2019-11-15T08:01:32-06:00 2018-12-31 350921680 CROWE LLP 750 N St Paul Suite 850 Dallas TX 75201 990 2018-01-01 752917570 Anesthesiologists for Children ANES 2144567000 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 Jeremiah Radandt EVP Finance & CFO 2019-11-15 true Rachel Spurlock P00520729 2147775200 2018 2020-03-31 21:24:44Z Stephen Kimatian MD 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 33115530 false X N/A X 2000 TX PROVIDE ANESTHESIA SERVICES TO PATIENTS AT CHILDREN'S MEDICAL CENTER OF DALLAS 5 4 45 4 0 0 15029 1632 37763381 33113898 0 0 403116 0 38181526 33115530 0 0 0 32739957 32409767 0 0 0 3558773 5371796 36298730 37781563 1882796 -4666033 12069832 6290041 7369407 6255649 4700425 34392 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 34599855 0 33113898 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. 34599855 true false false false false false false false false false false false true false false 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 18 0 true 45 true false false false false false false true 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 Stephanie K Smith 2144567000 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 Stephen Kimatian MD Chair & President 1.0 0 X X 0 0 0 Stephen Q Hoang MD Director & Anesthesiologist 40.0 0 X 489066 0 25939 Ron Mitchell MD Director & Anesthesiologist 1.0 0 X 0 0 0 Maeve Sheehan MD Director & Anesthesiologist 1.0 0 X 0 0 0 Charles Whitten MD Director & Anesthesiologist 1.0 0 X 0 0 0 Nancy Rollins MD Director & Anesthesiologist (until 2/7/2018) 1.0 0 X 0 0 0 Tammie L Sibley Treasurer (CHST SVP Finance) 1.0 49.0 X 0 347144 63065 Lisa M Frenkel Secretary 1.0 49.0 X 0 275033 5732 Jerry D Lee Treasurer (until 4/13/2018) 1.0 49.0 X 0 906965 37689 David T Bui Anesthesiologist 40.0 0 X 535279 0 8548 Cynthia R Gonzales Anesthesiologist 40.0 0 X 485805 0 11125 Amy Hogge Anesthesiologist 40.0 0 X 501248 0 6348 Gary R Turner Anesthesiologist 40.0 0 X 483895 0 11970 Weiwei Boone Anesthesiologist 40.0 0 X 489703 0 35954 Stephanie K Smith Former Corporate Secretary 0.0 40.0 X 0 162833 4591 2984995 1691975 210961 37 true true false UTSW HI 108 5323 Harry Hines Blvd Dallas TX 753908886 Phys & Medical Svcs 22608131 MEDAC INC 804 SCOTT NIXON MEMORIAL DR AUGUSTA GA 30907 BILLING & PRAC. MGMT 901912 AEGIS ANESTHESIA ASSOCIATES 1900 ENCHANTED WAY 100 Grapevine TX 76051 Medical Services 178903 3 1632 1632 PROFESSIONAL SVC REV 621110 17958211 17958211 Medicaid Subsidy Revenue 621110 14496277 14496277 Chief Stipend Revenue 621110 315000 315000 Other Medical Services Revenue 621110 344410 344410 0 0 0 0 33113898 0 0 0 0 0 0 0 0 0 33115530 33113898 0 0 515005 515005 30628786 30013363 615423 423671 415299 8372 563301 552532 10769 279004 273491 5513 196767 196767 0 0 778099 774792 3307 15625 15625 913 750 163 11314 11314 122484 118782 3702 219702 219702 Shared Services 2487800 2487800 Bad Debt Expense 1485322 1485322 Collection Fees 43002 43002 Dietary and Food Costs 10768 7111 3657 0 0 0 0 37781563 34599855 3181708 0 2009945 1395815 0 0 0 0 5625 0 0 0 0 0 0 10054262 4894226 12069832 6290041 7369407 6255649 0 0 0 0 7369407 6255649 4700425 34392 4700425 34392 12069832 6290041 -4666033 0 X false true X true false X 48082 7436 4739 15029 1632 76918 29378156 35431960 34722026 38166497 33113898 170812537 0 0 0 29426238 35439396 34726765 38181526 33115530 170889455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170889455 12897 5606 0 0 0 18503 0 12897 5606 0 0 0 18503 0 0 0 0 0 0 0 29439135 35445002 34726765 38181526 33115530 170907958 0.9999 0.9998 0.0001 0.0002 X LT Advances - Affiliates 4894226 4894226 true true false false false false false true false Stephen Q Hoang MD Director & Anesthesiologist 479436 0 0 0 9630 0 18500 0 7439 0 515005 0 0 0 Stephanie K Smith Former Corporate Secretary 0 128098 0 14598 0 20137 0 0 0 4591 0 167424 0 0 Tammie L Sibley Treasurer (CHST SVP Finance) 0 277938 0 67464 0 1742 0 52448 0 10616 0 410209 0 0 Lisa M Frenkel Secretary 0 228264 0 42092 0 4677 0 0 0 5732 0 280765 0 0 Jerry D Lee Treasurer (until 4/13/2018) 0 85821 0 111213 0 709931 0 31756 0 5933 0 944655 0 0 David T Bui Anesthesiologist 478327 0 0 0 56953 0 0 0 8548 0 543828 0 0 0 Cynthia R Gonzales Anesthesiologist 475750 0 1000 0 9055 0 0 0 11125 0 496929 0 0 0 Amy Hogge Anesthesiologist 480527 0 0 0 20720 0 0 0 6348 0 507595 0 0 0 Gary R Turner Anesthesiologist 474904 0 0 0 8990 0 0 0 11970 0 495865 0 0 0 Weiwei Boone Anesthesiologist 469421 0 0 0 20282 0 18500 0 17454 0 525657 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 Severance Payment: *Severance - Jerry Lee - $475,800. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Non-Qualified Retirement Plan: * Children's Health Savings Restoration Plan - Jerry Lee received $13,682 as taxable income from the Savings Restoration Plan. *Children's Health Executive Defined Contribution Retirement Plan (EDCRP) - Jerry Lee received $177,633 as taxable income from the EDCRP. Employees who received compensation reported as deferred in column C from the EDCRP include: Jerry Lee - $18,351, Tammie Sibley - $41,448. Schedule J, Part I, Line 7 Non-fixed payments Non-Fixed Payments - The Human Resources Committee of the Board of Directors of Children's Health System of Texas retains the authority to adjust annual payout percentages solely at their discretion. There were no non-fixed payments in 2018. 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 CHILDREN'S HEALTH SYSTEM OF TEXAS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752062019 MANAGEMENT COMPANY TX 501(c)(3) Type II N/A false OCH Holdings 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 474837308 Hospital TX 501(c)(3) 3 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 N/A false WOMEN'S AUXILIARY OF CMCD 12720 HILLCREST RD DALLAS TX 75230 752485538 WOMEN'S AUXILIARY TX 501(c)(3) 10 N/A false CHST Physician Group 1 1935 Medical District Drive Dallas TX 75235 813582843 Physician TX 501(c)(3) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS 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 Wellness Innovations LLC 1935 Medical District Drive Dallas TX 75235 475246461 Physicians TX CHST Investment Holdings LLC Unrelated false false 0 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 LTD 878 West Bay Road PO Box 1159 Grand Cayman Grand Cayman CJ KY11202 981318151 Self-insurance CJ NA C Corporation false Wellness Innovations Physician Partners 1935 Medical District Drive Dallas TX 75235 811734937 Physicians TX NA C Corporation false Children's Health 1935 Medical District Drive Dallas TX 75235 833809987 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