COMPLEX CARE MEDICAL SERVICES CORPORATION: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- COMPLEX CARE MEDICAL SERVICES CORPORATION (EIN 46-1893597)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-15
- IRS object ID
- 201903199349302970
- Schema version
- 2018v3.1
- 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 | 2019-11-15T08:32:17-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 N St Paul Suite 850 | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 461893597 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Complex Care Medical Services Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMP | BusinessNameControlTxt |
| Phone | 2144567000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1935 MEDICAL DISTRICT DRIVE | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75235 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jeremiah Radandt | PersonNm |
| Person Title | EVP Finance & CFO | PersonTitleTxt |
| Signature | 2019-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Rachel Spulock | PreparerPersonNm |
| PTIN | P00520729 | PTIN |
| Phone | 2147775200 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ray Tsai MD | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1935 MEDICAL DISTRICT DRIVE | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75235 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,104,515 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | TO SERVE AS THE MEDICAL HOME FOR CHILDREN WITH COMPLEX MEDICAL ILLNESSES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 20 | TotalEmployeeCnt |
| Total Volunteers | 3 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $280 | PYContributionsGrantsAmt |
| CY Contributions Grants | $20,203 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $735,672 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,084,312 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $735,952 | PYTotalRevenueAmt |
| CY Total Revenue | $1,104,515 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,429,731 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,671,057 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,235,621 | PYOtherExpensesAmt |
| CY Other Expenses | $1,678,874 | CYOtherExpensesAmt |
| PY Total Expenses | $3,665,352 | PYTotalExpensesAmt |
| CY Total Expenses | $3,349,931 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,929,400 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,245,416 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,641,942 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,554,155 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,783,371 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,331,680 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$8,141,429 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$10,777,525 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO SERVE AS THE MEDICAL HOME FOR CHILDREN WITH COMPLEX MEDICAL ILLNESSES WHERE A MULTI-DISCIPLINARY TEAM OF CARE GIVERS OVERSEE AND COORDINATE THEIR CARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,817,573 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,084,312 | RevenueAmt |
| Desc | TO SERVE AS THE MEDICAL HOME FOR CHILDREN WITH COMPLEX MEDICAL ILLNESSES WHERE A MULTI-DISCIPLINARY TEAM OF CARE GIVERS OVERSEE AND COORDINATE THEIR CARE. | Desc |
| Total Program Service Expenses | $1,817,573 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| 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 | Yes (true) | 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 | false | 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 20 | 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 | Yes (true) | 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 | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | 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 | false | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHANIE K SMITH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2144567000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1935 MEDICAL DISTRICT DRIVE | AddressLine1Txt |
| City | DALLAS | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75235 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| William R Morrow MD | ||||||||
| Director and President (until 7/21/2018) | 1.0 | 54.0 | Yes (X) | Yes (X) | $0 | $2,248,262 | $115,677 | |
| John Andersen MD | ||||||||
| Director | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Andrew Gelfand MD | ||||||||
| Director | 1.0 | 13.0 | Yes (X) | $0 | $36,745 | $0 | ||
| William Scott MD | ||||||||
| Director | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Michelle Thomas MD | ||||||||
| Chair | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| Ray Tsai MD | ||||||||
| President (CHST SVP Ops) | 1.0 | 54.0 | Yes (X) | $0 | $684,614 | $155,384 | ||
| Tammie L Sibley | ||||||||
| Treasurer (CHST SVP Finance) | 1.0 | 49.0 | Yes (X) | $0 | $347,144 | $63,065 | ||
| Lisa M Frenkel | ||||||||
| Secretary | 1.0 | 49.0 | Yes (X) | $0 | $275,033 | $5,732 | ||
| Jerry D Lee | ||||||||
| Treasurer (until 4/13/2018) | 1.0 | 49.0 | Yes (X) | $0 | $906,965 | $37,689 | ||
| Stephanie K Smith | ||||||||
| Former Corporate Secretary | 0.0 | 40.0 | $0 | $162,833 | $4,591 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,661,596 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $382,138 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UTSW | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | HI 108 5323 Harry Hines Blvd | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 753908886 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Phys & Medical Services | ServicesDesc |
| Compensation | $1,570,649 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $20,203 | RelatedOrganizationsAmt |
| Total Contributions | $20,203 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Revenue | 621110 | $1,066,783 | $1,066,783 |
| Other Medical Service Revenue | 621110 | $17,529 | $17,529 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,084,312 | TotalProgramServiceRevenueAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,104,515 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,084,312 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,303,843 | TotalAmt |
| Program Services | $666,592 | ProgramServicesAmt |
| Management And General | $637,251 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,502 | TotalAmt |
| Program Services | $39,623 | ProgramServicesAmt |
| Management And General | $37,879 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,059 | TotalAmt |
| Program Services | $98,635 | ProgramServicesAmt |
| Management And General | $94,424 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,653 | TotalAmt |
| Program Services | $49,414 | ProgramServicesAmt |
| Management And General | $47,239 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $694,615 | TotalAmt |
| Program Services | $694,259 | ProgramServicesAmt |
| Management And General | $356 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,416 | TotalAmt |
| Program Services | $7,186 | ProgramServicesAmt |
| Management And General | $3,230 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28 | TotalAmt |
| Management And General | $28 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,232 | TotalAmt |
| Program Services | $73,715 | ProgramServicesAmt |
| Management And General | $78,517 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $459 | TotalAmt |
| Management And General | $459 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,670 | TotalAmt |
| Program Services | $1,972 | ProgramServicesAmt |
| Management And General | $1,698 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,767 | TotalAmt |
| Program Services | $114,767 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| Shared Services | $627,455 | $627,455 | |
| Dietary and Food Costs | $41,505 | $2,704 | $38,801 |
| Medical Surgical Supplies | $22,949 | $22,949 | |
| Provision for Doubtful Accounts | $498 | $498 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,280 | TotalAmt |
| Program Services | $9,162 | ProgramServicesAmt |
| Management And General | $1,118 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,349,931 | TotalAmt |
| Program Services | $1,817,573 | ProgramServicesAmt |
| Management And General | $1,532,358 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,828 | BOYAmt |
| EOY | $37,807 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,969,678 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $453,330 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,631,114 | BOYAmt |
| EOY | $1,516,348 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,641,942 | BOYAmt |
| EOY | $1,554,155 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,329,958 | BOYAmt |
| EOY | $417,071 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,453,413 | BOYAmt |
| EOY | $11,914,609 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,783,371 | BOYAmt |
| EOY | $12,331,680 | EOYAmt |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$8,141,429 | BOYAmt |
| EOY | -$10,777,525 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$8,141,429 | BOYAmt |
| EOY | -$10,777,525 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,641,942 | BOYAmt |
| EOY | $1,554,155 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,245,416 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$390,680 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,833,316 | OtherCostOrOtherBasisAmt |
| Depreciation | $374,071 | DepreciationAmt |
| Book Value | $1,459,245 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $136,362 | OtherCostOrOtherBasisAmt |
| Depreciation | $79,259 | DepreciationAmt |
| Book Value | $57,103 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,516,348 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| LT Advances - Affiliates | $11,869,445 |
| LT Deferred Rent | $45,164 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,914,609 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | 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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| William R Morrow MD | ||||||||||||||
| Director and President (until 7/21/2018) | $0 | $327,078 | $0 | $471,289 | $0 | $1,449,895 | $0 | $110,636 | $0 | $5,041 | $0 | $2,363,939 | $0 | $0 |
| Stephanie K Smith | ||||||||||||||
| Former Corporate Secretary | $0 | $128,098 | $0 | $14,598 | $0 | $20,137 | $0 | $0 | $0 | $4,591 | $0 | $167,424 | $0 | $0 |
| Ray Tsai MD | ||||||||||||||
| President (CHST SVP Ops) | $0 | $385,115 | $0 | $240,355 | $0 | $59,144 | $0 | $138,665 | $0 | $16,720 | $0 | $839,998 | $0 | $0 |
| Tammie L Sibley | ||||||||||||||
| Treasurer (CHST SVP Finance) | $0 | $277,938 | $0 | $67,464 | $0 | $1,742 | $0 | $52,448 | $0 | $10,616 | $0 | $410,209 | $0 | $0 |
| Lisa M Frenkel | ||||||||||||||
| Secretary | $0 | $228,264 | $0 | $42,092 | $0 | $4,677 | $0 | $0 | $0 | $5,732 | $0 | $280,765 | $0 | $0 |
| Jerry D Lee | ||||||||||||||
| Treasurer (until 4/13/2018) | $0 | $85,821 | $0 | $111,213 | $0 | $709,931 | $0 | $31,756 | $0 | $5,933 | $0 | $944,655 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | CHILDREN'S HEALTH SYSTEM OF TEXAS (EIN 75-2062019) IS THE SOLE MEMBER AND COMMON PAYING AGENT FOR COMPLEX CARE MEDICAL SERVICES CORPORATION (CCMSC). THEREFORE, CCMSC'S TOP MANAGEMENT OFFICIAL, THE PRESIDENT, IS COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). The CHST process for determining the CCMSC President's compensation is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for the CCMSC President. 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. When appropriate, an independent compensation consultant may be engaged. COMPENSATION PROGRAM COMPONENTS: The elements of total compensation provided to the CCMSC President includes: - 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 the CCMSC President 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 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 - William Morrow received $12,299 as taxable income from the Savings Restoration Plan. Jerry Lee received $13,682 as taxable income from the Savings Restoration Plan. Employees who participated in the Savings Restoration Plan include Ray Tsai. *Children's Health Executive Defined Contribution Retirement Plan (EDCRP). William Morrow received $503,367 as taxable income from the EDCRP. Jerry Lee received $177,633 as taxable income from the EDCRP. Ray Tsai received $55,523 as taxable income from the EDCRP. Employees who received compensation reported as deferred in column C from the EDCRP include: William Morrow - $99,636, Ray Tsai - $120,550, Tammie Sibley - $41,448, Jerry Lee - $18,351. |
| 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. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part V, Line 2a | CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST) EIN 75-2062019 IS THE COMMON PAYING AGENT FOR COMPLEX CARE MEDICAL SERVICES CORPORATION (CCMSC) THEREFORE, ALL APPLICABLE IRS TAX COMPLIANCE FILINGS ARE REPORTED BY CHST ON BEHALF OF CCMSC. CCMSC HAS APPROXIMATELY 20 EMPLOYEES. |
| Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL | CHILDREN'S HEALTH SYSTEM OF TEXAS (EIN 75-2062019) IS THE SOLE MEMBER AND COMMON PAYING AGENT FOR COMPLEX CARE MEDICAL SERVICES CORPORATION (CCMSC). THEREFORE, CCMSC'S TOP MANAGEMENT OFFICIAL IS EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). Compensation setting takes place at the related entity 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 15b PROCESS TO ESTABLISH COMPENSATION OF OFFICERS AND OTHER KEY EMPLOYEES | Line 15b is answered no in accordance with the IRS Form 990 instructions because salary is paid and determined by a related party, Children's Health System of Texas (CHST). CHST is the sole member and officers are employed and paid by CHST. |
| 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 CCMSC 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. 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 | Complex Care Medical Services Corporation 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. |
| Form 990, Part IX, Line 11g Other Fees | Contract Medical - Total Expense: 691900, Program Service Expense: 691544, Management and General Expenses: 356, Fundraising Expenses: ; Consulting Fees - Total Expense: 2715, Program Service Expense: 2715, Management and General Expenses: , Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Company Terminations - -390680; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (19 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 | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | |
| Anesthesiologists for Children | |||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 752917570 | PHYSICIANS | TX | 501(c)(3) | 10 | CHILDREN'S HEALTH SYSTEM OF TEXAS | false | |
| Dallas Physician Medical Services for Childrens | |||||||||||
| 1935 MEDICAL DISTRICT DRIVE | DALLAS | TX | 75235 | 810584868 | PHYSICIANS | TX | 501(c)(3) | 3 | 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 | |
| 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 | false | N/A | |
| 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 | false | N/A | |
| WOMEN'S AUXILIARY OF CMCD | |||||||||||
| 12720 HILLCREST RD | DALLAS | TX | 75230 | 752485538 | WOMEN'S AUXILIARY | TX | 501(c)(3) | 10 | false | N/A | |
| 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 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wellness Innovations LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1935 Medical District Drive | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75235 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 475246461 | EIN |
| Primary Activities | Physicians | PrimaryActivitiesTxt |
| Legal Domicile State | TX | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHST Investment Holdings LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | Unrelated | PredominantIncomeTypeTxt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
| Ownership | 0 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | Address Line2ForeignAddress/AddressLine2Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | ||||||||||||||||
| 981318151 | Self-insurance | NA | C Corporation | false | 878 West Bay Road | PO Box 1159 | Grand Cayman | Grand Cayman | CJ | KY11202 | CJ | |||||
| 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 | |||||||
| 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 | Yes (true) | 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 | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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