2014-10-14T16:10:25-05:00 2013-11-30 366055558 Grant Thornton LLP 1717 Main Street Suite 1500 Dallas TX 75201 990 2012-12-01 453462044 Children's Medical Center Research Institute at the UTSW Medical Center CHIL 2144567000 1935 Medical District Dr Dallas TX 75235 Jerry Lee 2144567000 2014-10-14 1 Kimberly Temple CPA P00669176 2145612300 2012 2016-02-25 16:41:14Z Christopher J Durovich 1935 Medical District Dr Dallas TX 75235 3654553 0 X N/A X 2009 TX Basic and/or clinical research in children's health issues. 7 6 0 0 0 0 0 3654553 0 0 0 0 0 0 0 3654553 575713 0 0 0 0 1074971 0 0 0 5722236 2960218 6297949 4035189 -6297949 -380636 4044474 4318798 10342423 10997383 -6297949 -6678585 The organization shall undertake, sponsor, and administer basic and/or clinical research in children's health issues. 0 0 3052310 0 The organization plans, develops, and carries out research conducive to the diagnosis, treatment, and cure of childhood health issues. 3052310 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 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 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Stephanie K Smith 2144567000 1935 Medical District Drive Dallas TX 75235 Christopher J Durovich 1.00 60.00 X 0 1975308 85059 Thomas Baker 1.00 1.00 X 0 0 0 David W Biegler 1.00 1.00 X 0 0 0 Robert A Chereck 1.00 1.00 X 0 0 0 Daniel K Podolsky MD 1.00 0.00 X 0 0 0 David Russell PhD 1.00 0.00 X 0 0 0 Arnim Dontes 1.00 0.00 X 0 0 0 Sean Morrison PhD 55.00 1.00 X 75000 0 0 Michele Chulick 1.00 55.00 X 0 180740 0 Ray R Dziesinski 1.00 55.00 X 0 722122 20019 Regina M Coggins 1.00 55.00 X 0 466685 18606 Patricia U Winning 1.00 55.00 X 0 741612 45224 Teresa Egan 40.00 1.00 X 0 289018 886 Michael Serber 1.00 0.00 X 0 0 0 Stephanie K Smith 1.00 40.00 X 0 102713 744 75000 4478198 170538 0 0 1 0 UTSW 5323 Harry Hines Blvd Dallas TX 75390 Physician Services 4011389 1 3654553 3654553 3654553 0 0 0 93750 93750 859760 265713 594047 4633 4633 101368 14224 87144 15460 15460 62703 62703 1875 1875 22173 11756 10417 615 615 2425855 2262692 163163 29810 28516 1294 28218 28218 81842 81842 Flow Cytometry 250709 250709 Medical Surg. Supplies 42154 42154 Catering, Meals, Coffee 8604 8604 Business Relations 5660 5660 4035189 3052310 982879 0 4044474 2293105 1048612 246064 812859 81842 0 731017 4044474 4318798 405934 654275 9936489 10343108 10342423 10997383 X -6297949 -6678585 -6297949 -6678585 4044474 4318798 -380636 0 X 0 1 X 1 0 X X X X 0 0 0 CMCD 750800628 3 1 1 1 0 UTSWMC 756002868 6 1 1 1 0 2 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 812859 81842 731017 731017 Advances from CMCD 10295753 Deferred Rent 47355 10343108 Part X, Line 2: The organization was not required to have a FIN 48 footnote disclosure. 0 1 0 0 0 0 0 0 0 Christopher J Durovich 0 893847 0 934334 0 147127 0 60405 0 24653 0 2060366 0 514968 Michele Chulick 0 149740 0 30000 0 1000 0 0 0 0 0 180740 0 0 Ray R Dziesinski 0 383861 0 287925 0 50336 0 13379 0 6639 0 742140 0 173018 Regina M Coggins 0 299144 0 119574 0 47967 0 7550 0 11056 0 485291 0 39394 Patricia U Winning 0 379696 0 306500 0 55416 0 36620 0 8604 0 786836 0 191137 Teresa Egan 0 189306 0 55000 0 44712 0 0 0 886 0 289904 0 0 Part I, Line 3 The corporation's (CRI) president and other officers are employed and compensated by Children's Medical Center of Dallas (Children's). The Children's process is as follows: 1. The Human Resources Committee of the 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. Part I, Line 4b Non-Qualified Retirement Plan: * Children's Medical Center of Dallas Retirement Income Restoration Plan - There were no employees that received taxable income from the Retirement Income Restoration Plan in 2013. Employees who participate in the Retirement Income Restoration Plan are Christopher J Durovich and Patricia U Winning. * Children's Medical Center of Dallas Savings Restoration Plan - There were no employees that received taxable income from the Savings Restoration Plan. Employees who participate in the Savings Restoration Plan are Christopher J Durovich, Michele Chulick, Patricia U Winning, Regina M Coggins, and Ray R Dziesinski. Form 990, Part VI, Section A, line 6 Children's Health Services of Texas (CHST) is the sole member. Form 990, Part VI, Section A, line 7a Directors are appointed by the sole member and approved by the current CRI Board of Directors. Form 990, Part VI, Section A, line 7b Sole member reserve powers are specified in CRI's bylaws and represent actions by the organization which require sole member approval. These powers generally include specified financial decisions, appointment of directors, and strategic planning. Form 990, Part VI, Section B, line 11 The draft Form 990 is presented to the Board of Directors by the treasurer at either a scheduled meeting or sent electronically for their review. Form 990, Part VI, Section B, line 12c Directors execute a conflict of interest disclosure statement each year at the annual meeting of the Board of Directors. Any disclosures made in the statements are presented to the Board of Directors for discussion and review at that time. Form 990, Part VI, Section B, line 15 The corporation's president and other officers are employed and compensated by Children's Medical Center of Dallas (Children's). The Children's process is as follows: 1. The Human Resources Committee of the Board is responsible for setting the compensation for executives, except the President and CEO of Children's, 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, Section C, line 19 Governing documents, conflict of interest policy and financial statements are made available upon request. Children's Health Svc of Texas 1935 Medical District Drive Dallas TX 75235 752062019 Management Company TX 501(c)(3) Line 11a, I N/A 0 Children's Medical Center of Dallas 1935 Medical District Drive Dallas TX 75235 750800628 Hospital TX 501(c)(3) Line 3 Children's Hlth Svc of TX 0 Children's Medical Center Foundation 1935 Medical District Drive Dallas TX 75235 752062015 Foundation TX 501(c)(3) Line 7 Children's Hlth Svc of TX 0 Physicians For Children 1935 Medical District Drive Dallas TX 75235 752854505 Physicians TX 501(c)(3) Line 9 Children's Medical Center of Dallas 0 Anesthesiologists For Children 1935 Medical District Drive Dallas TX 75235 752917570 Physicians TX 501(c)(3) Line 9 Children's Medical Center of Dallas 0 Dallas Phys Medical Svcs for Children Inc 1935 Medical District Drive Dallas TX 75235 810584868 Physicians TX 501(c)(3) Line 9 Children's Medical Center of Dallas 0 Complex Care Med Svcs Corp 1935 Medical District Drive Dallas TX 75235 461893597 Medical Services TX Pending Pending Children's Medical Center of Dallas 0 Pediatric Partners For Children 1935 Medical District Drive Dallas TX 75235 461917702 Clinically Integrated Network TX Pending Pending Children's Medical Center of Dallas 0 Children's Medical Center Services 1935 Medical District Drive Dallas TX 75235 461934007 Medical Services TX Pending Pending Children's Medical Center of Dallas 0 Children's Population Health 1935 Medical District Drive Dallas TX 75235 463104601 Population health TX Pending Pending Children's Hlth Svc of TX 0 The Health and Wellness Alliance for Children 1935 Medical District Drive Dallas TX 75235 463080586 Physicians TX 501(c)(3) Line 11a, I Children's Hlth Svc of TX 0 Children's Medical Center Health Plan 1935 Medical District Drive Dallas TX 75235 462737696 HMO TX Pending Pending Children's Hlth Svc of TX 0 Physicians Quality Alliance of North Texas 1935 Medical District Drive Dallas TX 75235 464049491 Physicians TX Pending Pending Children's Hlth Svc of TX 0 Specialists for Children 1935 Medical District Drive Dallas TX 75235 463110125 Physicians TX Pending Pending Children's Medical Center of Dallas 0 Community Providers for Children 1935 Medical District Drive Dallas TX 75235 463675742 Physicians TX Pending Pending Children's Medical Center of Dallas 0 Southwestern Medical District 1935 Medical District Drive Dallas TX 75235 204101612 Medical District TX 501(c)(3) Line 11a, I N/A 0 Women's Auxiliary of CMCD 1935 Medical District Drive Dallas TX 75235 752485538 Women's Auxiliary TX 501(c)(3) Line 9 N/A 0 Alternative Care Systems 1935 Medical District Drive Dallas TX 75235 752244475 Other Medical Svcs TX Children's Hlth Svc of TX C 0 Children's Insurance Co 76 St Paul Street Suite 500 Burlington VT 05401 030328102 Insurance VT Children's Med Ctr of Dallas C 0 0 0 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 0 0