2014-11-13T08:35:35-06:00 2013-12-31 366055558 Grant Thornton LLP 1717 Main Street Suite 1500 Dallas TX 75201 990 2013-01-01 750800628 Children's Medical Center of Dallas CHIL 2144567000 1935 Medical District Drive Dallas TX 75235 Jerry Lee VP, Accounting & Revenue Cycle 2144567000 2014-11-12 1 Kimberly Temple CPA P00669176 2145612300 2013 2015-11-30 17:44:51Z Christopher J Durovich 1935 Medical District Dr Dallas TX 75235 1111266701 0 X www.childrens.com X 1986 TX Dedicated to making life better for children 21 20 6799 1000 0 0 28808277 28807800 984976635 1029307149 24210891 27194699 26856715 25898968 1064852518 1111208616 21500 12400 0 0 517642683 503539451 0 0 0 407504890 440969265 925169073 944521116 139683445 166687500 2116928959 2410473260 693568732 645351702 1423360227 1765121558 X Children's Medical Center of Dallas is dedicated to making life better for children. Children's is committed to carry out this mission through adherence to four guiding principles: quality care; research & innovation; education & advocacy; and excellence & accountability. 0 0 703131926 12400 1051288106 Consistent with its charitable mission, Children's maintains a policy of accepting all patients within its primary service area regardless of ability to pay. The local service regions stretch from the Oklahoma border south to Waco and from Parker County (west of Ft. Worth) east to Wood County. For the fiscal year ended December 31, 2013, Children's absorbed $151 million of uncompensated healthcare services as a result of this open-door charitable policy. Children's participates in applicable government sponsored entitlement programs. For the year ended December 31, 2013, approximately 58% of Children's gross revenue is attributable to patients enrolled in state Medicaid programs.During 2013, Children's served approximately 150,000 patients. Children's had 45,770 patient admissions resulting in 104,365 patient days, and provided services in 544,955 outpatient visits. In addition, the hospital staff performed 17,820 day surgeries. In recognizing its mission to the community, Children's participates in the Medicaid, Medicare, Children's Health Insurance Program (CHIP), Chronically Ill and Disabled Children (CIDC), and Champus government programs. Under an agreement with the Dallas County Hospital District, Children's provides services to the indigent children of Dallas County. 5029673 7520119 Children's is the primary pediatric teaching hospital for the University of Texas Southwestern Medical School at Dallas and has the fifth largest pediatric training program in the country. Currently, there are 100 pediatric residents, three chief residents and approximately 120 pediatric subspecialty residents and fellows enrolled in this training program. Children's offers fellowships/residencies in these pediatric subspecialties, as well as internships and fellowships/residencies in nursing, dentistry, allied health, social sciences and religious studies. In addition to internship and fellowship programs, many students representing a variety of health care professions come to Children's to complete a pediatric rotation as a requisite of their training. 2676054 4001104 Through Children's affiliation with UTSW Medical Center, ongoing research is promoted in many different clinical areas of the hospital. The end goal of this research is the development of newer, more effective diagnostic & treatment methods to meet the health care needs of children. All research involving human subjects is approved by the Institutional Review Board at UTSW. Joint areas of research efforts between UTSW's Department of Pediatrics & Children's are: critical care, immunology, gastroenterology, emergency medicine, radiology, nutrition, endocrinology, psychiatry, cardiology, pharmacology, nephrology, neurology, pulmonology, rheumatology, infectious diseases & hematology/oncology. Many of these clinical studies have been published in medical journals & presented to professional health care societies. 710837653 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1368 0 1 6799 1 0 0 0 0 0 0 0 0 0 0 X 21 20 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 X Stephanie K Smith 2144567000 1935 Medical District Drive Dallas TX 75235 X Christopher J Durovich President,CEO,Ex Off Vtg 60.00 X X 1928033 0 46184 Robert Chereck Chairman & Director 1.00 X X 0 0 0 Richie L Butler Director 1.00 X 0 0 0 John Eagle Director 1.00 X 0 0 0 Robert A Estrada Director 1.00 X 0 0 0 Jeremy B Ford Director 1.00 X 0 0 0 Ed Heffernan Director 1.00 X 0 0 0 Richard Knight Jr Director 1.00 X 0 0 0 Tracey Kozmetsky Director 1.00 X 0 0 0 Charles Matthews Jr Director 1.00 X 0 0 0 Ronald D McCray Director 1.00 X 0 0 0 Thomas A Montgomery Director 1.00 X 0 0 0 Anne Motsenbocker Director 1.00 X 0 0 0 Connie O'Neill Director 1.00 X 0 0 0 Robert W Peterson Director 1.00 X 0 0 0 John F Scovell Director 1.00 X 0 0 0 Barbara Stuart Director 1.00 X 0 0 0 Gifford Touchstone Director 1.00 X 0 0 0 John F Young Director 1.00 X 0 0 0 David Biegler Ex Officio Voting Member 1.00 X 0 0 0 Steven M Gruber Ex Officio Voting Member 1.00 X 0 0 0 Douglas G Hock EVP, Hosp Clnc Ops & COO 55.00 X 816439 0 21486 Michele Chulick EVP, Corporate Svs 55.00 X 557540 0 7757 Julio Perez-Fontan MD EVP, Medical Affairs 55.00 X 480000 0 0 Peter W Roberts EVP, Pop Hlth & Netw Dev 55.00 X 984888 0 22833 Kern Wildenthal MD PhD EVP, CMC and Foundation Pres. 55.00 X 425294 0 12875 Michael Frick SVP, Dvlpmt (term date 05/15/2013) 55.00 X 798071 0 0 David G Biggerstaff SVP, Clinical and Support 55.00 X 443532 0 25134 Ray R Dziesinski SVP, Chief Treasury Officer 55.00 X 683091 0 34210 David Eager SVP, CFO, Treasurer 55.00 X 210450 0 1160 Regina M Coggins SVP, Ext Rel and Gen Couns 55.00 X 488327 0 30486 Pamela K Arora SVP, Chief Info Officer 55.00 X 518085 0 24689 Kimberly S Besse SVP, Chief HR Officer 55.00 X 370222 0 23775 Mary E Stowe RN SVP, Chief Nursing Officer 55.00 X 451519 0 15364 Patricia U Winning SVP, Strategy and Physician Orgs 55.00 X 692832 0 16988 Trent C Smith SVP, MyC Pres (term date 02/15/2013) 55.00 X 817634 0 16653 Daniel T Carney VP, Facilities Development & Ops 50.00 X 348835 0 24053 Joseph Egan VP, Acad Rel & Budget Mgmt 50.00 X 144049 0 5675 Keri Kaiser VP, Mktg & Communications 50.00 X 231975 0 10216 Jerry Lee VP, Acctg and Revenue Cycle 50.00 X 318998 0 23640 Mitchell Mulvehill VP, Finance and Treasury 50.00 X 300130 0 21849 Beth Peters VP, Legal and Compliance 50.00 X 236637 0 15477 Jeffery J Vawrinek VP, Legal Affr & Governance 50.00 X 307701 0 8502 Vanessa U Walls VP, Ambulatory Services 50.00 X 304790 0 27482 Thomas M Zellers MD VP, Medical Staff Affairs 50.00 X 150000 0 0 Mark Ziemianski VP, Business Analytics 50.00 X 156194 0 8837 Stephanie K Smith Corporate Secretary 40.00 X 110048 0 4796 Justin J Lombardo VP, Lrng Inst (term date 2/15/2013) 50.00 X 484927 0 9762 Ronald C Skillens Jr VP, Cp/In Aud (term date 03/31/2013) 50.00 X 370249 0 13032 Paul M Musgrave VP, Planning (term date 05/31/2013) 50.00 X 505074 0 9312 Denise Levis-Hewson VP, Clin Intgrtd Ntwrk 50.00 X 394168 0 4547 Christopher Menzies MD VP, Chief Med Information Offcr 50.00 X 290400 0 1592 Cynthia Bassel