Pediatric Specialty Group Inc: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- Pediatric Specialty Group Inc (EIN 46-3756071)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201713199349307901
- Schema version
- 2016v3.0
- 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 | 2017-11-15T12:01:38-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | 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 HORWATH LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 East Las Olas Blvd Suite 1100 | AddressLine1Txt |
| City | Fort Lauderdale | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 333014230 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463756071 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pediatric Specialty Group Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PEDI | BusinessNameControlTxt |
| Phone | 3056666511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3100 SW 62ND AVENUE | AddressLine1Txt |
| City | MIAMI | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33155 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Timothy Birkenstock | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2017-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brittney Kocaj | PreparerPersonNm |
| PTIN | P01320603 | PTIN |
| Phone | 9542028600 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pediatric Specialists of America | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NARENDRA KINI MD | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3100 SW 62ND AVENUE | AddressLine1Txt |
| City | MIAMI | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33155 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $65,695,938 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.miamichildrens.com/pediatric-specialists-of-america | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | We are an outstanding group of physicians bringing lifelong health and hope to children and families through innovative compassionate care. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 286 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $181,849 | PYContributionsGrantsAmt |
| CY Contributions Grants | $250,985 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $56,743,742 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $65,423,811 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $54,826 | PYOtherRevenueAmt |
| CY Other Revenue | $21,142 | CYOtherRevenueAmt |
| PY Total Revenue | $56,980,417 | PYTotalRevenueAmt |
| CY Total Revenue | $65,695,938 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $55,776,143 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $65,456,666 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $25,258,812 | PYOtherExpensesAmt |
| CY Other Expenses | $28,359,025 | CYOtherExpensesAmt |
| PY Total Expenses | $81,034,955 | PYTotalExpensesAmt |
| CY Total Expenses | $93,815,691 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$24,054,538 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$28,119,753 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,658,831 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,747,300 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,584,806 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $284,712 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,074,025 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,462,588 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Pediatric Specialties of America ("PSA") is a physician-directed, multi-specialty pediatric group with a regional, national, and international presence in providing pediatric-centric care through a collaborative team approach, excellence in clinical care, education, and research. (Continued on Schedule O) | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $75,052,555 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $65,444,953 | RevenueAmt |
