STRATEGY STUDIO / PUBLIC DATA EXPLORER

COOK CHILDRENS PHYSICIAN NETWORK: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
COOK CHILDRENS PHYSICIAN NETWORK (EIN 75-2485366)
Tax period
2014-10-01 to 2015-09-30
Filed
2016-08-14
IRS object ID
201642279349300824
Schema version
2014v6.0
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)
Return2016-08-14T22:20:56-05:00ReturnTs
Tax Period End2015-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12800 Post Oak Blvd Ste 3200AddressLine1Txt
CityHOUSTONCityNm
State AbbreviationTXStateAbbreviationCd
ZIP77056ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN752485366EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COOK CHILDREN'S PHYSICIAN NETWORKBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% CORY RHOADESInCareOfNm
Business Name ControlCOOKBusinessNameControlTxt
Phone6828854000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 SEVENTH AVENUEAddressLine1Txt
CityFORT WORTHCityNm
State AbbreviationTXStateAbbreviationCd
ZIP76104ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCORY RHOADESPersonNm
Person TitleVP & CHIEF ACCOUNTING OFFICERPersonTitleTxt
Phone6828854000PhoneNum
Signature2016-08-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAmanda MayaPreparerPersonNm
PTINP01067777PTIN
Phone7134994600PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-12-15 16:53:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerW BRITT NELSON MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 SEVENTH AVEAddressLine1Txt
CityFORT WORTHCityNm
State AbbreviationTXStateAbbreviationCd
ZIP76104ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$250,466,633GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.COOKCHILDRENS.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1992FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionKNOWING THAT EVERY CHILD'S LIFE IS SACRED, OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE AND INJURY.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee1128TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$52,353,709PYContributionsGrantsAmt
CY Contributions Grants$52,791,690CYContributionsGrantsAmt
PY Program Service Revenue$178,040,964PYProgramServiceRevenueAmt
CY Program Service Revenue$197,526,634CYProgramServiceRevenueAmt
PY Investment Income-$30,871PYInvestmentIncomeAmt
CY Investment Income$4,200CYInvestmentIncomeAmt
PY Other Revenue$42,501PYOtherRevenueAmt
CY Other Revenue$121,344CYOtherRevenueAmt
PY Total Revenue$230,406,303PYTotalRevenueAmt
CY Total Revenue$250,443,868CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$3,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$184,529,652PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$197,720,633CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$46,250,628PYOtherExpensesAmt
CY Other Expenses$52,542,093CYOtherExpensesAmt
PY Total Expenses$230,780,280PYTotalExpensesAmt
CY Total Expenses$250,265,726CYTotalExpensesAmt
PY Revenues Less Expenses-$373,977PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$178,142CYRevenuesLessExpensesAmt
Total Assets BOY$40,529,114TotalAssetsBOYAmt
Total Assets EOY$35,891,473TotalAssetsEOYAmt
Total Liabilities BOY$32,033,467TotalLiabilitiesBOYAmt
Total Liabilities EOY$27,217,684TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$8,495,647NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,673,789NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionKNOWING THAT EVERY CHILD'S LIFE IS SACRED, OUR PROMISE IS TO IMPROVE THE HEALTH OF EVERY CHILD IN OUR REGION THROUGH THE PREVENTION AND TREATMENT OF ILLNESS, DISEASE, AND INJURY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$222,704,401ExpenseAmt
Revenue$197,647,978RevenueAmt
