2016-07-18T14:58:45-05:00 2015-09-30 750800661 METHODIST HOSPITALS OF DALLAS PO BOX 655999 DALLAS TX 752655999 990 2014-10-01 352436666 METHODIST PATIENT CENTERED ACO METH 2149474527 1441 N BECKLEY AVE TAX DEPT DALLAS TX 75203 MICHAEL J SCHAEFER TREASURER 2149474527 2016-07-18 1 DWIGHT WILLIAMS P00544474 2149474581 2016-07-18 2014 2016-09-27 15:27:22Z X MICHAEL J SCHAEFER 1441 N BECKLEY AVE TAX DEPT DALLAS TX 75203 5260903 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. 15 2 0 0 0 0 0 0 6231468 5260903 0 0 0 0 6231468 5260903 0 0 0 0 0 1560078 0 0 0 6216908 4418193 6216908 5978271 14560 -717368 14560 5260903 0 5963711 14560 -702808 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 5349652 5260903 METHODIST PATIENT CENTERED ACO (MPCACO) IS A TX NONPORFIT CORPORATION FORMED TO PARTICIPATE IN THE MEDICARE SHARED SAVINGS PROGRAM(MSSP) AS AN ACCOUNTABLE CARE ORGANIZATIOIN (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 THEN $125 MILLION IN UNREIMBURSED CHARITY CARE, REPRESENTING 12.4% OF NET REVENUE. (CONTINUED ON SCHEDULE O) 5349652 1 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 32 0 0 0 0 0 0 0 0 0 0 X 15 2 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 CHAIRMAN/CMO/DIRECTOR 15.00 25.00 X X 20429 323433 33155 STEPHEN MANSFIELD PHD DIRECTOR/PRESIDENT 2.00 40.00 X X 0 1842534 271574 BASSEM MOSTAFA- ELSAWY MD DIRECTOR 2.00 40.00 X 0 250003 22205 MICHAEL FINCH MD DIRECTOR 2.00 5.00 X 0 20000 0 NANCY GEORGEKUTTY MD DIRECTOR 2.00 X 20429 0 0 BRIAN JONES MD DIRECTOR 2.00 40.00 X 0 356990 32679 MARTIN KOONSMAN MD DIRECTOR 2.00 15.00 X 0 131143 0 MICHAEL MARSHAL DIRECTOR 2.00 40.00 X 0 435507 39400 NHAN NGUYEN MD DIRECTOR 2.00 5.00 X 0 31250 0 ALFONSO RAMIREZ MD DIRECTOR 2.00 5.00 X 20429 1492 0 PAMELA SINGH MD DIRECTOR 2.00 40.00 X 0 189606 1914 LUCIOUS WILLIAMS DIRECTOR 2.00 X 0 0 0 ARTURO AVILES DIRECTOR 2.00 10.00 X 0 64907 0 LAURA IRVINE DIRECTOR 2.00 40.00 X 0 748868 99381 MICHAEL J SCHAEFER SEC/TREA 2.00 40.00 X 0 971638 72712 SAM BAGCHI MD FORMER DIRECTOR 2.00 40.00 X 0 443140 63422 61287 5810511 636442 0 1 1 0 0 SHARED SAVINGS INCOME 621990 5260903 5260903 5260903 5260903 5260903 0 0 X 1278366 1278366 281712 281712 4229702 3601083 628619 3630 3630 154934 154934 15704 15704 REPAIR AND MAINTENANCE 14223 14223 5978271 5349652 628619 0 14560 5260903 14560 5260903 5963711 0 5963711 X 0 0 0 0 14560 -702808 14560 -702808 14560 5260903 -717368 0 X X 0 0 0 X 6231468 5260903 11492371 6231468 5260903 11492371 0 0 0 11492371 6231468 5260903 11492371 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 2014. 1 0 1 0 0 1 0 1 1 0 MELISSA GERDES MD CHAIRMAN/CMO/DIRECTOR 0 264224 0 58314 20429 895 0 9573 0 23582 20429 356588 0 0 STEPHEN MANSFIELD PHD DIRECTOR/PRESIDENT 0 1043846 0 549687 0 249001 0 248546 0 23028 0 2114108 0 237758 BASSEM MOSTAFA- ELSAWY MD DIRECTOR 0 237571 0 74 0 12358 0 11577 0 10628 0 272208 0 0 BRIAN JONES MD DIRECTOR 0 252000 0 79141 0 25849 0 15600 0 17079 0 389669 0 0 MICHAEL MARSHAL DIRECTOR 0 264593 0 135865 0 35049 0 15600 0 23800 0 474907 0 0 PAMELA SINGH MD DIRECTOR 0 122981 0 54654 0 11971 0 1287 0 627 0 191520 0 0 LAURA IRVINE DIRECTOR 0 499712 0 191188 0 57968 0 89331 0 10050 0 848249 0 55599 MICHAEL J SCHAEFER SEC/TREA 0 546362 0 245475 0 179801 0 18850 0 53862 0 1044350 0 98581 SAM BAGCHI MD FORMER DIRECTOR 0 359558 0 76331 0 7251 0 36589 0 26833 0 506562 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 315235. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 315235. MHS ADMIN & SUPPORT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 313384. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 313384. PURCHASED SERVICES FROM MHS: PROGRAM SERVICE EXPENSES 3601083. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3601083. 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. METHODIST HOSPITALS OF DALLAS 1441 N BECKLEY AVE DALLAS TX 75203 750800661 MEDICAL SERVICES TX 501(C)(3) BOX 3 0 DALLAS METHODIST HOSPITALS FOUNDATION 1441 N BECKLEY AVE DALLAS TX 75203 751548343 FUND RAISING TO SUPPORT EXEMPT FUNCTIONS OF MHS TX 501(C)(3) BOX 7 METHODIST HOSPITALS OF DALLAS 0 NELLE NORRELL FOUNDATION 1441 N BECKLEY AVE DALLAS TX 75203 756034201 FUND RAISING TO SUPPORT EXEMPT FUNCTIONS OF MHS TX 501(C)(3) BOX 11 TYPE 1 METHODIST HOSPITALS OF DALLAS 0 METHODIST TRANSPLANT PHYSICIANS 1441 N BECKLEY AVE DALLAS TX 75203 010612870 MEDICAL SERVICES TX 501(C)(3) BOX 11 TYPE 1 METHODIST HOSPITALS OF DALLAS 0 MEDHEALTH 1441 N BECKLEY AVE DALLAS TX 75203 752896138 MEDICAL SERVICES TX 501(C)(3) BOX 11 TYPE 1 METHODIST HOSPITALS OF DALLAS 0 PHYSICANS ASSOC OF SW DALLAS 1441 N BECKLEY AVE DALLAS TX 75203 752966610 MEDICAL SERVICES TX 501(C)(3) BOX 11 TYPE 1 METHODIST HOSPITALS OF DALLAS 0 ASSOC IN ACUTE SURGICAL CARE 1441 N BECKLEY AVE DALLAS TX 75203 262126265 MEDICAL SERVICES TX 501(C)(3) BOX 11 TYPE 1 METHODIST HOSPITALS OF DALLAS 0 MHSR MEDICAL CENTER 1441 N BECKLEY AVE DALLAS TX 75203 264193362 MEDICAL SERVICES TX 501(C)(3) BOX 11 TYPE 1 METHODIST HOSPITALS OF DALLAS 0 METHODIST URGENT CARE 1441 N BECKLEY AVE DALLAS TX 75203 471054059 MEDICAL SERVICES TX 501(C)(3) PENDING BOX 11 TYPE 1 METHODIST HOSPITALS OF DALLAS 0 METHODIST CDI 1441 N BECKLEY AVE DALLAS TX 75203 465265469 MEDICAL SERVICES TX 501(C)(3) PENDING BOX 11 TYPE 1 METHODIST HOSPITALS OF DALLAS 0 DALLAS COUNTY INDIGENT CARE CORP 1441 N BECKLEY AVE DALLAS TX 75203 260610562 FUNDING FOR INDIGENT CARE TX 501(C)(3) BOX 11 TYPE 1 N/A 0 TARRANT COUNTY INDIGENT CARE 612 E LAMAR STREET ARLINGTON TX 76011 260648532 FUNDING FOR INDIGENT CARE TX 501(C)(3) BOX 11 TYPE 1 N/A 0 CAREFLIGHT 3110 S GREATSOUTHWEST PKWY GRAND PRARIE TX 75052 751657155 MEDICAL TRANSPORT TX 501(C)(3) BOX 11 TYPE 3 N/A 0 DALLAS METHODIST PHYSICIANS NETWORK 1441 N BECKLEY AVE DALLAS TX 75203 752693707 HEALTH CARE CONTRACTING TX 501(C)(6) METHODIST HOSPITALS OF DALLAS 0 PAVILION PROPERTIES 1441 N BECKLEY AVE DALLAS TX 75203 752284449 REAL ESTATE TITLE HOLDING TX 501(C)(2) METHODIST HOSPITALS OF DALLAS 0 MHS-CHC ILP 3020 W WHEATLAND RD DALLAS TX 75237 205000978 REHAB HOSPITAL TX MHS-CHC LLC N/A 0 0 MHS-CHC LLC 3020 W WHEATLAND RD DALLAS TX 75237 204921888 REHAB HOSPITAL TX METHODIST HOSPITAL OF DALLAS N/A 0 0 METHODIST MCKINNEY HOSPITAL LLC 11221 ROE AVE LEAWOOD KS 66211 208847736 HOSPITAL TX METHODIST HOSPITAL OF DALLAS N/A 0 0 METHODIST MCKINNEY HOSPITAL PROPERT 11221 ROE AVE LEAWOOD KS 66211 261943814 REAL ESTATE HOLDING TX METHODIST HOSPITAL OF DALLAS N/A 0 0 MHD-USO MANAGEMENT COMPANY LP ONE POST STREET 35TH FLOOR SAN FRANCISCO TX 94104 203844027 MEDICAL SERVICES TX NORTH TEXAS HEALTH FACILITIES MGMT N/A 0 0 MHD-USO GENERAL LLCP ONE POST ST35TH FLOOR ATTN TAX DEPT SAN FRANCISCO CA 94104 203843579 MEDICAL SERVICES TX NORTH TEXAS HEALTH FACILITIES MGMT N/A 0 0 METDALSPI LLC 11221 ROE AVE LEAWOOD KS 66211 263195791 HOSPITAL TX METDALSPI HOLDING LLC N/A 0 0 METDALSPI HOLDING LLC 11221 ROE AVE LEAWOOD KS 66211 263207402 HOSPITAL TX METHODIST HOSPITAL OF DALLAS N/A 0 0 SRPMEDICA INVESTORS - ADDISON LP 8343 DOUGLAS AVE SUITE 350 DALLAS TX 75225 264517265 REAL ESTATE HOLDING TX METHODIST HOSPITAL OF DALLAS N/A 0 0 MHSS- MOB ADDISON LP 8343 DOUGLAS AVE SUITE 350 DALLAS TX 75225 454892826 REAL ESTATE HOLDING TX NORTH TEXAS HEALTH FACILITIES MGMT N/A 0 0 LHCG XXXIII LLC 420 WEST PINHOOK RD SUITE A LAFAYETTE LA 70503 454894023 HOME CARE LA NORTH TEXAS HEALTH FACILITIES MGMT N/A 0 0 METHODIST DIAGNOSTIC IMAGING OF TEXAS LLC 5775 WAYZATA BLVD 400 ST LOUIS PARK MN 55416 472352211 MEDICAL SERVICES TX METHODIST HOSPITAL OF DALLAS N/A 0 0 METHODIST URGENT CARE OF TEXAS LLC 265 BROOKVIEW CENTRE WAY 400 KNOXVILLE TN 37919 352509140 MEDICAL SERVICES TX METHODIST HOSPITAL OF DALLAS N/A 0 0 TEXAS REHABILITATION HOSPITAL OF ARLINGTON 113 SEABOARD LANE SUITE B201 FRANKLIN TN 37067 371748838 REHAB HOSPITAL TX NORTH TEXAS HEALTH FACILITIES MGMT N/A 0 0 NORTH TEXAS HEALTH FACILITIES MANAGEMENT 1441 N BECKLEY AVE DALLAS TX 75203 751700994 FACILITY AND PHYSICIAN MGMT TX METHODIST HOSPITALS OF DALLAS C 0 METHCATH OIL COMPANY 4833 ROYAL LANE DALLAS TX 75229 751974095 OIL & GAS HOLDINGS TX METHODIST HOSPITALS OF DALLAS C 0 COLLECTECH FINANCIAL SERVICESINC 1441 N BECKLEY AVE DALLAS TX 75203 752369856 BILLING & COLLECTION TX NORTH TEXAS FACILTIES MGMT C 0 RICHARDSON PHYSICIANS ALLIANCE 1441 N BECKLEY AVE DALLAS TX 75203 770591925 PHYSICIAN SERVICES TX METHODIST HOSPITALS OF DALLAS C 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 METHODIST HOSPITAL OF DALLAS M 895638 CASH METHODIST HOSPITAL OF DALLAS E 5963711 CASH PAVILION PROPERTIES K 55678 FMV