2017-07-14T15:08:48-05:00 2016-08-31 750786316 WEAVER AND TIDWELL LLP 2821 W 7TH STREET SUITE 700 FORT WORTH TX 76107 990 2015-09-01 752655008 UT SOUTHWESTERN MONCRIEF CANCER CENTER UTSO 8172889800 400 W MAGNOLIA AVE FORT WORTH TX 76104 ARNIM E DONTES SECRETARY AND TREASURER 8172889800 2017-07-14 1 HEIDI J DOLAN P00934271 8173327905 2015 2021-01-29 14:40:06Z MONCRIEF CANCER INSTITUTE KEITH ARGENBRIGHT MD 400 W MAGNOLIA AVE FORT WORTH TX 76104 12103447 0 X WWW.MONCRIEF.COM X 1958 TX TO PROVIDE COUNSELING AND SUPPORT RESOURCES TO CANCER PATIENTS AND THEIR FAMILIES. 4 1 0 0 0 0 14587952 9787765 0 0 80809 53952 1227540 1786384 15896301 11628101 181990 172398 0 0 0 0 0 0 0 9697348 13595864 9879338 13768262 6016963 -2140161 41222642 39979782 1478259 2432553 39744383 37547229 X TO BE A LEADER IN OUR COMMUNITY'S EFFORTS TO FIGHT CANCER AND REDUCE ITS BURDEN THROUGHOUT THE CONTINUUM OF CARE SETTING, USING EDUCATION, AWARENESS, PREVENTION, EARLY DETECTION, BEHAVIORAL AND NUTRITIONAL SCIENCES AND RESEARCH. 0 0 2667185 84682 SURVIVORSHIP PROGRAM PROVIDES SERVICES TO COMMUNITY AND SURROUNDING COUNTIES' CANCER SURVIVOR PATIENTS. SERVICES PROVIDED INCLUDE NUTRITION COUNSELING PROVIDED BY REGISTERED AND LICENSED DIETITIANS WHO WORK TO EDUCATE SURVIVORS ON THE ROLE NUTRITION PLAYS IN CANCER TREATMENT AND RECOVERY. ADDITIONALLY, THE SURVIVORSHIP PROGRAM OFFERS FITNESS INSTRUCTION AND PROGRAMS TO CANCER SURVIVORS OFFERED BY A SPECIALIZED FITNESS INSTRUCTOR. OTHER SERVICES INCLUDE COUNSELING, FINANCIAL ASSISTANCE, SOCIAL WORK, TRANSPORTATION AND SUPPORT RESOURCES TO CANCER PATIENTS AND THEIR FAMILIES WITHIN TARRANT COUNTY AND THE SURROUNDING AREAS. LASTLY, CANCER SURVIVORSHIP INCLUDES CONTINUED SURVEILLANCE. 1517506 632 COLON CANCER SCREENING - CANCER PREVENTION AND RESEARCH INSTITUTE OF TEXAS (CPRIT) - PROVIDES FUNDING ALLOWING MONCRIEF CANCER INSTITUTE TO PROVIDE SCREENING AND NAVIGATION FOR EARLY COLON CANCER DETECTION TO UNDERSERVED ADULTS IN TARRANT AND SURROUNDING COUNTIES. 3811504 7170 BREAST AND CERVICAL CANCER SERVICES - PROVIDES CLINICAL BREAST EXAMS AND MAMMOGRAMS TO UNINSURED LOW INCOME WOMEN. THE PROGRAM ALSO PROVIDES ADDITIONAL DIAGNOSTIC SERVICES FOR WOMEN WITH POSITIVE MAMMOGRAM RESULTS. PROGRAM IS AIMED AT FINDING EARLY STAGE CANCERS WHICH HAVE THE HIGHEST RATE OF SUCCESSFUL TREATMENT OUTCOMES. 318839 55833 OUTREACH PROGRAM 692405 GENETICS - A RESEARCH-BASED PROGRAM THAT PROVIDES TESTING TO DETERMINE WHETHER CERTAIN CANCERS HAVE A HEREDITARY COMPONENT. THIS TESTING NOT ONLY HELPS TO STUDY CANCER BIOLOGY, IT CAN PROVIDE INSIGHT FOR PATIENTS AND FAMILY MEMBERS THAT MAY BE PREDISPOSED TO CERTAIN CANCERS. 46004 24081 OTHER LOCAL 1057248 79914 9053443 1 1 0 0 0 0 0 1 0 1 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 108 0 1 0 0 0 0 0 0 0 0 0 0 0 X 4 1 0 0 0 0 1 1 0 1 1 0 0 0 0 1 1 0 0 0 X KEITH ARGENBRIGHT MD 8172889898 400 W MAGNOLIA AVE FORT WORTH TX 76104 WILLIS C MADDREY MD PRESIDENT/CHAIRMAN 1.00 40.00 X X 0 586697 51507 ARNIM E DONTES SECRETARY AND TREASURER 1.00 40.00 X X 0 710682 40073 KIT MONCRIEF DIRECTOR 1.00 X 0 0 0 JAMES WILLSON JR MD DIRECTOR 1.00 40.00 X 0 624744 35169 KEITH ARGENBRIGHT MD MEDICAL DIRECTOR FOR MCI 1.00 40.00 X 0 363464 40073 MICHAEL SERBER ASSISTANT TREASURER 1.00 40.00 X 0 277504 37718 0 2563091 204540 0 0 1 0 JPS HEALTH NETWORK 1500 S MAIN STREET FORT WORTH TX 76104 SCREENING SERVICES 461522 POWELL CONSTRUCTION 1502 OAK GLEN CT ARLINGTON TX 76012 GENERAL CONTRACTOR 321202 ROSE IMAGING SPECIALIST PA PO BOX 203268 DALLAS TX 753203268 SCREENING SERVICES 311273 KELLY HART & HALLMAN LLP 201 MAIN ST 2500 FORT WORTH TX 76102 LEGAL SERVICES 149397 DENTON REGIONAL MEDICAL CENTER 3535 S INTERSTATE 35 E DENTON TX 76210 MEDICAL SERVICES 122166 5 3423381 6364384 9787765 53952 53952 2261730 475346 1786384 1786384 1786384 11628101 0 0 1840336 X 91268 91268 81130 81130 160388 75809 84579 53100 53100 9637286 7399291 2237995 658984 538625 120359 375357 295135 80222 200101 46408 153693 809463 150823 658640 137223 101202 36021 1026023 1026023 110165 110165 MEDICAL SUPPLIES 184383 184383 CERTIFICATION & CONT ED 117547 74659 42888 MISCELLANEOUS 108394 3511 104883 MINOR ASSETS 7333 6619 714 10117 4580 5537 13768262 9053443 4714819 0 1920815 793885 1138440 182662 184190 177863 48525511 14779447 34973434 33746064 3005763 5079308 41222642 39979782 1448259 2297249 30000 135304 1478259 2432553 X 38226822 36086661 1517561 1460568 39744383 37547229 41222642 39979782 X -2140161 -56993 X 0 1 X 0 1 1 X X 1 UT SOUTHWESTERN MEDICAL CENTER 756002868 6 1 6126108 0 1 6126108 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 518965 0 1517561 -56992 1460569 1630134 -112573 1517561 1540529 89605 1630134 1512501 28028 1540529 1503747 8754 1512501 1.00000 0 0 4285018 4285018 40492397 12134012 28358385 1187213 1187213 0 1796918 1458222 338696 763965 763965 33746064 BENEFICIAL INTEREST IN PERPETUAL TRUST 1460568 DUE FROM MONCRIEF CANCER FOUNDATION 1640352 A/R RELATED PARTY 1978388 5079308 X 12103447 475346 475346 11628101 0 11628101 14300601 532339 532339 13768262 0 13768262 PART X, LINE 2: MONCRIEF AND THE FOUNDATION ARE BOTH GENERALLY EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. MONCRIEF IS SUBJECT TO FEDERAL INCOME TAXES ON UNRELATED BUSINESS INCOME. NO FEDERAL INCOME TAXES WERE INCURRED FOR UNRELATED BUSINESS INCOME FOR THE YEARS ENDED AUGUST 31, 2016 AND 2015. BOTH ENTITIES RECOGNIZE IN ITS FINANCIAL STATEMENTS THE FINANCIAL EFFECT OF A TAX POSITION, IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTION OF ANY APPEALS OR LITIGATION PROCESSES, BASED UPON THE TECHNICAL MERITS OF THE POSITION. TAX POSITIONS TAKEN RELATED TO MONCRIEF AND THE FOUNDATION'S UNRELATED BUSINESS INCOME AND ITS TAX EXEMPT STATUS AS A NONPROFIT ORGANIZATION FOR FEDERAL TAX PURPOSES HAVE BEEN REVIEWED, AND MANAGEMENT IS OF THE OPINION THAT MATERIAL POSITIONS TAKEN BY EACH ENTITY WOULD MORE LIKELY THAN NOT BE SUSTAINED BY EXAMINATION. ACCORDINGLY, NEITHER ENTITY HAS RECORDED AN INCOME TAX LIABILITY FOR UNCERTAIN TAX BENEFITS. AS OF AUGUST 31, 2016, THE FOUNDATION'S TAX YEARS 2013 AND THEREAFTER REMAIN SUBJECT TO EXAMINATION. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 475,346. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 56,993. RENTAL EXPENSE 475,346. 