2017-03-13T07:56:43-05:00 2016-04-30 BKD LLP 2800 Post Oak Blvd Ste 3200 HOUSTON TX 77056 990 2015-05-01 742577746 DRISCOLL CHILDREN'S HOSPITAL % GREGORY WARD DRIS 3616946126 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 ERIC HAMON EXECUTIVE VP AND CFO 7134994600 2016-09-15 true M P Gerich P00226776 7134994600 2015 2021-01-29 14:40:06Z ERIC HAMON 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 442833841 false X DRISCOLLCHILDRENS.ORG X 1953 TX REMEMBERING ALWAYS OUR COMMITMENT TO RELIEVE SUFFERING AND MEET THE NEEDS OF CHILDREN; IT IS OUR MISSION TO OFFER HOPE & HEALING IN AN ENVIRONMENT OF TRUST, COMPASSION, & CARE. 14 12 1896 471 0 0 15349226 17052478 268488481 315418135 9954947 11460700 40150198 61280489 333942852 405211802 24368594 26202178 0 0 120776062 125990601 0 0 1526803 109250669 117952613 254395325 270145392 79547527 135066410 663371301 724524848 126726017 92304515 536645284 632220333 REMEMBERING ALWAYS OUR COMMITMENT TO RELIEVE SUFFERING AND MEET THE NEEDS OF CHILDREN; IT IS THE HOSPITAL'S MISSION TO OFFER HOPE AND HEALING IN AN ENVIRONMENT OF TRUST, COMPASSION, AND CARE. false false 262028576 26202178 315418135 PROVISION OF HIGH QUALITY HOSPITAL, MEDICAL, AND NURSING SERVICES TO CHILDREN IN THE SURROUNDING SOUTH TEXAS REGION WITHOUT REGARD TO THE ABILITY TO PAY. CARE IS PERFORMED ON BOTH AN INPATIENT AND AN OUTPATIENT BASIS. 262028576 true true false true false false false false false true true true false false true false false true false false true false false false false false true true true false true false false false false false false false false false false false false false true true true true false true 364 0 true 1896 true false true CJ false false false false false false false false X 14 12 false false false false true false true true true false false true true true true true true true true false X GREGORY WARD 3616946126 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 X PAUL CHAPA DIRECTOR 1.0 0.0 X 0 0 0 JULIE BUCKLEY DIRECTOR 1.0 1.0 X 0 0 0 MIKE CARRELL DIRECTOR 1.0 0.0 X 0 0 0 MURRAY BASS JR DIRECTOR 1.0 0.0 X 0 0 0 JIM DEVLIN DIRECTOR 1.0 0.0 X 0 0 0 WES HOSKINS DIRECTOR 1.0 1.0 X 0 0 0 LENORA KEAS DIRECTOR 1.0 0.0 X 0 0 0 REBA CARDENAS MCNAIR DIRECTOR 1.0 0.0 X 0 0 0 S LOYD NEAL JR CHAIRMAN 1.0 2.0 X 0 10000 0 ESTELA O'DANIEL MD DIRECTOR 1.0 0.0 X 0 0 0 LEON SMITH-HARRISON MD DIRECTOR 1.0 39.0 X 0 495801 45166 BILL STERETT DIRECTOR 1.0 1.0 X 0 0 0 SAM L SUSSER VICE CHAIRMAN 1.0 3.0 X X 0 0 0 C IVAN WILSON DIRECTOR 1.0 3.0 X 0 10000 0 STEVE WOERNER CEO & VICE CHAIRMAN 38.0 4.0 X X 525869 0 484750 D ERIC HAMON EXECUTIVE VICE PRESIDENT & CFO 33.0 12.0 X 401939 22000 268351 DALE V OBERMUELLER VICE PRESIDENT CPSST 36.0 4.0 X 515662 0 245913 WILLIAM LARSEN VICE PRESIDENT ADMINISTRATION 40.0 1.0 X 311304 0 79270 DONNA M QUINN VICE PRESIDENT OPERATIONS 40.0 1.0 X 392948 0 168431 MARTHA A AVERY VICE PRESIDENT OF DEVELOPMENT 1.0 40.0 X 265300 0 80534 GREGORY A WARD VICE PRESIDENT ADMINISTRATION 40.0 1.0 X 331481 0 106829 KAREN C LONG VICE PRESIDENT & CPCO 40.0 0.0 X 264063 0 51914 JENNIFER R HENDERSON GENERAL COUNSEL 40.0 1.0 X 312875 0 24995 LORRAINE A ANTONI NEONATAL NURS PRACTITIONER 40.0 0.0 X 214855 0 35903 MIGUEL PEREZ III SYSTEM DIRECTOR IS CIO 40.0 0.0 X 201809 0 40001 PATRICIA CARR ASSOCIATE CHIEF NURSE EXEC 40.0 0.0 X 199145 0 35708 TAMMY WEAVER ASSISTANT VICE PRESIDENT 40.0 0.0 X 193754 0 27085 4131004 537801 1694850 141 false true false UNIVERSITY OF TEXAS MEDICAL BRANCH 201 UNIVERSITY BLVD JOHN SEALY BLD GALVESTON TX 775550591 PHYSICIANS/TEACH/LAB 7355931 FULTON CONSTRUCTION CORP COASTCON 1102 SECOND ST CORPUS CHRISTI TX 78404 CONSTRUCTION 3941957 SODEXO SERVICES OF TEXAS LP 3033 FIFTH AVE STE 250 SAN DIEGO CA 92103 MANAGEMENT 3130984 HURON CONSULTING GROUP INC 550 W VAN BUREN ST CHICAGO IL 60607 CONSULTING 2282115 EPIC SYSTEMS CORP 1979 MILKY WAY VERONA WI 53593 HEALTHCARE SOFTWARE 2250248 80 14581599 2384605 86274 17052478 Net Patient Service Revenue 621110 315418135 315418135 315418135 13071615 13071615 0 0 583015 583015 0 583015 583015 35989850 21274 37622039 -1632189 21274 -1610915 -1610915 0 0 0 Cafeteria and Vending Sales 722320 964180 964180 Medical Education 621110 1847079 1847079 DELIVERY SYSTEM REFORM INCENTIVE PMT 624410 53012379 53012379 4873836 4873836 60697474 405211802 315418135 72741189 X 26202178 26202178 0 0 0 4505530 4494558 10972 0 94434344 89501763 4243606 688975 5481486 5143742 296437 41307 14669662 13926142 651200 92320 6899579 6556807 300772 42000 1532256 1532256 149416 149416 0 0 0 0 34701500 34463304 161712 76484 2705362 2221385 62726 421251 7191961 7038663 42580 110718 7248851 7248851 0 4875073 4873648 1425 59429 22265 28757 8407 0 0 47839 47839 0 10313980 10309855 4125 4401730 3906570 495160 Bad Debt Expense 8565438 8565438 Medical Supplies 26342695 26342556 30 109 Equipment Rental/Maintenance 7117194 7083165 6066 27963 ADMINISTRATIVE 2349247 2349799 -552 350642 48376 300094 2172 270145392 262028576 6590013 1526803 13570205 2540852 33909682 9077295 1118690 597935 31553868 39050207 0 0 0 0 10791623 13302946 1562981 2016162 2241740 3371803 299791742 193764585 93259150 106027157 0 0 454001641 529351969 0 0 0 0 21361721 19188522 663371301 724524848 33697053 36474378 0 0 211628 0 19000000 0 0 0 0 0 0 0 0 0 73817336 55830137 126726017 92304515 X 521901892 616326113 3125392 2849220 11618000 13045000 536645284 632220333 663371301 724524848 X 135066410 -29100112 1526815 -11918064 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 264655 false false false 264655 false false SCHEDULE C, PART II-B, LINE 1F GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES PAYMENTS MADE TO VARIOUS ORGANIZATIONS FOR THE PURPOSE OF MEETING WITH AND CALLING GOVERNMENT OFFICIALS OR LEGISLATORS AND SENDING LETTERS OR PUBLICATIONS TO GOVERNMENT OFFICIALS AND LEGISLATORS REGARDING ISSUES THAT HAVE AN IMPACT ON THE EXEMPT PURPOSE OF THE HOSPITAL. 7641973 524276 -91682 8074567 6611029 640814 390130 7641973 5840401 385661 384967 6611029 3867634 1344707 628060 5840401 3730935 242161 -105462 3867634 0.59740 0.40260 false true true 10141347 10141347 136581751 78090868 58490883 1855396 1709782 145614 141548960 113963935 27585025 9664288 0 9664288 106027157 Vanguard 529351969 C 529351969 0 Self Insurance Claims Payable 4835499 Due to Third Party Payor 50994588 Other Liabilities 50 55830137 366538183 -29100112 -7296201 -36396313 402934496 2277306 2277306 405211802 256020887 -1526815 -4032252 -5559067 261579954 8565438 8565438 270145392 SCHEDULE D, PART V, LINE 4 INTENDED USE OF ENDOWMENT FUNDS DRISCOLL CHILDREN'S HOSPITAL INDIRECTLY HOLDS ENDOWMENT FUNDS THROUGH THE DRISCOLL CHILDREN'S HOSPITAL DEVELOPMENT FOUNDATION. THE INTENDED USE OF THESE FUNDS IS TO FURTHER THE DEVELOPMENT FOUNDATION'S MISSION OF PROVIDING SERVICES TO CHILDREN AT DRISCOLL CHILDREN'S HOSPITAL. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS UNDER FIN 48 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D RECONCILIATION OF AUDITED FINANCIAL STATEMENTS TO FORM 990 NET ASSETS RELEASED FROM RESTRICTION $ 887,910 PROVISION FOR BAD DEBT $ (8,565,438) OTHER CHANGES NOT CLASSIFIED AS CONTRIBUTIONS $ 381,327 ------------- $ (7,296,201) SCHEDULE D, PART XI, LINE 4B RECONCILIATION OF AUDITED FINANCIAL STATEMENTS TO FORM 990 CONTRIBUTION RECORDED TO NET ASSETS $ 2,277,306 SCHEDULE D, PART XII, LINE 2D RECONCILIATION OF AUDITED FINANCIAL STATEMENTS TO FORM 990 INTERCOMPANY SUPPORT $ (4,032,252) SCHEDULE D, PART XII, LINE 4B RECONCILIATION OF AUDITED FINANCIAL STATEMENTS TO FORM 990 PROVISION FOR BAD DEBT $ 8,565,438 false Central America and the Caribbean Investments INVESTMENT true false true false false false true true true X true X true false true true 3473888 3473888 0.01360 175202837 180988720 -5785883 122832 93384 29448 0.00010 178799557 181082104 -2282547 0.01370 1622735 1622735 0.00630 5668762 1847079 3821683 0.01490 40965257 40965257 0.16000 48256754 1847079 46409675 0.18120 227056311 182929183 44127128 0.19490 true 5885123 5885123 1081534 1242960 -161426 X true true 1 1 DRISCOLL CHILDREN'S HOSPITAL 3533 SOUTH ALAMEDA STREET CORPUS CHRISTI TX 78411 driscollchildrens.org 000488 X X X X X DRISCOLL CHILDREN'S HOSPITAL 1 false false true X X X X X X X X 13 true true false true X HTTP://WWW.DRISCOLLCHILDRENS.ORG/ X WWW.COASTALBENDHEALTHFINDER.COM X X true 14 false true false true X 200. 400. X X X X X true true X X X true X SEE DISCLOSURE IN SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM PERSONS FOR CHNA INTERVIEW OF FOCUS GROUPS, INPUT FROM COMMUNITY GROUPS SUCH AS UNITED WAY AND SCHOOL DISTRICTS, SOCIAL SERVICE AND DEMOGRAPHIC DATA FROM THE PATIENT DATABASES OF EACH PARTICIPATING HOSPITAL; STATISTICS FROM GOVERNMENT DATABASES OBTAINED FOR THE ASSESSMENT BY TEXAS A&M UNIVERSITY AT CORPUS CHRISTI. SCHEDULE H, PART V, SECTION B, LINE 6A CHNA CONDUCTED WITH OTHER HOSPITAL FACILITIES CHRISTUS SPOHN HEALTH SYSTEM; CORPUS CHRISTI MEDICAL CENTER SCHEDULE H, PART V, SECTION B, LINE 7D DRISCOLL CHILDREN'S HOSPITAL WAS ESTABLISHED BY THE WILL OF CLARA DRISCOLL TO PROVIDE HOSPITAL CARE TO CHILDREN WHOSE FAMILIES CANNOT AFFORD TO PAY. THE MISSION AND OPERATIONS OF THE HOSPITAL COMPLY TO THIS DAY WITH THE INTENT OF THE WILL. THE HOSPITAL'S MEDICAL STAFF INCLUDES EMPLOYED PHYSICIANS AS WELL AS PHYSICIANS IN PRIVATE PRACTICE. EXAMPLES OF THE HOSPITAL GIVING INFORMATION TO THE PUBLIC REGARDING COMMUNITY HEALTH ISSUES WERE TELEVISION AND RADIO NEWS STORIES ABOUT H1N1 FLU AND MRSA. THE PUBLIC WAS INFORMED ABOUT SYMPTOMS AND WHAT TO DO IF SOMEONE HAD THESE SYMPTOMS. SCHEDULE H, PART V, SECTION B, LINE 16I OTHER MEASURES USED TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY THE WEBSITE PROVIDES PHONE NUMBERS FOR INQUIRIES ABOUT CHARITY AND DISCOUNTS. SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS NOT ADDRESSED IN CHNA THE NEEDS DESCRIBED AND DEFINED IN THE ASSESSMENT ARE TOO PERVASIVE FOR ANY SINGLE HOSPITAL TO ADDRESS ON ITS OWN DUE TO LIMITED RESOURCES. THESE NEEDS INCLUDE BARRIERS TO HEALTHCARE ACCESS; CULTURAL INFLUENCES ON DIABETES AND OBESITY; POVERTY AND POOR EDUCATION AMONG OTHERS. LIMITED RESOURCES PREVENTED A COMPREHENSIVE PLAN FROM BEING DEVELOPED. EXPANDING THE ASSESSMENT STAKEHOLDERS (SUCH AS INCLUDING COUNTY HEALTH OFFICERS) WILL PROVIDE A BETTER OPPORTUNITY FOR A COMPREHENSIVE PLAN TO ADDRESS THIS AREA'S HEALTH NEEDS. SCHEDULE H, PART V, SECTION B, LINE 13B PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE EACH PATIENT'S FAMILY IS PROVIDED WITH WRITTEN MATERIAL AS WELL AS PERSONAL INSTRUCTION AS TO ASSISTANCE THAT IS AVAILABLE TO THEM. STATE EMPLOYEES ARE ON SITE TO EXPEDITE THE MEDICAID ENROLLMENT PROCESS. OTHER THIRD PARTIES ARE ENGAGED TO ASSIST PATIENTS WITH ENROLLMENT. SCHEDULE H, PART V, SECTION B, LINE 16A FAP WAS WIDELY AVAILABLE ON THE FOLLOWING WEBSITE: HTTP://WWW.DRICOLLCHILDRENS.ORG/PATIENT-SERVICES/BILLING SCHEDULE H, PART I, LINE 3A DRISCOLL CHILDREN'S HOSPITAL USES A RANGE OF 0 - 300% IN DETERMINING WHAT IS THE FPG FAMILY INCOME LIMIT FOR ELIGIBILITY FOR FREE CARE. SCHEDULE H, PART III, SECTION A, LINE 2 PART III, QUESTIONS: PATIENT ACCOUNTS RECEIVABLE: THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHER. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE COST METHODOLOGY USED WAS RATIO OF COST TO CHARGES. SCHEDULE H, PART III, SECTION A, LINE 3 PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE COST METHODOLOGY USED WAS RATIO OF COST TO CHARGES. THE HOSPITAL SERVES A LARGE AREA THAT INCLUDES SOME OF THE LOWEST INCOME PER CAPITA COUNTIES IN THE UNITED STATES. A RELATIVELY SMALL NUMBER OF PATIENTS DO NOT QUALIFY FOR GOVERNMENT PROGRAMS AS WELL AS BEING UNINSURED OR UNDERINSURED. IF THE PATIENTS DO NOT QUALIFY FOR CHARITY UNDER HOSPITAL POLICY CRITERIA THEN THE ACCOUNT IS WRITTEN OFF AS A BAD DEBT. SCHEDULE H, PART III, SECTION A, LINE 4 THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE FINANCIAL STATEMENTS PAGES 8 AND 9 DESCRIBES THE ORGANIZATION'S BAD DEBT EXPENSE. SCHEDULE H, PART III, SECTION B, LINE 8 MEDICARE IS COST SETTLED FOR THIS HOSPITAL AND THE COST SHOWN WERE CALCULATED ON THE MEDICARE COST REPORT. SCHEDULE H, PART III, SECTION C, LINE 9B AT ANY TIME, A PATIENT MAY REQUEST FINANCIAL ASSISTANCE WHICH INCLUDES UP TO 100% OF THE ACCOUNT BALANCE. SCHEDULE H, PART VI, LINE 2 INPUT FROM PERSONS FOR CHNA, INTERVIEW OF FOCUS GROUPS, INPUT FROM COMMUNITY GROUPS SUCH AS UNITED WAY AND SCHOOL DISTRICTS, SOCIAL SERVICE AND DEMOGRAPHIC DATA FROM THE PATIENT DATABASES OF EACH PARTICIPATING HOSPITAL; STATISTICS FROM GOVERNMENT DATABASES OBTAINED FOR THE ASSESSMENT BY TEXAS A&M UNIVERSITY AT CORPUS CHRISTI. SCHEDULE H, PART VI, LINE 3 EACH PATIENT'S FAMILY IS PROVIDED WITH WRITTEN MATERIAL AS WELL AS PERSONAL INSTRUCTION AS TO ASSISTANCE THAT IS AVAILABLE TO THEM. STATE EMPLOYEES ARE ON SITE TO EXPEDITE THE MEDICAID ENROLLMENT PROCESS. OTHER THIRD PARTIES ARE ENGAGED TO ASSIST PATIENTS WITH ENROLLMENT. SCHEDULE H, PART VI, LINE 4 THE HOSPITAL SERVES THE CHILDREN OF A 31 COUNTY AREA THAT COVERS SOUTH TEXAS TO THE BORDER WITH MEXICO. MOST OF THE COUNTIES IN THIS AREA HAVE THE LOWEST INCOME PER CAPITA IN THE COUNTRY. APPROXIMATELY 70% OF THE HOSPITAL'S PATIENTS ARE ENROLLED IN A GOVERNMENT PROGRAM. SCHEDULE H, PART VI, LINE 5 THE HOSPITAL SUBSIDIZES PEDIATRIC SPECIALISTS IN ORDER TO PROVIDE THESE SERVICES TO ITS SERVICE AREA. A SUBSTANTIAL AMOUNT OF HOSPITAL RESOURCES ARE USED TO PROVIDE SERVICES TO THE COMMUNITY IN THE FORM OF HEALTH EDUCATION, PREVENTION AND AWARENESS, AND HOSPITAL/CLINIC SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. SCHEDULE H, PART VI, LINE 6 THE HOSPITAL IS AFFILIATED WITH SEVERAL PHYSICIAN ORGANIZATIONS TO PROVIDE SUPPORT FOR PEDIATRICIANS AND PEDIATRIC SPECIALISTS TO SERVE AREAS OF SOUTH TEXAS THAT OTHERWISE WOULD NOT HAVE THESE SERVICES AVAILABLE. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT TEXAS SHEDULE H, PART I, LINE 7, COLUMN F BAD DEBT EXPENSE OF $8,565,438 WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR THE CALCULATION OF "PERCENT OF TOTAL EXPENSE" IN THIS COLUMN. true CHILDREN'S PHYS SERVICES OF SOUTH TEXAS 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78401 742620408 501 (C) (3) 26202178 CHARITABLE 1 SCHEDULE I, PART I, LINE 2 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES THE ORGANIZATION USES PUBLIC AND PRIVATE DATA TO MONITOR THE USE OF FUNDS, AS NEEDED. X true true X X X X X false true false false false false false false false LEON SMITH-HARRISON MD DIRECTOR 0 477181 0 0 0 18620 0 22938 0 22228 0 540967 0 0 STEVE WOERNER CEO & VICE CHAIRMAN 301032 0 206837 0 18000 0 460816 0 23934 0 1010619 0 0 0 JENNIFER R HENDERSON GENERAL COUNSEL 236593 0 55853 0 20429 0 21427 0 3568 0 337870 0 0 0 LORRAINE A ANTONI NEONATAL NURS PRACTITIONER 186299 0 20950 0 7606 0 15245 0 20658 0 250758 0 0 0 MIGUEL PEREZ III SYSTEM DIRECTOR IS CIO 176610 0 24133 0 1066 0 19124 0 20877 0 241810 0 0 0 PATRICIA CARR ASSOCIATE CHIEF NURSE EXEC 161494 0 22031 0 15620 0 16460 0 19248 0 234853 0 0 0 TAMMY WEAVER ASSISTANT VICE PRESIDENT 170387 0 22464 0 903 0 15936 0 11149 0 220839 0 0 0 D ERIC HAMON EXECUTIVE VICE PRESIDENT & CFO 234657 22000 112860 0 54422 0 240039 0 28312 0 670290 22000 0 0 DALE V OBERMUELLER VICE PRESIDENT CPSST 437587 0 60075 0 18000 0 225658 0 20255 0 761575 0 0 0 WILLIAM LARSEN VICE PRESIDENT ADMINISTRATION 244324 0 55508 0 11472 0 50644 0 28626 0 390574 0 0 0 DONNA M QUINN VICE PRESIDENT OPERATIONS 341601 0 51323 0 24 0 149983 0 18448 0 561379 0 0 0 MARTHA A AVERY VICE PRESIDENT OF DEVELOPMENT 195751 0 51255 0 18294 0 63984 0 16550 0 345834 0 0 0 GREGORY A WARD VICE PRESIDENT ADMINISTRATION 281080 0 49230 0 1171 0 85776 0 21053 0 438310 0 0 0 KAREN C LONG VICE PRESIDENT & CPCO 217194 0 46845 0 24 0 41668 0 10246 0 315977 0 0 0 SCHEDULE J, PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES: DUES AND CHARGES ARE PAID FOR DALE OBERMUELLER. ANY REIMBURSEMENTS FOR PERSONAL EXPENDITURES WERE INCLUDED IN MR. OBERMUELLER'S FORM W-2. SCHEDULE J, PART I, LINE 4C THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) NONQUALIFIED RETIREMENT PLAN: NAME AMOUNT PAID BY STEVE WOERNER $ 370,457 DRISCOLL CHILDREN'S HOSPITAL D. ERIC HAMON $ 171,303 DRISCOLL CHILDREN'S HOSPITAL MARTHA AVERY $ 19,799 DRISCOLL CHILDREN'S HOSPITAL DONNA M. QUINN $ 105,408 DRISCOLL