2012-08-14T16:44:49-05:00 2011-09-30 PRICEWATERHOUSECOOPERS LLP 301 COMMERCE STREET SUITE 2350 FORT WORTH TX 76102 990 2010-10-01 750818178 Texas Scottish Rite Hospital for Crippled Children TEXA 2145597625 2222 Welborn Street Dallas TX 752193924 Sharon Ellis 2145597625 2012-08-13 true J Scott Moore 8178109998 2010 2016-02-24 21:20:13Z Texas Scottish Rite Hospital JC Montgomery Jr President 2222 Welborn Street Dallas TX 752193924 981631297 false X www.tsrhc.org X 1921 TX To provide the highest quality care to improve the lives of children with orthopaedic and related conditions and specific learning disabilities. TSRHC focuses on patient care, research and education. 40 40 941 800 1229447 -973910 16705053 19581362 613163 800636 39721270 88035325 57876822 119254903 114916308 227672226 90000 100000 0 0 68190420 71847765 0 0 5492196 41166687 38668658 109447107 110616423 5469201 117055803 1255751307 1315057415 48505553 87797408 1207245754 1227260007 X To provide the highest quality care to improve the lives of children with orthopaedic and related conditions and specific learning disabilities. TSRHC focuses on patient care, research and education. false false 66371009 100000 Orthopaedics program includes outpatient clinic visits and inpatient stays for diagnosis and treatment. The Hospital's commitment to research, treatment and therapy for conditions including scoliosis, clubfoot, dislocated hip, Legg-Perthes, limb-length and limb deficiencies has provided medical breakthrough and technologies such as the TSRHC SILO 5.5 spinal system, True/lok external fixation system and the discovery of the first gene associated with idiopathic scoliosis. These advancements have impacted the lives of children throughout the world. To date, 20 of our researcher's discoveries have been patented. 8725531 Neurology program includes outpatient clinic visits for diagnosis and treatment of conditions such as: Charcot-Marie-Tooth and Tuberous Sclerosis. 7370808 Pediatric developmental disabilities program includes outpatient clinic visits for diagnosis and treatment of conditions such as Spina Bifida and Cerebral Palsy. 5285461 0 800636 Center for Dyslexia Program 4832020 0 0 Childrens Arthritis Clinic 1861343 0 0 Dental/Eye Clinic and Child Development 11978824 0 800636 94446172 true true false true false false false false true true false false true true false true false false false true false false false true true true true true false true true false false false false false false false false false false true false false false false true true true false false true 288 0 true 941 true true true false false false false true true false false false true false X 40 40 true false false false false false false true true false false true true true true true true true true false X Jean Allen 2145597507 2222 WELBORN STREET DALLAS TX 75219 X M Douglas Adkins 4.0 X 0 0 0 Fred E Allen 4.0 X 0 0 0 Pat Beard 4.0 X 0 0 0 W Eugene Brookshire 3.0 X 0 0 0 Russell C Brown 3.0 X 0 0 0 W Vernon Burke Jr 3.0 X 0 0 0 Clifford E Butler 3.0 X 0 0 0 Harold D Carter 4.0 X 0 0 0 Ronald L Carter 3.0 X 0 0 0 Daniel H Chapman 4.0 X 0 0 0 Graham H Childress 4.0 X 0 0 0 David Counts Jr 4.0 X 0 0 0 Stephen F Cross 3.0 X 0 0 0 Kenneth C Curry 2.0 X 0 0 0 Dan F Davidson 4.0 X 0 0 0 Joe M Dealey Jr 3.0 X 0 0 0 Lee Drain 4.0 X 0 0 0 Claude O Ervin 4.0 X 0 0 0 Jerry C Gilmore 4.0 X 0 0 0 Robert J Glasgow 4.0 X 0 0 0 WM Gower 4.0 X 0 0 0 William C Gray 4.0 X 0 0 0 Thomas F Griffin 3.0 X 0 0 0 Reese L Harrison Jr 4.0 X 0 0 0 Leonard P Harvey 3.0 X 0 0 0 Ted Hennis 3.0 X 0 0 0 Vester T Hughes Jr 4.0 X 0 0 0 Brack Jones Jr 3.0 X 0 0 0 James E Laney 4.0 X 0 0 0 Leo G Martin Jr 3.0 X 0 0 0 Douglas S Maxey 3.0 X 0 0 0 John C Nobles 4.0 X 0 0 0 Robert A Northcutt 4.0 X 0 0 0 Lyndon L Olson Jr 6.0 X 0 0 0 C Clifton Robinson 4.0 X 0 0 0 Ronald L Skaggs 4.0 X 0 0 0 Guy F Stovall Jr 4.0 X 0 0 0 Ralph Wayne 3.0 X 0 0 0 Jerry D Webber 3.0 X 0 0 0 JM Willson Jr 4.0 X 0 0 0 JC Montgomery Jr 40.0 X 547614 0 16472 Robert