2017-11-13T16:02:16-06:00 2016-12-31 350921680 CROWE HORWATH LLP 750 N St Paul Suite 850 Dallas TX 75201 990 2016-01-01 461392824 Texas Children's Health Plan The Center TEXA 8328242982 6621 FANNIN STREET HOUSTON TX 77030 Weldon Gage EXECUTIVE VICE PRESIDENT & CFO 2017-11-13 true RACHEL SPURLOCK P00520729 2147775200 2016 2017-02-10 21:41:12Z Texas Children's Health Plan-The Center for Children and Women Weldon Gage 6621 FANNIN STREET Houston TX 77030 96191818 false X WWW.JOINTHECENTER.ORG X 2008 TX TO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION, AND RESEARCH. 5 2 186 0 0 0 0 69163383 96188779 0 9258 3039 69172641 96191818 0 0 9059619 11978130 0 0 60005039 84213688 69064658 96191818 107983 0 36480695 35419475 10039840 8931183 26440855 26488292 TO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION, AND RESEARCH. false false 92215055 96188779 TEXAS CHILDREN'S HEALTH PLAN - THE CENTER FOR CHILDREN AND WOMEN (CCW), IN FULFILLING ITS PURPOSE OF SUPPORTING TEXAS CHILDREN'S HEALTH PLAN, ESTABLISHES PATIENT AND FAMILY-CENTERED MEDICAL HOMES PROVIDING CARE TO PRIMARILY MEDICAID AND CHIP PATIENTS THAT ARE MEMBERS OF TEXAS CHILDREN'S HEALTH PLAN. THE MEDICAL HOMES ARE SPECIFICALLY IN SUPPORT OF TEXAS CHILDREN'S HEALTH PLAN'S MISSION TO PROVIDE CARE THAT IS ACCESSIBLE, COORDINATED, COMPREHENSIVE, CONTINUOUS, CULTURALLY SENSITIVE, COMMUNITY-BASED AND FAMILY-CENTERED. 92215055 true false false false false false false false false false true false false true true true true false false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 19 0 true 186 true false false false false false false false false false false X 5 2 false false false false true true true true false false false true true true true true true false false false X Anna Mateja 8328281020 1919 S Braeswood Blvd Houston TX 77030 Michael A Belfort MD PhD Board Member / Secretary 1.0 3.0 X X 0 207460 0 Angelo P Giardino MD PHD Board Member / Chairman / Chief Medical Officer 1.0 39.0 X X 0 572059 158428 Lisa Hollier Board Member / Medical Director for Obstetrics and Gynecology 1.0 1.0 X X 0 0 0 Mark W Kline MD Board Member / Vice Chairman 1.0 4.0 X X 0 217576 0 Heidi Schwarzwald Board Member / Pediatric Medical Director 1.0 1.0 X X 0 0 0 Christopher Born SCHEDULE O 1.0 39.0 X 0 1585608 120925 Anna Mateja Chief Financial Officer 1.0 39.0 X 0 412525 120131 Dace Reinholds Assistant Secretary 1.0 39.0 X 0 222476 30533 Tangula Taylor Director of Business Development and Community Initiatives 40.0 0.0 X 223853 0 37984 Randy Wright Schedule O 1.0 39.0 X 0 674125 6160 Toronda Baker Education Coordinator - TCHP/TCHPC 40.0 0 X 104740 0 19188 Maria Dahl NURSE PRACTITIONER 40.0 0 X 101909 0 21449 Melissa Denby NURSE PRACTITIONER 40.0 0 X 124547 0 22260 Sydnee Lucas NURSE PRACTITIONER 40.0 0 X 101835 0 12153 Kimeco Williams NURSE PRACTITIONER 40.0 0 X 110190 0 17129 767074 3891829 566340 6 false true false BAYLOR COLLEGE OF MEDICINE 1 BAYLOR PLAZA HOUSTON TX 77030 PHYSCN & FACULTY SVC 5753002 THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON PO BOX 301365 DALLAS TX 753031365 STAFFING SERVICES 570112 PACIFIC INTERPRETERS PO BOX 204313 DALLAS TX 753204313 INTERPRETING SERVICES 282271 PHYSICIAN RESOURCES INC 1818 MEMORIAL DRIVE 200 HOUSTON TX 77007 PHYSICIAN STAFFING 145310 BRI 1833 6330 LLC 6330 WEST LOOP SOUTH SUITE 13180 BELLAIRE TX 77401 PROPERTY MANAGEMENT 116851 6 0 PREMIUM REVENUE 900099 84746332 84746332 PROVIDER SUPPORT 900099 10424393 10424393 NET PATIENT SERVICE REVENUE 622310 424675 424675 CMS Incentives 900099 412645 412645 PROGRAM SERVICE RENTAL 900099 180734 180734 0 0 0 0 96188779 0 0 0 0 OTHER REVENUE 900099 3039 3039 0 0 0 0 3039 96191818 96188779 0 3039 X 261837 261837 9272766 8608452 664314 364164 158958 205206 1384697 1311857 72840 694666 638245 56421 10809582 10155632 653950 0 134978 130167 4811 10792 10076 716 1694274 1581549 112725 16568 12605 3963 14359 12433 1926 3693293 3479381 213912 259772 254908 4864 MEDICAL EXPENSE PER PROVIDER AGREEMENT 59645799 59645799 VENDED SERVICES FROM TCH AND TCHP 5647609 3950364 1697245 MEDICAL SUPPLIES 2190721 2190721 EDUCATIONAL MATERIALS 37061 17300 19761 58880 56608 2272 0 96191818 92215055 3976763 0 10838345 12588445 0 0 0 127687 129833 26527175 11362854 18805824 15164321 0 0 6708839 7536876 36480695 35419475 4163232 3157468 32702 44378 5843906 5729337 10039840 8931183 X 26440855 26488292 26440855 26488292 36480695 35419475 X 0 47437 X false true X true false X X X 1 TEXAS CHILDREN'S HEALTH PLAN 760486264 9 true 92215055 0 1 92215055 0 true false false false false false false false false false false false false false false true false 18465976 4775058 13690918 8061199 6587796 1473403 15164321 DUE FROM AFFILIATES 3180 MISCELLANEOUS RECEIVABLE 7533696 TENANT IMPROVEMENTS REIMBURSEMENT RECEIVABLE 7536876 DEFERRED RENT 4718346 DUE TO AFFILIATES 1010991 5729337 X 96191818 0 0 96191818 0 0 96191818 96191818 0 0 96191818 0 0 96191818 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION ON THE ACCOMPANYING BALANCE SHEETS AS OF DECEMBER 31, 2016 OR 2015. false true false false false false false false false Michael A Belfort MD PhD Board Member / Secretary 0 0 0 207460 0 0 0 0 0 0 0 207460 0 0 Angelo P Giardino MD PHD Board Member / Chairman / Chief Medical Officer 0 476426 0 73725 0 21908 0 145783 0 12645 0 730487 0 0 Mark W Kline MD Board Member / Vice Chairman 0 0 0 217576 0 0 0 0 0 0 0 217576 0 0 Christopher Born SCHEDULE O 0 545110 0 416689 0 623809 0 101420 0 19505 0 1706533 0 160922 Anna Mateja Chief Financial Officer 0 301400 0 53925 0 57200 0 94785 0 25346 0 532656 0 35923 Dace Reinholds Assistant Secretary 0 205336 0 15300 0 1840 0 18973 0 11560 0 253009 0 0 Tangula Taylor Director of Business Development and Community Initiatives 204440 0 18300 0 1113 0 15997 0 21987 0 261837 0 0 0 Randy Wright Schedule O 0 133117 0 39975 0 501033 0 2302 0 3858 0 680285 0 312024 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation COMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS ESTABLISHED BY TEXAS CHILDREN'S AND TEXAS CHILDREN'S HOSPITAL, USING THE FOLLOWING METHODS: *COMPENSATION COMMITTEE *INDEPENDENT COMPENSATION CONSULTANT *COMPENSATION SURVEY OR STUDY *APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan 457 (F) PLAN: PAID/DEFERRED CHRISTOPHER BORN 505,086 / 80,220 ANGELO P. GIARDINO, MD, PHD 73,725 / 124,583 ANNA MATEJA 89,848 / 73,585 RANDY WRIGHT 482,802 / 0 DIRECTOR INCENTIVE PLAN: PAID/DEFERRED DACE REINHOLDS 15,300 / 0 TANGULA TAYLOR 18,300 / 0 457(F): THE 457(F) PLAN IS A DEFERRED COMPENSATION PLAN THAT ALLOWS ELIGIBLE EXECUTIVES, FROM THE ASSISTANT VICE PRESIDENT LEVEL TO CHIEF EXECUTIVE OFFICER, TO CONTRIBUTE MONEY ON A PRE-TAX BASIS. FUNDS MAY BE DEFERRED INTO THIS ACCOUNT FROM ANY OF FOUR SOURCES: BASE SALARY, ANNUAL INCENTIVE PLAN, LONG-TERM INCENTIVE PLAN, AND CAPITAL ACCUMULATION ACCOUNT FROM A FLEXIBLE BENEFIT ACCOUNT SURPLUS. THESE VEST AFTER THREE YEARS IN THE 457(F) WITH THE EXCEPTION OF THE CAPITAL ACCUMULATION ACCOUNT WHICH VESTS AFTER FIVE YEARS IN THE 457(F) PLAN. DIRECTOR INCENTIVE PLAN: THE DIRECTOR INCENTIVE PLAN IS AN ANNUAL INCENTIVE PLAN IN WHICH ELIGIBLE DIRECTORS PARTICIPATE. THE PLAN SHARES GOALS WITH THE EXECUTIVE ANNUAL INCENTIVE PLAN, FOCUSING ON FACTORS SUCH AS FINANCIAL PERFORMANCE, QUALITY GOALS, AND PATIENT SATISFACTION. IN ADDITION, THERE ARE INDIVIDUAL COMPONENTS FOR EACH DIRECTOR WHICH VARY DEPENDING ON THE EXPECTED OUTCOMES FOR THAT AREA AND/OR YEAR. Form 990, Part VI, Line 6 Classes of members or stockholders TEXAS CHILDREN'S HEALTH PLAN IS THE SOLE CORPORATE MEMBER OF TEXAS CHILDREN'S HEALTH PLAN - THE CENTER. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body TEXAS CHILDREN'S HEALTH PLAN, AS THE SOLE MEMBER CORPORATION, HAS THE AUTHORITY TO ELECT THE BOARD OF DIRECTORS OF THE ORGANIZATION. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders PER THE ORGANIZATION'S BYLAWS THE MEMBER HAS CERTAIN RESERVED POWERS: -APPROVE, INTERPRET OR CHANGE THE PURPOSE OF THE CORPORATION. -FIX THE NUMBER OF DIRECTORS AND APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY DIRECTOR OF THE CORPORATION. -APPROVE THE MERGER, DISSOLUTION OR CONSOLIDATION, OR REORGANIZATION OF THE CORPORATION. -APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION OF PROPERTY OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATION'S BUSINESS, WHEN SUCH ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION IS ABOVE SPECIFIED FINANCIAL LEVELS SET IN ACCORDANCE WITH POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBER. -APPROVE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. -ADOPTION OR AMENDMENT OF SALARIES OR OTHER COMPENSATION (INCLUDING THE AWARDING OF ANY INCENTIVE COMPENSATION) OF THE OFFICERS OF THE CORPORATION, PHYSICIAN EMPLOYEES OF THE CORPORATION, IF ANY, AND PHYSICIANS WHO ARE INDEPENDENT