STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN INC (EIN 81-0584868)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-13
IRS object ID
201823179349302837
Schema version
2017v2.2
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

FieldValueIRS element (for citing)
Return2018-11-13T11:02:56-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN810584868EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Dallas Physician Medical Services for Children IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlDALLBusinessNameControlTxt
Phone2144567000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 MEDICAL DISTRICT DRIVEAddressLine1Txt
CityDALLASCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTammie SibleyPersonNm
Person TitleTreasurerPersonTitleTxt
Signature2018-11-13SignatureDt
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Ray Tsai MDBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 MEDICAL DISTRICT DRIVEAddressLine1Txt
CityDALLASCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$11,793,410GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionPROVIDE SERVICES TO PATIENTS AT SEVERAL HOSPITALS, INCLUDING CHILDREN'S MEDICAL CENTER DALLAS.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee31TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$10,150,397PYProgramServiceRevenueAmt
CY Program Service Revenue$11,793,410CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$10,150,397PYTotalRevenueAmt
CY Total Revenue$11,793,410CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,629,602PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,484,013CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,420,579PYOtherExpensesAmt
CY Other Expenses$4,863,371CYOtherExpensesAmt
PY Total Expenses$13,050,181PYTotalExpensesAmt
CY Total Expenses$15,347,384CYTotalExpensesAmt
PY Revenues Less Expenses-$2,899,784PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,553,974CYRevenuesLessExpensesAmt
Total Assets BOY$1,766,527TotalAssetsBOYAmt
Total Assets EOY$768,504TotalAssetsEOYAmt
Total Liabilities BOY$8,564,171TotalLiabilitiesBOYAmt
Total Liabilities EOY$11,120,121TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$6,797,644NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$10,351,617NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE DENTAL, GENERAL PEDIATRIC, AND PEDIATRIC SUB-SPECIALTY SERVICES, INCLUDING, BUT NOT LIMITED TO EMERGENCY DEPARTMENT COVERAGE, INPATIENT COVERAGE, ORTHOPEDIC SURGERY, AND CRANIOFACIAL ORTHODONTICS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$13,559,686ExpenseAmt
Revenue$11,793,410RevenueAmt
DescPROVIDE PHYSICIAN SERVICES TO PATIENTS AT CHILDREN'S MEDICAL CENTER DALLAS. THESE SERVICES ARE PROVIDED WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY.Desc
Total Program Service Expenses$13,559,686TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document26IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee31EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OfYes (true)Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jeffrey VawrinekBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2144567000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 MEDICAL DISTRICT DRIVEAddressLine1Txt
CityDALLASCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
William Morrow MD
Dir. and Pres., DPMSC & Pres Phys Orgs and Acdmc Rel CCO, CHST1.054.0Yes (X)Yes (X)$0$927,755$19,867
John Polousky MD
Board Member and Medical Director50.00Yes (X)$829,459$0$19,120
Michael Tate MD
Board Member and Medical Director50.00Yes (X)$311,399$0$25,600
Ray Tsai MD
Vice President, DPMSC & SVP System Ambulatory Services, CHST1.054.0Yes (X)$0$628,244$31,511
Jerry Lee
Treasurer, DPMSC & VP Accounting and Treasury, CHST1.049.0Yes (X)$0$390,313$32,789
Lisa Frenkel
Secretary, DPMSC & Associate General Counsel, CHST1.049.0Yes (X)$0$268,217$12,100
Dustin Loveland MD
Physician40.00$695,245$0$18,844Yes (X)
Christopher Redman MD
Physician40.00$608,877$0$17,648Yes (X)
Kathryn Bauer MD
Physician40.00$533,212$0$13,199Yes (X)
David Brown MD
Physician40.00$434,513$0$12,706Yes (X)
Yongjong Park DDS
Dentist Orthodontist40.00$352,309$0$11,552Yes (X)
Stephanie Smith
Former Officer, DPMSC & Sr Legal Counsel, CHST0.050.0$0$140,567$11,005Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,765,014TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,355,095TotReportableCompRltdOrgAmt
Total Other Compensation$225,942TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2Txt
COMPHEALTH
PO Box 972651DallasTX75397Physician Services$575,479
TCN PEDIATRIC NEUROLOGY PLLC
4032 McDermott RoadPlanoTX75024Physician Services$541,750Suite 100
GREATER DALLAS ORTHOPEDICS
12230 COIT RD STE 100DALLASTX75251PHYSICIAN Services$458,616
Weatherby Locums Inc
6451 N Federal HighwayFt LauderdaleFL33308Physician Services$227,869Suite 800
ALINA OLTEANU
3001 AURORA DRPlanoTX75093Physician Services$109,701
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROFESSIONAL SVC REVDesc
Business621110BusinessCd
Total Revenue Column$11,793,410TotalRevenueColumnAmt
Related Or Exempt Func Income$11,793,410RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$11,793,410TotalProgramServiceRevenueAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,793,410TotalRevenueColumnAmt
Related Or Exempt Func Income$11,793,410RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,140,858TotalAmt
Program Services$1,140,858ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,220,294TotalAmt
Program Services$7,091,887ProgramServicesAmt
Management And General$128,407ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$423,323TotalAmt
Program Services$415,795ProgramServicesAmt
Management And General$7,528ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,119,244TotalAmt
Program Services$1,099,339ProgramServicesAmt
Management And General$19,905ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$580,294TotalAmt
Program Services$569,974ProgramServicesAmt
Management And General$10,320ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,237,452TotalAmt
Program Services$2,237,452ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$43,043TotalAmt
Program Services$12,468ProgramServicesAmt
Management And General$30,575ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,818TotalAmt
Program Services$1,480ProgramServicesAmt
Management And General$338ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$755,745TotalAmt
Program Services$741,951ProgramServicesAmt
Management And General$13,794ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$24,490TotalAmt
Program Services$22,832ProgramServicesAmt
Management And General$1,658ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$98,152TotalAmt
Program Services$94,142ProgramServicesAmt
Management And General$4,010ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$22,571TotalAmt
Program Services$22,571ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$84,576TotalAmt
Program Services$84,512ProgramServicesAmt
Management And General$64ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
Shared Services$1,569,587$1,569,587
Medical Surgical Supplies$12,418$12,418
Transltn & Interprtn Srvc$2,847$2,847
Dietary and Food Costs$1,937$272$1,665

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$8,735TotalAmt
Program Services$7,495ProgramServicesAmt
Management And General$1,240ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$15,347,384TotalAmt
Program Services$13,559,686ProgramServicesAmt
Management And General$1,787,698ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,618,296BOYAmt
EOY$643,421EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$576BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$172,995LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$47,912LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$147,655BOYAmt
EOY$125,083EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,766,527BOYAmt
EOY$768,504EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$611,165BOYAmt
EOY$623,138EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,953,006BOYAmt
EOY$10,496,983EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,564,171BOYAmt
EOY$11,120,121EOYAmt

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$6,797,644BOYAmt
EOY-$10,351,617EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$6,797,644BOYAmt
EOY-$10,351,617EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,766,527BOYAmt
EOY$768,504EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$3,553,974ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$1OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$172,995OtherCostOrOtherBasisAmt
Depreciation$47,912DepreciationAmt
Book Value$125,083BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$125,083TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLT ADVANCES-AffiliatesDesc
Amt$10,496,983Amt
FieldValueIRS element (for citing)
Total Liability$10,496,983TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2FormAndLineReferenceDesc
ExplanationTHE DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN, INC.'S CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEAR ENDING DECEMBER 31, 2017 DO NOT CONTAIN A FIN 48 (ASC 740) FOOTNOTE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
William Morrow MD
Dir. and Pres., DPMSC & Pres Phys Orgs and Acdmc Rel CCO, CHST$0$556,606$0$291,820$0$79,328$0$10,800$0$9,067$0$947,622$0$0
John Polousky MD
Board Member and Medical Director$691,680$0$133,333$0$4,446$0$10,800$0$8,320$0$848,579$0$0$0
Michael Tate MD
Board Member and Medical Director$300,590$0$10,000$0$809$0$16,200$0$9,400$0$336,999$0$0$0
Stephanie Smith
Former Officer, DPMSC & Sr Legal Counsel, CHST$0$124,399$0$12,883$0$3,285$0$6,793$0$4,213$0$151,572$0$0
Ray Tsai MD
Vice President, DPMSC & SVP System Ambulatory Services, CHST$0$375,621$0$207,525$0$45,098$0$14,901$0$16,610$0$659,754$0$0
Jerry Lee
Treasurer, DPMSC & VP Accounting and Treasury, CHST$0$278,646$0$66,547$0$45,120$0$14,507$0$18,282$0$423,102$0$0
Lisa Frenkel
Secretary, DPMSC & Associate General Counsel, CHST$0$221,768$0$40,627$0$5,823$0$6,532$0$5,569$0$280,317$0$0
Dustin Loveland MD
Physician$461,475$0$226,063$0$7,707$0$10,800$0$8,044$0$714,089$0$0$0
Christopher Redman MD
Physician$468,152$0$138,448$0$2,277$0$10,800$0$6,848$0$626,525$0$0$0
Kathryn Bauer MD
Physician$470,774$0$58,333$0$4,104$0$10,800$0$2,399$0$546,410$0$0$0
David Brown MD
Physician$418,082$0$13,933$0$2,499$0$3,288$0$9,418$0$447,220$0$0$0
Yongjong Park DDS
Dentist Orthodontist$339,010$0$10,000$0$3,298$0$0$0$11,552$0$363,861$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationCHILDREN'S HEALTH SYSTEM OF TEXAS IS THE SOLE MEMBER FOR DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN (DPMSC). THEREFORE, DPMSC'S TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). The CHST process for determining executive compensation is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for executives. The Committee is comprised of independent, non-employee directors. A written compensation philosophy has been developed by the Human Resources Committee for timeliness and appropriateness and defines the desired peer groups for compensation surveys. COMPENSATION PROGRAM COMPONENTS: The elements of total compensation provided to CHST executives include: - Cash compensation (i.e., base salary, short-term and long-term incentive compensation, and/or other cash compensation), determined in consideration of competitive market practices, organizational and individual performance, recruitment and retention considerations, and other relevant factors. - Standard benefits, assisting in each executive's medical, dental, disability, life insurance, time off, and retirement needs, reflective of the employment status (i.e., full or part time) of the executive. - Supplemental benefits, including supplemental insurance, retirement benefits, and/or other supplemental benefits determined by the Committee to be appropriate and reasonable in relation to marketplace practices. Compensation and benefits decisions are made in consideration of each executive's position, responsibilities, skills, effort, and performance, in relation to documented practices within the appropriate comparator group(s). PEER GROUP: The Committee has defined its primary peer group for executives as not-for-profit health care organizations similar in size, structure, and complexity. This group will include leading pediatric health systems as well as integrated health systems and academic medical centers. - Data will be compiled in a manner consistent with the IRS Intermediate Sanctions rules of federal tax law, to reflect what is "ordinarily paid to like executives by like enterprises under like circumstances." - In certain circumstances, market data from additional comparator groups (e.g., research institutions, insurance industry, and general industry companies) may also be referenced. - The specific nature of the role at CHST will be considered when adding comparator groups outside of the primary peer group, and the Committee will discuss and agree on the appropriateness of adding comparator groups whenever the specific nature of the CHST role requires additional comparator groups to be used.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planNon-Qualified Retirement Plan: * Children's Health Savings Restoration Plan - There were no employees that received taxable income from the Savings Restoration Plan. Dr. William Morrow and Jerry Lee participated in the Savings Restoration Plan.
Schedule J, Part I, Line 7 Non-fixed paymentsNon-Fixed Payments - The Human Resources Committee of the Board of Directors of Children's Health System of Texas retains the authority to adjust annual payout percentages solely at their discretion. There were no non-fixed payments in 2017.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIALCHILDREN'S HEALTH SYSTEM OF TEXAS IS THE SOLE MEMBER FOR DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN (DPMSC). THEREFORE, DPMSC'S TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). The CHST process for determining executive compensation is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for executives. The Committee is comprised of independent, non-employee directors. A written compensation philosophy has been developed by the Human Resources Committee for timeliness and appropriateness and defines the desired peer groups for compensation surveys. COMPENSATION PROGRAM COMPONENTS: The elements of total compensation provided to CHST executives include: - Cash compensation (i.e., base salary, short-term and long-term incentive compensation, and/or other cash compensation), determined in consideration of competitive market practices, organizational and individual performance, recruitment and retention considerations, and other relevant factors. - Standard benefits, assisting in each executive's medical, dental, disability, life insurance, time off, and retirement needs, reflective of the employment status (i.e., full or part time) of the executive. - Supplemental benefits, including supplemental insurance, retirement benefits, and/or other supplemental benefits determined by the Committee to be appropriate and reasonable in relation to marketplace practices. Compensation and benefits decisions are made in consideration of each executive's position, responsibilities, skills, effort, and performance, in relation to documented practices within the appropriate comparator group(s). PEER GROUP: The Committee has defined its primary peer group for executives as not-for-profit health care organizations similar in size, structure, and complexity. This group will include leading pediatric health systems as well as integrated health systems and academic medical centers. - Data will be compiled in a manner consistent with the IRS Intermediate Sanctions rules of federal tax law, to reflect what is "ordinarily paid to like executives by like enterprises under like circumstances." - In certain circumstances, market data from additional comparator groups (e.g., research institutions, insurance industry, and general industry companies) may also be referenced. - The specific nature of the role at CHST will be considered when adding comparator groups outside of the primary peer group, and the Committee will discuss and agree on the appropriateness of adding comparator groups whenever the specific nature of the CHST role requires additional comparator groups to be used.
Form 990, Part VI, Line 6 Classes of members or stockholdersChildren's Health System of Texas (CHST) is the sole member.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyDirectors are appointed by the sole member and approved by the current DPMSC Board of Directors.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersMember reserve powers are specified in the organization's bylaws and represent those actions by the organization which require member approval to be effective. These powers generally encompass changes in the mission of the organization, addition of new members, certain dispositions of assets, amendments to the organization's Certificate of Formation and Bylaws, and appointment of directors.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyDallas Physician Medical Services for Children has delegated its oversight and review of the Form 990 to the Board of Directors of Children's Health System of Texas (CHST), its Sole Member. A draft of the Form 990 is presented to the CHST Audit Committee for review prior to filing. A copy of the Final Form 990 is made available to the CHST directors through our Board portal before it is filed.
Form 990, Part VI, Line 12c Conflict of interest policyOfficers, directors, and key employees received a copy of the Statement of Interest form to execute. Disclosures made are reviewed by the CHST Legal Department and the Chief Compliance Officer and discussed as necessary at the appropriate Committee and Board meetings to determine if further action is needed.
Form 990, Part VI, Line 19 Required documents available to the publicCertificate of Formation, Consolidated Financial Statements , and the conflict of interest policy is made available upon request.
Form 990, Part IX, Line 11g Other FeesConsulting & Professional fees - Total Expense: 19167, Program Service Expense: 19167, Management and General Expenses: , Fundraising Expenses: ; Contract Medical - Total Expense: 2218285, Program Service Expense: 2218285, Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesRounding - 1;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Children's Medical Center of Dallas
1935 MEDICAL DISTRICT DRIVEDALLASTX75235750800628HospitalTX501(c)(3)3CHILDREN'S HEALTH SYSTEM OF TEXASfalse
Children's Medical Center Foundation
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752062015FoundationTX501(c)(3)7CHILDREN'S HEALTH SYSTEM OF TEXASfalse
Anesthesiologists for Children
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752917570PHYSICIANSTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse
Physicians for Children
1935 MEDICAL DISTRICT DRIVEDALLASTX75235810584868PHYSICIANSTX501(c)(3)3CHILDREN'S HEALTH SYSTEM OF TEXASfalse
COMPLEX CARE MED SVC CORP
1935 MEDICAL DISTRICT DRIVEDALLASTX75235461893597MEDICAL SERVICESTX501(c)(3)3CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S MEDICAL CENTER HEALTH PLAN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235462737696HMOTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S MED CTR RESEARCH INST AT UTSWMC
1935 MEDICAL DISTRICT DRIVEDALLASTX75235453462044RESEARCH INSTITUTETX501(c)(3)Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
PEDIATRIC PARTNERS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235461917702CLINICALLY INTEGRATED NETWORKTX501(c)(3)Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S POPULATION HEALTH
1935 MEDICAL DISTRICT DRIVEDALLASTX75235463104601POPULATION HEALTHTX501(c)(3)Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHILDREN'S HEALTH SYSTEM OF TEXAS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752062019MANAGEMENT COMPANYTX501(c)(3)Type IIfalseN/A
OCH Holdings
1935 MEDICAL DISTRICT DRIVEDALLASTX75235474837308HospitalTX501(c)(3)3CHILDREN'S HEALTH SYSTEM OF TEXASfalse
PHYSICIANS QUALITY ALLIANCE OF NORTH TEXAS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235464049491PHYSICIANSTX501(c)(3)Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
SOUTHWESTERN MEDICAL DISTRICT
1935 MEDICAL DISTRICT DRIVEDALLASTX75235204101612MEDICAL DISTRICTTX501(c)(3)Type IfalseN/A
WOMEN'S AUXILIARY OF CMCD
12720 HILLCREST RDDALLASTX75230752485538WOMEN'S AUXILIARYTX501(c)(3)10falseN/A
THE HEALTH AND WELLNESS ALLIANCE FOR CHILDREN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235463080586PHYSICIANSTX501(c)(3)Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHST Physician Group 1
1935 Medical District DriveDallasTX75235813582843PhysicianTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHST Physician Group 2
1935 Medical District DriveDallasTX75235813679995PhysicianTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHST Physician Group 3
1935 Medical District DriveDallasTX75235813691209PhysicianTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHST Physician Group 4
1935 Medical District DriveDallasTX75235814577909PhysicianTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHST Physician Group 5
1935 Medical District DriveDallasTX75235814848085PhysicianTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse
CHST Physician Group 6
1935 Medical District DriveDallasTX75235814865847PhysicianTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Wellness Innovations LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 Medical District DriveAddressLine1Txt
CityDallasCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd
FieldValueIRS element (for citing)
EIN475246461EIN
Primary ActivitiesPhysiciansPrimaryActivitiesTxt
Legal Domicile StateTXLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CHST Investment Holdings LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeUnrelatedPredominantIncomeTypeTxt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
Ownership0OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtAddress Line2ForeignAddress/AddressLine2TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmt
ALTERNATIVE CARE SYSTEMS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752244475OTHER MEDICAL SERVICESTXCHSTC Corporation0false
NTPSS INC
1935 MEDICAL DISTRICT DRIVEDALLASTX75235471036641PHYSICIAN SOLUTIONSTXPediatric PartnersC Corporation0false
Texas Bluebonnet Insurance Company
1935 Medical District DriveDallasTX75235475032893Insurance CompanyTXCHSTC Corporation0false
TEXAS TRINITY RIVER ASSURANCE COMPANY LTD
981318151Self-insuranceCHSTC Corporation0false878 West Bay RoadPO Box 1159Grand CaymanGrand CaymanCJKY11202CJ
Wellness Innovations Physician Partners
1935 Medical District DriveDallasTX75235811734937PhysiciansTXCHSTC Corporation0false$0$0
Children's BMG
1935 Medical District DriveDallasTX75235475057374PhysiciansTXCHSTC Corporation0false$0$0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd