Pediatric Specialty Group Inc: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- Pediatric Specialty Group Inc (EIN 46-3756071)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-15
- IRS object ID
- 202103199349316195
- Schema version
- 2020v4.0
- 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) |
|---|---|---|
| Return | 2021-11-15T14:02:51-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 East Las Olas Blvd Suite 1100 | AddressLine1Txt |
| City | Fort Lauderdale | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 333014230 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463756071 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pediatric Specialty Group Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PEDI | BusinessNameControlTxt |
| Phone | 3056666511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3100 SW 62ND AVENUE | AddressLine1Txt |
| City | MIAMI | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33155 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dawn Javersack | PersonNm |
| Person Title | SVP and CFO | PersonTitleTxt |
| Signature | 2021-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Dawn | PersonFirstNm |
| Person Last | Javersack | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brittney Kocaj | PreparerPersonNm |
| PTIN | P01320603 | PTIN |
| Phone | 9542028600 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Nicklaus Childrens Pediatric Specialists | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Matthew A Love | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3100 SW 62ND AVENUE | AddressLine1Txt |
| City | MIAMI | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33155 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $58,299,031 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.nicklauschildrens.org/about-us/pediatric-specialists | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2012 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | Pediatric Specialty Group, Inc. (d/b/a Nicklaus Children's Pediatric Specialists ("NCPS")) IS A PHYSICIAN-DIRECTED, MULTI-SPECIALTY PEDIATRIC GROUP WITH A REGIONAL, NATIONAL, AND INTERNATIONAL PRESENCE IN PROVIDING PEDIATRIC-CENTRIC CARE THROUGH A COLLABORATIVE TEAM APPROACH, EXCELLENCE IN CLINICAL CARE, EDUCATION, AND RESEARCH. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 533 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,050,346 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,658,824 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $71,457,446 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $56,633,609 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $25,365 | PYOtherRevenueAmt |
| CY Other Revenue | $6,598 | CYOtherRevenueAmt |
| PY Total Revenue | $72,533,157 | PYTotalRevenueAmt |
| CY Total Revenue | $58,299,031 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $74,863,270 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $63,702,540 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $31,402,970 | PYOtherExpensesAmt |
| CY Other Expenses | $27,193,752 | CYOtherExpensesAmt |
| PY Total Expenses | $106,266,240 | PYTotalExpensesAmt |
| CY Total Expenses | $90,896,292 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$33,733,083 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$32,597,261 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,821,169 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,821,169 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $0 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Pediatric Specialty Group, Inc. (d/b/a Nicklaus Children's Pediatric Specialists ("NCPS")) IS A PHYSICIAN-DIRECTED, MULTI-SPECIALTY PEDIATRIC GROUP WITH A REGIONAL, NATIONAL, AND INTERNATIONAL PRESENCE IN PROVIDING PEDIATRIC-CENTRIC CARE THROUGH A COLLABORATIVE TEAM APPROACH, EXCELLENCE IN CLINICAL CARE, EDUCATION, AND RESEARCH. (Continued on Schedule O) | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $72,724,089 | ExpenseAmt |
| Revenue | $56,640,207 | RevenueAmt |
| Desc | IN 2020, NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS EMPLOYED 251 PROVIDERS TO SUPPORT THE ONGOING FUNCTIONS OF NICKLAUS CHILDREN'S HEALTH SYSTEM AND NICKLAUS CHILDREN'S HOSPITAL IN THE FOLLOWING SUB-SPECIALTIES: ADOLESCENT MEDICINE, ALLERGY/IMMUNOLOGY, CARDIOLOGY, CARDIOVASCULAR SURGERY, CLINICAL GENETICS AND METABOLISM, CRITICAL CARE MEDICINE, EMERGENCY MEDICINE, ENDOCRINOLOGY, GASTROENTEROLOGY, GENERAL PEDIATRICS, INFECTIOUS DISEASES, MATERNAL FETAL, NEPHROLOGY, NEUROPSYCHOLOGY, NEUROSURGERY, NUTRITION, OPHTHALMOLOGY, ORTHOPEDICS, OTOLARYNGOLOGY, PLASTIC AND RECONSTRUCTIVE SURGERY, PSYCHIATRY,PHYSIATRY AND PSYCHOLOGY, RADIOLOGY/SEDATION AND RHEUMATOLOGY. (CONTINUED ON SCHEDULE O) | Desc |
| Total Program Service Expenses | $72,724,089 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | Yes (true) | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 34 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 533 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Laurie Levine | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3056666511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5301 Blue Lagoon Drive | AddressLine1Txt |
| City | MIAMI | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33126 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Alex Soto | |||||||||
| Chairman & Director | 0.1 | 1.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Chad A Perlyn | |||||||||
| Director & Interim President & Sec (as of Aug 2020) | 40.0 | 0 | Yes (X) | Yes (X) | $1,023,763 | $0 | $53,107 | ||
| Craig J Spurdle | |||||||||
| Director & Vice Chair | 40.0 | 0 | Yes (X) | Yes (X) | $1,021,470 | $0 | $8,813 | ||
| Ramesh C Sachdeva | |||||||||
| Director, President & Sec untilAug 2020 | 0.1 | 40.0 | Yes (X) | Yes (X) | $0 | $585,014 | $91,426 | ||
| Alisa Muniz Crim | |||||||||
| Director | 40.0 | 0 | Yes (X) | $408,590 | $0 | $14,412 | |||
| Anthony F Rossi | |||||||||
| Director - Partial Yr. | 40.0 | 0 | Yes (X) | $471,060 | $0 | $21,284 | |||
| Barbara Pena MD | |||||||||
| Director/Attending Physician | 40.0 | 0 | Yes (X) | $237,944 | $0 | $25,157 | |||
| David Drossner MD | |||||||||
| Director/Attending Physician | 40.0 | 0 | Yes (X) | $527,986 | $0 | $26,299 | |||
| DR Sara Rivero-Conil | |||||||||
| Director/Mgr Clinical Psych | 40.0 | 0 | Yes (X) | $154,592 | $0 | $14,250 | |||
| Jaret Davis | |||||||||
| Director | 0.1 | 1.5 | Yes (X) | $0 | $0 | $0 | |||
| Marcelo Laufer MD | |||||||||
| Director | 0.1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Maria Ramon-Coton MD | |||||||||
| Director/Chief Urgent Care | 40.0 | 0 | Yes (X) | $278,396 | $0 | $20,143 | |||
| Mario Murgado | |||||||||
| Director | 0.1 | 1.5 | Yes (X) | $0 | $0 | $0 | |||
| Matthew Love | |||||||||
| Director- NCHS Pres/CEO | 0.1 | 40.5 | Yes (X) | $0 | $906,180 | $204,098 | |||
| Miladys Palau-Collazo MD | |||||||||
| Attending Physician & Partial Year Director | 40.0 | 0 | Yes (X) | $113,104 | $0 | $17,122 | |||
| Nicole Christin MD | |||||||||
| Director/Attending Physician | 40.0 | 0 | Yes (X) | $267,723 | $0 | $9,297 | |||
| Ricky Patel ESQ | |||||||||
| Director | 0.1 | 0.6 | Yes (X) | $0 | $0 | $0 | |||
| Sandeep Dave | |||||||||
| Director | 40.0 | 0 | Yes (X) | $796,765 | $0 | $11,094 | |||
| Stephen George | |||||||||
| Director | 40.0 | 0 | Yes (X) | $984,360 | $0 | $20,072 | |||
| Toba N Niazi | |||||||||
| Director | 40.0 | 0 | Yes (X) | $1,039,000 | $0 | $9,616 | |||
| Dawn E Javersack | |||||||||
| SVP/CFO Health System | 0.1 | 40.4 | Yes (X) | $0 | $423,463 | $65,573 | |||
| Jodi Laurence | |||||||||
| SVP and General Counsel | 0.1 | 40.4 | Yes (X) | $0 | $382,573 | $80,301 | |||
| Marcos A Mestre | |||||||||
| Senior Medical Director | 1.0 | 40.0 | Yes (X) | $0 | $305,901 | $27,668 | |||
| Maria Jayoussi | |||||||||
| NCPS CFO | 40.0 | 0 | Yes (X) | $143,631 | $0 | $12,439 | |||
| Brian Ho | |||||||||
| Physician | 40.0 | 0 | $714,766 | $0 | $5,975 | Yes (X) | |||
| John Ragheb | |||||||||
| Chief Neurosurgery | 40.0 | 0 | $1,035,048 | $0 | $29,283 | Yes (X) | |||
| Redmond P Burke | |||||||||
| Chief Cardiovascular Surg | 40.0 | 0 | $1,955,063 | $0 | $19,693 | Yes (X) | |||
| Shelly Wang | |||||||||
| Attending Physician | 40.0 | 0 | $636,508 | $0 | $18,126 | Yes (X) | |||
| Thomas J Errico | |||||||||
| Orthopedic Attending Physician | 40.0 | 0 | $858,617 | $0 | $13,834 | Yes (X) | |||
| Narendra M Kini | |||||||||
| CEO/Director (Former) | 0.0 | 0.0 | $0 | $1,178,819 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $12,668,388 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,781,950 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $819,081 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 224 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ALLSCRIPTS HEALTHCARE LLC | |||||
| 24630 NETWORK PLACE | CHICAGO | IL | 606731246 | Maintenance Service /IT | $1,081,685 |
| SULLIVAN COTTER AND ASSOCIATES | |||||
| 62272 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 606930622 | Consulting - Compensation programs | $243,752 |
| PRICEWATERHOUSE COOPERS LLP | |||||
| 3109 W DR MARTIN L K JR BLV | TAMPA | FL | 33607 | PROFESSIONAL SERVICES | $108,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $201,869 | RelatedOrganizationsAmt |
| Government Grants | $1,456,955 | GovernmentGrantsAmt |
| Total Contributions | $1,658,824 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 561110 | $55,994,788 | $55,994,788 |
| M.U INCENTIVE PAYMENTS | 900099 | $638,821 | $638,821 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $56,633,609 | TotalProgramServiceRevenueAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Exclusion | $0 | ExclusionAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $6,598 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,598 | RelatedOrExemptFuncIncomeAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,598 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $58,299,031 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $56,640,207 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,548,216 | TotalAmt |
| Program Services | $4,438,573 | ProgramServicesAmt |
| Management And General | $1,109,643 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,714,140 | TotalAmt |
| Program Services | $40,571,312 | ProgramServicesAmt |
| Management And General | $10,142,828 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $418,700 | TotalAmt |
| Program Services | $325,562 | ProgramServicesAmt |
| Management And General | $93,138 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,054,134 | TotalAmt |
| Program Services | $3,242,719 | ProgramServicesAmt |
| Management And General | $811,415 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,967,350 | TotalAmt |
| Program Services | $2,383,866 | ProgramServicesAmt |
| Management And General | $583,484 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,546,604 | TotalAmt |
| Program Services | $14,837,283 | ProgramServicesAmt |
| Management And General | $3,709,321 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,613 | TotalAmt |
| Program Services | $18,890 | ProgramServicesAmt |
| Management And General | $4,723 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $441,002 | TotalAmt |
| Program Services | $352,802 | ProgramServicesAmt |
| Management And General | $88,200 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,574 | TotalAmt |
| Program Services | $6,859 | ProgramServicesAmt |
| Management And General | $1,715 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,189,447 | TotalAmt |
| Program Services | $2,551,558 | ProgramServicesAmt |
| Management And General | $637,889 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,001 | TotalAmt |
| Program Services | $141,601 | ProgramServicesAmt |
| Management And General | $35,400 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,617,828 | TotalAmt |
| Program Services | $2,894,262 | ProgramServicesAmt |
| Management And General | $723,566 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $775,190 | $620,152 | $155,038 |
| Dues & Subscriptions | $349,894 | $279,915 | $69,979 |
| Course Expenses | $53,229 | $42,583 | $10,646 |
| Recruitment Expenses | $12,389 | $9,911 | $2,478 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$1,019 | TotalAmt |
| Program Services | $6,241 | ProgramServicesAmt |
| Management And General | -$7,260 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,896,292 | TotalAmt |
| Program Services | $72,724,089 | ProgramServicesAmt |
| Management And General | $18,172,203 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,130 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,437,763 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,769 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,378,507 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,821,169 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,907,194 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,913,975 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,821,169 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,821,169 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$32,597,261 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $0 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $32,597,261 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc |
|---|
| Intercompany payables |
| Current portion of liability for self-insurance |
| Operating Lease Liabilities |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $0 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | PEDIATRIC SPECIALISTS OF AMERICA'S (PSA) FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF NICKLAUS CHILDREN'S HEALTH SYSTEM (NCHS), A RELATED ORGANIZATION. NCHS' ASC 740 FOOTNOTE FOR THE YEAR ENDED DECEMBER 31, 2020, READS AS FOLLOWS: "THE SYSTEM AND CERTAIN OF ITS AFFILIATED ORGANIZATIONS QUALIFY AS TAX-EXEMPT, NONPROFIT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). THE HOSPITAL, NCPS, THE FOUNDATION, AND THE RESEARCH INSTITUTE ARE EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE AS DESCRIBED IN SECTION 501(C)(3). THESE TAX-EXEMPT ENTITIES HAD NO TAX PROVISION FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019. THE CAPTIVE INSURANCE COMPANY IS NOT SUBJECT TO INCOME TAXES, AS NO INCOME TAXES ARE LEVIED IN THE CAYMAN ISLANDS. THE SYSTEM BELIEVES THERE IS NO UNCERTAIN TAX LIABILITY WHICH SHOULD BE RECORDED AS OF DECEMBER 31, 2020 AND 2019. THE HEALTH PLAN IS A LIMITED LIABILITY COMPANY WHICH IS TAXED AS A PARTNERSHIP AND THEREFORE IS GENERALLY NOT A TAXPAYING ENTITY FOR FEDERAL OR STATE INCOME TAX PURPOSES. IN LIEU OF CORPORATE INCOME TAXES, THE MEMBERS ARE TAXED ON THE HEALTH PLAN'S TAXABLE INCOME. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THESE FINANCIAL STATEMENTS." | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (24 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Narendra M Kini | ||||||||||||||
| CEO/Director (Former) | $0 | $0 | $0 | $0 | $0 | $1,178,819 | $0 | $0 | $0 | $0 | $0 | $1,178,819 | $0 | $0 |
| Chad A Perlyn | ||||||||||||||
| Director & Interim President & Sec (as of Aug 2020) | $1,022,161 | $0 | $0 | $0 | $1,602 | $0 | $29,769 | $0 | $23,338 | $0 | $1,076,871 | $0 | $0 | $0 |
| Ramesh C Sachdeva | ||||||||||||||
| Director, President & Sec untilAug 2020 | $0 | $578,585 | $0 | $0 | $0 | $6,429 | $0 | $78,248 | $0 | $13,178 | $0 | $676,440 | $0 | $0 |
| Craig J Spurdle | ||||||||||||||
| Director & Vice Chair | $1,001,280 | $0 | $0 | $0 | $20,190 | $0 | $8,550 | $0 | $263 | $0 | $1,030,283 | $0 | $0 | $0 |
| Nicole Christin MD | ||||||||||||||
| Director/Attending Physician | $267,453 | $0 | $0 | $0 | $270 | $0 | $2,373 | $0 | $6,924 | $0 | $277,020 | $0 | $0 | $0 |
| David Drossner MD | ||||||||||||||
| Director/Attending Physician | $527,686 | $0 | $0 | $0 | $300 | $0 | $3,305 | $0 | $22,994 | $0 | $554,285 | $0 | $0 | $0 |
| Stephen George | ||||||||||||||
| Director | $964,591 | $0 | $0 | $0 | $19,770 | $0 | $7,277 | $0 | $12,795 | $0 | $1,004,433 | $0 | $0 | $0 |
| Matthew Love | ||||||||||||||
| Director- NCHS Pres/CEO | $0 | $880,893 | $0 | $0 | $0 | $25,287 | $0 | $179,228 | $0 | $24,870 | $0 | $1,110,278 | $0 | $0 |
| Alisa Muniz Crim | ||||||||||||||
| Director | $408,140 | $0 | $0 | $0 | $450 | $0 | $3,745 | $0 | $10,667 | $0 | $423,003 | $0 | $0 | $0 |
| Toba N Niazi | ||||||||||||||
| Director | $1,038,700 | $0 | $0 | $0 | $300 | $0 | $7,043 | $0 | $2,573 | $0 | $1,048,616 | $0 | $0 | $0 |
| Barbara Pena MD | ||||||||||||||
| Director/Attending Physician | $237,254 | $0 | $0 | $0 | $690 | $0 | $2,163 | $0 | $22,994 | $0 | $263,101 | $0 | $0 | $0 |
| Maria Ramon-Coton MD | ||||||||||||||
| Director/Chief Urgent Care | $276,416 | $0 | $0 | $0 | $1,980 | $0 | $2,585 | $0 | $17,558 | $0 | $298,539 | $0 | $0 | $0 |
| DR Sara Rivero-Conil | ||||||||||||||
| Director/Mgr Clinical Psych | $154,317 | $0 | $0 | $0 | $275 | $0 | $1,105 | $0 | $13,145 | $0 | $168,842 | $0 | $0 | $0 |
| Anthony F Rossi | ||||||||||||||
| Director - Partial Yr. | $469,080 | $0 | $0 | $0 | $1,980 | $0 | $4,398 | $0 | $16,886 | $0 | $492,344 | $0 | $0 | $0 |
| Sandeep Dave | ||||||||||||||
| Director | $776,815 | $0 | $0 | $0 | $19,950 | $0 | $4,273 | $0 | $6,821 | $0 | $807,859 | $0 | $0 | $0 |
| Dawn E Javersack | ||||||||||||||
| SVP/CFO Health System | $0 | $418,147 | $0 | $0 | $0 | $5,316 | $0 | $55,389 | $0 | $10,185 | $0 | $489,036 | $0 | $0 |
| Maria Jayoussi | ||||||||||||||
| NCPS CFO | $136,898 | $0 | $0 | $0 | $6,733 | $0 | $8,000 | $0 | $4,439 | $0 | $156,069 | $0 | $0 | $0 |
| Jodi Laurence | ||||||||||||||
| SVP and General Counsel | $0 | $376,723 | $0 | $0 | $0 | $5,850 | $0 | $62,471 | $0 | $17,830 | $0 | $462,873 | $0 | $0 |
| Marcos A Mestre | ||||||||||||||
| Senior Medical Director | $0 | $305,268 | $0 | $0 | $0 | $632 | $0 | $4,677 | $0 | $22,991 | $0 | $333,569 | $0 | $0 |
| Redmond P Burke | ||||||||||||||
| Chief Cardiovascular Surg | $1,953,083 | $0 | $0 | $0 | $1,980 | $0 | $2,808 | $0 | $16,886 | $0 | $1,974,756 | $0 | $0 | $0 |
| Thomas J Errico | ||||||||||||||
| Orthopedic Attending Physician | $856,316 | $0 | $0 | $0 | $2,301 | $0 | $8,538 | $0 | $5,295 | $0 | $872,451 | $0 | $0 | $0 |
| Brian Ho | ||||||||||||||
| Physician | $714,496 | $0 | $0 | $0 | $270 | $0 | $0 | $0 | $5,975 | $0 | $720,740 | $0 | $0 | $0 |
| John Ragheb | ||||||||||||||
| Chief Neurosurgery | $1,013,568 | $0 | $0 | $0 | $21,480 | $0 | $6,958 | $0 | $22,325 | $0 | $1,064,330 | $0 | $0 | $0 |
| Shelly Wang | ||||||||||||||
| Attending Physician | $636,268 | $0 | $0 | $0 | $240 | $0 | $5,331 | $0 | $12,795 | $0 | $654,635 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 METHODS USED BY RELATED ORGANIZATION TO ESTABLISH CEO'S COMPENSATION | The organization relied on the methods of establishing compensation for the organization's CEO employed by NICKLAUS CHILDREN'S HEALTH SYSTEM. (EIN: 45-3481327). NICKLAUS CHILDREN'S HEALTH SYSTEM uses the following methods to establish such compensation: - Compensation Committee - Independent Compensation Consultant - Compensation survey or study - Approval by the Board or Compensation Committee. |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE YEAR - NARENDRA M KINI - 1,178,819.20 |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | THE FOLLOWING CONTRIBUTIONS WERE MADE TO A SECTION 457(F) PLAN DURING THE YEAR - MARIA JAYOUSSI 8,000.10 CHAD A PERLYN 25,000.00 MARCOS A MESTRE 4,000.00 MATTHEW LOVE 174,520.32 DAWN E JAVERSACK 55,388.58 RAMESH C. SACHDEVA 73,503.04 JODI LAURENCE 59,585.76 |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail (3 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| NICKLAUS CHILDREN'S HEALTH SYSTEM | |||||||||
| Cash | 2020-12-31 | $1,020 | BV | 453481327 | 3100 SW 62ND AVENUE | Miami | FL | 33155 | 501(C)(3) |
| NICKLAUS CHILDREN'S HEALTH SYSTEM | |||||||||
| Accounts and Others Receivables | 2020-12-31 | $7,416,744 | BV | 453481327 | 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 501(C)(3) |
| NICKLAUS CHILDREN'S HEALTH SYSTEM | |||||||||
| Other Assets | 2020-12-31 | $1,801,800 | BV | 453481327 | 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 501(C)(3) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | Yes (true) | DirectorOfSuccessorInd |
| Employee Of Successor | Yes (true) | EmployeeOfSuccessorInd |
| Owner Of Successor | false | OwnerOfSuccessorInd |
| Receive Compensation | false | ReceiveCompensationInd |
| Assets Distributed | Yes (true) | AssetsDistributedInd |
| Required To Notify AG | Yes (true) | RequiredToNotifyAGInd |
| Attorney General Notified | Yes (true) | AttorneyGeneralNotifiedInd |
| Liabilities Paid | false | LiabilitiesPaidInd |
| Bonds Outstanding | false | BondsOutstandingInd |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule N, Part I, Line 1, Column (f) NAME & ADDRESS OF RECEIPENT - ITEMS 1 - 4 | NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC- BECAME A DISREGARDED ENTITY OF NICKLAUS CHILDREN'S HEALTH SYSTEM, INC. SEE FORM 990, PART IV, LINE 4 AND ATTACHED FLORIDA NOTICE OF CONVERSION TO LIMITED LIABILITY COMPANY CERTIFICATE |
| Schedule N, Part I, Line 5 Liabilities | THE FILING ORGANIZATION BECAME A DISREGARDED ENTITY OF NICKLAUS CHILDREN'S HEALTH SYSTEM, INC. AS A RESULT, THE QUESTION REGARDING THE LIQUIDATION OF LIABILITIES IS NOT APPLICABLE. |
| Schedule N, Part I, Line 2a Interested person is a director or trustee of successor org. | ALL BOARD MEMBERS OF PEDIATRIC SPECIALTY GROUP REMAINED AS REPORTED AFTER CONVERSION TO A DISREGARDED LLC. |
| Schedule N, Part I, Line 2b Interested person is an employee or ind. contractor of successor org. | ALL OFFICERS OF THE PEDIATRIC SPECIALTY GROUP REMAINED AS REPORTED AFTER CONVERSION TO A DISREGARDED LLC. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 1 ORGANIZATION'S MISSION | THE CORPORATION IS ORGANIZED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES WITH THE MISSION OF ENHANCING WELLNESS IN PEDIATRIC PATIENTS THROUGH THE OPTIMAL DELIVERY OF PEDIATRIC MULTI-SPECIALTY CARE REGARDLESS OF THE ABILITY TO PAY, COVERING THE UNDERSERVED AND UNINSURED. |
| Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION | OVERALL, THE 2020 PROGRAM ACCOMPLISHMENTS OF NCPS PHYSICIANS INCLUDE BEING INTERNATIONALLY RECOGNIZED FOR CARE EXCELLENCE BY BEING RANKED ATHE NATION'S BEST IN 5 OF THE ABOVE LISTED SPECIALTIES SURVEYED BY U.S. NEWS AND WORLD REPORT IN ITS 2020-20201 LISTING OF " BEST CHILDREN'S HOSPITALS." (RESULTS WERE RELEASED IN 2020.) NICKLAUS CHILDREN'S HOSPITAL HAD MORE RANKED PEDIATRIC PROGRAMS THAN ANY OTHER HOSPITAL IN SOUTH FLORIDA. CATEGORIES IN WHICH THE NCPS SPECIALTIES WERE RANKED IN 2020 INCLUDE CARDIOLOGY AND HEART SURGERY, DIABETES AND ENDOCRINOLOGY, NEONATOLOGY. NEUROLOGY & NEUROSURGERY, ORTHOPEDICS,AND PULMONOLOGY. COLLECTIVELY THE NCPS SPECIALISTS GENERATED MORE THAN 443,914 ENCOUNTERS IN 2020 SERVING PREDOMINATELY POOR AND UNDERSERVED COMMUNITIES IN ORDER TO IMPROVE POPULATION HEALTH AND WELL-BEING FOR THE CHILDREN THAT WE SERVE. EXPANSION OF SERVICE AREAS INCLUDED MIAMI DADE COUNTY, BROWARD COUNTY, PALM BEACH COUNTY AND COLLIER COUNTY. |
| Form 990, Part VI, Line 15a DETERMINING COMPENSATION FOR CEO AND EXECUTIVE DIRECTOR | THE CEO IS PAID BY NICKLAUS CHILDREN'S HEALTH SYSTEM, INC. A RELATED ORGANIZATION, THEREFORE THIS HAS BEEN ANSWERED NO IN ACCORDANCE WITH THE INSTRUCTIONS. THE ORGANIZATION AND COMPENSATION COMMITTEE OF NICKLAUS CHILDREN'S HEALTH SYSTEM'S BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD. PERSONS WITH A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE ARE NOT INVOLVED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION AGREEMENT ARE CONTEMPORANEOUS DOCUMENTED. THIS PROCESS IS COMPLETED IN THE FIRST QUARTER EACH YEAR. |
| Form 990, Part VI, Line 15b Determining compensation for other officers or key employees | Nicklaus Children's Pediatric Specialists RELIED ON THE METHODS OF ESTABLISHING COMPENSATION USED BY NICKLAUS CHILDREN'S HEALTH SYSTEM. THE ORGANIZATION AND COMPENSATION COMMITTEE OF NICKALUS CHILDREN'S HEALTH SYSTEM, INC.'S BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD. PERSONS WITH A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE ARE INVOLVED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION AGREEMENT ARE CONTEMPORANEOUS DOCUMENTED. THIS PROCESS IS COMPLETED IN THE FIRST QUARTER EACH YEAR. |
| Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS. | Mario Murgado, MATTHEW A. LOVE, Jodi Laurence, and Dawn Javersack have a business relationship due to serving on the board of directors of Children's Health Ventures. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | There shall be an Executive Committee of the Board of Directors composed of three (3) Directors elected by the Board of Directors, one of whom must be the Chair of the Board and one of whom must be a physician employed by the Corporation. No non-Director members shall serve on the Executive Committee. A majority of the members of the Executive Committee shall constitute a quorum for the transaction of business and for taking any action. The Executive Committee shall have and exercise the authority designated to it by the Board of Directors in the management of the Corporation. The Executive Committee shall report to the Board of Directors any action taken by the Executive Committee at the next meeting of the Board of Directors. Members of the Executive Committee may be removed by the Board at any regular or special meeting of the Board of Directors. |
| Form 990, Part VI, Line 4 Significant changes to organizational documents | NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS WAS CONVERTED TO A DISREGARDED ENTITY OF MIAMI CHILDREN'S HEALTH SYSTEM AS OF 12/31/2020. SEE ATTACHED ARTICLES OF CONVERSION AND ARTICLES OF ORGANIZATION. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | THE ORGANIZATION'S SOLE MEMBER IS NICKLAUS CHILDREN'S HEALTH SYSTEM, INC. THE SOLE MEMBER HAS THE AUTHORITY TO ELECT MEMBERS TO THE BOARD OF DIRECTORS AND APPROVE DECISIONS OF THE BOARD. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | THE ELECTED MEMBERS OF THE BOARD SHALL BE ELECTED BY NICKLAUS CHILDREN'S HEALTH SYSTEM (THE SOLE MEMBER), AFTER TAKING INTO CONSIDERATION ANY RECOMMENDATIONS OF THE BOARD. THE NUMBER OF DIRECTORS OF THE CORPORATION SHALL BE ESTABLISHED BY RESOLUTION OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER; PROVIDED THAT THERE SHALL BE NO FEWER THAN 6 AND NO MORE THAN 15 DIRECTORS. ANY DIRECTOR MAY BE REMOVED FROM OFFICE BY ACTION OF THE SOLE MEMBER OR THE ELECTED MEMBERS OF THE BOARD SO PERMITTED TO VOTE, FOR ANY CAUSE OR REASON DEEMED SUFFICIENT BY THE MEMBER OR THE ELECTED MEMBERS OF THE BOARD SO PERMITTED TO VOTE. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | The Board shall not take any action with respect to the following without the approval of Nicklaus Children's Health System (the sole Member): a) Modify the mission, purpose or scope of the CORPORATION, or materially change the location, size or scope of services, programs, operations or educational or medical school affiliations of the CORPORATION or related agreements; b) Create any entity in which the CORPORATION is the sole member or sole shareholder, or any entity in which the CORPORATION has a direct or indirect oversight role, which may include not-for-profit, for profit, limited liability companies, or any other legal entity; c) Sell, lease, purchase, create, dissolve, convey, mortgage, grant a security interest or otherwise dispose of any affiliated, controlled, or joint venture entity, any real or personal property or other assets (or any interest in any of the foregoing), or incur debt for money borrowed or guarantee the debt of another, not in the ordinary course of business; d) Approve annual operating or capital budgets, strategic and long-range plans, major fund-raising programs, physician compensation or other agreements, managed care contracts or other financial commitments or material deviations from such budgets, plans, agreements or commitments; and e) Approve financial, accounting, human resource, employee benefit, compliance policies or procedures, medical staff bylaws (including amendments) or other policies and procedures, or the appointment or engagement of auditors, legal counsel and consultants, which are in any way contrary to the policies and procedures adopted from time to time by the Member. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE FOLLOWING DESCRIBES THE PROCESS FOR PROVIDING THE BOARD OF DIRECTORS WITH A COPY OF THE FORM 990 AND REVIEWING IT: 1. THE DRAFT TAX FORM 990 WILL BE EMAILED TO THE AUDIT AND COMPLIANCE COMMITTEE CHAIR FOR REVIEW AND COMMENTS PRIOR TO FILING. 2. THE PAID TAX PREPARER WILL PRESENT A SUMMARY OF THE INFORMATION TO THE FINANCE COMMITTEE OF THE BOARD. 3. QUESTIONS WILL BE ANSWERED AND IF NECESSARY, TAX FORMS WILL BE ADJUSTED. THE CHAIR WILL APPROVE THE FORM 990. 4. THE FINAL FORM 990 WILL BE POSTED ON THE BOARD WEB PORTAL PRIOR TO FILING. |
| Form 990, Part VI, Line 12c Conflict of interest policy | ALL Nicklaus Children's Pediatric Specialists ("NCPS") EMPLOYEES ARE INFORMED UPON HIRE, AND ON AN ANNUAL BASIS THEREAFTER, THAT THEY HAVE AN AFFIRMATIVE DUTY TO DISCLOSE ANY ACTUAL, POTENTIAL OR PERCEIVED CONFLICT OF INTEREST. THEY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM UPON HIRE, ANNUALLY AND WHENEVER A CHANGE IN CIRCUMSTANCES WARRANTS. CONFLICT OF INTEREST DISCLOSURE FORMS ARE FORWARDED TO THE COMPLIANCE DEPARTMENT BY THE TALENT MANAGEMENT AND EFFECTIVENESS DEPARTMENT. THESE FORMS ARE INITIALLY REVIEWED BY COMPLIANCE DEPARTMENT STAFF. WHEN DEEMED NECESSARY, THE COMPLIANCE DEPARTMENT COLLABORATES WITH THE LEGAL DEPARTMENT. CONFLICTS OF INTEREST THAT NECESSITATE BOARD AWARENESS AND ACTION ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD FOR RESOLUTION AND IMPOSITION OF SANCTIONS, IF WARRANTED. ANY POTENTIALLY CONFLICTED BOARD MEMBERS ARE RECUSED FROM BOARD DELIBERATIONS AND VOTING ON ITEMS IN WHICH THEY HAVE A POTENTIAL CONFLICT. IN ADDITION, ON AN ANNUAL BASIS, BOARD MEMBERS, PRINCIPAL OFFICERS, AND BOARD-DELEGATED COMMITTEE MEMBERS SIGN A STATEMENT WHICH AFFIRMS THAT EACH INDIVIDUAL: (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY, AND (D) UNDERSTANDS THAT NCPS IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF IT'S TAX-EXEMPT PURPOSES. A PROCESS IS IN PLACE FOR MANAGING SITUATIONS IN WHICH IT IS DISCOVERED THAT AN INDIVIDUAL WHO IS COVERED BY NCPS'S CONFLICT OF INTEREST POLICY FAILED TO PROPERLY DISCLOSE A POTENTIAL CONFLICT OF INTEREST. |
| Form 990, Part VI, Line 19 Required documents available to the public | FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL, REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
| Form 990, Part IX, Line 11g Other Fees | LABORATORY SERVICES - Total Expense: -4980, Program Service Expense: -3984, Management and General Expenses: -996, Fundraising Expenses: ; FREIGHT - Total Expense: 250, Program Service Expense: 200, Management and General Expenses: 50, Fundraising Expenses: ; INSPECTIONS - Total Expense: 256, Program Service Expense: 205, Management and General Expenses: 51, Fundraising Expenses: ; FREIGHT - DOMESTIC - Total Expense: 503, Program Service Expense: 402, Management and General Expenses: 101, Fundraising Expenses: ; MISCELLANEOUS EXPENSES - Total Expense: 502, Program Service Expense: 402, Management and General Expenses: 100, Fundraising Expenses: ; STORAGE FEES - Total Expense: 2306, Program Service Expense: 1845, Management and General Expenses: 461, Fundraising Expenses: ; LICENSES AND OTHER TAXES - Total Expense: 5748, Program Service Expense: 4598, Management and General Expenses: 1150, Fundraising Expenses: ; COLLECTION SERVICES - Total Expense: 41395, Program Service Expense: 33116, Management and General Expenses: 8279, Fundraising Expenses: ; CONSULTANTS - Total Expense: 242547, Program Service Expense: 194038, Management and General Expenses: 48509, Fundraising Expenses: ; MEDICAL FEES - Total Expense: 502920, Program Service Expense: 402336, Management and General Expenses: 100584, Fundraising Expenses: ; MANAGEMENT FEE EXPENSE - Total Expense: 1005903, Program Service Expense: 804722, Management and General Expenses: 201181, Fundraising Expenses: ; CODING SERVICES - Total Expense: 2910619, Program Service Expense: 2328495, Management and General Expenses: 582124, Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 3324891, Program Service Expense: 2659913, Management and General Expenses: 664978, Fundraising Expenses: ; SUPPORT FEE EXPENSE - Total Expense: 10513744, Program Service Expense: 8410995, Management and General Expenses: 2102749, Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Equity Transfer with affiliated entity - conversion to disregarded LLC - 32597261; |
| FORM 990, PART V, LINES 1A AND 2A FORMS W-2 AND 1099 FILED | MIAMI CHILDREN'S HEALTH SYSTEM, INC. (EIN 45-3481327) FILES IN ITS NAME ALL FORMS W-2 AND 1099 FOR THE FILING ORGANIZATION, PEDIATRIC SPECIALTY GROUP, INC. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Business Name Line2DisregardedEntityName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| VARIETY CHILDREN'S HOSPITAL | |||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 590638499 | HOSPITAL | FL | 501(c)(3) | 3 | MCHS | false | |
| MIAMI CHILDREN'S HOSPITAL WORKER'S COMPENSATION TRUST | |||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 597021572 | WC CLAIMS | FL | 4947 (a)(1) | VCH | false | ||
| VARIETY CHILDREN'S HOSPITAL PROFESSIONAL LIABILITY TRUST | |||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 592551434 | LIAB. CLAIMS | FL | 4947 (a)(1) | VCH | false | ||
| MIAMI CHILDREN'S HOSPITAL RESEARCH INSTITUTE INC | |||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 592602318 | RESEARCH | FL | 501(c)(3) | 3 | VCH | false | |
| MIAMI CHILDREN'S HEALTH SYSTEM INC | |||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 453481327 | HEALTHCARE | FL | 501(c)(3) | Type II | NA | false | |
| MIAMI CHILDREN'S HEALTH SYSTEM FOUNDATION INC (DBA NICKLAUS CHILDREN'S HOSP | |||||||||||
| 3100 SW 62ND AVENUE | MIAMI | FL | 33155 | 461784918 | FOUNDATION | FL | 501(c)(3) | 7 | MCHS | false | ITAL FOUNDATION INC) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | Address Line2USAddress/AddressLine2Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|---|---|
| MIAMI CHILDREN'S HOSPITAL AMBULATORY SURGERY CENTER LLC | |||||||||
| 800 SW 108TH AVENUE | SUITE 200 | MIAMI | FL | 33174 | 463406805 | AMBULATORY CENTER | FL | NA | N/A |
| MIAMI CHILDREN'S HEALTH PLAN LLC | |||||||||
| 3100 SW 62ND AVE | MIAMI | FL | 33155 | 823111550 | INSURANCE | FL | NA | N/A | |
| MIAMI HOSPITAL HOLDINGS LLC | |||||||||
| 11221 ROE AVE SUITE 320 | LEAWOOD | KS | 66211 | 464077635 | HOLDING COMPANY | FL | NA | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1ForeignAddress/AddressLine1Txt | Address Line2ForeignAddress/AddressLine2Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MIAMI CHILDREN'S INSURANCE CO SPC LTD | |||||||||||||||
| 720 WEST BAY ROAD | PO BOX 69GT BUCKINGHAM SQUARE | GEORGETOWN | GRAND CAYMAN | CJ | 980442086 | INSURANCE | CJ | NA | C Corporation | false | |||||
| CHILDREN'S HEALTH VENTURES INC AND SUBSIDIARIES | |||||||||||||||
| 454541147 | MERCHANT WHOLESALE | NA | C Corporation | false | 3100 SW 62ND AVENUE | MIAMI | FL | 331553009 | FL | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |