2021-11-12T13:02:10-06:00 2020-12-31 350921680 CROWE LLP 750 N St Paul Suite 850 Dallas TX 752013246 990 2020-01-01 752062019 Children's Health System of Texas CHIL 2144567000 1935 Medical District Drive Dallas TX 75235 Robert Fries EVP and Chief Financial Officer 2021-11-12 false Robert Fries 999009999 Rachel Spurlock P00520729 2147775200 2020 2022-09-23 18:48:47Z Children's Health Christopher J Durovich 1935 Medical District Drive Dallas TX 75235 476882431 false X N/A X 1985 TX TO ASSIST IN THE MANAGEMENT OF RELATED 501(C)(3) ORGANIZATIONS. 14 13 8422 13 0 0 2842176 1727465 49483188 473131120 1623703 -1105465 0 53949067 473753120 60000 297100 0 176876374 205270304 0 0 -121144807 239222678 55791567 444790082 -1842500 28963038 1076884114 1327985975 1803320648 2094736468 -726436534 -766750493 TO ASSIST IN THE MANAGEMENT OF RELATED 501(C)(3) ORGANIZATIONS, THAT ARE A PART OF AN INTEGRATED PEDIATRIC HEALTH CARE SYSTEM WITH A MISSION TO MAKE LIFE BETTER FOR CHILDREN. false false 136884043 297100 473131120 Children's Health System of Texas (CHST) assists in the management of related 501(c)(3) organizations that are part of an integrated pediatric health care system with a mission to make life better for children. CHST supports two full-service hospitals and one specialty hospital as well as an extensive network offering virtual, urgent, primary, specialty care and more to the children of North Texas and beyond. 136884043 true true false true false false false false false true false true true true true false true false false true false false false false false false true true true false false false false false false false false false false false false true true true true false false true X 755 0 true 8422 true false true CJ false false false false false false false false false false true false X 14 13 true false false false false false false true true false false true true true true true true true true true true X Amy Yeager 2144567000 1935 Medical District Drive Dallas TX 75235 Christopher J Durovich President & CEO 57.0 3.0 X X 4062464 0 73462 Anne Motsenbocker Director 1.0 0 X 0 0 0 Caren Kline Director 1.0 0 X 0 0 0 Charles Matthews Jr Director 1.0 0 X 0 0 0 Connie O'Neill Director 1.0 1.0 X 0 0 0 Ed Heffernan Chairman 1.0 2.0 X 0 0 0 Lee Hobson Director 1.0 0 X 0 0 0 Lee Jackson Director 1.0 0 X 0 0 0 Lou Grabowsky Director 1.0 0 X 0 0 0 Michael Dardick Director 1.0 1.0 X 0 0 0 Rebecca Egelston Caso Director 1.0 0 X 0 0 0 Robert A Chereck Director 1.0 1.0 X 0 0 0 Steven M Gruber Director 1.0 2.0 X 0 0 0 Thomas A Montgomery Director 1.0 2.0 X 0 0 0 Amy Yeager EVP Compliance & Legal Affairs (Effec. 9/13/2020) 51.0 4.0 X 596605 0 167297 James Herring EVP & Chief of Staff (Term. 3/15/2020) 40.0 0.0 X 370963 0 19973 Jeremiah Radandt President, Corporate Svcs & CFO 50.0 5.0 X 847291 0 229097 Julie C Hall-Barrow SVP Network Development and Innovation 55.0 0 X 563588 0 106596 Kenneth Stewart EVP Compliance & Legal Affairs 53.0 1.0 X 881849 0 213397 Keri A Kaiser SVP Marketing and Comm., Chief Marketing Officer & Chief Exp. Officer 55.0 0 X 598602 0 168687 Kimberly Besse EVP & Chief HR Officer 55.0 0 X 835820 0 206906 Lindsey Tyra SVP Chief Strategy Officer (Effec. 9/13/2020) 55.0 0 X 302113 0 380890 Matthew P Moore SVP Govt. and Community Relations & COS 50.0 0 X 458654 0 151562 Miya Maysent SVP Talent Management (Effec. 6/22/2020) 55.0 0 X 144621 0 98048 Pamela Arora SVP Information Svcs & CIO 55.0 0 X 1001024 0 191738 Peter C Perialas President CHCN & Chief Strategy Officer 52.0 3.0 X 1169124 0 268219 Robert Fries SVP Finance (Effec. 7/13/2020) 55.0 0 X 201028 0 41567 Thomas Burt SVP Total Rewards and HR Operations 55.0 0 X 470235 0 219924 William M Elvey SVP Facilities and Real Estate 55.0 0 X 590917 0 40196 Benigno Salinas SVP Operations 55.0 0 X 275852 0 70296 Brenda Clayton SVP Supply Chain 55.0 0 X 315729 0 68467 Chris Akeroyd SVP & CIO 55.0 0 X 385242 0 97484 Coleman Skinner SVP Revenue Cycle 55.0 0 X 489470 0 119071 David T Berry President Strategic Capital Projects 2.0 53.0 X 1124048 0 240422 Doris E Hunt EVP Corporate Services 53.0 2.0 X 725632 0 85208 James Rhodes SVP JPE Strategic Development 55.0 0 X 303300 0 70468 Javier Montemayor SVP CCO Accreditation and Reg Affairs 55.0 0 X 422966 0 94658 Jean Storey SVP Cardiac and Maternal Fetal and Neonatal Svcs 55.0 0 X 464803 0 107125 Jodi Landon SVP Managed Care 55.0 0 X 484221 0 120265 Joe Cavender SVP Dallas Market ACNO 55.0 1.0 X 483941 0 117486 Linda Dunlap SVP Chief Process Officer 55.0 0 X 414310 0 107494 Mark E Ziemianski SVP Advanced Analytics and Informatics CDO 55.0 0 X 406241 0 106632 Matthew M Davis Dallas Market EVP 55.0 0 X 739530 0 172561 Ray Tsai MD SVP Dallas Market Operations 49.0 6.0 X 804864 0 190570 Rustin Morse MD SVP Quality and Safety 54.0 1.0 X 416096 0 61070 Tammy Webb EVP Clinical Shared Svcs & CNO 53.0 1.0 X 472249 0 104469 Vanessa U Walls Northern Market EVP 55.0 0.0 X 648593 0 138064 Brenda Paulsen VP Research Admin Prof Svc Ops 40.0 0 X 432278 0 90629 Christopher Menzies VP Chief Med Information Offcr 40.0 0 X 563765 0 107629 Dean Cannon MD VP Medical Director CMC Health Plan 15.0 40.0 X 434537 0 262214 Patricia Gonzalez Chief Health Equity and Inclusion Officer 40.0 0 X 619985 0 27540 William Long VP and CISO and IS Ops 40.0 0 X 923502 0 75687 Brent E Christopher Former Officer 0.0 55.0 X 1007338 0 210023 Claud Kern Wildenthal MD PhD Former Officer 0.0 0.0 X 372163 0 0 Richard P Goode Former Officer 0.0 0.0 X 1830749 0 0 28656302 0 5423091 1123 true true false UTSW 5323 HARRY HINES BLVD DALLAS TX 753908886 HEALTHCARE SERVICES 107700833 UNIQUE DIGITAL INC 10595 WESTOFFICE DRIVE HOUSTON TX 77042 IT SERVICES AND EQUIPMENT 9877990 COLLE MCVOY LLC 400 1st Ave N Minneapolis MN 55401 Marketing 9288380 CONNECTION PO Box 536464 Pittsburg PA 15253 IT services and equipment 6238199 EPIC SYSTEMS CORPORATION Box 88314 Milwakee WI 53288 Healthcare Billing 5491589 309 1727465 1727465 Health System Service Revenue 622110 77326704 77326704 Reimbursement of Shared Services 900099 395804416 395804416 0 0 0 0 473131120 2023846 2023846 0 0 0 3129311 0 -3129311 -3129311 -3129311 0 0 0 0 0 473753120 473131120 0 -1105465 124600 124600 172500 172500 26730418 8183304 18547114 145322834 44489423 100833411 5212636 1595807 3616829 16195580 4958147 11237433 11808836 3615181 8193655 2483994 2483994 595199 595199 141822 141822 39338388 12043133 27295255 0 14567518 4459729 10107789 73165095 22398909 50766186 56784780 17384206 39400574 9870456 3021761 6848695 309013 94602 214411 180671 55311 125360 24069514 7368689 16700825 14433930 4418832 10015098 Medical & Surgical Supplies 2348459 2348459 Bad Debt 494704 151450 343254 franchise and excise tax 428829 428829 insurance procurement tax 10306 10306 0 0 0 0 444790082 136884043 307906039 0 80226687 218188763 375026021 28306675 30804572 0 0 0 0 6247349 11607192 42819225 43915245 357533780 199128261 144928406 158405519 0 0 251239274 399329751 613825410 1076884114 1327985975 51738582 59844836 0 0 4299919 3872709 1747282147 2031018923 1803320648 2094736468 X -726436534 -766750493 -726436534 -766750493 1076884114 1327985975 X 28963038 -69276997 X false true X true false X X 10 Children's Health Clinical Operations 750800628 3 true 344903968 0 Children's Medical Center Foundation 752062015 7 true 0 0 Anesthesiologists For Children 752917570 9 true 5778744 0 Dallas Phys Med Svcs for Children Inc 810584868 3 true 30754003 0 Physicians For Children 752854505 3 true 0 0 Complex Care Med Svc Corp 461893597 3 true 989511 0 Children's Medical Center Health Plan 462737696 9 true 356224 0 OCH Holdings 474837308 3 true 10963782 0 8 393746232 0 true false false false false false false false false false false false false false false false Schedule A, Part I, Line 12g(ii) Type of Organization Children's Med Ctr Research Inst at UTSWMC - 509(a)(3) Type I; Pediatric Partners - 509(a)(3) Type I; Physicians Quality Alliance of North Texas - 509(a)(3) Type I; Schedule A, Part IV, Section C, Line 1 Majority director detail The fact that the management of CHST is vested in the same persons that control and manage the supported organizations allows CHST and its supported organizations to function collectively as a health system. CHST provides management and administrative support to the supported organizations and various other services that further the supported organizations' tax-exempt purpose of providing health services to the community. The fact that one or more members of the core leadership team of each of the supported organizations is also a member of the CHST core leadership team assures that CHST is responsive to the needs and demands of the supported organizations. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true 141822 141822 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY In 2020, CHST paid membership dues to organizations in which a portion of the membership dues were related to lobbying activities. NACH (National Association of Children's Hospitals), THA (Texas Hospital Association), THOT (Teaching Hospitals of Texas), and CHAT (Children's Hospital Association of Texas) identified a portion of their membership dues as being related to lobbying activities. Lobbying percentages were identified by said organizations and applied to 2020 membership dues. In addition, CHST paid professional and consulting fees related to other lobbying activities. 69975251 69975251 12878039 1946371 10931668 5894085 1706100 4187985 246062936 195475790 50587146 22723469 22723469 158405519 Investments in Affiliates 251239274 C 251239274 Investments in Affiliates UTSW Physician Guarantees 2480648 Insurance Recoveries 30572546 Due from Affiliates 493564489 Operating Lease Assets 87207727 613825410 LT Advances - Affiliates 1864793690 UTSW Phys Guarantees 6850621 LT Deferred Rent 480936 LT Non-Qualified Plan Reserve for Professional Liab 41957630 Other Liabilities 24884735 Other LT Liabilities Operating Lease Liabilities 92051311 2031018923 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote 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 2017 through 2020 in Children's Health main taxing jurisdictions. false Central America and the Caribbean 0 0 Investments 27563184 0 0 0 0 0 0 27563184 0 27563184 false false true false false false true Ronald McDonald House of Dallas 4707 Bengal Street Dallas TX 75235 751609401 501(C)(3) 50000 BOOK PROGRAM SUPPORT The Crystal Charity Ball 3838 Oak Lawn Avenue Suite L150 Dallas TX 75219 756035893 501(C)(3) 25000 BOOK PROGRAM SUPPORT Junior League of Dallas Inc 8003 Inwood Road Dallas TX 75209 751004680 501(C)(3) 15000 BOOK PROGRAM SUPPORT Children's Cancer Fund 4201 Spring Valley Suite 370 Dallas TX 75244 752113401 501(C)(3) 25000 BOOK PROGRAM SUPPORT 4 0 Grace Lee Scholarship 7 21000 James J. Farnsworth Scholarship 10 10000 Lisa Milonovich Scholarship 3 10500 May Smith Scholarship 20 100000 Nursing Division Tuition Assistance Program 4 12000 Women's Auxiliary Scholarship 10 19000 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Standard policies and procedures for the grant administration process are established for the purpose of assisting staff in their efforts to administer grant programs in accordance with the rules and regulations governing those programs. It is the responsibility of the project director to monitor that the funds are used for their intended purpose. May Smith Scholars Program The heritage of nursing is rich at Children's Health, which traces its roots back to a clinic started by nurse May Forster Smith. This scholarship is named for Nurse Smith, who began an open-air clinic for infants in 1913. That pioneering spirit continues in the 21st century. The May Smith Scholars Program provides financial assistance for baccalaureate students interested in pediatric nursing. Eligibility Applicants must meet all of the following criteria to be eligible to apply for this scholarship: - Be a current sophomore or junior undergraduate baccalaureate nursing student. - Have a cumulative 3.0 GPA on a 4.0 scale. No exceptions will be made. Award Details - A limited number of scholarships in the amount of $5,000 will be awarded each year. - Students may reapply each year as long as they continue to meet the eligibility criteria. - The scholarships will be applied to tuition, fees, books, supplies and equipment required for course load at accredited, nonprofit four-year colleges/universities in the United States. - Students may transfer from one institution to another and retain the award. Women's Auxiliary Scholarship Program The Women's Auxiliary to Children's Medical Center offers educational support to nursing and allied health students who are registered for, or currently enrolled in, an accredited program through the Educational Assistance Program for Nursing and Allied Health Students. Eligibility Applicants must meet all of the following criteria to be eligible to apply for this scholarship: - Be a current junior, senior or graduate student enrolled full or part-time in an accredited undergraduate, or graduate, nursing or allied health program. - Have a cumulative 3.0 GPA on a 4.0 scale. No exceptions will be made. Award Details - A limited number of scholarships in the amount of $3,000 will be awarded each year. - Students may reapply each year as long as they continue to meet the eligibility criteria. - The scholarships will be applied to tuition, fees, books, supplies and equipment required for course load at accredited, nonprofit four-year colleges/universities in the United States. - Students may transfer from one institution to another and retain the award. - Interviews will be scheduled for those candidates who best meet the requirements of the program. Panel interviews may be scheduled to include staff from the student's chosen area of study. James J. Farnsworth Health Career Scholarship Program The James J. Farnsworth Health Career Scholarship offers educational support to students planning careers in pediatric health care. The scholarship is named in honor of James J. Farnsworth and was established from gifts to endowments made in tribute to Mr. Farnsworth by his friends and colleagues. Mr. Farnsworth served as president of Children's Medical Center Dallas, as part of Children's Health, for more than 30 years and was a fellow in the College of Healthcare Executives. Eligibility Applicants must meet all of the following criteria to be eligible to apply for this scholarship: - Be a current sophomore, junior, senior or graduate student, planning a career in pediatric healthcare. - Preference will be given to students who fall into the following categories: - Former patients of Children's Health - Current full or part-time employees - Former or current volunteers at Children's Health - Parent is employed at Children's Health - Parent is volunteer at Children's Health - Students demonstrating strong academic achievement No exceptions will be made. Award Details - A limited number of scholarships in the amount of $1,000 will be awarded each year. - Students may reapply each year as long as they continue to meet the eligibility criteria. - The scholarships will be applied to tuition, fees, books, supplies and equipment required for course load at accredited, nonprofit four-year colleges/universities in the United States. - Students may transfer from one institution to another and retain the award. Grace Lee Scholarship for Clinical Education The Grace Lee Scholarship for Clinical Education recently was established in honor of Grace Lee, a former patient at Children's Health and in recognition of the exemplary care provided by clinical staff members who contributed to her comprehensive care. The scholarship will provide financial assistance for the continuing education of clinical employees who are direct caregivers at Children's Health. Eligibility Applicants must meet all of the following criteria to be eligible to apply for this scholarship: - Be a full-time clinical employee of Children's Health with two years of continuous employment at Children's Health as of the application deadline. - Be enrolled in or accepted into an accredited healthcare education program. - Be recommended by an immediate supervisor or department director. - Have a cumulative 3.0 GPA on a 4.0 scale. No exceptions will be made. Award Details - A limited number of scholarships in the amount of $3,000 will be awarded each year. - Students may reapply each year as long as they continue to meet the eligibility criteria. - The scholarships will be applied to tuition, fees, books, supplies and equipment required for course load at accredited, nonprofit two- or four-year colleges/universities in the United States. - Students may transfer from one institution to another and retain the award. Lisa M. Milonovich Scholarship Program The Lisa M. Milonovich Scholarship for Nursing Education provides financial assistance to support those choosing nursing as a career path as well as those in nursing who want to further their education. Named in honor of Lisa M. Milonovich, a long-time, dedicated Advanced Practice Nurse at Children's Health, the scholarship was endowed by Lisa's family and many, many friends and colleagues who greatly admired her thirst for knowledge and achievements in nursing. Applicants must meet all of the following criteria to be eligible for this scholarship: - Be a full-time or part-time Children's Health employee with one year of continuous employment. - Maintain an overall grade-point average of 3.0 on a 4.0 scale or have a cumulative 3.0 GPA prior to being accepted into an accredited program. - Demonstrate financial need and a commitment to pursue additional education. Recipients may be graduating high school students, Nurses' Aides, LVNs, RNs, and/or those seeking advanced nursing degrees. - Commit to two years of additional employment at Children's Health after completion of the educational program for which the scholarship was awarded. Award Details - Scholarships may not be applied to room and board and cannot be used to purchase a laptop if not required for all students attending the institution or course. - A limited number of scholarships up to $3,500 will be awarded each year. - Students may reapply each year as long as they continue to meet the eligibility criteria. - The scholarships will be applied to tuition, fees, books, supplies and equipment required for course load at accredited, nonprofit two- or four-year colleges/universities in the United States. - Students may transfer from one institution to another and retain the award. Nursing Division Tuition Assistance Program Overview The scholarship and tuition assistance programs available at Children's Health demonstrate the value we place on providing exceptional, highly qualified training for our clinical staff. As part of the Children's Health Nursing initiative to encourage all direct-care RNs to attain a BSN or higher by 2020, academic opportunities are essential. Scholarships for RNs seeking a BSN are available through the Nursing Division Tuition Assistance Program. Eligibility Applicants must meet all of the following criteria to be eligible for this award: - Be a full-time or part-time Children's Health employee. - Be in good standing with direct supervisor. - Be an existing Registered Nurse (RN) enrolled in a BSN completion program. Award Details - A limited number of awards in the amount of $1,000-$2,000 will be awarded each year. - Students may reapply each year as long as they continue to meet the eligibility criteria. - The tuition assistance program will be applied to tuition, fees, books, supplies and equipment required for course load at accredited, nonprofit two- or four-year colleges/universities in the United States. X true true X X X X X true true false false false false false false false Christopher J Durovich President & CEO 1367076 0 1616060 0 1079328 0 32423 0 41039 0 4135926 0 0 0 Brent E Christopher Former Officer 543292 0 257277 0 206769 0 187603 0 22421 0 1217361 0 0 0 Richard P Goode Former Officer 0 0 0 0 1830749 0 0 0 0 0 1830749 0 0 0 Claud Kern Wildenthal MD PhD Former Officer 372163 0 0 0 0 0 0 0 0 0 372163 0 0 0 Pamela Arora SVP Information Svcs & CIO 446074 0 318042 0 236907 0 158140 0 33598 0 1192762 0 0 0 Kimberly Besse EVP & Chief HR Officer 427778 0 195929 0 212113 0 159606 0 47300 0 1042726 0 0 0 Thomas Burt SVP Total Rewards and HR Operations 306764 0 93279 0 70192 0 184500 0 35424 0 690159 0 0 0 William M Elvey SVP Facilities and Real Estate 307516 0 150962 0 132439 0 10634 0 29561 0 631113 0 0 0 Robert Fries SVP Finance (Effec. 7/13/2020) 182257 0 0 0 18771 0 29017 0 12550 0 242596 0 0 0 Julie C Hall-Barrow SVP Network Development and Innovation 351583 0 151421 0 60584 0 87700 0 18896 0 670183 0 0 0 James Herring EVP & Chief of Staff (Term. 3/15/2020) 117692 0 234014 0 19257 0 19500 0 473 0 390936 0 0 0 Keri A Kaiser SVP Marketing and Comm., Chief Marketing Officer & Chief Exp. Officer 341559 0 160598 0 96445 0 124555 0 44132 0 767289 0 0 0 Miya Maysent SVP Talent Management (Effec. 6/22/2020) 142419 0 0 0 2202 0 77577 0 20471 0 242669 0 0 0 Matthew P Moore SVP Govt. and Community Relations & COS 312165 0 88484 0 58005 0 128515 0 23047 0 610216 0 0 0 Peter C Perialas President CHCN & Chief Strategy Officer 719613 0 298253 0 151258 0 237046 0 31173 0 1437343 0 0 0 Jeremiah Radandt President, Corporate Svcs & CFO 568835 0 229425 0 49032 0 187563 0 41534 0 1076389 0 0 0 Kenneth Stewart EVP Compliance & Legal Affairs 596279 0 275310 0 10261 0 191400 0 21997 0 1095247 0 0 0 Lindsey Tyra SVP Chief Strategy Officer (Effec. 9/13/2020) 239266 0 61065 0 1782 0 351638 0 29252 0 683003 0 0 0 Amy Yeager EVP Compliance & Legal Affairs (Effec. 9/13/2020) 432519 0 158686 0 5400 0 127949 0 39348 0 763901 0 0 0 Chris Akeroyd SVP & CIO 268338 0 67253 0 49652 0 63286 0 34198 0 482726 0 0 0 David T Berry President Strategic Capital Projects 622506 0 283091 0 218451 0 208430 0 31993 0 1364471 0 0 0 Joe Cavender SVP Dallas Market ACNO 269101 0 131670 0 83170 0 79500 0 37986 0 601427 0 0 0 Brenda Clayton SVP Supply Chain 247236 0 64024 0 4469 0 42631 0 25835 0 384195 0 0 0 Matthew M Davis Dallas Market EVP 428327 0 186094 0 125108 0 148027 0 24534 0 912090 0 0 0 Linda Dunlap SVP Chief Process Officer 247825 0 74011 0 92474 0 73660 0 33834 0 521804 0 0 0 Doris E Hunt EVP Corporate Services 412485 0 181246 0 131901 0 47983 0 37225 0 810840 0 0 0 Jodi Landon SVP Managed Care 290937 0 84162 0 109123 0 83582 0 36683 0 604486 0 0 0 Javier Montemayor SVP CCO Accreditation and Reg Affairs 298847 0 71819 0 52300 0 75026 0 19632 0 517624 0 0 0 Rustin Morse MD SVP Quality and Safety 215088 0 177060 0 23948 0 42033 0 19036 0 477166 0 0 0 James Rhodes SVP JPE Strategic Development 240721 0 61065 0 1514 0 36172 0 34296 0 373768 0 0 0 Benigno Salinas SVP Operations 202851 0 52080 0 20921 0 44774 0 25523 0 346148 0 0 0 Coleman Skinner SVP Revenue Cycle 333662 0 89155 0 66652 0 80589 0 38482 0 608540 0 0 0 Jean Storey SVP Cardiac and Maternal Fetal and Neonatal Svcs 314074 0 142643 0 8086 0 68250 0 38875 0 571929 0 0 0 Ray Tsai MD SVP Dallas Market Operations 380257 0 214957 0 209649 0 144723 0 45847 0 995434 0 0 0 Vanessa U Walls Northern Market EVP 393023 0 175560 0 80010 0 98269 0 39794 0 786657 0 0 0 Tammy Webb EVP Clinical Shared Svcs & CNO 378879 0 41147 0 52222 0 79765 0 24704 0 576718 0 0 0 Mark E Ziemianski SVP Advanced Analytics and Informatics CDO 246285 0 73631 0 86325 0 72434 0 34198 0 512873 0 0 0 Dean Cannon MD VP Medical Director CMC Health Plan 341666 0 90512 0 2358 0 228057 0 34157 0 696751 0 0 0 Patricia Gonzalez Chief Health Equity and Inclusion Officer 63525 0 92757 0 463703 0 17474 0 10065 0 647525 0 0 0 William Long VP and CISO and IS Ops 237049 0 126301 0 560152 0 58149 0 17539 0 999189 0 0 0 Christopher Menzies VP Chief Med Information Offcr 376173 0 100771 0 86820 0 95251 0 12378 0 671393 0 0 0 Brenda Paulsen VP Research Admin Prof Svc Ops 257403 0 72183 0 102693 0 73841 0 16788 0 522907 0 0 0 Schedule J, Part I, Line 3 PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL The Children's Health System of Texas (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 1a Discretionary spending account The TBA (taxable benefit allowance) was designed to provide executives with reimbursement for travel related expenses between CHST and its Affiliates locations and to acquire supplemental benefits. There is currently only one officer who receives payments from the TBA. Schedule J, Part I, Line 4a Severance or change-of-control payment William Long - $283,000 Patricia Gonzalez - $288,600 Richard Goode - $1,830,749 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Savings Restoration Plan: Employees who received taxable income from the Savings Restoration Plan include: Pamela Arora - $77,688, Kimberly Besse - $28,610, Christopher Durovich - $157,933, Jodi Landon - $3,892, Ray Tsai - $8,306, Vanessa Walls - $13,767. Executive Defined Contribution Retirement Plan (EDCRP): Employees who received taxable income from the EDCRP include: Chris Akeroyd - $47,935, Pamela Arora - $150,439, David Berry - $182,830, Kimberly Besse - $154,968, Thomas Burt - $62,357, Joe Cavender - $57,337, Brent Christopher - $182,387, Matthew Davis - $120,958, Linda Dunlap - $65,123, Christopher Durovich - $660,818, William Elvey - $101,594, Patricia Gonzalez - $174,690, Julie Hall-Barrow - $53,927, James Herring - $17,654, Doris Hunt - $126,013, Keri Kaiser - $92,987, Jodi Landon - $80,656, William Long - $274,609, Christopher Menzies - $83,242, Javier Montemayor - $47,549, Matthew Moore - $56,023, Brenda Paulsen - $75,976, Peter Perialas - $145,975, Jeremiah Radandt - $41,723, Coleman Skinner - $63,090, Jean Storey - $4,971, Ray Tsai - $177,802, Vanessa Walls - $60,021, Mark Ziemianski - $62,682. Employees who participated in and have contributions to the EDCRP include: Chris Akeroyd - $55,343, Pamela Arora - $138,640, David Berry - $197,030, Kimberly Besse - $140,106, Thomas Burt - $165,000, Dean Cannon - $216,924, Joe Cavender - $60,000, Brent Christopher - $170,503, Brenda Clayton - $32,060, Matthew Davis - $130,927, Linda Dunlap - $56,845, Christopher Durovich - $12,923, Robert Fries - $29,017, Patricia Gonzalez - $11,100, Julie Hall-Barrow - $71,846, Doris Hunt - $32,395, Keri Kaiser - $107,455, Jodi Landon - $64,082, William Long - $49,595, Miya Maysent - $72,500, Christopher Menzies - $75,751, Javier Montemayor - $61,737, Matthew Moore - $113,885, Rustin Morse - $31,500, Brenda Paulsen - $56,741, Peter Perialas - $219,946, Jeremiah Radandt - $176,163, James Rhodes - $31,306, Benigno Salinas - $29,058, Coleman Skinner - $69,189, Kenneth Stewart - $180,000, Jean Storey - $48,750, Ray Tsai - $125,223, Lindsey Tyra - $334,538, Vanessa Walls - $81,169, Tammy Webb - $68,365, Amy Yeager - $116,549, Mark Ziemianski - $56,609. 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 Christopher Durovich, James H erring, and Peter Perialas - Business relationship, Amy Yeager, Jeremiah Radandt, and Peter Perialas - Business relationship Form 990, Part VI, Line 11b Review of form 990 by governing body A draft of the Form 990 is presented to the corporation's Audit Committee for review. A copy of the Form 990 is made available to the directors through our Board portal before it is filed with the IRS. Form 990, Part VI, Line 12c Conflict of interest policy Officers, directors, and key employees annually receive 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 15a Process to establish compensation of top management official The Children's Health System of Texas (CHST) process for determining compensation for officers and executives is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for officers and 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. Form 990, Part VI, Line 15b Process to establish compensation of other employees The Children's Health System of Texas (CHST) process for determining compensation for officers and executives is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for officers and 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. 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. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Non controlling interest in Joint Ventures - -15991443; Net Periodic pension costs - -61690; Transfer of Land from CHCO - -50942426; Live Oak Changes in Net Assets - -1784745; Pediatric Imaging Change in Net Assets - -496693; CHST HOLDINGS 1 LLC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 472374583 HEALTH CARE RELATED INVESTMENTS TX -2579449 2888001 CHILDREN'S HEALTH SYSTEM OF TEXAS CHST HOLDINGS 2 LLC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 472819566 HEALTH CARE RELATED INVESTMENTS TX 0 0 CHILDREN'S HEALTH SYSTEM OF TEXAS CHST HOLDINGS 3 LLC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 472845243 HEALTH CARE RELATED INVESTMENTS TX -9072098 0 CHILDREN'S HEALTH SYSTEM OF TEXAS CHST HOLDINGS 4 LLC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 472851889 HEALTH CARE RELATED INVESTMENTS TX 2018886 1467000 CHILDREN'S HEALTH SYSTEM OF TEXAS CHST Investment Holdings LLC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 472874792 HEALTH CARE RELATED INVESTMENTS TX -4276403 31704263 CHILDREN'S HEALTH SYSTEM OF TEXAS CHST Holdings 6 LLC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 811003744 HEALTH CARE RELATED INVESTMENTS TX 1439706 6767473 CHILDREN'S HEALTH SYSTEM OF TEXAS CHST Holdings 7 LLC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 811010503 HEALTH CARE RELATED INVESTMENTS TX 0 0 CHILDREN'S HEALTH SYSTEM OF TEXAS Pediatric Ambulatory Surgery Center Southlake LLC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 475207507 HEALTH CARE RELATED INVESTMENTS TX 0 0 CHILDREN'S HEALTH SYSTEM OF TEXAS Pediatric Ambulatory Surgery Centers LLC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 475215454 HEALTH CARE RELATED INVESTMENTS TX 0 0 CHILDREN'S HEALTH SYSTEM OF TEXAS Pediatric Imaging Associates LLC 1936 MEDICAL DISTRICT DRIVE DALLAS TX 75236 474371967 HEALTH CARE RELATED INVESTMENTS TX -802124 3582416 CHILDREN'S HEALTH SYSTEM OF TEXAS Pediatric Imaging Partners LLC 1937 MEDICAL DISTRICT DRIVE DALLAS TX 75237 472104673 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