2014-08-15T14:34:30-05:00 2013-09-30 PRICEWATERHOUSECOOPERS LLP 301 COMMERCE STREET SUITE 2350 FORT WORTH TX 76102 990 2012-10-01 750818178 TEXAS SCOTTISH RITE HOSPITAL for Crippled Children % JEAN ALLEN CONTROLLER TEXA 2145595000 2222 Welborn Street Suite Dallas TX 752193924 WILLIAM R HUSTON 2145597628 2014-08-15 true J Scott Moore 8178109998 2012 2015-11-30 17:44:51Z ROBERT L WALKER 2222 Welborn street Dallas TX 752193924 954203611 false X www.tsrhc.org X 1921 TX TO PROVIDE THE HIGHEST QUALITY CARE TO IMPROVE THE LIVES OF CHILDREN WITH ORTHOPAEDIC AND RELATED CONDITIONS AND SPECIFIC LEARNING DISABILITIES. TSRHC FOCUSES ON PATIENT CARE, RESEARCH AND EDUCATION. 40 40 1046 739 748628 -1947484 19506054 21958386 532099 40551994 52091664 107397612 134786159 127576361 206915976 297484353 200000 200000 0 0 75849350 87316292 0 0 5939157 45068786 45965525 121118136 133481817 85797840 164002536 1568727340 1820397325 114619170 97636484 1454108170 1722760841 X TO PROVIDE THE HIGHEST QUALITY CARE TO IMPROVE THE LIVES OF CHILDREN WITH ORTHOPAEDIC AND RELATED CONDITIONS AND SPECIFIC LEARNING DISABILITIES. TSRHC FOCUSES ON PATIENT CARE, RESEARCH, AND EDUCATION. false false 77538594 200000 40153042 Orthopaedics program includes outpatient clinic visits and inpatient stays for diagnosis and treatment. The Hospital's commitment to research, treatment and therapy for conditions including scoliosis, clubfoot, dislocated hip, Legg-Perthes, limb-length and limb deficiencies has provided medical breakthrough and technologies such as the TSRHC SILO 5.5 spinal system, True/lok external fixation system and the discovery of the first gene associated with idiopathic scoliosis. These advancements have impacted the lives of children throughout the world. To date, 20 of our researcher's discoveries have been patented. 10195768 THE NEUROLOGY PROGRAM PROVIDES CARE FOR ORTHOPAEDIC PATIENTS WHO ALSO HAVE RELATED NEUROLOGICAL DISORDERS AND NEUROMUSCULAR DISEASES, SUCH AS CHARCOT-MARIE-TOOTH AND TUBEROUS SCLEROSIS. SPECIALIZED CLINICS HAVE BEEN DEVELOPED TO PROVIDE PROACTIVE PATIENT CARE INVOLVING THE CHILD'S FAMILY AND THE MEDICAL TEAM. IN COLLABORATION WITH MAJOR UNIVERSITIES AROUND THE COUNTRY, TSRHC HAS CREATED A CONSORTIUM FOCUSED ON CHILDHOOD MOTOR DISORDERS. 8606817 Pediatric developmental disabilities program includes outpatient clinic visits for diagnosis and treatment of conditions such as Spina Bifida and Cerebral Palsy. CHILDREN WITH DEVELOPMENTAL DISABILITIES OFTEN HAVE PHYSICAL, SOCIAL, LEARNING OR BEHAVIOR CHALLENGES. THE PROGRAM TAKES AN INTERDISCIPLINARY APPROACH TO PROVIDING THE BEST POSSIBLE FAMILY CENTERED CARE. 14002629 398952 110343808 true true false true false false false false false true true false false true true true false true false false true false false false true true true true true false true true false false false false false false false false false false true false false false false true true true false false true 325 0 true 1046 true true true false false false false true true false false false false X 40 40 true false false false false false false true true false false true true true true true true true true false X JEAN ALLEN CONTROLLER 2145597507 2222 WELBORN STREET DALLAS TX 752193924 M Douglas Adkins 4.0 1.0 X FRED E ALLEN 4.0 0.0 X PAT BEARD DECEASED 1.0 0.0 X W EUGENE BROOKSHIRE 3.0 1.0 X RUSSELL C BROWN 3.0 0.0 X W VERNON BURKE JR 3.0 1.0 X CLIFFORD E BUTLER 3.0 0.0 X HAROLD D CARTER 4.0 1.0 X RONALD L CARTER 3.0 1.0 X DANIEL H CHAPMAN 4.0 1.0 X GRAHAM H CHILDRESS 4.0 0.0 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CO 50 SOUTH LASALLE CHICAGO IL 60603 INVESTMENT MGMT 995111 HKS INC POB 731121 DALLAS TX 75373 ARCHITECTURAL 560527 29 X 3366396 18591990 1183994 21958386 DYSLEXIA PROGRAM 900099 398952 398952 OUTPATIENT REVENUE 621498 3218860 3218860 INPATIENT REVENUE 622310 36905601 36905601 ALL OTHER PROGRAM SERVICES 28581 28581 40551994 35968015 35968015 63430 63430 119872900 119872900 337922 64030 273892 0 273892 273892 725374740 300059 654042133 266499 71332607 33560 71366167 14750 71351417 579222 3366396 1171879 -592657 -592657 33680 8400 25280 25280 2294063 1166317 1127746 586187 541559 SURFACE DAMAGE INCOME 110000 6721509 6721509 HUNTING PERMITS 110000 11475 11475 ALL OTHER REVENUE 136216 136216 6869200 297484353 40551994 748628 234225345 200000 200000 0 0 0 8033999 3770199 3112007 1151793 0 55243869 48964389 4124311 2155169 12639817 11420281 919997 299539 7782398 6978148 484808 319442 3616209 3198426 263370 154413 0 287222 287222 184320 184320 5204 5204 0 4507493 4507493 4488321 3331885 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The Hospital retained the services of Greenberg Traurig LLP to meet with various state legislators or staff and incurred related expenses in the amount of $500. 124107569 4082409 9512276 3804624 133897630 115329338 4378890 7772123 3372782 124107569 115713126 2591978 -303985 2671781 115329338 109297675 7717507 2211598 3513654 115713126 117418863 4633892 -5781788 6974517 109296450 0.03000 0.49000 0.48000 true false 23825023 23825023 129059056 72410853 56648203 75297051 60852642 14444409 289666 289666 95207301 INVESTMENT REAL ESTATE 12192085 BENEFICIAL INTEREST IN TRUSTS 88559148 MINERAL INTEREST 2260 100753493 0 ACCRUED PENSION COSTS 19622656 MANAGEMENT BENEFIT PLAN 2483484 HEALTH INSURANCE PAYABLE 1277044 RESERVE FOR MALPRACTICE INS CLAIMS 590703 CHARITABLE GIFT ANNUITIES 5147308 TRUST OBLIGATIONS 5956665 RESERVE FOR RESTORATION PLAN 22889476 DEFERRED INCOME 568360 RESERVE FOR 3RD PARTY PAYOR SETTLEMENT 3733029 62268725 X SCHEDULE D PART V, LINE 4: THE INCOME FROM THE ORGANIZATIONS'S PERMANENT ENDOWMENT FUNDS AND THE TEMPORARILY RESTRICTED ENDOWMENT FUNDS ARE USED TO SUPPORT THE OPERATIONS OF THE MEDICAL, RESEARCH AND LEARNING PROGRAMS OF THE HOSPITAL. SCHEDULE D PART X, LINE 2: AUDIT FOOTNOTE 11 - INCOME TAXES GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAX AUTHORITY. THE HOSPITAL HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE HOSPITAL BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE TAX AUTHORITIES FOR YEARS PRIOR TO 2010. East Asia and the Pacific Investments 67536205 Europe (Including Iceland and Greenland) Investments 119971704 Middle East and North Africa Investments 322117 North America Investments 12838656 South America Investments 8873911 Sub-Saharan Africa Investments 4610988 East Asia and the Pacific Investments Investment mgmt fees 643616 Europe (Including Iceland and Greenland) Investments Investment mgmt fees 1143323 Middle East and North Africa Investments Investment mgmt fees 3070 North America Investments Investment mgmt fees 125324 South America Investments Investment mgmt fees 84568 Sub-Saharan Africa Investments Investment mgmt fees 43942 Europe (Including Iceland and Greenland) Program Services CONFERENCES, TRAINING 50522 North America Program Services CONFERENCES, TRAINING 28903 South Asia Program Services CONFERENCES, TRAINING 5563 216282412 216282412 true false true false false false X X X X X false AUCTION 800358 702442 97916 10800 59105 13343 162515 MARATHON 444610 444610 2450 1130 12618 55 2631205 2154269 476936 89914 129622 120617 14900 554865 3876173 3301321 574852 92364 140422 180852 28243 729998 1171879 -597027 false false 33680 8400 false 33680 8400 8400 25280 TX false IN THE STATE OF TEXAS OCCASIONAL GAMING ACTIVITIES (UP TO TWO PER YEAR) DO NOT REQUIRE SUCH A LICENSE. false true false 0.53000 0.47000 JEAN ALLEN CONTROLLER TEXAS SCOTT 2222 WELBORN STREET DALLAS TX 75219 false NA N/A false true true true X true X 200. true false false 10230267 10230267 0.07700 27896752 10419813 17476939 0.13100 38127019 10419813 27707206 0.20800 22877743 22877743 0.17100 1270449 1270449 0.01000 11863368 539000 11324368 0.08500 36011560 539000 35472560 0.26600 74138579 10958813 63179766 0.47400 1326509 1326509 0.01000 1326509 1326509 0.01000 true 3792000 16154 23584 -7430 X true true 1 1 TEXAS SCOTTISH RITE HOSPITAL

2222 WELBORN STREET DALLAS TX 75219

www.tsrhc.org X X X X X ORTHOPAEDIC, neurodevelopment & musculoskeletal TX SCOT RITE HOSPITAL FOR CHILDREN 1 true X X X X X X X X X 13 true false true X X X X X X X X X X false false true true 200. false true X X X X X X true true X X X X X true false true X false false Part 1, Line 3c Financial Assistance Since its founding in 1921 as a Masonic charity, Texas Scottish Rite Hospital for Children ("TSRHC") has provided treatment free of charge. The Hospital began accepting reimbursement for patient care in October 2012, implementing charges for different service lines throughout a transition period, though remaining committed to providing care to all children who have needs within the scope of services provided by the Hospital regardless of a family's ability to pay. In furtherance of the Hospital's mission and values, the Hospital has a Financial Assistance/Charity Care policy, providing care at no charge or at a discounted rate to those who are financially indigent, medically indigent or uninsured. TSRHC is still in the transition phase of accepting reimbursement for various patient service. The hospital continues to provide additional unreimbursed care. THE COST OF UNREIMBURSED CARE IS INCLUDED IN OTHER COMMUNITY BENEFITS SECTION. (SCHEDULE H, PART I, LINE 7E) Financially indigent patients, or those whose income is less than or equal to 200% of FPG, receive a 100% discount. Medically indigent patients, or those whose income is greater than 200% of FPG, whose hospital charges exceed 3% of their annual income and who are unable to pay are provided a discount. Part 1, Line 6a COMMUNITY BENEFIT REPORT Prior to October 1, 2012, TSRHC did not bill patients for services and was not required to file a Community Benefit Report. For fiscal year ending September 30, 2013 a Community Benefit Report has been filed with the State of Texas. Part 1, Line 7 Costing Methodology Lines 7 (a) and (b) community benefit expense in column (c) were calculated using Worksheet 2: Ratio of Patient Care Cost to Charges. Lines 7 (e), (f), and (h) community benefit expense were calculated using a step down cost allocation method. Part II Promotion of the Health of the Community Community Programs TSRHC offers its facilities to local, national and international organizations for medical and other health-related education. Among the groups who used our facilities for such purposes in fiscal 2013 were the Dallas-Fort Worth Hospital Council, who hosted forums on sexual abuse and the retaining of health-care employees; the North Dallas Chamber of Commerce, which held its annual Health Care Conference at TSRHC; LAUNCHABILITY (AN ORGANIZATION THAT HELPS CHILDREN AND ADULTS WITH DEVELOPMENTAL DISABILITIES ACHIEVE THEIR MAXIMUM POTENTIAL), WHICH HELD ITS ANNUAL PLANNING MEETING AT TSRHC; and Southern Methodist University, who provided ethics education at its annual Conference of Professions.SUPPORT GROUPS WHO MET AT TSRHC IN FISCAL 2013 INCLUDE THE HANDS DOWN SUPPORT GROUP; THE MYOSITIS SUPPORT GROUP OF NORTH TEXAS; SUCCESSFUL BRIDGES, A SPINA BIFIDA SUPPORT GROUP; AND THE REGIONAL ARTHGRYPOSIS SUPPORT GROUP. IN TOTAL, MORE THAN 1,000 MEETINGS OF EXTERNAL ORGANIZATIONS ARE HELD ANNUALLY IN THE HOSPITALS'S CONFERENCE CENTER. TSRHC also hosted and co-sponsored Continuing Medical Education (CME) programs for health-care professionals with the University of Texas Southwestern Medical Center, including the Annual Carrell-Krusen Neuromuscular Symposium and the Pediatric Orthopaedic Education Series (POES). Those attending POES may earn CME credits while learning about the latest in scoliosis, hip dislocation, foot deformities, infections, sports injuries and more. The series is presented by the orthopaedic physicians of TSRHC. The Bernice and Brudus Meyerson Junior Volunteer Program consists of two five-week summer sessions that offer a wide range of volunteer opportunities throughout the hospital for students ages 14 to 17. Junior volunteers acquire real-life work experience in a variety of departments including clinics, nursing and Child Life; plan an annual book sale that raises money for the Legacy Scholarship Program, which provides financial assistance to former patients for college or career training; gain a positive, character-building experience that will open doors to future college and career pursuits while making a difference in children's lives. The hospital also hosts free public events in cooperation with leading community organizations intended to educate area residents about topics important to the community's safety and vitality. Events focus on awareness of child safety, Texas agriculture and volunteer service, including use of the T. Boone Pickens Training and Conference Center at TSRHC; the Rotary Club of Dallas Bike Rodeo and Child Safety Day; Farm and Ranch Day; Reverchon Roundup, a large-scale community volunteer effort to make the adjacent Reverchon Park cleaner and safer for members of the Dallas-Fort Worth community; and Allen Shivers Park, located on the hospital's campus as a haven for TSRHC patients, families and community members for 25 years. Therapeutic Recreation Programs: Besides daily services for children staying in the hospital and for outpatients as part of their clinic experience, Therapeutic Recreation provides outreach programs to help connect TSRHC patients to resources in the community. Sports and recreation programs at TSRHC include Learn to Golf, a program that provides the tools and instruction needed for young patients to experience the rehabilitative benefits of the game of golf; a ski trip for amputee patients; and seven specialty camps for children age 4 to 17, including camps for patients with tuberous sclerosis complex, upper limb differences, spina bifida, and juvenile arthritis and hand differences. Part III, Section A, Line 2 Methodology to Determine Bad Debt Bad debt expense is comprised of actual uncollectible amounts plus an allowance based on historical data. Discounts are not included in bad debt. Part III, Section A, Line 3 Bad Debt Exclusion of Financial Assistance Bad debt expense does not include any costs attributable to patients eligible under financial assistance policy. Part III, Section A, Line 4 Audit Bad Debt Footnote (page 23 of Audited Financials) The Hospital maintains allowances for uncollectible accounts for estimated losses resulting from a payor's inability to make payments on accounts. The Hospital assesses the reasonableness of the allowance account based on historical write-offs, cash collections, the aging of the accounts and other economic factors. Accounts are written off when collection efforts are unsuccessful. Management continually monitors and adjusts its allowances associated with its receivables. The allowance for doubtful accounts for the year ended September 30, 2013 was $3,792,000. Part III, Section B, Line 8 Medicare Allowable Costs The estimated costs of providing charity care services to Medicare patients are based on a calculation which applies a ratio of costs to charges as determined in the Medicare Cost Report. The ratio of costs to charges is calculated based on total expenses divided by gross patient services revenue. The shortfall is not included as a community benefit. Part III, Section C, Line 9b Collection Practices Before initiating a statement mailing process, the Hospital applies all third party payments and if a patient liability remains, the patient information is reviewed to ensure that the patient has been screened for financial assistance eligibility to ensure that the appropriate discount has been applied based on the financial assistance and charity care policy. Part V, Section B, Lines 1 and 3 Input from persons who represent the community and persons consulted TSRHC engaged the services of the Dallas-Fort Worth Hospital Council Foundation (DFWHCF) to assess the needs of the community and collaborate with TSRHC in producing the hospital's CHNA report. The mission of the DFWHCF is to serve as a catalyst for continual improvement in community health and health care delivery through education, research, communication, collaboration, and coordination. DFWHCF is a trusted community resource expanding knowledge and developing new insight for the continuous improvement of health and health care. DFWHCF aligns information collection, analytics, and reporting capabilities to improve clinical effectiveness, care coordination and population health. DFWHCF research staff has experience conducting community health needs assessments and developing comprehensive health service plans. Primary data was obtained from patients and key informants through telephone, written and face-to-face surveys. The DFWHCF contacted 957 patients and their families on behalf of TSRHC during the period of May 14 - July 3, 2013. A randomized sample of patients accessing the five core services areas of the hospital - pediatric orthopaedics, neurology, rheumatology, pediatric developmental disabilities and dyslexia - were queried and data was collected for use in this analysis. A significant number of medically underserved, low income and minority patients and patient families were included in the patient survey, reflecting the mix of patients seen at TSRHC. Key informant information was collected from 24 identified stakeholders during the period of June 19 - July 12, 2013. Experts in public health, social services, hospital administration, care management and acute pediatric specialty care were interviewed using a pre-determined list of questions. Key informants represent organizations serving a significant number of medically underserved, low income and minority patients and patient families. Secondary data regarding attributes and factors such as health status, socioeconomic status, standards of care, public health and published guidelines were acquired from a variety of sources, including but not limited to the Texas Department of State Health Services, Centers for Disease Control and Prevention, Healthy People 2020, Healthy Communities Network, American Community Survey and local public health authorities. Other organizations supporting this CHNA include the Arthritis Foundation, Dallas County Health and Human Services, Dallas-Fort Worth Hospital Council Foundation, Ronald McDonald House of Dallas and the Tarrant County Department of Health. Assessment of the TSRHC community core and ancillary services was accomplished through mixed methodology. Qualitative data was obtained from informants, categorized and interpreted, leading to the identification of trends and anomalies. Quantitative data was collected from patient survey responses, converted to numerical representations, and analyzed with statistical software. Based on an analysis of primary data, conclusions were made and needs identified. State and regional data determined indicators with the most significant impact on health access and quality for the TSRHC community. Part V, Section B, Line 5a The Hospital's Community Health Needs Assessment can be reviewed at www.tsrhc.org Part V, Section B, Line 6i Needs Identified in Recently Conducted CHNA As part of its Community Health Needs Assessment (CHNA), Texas Scottish Rite Hospital for Children (TSRHC) and The Dallas Fort Worth Hospital Council Foundation (DFWHCF) reached a consensus about significant community health needs based on the frequency and importance of survey responses received. TSRHC leadership identified and prioritized three significant needs within the scope of the hospital's practice that reach beyond the specific pediatric orthopaedic needs normally identified by our patients. It is the intention of TSRHC to address all three of the significant community health needs identified, within the scope of the Hospital's mission and scope of practice. TSRHC will continue to fulfill its primary mission by providing premier pediatric orthopaedic services, conducting pioneering research related to the conditions we treat and providing education in our specialty areas as a leading teaching hospital. Continuing the hospital's policy to treat patients regardless of the family's ability to pay addresses a significant barrier to care identified in community-based research. The following three needs were prioritized in the hospital's CHNA according to the magnitude of the need, its alignment with TSRHC's strengths and expertise and the opportunity to identify and refer or partner with other organizations that can more effectively meet the need: 1. Improve Access to Health Care Services 2. Improve Coordination of Care 3. Improve Child Health Status TSRHC is developing a strategy to address these prioritized needs that align with the hospital's mission and scope of practice. Strategy For Improving Access: TSRHC will further enhance its outreach program to ensure patient and patient families are aware of hospital services and overcoming barriers to access to care. TSRHC has adopted a financial assistance program and those families that meet the eligibility criteria may qualify for free or discounted care. The hospital will continue to be rigorous in its efforts to communicate that policy and ensure that financial burdens are never a barrier to patient care. TSRHC research data and informant interviews identified the current and growing shortage of pediatric orthopaedic specialists as a barrier to care. Adding to the anticipated high demand for physicians and surgeons is the expectation that a large number of physicians are expected to retire between 2008 and 2018. To address this need, TSRHC will: a. Provide medical education - TSRHC will function as a premier teaching institution, providing comprehensive education and training to orthopaedic residents and post-graduate orthopaedic fellows and contributing to the education of allied health professionals by providing clinical experience and didactic education for students as well as continuing education for health care professionals. Currently, TSRHC is affiliated with 56 institutions including colleges, universities and technical training programs. TSRHC provides four clinical fellowships each year. The Dorothy and Bryant Edwards Fellowship in Pediatric Orthopaedics and Scoliosis began in 1990 and provides training in all aspects of reconstructive pediatric orthopaedics, trauma and infections. In addition, TSRHC offers a six-month international pediatric orthopaedic and scoliosis fellowship training program. As of September 2013, the TSRHC orthopaedic medical staff has trained a total of 140 orthopaedic fellows, 30 international orthopaedic fellows and 411 orthopaedic residents. In addition, fellows from some of the major hand centers in North America as well as from countries throughout the world train here in the subspecialty of pediatric hand surgery for varying lengths of time. b. Provide clinical training and/or didactic education for allied health professionals in every discipline represented at the hospital - The hospital maintains affiliation agreements with more than 50 colleges, universities and technical training programs. A significant portion of the clinical education provided is to future nurses. More than 200 nursing students from five different nursing schools participate in clinical practice rotations at TSRHC in the course of a typical year. More than 300 nursing students from five other nursing programs are provided short courses and lectures by TSRHC nursing staff. Other disciplines which provide clinical, technical and/or administrative education to students in their area of expertise include Administrators, Child Life Specialists, Dieticians, Dentists, Dental Assistants, Dental Hygienists, Advanced Practice Professionals, Orthotists and Prosthetists; Physical and Occupational Therapists; Psychologists, Radiographers, Social Workers, Sonographers and Therapeutic Recreation Specialists. c. Introduce, expand or enhance telemedicine/telehealth initiatives to increase patient access to health care - Telemedicine encompasses different types of programs and services provided for each patient, including specialist referral services, patient consultations, remote access, medical education and consumer medical and health information. TSRHC is committed to providing a culturally appropriate environment for its pediatric patients and their families. A diverse cohort of employees and volunteers ensures reflectivity of its current and future patient mix. TSRHC employs the skills, expertise, and care of more than 850 employees and further, has the benefit of more than 800 volunteers. We also provide extensive language translation services to patients and their families through hospital staff and contracted outside services. In addition, employees are required to complete online training and education courses that include cultural sensitivity and patient communication segments. Strategy For Improving Care Coordination: TSRHC will encourage more coordination between general practitioners and TSRHC specialists either through the use of an Electronic Health Record (EHR) or similar mechanisms. TSRHC is making a significant investment in its information systems infrastructure and human resources to expand and enhance our ability to collaborate and communicate with other health care providers who also play a role in the total spectrum of patient care for the patients we share. Each month TSRHC receives referrals from 500-600 physicians. It is very important to us that each one of these patients is well taken care of and that our assessments and treatments are communicated back to these physicians. TSRHC is also committed to helping each family find the medical expertise and resources that they need if the services that they require are not within our scope of practice. Our Christi Carter Urschel Family Resource Center utilizes full time social workers to help parents and siblings of children with physical and developmental limitations and served ABOUT 2,000 families last year with resources to help them through a variety of needs. We also helped to coordinate more than 1,800 appointments outside the walls of our facility for patients last year. That program will be evaluated and opportunities for improving care considered. Care options change for patients after age 18 or 21, depending on the type of services received. Social workers and financial counselors help families understand options and help them navigate processes to acquire funding as adults. TSRHC will continue to work with government-supported income (SSI/SSDI) and/or medical coverage (Medicaid, Medicare, etc.) to facilitate continuing care. For patients who need guardianship after the age of 18, TSRHC social workers will help connect families to attorneys that help with the process. Strategy for Improving Child Health Status: TSRHC continuously assesses the quality of care provided not only with an ongoing patient care evaluation process, but also in collaboration with The Sarah M. and Charles E. Seay Center for Musculoskeletal Research that is comprised of five centers for excellence. TSRHC will continue to bring clinicians, researchers and other healthcare professionals and supporting staff together to perform innovative and clinically relevant research on challenging pediatric disorders. TSRHC continues to develop a broad network including providers of general pediatric services. We will continue to support conferences, symposia and other learning opportunities dedicated to improving child health. TSRHC will remain committed to a robust research program that will help us to increase our knowledge, treatment options, and overall care of the patient. We currently have research programs in all of our centers for excellence and through these projects we are able to enhance our patient care. Many of our patients have obesity issues, as well as other nutritional needs. Although TSRHC does not have a formal obesity clinic, we are committed to meeting the needs of the whole child. TSRHC has clinical dieticians on staff available to all patients. TSRHC takes an interdisciplinary approach to weight management, which in Part V, Section B, Line 7 Needs not Addressed in CHNA and Reasons When TSRHC is unable to provide services for all of the needs described in the CHNA, TSRHC identifies external resources that are available to the family by providing contacts for existing health care programs within the community available to address the identified needs. Many families travel from outside the area to come to TSRHC. Social workers refer families to the Ronald McDonald House (RMH) which provides lodging, meals and transportation at very little to no cost. If RMH does not have a vacancy, social workers provide a list of other hotels in the vicinity where families may choose to stay. Social workers and Medical Consult Coordinators help families arrange to receive follow-up care with the services listed below as ordered by the medical staff. Patient families chose their vendor(s) from a list of vendors provided by social workERs based on location and the patient's funding course: o Weight Management o Outpatient Physical Rehabilitation o Home Health Services o Durable Medical Equipment o Medical Supplies o Testing and specialists o Mental Health TSRHC transitions patients to adult providers as they approach the age of 18. A group of TSRHC social workers, nurses, administrators and medical staff work to transition TSRHC patients to ensure that all patients needing additional coordination as they age out of services receive the necessary assistance. Categories of care with which staff helps transition patients to adult care include legal and guardianship issues, primary and specialty care, funding and vocational and other educational programs. Part V, Section B, Line 11 Eligibility for Discounted Care Financially indigent patients, or those whose income is less than or equal to 200% of FPG, receive a 100% discount. Medically indigent patients, or those whose income is greater than 200% of FPG, whose costs for care exceeds 3% of their annual income and who are unable to pay are provided a discount. Part V, Section B, Line 20d FAP-Eligible Individuals Patients treated for emergency or other medically necessary care are informed of the financial assistance program and the application process. All uninsured patients will be provided a discount at the lowest contracted rate the Hospital has with any insurance company for the particular service received . LINE 2 Needs Assessment In addition to the CHNA described above, TSRHC collaborated and attended task force meetings with the Dallas-Fort Worth Hospital Council (DFWHC) and area hospitals for the DFWHC Community Needs Assessment and the 1115 Waiver of the Social Security Act. The hospital is part of Regional Healthcare Partnership 9 (RHP). These efforts were consistent with the Centers for Medicare and Medicaid Services triple aim to improve the experience of care, improve the health of populations in our RHP, and to reduce the cost of healthcare without compromising quality. There were two components of the DFWHC work: the Uncompensated Care Pool and the Delivery System Reform Incentive Payment Program (DSRIP) for hospitals. The results of the DFWHC Community Needs Assessment were utilized in the development and implementation of projects to meet the needs of the community in RHP 9. Also in 2013, TSRHC added a full time physician relations staff member to our Patient Access team. The primary goal of the Physician Relations Department is to better communicate and interact with the primary care physicians in our area. Over this past year, we were able to visit over 1,500 physician offices and respond immediately to any challenges or issues that they had referring patients to our institution. LINE 3 Patient Education of Eligibility for Assistance. Families are contacted by family services counselors prior to surgical procedures to inform them about the financial assistance program and to assess their potential qualification for federal, state or local government programs. Families are notified upon check-in for outpatient appointments that family services counselors are available to offer the same application and screening assistance. Lastly, families are notified on their statements from the hospital to contact a family services counselor if they have any concern about their ability to pay their amount due. The hospital also has sent out two sets of letters to all active patients in the past 2 years notifying them of the hospital's move toward billing, the importance of keeping appointments/procedures scheduled regardless of any outstanding balances or their ability to pay, and information about the Hospital's financial assistance/charity care policy. The facility has also posted specifics about available financial assistance in major waiting areas. LINE 4 Community information - Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves. The community served by TSRHC can best be defined by understanding its patient population and clinical focus. TSRHC is a 501(c)(3) specialty hospital located in Dallas, Texas, which treats pediatric orthopaedic and related neurological disorders. TSRHC provides premiere pediatric orthopaedic and dyslexia services for children from birth up to 18 years of age who offer hope of improvement through the services provided by the hospital. Access to services is by physician referral. Though TSRHC is dedicated to providing care for children from across Texas, more than 80 percent of its patients live in a 25-county geography located in northeast Texas. This primary service area includes the counties of Bosque, Collin, Cooke, Dallas, Denton, Ellis, Erath, Fannin, Grayson, Henderson, Hood, Hunt, Johnson, Kaufman, Lamar, Montague, Navarro, Palo Pinto, Parker, Rockwall, Smith, Somervell, Tarrant, Van Zandt, and Wise. These counties are located in the northeast quadrant of the state and were used as the basis for the socioeconomic profiles and to further define the TSRHC community. According to the Census Bureau, the estimated population for the primary service area in calendar year 2012 was 7,444,444 people. The median household income for the primary service area is $50,942. This is slightly higher than the median household income for Texas, which is $50,920, and slightly lower than the median household income for the U.S., which is $52,762. Approximately 25% of the primary service area population is 18 years or younger. Medical care is provided to children with orthopaedic and related conditions not treated at other medical facilities. Many providers at TSRHC receive referrals from physicians and children's hospitals in the primary service area because the patient's condition is either too acute or in some cases, so rare, the referring facility does not have adequately trained or experienced staff to provide the necessary care. The hospital has a process to determine if TSRHC is the appropriate facility to meet a child's clinical needs. The process begins with a telephone or other referral from a physician or an application for services. An internal mechanism is utilized to determine if TSRHC can appropriately meet the needs of the patient through one of its service lines when the child's diagnosis is not a clear-cut orthopaedic condition. When TSRHC is unable to provide services, TSRHC, as part of its care coordination services, identifies referral resources that are provided to the family. In addition to general pediatric orthopaedic services, the pediatric orthopaedic services for which patients are primarily referred to TSRHC include scoliosis and spine disorders, clubfoot and other foot disorders, reduction deficits (limb lengthening), hand and upper limb disorders, hip disorders and neurologic, rheumatologic and other pediatric developmental disabilities treated in addition or related to other orthopaedic conditions. LINE 5 Promotion of community health - Provide any other information important to describing how the organization's hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community. Research: Since opening its doors in 1921, TSRHC has strived to discover new and better ways to care for children affected by pediatric orthopaedic conditions and certain related neurological disorders. The hospital's dedicated research center, the Sarah M. and Charles E. Seay Center for Musculoskeletal Research, is made up of five Centers for Excellence supported by research divisions and core facilities: Scoliosis & Spine, Clubfoot & Foot Disorders, Hip Disorders, Limb Length Discrepancies and Hand Differences. Through the years, TSRHC researchers and physicians have generated more than 20 patents and made important discoveries that have helped children worldwide. These findings and innovations allow the medical community to form new hypotheses to explain what causes certain conditions while providing tools for future research. The major discoveries and research applications at TSRHC include the first gene associated with idiopathic scoliosis; two more genetic markers of the condition; the TSRH SILO 5.5 Spinal System; the TRUE/LOK External Fixation System; and the TRUE/LOK Hexapod System. Medical Education: For more than 30 years, in association with the University of Texas Southwestern Medical Center, TSRHC has provided an extraordinary educational experience in the field of pediatric orthopaedics to promising orthopaedic surgeons. More than 140 physicians have benefited from the TSRHC Fellowship in Pediatric Orthopaedics and Scoliosis, going on to hold prestigious medical positions around the country and across the world. In addition to the fellowship program, the hospital participates in residency training programs in neurology, rheumatology, orthopaedics, psychology, radiology and pediatric development disabilities. The hospital has various affiliation programs for education in nursing, physical therapy, occupational therapy, prosthetics and various other disciplines. Community Health Education and Outlook: Family Resource Center: The Christi Carter Urschel Family Resource Center, founded in 1988, provides health information and support services to patients and families in order to help them make informed health care decisions and improve their quality of life. Staff also provides referrals to medical providers for conditions not treated at TSRHC. The center serves an average of 2,000 families annually. Family Room and Chapel: The Family Room is primarily utilized by patient families as a comfortable surgery waiting area while the Chapel located next door provides a place of worship with nondenominational services each Sunday. Child Life Playroom: The Playroom features staff specialists who focus on each patient and their family's specific needs by promoting optimal psychosocial development. Family Services Department: Family Services serves as a support center for patients and families in four primary areas: determining how to meet their financial obligations for health care serv true PEDI-ORTHO HEALTH CORPORATION 2222 WELBORN DALLAS TX 75219 752665759 501(c)(3) 100000 FMV NONE TSRH FOR CHILDREN FOUNDATION 2222 WELBORN DALLAS TX 75219 460683787 501(c)(3) 100000 FMV NONE 2 SCHEDULE I Part I, Line 1 USE OF GRANT FUNDS: THE GRANT TO PEDI-ORTHO HEALTH CORPORATION, A RELATED MEDICAL ENTITY, IS TO SUPPORT THE MEDICAL SERVICES OF ITS PHYSICIANS. THE HOSPITAL, AS A SOLE MEMBER, MONITORS THE ACTIVITIES OF THE ENTITY WHICH PROVIDES PEDIATRIC ORTHOPAEDIC PHYSICIANS TO LOCAL MEDICAL FACILITIES THAT CARE FOR CHILDREN. THE ENTITY IS INDEPENDENTLY AUDITED ANNUALLY AND THE HOSPITAL RECEIVES A COPY OF THE AUDITIED FINANCIAL STATEMENTS. Schedule I Part I, Line 2 Use of grant Funds: THE GRANT TO TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN FOUNDATION, A RELATED SUPPORT ORGANIZATION, IS TO PROVIDE START UP FUNDING. THE HOSPITAL, AS A SOLE MEMBER, MONITORS THE ACTIVITIES OF THE ENTITY WHOSE PURPOSE IS TO PROVIDE SUPPORT TO THE HOSPITAL. X X false true X X X X false true false false false false false false false ROBERT WALKER 496106 0 0 518539 0 0 0 21410 0 1036055 0 8088 0 J C MONTGOMERY JR 444940 0 0 88903 0 0 0 20410 0 554253 0 39702 0 SHARON ELLIS 302946 0 0 58085 0 15000 0 17125 0 393156 0 0 0 LORI DALTON 267992 0 0 62887 0 15000 0 25197 0 371076 0 0 0 MARK BATEMAN 254732 0 0 47001 0 15000 0 21971 0 338704 0 0 0 M SCOTT PERRYMAN 236442 0 0 27256 0 1200 0 22590 0 287488 0 0 0 DEBRA SAYLES 220445 0 0 12565 0 115332 0 12658 0 361000 0 0 0 KRISTINA KEEVER-SMITH 190189 0 0 27313 0 33197 0 6349 0 257048 0 0 0 DON KATZ 167814 0 0 20140 0 37980 0 21595 0 247529 0 0 0 STEPHANIE BRIGGER 133728 0 0 34287 0 27537 0 14117 0 209669 0 0 0 JEAN ALLEN 121663 0 0 29913 0 8991 0 19068 0 179635 0 0 0 JEREMY HOWELL 139430 0 0 7938 0 9151 0 21717 0 178236 0 0 0 J ANTHONY HERRING 549824 0 0 0 94474 0 0 0 18043 0 662341 0 45917 0 DANIEL SUCATO 535054 91800 0 65185 0 88320 0 23702 0 712261 91800 0 0 JOHN BIRCH 464506 0 0 342278 0 81201 0 26702 0 914687 0 0 0 B STEPHENS RICHARDS 500387 47800 0 114615 0 61471 0 22497 0 698970 47800 0 0 JAMES STURGIS 165262 0 0 10001 0 33325 0 19646 0 228234 0 0 0 CHARLES JOHNSTON 471059 0 0 199889 0 81314 0 18410 0 770672 0 0 0 KARL RATHJEN 467560 76200 0 66493 0 66733 0 12903 0 613689 76200 0 0 LORI KAROL 446920 31950 0 55821 0 74408 0 24702 0 601851 31950 0 0 FARZANEH SAFAVI 441127 0 0 154884 0 74152 0 22702 0 692865 0 0 0 GAIL HACKNEY 337883 0 0 322421 0 58671 0 21803 0 740778 0 0 0 SCHEDULE J PART 1, LINE 1A: TRAVEL FOR COMPANIONS (INCLUDED ON SCH J, PART II, COL B(III) & W-2 BOX 5) J. ANTHONY HERRING 800 B. STEPHENS RICHARDS 800 JOHN BIRCH 800 CHARLES JOHNSTON 800 KARL RATHJEN 800 SOCIAL CLUB DUES (INCLUDED ON SCH J, PART II, COL B(III) & W-2 BOX 5) JC MONTGOMERY, JR. 2,640 SCHEDULE J PART I, LINE B: THE CORPORATION DOES NOT HAVE A WRITTEN POLICY REGARDING REIMBURSEMENT FOR TRAVEL FOR COMPANIONS. CERTAIN EMPLOYEES ARE ALLOWED $800 ANNUALLY FOR TRAVEL FOR COMPANIONS. THE ORGANIZATION PAID A PORTION OF THE SOCIAL CLUB DUES. SUBSTANTITION OF EXPENSES WERE REQUIRED PRIOR TO REIMBURSEMENT AND THESE ITEMS WERE INCLUDED AS TAXABLE INCOME ON SCHEDULE J. SCHEDULE J PART I, LINE 4B: 1)THE RESTORATION OF RETIREMENT INCOME PLAN (RRIP) IS A NON-QUALIFIED PLAN PROVIDING SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN EMPLOYEES WHOSE BENEFITS UNDER THE TAX-QUALIFIED RETIREMENT PLAN HAVE BEEN LIMITED BY THE MAXIMUM BENEFIT AND MAXIMUM COMPENSATION LIMITATIONS IMPOSED UNDER THE TAX-QUALIFIED RETIREMENT PLAN IN ORDER TO COMPLY WITH THE INTERNAL REVENUE CODE. THE TOTAL ACCUMULATED BENEFIT THAT HAS ACCRUED FOR A PARTICIPANT UNDER THE RRIP NORMALLY BECOMES VESTED AND TAXABLE TO A PARTICIPANT WHEN HE OR SHE EITHER HAS ATTAINED AGE 55 AND COMPLETED 15 YEARS OF SERVICE OR ATTAINS AGE 65. THE BENEFIT ACCRUALS FOR A PARTICIPANT AFTER THE DATE OF INITIAL VESTING ARE TAXABLE TO THE PARTICIPANT WHEN AND AS ACCRUED. RRIP BENEFITES BECOME PAYABLE AFTER TERMINATION OF EMPLOYMENT. UNDER THE TERMS OF THE RRIP, THE FOLLOWING EMPLOYEES ARE NON-VESTED PARTICIPANTS WHO ARE ACCRUING AN ANNUAL BENEFIT IN 2012. (INCLUDED ON SCH J, PART II, COL C) DANIEL SUCATO 58,915 KARL RATHJEN 34,819 LORI KAROL 32,692 UNDER THE TERMS OF THE RRIP, THE FOLLOWING EMPLOYEE VESTED IN THIS PLAN IN CALENDAR YEAR 2012 AND HER CUMULATIVE ACCRUED BENEFITS SINCE INCEPTION, AS REFERENCED BELOW, ARE SUBJECT TO TAXATION. (INCLUDED ON SCH. J, PART II, COL (B)(III), AND W-2, BOX 5) GAIL HACKNEY 301,241 UNDER THE TERMS OF THE RRIP THE FOLLOWING EMPLOYEES HAVE PREVIOUSLY VESTED IN THE RRIP AND ACCRUED ADDITIONAL BENEFITS DURING 2012, WHICH ARE SUBJECT TO TAXATION, IN THE FOLLOWING AMOUNTS. (INCLUDED IN SCH J, PART II, COL B (III), AND W-2, BOX 5) ROBERT WALKER 437,524 B. STEPHEN RICHARDS 56,416 JOHN BIRCH 188,612 CHARLES JOHNSTON 118,189 FARZANEH SAFAVI 106,052 2)THE MANAGEMENT BENEFIT PLAN IS A NON-QUALIFIED PLAN PROVIDING SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN ELIGIBLE EMPLOYEES WHO BECAME PARTICIPANTS PRIOR TO 1988. MONTHLY RETIREMENT INCOME BENEFITS BECOME PAYABLE UNDER THE PLAN COMMENCING AT AGE 65 (OR EARLIER DISABILITY), AND ARE TAXABLE TO PARTICIPANT WHEN AND AS PAID. UNDER THE TERMS OF THE MANAGEMENT BENEFIT PLAN, THE FOLLOWING EMPLOYEES ACCRUED A BENEFIT IN 2012. (INCLUDED ON SCHEDULE J, PART II, COLUMN B(III), AND W-2, BOX 5) JOHN BIRCH 18,324 CHARLES JOHNSTON 22,507 UNDER THE TERMS OF THE MANAGEMENT BENEFIT PLAN, THE FOLLOWING EMPLOYEES RECEIVED PAYMENTS IN 2012. (AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B(III), AND W-2, BOX 1 AND 5). JC MONTGOMERY, JR. 39,702 J. ANTHONY HERRING 45,917 ROBERT WALKER 8,088 3)THE FLEXIBLE BENEFITS PLAN IS A NON-QUALIFIED PLAN PROVIDING LIFE INSURANCE, DISABILITY INSURANCE, LONG-TERM CARE INSURANCE AND/OR RETIREMENT BENEFITS TO ELIGIBLE EMPLOYEES AT THEIR ELECTION. THE INSURANCE PREMIUM AND RETIREMENT ACCOUNT CONTRIBUTION AMOUNTS ALLOCATED TO A PARTICIPANT UNDER THIS PLAN FOR EACH YEAR ARE TAXABLE TO THE PARTICIPANT FOR SUCH YEAR. THE EARNINGS ON RETIREMENT ACCOUNT CONTRIBUTIONS BECOME TAXABLE TO A PARTICIPANT WHEN PAID OR MADE AVAILABLE TO THE PARTICIPANT. UNDER THE TERMS OF THE FLEXIBLE BENEFITS PLAN, THE FOLLOWING EMPLOYEES WERE TAXED ON THE FOLLOWING AMOUNTS FOR CALENDAR YEAR 2012 (INCLUDED IN SCHEDULE J, PART II, COL B(III), AND W-2, BOX 5. JC MONTGOMERY, JR. 22,774 ROBERT WALKER 15,754 SCOTT PERRYMAN 11,250 SHARON ELLIS 15,038 LORI DALTON 13,905 KRISTINA KEEVER-SMITH 9,549 MARK BATEMEN 11,588 STEPHANIE BRIGGER 6,981 JEAN ALLEN 6,692 JAMES STURGIS 7,638 DEBRA SAYLES 9,548 J. ANTHONY HERRING 26,963 B. STEPHENS RICHARDS 22,170 JOHN BIRCH 22,170 CHARLES JOHNSTON 22,170 KARL RATHJEN 21,296 DANIEL SUCATO 21,296 LORI KAROL 21,296 FARZANEH SAFAVI 21,028 A CITY OF PARKER TX CULTURAL EDUCATION FACILITIES 270365113 2010-12-30 23000000 CONSTRUCT & EQUIP POWER PLANT false false false A 0 0 23000000 0 419518 0 111125 995247 0 22735606 0 0 2012 false false true true A false false false false 0 false false false false A false true true true JPMORGAN CHASE 10. false false false 0 false false A false SCHEDULE K, PART IV, LINE 2B: 0 CONSTRUCTION FUND TO BE EXEMPT FROM REBATE BASED ON TWO YEAR SPEND DOWN RULES. X 39 1025979 MARKET VALUE X 2 133000 MARKET VALUE X MINERAL INTERESTS 15 15 MARKET VALUE X TRACTOR/LOADER/BACKHOE 1 25000 MARKET VALUE false false false Schedule M PART I, COLUMN (B): COLUMN (B) REFLECTS THE NUMBER OF CONTRIBUTIONS. OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D: CENTER FOR DYSLEXIA PROGRAM PROVIDES TREATMENT FOR LEARNING DISORDERS AND DEVELOPS TEACHING MATERIAL FOR TEACHING CHILDREN WITH DYSLEXIA. ARTHRITIS CENTER FOR DIAGNOSIS AND TREATMENT. OTHER SERVICES THAT SUPPORT ALL HOSPITAL CLINICS AS DETERMINED BY A PHYSICIAN INCLUDE: DENTAL; OPHTHALMOLOGY; OCCUPATIONAL THERAPY; ORTHOTICS; PHYSICAL THERAPY; PROSTHETICS; CHILD LIFE; PATIENT INTERVENTIONS; DEVELOPMENTAL ASSESSMENT; AND PHARMACY. DESCRIPTION GRANTS EXPENSES REVENUE CENTER FOR DYSLEXIA PROGRAM $0 $6,179,253 $398,952 CHILDRENS ARTHRITIS CLINIC 0 5,649,603 DENTAL/EYE CLINIC AND CHILD DEVELOPMENT 0 2,173,773 TOTALS $0 $14,002,629 $398,952 FAMILY AND BUSINESS RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2: LYNDON OLSON AND PAT BEARD HAD A BUSINESS RELATIONSHIP. LYNDON OLSON AND RON CARTER HAVE A BUSINESS RELATIONSHIP. J. ANTHONY HERRING, MD, JOHN BIRCH, MD, CHARLES JOHNSTON, MD, LORI KAROL, MC, B. STEPHENS RICHARDS, MD, KARL RATHJEN, MD, AND DANIEL SUCATO, MD, HAVE A BUSINESS RELATIONSHIP WITH ROBERT WALKER, Sharon Ellis AND LORI DALTON IN THAT THE PHYSICIANS ARE DIRECTORS OF PEDI-ORTHO HEALTH CORPORATION, AN ENTITY FOR WHICH TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN IS THE SOLE MEMBER, IN WHICH THE LATTER INDIVIDUALS SERVE AS OFFICERS. LORI DALTON, Sharon Ellis AND KRISTINA KEEVER-SMITH HAVE A BUSINESS RELATIONSHIP IN THAT THEY ARE EMPLOYED BY TEXAS SCOTTISH HOSPITAL FOR CHILDREN AND ALSO SERVE AS OFFICERS OF LEGACY SCHOLARSHIP FUND, A RELATED ENTITY. J.C. MONTGOMERY, JR., LORI DALTON, Sharon Ellis AND KARL RATHJEN HAVE A BUSINESS RELATIONSHIP IN THAT THEY ARE EMPLOYED BY TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN AND ALSO SERVE AS OFFICERS OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN FOUNDATION, AN ENTITY FOR WHICH TEXAS SCOTTISH HOSPITAL FOR CHILDREN IS THE SOLE MEMBER. PROCESS USED TO REVIEW 990 Form 990, Part VI , Section B, Line 11b: THE FORM 990 IS PREPARED INTERNALLY IN CONJUNCTION WITH OUTSIDE ACCOUNTANTS AND THEN REVIEWED BY MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE AUDIT COMMITTEE FOR REVIEW AND DISCUSSION. THE FORM 990 IS PROVIDED TO THE BOARD THROUGH ACCESS TO A SECURE PORTAL FOR REVIEW BEFORE IT IS FILED. COMPLIANCE WITH WRITTEN CONFLICT OF INTEREST POLICY Form 990, Part VI, Section B, Line 12c: THE ORGANIZATION ANNUALLY REQUIRES OFFICERS, KEY EMPLOYEES AND TRUSTEES TO COMPLETE A CONFLICTS OF INTEREST FORM DISCLOSING ACTUAL OR POTENTIAL CONFLICTS OF INTEREST IN COMPLIANCE WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY. ADDITIONALLY, THESE INDIVIDUALS ARE TO REPORT ANY NEW MATTERS THAT ARISE DURING THE YEAR IF THEY BECOME AWARE OF A TRANSACTION THAT IS UNDER CONSIDERATION THAT PRESENTS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. ANNUALLY THE GENERAL COUNSEL PREPARES AND SUBMITS A SUMMARY OF THE DISCLOSED POTENTIAL CONFLICTS TO THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES. ADDITIONALLY, AT THE TIME A KEY STAFF MEMBER IS HIRED OR PROMOTED TO A POSITION WITH ADMINISTRATIVE OR MANAGEMENT RESPONSIBILITIES, THE ORGANIZATION PROVIDES THE INDIVIDUAL WITH A COPY OF THE CONFLICTS OF INTEREST POLICY AND THE INDIVIDUAL IS REQUIRED TO COMPLETE A CONFLICTS OF INTEREST DISCLOSURE FORM. ALL MATERIAL FACTS SURROUNDING CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS INVOLVING A CONFLICT OF INTEREST ARE TO BE DISCLOSED TO ENSURE THAT THE CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR TO THE HOSPITAL AT THE TIME IT IS AUTHORIZED, APPROVED, OR RATIFIED. PROCESS FOR DETERMINING COMPENSATION Form 990, Part VI, Section B, Line 15a and 15b: THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES ANNUALLY REVIEWS AND APPROVES SALARY AND BENEFITS FOR EXECUTIVE STAFF AND KEY EMPLOYEES OF THE ORGANIZATION. THE HOSPITAL REVIEWS VARIOUS EXECUTIVE/PHYSICIAN COMPENSATION SURVEYS, INCLUDING DATA FROM PEDIATRIC HOSPITALS ON BOTH A LOCAL AND NATIONAL BASIS. PERIODICALLY, AN INDEPENDENT CONSULTANT REVIEWS SALARY AND BENEFITS OF EXECUTIVES, PHYSICIANS AND KEY EMPLOYEES. THIS REVIEW WAS LAST UNDERTAKEN IN FISCAL YEAR 2012 FOR the ceo and chief of staff. ADDITIONALLY, THE HOSPITAL GATHERS PHYSICIAN COMPENSATION DATA FROM LOCAL AND PRIVATE PRACTICE SETTINGS. THIS INFORMATION IS COLLECTIVELY TAKEN INTO CONSIDERATION AND PRESENTED TO THE COMMITTEE WHEN DETERMINING COMPENSATION. Governing Document, Conflict of Interest Policy and Financial Statements Form 990, Part VI, Section C, Line 19: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MAINTAINED BY THE HOSPITAL AND ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 9: PENSION LIABILITY ADJUSTMENT $37,779,459 CHANGE IN BENEFICIAL INTEREST IN TRUSTS $4,908,059 TOTAL $42,687,518 PEDI-ORTHO HEALTH CORP 2222 WELBORN STREET DALLAS TX 75219 752665759 PHYSICIANS TX 501(C) (3) 9 NA true LEGACY SCHOLARSHIP PROGRAM 2222 WELBORN STREET DALLAS TX 75219 752106637 SCHOLARSHIP TX 501(C) (3) 7 NA false TSRH TRUST JPMORGAN CHASE BANK POB 3038 MILWAUKEE WI 53201 756013875 SUPPORT ORGAN WI 501(C) (3) 11.d NA false TSRH FOR CHILDREN FOUNDATION 2222 WELBORN STREET DALLAS TX 75219 460683787 SUPPORT ORGAN TX 501(C) (3) 7 NA true NA NA false true false false false false false false false false false true true true true false true true true PEDI-ORTHO HEALTH CORP B 100000 MARKET PEDI-ORTHO HEALTH CORP L 71243 MARKET PEDI-ORTHO HEALTH CORP M 58966 MARKET PEDI-ORTHO HEALTH CORP Q 1488422 MARKET TSRH FOR CHILDREN FOUNDATION B 100000 MARKET