CHILD STUDY CENTER: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- CHILD STUDY CENTER (EIN 75-1099536)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-08-12
- IRS object ID
- 202142249349301604
- Schema version
- 2019v5.2
- 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 | 2021-08-12T09:26:48-05:00 | ReturnTs |
| Tax Period End | 2020-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14241 DALLAS PARKWAY SUITE 1100 | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75254 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 751099536 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Child Study Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % CORY RHOADES | InCareOfNm |
| Business Name Control | CHIL | BusinessNameControlTxt |
| Phone | 8173368611 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 W Lancaster | AddressLine1Txt |
| City | Fort Worth | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76102 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CORY R RHOADES | PersonNm |
| Person Title | CFO, SVP FINANCE | PersonTitleTxt |
| Phone | 8173368611 | PhoneNum |
| Signature | 2021-08-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kevin Ensminger | PreparerPersonNm |
| PTIN | P01310558 | PTIN |
| Phone | 9727028262 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | NANCY CYCHOL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 W LANCASTER | AddressLine1Txt |
| City | FORT WORTH | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,931,543 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CSCFW.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1962 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | THE CENTER PROVIDES CHILDREN WITH complex DEVELOPMENTAL & BEHAVIORAL DISABILITIES THE HIGHEST QUALITY diagnosis TREATMENT AND EDUCATION TO HELP THEM ACHIEVE THEIR FULL POTEntial | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 107 | TotalEmployeeCnt |
| Total Volunteers | 58 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,858,875 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,484,979 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,044,506 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,446,564 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $6,903,381 | PYTotalRevenueAmt |
| CY Total Revenue | $4,931,543 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $170,949 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $230,988 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,856,902 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,801,651 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,720,244 | PYOtherExpensesAmt |
| CY Other Expenses | $2,374,085 | CYOtherExpensesAmt |
| PY Total Expenses | $8,748,095 | PYTotalExpensesAmt |
| CY Total Expenses | $8,406,724 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,844,714 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,475,181 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,194,905 | TotalAssetsBOYAmt |
| Total Assets EOY | $15,828,702 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,882,284 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,991,264 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,312,621 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,837,438 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE CHILD STUDY CENTER (CSC) PROVIDES CHILDREN WITH COMPLEX DEVELOPMENTAL AND BEHAVIORAL DISABILITIES THE HIGHEST QUALITY DIAGNOSIS, TREATMENT AND EDUCATION TO HELP THEM ACHIEVE THEIR FULL POTENTIAL. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,004,147 | ExpenseAmt |
| Revenue | $102,106 | RevenueAmt |
| Desc | DEVELOPMENTAL PEDIATRIC SERVICES: CSC CONDUCTS COMPREHENSIVE NEURODEVELOPMENT PEDIATRIC EVALUATIONS AND FOLLOW-UP FOR CHILDREN IN ORDER TO PROVIDE DIAGNOSTIC AND TREATMENT SERVICES AND SAW OVER 4,081 PATIENT VISITS IN 2020 FOR CHILDREN WHO HAVE, OR ARE AT RISK FOR DEVELOPMENTAL DISABILITIES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,429,631 | ExpenseAmt |
| Revenue | $2,061,092 | RevenueAmt |