DescCOOK CHILDREN'S PHYSICIAN NETWORK (CCPN) IS THE LARGEST PEDIATRIC MULTI-SPECIALTY PHYSICIAN GROUP IN NORTH TEXAS. THE NETWORK INCLUDES MORE THAN 360 PHYSICIANS AND 200 MID-LEVEL PROVIDERS IN ADDITION TO THOUSANDS OF OTHER CARING EMPLOYEES. DURING 2015, THE PROVIDER COUNT GREW BY 36, INCLUDING 20 NET NEW PHYSICIANS AND 17 NET NEW MIDLEVEL PROVIDERS. PATIENT FAMILIES HAVE ACCESS TO THE FOLLOWING SPECIALTIES VIA TELEMEDICINE: CARDIOLOGY, CARE TEAM, ENDOCRINOLOGY, GENETICS/METABOLIC GENETICS, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASES, NEONATOLOGY, NEPHROLOGY, NEUROLOGY, NEUROPSYCHOLOGY, PEDIATRIC INTENSIVISTS, PSYCHOLOGY AND RHEUMATOLOGY. THESE SPECIALISTS HOSTED 1,423 VISITS VIA TELEMEDICINE IN 2014 OFFERING IMMEDIATE CARE AND PATIENT MONITORING AND SAVING MANY HOURS OF TRAVEL FOR PATIENT FAMILIES. THE NETWORK'S PHYSICIANS AND SPECIALISTS HAVE OFFICES IN TARRANT, DENTON AND HOOD COUNTIES AND PROVIDE A PRIMARY CARE HOME IN ECONOMICALLY DISADVANTAGED AREAS WHERE ACCESS TO PEDIATRIC HEALTH CARE IS DIFFICULT TO OBTAIN. THE PHYSICIAN NETWORK HAS INCREASED ACCESS TO PEDIATRIC SPECIALTY CARE THROUGH OUTREACH CLINICS IN MANY COMMUNITIES IN NORTH, WEST AND CENTRAL TEXAS. EACH MONTH, PHYSICIANS TRAVEL TO PROVIDE SERVICES IN SEVERAL AREAS THAT ARE NOT LARGE ENOUGH TO SUPPORT FULL-TIME SPECIALTY CARE. COOK CHILDREN'S OFFERS SIX NEIGHBORHOOD CLINICS (FIVE IN FORT WORTH AND ONE IN ARLINGTON). THAT OFFER WELL- AND SICK-CHILD VISITS AND DENTAL CARE AND PROVIDE VACCINES. STAFF SPEAK BOTH ENGLISH AND SPANISH AND CLINICS ACCEPT MOST CHIP, MEDICAID AND COMMERCIAL INSURANCE PLANS. THE CLINICAL STAFF IS LED BY 19 TOTAL PHYSICIANS, TWO DENTISTS, AND SIX NURSE PRACTITIONERS. AN ADDITIONAL NEIGHBORHOOD CLINIC IS SCHEDULED TO OPEN IN 2016. PATIENT FAMILIES CONTINUE TO BENEFIT FROM THE AFTER-HOURS CLINIC TIMES AND THE PATIENT PORTAL, MYCOOKCHILDRENS.ORG, WHICH PROVIDES FAMILIES ON-DEMAND ACCESS TO PRIOR VISIT SUMMARIES, MEDICATION LISTS, VACCINE RECORDS, LAB RESULTS AND APPOINTMENT REQUESTS.Desc
Total Program Service Expenses$222,704,401TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
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 AssetsYes (true)ReportOtherAssetsInd
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 MemYes (true)BusinessRlnWithFamMemInd
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 EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document66IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1128EmployeeCnt
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 Members13GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
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 BodyYes (true)Form990ProvidedToGvrnBodyInd
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 CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCORY RHOADESPersonNm
Phone6828854000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 SEVENTH AVENUEAddressLine1Txt
CityFORT WORTHCityNm
State AbbreviationTXStateAbbreviationCd
ZIP76104ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JAMES P MILLER MD
TRUSTEE41.00.0Yes (X)$913,379$0$37,287
DEBORAH SCHUTTE MD
TRUSTEE-VICE CHAIR SPLTY CARE42.01.0Yes (X)$514,355$0$35,787Yes (X)
BARRY BZOSTEK MD
TRUSTEE41.00.0Yes (X)$212,481$0$10,766
MARK MAZADE MD
TRUSTEE41.00.0Yes (X)$285,770$0$33,588
SANDRA ARCA MD
TRUSTEE-TREASURER42.01.0Yes (X)$284,259$0$40,045Yes (X)
LINDA M THOMPSON MD
TRUSTEE-CHAIRMAN42.02.0Yes (X)$313,659$0$16,834Yes (X)
TODD WOLF MD
TRUSTEE-SECRETARY42.01.0Yes (X)$405,579$0$34,037Yes (X)
VANESSA CHARETTE MD
TRUSTEE-VICE CHAIRMAN, PRIMARY42.01.0Yes (X)$419,926$0$17,133Yes (X)
BRYAN STEINMANN MD
TRUSTEE41.00.0Yes (X)$273,898$0$33,616
DEBORAH VERT DO
TRUSTEE41.00.0Yes (X)$398,519$0$25,562
KENNETH HEYM MD
TRUSTEE41.00.0Yes (X)$305,413$0$33,862
SANDRA PEAK MD
TRUSTEE41.00.0Yes (X)$309,369$0$28,674
WILFRED L RAINE MD
TRUSTEE41.00.0Yes (X)$400,848$0$31,629
SAM CANTU MD
TRUSTEE41.01.0Yes (X)$372,539$0$31,470
MATTHEW DZURIK MD
TRUSTEE41.01.0Yes (X)$452,834$0$26,218
BRADLEY MERCER MD
TRUSTEE41.00.0Yes (X)$467,577$0$37,287
JANELL MASON-BRISCOE
ASST VP, PRIM CARE & SPLTY SVC40.00.0$233,937$0$14,101Yes (X)
W BRITT NELSON MD
PRESIDENT40.00.0$724,313$0$39,825Yes (X)
ROBERT GOODWILL
VP, OPNS PRIM CARE & SPLTY SVC40.00.0$394,048$0$28,138Yes (X)
SHERI KANTNER
SECRETARY40.00.0$71,938$0$20,807Yes (X)
