2013-05-13T21:51:56-05:00 2012-06-30 990 2011-07-01 751947007 All Saints Health Foundation ALLS 8179227707 2001 Bryan Street No 2200 Dallas TX 752013005 Michael McMahon 8179227707 2013-05-09 2011 2016-02-24 21:20:13Z Michael McMahon 1400 Eighth Avenue Fort Worth TX 76104 9520402 0 X www.BaylorHealth.com X 1983 TX Philanthropic support services to help Baylor All Saints Medical Center achieve its mission of providing exemplary patient care to the residents of Tarrant County and the surrounding communities 22 19 10 0 0 0 4435884 3031777 0 0 1808894 991307 -65292 -70797 6179486 3952287 4394028 1521753 0 0 990503 875210 0 0 483842 853773 433237 6238304 2830200 -58818 1122087 42371407 42798094 9881803 10427952 32489604 32370142 X All Saints Health Foundation exists to support Baylor All Saints Medical Center at Fort Worth in serving all people through exemplary health care and education. 0 0 2140300 1521753 See Schedule OAll Saints Health Foundation (ASHF) provides philanthropic support to Baylor All Saints Medical Center (BASMC), the organization's sole member. BASMC is a faith-based, non-profit acute care hospital providing quality patient care to the residents of Tarrant County and surrounding communities for more than 100 years. ASHF solicits and raises funds on behalf and for the benefit of BASMC through grants, annual fund appeals, special project developments, capital campaigns and planned giving programs. Every dollar remains in the community to support and promote the health of the community through medical programs, medical education and other community services. Significant programs and services supported through these grants during the year are described below.Diabetes Research and Islet Cell Transplantation-Described as epidemic by national public health officials, diabetes is a devastating, lifelong condition that affects people of every age, race, and nationality, robbing them of years and quality of life. Baylor's Diabetes Research Team is working to establish islet cell transplantation as a treatment and potential cure for Type I (juvenile) diabetes. Beyond diabetes, this cell therapy research will have applications in cardiovascular care, neurological diseases and cancer. The Joan Katz Breast Center at BASMC-The center offers comprehensive breast cancer services on one campus to better serve men and women diagnosed with breast cancer. Patients who are newly diagnosed, in the midst of treatments or living as breast cancer survivors, may come to The Joan Katz Breast Center and receive breast cancer education, emotional counseling, genetic testing, patient and family support, assistance with social services, lymphedema services, fitness and nutrition information and patient navigation. The BASMC Paul and Judy Andrews Women's Hospital-Opened March 31, 2008, the Andrews Women's Hospital is designed specifically to meet the health care needs of women of all ages. Services at the facility include breast imaging and screenings, gynecology and oncology, osteoporosis screenings and treatment, genetic testing, pelvic medicine and women's wellness and rehabilitation. In 2009, a generous gift was received and designated to ensure that the unique culture and highest standards of quality are maintained at the Andrews Women's Hospital.Oncology Program-BASMC's multidisciplinary cancer program combines advanced knowledge and quality medical treatment. An expanded medical oncology unit on the 7th floor of the Nicholas and Loella Martin Tower offers 26 dedicated inpatient beds and includes an outpatient infusion center with a capacity for 13 patients to receive outpatient chemotherapy fluids or blood products.Cardiovascular Program-BASMC's expanded cardiac catheterization lab at the Albert Goggans, M.D. and Robert W. Brown Regional Heart Center at BASMC offers advanced heart care treatment protocols for a wide range of heart and vascular conditions. The center's cardiac catheterization lab, the Ryan Center for Electrophysiology, provides non-invasive cardiology, cardiovascular surgery, cardiopulmonary rehabilitation, specialized intensive care units, and a progressive care unit. 2140300 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 18 1 1 10 1 0 0 0 0 0 1 1 0 0 0 0 X 22 19 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Amy Martin 2148202677 3600 Gaston Ave Suite 100 Dallas TX 75246 X Cynthia M Adams 1.00 X 0 0 0 Mary Alice Brumley 1.00 X 0 0 0 Raymond G Dickerson 1.00 X 0 0 0 Porter Farrell 1.00 X 0 0 0 Joan Friedman 1.00 X 0 0 0 Gene Gray 1.00 X 0 0 0 Scot C Hollman 1.00 X 0 0 0 Raymond Kelly III 1.00 X 0 0 0 Robert Lansford 1.00 X 0 0 0 Marty Leonard 1.00 X 0 0 0 Bobby Mays 1.00 X 0 0 0 D Alan Meeker 1.00 X 0 0 0 H Gray Mills 1.00 X 0 0 0 Scott Mooring III 1.00 X 0 0 0 Steven Newton 1.00 X 0 615108 152291 Cynthia G Reaves 1.00 X 0 0 0 Everett A Roberts 1.00 X 0 0 0 G Whitney Smith 1.00 X 0 0 0 Mary Katherine Tetirick 1.00 X 0 0 0 Anna Belle Thomas 1.00 X 0 0 0 Robert Watson MD 1.00 X 0 254109 33178 Marlon Levy MD 1.00 X 0 810271 47572 Amy Martin 1.00 X 0 202688 8168 Preshie Wilson 1.00 X 0 238561 28749 Michael McMahon 40.00 X 149048 0 29433 Suzanne Russell 40.00 X 102011 0 22092 Jason Whitfield 0.00 X 0 305172 65165 251059 2425909 386648 2 1 1 0 0 401987 2629790 708631 3031777 634367 634367 5672215 5315275 356940 356940 356940 66750 401987 212247 -145497 -145497 115293 40593 74700 74700 3952287 0 0 920510 1521753 1521753 216429 54108 64929 97392 546235 243035 78441 224759 32704 14551 4696 13457 29004 12905 4165 11934 50838 20302 9160 21376 61703 24641 11117 25945 144442 57682 26025 60735 27 11 5 11 2964 1184 534 1246 225 89 41 95 888 355 160 373 Bad Debt Expense 174643 174643 Dues & Memberships 21087 8421 3799 8867 Special Functions 13214 5277 2381 5556 Donor Relations 10683 10683 3361 1343 605 1413 2830200 2140300 206058 483842 436231 385015 5261314 3594498 107509 106472 1925 1037 36671937 38817544 42371407 42798094 9884208 10384099 -2405 43853 9881803 10427952 X -4985565 -8305124 15512921 19336708 21962248 21338558 32489604 32370142 42371407 42798094 X 1122087 -1241549 X 0 1 1 X 0 X 6019596 5406096 3366596 4435884 3147070 22375242 6019596 5406096 3366596 4435884 3147070 22375242 5718259 16656983 2682546 780255 425770 621942 678004 5188517 27563759 255510 0.60430 0.59920 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25461116 1775405 -1140750 40593 26055178 19102913 2532795 3861153 35745 25461116 16324478 1218570 1653672 93807 19102913 18461396 56173 -1813716 379375 16324478 0.07600 0.92400 0 0 70910 70910 0 36599 35562 1037 1037 JP Morgan Investments 38817544 F 38817544 Trusts and Annuities 43853 43853 Description of Intended Use of Endowment Funds: Part V, Line 4: Endowment In 1982, All Saints Health Foundation was formed with a generous gift from the Ella C. McFadden Charitable Trust to help Baylor All Saints Medical Center (formerly All Saints Health System) continue to provide quality healthcare services to the community. The McFadden Endowment, along with other endowed gifts, support capital projects, staff and patient education, program salaries, and other initiatives that further the vision and mission of Baylor All Saints Medical Center. Description of Uncertain Tax Positions Under FIN 48: Part X: The filing organization does not have separate individual audited financial statements; however, the organization is included in Baylor Health Care System's combined audited financial statements (System). The System follows the provisions of ASC 740 "Income Taxes." As of June 30, 2012 and 2011, the System had no material gross unrecognized tax benefits. Awards Dinner 214000 180250 33750 14660 46125 18500 16187 Beyond the Bag 254737 221737 33000 75954 25609 15212 468737 401987 66750 90614 71734 18500 31399 212247 -145497 115293 40593 0 115293 40593 40593 74700 TX 0 No licensing requirement in TX. 0 0 0 1.00000 0.00000 All Saints Health Foundation 1400 8th Avenue Fort Worth TX 76104 0 0 1 Baylor All Saints Medical Center 1400 Eighth Avenue Fort Worth TX 76104 751008430 501(c)(3) 1511903 9850 FMV Ultrasound Machine Patient care, education, medical equipment 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Monitoring Grants & Other Assistance As part of its mission, the organization provides grants and other assistance to Baylor All Saints Medical Center ("BASMC"), the organization's sole member. All grants and other assistance are subject to the policies and procedures set forth by Baylor Health Care System, BASMC's sole member, which ensures all funds received are used in accordance with BASMC's exempt purpose. X X 1 1 X X X X 0 1 0 0 0 0 0 1 0 Steven Newton 0 400597 0 158695 0 55816 0 130523 0 21768 0 767399 0 41994 Robert Watson MD 0 253799 0 0 0 310 0 12250 0 20928 0 287287 0 0 Marlon Levy MD 0 801952 0 0 0 8319 0 14507 0 33065 0 857843 0 6466 Amy Martin 0 155898 0 45870 0 920 0 7795 0 373 0 210856 0 0 Preshie Wilson 0 203373 0 34878 0 310 0 10365 0 18384 0 267310 0 0 Michael McMahon 137159 0 11534 0 355 0 7251 0 22182 0 178481 0 0 0 Jason Whitfield 0 236491 0 46978 0 21703 0 37390 0 27775 0 370337 0 19797 Part I, Line 1a Health or social club dues or initiation fees - The organization may reimburse eligible employees for dues for a health club and/or a social club where there is a bona fide business need for the membership. Such reimbursements are treated as taxable compensation to the extent any part of the membership is used for personal use. One person listed in the Form 990, Part VII, Section A, received this benefit during the tax year. Part I, Line 1a Tax indemnification and gross up payments-The organization provides tax indemnification where an authorized member of management determines there is justification to reimburse an individual for the tax impact on certain taxable, non-cash benefits provided to them. All tax indemnification payments provided are treated as taxable compensation. One of the persons listed in the Form 990, Part VII, Section A, received this benefit during the tax year. Part I, Line 4b In order to recruit and retain key talent, Baylor Health Care System ("BHCS") offers a supplemental non qualified retirement plan to eligible employees. The plan provides an annual benefit (based on a percentage of compensation) to the employee that is paid to the employee on a future date upon vesting in the plan. The following individual(s) participated in and/or received payments (noted in parenthesis) from BHCS' supplemental non qualified retirement plan during the tax year: Jason Whitfield ($19,797), Marlon Levy, M.D. ($6,466) and Steve Newton ($41,994). Also, certain senior officers, as designated by the organization's governing body, are eligible to participate in a Long Term Incentive Plan that is designated to recognize key senior leaders value and contribution to the organization as well as align their compensation to the long term strategy of the organization. Performance targets are based upon a percentage of the participants base salary and are developed by independent third party expert(s) using market competitive data within the guides of reasonableness. The plan is based on the organization's three-year performance against its peers, determined based on peer rankings or percentile rankings in quality, patient satisfaction and financial performance. At the end of three years, awards are determined by the organization's governing body for participants. Payouts are partially made in cash and the remainder vests over an additional two year period. The following individual participated in and/or received payments (noted in parenthesis) from this plan during the tax year: Steven Newton ($67,694). Part I, Line 7 As a controlled affiliate of Baylor Health Care System ("BHCS"), the organization has adopted and implemented BHCS's Performance Award Program to provide a market competitive total cash compensation incentive program that is designed to attract and retain key leaders and establish greater individual accountability and alignment to business performance. Payout targets are based upon a percentage of base pay and are developed by independent third party expert(s) using comparable market competitive data within the bounds of reasonableness and that are reviewed and approved by BHCS's governing body. Payout levels are based upon a combination of system, entity, and individual performance using various metrics related to quality, patient satisfaction, employee retention, and financal stewardship. BHCS's governing body may approve modifications to annual incentive awards provided under the program consistent with market comparability data. Supplemental Information Part III Supplemental Information: Governing Body Compensation: The members of the governing body serve on a voluntary basis and receive no cash compensation from the organization for these duties as a member of the governing body. Three members received compensation from a related organization in their capacity as a Medical Director, employed physician, or President of the related organization. X 5 622804 Fair Market Value X 1 150 Fair Market Value X 1 9850 Fair Market Value X Auction/Raffle Items 44 75827 Fair Market Value 0 0 1 0 Method for Determining Number of Contributors: Part I, Column (b): The organization is reporting based on the number of contributions, not the number of items contributed. Form 990, Part VI, Section A, line 6 Members or stockholders: The organization is a Texas nonprofit membership organization in which BASMC, a tax exempt, Texas nonprofit corporation, is the sole member. Form 990, Part VI, Section A, line 7a Election of Members of governing body by members, stockholders, or other persons: The sole member, BASMC, appoints and removes the members of the governing body. Form 990, Part VI, Section A, line 7b Governing body decisions subject to approval: The sole member, BASMC, has final authority over certain decisions/ powers of the organization such as approval of the organization's articles of incorporation and bylaws and amendments thereto, appointment and removal of the members of the governing body, approval of dissolutions and mergers, and other similar decisions/powers over the organization. Form 990, Part VI, Section B, line 11 Process used to review the Form 990: The Form 990 is prepared and reviewed by Baylor Health Care System's ("BHCS") tax department. During the return preparation process the tax department works with other functional areas including finance, accounting, treasury, legal, human resources, and corporate compliance for advice, information and assistance to prepare a complete and accurate return. Upon completion, the Form 990 is reviewed by the organization's President, financial officer and/or other key officers. A complete final copy of the return is provided to the organization's governing body prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Process used to monitor and enforce compliance with the organization's conflict of interest policy: Persons with the actual or perceived ability to influence the organization have the duty to disclose annually and otherwise promptly as potential conflicts are identified, any familial, professional or financial relationships with entities or individuals that do, or seek to do business with the organization or that compete with the organization. These individuals include the organization's officers, governing body, management, physicians with administrative services agreements and other key personnel who interact with outside organizations or businesses on behalf of the organization. The BHCS Board of Trustees Audit and Compliance Committee and the BHCS Corporate Compliance Committee review all relevant disclosures submitted by these individuals to determine whether a conflict of interest exists and to determine an appropriate resolution, if necessary. Any individual with a perceived or potential conflict is prohibited from voting or participating in the decision making process regarding such transaction with that individual. Form 990, Part VI, Section B, line 15 Process for determining compensation: The organization, a controlled affiliate of BHCS, recognizes that those chosen to lead the organization are vital to its ongoing success and growth. Thus, it must attract, retain and engage the highest quality officers and key employees to lead the organization and help BHCS maintain its national reputation for achieving high targets for medical quality, patient safety, and patient satisfaction. A significant portion of the organization's officers' and key employees' total compensation is based on significant performance achievements. This strategy, known as the Performance Award Program, works to put a greater emphasis on the importance of the organization achieving targeted improvements in the areas of People, Quality, Patient Satisfaction and Financial Stewardship, annually. Total executive compensation is part of an integrated talent management strategy developed by the BHCS Board of Trustees and its Compensation and Governance Committee (Committee) to attract, motivate, and retain the best leadership resources for the organization. Executive compensation is determined pursuant to guidelines outlined in the intermediate sanction rules under IRC Section 4958 including taking steps to meet the rebuttable presumption standard of reasonableness under Treasury Regulation 53.4958-6, as summarized below. When making compensation decisions, the organization compares itself to similar-sized, and structured businesses including other integrated health care service systems and other similar-sized organizations, both locally and nationally. The BHCS Board of Trustees and Committee, on behalf of the organization, work directly with independent compensation expert(s) to identify reasonable and competitive market rates as well as provide an annual review of the total compensation of the organization's top management officials and key employees. The Committee is made up of members of the BHCS Board of Trustees, who are independent, community volunteers. Guided by the information provided by the independent compensation expert(s), the Committee approves and recommends to the BHCS Board of Trustees salary increases, earned incentives, and benefit offerings for the organization's President, other officers and/or key employees to be comparable to similar organizations for similar services and/or positions. Furthermore, the Committee is charged with the responsibility of reviewing annually the major elements of the executive compensation program to assure designs remain consistent with the business needs, market practices, and compensation philosophy. As part of the decision making process, the Committee will often meet in executive session to discuss and review recommendations made by the independent compensation expert(s). During the executive session no officer or key employee whose compensation is being reviewed is present during these discussions. All decisions are contemporaneously documented in the Committee minutes which are timely reviewed and approved by the Committee. Form 990, Part VI, Section C, line 19 Process for making governing documents, conflict of interest policy, & financial statements available to the public: The organization's articles of incorporation and amendments thereto are made available to the public by the filing of those documents with the Texas Secretary of State. Also, the organization is included within the combined financial statements of BHCS that are made available to the public by the posting of those documents through DAC Bond. The organization's other governing documents and conflicts of interest policy are not made available to the public. Form 990, Part VII: Hours devoted to related organization: The persons listed below also serve as employees of a related organization. The average hours per week devoted to the related organization are listed below: Jason Whitfield (40 Hours) Preshie Wilson (40 Hours) Amy Martin (40 Hours) Marlon Levy, M.D. (40 Hours) Steven Newton (40 Hours) Robert Watson (28 Hours) Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -1,224,616. Transfers Between Entities Under Common Control -9,850. Change in Value Split Interest Agreements -7,083. Total to Form 990, Part XI, Line 5: -1,241,549. Supplemental Information: IRC Section 6038 Statement: All Saints Health Foundation (ASHF) is controlled by BASMC, Employer Identification Number 75-1008430, which is controlled by BHCS, Employer Identification Number 75-1812652. BHCS also owns Health Care Insurance Company of Texas, Ltd. (HCIC). HCIC is a controlled foreign corporation. BHCS furnishes all information required of ASHF by IRC Section 6038 and the regulations thereunder with respect to HCIC. Therefore, pursuant to Treasury Regulation Sec. 1.6038-2(j)(2), ASHF is excepted from providing such information. BHCS files its Return of Organization Exempt from Income Tax in Ogden, Utah. Baylor Health Care System 2001 Bryan Street Suite 2200 Dallas TX 75201 751812652 Management Services TX 501(c)(3) 11, Type III N/A 0 Baylor University Medical Center 2001 Bryan Street Suite 2200 Dallas TX 75201 751837454 Acute Care Hospital TX 501(c)(3) 3 Baylor Health Care System 1 Baylor Medical Centers at Garland and McKinney 2001 Bryan Street Suite 2200 Dallas TX 75201 751037591 Acute Care Hospital TX 501(c)(3) 3 Baylor Health Care System 1 Baylor Medical Center at Irving 2001 Bryan Street Suite 2200 Dallas TX 75201 752586857 Acute Care Hospital TX 501(c)(3) 3 Baylor Health Care System 1 Baylor Medical Center at Waxahachie 2001 Bryan Street Suite 2200 Dallas TX 75201 751844139 Acute Care Hospital TX 501(c)(3) 3 Baylor Health Care System 1 Baylor Regional Medical Center at Plano 2001 Bryan Street Suite 2200 Dallas TX 75201 820551704 Acute Care Hospital TX 501(c)(3) 3 Baylor Health Care System 1 Baylor Regional Medical Center at Grapevine 2001 Bryan Street Suite 2200 Dallas TX 75201 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TX 75201 751436779 Post Office TX N/A C Health Care Insurance Company of Texas Ltd PO Box GT 2nd Fl Buckingham Sq Grand Cayman CJ 980403182 Investments CJ N/A C Baylor Medical Center at Grapevine Condominium Owners Association Inc 2001 Bryan Street Suite 2200 Dallas TX 75201 752747555 Condo Association TX N/A C BUMCRoberts Condominium Owners Association Inc 2001 Bryan Street Suite 2200 Dallas TX 75201 752897806 Condo Association TX N/A C Baylor All Saints Med Cntr at Ft Worth Condo Owners Association Inc 2001 Bryan Street Suite 2200 Dallas TX 75201 261661900 Condo Association TX N/A C Baylor Quality Health Care Alliance LLC 2001 Bryan Street Suite 2200 Dallas TX 75201 454015863 ACO TX N/A C 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 Baylor All Saints Medical Center B 1521753 GAAP