Walker 40.0 X 463907 0 75286 Sharon Ellis 40.0 X 337111 0 20495 Lori Dalton 40.0 X 305809 0 51722 Kristina Keever-Smith 40.0 X 205294 0 47270 Mark Bateman 40.0 X 42005 0 0 Stephanie Brigger 40.0 X 159586 0 29133 Jean Allen 40.0 X 143351 0 15907 James Sturgis 40.0 X 166926 0 49193 Debbie Sayles 40.0 X 210975 0 51310 Don Katz 40.0 X 168753 0 40380 J Anthony Herring 40.0 X 648660 0 14305 B Stephens Richards 40.0 X 1242103 98100 59428 John Birch 40.0 X 639778 5700 104328 Charles Johnston 40.0 X 607097 15600 108590 Karl Rathjen 40.0 X 479118 88600 55018 Daniel Sucato 40.0 X 475261 108900 57970 James Brown 40.0 X 152199 0 52627 Donald SMith 40.0 X 112649 0 52815 7108196 316900 902249 29 true true false HC BECK LTD 1807 ROSS AVE SUITE 500 DALLAS TX 752018006 CONSTRUCTION 1350246 UT SOUTHWESTERN MEDICAL CENTER 5323 HARRY HINES BLVD DALLAS TX 753909029 PROFESSIONAL FEES 1037285 THE NORTHERN TRUST CO PO BOX 75599 CHICAGO IL 606755599 INVESTMENT MGMt fees 806543 HKS INC 1919 McKINNEY AVE DALLAS TX 752011753 PROFESSIONAL FEES 573701 COMMUNITY HOSPITAL CONSULTING INC 5801 TENNYSON PKWY 550 PLANO TX 750246116 PROFESSIONAL FEES 408840 23 3080165 16501197 1271856 19581362 Dyslexia program 900099 800636 800636 800636 27295100 27295100 1132331 1132331 110003884 110003884 365802 48323 317479 317479 317479 811064065 309050 751519821 245400 59544244 63650 59607894 7500 59600394 741097 3080165 1027531 -286434 -286434 30221 9225 20996 20996 1850841 1108771 742070 751566 -9496 Surface damage income 110000 7986527 7986527 Hunting permit 110000 257505 257505 All other revenue 212876 212876 8456908 227672226 800636 1229447 206060781 100000 100000 0 0 0 4288352 1225030 1962269 1101053 0 48825765 45544417 1241995 2039353 7764309 7419332 171251 173726 7736559 7274670 158804 303085 3232780 2951594 135498 145688 0 128954 128954 186363 186363 110323 110323 0 736759 736759 2667480 2480203 162573 24704 23079 19549 2476 1054 15822060 14349119 526636 946305 1666565 1396976 186161 83428 0 2804609 2483144 260850 60615 359003 259123 78170 21710 0 50631 44675 5880 76 556655 490813 53427 12415 0 8625994 7351430 1100979 173585 861301 637012 194495 29794 Ad valorem taxes 1874947 1874947 Ranch operations 1733575 1733575 Prior year expenses & special 460360 460360 Reclass officers; directors & 419085 -794690 375605 110616423 94446172 10678055 5492196 X 32242 37947 1295010 11023330 199774 152836 1681245 1920953 5233009 4591535 201161140 117531731 94762398 83629409 1068117387 1125938137 221 163329 84430021 87599939 1255751307 1315057415 8939144 11909468 23000000 39566409 52887940 48505553 87797408 X 1093277080 1113593928 56844998 55819492 57123676 57846587 1207245754 1227260007 1255751307 1315057415 X 117055803 -97041550 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 34446 false true 75877 110323 false Schedule C Part II-B, Line 1b and 1g: JC MONTGOMERY, JR., ROBERT WALKER, LORI DALTON AND KARL RATHJEN, MD met with Texas legislators and committees and had associated expenses including travel and allocated compensation in the amount of $34,446. Schedule C Part II-B, Line 1i: THE HOSPITAL RETAINED THE SERVICES OF GREENBERG TRAURIG LLP TO MEET WITH VARIOUS STATE LEGISLATORS OR STAFF AND INCURRED RELATED EXPENSES IN THE AMOUNT OF $72,844. PER NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS, $3,033 OF THE HOSPITAL'S ANNUAL DUES WAS ALLOCATED TO LOBBYING. 115713126 2591978 -303985 0 2671781 0 115329338 109297675 7717507 2211598 0 3513654 0 115713126 117418863 4633892 -5781788 0 6974517 0 109296450 0.01442 0.50158 0.48400 true false 0 23066024 23066024 0 110236134 62450748 47785386 0 0 0 0 0 67569317 55080983 12488334 0 289665 0 289665 83629409 INVESTMENT REAL ESTATE 11855516 INTERESTS IN TRUSTS 75742225 MINERAL INTERESTS 2198 87599939 0 Pension 43696652 Insurance 1316112 Deferred management benefit cost 2202435 Reserve for malpractice claims 614158 Charitable gift annuities 5058583 52887940 227672226 110616423 117055803 -82588431 -90000 -14454374 -97132805 19922998 142976191 -82588431 1404656 -81183775 224159966 3195575 316685 3512260 227672226 109388013 2193850 2193850 107194163 3195575 226685 3422260 110616423 Endowment Funds Part V, Line 4: The income from the organization's permanent endowment funds and the temporarily restricted endowment funds are used to support the operations of the medical, research and learning programs of the hospital. Schedule D Part XI, Line 8: Changes in beneficial interests in trusts -789,194 Pension liability adjustment -13,663,925 Rounding -1,255 Total Line 8 -14,454,374 Schedule D Part XII, Line 2d: Unrealized change in beneficial interest in trusts -789,194 Rental expenses 48,323 Special event direct expenses 1,027,531 Gaming direct expenses 9,225 Ranch COGS 1,108,771 Total Line 2d 1,404,656 Schedule D Part XII, Line 4b: Pedi-Ortho Health COrp grants deducted from interest in audit 190,000 COGS reclassed from revenue offest in audit 126,685 Total line 4b 316,685 Schedule D Part XIII, Line 2d: Rental Expenses 48,323 Fundraising direct expense 1,027,531 Gaming expense 9,225 Cost of goods sold 1,108,771 Total Line 2d 2,193,850 Schedule D Part XIII, Line 4b: Grant expense to Pedi-Ortho Health Corp 100,000 Reclass of livestock COGS 126,685 Total line 4b 226,685 East Asia and the Pacific 0 0 Investments 31390307 Europe (Including Iceland and Greenland) 0 0 Investments 90345140 Middle East and North Africa 0 0 Investments 513183 North America 0 0 Investments 9209198 East Asia and the Pacific 0 0 Investment Mgmt Fees 19118 Europe (Including Iceland and Greenland) 0 0 Investment Mgmt Fees 55025 Middle East and North Africa 0 0 Investment Mgmt Fees 313 North America 0 0 Investment Mgmt Fees 5609 East Asia and the Pacific 0 0 Program Services Conferences; training 20098 Middle East and North Africa 0 0 Program Services Conferences; training 1082 North America 0 0 Program Services Conferences; training 16336 0 0 0 0 131575409 131575408 false false false false false false X X X X false TX Auction 847990 659170 188820 18032 900 125658 Marathon 496602 496602 1562 10461 44 2424106 1875694 548412 78384 9000 157003 3530 614242 3768698 3031466 737232 78384 9000 176597 4430 750361 1018772 -281540 30221 9225 false 30221 9225 9225 20996 TX false In the State of Texas occasional gaming activities (up to two per year) do not require such a license. false true false 0.58000 0.42000 Jean Allen Controller Texas Scott 2222 Welborn Street Dallas TX 75219 false false 0 true true false false true 82172897 82172897 0.74290 82172897 82172897 0.74290 521650 521650 0.00470 6414404 6414404 0.05800 6936054 6936054 0.06270 89108951 89108951 0.80560 5337221 5337221 0.04820 5337221 5337221 0.04820 0 0 0 1 1 Texas Scottish Rite Hospital

2222 Welborn Street Dallas TX 752193924

X X X X X Orthopaedic, neurodevelopment & musculoskeletal Texas Scottish Rite Hospital 1 X X Schedule H Part I, Line 3c, 6 and 7, Part II, Part III, PART V: Community Information, COMMUNITY BUILDING ACTIVITIES AND COMMUNITY BENEFITS REPORT: TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN's (TSRHC) HISTORY AND MISSION IS TO SERVE ALL PATIENTS WHOSE CARE IS WITHIN OUR SCOPE OF SERVICES, SPECIFICALLY RELATING TO TSRHC'S SPECIALIZATION IN PEDIATRIC ORTHOPAEDICS AND LEARNING DISORDERS, AT NO CHARGE. THUS, ALL CARE DURING THE REPORTING PERIOD WAS FREE TO ALL PATIENTS. BECAUSE OF THE NATURE OF THESE BENEFITS, THE HOSPITAL DOES NOT DISTINGUISH BETWEEN CHARITY CARE AND COMMUNITY BENEFITS. TSRHC DOES NOT HAVE BAD DEBT EXPENSE OR MEDICARE REVENUES AND EXPENSES AS TRADITIONALLY DEFINED. THEREFORE, ALL OF THE EXPENSES FOR MEDICAL CARE PROVIDED BY TSRHC ARE FOR THE COMMUNITY BENEFIT. Because the hospital provided care without expectation of reimbursement, TSRHC is exempt from the filing of state community benefit report. FURTHER, BECAUSE OF THE SPECIALIZED SERVICES PROVIDED AT TSRHC AND THE PROVISION OF CARE WITHOUT EXPECTATION OF REIMBURSEMENT, THE HOSPITAL DOES NOT MAINTAIN AN EMERGENCY DEPARTMENT. IT DOES HAVE AN EMERGENCY TREATMENT ROOM AND ADDRESSES