STEPHEN W KIMMEL
TREASURER4.036.0$65,793$532,322$25,307Yes (X)
VINCENT TAM MD
MEDICAL DIRECTOR40.00.0$1,636,532$0$37,287Yes (X)
JOSE L IGLESIAS MD
PHYSICIAN40.01.0$937,262$0$25,547Yes (X)
MARK PALMER MD
PHYSICIAN40.00.0$1,557,229$0$27,343Yes (X)
JOHN UFFMAN MD
MEDICAL DIRECTOR40.00.0$959,877$0$31,594Yes (X)
JOHNNIE HONEYCUTT MD
PHYSICIAN40.00.0$995,073$0$34,037Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$13,906,407TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$532,322TotReportableCompRltdOrgAmt
Total Other Compensation$757,781TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K480IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
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
ATHENAHEALTH
311 ARSENAL STWATERTOWNMA02472CLAIMS PROCESSING$10,222,517
TARRANT CONSTRUCTION SERVICES
2225 W PETERSMITH STFORT WORTHTX76102CONSTRUCTION$1,013,439
MUCKLEROY FALLS
5801 EDWARDS RANCH RD 100FORT WORTHTX76104CONSTRUCTION$617,787
ADVISORY BOARD COMPANY
PO BOX 79461BALTIMOREMD21279CONSULTING$217,327
CREDIT SYSTEMS INTERNATIONAL
PO BOX 1088ARLINGTONTX76004COLLECTIONS$206,633
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Related Organizations$52,613,045RelatedOrganizationsAmt
Government Grants$176,145GovernmentGrantsAmt
All Other Contributions$2,500AllOtherContributionsAmt
Total Contributions$52,791,690TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT FEES621110$167,259,374$167,259,374
CONTRACTED FEES621110$3,543,336$3,543,336
MANAGEMENT FEES900099$25,271,593$25,271,593
OTHER INCOME621110$1,373,480$1,373,480
RESEARCH900099$78,851$78,851
FieldValueIRS element (for citing)
Total Program Service Revenue$197,526,634TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

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

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$26,965OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$22,765OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$4,200OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,200TotalRevenueColumnAmt
Exclusion$4,200ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$121,344TotalRevenueColumnAmt
Related Or Exempt Func Income$121,344RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$121,344OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$250,443,868TotalRevenueColumnAmt
Related Or Exempt Func Income$197,647,978RelatedOrExemptFuncIncomeAmt
Exclusion$4,200ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$3,000TotalAmt
Program Services$3,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$8,675,652TotalAmt
Program Services$6,946,534ProgramServicesAmt
Management And General$1,729,118ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$112,318TotalAmt
Program Services$112,318ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$163,962,139TotalAmt
Program Services$158,994,757ProgramServicesAmt
Management And General$4,967,382ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$24,970,524TotalAmt
Program Services$23,609,414ProgramServicesAmt
Management And General$1,361,110ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$4,417,856TotalAmt
Management And General$4,417,856ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,950,530TotalAmt
Program Services$1,013,692ProgramServicesAmt
Management And General$936,838ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$112,453TotalAmt
Program Services$58,099ProgramServicesAmt
Management And General$54,354ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$497,731TotalAmt
Program Services$572,259ProgramServicesAmt
Management And General-$74,528ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$6,087,213TotalAmt
Program Services$5,910,449ProgramServicesAmt
Management And General$176,764ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$258,004TotalAmt
Program Services$240,950ProgramServicesAmt
Management And General$17,054ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$150,447TotalAmt
Program Services$5,453ProgramServicesAmt
Management And General$144,994ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,918TotalAmt
