2011-11-11T14:19:06-06:00 2010-12-31 Grant Thornton LLP 1717 Main Street Suite 1500 Dallas TX 75201 990 2010-01-01 752917570 Anesthesiologists For Children ANES 2144567000 1935 Medical District Drive Dallas TX 75235 Jerry Lee 2144567000 2011-11-11 1 Kimberly Temple CPA 2145612300 2010 2016-02-24 21:20:13Z Jerry Lee 1935 Medical District Dr Dallas TX 75235 23794490 0 X N/A X 2001 TX To Provide Anesthesia Services to patients at Children's Medical Center of Dallas 7 3 26 0 0 0 0 33650 15362422 17960879 0 0 6359163 5799961 21721585 23794490 0 0 0 0 11285613 11023316 0 0 0 11277789 12960517 22563402 23983833 -841817 -189343 4912038 4476322 6964097 6717724 -2052059 -2241402 To provide Anesthesia services to patients at Children's Medical Center in Dallas, Texas. These services are provided without regard to the patient's ability to pay for the services. 0 0 22825117 23794490 Provide Anesthesia Services to Patients at Children's Medical Center in Dallas, Texas. These services are provided without regard to the patient's ability to pay for the services. 22825117 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 20 0 1 26 1 0 0 0 0 0 0 0 0 0 0 X 7 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X Stephanie K Smith 2144567040 1935 Medical District Drive Dallas TX 75235 X Julio Perez Fontan MD 50.00 X X 0 480000 0 Desmond Henry MD 40.00 X X 162863 0 0 Jerry Lee 40.00 X 0 222007 14998 Stephanie K Smith 40.00 X 0 76686 4224 David Bui MD 1.00 X 0 0 0 Robert Foglia MD 40.00 X 0 694000 0 Alan Farrow-Gillespie MD 1.00 X 0 0 0 Charles Witten MD 1.00 X 0 0 0 Thomas Zellers MD 40.00 X 0 113333 0 Christopher Meggyesy MD 40.00 X 528322 0 2711 Cynthia Gonzales MD 40.00 X 505095 0 288 Vera Barbosa MD 40.00 X 502267 0 6195 Debra Tyler MD 40.00 X 499582 0 1009 Stephen Hoang MD 40.00 X 495875 0 2898 2694004 1586026 32323 24 0 1 0 UTSW 5323 Harry Hines Blvd Dallas TX 753908886 Anesthesiologist 9947273 Summit Healthcare Mgmt 4916 Overton Plaza Ft Worth TX 76109 Anesthesiologist 592225 Medical Protective Co 23289 Network Place Chicago IL 606731232 Anesthesiologist 255820 Mike C Murphy 1813 Creekside Ct Garland TX 75040 Anesthesiologist 171780 4 33650 33650 Professional Svc Rev 621110 17960879 17960879 17960879 Recruitment Support 900099 4392986 4392986 Call Coverage 621110 931850 931850 475125 475125 5799961 23794490 23760840 0 0 162863 162863 10066750 10066750 234109 234109 251156 238982 12174 308438 308438 325008 325008 9760976 9760976 24948 24948 2093 2093 12460 12460 6619 6619 305692 305692 Prov for Doubtful Accts 1728228 1728228 Consulting Fees 791659 791659 2834 2834 23983833 22825117 1158716 0 2442293 1908504 2218275 2344589 135 135 251335 223094 4912038 4476322 2177023 1075584 4787074 5642140 6964097 6717724 X -2052059 -2241402 -2052059 -2241402 4912038 4476322 -189343 0 X 0 1 1 X 0 X 33650 33650 6520564 19001080 32691710 40227440 41463061 139903855 6520564 19001080 32691710 40227440 41496711 139937505 0 34794 34794 34794 34794 139902711 6520564 19001080 32691710 40227440 41496711 139937505 0.99980 0.99920 0.00000 X 0 LT Advances - AFC 5502808 LT Receivables/Payable-CMC 139332 5642140 AFC 12/31/2010 Consolidated Financial Statements do not contain a FIN48 Statement. 0 0 0 0 0 0 0 0 0 Julio Perez Fontan MD 0 480000 0 0 0 0 0 0 0 0 0 480000 0 0 Desmond Henry MD 162863 0 0 0 0 0 0 0 0 0 162863 0 0 0 Jerry Lee 0 172590 0 28500 0 20917 0 10674 0 4324 0 237005 0 0 Robert Foglia MD 0 694000 0 0 0 0 0 0 0 0 0 694000 0 0 Christopher Meggyesy MD 472307 0 0 0 56015 0 0 0 2711 0 531033 0 0 0 Cynthia Gonzales MD 474730 0 0 0 30365 0 0 0 288 0 505383 0 0 0 Vera Barbosa MD 468824 0 0 0 33443 0 0 0 6195 0 508462 0 0 0 Debra Tyler MD 474009 0 0 0 25573 0 0 0 1009 0 500591 0 0 0 Stephen Hoang MD 472120 0 0 0 23755 0 0 0 2898 0 498773 0 0 0 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 Anesthesiologists For Children Board of Directors. Form 990, Part VI, Section A, line 7b Sole member reserve powers are specified in Anesthesiologists For Children bylaws and represent those actions by the organization which require sole member approval to be effective. These powers generally encompass specific 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 its treasurer at either a scheduled meeting or sent electronically for board review before being filed with the IRS. Form 990, Part VI, Section B, line 12c Directors execute a conflict of interest disclosure statement every year at the annual meeting of the 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 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 Governing documents, conflict of interest policy, and financial statements are made available to the public upon request. Form 990, Part VII, Section A, Column B The following Vice President worked 50 hours per week for a related organization: Julio Perez Fontan, M.D. The following Directors worked 40 hours per week for a related organization: Jerry Lee Stephanie K Smith, JD Robert Foglia, M.D. Thomas Zellers, M.D. Children's Medical Center of Dallas 1935 Medical District Drive Dallas TX 75235 750800628 HOSPITAL TX 501 (c)(3) Line 3 Children's Health Svcs of Texas 0 Dallas Physician Medical Services 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 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 Children's Health Services of Texas 1935 Medical District Drive Dallas TX 75235 752062019 Management company TX 501 (c)(3) Line 11a, I N/A 0 Children's Med Ctr Foundation 1935 Medical District Drive Dallas TX 75235 752062015 Foundation TX 501 (c)(3) Line 11a, I Children's Health Svcs of Texas 0 Southwestern Medical District 5323 Harry Hines Blvd Dallas TX 75390 204101612 Medical District TX 501 (c)(3) Line 11a, I N/A 0 Women's Auxiliary to CMC 12720 Hillcrest Road Dallas TX 75230 752485538 Women's Auxiliary TX 501 (c)(3) Line 9 N/A 0 Children's Insurance Company 76 St Paul Street Suite 500 Burlington VT 05401 030328102 Insurance TX N/A C Alternative Care Systems 1935 Medical District Drive Dallas TX 75235 752244475 Other Medical Svcs TX N/A C 0 0 0 0 1 0 0 0 0 0 1 0 1 1 0 1 0 1