| Desc | In 2016, Pediatric SPECIALTIES OF AMERICA employed almost 200 Providers to support the ongoing functions of Miami Children's Health System and Nicklaus Children's Hospital in the following sub-specialties: Adolescent Medicine, Allergy/Immunology, Cardiology, Cardiovascular Surgery, Clinical Genetics and Metabolism, Critical Care Medicine, Dentistry, Emergency Medicine, Endocrinology, Gastroenterology, General Pediatrics, Infectious Diseases, Nephrology, Neuropsychology, Neurosurgery, Ophthalmology, Orthopedics, Otolaryngology, Plastic and Reconstructive Surgery, Psychiatry and Psychology, Radiology and Rheumatology Sedation. Overall, the 2016 program accomplishments of PSA physicians include being internationally recognized for care excellence by being ranked among the Nation's Best in 3 of the above listed specialties surveyed by U.S. News and World report in its 2016-2017 listing of "America's Best Children's Hospitals." (Results were released in 2016.) Nicklaus Children's Hospital had more ranked pediatric programs than any other hospital in South Florida. Categories in which the PSA specialties were ranked in 2016 include Cardiology and Heart Surgery, Neurology & Neurosurgery and Orthopedics. Collectively the PSA specialists generated more than 580,000 encounters in 2016 serving predominately poor and underserved communities in order to improve population health and well-being for the children that we serve. Expansion of service areas included Miami Dade County, Broward County, Palm Beach County and Collier County. | Desc |
| Total Program Service Expenses | $75,052,555 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| 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 | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | 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 |
| IRP Document | 27 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 286 | 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 | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | Yes (true) | 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 | Michael Durr | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3056666511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5301 Blue Lagoon Drive | AddressLine1Txt |
| City | MIAMI | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33126 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Marcos Mestre MD | ||||||||
| Director/ Acting Chair/ Vice-Chair | 40.0 | 0.4 | Yes (X) | Yes (X) | $336,173 | $0 | $37,494 | |
| Leonard Feld MD | ||||||||
| Director/ President | 40.0 | 0 | Yes (X) | Yes (X) | $904,882 | $0 | $36,650 | |
| Andrij Susla | ||||||||
| Secretary/ Deputy General Counsel | 0.1 | 40.0 | Yes (X) | Yes (X) | $0 | $239,248 | $30,562 | |
| Narendra Kini MD | ||||||||
| CEO & Director | 0.1 | 40.4 | Yes (X) | Yes (X) | $0 | $1,363,509 | $230,340 | |
| John Ragheb | ||||||||
| Director | 40.0 | 0 | Yes (X) | $1,146,916 | $0 | $38,672 | ||
| Alex Soto | ||||||||
| Director | 0.1 | 1.5 | Yes (X) | $0 | $0 | $0 | ||
| Sandeep Dave MD | ||||||||
| Director | 40.0 | 0 | Yes (X) | $945,714 | $0 | $19,243 | ||
| Robert Hannan MD | ||||||||
| Director | 40.0 | 0 | Yes (X) | $723,005 | $0 | $46,372 | ||
| Jose Rosa-Olivares MD | ||||||||
| Director | 40.0 | 0 | Yes (X) | $286,470 | $0 | $39,010 | ||
| Michelle Blumstein MD | ||||||||
| Director | 40.0 | 0 | Yes (X) | $220,387 | $0 | $24,274 | ||
| Alisa Muniz Crim MD | ||||||||
| Director | 40.0 | 0 | Yes (X) | $345,461 | $0 | $14,246 | ||
| Earle Heckathorn | ||||||||
| Director (Partial Year) | 40.0 | 0 | Yes (X) | $227,460 | $0 | $21,526 | ||
| John Rhodes MD | ||||||||
| Director | 40.0 | 0 | Yes (X) | $718,321 | $0 | $42,326 | ||
| Timothy Birkenstock | ||||||||
| Treasurer & CFO | 0.2 | 40.4 | Yes (X) | $0 | $644,466 | $91,227 | ||
| Redmond P Burke MD | ||||||||
| Cardiovascular Surgery Director | 40.0 | 0 | $1,898,835 | $0 | $47,416 | Yes (X) | ||
| Harry Shufflebarger MD | ||||||||
| Physician | 40.0 | 0 | $1,240,645 | $0 | $48,720 | Yes (X) | ||
| Jahangir K Asghar MD | ||||||||
| Physician | 40.0 | 0 | $1,172,983 | $0 | $44,334 | Yes (X) | ||
| Sanjiv Bhatia MD | ||||||||
| Physician | 40.0 | 0 | $889,774 | $0 | $10,156 | Yes (X) | ||
| Stephen M Swirsky DO | ||||||||
| Physician | 40.0 | 0 | $758,831 | $0 | $39,916 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $11,815,857 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,247,223 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $862,484 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 188 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| Nicklaus Children's Hospital | ||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | MANAGEMENT AND SUPPORT SERVICES | $12,758,032 | |
| Tactical Management Inc | ||||||
| 2699 Lee Road | Winter Park | FL | 32789 | Coding Services | $2,596,539 | |
| Carecloud | ||||||
| PO Box 347838 | Pittsburgh | PA | 152514838 | Collection Services | $1,773,117 | |
| Crestwood Services | ||||||
| 3350 NW 53 St | Ft Lauderdale | FL | 33309 | Janitorial Services | $840,197 | Ste 106 |
| Strict Force Security | ||||||
| 4000 Ponce de Leon | Coral Gables | FL | 33145 | Security | $589,281 | te 470 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Related Organizations | $234,439 | RelatedOrganizationsAmt |
| All Other Contributions | $16,546 | AllOtherContributionsAmt |
| Total Contributions | $250,985 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 561110 | $65,117,819 | $65,117,819 |
| M.U Incentive Payments | 900099 | $276,250 | $276,250 |
| Telehealth Services | 900099 | $29,742 | $29,742 |
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 | $65,423,811 | 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 |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Lab Service | 621500 | $12,480 | $12,480 |
| Conference | 900099 | $3,450 | $3,450 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,212 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,212 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $21,142 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,695,938 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $65,444,953 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,175,602 | TotalAmt |
| Program Services | $4,940,482 | ProgramServicesAmt |
| Management And General | $1,235,120 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,787,224 | TotalAmt |
| Program Services | $41,429,779 | ProgramServicesAmt |
| Management And General | $10,357,445 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,765,103 | TotalAmt |
| Program Services | $2,212,082 | ProgramServicesAmt |
| Management And General | $553,021 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,164,264 | TotalAmt |
| Program Services | $1,731,411 | ProgramServicesAmt |
| Management And General | $432,853 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,564,473 | TotalAmt |
| Program Services | $2,051,578 | ProgramServicesAmt |
| Management And General | $512,895 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,755,767 | TotalAmt |
| Program Services | $15,804,614 | ProgramServicesAmt |
| Management And General | $3,951,153 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,391 | TotalAmt |
| Program Services | $14,713 | ProgramServicesAmt |
| Management And General | $3,678 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $648,613 | TotalAmt |
| Program Services | $518,890 | ProgramServicesAmt |
| Management And General | $129,723 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Program Services | $8,000 | ProgramServicesAmt |
| Management And General | $2,000 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,589 | TotalAmt |
| Program Services | $219,671 | ProgramServicesAmt |
| Management And General | $54,918 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $282,039 | TotalAmt |
| Program Services | $225,631 | ProgramServicesAmt |
| Management And General | $56,408 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,432,324 | TotalAmt |
| Program Services | $2,745,859 | ProgramServicesAmt |
| Management And General | $686,465 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Bad Debts | $2,216,463 | $1,773,170 | $443,293 |
| Medical Supplies | $719,153 | $575,322 | $143,831 |
| Recruitment Expenses | $449,481 | $359,585 | $89,896 |
| Dues & Subscriptions | $288,596 | $230,877 | $57,719 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $263,609 | TotalAmt |
| Program Services | $210,891 | ProgramServicesAmt |
| Management And General | $52,718 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,815,691 | TotalAmt |
| Program Services | $75,052,555 | ProgramServicesAmt |
| Management And General | $18,763,136 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,010 | BOYAmt |
| EOY | $384,169 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,642,321 | BOYAmt |
| EOY | $11,659,281 | 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) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,500 | BOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,030 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $9,030 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
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 |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $694,820 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,658,831 | BOYAmt |
| EOY | $12,747,300 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,584,806 | BOYAmt |
| EOY | $284,712 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,584,806 | BOYAmt |
| EOY | $284,712 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,074,025 | BOYAmt |
| EOY | $12,462,588 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,074,025 | BOYAmt |
| EOY | $12,462,588 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,658,831 | BOYAmt |
| EOY | $12,747,300 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$28,119,753 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $37,508,316 | 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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,030 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $9,030 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,030 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Physician Start-Up Payments | Desc |
| Book Value | $694,820 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $694,820 | TotalBookValueOtherAssetsAmt |
| Total Liability | $0 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | PEDIATRIC SPECIALTIES OF AMERICA'S (PSA) FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MIAMI CHILDREN'S HEALTH SYSTEM (MCHS), A RELATED ORGANIZATION. MCHS' FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED DECEMBER 31, 2016, READS AS FOLLOWS: "THE SYSTEM AND CERTAIN OF ITS AFFILIATED ORGANIZATIONS QUALIFY AS TAX-EXEMPT, NONPROFIT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). THE HOSPITAL, PSA, MCHSF AND THE RESEARCH INSTITUTE ARE EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE AS DESCRIBED IN SECTION 501(C)(3). THESE TAX EXEMPT ENTITIES HAD NO TAX PROVISION FOR THE YEARS ENDED DECEMBER 31, 2016 AND 2015. THE CAPTIVE INSURANCE COMPANY IS NOT SUBJECT TO INCOME TAXES, AS NO INCOME TAXES ARE LEVIED IN THE CAYMAN ISLANDS. THE SYSTEM BELIEVES THERE IS NO UNCERTAIN TAX LIABILITY WHICH SHOULD BE RECORDED AS OF DECEMBER 31, 2016 AND 2015." | ExplanationTxt |
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 | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Marcos Mestre MD | ||||||||||||||
| Director/ Acting Chair/ Vice-Chair | $222,443 | $0 | $95,404 | $0 | $18,326 | $0 | $7,390 | $0 | $30,104 | $0 | $373,667 | $0 | $0 | $0 |
| Leonard Feld MD | ||||||||||||||
| Director/ President | $540,978 | $0 | $241,717 | $0 | $122,187 | $0 | $7,950 | $0 | $28,700 | $0 | $941,532 | $0 | $36,658 | $0 |
| Andrij Susla | ||||||||||||||
| Secretary/ Deputy General Counsel | $0 | $206,348 | $0 | $14,566 | $0 | $18,334 | $0 | $0 | $0 | $30,562 | $0 | $269,810 | $0 | $0 |
| Narendra Kini MD | ||||||||||||||
| CEO & Director | $0 | $871,366 | $0 | $428,534 | $0 | $63,609 | $0 | $192,217 | $0 | $38,123 | $0 | $1,593,849 | $0 | $33,398 |
| John Ragheb | ||||||||||||||
| Director | $1,121,591 | $0 | $0 | $0 | $25,325 | $0 | $7,950 | $0 | $30,722 | $0 | $1,185,588 | $0 | $0 | $0 |
| Sandeep Dave MD | ||||||||||||||
| Director | $432,269 | $0 | $495,119 | $0 | $18,326 | $0 | $7,950 | $0 | $11,293 | $0 | $964,957 | $0 | $0 | $0 |
| Robert Hannan MD | ||||||||||||||
| Director | $698,459 | $0 | $0 | $0 | $24,546 | $0 | $7,950 | $0 | $38,422 | $0 | $769,377 | $0 | $0 | $0 |
| Jose Rosa-Olivares MD | ||||||||||||||
| Director | $233,043 | $0 | $44,112 | $0 | $9,315 | $0 | $7,484 | $0 | $31,526 | $0 | $325,480 | $0 | $0 | $0 |
| Michelle Blumstein MD | ||||||||||||||
| Director | $184,482 | $0 | $18,436 | $0 | $17,469 | $0 | $6,180 | $0 | $18,094 | $0 | $244,661 | $0 | $0 | $0 |
