ANESTHESIOLOGISTS FOR CHILDREN: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ANESTHESIOLOGISTS FOR CHILDREN (EIN 75-2917570)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201333179349301023
- Schema version
- 2012v2.1
- 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 | 2013-11-13T09:05:11-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 366055558 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Grant Thornton LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1717 Main Street Suite 1500 | AddressLine1 |
| City | Dallas | City |
| State | TX | State |
| ZIP Code | 75201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752917570 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Anesthesiologists For Children | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ANES | NameControl |
| Phone | 2144567000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1935 Medical District Drive | AddressLine1 |
| City | Dallas | City |
| State | TX | State |
| ZIP Code | 75235 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jerry Lee | Name |
| Title | Treasurer, VP Acctng & Rev Cycle | Title |
| Phone | 2144567000 | Phone |
| Date Signed | 2013-11-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kimberly Temple CPA | Name |
| PTIN | P00669176 | PTIN |
| Phone | 2145612300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Jerry Lee | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1935 Medical District Dr | AddressLine1 |
| City | Dallas | City |
| State | TX | State |
| ZIP Code | 75235 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 24701472 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2000 | YearFormation |
| State Legal Domicile | TX | StateLegalDomicile |
| Activity Or Mission Description | Provide anesthesia services to patients at Children's Medical Center in Dallas, Texas | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 33 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 30466 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 10800 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 25164293 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 24409231 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 231475 | OtherRevenuePriorYear |
| Other Revenue Current Year | 281441 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 25426234 | TotalRevenuePriorYear |
| Total Revenue Current Year | 24701472 | 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 | 11404880 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11218129 | 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 | 14722705 | OtherExpensePriorYear |
| Other Expenses Current Year | 14552287 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 26127585 | TotalExpensesPriorYear |
| Total Expenses Current Year | 25770416 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -701351 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1068944 | RevenuesLessExpensesCY |
| Total Assets BOY | 5113435 | TotalAssetsBOY |
| Total Assets EOY | 4898945 | TotalAssetsEOY |
| Total Liabilities BOY | 8056187 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 8910641 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -2942752 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -4011696 | NetAssetsOrFundBalancesEOY |
| Mission Description | Provide anesthesia services to patients at Children's Medical Center in Dallas, Texas. These services are provided without regard to patient's ability to pay for the services. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 24831298 | Expense |
| Revenue | 24690672 | Revenue |
| Description | Provide anesthesia services to patients at Children's Medical Center inDallas, Texas. These services are provided without regard to thepatient's ability to pay for the services. | Description |
| Total Program Service Expense | 24831298 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 24 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 33 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Stephanie K Smith | NamePerson |
| Telephone Number | 2144567000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1935 Medical District Drive | AddressLine1 |
| City | Dallas | City |
| State | TX | State |
| ZIP Code | 75235 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Julio Perez-Fontan MD | ||||||||
| Chairman, Director | 1.00 | 55.00 | X | X | 0 | 480000 | 0 | |
| Desmond Henry MD | ||||||||
| President, Director | 1.00 | 40.00 | X | X | 0 | 151875 | 0 | |
| David Bui MD | ||||||||
| Director, Anesthesiologist | 40.00 | 0.00 | X | 470358 | 0 | 11638 | ||
| Alan Farrow-Gillespie MD | ||||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| Charles Whitten MD | ||||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | ||
| Robert Foglia MD | ||||||||
| Director | 1.00 | 40.00 | X | 0 | 150000 | 0 | ||
| Thomas Zellers MD | ||||||||
| Director | 1.00 | 50.00 | X | 0 | 150000 | 0 | ||
| Jerry Lee | ||||||||
| Treasurer | 1.00 | 50.00 | X | 0 | 291531 | 13939 | ||
| Stephanie K Smith | ||||||||
| Corporate Secretary | 1.00 | 40.00 | X | 0 | 102713 | 744 | ||
| Christopher Meggyesy MD | ||||||||
| Anesthesiologist | 40.00 | 0.00 | 557819 | 0 | 3537 | X | ||
| Shannon Roden MD | ||||||||
| Anesthesiologist | 40.00 | 0.00 | 512577 | 0 | 4673 | X | ||
| Stephen Hoang MD | ||||||||
| Anesthesiologist | 40.00 | 0.00 | 504326 | 0 | 3534 | X | ||
| Jesse Dadson MD | ||||||||
| Anesthesiologist | 40.00 | 0.00 | 500885 | 0 | 16051 | X | ||
| Hadi Sakhai MD | ||||||||
| Anesthesiologist | 40.00 | 0.00 | 500523 | 0 | 8287 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3046488 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1326119 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 62403 | TotalOtherCompensation |
| Number Individuals GT100 K | 25 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| UTSW | |||||
| 5323 Harry Hines Blvd | Dallas | TX | 75390 | Anesthesiologist | 11668062 |
| Mike C Murphy | |||||
| 1813 Creekside Ct | Garland | TX | 75040 | Anesthesiologist | 583123 |
| Medac Inc | |||||