EMERGENCY CONDITIONS WITHIN THE SCOPE OF SERVICES PROVIDED AT THE HOSPITAL WITHOUT DISCRIMINATION AND REGARDLESS OF ABILITY TO PAY. TSRHC TREATS CHILDREN PRIMARILY from TEXAS WITH SOME TEACHING CASES COMING FROM BROADer GEOGRAPHIC AREAS. THE HOSPITAL TREATS CHILDREN WITH ORTHOPAEDIC CONDITIONS, SUCH AS SCOLIOSIS, CLUBFOOT, HIP AND HAND DISORDERS AND LIMB LENGTH DIFFERENCES AS WELL AS CERTAIN RELATED NEUROLOGICAL DISORDERS AND LEARNING DISORDERS, SUCH AS DYSLEXIA. ADMISSION IS OPEN TO CHILDREN FROM BIRTH TO 18 YEARS OF AGE. TSRHC is a global leader in the field of pediatric orthopaedics and strives to improve the care of children worldwide through state-of-the-art medical treatment, innovative research, education programs that train physicians in advanced techniques and other community building activities. The hospital was established in 1921 when a group of Texas Masons approached Dallas' first orthopaedic surgeon, Dr. W. B. Carrell, about caring for children with polio regardless of their family's ability to pay. With the introduction of the Salk and Sabin vaccines in the mid-1950s, virtually eradicating polio in the Western Hemisphere, TSRHC broadened its focus to other pediatric orthopaedic conditions. The hospital continues to "write the book" on the treatment of orthopaedic conditions affecting children. TSRHC physicians are now working on the fifth edition of the textbook Tachdjian's Pediatric Orthopaedics from Texas Scottish Rite Hospital for Children, the standard reference guide for orthopaedic surgeons around the world. TREATMENT - The hospital physicians, staff and volunteers share a commitment to helping children lead happy and healthy lives. Extending beyond medical treatment in the hospital's specialty areas, TSRHC cares for the whole child, both physically and emotionally. The hospital has treated more than 210,000 children since its inception, with an average of about 40,000 clinic visits per year. In fiscal 2011, TSRHC had: - 15,000 active patients - 40,513 outpatient visits - 2,075 surgeries performed Treatment as well as research is built around five Centers for Excellence: - Scoliosis & Spine - Clubfoot & Foot Disorders - Hip Disorders - Limb Length Discrepancies - Hand Differences EDUCATION - For more than 30 years, in association with the University of Texas Southwestern Medical Center, TSRHC has provided an extraordinary educational experience in the field of pediatric ORTHOPAEDICS To promising orthopaedic surgeons. More than 160 physicians have benefited from the TSRHC Fellowship in Pediatric Orthopaedics and Scoliosis, going on to hold prestigious medical positions around the country and across the world. Program participants receive in-depth training in all aspects of reconstructive pediatric orthopaedics, trauma and infections. Each year, four or five physicians who qualify for a highly coveted spot in the 12-month fellowship work alongside a full-time pediatric orthopaedist for a one- or two-month period before rotating to another physician, giving each fellow a firsthand, in-depth and invaluable learning experience with some of the world's most respected pediatric orthopaedists. In addition, fellows receive firsthand training from the hospital's clinical staff, a team trained to address the most complex treatment regimens. When fellows leave the program, they remain connected to TSRHC through correspondence, educational conferences and various medical association gatherings. Among these educational opportunities is the hospital's Brandon Carrell Visiting Professorship. Over the course of the two-day meeting, visiting pediatric orthopaedic specialists present lectures and lead discussions about developments in their fields. Former fellows also share the knowledge and experience gained during their fellowship as TSRHC ambassadors caring for children within their respective medical institutions and communities. IN ADDITION TO THE FELLOWSHIP PROGRAM, THE HOSPITAL PARTICIPATES IN RESIDENCY TRAINING PROGRAMS IN