt |
| Total Contributions | $2,030,146 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $28,854,642 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $28,854,642 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $28,854,642 | TotalProgramServiceRevenueAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,884,788 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $28,854,642 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,929,506 | TotalAmt |
| Program Services | $1,929,506 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,023,183 | TotalAmt |
| Program Services | $19,859,737 | ProgramServicesAmt |
| Management And General | $9,163,446 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,780,143 | TotalAmt |
| Program Services | $1,218,101 | ProgramServicesAmt |
| Management And General | $562,042 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,232,802 | TotalAmt |
| Program Services | $2,212,114 | ProgramServicesAmt |
| Management And General | $1,020,688 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,831,488 | TotalAmt |
| Program Services | $1,253,235 | ProgramServicesAmt |
| Management And General | $578,253 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,717,026 | TotalAmt |
| Program Services | $2,543,455 | ProgramServicesAmt |
| Management And General | $1,173,571 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,277,427 | TotalAmt |
| Program Services | $874,107 | ProgramServicesAmt |
| Management And General | $403,320 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,716,368 | TotalAmt |
| Program Services | $1,858,733 | ProgramServicesAmt |
| Management And General | $857,635 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,819,983 | TotalAmt |
| Program Services | $1,929,634 | ProgramServicesAmt |
| Management And General | $890,349 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,346 | TotalAmt |
| Program Services | $100,825 | ProgramServicesAmt |
| Management And General | $46,521 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $651,090 | TotalAmt |
| Program Services | $445,522 | ProgramServicesAmt |
| Management And General | $205,568 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,128 | TotalAmt |
| Program Services | $183,128 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| Shared Services | $16,768,533 | $16,768,533 | |
| Medical Surgical Supplies | $1,254,706 | $1,254,706 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,332,729 | TotalAmt |
| Program Services | $35,662,803 | ProgramServicesAmt |
| Management And General | $31,669,926 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $400 | BOYAmt |
| EOY | $400 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,096,788 | BOYAmt |
| EOY | $4,947,866 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,239,546 | BOYAmt |
| EOY | $1,007,460 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,397,611 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,945,384 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,764,832 | BOYAmt |
| EOY | $4,452,227 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,875,641 | BOYAmt |
| EOY | $22,713,294 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,977,207 | BOYAmt |
| EOY | $33,121,247 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,475,773 | BOYAmt |
| EOY | $9,204,246 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,897,247 | BOYAmt |
| EOY | $144,760,755 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,373,020 | BOYAmt |
| EOY | $153,965,001 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$84,395,813 | BOYAmt |
| EOY | -$120,843,754 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$84,395,813 | BOYAmt |
| EOY | -$120,843,754 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,977,207 | BOYAmt |
| EOY | $33,121,247 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$36,447,941 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,762,608 | OtherCostOrOtherBasisAmt |
| Depreciation | $593,106 | DepreciationAmt |
| Book Value | $1,169,502 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $599,833 | OtherCostOrOtherBasisAmt |
| Depreciation | $226,318 | DepreciationAmt |
| Book Value | $373,515 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,390,836 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,125,960 | DepreciationAmt |
| Book Value | $1,264,876 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,644,334 | OtherCostOrOtherBasisAmt |
| Book Value | $1,644,334 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,452,227 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other Assets | Desc |
| Book Value | $22,713,294 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $22,713,294 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LT ADVANCES-Affiliates | Desc |
