2018-11-13T11:02:26-06:00 2017-12-31 990 2017-01-01 752917570 Anesthesiologists for Children ANES 2144567000 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 Tammie Sibley Treasurer 2018-11-13 2017 2018-06-14 16:35:46Z Stephen Kimatian MD 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 38181526 false X N/A X 2000 TX PROVIDE ANESTHESIA SERVICES TO PATIENTS AT CHILDREN'S MEDICAL CENTER OF DALLAS 6 5 46 5 0 0 4739 15029 34722026 37763381 0 403116 34726765 38181526 0 0 29717595 32739957 0 0 3340852 3558773 33058447 36298730 1668318 1882796 9103705 12069832 6286073 7369407 2817632 4700425 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 33839783 38166497 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. 33839783 true 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 8 0 true 46 true false false false false false false true false false false X 6 5 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 Director & President 1.0 0 X X 0 0 0 Stephen Hoang Director & Anesthesiologist 40.0 0 X 490495 0 25063 Ron Mitchell MD Director 1.0 0 X 0 0 0 Nancy Rollins MD Director 1.0 0 X 0 0 0 Charles Whitten MD Director 1.0 0 X 0 0 0 Desmond Henry MD Chair 1.0 0 X 0 0 0 Jerry Lee Treasurer, AFC & VP Acctg/Treasury, CHST 1.0 49.0 X 0 390313 32789 Lisa Frenkel Secretary, AFC & Assoc Gen Counsel, CHST 1.0 49.0 X 0 268217 12100 Shannon Ternan Anesthesiologist 40.0 0 X 493226 0 28474 Weiwei Boone Anesthesiologist 40.0 0 X 491829 0 35537 Cynthia Gonzales Anesthesiologist 40.0 0 X 487686 0 28967 Matthew Miller Anesthesiologist 40.0 0 X 487237 0 22674 Shandel Molinar Anesthesiologist 40.0 0 X 486878 0 19987 Stephanie Smith Former Officer, AFC & Sr. Counsel, CHST 0.0 50.0 X 0 140567 11005 2937350 799097 216597 0 true true false UTSW HI 108 5323 Harry Hines Blvd Dallas TX 753908886 Phys & Medical Svcs 18426092 MEDAC INC 804 SCOTT NIXON MEMORIAL DR AUGUSTA GA 30907 BILLING & PRAC. MGMT 863377 AEGIS ANESTHESIA ASSOCIATES 1900 ENCHANTED WAY 100 Grapevine TX 76051 Medical Services 450000 3 15029 15029 PROFESSIONAL SVC REV 621110 23956158 23956158 Prov for Doubtful Accts 621110 -2337019 -2337019 Medicaid Subsidy Revenue 621110 15829242 15829242 Chief Stipend Revenue 621110 315000 315000 0 0 0 0 37763381 0 0 0 0 Other Medical Service Revenue 621110 403116 403116 0 0 0 0 403116 38181526 38166497 0 0 490495 490495 29531921 29004805 527116 457247 449219 8028 1499522 1473194 26328 760772 747415 13357 537407 537407 0 0 894306 888343 5963 18038 18038 235 235 12163 10694 1469 109179 108852 327 106000 106000 Shared Services 1831185 1831185 Collection Fees 42194 42194 Dietary and Food Costs 5566 2586 2980 External Charitable Support 2500 2500 0 0 0 0 36298730 33839783 2458947 0 1741611 2009945 0 0 0 11038 5625 0 0 0 0 0 0 7351056 10054262 9103705 12069832 6286073 7369407 0 0 0 6286073 7369407 2817632 4700425 2817632 4700425 9103705 12069832 X 1882796 -3 X false true X true false X 16915 48082 7436 4739 15029 92201 68819857 29378156 35431960 34722026 38166497 206518496 0 0 0 68836772 29426238 35439396 34726765 38181526 206610697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206610697 14727 12897 5606 0 0 33230 0 14727 12897 5606 0 0 33230 0 0 0 0 0 0 0 68851499 29439135 35445002 34726765 38181526 206643927 0.9998 0.9998 0.0002 0.0002 X LT Advances - Affiliates 10054262 10054262 Schedule D, Part V, Line 2 THE ANESTHESIOLOGISTS FOR CHILDREN'S CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEAR ENDING DECEMBER 31, 2017 DO NOT CONTAIN A FIN 48 (ASC 740) FOOTNOTE. false true false false false false false true false Stephen Hoang Director & Anesthesiologist 479812 0 0 0 10683 0 18000 0 7063 0 515558 0 0 0 Stephanie Smith Former Officer, AFC & Sr. Counsel, CHST 0 124399 0 12883 0 3285 0 6793 0 4213 0 151572 0 0 Jerry Lee Treasurer, AFC & VP Acctg/Treasury, CHST 0 278646 0 66547 0 45120 0 14507 0 18282 0 423102 0 0 Lisa Frenkel Secretary, AFC & Assoc Gen Counsel, CHST 0 221768 0 40627 0 5823 0 6532 0 5569 0 280317 0 0 Shannon Ternan Anesthesiologist 473642 0 2800 0 16784 0 15241 0 13233 0 521700 0 0 0 Weiwei Boone Anesthesiologist 469338 0 0 0 22491 0 18000 0 17537 0 527366 0 0 0 Cynthia Gonzales Anesthesiologist 475908 0 0 0 11778 0 18000 0 10967 0 516653 0 0 0 Matthew Miller Anesthesiologist 482051 0 0 0 5186 0 17850 0 4824 0 509911 0 0 0 Shandel Molinar Anesthesiologist 483088 0 0 0 3789 0 16200 0 3787 0 506864 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. 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). 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. 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 plan Non-Qualified Retirement Plan: * Children's Health Savings Restoration Plan - There were no employees that received taxable income from the Savings Restoration Plan. Jerry Lee participated in the Savings Restoration Plan. 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 2017. 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. 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). 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. 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. 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 received a copy of the Statement of Interest form to execute. Disclosures made are reviewed by the CHST Legal Department and the Chief Compliance Officer and discussed as necessary at the appropriate Committee and Board meetings to determine if further action is needed. Form 990, Part VI, Line 19 Required documents available to the public Certificate of Formation, Consolidated Financial Statements , and the conflict of interest policy is made available upon request. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Rounding - -3; Children's Medical Center of Dallas 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 POPULATION HEALTH 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 463104601 POPULATION HEALTH 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 THE HEALTH AND WELLNESS ALLIANCE FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 463080586 PHYSICIANS TX 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM OF TEXAS 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 CHST C Corporation 0 false NTPSS INC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 471036641 PHYSICIAN SOLUTIONS TX Pediatric Partners C Corporation 0 false Texas Bluebonnet Insurance Company 1935 Medical District Drive Dallas TX 75235 475032893 Insurance Company TX CHST C Corporation 0 false TEXAS TRINITY RIVER ASSURANCE COMPANY LTD 878 West Bay Road PO Box 1159 Grand Cayman Grand Cayman CJ KY11202 981318151 Self-insurance CJ CHST C Corporation 0 false Wellness Innovations Physician Partners 1935 Medical District Drive Dallas TX 75235 811734937 Physicians TX CHST C Corporation 0 0 0 false Children's BMG 1935 Medical District Drive Dallas TX 75235 475057374 Physicians TX CHST C Corporation 0 0 0 false false false true false true false false false false false false true false true true false false false false