| Alisa Muniz Crim MD | ||||||||||||||
| Director | $305,021 | $0 | $40,106 | $0 | $334 | $0 | $7,950 | $0 | $6,296 | $0 | $359,707 | $0 | $0 | $0 |
| Earle Heckathorn | ||||||||||||||
| Director (Partial Year) | $180,898 | $0 | $21,348 | $0 | $25,214 | $0 | $3,739 | $0 | $17,787 | $0 | $248,986 | $0 | $0 | $0 |
| John Rhodes MD | ||||||||||||||
| Director | $682,486 | $0 | $11,111 | $0 | $24,724 | $0 | $7,950 | $0 | $34,376 | $0 | $760,647 | $0 | $0 | $0 |
| Timothy Birkenstock | ||||||||||||||
| Treasurer & CFO | $0 | $418,453 | $0 | $88,560 | $0 | $137,453 | $0 | $66,884 | $0 | $24,343 | $0 | $735,693 | $0 | $0 |
| Redmond P Burke MD | ||||||||||||||
| Cardiovascular Surgery Director | $1,460,369 | $0 | $413,141 | $0 | $25,325 | $0 | $7,950 | $0 | $39,466 | $0 | $1,946,251 | $0 | $0 | $0 |
| Harry Shufflebarger MD | ||||||||||||||
| Physician | $1,214,138 | $0 | $0 | $0 | $26,507 | $0 | $7,950 | $0 | $40,770 | $0 | $1,289,365 | $0 | $0 | $0 |
| Jahangir K Asghar MD | ||||||||||||||
| Physician | $782,173 | $0 | $372,476 | $0 | $18,334 | $0 | $7,950 | $0 | $36,384 | $0 | $1,217,317 | $0 | $0 | $0 |
| Sanjiv Bhatia MD | ||||||||||||||
| Physician | $869,409 | $0 | $1,040 | $0 | $19,325 | $0 | $7,950 | $0 | $2,206 | $0 | $899,930 | $0 | $0 | $0 |
| Stephen M Swirsky DO | ||||||||||||||
| Physician | $689,597 | $0 | $46,963 | $0 | $22,271 | $0 | $7,950 | $0 | $31,966 | $0 | $798,747 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 METHODS USED BY RELATED ORGANIZATION TO ESTABLISH CEO'S COMPENSATION | The organization relied on the methods of establishing compensation for the organization's CEO/Executive Director employed by MIAMI CHILDREN'S HEALTH SYSTEM. (EIN: 45-3481327). MIAMI CHILDREN'S HEALTH SYSTEM uses the following methods to establish such compensation: - Compensation Committee - Independent Compensation Consultant - Compensation survey or study - Approval by the Board or Compensation Committee. |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | Earle Heckathorn - 12 weeks severance of $51,408 (terminated 7/5/2016) |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | THE FOLLOWING CONTRIBUTIONS WERE MADE TO A SECTION 457(F) PLAN DURING THE YEAR - NARENDRA KINI- $184,267 TIMOTHY BIRKENSTOCK - $66,884 THE FOLLOWING DISTRIBUTIONS WERE MADE FROM A SECTION 457(F) PLAN DURING THE YEAR - NARENDRA KINI- $33,398 LEONARD FELD- $36,658 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 1 ORGANIZATION'S MISSION | The Corporation is organized exclusively for charitable, educational, and scientific purposes with the mission of enhancing wellness in pediatric patients through the optimal delivery of pediatric multi-specialty care. |
| Form 990, Part VI, Line 15a DETERMINING COMPENSATION FOR CEO AND EXECUTIVE DIRECTOR | THE ORGANIZATION AND COMPENSATION COMMITTEE OF MIAMI CHILDREN'S HEALTH SYSTEM'S BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD AND USED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. THIS PROCESS IS COMPLETED IN THE FIRST QUARTER EACH YEAR. The CEO is paid by Miami Children's Health System, Inc., a related organization, therefore this has been answered no in accordance with the instructions. |
| Form 990, Part VI, Line 15b Determining compensation for other officers or key employees | THE ORGANIZATION AND COMPENSATION COMMITTEE OF MIAMI CHILDREN'S HEALTH SYSTEM, INC.'S BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD AND USED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. PEDIATRIC SPECIALTIES OF AMERICA RELIED ON THE METHODS OF ESTABLISHING COMPENSATION USED BY MIAMI CHILDREN'S HEALTH SYSTEM. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | There shall be an Executive Committee of the Board of Directors composed of three (3) Directors elected by the Board of Directors, one of whom must be the Chair of the Board and one of whom must be a physician employed by the Corporation. No non-Director members shall serve on the Executive Committee. A majority of the members of the Executive Committee shall constitute a quorum for the transaction of business and for taking any action. The Executive Committee shall have and exercise the authority designated to it by the Board of Directors in the management of the Corporation. The Executive Committee shall report to the Board of Directors any action taken by the Executive Committee at the next meeting of the Board of Directors. Members of the Executive Committee may be removed by the Board at any regular or special meeting of the Board of Directors. |