| Amt | $144,760,755 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $144,760,755 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | Dallas Physician Medical Services for Children's financial information is included in the consolidated audited financial statements of Children's Health System of Texas, a related organization. Children's Health System of Texas's FIN 48 (ASC 740) footnote for the year ended December 31, 2021, reads as follows: "The authoritative guidance in ASC 740 Income Taxes, creates a single model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the accompanying consolidated balance sheets. The statute of limitations remains open for tax years 2018 through 2021 in Children's Health main taxing jurisdictions." | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ray Tsai MD | ||||||||||||||
| Former Officer | $0 | $89,812 | $0 | $250,098 | $0 | $1,125,035 | $0 | $45,481 | $0 | $11,115 | $0 | $1,521,541 | $0 | $0 |
| Michael Day MD | ||||||||||||||
| Director and Medical Director | $409,892 | $0 | $118,997 | $0 | $5,915 | $0 | $13,142 | $0 | $37,002 | $0 | $584,948 | $0 | $0 | $0 |
| Dawn Johnson MD | ||||||||||||||
| Director and Medical Director (Effec. 01/01/2021) | $316,555 | $0 | $25,733 | $0 | $6,648 | $0 | $9,938 | $0 | $17,416 | $0 | $376,290 | $0 | $0 | $0 |
| Dustin Loveland MD | ||||||||||||||
| Director and Medical Director (Effec. 01/01/2021) | $689,017 | $0 | $225,163 | $0 | $3,413 | $0 | $15,174 | $0 | $35,500 | $0 | $968,267 | $0 | $0 | $0 |
| Michael B Tate MD | ||||||||||||||
| Director and Medical Director | $0 | $368,494 | $0 | $90,457 | $0 | $4,114 | $0 | $65,401 | $0 | $42,698 | $0 | $571,164 | $0 | $0 |
| David T Berry | ||||||||||||||
| Former Officer | $0 | $639,433 | $0 | $349,623 | $0 | $231,726 | $0 | $227,356 | $0 | $34,446 | $0 | $1,482,584 | $0 | $0 |
| Dai H Chung MD | ||||||||||||||
| President (Effec. 01/01/2021) | $16,667 | $900,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $16,667 | $900,000 | $0 | $0 |
| Lisa M Frenkel | ||||||||||||||
| Secretary | $0 | $310,557 | $0 | $99,513 | $0 | $47,831 | $0 | $48,721 | $0 | $16,447 | $0 | $523,069 | $0 | $0 |
| Peter C Perialas Jr | ||||||||||||||
| Vice President | $0 | $911,324 | $0 | $489,187 | $0 | $147,838 | $0 | $294,900 | $0 | $32,707 | $0 | $1,875,956 | $0 | $0 |
| Kathryn Bauer MD | ||||||||||||||
| Physician | $442,307 | $0 | $11,288 | $0 | $3,030 | $0 | $11,600 | $0 | $3,116 | $0 | $471,341 | $0 | $0 | $0 |
| Clarisa Garcia MD | ||||||||||||||
| Medical Director | $302,048 | $0 | $118,702 | $0 | $2,953 | $0 | $15,961 | $0 | $37,017 | $0 | $476,681 | $0 | $0 | $0 |
| William Laird MD | ||||||||||||||
| Medical Director | $345,822 | $0 | $99,662 | $0 | $23,158 | $0 | $19,500 | $0 | $42,000 | $0 | $530,142 | $0 | $0 | $0 |
| Christopher Redman MD | ||||||||||||||
| Physician | $592,369 | $0 | $217,813 | $0 | $3,533 | $0 | $14,882 | $0 | $36,857 | $0 | $865,454 | $0 | $0 | $0 |
| Amit Verma MD | ||||||||||||||
| Medical Director | $358,573 | $0 | $168,634 | $0 | $22,684 | $0 | $19,500 | $0 | $41,357 | $0 | $610,748 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | CHILDREN'S HEALTH SYSTEM OF TEXAS IS THE SOLE MEMBER FOR DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN (DPMSC). THEREFORE, DPMSC'S TOP MANAGEMENT OFFICIAL IS EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). The CHST process for determining executive compensation is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for executives. The Committee is comprised of independent, non-employee directors. A written compensation philosophy has been developed by the Human Resources Committee for timeliness and appropriateness and defines the desired peer groups for compensation surveys. The HR Committee engages the services of an independent compensation consultant for executive compensation. COMPENSATION PROGRAM COMPONENTS: The elements of total compensation provided to CHST executives include: - Cash compensation (i.e., base salary, short-term and long-term incentive compensation, and/or other cash compensation), determined in consideration of competitive market practices, organizational and individual performance, recruitment and retention considerations, and other relevant factors. - Standard benefits, assisting in each executive's medical, dental, disability, life insurance, time off, and retirement needs, reflective of the employment status (i.e., full or part time) of the executive. - Supplemental benefits, including supplemental insurance, retirement benefits, and/or other supplemental benefits determined by the Committee to be appropriate and reasonable in relation to marketplace practices. Compensation and benefits decisions are made in consideration of each executive's position, responsibilities, skills, effort, and performance, in relation to documented practices within the appropriate comparator group(s). PEER GROUP: The Committee has defined its primary peer group for executives as not-for-profit health care organizations similar in size, structure, and complexity. This group will include leading pediatric health systems as well as integrated health systems and academic medical centers. - Data will be compiled in a manner consistent with the IRS Intermediate Sanctions rules of federal tax law, to reflect what is "ordinarily paid to like executives by like enterprises under like circumstances." - In certain circumstances, market data from additional comparator groups (e.g., research institutions, insurance industry, and general industry companies) may also be referenced. - The specific nature of the role at CHST will be considered when adding comparator groups outside of the primary peer group, and the Committee will discuss and agree on the appropriateness of adding comparator groups whenever the specific nature of the CHST role requires additional comparator groups to be used. |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | Ray Tsai - $627,450 |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | Executive Defined Contribution Retirement Plan (EDCRP): Employees who received taxable income from the EDCRP include: Peter Perialas- $137,823 Ray Tsai - $439,738 David Berry - $193,414 Employees who participated in and have contributions to the EDCRP include: Peter Perialas - $277,500 Ray Tsai - $24,133 David Berry - $202,340 Michael Tate - $45,901 Lisa Frenkel - $37,777 |
| Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL | NAME - DAI H. CHUNG, MD, COMPENSATION FROM UNRELATED ORGANIZATION - 16667.000000, NAME OF UNRELATED ORGANIZATION - UT SOUTHWESTERN MEDICAL CENTER, TYPE OF COMPENSATION - COMPENSATION FOR SERVICES PROVIDED TO CHILDREN'S HEALTH ENTITIES AS PART OF A MSA BETWEEN THE ORGANIZATIONS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15 PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL AND OFFICERS | CERTAIN INDIVIDUALS IDENTIFIED HEREIN AS OFFICERS OF THE CORPORATION ARE EMPLOYED AND COMPENSATED BY A RELATED ORGANIZATION, CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). THE INDIVIDUALS PERFORM SERVICES FOR THE CORPORATION, AND IN SOME CASES OTHER RELATED ORGANIZATIONS, BY ARRANGEMENT BETWEEN CHST AND SUCH ORGANIZATION(S). AS SET FORTH IN THE SCHEDULE R, THE CORPORATION AND THE CHST ARE RELATED ORGANIZATIONS. IN THEIR DUTIES AS OFFICERS OF THE CORPORATION THEY HAVE NO INFLUENCE OVER THE COMPENSATION PROCESS PERFORMED BY CHST, WHICH IS EXPLAINED IN SCHEDULE J, PART I, LINE 3. |
| Form 990, Part VI, Line 8b Committees | Children's Health System of Texas has established seven standing Committees of the Board, which have the authority to act for and on behalf of CHST, Children's Health Clinical Operations, Children's Medical Center Foundation, and their affiliates, operating divisions and division facilities to fulfill the responsibilities designated in the respective Committee charters. Written minutes are prepared and maintained for all formal meetings of each Committee. Actions by Written Consent are also prepared and maintained as they occur. |
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | David Berry and Lisa Frenkel - Business relationship, David Berry and Peter Perialas - Business relationship, Lisa Frenkel, Michael Brad Tate, and Ray Tsai - Business relationship, Peter Perialas and Ray Tsai - Business relationship, Dai Chung, Lisa Frenkel, and Peter Perialas - Business relationship |
| Form 990, Part VI, Line 6 Classes of members or stockholders | Children's Health System of Texas (CHST) is the sole member. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Directors are appointed by the member and approved by the current DPMSC Board of Directors. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Member reserve powers are specified in DPMSC's Bylaws and represent actions by the organization which require member approval. These powers generally encompass changes in the mission of the organization, addition of new members, certain dispositions of assets, amendments to the organization's Certificate of Formation and Bylaws, and appointment of directors. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | A draft of the Form 990 is presented to the CHST Audit Committee for review. A copy of the Form 990 is made available to the directors of the organization's parent corporation, Children's Health System of Texas, through our Board portal before it is filed. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Officers, directors, and key employees receive annually a copy of the Children's Health Statement of Interest form to complete. Disclosures made are reviewed by the CHST Legal Department and the Chief Compliance Officer, who are authorized under the Children's Health Conflict of Interest Policy to make determinations under the Policy regarding persons who are medical staff members or employees of Children's Health and its affiliates. Disclosures made by senior officers (as defined in the Policy) are reviewed by the Compliance Officer, the Chief Legal Officer, and CHST's President and Chief Executive Officer to determine if a conflict exists. Disclosures made by directors of CHST and its affiliates, as well as by the President and Chief Executive Officer of CHST, are discussed as necessary with the appropriate delegated Board Committee and, if required pursuant to the Policy, by the appropriate Board of Directors at meetings to determine if further action is needed. A Statement of Interest must be completed annually and Board members are requested to report changes if they occur. A Committee or Board member with a potential conflict is prohibited from participating in deliberations regarding the transaction in question and will recuse themselves from voting. |
