2018-03-23T16:44:16-05:00 2017-08-31 752393478 WHITLEY PENN LLP 1400 WEST 7TH STREET STE 400 FT WORTH TX 76102 990 2016-09-01 752655008 UT SOUTHWESTERN MONCRIEF CANCER CENTER UTSO 8172889800 400 W MAGNOLIA AVE FORT WORTH TX 76104 ARNIM E DONTES SECRETARY AND TREASURER 8172889800 2018-03-23 1 CHRISTY CATES P00440503 8172599100 12.0.230.112 2018-03-23 14:12:17 CD P 477C79233C126127AD56878610F88F23DA97249F 477C79233C126127AD56878610F88F23DA97249F 2016 2021-01-29 14:40:06Z MONCRIEF CANCER INSTITUTE ARNIM E DONTES 400 W MAGNOLIA AVE FORT WORTH TX 76104 12473036 0 X WWW.MONCRIEF.COM X 1958 TX TO PROVIDE COUNSELING AND SUPPORT RESOURCES TO CANCER PATIENTS AND THEIR FAMILIES. 3 1 0 0 0 0 9787765 10020995 0 0 53952 50778 1786384 2401263 11628101 12473036 172398 146261 0 0 0 0 0 0 0 13595864 13397590 13768262 13543851 -2140161 -1070815 39979782 38796166 2432553 2216482 37547229 36579684 TO BE A LEADER IN OUR COMMUNITY'S EFFORTS TO FIGHT CANCER AND REDUCE ITS BURDEN THROUGHOUT THE CONTINUUM OF CARE SETTING, USING EDUCATION, AWARENESS, PREVENTION, EARLY DETECTION, BEHAVIORAL AND NUTRITIONAL SCIENCES AND RESEARCH. 0 0 3256621 743 MONCRIEF CANCER INSTITUTE'S BREAST AND CERVICAL CANCER SCREENING PROGRAM OFFERS MAMMOGRAMS, CLINICAL BREAST EXAMS, AND PAP TESTS TO UNDERSERVED/UNINSURED WOMEN. THE PROGRAM HAS A COMPREHENSIVE PATIENT NAVIGATION PROCESS TO ENSURE PATIENTS WITH LIMITED ACCESS ARE ABLE TO OBTAIN THE RECOMMENDED SCREENING. PATIENTS WITH POSITIVE FINDINGS ARE NAVIGATED TO OBTAIN FURTHER STUDIES AND THERAPEUTIC OPTIONS SHOULD THEY BE REQUIRED. MONCRIEF PARTNERS WITH OVER 50 HOSPITALS, CLINICS AND HEALTHCARE PROVIDERS IN MORE THAN 30 COUNTIES ACROSS NORTH TEXAS. IN 2016, THE PROGRAM SERVED OVER 10,000 WOMEN. 2810800 63293 MONCRIEF CANCER INSTITUTE'S SURVIVORSHIP PROGRAM PROVIDES A WIDE RANGE OF SUPPORT SERVICES TO CANCER PATIENTS AND SURVIVORS. THE PROGRAM INCLUDES FREE ONE-ON-ONE EXERCISE SESSIONS, NUTRITION PLANNING TO PROMOTE HEALING, CLINICAL CARE WITH A PHYSICIAN ASSISTANT AND ONCOLOGY NURSE, AND HELP WITH EMOTIONAL AND FINANCIAL CHALLENGES. MONCRIEF'S 18-WHEELER MOBILE CANCER SURVIVOR CLINIC TRAVELS TO NINE COUNTIES IN NORTH TEXAS TO DELIVER FREE SERVICES TO THE RURAL UNDERSERVED. IN 2016, THE PROGRAM ENROLLED 1,139 PATIENTS AND PROVIDED OVER 3,700 MULTIDISCIPLINARY ENCOUNTERS. 1223419 MONCRIEF CANCER INSTITUTE'S COLORECTAL CANCER SCREENING PROGRAM IS AVAILABLE AT NO COST FOR INDIVIDUALS WHO ARE UNDERSERVED/UNINSURED AND MEET THE CLINICAL ELIGIBILITY REQUIREMENTS. PATIENTS ARE MAILED AN AT-HOME COLON CANCER SCREENING TEST. PATIENTS WITH POSITIVE FINDINGS ARE NAVIGATED TO OBTAIN A COLONOSCOPY. MONCRIEF PARTNERS WITH HOSPITALS, CLINICS AND HEALTHCARE PROVIDERS IN MORE THAN 20 COUNTIES ACROSS NORTH TEXAS. IN 2016, OVER 30,000 AT-HOME COLON CANCER SCREENING TESTS WERE MAILED. 1127593 82225 1127593 82225 8418433 1 1 0 0 0 0 0 1 0 1 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 122 0 1 0 0 0 0 0 0 0 0 0 0 0 X 3 1 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X KEITH ARGENBRIGHT MD 8172889898 400 W MAGNOLIA AVE FORT WORTH TX 76104 WILLIS MADDREY MD PRESIDENT AND CHAIRMAN 1.00 40.00 X X 0 594539 52804 ARNIM DONTES SECRETARY AND TREASURER 1.00 40.00 X X 0 736100 41263 KIT MONCRIEF DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL SERBER ASSISTANT TREASURER 1.00 40.00 X 0 502564 39667 KEITH ARGENBRIGHT MD MEDICAL DIRECTOR FOR MCI 1.00 40.00 X 0 392549 39456 0 2225752 173190 0 0 1 0 JPS HEALTH NETWORK 1500 S MAIN ST FORT WORTH TX 76104 MEDICAL SERVICES 519686 ROSE IMAGING SPECIALISTS PA 714 FM 1960 HOUSTON TX 77090 MEDICAL SERVICES 294228 COLUMBIA MEDICAL CENTER OF TEXAS 3535 S INTERSTATE 35 E DENTON TX 76210 MEDICAL SERVICES 153110 MARY STEWART 2416 MEDFORD CT W FORT WORTH TX 76109 CONSULTING SERVICES 117565 GREENBERG TRAURIG LLP 220 ROSS AVE STE 5200 DALLAS TX 75201 LEGAL SERVICES 106588 5 2715153 7305842 10020995 50778 50778 1295 1295 2399968 0 2399968 2399968 2399968 12473036 0 0 2452041 X 59580 59580 86681 86681 60184 60184 205557 205557 75468 75468 9470293 7518897 1951396 434200 265601 168599 329214 174286 154928 156229 33761 122468 653993 34197 619796 135483 76333 59150 1456826 1456826 110180 110180 CERTIFICATIONS & CONTIN 153948 44590 109358 MEDICAL SUPPLIES 110553 98872 11681 MISCELLANEOUS 28786 8959 19827 AUTOMOBILE 16676 16676 13543851 8418433 5125418 0 793885 1198745 182662 346713 177863 141232 48870503 16199800 33746064 32670703 5079308 4438773 39979782 38796166 2297249 2062532 135304 153950 2432553 2216482 X 36086661 35015846 1460568 1563838 37547229 36579684 39979782 38796166 -1070815 103270 0 X 0 1 X 0 1 1 X X 1 UT SOUTHWESTERN MEDICAL CENTER 756002868 6 1 6830855 0 1 6830855 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 518965 0 1460569 103269 1563838 1517561 -56992 1460569 1630134 -112573 1517561 1540529 89605 1630134 1512501 28028 1540529 1.00000 0 0 4285018 4285018 41100052 13489404 27610648 1187213 1187213 0 1303067 1106531 196536 995153 416652 578501 32670703 BENEFICIAL INTEREST IN PERPETUAL TRUST 1563838 DUE FROM MONCRIEF CANCER FOUNDATION 1455504 ACCOUNTS RECEIVABLE - RELATED PARTY 1419431 4438773 X 12576306 103270 103270 12473036 0 12473036 13543851 0 13543851 0 13543851 PART X, LINE 2: MONCRIEF IS GENERALLY EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AS AN ORGANIZATION OTHER THAN A PRIVATE FOUNDATION. GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY MONCRIEF AND RECOGNIZE A TAX LIABILITY IF MONCRIEF HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY MONCRIEF AND HAS CONCLUDED THAT AS OF AUGUST 31, 2017, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. MONCRIEF IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 103,270. 0 FORT WORTH ADOLESCENT AND YOUNG ADULT CANCER COALITION 6713 BRANTS LN FORT WORTH TX 76116 473205260 501(C)(3) 5000 GENERAL ASSISTANCE FORT WORTH SOUTH INC 1601 MISTLETOE BLVD FORT WORTH TX 76104 752640191 501(C)(4) 5000 GENERAL ASSISTANCE CAREITY FOUNDATION PO BOX 126038 FORT WORTH TX 76126 061704800 501(C)(3) 15000 GENERAL ASSISTANCE SUSAN G KOMEN GREATER FORT WORTH PO BOX 99425 FORT WORTH TX 76199 752445070 501(C)(3) 10000 GENERAL ASSISTANCE DONOR DESIGNATED FUNDS 400 W MAGNOLIA AVE FORT WORTH TX 76104 752655008 501(C)(3) 24580 GENERAL ASSISTANCE PROVIDED TO OUTSIDE ORGANIZATIONS UNDER $5,000 PER ORGANIZATION 4 1 ASSISTANCE FOR INDIGENT CARE 89 86681 0 0 0 0 0 0 0 0 0 WILLIS MADDREY MD PRESIDENT AND CHAIRMAN 0 456794 0 137025 0 720 0 39303 0 13501 0 647343 0 0 ARNIM DONTES SECRETARY AND TREASURER 0 563107 0 172273 0 720 0 22525 0 18738 0 777363 0 0 MICHAEL SERBER ASSISTANT TREASURER 0 236290 0 83250 0 183024 0 20928 0 18739 0 542231 0 0 KEITH ARGENBRIGHT MD MEDICAL DIRECTOR FOR MCI 0 372549 0 20000 0 0 0 22525 0 16931 0 432005 0 0 ARNIM DONTES AND MICHAEL SERBER OFFICER - UT SOUTHWESTERN MONCRIEF CANCER CTR & UT SOUTHWESTERN MEDICAL C 6830855 MONCRIEF CANCER INSTITUTE HAS TRANSACTIONS WITH UT SOUTHWESTERN AS PART OF THE MASTER SERVICES AGREEMENT FOR SHARING OF EMPLOYEES AND OTHER RESOURCES RELATED TO INFORMATION RESOURCES, IT, ADVERTISING & PRINTING, CONSULTING AND MANAGEMENT. ARNIM DONTES AND MICHAEL SERBER ARE OFFICERS OF UT SOUTHWESTERN AND OFFICERS & DIRECTORS OF MONCRIEF CANCER INSTITUTE. 0 FORM 990, PART VI, SECTION A, LINE 6 DR. PODOLSKY, AS PRESIDENT OF UT SOUTHWESTERN, IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A DR. PODOLSKY, IN HIS CAPACITY AS MEMBER, HAS THE SOLE AUTHORITY TO APPOINT DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY MICHAEL SERBER, ASSISTANT TREASURER, AND ARNIM E. DONTES, SECRETARY AND TREASURER, BEFORE SUBMISSION TO DR. WILLIS MADDREY, PRESIDENT AND CHAIRMAN, FOR REVIEW. ALL BOARD MEMBERS CAN REQUEST A COPY OF THE 990. FORM 990, PART VI, SECTION B, LINE 12C MONCRIEF CANCER INSITUTE FOLLOWS THE WRITTEN CONFLICT OF INTEREST POLICY OF UT SOUTHWESTERN WHICH REQUIRES THE DIRECTORS AND OFFICERS TO SIGN CONFLICT OF INTEREST STATEMENTS WHICH ARE THEN REVIEWED BY THE BOARD. ANYONE WITH A CONFLICT IS RECUSED FROM DISCUSSION AND VOTING ON THE TRANSACTION, WITH THE CONFLICT BEING DOCUMENTED IN THE MINUTES. THE CONFLICT OF INTEREST STATEMENTS ARE A PART OF THE MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G LEASED EMPLOYEES COMPENSATION: PROGRAM SERVICE EXPENSES 4,814,578. MANAGEMENT AND GENERAL EXPENSES 1,765,179. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,579,757. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 2,132,994. MANAGEMENT AND GENERAL EXPENSES 11,280. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,144,274. CONSULTING: PROGRAM SERVICE EXPENSES 327,533. MANAGEMENT AND GENERAL EXPENSES 85,372. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 412,905. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 132,698. MANAGEMENT AND GENERAL EXPENSES 77,265. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 209,963. TRANSLATION SERVICES: PROGRAM SERVICE EXPENSES 111,094. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 111,094. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 12,300. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,300. MONCRIEF CANCER FOUNDATION 5323 HARRY HINES BLVD DALLAS TX 75390 752429817 ORGANIZED AND OPERATED FOR THE BENEFIT OF UT SOUTHWESTERN MEDICAL CENTER. TX 501(C)(3) 509(A)(3) 0 UT SOUTHWESTERN MEDICAL CENTER 5323 HARRY HINES BLVD DALLAS TX 75390 756002868 HIGHER EDUCATION, RESEARCH, AND PROVISION OF MEDICAL CARE. TX 501(C)(3) LINE 6 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 MONCRIEF CANCER FOUNDATION C 2715153 FMV UT SOUTHWESTERN MEDICAL CENTER J 917188 FMV UT SOUTHWESTERN MEDICAL CENTER N 251099 FMV UT SOUTHWESTERN MEDICAL CENTER O 6579756 FMV