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DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN INC (EIN 81-0584868)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-13
IRS object ID
201733179349302878
Schema version
2016v3.0
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

FieldValueIRS element (for citing)
Return2017-11-13T11:02:43-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

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)
PersonJERRY LEEPersonNm
Person TitleTreasurerPersonTitleTxt
Signature2017-11-09SignatureDt
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1W Robert Morrow MDBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11935 MEDICAL DISTRICT DRIVEAddressLine1Txt
CityDALLASCityNm
State AbbreviationTXStateAbbreviationCd
ZIP75235ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$10,150,397GrossReceiptsAmt
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 Body4VotingMembersGoverningBodyCnt
Voting Members Independent1VotingMembersIndependentCnt
Total Employee55TotalEmployeeCnt
Total Volunteers1TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$4,490,587PYProgramServiceRevenueAmt
CY Program Service Revenue$10,150,397CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$4,490,587PYTotalRevenueAmt
CY Total Revenue$10,150,397CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,498,196PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,629,602CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,725,451PYOtherExpensesAmt
CY Other Expenses$4,420,579CYOtherExpensesAmt
PY Total Expenses$5,223,647PYTotalExpensesAmt
CY Total Expenses$13,050,181CYTotalExpensesAmt
PY Revenues Less Expenses-$733,060PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,899,784CYRevenuesLessExpensesAmt
Total Assets BOY$1,427,115TotalAssetsBOYAmt
Total Assets EOY$1,406,270TotalAssetsEOYAmt
Total Liabilities BOY$5,324,975TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,203,914TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$3,897,860NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$6,797,644NetAssetsOrFundBalancesEOYAmt
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$10,772,295ExpenseAmt
Revenue$10,150,397RevenueAmt
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$10,772,295TotalProgramServiceExpensesAmt
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 Document47IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee55EmployeeCnt
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 OffalseForm8282PropertyDisposedOfInd
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 Members4GoverningBodyVotingMembersCnt
Independent Voting Member1IndependentVotingMemberCnt
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 (13 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
President DPMSC, Pres Phys Orgs Acdmc Rel CCO CHST1.054.0Yes (X)Yes (X)$0$822,400$18,621
Maeve Sheehan MD
Chair1.00Yes (X)$0$0$0
John Polousky MD
Medical Director50.00Yes (X)$830,946$0$6,488
Michael Tate MD
Medical Director50.00Yes (X)$271,607$0$9,046
Jerry Lee
Treasurer DPMSC, VP Acctg/Treas CHST1.049.0Yes (X)$0$395,942$32,898
Lisa Frenkel
Secretary DPMSC, Asst Gen Counsel CHST1.049.0Yes (X)$0$217,708$12,255
Dustin Loveland MD
Physician40.00$589,554$0$7,752Yes (X)
Christopher Redman MD
Physician40.00$529,546$0$6,014Yes (X)
Kathryn Bauer MD
Physician40.00$528,245$0$2,315Yes (X)
Yongjong Park MD
Dentist Orthodontist40.00$332,697$0$11,600Yes (X)
David Brown MD
Physician40.00$274,438$0$6,691Yes (X)
Patricia Winning
Former Pres DPMSC, SVP Business Development CHST0.050.0$0$767,498$115,175Yes (X)
Stephanie Smith
Former Secretary DPMSC, Sr Legal Counsel CHST0.050.0$0$135,085$11,262Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,357,032TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,338,633TotReportableCompRltdOrgAmt
Total Other Compensation$240,116TotalOtherCompensationAmt
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/ZIPCdServicesServicesDescCompensationCompensationAmt
COMPHEALTH
PO Box 972651DallasTX75397Physician Services$619,520
GREATER DALLAS ORTHOPEDICS
12230 COIT RD STE 100DALLASTX75251PHYSICIAN Services$415,227
SHIMADZU MEDICAL SYSTEMS
10625 NEWKIRK 500DallasTX75220Medical Services$158,000
ALINA OLTEANU
3001 AURORA DRPlanoTX75093Physician Services$114,855
PEDIATRIC SEARCH PARTNERS
6505 W PARK BLVD STE 306PlanoTX75093Recruitment Services$110,000
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$10,150,397TotalRevenueColumnAmt
Related Or Exempt Func Income$10,150,397RelatedOrExemptFuncIncomeAmt

