COMPLEX CARE MEDICAL SERVICES CORPORATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
COMPLEX CARE MEDICAL SERVICES CORPORATION (EIN 46-1893597)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-11
IRS object ID
201623169349301447
Schema version
2015v2.1
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

FieldValueIRS element (for citing)
Return2016-11-11T11:03:50-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN461893597EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Complex Care Medical Services CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMPBusinessNameControlTxt
Phone2144567000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 MEDICAL DISTRICT DRIVEAddressLine1Txt
CityDALLASCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJERRY LEEPersonNm
Person TitleTREASURERPersonTitleTxt
Signature2016-11-10SignatureDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1JERRY LEEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 MEDICAL DISTRICT DRIVEAddressLine1Txt
CityDALLASCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$121,676GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2012FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionTO SERVE AS THE MEDICAL HOME FOR CHILDREN WITH COMPLEX MEDICAL ILLNESSES.ActivityOrMissionDesc
Voting Members Governing Body4VotingMembersGoverningBodyCnt
Voting Members Independent2VotingMembersIndependentCnt
Total Employee10TotalEmployeeCnt
Total Volunteers2TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$1,770,185PYProgramServiceRevenueAmt
CY Program Service Revenue$121,676CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,770,185PYTotalRevenueAmt
CY Total Revenue$121,676CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$398,699PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,386,265CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,023,311PYOtherExpensesAmt
CY Other Expenses$828,489CYOtherExpensesAmt
PY Total Expenses$2,422,010PYTotalExpensesAmt
CY Total Expenses$2,214,754CYTotalExpensesAmt
PY Revenues Less Expenses-$651,825PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,093,078CYRevenuesLessExpensesAmt
Total Assets BOY$3,323,468TotalAssetsBOYAmt
Total Assets EOY$3,257,854TotalAssetsEOYAmt
Total Liabilities BOY$4,183,932TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,211,398TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$860,464NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$2,953,544NetAssetsOrFundBalancesEOYAmt
MissionTO SERVE AS THE MEDICAL HOME FOR CHILDREN WITH COMPLEX MEDICAL ILLNESSES WHERE A MULTI-DISCIPLINARY TEAM OF CARE GIVERS OVERSEE AND COORDINATE THEIR CARE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,692,333ExpenseAmt
Revenue$121,676RevenueAmt
DescTO SERVE AS THE MEDICAL HOME FOR CHILDREN WITH COMPLEX MEDICAL ILLNESSES WHERE A MULTI-DISCIPLINARY TEAM OF CARE GIVERS OVERSEE AND COORDINATE THEIR CARE.Desc
Total Program Service Expenses$1,692,333TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee10EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members4GoverningBodyVotingMembersCnt
Independent Voting Member2IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STEPHANIE K SMITHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2144567000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 MEDICAL DISTRICT DRIVEAddressLine1Txt
CityDALLASCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Michelle Thomas MD
Chair1.00Yes (X)$0$0$0
John Anderson MD
Director1.00Yes (X)$0$0$0
Andrew Gelfand MD
Director, Physician1.09.0Yes (X)$0$16,500$0
William Scott MD
Director, Physician1.049.0Yes (X)$0$190,181$0
W Robert Morrow MD
President, Pres Phys Orgs Acdmc Rel CCO CHST1.054.0$0$798,164$19,499Yes (X)
Stephanie K Smith
Secretary, Sr Legal Counsel CHST1.049.0$0$121,525$11,465Yes (X)
Jerry D Lee
Treasurer, VP Accounting and Treasury CHST1.049.0$0$393,636$33,484Yes (X)
Douglas G Hock
Pres COO CMC and Pres Clinical Services CHST0.055.0$0$1,013,374$39,974Yes (X)
Peter W Roberts
Pres Pop Hlth Insurance Svcs0.055.0$0$1,021,968$26,295Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,555,348TotReportableCompRltdOrgAmt
Total Other Compensation$130,717TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UTSWBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1HI 108 5323 HARRY HINES BLVDAddressLine1Txt
CityDALLASCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75390ZIPCd
FieldValueIRS element (for citing)
ServicesPHYS & MEDICAL SVCSServicesDesc
Compensation$502,205CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNet Patient RevenueDesc
Business621110BusinessCd
Total Revenue Column$121,676TotalRevenueColumnAmt
Related Or Exempt Func Income$121,676RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$121,676TotalProgramServiceRevenueAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$121,676TotalRevenueColumnAmt
Related Or Exempt Func Income$121,676RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,250,950TotalAmt
Program Services$1,096,043ProgramServicesAmt
Management And General$154,907ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$27,441TotalAmt
Program Services$24,043ProgramServicesAmt
Management And General$3,398ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$74,215TotalAmt
Program Services$65,025ProgramServicesAmt
Management And General$9,190ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$33,659TotalAmt
Program Services$29,491ProgramServicesAmt
Management And General$4,168ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$113,532TotalAmt
Management And General$113,532ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,850TotalAmt
Program Services$2,850ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$150,710TotalAmt
Program Services$105,685ProgramServicesAmt
Management And General$45,025ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$14,206TotalAmt
Program Services$9,806ProgramServicesAmt
Management And General$4,400ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$4,082TotalAmt
Management And General$4,082ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$158,253TotalAmt
Program Services$6,026ProgramServicesAmt
Management And General$152,227ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$995TotalAmt
Program Services$64ProgramServicesAmt
Management And General$931ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,235TotalAmt
Program Services$725ProgramServicesAmt
Management And General$510ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$104,838TotalAmt
Program Services$79,344ProgramServicesAmt
Management And General$25,494ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
COMMUNITY RELATIONS$233,526$233,526
Dietary and Food Costs$15,655$14,732$923
Medical Surgical Supplies$11,143$8,973$2,170
Special Events & Projects$1,000$1,000

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$16,464TotalAmt
Program Services$16,000ProgramServicesAmt
Management And General$464ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,214,754TotalAmt
Program Services$1,692,333ProgramServicesAmt
Management And General$522,421ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$83,877BOYAmt
EOY$1,446,932EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,767,804BOYAmt
EOY$443,972EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,478,486LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$111,536LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,471,787BOYAmt
EOY$1,366,950EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,323,468BOYAmt
EOY$3,257,854EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$219,195BOYAmt
EOY$1,083,858EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,964,737BOYAmt
EOY$5,127,540EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,183,932BOYAmt
EOY$6,211,398EOYAmt

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$860,464BOYAmt
EOY-$2,953,544EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$860,464BOYAmt
EOY-$2,953,544EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,323,468BOYAmt
EOY$3,257,854EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$2,093,078ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$2OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,406,298OtherCostOrOtherBasisAmt
Depreciation$99,030DepreciationAmt
Book Value$1,307,268BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$72,188OtherCostOrOtherBasisAmt
Depreciation$12,506DepreciationAmt
Book Value$59,682BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,366,950TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
LT Advances - Affiliates$5,110,448
LT Deferred Rent$17,092
FieldValueIRS element (for citing)
Total Liability$5,127,540TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEAR ENDING DECEMBER 31, 2015 DID NOT REQUIRE A FIN 48 FOOTNOTE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
William Scott MD
Director, Physician$0$190,181$0$0$0$0$0$0$0$0$0$190,181$0$0
Douglas G Hock
Pres COO CMC and Pres Clinical Services CHST$0$525,384$0$415,277$0$72,713$0$18,768$0$21,205$0$1,053,348$0$98,100
Peter W Roberts
Pres Pop Hlth Insurance Svcs$0$534,452$0$335,196$0$152,320$0$10,600$0$15,695$0$1,048,262$0$0
W Robert Morrow MD
President, Pres Phys Orgs Acdmc Rel CCO CHST$0$495,272$0$297,763$0$5,129$0$10,600$0$8,899$0$817,664$0$0
Jerry D Lee
Treasurer, VP Accounting and Treasury CHST$0$274,148$0$91,095$0$28,393$0$14,641$0$18,843$0$427,120$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationCHILDREN'S HEALTH SYSTEM OF TEXAS (EIN 75-2062019) IS THE SOLE MEMBER AND COMMON PAYING AGENT FOR COMPLEX CARE MEDICAL SERVICES CORPORATION (CCMSC). THEREFORE, CCMSC'S TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). THE CHILDREN'S HEALTH PROCESS FOR DETERMINING COMPENSATION IS AS FOLLOWS: 1. The Human Resources Committee of the CHST Board is responsible for setting the compensation for executives, except the President and CEO which is set by the Board of Directors. The Committee is comprised of independent, non-employee directors with no conflict of interest regarding executive compensation. A written compensation philosophy has been developed by the Human Resources Committee for timeliness and appropriateness. The philosophy defined desired comparator groups for compensation surveys. The comparator groups are from domestic healthcare industry sectors only and do not include any non-healthcare organizations. 2. The compensation philosophy also defines target levels relative to the marketplace comparator groups for base pay, base pay plus incentive pay, and fringe benefits provided to Children's Health executives. A third-party consultant, Sullivan Cotter, is engaged by the Human Resources Committee and provides independent, expert consulting services in the area of executive compensation market surveying, pay and benefits program design, and administrative services. Salaries for Children's Health executives (except for the President and CEO) are set by comparing the salaries paid for comparable positions in integrated systems, academic medical centers, and children's hospitals in similar size and scope of services to Children's Health. 3. The salary for the President and CEO is set in reference to salaries paid for Presidents and CEOs of children's hospitals in similar size and scope of services to Children's Health. The data is compiled by Sullivan Cotter and they develop and update annually salary ranges unique to each executive position. The Human Resources Committee approves base pay for each executive (except the President and CEO, whose base pay is approved by the Board of Directors) aimed in the aggregate at approximately the middle of executive pay ranges. 4. For other officers and key employees, Children's Health uses a combination of job evaluation and survey data to determine the market pay range.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planNon-Qualified Retirement Plan: * Children's Health Savings Restoration Plan - There were no employees that received taxable income from the Savings Restoration Plan. Dr. W. Robert Morrow and Jerry Lee participated in the Savings Restoration Plan.
Schedule J, Part I, Line 7 Non-fixed paymentsNon-Fixed Payments - The Human Resources Committee of the Board of Directors retains the authority to adjust annual payout percentages solely at their discretion. There were no non-fixed payments in 2015.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 2aCHILDREN'S HEALTH SYSTEM OF TEXAS (CHST) EIN 75-2062019 IS THE COMMON PAYING AGENT FOR COMPLEX CARE MEDICAL SERVICES CORPORATION (CCMSC) THEREFORE, ALL APPLICABLE IRS TAX COMPLIANCE FILINGS ARE REPORTED BY CHST ON BEHALF OF CCMSC. CCMSC HAS APPROXIMATELY 10 EMPLOYEES.
Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIALCHILDREN'S HEALTH SYSTEM OF TEXAS (EIN 75-2062019) IS THE SOLE MEMBER AND COMMON PAYING AGENT FOR COMPLEX CARE MEDICAL SERVICES CORPORATION (CCMSC). THEREFORE, CCMSC'S TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). THE CHILDREN'S HEALTH PROCESS FOR DETERMINING COMPENSATION IS AS FOLLOWS: 1. THE HUMAN RESOURCES COMMITTEE OF THE CHST BOARD IS RESPONSIBLE FOR SETTING THE COMPENSATION FOR EXECUTIVES, EXCEPT THE PRESIDENT AND CEO WHICH IS SET BY THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPRISED OF INDEPENDENT, NON-EMPLOYEE DIRECTORS WITH NO CONFLICT OF INTEREST REGARDING EXECUTIVE COMPENSATION. A WRITTEN COMPENSATION PHILOSOPHY HAS BEEN DEVELOPED BY THE HUMAN RESOURCES COMMITTEE FOR TIMELINESS AND APPROPRIATENESS. THE PHILOSOPHY DEFINED DESIRED COMPARATOR GROUPS FOR COMPENSATION SURVEYS. THE COMPARATOR GROUPS ARE FROM DOMESTIC HEALTHCARE INDUSTRY SECTORS ONLY AND DO NOT INCLUDE ANY NON-HEALTHCARE ORGANIZATIONS. 2. THE COMPENSATION PHILOSOPHY ALSO DEFINES TARGET LEVELS RELATIVE TO THE MARKETPLACE COMPARATOR GROUPS FOR BASE PAY, BASE PAY PLUS INCENTIVE PAY, AND FRINGE BENEFITS PROVIDED TO CHILDREN'S EXECUTIVES. A THIRD-PARTY CONSULTANT, SULLIVAN COTTER, IS ENGAGED BY THE HUMAN RESOURCES COMMITTEE AND PROVIDES INDEPENDENT, EXPERT CONSULTING SERVICES IN THE AREA OF EXECUTIVE COMPENSATION MARKET SURVEYING, PAY AND BENEFITS PROGRAM DESIGN, AND ADMINISTRATIVE SERVICES. SALARIES FOR CHILDREN'S EXECUTIVES (EXCEPT FOR THE PRESIDENT AND CEO) ARE SET BY COMPARING THE SALARIES PAID FOR COMPARABLE POSITIONS IN INTEGRATED SYSTEMS ACADEMIC MEDICAL CENTERS AND CHILDREN'S HOSPITALS IN SIMILAR SIZE AND SCOPE OF SERVICES TO CHILDREN'S. 3. THE SALARY FOR THE PRESIDENT AND CEO IS SET IN REFERENCE TO SALARIES PAID FOR PRESIDENTS AND CEOS OF CHILDREN'S HOSPITALS IN SIMILAR SIZE AND SCOPE OF SERVICES TO CHILDREN'S. THE DATA IS COMPILED BY SULLIVAN COTTER AND THEY DEVELOP AND UPDATE ANNUALLY SALARY RANGES UNIQUE TO EACH EXECUTIVE POSITION. THE HUMAN RESOURCES COMMITTEE APPROVES BASE PAY FOR EACH EXECUTIVE (EXCEPT THE PRESIDENT AND CEO, WHOSE BASE PAY IS APPROVED BY THE BOARD OF DIRECTORS) AIMED IN THE AGGREGATE AT APPROXIMATELY THE MIDDLE OF EXECUTIVE PAY RANGES. 4. FOR OTHER OFFICERS AND KEY EMPLOYEES, CHILDREN'S USES A COMBINATION OF JOB EVALUATION AND SURVEY DATA TO DETERMINE THE MARKET PAY RANGE.
Form 990, Part VI, Line 6 Classes of members or stockholdersChildren's Health System of Texas (CHST) is the sole member.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyDirectors are appointed by the sole member and approved by the current CCMSC Board of Directors.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersMember reserve powers are specified in the organization's Bylaws and represent those actions by the organization which require member approval. These powers generally encompass changes in the mission of the organization, addition of new members, certain dispositions of assets, amendments to the organization's Certificate of Formation and Bylaws, and appointment of directors.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyComplex Care Medical Services Corporation has delegated its oversight and review of the Form 990 to the Board of Directors of Children's Health System of Texas (CHST), its Sole Member. A draft of the Form 990 is presented to the CHST Audit Committee for review prior to filing. A copy of the Final Form 990 is made available to the CHST directors through our Board portal before it is filed.
Form 990, Part VI, Line 12c Conflict of interest policyOfficers, directors, and key employees received a copy of the Statement of Interest form to execute. Disclosures made are reviewed by the CHST Executive Vice President, Chief Legal Officer and General Counsel and the Chief Compliance Officer and discussed as necessary at the appropriate Board meeting to determine if further action is needed.
Form 990, Part VI, Line 19 Required documents available to the publicCertificate of Formation and Consolidated Financial Statements are publicly available. The conflict of interest policy is made available to the public upon request.
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesRounding - -2;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Children's Medical Center of Dallas
1935 MEDICAL DISTRICT DRIVEDALLASTX75235750800628HospitalTX501(c)(33CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S MEDICAL CENTER FOUNDATION
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752062015FOUNDATIONTX501(c)(37CHILDREN'S HEALTH SYSTEM OF TEXASfalse
PHYSICIANS FOR CHILDREN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752854505PHYSICIANSTX501(c)(33CHILDREN'S HEALTH SYSTEM OF TEXASfalse
DALLAS PHYS MED SVCS FOR CHILDREN INC
1935 MEDICAL DISTRICT DRIVEDALLASTX75235810584868PHYSICIANSTX501(c)(33CHILDREN'S HEALTH SYSTEM OF TEXASfalse
COMPLEX CARE MED SVC CORP
1935 MEDICAL DISTRICT DRIVEDALLASTX75235461893597MEDICAL SERVICESTX501(c)(33CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S MEDICAL CENTER HEALTH PLAN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235462737696HMOTX501(c)(39CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S MED CTR RESEARCH INST AT UTSWMC
1935 MEDICAL DISTRICT DRIVEDALLASTX75235433462044RESEARCH INSTITUTETX501(c)(3Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
PEDIATRIC PARTNERS FOR CHILDREN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235461917702CLINICALLY INTEGRATED NETWORKTX501(c)(3Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S MEDICAL CENTER SERVICES
1935 MEDICAL DISTRICT DRIVEDALLASTX75235461934007MEDICAL SERVICESTX501(c)(39CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S POPULATION HEALTH
1935 MEDICAL DISTRICT DRIVEDALLASTX75235463104601POPULATION HEALTHTX501(c)(3Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S HEALTH SYSTEM OF TEXAS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752062019MANAGEMENT COMPANYTX501(c)(3Type IIfalseN/A
ANESTHESIOLOGISTS FOR CHILDREN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752917570PHYSICIANSTX501(c)(39CHILDREN'S HEALTH SYSTEM OF TEXASfalse
SPECIALISTS FOR CHILDREN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235463110125PHYSICIANSTX501(c)(39CHILDREN'S HEALTH SYSTEM OF TEXASfalse
PHYSICIANS QUALITY ALLIANCE OF NORTH TEXAS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235464049491PHYSICIANSTX501(c)(3Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
COMMUNITY PROVIDERS FOR CHILDREN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235463675742PHYSICIANSTX501(c)(3Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
SOUTHWESTERN MEDICAL DISTRICT
1935 MEDICAL DISTRICT DRIVEDALLASTX75235204101612MEDICAL DISTRICTTX501(c)(3Type IfalseN/A
WOMEN'S AUXILIARY OF CMCD
12720 HILLCREST RDDALLASTX75230752485538WOMEN'S AUXILIARYTX501(c)(39falseN/A
THE HEALTH AND WELLNESS ALLIANCE FOR CHILDREN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235463080586PHYSICIANSTX501(c)(3Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
OCH Holdings
1935 Medical District DriveDallasTX75235474837308HospitalTX501(c)(33Children's Medical Center of Dallasfalse
Children's BMG dba One Care Domain
1935 Medical District DriveDallasTX75235475057374PhysicianTX501(c)(33CHILDREN'S HEALTH SYSTEM OF TEXASfalse
Wellness Innovations Physician Partners
1935 Medical District DriveDallasTX75235811734937PhysicianTX501(c)(33Wellness Innovations LLCfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Wellness Innovations LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 Medical District DriveAddressLine1Txt
CityDallasCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd
FieldValueIRS element (for citing)
EIN475246461EIN
Primary ActivitiesPhysiciansPrimaryActivitiesTxt
Legal Domicile StateTXLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CHST Investment Holdings LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeUnrelatedPredominantIncomeTypeTxt
Share Of Total Income$0ShareOfTotalIncomeAmt
Share Of EOY Assets$0ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
Ownership0.0OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
CHILDREN'S INSURANCE COMPANY
76 ST PAUL STREET SUITE 500BURLINGTONVT05401030328102INSURANCE COMPANYVTCHILDREN'S HEALTH SYSTEM OF TEXASC Corporation$0$00false
ALTERNATIVE CARE SYSTEMS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752244475OTHER MEDICAL SERVICESTXCHILDREN'S HEALTH SYSTEM OF TEXASC Corporation$0$00false
NTPSS INC
1935 MEDICAL DISTRICT DRIVEDALLASTX75235471036641PHYSICIAN SOLUTIONSTXPediatric PartnersC Corporation$0$00false
TEXAS BLUEBONNET HEALTH PLAN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235472252673HEALTH PLANTXCHILDREN'S HEALTH SYSTEM OF TEXASC Corporation$0$00false
Texas Bluebonnet Insurance Company
1935 Medical District DriveDallasTX75235475032893Insurance CompanyTXChildren's Health System of TexasC Corporation$0$00false
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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