2016-10-26T13:38:10-05:00 2015-12-31 350921680 CROWE HORWATH LLP 401 East Las Olas Blvd Suite 1100 Fort Lauderdale FL 333014230 990 2015-01-01 463756071 Pediatric Specialty Group Inc PEDI 3056666511 3100 SW 62ND AVENUE MIAMI FL 33155 Timothy Birkenstock CFO 2016-10-21 true Brittney Kocaj P01320603 9542028600 2015 2017-02-10 21:41:12Z Pediatric Specialties of America NARENDRA KINI 3100 SW 62ND AVENUE MIAMI FL 33155 56980417 false X www.nicklauschildrens.org X 2012 FL To inspire hope and promote lifelong health by providing the best care to every child. 13 1 248 1 0 0 0 181849 0 56743742 0 0 0 54826 0 56980417 0 0 0 0 0 55776143 0 0 0 0 25258812 0 81034955 0 -24054538 0 5658831 0 2584806 0 3074025 X Pediatric Specialties of America ("PSA") is a physician-directed, multi-specialty pediatric group with a regional, national, and international presence in providing pediatric-centric care through a collaborative team approach, excellence in clinical care, education, and research. (Continued on Schedule O) true false 64828755 0 56780462 In 2015, Pediatric SPECIALTIES OF AMERICA employed almost 200 Providers to support the ongoing functions of Miami Children's Health System and Nicklaus Children's Hospital in the following sub-specialties: Adolescent Medicine, Allergy/Immunology, Cardiology, Cardiovascular Surgery, Clinical Genetics and Metabolism, Critical Care Medicine, Dentistry, Emergency Medicine, Endocrinology, Gastroenterology, General Pediatrics, Neuropsychology, Neurosurgery, Ophthalmology, Orthopedics, Otolaryngology, Plastic and Reconstructive Surgery, Psychiatry and Psychology, Radiology and Rheumatology. Overall, the 2015 program accomplishments of Pediatric SPECIALTIES OF AMERICA physicians include being internationally recognized for care excellence by being ranked among the Nation's Best in 5 of the above listed specialties surveyed by U.S. News and World report in its 2015-2016 listing of "America's Best Children's Hospitals." (Results were released in 2015.) Nicklaus Children's Hospital had more ranked pediatric programs than any other hospital in Florida. Categories in which the PSA specialties were ranked in 2015 include Cardiology and Heart Surgery, Diabetes and Endocrinology, Gastroenterology & GI Surgery, Neurology/Neurosurgery and Orthopedics. Collectively the PSA specialists generated more than 511,000 encounters in 2015 serving predominately poor and underserved communities in order to improve population health and well-being for the children that we serve. 64828755 true true false false false false false false false false false false false false false 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 false false false true 16 0 true 248 true false false false false false false false false false false X 13 1 true false false false true true true true true false false true true true true true true false false false X Michael Durr 3056666511 5301 Blue Lagoon Drive MIAMI FL 33126 Leonard Feld MD Director / President 40.0 0 X X 362426 0 11419 Marcos Mestre MD Vice Chair/ Director 40.0 0.3 X X 284279 0 36044 Andrij Susla Secretary / Deputy General Counsel 0.1 40.0 X X 0 215405 30324 Narendra Kini MD CEO/ Director 0.1 40.4 X X 0 1378575 194707 Michelle Blumstein MD Director 40.0 0 X 279864 0 17705 Sandeep Dave MD Director 40.0 0 X 954340 0 18134 Robert Hannan MD Director 40.0 0 X 1028092 0 45400 Earle Heckathorn Director 40.0 0 X 227537 0 31042 Alisa Muniz Crim MD Director 40.0 0 X 366967 0 5097 John Ragheb Director 40.0 0 X 1181079 0 39024 John Rhodes MD Director 40.0 0 X 736561 0 32145 Jose Rosa-Olivares MD Director 40.0 0 X 267807 0 31072 Alex Soto Director 0.1 1.4 X 0 0 0 Tim Birkenstock Treasurer & CFO 0.1 40.3 X 0 486341 91821 Jahangir Asghar MD Physician 40.0 0 X 1102980 0 34363 Sanjiv Bhatia MD Physician 40.0 0 X 909333 0 421 Redmond P Burke MD Cardiovascular Surgery Director 40.0 0 X 1621709 0 45175 Harry Shufflebarger MD Physician 40.0 0 X 1292814 0 46552 Stephen Swirsky DO Physician 40.0 0 X 819918 0 29945 11435706 2080321 740390 164 false true false Nicklaus Children's Hospital 3100 SW 62ND AVENUE MIAMI FL 33155 MANAGEMENT AND SUPPORT SERVICES 11542471 Carecloud PO Box 347838 Pittsburgh PA 152514838 Collection Services 1864144 Tactical Management Inc 2699 Lee Road Winter Park FL 32789 Coding Services 1558433 Financial Health Strategies Inc 704 Quince Orchard Rd Gaithersburg MD 20878 Collection Services 212616 4 40000 141849 181849 Patient Service Revenue 561110 56743742 56743742 0 0 0 0 56743742 18106 18106 0 18106 18106 0 0 Lab Service 621500 36720 36720 0 0 0 0 36720 56980417 56780462 0 18106 X 0 0 5956034 4764827 1191207 43878089 35102472 8775617 2091948 1673558 418390 1811904 1449523 362381 2038168 1630534 407634 0 0 17916006 14332805 3583201 0 40500 32400 8100 615308 356989 258319 2450 1960 490 162784 130227 32557 299324 239459 59865 3963 3963 3355678 2684542 671136 Bad Debts 1718304 1374643 343661 Dues & Subscriptions 324129 259303 64826 Medical Supplies 676285 676285 Other expenses 144081 115265 28816 0 0 0 0 81034955 64828755 16206200 0 0 1010 0 0 0 0 0 5642321 0 0 0 0 0 0 0 0 15500 0 0 0 0 0 0 0 0 0 0 0 0 0 5658831 0 2584806 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2584806 X 0 3074025 0 0 0 0 0 0 0 0 0 0 0 3074025 0 5658831 X -24054538 27128563 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote PEDIATRIC SPECIALTIES OF AMERICA'S (PSA) FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MIAMI CHILDREN'S HEALTH SYSTEM (MCHS), A RELATED ORGANIZATION. MCHS' FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED DECEMBER 31, 2015, READS AS FOLLOWS: "THE SYSTEM AND CERTAIN OF ITS AFFILIATED ORGANIZATIONS QUALIFY AS TAX-EXEMPT, NONPROFIT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). THE HOSPITAL, PSA, MCHSF AND THE RESEARCH INSTITUTE ARE EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE AS DESCRIBED IN SECTION 501(C)(3). THESE TAX EXEMPT ENTITIES HAD NO TAX PROVISION FOR THE YEARS ENDED DECEMBER 31, 2015 AND 2014. THE CAPTIVE INSURANCE COMPANY IS NOT SUBJECT TO INCOME TAXES, AS NO INCOME TAXES ARE LEVIED IN THE CAYMAN ISLANDS. THE SYSTEM BELIEVES THERE IS NO UNCERTAIN TAX LIABILITY WHICH SHOULD BE RECORDED AS OF DECEMBER 31, 2015 AND 2014." false true false false false false false false false Leonard Feld MD Director / President 250177 0 75000 0 37249 0 0 0 11419 0 373845 0 0 0 Marcos Mestre MD Vice Chair/ Director 207837 0 75142 0 1300 0 6199 0 29845 0 320323 0 0 0 Andrij Susla Secretary / Deputy General Counsel 0 205651 0 9429 0 325 0 0 0 30324 0 245729 0 0 Narendra Kini MD CEO/ Director 0 782352 0 572332 0 23891 0 163209 0 31498 0 1573282 0 0 Michelle Blumstein MD Director 237724 0 41845 0 295 0 0 0 17705 0 297569 0 0 0 Sandeep Dave MD Director 436729 0 499235 0 18376 0 7950 0 10184 0 972474 0 0 0 Robert Hannan MD Director 1023350 0 0 0 4742 0 7950 0 37450 0 1073492 0 0 0 Earle Heckathorn Director 204408 0 2485 0 20644 0 0 0 31042 0 258579 0 0 0 Alisa Muniz Crim MD Director 302670 0 62997 0 1300 0 0 0 5097 0 372064 0 0 0 John Ragheb Director 1161716 0 0 0 19363 0 7950 0 31074 0 1220103 0 0 0 John Rhodes MD Director 709285 0 9336 0 17940 0 0 0 32145 0 768706 0 0 0 Jose Rosa-Olivares MD Director 202948 0 64384 0 475 0 0 0 31072 0 298879 0 0 0 Tim Birkenstock Treasurer & CFO 0 385294 0 77793 0 23254 0 68516 0 23305 0 578162 0 0 Jahangir Asghar MD Physician 821175 0 281481 0 324 0 0 0 34363 0 1137343 0 0 0 Sanjiv Bhatia MD Physician 888972 0 1000 0 19361 0 0 0 421 0 909754 0 0 0 Redmond P Burke MD Cardiovascular Surgery Director 1541238 0 78181 0 2290 0 7950 0 37225 0 1666884 0 0 0 Harry Shufflebarger MD Physician 1290317 0 0 0 2497 0 7950 0 38602 0 1339366 0 0 0 Stephen Swirsky DO Physician 731348 0 87120 0 1450 0 0 0 29945 0 849863 0 0 0 Schedule J, Part I, Line 3 METHODS USED BY RELATED ORGANIZATION TO ESTABLISH CEO'S COMPENSATION The organization relied on the methods of establishing compensation for the organization's CEO/Executive Director employed by MIAMI CHILDREN'S HEALTH SYSTEM. (EIN: 45-3481327). MIAMI CHILDREN'S HEALTH SYSTEM uses the following methods to establish such compensation: - 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 THE FOLLOWING CONTRIBUTIONS WERE MADE TO A SECTION 457(F) PLAN BY NICKLAUS CHILDREN'S HOSPITAL DURING THE YEAR - NARENDRA KINI - $155,259 TIMOTHY BIRKENSTOCK - $60,566 Form 990, Part III, Line 1 ORGANIZATION'S MISSION The Corporation is organized exclusively for charitable, educational, and scientific purposes with the mission of enhancing wellness in pediatric patients through the optimal delivery of pediatric multi-specialty care. Form 990, Part III, Line 2 New program services Refer to Part III, Line 4a. Form 990, Part VI, Line 15a DETERMINING COMPENSATION FOR CEO AND EXECUTIVE DIRECTOR THE ORGANIZATION AND COMPENSATION COMMITTEE OF MIAMI CHILDREN'S HEALTH SYSTEM'S BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD AND USED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. THIS PROCESS IS COMPLETED IN THE FIRST QUARTER EACH YEAR. The CEO is paid by Miami Children's Health System, Inc., a related organization, therefore this has been answered no in accordance with the instructions. Form 990, Part VI, Line 15b Determining compensation for other officers or key employees THE ORGANIZATION AND COMPENSATION COMMITTEE OF MIAMI CHILDREN'S HEALTH SYSTEM, INC.'S BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD AND USED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. PEDIATRIC SPECIALTIES OF AMERICA RELIED ON THE METHODS OF ESTABLISHING COMPENSATION USED BY MIAMI CHILDREN'S HEALTH SYSTEM. Form 990, Part VI, Line 1a Delegate broad authority to a committee There shall be an Executive Committee of the Board of Directors composed of three (3) Directors elected by the Board of Directors, one of whom must be the Chair of the Board and one of whom must be a physician employed by the Corporation. No non-Director members shall serve on the Executive Committee. A majority of the members of the Executive Committee shall constitute a quorum for the transaction of business and for taking any action. The Executive Committee shall have and exercise the authority designated to it by the Board of Directors in the management of the Corporation. The Executive Committee shall report to the Board of Directors any action taken by the Executive Committee at the next meeting of the Board of Directors. Members of the Executive Committee may be removed by the Board at any regular or special meeting of the Board of Directors. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons NARENDRA KINI AND TIMOTHY BIRKENSTOCK - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders THE ORGANIZATION'S SOLE MEMBER IS MIAMI CHILDREN'S HEALTH SYSTEM, INC. THE SOLE MEMBER HAS THE AUTHORITY TO ELECT MEMBERS TO THE BOARD OF DIRECTORS AND APPROVE DECISIONS OF THE BOARD. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE ELECTED MEMBERS OF THE BOARD SHALL BE ELECTED BY MIAMI CHILDREN'S HEALTH SYSTEM (THE SOLE MEMBER), AFTER TAKING INTO CONSIDERATION ANY RECOMMENDATIONS OF THE BOARD. THE NUMBER OF DIRECTORS OF THE CORPORATION SHALL BE ESTABLISHED BY RESOLUTION OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER; PROVIDED THAT THERE SHALL BE NO FEWER THAN 6 AND NO MORE THAN 15 DIRECTORS. ANY DIRECTOR MAY BE REMOVED FROM OFFICE BY ACTION OF THE SOLE MEMBER OR THE ELECTED MEMBERS OF THE BOARD SO PERMITTED TO VOTE, FOR ANY CAUSE OR REASON DEEMED SUFFICIENT BY THE MEMBER OR THE ELECTED MEMBERS OF THE BOARD SO PERMITTED TO VOTE. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The Board shall not take any action with respect to the following without the approval of Miami Children's Health System (the sole Member): a) Modify the mission, purpose or scope of the CORPORATION, or materially change the location, size or scope of services, programs, operations or educational or medical school affiliations of the CORPORATION or related agreements; b) Create any entity in which the CORPORATION is the sole member or sole shareholder, or any entity in which the CORPORATION has a direct or indirect oversight role, which may include not-for-profit, for profit, limited liability companies, or any other legal entity; c) Sell, lease, purchase, create, dissolve, convey, mortgage, grant a security interest or otherwise dispose of any affiliated, controlled, or joint venture entity, any real or personal property or other assets (or any interest in any of the foregoing), or incur debt for money borrowed or guarantee the debt of another, not in the ordinary course of business; d) Approve annual operating or capital budgets, strategic and long-range plans, major fund-raising programs, physician compensation or other agreements, managed care contracts or other financial commitments or material deviations from such budgets, plans, agreements or commitments; and e) Approve financial, accounting, human resource, employee benefit, compliance policies or procedures, medical staff bylaws (including amendments) or other policies and procedures, or the appointment or engagement of auditors, legal counsel and consultants, which are in any way contrary to the policies and procedures adopted from time to time by the Member. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FOLLOWING DESCRIBES PEDIATRIC SPECIALTIES OF AMERICA'S (PSA) PROCESS FOR PROVIDING ITS BOARD OF DIRECTORS WITH A COPY OF THE FORM 990 AND REVIEWING IT: 1. THE DRAFT TAX FORM 990 WILL BE MAILED TO THE FINANCE COMMITTEE OF THE PSA BOARD OF DIRECTORS FOR REVIEW AND COMMENT PRIOR TO REGULARLY SCHEDULED MEETING. 2. THE DRAFT TAX FORM 990 WILL BE REVIEWED WITH THE FINANCE COMMITTEE. 3. QUESTIONS WILL BE ANSWERED AND IF NECESSARY, TAX FORMS WILL BE ADJUSTED. 4. THE FINAL FORM 990 WILL BE POSTED ON THE PSA BOARD OF DIRECTOR'S WEB PORTAL. Form 990, Part VI, Line 12c Conflict of interest policy ALL PEDIATRIC SPECIALTIES OF AMERICA EMPLOYEES ARE INFORMED UPON HIRE, AND ON AN ANNUAL BASIS THEREAFTER, THAT THEY HAVE AN AFFIRMATIVE DUTY TO DISCLOSE ANY ACTUAL, POTENTIAL OR PERCEIVED CONFLICT OF INTEREST. THEY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM UPON HIRE, ANNUALLY AND WHENEVER A CHANGE IN CIRCUMSTANCES WARRANTS. CONFLICT OF INTEREST DISCLOSURE FORMS ARE FORWARDED TO THE COMPLIANCE DEPARTMENT BY THE TALENT MANAGEMENT AND EFFECTIVENESS DEPARTMENT. THESE FORMS ARE INITIALLY REVIEWED BY COMPLIANCE DEPARTMENT STAFF. WHEN DEEMED NECESSARY, THE COMPLIANCE DEPARTMENT COLLABORATES WITH THE LEGAL DEPARTMENT. CONFLICTS OF INTEREST THAT NECESSITATE BOARD AWARENESS AND ACTION ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD FOR RESOLUTION AND IMPOSITION OF SANCTIONS, IF WARRANTED. IN ADDITION, ON AN ANNUAL BASIS, BOARD MEMBERS, PRINCIPAL OFFICERS, AND BOARD-DELEGATED COMMITTEE MEMBERS SIGN A STATEMENT WHICH AFFIRMS THAT EACH INDIVIDUAL: (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY, AND (D) UNDERSTANDS THAT PSA IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF IT'S TAX-EXEMPT PURPOSES. A PROCESS IS IN PLACE FOR MANAGING SITUATIONS IN WHICH IT IS DISCOVERED THAT AN INDIVIDUAL WHO IS COVERED BY PSA'S CONFLICT OF INTEREST POLICY FAILED TO PROPERLY DISCLOSE A POTENTIAL CONFLICT OF INTEREST. Form 990, Part VI, Line 19 Required documents available to the public FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL, REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. Form 990, Part IX, Line 11g Other Fees Other fees for services - Total Expense: 6373535, Program Service Expense: 5098828, Management and General Expenses: 1274707, Fundraising Expenses: ; Support fees - Total Expense: 11542471, Program Service Expense: 9233977, Management and General Expenses: 2308494, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfer from affiliates - 27128563; MIAMI CHILDREN'S HOSPITAL WORKER'S COMPENSATION TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 597021572 WC CLAIMS FL 4947 (a)(1 VCH false VARIETY CHILDRE'S HOSPITAL PROFESSIONAL LIABILITY TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 592551434 LIAB. 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