| Form 990, Part VI, Line 19 Required documents available to the public | IRC section 6104 does not require disclosure of the financial statements, conflict of interest policy and governing documents. The Certificate of Formation, Consolidated Financial Statements, and the conflict of interest policy are made available upon request. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Children's Health Clinical Operations | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 750800628 | Hospital | TX | 501(c)(3) | 3 | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
| CHILDREN'S MEDICAL CENTER FOUNDATION | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 752062015 | FOUNDATION | TX | 501(c)(3) | 7 | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
| PHYSICIANS FOR CHILDREN | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 752854505 | PHYSICIANS | TX | 501(c)(3) | 3 | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
| COMPLEX CARE MED SVC CORP | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 461893597 | MEDICAL SERVICES | TX | 501(c)(3) | 3 | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
| CHILDREN'S MEDICAL CENTER HEALTH PLAN | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 462737696 | HMO | TX | 501(c)(3) | 10 | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
| CHILDREN'S MED CTR RESEARCH INST AT UTSWMC | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 453462044 | RESEARCH INSTITUTE | TX | 501(c)(3) | Type I | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
| PEDIATRIC PARTNERS | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 461917702 | CLINICALLY INTEGRATED NETWORK | TX | 501(c)(3) | Type I | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
| ANESTHESIOLOGISTS FOR CHILDREN | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 752917570 | PHYSICIANS | TX | 501(c)(3) | 10 | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
| PHYSICIANS QUALITY ALLIANCE OF NORTH TEXAS | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 464049491 | PHYSICIANS | TX | 501(c)(3) | Type I | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
| SOUTHWESTERN MEDICAL DISTRICT | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 204101612 | MEDICAL DISTRICT | TX | 501(c)(3) | Type I | NA | false |
| WOMEN'S AUXILIARY TO THE CHILDREN'S MEDICAL CENTER | ||||||||||
| 2777 N STEMMONS FWY 700 | DALLAS | TX | 75207 | 752485538 | WOMEN'S AUXILIARY | TX | 501(c)(3) | 10 | CHILDREN'S MEDICAL CENTER FOUNDATION | false |
| OCH Holdings | ||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 474837308 | Hospital | TX | 501(c)(3) | 3 | Children's Health Clinical Operations | false |
| CHILDREN'S HEALTH SYSTEM OF TEXAS | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 752062019 | MANAGEMENT COMPANY | TX | 501(c)(3) | Type II | NA | false |
| Bradford Memorial Hospital for Babies | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 756067819 | Hospital | TX | 501(c)(3) | 3 | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
| The Children's Hospital of Texas | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 756081004 | Hospital | TX | 501(c)(3) | 3 | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
| Richmond Freeman Memorial Clinic | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 237079698 | Hospital | TX | 501(c)(3) | 3 | CHILDREN'S HEALTH SYSTEM OF TEXAS | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|
| ALTERNATIVE CARE SYSTEMS | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 752244475 | OTHER MEDICAL SERVICES | TX | NA | C Corporation | false | |
| NTPSS INC | ||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 471036641 | PHYSICIAN SOLUTIONS | TX | NA | C Corporation | false | |
| Texas Bluebonnet Insurance Company | ||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 475032893 | Insurance Company | TX | NA | C Corporation | false | |
| Texas Trinity River Assurance Company | ||||||||||
| 981318151 | Self-insurance | NA | C Corporation | false | CJ | |||||
| Children's Health | ||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 833809987 | Other Medical Services | TX | NA | C Corporation | false | |
| CHFH Inc | ||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 831336111 | Other Medical Services | TX | NA | C Corporation | false | |
| Children's Health Care Network | ||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 834560427 | Other Medical Services | TX | NA | C Corporation | false | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Comments