Program Services$1,918ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,165,980TotalAmt
Program Services$955,797ProgramServicesAmt
Management And General$210,183ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,722,292TotalAmt
Program Services$1,721,313ProgramServicesAmt
Management And General$979ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$14,381,426$14,381,505-$79
COLLECTION EXPENSE$12,913,003$183,113$12,729,890
BAD DEBT EXPENSE$5,972,386$5,972,386$0
MINOR EQUIPMENT EXPENSE$1,593,226$1,008,818$584,408

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,317,628TotalAmt
Program Services$1,012,626ProgramServicesAmt
Management And General$305,002ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$250,265,726TotalAmt
Program Services$222,704,401ProgramServicesAmt
Management And General$27,561,325ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$8,832BOYAmt
EOY$10,686EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$11,046,459BOYAmt
EOY$10,916,858EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,051,258BOYAmt
EOY$9,613,513EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,089,879BOYAmt
EOY$1,179,125EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,022,371BOYAmt
EOY$172,050EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$15,701,100LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,852,970LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$8,981,293BOYAmt
EOY$9,848,130EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,560,000EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$9,329,022BOYAmt
EOY$2,591,111EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$40,529,114BOYAmt
EOY$35,891,473EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,194,021BOYAmt
EOY$6,954,131EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,839,446BOYAmt
EOY$20,263,553EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$32,033,467BOYAmt
EOY$27,217,684EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,495,647BOYAmt
EOY$8,673,789EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,495,647BOYAmt
EOY$8,673,789EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$40,529,114BOYAmt
EOY$35,891,473EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$178,142ReconcilationRevenueExpnssAmt
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 B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,838,647OtherCostOrOtherBasisAmt
Depreciation$1,289,998DepreciationAmt
Book Value$5,548,649BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,388,958OtherCostOrOtherBasisAmt
Depreciation$2,616,901DepreciationAmt
Book Value$1,772,057BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,597,027OtherCostOrOtherBasisAmt
Depreciation$1,905,704DepreciationAmt
Book Value$1,691,323BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$876,468OtherCostOrOtherBasisAmt
Depreciation$40,367DepreciationAmt
Book Value$836,101BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,848,130TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
OTHER ASSETS$281,495
FWPED'S MEDICAL RECORDS$1,448,611
FWPED'S PHYSICIAN RETEN. BONUS$729,167
FWPED'S NOTE RECEIVABLE$131,838
FieldValueIRS element (for citing)
Total Book Value Other Assets$2,591,111TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)

DescDescAmtAmt
ACCRUED PAYROLL$1,782,296
ACCRUED PHYSICIAN RECONS$9,306,599
DUE TO AFFILIATES$4,514,570
ACCRUED PTO LIABILITY$2,496,236
ACCRUED EXECUTIVE BONUS$593,846
CAPITAL LEASE OBLIGATION$22,653
ACCRUED COMP BONUS-CARE SHARE$746,437
ACCRUED PHYSICIAN BONUS-PERC$800,916
FieldValueIRS element (for citing)
Total Liability$20,263,553TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$243,123,073TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$5,972,386OtherRevenueAmt
Revenue Not Reported-$5,972,386RevenueNotReportedAmt
Revenue Subtotal$249,095,459RevenueSubtotalAmt
