2016-07-05T08:53:51-05:00 2015-08-31 760354302 HEADMAXWELL & MCKENNA PC 2200 MARKET STREET SUITE 401 GALVESTON TX 77550 990 2014-09-01 760682238 UTMB HEALTHCARE SYSTEMS INC UTMB 4097664000 301 UNIVERSITY BOULEVARD ROUTE 0109 GALVESTON TX 775550109 DAVID M CONNAUGHTON PRESIDENT AND CEO 4097664000 2016-07-05 1 JOHN R MCKENNA JR P00618649 4097636479 2014 2016-09-27 15:27:22Z DAVID M CONNAUGHTON 301 UNIVERSITY BLVD RT 0128 GALVESTON TX 775550128 31488259 0 X UTMBHCS.ORG X 1998 TX THE MISSION OF UTMB HEALTHCARE SYSTEMS, INC. (UTMB HCS) IS TO IMPROVE THE HEALTH OF TEXAS COMMUNITIES BY CREATING A NETWORK OF HEALTH CARE PROFESSIONALS ENGAGING IN STATE-OF-THE-ART PATIENT CARE, SCHOLARLY MEDICAL EDUCATION, AND INNOVATIVE RESEARCH. 8 0 604 0 0 0 0 0 24316262 31350104 132348 138155 0 0 24448610 31488259 0 0 0 0 14769897 18375150 0 0 0 8638231 11298301 23408128 29673451 1040482 1814808 11474141 13846116 1370021 2214312 10104120 11631804 THE MISSION OF UTMB HEALTHCARE SYSTEMS, INC. (UTMB HCS) IS TO IMPROVE THE HEALTH OF TEXAS COMMUNITIES BY CREATING A NETWORK OF HEALTH CARE PROFESSIONALS ENGAGING IN STATE-OF-THE-ART PATIENT CARE, SCHOLARLY MEDICAL EDUCATION, AND INNOVATIVE RESEARCH. 0 0 28944869 30989374 THE EXEMPT PURPOSE ACHIEVEMENT IS TO PROVIDE NURSE RECRUITING AND STAFFING, CASE MANAGEMENT, ETC. FOR THE UNIVERSITY OF TEXAS MEDICAL BRANCH HOSPITAL AND CLINICS. 263911 360730 THE EXEMPT PURPOSE ACHIEVEMENT IS TO PROVIDE PROPERTY MANAGEMENT FOR THE BENEFIT OF THE UNIVERSITY OF TEXAS MEDICAL BRANCH. UTMB HEALTHCARE SYSTEMS, INC. MANAGES AND LEASES PRIMARY CARE CLINICS FOR UTMB. 29208780 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 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 1 1 0 0 1 9 0 1 604 1 0 0 0 0 0 0 0 0 0 0 X 8 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X MARIA L GONZALEZ 4097664059 123 25TH STREET 9TH FLOOR GALVESTON TX 775550985 DAVID L CALLENDER MD CHAIR, SOLE MEMBER 1.00 39.00 X 0 891334 206980 DANNY O JACOBS MD VICE CHAIR 0.50 39.50 X 0 899341 103372 DONNA K SOLLENBERGER DIRECTOR 0.50 39.50 X 0 806515 107285 BEN RAIMER MD DIRECTOR 1.00 39.00 X 0 557933 3272 REX MCCALLUM MD DIRECTOR 0.50 39.50 X 0 477704 4921 SELWYN O ROGERS MD DIRECTOR 0.50 39.50 X 0 0 0 CHERYL A SADRO TREASURER 1.00 39.00 X X 0 87825 101797 DAVID M CONNAUGHTON PRESIDENT & CEO 1.00 39.00 X X 0 579061 8594 MARIA L GONZALEZ SECRETARY 9.00 31.00 X 0 69646 1738 GARLAND D ANDERSON MD FORMER VICE CHAIR 0.00 0.00 X 0 224046 180 BARBARA L THOMPSON MD FORMER DIRECTOR 0.00 0.00 X 0 404795 673 DONALD PROUGH MD FORMER DIRECTOR 0.00 0.00 X 0 621971 5318 0 5620171 544130 0 1 1 0 SUPPLEMENTAL HEALTH CARE SERVICES LIMITE PO BOX 27124 SALT LAKE CITY UT 841270124 TEMPORARY STAFF AGENCY 2771753 AMN HEALTHCARE INC 2735 COLLECTIONS CENTER DR CHICAGO IL 60693 TEMPORARY STAFF AGENCY 1754675 AMEDISTAF LLC PO BOX 595 TONTITOWN AR 72770 TEMPORARY STAFF AGENCY 1384487 MILLENIA MEDICAL SERVICES INC PO BOX 162713 ATLANTA GA 303212713 TEMPORARY STAFF AGENCY 1268066 CHG MEDICAL STAFFING INC PO BOX 974088 DALLAS TX 753974088 TEMPORARY STAFF AGENCY 431727 10 MANAGEMENT SERVICES 561499 30989374 30989374 PROPERTY MANAGEMENT 532000 360730 360730 31350104 138155 138155 31488259 31350104 0 138155 X 71085 71085 16790800 16532429 258371 104247 104247 167221 166688 533 1241797 1241797 63666 3433 60233 22522 9683 12839 10583889 10581461 2428 188583 188434 149 64580 47482 17098 27696 24044 3652 81163 67580 13583 14465 9009 5456 1152 760 392 109876 109876 140395 121857 18538 ALL OTHER EXPENSES 314 314 29673451 29208780 464671 0 451061 766414 5423725 8323323 3173867 2425269 90334 105832 3866935 1641657 2335154 2225278 11474141 13846116 1355879 2212248 14142 2064 1370021 2214312 X 0 0 0 0 10104120 11631804 10104120 11631804 11474141 13846116 1814808 -287124 0 X 0 1 X 0 0 X X 1 UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON 746000949 6 1 1626961 0 1 1626961 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION A, LINE 2: THE SUPPORTED ORGANIZATION IS NOT REQUIRED TO OBTAIN RECOGNITION OF ITS PUBLIC CHARITY STATUS SINCE IT IS A GOVERNMENTAL UNIT DESCRIBED IN IRC 170(B)(1)(A)(V). 716600 716600 3033881 1593463 1440418 6371 6371 0 110083 41823 68260 2225278 0 1 0 0 0 0 0 0 0 DAVID L CALLENDER MD CHAIR, SOLE MEMBER 0 664740 0 40320 0 186274 0 200000 0 6980 0 1098314 0 0 DANNY O JACOBS MD VICE CHAIR 0 735221 0 164080 0 40 0 100000 0 3372 0 1002713 0 0 DONNA K SOLLENBERGER DIRECTOR 0 647884 0 156291 0 2340 0 100000 0 7285 0 913800 0 0 BEN RAIMER MD DIRECTOR 0 432268 0 119914 0 5751 0 0 0 3272 0 561205 0 0 REX MCCALLUM MD DIRECTOR 0 410729 0 49835 0 17140 0 0 0 4921 0 482625 0 0 CHERYL A SADRO TREASURER 0 73928 0 0 0 13897 0 100000 0 1797 0 189622 0 0 DAVID M CONNAUGHTON PRESIDENT & CEO 0 355099 0 66384 0 157578 0 0 0 8594 0 587655 0 153703 GARLAND D ANDERSON MD FORMER VICE CHAIR 0 87320 0 0 0 136726 0 0 0 180 0 224226 0 0 BARBARA L THOMPSON MD FORMER DIRECTOR 0 339400 0 63795 0 1600 0 0 0 673 0 405468 0 0 DONALD PROUGH MD FORMER DIRECTOR 0 495765 0 122806 0 3400 0 0 0 5318 0 627289 0 0 PART I, LINE 3 COMPENSATION PROCEDURES OF RELATED ORGANIZATION THE CEO RECEIVES NO COMPENSATION FROM UTMB HEALTHCARE SYSTEMS, INC. HE IS COMPENSATED BY THE UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON. THE UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON USES AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, AND A COMPENSATION SURVEY TO ESTABLISH THE COMPENSATION OF THE CEO. PART I, LINE 4B DAVID L. CALLENDER, M.D. 457(F) $200,000.00 DONNA K. SOLLENBERGER 457(F) $100,000.00 DANNY O. JACOBS, M.D. 457(F) $100,000.00 CHERYL A SADRO 457(F) $100,000.00 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S CEO PRIOR TO BEING SIGNED. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATE SECRETARY REVIEWS THE ANNUAL CONFLICTS OF INTEREST QUESTIONNAIRE RESPONSES. UTMB'S OFFICE OF INSTITUTIONAL COMPLIANCE REGULARLY MONITORS CONFLICTS OF INTEREST, AND UTMB'S INTERNAL AUDIT DEPARTMENT PERIODICALLY VALIDATES THEIR ACTIVITIES. TO DATE THERE HAVE BEEN NO CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION, LINE 15A THE CEO RECEIVES NO COMPENSATION FROM UTMB HEALTHCARE SYSTEMS, INC. HE IS COMPENSATED BY THE UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON. HIS SALARY WAS DETERMINED FROM A REVIEW DONE BY AN INDEPENDENT CONSULTANT AND HE HAS A WRITTEN CONTRACT WITH UTMB IN WHICH HIS SALARY IS STATED. OFFICER COMPENSATION, LINE 15B OTHER OFFICERS RECEIVE NO COMPENSATION FROM UTMB HEALTHCARE SYSTEMS, INC. THEY ARE COMPENSATED BY THE UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST ONLY. FORM 990, PART IX, LINE 11G TEMPORARY STAFFING SERVICES: PROGRAM SERVICE EXPENSES 10,464,603. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,464,603. GENERAL SERVICES: PROGRAM SERVICE EXPENSES 260. MANAGEMENT AND GENERAL EXPENSES 2,428. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,688. FEES INCIDENTAL: PROGRAM SERVICE EXPENSES 92,066. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 92,066. PERFUSIONISTS: PROGRAM SERVICE EXPENSES 21,782. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,782. CONSULTANT SERVICES: PROGRAM SERVICE EXPENSES 2,750. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,750. UTMB HEALTH PLANS INC 301 UNIVERSITY BLVD RT 0109 GALVESTON TX 775550109 760480012 HMO & MANAGED CARE TX 501(C)(3) LINE 11A, I 0 UTMB AT GALVESTON 301 UNIVERSITY BLVD GALVESTON TX 77555 746000949 HIGHER EDUCATION TX 170(C)(1) 1 FHC FAMILY HEALTHCARE CENTERS INC 301 UNIVERSITY BLVD RT 0109 GALVESTON TX 775550109 760697230 INACTIVE TX UTMB HEALTHCARE SYSTEMS INC C 1.00000 0 HSI HEALTHCARE SERVICES INC 301 UNIVERSITY BLVD RT 0109 GALVESTON TX 775550109 760632955 INACTIVE TX UTMB HEALTHCARE SYSTEMS INC C 1.00000 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 0 0 UTMB HEALTH PLANS INC O 62737 % ALLOCATION UTMB AT GALVESTON J 137295 MANAGEMENT AGREEMENT UTMB AT GALVESTON L 30963993 MANAGEMENT AGREEMENT UTMB AT GALVESTON M 322637 MANAGEMENT AGREEMENT UTMB AT GALVESTON O 1279225 MANAGEMENT AGREEMENT UTMB AT GALVESTON Q 1004716 MANAGEMENT AGREEMENT