CONTRACTORS TO THE CORPORATION, IF ANY. -APPROVE DEBT INCURRED BY THE CORPORATION, WHICH IS IN EXCESS OF SUCH LIMITS AS ARE ESTABLISHED BY THE MEMBER. -APPROVE THE DISPOSITION OF ASSETS OF THE CORPORATION AT THE TIME OF ITS DISSOLUTION. -APPROVE ANY LONG-RANGE FINANCIAL AND STRATEGIC PLANS FOR THE CORPORATION. -SELECTION OF THE CORPORATION'S AUDITORS AND LEGAL COUNSEL. -CREATION OR SALE OF ANY SUBSIDIARIES OF THE CORPORATION. -ANY AFFILIATION, JOINT VENTURE, CONTRACT, EMPLOYMENT, RETENTION, INDEMNIFICATION, OR OTHER ARRANGEMENTS BETWEEN THE CORPORATION AND ANY INSURER, HEALTH MAINTENANCE ORGANIZATION, PREFERRED PROVIDER ORGANIZATION, MEDICAL SCHOOL, HOSPITAL, CLINIC, PHARMACY, PHYSICIAN, TEXAS CHILDREN'S HEALTH PLAN AFFILIATE, OR OTHER PROVIDER OF HEALTH OR RELATED SERVICES, INCLUDING, WITHOUT LIMITATION, ALL SERVICE TERMS AND COMPENSATION ARRANGEMENTS. -ESTABLISHMENT BY THE CORPORATION OF ANY TRAINING OR RESIDENCY PROGRAM. -THE GIVING, SEEKING, OR RECEIVING OF GRANTS. -ADOPTION OR AMENDMENT OF ANY INDEMNIFICATION RIGHTS, OBLIGATIONS, OR AGREEMENTS AFFECTING THE CORPORATION. -PURCHASE, ADOPTION, AMENDMENT, CANCELLATION, OR REPLACEMENT OF ANY INSURANCE COVERAGE FOR THE CORPORATION OR ITS DIRECTORS, OFFICERS AND AGENTS, AS WELL AS COPIES OF ANY NOTICES OF CANCELLATION RECEIVED BY THE CORPORATION. -THE COMMENCEMENT OF LITIGATION OR THE SETTLEMENT OF LITIGATION OR OTHER CLAIMS. -APPROVAL OF THE ADOPTION OR AMENDMENT OF FEE SCHEDULES RELATING TO PATIENT SERVICES. -DESIGNATION OF ADDITIONAL OR SUCCESSOR MEMBER(S). -TAKE ANY ACTION WHICH WOULD BE CONSISTENT WITH THE GOVERNING DOCUMENTS OR POLICIES OF THE MEMBER. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body NO SUCH COMMITTEES EXIST. Form 990, Part VI, Line 11b Review of form 990 by governing body PER A RESOLUTION APPROVED BY THE MEMBER'S BOARD OF TRUSTEES, THE MEMBER BOARD'S AUDIT & COMPLIANCE COMMITTEE HAS DELEGATED AUTHORITY TO REVIEW THE ORGANIZATION'S COMPLETED FORM 990 PRIOR TO FILING. FOLLOWING THE COMMITTEE'S REVEW, THE COMPLETED FORM 990 IS DISTRIBUTED TO THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION CONSISTENTLY MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY THROUGH TWO SEPARATE PROCESSES, ONE THAT APPLIES TO THE BOARD MEMBERS, AND A SECOND THAT APPLIES TO OFFICERS AND KEY EMPLOYEES. 1) BOARD MEMBERS: PER THE ORGANIZATION'S BOARD-APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE MEMBER'S BOARD LEADERSHIP AND PRESENTED TO THE MEMBER'S AUDIT & COMPLIANCE COMMITTEE. IF THE COMMITTEE DEEMS THERE ARE ANY SIGNIFICANT ISSUES, THE RESPONSES ARE THEN REVIEWED BY THE MEMBER BOARD'S EXECUTIVE COMMITTEE AND ANY REQUIRED ACTION (RECUSEMENT FROM BOARD DELIBERATIONS RELATED TO THE CONFLICT, ETC.) IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT. 2) OFFICERS / KEY EMPLOYEES: PER THE ORGANIZATION'S BOARD APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE COMPLIANCE SERVICES DEPARTMENT. IF THE DEPARTMENT DEEMS THERE ARE ANY SIGNIFICANT ISSUES, REQUIRED ACTION IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT AND THE BOARD IS NOTIFIED OF SUCH ACTIONS. Form 990, Part VI, Line 19 Required documents available to the public THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. Form 990, Part VII, Section A INCENTIVE COMPENSATION DRS. BELFORT AND KLINE, WHILE EMPLOYED BY BAYLOR COLLEGE OF MEDICINE, SERVE AS IN-CHIEFS DIRECTING PATIENT CARE AT TEXAS CHILDREN'S HOSPITAL. DUE TO THEIR SENIOR LEADERSHIP ROLES, THEY ARE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON THEIR CONTRIBUTIONS TO ACHIEVING THE ORGANIZATION'S STRATEGIC GOALS. ALL COMPENSATION IS EARNED IN THEIR CAPACITY AS PHYSICIAN LEADERS. Form 990, Part VII, Section A TITLES CHRISTOPHER BORN: PRESIDENT THROUGH 10/26/16 RANDy WRIGHT: PRESIDENT AS OF 10/26/16 Form 990, Part IX, Line 11g Other Fees HEALTHCARE PROFESSIONAL SERVICES - Total Expense: 10809582, Program Service Expense: 10155632, Management and General Expenses: 653950, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances CONTRIBUTED CAPITAL - 47437; SCHEDULE O FORM 5471 DISCLOSURE STATEMENT UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT: -TEXAS CHILDREN'S HOSPITAL FOUNDATION EIN:20-2380599 6621 FANNIN ST HOUSTON, TX 77030 -TEXAS CHILDREN'S EIN: 76-0461578 1919 S. BRAESWOOD BLVD, 4TH FL HOUSTON, TX 77030 TEXAS CHILDREN'S 1919 S BRAESWOOD BLVD 4TH FLOOR HOUSTON TX 77030 760461578 PARENT TX 501(c)(3) Type II NA false TEXAS CHILDREN'S PHYSICIAN GROUP 6621 FANNIN STREET HOUSTON TX 77030 260834681 HEALTH CARE TX 501(c)(3) 10 TEXAS CHILDREN'S false TEXAS CHILDREN'S WOMEN'S SPECIALISTS PO BOX 300630 HOUSTON TX 77230 261482195 HEALTH CARE TX 501(c)(3) Type II TEXAS CHILDREN'S false TEXAS CHILDREN'S HOSPITAL 6621 FANNIN STREET HOUSTON TX 77030 741100555 HOSPITAL TX 501(c)(3) 3 TEXAS CHILDREN'S false TEXAS CHILDREN'S HOSPITAL FOUNDATION 6621 FANNIN STREET HOUSTON TX 77030 202380599 SUPPORTING ORG TX 501(c)(3) Type II TEXAS CHILDREN'S false TCH PEDIATRIC ASSOCIATES INC PO BOX 300630 HOUSTON TX 77230 760460242 HEALTH CARE TX 501(c)(3) 10 TEXAS CHILDREN'S false TEXAS CHILDREN'S HEALTH PLAN 6330 WEST LOOP SOUTH SUITE 800 8TH FLOOR HOUSTON TX 77041 760486264 HEALTH CARE TX 501(c)(3) 10 TEXAS CHILDREN'S false TEXAS CHILDREN'S URGENT CARE 1919 S BRAESWOOD BLVD 4TH FLOOR HOUSTON TX 77030 472029489 HEALTH CARE TX 501(c)(3) 10 TCH PEDIATRIC ASSOCIATES INC false THE GORDON AND MARY CAIN PEDIATRIC NEUROLOGY RESEARCH FOUNDATION 9 GREENWAY PLAZA HOUSTON TX 77046 760246858 SUPPORTING ORG TX 501(c)(3) Type I TEXAS CHILDREN'S HOSPITAL false TCH INSURANCE COMPANY LTD 23 LIME BAY AVENUE GRAND CAYMAN CJ KY11102 980176652 INSURANCE CJ NA C Corporation false CVI GVF HOLDINGS 3 LTD UGLAND HOUSE SOUTH CHURCH ST GEORGE TOWN CJ KY11104 981078282 INVESTMENT CJ NA C Corporation false false false false false false false false false false false false false true false false false false false true