SVP, Foundation 55.00 X 241500 0 9443 Michele Whitsett VP, COO Foundation 50.00 X 247949 0 23342 Kimberly Altman VP, Pop Hlth Care Mgt Syst 50.00 X 258171 0 10745 James Herring FMR EVP,(term date 6/30/2012) 0.00 X 101795 0 0 John P Kline FMR SVP, (term date 10/31/2012) 0.00 X 123890 0 4956 16293437 0 536852 695 1 1 0 UTSW HI 108 5323 Harry Hines Blvd Dallas TX 753908886 Phys & Medical Svcs 59525670 JE Dunn Construction Co 16000 Dallas Pkwy 500 Dallas TX 75248 Construction Services 21870008 Medline Industries Inc 9303 Stoneview Dr Dallas TX 75237 Medical Supplies 17205358 Philips Health Care PO Box 100355 Atlanta GA 303840355 Medical Supplies 13101509 Comforce Technical Services PO Box 31001-0893 Pasadena CA 911100893 Staffing/Consulting Svcs 7625064 387 20862345 7945455 28807800 Inpatient Revenue 622110 1285724272 1285724272 Outpatient Revenue 621400 892338504 892338504 Day Surgery Revenue 621400 195208628 195208628 Prov for Dbtful Accts 622110 -40771862 -40771862 Deductions from Rev. 622110 -1303192393 -1303192393 1029307149 27252784 27252784 172477 0 172477 172477 172477 58085 -58085 -58085 -58085 Other Med Svc Revenue 622110 20948916 20948916 Dietary Revenue 621990 4607809 4607809 Vending Revenue 454210 169766 169766 25726491 1111208616 1054863874 0 27536942 X 12400 12400 14718543 3108634 11609909 380212092 303845733 76366359 30952152 24850462 6101690 48830311 39204246 9626065 28826353 23143728 5682625 5319016 1673757 3645259 2718060 2718060 532392 532392 133509144 124816217 8692927 5212736 225926 4986810 6413603 2083480 4330123 21652063 1521199 20130864 33841780 6329590 27512190 1528445 646610 881835 2905798 968326 1937472 17844349 13428995 4415354 56317687 42382602 13935085 7794794 145036 7649758 Med./Surgical Supplies 96312939 95405821 907118 Consulting & Prof Fees 20051431 1199869 18851562 Community Relations 18444025 18444025 Dietary and Food Costs 4597970 4289094 308876 5973033 3111903 2861130 944521116 710837653 233683463 0 221398992 211102906 185907889 246559708 131246984 197587737 10205126 9123939 10557487 22130766 1291890527 552669280 701130207 739221247 502599817 579851888 353882457 404895069 2116928959 2410473260 160024344 205475567 16827 0 386575772 379526700 132489 0 146819300 60349435 693568732 645351702 X 1125704796 1439078427 224474963 241967405 73180468 84075726 1423360227 1765121558 2116928959 2410473260 X 166687500 52230104 122843727 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 82434 82434 0 Part II-B, Line 1: In 2013, CMCD paid membership dues to organizations in which a portion of the membership dues were related to lobbying activities. NACH (National Association of Children's Hospitals), AHA (American Hospital Association), THA (Texas Hospital Association), TAVH (Texas Association of Voluntary Hospitals), THOT (Teaching Hospitals of Texas), and CHAT (Children's Hospital Association of Texas) identifed a portion of their membership dues as being related to lobbying activities. Lobbying percentages were identified by said organizations and applied to 2013 membership dues. 39925662 39925662 768250666 228430070 539820596 11377426 7028560 4348866 408829201 317210650 91618551 63507572 63507572 739221247 Net Assets of Foundation 326015887 Other Assets 27094205 LT Advances to Affiliates 51750292 Professional Risk Liability Deposit - CIC 34685 404895069 UTSW Phys Guarantees 8560957 Retirement Plan Accr 30460163 Rsv for Professional Liab 8203102 LT Deferred Rent 2940213 LT-Loan Pay-Urban Ventures 10185000 60349435 Part X, Line 2: In 2013 Children's Medical Center of Dallas was not required to have a FIN48 footnote disclosure. 1 1 X 1 X 1 X 1 1 0 1 1 20191781 367627 19824154 0.02100 510969762 434590566 76379196 0.08090 66798776 51231024 15567752 0.01650 597960319 486189217 111771102 0.11840 7577497 477558 7099939 0.00750 32949664 2265467 30684197 0.03250 0 0 0.00000 5906972 5906972 0.00630 2140993 107478 2033515 0.00220 48575126 2850503 45724623 0.04850 646535445 489039720 157495725 0.16690 493904 493904 0.00050 493904 493904 0.00050 1 10318609 1134671 7144521 1682280 5462241 X 1 1 1 NONE 2 1 Children's Medical Center of Dallas 1935 Medical District Drive Dallas TX 75235 www.childrens.com X X X X X Both Dallas and Legacy campuses share a license, A 2 Children's Medical Center at Legacy 7601 Preston Road Plano TX 75024 www.childrens.com X X X X X EIN, and MCR provider number. A Children's Medical Center of Dallas 1 X X X X X X X X X 13 1 0 1 X www.childrens.com X X X X X X X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X X 1 0 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Children's Medical Center of Dallas, - Facility 2: Children's Medical Center at Legacy Facility 1 -- Children's Medical Center of Dallas Part V, Section B, line 3: Each year, Children's recruits a citizen advisory council made up of key stakeholders serving children and knowledgeable in public health. These community leaders meet monthly to discuss children's health care issues and to contribute their experience, insights and expert recommendations for the the Beyond ABC report prepared by Children's. Additionally, the citizen advisory boards for Beyond ABC identify recommendations for advocates and public officials in order to improve the lives and health of children. Recent advisory boards have included city and county officials, former legislators, members of law enforcement, school district administrators, nonprofit organizations' executives, child-advocacy representatives, chambers of commerce and senior staff from corporations and financial institutions.Additionally, as part of the Texas Healthcare Transformation and Quality Improvement Program, the state of Texas has been divided into 20 regions. Hospitals within each region have worked together to develop plans to respond to health needs and transform the health care delivery system. Children's participates in the Regional Healthcare Partnership (RHP) Plans for Regions 9 and 10. Facility 1 -- Children's Medical Center of Dallas Part V, Section B, line 7: Some issues identified through the Children's CHNA have not been addressed in this plan. In initial discussion and subsequent prioritization, Children's Medical Center Needs Assessment Team considered the levels to which some needs were already being addressed in the service area. Additionally, some community needs fall out of the scope of expertise and resources of Children's Medical Center. Children's Community Health Implementation Strategy includes details on Needs Not Addressed. The section outlines how some of the needs identified in the assessment are addressed by others or in different ways. Facility 1 -- Children's Medical Center of Dallas Part V, Section B, line 10: Children's Medical Center uses the Federal Poverty Guidelines to determine eligibility for low income individuals. 200% of the Federal Poverty Guidelines is used for 100% charity adjustment, and 201% to 400% of the Federal Poverty Guidelines is used for a sliding scale adjustment. Facility 1 -- Children's Medical Center of Dallas Part V, Section B, line 12i: Children's Medical Center uses various documents and forms to verify income and expenses when determining the eligibilty for financial assistance of a patient and their family. These documents include, but are not limited to, W2 Form, wage and earning statement, pay check remittance, worker's compensation, unemployment compensation determination letters, income tax returns, statement from employer, bank statements, copy of checks, documents of sources of income, telephone verification of gross income with the employer, proof of participation in government assistance programs such as Medicaid, signed affadavit or attestation by patient, and veterans benefit statement. Facility 1 -- Children's Medical Center of Dallas Part V, Section B, line 14g: In addition to ensuring that the Children's charity care criteria is posted prominently and continuously in common entry points of the facility, a Director of Patient Financial Service ensures that the Children's charity care criteria is published annually in a local newspaper of general circulation in the county. Facility 1 -- Children's Medical Center of Dallas Part V, Section B, line 20d: Children's Medical Center determines the maximum amount that can be charged to individuals eligible for financial assistance for emergency or other medically necessary care by calculating the average commercial and government payor amounts received by Children's. Facility 1 -- Children's Medical Center of Dallas Part V, Section B, line 21: Facility 2 -- Children's Medical Center at Legacy Part V, Section B, line 3: Each year, Children's recruits a citizen advisory council made up of key stakeholders serving children and knowledgeable in public health. These community leaders meet monthly to discuss children's health care issues and to contribute their experience, insights and expert recommendations for the the Beyond ABC report prepared by Children's. Additionally, the citizen advisory boards for Beyond ABC identify recommendations for advocates and public officials in order to improve the lives and health of children. Recent advisory boards have included city and county officials, former legislators, members of law enforcement, school district administrators, nonprofit organizations' executives, child-advocacy representatives, chambers of commerce and senior staff from corporations and financial institutions.Additionally, as part of the Texas Healthcare Transformation and Quality Improvement Program, the state of Texas has been divided into 20 regions. Hospitals within each region have worked together to develop plans to respond to health needs and transform the health care delivery system. Children's participates in the Regional Healthcare Partnership (RHP) Plans for Regions 9 and 10. Facility 2 -- Children's Medical Center at Legacy Part V, Section B, line 7: Some issues identified through the Children's CHNA have not been addressed in this plan. In initial discussion and subsequent prioritization, Children's Medical Center Needs Assessment Team considered the levels to which some needs were already being addressed in the service area. Additionally, some community needs fall out of the scope of expertise and resources of Children's Medical Center. Children's Community Health Implementation Strategy includes details on Needs Not Addressed. The section outlines how some of the needs identified in the assessment are addressed by others or in different ways. Facility 2 -- Children's Medical Center at Legacy Part V, Section B, line 10: Children's Medical Center at Legacy uses the Federal Poverty Guidelines to determine eligibility for low income individuals. 200% of the Federal Poverty Guidelines is used for 100% charity adjustment, and 201% to 400% of the Federal Poverty Guidelines is used for a sliding scale adjustment. Facility 2 -- Children's Medical Center at Legacy Part V, Section B, line 12i: Children's Medical Center at Legacy uses various documents and forms to verify income and expenses when determining the eligibilty for financial assistance of a patient and their family. These documents include, but are not limited to, W2 Form, wage and earning statement, pay check remittance, worker's compensation, unemployment compensation determination letters, income tax returns, statement from employer, bank statements, copy of checks, documents of sources of income, telephone verification of gross income with the employer, proof of participation in government assistance programs such as Medicaid, signed affadavit or attestation by patient, and veterans benefit statement. Facility 2 -- Children's Medical Center at Legacy Part V, Section B, line 14g: In addition to ensuring that the Children's charity care criteria is posted prominently and continuously in common entry points of the facility, a Director of Patient Financial Service ensures that the Children's charity care criteria is published annually in a local newspaper of general circulation in the county. Facility 2 -- Children's Medical Center at Legacy Part V, Section B, line 20d: Children's Medical Center at Legacy determines the maximum amount that can be charged to individuals eligible for financial assistance for emergency or other medically necessary care by calculating the average commercial and government payor amounts received by Children's. 4 Ambulatory Care Pavilion Dallas 2350 Stemmons Fwy Dallas TX 75207 Outpatient Care Speciality Care Center in Southlake 470 E State Hwy 114 Southlake TX 76092 Outpatient Speciality Care Center Specialty Care Center Mesquite 1675 Republic Pkwy Suite 190 Mesquite TX 75150 Outpatient Speciality Care Center Specialty Care Center Rockwall 890 Rockwall Parkway Suite 100 Rockwall TX 75032 Outpatient Speciality Care Center Part I, Line 3c: Children's uses the Federal Poverty Guidelines to determine eligibility for low income individuals. 200% of the Federal Poverty Guidelines is used for 100% charity adjustment, and 201% to 400% of the Federal Poverty Guidelines is used for a sliding scale adjustment. Part I, Line 6a: Children's Community Benefit Report is prepared by our Public Relations department with collaboration from numerous departments within the hospital. Part I, Line 7: Children's uses Worksheet 2 from the Form 990 Schedule H instructions to calculate the costs for Part I, Line 7 and ratio of patient care cost to charges attributable to community benefits. Part I, Line 7g: Not applicable Part I, Ln 7 Col(f): Children's recorded $40,771,862 in bad debt expense for the year. The bad debt expense recorded was excluded from the calculation of community benefit expense. Part II, Community Building Activities: Children's is passionate about maintaining a vocal presence in legislative affairs on the local, state and federal levels and is at the forefront of governmental efforts that affect the community at large, from booster seat and car safety measures to critical funding initiatives. Additionally, Children's collaborates extensively with our partners in coalitions such as the Children's Hospital Association of Texas (CHAT) and the Texas Hospital Association (THA) at the state level, as well as the Children's Hospital Association (formerly the National Association of Children's Hospitals and Related Institutions). Children's President and Chief Executive Officer also serves on the Board of Trustees for the American Hospital Association. Through these affiliations, Children's is better able to advocate the development of an effective, comprehensive and appropriately funded children's health care system in Texas and across the country. Part III, Line 2: Children's uses Worksheet 2 from the Form 990 Schedule H instructions to calculate the bad debt expense and ratio of patient care cost to charges attributable to community benefits. Part III, Line 3: Children's uses its cost accounting system and the actual costs that are written off by patient accounts to calculate the bad debt expense attributable to patients eligible under the organization's charity care policy. Children's rationale for including a portion of bad debt as community benefit is that, bad debt expense should be treated as a community benefit as it is similar to other unreimbursed financial assistance, as reported in Part I, Line 7a, but for a different population (namely, those patients who would qualify for charity care if they completed the financial assistance application). Part III, Line 4: The following is the footnote disclosure related to the Allowance for Doubtful Accounts, provided with Children's Audited Financial Statements. Children's maintains allowances for doubtful accounts to reserve for potential write-offs relating to a patient's inability to make payments on an account. Accounts are written off when collection efforts have been exhausted. Children's routinely monitors its accounts receivable balances and utilizes historical collection experience to support the basis for its estimates of the provision for doubtful accounts. Part III, Line 8: Children's uses Worksheet A from the As Filed Medicare Cost Report and the IRS Schedule H Instructions to determine Medicare allowable costs. Part III, Line 9b: Children's has written debt collection policies which identify collection practices to be followed. The collection practices determine for what financial assistance a patient qualifies, and if a patient does not qualify for financial assistance, Children's also has written collection practices to be followed to determine if a patient qualifies for charity care. As part of the collection practice, Childrens' financial counselors review with the patient and their family the various state and federal programs available to them. Part VI, Line 2: In addition to the 2013 Community Health Needs Assessment, Children's has produced a comprehensive quality-of-life report on area children, Beyond ABC: Growing Up in Dallas County, since 1994. Beginning in 2008, a separate study has been published to focus on youth in Collin County as well. These biennial reports provide 10 years of trended data on the many factors facing children in our community. Beyond ABC analyzes more than 50 indicators of well-being with respect to health, education, safety and security for the more than 900,000 children that call those areas home.Children's has taken on the task of preparing Beyond ABC and distributing it to child advocates, service agencies, community leaders and lawmakers because of the presence the hospital holds in the community. In turn, these community leaders and organizations as well as Children's use the report to help determine how best to employ their resources each year. Part VI, Line 3: Children's Financial Counselors or Customer Service Representatives work with patients' guardians/guarantors to ensure that all public and voluntary assistance programs are fully explored.Children's has a financial program for patients who are considered indigent and do not qualify for a federal or state program. The eligibility criteria for financial assistance is based upon Federal Poverty Guidelines published annually. Patients eligible for financial assistance will have charges reduced to the lowest level charged to individuals who have insurance covering such care. Gross charges will not be used to calculate patient's bills.Children's will inform prospective patients of Children's charity care criteria by posting this information in common entry points and annually publishing this information in the community newspaper. Part VI, Line 4: Community Served by Children's Medical Center - Children's main campus is located at 1935 Medical District Drive, Dallas, Texas. The city of Dallas is the county seat of Dallas County. The city of Dallas is one of the most populous cities in Texas, as well as the United States.Children's also has an inpatient facility located at a second campus in Plano, Texas. Plano is in Collin County; which is also home to fast-growing cities like Frisco, Allen, McKinney and Prosper.Identification and Description of Geographical Community - The city of Dallas is the third largest city in Texas. The city of Dallas is accessible from I-30, I-35E, I-45 and I-635. Patients primarily originate from Texas (94.8 percent). Nearly 50 percent (48.8 percent) ofChildren's discharges originate in Dallas County, Texas.Collin County is one of the fastest growing areas in the United States, with its population between 2000 and 2010 growing from 491,000 to over 782,000. Community Population and Demographics - The U.S. Bureau of Census has compiled population and demographic data based on the 2010 census. The Nielsen Company, a firm specializing in the analysis of demographic data, has extrapolated this data to estimate population trends from 2013 through 2018. Based on the data, the overall population for Children's service area is projected to increase over the five-year period from 3,320,715 to 3,608,755. The age categories that represent youth and adolescents (0-14 and 15-20) is projected to increase 7.0 percent and 8.9 percent,respectively.According to the American Community Survey, 670,217 children under the age of 18 lived in Dallas County in 2012. Nearly 54 percent of all the children in Dallas County were Caucasian compared to approximately 67percent in Collin County.In terms of race, nearly 54 percent of all children in Dallas County were Caucasian, followed by 23 percent African-American. Although more than half of the children in Dallas County are Caucasian, only 35 percent of the Caucasian child population is non-Hispanic. Moreover, Hispanic children make up more than 52 percent of the child population of Dallas County.Service to the Community - Children's is well known for bringing exceptional medical and surgical care to the children of North Texas. Through community events, child-specific initiatives and organizational affiliations, the hospital invests in prevention, research, education, clinical excellence and advocacy to benefit all children.Children's devotes itself solely to caring for the complex medical needs of children. Children's provides patient care ranging from simple eye exams to specialized treatment in areas such as heart disease, hematology-oncology and cystic fibrosis. In addition, Children's is a major pediatric kidney, liver, intestine and heart transplant center. Through its established injury prevention, advocacy program and disease management programs, the hospital works diligently to educate the community so that no child has to ever to come through our doors.Children's is licensed for 595 beds and has more than 50 subspecialty programs spanning two campuses the main hospital in Dallas and a second full-service hospital in Plano. Children's was the first pediatric hospital in Dallas designated as a Level I Trauma Center. Children's is a private, not-for-profit hospital system that does not receive local tax dollars to offer the care provided. Children's is philanthropically supported in its efforts to provide care for every child who comes to us, regardless of their family's ability to pay. Donors also play a significant part in our ability to conduct research, education and advocacy.Combined, the two Children's facilities serve children through more than 677,000 patient encounters annually. But that doesn't prevent the offering of an elite level of individual care and attention to each family. As the primary pediatric teaching facility for the UT Southwestern Medical Center at Dallas, ("UTSW"), Children's is the only full-service, academic-affiliated pediatric hospital in North Texas. Through this academic affiliation, the Children's medical staff conducts research that is instrumental in developing treatments, therapies, and greater understanding of pediatric diseases and trains more than 200 pediatric residents and fellows annually. Part VI, Line 5: Children's mission is to make life better for children. We consider it our privilege and our responsibility to serve as ardent advocates for kids in Texas and across the country. To that end, we work tirelessly to ensure that children's voices are heard and that their needs are met. Our efforts to influence public policies that impact children's health are comprehensive and ongoing. Through programmatic initiatives, organizational partnerships and community events, Children's spreads its influence throughout the region and provides area children with much-needed access to a better quality of life. Whether that means establishing programs to increase services to the area's underserved children or fostering partnerships with existing organizations, Children's is committed to connecting families to the services they need.Children First! Collin County CoalitionChildren's is the founding member and sponsor of the Children First! Collin County Coalition, a nonpartisan alliance of more than 80 non-profit organizations. The coalition works to improve the quality of life of children through the development of initiatives related to public policy, advocacy, public awareness and community programs. The coalition's five work groups focus on economic security, education, family strengthening, health and safety. Community Outreach Through the efforts of the Community Relations staff at Children's, more area children who are eligible for Medicaid or the Children's Health Insurance Program (CHIP) are receiving coverage. Almost 18 percent of the children living in Dallas County are uninsured. Lack of health insurance leads to poorer health in childhood, greater rates of avoidable hospitalizations and higher childhood mortality. Uninsured children are 8 times more likely to have delayed care and 12 times more likely to have an unmet medical need than children with private insurance.Children's is committed to helping families obtain health insurance, an important factor in the health and well-being for our entire community. Children's has a vision to help address the shortage of primary pediatric medical care for families with limited resources.Dallas CHIP CoalitionChildren's founded and sponsors the Dallas Children's Health Insurance Program Coalition, an alliance of more than 90 organizations focused on helping families of uninsured children apply for CHIP or Medicaid. In addition, the coalition provides community leadership on public policy issues that affect the crisis of uninsured children in our community. MEDICAID/CHIP Outreach EventsAnnually, Children's coordinates two large community outreach events targeting the families of uninsured children. Working with the Dallas Children's Health Insurance Program Coalition, these events are promoted through school flyers and the media. Since 2005, these events have helped more than 12,000 families apply for coverage for more than 24,000 children. The coalition has trained more than 250 volunteers to assist families with applications for CHIP or Medicaid. School Based Medicaid/Chip Outreach Children's outreach team conducts Medicaid/Children's Health Insurance Program outreach at 8 area school districts with a combined enrollment of more than 350,000. Each student's family receives at least four communications during a school year with information on the importance of health insurance and the tools to apply for CHIP/Medicaid. In 10 years, Children's has trained more than 2,500 school staff and volunteers, completed more than 60,000 applications for Medicaid/CHIP and participated in over 700 special events. Children's serves as a liasioTackling an epidemic Texas ranks sixth in the nation for obesity in 10 to 17 year-olds, and the problem is even more pressing in Dallas County. More than one-third (36.1 percent) of Dallas Independent School District high-school students are obese or overweight, almost double the national average, according to the Department of State Health Services. In 2008, only one in five Dallas ISD third-graders passed the Texas-mandated school Fitnessgram assessment, compared to about one in three statewide. At Children's, we provide services to 7,500 patients each year with diagnoses that research shows to be obesity-related. These include cardiology, endocrine, gastrointestinal, pulmonary and psychiatric diagnoses. Dental OutreachAlthough effective methods exist to prevent tooth decay, cavities remain the most prevalent chronic condition among children-five times more common than asthma and seven times more common than hay fever. Inpartnership with UT Southwestern Medical Center at Dallas, a grant has been obtained so that children from the continuity clinics and ARCH (At-Risk Children) clinic who are identified as at-risk are now provided oral health education and fluoride varnish every three months to reduce their risk of cavities.Children's websiteOur hospital web site, www.childrens.com, empowers parents with the latest information about childhood illnesses, prevention, treatment and services available at the hospital. More than 1,300 common pediatric topics are addressed on the Web site. Also available are interactive guides promoting healthy living that target both children and their parents. The site also offers a free subscription to a monthly electronic newsletter that connects our community to the amazing things that take place at Children's every day.Reaching out to support the families of our communities is at the heart of the Children's mission. The challenge of ensuring the safety and well-being of all children is a driving force for the hospital, its employees and its medical staff. Assessing how many lives our services touch requires a look into our community, where the Children's influence has impact far beyond the hospital's walls.Disease Management and WellnessThe Disease Management and Wellness Department at Children's improves quality of life and decreases the use of healthcare services through education and pro-active self-management. Children's has seven disease-specific certifications, the most of any pediatric center in the United States. The programs offer access to evidence-based care and support that is needed for the management of conditions like asthma, diabetes and obesity.The disease management initiative is part of the hospital's ongoingefforts to reduce emergency department use, decrease admissions, curtail healthcare costs and ultimately, improve the quality of life for children with chronic conditions. Each program provides a family-centered environment that focuses on providing quality care to patients and overall increased disease awareness.Coaching coaches, athletes and parentsChildren's is committed to educating coaches, parents and young athletes on the importance of sports injury prevention. The hospital has a presence at dozens of coaches' clinics each year at facilities such as the Plano Sports Authority and Dallas Baseball Academy of Texas. During the clinics, Children's provides sports-specific injury-prevention cards and clipboards to thousands of coaches each year. So far, we have impacted the health and safety of 400,000 young athletes. Children's has also worked with companies such as Kohl's Corporation and their Sports Health and Wellness Outreach Program, to further support community outreach efforts. Spreading a message of water safetyDrowning is the second-leading cause of unintentional injury-related deaths among American children ages 1 to 14. The Know Before You Go Program spreads the message that every drowning is preventable when parents take appropriate precautions. The program includes distributing water safety materials, providing demonstrations on proper water rescue techniques and the use and proper fit of Coast Guard approved flotation devices. Working to reduce preventable injuriesMore than a decade ago, Children's formed the Safe Kids Dallas Area Coalition - the local chapter of Safe Kids Worldwide - to prevent childhood injuries. Traumatic injuries are the leading cause of death in Texas in children ages 1 to 14, and preventing these injuries is imperative at Children's - the first Level I trauma center in Texas (and one of only two in the state) that is solely dedicated to treating pediatric patients. Since 2002, the number of patients hospitalized because of motor vehicle crashes has steadily risen. Children's Injury Prevention Program has expanded its outreach efforts accordingly to bring car seat safety education and installation services to the community in an effort to reduce the number of children injured in car crashes. A specific initiative within the Safe Kids Dallas program is our car-seat safety inspection project. The project offers child safety-seat inspections by certified car seat technicians at Children's Dallas and Legacy campus so parents can learn to buckle up their children appropriately. Part VI, Line 6: Children's is not part of an affiliated health care system. Part VI, Line 7: Children's files a Community Benefit Plan with the State of Texas as required by Senate Bill 427. 1 TCU Evidence Based Practice and Research Collaborative - Evidence Based Practice Fellowship 2 2400 May Smith Scholars Program 3 7500 The Lisa M. Milonovich Scholarship for Nursing Education 1 1500 Women's Auxiliary Education Assistance Program 1 1000 Part I, Line 2 The TCU Evidence Based Practice and Research Collaborative - Evidence Based Practice Fellowship To prepare clinical nurses from collaborative hospitals to serve as leaders in their institutions to foster evidence based practice (EBP) to improve patient outcomes. Fellows will be empowered with EBP tools, skills, and experiences as they work on an institution-specific EBP project throughout the fellowship. Criteria for participants include: -Minimum of 2 years experience as a nurse -Minimum of 1 year on current unit -BSN -In good standing and willing to sign Fellow agreement -Employed > 50% time -Identified as a leader, either formal or informal, on assigned unit Each Institution Must Commit the Following: -Pay the Fellowship Fee of $1,200 per participant -Pay time to attend classes and 8 hours per two-week pay period or 4 hours per week to complete project -Provide support, mentors, and resources to the Fellow and the project -Ensure that the topic chosen is a priority, can be supported, and has the potential for sucess -Ensure that each Fellow's manager supports the project -Ensure that each Fellow's mentor supports the project May Smith Scholars Program The May Smith Scholars program provides both financial assistance and practical clinical experience for students interested in pediatric nursing. The scholarship program is named for May Forster Smith, who began an open-air clinic for infants in 1913 in Dallas. Sophomore and junior undergraduate students are eligible to apply to receive $5,000 each year for up to two years. Recipients of the scholarships must work at Children's as nurse externs for at least 400 hours during their undergraduate program. After graduation, recipients will be offered employment as registered nurses in one of the Children's Nurse Internship Tracts: Critical Care, Emergency, General Pediatrics, Hematology-Oncology, or Perioperative Services. The Lisa M. Milonovich Scholarship for Nursing Education The Lisa M. Milonovich Scholarship for Nursing Education provides financial assistance annually to support those choosing nursing as a career path, as well as those in nursing who want to further their education. Lisa, the scholarship's namesake, was a long-time, dedicated advanced practice nurse at Children's. The scholarship was endowed by Lisa's family and many friends and colleagues who greatly admired her. Scholarships shall be awarded on an annual basis with the recipients selected according to the following criteria: Be a full-time or part-time Children's employee with one year of continuous employment. Maintain an overall grade point average (GPA) of 3.0 on a 4.0 scale, or have a cumulative 3.0 GPA prior to being accepted into an accredited program. Demonstrate financial need and a commitment to pursue additional education. Recipients may be graduating high school students, nurse's aides, LVNs, RNs or those seeking advanced nursing degrees. Financial need shall be determined on an individual basis with appropriate documentation as determined by The Learning Institute. Commit to two years of additional employment at Children's after completion of the educational program for which the scholarship was awarded. Women's Auxiliary Educational Assistance Program The Women's Auxiliary to Children's offers educational support to nursing and allied health students who are registered for or currently enrolled in an accredited program through the Educational Assistance program for Nursing and Allied Health Students. Students who qualify may receive up to $1,000 per semester. Educational assistance is granted and paid on a per-semester basis. Students or prospective students of accredited nursing or allied health programs may apply if they: 1. Are junior or senior level students enrolled full or part time in an accredited undergraduate or graduate nursing program. 2. Maintain an overall grade point average of 3.0 on a 4.0 scale, or cumulative 3.0 prior to being accepted into an accredited program. Students are asked to sign agreements to work full time for 12 months at Children's for each academic year they receive education assistance or 6 months for each semester. If the students are offered employment with Children's but decline the offer, they will be obligated to repay the full amount plus interest calculated at the current prime interest rate at the time the offer is declined. X X X X 1 1 X X X X 1 1 0 0 0 0 0 1 0 Christopher J Durovich President,CEO,Ex Off Vtg 932216 0 979054 0 16763 0 25428 0 20756 0 1974217 0 293832 0 Douglas G Hock EVP, Hosp Clnc Ops & COO 467171 0 342056 0 7212 0 5747 0 15739 0 837925 0 108603 0 Michele Chulick EVP, Corporate Svs 497144 0 56320 0 4076 0 7757 0 0 0 565297 0 0 0 Julio Perez-Fontan MD EVP, Medical Affairs 480000 0 0 0 0 0 0 0 0 0 480000 0 0 0 Peter W Roberts EVP, Pop Hlth & Netw Dev 503493 0 476080 0 5315 0 10691 0 12142 0 1007721 0 0 0 Kern Wildenthal MD PhD EVP, CMC and Foundation Pres. 297827 0 123958 0 3509 0 10200 0 2675 0 438169 0 0 0 Michael Frick SVP, Dvlpmt (term date 05/15/2013) 147568 0 36364 0 614139 0 0 0 0 0 798071 0 0 0 David G Biggerstaff SVP, Clinical and Support 281029 0 160737 0 1766 0 9196 0 15938 0 468666 0 59158 0 Ray R Dziesinski SVP, Chief Treasury Officer 384066 0 293566 0 5459 0 20440 0 13770 0 717301 0 87742 0 David Eager SVP, CFO, Treasurer 136533 0 37000 0 36917 0 0 0 1160 0 211610 0 0 0 Regina M Coggins SVP, Ext Rel and Gen Couns 314001 0 161042 0 13284 0 11968 0 18518 0 518813 0 0 0 Pamela K Arora SVP, Chief Info Officer 327152 0 186816 0 4117 0 13680 0 11009 0 542774 0 81140 0 Kimberly S Besse SVP, Chief HR Officer 279226 0 87533 0 3463 0 9829 0 13946 0 393997 0 0 0 Mary E Stowe RN SVP, Chief Nursing Officer 286408 0 159762 0 5349 0 7082 0 8282 0 466883 0 71188 0 Patricia U Winning SVP, Strategy and Physician Orgs 373862 0 311809 0 7161 0 2550 0 14438 0 709820 0 105363 0 Trent C Smith SVP, MyC Pres (term date 02/15/2013) 35707 0 178773 0 603154 0 9011 0 7643 0 834288 0 0 0 Daniel T Carney VP, Facilities Development & Ops 258738 0 88365 0 1732 0 10476 0 13577 0 372888 0 0 0 Keri Kaiser VP, Mktg & Communications 220784 0 8421 0 2770 0 0 0 10216 0 242191 0 0 0 Jerry Lee VP, Acctg and Revenue Cycle 254661 0 59795 0 4542 0 9352 0 14289 0 342639 0 0 0 Mitchell Mulvehill VP, Finance and Treasury 256364 0 40518 0 3248 0 9263 0 12586 0 321979 0 0 0 Beth Peters VP, Legal and Compliance 212422 0 22635 0 1580 0 7903 0 7575 0 252115 0 0 0 Jeffery J Vawrinek VP, Legal Affr & Governance 230868 0 74840 0 1993 0 8502 0 0 0 316203 0 0 0 Vanessa U Walls VP, Ambulatory Services 224899 0 77562 0 2329 0 10052 0 17431 0 332273 0 0 0 Mark Ziemianski VP, Business Analytics 132927 0 10000 0 13267 0 4497 0 4340 0 165031 0 0 0 Justin J Lombardo VP, Lrng Inst (term date 2/15/2013) 33058 0 90348 0 361521 0 5454 0 4308 0 494689 0 0 0 Ronald C Skillens Jr VP, Cp/In Aud (term date 03/31/2013) 44757 0 71940 0 253552 0 5340 0 7692 0 383281 0 0 0 Paul M Musgrave VP, Planning (term date 05/31/2013) 104102 0 83209 0 317763 0 8012 0 1300 0 514386 0 0 0 Denise Levis-Hewson VP, Clin Intgrtd Ntwrk 277578 0 100000 0 16590 0 0 0 4547 0 398715 0 0 0 Christopher Menzies MD VP, Chief Med Information Offcr 258508 0 30281 0 1611 0 0 0 1592 0 291992 0 0 0 Cynthia Bassel SVP, Foundation 144721 0 93750 0 3029 0 8021 0 1422 0 250943 0 0 0 Michele Whitsett VP, COO Foundation 196479 0 47314 0 4156 0 10200 0 13142 0 271291 0 0 0 Kimberly Altman VP, Pop Hlth Care Mgt Syst 196614 0 60000 0 1557 0 2737 0 8008 0 268916 0 0 0 James Herring FMR EVP,(term date 6/30/2012) 0 0 101795 0 0 0 0 0 0 0 101795 0 0 0 John P Kline FMR SVP, (term date 10/31/2012) 0 0 123890 0 0 0 4956 0 0 0 128846 0 0 0 Part I, Line 1a * Children's written policy on business and educational travel prohibits first class travel except when approved in advance by the CEO or by the Board Chair. * Companion travel is prohibited except when it is deemed to further Children's business activities and must be approved in advance by the CEO or Board Chair. Approved companion travel is included as taxable income in 2013 for Christopher J Durovich. * Compensation is grossed up in limited circumstances with prior approval of the appropriate board committee. Approved one-time, grossed up compensation has been included as 2013 taxable income for Christopher J Durovich, David Eager, Mark Ziemianski, and Michael Frick. * In an effort to continue to attract quality leadership, Children's provides temporary housing allowances as a taxable benefit to executives and other key employees relocating to Dallas. Part I, Lines 4a-b Severance Payment and Non-Qualified Retirement Plan: * Severance - Trent C Smith - $459,000 * Severance - Michael Frick - $543,375 * Severance - Paul Musgrave - $233,400 * Severance - Justin Lombardo - $263,750 * Severance - Ron C Skillens, Jr - $190,750 * Retirement Income Restoration Plan - There were no employees that received taxable income from the Retirement Income Restoration Plan in 2013. Employees who participated in the Retirement Income Restoration Plan are Christopher J Durovich, Douglas G Hock, Mary E Stowe, and Patricia U Winning. * Savings Restoration Plan - Trent C Smith received $31,328 as taxable income from the Savings Restoration Plan, as a result of a Qualifying Termination under the severance plan. Justin Lombardo received $14,770 as taxable income from the Savings Restoration Plan, as a result of a Qualifying Termination under the severance plan. Ronald C Skillens, Jr received $2,333 as taxable income from the Savings Restoration Plan, as a result of a Qualifying Termination under the severance plan. Additional employees who participate in the Savings Restoration Plan are Christopher J Durovich, Douglas G Hock, Mary E Stowe, Patricia U Winning, Pamela Arora, Kimberly Besse, David G Biggerstaff, Daniel T Carney, Michele Chulick, Regina M Coggins, Ray R Dziesinski, Jerry Lee, Denise Levis-Hewson, Mitchell Mulvehill, Peter Roberts, Ray Tsai, Jeffrey Vawrinek, Vanessa Walls and Claud Wildenthal. Part I, Line 7 Non-Fixed Payments - The Human Resources Committee of the Board of Directors retains the authority to adjust annual payout percentages solely at their discretion. A N Central Tx Hlth Fac Dev Corp Hosp 521304502 65854RAL4 2009-07-01 193697772 Reimburse Construction Cost 0 0 0 B N Central Tx Hlth Fac Dev Corp Hosp 521304502 65854RBD1 2012-08-15 183637368 Refund Series 2002 Bonds 0 0 0 A 193697772 2819039 190566160 312573 2009 0 0 0 1 B 183637368 2020125 1 0 1 1 A 0 0 1 0 0 0.00210 0.00210 0 0 1 A 0 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 A 1 B 1 Schedule K, Part I, Line B Series 2012 Bonds were issued for the purpose of currently refunding the Issuer's Hospital Revenue Bonds (Children's Medical Center of Dallas Project) Series 2002 (original issue date prior to December 31, 2002). Form 990, Part VI, Section A, line 1 Children's Board membership includes four ex officio non voting members. Form 990, Part VI, Section A, line 1 An Executive Committee, whose