0 SUSAN G KOMEN NORTH TEXAS PO BOX 261730 PLANO TX 75026 752356437 501(C)(3) 6500 SUPPORT AND RESEARCH SUSAN G KOMEN GREATER FORT WORTH 2216 GREEN OAKS RD FORT WORTH TX 76116 752445070 501(C)(3) 12500 SUPPORT AND RESEARCH CAREITY FOUNDATION PO BOX 126038 FORT WORTH TX 76126 061704800 501(C)(3) 15000 SUPPORT AND RESEARCH AMERICAN CANCER SOCIETY 3301 WEST FREEWAY FORT WORTH TX 75017 131788491 501(C)(3) 11500 SUPPORT AND RESEARCH FORT WORTH ADOLESCENT AND YOUNG ADULT ONCOLOGY COALITION PO BOX 471332 FORT WORTH TX 76147 473205260 501(C)(3) 5000 SUPPORT AND RESEARCH FORT WORTH SOUTH INC 1606 MISTLETOE BLVD FORT WORTH TX 76104 752640191 501(C)(4) 10000 SUPPORT AND RESEARCH TARRANT SPECIAL EVENTS FOUNDATION 100 E WEATHERFORD STE 404 FORT WORTH TX 76196 472565482 501(C)(3) 5000 SUPPORT AND RESEARCH 6 1 ASSISTANCE FOR INDIGENT CARE 85 81130 0 0 0 0 0 0 0 0 0 WILLIS C MADDREY MD PRESIDENT/CHAIRMAN 0 450977 0 135000 0 720 0 38863 0 12644 0 638204 0 0 ARNIM E DONTES SECRETARY AND TREASURER 0 546712 0 163250 0 720 0 22525 0 17548 0 750755 0 0 JAMES WILLSON JR MD DIRECTOR 0 491724 0 132300 0 720 0 22525 0 12644 0 659913 0 0 KEITH ARGENBRIGHT MD MEDICAL DIRECTOR FOR MCI 0 343464 0 20000 0 0 0 22525 0 17548 0 403537 0 0 MICHAEL SERBER ASSISTANT TREASURER 0 228034 0 48750 0 720 0 20170 0 17548 0 315222 0 0 ARNIM E DONTES OFFICER - UT SOUTHWESTERN MONCRIEF CANCER CTR & UT SOUTHWESTERN MEDICAL CTR 6126108 FINANCIAL & ADMINISTRATIVE SERVICES 0 FORM 990, PART VI, SECTION A, LINE 6 DR. PODOLSKY IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A DR. PODOLSKY, IN HIS CAPACITY AS MEMBER, HAS THE SOLE AUTHORITY TO APPOINT DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION PROVIDES AUDITED FINANCIAL STATEMENTS AND SUPPORTING DOCUMENTATION UPON WHICH THE FORM 990 IS PREPARED. THE 990 IS REVIEWED BY MICHAEL SERBER, ASSISTANT TREASURER, AND ARNIM E. DONTES, SECRETARY AND TREASURER. IT IS THEN SUBMITTED TO DR. WILLIS MADDREY, PRESIDENT AND CHAIRMAN, FOR REVIEW. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS'S GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL: PROGRAM SERVICE EXPENSES 2,734,957. MANAGEMENT AND GENERAL EXPENSES 139,092. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,874,049. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 224,658. MANAGEMENT AND GENERAL EXPENSES 153,421. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 378,079. LEASED EMPLOYEES: PROGRAM SERVICE EXPENSES 4,051,351. MANAGEMENT AND GENERAL EXPENSES 1,893,633. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,944,984. CONSULTING: PROGRAM SERVICE EXPENSES 316,146. MANAGEMENT AND GENERAL EXPENSES 51,849. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 367,995. TRANSLATION SERVICES: PROGRAM SERVICE EXPENSES 72,179. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 72,179. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST -56,993. MONCRIEF CANCER FOUNDATION 5323 HARRY HINES BLVD DALLAS TX 75390 752429817 ORGANIZED & OPERATED FOR THE BENEFIT OF UT SOUTHWESTERN MED CTR TX 501(C)(3) 509(A)(3) 0 UT SOUTHWESTERN MEDICAL CENTER 5323 HARRY HINES BLVD DALLAS TX 75390 756002868 HIGHER EDUCATION, RESEARCH, AND PROVISION OF MEDICAL CARE TX 501(C)(3) LINE 6 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 MONCRIEF CANCER FOUNDATION C 3423381 CASH UT SOUTHWESTERN MEDICAL CENTER J 890474 CASH UT SOUTHWESTERN MEDICAL CENTER N 181124 CASH UT SOUTHWESTERN MEDICAL CENTER O 2767631 CASH