2016-11-09T18:00:55-06:00 2015-12-31 350921680 CROWE HORWATH LLP 750 N St Paul Suite 850 Dallas TX 75201 990 2015-01-01 750800628 Children's Medical Center of Dallas CHIL 2144567000 1935 Medical District Drive Dallas TX 75235 Jerry Lee CHST VP, Accounting & Treasury 2016-11-09 true RACHEL SPURLOCK P00520729 2147775200 2015 2017-02-10 21:41:12Z Children's Health Christopher J Durovich 1935 Medical District Drive Dallas TX 75235 1234255326 false X www.childrens.com X 1986 TX Dedicated to making life better for children 19 18 5000 2500 606544 -199695 16871919 6076382 1113687533 1160541223 71238833 29017573 34557007 38531392 1236355292 1234166570 182000 207000 0 506775200 548268592 0 0 483210074 499936093 990167274 1048411685 246188018 185754885 2590186076 3354427732 640494477 558327414 1949691599 2796100318 Children's Medical Center of Dallas is dedicated to making life better for children. Children's is committed to carry out this mission through adherence to four guiding principles: quality care; research & innovation; education & advocacy; and excellence & accountability. false false 782775619 207000 1197887080 Consistent with its charitable mission, Children's Health maintains a policy of accepting all patients within its primary service area regardless of ability to pay. The local service regions stretch from the Oklahoma border south to Waco and from Parker County (west of Ft. Worth) east to Wood County. For the fiscal year ended December 31, 2015, Children's Health absorbed $167 million of uncompensated healthcare services as a result of this open-door charitable policy. Children's Health participates in applicable government sponsored entitlement programs. For the year ended December 31, 2015, approximately 63% of Children's gross revenue is attributable to patients enrolled in state Medicaid programs. During 2015, Children's Health served children through more than 785,000 patient encounters. Children's Health had 30,296 patient admissions resulting in 119,660 patient days, and provided services in 595,059 outpatient visits. In recognizing its mission to the community, Children's Health participates in the Medicaid, Medicare, Children's Health Health Insurance Program (CHIP), and Children with Special Health Care Needs (CSHCN) government programs. Under an agreement with the Dallas County Hospital District, Children's Health provides services to the indigent children of Dallas County. Children's Health is the primary pediatric teaching hospital for the University of Texas Southwestern Medical School at Dallas and has the fifth largest pediatric training program in the country. Children's Health offers fellowships/residencies in pediatric subspecialties, as well as internships and fellowships/residencies in nursing, dentistry, allied health, social sciences and religious studies. In addition to internship and fellowship programs, many students representing a variety of health care professions come to Children's Health to complete a pediatric rotation as a requisite of their training. In addition, through the affiliation with UTSW Medical Center, ongoing research is promoted in many different clinical areas of the hospital. The end goal of this research is the development of newer, more effective diagnostic & treatment methods to meet the health care needs of children. All research involving human subjects is approved by the Institutional Review Board at UTSW. Joint areas of research efforts between UTSW's Department of Pediatrics & Children's are: critical care, immunology, gastroenterology, emergency medicine, radiology, nutrition, endocrinology, psychiatry, cardiology, pharmacology, nephrology, neurology, pulmonology, rheumatology, infectious diseases & hematology/oncology. Many of these clinical studies have been published in medical journals & presented to professional health care societies. 782775619 true true false true false false false false false false true false false true true false false true false false true false false false false false true true false true true true false false false false false false false false false false false false false false false true true true false false true 1349 0 true 5000 true true true false false false false false false false false false X 19 18 false false false false true true true true true false false false true true true true true false false false X Jeffrey Vawrinek 2144567000 1935 Medical District Drive Dallas TX 75235 Richard Knight Jr Chairman 1.0 1.0 X X 0 0 0 Christopher J Durovich President CEO CHST and CEO CMC, Ex Officio Vtg Mbr 1.0 59.0 X X 0 3387269 42143 David W Biegler Ex Officio Voting Mbr 1.0 3.0 X 0 0 0 Richie L Butler Director 1.0 0 X 0 0 0 Jeremy Ford Director 1.0 0 X 0 0 0 Steven M Gruber Director 1.0 1.0 X 0 0 0 Caren Kline Director 1.0 1.0 X 0 0 0 Charles Koetting Director 1.0 0 X 0 0 0 Tracey Kozmetsky Director 1.0 1.0 X 0 0 0 Jeff Lamb Director 1.0 0 X 0 0 0 CS Lee Director 1.0 0 X 0 0 0 Thomas A Montgomery Director 1.0 1.0 X 0 0 0 Anne Motsenbocker Director 1.0 0 X 0 0 0 P Scott Ozanus Director 1.0 0 X 0 0 0 Javier Palomarez Director 1.0 0 X 0 0 0 Robert Peterson Director 1.0 0 X 0 0 0 Mary Suhm Director 1.0 0 X 0 0 0 Gregg Tanner Director 1.0 0 X 0 0 0 Mark Zacheis Director 1.0 1.0 X 0 0 0 Douglas G Hock President COO CMC and EVP CHST 53.0 2.0 X 0 1013374 39974 Michele Chulick President CHST Ventures 1.0 54.0 X 0 905805 10600 Lawrence L Foust EVP and Chief Legal Officer 1.0 54.0 X 0 573322 22249 W Robert Morrow MD Pres Phys Orgs Acdmc Rel CCO 1.0 54.0 X 0 798164 19499 Kern Wildenthal Pres CMC Foundation 1.0 54.0 X 0 871992 13751 David G Biggerstaff Pres System Clin Operations 54.0 1.0 X 0 613435 23697 David E Eager EVP Chief Finanacial Officer 1.0 54.0 X 0 781951 22956 Mary E Stowe SVP and CNO 53.0 2.0 X 0 579519 30654 Michael Wiggins SVP Plano Administrator 54.0 1.0 X 0 268038 11193 Jeffrey Vawrinek VP Assoc General Counsel 1.0 49.0 X 0 421555 13108 Peter W Roberts Former CMCD Officer, Pres Pop Hlth Insurance Svcs 1.0 54.0 X 0 1021968 26295 Pamela Arora Former CMCD Officer, SVP and CIO 1.0 54.0 X 0 645827 27187 Cynthia Bassel Former CMCD Officer, SVP Foundation 1.0 54.0 X 0 522904 15917 Kimberly Besse Former CMCD Officer, SVP Chief HR Officer 1.0 54.0 X 0 548475 32788 Keri A Kaiser Former CMCD Officer, SVP Marketing Communications 1.0 54.0 X 0 336619 27271 Patricia U Winning Former CMCD Officer, SVP Business Development 0.0 55.0 X 0 762893 41075 Daniel T Carney Former CMCD Officer, VP Facilities Dev_Ops 49.0 1.0 X 0 686849 21115 Kenneth R Carr Former CMCD Officer, VP Clinical Support Srvcs 49.0 1.0 X 0 300215 29523 Joe D Cavender Former CMCD Officer, VP and ASSOCCNO 49.0 1.0 X 0 285043 26204 Jaquetta B Clemons Former CMCD Officer, VP Finance 1.0 49.0 X 0 324702 12706 Douglas D Duwe Former CMCD Officer, VP Academic Relations 1.0 49.0 X 0 287226 17464 Joseph Egan Former CMCD Officer, VP Bus Dev Strat Affiliations 1.0 49.0 X 0 316685 12233 Dorothy Foglia Former CMCD Officer, VP and ASSOCCNO 49.0 1.0 X 0 293693 26165 Michael W Hefton Former CMCD Officer, VP and ASSOCCNO 49.0 1.0 X 0 279968 33597 Jerry D Lee Former CMCD Officer, VP Accounting and Treasury 1.0 49.0 X 0 393636 33484 Rustin Morse MD Former CMCD Officer, VP Quality 49.0 1.0 X 0 463084 0 Beth A Peters Former CMCD Officer, VP Corp Compliance and CCO 1.0 49.0 X 0 300902 16073 Stephanie Slaughter Former CMCD Officer, VP Managed Care Strategy 1.0 49.0 X 0 366246 23397 Stephanie K Smith Former CMCD Officer, Sr Legal Counsel 1.0 49.0 X 0 121525 11465 Vanessa U Walls Former CMCD Officer, VP Regional Specialty Care Svc 49.0 2.0 X 0 357095 20146 Thomas Zellers MD Former CMCD Officer, VP Medical Staff Affairs 49.0 1.0 X 0 154000 0 Mark E Ziemianski Former CMCD Officer, VP Business Analytics 1.0 49.0 X 0 277035 25646 0 19261014 729577 0 true true true UTSW HI 108 5323 Harry Hines Blvd Dallas TX 753908886 Phys & Medical Svcs 94296354 RIGHT SOURCING INC PO Box 515743 Los Angeles CA 900515118 Staffing/Consulting Svcs 15778148 JE DUNN CONSTRUCTION COMPANY 16000 Dallas Pkwy 500 Dallas TX 75248 Contruction Services 12852014 DPR CONSTRUCTION 9606 MOPAC EXPRESSWAY STE 300 Austin TX 78759 Contruction Services 11851829 PRESIDIO NETWORKED SOLUTIONS PO Box 677638 Dallas TX 75267 Staffing/Consulting Svcs 5841262 358 5694220 382162 6076382 Net Patient Revenue 622110 1195493858 1195493858 Provisional for Doubtful Accounts 622110 -34952635 -34952635 0 0 0 0 1160541223 29106329 -222970 29329299 130664 130664 0 130664 130664 88756 -88756 0 -88756 -88756 Other Medical Service Revenue 622110 33272194 32442680 829514 Dietary Revenue 621990 4903177 4903177 Vending Revenue 454210 225357 225357 0 0 0 0 38400728 1234166570 1197887080 606544 29596564 X 0 0 207000 207000 0 0 0 0 0 0 0 0 0 0 0 0 448193720 347238332 100955388 0 17061338 13218281 3843057 0 51992651 40281335 11711316 0 31020883 24033446 6987437 0 0 0 0 0 1646834 0 1646834 0 251531 0 251531 0 0 0 0 0 0 0 0 0 0 0 154341400 130332592 24008808 0 13837198 11831 13825367 0 5062999 1971779 3091220 0 30769231 782245 29986986 0 0 0 0 0 37094803 6707382 30387421 0 2301399 665082 1636317 0 0 0 0 0 4275768 1735028 2540740 0 17182979 12190376 4992603 0 0 0 0 0 57102714 40511226 16591488 0 6652960 141320 6511640 0 Medical Surgical Supplies 112707440 112707440 0 0 Community Relations 41396582 41396582 0 0 Dietary and Food Costs 5013578 4392637 620941 0 Special Events & Projects 2682949 399776 2283173 0 7615728 3851929 3763799 0 1048411685 782775619 265636066 0 0 0 0 0 202842139 11174170 135934761 261599892 0 0 180818409 206296994 0 0 0 0 0 9827641 12866673 14890158 4101245 1176346802 424355578 765349087 751991224 570021564 458598760 30379232 122528343 0 0 0 680123085 1525270431 2590186076 3354427732 180169849 97999340 0 0 0 0 365548074 362405595 0 0 0 2534057 1292324 0 0 92242497 96630155 640494477 558327414 X 1440397479 2226514820 403513990 453821626 105780130 115763872 1949691599 2796100318 2590186076 3354427732 X 185754885 -45384990 0 0 722645004 -16606180 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true 355145 355145 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY In 2015, CMCD paid membership dues to organizations in which a portion of the membership dues were related to lobbying activities. NACH (National Association of Children's Hospitals), AHA (American Hospital Association), THA (Texas Hospital Association), TAVH (Texas Association of Voluntary Hospitals), THOT (Teaching Hospitals of Texas), and CHAT (Children's Hospital Association of Texas) identified a portion of their membership dues as being related to lobbying activities. Lobbying percentages were identified by said organizations and applied to 2015 membership dues. In addition, CMCD paid professional, consulting fees related to other lobbying activities. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY In 2015, CMCD paid membership dues to organizations in which a portion of the membership dues were related to lobbying activities. NACH (National Association of Children's Hospitals), AHA (American Hospital Association), THA (Texas Hospital Association), TAVH (Texas Association of Voluntary Hospitals), THOT (Teaching Hospitals of Texas), and CHAT (Children's Hospital Association of Texas) identified a portion of their membership dues as being related to lobbying activities. Lobbying percentages were identified by said organizations and applied to 2015 membership dues. In addition, CMCD paid professional, consulting fees related to other lobbying activities. 41433851 41433851 821267647 275891608 545376039 9325353 4762393 4562960 224278120 143701577 80576543 80041831 80041831 751991224 NET ASSETS OF THE FOUNDATION OTHER ASSETS LT ADVANCES TO AFFILIATES PROFESSIONAL RISK LIABILITY DEPOSIT - CIC Net Assets of Foundation 569558254 LT Advances to Affliates 944712336 Def. Loan Costs - Urban Ventur 475101 Def Bond Iss Costs 3530849 Other Assets 6993891 1525270431 UTSW PHYS GUARANTEES RETIREMENT PLAN ACCR RSV FOR PROFESSIONAL LIAB LT DEFERRED RENT LT-LOAN PAY-URBAN VENTURES Retirement Plan Accrual 76396297 Reserve for Professional Liability 7468248 LT Deferred Rent 2580610 LT - Loan Pay - Urban Ventures 10185000 96630155 Schedule D, Part X, Line 2 In 2015, Children's Medical Center of Dallas was not required to have a FIN48 footnote disclosure. Europe (Including Iceland and Greenland) Investments 650103 Central America and the Caribbean Investments 122561514 0 0 0 0 0 0 123211617 0 123211617 true false true false true false true true X true X true X true true false true true 20692399 291157 20401242 0.0195 623974417 559285229 64689188 0.0617 49665960 38508420 11157540 0.0106 0 0 694332776 598084806 96247970 0.0918 7773016 1081944 6691072 0.0064 36441598 2014556 34427042 0.0328 0 0.0 6012856 1334063 4678793 0.0045 2137868 156321 1981547 0.0019 0 0 52365338 4586884 47778454 0.0456 0 0 746698114 602671690 144026424 0.1374 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1000554 0 1000554 0.0010 0 0.0 0 0.0 0 0.0 0 0 1000554 0 1000554 0.0010 true 13991787 1022113 5163940 4432314 731626 X true true 2 1 Children's Medical Center of Dallas 1935 Medical District Drive Dallas TX 75235 www.childrens.com 138910807 X X X X X 2 CHILDREN'S MEDICAL Center Plano 7601 PRESTON ROAD PLANO TX 75024 WWW.CHILDRENS.COM 1720480627 X X X X X Children's Medical Center of Dallas 1 false false true X X X X X X X X X 13 true true false true X www.childrens.com X true 13 true www.childrens.com false false true X 200.0 400.0 X X X X true true X X X true X X X X true X false X X X X true X false false CHILDREN'S MEDICAL Center Plano 2 true false true X X X X X X X X X 13 true true false true X www.childrens.com X true 13 true www.childrens.com false false true X 200.0 400.0 X X X X true true X X X true X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Children's Medical Center of Dallas. Each year, Children's Health recruits a citizen advisory council made up of key stakeholders serving children and knowledgeable in public health. These community leaders meet monthly to discuss children's health care issues and to contribute their experience, insights and expert recommendations for the the Beyond ABC report prepared by Children'sHealth . Additionally, the citizen advisory boards for Beyond ABC identify recommendations for advocates and public officials in order to improve the lives and health of children. Recent advisory boards have included city and county officials, former legislators, members of law enforcement, school district administrators, nonprofit organizations' executives, child-advocacy representatives, chambers of commerce and senior staff from corporations and financial institutions. Additionally, as part of the Texas Healthcare Transformation and Quality Improvement Program, the state of Texas has been divided into 20 regions. Hospitals within each region have worked together to develop plans to respond to health needs and transform the health care delivery system. Children's Health participates in the Regional Healthcare Partnership (RHP) Plans for Regions 9 and 10. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Children's Medical Center of Dallas. Children's Medical Center of Dallas and Children's Medical Center Plano shared a state license, EIN, and MCR provider number prior to 2015. During 2015, Children's Medical Center Plano was issued a separate state license and MCR provider number. Both facilities continue to share an EIN. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Children's Medical Center of Dallas. Upon conducting the CHNA and developing the Community Health Implementation Strategy, Children's Health decided on priority areas of the identified health needs that were reviewed. The priority areas are those areas which Children's has decided to focus its resources and integrate into its strategic and operational plans. Multiple goals were developed for each priority area, along with strategies to accomplish those goals. Children's has implemented and/or is working towards implementation of the strategies for accomplishing the developed goals. Full details of priority areas, goals, and strategies are contained with the publically available CHNA and Community Health Implementation Strategy. Needs Not Addressed: Some issues identified through the Children's Health CHNA have not been addressed in this plan. In initial discussion and subsequent prioritization, Children's Medical Center Needs Assessment Team considered the levels to which some needs were already being addressed in the service area. Additionally, some community needs fall out of the scope of expertise and resources of Children's Medical Center. Children's Community Health Implementation Strategy includes details on Needs Not Addressed. The following are some of the needs identified in the assessment that are addressed by others or in different ways: safe and affordable housing, palliative care capacity/need for increased geriatric/long-term/home care resources, discourage elective deliveries/increase the percentage of women who receive prenatal care, provide comprehensive sexuality education/high incidence of STDs in RHP Region 10, protect green spaces/add bike lanes/improve access to parks. These needs are not being addressed by Children's as our priorities were established based on unmet community health needs that intersect with our mission and key clinical strengths. There are community and state agencies that have greater expertise in housing, palliative care, prenatal care, sex education, and protecting green spaces in our community. At this time, these issues have not been incorporated into our community benefit plan because we do not have the infrastructure, expertise, or funding needed to have a significant impact in these areas. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - Children's Medical Center of Dallas. Children's Health uses the Federal Poverty Guidelines to determine eligibility for low income individuals. 200% of the Federal Poverty Guidelines is used for 100% charity adjustment, and 201% to 400% of the Federal Poverty Guidelines is used for a sliding scale adjustment. Children's Health uses various documents and forms to verify income and expenses when determining the eligibility for financial assistance of a patient and their family. These documents include, but are not limited to, W2 Form, wage and earning statement, pay check remittance, worker's compensation, unemployment compensation determination letters, income tax returns, statement from employer, bank statements, copy of checks, documents of sources of income, telephone verification of gross income with the employer, proof of participation in government assistance programs such as Medicaid, signed affidavit or attestation by patient, and veterans benefit statement. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Children's Medical Center of Dallas. In addition to ensuring that the Children's Health charity care criteria is posted prominently and continuously in common entry points of the facility, a Director of Patient Financial Service ensures that the Children's Health charity care criteria is published annually in a local newspaper of general circulation in the county. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - Children's Medical Center of Dallas. Children's Health determines the maximum amount that can be charged to individuals eligible for financial assistance for emergency or other medically necessary care by calculating the average commercial and government payor amounts received by Children's Health, using the Look-back Method. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Children's Medical Center Plano. Each year, Children's Health recruits a citizen advisory council made up of key stakeholders serving children and knowledgeable in public health. These community leaders meet monthly to discuss children's health care issues and to contribute their experience, insights and expert recommendations for the the Beyond ABC report prepared by Children's Health. Additionally, the citizen advisory boards for Beyond ABC identify recommendations for advocates and public officials in order to improve the lives and health of children. Recent advisory boards have included city and county officials, former legislators, members of law enforcement, school district administrators, nonprofit organizations' executives, child-advocacy representatives, chambers of commerce and senior staff from corporations and financial institutions. Additionally, as part of the Texas Healthcare Transformation and Quality Improvement Program, the state of Texas has been divided into 20 regions. Hospitals within each region have worked together to develop plans to respond to health needs and transform the health care delivery system. Children's Health participates in the Regional Healthcare Partnership (RHP) Plans for Regions 9 and 10. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Children's Medical Center Plano. Children's Medical Center of Dallas and Children's Medical Center Plano shared a state license, EIN, and MCR provider number prior to 2015. During 2015, Children's Medical Center Plano was issued a separate state license and MCR provider number. Both facilities continue to share an EIN. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Children's Medical Center Plano. Upon conducting the CHNA and developing the Community Health Implementation Strategy, Children's Health decided on priority areas of the identified health needs that were reviewed. The priority areas are those areas which Children's Health has decided to focus its resources and integrate into its strategic and operational plans. Multiple goals were developed for each priority area, along with strategies to accomplish those goals. Children's Health has implemented and/or is working towards implementation of the strategies for accomplishing the developed goals. Full details of priority areas, goals, and strategies are contained with the publicly available CHNA and Community Health Implementation Strategy. Needs Not Addressed: Some issues identified through the Children's Health CHNA have not been addressed in this plan. In initial discussion and subsequent prioritization, Children's Medical Center Needs Assessment Team considered the levels to which some needs were already being addressed in the service area. Additionally, some community needs fall out of the scope of expertise and resources of Children's Medical Center. The Children's Health Community Health Implementation Strategy includes details on Needs Not Addressed. The following are some of the needs identified in the assessment that are addressed by others or in different ways: safe and affordable housing, palliative care capacity/need for increased geriatric/long-term/home care resources, discourage elective deliveries/increase the percentage of women who receive prenatal care, provide comprehensive sexuality education/high incidence of STDs in RHP Region 10, protect green spaces/add bike lanes/improve access to parks. These needs are not being addressed by Children's Health as our priorities were established based on unmet community health needs that intersect with our mission and key clinical strengths. There are community and state agencies that have greater expertise in housing, palliative care, prenatal care, sex education, and protecting green spaces in our community. At this time, these issues have not been incorporated into our community benefit plan because we do not have the infrastructure, expertise, or funding needed to have a significant impact in these areas. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - Children's Medical Center Plano. Children's Health uses the Federal Poverty Guidelines to determine eligibility for low income individuals. 200% of the Federal Poverty Guidelines is used for 100% charity adjustment, and 201% to 400% of the Federal Poverty Guidelines is used for a sliding scale adjustment. Children's Health uses various documents and forms to verify income and expenses when determining the eligibility for financial assistance of a patient and their family. These documents include, but are not limited to, W2 Form, wage and earning statement, pay check remittance, worker's compensation, unemployment compensation determination letters, income tax returns, statement from employer, bank statements, copy of checks, documents of sources of income, telephone verification of gross income with the employer, proof of participation in government assistance programs such as Medicaid, signed affidavit or attestation by patient, and veterans benefit statement. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Children's Medical Center Plano. In addition to ensuring that the Children's Health charity care criteria is posted prominently and continuously in common entry points of the facility, a Director of Patient Financial Service ensures that the Children's Health charity care criteria is published annually in a local newspaper of general circulation in the county. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - Children's Medical Center Plano. Children's Health determines the maximum amount that can be charged to individuals eligible for financial assistance for emergency or other medically necessary care by calculating the average commercial and government payor amounts received by Children's, using the Look-back Method. 6 Ambulatory Care Pavilion Dallas 2350 Stemmons Fwy Dallas TX 75207 OUTPATIENT CARE Specialty Center Southlake 470 E State Hwy 114 Southlake TX 76092 OUTPATIENT SPECIALTY CARE CENTER Specialty Center Mesquite 1675 Republic Pkwy Suite 190 MESQUITE TX 75150 Outpatient Specialty Care Center Specialty Center Rockwall 890 Rockwall Parkway Suite 100 Rockwall TX 75032 Outpatient Specialty Care Center Specialty Center Bass Center 6300 Harry Hines Blvd Dallas TX 75235 Outpatient Specialty Care Center Specialty Center Park Cities 8160 Walnut Hill Lane Dallas TX 75231 Outpatient Specialty Care Center Schedule H, Part I, Line 6a The Children's Health Community Benefit Report is prepared by our Public Relations department with collaboration from numerous departments within the hospital. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Children's uses Worksheet 2 from the Form 990 Schedule H instructions to calculate the costs for Part I, Line 7 and ratio of patient care cost to charges attributable to community benefits. Schedule H, Part II Community Building Activities Children's is passionate about maintaining a vocal presence in legislative affairs on the local, state and federal levels and is at the forefront of governmental efforts that affect the community at large, from booster seat and car safety measures to critical funding initiatives. Additionally, Children's collaborates extensively with our partners in coalitions such as the Children's Hospital Association of Texas (CHAT) and the Texas Hospital Association (THA) at the state level, as well as the Children's Hospital Association (formerly the National Association of Children's Hospitals and Related Institutions). Children's President and Chief Executive Officer also serves on the Board of Trustees for the American Hospital Association. Through these affiliations, Children's is better able to advocate the development of an effective, comprehensive and appropriately funded children's health care system in Texas and across the country. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Children's Health uses Worksheet 2 from the Form 990 Schedule H instructions to calculate the bad debt expense and ratio of patient care cost to charges attributable to community benefits. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Children's Health uses its cost accounting system and the actual costs that are written off by patient accounts to calculate the bad debt expense attributable to patients eligible under the organization's charity care policy. Children's rationale for including a portion of bad debt as community benefit is that, bad debt expense should be treated as a community benefit as it is similar to other unreimbursed financial assistance, as reported in Part I, Line 7a, but for a different population (namely, those patients who would qualify for charity care if they completed the financial assistance application). Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The following is the footnote disclosure related to the Allowance for Doubtful Accounts, provided with Children's Audited Financial Statements. Children's maintains allowances for doubtful accounts to reserve for potential write-offs relating to a patient's inability to make payments on an account. Accounts are written off when collection efforts have been exhausted. Children's routinely monitors its accounts receivable balances and utilizes historical collection experience to support the basis for its estimates of the provision for doubtful accounts. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Children's Health uses Worksheet A from the As Filed Medicare Cost Report and the IRS Schedule H Instructions to determine Medicare allowable costs. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Children's Health has written debt collection policies which identify collection practices to be followed. The collection practices determine for what financial assistance a patient qualifies, and if a patient does not qualify for financial assistance, Children's Health also has written collection practices to be followed to determine if a patient qualifies for charity care. As part of the collection practice, Children's Health financial counselors review with the patient and their family the various state and federal programs available to them. Schedule H, Part VI, Line 2 Needs assessment In addition to the 2013 Community Health Needs Assessment, Children's Health has produced a comprehensive quality-of life report on area children, Beyond ABC: Growing Up in Dallas County, since 1994. Beginning in 2008, a separate study has been published to focus on youth in Collin County as well. These biennial reports provide 10 years of trended data on the many factors facing children in our community. Beyond ABC analyzes more than 50 indicators of well-being with respect to health, education, safety and security for the more than 900,000 children that call those areas Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Children's Health Financial Counselors or Customer Service Representatives work with patients' guardians/guarantors to ensure that all public and voluntary assistance programs are fully explored. Children's Health has a financial program for patients who are considered indigent and do not qualify for a federal or state program. The eligibility criteria for financial assistance is based upon Federal Poverty Guidelines published annually. Patients eligible for financial assistance will have charges reduced to the lowest level charged to individuals who have insurance covering such care. Gross charges will not be used to calculate patient's bills. Schedule H, Part VI, Line 4 Community information Community Served by Children's Medical Center - Children's main campus is located at 1935 Medical District Drive, Dallas, Texas. The city of Dallas is the county seat of Dallas County. The city of Dallas is one of the most populous cities in Texas, as well as the United States. Children's also has an inpatient facility located at a second campus in Plano, Texas. Plano is in Collin County; which is also home to fast-growing cities like Frisco, Allen, McKinney and Prosper. Identification and Description of Geographical Community - The city of Dallas is the third largest city in Texas. The city of Dallas is accessible from I-30, I-35E, I-45 and I-635. Patients primarily originate from Texas (94.8 percent). Nearly 50 percent (48.8 percent) of Children's discharges originate in Dallas County, Texas. Collin County is one of the fastest growing areas in the United States, with its population between 2000 and 2010 growing from 491,000 to over 782,000. Community Population and Demographics - The U.S. Bureau of Census has compiled population and demographic data based on the 2010 census. The Nielsen Company, a firm specializing in the analysis of demographic data, has extrapolated this data to estimate population trends from 2013 through 2018. Based on the data, the overall population for Children's service area is projected to increase over the five-year period from 3,320,715 to 3,608,755. The age categories that represent youth and adolescents (0-14 and 15-20) is projected to increase 7.0 percent and 8.9 percent,respectively. According to the American Community Survey, 670,217 children under the age of 18 lived in Dallas County in 2012. Nearly 54 percent of all the children in Dallas County were Caucasian compared to approximately 67 percent in Collin County. In terms of race, nearly 54 percent of all children in Dallas County were Caucasian, followed by 23 percent African-American. Although more than half of the children in Dallas County are Caucasian, only 35 percent of the Caucasian child population is non-Hispanic. Moreover, Hispanic children make up more than 52 percent of the child population of Dallas County. Service to the Community - Children's Health is well known for bringing exceptional medical and surgical care to the children of North Texas. Through community events, child-specific initiatives and organizational affiliations, the hospital invests in prevention, research, education, clinical excellence and advocacy to benefit all children. Children's Health devotes itself solely to caring for the complex medical needs of children. Children's Health provides patient care ranging from simple eye exams to specialized treatment in areas such as heart disease, hematology-oncology and cystic fibrosis. In addition, Children's is a major pediatric kidney, liver, intestine and heart transplant center. Through its established injury prevention, advocacy program and disease management programs, the hospital works diligently to educate the community so that no child has to ever come through our doors. Combined, Children's Medical Center Dallas and Children's Medical Center Plano are licensed for 592 beds and has more than 50 subspecialty programs spanning the two campuses - the main hospital in Dallas and a second full-service hospital in Plano. Children's was the first pediatric hospital in Dallas designated as a Level I Trauma Center. Children's is a private, not-for-profit hospital system that does not receive local tax dollars to offer the care provided. Children's is philanthropically supported in its efforts to provide care for every child who comes to us, regardless of their family's ability to pay. Donors also play a significant part in our ability to conduct research, education and advocacy. Combined, the two Children's Health facilities serve children through more than 677,000 patient encounters annually. But that doesn't prevent the offering of an elite level of individual care and attention to each family. As the primary pediatric teaching facility for the UT Southwestern Medical Center at Dallas, ("UTSW"), Children's is the only full-service, academic-affiliated pediatric hospital in North Texas. Through this academic affiliation, the Children's medical staff conducts research that is instrumental in developing treatments, therapies, and greater understanding of pediatric diseases and trains more than 200 pediatric residents and fellows annually. Schedule H, Part VI, Line 5 Promotion of community health The mission of Children's Medical Center of Dallas (Children's Health) is to make life better for children. With oversight from a board of directors comprised of individuals who are representative of the community served, Children's Health promotes health and benefits the community through its two licensed hospitals - Children's Medical Center Dallas and Children's Medical Center Plano. Children's Health medical staff is open to physicians in the community who meet all requirements outlined in the Children's Health Medical/Dental Staff Bylaws. Children's Health considers it a privilege and responsibility to serve as ardent advocates for kids in Texas and across the country. To that end, we work tirelessly to ensure that children's voices are heard and that their needs are met. Our efforts to influence public policies that impact children's health are comprehensive and ongoing. Through programmatic initiatives, organizational partnerships and community events, Children's Health spreads its influence throughout the region and provides area children with much-needed access to a better quality of life. Whether that means establishing programs to increase services to the area's under served children or fostering partnerships with existing organizations, Children's Health is committed to connecting families to the services they need. Community Outreach - Through the efforts of the Community Relations staff at Children's Health, more area children who are eligible for Medicaid or the Children's Health Insurance Program (CHIP) are receiving coverage. Almost 18 percent of the children living in Dallas County are uninsured. Lack of health insurance leads to poorer health in childhood, greater rates of avoidable hospitalizations and higher childhood mortality. Uninsured children are 8 times more likely to have delayed care and 12 times more likely to have an unmet medical need than children with private insurance. Children's Health is committed to helping families obtain health insurance, an important factor in the health and well-being for our entire community. Children's Health has a vision to help address the shortage of primary pediatric medical care for families with limited resources. Dallas CHIP Coalition - Children's Health ounded and sponsors the Dallas Children's Health Insurance Program Coalition, an alliance of more than 90 organizations focused on helping families of uninsured children apply for CHIP or Medicaid. In addition, the coalition provides community leadership on public policy issues that affect the crisis of uninsured children in our community. MEDICAID/CHIP Outreach Events - Annually, Children's Health coordinates two large community outreach events targeting the families of uninsured children. Working with the Dallas Children's Health Insurance Program Coalition, these events are promoted through school flyers and the media. Since 2005, these events have helped more than 12,000 families apply for coverage for more than 24,000 children. The coalition has trained more than 250 volunteers to assist families with applications for CHIP or Medicaid. School Based Medicaid/Chip Outreach Children's Health outreach team conducts Medicaid/Children's Health Insurance Program outreach at area school districts with a combined enrollment of more than 350,000. Each student's family receives communications during a school year with information on the importance of health insurance and the tools to apply for CHIP/Medicaid. Children's Health serves as a liasion with the state for families who could not successfully navigate the state's eligibility system. Tackling an epidemic Texas ranks sixth in the nation for obesity in 10 to 17 year-olds, and the problem is even more pressing in Dallas County. More than one-third (36.1 percent) of Dallas Independent School District high-school students are obese or overweight, almost double the national average, according to the Department of State Health Services. In 2008, only one in five Dallas ISD third-graders passed the Texas-mandated school Fitnessgram assessment, compared to about one in three statewide. At Children's Health , we provide services to 7,500 patients each year with diagnoses that research shows to be obesity-related. These include cardiology, endocrine, gastrointestinal, pulmonary and psychiatric diagnoses. Dental Outreach Although effective methods exist to prevent tooth decay, cavities remain the most prevalent chronic condition among children-five times more common than asthma and seven times more common than hay fever. In partnership with UT Southwestern Medical Center at Dallas, a grant has been obtained so that children from the continuity clinics and ARCH (At-Risk Children) clinic who are identified as at-risk are now provided oral health education and fluoride varnish every three months to reduce their risk of cavities. Children's Health website Our hospital web site, www.childrens.com, empowers parents with the latest information about childhood illnesses, prevention, treatment and services available at the hospital. More than 1,300 common pediatric topics are addressed on the Web site. Also available are interactive guides promoting healthy living that target both children and their parents. Reaching out to support the families of our communities is at the heart of the Children's Health mission. The challenge of ensuring the safety and well-being of all children is a driving force for the hospital, its employees and its medical staff. Assessing how many lives our services touch requires a look into our community, where the Children's Health influence has impact far beyond the hospital's walls. Disease Management and Wellness The Disease Management and Wellness Department at Children's Health improves quality of life and decreases the use of healthcare services through education and pro-active self management. Children's Health has seven disease-specific certifications, the most of any pediatric center in the United States. The programs offer access to evidence-based care and support that is needed for the management of conditions like asthma, diabetes and obesity. The disease management initiative is part of the hospital's ongoing efforts to reduce emergency department use, decrease admissions, curtail healthcare costs and ultimately, improve the quality of life for children with chronic conditions. Each program provides a family-centered environment that focuses on providing quality care to patients and overall increased disease awareness. Coaching coaches, athletes and parents Children's Health is committed to educating coaches, parents and young athletes on the importance of sports injury prevention. The hospital has a presence at dozens of coaches' clinics each year at facilities such as the Plano Sports Authority and Dallas Baseball Academy of Texas. During the clinics, Children's provides sports-specific injury-prevention cards and clipboards to thousands of coaches each year. So far, we have impacted the health and safety of 400,000 young athletes. Children's Health has also worked with companies such as Kohl's Corporation and their Sports Health and Wellness Outreach Program, to further support community outreach efforts Spreading a message of water safety Drowning is the second-leading cause of unintentional injury-related deaths among American children ages 1 to 14. The Know Before You Go Program spreads the message that every drowning is preventable when parents take appropriate precautions. The program includes distributing water safety materials, providing demonstrations on proper water rescue techniques and the use and proper fit of Coast Guard approved flotation devices. Working to reduce preventable injuries More than a decade ago, Children's Health formed the Safe Kids Dallas Area Coalition - the local chapter of Safe Kids Worldwide - to prevent childhood injuries. Traumatic injuries are the leading cause of death in Texas in children ages 1 to 14, and preventing these injuries is imperative at Children's Health - the first Level I trauma center in Texas (and one of only two in the state) that is solely dedicated to treating pediatric patients. Since 2002, the number of patients hospitalized because of motor vehicle crashes has steadily risen. Children's Health Injury Prevention Program has expanded its outreach efforts accordingly to bring car seat safety education and installation services to the community in an effort to reduce the number of children injured in car crashes. A specific initiative within the Safe Kids Dallas program is our car-seat safety inspection project. The project offers child safety-seat inspections by certified car seat technicians at Children's Health Dallas and Plano campus so parents can learn to buckle up their children appropriately. Schedule H, Part VI, Line 6 Affiliated health care system Children's Medical Center Dallas and Children's Medical Center Plano are a part of Children's Health System of Texas. Children's Health System of Texas is the leading pediatric health care system in North Texas, the seventh largest pediatric health care provider in the nation (according to Modern Healthcare 2014), and the second busiest in terms of admissions and pediatric Emergency Department visits. A private, not-for-profit organization, Children's Health is anchored by two full-service hospitals and encompasses a full range of pediatric health, wellness and acute care services for children from birth to age 18, including specialty care, primary care, home health, a pediatric research institute and community outreach services, among other forms of health care delivery. Schedule H, Part VI, Line 7 State filing of community benefit report TX true May Smith 9 45000 Women's Auxiliary 10 20000 James J Farnsworth 3 6000 Grace Lee 3 9000 Milonovich 2 7000 Nursing Dividion Tuition Assistance 65 120000 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. May Smith Scholars Program The heritage of nursing is rich at Children's, which traces its roots back to a clinic started by nurse May Forster Smith. This scholarship is named for Smith, who began an open-air clinic for infants in 1913. That pioneering spirit continues in the 21st century. The May Smith Scholars Program provides financial assistance for baccalaureate students interested in pediatric nursing. Eligibility Applicants must meet all of the following criteria to be eligible to apply for this scholarship: *Be a current sophomore or junior undergraduate baccalaureate nursing student. *Have a cumulative 3.0 GPA on a 4.0 scale. Award Details *A limited number of scholarships in the amount of $5,000 will be awarded each year. *Students may reapply each year as long as they continue to meet the eligibility criteria. *The scholarships will be applied to tuition, fees, books, supplies and equipment required for course load at accredited, nonprofit four-year colleges/universities in the United States. *Students may transfer from one institution to another Women's Auxiliary Educational Assistance Program The Women's Auxiliary to Children's offers educational support to nursing and allied health students who are registered for, or currently enrolled in, an accredited program through the Educational Assistance program for Nursing and Allied Health Students. Eligibility Applicants must meet all of the following criteria to be eligible to apply for this scholarship: *Be a current junior, senior or graduate student enrolled full or part-time in an accredited undergraduate, or graduate, nursing or allied health program. *Have a cumulative 3.0 GPA on a 4.0 scale. Award Details *A limited number of scholarships in the amount of $2,000 will be awarded each year. *Students may reapply each year as long as they continue to meet the eligibility criteria. *The scholarships will be applied to tuition, fees, books, supplies and equipment required for course load at accredited, nonprofit four-year colleges/universities in the United States. *Students may transfer from one institution to another and retain the award. James J. Farnsworth Health Career Scholarship Program The James J. Farnsworth Health Career Scholarship offers educational support to students planning careers in pediatric healthcare. The scholarship is named in honor of James J. Farnsworth and was established from gifts to endowments made in tribute to Mr. Farnsworth by his friends and colleagues. Mr. Farnsworth served as president of Children's Medical Center Dallas for more than 30 years and was a fellow in the College of Healthcare Executives. Eligibility Applicants must meet all of the following criteria to be eligible to apply for this scholarship: *Be a current sophomore, junior, senior or graduate student, planning a career in pediatric healthcare. *Preference will be given to students who fall into the following categories: -Former patients of Children's -Current full or part-time employees -Former or current volunteers at Children's -Parent is employed at Children's -Parent is a volunteer at Children's -Students demonstrating strong academic achievement Award Details *A limited number of scholarships in the amount of $1,000 will be awarded each year. *Students may reapply each year as long as they continue to meet the eligibility criteria. *The scholarships will be applied to tuition, fees, books, supplies and equipment required for course load at accredited, nonprofit four-year colleges/universities in the United States. *Students may transfer from one institution to another and retain the award. Grace Lee Scholarship for Clinical Education The Grace Lee Scholarship for Clinical Education recently was established in honor of Grace Lee, a former patient at Children's and in recognition of the exemplary care provided by clinical staff members who contributed to her comprehensive care. The scholarship will provide financial assistance for the continuing education of clinical employees who are direct caregivers at Children's. Eligibility Applicants must meet all of the following criteria to be eligible to apply for this scholarship: *Be a full-time clinical employee of Children's with two years of continuous employment at Children's as of the application deadline. *Be enrolled in or accepted into an accredited healthcare education program. *Be recommended by an immediate supervisor or department director. *Have a cumulative 3.0 GPA on a 4.0 scale. Award Details *A limited number of scholarships in the amount of $3,000 will be awarded each year. *Students may reapply each year as long as they continue to meet the eligibility criteria. *The scholarships will be applied to tuition, fees, books, supplies and equipment required for course load at accredited, nonprofit two or four-year colleges/universities in the United States. *Students may transfer from one institution to another and retain the award. Nursing Division Tuition Assistance Program The Nursing Division is offering scholarships to full- and part-time RN staff enrolled in an accredited BSN program, up to $2,000 per nurse for full-time employment and $1000 for part-time employment. The Nursing Division can award up to $140,000. These scholarships support the Nursing Division's goal for all bedside nurses to have a BSN degree by 2020. Eligibility Applicants must meet all of the following criteria to be eligible to apply for this scholarship: *Be a full-time clinical employee of Children's in good standing. *Confirm proof of enrollment in an accredited BSN nursing program. Award Details *A limited number of scholarships in the amount of $1,000-2,000 will be awarded each year. *Students may reapply each year as long as they continue to meet the eligibility criteria. *The tuition assistance will be applied to tuition, fees, books, supplies and equipment required for course load at accredited, nonprofit two or four-year colleges/universities in the United States. *Students may transfer from one institution to another and retain the award. true true false false false false false true false Christopher J Durovich President CEO CHST and CEO CMC, Ex Officio Vtg Mbr 0 1014553 0 1368233 0 1004483 0 19874 0 22269 0 3429412 0 573151 Peter W Roberts Former CMCD Officer, Pres Pop Hlth Insurance Svcs 0 534452 0 335196 0 152320 0 10600 0 15695 0 1048262 0 0 Pamela Arora Former CMCD Officer, SVP and CIO 0 343898 0 261469 0 40461 0 15900 0 11287 0 673015 0 64652 Cynthia Bassel Former CMCD Officer, SVP Foundation 0 313241 0 202346 0 7318 0 10600 0 5317 0 538821 0 0 Kimberly Besse Former CMCD Officer, SVP Chief HR Officer 0 322698 0 181778 0 43999 0 15013 0 17775 0 581263 0 0 Keri A Kaiser Former CMCD Officer, SVP Marketing Communications 0 242215 0 87143 0 7261 0 10600 0 16671 0 363889 0 0 Patricia U Winning Former CMCD Officer, SVP Business Development 0 388607 0 314030 0 60256 0 24362 0 16714 0 803969 0 80126 Daniel T Carney Former CMCD Officer, VP Facilities Dev_Ops 0 173072 0 94572 0 419206 0 11639 0 9476 0 707965 0 0 Kenneth R Carr Former CMCD Officer, VP Clinical Support Srvcs 0 224984 0 71860 0 3371 0 16911 0 12612 0 329738 0 0 Joe D Cavender Former CMCD Officer, VP and ASSOCCNO 0 208645 0 73657 0 2741 0 16907 0 9297 0 311247 0 0 Jaquetta B Clemons Former CMCD Officer, VP Finance 0 277100 0 41994 0 5607 0 9640 0 3066 0 337408 0 0 Douglas D Duwe Former CMCD Officer, VP Academic Relations 0 225380 0 45406 0 16440 0 10600 0 6864 0 304690 0 0 Joseph Egan Former CMCD Officer, VP Bus Dev Strat Affiliations 0 204381 0 95333 0 16972 0 10600 0 1633 0 328918 0 0 Dorothy Foglia Former CMCD Officer, VP and ASSOCCNO 0 212233 0 75457 0 6003 0 15150 0 11015 0 319858 0 0 Michael W Hefton Former CMCD Officer, VP and ASSOCCNO 0 203190 0 73685 0 3092 0 18716 0 14881 0 313565 0 0 Jerry D Lee Former CMCD Officer, VP Accounting and Treasury 0 274148 0 91095 0 28393 0 14641 0 18843 0 427120 0 0 Rustin Morse MD Former CMCD Officer, VP Quality 0 463084 0 0 0 0 0 0 0 0 0 463084 0 0 Beth A Peters Former CMCD Officer, VP Corp Compliance and CCO 0 224645 0 74326 0 1932 0 9620 0 6453 0 316975 0 0 Stephanie Slaughter Former CMCD Officer, VP Managed Care Strategy 0 258011 0 97038 0 11197 0 10344 0 13053 0 389642 0 0 Stephanie K Smith Former CMCD Officer, Sr Legal Counsel 0 119977 0 0 0 1548 0 6923 0 4542 0 132990 0 0 Vanessa U Walls Former CMCD Officer, VP Regional Specialty Care Svc 0 245984 0 82749 0 28363 0 10416 0 9730 0 377242 0 0 Thomas Zellers MD Former CMCD Officer, VP Medical Staff Affairs 0 154000 0 0 0 0 0 0 0 0 0 154000 0 0 Mark E Ziemianski Former CMCD Officer, VP Business Analytics 0 203033 0 71986 0 2016 0 10600 0 15046 0 302682 0 0 Douglas G Hock President COO CMC and EVP CHST 0 525384 0 415277 0 72713 0 18768 0 21205 0 1053348 0 98100 Michele Chulick President CHST Ventures 0 554969 0 321690 0 29146 0 10600 0 0 0 916405 0 0 Lawrence L Foust EVP and Chief Legal Officer 0 476909 0 62285 0 34128 0 10600 0 11649 0 595571 0 0 W Robert Morrow MD Pres Phys Orgs Acdmc Rel CCO 0 495272 0 297763 0 5129 0 10600 0 8899 0 817664 0 0 Kern Wildenthal Pres CMC Foundation 0 533943 0 312731 0 25318 0 10600 0 3151 0 885743 0 0 David G Biggerstaff Pres System Clin Operations 0 332945 0 246040 0 34449 0 14982 0 8715 0 637131 0 67506 David E Eager EVP Chief Finanacial Officer 0 496312 0 281597 0 4042 0 10600 0 12356 0 804907 0 0 Mary E Stowe SVP and CNO 0 306622 0 236290 0 36607 0 20239 0 10415 0 610173 0 66514 Michael Wiggins SVP Plano Administrator 0 231305 0 26000 0 10733 0 6538 0 4655 0 279231 0 0 Jeffrey Vawrinek VP Assoc General Counsel 0 310176 0 85024 0 26355 0 13108 0 0 0 434663 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation CHILDREN'S HEALTH SYSTEM OF TEXAS (EIN 75-2062019) IS THE SOLE MEMBER AND COMMON PAYING AGENT FOR CHILDREN'S MEDICAL CENTER OF DALLAS (CMCD). THEREFORE, CMCD'S CEO, PRESIDENT, OTHER OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). THE CHILDREN'S HEALTH PROCESS FOR DETERMINING COMPENSATION IS AS FOLLOWS: 1. THE HUMAN RESOURCES COMMITTEE OF THE CHST BOARD IS RESPONSIBLE FOR SETTING THE COMPENSATION FOR EXECUTIVES, EXCEPT THE PRESIDENT AND CEO WHICH IS SET BY THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPRISED OF INDEPENDENT, NON-EMPLOYEE DIRECTORS WITH NO CONFLICT OF INTEREST REGARDING EXECUTIVE COMPENSATION. A WRITTEN COMPENSATION PHILOSOPHY HAS BEEN DEVELOPED BY THE HUMAN RESOURCES COMMITTEE FOR TIMELINESS AND APPROPRIATENESS. THE PHILOSOPHY DEFINED DESIRED COMPARATOR GROUPS FOR COMPENSATION SURVEYS. THE COMPARATOR GROUPS ARE FROM DOMESTIC HEALTHCARE INDUSTRY SECTORS ONLY AND DO NOT INCLUDE ANY NON-HEALTHCARE ORGANIZATIONS. 2. THE COMPENSATION PHILOSOPHY ALSO DEFINES TARGET LEVELS RELATIVE TO THE MARKETPLACE COMPARATOR GROUPS FOR BASE PAY, BASE PAY PLUS INCENTIVE PAY, AND FRINGE BENEFITS PROVIDED TO CHILDREN'S EXECUTIVES. A THIRD-PARTY CONSULTANT, SULLIVAN COTTER, IS ENGAGED BY THE HUMAN RESOURCES COMMITTEE AND PROVIDES INDEPENDENT, EXPERT CONSULTING SERVICES IN THE AREA OF EXECUTIVE COMPENSATION MARKET SURVEYING, PAY AND BENEFITS PROGRAM DESIGN, AND ADMINISTRATIVE SERVICES. SALARIES FOR CHILDREN'S EXECUTIVES (EXCEPT FOR THE PRESIDENT AND CEO) ARE SET BY COMPARING THE SALARIES PAID FOR COMPARABLE POSITIONS IN INTEGRATED SYSTEMS ACADEMIC MEDICAL CENTERS AND CHILDREN'S HOSPITALS IN SIMILAR SIZE AND SCOPE OF SERVICES TO CHILDREN'S. 3. THE SALARY FOR THE PRESIDENT AND CEO IS SET IN REFERENCE TO SALARIES PAID FOR PRESIDENTS AND CEOS OF CHILDREN'S HOSPITALS IN SIMILAR SIZE AND SCOPE OF SERVICES TO CHILDREN'S. THE DATA IS COMPILED BY SULLIVAN COTTER AND THEY DEVELOP AND UPDATE ANNUALLY SALARY RANGES UNIQUE TO EACH EXECUTIVE POSITION. THE HUMAN RESOURCES COMMITTEE APPROVES BASE PAY FOR EACH EXECUTIVE (EXCEPT THE PRESIDENT AND CEO, WHOSE BASE PAY IS APPROVED BY THE BOARD OF DIRECTORS) AIMED IN THE AGGREGATE AT APPROXIMATELY THE MIDDLE OF EXECUTIVE PAY RANGES. 4. FOR OTHER OFFICERS AND KEY EMPLOYEES, CHILDREN'S USES A COMBINATION OF JOB EVALUATION AND SURVEY DATA TO DETERMINE THE MARKET PAY RANGE. Schedule J, Part I, Line 4a Severance or change-of-control payment Severance Payment: * Severance - Daniel T Carney - $266,500 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Non-Qualified Retirement Plan: * Retirement Income Restoration Plan - Christopher J Durovich received $562,323 as taxable income from the Retirement Income restoration Plan in 2015. Additional employees who participated in the Retirement Income Restoration Plan include Douglas G Hock, Mary E Stowe, and Patricia U Winning. * Savings Restoration Plan - Christopher J Durovich received $302,815 as taxable income from the Savings Restoration Plan. Additional employees who participated in the Savings Restoration Plan include Peter Roberts, Patricia U Winning, Douglas G Hock, Ray Tsai, Michele Chulick, David Eager, Jeffrey Vawrinek, Pamela Arora, Vanessa U Walls, David G Biggerstaff, Mary E Stowe, Daniel T Carney, Jerry Lee, Kimberly Besse. Schedule J, Part I, Line 7 Non-fixed payments Non-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 2015. A N Central Tx Hlth Fac Dev Corp Hosp 521304502 65854RAL4 2009-07-01 193697772 Reimburse Construction Cost false false false B N Central Tx Hlth Fac Dev Corp Hosp 521304502 65854RBD1 2012-08-15 178386376 Refund Series 2002 Bonds false false false A 0 0 193697772 0 0 0 2819039 0 312573 190566160 0 2009 false false true true B 4110000 0 178386376 0 0 0 0 0 0 0 178386376 0 true false true true A false true true false true false 0.003 0.0 0.003 false false true B 0.0 A false false true false false false false false true B false true false false false false false false true A true B true Schedule K, Part I, Column (f) Row B Series 2012 Bonds were issued for the purpose of currently refunding the Issuer's Hospital Revenue Bonds (Children's Medical Center of Dallas Project) Series 2002 (original issue date prior to December 31, 2002). Schedule K, Part II, Line 11 Column B The other spent proceed are the refunding proceeds of the issue that are no longer in escrow. Schedule K, Part III, Line 3b Column A All agreements are reviewed by internal counsel and compliance specialists to insure they comply with rules, regulations, and policies and procedures. Schedule K, Part III, Line 3d Column A All agreements are reviewed by internal counsel and compliance specialists to insure they comply with rules, regulations, and policies and procedures. Form 990, Part V, Line 2a CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST) EIN 75-2062019 IS THE COMMON PAYING AGENT FOR CHILDREN'S MEDICAL CENTER OF DALLAS (CMCD) THEREFORE, ALL APPLICABLE IRS TAX COMPLIANCE FILINGS ARE REPORTED BY CHST ON BEHALF OF CMCD. CMCD HAS APPROXIMATELY 5,000 EMPLOYEES. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL CHILDREN'S HEALTH SYSTEM OF TEXAS (EIN 75-2062019) IS THE SOLE MEMBER AND COMMON PAYING AGENT FOR CHILDREN'S MEDICAL CENTER OF DALLAS (CMCD). THEREFORE, CMCD'S CEO, PRESIDENT, OTHER OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). THE CHILDREN'S HEALTH PROCESS FOR DETERMINING COMPENSATION IS AS FOLLOWS: 1. THE HUMAN RESOURCES COMMITTEE OF THE CHST BOARD IS RESPONSIBLE FOR SETTING THE COMPENSATION FOR EXECUTIVES, EXCEPT THE PRESIDENT AND CEO WHICH IS SET BY THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPRISED OF INDEPENDENT, NON-EMPLOYEE DIRECTORS WITH NO CONFLICT OF INTEREST REGARDING EXECUTIVE COMPENSATION. A WRITTEN COMPENSATION PHILOSOPHY HAS BEEN DEVELOPED BY THE HUMAN RESOURCES COMMITTEE FOR TIMELINESS AND APPROPRIATENESS. THE PHILOSOPHY DEFINED DESIRED COMPARATOR GROUPS FOR COMPENSATION SURVEYS. THE COMPARATOR GROUPS ARE FROM DOMESTIC HEALTHCARE INDUSTRY SECTORS ONLY AND DO NOT INCLUDE ANY NON-HEALTHCARE ORGANIZATIONS. 2. THE COMPENSATION PHILOSOPHY ALSO DEFINES TARGET LEVELS RELATIVE TO THE MARKETPLACE COMPARATOR GROUPS FOR BASE PAY, BASE PAY PLUS INCENTIVE PAY, AND FRINGE BENEFITS PROVIDED TO CHILDREN'S EXECUTIVES. A THIRD-PARTY CONSULTANT, SULLIVAN COTTER, IS ENGAGED BY THE HUMAN RESOURCES COMMITTEE AND PROVIDES INDEPENDENT, EXPERT CONSULTING SERVICES IN THE AREA OF EXECUTIVE COMPENSATION MARKET SURVEYING, PAY AND BENEFITS PROGRAM DESIGN, AND ADMINISTRATIVE SERVICES. SALARIES FOR CHILDREN'S EXECUTIVES (EXCEPT FOR THE PRESIDENT AND CEO) ARE SET BY COMPARING THE SALARIES PAID FOR COMPARABLE POSITIONS IN INTEGRATED SYSTEMS ACADEMIC MEDICAL CENTERS AND CHILDREN'S HOSPITALS IN SIMILAR SIZE AND SCOPE OF SERVICES TO CHILDREN'S. 3. THE SALARY FOR THE PRESIDENT AND CEO IS SET IN REFERENCE TO SALARIES PAID FOR PRESIDENTS AND CEOS OF CHILDREN'S HOSPITALS IN SIMILAR SIZE AND SCOPE OF SERVICES TO CHILDREN'S. THE DATA IS COMPILED BY SULLIVAN COTTER AND THEY DEVELOP AND UPDATE ANNUALLY SALARY RANGES UNIQUE TO EACH EXECUTIVE POSITION. THE HUMAN RESOURCES COMMITTEE APPROVES BASE PAY FOR EACH EXECUTIVE (EXCEPT THE PRESIDENT AND CEO, WHOSE BASE PAY IS APPROVED BY THE BOARD OF DIRECTORS) AIMED IN THE AGGREGATE AT APPROXIMATELY THE MIDDLE OF EXECUTIVE PAY RANGES. 4. FOR OTHER OFFICERS AND KEY EMPLOYEES, CHILDREN'S USES A COMBINATION OF JOB EVALUATION AND SURVEY DATA TO DETERMINE THE MARKET PAY RANGE. Form 990, Part VI, Line 1a Material differences in voting rights Children's Board membership includes five ex officio non voting members. Form 990, Part VI, Line 6 Classes of members or stockholders Children's Health System of Texas ("CHST"), a Texas non-profit corporation, is the sole member of the corporation. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body CHST elects all members of the organization's Board of Directors. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Member reserve powers are specified in the the organization's bylaws and represent those actions which require member approval. 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 body Children's Medical Center of Dallas 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 policy Officers, 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 needed. Form 990, Part VI, Line 19 Required documents available to the public Certificate of Formation is publicly available, Consolidated Financial Statements are attached to Form 990 and publicly available, and the conflict of interest policy is available upon request. Form 990, Part IX, Line 11g Other Fees Consulting & Professional fees - Total Expense: 15610150, Program Service Expense: 2215922, Management and General Expenses: 13394228, Fundraising Expenses: ; Contract Medical - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 10614580, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Trfs to/from CMCF - -75000000; Acc Pens Liab-OCI - -6477890; NetAssets-CMCF-Unrestct&Temp R - 50307636; NetAssets-CMCF-Endowment - 9983742; Other Adjustment - 4580332; CHILDREN'S MEDICAL CENTER FOUNDATION 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752062015 FOUNDATION TX 501(c)(3 7 CHILDREN'S HEALTH SYSTEM OF TEXAS false PHYSICIANS FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752854505 PHYSICIANS TX 501(c)(3 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false DALLAS PHYS MED SVCS FOR CHILDREN INC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 810584868 PHYSICIANS TX 501(c)(3 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false COMPLEX CARE MED SVC CORP 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 461893597 MEDICAL SERVICES TX 501(c)(3 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S MEDICAL CENTER HEALTH PLAN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 462737696 HMO TX 501(c)(3 9 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S MED CTR RESEARCH INST AT UTSWMC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 433462044 RESEARCH INSTITUTE TX 501(c)(3 Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false PEDIATRIC PARTNERS FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 461917702 CLINICALLY INTEGRATED NETWORK TX 501(c)(3 Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S MEDICAL CENTER SERVICES 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 461934007 MEDICAL SERVICES TX 501(c)(3 9 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S POPULATION HEALTH 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 463104601 POPULATION HEALTH TX 501(c)(3 Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S HEALTH SYSTEM OF TEXAS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752062019 MANAGEMENT COMPANY TX 501(c)(3 Type II N/A false ANESTHESIOLOGISTS FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752917570 PHYSICIANS TX 501(c)(3 9 CHILDREN'S HEALTH SYSTEM OF TEXAS false SPECIALISTS FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 463110125 PHYSICIANS TX 501(c)(3 9 CHILDREN'S HEALTH SYSTEM OF TEXAS false PHYSICIANS QUALITY ALLIANCE OF NORTH TEXAS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 464049491 PHYSICIANS TX 501(c)(3 Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false COMMUNITY PROVIDERS FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 463675742 PHYSICIANS TX 501(c)(3 Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false SOUTHWESTERN MEDICAL DISTRICT 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 204101612 MEDICAL DISTRICT TX 501(c)(3 Type I N/A false WOMEN'S AUXILIARY OF CMCD 12720 HILLCREST RD DALLAS TX 75230 752485538 WOMEN'S AUXILIARY TX 501(c)(3 9 N/A false THE HEALTH AND WELLNESS ALLIANCE FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 463080586 PHYSICIANS TX 501(c)(3 Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false OCH Holdings 1935 Medical District Drive Dallas TX 75235 474837308 Hospital TX 501(c)(3 3 Children's Medical Center of Dallas true Children's BMG dba One Care Domain 1935 Medical District Drive Dallas TX 75235 475057374 Physician TX 501(c)(3 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false Wellness Innovations Physician Partners 1935 Medical District Drive Dallas TX 75235 811734937 Physician TX 501(c)(3 3 Wellness Innovations LLC false Wellness Innovations LLC 1935 Medical District Drive Dallas TX 75235 475246461 Physicians TX CHST Investment Holdings LLC Unrelated 0 0 false false 0.0 CHILDREN'S INSURANCE COMPANY 76 ST PAUL STREET SUITE 500 BURLINGTON VT 05401 030328102 INSURANCE COMPANY VT CHILDREN'S HEALTH SYSTEM OF TEXAS C Corporation 0 0 0 false ALTERNATIVE CARE SYSTEMS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752244475 OTHER MEDICAL SERVICES TX CHILDREN'S HEALTH SYSTEM OF TEXAS C Corporation 0 0 0 false NTPSS INC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 471036641 PHYSICIAN SOLUTIONS TX Pediatric Partners C Corporation 0 0 0 false TEXAS BLUEBONNET HEALTH PLAN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 472252673 HEALTH PLAN TX CHILDREN'S HEALTH SYSTEM OF TEXAS C Corporation 0 0 0 false Texas Bluebonnet Insurance Company 1935 Medical District Drive Dallas TX 75235 475032893 Insurance Company TX Children's Health System of Texas C Corporation 0 0 0 false false false true true false false false false false false false false true true true false true true false OCH Holdings D 7870801 GAAP