membership must be approved by the Board of Directors of the Corporation, may be appointed annually. The Executive Committee shall have full power in the intervals between the meetings of the Board to perform any and all acts relating to the affairs of the Corporation and to exercise any and all powers of the Board in the management and direction of the business and conduct of the Corporation, subject to any limitations provided by applicable law, the Certificate of Formation of the Corporation or the Bylaws. It may meet or conduct its business in any fashion or by any means applicable to the meetings of the Board of Directors and shall keep a record of its proceedings and report the same to the Board at each succeeding meeting of the Board. Form 990, Part VI, Section A, line 6 Children's Health Services of Texas ("CHST"), a Texas non-profit corporation, is the sole member of the corporation. Form 990, Part VI, Section A, line 7a CHST elects all members of the organization's Board of Directors. Form 990, Part VI, Section A, line 7b A list of decisions requiring approval by the member is as follows: a) Any change in the mission or purpose of the Corporation; b) Any amendment to the Articles of Incorporation or Bylaws of the Corporation; c) Any addition of new Members; d) Any purchase or acquisition, sale, gift, lease, disposition of, mortgage or other encumbrance of any property, real, personal, or mixed by the Corporation, excluding routine expenditures, the value of which in the aggregate exceeds five percent (5%) of the total assets of the Corporation; e) Selling, exchanging, or otherwise disposing of all or substantially all of the Corporation's assets; f) Any incurrence or guarantee of indebtedness by the Corporation that in the aggregate exceeds five percent (5%) of the total assets of the Corporation; g) Any merger, acquisition, or consolidation of the Corporation or entering into any joint business venture with any other person, corporation or other legal entity that exceeds five percent (5%) of the total assets of the Corporation; h) Any dissolution of the Corporation; i) Any proposed amendments to the affiliation agreement between the Corporation and The UTSW Medical School (Medical School); (j) Appointment and removal of directors in accordance with Article 3 of these Bylaws; (k) Creation, acquisition, or disposition of any subsidiary or affiliated entity of the Corporation, the value of which in the aggregate exceeds five percent (5%) of the total assets of the Corporation; and (l) Approval of the annual budget for the Corporation. Form 990, Part VI, Section B, line 11 A draft of the Form 990 is presented to the organization's Audit Committee. The Chief Financial Officer provides a detailed review of the Form 990 and answers questions presented by the Committee members. Form 990, Part VI, Section B, line 12c The Board members receive a copy of the policy, along with a Disclosure of possible Conflict of Interests form to complete, with their annual Board appointment letter. All disclosures made are reviewed by the Chief Compliance Officer and Vice President of Legal Affairs and Governance prior to being presented and discussed at a meeting of the Board of Directors to determine if further action is required. Form 990, Part VI, Section B, line 15 The corporation's CEO, President, other officers, and key employees 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. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy and financial statements are made available upon request. Form 990, Part VII, Section A - Average Hours per Week Average hours per week have been identified as 60 hours/week for the CEO as there are numerous offsite community events which involve weekend, breakfast, and evening meetings. Average hours per week for Executive Vice Presidents and Senior Vice Presidents have been identified as 55 hours per week as they are involved with limited offsite community events. Average hours per week for Vice Presidents have been identified as 50 hours per week as they have some involvement with offsite community events. Form 990, Part IX, line 11g Contract Medical: Program service expenses 124,816,217. Management and general expenses 8,692,927. Fundraising expenses 0. Total expenses 133,509,144. Form 990, Part XI, line 9: Acc Pens Liab-OCI 94,456,027. Net Assets-CMCF-Unrest&Temp Rest 17,492,442. Net Assets-CMCF-Endowment 10,895,258. 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 Anesthesiologists For Children 1935 Medical District Drive Dallas TX 75235 752917570 Physicians TX 501(c)(3) Line 9 Children's Medical Center of Dallas 1 Dallas Phys Med Svcs Inc 1935 Medical District Drive Dallas TX 75235 810584868 Physicians TX 501(c)(3) Line 9 Children's Medical Center of Dallas 1 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 Physicians For Children 1935 Medical District Drive Dallas TX 75235 752854505 Physicians TX 501(c)(3) Line 9 Children's Medical Center of Dallas 1 Children's Med Ctr Research Inst at UTSWMC 1935 Medical District Drive Dallas TX 75235 433462044 Research Institute TX 501(c)(3) Line 11a, I Children's Hlth Svc of TX 0 Complex Care Med Svc Corp 1935 Medical District Drive Dallas TX 75235 461893597 Medical Services TX Pending Pending Children's Medical Center of Dallas 1 Pediatric Partners For Children 1935 Medical District Drive Dallas TX 75235 461917702 Clinically Integrated Network TX Pending Pending Children's Medical Center of Dallas 1 Children's Medical Center Services 1935 Medical District Drive Dallas TX 75235 461934007 Medical Services TX Pending Pending Children's Medical Center of Dallas 1 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 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 Specialists For Children 1935 Medical District Drive Dallas TX 75235 463110125 Physicians TX Pending Pending Children's Medical Center of Dallas 1 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 Community Providers for Children 1935 Medical District Drive Dallas TX 75235 463675742 Physicians TX Pending Pending Children's Hlth Svc of TX 0 Southwestern Medical District 5323 Harry Hines Dr Dallas TX 75390 204101612 Medical District TX 501(c)(3) Line 11a, I N/A 0 Women's Auxiliary of CMCD 12720 Hillcrest Rd Dallas TX 75230 752485538 Women's Auxiliary TX 501(c)(3) Line 9 N/A 0 Children's Insurance Company 76 St Paul Street Suite 500 Burlington VT 05401 030328102 Insurance Company VT Children's Medical Center of Dallas C 11578 11281117 1.00000 0 Alternative Care Systems 1935 Medical District Drive Dallas TX 75235 752244475 Other Medical Services TX Children's Hlth Svc of TX C 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 Anesthesiologists for Children D 7308919 actual cost Anesthesiologists for Children Q 713313 actual cost Physicians for Children D 25346111 actual cost Physicians for Children Q 1286812 actual cost Dallas Phys Medical Svcs for Children Inc D 36002 actual cost Dallas Phys Medical Svcs for Children Inc Q 80992 actual cost Complex Care Medical Services D 210146 actual cost Complex Care Medical Services Q 28216 actual cost Pediatric Partners for Children D 196411 actual cost Pediatric Partners for Children Q 30372 actual cost