DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN INC (EIN 81-0584868)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-12
IRS object ID
202143169349307374
Schema version
2020v4.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-11-12T13:05:35-06:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN350921680PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CROWE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1750 N St Paul Suite 850AddressLine1Txt
CityDallasCityNm
State AbbreviationTXStateAbbreviationCd
ZIP752013246ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN810584868EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Dallas Physician Medical Services for Children IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDALLBusinessNameControlTxt
Phone2144567000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 Medical District DriveAddressLine1Txt
CityDallasCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRobert FriesPersonNm
Person TitleEVP and Chief Financial OfficerPersonTitleTxt
Signature2021-11-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstRobertPersonFirstNm
Person LastFriesPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRachel SpurlockPreparerPersonNm
PTINP00520729PTIN
Phone2147775200PhoneNum
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1David BerryBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 Medical District DriveAddressLine1Txt
CityDallasCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$70,474,452GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionPROVIDE SERVICES TO PATIENTS AT SEVERAL HOSPITALS, INCLUDING CHILDREN'S MEDICAL CENTER DALLAS.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee601TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,640PYContributionsGrantsAmt
CY Contributions Grants$738,325CYContributionsGrantsAmt
PY Program Service Revenue$62,990,801PYProgramServiceRevenueAmt
CY Program Service Revenue$69,736,127CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$62,996,441PYTotalRevenueAmt
CY Total Revenue$70,474,452CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$68,574,154PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$80,686,969CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,703,560PYOtherExpensesAmt
CY Other Expenses$42,243,782CYOtherExpensesAmt
PY Total Expenses$78,277,714PYTotalExpensesAmt
CY Total Expenses$122,930,751CYTotalExpensesAmt
PY Revenues Less Expenses-$15,281,273PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$52,456,299CYRevenuesLessExpensesAmt
Total Assets BOY$3,937,625TotalAssetsBOYAmt
Total Assets EOY$21,977,207TotalAssetsEOYAmt
Total Liabilities BOY$35,877,139TotalLiabilitiesBOYAmt
Total Liabilities EOY$106,373,020TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$31,939,514NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$84,395,813NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE DENTAL, GENERAL PEDIATRIC, AND PEDIATRIC SUB-SPECIALTY SERVICES, INCLUDING, BUT NOT LIMITED TO EMERGENCY DEPARTMENT COVERAGE, INPATIENT COVERAGE, ORTHOPEDIC SURGERY, AND CRANIOFACIAL ORTHODONTICS REGARDLESS OF PAYOR SOURCE OR FINANCIAL STATUS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$84,118,011ExpenseAmt
Grant$0GrantAmt
Revenue$69,736,127RevenueAmt
DescPROVIDE PHYSICIAN SERVICES TO PATIENTS TREATED BY CHILDREN'S HEALTH CLINICAL OPERATIONS. THESE SERVICES ARE PROVIDED WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY.Desc
Total Program Service Expenses$84,118,011TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document107IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee601EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Amy YeagerBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2144567000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 MEDICAL DISTRICT DRIVEAddressLine1Txt
CityDALLASCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Ray Tsai MD
Chair & President (Term. 2/7/2020)1.054.0Yes (X)Yes (X)$0$804,864$190,570
John D Polousky MD
Director and Medical Director (Term. 6/30/2020)39.01.0Yes (X)$676,423$0$36,319
Michael Day MD
Director and Medical Director39.01.0Yes (X)$484,144$0$51,456
Michael Tate MD
Director and VP Med. Dir. Enterprise Care Mgmt.19.021.0Yes (X)$157,519$273,049$148,406
David T Berry
President (Effec. 2/7/2020)1.054.0Yes (X)$0$1,124,048$240,422
Lisa M Frenkel
Secretary1.039.0Yes (X)$0$378,324$55,864
Peter C Perialas
Vice President (Effec. 8/21/2020)1.054.0Yes (X)$0$1,169,124$268,219
Amit Verma MD
Medical Director ECHO40.00$467,579$0$65,500Yes (X)
Christopher Redman MD
Physician40.00$792,736$0$45,605Yes (X)
Dustin Loveland MD
Physician40.00$779,884$0$45,657Yes (X)
Eric Mendeloff MD
Medical Director ECHO40.00$6,099,984$0$22,755Yes (X)
Scott Sorenson MD
Physician40.00$793,316$0$47,787Yes (X)
Stephanie K Smith
Former Corporate Secretary0.040.0$0$204,254$25,397Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$10,251,584TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,953,663TotReportableCompRltdOrgAmt
Total Other Compensation$1,243,959TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K275IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtAddress Line2ContractorAddress/USAddress/AddressLine2TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
TCN PEDIATRIC NEUROLOGY PLLC
4032 McDermott RoadSuite 100PlanoTX75024Physician Services$611,575
MESA LOAN COMPANY OF ATHENS LP
909 ESE Loop 323Suite 650TylerTX75701Construction services$486,910
UTSW
HI 108 5323 Harry Hines BlvdDallasTX753908886Phys & Medical Services$413,954
TYTOCARE INC
215W 40th StreetNew YorkNY10018Telemedicine equipment$378,576
RANK ONE HEALTH LLC
PO Box 1044SangerTX76266Health care application$367,359
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K12CntrctRcvdGreaterThan100KCnt
Related Organizations$738,325RelatedOrganizationsAmt
Total Contributions$738,325TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business621110BusinessCd
Total Revenue Column$69,736,127TotalRevenueColumnAmt
Related Or Exempt Func Income$69,736,127RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$69,736,127TotalProgramServiceRevenueAmt

Rental Income Or Loss RentalIncomeOrLossGrp

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

Gain Or Loss GainOrLossGrp

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

Miscellaneous Revenue MiscellaneousRevenueGrp

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

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$70,474,452TotalRevenueColumnAmt
Related Or Exempt Func Income$69,736,127RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,485,741TotalAmt
Program Services$1,485,741ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$65,184,273TotalAmt
Program Services$59,342,016ProgramServicesAmt
Management And General$5,842,257ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,878,106TotalAmt
Program Services$2,620,151ProgramServicesAmt
Management And General$257,955ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,696,769TotalAmt
Program Services$6,096,559ProgramServicesAmt
Management And General$600,210ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,442,080TotalAmt
Program Services$4,043,951ProgramServicesAmt
Management And General$398,129ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,225,096TotalAmt
Program Services$2,025,668ProgramServicesAmt
Management And General$199,428ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,446,097TotalAmt
Program Services$1,316,488ProgramServicesAmt
Management And General$129,609ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,386,095TotalAmt
Program Services$3,082,610ProgramServicesAmt
Management And General$303,485ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,845,456TotalAmt
Program Services$2,590,427ProgramServicesAmt
Management And General$255,029ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$176,537TotalAmt
Program Services$160,715ProgramServicesAmt
Management And General$15,822ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$633,888TotalAmt
Program Services$577,075ProgramServicesAmt
Management And General$56,813ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$254,047TotalAmt
Program Services$254,047ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
Shared Services$30,754,003$30,754,003
Medical Surgical Supplies$522,563$522,563

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$122,930,751TotalAmt
Program Services$84,118,011ProgramServicesAmt
Management And General$38,812,740ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$400EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,840,421BOYAmt
EOY$2,096,788EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$2,239,546EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,059,125LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,294,293LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,097,204BOYAmt
EOY$3,764,832EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$13,875,641EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,937,625BOYAmt
EOY$21,977,207EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,767,887BOYAmt
EOY$12,475,773EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$26,109,252BOYAmt
EOY$93,897,247EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$35,877,139BOYAmt
EOY$106,373,020EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$31,939,514BOYAmt
EOY-$84,395,813EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$31,939,514BOYAmt
EOY-$84,395,813EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,937,625BOYAmt
EOY$21,977,207EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$52,456,299ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,762,608OtherCostOrOtherBasisAmt
Depreciation$503,132DepreciationAmt
Book Value$1,259,476BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$253,360OtherCostOrOtherBasisAmt
Depreciation$100,345DepreciationAmt
Book Value$153,015BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,390,836OtherCostOrOtherBasisAmt
Depreciation$1,690,816DepreciationAmt
Book Value$1,700,020BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$652,321OtherCostOrOtherBasisAmt
Book Value$652,321BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,764,832TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescOther AssetsDesc
Book Value$13,875,641BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$13,875,641TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLT ADVANCES-AffiliatesDesc
Amt$93,897,247Amt
FieldValueIRS element (for citing)
Total Liability$93,897,247TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationDallas Physician Medical Services for Children's financial information is included in the consolidated audited financial statements of Children's Health System of Texas, a related organization. Children's Health System of Texas's FIN 48 (ASC 740) footnote for the year ended December 31, 2020, reads as follows: "The authoritative guidance in ASC 740 Income Taxes, creates a single model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the accompanying consolidated balance sheets. The statute of limitations remains open for tax years 2017 through 2020 in Children's Health main taxing jurisdictions."ExplanationTxt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Ray Tsai MD
Chair & President (Term. 2/7/2020)$0$380,257$0$214,957$0$209,649$0$144,723$0$45,847$0$995,434$0$0
Michael Day MD
Director and Medical Director$423,986$0$54,067$0$6,090$0$14,590$0$36,866$0$535,600$0$0$0
John D Polousky MD
Director and Medical Director (Term. 6/30/2020)$465,882$0$186,667$0$23,874$0$11,390$0$24,929$0$712,742$0$0$0
Michael Tate MD
Director and VP Med. Dir. Enterprise Care Mgmt.$116,695$270,891$39,628$0$1,196$2,158$48,992$41,963$30,888$26,563$237,399$341,575$0$0
Stephanie K Smith
Former Corporate Secretary$0$173,878$0$27,497$0$2,879$0$9,932$0$15,465$0$229,651$0$0
David T Berry
President (Effec. 2/7/2020)$0$622,506$0$283,091$0$218,451$0$208,430$0$31,993$0$1,364,471$0$0
Lisa M Frenkel
Secretary$0$302,144$0$66,075$0$10,105$0$38,013$0$17,852$0$434,188$0$0
Peter C Perialas
Vice President (Effec. 8/21/2020)$0$719,613$0$298,253$0$151,258$0$237,046$0$31,173$0$1,437,343$0$0
Dustin Loveland MD
Physician$593,322$0$183,000$0$3,562$0$9,969$0$35,688$0$825,541$0$0$0
Eric Mendeloff MD
Medical Director ECHO$1,300,258$0$0$0$4,799,726$0$11,400$0$11,355$0$6,122,739$0$0$0
Christopher Redman MD
Physician$592,424$0$196,750$0$3,562$0$10,054$0$35,551$0$838,341$0$0$0
Scott Sorenson MD
Physician$591,588$0$197,500$0$4,228$0$11,400$0$36,387$0$841,103$0$0$0
Amit Verma MD
Medical Director ECHO$383,776$0$61,866$0$21,936$0$19,500$0$46,000$0$533,079$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationCHILDREN'S HEALTH SYSTEM OF TEXAS IS THE SOLE MEMBER FOR DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN (DPMSC). THEREFORE, DPMSC'S TOP MANAGEMENT OFFICIAL IS EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). The CHST process for determining executive compensation is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for executives. The Committee is comprised of independent, non-employee directors. A written compensation philosophy has been developed by the Human Resources Committee for timeliness and appropriateness and defines the desired peer groups for compensation surveys. The HR Committee engages the services of an independent compensation consultant for executive compensation. COMPENSATION PROGRAM COMPONENTS: The elements of total compensation provided to CHST executives include: - Cash compensation (i.e., base salary, short-term and long-term incentive compensation, and/or other cash compensation), determined in consideration of competitive market practices, organizational and individual performance, recruitment and retention considerations, and other relevant factors. - Standard benefits, assisting in each executive's medical, dental, disability, life insurance, time off, and retirement needs, reflective of the employment status (i.e., full or part time) of the executive. - Supplemental benefits, including supplemental insurance, retirement benefits, and/or other supplemental benefits determined by the Committee to be appropriate and reasonable in relation to marketplace practices. Compensation and benefits decisions are made in consideration of each executive's position, responsibilities, skills, effort, and performance, in relation to documented practices within the appropriate comparator group(s). PEER GROUP: The Committee has defined its primary peer group for executives as not-for-profit health care organizations similar in size, structure, and complexity. This group will include leading pediatric health systems as well as integrated health systems and academic medical centers. - Data will be compiled in a manner consistent with the IRS Intermediate Sanctions rules of federal tax law, to reflect what is "ordinarily paid to like executives by like enterprises under like circumstances." - In certain circumstances, market data from additional comparator groups (e.g., research institutions, insurance industry, and general industry companies) may also be referenced. - The specific nature of the role at CHST will be considered when adding comparator groups outside of the primary peer group, and the Committee will discuss and agree on the appropriateness of adding comparator groups whenever the specific nature of the CHST role requires additional comparator groups to be used.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planSavings Restoration Plan: Ray Tsai participated in the Savings Restoration Plan and received $8,306 of taxable income during 2020. Executive Defined Contribution Retirement Plan (EDCRP): Employees who received taxable income from the EDCRP include: Ray Tsai - $177,802, David Berry - $182,830, and Peter Perialas- $145,975. Employees who participated in and have contributions to the EDCRP include: Ray Tsai - $125,223, Peter Perialas - $219,946, Lisa Frenkel - $30,946, and David Berry - $197,030.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 15 PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL AND OFFICERSCertain individuals identified herein as Officers of the corporation are employed and compensated by a related organization, Children's Health System of Texas (CHST). The Individuals perform services for the corporation, and in some cases other related organizations, by arrangement between CHST and such organization(s). As set forth in the Schedule R, the corporation and the CHST are related organizations. In their duties as Officers of the corporation they have no influence over the compensation process performed by CHST, which is explained in Schedule J, Part I, Line 3.
Form 990, Part VI, Line 8b CommitteesChildren'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 personsDavid Berry and Lisa Frenkel - Business relationship, David Berry and Peter Perialas - Business relationship, Lisa Frenkel, Michael Brad Tate, and Ray Tsai - Business relationship, Peter Perialas and Ray Tsai - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholdersChildren's Health System of Texas (CHST) is the sole member.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyDirectors are appointed by the member and approved by the current DPMSC Board of Directors.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersMember reserve powers are specified in DPMSC's Bylaws and represent actions by the organization which require member approval. These powers generally encompass changes in the mission of the organization, addition of new members, certain dispositions of assets, amendments to the organization's Certificate of Formation and Bylaws, and appointment of directors.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyA draft of the Form 990 is presented to the CHST Audit Committee for review. A copy of the Form 990 is made available to the directors of the organization's parent corporation, Children's Health System of Texas, through our Board portal before it is filed.
Form 990, Part VI, Line 12c Conflict of interest policyOfficers, directors, and key employees receive annually a copy of the Children's Health Statement of Interest form to complete. Disclosures made are reviewed by the CHST Legal Department and the Chief Compliance Officer, who are authorized under the Children's Health Conflict of Interest Policy to make determinations under the Policy regarding persons who are medical staff members or employees of Children's Health and its affiliates. Disclosures made by senior officers (as defined in the Policy) are reviewed by the Compliance Officer, the Chief Legal Officer, and CHST's President and Chief Executive Officer to determine if a conflict exists. Disclosures made by directors of CHST and its affiliates, as well as by the President and Chief Executive Officer of CHST, are discussed as necessary with the appropriate delegated Board Committee and, if required pursuant to the Policy, by the appropriate Board of Directors at meetings to determine if further action is needed. A Statement of Interest must be completed annually and Board members are requested to report changes if they occur. A Committee or Board member with a potential conflict is prohibited from participating in deliberations regarding the transaction in question and will recuse themselves from voting.
Form 990, Part VI, Line 19 Required documents available to the publicIRC section 6104 does not require disclosure of the financial statements, conflict of interest policy and governing documents. The Certificate of Formation, Consolidated Financial Statements, and the conflict of interest policy are made available upon request.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Children's Health Clinical Operations
1935 MEDICAL DISTRICT DRIVEDALLASTX75235750800628HospitalTX501(c)(3)3CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S MEDICAL CENTER FOUNDATION
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752062015FOUNDATIONTX501(c)(3)7CHILDREN'S HEALTH SYSTEM OF TEXASfalse
PHYSICIANS FOR CHILDREN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752854505PHYSICIANSTX501(c)(3)3CHILDREN'S HEALTH SYSTEM OF TEXASfalse
COMPLEX CARE MED SVC CORP
1935 MEDICAL DISTRICT DRIVEDALLASTX75235461893597MEDICAL SERVICESTX501(c)(3)3CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S MEDICAL CENTER HEALTH PLAN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235462737696HMOTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S MED CTR RESEARCH INST AT UTSWMC
1935 MEDICAL DISTRICT DRIVEDALLASTX75235453462044RESEARCH INSTITUTETX501(c)(3)Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
PEDIATRIC PARTNERS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235461917702CLINICALLY INTEGRATED NETWORKTX501(c)(3)Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
ANESTHESIOLOGISTS FOR CHILDREN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752917570PHYSICIANSTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse
PHYSICIANS QUALITY ALLIANCE OF NORTH TEXAS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235464049491PHYSICIANSTX501(c)(3)Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
SOUTHWESTERN MEDICAL DISTRICT
1935 MEDICAL DISTRICT DRIVEDALLASTX75235204101612MEDICAL DISTRICTTX501(c)(3)Type INAfalse
WOMEN'S AUXILIARY TO THE CHILDREN'S MEDICAL CENTER
2777 N STEMMONS FWY 700DALLASTX75207752485538WOMEN'S AUXILIARYTX501(c)(3)10CHILDREN'S MEDICAL CENTER FOUNDATIONfalse
OCH Holdings
1935 Medical District DriveDallasTX75235474837308HospitalTX501(c)(3)3Children's Health Clinical Operationsfalse
CHILDREN'S HEALTH SYSTEM OF TEXAS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752062019MANAGEMENT COMPANYTX501(c)(3)Type IINAfalse
Bradford Memorial Hospital for Babies
1935 MEDICAL DISTRICT DRIVEDALLASTX75235756067819HospitalTX501(c)(3)3CHILDREN'S HEALTH SYSTEM OF TEXASfalse
The Children's Hospital of Texas
1935 MEDICAL DISTRICT DRIVEDALLASTX75235756081004HospitalTX501(c)(3)3CHILDREN'S HEALTH SYSTEM OF TEXASfalse
Richmond Freeman Memorial Clinic
1935 MEDICAL DISTRICT DRIVEDALLASTX75235237079698HospitalTX501(c)(3)3CHILDREN'S HEALTH SYSTEM OF TEXASfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
ALTERNATIVE CARE SYSTEMS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752244475OTHER MEDICAL SERVICESTXNAC Corporationfalse
NTPSS INC
1935 MEDICAL DISTRICT DRIVEDALLASTX75235471036641PHYSICIAN SOLUTIONSTXNAC Corporationfalse
Texas Bluebonnet Insurance Company
1935 Medical District DriveDallasTX75235475032893Insurance CompanyTXNAC Corporationfalse
Texas Trinity River Assurance Company
981318151Self-insuranceNAC CorporationfalseCJ
Children's Health
1935 Medical District DriveDallasTX75235833809987Other Medical ServicesTXNAC Corporationfalse
CHST Physician Group 1
1935 Medical District DriveDallasTX75235813582843PhysicianTXNAC Corporationfalse
CHFH Inc
1935 Medical District DriveDallasTX75235831336111Other Medical ServicesTXNAC Corporationfalse
Children's Health Care Network
1935 Medical District DriveDallasTX75235834560427Other Medical ServicesTXNAC Corporationfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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