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | NARENDRA KINI AND TIMOTHY BIRKENSTOCK - Business relationship |
| Form 990, Part VI, Line 6 Classes of members or stockholders | THE ORGANIZATION'S SOLE MEMBER IS MIAMI CHILDREN'S HEALTH SYSTEM, INC. THE SOLE MEMBER HAS THE AUTHORITY TO ELECT MEMBERS TO THE BOARD OF DIRECTORS AND APPROVE DECISIONS OF THE BOARD. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | THE ELECTED MEMBERS OF THE BOARD SHALL BE ELECTED BY MIAMI CHILDREN'S HEALTH SYSTEM (THE SOLE MEMBER), AFTER TAKING INTO CONSIDERATION ANY RECOMMENDATIONS OF THE BOARD. THE NUMBER OF DIRECTORS OF THE CORPORATION SHALL BE ESTABLISHED BY RESOLUTION OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER; PROVIDED THAT THERE SHALL BE NO FEWER THAN 6 AND NO MORE THAN 15 DIRECTORS. ANY DIRECTOR MAY BE REMOVED FROM OFFICE BY ACTION OF THE SOLE MEMBER OR THE ELECTED MEMBERS OF THE BOARD SO PERMITTED TO VOTE, FOR ANY CAUSE OR REASON DEEMED SUFFICIENT BY THE MEMBER OR THE ELECTED MEMBERS OF THE BOARD SO PERMITTED TO VOTE. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | The Board shall not take any action with respect to the following without the approval of Miami Children's Health System (the sole Member): a) Modify the mission, purpose or scope of the CORPORATION, or materially change the location, size or scope of services, programs, operations or educational or medical school affiliations of the CORPORATION or related agreements; b) Create any entity in which the CORPORATION is the sole member or sole shareholder, or any entity in which the CORPORATION has a direct or indirect oversight role, which may include not-for-profit, for profit, limited liability companies, or any other legal entity; c) Sell, lease, purchase, create, dissolve, convey, mortgage, grant a security interest or otherwise dispose of any affiliated, controlled, or joint venture entity, any real or personal property or other assets (or any interest in any of the foregoing), or incur debt for money borrowed or guarantee the debt of another, not in the ordinary course of business; d) Approve annual operating or capital budgets, strategic and long-range plans, major fund-raising programs, physician compensation or other agreements, managed care contracts or other financial commitments or material deviations from such budgets, plans, agreements or commitments; and e) Approve financial, accounting, human resource, employee benefit, compliance policies or procedures, medical staff bylaws (including amendments) or other policies and procedures, or the appointment or engagement of auditors, legal counsel and consultants, which are in any way contrary to the policies and procedures adopted from time to time by the Member. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE FOLLOWING DESCRIBES PEDIATRIC SPECIALTIES OF AMERICA'S (PSA) PROCESS FOR PROVIDING ITS BOARD OF DIRECTORS WITH A COPY OF THE FORM 990 AND REVIEWING IT: 1. THE DRAFT TAX FORM 990 WILL BE MAILED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE PSA BOARD OF DIRECTORS FOR REVIEW AND COMMENT PRIOR TO REGULARLY SCHEDULED MEETING. 2. THE DRAFT TAX FORM 990 WILL BE REVIEWED WITH THE AUDIT AND COMPLIANCE COMMITTEE. 3. QUESTIONS WILL BE ANSWERED AND IF NECESSARY, TAX FORMS WILL BE ADJUSTED. 4. THE FINAL FORM 990 WILL BE POSTED ON THE PSA BOARD OF DIRECTOR'S WEB PORTAL. |
| Form 990, Part VI, Line 12c Conflict of interest policy | ALL PEDIATRIC SPECIALTIES OF AMERICA EMPLOYEES ARE INFORMED UPON HIRE, AND ON AN ANNUAL BASIS THEREAFTER, THAT THEY HAVE AN AFFIRMATIVE DUTY TO DISCLOSE ANY ACTUAL, POTENTIAL OR PERCEIVED CONFLICT OF INTEREST. THEY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM UPON HIRE, ANNUALLY AND WHENEVER A CHANGE IN CIRCUMSTANCES WARRANTS. CONFLICT OF INTEREST DISCLOSURE FORMS ARE FORWARDED TO THE COMPLIANCE DEPARTMENT BY THE TALENT MANAGEMENT AND EFFECTIVENESS DEPARTMENT. THESE FORMS ARE INITIALLY REVIEWED BY COMPLIANCE DEPARTMENT STAFF. WHEN DEEMED NECESSARY, THE COMPLIANCE DEPARTMENT COLLABORATES WITH THE LEGAL DEPARTMENT. CONFLICTS OF INTEREST THAT NECESSITATE BOARD AWARENESS AND ACTION ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD FOR RESOLUTION AND IMPOSITION OF SANCTIONS, IF WARRANTED. IN ADDITION, ON AN ANNUAL BASIS, BOARD MEMBERS, PRINCIPAL OFFICERS, AND BOARD-DELEGATED COMMITTEE MEMBERS SIGN A STATEMENT WHICH AFFIRMS THAT EACH INDIVIDUAL: (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY, AND (D) UNDERSTANDS THAT PSA IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF IT'S TAX-EXEMPT PURPOSES. A PROCESS IS IN PLACE FOR MANAGING SITUATIONS IN WHICH IT IS DISCOVERED THAT AN INDIVIDUAL WHO IS COVERED BY PSA'S CONFLICT OF INTEREST POLICY FAILED TO PROPERLY DISCLOSE A POTENTIAL CONFLICT OF INTEREST. |
| Form 990, Part VI, Line 19 Required documents available to the public | FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL, REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | Miscellaneous - Total Revenue: 5212, Related or Exempt Function Revenue: 5212, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part IX, Line 11g Other Fees | Support Fees - Total Expense: 12758032, Program Service Expense: 10206426, Management and General Expenses: 2551606, Fundraising Expenses: ; Scanning/Coding Services - Total Expense: 4024747, Program Service Expense: 3219798, Management and General Expenses: 804949, Fundraising Expenses: ; Other Fees for Services - Total Expense: 2972988, Program Service Expense: 2378390, Management and General Expenses: 594598, Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Transfer from affiliates - 37508316; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| MIAMI CHILDREN'S HOSPITAL WORKER'S COMPENSATION TRUST | ||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 597021572 | WC CLAIMS | FL | 4947 (a)(1) | VCH | false | |
| VARIETY CHILDRE'S HOSPITAL PROFESSIONAL LIABILITY TRUST | ||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 592551434 | LIAB. CLAIMS | FL | 4947 (a)(1) | VCH | false | |
| MIAMI CHILDREN'S HOSPITAL FOUNDATION INC | ||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 591720704 | FOUNDATION | FL | 501(c)(3) | VCH | false | 7 |
| VARIETY CHILDREN'S HOSPITAL | ||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 590638499 | HOSPITAL | FL | 501(c)(3) | MCHS | false | 3 |
| MCH RESEARCH INSTITUTE INC | ||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 592602318 | RESEARCH | FL | 501(c)(3) | VCH | false | 3 |
| MIAMI CHILDREN'S HEALTH SYSTEM INC | ||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 453481327 | HEALTHCARE | FL | 501(c)(3) | NA | false | Type II |
| MIAMI CHILDREN'S HEALTH SYSTEM FOUNDATION INC | ||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 461784918 | FOUNDATION | FL | 501(c)(3) | MCHS | false | 7 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | Address Line2USAddress/AddressLine2Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|---|---|
| MIAMI CHILDREN'S HOSPITAL AMBULATORY SURGERY CENTER LLC | |||||||||
| 800 SW 108TH AVENUE | SUITE 200 | MIAMI | FL | 33174 | 463406805 | AMBULATORY CENTER | FL | VCH | Related |
| MIAMI HOSPITAL HOLDINGS LLC | |||||||||
| 11221 ROE AVE SUITE 320 | LEAWOOD | KS | 66211 | 464077635 | HOLDING COMPANY | FL | NA | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1ForeignAddress/AddressLine1Txt | Address Line2ForeignAddress/AddressLine2Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MIAMI CHILDREN'S INSURANCE CO SPC LTD | |||||||||||||||
| 720 WEST BAY ROAD | PO BOX 69FT BUCKINGHAM SQUARE | GEORGETOWN | GRAND CAYMAN | CJ | 980442086 | INSURANCE | CJ | VCH | C Corporation | false | |||||
| CHILDREN'S HEALTH VENTURES INC AND SUBS | |||||||||||||||
| 454541147 | MERCHANT WHOLESALE | MCHS | C Corporation | false | 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | FL | ||||||
| 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 | false | 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 | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |