2017-06-02T09:44:02-05:00 2016-09-30 750800661 METHODIST HOSPITALS OF DALLAS PO BOX 655999 DALLAS TX 752655999 990 2015-10-01 352436666 METHODIST PATIENT CENTERED ACO METH 2149474527 1441 N BECKLEY AVE TAX DEPT DALLAS TX 75203 MICHAEL J SCHAEFER TREASURER 2149474527 2017-06-02 1 DWIGHT WILLIAMS P00544474 2149474581 2017-06-02 2015 2021-01-29 14:40:06Z MICHAEL J SCHAEFER 1441 N BECKLEY AVE TAX DEPT DALLAS TX 75203 8437128 0 X METHODISTHEALTHSYSTEM.ORG/ACO X 2012 TX TO OPERATE AN ACCOUNTABLE CARE ORGANIZATION (ACO)TO:(A)PARTICIPATE IN THE MEDICARE SHARED SAVINGS PROGRAM (MSSP) AS SET FORTH IN SECTION 1899 OF THE SOCIAL SECURITY ACT AND RELATED REGULATIONS,(B) SERVE AS A VEHICLE FOR ADVANCING METHODIST HEALTH SYSTEM'S CLINICAL INTEGRATION AND QUALITY INITIATIVES,(C)SERVE AS A VEHICLE TO MANAGE, COORDINATE AND PROMOTE ACCOUNTABILITY FOR THE QUALITY, PATIENT SAFETY, COST AND OVERALL CARE OF PATIENTS, INCLUDING MEDICARE BENEFICIARIES, AND (D) SERVE AS A NETWORK TO PROVIDE COORDINATED QUALITY AND COST-EFFECTIVE MEDICAL AND HEALTH SERVICES. 16 0 0 0 0 0 0 0 5260903 8437128 0 0 0 0 5260903 8437128 0 0 0 0 1560078 2371900 0 0 0 4418193 6087901 5978271 8459801 -717368 -22673 5260903 5552036 5963711 5552036 -702808 0 X TO OPERATE AN ACCOUNTABLE CARE ORGANIZATION (ACO) TO: (A) PARTICIPATE IN THE MEDICARE SHARED SAVINGS PROGRAM (MSSP) AS SET FORTH IN SECTION 1899 OF THE SOCIAL SECURITY ACT AND RELATED REGULATIONS, (B) SERVE AS A VEHICLE FOR ADVANCING METHODIST HEALTH SYSTEM'S CLINICAL INTEGRATION AND QUALITY INITIATIVES, (C)SERVE AS A VEHICLE TO MANAGE, COORDINATE AND PROMOTE ACCOUNTABILITY FOR THE QUALITY, PATIENT SAFETY, COST AND OVERALL CARE OF PATIENTS, INCLUDING MEDICARE BENEFICIARIES, AND (D) SERVE AS A NETWORK TO PROVIDE COORDINATED QUALITY AND COST-EFFECTIVE MEDICAL AND HEALTH SERVICES. 0 0 8214249 8437128 METHODIST PATIENT CENTERED ACO (MPCACO) IS A TX NONPORFIT CORPORATION FORMED TO PARTICIPATE IN THE MEDICARE SHARED SAVINGS PROGRAM(MSSP) AS AN ACCOUNTABLE CARE ORGANIZATION (ACO). ON 7-1-12 THE CENTER FOR MEDICARE AND MEDICAID SERVICES(CMS) SELECTED MPCACO TO PARTICIPATE IN ITS MSSP. METHODIST HOSPITALS OF DALLAS IS A TEXAS NONPROFIT CORPORATION AND A 501(C)(3) ORGANIZATION AND THE SOLE MEMBER OF MPCACO. MHD PROVIDES QUALITY INTERGRAED CARE TO IMPROVE AND SAVE LIVES OF INDIVIDUALS THROUGHOUT NORTH TEXAS. MHD AFFILIATES HAD 463,778 PATIENT VISITS AND PROVIDED MORE THAN $150 MILLION IN UNREIMBURSED CHARITY CARE, REPRESENTING 10.95% OF NET PATIENT SERVICE REVENUE. AS REQUIRED BY SECTION 425.106( C) OF THE MSSP REGULATIONS, SECTION 3.2.1 (CONTINUED ON SCHEDULE O) OF THE MPCACO AMENDED AND RESTATED BYLAWS REQUIRES THAT AT LEAST 75% OF THE MEMBERS OF THE BOARD SHALL BE ACO PARTICIPANTS AS DEFINED IN THE MSSP REGULATIONS, OR REPRESENTATIVES OF THOSE PARTICIPANTS. TO INSURE MPCACO IS OPERATED IN FURTHERANCE OF MHD'S EXEMPT PURPOSES. DURING THE MOST RECENT REPORTING PERIOD OF JANUARY 1, 2015 THROUGH DECEMBER 31,2015 MEDICARE ADVISED THE ACO IT HAD PROPERLY REPORTED ON 33 QUALITY METRICS AND ACHIEVED MEDICARE SAVINGS OF $18,718,445 ON THE MEDICARE POPULATION SERVED BY THE ACO. PURSUANT TO THE SHARED SAVING AGREEMENT 45.4% OF THAT SAVINGS WAS DISTRIBUTED TO THE ACO. SUBSEQUENTLY A PORTION OF THAT DISTRIBUTION WAS SHARED WITH PHYSICIANS WHO HAD SIGNED UP FOR THE SHARED SAVINGS PROGRAM AND HAD ACHIEVED A MINIMUM NUMBER OF POINTS (10) BY COMPLETING TASKS OF PERFORMANCE IMPROVEMENT, ACO CITIZENSHIP, QUALITY AND/OR ELECTRONIC MEDICAL RECORDS. AN ADDITIONAL PORTION WAS DISTRIBUTED TO THE HOSPITALS IN THE METHODIST HEALTH SYSTEM AND THE BALANCE WAS RETAINED TO OFFSET A PORTION OF THE START-UP AND ADMINISTRATIVE COSTS OF THE ACO. 8214249 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 27 0 1 0 0 0 0 0 0 0 0 0 X 16 0 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X MICHAEL SCHAEFER 2149478181 1441 N BECKLEY AVE DALLAS TX 75203 MELISSA GERDES MD FORMER CHAIR/DIR/CMO 15.00 25.00 X X 0 411288 26933 BRIAN JONES MD CHAIR/DIR 2.00 40.00 X X 21385 352006 31298 STEPHEN MANSFIELD PHD PRESIDENT/DIR 2.00 40.00 X X 0 2091937 294061 BASSEM MOSTAFA- ELSAWY MD DIRECTOR 2.00 40.00 X 0 260697 20939 LAURA IRVINE DIRECTOR 2.00 40.00 X 0 850729 104671 MICHAEL MARSHAL DIRECTOR 2.00 40.00 X 0 485847 40182 ALFONSO RAMIREZ MD DIRECTOR 2.00 5.00 X 19833 0 0 LUCIOUS WILLIAMS DIRECTOR 2.00 X 0 0 0 NHAN NGUYEN MD DIRECTOR 2.00 5.00 X 0 0 0 NANCY GEORGEKUTTY MD DIRECTOR 2.00 X 0 0 0 ARTURO AVILES DIRECTOR 2.00 10.00 X 0 0 0 MARTIN KOONSMAN MD DIRECTOR 2.00 15.00 X 0 99702 17080 GEORGE WILLIAMS DIRECTOR 2.00 X 0 0 0 MICHAEL FINCH MD DIRECTOR 2.00 5.00 X 0 0 0 PAMELA SINGH MD DIRECTOR 2.00 40.00 X 21630 209035 5926 HERIBERTO JOSE CALLEJAS DIRECTOR 2.00 X 0 0 0 MICHAEL J SCHAEFER SEC/TREA 2.00 40.00 X 0 1116136 77206 SAM BAGCHI MD FORMER DIRECTOR 2.00 40.00 X 0 232822 41502 62848 6110199 659798 0 1 1 0 MEDHEALTH 1441 N BECKLEY AVE DALLAS TX 75203 MEDICAL 601754 DALLAS HOSPITALISTS PA 1441 N BECKLEY AVE DALLAS TX 75203 MEDICAL 299356 NORTH TEXAS CARDIOVASCULAR 221 WEST COLORADO 831 DALLAS TX 75208 MEDICAL 204294 3 SHARED SAVINGS INCOME 621990 8328054 8328054 CARE COORDINATION FROM 621990 109074 109074 8437128 8437128 8437128 0 0 X 62848 62848 1935194 1935194 250856 250856 123002 123002 5800153 5554601 245552 2717 2717 195894 195894 72407 72407 16730 16730 8459801 8214249 245552 0 5552036 5260903 5260903 5552036 5963711 5552036 5963711 5552036 X 0 0 0 725481 -702808 -725481 -702808 0 5260903 5552036 -22673 725481 0 X X 0 1 X 1 0 X 6231468 5260903 8437128 19929499 6231468 5260903 8437128 19929499 0 0 0 19929499 6231468 5260903 8437128 19929499 1.00000 1.00000 0.00000 X 0 X PART X, LINE 2: METHODIST HEALTH SYSTEM (MHS) HAS CONCLUDED THAT IT DOES NOT HAVE ANY UNRECOGNIZED TAX BENEFITS RESULTING FROM CURRENT OR PRIOR PERIOD TAX POSITIONS. ACCORDINGLY NO ADDITIONAL DISCLOSURES HAVE BEEN MADE IN THE CONSOLIDATED FINANCIAL STATEMENTS. MHS DOES NOT HAVE ANY OUTSTANDING INTEREST OR PENALTIES, AND NONE HAVE BEEN RECORDED IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS FOR THE YEARS ENDED SEPTEMBER 30, 2015 AND 2016. 1 0 1 0 0 1 0 1 1 0 MELISSA GERDES MD FORMER CHAIR/DIR/CMO 0 350201 0 55643 0 5444 0 7379 0 19554 0 438221 0 0 BRIAN JONES MD CHAIR/DIR 0 261693 0 58953 21385 31360 0 13331 0 17967 21385 383304 0 0 STEPHEN MANSFIELD PHD PRESIDENT/DIR 0 1147808 0 673750 0 270379 0 270529 0 23532 0 2385998 0 252419 BASSEM MOSTAFA- ELSAWY MD DIRECTOR 0 254824 0 0 0 5873 0 9760 0 11179 0 281636 0 0 LAURA IRVINE DIRECTOR 0 545209 0 226961 0 78559 0 94603 0 10068 0 955400 0 69187 MICHAEL MARSHAL DIRECTOR 0 274769 0 163198 0 47880 0 15826 0 24356 0 526029 0 0 PAMELA SINGH MD DIRECTOR 0 135056 0 67288 21630 6691 0 5459 0 467 21630 214961 0 0 MICHAEL J SCHAEFER SEC/TREA 0 593039 0 298898 0 224199 0 16709 0 60497 0 1193342 0 103754 SAM BAGCHI MD FORMER DIRECTOR 0 231619 0 0 0 1203 0 24887 0 16615 0 274324 0 0 PART I, LINE 4B SOME OFFICERS AND DIRECTORS PARTICIPATE IN A 457(F) PLAN AT A RELATED ORGANIZATION. CONTRIBUTIIONS TO A SECTION 457(F) NON-QUALIFIED PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN C. PART I, LINE 5 CERTAIN DIRECTORS AND OFFICERS WORK FOR RELATED ORGANIZATIONS WHERE BONUS CALCULATIONS INCLUDE A SECTION ON OPERATING EFFICIENCY WHICH INCLUDES A SUB-SECTION RELATED TO OPERATING REVENUE GROWTH. PART I, LINE 6 CERTAIN DIRECTORS AND OFFICERS WORK FOR RELATED ORGANIZATIONS WHERE BONUS CALCULATIONS INCLUDE A SECTION ON OPERATING EFFICIENCY WHICH INCLUDES A SUB-SECTION RELATED TO MANAGING OPERATING EXPENSE GROWTH AND NET OPERATING INCOME MARGIN. PART I, LINE 7 IN ORDER TO RECRUIT AND RETAIN KEY TALENT, MHS OFFERS SHORT AND LONG TERM INCENTIVE PLANS FOR KEY EMPLOYEES. FOR TAX YEAR 2014 THE INCENTIVE PLANS WERE TARGETED TO SUCH GOALS AS INCREASING PHYSICIAN ALIGNMENT WITH MHS, IMPROVEMENTS IN THE QUALITY OF CARE METRICS, PATIENT SATISFACTION GOALS, IDENTIFICATION OF A COMPREHENSIVE EMR SOLUTION FOR MHS AND GROWTH IN NUMBER OF AMBULATORY SITES AND FAMILY HEALTH CENTERS. THERE WERE ALSO FINANCIAL TARGETS RELATED TO OPERATING MHS FINANCIAL AFFAIRS EFFICIENTLY. FORM 990, PART VI, SECTION A, LINE 6 METHODIST HOSPITALS OF DALLAS (IT'S 501(C)(3) PARENT) IS THE SOLE MEMBER OF THE ORGANIZATION AND HAS APPROVAL RIGHTS REGARDING ACTIONS OF THE BOARD FORM 990, PART VI, SECTION A, LINE 7A METHODIST HOSPITALS OF DALLAS (IT'S 501(C)(3) PARENT) IS THE SOLE MEMBER OF THE ORGANIZATION AND HAS APPROVAL RIGHTS REGARDING ACTIONS OF THE BOARD FORM 990, PART VI, SECTION A, LINE 7B METHODIST HOSPITALS OF DALLAS (IT'S 501(C)(3) PARENT) IS THE SOLE MEMBER OF THE ORGANIZATION AND HAS APPROVAL RIGHTS REGARDING ACTIONS OF THE BOARD FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY THE MHS TAX DEPARTMENT. DURING THE RETURN PREPARATION PROCESS THE TAX DEPARTMENT LOOKS TO OTHER FUNCTIONAL AREAS INCLUDING FINANCE, HUMAN RESOURCES, ACCOUNTING, LEGAL, CORPORATE COMPLIANCE, AND TREASURY FOR ASSISTANCE IN PREPARING A COMPLETE AND ACCURATE RETURN. UPON COMPLETION THE RETURN IS REVIEWED WITH THE REPORTING ORGANIZATIONS APPLICABLE SENIOR FINANCIAL OFFICER PRIOR TO FILING. FURTHER, AS PART OF THE ANNUAL FINANCIAL AUDIT OF MHS THE FORM 990'S OF ALL OF ITS SUBSIDIARY ORGANIZATIONS ARE PROVIDED TO A NATIONAL ACCOUNTING FIRM FOR REVIEW. MHS IS THE SOLE MEMBER AND PARENT COMPANY OF THIS REPORTING ORGANIZATION. THE MHS INDIVIDUAL RETURN IS REVIEWED WITH A COMMITTEE OF ITS SENIOR BOARD MEMBERS AND THEN PROVIDED ELECTRONICALLY TO ALL OF THE MHS BOARD MEMBERS PRIOR TO THE FILING OF THE MHS RETURN. WHILE THE RETURN OF THIS REPORTING ORGANIZATION IS NOT INDIVIDUALLY REVIEWED BY ITS SEPARATE BOARD MHS BELIEVES THAT SUFFICIENT QUALITY CONTROL AND OVERALL GOVERNANCE OVERSIGHT EXISTS THROUGHOUT THE PREPARATION STAGES OF ALL OF THE MHS RELATED RETURNS. FURTHER MHS BELIEVES THAT THE LEVEL OF DETAILED MHS BOARD REVIEW OF THE PARENT ORGANIZATION'S RETURN IS SUFFICIENT TO INSURE THAT ALL OF THE INTENDED TAX-EXEMPT AND GOVERNANCE REQUIREMENTS FOR THE ENTIRE ORGANIZATION ARE MET. THE FORM 990 OF ANY OF THE MHS ENTITIES IS ALWAYS AVAILABLE TO ANY BOARD MEMBER AT THEIR REQUEST. FORM 990, PART VI, SECTION B, LINE 12C MHS ,THE PARENT ORGANIZATION, PROVIDES ALL OFFICERS AND DIRECTORS OF ALL OF ITS COMPANIES AN ANNUAL CONFLICT QUESTIONAIRRE. THERE IS ALSO INTERAL AUDIT REVIEW AND CHIEF COMPLIANCE OFFICER REVIEW. FORM 990, PART VI, SECTION B, LINE 15 THERE ARE NO EMPLOYEES OF THE ORGANIZATION. SERVICES ARE PROVIDED VIA A SHARED SERVICES AGREEMENT WITH METHODIST HEALTH SYSTEM THE ORGANIZATIONS SOLE MEMBER. COMPENSATION OF EMPLOYEES OF THE METHODIST HEALTH SYSTEM ARE SUBJECT TO THE LISTED PROCESSES TO ASSURE FAIR MARKET VALUE COMPENSATION PROGRAMS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G AUDIT,LEGAL & CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 300. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 300. MHS ADMIN & SUPPORT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 65513. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65513. PURCHASED SERVICES FROM MHS: PROGRAM SERVICE EXPENSES 137626. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 137626. PHYSICIAN SHARED SAVINGS: PROGRAM SERVICE EXPENSES 2640957. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2640957. HOSPITAL SHARED SAVINGS: PROGRAM SERVICE EXPENSES 2776018. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2776018. MEMBERSHIP DUES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 179739. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 179739. FORM 990, PART XII, LINE 2C: THE SELECTION OF THE INDEPENDENT AUDITORS IS MADE BY THE AUDIT COMMITTEE OF THE METHODIST HEALTH SYSTEM BOARD.(PARENT ORGANIZATION) THERE HAS BEEN NO CHANGE IN THE WAY THE IT WAS CONSOLIDATED WITH THE FINANCIAL STATEMENTS OF THE PARENT AND AT THE PARENT LEVEL THERE WERE NO CHANGES IN EITHER THE OVERSIGHT PROCESS OR THE SELECTION PROCESS. 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