2017-11-13T11:01:43-06:00 2016-12-31 990 2016-01-01 461893597 Complex Care Medical Services Corporation COMP 2144567000 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 JERRY LEE TREASURER 2017-11-09 2016 2017-02-10 21:41:12Z W Robert Morrow MD 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 172482 false X N/A X 2012 TX TO SERVE AS THE MEDICAL HOME FOR CHILDREN WITH COMPLEX MEDICAL ILLNESSES. 5 3 10 3 0 0 0 121676 172482 0 0 121676 172482 0 0 1386265 731213 0 0 828489 1699755 2214754 2430968 -2093078 -2258486 3257854 2184972 6211398 7397001 -2953544 -5212029 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. false false 1755570 172482 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. 1755570 true false false false false false false false false false true false false false true 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 2 0 true 10 true false false false false false false false false false false X 5 3 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 William Morrow MD Director/President CCMSC, Pres Phys Orgs Acdmc Rel CCO CHST 1.0 54.0 X X 0 822400 18621 Michelle Thomas MD Chair 1.0 0 X 0 0 0 John Andersen MD Director 1.0 0 X 0 0 0 Andrew Gelfand MD Director 1.0 6.0 X 0 18674 0 William Scott MD Director 1.0 0 X 0 0 0 Jerry Lee Treasurer CCMSC, VP Acctg/Treas CHST 1.0 49.0 X 0 395942 32898 Lisa Frenkel Secretary CCMSC, Asst Gen Counsel CHST 1.0 49.0 X 0 217708 12255 Peter Roberts Former President CCMSC, Pres Pop Health CHST 0.0 55.0 X 0 1108100 27028 Douglas Hock Former President CCMSC, COO CMC, Pres Clinical Ops CHST 0.0 55.0 X 0 247782 856 Stephanie Smith Former Officer CCMSC, Sr Legal Counsel CHST 0.0 50.0 X 0 135085 11262 Scott Katz MD Former Director CCMSC, Contract Physician Related Orgs 0.0 5.0 X 0 10597 0 0 2956287 102920 0 true true false UTSW HI 108 5323 HARRY HINES BLVD DALLAS TX 75390 PHYS & MEDICAL SVCS 986778 1 0 Net Patient Revenue 621110 172482 172482 0 0 0 0 172482 0 0 0 0 0 0 0 0 0 172482 172482 0 0 X 526227 526227 47624 47624 100850 100850 56512 56512 885157 858438 26719 0 14022 10030 3992 153487 1260 152227 1621 1621 4325 1603 2722 112260 112260 Shared Services 488481 488481 Dietary and Food Costs 13162 11905 1257 Medical Surgical Supplies 12312 12312 Transltn & Interprtn Srvc 10328 10328 4600 4600 0 0 2430968 1755570 675398 0 1446932 443972 439090 0 0 0 1969678 223796 1366950 1745882 0 0 0 0 3257854 2184972 1083858 239268 5127540 7157733 6211398 7397001 -2953544 -5212029 -2953544 -5212029 3257854 2184972 X -2258486 1 X false true X true false X 1833316 190710 1642606 136362 33086 103276 1745882 LT Advances - Affiliates 7126961 LT Deferred Rent 30772 7157733 Schedule D, Part X, Line 2 THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEAR ENDING DECEMBER 31, 2016 DID NOT REQUIRE A FIN 48 FOOTNOTE. false true false false false false false true false William Morrow MD Director/President CCMSC, Pres Phys Orgs Acdmc Rel CCO CHST 0 534242 0 283208 0 4950 0 10600 0 8021 0 841021 0 0 Scott Katz MD Former Director CCMSC, Contract Physician Related Orgs 0 10597 0 0 0 0 0 0 0 0 0 10597 0 0 Peter Roberts Former President CCMSC, Pres Pop Health CHST 0 556306 0 391408 0 160386 0 12976 0 14052 0 1135128 0 0 Douglas Hock Former President CCMSC, COO CMC, Pres Clinical Ops CHST 0 22659 0 154402 0 70721 0 0 0 856 0 248638 0 0 Stephanie Smith Former Officer CCMSC, Sr Legal Counsel CHST 0 123291 0 10547 0 1247 0 6812 0 4450 0 146347 0 0 Jerry Lee Treasurer CCMSC, VP Acctg/Treas CHST 0 270923 0 87472 0 37547 0 14597 0 18301 0 428840 0 0 Lisa Frenkel Secretary CCMSC, Asst Gen Counsel CHST 0 213182 0 0 0 4526 0 6590 0 5665 0 229963 0 0 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, OTHER OFFICERS, 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 in 2016. Dr. William Morrow, Douglas Hock, Peter Roberts, and 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 retains the authority to adjust annual payout percentages solely at their discretion. There were no non-fixed payments in 2016. 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 10 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, OTHER OFFICERS, 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 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 received a copy of the Statement of Interest form to execute. Disclosures made are reviewed by the CHST Executive Vice President, Chief Legal Officer and General Counsel and the Chief Compliance Officer and discussed as necessary at the appropriate Board meeting to determine if further action is needed. Form 990, Part VI, Line 19 Required documents available to the public Certificate of Formation and Consolidated Financial Statements are publicly available. The conflict of interest policy is made available to the public upon request. Form 990, Part IX, Line 11g Other Fees Consulting & Professional Fees - Total Expense: 7097, Program Service Expense: , Management and General Expenses: 7097, Fundraising Expenses: ; Contract Medical - Total Expense: 878060, Program Service Expense: 858438, Management and General Expenses: 19622, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Rounding - 1; 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 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 433462044 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 MEDICAL CENTER SERVICES 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 461934007 MEDICAL SERVICES TX 501(c)(3) 10 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 SPECIALISTS FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 463110125 PHYSICIANS TX 501(c)(3) 10 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 COMMUNITY PROVIDERS FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 463675742 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 Children's BMG dba One Care Domain 1935 Medical District Drive Dallas TX 75235 475057374 Physician TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false Wellness Innovations Physician Partners 1935 Medical District Drive Dallas TX 75235 811734937 Physician TX 501(c)(3) 3 Wellness Innovations LLC 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 CHILDREN'S INSURANCE COMPANY 76 ST PAUL STREET SUITE 500 BURLINGTON VT 05401 030328102 INSURANCE COMPANY VT CHILDREN'S HEALTH SYSTEM OF TEXAS C Corporation 0 false ALTERNATIVE CARE SYSTEMS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752244475 OTHER MEDICAL SERVICES TX CHILDREN'S HEALTH SYSTEM OF TEXAS 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 Children's Health System of Texas C Corporation 0 false TEXAS TRINITY RIVER ASSURANCE COMPANY LTD 878 West Bay Road PO Box 1159 Grand Cayman CJ KY11202 981318151 Self-insurance CJ Children's Health System of Texas C Corporation 0 false false false false false true false false false false false false true false true true false false false false