NEUROLOGY, RHEUMATOLOGY, ORTHOPAEDICS, PSYCHOLOGY, RADIOLOGY AND PEDIATRIC DEVELOPMENTAL DISABILITIES. THE HOSPITAL HAS VARIOUS AFFILIATION PROGRAMS FOR EDUCATION IN NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, PROSTHETICS AND VARIOUS OTHER DISCIPLINES. In addition, TSRHC offers its facilities to local, national and international organizations for medical and other health-related education. In 2011, that included a Spine Summit for surgeons, nurses and physician's assistants, co-sponsored by the University of Texas Southwestern Medical Center, and the 33rd annual Carrell-Krusen Neuromuscular Symposium, co-sponsored by UT-Southwestern and Children's Medical Center of Dallas. RESEARCH - Since opening its doors in 1921, TSRHC has strived to discover new and better ways to care for children affected by pediatric orthopaedic conditions and certain related neurological disorders. Our dedicated research center, the Sarah M. and Charles E. Seay Center for Musculoskeletal Research, is made up of five Centers for Excellence supported by research divisions and core facilities. Each center integrates the services and knowledge of investigators from various educational backgrounds, such as orthopaedic surgery, biomechanical engineering, genetics, statistics, histology, and motion analysis. Through the years, TSRHC researchers and physicians have generated more than 20 patents and made important discoveries that have helped children worldwide. These findings and innovations allow the medical community to form new hypotheses to explain what causes certain conditions while providing tools for future research. Among the major discoveries and research applications at TSRHC: - The first gene associated with idiopathic scoliosis, a progressive condition that causes the spine to curve. The study is outlined in the May 2007 issue of The American Journal of Human Genetics. - Two more genetics markers for idiopathic scoliosis. The genes are involved in neurological development. The study is outlined in the April 1, 2011 issue of the journal, Human Molecular Genetics. - The TSRH SILO 5.5 Spinal System, developed in 2005, a modified design of the TSRH Spinal System designed in the 1980s. It allows for shorter surgery and uses lower profile implants for patient comfort. - The TRUE/LOK External Fixation System, developed in 1998. - The TSRH Spinal System, developed in the 1980s. Hospital patents include CHD7 genetics polymorphisms associated with a susceptibility to idiopathic scoliosis; a genetic marker for autoimmune disorder; a golf prosthesis; an External Fixation device and method; a Positional Spinal Fixation device; and a spinal hook. THERAPEUTIC RECREATION - TSRHC IS COMMITTED TO CARING FOR THE OVERALL HEALTH OF THE CHILD, BOTH PHYSICALLY AND EMOTIONALLY. TSRHC IS ABLE TO EXTEND ITS MEDICAL TREATMENT TO TEXAS CHILDREN THROUGH THE COMMUNITY OUTREACH AND EDUCATION PROVIDED TO PATIENTS AND THEIR FAMILIES BY THE HOSPITAL'S THERAPEUTIC RECREATION DEPARTMENT. THERAPEUTIC RECREATION'S INPATIENT PROGRAM PROVIDES DAILY SERVICES FOR CHILDREN STAYING IN THE HOSPITAL AS WELL AS SERVICE CONSULTATIONS FOR OUTPATIENTS AS PART OF THEIR CLINIC EXPERIENCE. IN ADDITION, THE DEPARTMENT PROVIDES OUTREACH PROGRAMS TO HELP CONNECT TSRHC PATIENTS TO RESOURCES IN THE COMMUNITY. THE HOSPITAL ALSO PROVIDES THERAPY-BASED PROGRAMS SUCH AS THE CHANCE TO DANCE PROGRAM, RITE 2 PLAY, SUMMER ALL STARS AND EQUIPMENT LOANS. 1. PATIENT SUPPORT SPORTS AND RECREATION PROGRAMS AT TSRHC INCLUDE LEARN TO GOLF AND SEVEN CAMPS FOR PATIENTS AGE 4 TO 17. EACH CAMP HELPS FOSTER INDEPENDENCE AND SELF-CONFIDENCE, WHILE DEVELOPING AND IMPROVING COMMUNICATION AND PROBLEM SOLVING SKILLS FOR TSRHC PATIENTS: - LEARN TO GOLF, LAUNCHED BY THE THERAPEUTIC RECREATION DEPARTMENT IN 1998, PROVIDES THE TOOLS AND INSTRUCTION NEEDED FOR YOUNG PATIENTS TO EXPERIENCE THE REHABILITATIVE BENEFITS OF THE true Pedi-Ortho Health Corporation 2222 Welborn Street Dallas TX 752193924 752665759 501(c)(3) 100000 0 FMV none CARE AND RESEARCH - CHILDREN'S MEDICAL CENTER 1 0 Schedule I Part I, Line 2: The grant is to support the medical services of the physicians of Pedi-Ortho Health Corporation. The recipient of the grant is a related medical entity and the hospital, as a sole member, monitors the activities of entity which provides pediatric orthopaedic physicians to local medical facilities that care for children. The entity is independently audited annually and the hospital receives a copy of the audited financial statements. X X false true X X X X false true false false false false false false false JC Montgomery Jr 486037 0 0 0 61577 0 0 0 16472 0 564086 0 19057 0 Robert Walker 292833 0 0 0 171074 0 58481 0 16805 0 539193 0 0 0 Sharon Ellis 281476 0 0 0 55635 0 6442 0 14053 0 357606 0 0 0 Lori Dalton 251703 0 0 0 54106 0 33000 0 18722 0 357531 0 0 0 Kristina Keever-Smith 179157 0 0 0 26137 0 31198 0 16072 0 252564 0 0 0 Stephanie Brigger 125912 0 0 0 33674 0 16039 0 13094 0 188719 0 0 0 Jean Allen 117928 0 0 0 25423 0 0 0 15907 0 159258 0 0 0 James Sturgis 148714 0 0 0 18212 0 35167 0 14026 0 216119 0 0 0 Debbie Sayles 200150 0 0 0 10825 0 39296 0 12014 0 262285 0 0 0 Don Katz 151718 0 0 0 17035 0 24837 0 15543 0 209133 0 0 0 J Anthony Herring 578594 0 0 0 70066 0 0 0 14305 0 662965 0 22040 0 B Stephens Richards 440455 98100 0 0 801648 0 42839 0 16589 0 1301531 98100 731369 0 John Birch 439554 5700 0 0 200224 0 86838 0 17490 0 744106 5700 0 0 Charles Johnston 442739 15600 0 0 164358 0 94285 0 14305 0 715687 15600 0 0 Karl Rathjen 415333 88600 0 0 63785 0 42801 0 12217 0 534136 88600 0 0 Daniel Sucato 428228 108900 0 0 47033 0 42148 0 15822 0 533231 108900 0 0 James Brown 123628 0 0 0 28571 0 37201 0 15426 0 204826 0 0 0 Donald SMith 102838 0 0 0 9811 0 39736 0 13079 0 165464 0 0 0 Schedule J Part I, Line 1a: Travel for companions (included on Sch J, Part II, Col B(III) & W-2 box 5) J. Anthony Herring 800 B. Stephens Richards 800 JOhn Birch 800 Karl Rathjen 470 Social Club Dues (included on Sch J, Part II, Col B (III) & W-2 Box 5) JC Montgomery, Jr. 2,640 Schedule J Part I, Line 1b: The corporation does not have a written policy regarding reimbursement for travel for companions or social club dues. A procedure was consistently followed and monitored as noted in part 1, 2 and these items were included as taxable income on Schedule J. Schedule J PArt I, Line 4b: Restoration plan is a non-qualified pension related benefit available to eligible employees. The purpose of this plan is to provide that the total pension and pension-related benefits of eligible employees, whose benefits are restricted under the defined benefit plan due to IRS limitation, are the same as other eligible employees participating in the defined benefit plan. Eligible employees accrue a benefit on an annual basis. These amounts are deferred and are not vested until the eligible employee has attained age 55 and completed 15 years of service or attained age 65. Upon vesting, the cumulative accrued benefit, since inception, is subject to taxation; and all future accruals will be subject to taxation on an annual basis. Participants are eligible to receive benefits upon termination of employment. Under the terms of the Restoration Plan, the following employees are non-vested participants who are accruing an annual benefit in 2010. (Included on Sch J, Part II, Col C) KArl rATHJEN 8,716 Daniel Sucato 9,316 Under the terms of the Restoration Plan, the following employee vested in this Plan in calendar year 2010 and his cumulative accrued benefits since inception, as referenced below, are subject to taxation. (Included on W-2, Box 5) B. Stephens Richards 745,690 The following employees have vested in the Restoration Plan and accrued benefits during 2010, which are subject to taxation, in the following amounts. (Included in Sch J, Part II, Col B (III) and W-2, box 5) Robert Walker 97,423 John Birch 86,954 Charles Johnston 88,755 The 81 plan deferred is a non-qualified retirement plan for eligible employees (included