2020-11-16T08:01:45-06:00 2019-12-31 350921680 CROWE LLP 750 N St Paul Suite 850 Dallas TX 75201 990 2019-01-01 752917570 Anesthesiologists for Children ANES 2144567000 1935 Medical District Drive Dallas TX 75235 Robert Fries Senior Vice President, Finance 2020-11-16 true Rachel Spurlock P00520729 2147775200 2019 2021-01-29 14:40:06Z Stephen Kimatian MD 1935 Medical District Drive Dallas TX 75235 36709154 false X N/A X 2000 TX PROVIDE ANESTHESIA SERVICES TO PATIENTS AT CHILDREN'S MEDICAL CENTER OF DALLAS 5 4 79 4 0 0 1632 9630 33113898 36699524 0 0 0 0 33115530 36709154 0 0 0 32409767 37625498 0 0 0 5371796 4565246 37781563 42190744 -4666033 -5481590 6290041 2445240 6255649 7892438 34392 -5447198 PROVIDE ANESTHESIA SERVICES TO PATIENTS AT CHILDREN'S MEDICAL CENTER OF DALLAS. THESE SERVICES ARE PROVIDED WITHOUT REGARD TO PATIENT'S ABILITY TO PAY FOR THE SERVICES. false false 38266817 0 36699524 PROVIDE ANESTHESIA SERVICES TO PATIENTS AT CHILDREN'S MEDICAL CENTER OF DALLAS. THESE SERVICES ARE PROVIDED WITHOUT REGARD TO PATIENT'S ABILITY TO PAY FOR THE SERVICES. 38266817 true true false false false false false false false false false false true false true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 17 0 true 79 true false false false false false false false false false false false false X 5 4 false false false false true true true true true false false false true true true true true false false false X Amy Yeager 2144567000 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 Stephen Kimatian MD Chair & President 55.0 0 X X 0 0 0 Charles Whitten MD Director & Anesthesiologist 1.0 0 X 0 0 0 Maeve Sheehan MD Director & Anesthesiologist 1.0 0 X 0 0 0 Ron Mitchell MD Director & Anesthesiologist 1.0 0 X 0 0 0 Stephen Q Hoang MD Director & Anesthesiologist 40.0 0 X 493806 0 25384 Lisa M Frenkel Secretary 1.0 5.0 X 0 318389 6579 Tammie L Sibley Treasurer (CHST SVP Finance) (Until 11/6/19) 1.0 49.0 X 0 1152385 67689 Amy Hogge Anesthesiologist 40.0 0 X 510119 0 21411 David T Bui Anesthesiologist 40.0 0 X 542240 0 19770 Gary R Turner Anesthesiologist 40.0 0 X 541969 0 29203 Hadi Sakhai Anesthesiologist 40.0 0 X 505999 0 35654 Weiwei Boone Anesthesiologist 40.0 0 X 497056 0 32162 Stephanie K Smith Former Corporate Secretary 0.0 40.0 X 0 154475 4593 3091189 1625249 242445 48 true true false UTSW HI 108 5323 Harry Hines Blvd Dallas TX 753908886 Phys & Medical Svcs 17349230 MEDAC INC 804 SCOTT NIXON MEMORIAL DR AUGUSTA GA 30907 BILLING & PRAC. MGMT 2665488 2 9630 9630 PROFESSIONAL SVC REV 621110 22446845 22446845 Medicaid Subsidy Revenue 621110 13377955 13377955 Chief Stipend Revenue 621110 377500 377500 Other Medical Services Revenue 621110 497224 497224 0 0 0 0 36699524 0 0 0 0 0 0 0 0 0 36709154 36699524 0 0 519190 519190 34827949 34359300 468649 593885 572542 21343 982043 907282 74761 702431 668468 33963 219097 219097 0 0 627175 627175 47353 47353 9146 8640 506 1968 1631 337 106844 104336 2508 220000 220000 Shared Services 3299551 3299551 Collection Fees 22270 22270 Dietary and Food Costs 8333 8333 Miscellaneous expenses 3509 3470 39 0 0 0 0 42190744 38266817 3923927 0 1395815 1898845 0 0 0 0 0 0 0 0 0 0 4894226 546395 6290041 2445240 6255649 7892438 0 0 0 0 6255649 7892438 34392 -5447198 34392 -5447198 6290041 2445240 -5481590 0 X false true X true false X 7436 4739 15029 1632 9630 38466 35431960 34722026 38166497 33113898 38522347 179956728 0 0 0 35439396 34726765 38181526 33115530 38531977 179995194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179995194 5606 0 0 0 0 5606 0 5606 0 0 0 0 5606 0 0 0 0 0 0 0 35445002 34726765 38181526 33115530 38531977 180000800 1.0000 0.9999 0.0000 0.0001 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED LT Advances - Affiliates 546395 546395 LT ADVANCES-AFC LT RECEIVABLE/PAYABLE-CMC 0 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Anesthesiologist 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, 2019, 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 2016 through 2019 in Children's Health main taxing jurisdictions." true true false false false false false false false Stephen Q Hoang MD Director & Anesthesiologist 457014 0 0 0 36792 0 18599 0 6785 0 519190 0 0 0 Stephanie K Smith Former Corporate Secretary 0 132475 0 20759 0 1241 0 0 0 4593 0 159068 0 0 Lisa M Frenkel Secretary 0 257119 0 51226 0 10044 0 0 0 6579 0 324968 0 0 Tammie L Sibley Treasurer (CHST SVP Finance) (Until 11/6/19) 0 272798 0 257450 0 622137 0 54936 0 12753 0 1220074 0 0 Weiwei Boone Anesthesiologist 450637 0 0 0 46419 0 19000 0 13162 0 529218 0 0 0 David T Bui Anesthesiologist 456028 0 0 0 86212 0 12000 0 7770 0 562010 0 0 0 Amy Hogge Anesthesiologist 461387 0 0 0 48732 0 19000 0 2411 0 531530 0 0 0 Hadi Sakhai Anesthesiologist 446145 0 0 0 59854 0 18000 0 17654 0 541653 0 0 0 Gary R Turner Anesthesiologist 451396 0 0 0 90573 0 16800 0 12403 0 571172 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The top management official is neither an employee of nor compensated by Anesthesiologists for Children (AFC). Rather, the top management official is an employee of the University of Texas Southwestern Medical Center (UTSWMC). UTSWMC IS NOT A RELATED ORGANIZATION OF AFC. THEREFORE, THERE IS NO COMPENSATION REPORTED for the Top management official on AFC's Form 990. Schedule J, Part I, Line 4a Severance or change-of-control payment Tammie Sibley - $472,500. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Executive Defined Contribution Retirement Plan (EDCRP): Employees who received taxable income from the EDCRP include: Tammie Sibley - $119,039. Employees who participated in and have contributions to the EDCRP include: Tammie Sibley - $44,538. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL The top management official is neither an employee of nor compensated by Anesthesiologists for Children (AFC). Rather, the top management official is an employee of the University of Texas Southwestern Medical Center (UTSWMC). UTSWMC IS NOT A RELATED ORGANIZATION OF AFC. THEREFORE, THERE IS NO COMPENSATION REPORTED FOR the top management official. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OFFICERS CHILDREN'S HEALTH SYSTEM OF TEXAS IS THE SOLE MEMBER FOR ANESTHESIOLOGISTS FOR CHILDREN (AFC). THEREFORE, AFC'S Officers, other than the top management official, AND KEY EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). Form 990, Part VI, Line 8b Committees Children's Health System of Texas has established seven standing Committees of the Board, which have the authority to act for and on behalf of CHST, Children's Health Clinical Operations, Children's Medical Center Foundation, and their affiliates, operating divisions and division facilities to fulfill the responsibilities designated in the respective Committee charters. Written minutes are prepared and maintained for all formal meetings of each Committee. Actions by Written Consent are also prepared and maintained as they occur. Form 990, Part VI, Line 6 Classes of members or stockholders Children's Health System of Texas (CHST) is the sole member. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Directors are appointed by the sole member and approved by the current AFC Board of Directors. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Member reserve powers are specified in the organization's bylaws and represent those actions by the organization which require member approval to be effective. These powers generally encompass changes in the mission of the organization, addition of new members, certain dispositions of assets, amendments to the organization's Certificate of Formation and Bylaws, and appointment of directors. Form 990, Part VI, Line 11b Review of form 990 by governing body Anesthesiologist for Children has delegated its oversight and review of the Form 990 to the Board of Directors of Children's Health System of Texas (CHST), its Sole Member. A draft of the Form 990 is presented to the CHST Audit Committee for review prior to filing. A copy of the Final Form 990 is made available to the CHST directors through our Board portal before it is filed. Form 990, Part VI, Line 12c Conflict of interest policy Officers, directors, and key employees receive annually a copy of the Children's Health Statement of Interest form to complete. Disclosures made are reviewed by the CHST Legal Department and the Chief Compliance Officer, who are authorized under the Children's Health Conflict of Interest Policy to make determinations under the Policy regarding persons who are medical staff members or employees of Children's Health and its affiliates. Disclosures made by senior officers (as defined in the Policy) are reviewed by the Compliance Officer, the Chief Legal Officer, and CHST's President and Chief Executive Officer to determine if a conflict exists. Disclosures made by directors of CHST and its affiliates, as well as by the President and Chief Executive Officer of CHST, are discussed as necessary with the appropriate delegated Board Committee and, if required pursuant to the Policy, by the appropriate Board of Directors at meetings to determine if further action is needed. A Statement of Interest must be completed annually and Board members are requested to report changes if they occur. A Committee or Board member with a potential conflict is prohibited from participating in deliberations regarding the transaction in question and will recuse themselves from voting. Form 990, Part VI, Line 19 Required documents available to the public IRC section 6104 does not require disclosure of the financial statements, conflict of interest policy and governing documents. The Certificate of Formation, Consolidated Financial Statements, and the conflict of interest policy are made available upon request. Children's Health Clinical Operations 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 750800628 Hospital TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S MEDICAL CENTER FOUNDATION 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752062015 FOUNDATION TX 501(c)(3) 7 CHILDREN'S HEALTH SYSTEM OF TEXAS false PHYSICIANS FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752854505 PHYSICIANS TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false DALLAS PHYS MED SVCS FOR CHILDREN INC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 810584868 PHYSICIANS TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false COMPLEX CARE MED SVC CORP 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 461893597 MEDICAL SERVICES TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S MEDICAL CENTER HEALTH PLAN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 462737696 HMO TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S MED CTR RESEARCH INST AT UTSWMC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 453462044 RESEARCH INSTITUTE TX 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false PEDIATRIC PARTNERS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 461917702 CLINICALLY INTEGRATED NETWORK TX 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false PHYSICIANS QUALITY ALLIANCE OF NORTH TEXAS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 464049491 PHYSICIANS TX 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false SOUTHWESTERN MEDICAL DISTRICT 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 204101612 MEDICAL DISTRICT TX 501(c)(3) Type I NA false WOMEN'S AUXILIARY TO THE CHILDREN'S MEDICAL CENTER 2777 N STEMMONS FWY 700 DALLAS TX 75207 752485538 WOMEN'S AUXILIARY TX 501(c)(3) 10 CHILDREN'S MEDICAL CENTER FOUNDATION false OCH Holdings 1935 Medical District Drive Dallas TX 75235 474837308 Hospital TX 501(c)(3) 3 Children's Health Clinical Operations false CHST Physician Group 2 1935 Medical District Drive Dallas TX 75235 813679995 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHST Physician Group 3 1935 Medical District Drive Dallas TX 75235 813691209 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHST Physician Group 4 1935 Medical District Drive Dallas TX 75235 814577909 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHST Physician Group 5 1935 Medical District Drive Dallas TX 75235 814848085 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHST Physician Group 6 1935 Medical District Drive Dallas TX 75235 814865847 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S HEALTH SYSTEM OF TEXAS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752062019 MANAGEMENT COMPANY TX 501(c)(3) Type II NA false Bradford Memorial Hospital for Babies 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 756067819 Hospital TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false The Children's Hospital of Texas 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 756081004 Hospital TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false Richmond Freeman Memorial Clinic 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 237079698 Hospital TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false Legacy Trail Surgery Center LLC dba Live Oak Surgery Center 7211 Preston Rd Ste 2100 Plano TX 750240258 822278618 Surgery Center TX NA N/A ALTERNATIVE CARE SYSTEMS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752244475 OTHER MEDICAL SERVICES TX NA C Corporation false NTPSS INC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 471036641 PHYSICIAN SOLUTIONS TX NA C Corporation false Texas Bluebonnet Insurance Company 1935 Medical District Drive Dallas TX 75235 475032893 Insurance Company TX NA C Corporation false Texas Trinity River Assurance Company 981318151 Self-insurance CJ NA C Corporation false Children's Health 1935 Medical District Drive Dallas TX 75235 833809987 Other Medical Services TX NA C Corporation false CHST Physician Group 1 1935 Medical District Drive Dallas TX 75235 813582843 Physician TX NA C Corporation false CHFH Inc 1935 Medical District Drive Dallas TX 75235 831336111 Other Medical Services TX NA C Corporation false CHILDREN'S HEALTH CARE NETWORK 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 834560427 OTHER MEDICAL SERVICES TX NA C Corporation false false false true true false false false false false false false true false true true false false false false