2014-07-15T16:34:30-05:00 2013-08-31 750786316 WEAVER AND TIDWELL LLP 2821 W 7TH STREET SUITE 700 FORT WORTH TX 76107 990 2012-09-01 752655008 UT SOUTHWESTERN MONCRIEF CANCER CENTER UTSO 8172889800 400 WEST MAGNOLIA AVENUE FORT WORTH TX 76104 ARNIM DONTES 8172889800 2014-07-15 1 IRA L NEVELOW P00083210 8173327905 2012 2015-11-30 17:44:51Z MONCRIEF CANCER INSTITUTE KEITH ARGENBRIGHT MD 400 WEST MAGNOLIA AVENUE FORT WORTH TX 76104 14833910 0 X WWW.MONCRIEF.COM X 1958 TX TO PROVIDE COUNSELING AND SUPPORT RESOURCES TO CANCER PATIENTS AND THEIR FAMILIES. 4 1 0 8 0 0 16430869 9258831 427371 422063 228829 66673 848315 837016 17935384 10584583 226466 1553033 0 0 3173667 0 0 0 0 2823020 7420905 6223153 8973938 11712231 1610645 96438807 37689612 4146476 3383244 92292331 34306368 X TO FURTHER THE HUMANITARIAN MISSION OF THE UT SOUTHWESTERN MONCRIEF CANCER CENTER ORGANIZATION, BY PROMOTING COMMUNITY EFFORTS TO FIGHT CANCER AND REDUCE ITS BURDEN THROUGHOUT THE CONTINUUM OF CARE UTILIZING: EDUCATION AND COMMUNITY AWARENESS, PREVENTION AND EARLY DETECTION, BEHAVIORAL AND NUTRITIONAL SCIENCES, AND RESEARCH AND INNOVATIVE TECHNOLOGIES. 0 0 1488062 BREAST AND CERVICAL CANCER SERVICES - PROVIDES CLINICAL BREAST EXAMS AND MAMMOGRAMS TO UNINSURED LOW INCOME WOMEN. THE PROGRAM ALSO PROVIDES ADDITIONAL DIAGNOSTIC SERVICES FOR WOMEN WITH POSITIVE MAMMOGRAM RESULTS. PROGRAM IS AIMED AT FINDING EARLY STAGE CANCERS WHICH HAVE THE HIGHEST RATE OF SUCCESSFUL TREATMENT OUTCOMES. 4348135 1400000 422427 SURVIVORSHIP PROGRAM PROVIDES SERVICES TO COMMUNITY AND SURROUNDING COUNTY CANCER SURVIVOR PATIENTS. SERVICES PROVIDED INCLUDE NUTRITION COUNSELING PROVIDED BY REGISTERED AND LICENSED DIETITIANS WHO WORK TO EDUCATE SURVIVORS ON THE ROLE NUTRITION PLAYS IN CANCER TREATMENT AND RECOVERY. ADDITIONALLY, THE SURVIVORSHIP PROGRAM OFFERS FITNESS INSTRUCTION AND PROGRAMS TO CANCER SURVIVORS OFFERED BY A LICENSED FITNESS INSTRUCTOR. OTHER SERVICES INCLUDE COUNSELING, FINANCIAL ASSISTANCE, SOCIAL WORK, TRANSPORTATION AND SUPPORT RESOURCES TO CANCER PATIENTS AND THEIR FAMILIES WITHIN TARRANT COUNTY AND THE SURROUNDING AREAS. LASTLY, CANCER SURVIVORSHIP INCLUDES CONTINUED SURVEILLANCE. OUR PROGRAM WILL ASSIST PATIENTS IN NAVIGATING SURVEILLANCE VISITS. 935013 KOMEN MOBILE MAMMOGRAPHY SCREENINGS - REGISTERED AND LICENSED MEDICAL STAFF PROVIDE APPROPRIATE PATIENTS WITH ADVANCED TECHNOLOGICAL MAMMOGRAPHY SERVICES TO DETECT, DIAGNOSE AND FIGHT CANCER. 328645 153033 BREAST SCREENING PREVENTION AND NAVIGATION SERVICES TO PROVIDE MAMMOGRAMS TO UNINSURED AND UNDERINSURED LOW-INCOME WOMEN. THE PROGRAM ALSO PROVIDES ADDITIONAL DIAGNOSTIC SERVICES FOR WOMEN WITH POSITIVE MAMMOGRAM RESULTS. PROGRAM IS AIMED AT SUCCESSFUL NAVIGATION OF EARLY DETECTION SERVICES AND EFFECTIVE NAVIGATION OF POSITIVE RESULTS TO ACHIEVE THE HIGHEST RATE OF SUCCESSFUL TREATMENT OUTCOMES. 328645 153033 7099855 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 50 0 1 0 0 0 0 0 0 0 0 0 X 4 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X MICHELE HENDERSON 8172889868 400 W MAGNOLIA FORT WORTH TX 76104 WILLIS C MADDREY MD 1.00 40.00 X X 0 565223 46161 ARNIM DONTES 1.00 40.00 X X 0 473118 29977 KIT MONCRIEF 1.00 X 0 0 0 JAMES WILLSON JR MD 1.00 40.00 X 0 606120 49136 KEITH ARGENBRIGHT MD 1.00 40.00 X 0 329067 32992 RANDALL COCHRAN 1.00 40.00 X 0 84903 21812 MICHAEL SERBER 1.00 40.00 X 0 228978 53718 JOHN FREESE MD 1.00 X 0 0 0 0 2287409 233796 0 0 1 0 WOMEN'S DIAGNOSTIC 15601 DALLAS PARKWAY STE500 ADDISON TX 75001 PROFESSIONAL 380811 JPS HEALTH NETWORK 1350 S MAIN ST 400 FORT WORTH TX 76104 PROFESSIONAL 166088 ROSE IMAGING SPECIALIST PA PO BOX 203268 DALLAS TX 75320 PROFESSIONAL 140333 TEXAS HEALTH HARRIS MEDTHODIST FW PO BOX 916063 FORT WORTH TX 76191 PROFESSIONAL 110864 4 4651592 1962196 2645043 9258831 PATIENT COUNSELING 624100 422063 422063 422063 62778 62778 1638730 802078 836652 836652 836652 3451144 3447249 3895 3895 3895 RECOVERED EXPENSES 624100 364 364 364 10584583 422427 0 903325 X 1477900 1477900 75133 75133 99069 82227 16842 50266 50266 5680448 4479517 1200931 162622 152310 10312 74166 52658 21508 47990 34073 13917 375889 120687 255202 81023 59543 21480 290 290 645144 483858 161286 94457 13466 80991 MISCELLANEOUS 75781 42098 33683 CERTIFICATIONS AND CONT 33760 26385 7375 8973938 7099855 1874083 0 232039 1685137 1004380 1964538 76773 373819 40727220 10525707 29043258 30201513 4465022 1111527 61617335 2353078 96438807 37689612 4059463 1945161 72750 26479 14263 1411604 4146476 3383244 X 29043258 32765839 2074100 0 61174973 1540529 92292331 34306368 96438807 37689612 X 1610645 37836 -59634444 X 0 1 X 0 0 X X X 0 0 0 UT SOUTHWESTERN MEDICAL CENTER SYSTEM 756002868 7 1 1 1 5699855 1 5699855 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 59662472 7500 8713941 4887873 667486 62828554 70046141 4855085 15238754 59662472 67452447 6459043 3865349 70046141 65070987 8082480 5701020 67452447 77004182 -9414422 2518773 65070987 1.00000 0 1 1 4285018 4285018 34800185 9710129 25090056 1508393 815578 692815 133624 133624 30201513 OTHER RECEIVABLES 812549 BENEFICIAL INTEREST IN PERPETUAL TRUST 1540529 2353078 CAPITAL LEASES 4258 PAYABLE TO MONCRIEF FOUNDATION 1407346 1411604 X 11448266 37835 830105 867940 10580326 4257 4257 10584583 9771757 802078 802078 8969679 4259 4259 8973938 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: MONCRIEF AND THE FOUNDATION ARE BOTH GENERALLY EXEMPT FROM FEDERAL INCOME TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. MONCRIEF IS SUBJECT TO FEDERAL INCOME TAXES ON UNRELATED BUSINESS INCOME. NO FEDERAL INCOME TAXES WERE INCURRED FOR UNRELATED BUSINESS INCOME FOR THE YEARS ENDED AUGUST 31, 2013 AND 2012. BOTH ENTITIES RECOGNIZE IN ITS FINANCIAL STATEMENTS THE FINANCIAL EFFECT OF A TAX POSITION, IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTION OF ANY APPEALS OR LITIGATION PROCESSES, BASED UPON THE TECHNICAL MERITS OF THE POSITION. TAX POSITIONS TAKEN RELATED TO MONCRIEF AND THE FOUNDATION'S UNRELATED BUSINESS INCOME AND ITS TAX EXEMPT STATUS AS A NONPROFIT ORGANIZATION FOR FEDERAL TAX PURPOSES HAVE BEEN REVIEWED, AND MANAGEMENT IS OF THE OPINION THAT MATERIAL POSITIONS TAKEN BY EACH ENTITY WOULD MORE LIKELY THAN NOT BE SUSTAINED BY EXAMINATION. ACCORDINGLY, NEITHER ENTITY HAS RECORDED AN INCOME TAX LIABILITY FOR UNCERTAIN TAX BENEFITS. AS OF AUGUST 31, 2013, THE FOUNDATION'S TAX YEARS 2010 AND THEREAFTER REMAIN SUBJECT TO EXAMINATION. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 28,027. RENTAL EXPENSES 802,078. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECOVERED EXPENSES 362. GAIN ON SALE OF SECURITIES 3,895. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 802,078. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECOVERED EXPENSES 364. GAIN ON SALE OF SECURITIES 3,895. 0 JEWEL CHARITY BALL PO BOX 472149 FORT WORTH TX 76147 752267609 501(C)(3) 10000 SUPPORT AND RESEARCH CAREITY FOUNDATION PO BOX 126038 FORT WORTH TX 76126 061704800 501(C)(3) 15000 SUPPORT AND RESEARCH SUSAN G KOMEN FOR THE CURE PO BOX 650309 DALLAS TX 75265 751835298 501(C)(3) 15000 SUPPORT AND RESEARCH AMERICAN CANCER SOCIETY PO BOX 831041 DALLAS TX 75283 131788491 501(C)(3) 12600 SUPPORT AND RESEARCH FORT WORTH ADELESCENTS & YOUNG ADULT ONCOLOGY COALITION PO BOX 471332 FORT WORTH TX 76147 432087946 501(C)(3) 5000 SUPPORT AND RESEARCH ASSISTANCE FOR INDIGENT CARE 0 0 0 0 0 0 0 0 0 WILLIS C MADDREY MD 0 434303 0 130200 0 720 0 37611 0 8550 0 611384 0 0 ARNIM DONTES 0 366356 0 81042 0 25720 0 21250 0 8727 0 503095 0 0 JAMES WILLSON JR MD 0 473100 0 132300 0 720 0 40216 0 8920 0 655256 0 0 KEITH ARGENBRIGHT MD 0 329067 0 0 0 0 0 22084 0 10908 0 362059 0 0 MICHAEL SERBER 0 203978 0 25000 0 0 0 43269 0 10449 0 282696 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION PROVIDES AUDITED FINANCIAL STATEMENTS AND SUPPORTING DOCUMENTATION UPON WHICH THE FORM 990 IS PREPARED. THE 990 IS REVIEWED BY MICHAEL SERBER, ASSISTANT TREASURER, AND ARMIN DONTES, SECRETARY AND TREASURER. IT IS THEN SUBMITTED TO DR. WILLIS MADDREY, PRESIDENT AND CHARIMAN, FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C MONCRIEF CANCER CENTER HAS A WRITTEN CONFLICT OF INTEREST POLICY WHICH REQUIRES THE DIRECTORS AND OFFICERS TO SIGN CONFLICT OF INTEREST STATEMENTS WHICH ARE THEN REVIEWED BY THE BOARD. ANYONE WITH A CONFLICT IS RECUSED FROM DISCUSSION AND VOTING ON THE TRANSACTION, WITH THE CONFLICT BEING DOCUMENTED IN THE MINUTES. THE CONFLICT OF INTEREST STATEMENTS ARE A PART OF THE MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS'S GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. OTHER FEES FORM 990, PART IX, LINE 11G TECHNICAL CONSULTANTS: PROGRAM SERVICE EXPENSES 14,580. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,580. OTHER PROFESSIONAL : PROGRAM SERVICE EXPENSES 1,737,038. MANAGEMENT AND GENERAL EXPENSES 321,553. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,058,591. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 2,727,899. MANAGEMENT AND GENERAL EXPENSES 879,378. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,607,277. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 28,028. REMOVE MONCRIEF CANCER FOUNDATION NET ASSETS TO AGREE TO AUDITED FIN STMT -59,662,472. MONCRIEF CANCER FOUNDATION 5323 HARRY HINES BLVD DALLAS TX 75390 752429817 ORGANIZED AND OPERATED FOR THE BENEFIT OF UT SOUTHWESTERN MEDICAL CENTER TX 501(C)(3) 509(A)(3) 0 UT SOUTHWESTERN MEDICAL CENTER SYSTEM 5323 HARRY HINES BLVD DALLAS TX 75390 756002868 MEDICAL CARE PROVIDER TX 501(C)(3) LINE 6 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 MONCRIEF CANCER FOUNDATION B 1400000 CASH MONCRIEF CANCER FOUNDATION C 4651592 CASH UT SOUTHWESTERN MEDICAL CENTER SYSTEM N 759466 CASH UT SOUTHWESTERN MEDICAL CENTER SYSTEM O 3326759 CASH