CHILDREN'S HOSPITAL GREGORY A. WARD $ 55,281 DRISCOLL CHILDREN'S HOSPITAL DALE OBERMUELLER $ 176,233 DRISCOLL CHILDREN'S HOSPITAL FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS ROBERT DRISCOLL, JULIA DRISCOLL, AND ROBERT DRISCOLL JR. FOUNDATION IS THE SOLE MEMBER OF DRISCOLL CHILDREN'S HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS OR STOCKHOLDERS THE MEMBER HAS TO APPROVE THE BOARD MEMBERS ELECTIONS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990 THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE ITS FORM 990. ONCE THE FORM 990 IS PREPARED BY THE ACCOUNTING FIRM AND REVIEWED BY THE ORGANIZATION'S INTERNAL FINANCIAL TEAM. THE FINAL FORM IS PRESENTED TO THE GOVERNING BODY BY THE SENIOR VP/CFO PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY THE ORGANIZATION HIRES AN EMPLOYEE TO LEAD COMPLIANCE EFFORTS AND REPORT COMPLIANCE ISSUES THAT MAY ARISE. IN ADDITION, THE BOARD COMMITTEE REVIEWS THOSE ISSUES AND REPORTS. FORM 990, PART VI, SECTION B, LINES 15A & 15B PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION USES MGMA AND SULLIVAN COTTER PERCENTILES TO SET BASE COMPENSATION AND SKILL LEVELS. IF COMPENSATION LEVELS EXCEED CERTAIN PERCENTILES, A THIRD OUTSIDE CONSULTING FIRM IS USED TO VALUE THE MARKET VALUE FOR SERVICES RENDERED AND FOR GROUP COVERAGE AGREEMENTS. FOR CERTAIN COVERAGE AGREEMENTS, A FOURTH CONSULTING FIRM ASSISTS IN DETERMINING MARKET VALUE. COMPENSATION IS APPROVED BY THE ORGANIZATION'S GOVERNING BODY WITH THE DELIBERATION AND DECISION DOCUMENTED CONTEMPORANEOUSLY. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART V, SECTION C, LINES 1A & 2B NUMBER OF EMPLOYEES DRISCOLL CHILDREN'S HOSPITAL REPORTS PAYROLL AND CONTRACTOR REPORTING FOR ALL ENTITIES WITHIN THE DRISCOLL SYSTEM INCLUDING: DRISCOLL CHILDREN'S HEALTH PLAN 74-2838488 ROBERT AND JULIA DRISCOLL FOUNDATION 74-1170270 DRISCOLL HEALTHCARE SERVICES 01-0962276 CHILDRENS PHYSICIAN SERVICES OF SOUTH TX 74-2620408 DRISCOLL PHYSICIANS GROUP 74-2988134 DRISCOLL MATERNAL & FETAL PHYSICIANS GROUP 72-1234461 DRISCOLL VALLEY PHYSICIANS GROUP 20-1234322 DRISCOLL CHILDREN'S HOSPITAL DEVELOPMENT FDN 74-2358461 FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS ASSETS RELEASED FROM RESTRICTION $ (758,643) TRANSFER FROM AFFILIATES $ (17,000,000) CHANGE IN BENEFICIAL INTEREST IN TRUST $ 1,427,000 INTERCOMPANY SUPPORT $ 4,032,252 OTHER CHANGES NOT CLASSIFIED AS CONTRIBUTIONS $ 381,327 -------------- $ (11,918,064) FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN CONTRACTS TOTAL FEES:20303150 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:2859043 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:2587762 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES FOR SVCS TOTAL FEES:8951545 DRISCOLL CHILDRENS HEALTH PLAN 615 N UPPER BROADWAY STE 1621 CORPUS CHRISTI TX 78401 742838488 MEDICAID HMO TX 501(c)(3) 9 DCH true ROBERT BELL PARRISH MEMORIAL TRUST 615 N UPPER BROADWAY STE 1635 CORPUS CHRISTI TX 78401 746416039 CHARITABLE TX 501(C)(3) 11A DRISCOLL FDN false ROBERT AND JULIA DRISCOLL FOUNDATION 615 N UPPER BROADWAY STE 1635 CORPUS CHRISTI TX 78401 741170270 CHARITABLE TX 501(C)(3) 11C NA false JACK AND DORIS SMOTHERS MEDICAL FOUNDATI 615 N UPPER BROADWAY STE 1635 CORPUS CHRISTI TX 78401 742750622 CHARITABLE TX 501(C)(3) 11A DRISCOLL FDN false CHILDREN'S PHYS SERVICES OF SOUTH TEXAS 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 742620408 HEALTHCARE TX 501(C)(3) 3 DCH true DRISCOLL PHYSICIANS GROUP 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 742988134 HEALTHCARE TX 501(C)(3) 3 DCH true DRISCOLL MATERNAL AND FETAL PHYSICIANS G 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 201234461 HEALTHCARE TX 501(C)(3) 9 DCH true DRISCOLL VALLEY PHYSICIANS GROUP 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 201234322 HEALTHCARE TX 501(C)(3) 3 DCH true DRISCOLL CHILDREN'S HOSPITAL DEVELOPMENT 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 742358461 CHARITABLE TX 501(C)(3) 7 NA false AUXILIARY TO DRISCOLL CHILDREN'S HOSPITA 3533 SOUTH ALAMEDA CORPUS CHRISTI TX 78411 741260701 SUPPORT HOSP TX 501(C)(3) 11A NA false DRISCOLL HEALTHCARE SERVICES 3533 S ALAMEDA ST CORPUS CHRISTI TX 78411 010962276 AVIATION TX 501(C)(3) 11A DCH true ALLEGRA INSURANCE COMPANY LTD PO BOX 1085 5TH FLOOR QUEENSGATE HOUSE GRAND CAYMAN CJ 000000000 INSURANCE CJ DCH C CORPORATION 5111899 30366177 1.00000 true true true true false false false false false false true false true false false true true true true true CHILDREN'S PHYSICIAN SERVICES OF SOUTH TEXAS A 204217 ACTUAL DRISCOLL PHYSICIANS GROUP A 124794 ACTUAL DRISCOLL VALLEY PHYSICIANS GROUP A 192279 ACTUAL DRISCOLL MATERNAL & FETAL PHYSICIANS GROUP A 50940 ACTUAL CHILDREN'S PHYSICIAN SERVICES OF SOUTH TEXAS B 26470319 ACTUAL DRISCOLL DEVELOPMENT FOUNDATION C 2596815 ACTUAL DRISCOLL PHYSICIANS GROUP O -169038 ACTUAL DRISCOLL HEALTHCARE SERVICES P -5600161 ACTUAL CHILDREN'S PHYSICIAN SERVICES OF SOUTH TEXAS P -3500256 ACTUAL DRISCOLL PHYSICIANS GROUP P -3057040 ACTUAL DRISCOLL VALLEY PHYSICIANS GROUP P -656833 ACTUAL DRISCOLL MATERNAL & FETAL PHYSICIANS GROUP Q 5527944 ACTUAL DRISCOLL DEVELOPMENT FOUNDATION Q 1749882 ACTUAL DRISCOLL CHILDREN'S HEALTH PLAN Q 59501939 ACTUAL AUXILIARY TO DRISCOLL CHILDREN'S HOSPITAL Q 212147 ACTUAL ALLEGRA INSURANCE COMPANY R 405013 ACTUAL DRICOLL DEVELOPMENT FOUNDATION S -1749882 ACTUAL DRISCOLL CHILDREN'S HEALTH PLAN S -59500000 ACTUAL