| Desc | APPLIED BEHAVIORAL ANALYSIS: CSC PROVIDES BEHAVIORAL ANALYTIC SERVICES TO CHILDREN WITH DEVELOPMENTAL DISABILITIES WHO EITHER DISPLAY DIFFICULT BEHAVIORS SUCH AS NONCOMPLIANCE, TANTRUMS, PROPERTY DESTRUCTION, SELF-INJURY AND AGGRESSION OR LACK DESIREABLE SKILLS SUCH AS SELF-HELP, SOCIAL, PLAY, ACADEMIC AND LANGUAGE. THIS PROGRAM ALSO PROVIDES EDUCATIONAL OPPORTUNITIES FOR CHILDREN WITH DIAGNOSES OF AUTISM SPECTRUM DISORDER USING APPLIED BEHAVIOR ANALYSIS METHODS. THESE CHILDREN MAY ATTEND UP TO 35 HOURS PER WEEK WITH ONE-ON-ONE INSTRUCTION FROM PROGRAM SPECIALISTS UNDER THE SUPERVISION OF BOARD CERTIFIED BEHAVIOR ANALYSTS. ADDITIONAL SUPPORT IS PROVIDED BY THE DEVELOPMENTAL PEDIATRIC DEPT FOR DIAGNOSIS AND TREATMENT SERVICES. DURING 2020, VISITS TOTALED 5,064 AND TREATMENT SERVICES WERE PROVIDED TO A TOTAL OF 121 UNDUPLICATED PATIENTS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,553,152 | ExpenseAmt |
| Grant | $230,988 | GrantAmt |
| Revenue | $1,033,196 | RevenueAmt |
| Desc | THE JANE JUSTIN SCHOOL: CSC PROVIDES STRUCTURED EDUCATIONAL SERVICES, COMPREHENSIVE EVALUATION AND DIAGNOSIS FOR CHILDREN WITH DEVELOPMENTAL AND/OR LEARNING DISABILITIES. THESE SERVICES ARE HOPED TO MAXIMIZE POTENTIAL FOR OPTIMUM ACADEMIC AND SOCIAL DEVELOPMENT. AN ESTIMATE OF 85 UNDUPLICATED CHILDREN RECEIVED EDUCATIONAL SERVICES IN 2020. IN ADDITION, WE HAVE EXPANDED OUR UPPER SCHOOL TO AGE 21 AND PREPARE THESE STUDENTS TO SUCCESSFULLY TRANSITION TO ADULTHOOD WITH NECESSARY SKILLS TO LIVE INDEPENDENTLY AND SECURE MEANINGFUL EMPLOYMENT. THE ADDITION OF A BOARD CERTIFIED BEHAVIOR ANALYST AND JOB COACH ARE ENSURING THESE STUDENTS ARE EXPERIENCING EVIDENCE-BASED VOCATIONAL TRAINING AND OFF-SITE JOB OPPORTUNITIES AS WELL. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (13 entries)
| ExpenseExpenseAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|
| $460,848 | $250,170 | PSYCHOLOGICAL SERVICE: CSC PROVIDES SERVICES TO |
| CHILDREN AND ADOLESCENTS WITH dEVELOPMENTAL | ||
| DISABILITIES. THESE SERVICES INCLUDE CONDUCTING | ||
| COMPREHENSIVE PSYCHOLOGICAL EVALUATIONS OF THE | ||
| DISABILITIES AND THEIR RELATED EMOTIONAL AND/OR | ||
| BEHAVIORAL DIFFICULTIES WHICH INCLUDE | ||
| RECOMMENDATIONS FOR TREATMENT. IN ADDITION, CSC | ||
| PSYCHOLOGY PROVIDES INDIVIDUAL THERAPY, PARENT | ||
| TRAINING, AND PARENT-CHILD THERAPY TO REDUCE | ||
| ANXIETY AND DISRUPTIVE BEHAVIORS OCCURING AS A | ||
| RESULT OF DEVELOPMENTAL DISABILITIES. DURING | ||
| 2020, CSC PSYCHOLOGY PROVIDED OVER 1,425 PATIENT | ||
| VISITS WITH THESE SERVICES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $460,848 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $250,170 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $5,447,778 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | 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 | Yes (true) | 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 | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 107 | 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 | Yes (true) | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | Yes (true) | 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 | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CORY RHOADES | PersonNm |
| Phone | 6828854000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 SEVENTH AVENUE | AddressLine1Txt |
| City | FORT WORTH | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76104 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| RICK W MERRILL | |||||||||
| CEO | 1.0 | 39.0 | Yes (X) | $63,395 | $2,049,762 | $248,553 | |||
| STEPHEN W KIMMEL | |||||||||
| CFO/EVP, System Finance | 1.0 | 39.0 | Yes (X) | $28,311 | $915,397 | $119,653 | |||
| NANCY C CYCHOL | |||||||||
| PRESIDENT/CHIEF HOSPITAL SVCS | 1.0 | 40.0 | Yes (X) | $0 | $938,408 | $42,263 | |||
| STANLEY E DAVIS | |||||||||
| SR VP, COO | 1.0 | 40.0 | Yes (X) | $0 | $543,653 | $107,996 | |||
| SPENCER D SEALS | |||||||||
| VP CONSTRUCTION & REAL ESTATE | 1.0 | 40.0 | Yes (X) | $0 | $247,940 | $52,417 | |||
| JOYCE MAUK | |||||||||
| MEDICAL DIRECTOR | 40.0 | 0.0 | $194,113 | $0 | $34,335 | Yes (X) | |||
| CARA MARTZ | |||||||||
| SECRETARY | 1.0 | 40.0 | Yes (X) | $0 | $157,852 | $31,463 | |||
| SHIRLEY GRAHAM | |||||||||
| DIRECTOR OF FINANCE | 40.0 | 0.0 | $142,776 | $0 | $25,849 | Yes (X) | |||
| DUY LE | |||||||||
| MANAGER ABA/BDC | 40.0 | 0.0 | $112,610 | $0 | $44,931 | Yes (X) | |||
| MARGARET DEMPSEY | |||||||||