Other Revenues Not Included$1,348,409OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$1,348,409RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$250,443,868TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$244,289,140TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$4,200OtherExpensesIncludedAmt
Expenses Not Reported-$4,200ExpensesNotReportedAmt
Expenses Subtotal$244,293,340ExpensesSubtotalAmt
Other Expenses Not Included$5,972,386OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$5,972,386ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$250,265,726TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINES 2D & 4BRECONCILIATION OF REVENUE FINANCIAL STATEMENTS TO FORM 990 BAD DEBT EXPENSE: ($ 5,972,386) GAIN ON DISPOSAL OF ASSETS: $ 4,200 CONTRIBUTIONS FROM CCHF RECORDED TO NET ASSETS: 1,344,209 -------------- TOTAL $ 1,348,409
PART XII, LINES 2D & 4BRECONCILIATION OF EXPENSES FINANCIAL STATEMENTS TO FORM 990 GAIN ON DISPOSAL OF ASSETS: ( $ 4,200 ) BAD DEBT EXPENSE: $ 5,972,386

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssfalseWrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
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 PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (25 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
JAMES P MILLER MD
TRUSTEE$870,693$0$0$0$42,686$0$19,500$0$17,787$0$950,666$0$0$0
DEBORAH SCHUTTE MD
TRUSTEE-VICE CHAIR SPLTY CARE$494,461$0$10,000$0$9,894$0$19,500$0$16,287$0$550,142$0$0$0
JANELL MASON-BRISCOE
ASST VP, PRIM CARE & SPLTY SVC$180,620$0$45,349$0$7,968$0$8,098$0$6,003$0$248,038$0$0$0
BARRY BZOSTEK MD
TRUSTEE$186,545$0$15,000$0$10,936$0$0$0$10,766$0$223,247$0$0$0
MARK MAZADE MD
TRUSTEE$274,124$0$0$0$11,646$0$16,140$0$17,448$0$319,358$0$0$0
SANDRA ARCA MD
TRUSTEE-TREASURER$275,540$0$0$0$8,719$0$18,276$0$21,769$0$324,304$0$0$0
LINDA M THOMPSON MD
TRUSTEE-CHAIRMAN$284,332$0$18,750$0$10,577$0$16,250$0$584$0$330,493$0$0$0
TODD WOLF MD
TRUSTEE-SECRETARY$272,626$0$125,313$0$7,640$0$16,250$0$17,787$0$439,616$0$0$0
W BRITT NELSON MD
PRESIDENT$404,791$0$176,358$0$143,164$0$19,500$0$20,325$0$764,138$0$0$0
VANESSA CHARETTE MD
TRUSTEE-VICE CHAIRMAN, PRIMARY$413,756$0$0$0$6,170$0$16,531$0$602$0$437,059$0$0$0
BRYAN STEINMANN MD
TRUSTEE$264,550$0$0$0$9,348$0$18,982$0$14,634$0$307,514$0$0$0
DEBORAH VERT DO
TRUSTEE$392,150$0$0$0$6,369$0$18,772$0$6,790$0$424,081$0$0$0
ROBERT GOODWILL
VP, OPNS PRIM CARE & SPLTY SVC$288,736$0$101,924$0$3,388$0$10,400$0$17,738$0$422,186$0$0$0
KENNETH HEYM MD
TRUSTEE$283,673$0$11,000$0$10,740$0$16,250$0$17,612$0$339,275$0$0$0
SANDRA PEAK MD
TRUSTEE$303,358$0$0$0$6,011$0$16,250$0$12,424$0$338,043$0$0$0
WILFRED L RAINE MD
TRUSTEE$385,140$0$0$0$15,708$0$19,500$0$12,129$0$432,477$0$0$0
SAM CANTU MD
TRUSTEE$366,361$0$0$0$6,178$0$10,400$0$21,070$0$404,009$0$0$0
MATTHEW DZURIK MD
TRUSTEE$426,310$0$0$0$26,524$0$16,250$0$9,968$0$479,052$0$0$0
STEPHEN W KIMMEL
TREASURER$43,941$355,520$19,825$160,401$2,027$16,401$1,144$9,256$1,640$13,267$68,577$554,845$0$0
BRADLEY MERCER MD
TRUSTEE$458,217$0$0$0$9,360$0$19,500$0$17,787$0$504,864$0$0$0
VINCENT TAM MD
MEDICAL DIRECTOR$1,617,730$0$0$0$18,802$0$19,500$0$17,787$0$1,673,819$0$0$0
JOSE L IGLESIAS MD
PHYSICIAN$896,868$0$0$0$40,394$0$10,400$0$15,147$0$962,809$0$0$0
MARK PALMER MD
PHYSICIAN$1,546,727$0$0$0$10,502$0$16,250$0$11,093$0$1,584,572$0$0$0
JOHN UFFMAN MD
MEDICAL DIRECTOR$921,851$0$0$0$38,026$0$10,400$0$21,194$0$991,471$0$0$0
JOHNNIE HONEYCUTT MD
PHYSICIAN$770,860$0$191,219$0$32,994$0$16,250$0$17,787$0$1,029,110$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1ASHERI KANTNER $125.00 LINDA THOMPSON, MD $125.00
SCHEDULE J, PART I, LINE 1BTHERE IS NO WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF TAX INDEMNIFICATION AND GROSS-UP PAYMENTS BECAUSE THE COMPANY DOES NOT GENERALLY ALLOW FOR GROSS-UPS IN TAX PAYMENTS EXCEPT IN UNUSUAL CIRCUMSTANCES AND ONLY THEN IF APPROVED BY SENIOR MANAGEMENT. IN THIS CASE, $500.00 GIFT CARDS WERE DISTRIBUTED AT CHRISTMAS TO NON-EXECUTIVE EMPLOYEES. THE SENIOR VICE PRESIDENT OF HUMAN RESOURCES APPROVED THE GROSS-UP OF $125.00 PER CARD SO EMPLOYEES RECEIVE THE FULL STATED BENEFIT OF THE GIFT CARD.