in Sch J, Part II, Col C) Robert Walker 16,636 John Birch 36,758 Charles Johnston 43,890 Donald Smith 19,935 James Brown 13,787 The 81 plan is a non-qualified retirement plan for eligible employees (included in sCH j, pART ii, cOL b (III) and W-2, box 5) JC Montgomery, Jr. 20,645 Robert Walker 6,907 J. Anthony Herring 21,137 John Birch 15,404 Charles Johnston 18,927 James Brown 5,629 Donald SMith 8,948 The management benefit plan is a supplemental benefit plan with the rights to choose between life insurance, disability insurance, long term care insurance and retirement benefits. The value of the benefit is reported as compensation. All retirement benefits are immediately vested at the time earned (included in Sch J, Part II, Col B (III)and W-2 Box 5) JC Montgomery, Jr. 22,110 Robert Walker 14,850 Sharon Ellis 14,175 Lori Dalton 12,375 Kristina Keever-Smith 9,000 Stephanie Brigger 6,580 Jean Allen 6,308 James Sturgis 7,200 Debbie Sayles 9,000 J. Anthony Herring 26,178 B. Stephens Richards 20,898 John Birch 20,898 Charles Johnston 20,898 Karl Rathjen 20,072 DANIEL SUCATO 20,072 City of Parker Tx Cultural Education Facilities 270365113 2010-12-30 23000000 Construct & equip power plant false false false 0 0 23000000 0 144232 0 111125 348115 0 2659735 0 18604450 false false false true false false false false false 0.00000 0.00000 0.00000 true false true true JPMorgan Chase 10. false false false false SCHEDULE K PART IV, LINE 6: EXPECT CONSTRUCTION FUND TO BE EXEMPT FROM REBATE BASED ON TWO YEAR SPEND DOWN RULES. X 4 17806 market value X 11 428350 market value X 4 825700 market value 0 false false false Other Program Services Form 990, Part III , Line 4D: Center for Dyslexia Program provides treatment for learning disorders and develops teaching material for teaching children with dyslexia. Arthritis Center for Diagnosis and Treatment. Other services that support all hospital clinics as determined by a physician include: Dental; ophthalmology; occupational therapy; orthotics; physical therapy; prosthetics; child life; patient interventions; developmental assessment; and pharmacy. Description Expenses Revenue center for dyslexia program 5,285,461 800,636 childrens arthritis clinic 4,832,020 0 dental/eye clinic and child development 1,861,343 0 Total 11,978,824 800,636 Family and business relationships Form 990, Part VI, Section A, Line 2: Lyndon Olson and pat beard have a business relationship through central national bank. J. ANTHONY HERRING, MD, JOHN BIRCH, MD, CHARLES JOHNSTON, MD, B. STEPHENS RICHARDS, MD, KARL RATHJEN, MD, AND DANIEL SUCATO, MD, HAVE A BUSINESS RELATIONSHIP WITH JC MONTGOMERY, jr., ROBERT WALKER, LORI DALTON AND SHARON ELLIS IN THAT THE PHYSICIANS ARE DIRECTORS OF PEDI-ORTHO HEALTH CORPORATION, AN ENTITY FOR WHICH TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN IS THE SOLE MEMBER, IN WHICH THE LATTER INDIVIDUALS SERVE AS OFFICERS. SHARON ELLIS, LORI DALTON AND KRIStina KEEVER-SMITH HAVE A BUSINESS RELATIONSHIP IN THAT THEY ARE EMPLOYED BY TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN AND ALSO SERVE AS OFFICERS OF LEGACY SCHOLARSHIP FUND, A RELATED ENTITY. Process used to review 990 Form 990, Part VI , Section B, Line 11b: The Form 990 is prepared INTERNALLY IN CONJUNCTION WITH outside accountants and then reviewed by management. A copy of the Form 990 is provided to the audit committee for review and discussion. The Form 990 is made available to the board for review before it is filed. Compliance with written conflict of interest policy Form 990, Part VI, Section B, Line 12c: The organization annually requires officers, key employees and trustees to complete a conflicts of interest form disclosing actual or potential conflicts of interest in compliance with the organization's conflicts of interest policy. Additionally, these individuals are to report any new matters that arise during the year if they become aware of a transaction that is under consideration that presents an actual or potential conflict of interest. Annually the general counsel prepares and submits a summary of the disclosed potential conflicts to the audit committee of the board of trustees. Additionally, at the time a key staff member is hired or promoted to a position with administrative or management responsibilities, the organization provides the individual with a copy of the conflicts of interest policy and the individual is required to complete a conflicts of interest disclosure form. All material facts surrounding contracts, transactions, or arrangements involving a conflict of interest are to be disclosed to ensure that the contract, transaction or arrangement is fair to the hospital at the time it is authorized, approved, or ratified. Process for determining compensation Form 990, Part VI, Section B, Line 15a and 15b: The compensation committee of the board of trustees annually reviews and approves salary and benefits for executive staff and key employees of the organization. THe hospital reviews various executive/physician compensation surveys, including data from pediatric hospitals on both a local and national basis. Periodically, an independent consultant reviews salary and benefits of executives, physicians and key employees. THIS REVIEW AS LAST UNDERTAKEN IN FISCAL YEAR 2011 FOR JC MONTGOMERY,jr., ROBERT WALKER, SHARON ELLIS, LORI DALTON, KRIStina KEEVER-SMITH, MARK BATEMAN, STEPHANIE BRIGGER, JEAN ALLEN, JIM STURGIS, DEBBIE SAYLES, DON KATZ, J. ANTHONY HERRING, B. STEPHENS RICHARDS, JOHN BIRCH, CHARLES JOHNSTON, KARL RATHJEN AND DANIEL SUCATO. Additionally, the hospital gathers physician compensation data from local academic and private practice settings. This information is collectively taken into consideration and presented to the committee when determining compensation. Governing Document, Conflict of Interest Policy and Financial Statements Form 990, Part VI, Section C, Line 19: Governing documents, conflict of interest policy and financial statements are maintained by the hospital and are made available to the public upon request by the Office of the general counsel. Other Changes in Net Assets Form 990, Part XI, Line 5: Net unrealized gains (losses) on investments -82,588,431 Changes in beneficial interest in trusts -789,194 Pension liability adjustment -13,663,925 total changes in net assets -97,041,550 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JC Montgomery, Jr. TITLE:President HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Robert Walker TITLE:Exec. Vice President HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Sharon Ellis TITLE:VP & CFO HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Lori Dalton TITLE:VP and General COunsel HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Kristina Keever-Smith TITLE:Vice President HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jean Allen TITLE:Controller HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J. Anthony Herring TITLE:Chief of Staff HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:B. Stephens Richards TITLE:Asst. Chief of Staff HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:John Birch TITLE:Asst. Chief of Staff HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Charles Johnston TITLE:Asst. Chief of Staff HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Karl Rathjen TITLE:ORTHOPAEDIC SURGEON HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Daniel Sucato TITLE:ORTHOPAEDIC SURGEON HOURS:1 Pedi-Ortho Health Corporation 2222 Welborn Street Dallas TX 75219 752665759 Physicians TX 501(c)(3) Line 5 NA Legacy Scholarship Program 2222 Welborn Street Dallas TX 75219 752106637 Scholarship TX 501(c)(3) Line 7 NA Texas Scottish Rite Hospital Trust C/O JPMorgan Bank Box 3038 Milwaukee WI 53201 756013875 Support Org WI 501(c)(3) Line 11D&E NA false true true false false false false false false false true false false true false true true true Pedi-Ortho Health Corporation B 100000 Pedi-Ortho Health Corporation N 65169 Pedi-Ortho Health Corporation P 399866