2016-08-11T17:01:29-05:00 2015-09-30 350921680 CROWE HORWATH LLP 750 N St Paul Suite 850 Dallas TX 75201 990 2014-10-01 260834681 Texas Children's Physician Group TEXA 8328242982 6621 Fannin Street Houston TX 77030 WELDON GAGE Executive Vice President & CFO 2016-07-21 true Rachel Spurlock P00520729 2147775200 2014 2016-09-27 15:27:22Z Texas Children's Physician SVCS Org WELDON GAGE 6621 Fannin Street Houston TX 77030 384901587 false X N/A X 2005 TX TO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION AND RESEARCH. 7 1 325 0 0 0 1950 0 340300287 384894871 0 0 6145 6716 340308382 384901587 0 0 0 0 31905110 36278097 0 0 0 308158892 348499054 340064002 384777151 244380 124436 80228838 90962776 59329923 69939425 20898915 21023351 TO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION AND RESEARCH. false false 380248613 384894871 TEXAS CHILDREN'S PHYSICIAN GROUP (TCPG) PERFORMS MANAGED CARE CONTRACTING, BILLING AND COLLECTION SERVICES FOR BAYLOR COLLEGE OF MEDICINE FACULTY AND OTHER HEALTHCARE PROFESSIONALS WHO PROVIDE SERVICES AT TEXAS CHILDREN'S HOSPITAL OR WHO PARTICIPATE IN TEXAS CHILDREN'S PROGRAMS. 380248613 true false false false false false false false false false true false false true true 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 true true false false true 41 0 true 325 true false false false false false false false false false false X 7 1 false false false false true true true true false false false true true true true true true false false false X JENNIFER WILSON 8328242972 1919 S Braeswood Blvd Houston TX 77030 Charles D Fraser Jr MD BOARD CHAIRMAN 1.00 1.00 X X 0 361374 0 Dean B Andropoulos MD BOARD MEMBER 1.00 1.00 X 0 100050 0 Michael A Belfort MD PhD BOARD MEMBER 1.00 3.00 X 0 254797 0 George Bisset III MD Board Member 39.00 1.00 X 822060 0 36166 Mark W Kline MD BOARD MEMBER 1.00 4.00 X 0 237908 0 Stephen Sigworth MD BOARD MEMBER 1.00 0 X 0 0 0 James Versalovic MD PhD BOARD MEMBER 1.00 1.00 X 0 100050 0 Dace Reinholds ASSISTANT SECRETARY 1.00 39.00 X 0 212317 26222 Mark Mullarkey President 6.00 34.00 X 0 389214 96949 Mary Jo Andre Senior Vice President 20.00 20.00 X 0 429174 84394 Mallory Caldwell Senior Vice President 1.00 39.00 X 0 574866 131215 Catherine Codispoti Assistant Vice President 1.00 39.00 X 0 186259 21012 Cris Daskevich Senior Vice President 1.00 39.00 X 0 451939 97097 Kimberly Bobo MD Physician 40.00 0.00 X 511756 0 30015 Damla Dryden MD Physician 40.00 0.00 X 623812 0 31700 Wanda Mott MD Physician 40.00 0.00 X 543204 0 38461 Bart Putterman MD Physician 39.00 1.00 X 625875 0 41237 David Zepeda MD Physician 39.00 1.00 X 533733 0 32851 Susan MacDonald Former President 1.00 39.00 X 0 1767765 157897 John R Nickens IV FORMER VICE PRESIDENT 0.00 40.00 X 0 427292 93477 3660440 5493005 918693 57 true true false CULBERT HEALTHCARE SOLUTIONS 800 Cummings Park Drive Suite 6000 Woburn MA 01801 MANAGEMENT CONSULTING 1354166 ABEO MANAGEMENT CORPORATION 4100 INTERNATIONAL PLAZA SUITE 600 Suite 600 FORT WORTH TX 76109 ANESTHESIA BILLING AND COLLECTIONS 1255762 OptumInsight 2771 Momentum Place Chicago IL 60689 Claims Manager Support 570007 PST PRODUCTS INC PO BOX 742526 Altanta GA 30374 ANATOMIC PATHOLOGY BILLING AND COLLECTIONS 412048 PRAIRIE HILLS ADVISORS LLC 5706 Sandhill Dr MIDDLETON WI 53562 MANAGEMENT CONSULTING 386488 11 X 0 NET PATIENT SERVICE REVENUE 622310 235692210 235692210 PROGRAM SUPPORT 900099 141237493 141237493 BILLING AND COLLECTION 561000 6570372 6570372 VENDED SERVICES 900099 872158 872158 PROVIDER INCENTIVES 900099 437662 437662 84976 84976 0 0 384894871 0 0 0 0 MISCELLANEOUS 900099 6716 6716 0 0 0 0 6716 384901587 384894871 0 6716 832085 832085 30472654 27506482 2966172 1216606 1174052 42554 2251688 1857868 393820 1505064 1280708 224356 3919884 3823771 96113 0 506631 487522 19109 145290 143581 1709 1279883 1265127 14756 256730 247493 9237 152276 145516 6760 696961 696961 370637 366275 4362 PROGRAM SUPPORT - BAYLOR 315791339 315791339 BAD DEBT 16223095 16223095 VENDED PHYSICIAN EXPENSES 7677283 7673646 3637 COLLECTION EXPENSES 727476 727476 751569 733092 18477 0 384777151 380248613 4528538 0 6194940 8101149 18597605 20683133 0 0 0 171261 36875 4480420 2829443 2344671 1650977 0 0 52920361 60490642 80228838 90962776 31270025 35433493 359409 275975 0 27700489 34229957 59329923 69939425 X 20898915 21023351 20898915 21023351 80228838 90962776 124436 0 X false true X true false X 1950 1950 259755367 304417412 328177239 340300287 384894871 1617545176 3022 5538 6145 6716 21421 259755367 304420434 328182777 340308382 384901587 1617568547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1617568547 33 0 0 0 0 33 33 0 0 0 0 33 0 0 0 0 0 0 259755400 304420434 328182777 340308382 384901587 1617568580 1.0000 1.0000 0.0000 0.0000 X 81784 5452 76332 1944206 1153837 790369 2451163 1670154 781009 3267 3267 1650977 OTHER MISC RECEIVABLE - BAYLOR 13496463 ST. JOSEPH NICU RECEIVABLE 78200 OTHER MISC RECEIVABLE 57873 RECEIVABLE FROM RELATED ENTITIES 46858106 60490642 DUE TO RELATED ENTITIES 34229957 34229957 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS AS OF SEPTEMBER 30, 2015 OR 2014. true true false false false false false false false Charles D Fraser Jr MD BOARD CHAIRMAN 0 0 0 361374 0 0 0 0 0 0 0 361374 0 0 Michael A Belfort MD PhD BOARD MEMBER 0 0 0 254797 0 0 0 0 0 0 0 254797 0 0 George Bisset III MD Board Member 716815 0 100000 0 5245 0 19761 0 16405 0 858226 0 0 0 Mark W Kline MD BOARD MEMBER 0 0 0 237908 0 0 0 0 0 0 0 237908 0 0 Susan MacDonald Former President 0 922316 0 0 0 845449 0 141290 0 16607 0 1925662 0 613207 Dace Reinholds ASSISTANT SECRETARY 0 183808 0 19658 0 8851 0 17048 0 9174 0 238539 0 0 Mark Mullarkey President 0 306393 0 81000 0 1821 0 64259 0 32690 0 486163 0 0 John R Nickens IV FORMER VICE PRESIDENT 0 321018 0 84300 0 21974 0 63914 0 29563 0 520769 0 0 Mary Jo Andre Senior Vice President 0 295785 0 81800 0 51589 0 58830 0 25564 0 513568 0 31349 Mallory Caldwell Senior Vice President 0 436984 0 118000 0 19882 0 103983 0 27232 0 706081 0 0 Catherine Codispoti Assistant Vice President 0 163921 0 21326 0 1012 0 12126 0 8886 0 207271 0 0 Cris Daskevich Senior Vice President 0 301777 0 84300 0 65862 0 60750 0 36347 0 549036 0 45919 Kimberly Bobo MD Physician 345139 0 165181 0 1436 0 20800 0 9215 0 541771 0 0 0 Damla Dryden MD Physician 378245 0 226746 0 18821 0 20800 0 10900 0 655512 0 0 0 Wanda Mott MD Physician 374943 0 147436 0 20825 0 20550 0 17911 0 581665 0 0 0 Bart Putterman MD Physician 450481 0 155113 0 20281 0 20800 0 20437 0 667112 0 0 0 David Zepeda MD Physician 392417 0 137205 0 4111 0 13000 0 19851 0 566584 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Compensation for the organization's top management official is established by Texas Children's and Texas Children's Hospital, using the following methods: * Compensation Committee * Independent Compensation Consultant * Compensation Survey or Study * Approval by the Board or Compensation Committee Schedule J, Part I, Line 4a Severance or change-of-control payment SEVERANCE PAY: SUSAN MACDONALD 143,662 SEVERANCE IS DETERMINED ON A CASE-BY-CASE BASIS, WITH LEGAL COUNSEL INVOLVED IN THE DECISION. CONSIDERATION IS GIVEN TO FACTORS SUCH AS LENGTH OF SERVICE AND LEVEL OF POSITION WITH THE ORGANIZATION. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan CY 2014 457(F) PLAN: PAID/DEFERRED GEORGE BISSET, III, MD 0 / 3,900 MARY JO ANDRE 113,149 / 38,280 CRIS DASKEVICH 130,219 / 40,200 SUSAN MACDONALD 613,207 / 120,740 MARK MULLARKEY 81,000 / 43,709 JOHN R NICKENS 84,300 / 43,364 MALLORY CALDWELL 118,000 / 88,533 DIRECTOR INCENTIVE PLAN: PAID/DEFERRED CATHERINE CODISPOTI 21,076 / 0 DACE REINHOLDS 19,608 / 0 457(F): THE 457(F) PLAN IS A DEFERRED COMPENSATION PLAN THAT ALLOWS ELIGIBLE EXECUTIVES, FROM THE ASSISTANT VICE PRESIDENT LEVEL TO CHIEF EXECUTIVE OFFICER, TO CONTRIBUTE MONEY ON A PRE-TAX BASIS. FUNDS MAY BE DEFERRED INTO THIS ACCOUNT FROM ANY OF FOUR SOURCES: BASE SALARY, ANNUAL INCENTIVE PLAN LONG-TERM INCENTIVE PLAN AND CAPITAL ACCUMULATION ACCOUNT FROM A FLEXIBLE BENEFIT ACCOUNT SURPLUS. THESE VEST AFTER THREE YEARS IN THE 457(F) WITH THE EXCEPTION OF THE CAPITAL ACCUMULATION ACCOUNT WHICH VESTS AFTER FIVE YEARS IN THE 457(F) PLAN. DIRECTOR INCENTIVE PLAN: THE DIRECTOR INCENTIVE PLAN IS AN ANNUAL INCENTIVE PLAN IN WHICH ELIGIBLE DIRECTORS PARTICIPATE. THE PLAN SHARES GOALS WITH THE EXECUTIVE ANNUAL INCENTIVE PLAN, FOCUSING ON FACTORS SUCH AS FINANCIAL PERFORMANCE, QUALITY GOALS, AND PATIENT SATISFACTION. IN ADDITION, THERE ARE INDIVIDUAL COMPONENTS FOR EACH DIRECTOR WHICH VARY DEPENDING ON THE EXPECTED OUTCOMES FOR THAT AREA AND / OR YEAR. Form 990, Part VI, Line 6 Classes of members or stockholders TEXAS CHILDREN'S IS THE SOLE CORPORATE MEMBER OF TEXAS CHILDREN'S PHYSICIAN GROUP. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body TEXAS CHILDREN'S ANNUALLY APPOINTS THE ORGANIZATION'S BOARD OF DIRECTORS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders PER THE ORGANIZATION'S BYLAWS, THE MEMBER HAS CERTAIN RESERVED POWERS: -APPROVE, INTERPRET OR CHANGE THE PURPOSE OF THE CORPORATION. -FIX THE NUMBER, APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY DIRECTOR OF THE CORPORATION. -APPROVE THE MERGER, DISSOLUTION OR CONSOLIDATION OR REORGANIZATION OF THE CORPORATION. -APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER, OR OTHER ALIENATION OF PROPERTY OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATION'S BUSINESS, WHEN SUCH ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION IS ABOVE SPECIFIC FINANCIAL LEVELS SET IN ACCORDANCE WITH POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBER. -APPROVE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. -Adoption or amendment of salaries or other compensation (including the awarding of any incentive compensation) of the officers of the Corporation, physician employees of the Corporation, if any, and physicians who are independent contractors to the Corporation, if any. -APPROVE DEBT INCURRED BY THE CORPORATION, WHICH IS IN EXCESS OF SUCH LIMITS AS ARE ESTABLISHED BY THE MEMBER. -APPROVE THE DISPOSITION OF ASSETS OF THE CORPORATION AT THE TIME OF ITS DISSOLUTION. -APPROVE ANY LONG-RANGE FINANCIAL OR STRATEGIC PLANS FOR THE CORPORATION. - Selection of the corporation's auditors and legal counsel. - Creation or sale of any subsidiaries of the Corporation. - APPROVE Any affiliation joint venture, contract, employment, retention, indemnification or other arrangements between the Corporation and any insurer, health maintenance organization, preferred provider organization, medical school, hospital, clinic, pharmacy, physician, Hospital affiliate or other provider of health or related services, including, without limitation, all service terms and compensation arrangements. - Establishment by the Corporation of any training or residency program. - The giving, seeking, or receiving of grants. - Adoption or amendment of any indemnification rights, obligations, or agreements affecting the Corporation. - Purchase, adoption, amendment, cancellation, or replacement of any insurance coverage for the Corporation or its Directors, officers and agents, as well as copies of any notices of cancellation received by the Corporation. - The commencement of litigation or the settlement of litigation or other claims. - Approval of the adoption or amendment of fee schedules relating to patient services. - Designation of additional or successor Member(s). - Any other matters with respect to which exclusive authority is granted to the Member by law, the Amended and Restated Certificate of Formation, or these Bylaws. Notwithstanding the foregoing, the Member shall have the authority as provided under the BOC, the Amended and Restated Certificate of Formation, and these Bylaws. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body NO SUCH COMMITTEES EXIST. Form 990, Part VI, Line 11b Review of form 990 by governing body PER A RESOLUTION APPROVED BY THE MEMBER'S BOARD OF DIRECTORS, THE MEMBER BOARD'S AUDIT & COMPLIANCE COMMITTEE HAS THE DELEGATED AUTHORITY TO REVIEW THE ORGANIZATION'S COMPLETED FORM 990 PRIOR TO FILING. FOLLOWING THE COMMITTEE'S REVIEW, THE COMPLETED FORM 990 IS DISTRIBUTED TO THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION CONSISTENTLY MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY THROUGH TWO SEPARATE PROCESSES, ONE THAT APPLIES TO THE BOARD MEMBERS, AND A SECOND THAT APPLIES TO OFFICERS AND KEY EMPLOYEES. 1) BOARD MEMBERS: PER THE ORGANIZATION'S BOARD-APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE MEMBER'S BOARD LEADERSHIP AND PRESENTED TO THE MEMBER'S AUDIT & COMPLIANCE COMMITTEE. IF THE COMMITTEE DEEMS THERE ARE ANY SIGNIFICANT ISSUES, THE RESPONSES ARE THEN REVIEWED BY THE MEMBER BOARD'S EXECUTIVE COMMITTEE AND ANY REQUIRED ACTION (RECUSEMENT FROM BOARD DELIBERATIONS RELATED TO THE CONFLICT, ETC.) IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT. 2) OFFICERS / KEY EMPLOYEES: PER THE ORGANIZATION'S BOARD-APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE COMPLIANCE SERVICES DEPARTMENT. IF THE DEPARTMENT DEEMS THERE ARE ANY SIGNIFICANT ISSUES, REQUIRED ACTION IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT AND THE BOARD IS NOTIFIED OF SUCH ACTIONS. Form 990, Part VI, Line 19 Required documents available to the public THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. Form 990, Part VII, Section A INCENTIVE COMPENSATION DRS. ANDROPOULOS, BELFORT, FRASER, KLINE AND VERSALOVIC, WHILE EMPLOYED BY BAYLOR COLLEGE OF MEDICINE, SERVE AS CHIEFS DIRECTING PATIENT CARE AT TEXAS CHILDREN'S HOSPITAL. DUE TO THEIR SENIOR LEADERSHIP ROLES, THEY ARE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON THEIR CONTRIBUTIONS TO ACHIEVING THE ORGANIZATION'S STRATEGIC GOALS. ALL COMPENSATION IS EARNED IN THEIR CAPACITY AS PHYSICIAN LEADERS. Form 990, Part VII, Section A AVERAGE HOURS GEORGE BISSET, III, M.D.'S 39 HOURS PER WEEK REPRESENTS HIS ROLE AS A TEXAS CHILDREN'S PHYSICIAN GROUP BOARD MEMBER (1 HOUR AVERAGE PER WEEK) AS WELL AS HIS ROLE AS A COMPENSATED PHYSICIAN. Form 990, Part VIII, Line 2f Other Program Service Revenue CLEAN CLAIMS INTEREST - Total Revenue: 84976, Related or Exempt Function Revenue: 84976, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; SCHEDULE O FORM 5471 DISCLOSURE UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT: -TEXAS CHILDREN'S HOSPITAL FOUNDATION EIN:20-2380599 6621 FANNIN ST HOUSTON, TX 77030 -TEXAS CHILDREN'S EIN: 76-0461578 1919 S. BRAESWOOD BLVD, 4TH FL HOUSTON, TX 77030 TEXAS CHILDREN'S 1919 S BRAESWOOD 4 FL HOUSTON TX 77030 760461578 PARENT TX 501(c)(3 Type II NA false TEXAS CHILDREN'S HEALTH PLAN 2450 HOLCOMBE SUITE 34L HOUSTON TX 77021 760486264 HEALTH CARE TX 501(c)(3 9 TEXAS CHILDREN'S true TEXAS CHILDREN'S WOMEN'S SPECIALISTS PO BOX 300630 HOUSTON TX 77230 261482195 HEALTH CARE TX 501(c)(3 Type II TEXAS CHILDREN'S true TEXAS CHILDREN'S HOSPITAL 6621 FANNIN STREET HOUSTON TX 77030 741100555 HOSPITAL TX 501(c)(3 3 TEXAS CHILDREN'S true TEXAS CHILDREN'S HOSPITAL FOUNDATION 6621 FANNIN STREET HOUSTON TX 77030 202380599 SUPPORTING ORG TX 501(c)(3 Type II TEXAS CHILDREN'S true TCH PEDIATRIC ASSOCIATES INC PO BOX 300630 HOUSTON TX 77230 760460242 HEALTH CARE TX 501(c)(3 9 TEXAS CHILDREN'S true TEXAS CHILDREN'S HEALTH PLAN - THE CENTER 6621 FANNIN STREET HOUSTON TX 77030 461392824 HEALTH CARE TX 501(c)(3 Type I TEXAS CHILDREN'S HEALTH PLAN INC true TEXAS CHILDREN'S URGENT CARE 1919 S BRAESWOOD BLVD 4TH FLOOR HOUSTON TX 77030 472029489 HEALTH CARE TX 501(c)(3 9 TCH PEDIATRIC ASSOCIATES INC true THE GORDON AND MARY CAIN PEDIATRIC NEUROLOGY RESEARCH FOUNDATION 9 GREENWAY PLAZA HOUSTON TX 77046 760246858 SUPPORTING ORG TX 501(c)(3 Type I TEXAS CHILDREN'S HOSPITAL true TCH INSURANCE COMPANY LTD 23 LIME BAY AVE GRAND CAYMAN CJ KY11102 980176652 INSURANCE CJ NA C Corporation true CVI GVF HOLDINGS 3 LTD UGLAND HOUSE SOUTH CHURCH ST GEORGE TOWN CJ KY11104 981078282 INVESTMENT CJ NA C Corporation true false false false false false false false false false false false true true true true true false true true TEXAS CHILDRENS WOMENS SPECIALISTS L 481018 COST TEXAS CHILDRENS WOMENS SPECIALISTS M 7344683 COST TEXAS CHILDRENS WOMENS SPECIALISTS L 1243965 COST TEXAS CHILDRENS HOSPITAL P 119346317 COST TEXAS CHILDRENS HOSPITAL L 4040742 COST TEXAS CHILDRENS HOSPITAL S 141237493 COST TEXAS CHILDRENS HEALTH PLAN L 34253809 COST TCH INSURANCE COMPANY LTD R 350314 COST