2017-08-14T12:02:28-05:00 2016-09-30 350921680 CROWE HORWATH LLP 750 N St Paul Suite 850 Dallas TX 75201 990 2015-10-01 261482195 Texas Children's Women's Specialists TEXA 8328242982 PO Box 300630 Houston TX 772300630 WELDON GAGE Executive Vice President & CFO 2017-08-14 true Rachel Spurlock P00520729 2147775200 2015 2021-01-29 14:40:06Z WELDON GAGE PO Box 300630 Houston TX 772300630 8042210 false X women.texaschildrens.org X 2007 TX TO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION AND RESEARCH. 6 0 99 0 0 0 0 7372140 8042210 0 0 7372140 8042210 0 0 3864076 4388823 0 0 4732658 4719315 8596734 9108138 -1224594 -1065928 42117901 48700583 50461998 58110608 -8344097 -9410025 TO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION AND RESEARCH. false false 8098414 8042210 PATIENT CARE: TEXAS CHILDREN'S WOMEN'S SPECIALISTS IS A GROUP OF BOARD CERTIFIED PHYSICIANS, NURSE MIDWIVES, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS DEDICATED TO PROVIDING OBSTETRIC AND GYNECOLOGICAL PHYSICIAN SERVICES AND THE HIGHEST QUALITY HEALTHCARE FOR WOMEN, DELIVERING 3,120 BABIES DURING FISCAL YEAR ENDED SEPTEMBER 30, 2016. 8098414 true false false false false false false false false false true false false true true true 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 true true false false true 8 0 true 99 true false false false false false false false false false false X 6 0 false false false false true true true true false false false true true true true true true false false false X JENNIFER WILSON 8328242972 1919 S Braeswood Blvd Houston TX 77030 Michael A Belfort MD PhD BOARD CHAIRMAN 1.0 3.0 X X 0 248526 0 Angelo P Giardino MD PHD BOARD MEMBER 1.0 39.0 X 0 1003372 93421 Samuel Law II MD BOARD MEMBER 1.0 39.0 X 0 147899 33713 Bart Putterman MD BOARD MEMBER 1.0 39.0 X 0 622284 47066 Edward E Yosowitz MD BOARD MEMBER 1.0 39.0 X 0 288518 42672 David Zepeda MD BOARD MEMBER 1.0 39.0 X 0 516607 36874 Cris Daskevich President 1.0 39.0 X 0 891055 100403 Dace Reinholds Assistant Secretary 1.0 39.0 X 0 228736 28318 Mark A Wallace CHIEF EXECUTIVE OFFICER 1.0 39.0 X 0 5491659 45447 Robert Turner Director 40.0 0 X 167999 0 31991 Keith Boggs Practice Manager 40.0 0 X 109381 0 24828 Christopher Born Former President 0.0 40.0 X 0 1301667 125696 Chanda Cashen Former Vice President 0.0 40.0 X 0 684104 67256 Wanda Mott MD FORMER BOARD MEMBER 0.0 40.0 X 0 542714 41968 277380 11967141 719653 2 true true false COMFORCE TECHNICAL SERVICES PO BOX 9695 UNIONDALE NY 115559695 STAFFING SERVICES 185136 1 0 VENDED PHYSICIAN SERVICES 900099 8024025 8024025 NON-PATIENT REVENUE 900099 18185 18185 0 0 0 0 8042210 0 0 0 0 0 0 0 0 0 8042210 8042210 0 0 205073 205073 3265309 3265309 131673 131673 530565 520536 10029 256203 244944 11259 316572 295101 21471 0 8772 7866 906 106834 90465 16369 2227 1979 248 16615 15757 858 12989 11610 1379 807463 686642 120821 381348 376126 5222 MANAGEMENT FEES 1958712 1347098 611614 MEDICAL SUPPLIES 1057725 1057725 RECORD STORAGE 14712 12524 2188 LAUNDRY & CLEANING 11875 10094 1781 23471 22965 506 0 9108138 8098414 1009724 0 200 200 1320 0 0 0 316587 421952 11275839 4007451 8075850 7268388 0 0 0 0 33723944 41010043 42117901 48700583 213306 320718 50248692 57789890 50461998 58110608 X -8344097 -9410025 -8344097 -9410025 42117901 48700583 -1065928 0 X false true X true false X X 1 TEXAS CHILDREN'S HOSPITAL 741100555 3 true 8098414 0 1 8098414 0 true false false false false false false false false false false false false false false false Schedule A, Part IV, Section C, Line 1 Majority director detail The CEO of Texas Children's Women's Specialists (WSH) is the President and CEO of Texas Children's (TC). TC is the sole corporate member of WSH and as such has extensive rights and powers (including the authority to appoint and remove board members) over WSH as reflected in the bylaws. 3337428 671894 2665534 36236 36236 0 7902175 3299321 4602854 7268388 DUE FROM TEXAS CHILDREN'S PHYSICIAN GROUP 41009481 DUE FROM TEXAS CHILDREN'S HEALTH PLAN - THE CENTER 211 DUE FROM TEXAS CHILDREN'S URGENT CARE 351 41010043 DUE TO TEXAS CHILDREN'S HOSPITAL 57782809 DUE TO TCH PEDIATRIC ASSOCIATES 7081 57789890 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS AS OF SEPTEMBER 30, 2016 OR 2015. false true false false false false false false false Michael A Belfort MD PhD BOARD CHAIRMAN 0 0 0 248526 0 0 0 0 0 0 0 248526 0 0 Wanda Mott MD FORMER BOARD MEMBER 0 374174 0 148350 0 20190 0 20950 0 21018 0 584682 0 0 Angelo P Giardino MD PHD BOARD MEMBER 0 396041 0 586700 0 20631 0 82062 0 11359 0 1096793 0 0 Samuel Law II MD BOARD MEMBER 0 146044 0 0 0 1855 0 14836 0 18877 0 181612 0 0 Bart Putterman MD BOARD MEMBER 0 465458 0 136115 0 20711 0 20950 0 26116 0 669350 0 0 Edward E Yosowitz MD BOARD MEMBER 0 277395 0 0 0 11123 0 20950 0 21722 0 331190 0 0 David Zepeda MD BOARD MEMBER 0 390778 0 121718 0 4111 0 13000 0 23874 0 553481 0 0 Christopher Born Former President 0 494061 0 716100 0 91506 0 104770 0 20926 0 1427363 0 70462 Cris Daskevich President 0 329803 0 499400 0 61852 0 66510 0 33893 0 991458 0 41655 Dace Reinholds Assistant Secretary 0 195614 0 23500 0 9622 0 17825 0 10493 0 257054 0 0 Mark A Wallace CHIEF EXECUTIVE OFFICER 0 1250186 0 2685500 0 1555973 0 23550 0 21897 0 5537106 0 1264825 Chanda Cashen Former Vice President 0 313282 0 369200 0 1622 0 55944 0 11312 0 751360 0 0 Robert Turner Director 146702 0 13900 0 7397 0 12641 0 19350 0 199990 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Compensation for the organization's top management official is established by Texas Children's and Texas Children's Hospital, using the following methods: * Compensation Committee * Independent Compensation Consultant * Compensation Survey or Study * Approval by the Board or Compensation Committee Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan CY 2015 457(F) PLAN: PAID/DEFERRED CHRIS BORN 786,562 / 83,820 CRIS DASKEVICH 541,055 / 45,560 CHANDA CASHEN 369,200 / 36,120 ANGELO P. GIARDINO, MD, PHD 586,700 / 61,112 MARK A WALLACE 4,182,165 / 0 DIRECTOR INCENTIVE PLAN: PAID/DEFERRED ROBERT TURNER 13,900 / 0 DACE REINHOLDS 23,500 / 0 457(F): THE 457(F) PLAN IS A DEFERRED COMPENSATION PLAN THAT ALLOWS ELIGIBLE EXECUTIVES, FROM THE ASSISTANT VICE PRESIDENT LEVEL TO CHIEF EXECUTIVE OFFICER, TO CONTRIBUTE MONEY ON A PRE-TAX BASIS. FUNDS MAY BE DEFERRED INTO THIS ACCOUNT FROM ANY OF FOUR SOURCES: BASE SALARY, ANNUAL INCENTIVE PLAN, LONG-TERM INCENTIVE PLAN, AND CAPITAL ACCUMULATION ACCOUNT FROM A FLEXIBLE BENEFIT ACCOUNT SURPLUS. THESE VEST AFTER THREE YEARS IN THE 457(F) WITH THE EXCEPTION OF THE CAPITAL ACCUMULATION ACCOUNT WHICH VESTS AFTER FIVE YEARS IN THE 457(F) PLAN. DIRECTOR INCENTIVE PLAN: THE DIRECTOR INCENTIVE PLAN IS AN ANNUAL INCENTIVE PLAN IN WHICH ELIGIBLE DIRECTORS PARTICIPATE. THE PLAN SHARES GOALS WITH THE EXECUTIVE ANNUAL INCENTIVE PLAN, FOCUSING ON FACTORS SUCH AS FINANCIAL PERFORMANCE, QUALITY GOALS, AND PATIENT SATISFACTION. IN ADDITION, THERE ARE INDIVIDUAL COMPONENTS FOR EACH DIRECTOR WHICH VARY DEPENDING ON THE EXPECTED OUTCOMES FOR THAT AREA AND/OR YEAR. Form 990, Part VI, Line 6 Classes of members or stockholders TEXAS CHILDREN'S IS THE SOLE CORPORATE MEMBER OF TEXAS CHILDREN'S WOMEN'S SPECIALISTS. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body TEXAS CHILDREN'S ANNUALLY APPOINTS THE ORGANIZATION'S BOARD OF DIRECTORS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders PER THE ORGANIZATION'S BYLAWS, THE MEMBER HAS CERTAIN RESERVED POWERS: -APPROVE, INTERPRET OR CHANGE THE PURPOSE OF THE CORPORATION. -FIX THE NUMBER, APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY DIRECTOR OF THE CORPORATION. -APPROVE THE MERGER, DISSOLUTION OR CONSOLIDATION OR REORGANIZATION OF THE CORPORATION. -APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF PROPERTY OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATION'S BUSINESS, WHEN SUCH ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION IS ABOVE SPECIFIC FINANCIAL LEVELS SET IN ACCORDANCE WITH POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBER. -APPROVE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. -ADOPTION OR AMENDMENT OF SALARIES OR OTHER COMPENSATION (INCLUDING THE AWARDING OF ANY INCENTIVE COMPENSATION) OF THE OFFICERS OF THE CORPORATION, PHYSICIAN EMPLOYEES OF THE CORPORATION, IF ANY, AND PHYSICIANS WHO ARE INDEPENDENT CONTRACTORS TO THE CORPORATION. -APPROVE DEBT INCURRED BY THE CORPORATION, WHICH IS IN EXCESS OF SUCH LIMITS AS ARE ESTABLISHED BY THE MEMBER. -APPROVE THE DISPOSITION OF ASSETS OF THE CORPORATION AT THE TIME OF ITS DISSOLUTION. -APPROVE ANY LONG-RANGE FINANCIAL OR STRATEGIC PLANS FOR THE CORPORATION. -SELECTION OF THE CORPORATION'S AUDITORS AND LEGAL COUNSEL. -CREATION OR SALE OF ANY SUBSIDIARIES OF THE CORPORATION. -APPROVE ANY AFFILIATION, JOINT VENTURE, CONTRACT, EMPLOYMENT, RETENTION, INDEMNIFICATION, OR OTHER ARRANGEMENTS BETWEEN THE CORPORATION AND ANY INSURER, HEALTH MAINTENANCE ORGANIZATION, PREFERRED PROVIDER ORGANIZATION, MEDICAL SCHOOL, HOSPITAL, CLINIC, PHARMACY, PHYSICIAN, HOSPITAL AFFILIATE OR OTHER PROVIDER OF HEALTH OR RELATED SERVICES, INCLUDING, WITHOUT LIMITATION, ALL SERVICE TERMS AND COMPENSATION ARRANGEMENTS. -ESTABLISHMENT BY THE CORPORATION OF ANY TRAINING OR RESIDENCY PROGRAM. -THE GIVING, SEEKING OR RECEIVING OF GRANTS. -ADOPTION OR AMENDMENT OF ANY INDEMNIFICATION RIGHTS, OBLIGATIONS, OR AGREEMENTS AFFECTING THE CORPORATION. - PURCHASE, ADOPTION, AMENDMENT, CANCELLATION OR REPLACEMENT OF ANY INSURANCE COVERAGE FOR THE CORPORATION OR ITS DIRECTORS, OFFICERS, AND AGENTS, AS WELL AS COPIES OF ANY NOTICES OF CANCELLATION RECEIVED BY THE CORPORATION. -THE COMMENCEMENT OF LITIGATION OR THE SETTLEMENT OF LITIGATION OR OTHER CLAIMS. -Approval of the adoption or amendment of fee schedules relating to patient services. -Designation of additional or successor Member(s). -TAKE ANY ACTION WHICH WOULD BE CONSISTENT WITH THE GOVERNING DOCUMENTS OR POLICIES OF THE MEMBER. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body No such committees exist. Form 990, Part VI, Line 11b Review of form 990 by governing body PER A RESOLUTION APPROVED BY THE MEMBER'S BOARD OF DIRECTORS, THE MEMBER BOARD'S AUDIT & COMPLIANCE COMMITTEE HAS THE DELEGATED AUTHORITY TO REVIEW THE ORGANIZATION'S COMPLETED FORM 990 PRIOR TO FILING. FOLLOWING THE COMMITTEE'S REVIEW, THE COMPLETED FORM 990 IS DISTRIBUTED TO THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION CONSISTENTLY MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY THROUGH TWO SEPARATE PROCESSES, ONE THAT APPLIES TO THE BOARD MEMBERS, AND A SECOND THAT APPLIES TO OFFICERS AND KEY EMPLOYEES. 1) BOARD MEMBERS: PER THE ORGANIZATION'S BOARD-APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE MEMBER'S BOARD LEADERSHIP AND PRESENTED TO THE MEMBER'S AUDIT & COMPLIANCE COMMITTEE. IF THE COMMITTEE DEEMS THERE ARE ANY SIGNIFICANT ISSUES, THE RESPONSES ARE THEN REVIEWED BY THE MEMBER BOARD'S EXECUTIVE COMMITTEE AND ANY REQUIRED ACTION (RECUSEMENT FROM BOARD DELIBERATIONS RELATED TO THE CONFLICT, ETC.) IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT. 2) OFFICERS / KEY EMPLOYEES: PER THE ORGANIZATION'S BOARD-APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE COMPLIANCE SERVICES DEPARTMENT. IF THE DEPARTMENT DEEMS THERE ARE ANY SIGNIFICANT ISSUES, REQUIRED ACTION IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT AND THE BOARD IS NOTIFIED OF SUCH ACTIONS. Form 990, Part VI, Line 19 Required documents available to the public THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. Form 990, Part VII, Section A, Line 1a, Column (B) Average Hours MICHAEL A. BELFORT, M.D., PH.D. RECEIVES COMPENSATION IN HIS CAPACITY AS A PHYSICIAN, NOT AS A BOARD MEMBER. SAMUEL LAW II, M.D. RECEIVES COMPENSATION IN HIS CAPACITY AS A PHYSICIAN, NOT AS A BOARD MEMBER. ANGELO P. GIARDINO, M.D., PH.D. RECEIVES COMPENSATION IN HIS CAPACITY AS AN EMPLOYEE, NOT AS A BOARD MEMBER. BART PUTTERMAN, M.D. RECEIVES COMPENSATION IN HIS CAPACITY AS A PHYSICIAN, NOT AS A BOARD MEMBER. EDWARD E. YOSOWITZ, M.D. RECEIVES COMPENSATION IN HIS CAPACITY AS A PHYSICIAN, NOT AS A BOARD MEMBER. DAVID ZEPEDA, M.D. RECEIVES COMPENSATION IN HIS CAPACITY AS A PHYSICIAN, NOT AS A BOARD MEMBER. Form 990, Part VII, Section A INCENTIVE COMPENSATION DR. MICHAEL A. BELFORT, WHILE EMPLOYED BY BAYLOR COLLEGE OF MEDICINE, SERVES AS AN IN-CHIEF DIRECTING PATIENT CARE AT TEXAS CHILDREN'S HOSPITAL. DUE TO HIS SENIOR LEADERSHIP ROLE, HE IS ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON HIS CONTRIBUTION TO ACHIEVING THE ORGANIZATION'S STRATEGIC GOALS. ALL COMPENSATION IS EARNED IN HIS CAPACITY AS A PHYSICIAN LEADER. SCHEDULE O FORM 5471 DISCLOSURE STATEMENT UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT: -TEXAS CHILDREN'S HOSPITAL FOUNDATION EIN:20-2380599 6621 FANNIN ST HOUSTON, TX 77030 -TEXAS CHILDREN'S EIN: 76-0461578 1919 S. BRAESWOOD BLVD, 4TH FL HOUSTON, TX 77030 TEXAS CHILDREN'S 1919 S BRAESWOOD BLVD 4TH FL HOUSTON TX 77030 760461578 PARENT TX 501(c)(3 Type II NA false TEXAS CHILDREN'S PHYSICIAN GROUP 6621 FANNIN STREET HOUSTON TX 77030 260834681 HEALTH CARE TX 501(c)(3 9 TEXAS CHILDREN'S true TEXAS CHILDREN'S HEALTH PLAN 6330 WEST LOOP SOUTH SUITE 800 8TH FLOOR HOUSTON TX 77021 760486264 HEALTH CARE TX 501(c)(3 9 TEXAS CHILDREN'S true TEXAS CHILDREN'S HOSPITAL 6621 FANNIN STREET HOUSTON TX 77030 741100555 HOSPITAL TX 501(c)(3 3 TEXAS CHILDREN'S true TEXAS CHILDREN'S HOSPITAL FOUNDATION 6621 FANNIN STREET HOUSTON TX 77030 202380599 SUPPORTING ORG TX 501(c)(3 Type II TEXAS CHILDREN'S true TCH PEDIATRIC ASSOCIATES INC PO BOX 300630 HOUSTON TX 77230 760460242 HEALTH CARE TX 501(c)(3 9 TEXAS CHILDREN'S true TEXAS CHILDREN'S HEALTH PLAN - THE CENTER 6621 FANNIN STREET HOUSTON TX 77030 461392824 HEALTH CARE TX 501(c)(3 Type I TEXAS CHILDREN'S HEALTH PLAN true TEXAS CHILDREN'S URGENT CARE 1919 S BRAESWOOD BLVD 4TH FLOOR HOUSTON TX 77030 472029489 HEALTH CARE TX 501(c)(3 9 TCH PEDIATRIC ASSOCIATES INC true THE GORDON AND MARY CAIN PEDIATRIC NEUROLOGY RESEARCH FOUNDATION 9 GREENWAY PLAZA HOUSTON TX 77046 760246858 SUPPORTING ORG TX 501(c)(3 Type I TEXAS CHILDREN'S HOSPITAL true TCH INSURANCE COMPANY LTD 23 LIME BAY AVE GRAND CAYMAN CJ KY11102 980176652 INSURANCE CJ NA C Corporation true CVI GVF HOLDINGS 3 LTD UGLAND HOUSE SOUTH CHURCH ST GEORGE TOWN CJ KY11104 981078282 INVESTMENT CJ NA C Corporation true false false false false false false false false false false false true true true true false false true false TEXAS CHILDREN'S PHYSICIAN GROUP L 8024025 COST TEXAS CHILDREN'S PHYSICIAN GROUP M 522152 COST TEXAS CHILDRENS HOSPITAL M 667884 COST TEXAS CHILDREN'S PHYSICIAN GROUP M 1290828 COST TCH INSURANCE COMPANY LTD R 372287 COST