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$10,150,397TotalProgramServiceRevenueAmt

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$10,150,397TotalRevenueColumnAmt
Related Or Exempt Func Income$10,150,397RelatedOrExemptFuncIncomeAmt
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$1,102,553TotalAmt
Program Services$1,102,553ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,750,932TotalAmt
Program Services$5,386,073ProgramServicesAmt
Management And General$364,859ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$311,918TotalAmt
Program Services$292,129ProgramServicesAmt
Management And General$19,789ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$994,912TotalAmt
Program Services$931,791ProgramServicesAmt
Management And General$63,121ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$469,287TotalAmt
Program Services$439,514ProgramServicesAmt
Management And General$29,773ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,755,986TotalAmt
Program Services$1,755,986ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$99,026TotalAmt
Program Services$75,238ProgramServicesAmt
Management And General$23,788ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$5,298TotalAmt
Program Services$3,484ProgramServicesAmt
Management And General$1,814ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$669,398TotalAmt
Program Services$633,589ProgramServicesAmt
Management And General$35,809ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$34,521TotalAmt
Program Services$34,245ProgramServicesAmt
Management And General$276ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$46,402TotalAmt
Program Services$45,259ProgramServicesAmt
Management And General$1,143ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$10,345TotalAmt
Program Services$10,345ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$38,031TotalAmt
Program Services$37,995ProgramServicesAmt
Management And General$36ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
Shared Services$1,736,795$1,736,795
Medical Surgical Supplies$18,714$18,714
Dietary and Food Costs$6,063$683$5,380

All Other Expenses AllOtherExpensesGrp

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

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$13,050,181TotalAmt
Program Services$10,772,295ProgramServicesAmt
Management And General$2,277,886ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,075,496BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$350,856BOYAmt
EOY$1,258,039EOYAmt

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$763BOYAmt
EOY$576EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$172,995LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$25,340LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$147,655EOYAmt

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$1,427,115BOYAmt
EOY$1,406,270EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$413,161BOYAmt
EOY$611,165EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,911,814BOYAmt
EOY$7,592,749EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,324,975BOYAmt
EOY$8,203,914EOYAmt

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$3,897,860BOYAmt
EOY-$6,797,644EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$3,897,860BOYAmt
EOY-$6,797,644EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,427,115BOYAmt
EOY$1,406,270EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$2,899,784ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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$25,340DepreciationAmt
Book Value$147,655BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$147,655TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLT ADVANCES-AffiliatesDesc
Amt$7,592,749Amt
FieldValueIRS element (for citing)
Total Liability$7,592,749TotalLiabilityAmt

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, 2016 DO NOT CONTAIN A FIN 48 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
President DPMSC, Pres Phys Orgs Acdmc Rel CCO CHST$0$534,242$0$283,208$0$4,950$0$10,600$0$8,021$0$841,021$0$0
John Polousky MD
Medical Director$693,512$0$133,333$0$4,101$0$0$0$6,488$0$837,434$0$0$0
Michael Tate MD
Medical Director$254,781$0$16,000$0$826$0$0$0$9,046$0$280,653$0$0$0
Patricia Winning
Former Pres DPMSC, SVP Business Development CHST$0$400,707$0$306,674$0$60,117$0$99,056$0$16,119$0$882,673$0$80,495
Stephanie Smith
Former Secretary DPMSC, Sr Legal Counsel CHST$0$123,291$0$10,547$0$1,247$0$6,812$0$4,450$0$146,347$0$0
Jerry Lee
Treasurer DPMSC, VP Acctg/Treas CHST$0$270,923$0$87,472$0$37,547$0$14,597$0$18,301$0$428,840$0$0
Lisa Frenkel
Secretary DPMSC, Asst Gen Counsel CHST$0$213,182$0$0$0$4,526$0$6,590$0$5,665$0$229,963$0$0
Dustin Loveland MD
Physician$467,248$0$120,080$0$2,226$0$0$0$7,752$0$597,306$0$0$0
Christopher Redman MD
Physician$468,986$0$58,333$0$2,226$0$0$0$6,014$0$535,559$0$0$0
Kathryn Bauer MD
Physician$472,685$0$53,333$0$2,226$0$0$0$2,315$0$530,559$0$0$0
Yongjong Park MD
Dentist Orthodontist$329,400$0$0$0$3,297$0$0$0$11,600$0$344,297$0$0$0
David Brown MD
Physician$272,829$0$0$0$1,609$0$0$0$6,691$0$281,128$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 retains the authority to adjust annual payout percentages solely at their discretion. There were no non-fixed payments in 2016.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 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 Executive Vice President, Chief Legal Officer and General Counsel and the Chief Compliance Officer and discussed as necessary at the appropriate Board meeting to determine if further action is needed.
Form 990, Part VI, Line 19 Required documents available to the publicCertificate of Formation and Consolidated Financial Statements are publicly available. The conflict of interest policy is made available to the public upon request.
Form 990, Part IX, Line 11g Other FeesConsulting & Professional fees - Total Expense: 1755986, Program Service Expense: 1755986, Management and General Expenses: , Fundraising Expenses: ;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)

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Children's Medical Center of Dallas
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Children's Medical Center Foundation
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Anesthesiologists for Children
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752917570PHYSICIANSTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse
Physicians for Children
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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 DRIVEDALLASTX75235433462044RESEARCH 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 MEDICAL CENTER SERVICES
1935 MEDICAL DISTRICT DRIVEDALLASTX75235461934007MEDICAL SERVICESTX501(c)(3)10CHILDREN'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
SPECIALISTS FOR CHILDREN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235463110125PHYSICIANSTX501(c)(3)10CHILDREN'S HEALTH SYSTEM OF TEXASfalse
PHYSICIANS QUALITY ALLIANCE OF NORTH TEXAS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235464049491PHYSICIANSTX501(c)(3)Type ICHILDREN'S HEALTH SYSTEM OF TEXASfalse
COMMUNITY PROVIDERS FOR CHILDREN
1935 MEDICAL DISTRICT DRIVEDALLASTX75235463675742PHYSICIANSTX501(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
Children's BMG dba One Care Domain
1935 Medical District DriveDallasTX75235475057374PhysicianTX501(c)(3)3CHILDREN'S HEALTH SYSTEM OF TEXASfalse
Wellness Innovations Physician Partners
1935 Medical District DriveDallasTX75235811734937PhysicianTX501(c)(3)3Wellness Innovations LLCfalse
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

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Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

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CHILDREN'S INSURANCE COMPANY
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ALTERNATIVE CARE SYSTEMS
1935 MEDICAL DISTRICT DRIVEDALLASTX75235752244475OTHER MEDICAL SERVICESTXCHILDREN'S HEALTH SYSTEM OF TEXASC Corporation0false
NTPSS INC
1935 MEDICAL DISTRICT DRIVEDALLASTX75235471036641PHYSICIAN SOLUTIONSTXPediatric PartnersC Corporation0false
Texas Bluebonnet Insurance Company
1935 Medical District DriveDallasTX75235475032893Insurance CompanyTXChildren's Health System of TexasC Corporation0false
TEXAS TRINITY RIVER ASSURANCE COMPANY LTD
981318151Self-insuranceChildren's Health System of TexasC Corporation0false878 West Bay RoadPO Box 1159Grand CaymanCJKY11202CJ
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