2021-05-13T10:24:15-05:00 2020-06-30 990 2019-07-01 593425191 PEDIATRIC PHYSICIAN SERVICES INC PEDI 4439975771 3910 KESWICK RD S BLDG BALTIMORE MD 21211 GERAD THERIAC CFO 4439975771 2021-05-13 2019 2022-09-23 18:48:47Z GERAD THERIAC 501 SIXTH AVE S ST PETERSBURG FL 33701 105136466 0 X WWW.HOPKINSALLCHILDRENS.ORG X 1997 FL PROVIDE HEALTHCARE SERVICES BY PEDIATRIC SPECIALTY PHYSICIANS 8 1 403 0 0 0 9601998 2704318 91707061 102419837 24058 12311 0 0 101333117 105136466 0 0 0 0 72699845 75897957 0 0 0 28306759 29175961 101006604 105073918 326513 62548 13197810 6942011 13845971 7527624 -648161 -585613 THE CORPORATION IS ORGANIZED FOR CHARITABLE, EDUCATIONAL AND SCIENTIFIC PURPOSES, AND TO PROVIDE HEALTHCARE SERVICES OF PEDIATRIC SPECIALTY PHYSICIANS AND OTHER PERSONNEL TO THE PATIENTS OF JOHNS HOPKINS ALL CHILDREN'S HOSPITAL AND AFFILIATED LOCATIONS. 0 0 105073918 102419837 PEDIATRIC PHYSICIAN SERVICES IS A MULTI-SPECIALTY PEDIATRIC PHYSICIAN CLINIC AFFILIATED WITH JOHNS HOPKINS ALL CHILDREN'S HOSPITAL. PEDIATRIC PHYSICIAN SERVICES PROVIDES PHYSICIAN AND OTHER HEALTHCARE SERVICES TO THE PATIENTS AT JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, INC. IN ADDITION, THE PHYSICIANS AT PEDIATRIC PHYSICIAN SERVICES PROVIDE PATIENT, NURSING AND MEDICAL STUDENT EDUCATION AND PARTICIPATE IN CLINICAL RESEARCH STUDIES WITH JOHNS HOPKINS ALL CHILDREN'S HOSPITAL AND ALL CHILDREN'S RESEARCH INSTITUTE. 105073918 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 18 0 1 403 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 1 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X THE CORPORATION 4439975771 3910 KESWICK RD S BLDG BALTIMORE MD 21211 KEVIN W SOWERS MSN RN FAA FORMER CEO/TRUSTEE 1.00 59.00 X 0 1922816 256802 JONATHAN ELLEN MD FORMER CEO/TRUSTEE 1.00 59.00 X 0 925399 73019 CAROLYN CAREY NEUROSURGEON 40.00 0.00 X 910229 0 28564 LUIS RODRIGUEZ NEUROSURGEON 40.00 0.00 X 890346 0 34832 GERALD TUITE NEUROSURGEON 40.00 0.00 X 888765 0 20293 PAUL DANIELSON PHYSICIAN DIVISION CHIEF 40.00 0.00 X 856211 0 39082 GERHARD ZIEMER MEDICAL DIRECTOR 40.00 20.00 X 832135 0 3417 ROBERTA ALESSI VP/COO/TRUSTEE 5.00 55.00 X X 0 565102 141736 TOM KMETZ TRUSTEE 1.00 59.00 X 0 679358 0 PAUL COLOMBANI MD FORMER PRESIDENT/TRUSTEE 15.00 45.00 X 0 549125 50757 DAVID CLENDENIN MD INTERIM PRESIDENT/TRUSTEE 40.00 10.00 X X 541706 0 28879 WASSAM RAHMAN DEPT CHAIR EMERGENCY MEDICINE 40.00 0.00 X 450688 0 51316 JOSEPH PERNO VICE CHAIR PEDIATRIC MEDICINE 40.00 0.00 X 0 449436 18924 MARGUERITE CRAWFORD FORMER KEY EMPLOYEE 40.00 0.00 X 429271 0 27989 CHRISTOPHER WHITBY VP/CFO/TRUSTEE 1.00 59.00 X X 0 305695 21027 SYLVIA POWELL TRUSTEE 1.00 59.00 X 0 268544 56611 JEFF ROONEY INTERIM VP/CFO/TRUSTEE 1.00 59.00 X X 0 302570 0 ANGELA GREEN TRUSTEE 1.00 59.00 X 0 110900 13683 KEVIN CREWS SECRETARY 5.00 55.00 X 0 73464 3019 STEPHEN KENNEDY MD TRUSTEE 1.00 0.00 X 0 0 0 5799351 6152409 869950 250 1 1 1 WEATHERBY MEDICAL STAFFING PO BOX 972633 DALLAS TX 75397 LABOR SERVICES 636375 COMPHEALTH INC PO BOX 972651 DALLAS TX 75397 LABOR SERVICES 493912 PROVIDENCE HEALTHCARE GROUP 2911 TURTLE CREEK BLVD STE 300 DALLAS TX 75219 RECRUITING SERVICES 227099 LOCUMTENENS COM PO BOX 405547 ATLANTA GA 30384 LABOR SERVICES 143767 4 1009464 1694854 2704318 CONTRACT REIMBURSEMENT 621110 63365973 63365973 PATIENT SERVICE REV. 621110 39053864 39053864 102419837 12311 12311 105136466 102419837 0 12311 1052097 1052097 64661869 64661869 10183991 10183991 41990 41990 19134 19134 4561533 4561533 456 456 243214 243214 143661 143661 1045962 1045962 1541306 1541306 113457 113457 1120 1120 160682 160682 5589384 5589384 HOSPITAL LEASE UTILIZAT 7598006 7598006 PURCHASED SERVICES- INT 7111019 7111019 DUES, LICENSES & FEES 561819 561819 MEDICAL SUPPLIES 443218 443218 105073918 105073918 0 0 2433805 342209 9566012 4835973 2050527 1846035 365173 204492 832820 1559337 13197810 6942011 9154111 7169513 4691860 358111 13845971 7527624 X -648161 -585613 -648161 -585613 13197810 6942011 62548 0 X 0 1 X 1 0 X 131990 16879328 9601998 2704318 29317634 57044967 62844715 84742722 91707061 102419837 398759302 57044967 62976705 101622050 101309059 105124155 428076936 0 0 0 428076936 13219 22788 44804 24058 12311 117180 13219 22788 44804 24058 12311 117180 57058186 62999493 101666854 101333117 105136466 428194116 0.99970 0.99970 0.00030 0.00030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1709933 1505442 204491 340594 340593 1 204492 OTHER ASSETS 956713 DUE FR AFFILIATES 542922 OPERATING LEASE ROU ASSETS 59702 1559337 DUE TO AFFILIATES 297546 OPERATING LEASE ROU LIABILITIES 60565 358111 X PART X, LINE 2: FASB GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES CLARIFIES THE ACCOUNTING FOR UNCERTAINTY OF INCOME TAX POSITIONS. THIS GUIDANCE DEFINES THE THRESHOLD FOR RECOGNIZING TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS AS "MORE LIKELY THAN NOT" THAT THE POSITION IS SUSTAINABLE, BASED ON ITS TECHNICAL MERITS. THE GUIDANCE ALSO PROVIDES GUIDANCE ON THE MEASUREMENT, CLASSIFICATION AND DISCLOSURE OF TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS. THERE WAS NO IMPACT ON PEDIATRIC PHYSICIAN SERVICES' FINANCIAL STATEMENTS DURING THE YEARS ENDED JUNE 30, 2020 AND 2019. X 1 1 X X X X X 1 1 0 0 0 0 0 1 0 KEVIN W SOWERS MSN RN FAA FORMER CEO/TRUSTEE 0 1248448 0 626950 0 47418 0 243973 0 12829 0 2179618 0 0 JONATHAN ELLEN MD FORMER CEO/TRUSTEE 0 349422 0 0 0 575977 0 43295 0 29724 0 998418 0 206133 CAROLYN CAREY NEUROSURGEON 688912 0 0 0 221317 0 4026 0 24538 0 938793 0 0 0 LUIS RODRIGUEZ NEUROSURGEON 675566 0 0 0 214780 0 8400 0 26432 0 925178 0 0 0 GERALD TUITE NEUROSURGEON 689010 0 0 0 199755 0 0 0 20293 0 909058 0 0 0 PAUL DANIELSON PHYSICIAN DIVISION CHIEF 660507 0 0 0 195704 0 8400 0 30682 0 895293 0 0 0 GERHARD ZIEMER MEDICAL DIRECTOR 109735 0 0 0 722400 0 0 0 3417 0 835552 0 0 0 ROBERTA ALESSI VP/COO/TRUSTEE 0 413199 0 82836 0 69067 0 123496 0 18240 0 706838 0 0 TOM KMETZ TRUSTEE 0 652316 0 0 0 27042 0 0 0 0 0 679358 0 0 PAUL COLOMBANI MD FORMER PRESIDENT/TRUSTEE 0 344749 0 204376 0 0 0 41750 0 9007 0 599882 0 0 DAVID CLENDENIN MD INTERIM PRESIDENT/TRUSTEE 417663 0 0 0 124043 0 8400 0 20479 0 570585 0 0 0 WASSAM RAHMAN DEPT CHAIR EMERGENCY MEDICINE 358215 0 0 0 92473 0 8400 0 42916 0 502004 0 0 0 JOSEPH PERNO VICE CHAIR PEDIATRIC MEDICINE 0 447426 0 0 0 2010 0 0 0 18924 0 468360 0 0 MARGUERITE CRAWFORD FORMER KEY EMPLOYEE 324321 0 0 0 104950 0 8400 0 19589 0 457260 0 0 0 CHRISTOPHER WHITBY VP/CFO/TRUSTEE 0 183870 0 28160 0 93665 0 0 0 21027 0 326722 0 12970 SYLVIA POWELL TRUSTEE 0 224821 0 29413 0 14310 0 28920 0 27691 0 325155 0 0 JEFF ROONEY INTERIM VP/CFO/TRUSTEE 0 0 0 0 0 302570 0 0 0 0 0 302570 0 0 PART I, LINE 1A A HIGHEST PAID EMPLOYEE LISTED ON THIS RETURN RECEIVED A GROSS-UP PAYMENT ON AN AWARDED BONUS. PART I, LINES 4A-B PART I, LINE 4A: SEVERANCE PAYMENTS: JONATHAN ELLEN, M.D. $362,500 GERHARD ZIEMER $688,248.45 CHRISTOPHER WHITBY $59,316.96 PART I, LINE 4B: A SELECT GROUP OF SENIOR LEADERS OF THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION (JHHSC) PARTICIPATE IN SUPPLEMENTAL RETIREMENT/DEFERRED COMPENSATION PROGRAMS, INCLUDING SOME LEGACY ARRANGEMENTS THAT ARE NO LONGER AVAILABLE TO NEW HIRES. PRE-2011 PARTICIPANTS RECEIVE CASH PAYMENTS EACH YEAR DETERMINED WITH REFERENCE TO THEIR SERVICE WITH JHHSC AND THEIR FINAL AVERAGE COMPENSATION. AS OF JANUARY 2019, FUTURE CASH PAYMENTS ARE MADE ACCORDING TO A FIXED SCHEDULE FOR THESE PARTICIPANTS. POST-2011 PARTICIPANTS ACCRUE BENEFITS UNDER A DEFINED CONTRIBUTION FORMULA WHERE CONTRIBUTIONS ARE TIERED BY POSITION LEVEL. CONTRIBUTIONS MADE IN 2018 AND PRIOR YEARS GENERALLY VEST AFTER THE LATER OF FIVE YEARS OF SERVICE WITH JHHSC OR THREE YEARS OF PLAN PARTICIPATION; CONTRIBUTIONS MADE IN 2019 AND FUTURE YEARS VEST THREE YEARS AFTER EACH CONTRIBUTION IS MADE, WITH FULL VESTING ON THE LATER OF AGE 65 OR THREE YEARS OF PLAN PARTICIPATION. ALL CONTRIBUTIONS VEST ON DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. IF A PARTICIPANT VOLUNTARILY TERMINATES EMPLOYMENT OR IS TERMINATED BY THE EMPLOYER FOR CAUSE PRIOR TO THE APPLICABLE VESTING DATE, THE PARTICIPANT'S ENTIRE NON-VESTED BENEFIT IS FORFEITED ALL OF THESE ARRANGEMENTS WERE APPROVED, IN ADVANCE, BY AN INDEPENDENT COMPENSATION COMMITTEE, WHICH BASED ITS DECISION ON DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT. PARTICIPANTS' INTERESTS UNDER THESE ARRANGEMENTS ARE NOT GUARANTEED OR SECURED AT ANY WAY AND AT ALL TIMES ARE SUBJECT TO CLAIMS OF EMPLOYER'S BANKRUPTCY/INSOLVENCY CREDITORS. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A RECEIVED PAYMENT FROM ONE OR MORE SUPPLEMENTAL RETIREMENT/DEFERRED COMPENSATION PROGRAMS, WITH PAYMENTS REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III); THE TOTAL OF AMOUNTS PAYABLE DURING 2019 BUT REPORTED AS DEFERRED COMPENSATION IN COLUMN (C) IN PREVIOUS YEARS IS REPORTED IN SCHEDULE J, PART II, COLUMN (F). THE AMOUNTS BELOW MAY REFLECT ANNUAL CASH PAYMENTS OR MULTIPLE YEARS OF ACCRUALS THAT VESTED IN 2019. CHRISTOPHER WHITBY $13,854.06 PART I, LINE 7 ANNUAL INCENTIVE PLAN: EXECUTIVES PARTICIPATE IN AN ANNUAL INCENTIVE PLAN THAT REWARDS PARTICIPANTS FOR THE ACHIEVEMENT OF ORGANIZATION OBJECTIVES APPROVED BY THE JOHNS HOPKINS MEDICINE COMPENSATION COMMITTEE EACH YEAR, INCLUDING FINANCIAL AND NON-FINANCIAL MEASURES. A PORTION OF THE OVERALL AWARD IS DETERMINED BASED ON INDIVIDUAL PERFORMANCE. FORM 990, PART I, LINE 8 PURSUANT TO THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY (CARES) ACT, PEDIATRIC PHYSICIANS SERVICES, INC. RECOGNIZED $1,694,854 OF FUNDING FROM THE PROVIDER RELIEF FUND ADMINISTERED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION, AN AGENCY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES DURING FY20. THIS AMOUNT HAS BEEN RECOGNIZED AS GRANT REVENUE ON PART I, LINE 8 OF THE ORGANIZATION'S FORM 990. FORM 990, PART V, QUESTION 2A ALL COMPENSATION OF PEDIATRIC PHYSICIAN SERVICES EMPLOYEES IS PAID THROUGH ALL CHILDREN'S HEALTH SYSTEM, INC. USING ITS FEDERAL TAX ID NUMBER. THIS IS KNOWN AS A COMMON PAYMASTER AGREEMENT. EMPLOYEES OF ALL CHILDREN'S HEALTH SYSTEM AND ITS OTHER SUBSIDIARIES ARE ALSO PAID THROUGH THE SAME AGREEMENT. FORM 990, PART VI, SECTION A, LINE 6 ALL CHILDREN'S HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF PEDIATRIC PHYSICIAN SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A ALL CHILDREN'S HEALTH SYSTEM, INC, A IRC 501(C)(3) TAX EXEMPT SOLE MEMBER OF PEDIATRIC PHYSICIAN SERVICES, ELECTS THE BOARD OF TRUSTEES. THIS IS SUBJECT TO THE APPROVAL OF THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION, A IRC 501(C)(3) TAX EXEMPT SOLE MEMBER OF ALL CHILDREN'S HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7B THE GOVERNING BODY OF PEDIATRIC PHYSICIAN SERVICES, INC. IS EMPOWERED BY ITS BYLAWS TO MAKE CERTAIN DECISIONS; ALL OTHER DECISIONS ARE SUBJECT TO APPROVAL OF THE SOLE MEMBER ALL CHILDREN'S HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 8B PEDIATRIC PHYSICIAN SERVICES, INC. CURRENTLY ONLY HAS A GOVERNING BODY WITH NO ADDITIONAL COMMITTEES, BUT RELIES ON THE COMMITTEES OF JOHNS HOPKINS HEALTH SYSTEM. THE COMMITTEES OF JOHNS HOPKINS HEALTH SYSTEM HAVE DOCUMENTED ITS MEETINGS AND ACTIONS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE FILING ENTITY AS PART OF ALL CHILDREN'S HEALTH SYSTEM, HAS AN ANNUAL CONFLICT OF INTEREST DISCLOSURE PROCESS THAT HAS BEEN FORMALLY DOCUMENTED IN POLICY. THE PROCESS IS FACILITATED BY THE COMPLIANCE OFFICER WITH OVERSIGHT FROM THE ALL CHILDREN'S HEALTH SYSTEM (PARENT) BOARD'S COMPLIANCE COMMITTEE. DISCLOSURES ARE REQUESTED FROM KEY EMPLOYEES, KEY CONTRACTORS, BOARD MEMBERS AND OFFICERS, AND DESIGNATED MEDICAL STAFF. ALL DISCLOSURES ARE REVIEWED BY THE COMPLIANCE OFFICER. SELECTED DISCLOSURES ARE REVIEWED BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER. A FORMAL REPORT IS MADE ANNUALLY TO THE COMPLIANCE COMMITTEE WHERE CONFLICT MANANGEMENT IS ADDRESSED FOR EMPLOYEES, CONTRACTORS, AND PHYSICIANS. BOARD MEMEBER DISCLOSURES ARE REVIEWED BY THE RESPECTIVE BOARD PRESIDENTS FOR CONFLICT MANAGEMENT. BOARD MEMBERS ARE REQUIRED TO DECLARE ANY POTENTIAL CONFLICTS PRIOR TO CONDUCTING BUSINESS AT EACH MEETING. IF A CONFLICT IS FOUND TO EXIST BY A BOARD MEMBER, THE BOARD MEMBER IS PROHIBITED FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 EVERY THREE YEARS AN INDEPENDENT STUDY IS CONDUCTED GATHERING INDUSTRY COMPENSATION AVERAGES FROM SELECT PEER INSTITUTIONS. EVERY YEAR THE JOHNS HOPKINS BOARD OF TRUSTEES COMPENSATION COMMITTEE REVIEWS COMPENSATION AMOUNTS FOR OFFICERS AND ALL EMPLOYEES AT THE DIRECTOR AND HIGHER LEVELS. FORM 990, PART VI, SECTION C, LINE 19 PEDIATRIC PHYSICIAN SERVICES, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. JOHNS HOPKINS HEALTH SYSTEM CORPORATION 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 521465301 SUPPORTING ORGANIZATION MD 501(C)(3) LINE 12C, III-FI JOHNS HOPKINS HEALTH SYSTEM CORP 0 THE JOHNS HOPKINS HOSPITAL 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 520591656 HOSPITAL MD 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORP 0 LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR 5255 LOUGHBORO RD NW WASHINGTON DC 20016 530196602 HOSPITAL DC 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORP 0 JOHNS HOPKINS COMMUNITY PHYSICIANS INC 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 521467441 HEALTHCARE SERVICES MD 501(C)(3) LINE 12C, III-FI JOHNS HOPKINS HEALTH SYSTEM CORP 0 JOHNS HOPKINS MEDICAL SERVICES CORPORATION 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 521232569 HEALTHCARE SERVICES MD 501(C)(3) LINE 12B, II JOHNS HOPKINS HEALTH SYSTEM CORP 0 JOHNS HOPKINS BAYVIEW MEDICAL CENTER INC 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 521341890 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