COOK CHILDRENS PHYSICIAN NETWORK: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- COOK CHILDRENS PHYSICIAN NETWORK (EIN 75-2485366)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-14
- IRS object ID
- 201302269349301930
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-14T11:57:29-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2800 Post Oak Blvd Ste 3200 | AddressLine1 |
| City | HOUSTON | City |
| State | TX | State |
| ZIP Code | 77056 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752485366 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COOK CHILDREN'S PHYSICIAN NETWORK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % CORY RHOADES | InCareOfName |
| Name Control | COOK | NameControl |
| Phone | 6828854480 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 SEVENTH AVENUE | AddressLine1 |
| City | FORT WORTH | City |
| State | TX | State |
| ZIP Code | 76104 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CORY RHOADES | Name |
| Title | VP & CHIEF ACCOUNTING OFFICER | Title |
| Date Signed | 2013-08-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | M Paige Gerich | Name |
| Phone | 7134994600 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | W BRITT NELSON MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 SEVENTH AVE | AddressLine1 |
| City | FORT WORTH | City |
| State | TX | State |
| ZIP Code | 76104 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 204462236 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.COOKCHILDRENS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1992 | YearFormation |
| State Legal Domicile | TX | StateLegalDomicile |
| Activity Or Mission Description | KNOWING THAT EVERY CHILD'S LIFE IS SACRED, IT IS THE PROMISE OF COOK CHILDREN'S TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE, AND INJURY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 980 | TotalNbrEmployees |
| Total Nbr Volunteers | 23 | TotalNbrVolunteers |
| Total Gross UBI | 887181 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 752694 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 42965376 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 41651749 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 143331135 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 161752152 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4456 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1599572 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1046085 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 187896083 | TotalRevenuePriorYear |
| Total Revenue Current Year | 204454442 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 145972094 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 160652263 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 41801348 | OtherExpensePriorYear |
| Other Expenses Current Year | 43518770 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 187773442 | TotalExpensesPriorYear |
| Total Expenses Current Year | 204171033 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 122641 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 283409 | RevenuesLessExpensesCY |
| Total Assets BOY | 34104541 | TotalAssetsBOY |
| Total Assets EOY | 35649158 | TotalAssetsEOY |
| Total Liabilities BOY | 21819581 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 23080789 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 12284960 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 12568369 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | KNOWING THAT EVERY CHILD'S LIFE IS SACRED, IT IS THE PROMISE OF COOK CHILDREN'S TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE, AND INJURY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 181603771 | Expense |
| Revenue | 161911056 | Revenue |
| Description | Cook Children's Physician Network (CCPN) is the largest pediatric multi-specialty physician group in North Texas. The network includes more than 300 physicians and thousands of other caring employees who provide medical care in 60 locations to more than 30 primary care and subspecialty practices. In 2012, CCPN grew by 20 providers: 14 physicians (five primary care, one primary care locum, two hospitalists and six specialists) and six midlevel providers (two physician assistants and four certified registered nurse anesthetists). Additionally, we offer access to seven specialties via telemedicine: Endocrinology, Genetics, Hematology and Oncology, Infectious Disease, Nephrology, Neurology and Psychiatry. These specialists hosted 875 visits via telemedicine in 2012 - saving many hours of travel for patient families. The network's physicians and specialists have offices in Tarrant, Denton and Hood counties and provide a primary care home in economically disadvantaged neighborhoods and areas where access to pediatric health care is difficult to come by. The physician network has also increased access to pediatric specialty care through outreach clinics in many communities in North, West and Central Texas. Each month, physicians travel to provide services in several areas that are not large enough to support full-time specialty care. The San Angelo Specialty Clinic was relocated to a larger facility which allows more than double the exam room space to accommodate more specialties. Also, Southlake Urgent Care and Pediatric Specialties celebrated one year anniversaries in 2012. In its first year, the clinic had 9,902 total visits, compared to 7,502 projected, which is an average of 200 more monthly visits than anticipated. Patients benefited from a new patient Internet portal in 2012, call mycookchildrens. To date, more than 46,000 patients have registered for the portal, which provides families on-demand access to prior visit summaries, medication lists, vaccine records, lab results and appointment requests. | Description |
| Total Program Service Expense | 181603771 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 91 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 980 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | CORY RHOADES | NamePerson |
| Telephone Number | 6828854480 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 SEVENTH AVENUE | AddressLine1 |
| City | FORT WORTH | City |
| State | TX | State |
| ZIP Code | 76104 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Other CompensationOtherCompensation | OfficerOfficer | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| MICHAEL J DEITCHMAN MD | ||||||||
| TRUSTEE | 41.0 | X | 263520 | 11518 | ||||
| FRANK MCGEHEE MD | ||||||||
| TRUSTEE-TREASURER | 42.0 | X | 698123 | 14149 | X | |||
| JAMES P MILLER MD | ||||||||
| TRUSTEE | 41.0 | X | 1071849 | 31922 | ||||
| DEBORAH SCHUTTE MD | ||||||||
| TRUSTEE-VICE CHAIRMAN | 42.0 | X | 479849 | 28901 | X | |||
| JASON V TERK MD | ||||||||
| TRUSTEE - VICE CHAIRMAN | 42.0 | X | 364869 | 29912 | X | |||
| JAMES C WHEELER MD | ||||||||
| TRUSTEE | 41.0 | X | 472534 | 39643 | ||||
| M SUZANNE WHITWORTH MD | ||||||||
| TRUSTEE | 41.0 | X | 153555 | 10597 | ||||
| KEVIN D WYLIE DO | ||||||||
| TRUSTEE-SECRETARY | 42.0 | X | 249883 | 26313 | X | |||
| BARRY BZOSTEK MD | ||||||||
| TRUSTEE | 41.0 | X | 228541 | 7488 | ||||
| MARK MAZADE MD | ||||||||
| TRUSTEE | 41.0 | X | 267843 | 23836 | ||||
| AUDREY ROGERS MD | ||||||||
| TRUSTEE | 41.0 | X | 238463 | 21126 | ||||
| SANDRA ARCA MD | ||||||||
| TRUSTEE | 41.0 | X | 242963 | 23066 | ||||
| VANESSA CHARETTE MD | ||||||||
| TRUSTEE | 41.0 | X | 242868 | 15374 | ||||
| LINDA M THOMPSON MD | ||||||||
| TRUSTEE-SECRETARY | 42.0 | X | 247890 | 15894 | X | |||
| TODD WOLF MD | ||||||||
| TRUSTEE | 41.0 | X | 384301 | 34467 | ||||
| RYAN CHAMPLIN | ||||||||
| VP, OPERATIONS | 40.0 | 373079 | 32242 | X | ||||
| JANELL MASON-BRISCOE | ||||||||
| INTERIM VP. OPERATIONS | 38.0 | 229038 | 12972 | X | ||||
| RICHARD P GOODE | ||||||||
| CHIEF FINANCIAL OFFICER | 4.0 | 72485 | 30910 | X | 586468 | |||
| RICK W MERRILL | ||||||||
| CHIEF EXECUTIVE OFFICER | 4.0 | 139799 | 166518 | X | 1131099 | |||
| W BRITT NELSON MD | ||||||||
| PRESIDENT | 40.0 | 596389 | 30977 | X | ||||
| NICHOLAS A OGUNMOLA MD | ||||||||
| PHYSICIAN | 40.0 | 821200 | 19513 | X | ||||
| VINCENT TAM MD | ||||||||
| MEDICAL DIRECTOR | 40.0 | 1244714 | 31661 | X | ||||
| PATRICK THOMAS MD | ||||||||
| PHYSICIAN | 40.0 | 806161 | 27902 | X | ||||
| CHAD HAMNER MD | ||||||||
| PHYSICIAN | 40.0 | 811780 | 28898 | X | ||||
| JOSE L IGLESIAS MD | ||||||||
| PHYSICIAN | 40.0 | 793020 | 22891 | X | ||||
| THEODORE MATTHEWS | ||||||||
| VP, FINANCE | 0.0 | 132205 | 11777 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 11626921 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1717567 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 750467 | TotalOtherCompensation |
| Number Individuals GT100 K | 365 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| JESSE A CLAUDIA L ROCHA | |||||
| 1413 HEIDI COURT | FORT WORTH | TX | 76108 | JANITORIAL | 197032 |
| SULLIVAN COTTER AND ASSOC | |||||
| 62272 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | CONSULTING | 119492 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Related Organizations | 41408120 | RelatedOrganizations |
| Government Grants | 202126 | GovernmentGrants |
| All Other Contributions | 41503 | AllOtherContributions |
| Total Contributions | 41651749 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT FEES | 621110 | 143010603 | 143010603 |
| CONTRACTED FEES | 621110 | 2631536 | 2631536 |
| MANAGEMENT FEES | 900099 | 14703482 | 14703482 |
| OTHER INCOME | 621110 | 1363988 | 1363988 |
| RESEARCH | 900099 | 42543 | 42543 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 161752152 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 12250 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 7794 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 4456 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4456 | TotalRevenueColumn |
| Exclusion | $4,456 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| GROUP PURCH SALES | 561439 | 887181 | 887181 | |
| OTHER INCOME | 900099 | 158904 | 158904 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1046085 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 204454442 | TotalRevenueColumn |
| Related Or Exempt Function Income | 161911056 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 887181 | UnrelatedBusinessRevenue |
| Exclusion | $4,456 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7966038 | Total |
| Program Services | 6306481 | ProgramServices |
| Management And General | 1659557 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 103617 | Total |
| Program Services | 103617 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133158426 | Total |
| Program Services | 129032501 | ProgramServices |
| Management And General | 4125925 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19424182 | Total |
| Program Services | 17569334 | ProgramServices |
| Management And General | 1854848 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2960514 | Total |
| Management And General | 2960514 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102767 | Total |
| Management And General | 102767 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1499184 | Total |
| Program Services | 1177572 | ProgramServices |
| Management And General | 321612 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78966 | Total |
| Program Services | 40574 | ProgramServices |
| Management And General | 38392 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11788493 | Total |
| Program Services | 11528446 | ProgramServices |
| Management And General | 260047 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5912873 | Total |
| Program Services | 5077075 | ProgramServices |
| Management And General | 835798 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 301247 | Total |
| Program Services | 263429 | ProgramServices |
| Management And General | 37818 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 170986 | Total |
| Program Services | 150723 | ProgramServices |
| Management And General | 20263 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1775 | Total |
| Program Services | 1775 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 571038 | Total |
| Program Services | 554237 | ProgramServices |
| Management And General | 16801 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1781930 | Total |
| Program Services | 1779792 | ProgramServices |
| Management And General | 2138 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBT EXPENSE | 5348651 | 5367830 | -19179 | 0 |
| PHYSICIAN EXPENSES | 1225215 | 1222506 | 2709 | |
| COLLECTION EXPENSE | 10193308 | -7060 | 10200368 | |
| TELEPHONE TRIAGE | 348462 | 348462 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1233361 | Total |
| Program Services | 1086477 | ProgramServices |
| Management And General | 146884 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 204171033 | Total |
| Program Services | 181603771 | ProgramServices |
| Management And General | 22567262 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10012 | BOY |
| EOY | 9576 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19724374 | BOY |
| EOY | 20240947 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10231799 | BOY |
| EOY | 10817313 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 846566 | BOY |
| EOY | 1072746 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1223540 | BOY |
| EOY | 1113770 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 5762007 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3727298 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1825219 | BOY |
| EOY | 2034709 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 243031 | BOY |
| EOY | 360097 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34104541 | BOY |
| EOY | 35649158 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3276455 | BOY |
| EOY | 3113666 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18543126 | BOY |
| EOY | 19967123 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21819581 | BOY |
| EOY | 23080789 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12284960 | BOY |
| EOY | 12568369 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12284960 | BOY |
| EOY | 12568369 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34104541 | BOY |
| EOY | 35649158 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 283409 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Land | Land |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1138523 | OtherCostOrOtherBasis |
| Depreciation | 1045034 | Depreciation |
| Book Value | 93489 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1745561 | OtherCostOrOtherBasis |
| Depreciation | 823484 | Depreciation |
| Book Value | 922077 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2817373 | OtherCostOrOtherBasis |
| Depreciation | 1854743 | Depreciation |
| Book Value | 962630 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 60550 | OtherCostOrOtherBasis |
| Depreciation | 4037 | Depreciation |
| Book Value | 56513 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2034709 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (7 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED PAYROLL | $832,159 |
| ACCRUED PHYSICIAN RECONS | $7,932,657 |
| DUE TO AFFILIATES | $4,270,889 |
| ACCRUED PTO LIABILITY | $2,669,076 |
| ACCRUED EXECUTIVE BONUS | $433,970 |
| ACCRUED EIB LIABILITY | $3,772,076 |
| CAPITAL LEASE OBLIGATION | $56,296 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 19967123 | TotalOfAmounts |
| Total Revenue | 204454442 | TotalRevenue |
| Total Expenses | 204171033 | TotalExpenses |
| Excess Or Deficit For Year | 283409 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 283409 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 204449986 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 204449986 | RevenueSubtotal |
| Other Revenues Not Included | 4456 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 4456 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 204454442 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 204166577 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 204166577 | ExpensesSubtotal |
| Other Expenses Not Included | 4456 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 4456 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 204171033 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER CHANGES | Identifier |
| Return Reference | PART VII, LINE 4B & PART VIII, LINE 4B | ReturnReference |
| Explanation | GAIN ON ASSET DISPOSITION: $4,456 | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (26 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL J DEITCHMAN MD | |||||||||||||
| 262160 | 0 | 1360 | 0 | 11518 | 275038 | ||||||||
| FRANK MCGEHEE MD | |||||||||||||
| 694239 | 0 | 3884 | 0 | 14149 | 712272 | ||||||||
| JAMES P MILLER MD | |||||||||||||
| 1054107 | 0 | 17742 | 17619 | 14303 | 1103771 | ||||||||
| DEBORAH SCHUTTE MD | |||||||||||||
| 478114 | 0 | 1735 | 15313 | 13588 | 508750 | ||||||||
| JASON V TERK MD | |||||||||||||
| 363429 | 0 | 1440 | 18375 | 11537 | 394781 | ||||||||
| JAMES C WHEELER MD | |||||||||||||
| 470824 | 0 | 1710 | 18375 | 21268 | 512177 | ||||||||
| M SUZANNE WHITWORTH MD | |||||||||||||
| 151839 | 0 | 1716 | 7051 | 3546 | 164152 | ||||||||
| KEVIN D WYLIE DO | |||||||||||||
| 229291 | 19797 | 795 | 10775 | 15538 | 276196 | ||||||||
| RYAN CHAMPLIN | |||||||||||||
| 260042 | 88793 | 24244 | 15313 | 16929 | 405321 | ||||||||
| JANELL MASON-BRISCOE | |||||||||||||
| 171186 | 56302 | 1550 | 8320 | 4652 | 242010 | ||||||||
| THEODORE MATTHEWS | |||||||||||||
| 12445 | 44800 | 74960 | 9967 | 1810 | 143982 | ||||||||
| RICHARD P GOODE | |||||||||||||
| 42426 | 17728 | 12331 | 1684 | 1716 | 75885 | 343250 | 143440 | 99778 | 13629 | 13881 | 613978 | ||
| RICK W MERRILL | |||||||||||||
| 76399 | 46475 | 16925 | 16610 | 1707 | 158116 | 618139 | 376024 | 136936 | 134390 | 13811 | 1279300 | 29040 | 234960 |
| NICHOLAS A OGUNMOLA MD | |||||||||||||
| 819490 | 0 | 1710 | 15313 | 4200 | 840713 | ||||||||
| VINCENT TAM MD | |||||||||||||
| 1242572 | 0 | 2142 | 15313 | 16348 | 1276375 | ||||||||
| BARRY BZOSTEK MD | |||||||||||||
| 179400 | 46250 | 2891 | 0 | 7488 | 236029 | ||||||||
| MARK MAZADE MD | |||||||||||||
| 266135 | 400 | 1308 | 12201 | 11635 | 291679 | ||||||||
| AUDREY ROGERS MD | |||||||||||||
| 236261 | 0 | 2202 | 11519 | 9607 | 259589 | ||||||||
| SANDRA ARCA MD | |||||||||||||
| 240787 | 500 | 1676 | 0 | 23066 | 266029 | ||||||||
| VANESSA CHARETTE MD | |||||||||||||
| 240596 | 2066 | 206 | 9906 | 5468 | 258242 | ||||||||
| LINDA M THOMPSON MD | |||||||||||||
| 247856 | 0 | 34 | 10528 | 5366 | 263784 | ||||||||
| TODD WOLF MD | |||||||||||||
| 343084 | 40796 | 421 | 14086 | 20381 | 418768 | ||||||||
| W BRITT NELSON MD | |||||||||||||
| 437744 | 133876 | 24769 | 18375 | 12602 | 627366 | ||||||||
| PATRICK THOMAS MD | |||||||||||||
| 805621 | 0 | 540 | 9800 | 18102 | 834063 | ||||||||
| CHAD HAMNER MD | |||||||||||||
| 810394 | 0 | 1386 | 9800 | 19098 | 840678 | ||||||||
| JOSE L IGLESIAS MD | |||||||||||||
| 774810 | 0 | 18210 | 9800 | 13091 | 815911 | ||||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NAMES, AMOUNTS, AND DETAILS OF ARRANGEMENTS | PART 1, QUESTION 4 | RICK W. MERRILL PARTICIPATES, BUT RECEIVED 0 PAYMENT DURING CALENDAR YEAR 2011. |
| ALLOCATION OF CEO AND CFO SALARIES | SCHEDULE J, PART II | COOK CHILDREN'S HEALTH CARE SYSTEM IS COMPRISED OF 9 COMPANIES, INCLUDING A MEDICAL CENTER, PHYSICIAN NETWORK, HEALTH PLAN, HOME HEALTH COMPANY, INDEMNITY COMPANY, HEALTH FOUNDATION, NORTHEAST HOSPITAL, PEDIATRIC SURGERY CENTER, AND HEALTH CARE SYSTEM COMPANY. THE CEO AND CFO ARE RESPONSIBLE FOR THE OVERSIGHT OF ALL FOREMENTIONED COMPANIES. AS A RESULT, THEIR SALARIES ARE ALLOCATED PRO-RATA, BASED ON THE AMOUNT OF TIME THEY SPEND WITH EACH COMPANY. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | TOM ROGERS JR MD | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | A. ROGERS FATHER-IN-LAW | Relationship |
| Amount Of Transaction | 103617 | AmountOfTransaction |
| Description Of Transaction | COMPENSATION | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (19 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| MEMBERS OR STOCKHOLDERS | FORM 990, PART VI, QUESTION 6 | COOK CHILDREN'S HEALTH CARE SYSTEM, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION. |
| MEMBER ELECTION ABILITIES | FORM 990, PART VI, QUESTION 7A | AS THE SOLE MEMBER OF THE ORGANIZATION, COOK CHILDREN'S HEALTH CARE SYSTEM HAS THE POWER TO DETERMINE THE NUMBER OF MEMBERS OF THE BOARD OF TRUSTEES AND TO ELECT THE MEMBERS OF THE BOARD OF TRUSTEES. |
| MEMBER DECISION ABILITIES | FORM 990, PART VI, QUESTION 7B | As the sole member of the organization, Cook Children's Health Care System has the exclusive power to do any of the following: a. Amend, alter or repeal the bylaws; b. Amend the certificate of formation of the organization; c. Determine the number of members of the Board of Trustees and to elect the members of the Board of Trustees; d. Approve any merger, acquisition, liquidation, winding up, termination or consolidation of the organization; e. Approve the sale, gift or other disposition of all or substantially all of the property of the organization; and f. Approve the creation of, or investment in, any subsidiary entity. |
| PROCESS FOR REVIEW OF THE 990 | FORM 990, PART VI, QUESTION 11B | The organization engages an outside accounting firm to assist in the preparation of the Form 990 and related filings. All information provided to the outside accounting firm is gathered by key company employees and executives. Once the Form 990 is prepared, it is reviewed by company Finance, Legal and Compliance staff and then provided to the Board of Trustees for review. In addition, it is presented to the Cook Children's Health Care System Audit Committee for review. Subsequent to Audit Committee review, the Form 990 is filed with the Internal Revenue Service and made available to the public for review. |
| WRITTEN CONFLICT OF INTEREST POLICY | FORM 990, PART VI, QUESTION 12C | Every year the Legal Department of the Cook Children's Health Care System ("System") sends out a Form 990 Questionnaire/Conflict of Interest Disclosure Statement to officers, directors, trustees and key employees of all System companies. The responses are reviewed by the Legal, Finance, and Compliance Departments. Follow up and/or corrective action is taken as needed with respect to responses that indicate the existence of actual or potential conflicts of interest. The responses to the questionnaires and follow-up information are provided to the System Audit Committee for review and follow-up. Further, the Audit Committee of Cook Children's Health Care System is responsible for monitoring the implementation and enforcement of the Conflict of Interest Policy in force for all affiliated companies of the Cook Children's Health Care System. The Audit Committee is also responsible for oversight of the Compliance Department of Cook Children's Health Care System. The Compliance Department maintains a hot-line to receive reports of inappropriate activities including activities that might constitute a conflict of interest. Internal Audit and Compliance also conduct random audits of corporate activities such as expense reimbursements and accounts payable to determine if any inappropriate payments are being made to individuals, some of which could be evidence of a conflict of interest. Any corrective action related to conflicts of interest would be reported to the Audit Committee for review, approval, and modification, as necessary. |
| REVIEW AND APPROVAL OF COMPENSATION | FORM 990, PART VI, QUESTION 15A & 15B | Cook Children's Health Care System has established a Compensation Committee with oversight of executive and physician compensation. The Compensation Committee approves compensation arrangements in advance, which includes a review and approval by independent persons, using comparable market data relating to compensation, which is provided by Sullivan Cotter and Associates, Inc., an independent, nationally recognized compensation consultant. The Compensation Committee documents the basis for its determinations following contemporaneous substantiation of the Compensation Committee's deliberation and decision. The Compensation Committee requires the compensation consultant to update market data periodically, usually every two years, with interim reviews being conducted as needed. With regard to physician compensation, the Compensation Committee also retains the law firm of McDermott, Will & Emery of Chicago, Illinois, to issue a reasonableness opinion covering the physician compensation plan for Cook Children's Physician Network. |
| MAKING GOVERNING DOCUMENTS PUBLIC | FORM 990, PART VI, QUESTION 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, EXCEPT TO THE EXTENT THEY ARE ON FILE WITH THE SECRETARY OF STATE OF TEXAS. THE CONFLICT OF INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE AND AVAILABLE TO ALL EMPLOYEES AND BOARD MEMBERS OF COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES. CONSOLIDATED FINANCIAL STATEMENTS ARE REPORTED ELECTRONICALLY FOR ALL COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES VIA THE ELECTRONIC MUNICIPAL MARKET ACCESS ("EMMA") WEB SITE. |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MICHAEL J. DEITCHMAN, MD TITLE:TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:FRANK MCGEHEE, MD TITLE:TRUSTEE-TREASURER HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JAMES P. MILLER, MD TITLE:TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DEBORAH SCHUTTE, MD TITLE:TRUSTEE-VICE CHAIRMAN HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JASON V. TERK, MD TITLE:TRUSTEE - VICE CHAIRMAN HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:M. SUZANNE WHITWORTH, MD TITLE:TRUSTEE HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:KEVIN D. WYLIE, DO TITLE:TRUSTEE-SECRETARY HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:VANESSA CHARETTE, MD TITLE:TRUSTEE HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:LINDA M. THOMPSON, MD TITLE:TRUSTEE-SECRETARY HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JANELL MASON-BRISCOE TITLE:INTERIM VP. OPERATIONS HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RICHARD P. GOODE TITLE:CHIEF FINANCIAL OFFICER HOURS:36 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RICK W. MERRILL TITLE:CHIEF EXECUTIVE OFFICER HOURS:36 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| COOK CHILDREN'S MEDICAL CENTER | ||||||||||
| 801 SEVENTH AVE | FORT WORTH | TX | 76104 | 752051646 | HOSPITAL | TX | 501(C)(3) | 3 | CCHCS | false |
| WI COOK FOUNDATION | ||||||||||
| 801 SEVENTH AVENUE | FORT WORTH | TX | 76104 | 752051649 | FUNDRAISING | TX | 501(C)(3) | 11D | NA | false |
| COOK CHILDREN'S HOME HEALTH | ||||||||||
| 801 SEVENTH AVENUE | FORT WORTH | TX | 76104 | 752896983 | HEALTHCARE | TX | 501(C)(3) | 11C | CCHCS | false |
| COOK CHILDREN'S HEALTH CARE SYSTEM | ||||||||||
| 801 SEVENTH AVE | FORT WORTH | TX | 76104 | 752705881 | SUPPORT | TX | 501(C)(3) | 11C | CCHF | false |
| COOK CHILDREN'S HEALTH PLAN | ||||||||||
| 801 SEVENTH AVE | FORT WORTH | TX | 76104 | 760585240 | INSURANCE | TX | 501(C)(3) | 11C | CCHCS | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COOK CHILDREN'S HEALTH SERVICES | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 7TH AVENUE | AddressLine1 |
| City | FORT WORTH | City |
| State | TX | State |
| ZIP Code | 76104 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454024843 | EIN |
| Primary Activity | HEALTHCARE | PrimaryActivity |
| Legal Domicile State | TX | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CCHCS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORPORATION | TypeOfEntity |
| Share Of Total Income | 0 | ShareOfTotalIncome |
| Share Of EOY Assets | 0 | ShareOfEOYAssets |
| Percentage Ownership | 0.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
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