PART I, QUESTION 3METHODS USED BY CCHCS TO ESTABLISH COMPENSATION OF THE CEO/EXEC DIRECTOR: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
SCHEDULE J, PART I, LINE 4BPARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PARTICIPANTS IN SERP IN W-2 DEF COMP PAID BY -------------------- -------- -------- -------- MATTHEW DZURIK, MD 17,500 NONE CCPN JOHNNIE HONEYCUTT, MD 17,500 NONE CCPN JOSE L. IGLESIAS, MD 17,500 NONE CCPN JAMES P. MILLER, MD 17,500 NONE CCPN W. BRITT NELSON, MD 67,350 NONE CCPN JOHN UFFMAN, MD 17,500 NONE CCPN

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
TOM ROGERS JR MD
A. ROGERS FATHER-IN-LAW$112,318COMPENSATIONfalse
YVETTE DZURIK MD
M.DZURIK SPOUSE$126,757COMPENSATIONfalse

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 4THE ORGANIZATION RESTATED THE BYLAWS EFFECTIVE 10/27/2015.
FORM 990, PART VI, QUESTION 7AMEMBER ELECTION ABILITIES: AS THE SOLE MEMBER OF THE ORGANIZATION, COOK CHILDREN'S HEALTH CARE SYSTEM HAS THE ABSOLUTE RIGHT TO APPOINT OR APPROVE MEMBERSHIP ON THE BOARD OF DIRECTORS OF THE ORGANIZATION.
FORM 990, PART VI, QUESTION 7BMEMBER DECISION ABILITIES: AS THE SOLE MEMBER OF THE ORGANIZATION, COOK CHILDREN'S HEALTH CARE SYSTEM HAS THE EXCLUSIVE AND RESERVED POWER TO DO ANY OF THE FOLLOWING: A. APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE ORGANIZATION AND THE LONG-RANGE FINANCIAL AND STRATEGIC PLANS FOR THE CORPORATION; B. APPROVE DEVIATIONS FROM ANNUAL OPERATING AND CAPITAL BUDGETS IN EXCESS OF SUCH LIMITS AS ESTABLISHED BY THE MEMBER; C. APPROVE THE PURCHASE OR ACQUISITION OF ANY PROPERTY, REAL, PERSONAL, OR MIXED, BY THE ORGANIZATION IN EXCESS OF SUCH LIMITS AS ESTABLISHED BY THE MEMBER; D. APPROVE THE SALE, GIFT OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE ORGANIZATION; E. APPROVE THE MORTGAGE OR OTHER ENCUMBRANCE OF ANY PROPERTY, REAL, PERSONAL, OR MIXED, OF THE ORGANIZATION IN EXCESS OF SUCH LIMITS AS ESTABLISHED BY THE MEMBER; F. APPROVE THE ACQUISITION, LIQUIDATION, MERGER, WINDING UP, TERMINATION, OR CONSOLIDATION OF THE ORGANIZATION; G. APPROVE THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY, JOINT VENTURE, ACCOUNTABLE CARE ORGANIZATION OR SIMILAR ENTITIES; H. APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE CERTIFICATE OF FORMATION OF THE ORGANIZATION AND THESE BYLAWS; I. APPROVE INCURRING DEBT WHICH WOULD EXCEED SUCH LIMITS ESTABLISHED BY THE MEMBER; J. APPROVE THE SETTLEMENT OF CLAIMS AND LITIGATION OF THE ORGANIZATION; AND K. SUBSEQUENT TO THE ORGANIZING AND INCORPORATING PHYSICIAN'S SELECTION OF THE INITIAL BOARD OF DIRECTORS, APPROVE THE APPOINTMENT OR ELECTION OF DIRECTORS IN ACCORDANCE WITH SECTION 3.2 OF THE ORGANIZATION'S BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11BPROCESS FOR REVIEW OF THE 990: THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO ASSIST IN THE PREPARATION OF THE FORM 990 AND RELATED FILINGS. ALL INFORMATION PROVIDED TO THE OUTSIDE ACCOUNTING FIRM IS GATHERED BY KEY COMPANY EMPLOYEES AND EXECUTIVES. ONCE THE FORM 990 IS PREPARED, IT IS REVIEWED BY COMPANY FINANCE, LEGAL AND COMPLIANCE STAFF AND THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT. IN ADDITION, IT IS PRESENTED TO THE COOK CHILDREN'S HEALTH CARE SYSTEM AUDIT COMMITTEE FOR REVIEW AND COMMENT. SUBSEQUENT TO AUDIT COMMITTEE REVIEW, THE FORM 990 IS FILED WITH THE INTERNAL REVENUE SERVICE AND MADE AVAILABLE TO THE PUBLIC FOR REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CWRITTEN CONFLICT OF INTEREST POLICY: EVERY YEAR THE LEGAL DEPARTMENT OF THE COOK CHILDREN'S HEALTH CARE SYSTEM ("SYSTEM") SENDS OUT A FORM 990 QUESTIONNAIRE/CONFLICT OF INTEREST DISCLOSURE STATEMENT TO OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES OF ALL SYSTEM COMPANIES, AS WELL AS CERTAIN OTHER EMPLOYEES, INCLUDING PHYSICIANS, WHO ARE DETERMINED TO BE EMPLOYED IN POSITIONS THAT MIGHT BE SUBJECT TO THE SYSTEM'S CONFLICT OF INTEREST POLICY. THE RESPONSES ARE REVIEWED BY THE LEGAL, FINANCE, AND COMPLIANCE DEPARTMENTS. FOLLOW UP AND/OR CORRECTIVE ACTION IS TAKEN AS NEEDED WITH RESPECT TO RESPONSES THAT INDICATE THE EXISTENCE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE RESPONSES TO THE QUESTIONNAIRES AND FOLLOW-UP INFORMATION ARE PROVIDED TO THE SYSTEM AUDIT COMMITTEE FOR REVIEW AND FOLLOW-UP. FURTHER, THE AUDIT COMMITTEE OF COOK CHILDREN'S HEALTH CARE SYSTEM IS RESPONSIBLE FOR MONITORING THE IMPLEMENTATION AND ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY THAT IS APPLICABLE TO ALL AFFILIATED COMPANIES OF THE COOK CHILDREN'S HEALTH CARE SYSTEM. THE AUDIT COMMITTEE IS ALSO RESPONSIBLE FOR OVERSIGHT OF THE COMPLIANCE DEPARTMENT OF COOK CHILDREN'S HEALTH CARE SYSTEM. THE COMPLIANCE DEPARTMENT MAINTAINS A HOT-LINE TO RECEIVE REPORTS OF INAPPROPRIATE ACTIVITIES INCLUDING ACTIVITIES THAT MIGHT CONSTITUTE A CONFLICT OF INTEREST. INTERNAL AUDIT AND COMPLIANCE ALSO CONDUCT RANDOM AUDITS OF CORPORATE ACTIVITIES SUCH AS EXPENSE REIMBURSEMENTS AND ACCOUNTS PAYABLE TO DETERMINE IF ANY INAPPROPRIATE PAYMENTS ARE BEING MADE TO INDIVIDUALS, SOME OF WHICH COULD BE EVIDENCE OF A CONFLICT OF INTEREST. ANY CORRECTIVE ACTION RELATED TO CONFLICTS OF INTEREST WOULD BE REPORTED TO THE AUDIT COMMITTEE FOR REVIEW, APPROVAL, AND MODIFICATION, AS NECESSARY, WITH FURTHER REPORTING TO THE SYSTEM BOARD OF TRUSTEES AS APPROPRIATE.
FORM 990, PART VI, QUESTION 15A & 15BREVIEW AND APPROVAL OF COMPENSATION: COOK CHILDREN'S HEALTH CARE SYSTEM HAS ESTABLISHED A COMPENSATION COMMITTEE WITH OVERSIGHT OF EXECUTIVE AND PHYSICIAN COMPENSATION, WHICH INCLUDES THE ORGANIZATION'S CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE COMPENSATION COMMITTEE APPROVES COMPENSATION ARRANGEMENTS IN ADVANCE, WHICH INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT COMMITTEE MEMBERS, USING COMPARABLE MARKET DATA RELATING TO COMPENSATION, WHICH IS PROVIDED BY SULLIVAN COTTER AND ASSOCIATES, INC., AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE DOCUMENTS THE BASIS FOR ITS DETERMINATIONS FOLLOWING CONTEMPORANEOUS SUBSTANTIATION OF THE COMPENSATION COMMITTEE'S DELIBERATIONS AND DECISIONS. THE COMPENSATION COMMITTEE REQUIRES THE COMPENSATION CONSULTANT TO UPDATE MARKET DATA PERIODICALLY, USUALLY EVERY TWO YEARS, WITH INTERIM REVIEWS BEING CONDUCTED AS NEEDED. WITH REGARD TO PHYSICIAN COMPENSATION, THE COMPENSATION COMMITTEE ALSO RETAINS THE LAW FIRM OF MCDERMOTT, WILL & EMERY OF CHICAGO, ILLINOIS, TO ISSUE A REASONABLENESS OPINION COVERING THE PHYSICIAN COMPENSATION PLAN FOR COOK CHILDREN'S PHYSICIAN NETWORK.
FORM 990, PART VI, QUESTION 19MAKING GOVERNING DOCUMENTS PUBLIC: THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, EXCEPT TO THE EXTENT THEY ARE ON FILE WITH THE SECRETARY OF STATE OF TEXAS. THE CONFLICT OF INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE AND AVAILABLE TO ALL EMPLOYEES AND BOARD MEMBERS OF COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES. CONSOLIDATED FINANCIAL STATEMENTS ARE REPORTED ELECTRONICALLY FOR ALL COOK CHILDREN'S HEALTH CARE SYSTEM ENTITIES VIA THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEB SITE.
FORM 990 PART VI, QUESTION 6SOLE MEMBER: COOK CHILDREN'S HEALTH CARE SYSTEM, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE ORGANIZATION.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
COOK CHILDREN'S MEDICAL CENTER
801 SEVENTH AVEFORT WORTHTX76104752051646HOSPITALTX501(C)(3)3CCHCSYes (true)
WI COOK FOUNDATION
801 SEVENTH AVENUEFORT WORTHTX76104752051649FUNDRAISINGTX501(C)(3)11DNAfalse
COOK CHILDREN'S HOME HEALTH
801 SEVENTH AVENUEFORT WORTHTX76104752896983HEALTHCARETX501(C)(3)9CCHCSYes (true)
COOK CHILDREN'S HEALTH CARE SYSTEM
801 SEVENTH AVEFORT WORTHTX76104752705881HLTH CARE SUPTX501(C)(3)11CCCHFfalse
COOK CHILDREN'S HEALTH PLAN
801 SEVENTH AVEFORT WORTHTX76104760585240INSURANCETX501(C)(3)9CCHCSYes (true)
ROSEDALE OFFICE BUILDING INC
1500 W ROSEDALEFORT WORTHTX76104460866421TITLE HOLDINGTX501(C)(2)N/ACCHFfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1COOK CHILDREN'S HEALTH SERVICESBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 7TH AVENUEAddressLine1Txt
CityFORT WORTHCityNm
State AbbreviationTXStateAbbreviationCd
ZIP76104ZIPCd
FieldValueIRS element (for citing)
EIN454024843EIN
Primary ActivitiesHEALTHCAREPrimaryActivitiesTxt
Legal Domicile StateTXLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CCHCSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC CORPORATIONEntityTypeTxt
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangeYes (true)AssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
COOK CHILDREN'S MEDICAL CENTER
O$63,342,092FMV
COOK CHILDREN'S MEDICAL CENTER
A$1,054,998FMV
COOK CHILDREN'S MEDICAL CENTER
R$2,541,676FMV
COOK CHILDREN'S MEDICAL CENTER
Q$412,565FMV
COOK CHILDREN'S HEALTH PLAN
B$13,279,683FMV