| MANAGER OF PSYCHOLOGY | 40.0 | 0.0 | $123,168 | $0 | $24,614 | Yes (X) | |||
| WILLIAM M ROBINSON | |||||||||
| DIRECTOR, CSC | 40.0 | 0.0 | $104,379 | $0 | $16,579 | Yes (X) | |||
| TRACY L HARRINGTON | |||||||||
| PSYCHOLOGIST | 40.0 | 0.0 | $102,473 | $0 | $8,238 | Yes (X) | |||
| STEVE PHILLIPS | |||||||||
| TRUSTEE | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| PETER PHILPOTT | |||||||||
| TRUSTEE - Chairman end: 06/19 | 1.0 | 3.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| BILLIE R PUGH JR MD | |||||||||
| TRUSTEE | 1.0 | 3.0 | $0 | $0 | $0 | Yes (X) | |||
| ANDY J BROADUS | |||||||||
| TRUSTEE | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| J HEATH COFFMAN | |||||||||
| TRUSTEE | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| JERRY R CONATSER | |||||||||
| Trustee - Chairman | 2.0 | 5.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| PAUL COULTER | |||||||||
| TRUSTEE | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| JUDGE JEFF CURETON | |||||||||
| SECRETARY/TREASURER | 2.0 | 2.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| RICHARD W DYESS | |||||||||
| TRUSTEE - Vice Chair | 2.0 | 4.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| LISA H JAMIESON | |||||||||
| TRUSTEE | 1.0 | 1.0 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $871,225 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,853,012 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $756,891 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,484,979 | RelatedOrganizationsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Total Contributions | $1,484,979 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Outpatient Clinical Services | 621498 | $2,406,004 | $2,406,004 |
| Jane Justin School | 621498 | $1,018,230 | $1,018,230 |
| Other Operating Revenue | 900099 | $22,330 | $22,330 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,446,564 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,931,543 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,446,564 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,988 | TotalAmt |
| Program Services | $230,988 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $700,757 | TotalAmt |
| Program Services | $309,651 | ProgramServicesAmt |
| Management And General | $391,106 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,790,517 | TotalAmt |
| Program Services | $3,066,098 | ProgramServicesAmt |
| Management And General | $724,419 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,928 | TotalAmt |
| Program Services | $141,971 | ProgramServicesAmt |
| Management And General | $23,957 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $832,701 | TotalAmt |
| Program Services | $656,559 | ProgramServicesAmt |
| Management And General | $176,142 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,748 | TotalAmt |
| Program Services | $244,639 | ProgramServicesAmt |
| Management And General | $67,109 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $716,499 | TotalAmt |
| Management And General | $716,499 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,261 | TotalAmt |
| Program Services | $17,379 | ProgramServicesAmt |
| Management And General | $66,882 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,315 | TotalAmt |
| Program Services | $2,315 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,093 | TotalAmt |
| Program Services | $57,152 | ProgramServicesAmt |
| Management And General | $47,941 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,006 | TotalAmt |
| Management And General | $129,006 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,632 | TotalAmt |
| Program Services | $3,596 | ProgramServicesAmt |
| Management And General | $1,036 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,718 | TotalAmt |
| Program Services | $19,003 | ProgramServicesAmt |
| Management And General | $1,715 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,074 | TotalAmt |
| Program Services | $7,147 | ProgramServicesAmt |
| Management And General | $8,927 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $534,590 | TotalAmt |
| Program Services | -$121 | ProgramServicesAmt |
| Management And General | $534,711 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Physician Remuneration | $602,353 | $602,353 | |
| Minor Equipment | $49,680 | $49,680 | |
| Repairs and Maintenance | $57,046 | $1,165 | $55,881 |
| Bad Debt Expense | $20,840 | $20,840 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,978 | TotalAmt |
| Program Services | $17,363 | ProgramServicesAmt |
| Management And General | $13,615 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,406,724 | TotalAmt |
| Program Services | $5,447,778 | ProgramServicesAmt |
| Management And General | $2,958,946 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,542 | BOYAmt |
| EOY | $7,121 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,783 | BOYAmt |
| EOY | $187,987 | 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 |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $642 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,897,514 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,300,849 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,001,785 | BOYAmt |
| EOY | $15,596,665 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,795 | BOYAmt |
| EOY | $36,287 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,194,905 | BOYAmt |
| EOY | $15,828,702 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,595,862 | BOYAmt |
| EOY | $7,578,608 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $286,422 | BOYAmt |
| EOY | $412,656 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,882,284 | BOYAmt |
| EOY | $7,991,264 | 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 | $11,312,621 | BOYAmt |
| EOY | $7,837,438 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,312,621 | BOYAmt |
| EOY | $7,837,438 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,194,905 | BOYAmt |
| EOY | $15,828,702 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$3,475,181 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$2 | PriorPeriodAdjustmentsAmt |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,278,150 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,025,154 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,342,091 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,858,875 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,484,979 | CurrentTaxYearAmt |
| Total | $10,989,249 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,278,150 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,025,154 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,342,091 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,858,875 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,484,979 | CurrentTaxYearAmt |
| Total | $10,989,249 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $144,740 | SubstantialContributorsTotAmt |
| Public Support Total170 | $10,844,509 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $258,469 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $159,381 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $131,908 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $549,758 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $11,539,007 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $21,181,131 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.93981 | PublicSupportCY170Pct |
| Public Support PY170 | 0.89560 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 1 | FormAndLineReferenceDesc |
| Explanation | GIFTS, GRANTS, CONTRIbUTIONS, AND MEMBERSHIP FEES: ADDITIONAL CONTRIBUTIONS WERE ADDED TO THIS LINE IN COLUMNS (A)-(D) THAT ARE NOT REPORTED AS REVENUE ON PART VIII, LINE 1H OF THE 990. THESE ADDITIONAL AMOUNTS FOR EACH OF THE FOUR YEARS LISTED REPRESENT THE CONTRIBUTIONS FROM SUPPORTING ORGANIZATION, THE CHILD STUDY CENTER FOUNDATION. A PERCENTAGE OF THESE CONTRIBUTIONS ARE DISTRIBUTED EACH YEAR TO SUPPORT THE CHILD STUDY CENTER OPERATIONS. THEY ARE REPORTED ON THE CONSOLIDATED AUDIT REPORT FOR BOTH ORGANIZATIONS. | ExplanationTxt |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $23,644,868 | BeginningYearBalanceAmt |
| Contributions | $250 | ContributionsAmt |
| Investment Earnings Or Losses | $983,512 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $572,208 | OtherExpendituresAmt |
| End Year Balance | $24,056,422 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $23,214,012 | BeginningYearBalanceAmt |
| Contributions | $50 | ContributionsAmt |
| Investment Earnings Or Losses | $1,086,495 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $655,689 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $23,644,868 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $22,793,615 | BeginningYearBalanceAmt |
| Contributions | $25,225 | ContributionsAmt |
| Investment Earnings Or Losses | $1,007,386 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $612,214 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $23,214,012 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $20,401,225 | BeginningYearBalanceAmt |
| Contributions | $25,678 | ContributionsAmt |
| Investment Earnings Or Losses | $3,383,845 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $890,562 | OtherExpendituresAmt |
| Administrative Expenses | $126,571 | AdministrativeExpensesAmt |
| End Year Balance | $22,793,615 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $20,671,313 | BeginningYearBalanceAmt |
| Contributions | $105,227 | ContributionsAmt |
| Investment Earnings Or Losses | $507,606 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $794,533 | OtherExpendituresAmt |
| Administrative Expenses | $88,388 | AdministrativeExpensesAmt |
| End Year Balance | $20,401,225 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.66536 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.33464 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,425,000 | OtherCostOrOtherBasisAmt |
| Book Value | $6,425,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,711,815 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,090,669 | DepreciationAmt |
| Book Value | $7,621,146 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $396,182 | OtherCostOrOtherBasisAmt |
| Depreciation | $149,395 | DepreciationAmt |
| Book Value | $246,787 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,364,517 | OtherCostOrOtherBasisAmt |
| Depreciation | $60,785 | DepreciationAmt |
| Book Value | $1,303,732 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,596,665 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $4,679,715 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$251,828 | OtherRevenueAmt |
| Revenue Not Reported | -$251,828 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,931,543 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $4,931,543 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $8,154,896 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $8,154,896 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $251,828 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $251,828 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $8,406,724 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | INTENDED USES OF ENDOWMENT FUND: RELATED ORGANIZATION, WI COOK FOUNDATION HOLDS AND ADMINISTERS THE ENDOWMENT TO HELP FUND THE CHILD STUDY CENTER'S OPERATIONS AND CAPITAL REPLACEMENT NEEDS. |
| SCHEDULE D, PART X, LINE 2 | ASC 740 FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| SCHEDULE D, PART XI, LINE 2D | RECONCILIATION OF REVENUE PER AUDITED FINANCIALS TO RETURN: SCHOLARSHIPS GIVEN $ (230,988) BAD DEBT $ (20,840) ---------- TOTAL: $ (251,828) |
| SCHEDULE D, PART XII, LINE 4B | RECONCILIATION OF EXPENSES PER AUDITED FINANCIALS TO RETURN: SCHOLARSHIPS GIVEN $ 230,988 BAD DEBT $ 20,840 ---------- TOTAL: $ 251,828 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIP FOR SERVICES | GrantTypeTxt |
| Recipient | 34 | RecipientCnt |
| Cash Grant | $230,988 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: FAMILIES MUST COMPLETE A FINANCIAL NEEDS APPLICATION TO APPLY FOR SCHOLARSHIP. THESE APPLICATIONS ARE SUBMITTED TO AN OUTSIDE FIRM, FAST (FINANCIAL AID FOR SCHOOL TUITION), WHICH REVIEWS THE APPLICATION AND THEN MAKES A RECOMMENDATION OF SCHOLARSHIP AMOUNT. THIS INFORMATION IS ANALYZED BY THE SCHOOL SCHOLARSHIP COMMITTEE CONSISTING OF STAFF AND BOARD MEMBERS, WHERE THE SCHOLARSHIP AWARD IS DETERMINED FOR ALL FAMILIES THAT HAVE APPLIED FOR FINANCIAL ASSISTANCE. FAMILIES CAN ACCEPT, DECLINE OR APPEAL THE SCHOLARSHIP AWARD DECISION IN WRITING. ADDITIONAL WRITTEN FINANCIAL DOCUMENTATION MUST BE PROVIDED TO THE COMMITTEE FOR ANY APPEALS. FINAL SCHOLARSHIP AWARDS ARE DETERMINED BY THE COMMITTEE FOR ACCEPTANCE OR REJECTION BY THE FAMILY. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | 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 |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARA MARTZ | ||||||||||||||
| SECRETARY | $0 | $121,670 | $0 | $31,749 | $0 | $4,433 | $0 | $7,704 | $0 | $23,759 | $0 | $189,315 | $0 | $0 |
| SPENCER D SEALS | ||||||||||||||
| VP CONSTRUCTION & REAL ESTATE | $0 | $181,402 | $0 | $53,900 | $0 | $12,638 | $0 | $15,880 | $0 | $36,537 | $0 | $300,357 | $0 | $0 |
| NANCY C CYCHOL | ||||||||||||||
| PRESIDENT/CHIEF HOSPITAL SVCS | $0 | $561,783 | $0 | $250,634 | $0 | $125,991 | $0 | $21,000 | $0 | $21,263 | $0 | $980,671 | $0 | $0 |
| STEPHEN W KIMMEL | ||||||||||||||
| CFO/EVP, System Finance | $17,096 | $552,787 | $7,719 | $249,579 | $3,496 | $113,031 | $2,679 | $86,608 | $911 | $29,455 | $31,901 | $1,031,460 | $0 | $66,071 |
| STANLEY E DAVIS | ||||||||||||||
| SR VP, COO | $0 | $365,484 | $0 | $152,013 | $0 | $26,156 | $0 | $68,188 | $0 | $39,808 | $0 | $651,649 | $0 | $0 |
| JOYCE MAUK | ||||||||||||||
| MEDICAL DIRECTOR | $134,924 | $0 | $0 | $59,189 | $0 | $14,552 | $0 | $19,783 | $0 | $228,448 | $0 | $0 | $0 | |
| SHIRLEY GRAHAM | ||||||||||||||
| DIRECTOR OF FINANCE | $116,643 | $0 | $17,522 | $0 | $8,611 | $0 | $10,737 | $0 | $15,112 | $0 | $168,625 | $0 | $0 | $0 |
| DUY LE | ||||||||||||||
| MANAGER ABA/BDC | $108,592 | $0 | $1,000 | $0 | $3,018 | $0 | $9,174 | $0 | $35,757 | $0 | $157,541 | $0 | $0 | $0 |
| RICK W MERRILL | ||||||||||||||
| CEO | $36,228 | $1,171,379 | $19,224 | $621,572 | $7,943 | $256,811 | $6,510 | $210,490 | $947 | $30,606 | $70,852 | $2,290,858 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3 | METHODS USED BY CCHCS TO ESTABLISH COMPENSATION OF THE CEO/EXEC DIRECTOR: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| SCHEDULE J, PART I, LINE 4B | PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PARTICIPANTS IN SERP IN W-2 DEF COMP PAID BY -------------------- --------- --------- ------- RICK W. MERRILL 140,060 196,000 CCHS STEPHEN W. KIMMEL 66,071 75,286 CCHS Nancy Cychol 69,761 none cchs STANLEY E. DAVIS none 47,188 CCHS |
| SCHEDULE J, PART II | ALLOCATION OF CEO AND CFO SALARIES: SALARIES FOR THE CEO AND CFO ARE ALLOCATED PRO-RATA BASED ON THE AMOUNT OF TIME THEY SPEND WITH EACH OF THE FOLLOWING COMPANIES: COOK CHILDREN'S MEDICAL CENTER COOK CHILDREN'S PHYSICIAN NETWORK COOK CHILDREN'S HEALTH FOUNDATION COOK CHILDREN'S HOME HEALTH COOK CHILDREN'S HEALTH CARE SYSTEM COOK CHILDREN'S HEALTH PLAN CHILD STUDY CENTER |
| SCHEDULE J, PART I, LINE 1A | Tax Gross up payments: Margaret Dempsey $220 gross up Shirley Graham $118.77 gross up Tracy Harrington $220 gross up Duy D Le $220 gross up M. Cara Martz $220 gross up |
| SCHEDULE J, PART I, LINE 1B | GROSS UP DISCLOSURE: There is no written policy regarding payment or reimbursement of tax indemnification and gross-up payments because the company does not generally allow for gross-up payments except in specific circumstances and then only if approved by senior management followed by review of the companys compliance and legal departments. These types of reimbursements generally relate to taxes owed by individuals who receive nominal incentive payments for service awards or quality improvement programs, and the gross-up payments usually are immaterial, $250 or less. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | SOLE MEMBER: COOK CHILDREN'S MEDICAL CENTER, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBER ELECTION ABILITIES: AS THE SOLE MEMBER OF THE ORGANIZATION, COOK CHILDREN'S MEDICAL CENTER, HAS THE POWER TO DETERMINE THE NUMBER OF MEMBERS OF THE BOARD OF TRUSTEES AND TO ELECT THE MEMBERS OF THE BOARD OF TRUSTEES. THE NUMBER OF TRUSTEES ON THE BOARD OF TRUSTEES SHALL BE NINE, ALL OF WHICH SHALL BE ELECTED BY THE MEMBER AS FOLLOWS: THE TRUSTEESHIP COMMITTEE OF WI COOK FOUNDATION INC. SHALL APPROVE AND SUBMIT FIVE TRUSTEES TO SERVE, AND THE BOARD OF DIRECTORS OF CHILD STUDY CENTER (CSC) SHALL SUBMIT TO THE TRUSTEESHIP COMMITTEE FOUR TRUSTEES DURING A TRANSITION PERIOD. THE TRUSTEESHIP COMMITTEE MUST APPROVE THE PROPOSED SLATE OF CHILD STUDY CENTER TRUSTEES AND SUBMIT THE NAMES FOR FINAL APPROVAL BY THE MEMBER. THE MEMBER SHALL VOTE TO APPROVE OR REJECT THE SUBMITTED SLATE OF CSC TRUSTEES. IF THE TRUSTEESHIP COMMITTEE OR THE MEMBER REJECTS ALL OR A PORTION OF THE SUBMITTED SLATE OF CSC TRUSTEES, THE REJECTED PORTION OF THE SLATE WILL BE TABLED AND AN ALTERNATE SLATE TO SUCH PORTION WILL BE PREPARED AS PROVIDED ABOVE FOR CONSIDERATION BY THE TRUSTEESHIP COMMITTEE AND, ULTIMATELY, THE MEMBER. THE MEMBER SHALL THEN VOTE TO ACCEPT OR REJECT THE ALTERNATE SLATE OF CSC TRUSTEES AT ITS NEXT REGULARLY SCHEDULED MEETING OR AT A SPECIAL MEETING NO LATER THAN 90 DAYS FROM THE RECEIPT OF THE ALTERNATE SLATE. IF THE TRUSTEESHIP COMMITTEE, OR THE MEMBER REJECTS ALL OR A PORTION OF THE ALTERNATE SLATE, THE PROCESS SET FORTH IN THIS SECTION 2(A)(2) SHALL CONTINUE UNTIL THE SLATE OF CSC TRUSTEES IS COMPLETE. |
| FORM 990, PART VI, SECTION A, LINE 7B | MEMBER DECISION ABILITIES: AS THE SOLE MEMBER OF THE ORGANIZATION, COOK CHILDREN'S MEDICAL CENTER HAS THE EXCLUSIVE POWER AND RESERVED POWER TO DO ANY OF THE FOLLOWING: A. AMEND, ALTER OR REPEAL THE BYLAWS; B. AMEND THE CERTIFICATE OF FORMATION OF THE ORGANIZATION; C. DETERMINE THE NUMBER OF MEMBERS OF THE BOARD OF TRUSTEES AND TO ELECT THE MEMBERS OF THE BOARD OF TRUSTEES; D. APPROVE ANY MERGER, ACQUISITION, LIQUIDATION, WINDING UP, TERMINATION OR CONSOLIDATION OF THE ORGANIZATION; E. APPROVE THE SALE, GIFT OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE ORGANIZATION; F. APPROVE THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY; G. APPROVE CAPITAL AND OPERATING BUDGETS OF THE ORGANIZATION; H. APPROVE THE FILING OF ANY LAWSUITS, OR ANY SETTLEMENT OF CLAIMS OR LITIGATION TO WHICH THE CORPORATION IS A PARTY. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF FORM 990: THE ORGANIZATION ENGAGES AN OUTSIDE INDEPENDENT ACCOUNTING FIRM TO ASSIST IN THE PREPARATION OF THE FORM 990 AND RELATED FILINGS. ALL INFORMATION PROVIDED TO THE OUTSIDE ACCOUNTING FIRM IS GATHERED BY KEY COMPANY EMPLOYEES AND EXECUTIVES. ONCE THE FORM 990 IS PREPARED, IT IS REVIEWED BY COMPANY FINANCE, LEGAL AND COMPLIANCE STAFF AND THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT. IN ADDITION, IT IS PRESENTED TO THE COOK CHILDREN'S HEALTH CARE SYSTEM AUDIT COMMITTEE FOR REVIEW AND COMMENT. SUBSEQUENT TO AUDIT COMMITTEE REVIEW, THE FORM 990 IS FILED WITH THE INTERNAL REVENUE SERVICE AND MADE AVAILABLE TO THE PUBLIC FOR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | WRITTEN CONFLICT OF INTEREST POLICY: Every year the Legal Department of the Cook Childrens Health Care System ("SYSTEM") SENDS OUT A FORM 990 QUESTIONNAIRE/CONFLICT OF INTEREST Disclosure Statement to officers, directors, trustees and key employees of all System companies, as well as certain other employees, including physicians, who are determined to be employed in positions that might be subject to the Systems Conflict of Interest Policy. The responses are reviewed by the Legal, Finance, and Compliance Departments. Follow up and/or corrective action is taken as needed with respect to responses that indicate the existence of actual or potential conflicts of interest. A summary of the responses to the questionnaires and follow-up information are provided to the System Audit Committee for review and follow-up. Further, the Audit Committee of Cook Childrens Health Care System is responsible for monitoring the implementation and enforcement of the Conflict of Interest Policy that is applicable to all affiliated companies of the Cook Childrens Health Care System. The Audit Committee is also responsible for oversight of the Compliance Department of Cook Childrens Health Care System. The Compliance Department maintains a hotline to receive reports of inappropriate activities including activities that might constitute a conflict of interest. Internal Audit and Compliance also conduct random audits of corporate activities such as expense reimbursements and accounts payable to determine if any inappropriate payments are being made to individuals, some of which could be evidence of a conflict of interest. Any corrective action related to conflicts of interest would be reported to the Audit Committee for review, approval, and modification, as necessary, with further reporting to the System Board of Trustees as appropriate. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | rEVIEW OF OTHER OFFICER AND KEY EMPLOYEES COMPENSATION: COOK CHILDREN'S HEALTH CARE SYSTEM HAS ESTABLISHED A COMPENSATION COMMITTEE WITH OVERSIGHT OF EXECUTIVE AND PHYSICIAN COMPENSATION, WHICH INCLUDES THE ORGANIZATION'S CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE COMPENSATION COMMITTEE APPROVES COMPENSATION ARRANGEMENTS IN ADVANCE, WHICH INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT COMMITTEE MEMBERS, USING COMPARABLE MARKET DATA RELATING TO COMPENSATION, WHICH IS PROVIDED BY SULLIVAN COTTER AND ASSOCIATES, INC. FOR EXECUTIVE COMPENSATION AND BY ECG MANAGEMENT CONSULTANTS FOR PHYSICIAN COMPENSATION, BOTH OF WHICH ARE INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS FOLLOWING CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION COMMITTEE'S DELIBERATIONS AND DECISIONS. THE COMPENSATION COMMITTEE REQUIRES THE COMPENSATION CONSULTANT TO UPDATE MARKET DATA PERIODICALLY, USUALLY EVERY TWO YEARS, WITH INTERIM REVIEWS BEING CONDUCTED AS NEEDED. WITH REGARD TO PHYSICIAN COMPENSATION, THE COMPENSATION COMMITTEE ALSO RETAINS THE LAW FIRM OF MCDERMOTT, WILL & EMERY OF CHICAGO, ILLINOIS, TO ISSUE A REASONABLENESS OPINION COVERING THE PHYSICIAN COMPENSATION PLAN FOR COOK CHILDREN'S PHYSICIAN NETWORK. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABILITY OF DOCUMENTS: THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, EXCEPT TO THE EXTENT THEY ARE ON FILE WITH THE SECRETARY OF STATE OF TEXAS. THE CONFLICT OF INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE AND AVAILABLE TO ALL EMPLOYEES AND BOARD MEMBERS OF COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES. CONSOLIDATED FINANCIAL STATEMENTS ARE REPORTED ELECTRONICALLY FOR ALL COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES VIA THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE. |
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS RELATIONSHIPS: Lisa Jamieson and Jerry Conatser have a business relationship. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| COOK CHILDREN'S HEALTH PLAN | ||||||||||
| 801 SEVENTH AVENUE | FORT WORTH | TX | 76104 | 760585240 | INSURANCE | TX | 501(C)(3) | 10 | CCHCS | Yes (true) |
| COOK CHILDREN'S PHYSICIAN NETWORK | ||||||||||
| 801 SEVENTH AVENUE | FORT WORTH | TX | 76104 | 752485366 | PHYSICIAN SVC | TX | 501(C)(3) | 3 | CCHCS | Yes (true) |
| WI COOK FOUNDATION | ||||||||||
| 801 SEVENTH AVENUE | FORT WORTH | TX | 76104 | 752051649 | FUNDRAISING | TX | 501(C)(3) | 7 | NA | false |
| COOK CHILDREN'S MEDICAL CENTER | ||||||||||
| 801 SEVENTH AVENUE | FORT WORTH | TX | 76104 | 752051646 | HOSPITAL | TX | 501(C)(3) | 3 | CCHCS | Yes (true) |
| COOK CHILDREN'S HOME HEALTH | ||||||||||
| 801 SEVENTH AVENUE | FORT WORTH | TX | 76104 | 752896983 | HEALTHCARE | TX | 501(C)(3) | 10 | CCHCS | Yes (true) |
| ROSEDALE OFFICE BUILDING INC | ||||||||||
| 1500 W ROSEDALE | FORT WORTH | TX | 76104 | 460866421 | TITLE HOLDING | TX | 501(C)(2) | N/A | CCHF | false |
| COOK CHILDREN'S HEALTHCARE SYSTEM | ||||||||||
| 801 SEVENTH AVENUE | FORT WORTH | TX | 76104 | 752705881 | SUPPORT | TX | 501(C)(3) | 12C | CCHF | false |
| COOK CHILDREN HEALTH ENTERPRISE INC | ||||||||||
| 801 SEVENTH AVENUE | FORT WORTH | TX | 76104 | 842625990 | HLTH CARE SUP | TX | 501(C)(3) | 12B | CCHF | false |
| COOK CHILDREN'S MEDICAL CENTER PROSPER | ||||||||||
| 801 SEVENTH AVE | FORT WORTH | TX | 76104 | 852354189 | HEALTHCARE | TX | 501(C)(3) | 3 | CCHCS | Yes (true) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COOK CHILDREN'S HEALTH SERVICES INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 SEVENTH AVENUE | AddressLine1Txt |
| City | FORT WORTH | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 76104 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454024843 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | TX | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CCHCS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C-CORP | EntityTypeTxt |
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| 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 | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| COOK CHILDREN'S PHYSICIAN NETWORK | ||
| O | $602,353 | FMV |
| COOK CHILDREN'S MEDICAL CENTER | ||
| O | $135,743 | FMV |
Comments