| 804 Scott Nixon Memorial Dr | Augusta | GA | 30907 | Billing & Prac. Mgmt | 547112 |
| Medical Pro | |||||
| 23257 Network Place | Chicago | IL | 60673 | Risk Mgmt Insurance | 180429 |
| Carol Burns MD | |||||
| 4423 Hollow Oak Dr | Dallas | TX | 75287 | Anesthesiologist | 142450 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| Related Organizations | 10800 | RelatedOrganizations |
| Total Contributions | 10800 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Professional Svc Rev | 621110 | 17026891 | 17026891 |
| Coverage Revenue | 621110 | 8503085 | 8503085 |
| Prov for Dbtful Accts | 621110 | -1120745 | -1120745 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 24409231 | TotalProgramServiceRevenue |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Chief Stipend | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 281441 | TotalRevenueColumn |
| Related Or Exempt Function Income | 281441 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 281441 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24701472 | TotalRevenueColumn |
| Related Or Exempt Function Income | 24690672 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 481997 | Total |
| Program Services | 481997 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9711404 | Total |
| Program Services | 9465002 | ProgramServices |
| Management And General | 246402 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 284415 | Total |
| Program Services | 277540 | ProgramServices |
| Management And General | 6875 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 376664 | Total |
| Program Services | 367579 | ProgramServices |
| Management And General | 9085 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 363649 | Total |
| Program Services | 354859 | ProgramServices |
| Management And General | 8790 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 648538 | Total |
| Management And General | 648538 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2500 | Total |
| Program Services | 2500 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13456622 | Total |
| Program Services | 13456622 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22465 | Total |
| Program Services | 15542 | ProgramServices |
| Management And General | 6923 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14908 | Total |
| Program Services | 14908 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 419 | Total |
| Management And General | 419 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20806 | Total |
| Program Services | 11278 | ProgramServices |
| Management And General | 9528 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 76291 | Total |
| Program Services | 75925 | ProgramServices |
| Management And General | 366 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 264150 | Total |
| Program Services | 264150 | ProgramServices |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Collection Fees | 37269 | 37269 | |
| Catering, Meals, Coffee | 4790 | 2627 | 2163 |
| Business Relations | 3529 | 3500 | 29 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25770416 | Total |
| Program Services | 24831298 | ProgramServices |
| Management And General | 939118 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2225822 | BOY |
| EOY | 2980856 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2681862 | BOY |
| EOY | 1752083 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 205751 | BOY |
| EOY | 166006 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5113435 | BOY |
| EOY | 4898945 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2330151 | BOY |
| EOY | 2345349 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5726036 | BOY |
| EOY | 6565292 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8056187 | BOY |
| EOY | 8910641 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -2942752 | BOY |
| EOY | -4011696 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -2942752 | BOY |
| EOY | -4011696 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5113435 | BOY |
| EOY | 4898945 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -1068944 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 33650 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 30466 | CurrentTaxYearMinus1Year |
| Current Tax Year | 10800 | CurrentTaxYear |
| Total | 74916 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 32691710 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 40227440 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 41463061 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 49455696 | CurrentTaxYearMinus1Year |
| Current Tax Year | 49738411 | CurrentTaxYear |
| Total | 213576318 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 32691710 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 40227440 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 41496711 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 49486162 | CurrentTaxYearMinus1Year |
| Current Tax Year | 49749211 | CurrentTaxYear |
| Total | 213651234 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 213651234 | PublicSupportTotal509 |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 32691710 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 40227440 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 41496711 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 49486162 | CurrentTaxYearMinus1Year |
| Current Tax Year | 49749211 | CurrentTaxYear |
| Total | 213651234 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 1.00000 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 1.00000 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
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) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| LT Advances-AFC | $5,502,808 |
| LT Receivable/Payable-CMC | $1,062,484 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 6565292 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Part X, Line 2: The Anesthesiologists for Children's consolidated financial statements for the year ending December 31, 2012 do not contain a FIN 48 footnote. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Julio Perez-Fontan MD | ||||||||||||||
| Chairman, Director | 0 | 480000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 480000 | 0 | 0 |
| Desmond Henry MD | ||||||||||||||
| President, Director | 0 | 151875 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 151875 | 0 | 0 |
| David Bui MD | ||||||||||||||
| Director, Anesthesiologist | 463380 | 0 | 0 | 0 | 6978 | 0 | 0 | 0 | 11638 | 0 | 481996 | 0 | 0 | 0 |
| Jerry Lee | ||||||||||||||
| Treasurer | 0 | 247110 | 0 | 40688 | 0 | 3733 | 0 | 9529 | 0 | 4410 | 0 | 305470 | 0 | 0 |
| Christopher Meggyesy MD | ||||||||||||||
| Anesthesiologist | 471482 | 0 | 0 | 0 | 86337 | 0 | 0 | 0 | 3537 | 0 | 561356 | 0 | 0 | 0 |
| Shannon Roden MD | ||||||||||||||
| Anesthesiologist | 470346 | 0 | 0 | 0 | 42231 | 0 | 0 | 0 | 4673 | 0 | 517250 | 0 | 0 | 0 |
| Stephen Hoang MD | ||||||||||||||
| Anesthesiologist | 471484 | 0 | 0 | 0 | 32842 | 0 | 0 | 0 | 3534 | 0 | 507860 | 0 | 0 | 0 |
| Jesse Dadson MD | ||||||||||||||
| Anesthesiologist | 458967 | 0 | 0 | 0 | 41918 | 0 | 0 | 0 | 16051 | 0 | 516936 | 0 | 0 | 0 |
| Hadi Sakhai MD | ||||||||||||||
| Anesthesiologist | 466731 | 0 | 0 | 0 | 33792 | 0 | 0 | 0 | 8287 | 0 | 508810 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 7 | ReturnReference |
| Explanation | Non-Fixed Payments - The Human Resources Committee of the Board of Directors retains the authority to adjust annual payout percentages solely at their discretion. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | Children's Medical Center of Dallas (Children's) is the sole member. | |
| Form 990, Part VI, Section A, line 7a | Directors are appointed by the sole member and approved by the current AFC Board of Directors. | |
| Form 990, Part VI, Section A, line 7b | Sole member reserve powers are specified in AFC's bylaws and represent actions by the organization which require sole member approval. These powers generally include specified financial decisions, appointment of directors, and strategic planning. | |
| Form 990, Part VI, Section B, line 11 | The draft Form 990 is presented to the Children's Board of Directors by their treasurer at either a scheduled meeting or sent electronically for their review. | |
| Form 990, Part VI, Section B, line 12c | Directors execute a conflict of interest disclosure statement each year at the annual meeting of the AFC Board of Directors. Any disclosures made in the statements are presented to the Board of Directors for discussion and review at that time. | |
| Form 990, Part VI, Section B, line 15b | The top management official and officers of Anesthesiologists For Children (AFC) receive no compensation from AFC. For physicians, AFC obtains an outside consulting company to provide compensation analysis regarding the fair market value of AFC's salary structure, which is presented to the Board of Directors for approval. | |
| Form 990, Part VI, Section C, line 19 | The governing documents, conflict of interest policy, and financial statements are made available to the public when they are requested. | |
| Form 990, Part IX, line 11g | Contract Medical: Program service expenses 12,993,575. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,993,575. Consulting & Professional fees: Program service expenses 463,047. Management and general expenses 0. Fundraising expenses 0. Total expenses 463,047. | Other Fees |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (11 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 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Children's Medical Center of Dallas | |||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 750800628 | Hospital | TX | 501(c)(3) | Line 3 | Children's Hlth Svc of TX | 0 | |
| Physicians For Children | |||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 752854505 | Physicians | TX | 501(c)(3) | Line 9 | Children's Medical Center of Dallas | 0 | |
| Dallas Phys Medical Svs for Children Inc | |||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 810584868 | Physicians | TX | 501(c)(3) | Line 9 | Children's Medical Center of Dallas | 0 | |
| Children's Health Svc of Texas | |||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 752062019 | Management Company | TX | 501(c)(3) | Line 11a, I | 0 | N/A | |
| Children's Medical Center Foundation | |||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 752062015 | Foundation | TX | 501(c)(3) | Line 7 | Children's Hlth Svc of TX | 0 | |
| Children's Med Ctr Research Inst at UTSWMC | |||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 433462044 | Research Institute | TX | Pending | Pending | Children's Hlth Svc of TX | 0 | |
| Complex Care Medical Services | |||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 461893597 | Medical Services | TX | Pending | Pending | Children's Medical Center of Dallas | 0 | |
| Pediatric Partners For Children | |||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 461917702 | Clinically Integrated Network | TX | Pending | Pending | Children's Medical Center of Dallas | 0 | |
| Children's Medical Center Services | |||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 461934007 | Medical Services | TX | Pending | Pending | Children's Medical Center of Dallas | 0 | |
| Southwestern Medical District | |||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 204101612 | Medical District | TX | 501(c)(3) | Line 11a, I | 0 | N/A | |
| Women's Auxiliary of CMCD | |||||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 752485538 | Women's Auxiliary | TX | 501(c)(3) | Line 9 | 0 | N/A | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| Children's Insurance Company | |||||||||
| 76 St Paul Street Suite 500 | Burlington | VT | 05401 | 030328102 | Insurance Company | VT | N/A | C | 0 |
| Alternative Care Systems | |||||||||
| 1935 Medical District Drive | Dallas | TX | 75235 | 752244475 | Other Medical Services | TX | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
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