2012-11-14T12:25:04-06:00 2011-12-31 861065772 Deloitte Tax LLP 1111 Bagby Street Suite 4500 Houston TX 77002 990 2011-01-01 571201170 TMH PHYSICIAN ORGANIZATION TMHP 8326676160 6565 Fannin No GB-240 Houston TX 770302707 Edward L Tyrrell 8326676160 2012-11-14 1 Nancy Z Evetts P00407310 7139822000 2011 2016-02-24 21:20:13Z H Dirk Sostman MD 6565 Fannin No GB-240 Houston TX 770302707 268744865 0 5792 X N/A X 2004 TX See Schedule O 19 0 1554 0 0 0 544423 457077 239027516 268287788 0 0 0 0 239571939 268744865 28303 22845 0 0 184591648 209738537 0 0 0 55427927 62815279 240047878 272576661 -475939 -3831796 30988752 36437472 38339144 47606666 -7350392 -11169194 X See Schedule O 0 0 261706793 22845 268287788 See Schedule O 261706793 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1554 1 0 0 0 0 0 0 0 0 0 0 0 X 19 0 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X Edward L Tyrrell FACHE 8326676160 6565 Fannin GB-240 Houston TX 770302707 X Marc L Boom MD 7.00 X X 0 806857 45656 H Dirk Sostman MD 9.00 X X 0 800192 71106 Stuart M Dobbs MD 2.00 X 0 149013 0 Victor Fainstein MD 2.00 X 0 81303 0 Stanley Appel MD 50.00 X 706602 0 42623 Barbara L Bass MD 50.00 X 1348630 0 61756 Timothy B BooneMD PHD 50.00 X 772428 0 49115 E Brian Butler MD 50.00 X 622814 0 59060 James M Musser MD PHD 45.00 X 895043 0 63963 Jamie Gateno DDS MD 50.00 X 347868 0 58992 Robert G Grossman MD 50.00 X 572461 0 39965 Alan Kaplan MD 50.00 X 487562 0 44452 Andrew G Lee MD 50.00 X 495267 0 41002 King J Li MD 50.00 X 532434 0 34880 Alan B Lumsden MD 50.00 X 951641 0 48046 Ken Mathis MD 50.00 X 792096 0 71106 Joseph Naples MD 50.00 X 559709 0 24568 Miguel Quinones MD 50.00 X 628964 0 46814 Richard J Robbins MD 50.00 X 982315 0 43312 John E Hagale 1.00 X 0 1045155 56882 Edward L Tyrrell 3.00 X 0 436507 47814 Aldona Spiegel MD 50.00 X 1692366 0 50772 Pierre Chevray MD 50.00 X 1558556 0 26303 Timothy Sitter MD 50.00 X 1201477 0 44752 Michael Klebuc MD 50.00 X 1202763 0 61663 Vincent Phan MD 50.00 X 1773452 0 48245 Ayse O McCracken 0.00 X 140781 0 16534 18265229 3319027 1199381 383 1 1 0 ATHENAHEALTH INC P O BOX 415615 BOSTON MA 02241 A/R SERVICES 4115509 PER-SE' TECHNOLOGIES P O BOX 403421 ATLANTA GA 30384 COLLECTION SERVICES 2078465 ADDISION SEARCH LLC 222 S RIVERSIDE PLAZA SUITE 1710 CHICAGO IL 60606 STAFFING SERVICE 553627 PULSE STAFFING 5353 WEST ALABAMA HOUSTON TX 77056 MEDICAL TEMP STAFFING 454645 ALLEGRO TRAVEL 19 BRIAR HOLLOW SUITE 246 HOUSTON TX 77027 TRAVEL SERVICES 338485 13 352077 105000 457077 Professional Fees 900099 176399339 176399339 I/C Hospital Assoc Rev 900099 86257265 86257265 5631184 5631184 268287788 268744865 268287788 0 0 22845 22845 11582803 11425488 157315 166783288 163898442 2884846 9967856 9808541 159315 13391911 13157133 234778 8012679 7876189 136490 1020000 1020000 2450 2450 14128331 8570718 5557613 376518 376518 7594655 7400921 193734 71162 67617 3545 9014167 8698909 315258 1706190 1687085 19105 619590 600174 19416 2264122 2102089 162033 5474544 5472346 2198 Bad Debt 12307514 12307514 Medical Supplies 6479250 6475073 4177 Research Funding 1458872 1458872 Intercompany Expense 287059 287014 45 10855 10855 272576661 261706793 10869868 0 657305 1036783 14670923 16132747 138961 176383 445462 252976 28262955 10969319 13976966 17293636 1099135 1544947 30988752 36437472 26851449 23906871 11487695 23699795 38339144 47606666 X -7350392 -11169194 -7350392 -11169194 30988752 36437472 X -3831796 12994 X 0 1 1 X 0 X X X 0 0 0 The Methodist Hospital 741180155 3 1 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10543553 168124 10375429 17719402 10801195 6918207 17293636 Due to Related Organization 23699795 23699795 Description of Uncertain Tax Positions Under FIN 48: Part X: TMH Physician Organization's financial statements were audited by an independent accountant as part of a consolidated finanical statement of the Methodist Hospital System (TMHS). TMHS did not recognize any adjustments related to uncertain tax positions as of December 31, 2011. 1 Houston Area Parkinson Society 2700 Southwest Fwy Ste 296 Houston TX 77098 510138356 501 (c)(3) 10000 Donation Fort Bend Education Foundation P O Box 1004 Sugar Land TX 774871004 760383233 501 (c)(3) 5000 Donation 2 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Prior to TMH Physician Organization's approval of a grant to a requesting organization, the following criteria must be met: - The requesting organization must be an organization exempt from federal income tax under Section 501 (c) (3) of the Internal Revenue Code. - The requesting organization must provide a recognizable or demonstrable benefit to the community. - The mission of the requesting organization must augment the mission of TMH Physician Organization. - The requesting organization's mission and services should not duplicate and must not conflict with TMH Physician Organization. By following the above criteria, the Organization ensures all grants are used by receiving organizations for their exempt purpose. 0 1 0 0 0 0 0 1 0 Marc L Boom MD 0 551068 0 195036 0 60753 0 25600 0 20056 0 852513 0 0 H Dirk Sostman MD 0 613693 0 92009 0 94490 0 25600 0 45506 0 871298 0 0 Stanley Appel MD 663784 0 0 0 42818 0 25600 0 17023 0 749225 0 0 0 Barbara L Bass MD 1286568 0 0 0 62062 0 21000 0 40756 0 1410386 0 0 0 Timothy B BooneMD PHD 681571 0 80000 0 10857 0 21000 0 28115 0 821543 0 0 0 E Brian Butler MD 400221 0 215410 0 7183 0 21000 0 38060 0 681874 0 0 0 James M Musser MD PHD 686661 0 175000 0 33382 0 23300 0 40663 0 959006 0 0 0 Jamie Gateno DDS MD 335593 0 0 0 12275 0 21000 0 37992 0 406860 0 0 0 Robert G Grossman MD 542504 0 15000 0 14957 0 20700 0 19265 0 612426 0 0 0 Alan Kaplan MD 478304 0 0 0 9258 0 25600 0 18852 0 532014 0 0 0 Andrew G Lee MD 442522 0 50000 0 2745 0 21000 0 20002 0 536269 0 0 0 King J Li MD 507191 0 0 0 25243 0 21000 0 13880 0 567314 0 0 0 Alan B Lumsden MD 791579 0 150000 0 10062 0 21000 0 27046 0 999687 0 0 0 Ken Mathis MD 786714 0 0 0 5382 0 25600 0 45506 0 863202 0 0 0 Joseph Naples MD 449468 0 60000 0 50241 0 21000 0 3568 0 584277 0 0 0 Miguel Quinones MD 599246 0 0 0 29718 0 25600 0 21214 0 675778 0 0 0 Richard J Robbins MD 731517 0 205745 0 45053 0 21000 0 22312 0 1025627 0 0 0 John E Hagale 0 567806 0 254574 0 222775 0 25600 0 31282 0 1102037 0 0 Edward L Tyrrell 0 285888 0 97553 0 53066 0 25600 0 22214 0 484321 0 0 Aldona Spiegel MD 1223247 0 464182 0 4937 0 21000 0 29772 0 1743138 0 0 0 Pierre Chevray MD 598440 0 946093 0 14023 0 21000 0 5303 0 1584859 0 0 0 Timothy Sitter MD 682865 0 513230 0 5382 0 21000 0 23752 0 1246229 0 0 0 Michael Klebuc MD 687017 0 503018 0 12728 0 21000 0 40663 0 1264426 0 0 0 Vincent Phan MD 984974 0 784968 0 3510 0 20533 0 27712 0 1821697 0 0 0 Ayse O McCracken 11478 0 99813 0 29490 0 16474 0 60 0 157315 0 0 0 Supplemental Information Part III Form 990, Schedule J, Part I, Question 3: The CEO of this organization is employed by a related organization who utilized the following items to establish compensation: (1)compensation committee; (2)independent compensation consultant; (3)compensation survey or study; (4)approval by the board or compensation committee. Supplemental Information Part III Form 990, Schedule J, Part I, Question 4a The Methodist Hospital System has a formal severance plan. Eligible employees include all staff including hourly staff up through senior vice presidents provided they work at least 20 hours per week and are not otherwise covered by a physician employment agreement. The plan only provides salary and benefits in the event an eligible employee is involuntarily terminated due to the elimination of their position or if their current position is significantly impacted by an organizational restructuring or change in requirement and a comparable position is not available within the organization. The eligible person must also sign a termination agreement in order to receive salary continuation and benefits under the plan to which they would not normally be eligible to receive under a voluntary resignation. Supplemental Information Part III Form 990, Schedule J, Part I, Question 4b Marc L Boom, MD: $42,240; John E Hagale: $107,421; H Dirk Sostman, MD: $63,650; Edward L Tyrrell: $14,159; Ayse O McCraken: $28,398; all received monies from Supplemental Executive Retirement Plan (SERP) described below: The SERP is a non qualified employer funded plan. Contributions are made annually into a tax deferred account and are considered taxable upon vesting (i.e. completion of three years of vesting service). Once vested, each year's subsequent contribution is taxable within the calendar year in which the deposit was made. Account balances cannot be accessed until retirement or termination (whichever occurs first) and may be subject to non-revocable distribution options selected upon employment. Stanley H Appel, MD: $26,750; Barbara L Bass, MD: $52,000; James Musser, MD: $28,000; King J Li, MD: $20,442; Richard Robbins: $29,607; Joseph Naples, MD: $27,000, all received monies from Supplemental Physician Retirement Plan (SPRP) described below: The Supplemental Physician Retirement Plan is a non qualified employer funded plan. Funding is based upon a predetermined percentage of base salary paid. Contributions are made biweekly into a tax deferred account and are considered taxable upon vesting (i.e. completion of three years of vesting service). Once vested, each year's subsequent contribution is taxable within the calendar year in which the deposit was made. Account balances cannot be accessed until retirement or termination (whichever occurs first) and may be subject to non-revocable distribution options selected upon employment. Supplemental Information Part III Form 990, Schedule J, Part I, Question 7: This organization provides variable compensation opportunity through an annual management incentive plan. A percent of the bonus payout is based on the consolidated operating income result of The Methodist Hospital, which includes the operating income results of this organization. The targeted operating income is part of the annual budget approved by the governing Board which takes into consideration operational goals, market conditions, past operating performance, and external benchmarking information. Hilary Beaver MD See Part V 213859 Employment 0 Joan Appel See Part V 104772 Employment 0 Hilary Beaver, MD - Family member of Andrew G Lee, MD, Board DirectorJoan Appel - Family member of Stanley M. Appel, MD, Board Director Description of Organization Mission Form 990, Part I and Part III, Line 1 This organization is part of The Methodist Hospital System, whose mission is: To provide high quality, cost-effective health care that delivers the best value to the people we serve in a spiritual environment of caring in association with internationally recognized teaching and research. Program Service Accomplishments Form 990, Part III, Line 4a The TMH Physician Organization was organized to engage in activities to further one or more of the following specific purposes: (i) the carrying out of scientific research and research projects in the public interest in the fields of medical sciences, medical economics, public health, sociology, and related areas; (ii) the supporting of medical education in medical schools through grants and scholarships, (iii) the improving and developing of abilities of individuals and institutions studying, teaching, and practicing medicine; (iv) the engaging in the instruction of the general public in the area of medical science, public health and hygiene and related instruction useful to the individual and beneficial to the community; and (v) the delivery of various modalities of health care to the public. In 2011, TMH Physician Organization pursued the above specific purposes largely through the employment of physicians that were organized in the departments according to the specialities. In 2011, TMH Physician Organization provided services to over 160,000 unique patients and had more than 671,000 patient visits (excluding Anesthesia, MASTOS and Pathology services). As of December 31, 2011, the Physician Organization employed 319 physicians and 807 staff. Educational opportunities were provided to 192 TMHPO residents and fellows from various ACGME approved programs. Form 990, Part VI, Section A, line 6 The Methodist Hospital is the sole Corporate Member of this organization. Form 990, Part VI, Section A, line 7a The sole Corporate Member of the organization, The Methodist Hospital appoints the Board of Directors. Form 990, Part VI, Section A, line 7b The sole Corporate Member of the Organization (The Methodist Hospital) reserves the following powers: -to appoint and remove with or without cause the Directors of the organization; -to approve the incurrence by the organization of any indebtedness and all guarantees of the debt of another party; -to approve the annual operating and capital budgets of the organization after they are prepared and approved by the organization's Board of Directors; -to approve the dissolution of the organization; -to approve the organization's participation in partnerships and joint ventures; -to approve the acquisition or disposition by the organization of real property from or to a non-Corporation controlled organization through ownership, lease or otherwise; -to approve the disposition or acquisition by the organization of, or the investment by the organization in, another business or all or a portion of the business or operations of another business; -to establish, acquire or invest in any new or different business; and -to direct the organization in its actions as the corporate member or shareholder of other entities, including but not limited to, approving amendments to the articles of incorporation and bylaws of such other organizations. Form 990, Part VI, Section B, line 11 Management, including certain Officers, works diligently to complete the Form 990 and attached schedules (Return) in a thorough manner. The Return is prepared by a Paid Preparer. Form 990, Part VI, Section B, line 12c All Individuals serving in a significant decision making capacity complete a Conflict of Interest (COI) questionnaire annually. A comprehensive evaluation and thorough review of all disclosures is performed by a 6-member COI Committee comprised of executives, management, and staff. The results of the COI disclosures are reported to the parent corporation, The Methodist Hospital's Audit & Compliance Committee and Board of Directors, including the actions being taken to protect the integrity of decision-making. In addition, disclosure results are also communicated to management and to affected committee chairs to promote transparency and to ensure that actions are taken and restrictions are imposed where appropriate. Conflicted individuals may not vote or exert self-serving influence on the disclosed matter. Form 990, Part VI, Section B, line 15 The Methodist Hospital (sole corporate member) follows IRS regulations as it relates to establishing a rebuttable presumption of reasonableness related to total compensation of the CEO of this organization as well as other key employees and compensated officers of the organization listed below. It has established a process that includes the following elements: A separate committee of the board of TMH (the "Board Committee"), comprised of independent directors meets at least annually to review, deliberate and make recommendations to the Board of TMH as it relates to any changes in total compensation including base pay, bonus awards from incentive programs or benefits and perquisites of the CEO. For 2011, the Board Committee reviewed and recommended compensation packages for the following positions: -EVP/Chief Academic Officer/Chief Medical Officer, The Methodist Hospital who also serves as Chairperson & CEO for The Methodist Hospital Physician Organization(TMHPO) -EVP, The Methodist Hospital (Secretary, TMHPO) -EVP, Chief Financial Officer/Chief Administrative Officer, The Methodist Hospital (Assistant Secretary, TMHPO) The Board Committee establishes that no member has any conflict of interest with regard to the executive compensation arrangements being approved. The Board Committee reviews and considers information provided by an external consultant engaged to ensure it has direct access to: -Compensation information paid by comparable organizations, for functionally comparable positions. -Compensation norms in the organization's immediate locale and from other independent compensation surveys by nationally recognized independent firms that represent the organization's logical peer group. -Compensation information that includes information on base salary, incentives, benefits and perquisites for total compensation comparison purposes to ensure reasonable competitive ranking. The Board Committee relies on the comparability data to reach consensus that its recommendations to the Board regarding executive compensation changes are reasonable and in line with organization's overall total compensation philosophy for executive pay. The deliberations and decisions of the Board Committee are contemporaneously substantiated. The compensation for positions held by the other compensated Officers and Directors listed on Part VII, Section A is determined based on a thorough review of numerous compensation studies conducted by nationally recognized, independent firms that provide market data for total compensation for similar positions. The compensation information considered includes information on base salary, incentives, and benefits for total compensation purposes to ensure reasonable competitive ranking in order to meet recruitment and retention objectives that secure the talent required to contribute to organizational success. Form 990, Part VI, Section C, line 19 The governing documents (except the Articles of Incorporation, which are on file with the Secretary of the State of Texas), conflict of interest policy and financial statements of the organization are not made available to the general public. Form 990, Part VII, Section A, Column B Certain officers/directors of TMH Physician Organization are employees of The Methodist Hospital or its affiliates. These officers and directors who are employed by this or other related organizations work in excess of 50 hours per week on behalf of this organization and other organizations of the Methodist Hospital System (System). The compensation shown on Schedule J reflects the total compensation earned for the officers/directors for the combined hours spent working for all the organizations in the System. However, the hours reflected in Part VII, Section A are the estimated hours spent working only on behalf of this organization. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Equip Transfers - Restricted Funds 12,994. Total to Form 990, Part XI, Line 5: 12,994. Methodist Hospital Self-Insurance Trust 6565 Fannin Houston TX 77030 741948396 Insurance Trust TX 501 ( c ) (3) Line 11a, I The Methodist Hospital 0 San Jacinto Family Practice Education Foundation 4401 Garth Road Baytown TX 77521 760556120 Health Care Education TX 501 ( c ) (3) Line 11a, I San Jacinto Methodist Hospital 0 San Jacinto Medical Group 4401 Garth Road Baytown TX 77521 760516915 Health Care TX 501 ( c ) (3) Line 11a, I San Jacinto Methodist Hospital 0 The Methodist Health Care System STD Plan Trust 6565 Fannin Houston TX 77030 766161019 Insurance Trust TX Section 671 The Methodist Hospital 0 Medvest 1 Limited 6565 Fannin Houston TX 77030 760534067 Health Care Investments TX N/A Allied Methodist Hospital Physicians 6565 Fannin Houston TX 77030 760551274 Physician Group TX N/A C Medvest Holdings Inc 6565 Fannin Houston TX 77030 760667765 Health Care Investments TX N/A C Medvest Incorporated 6565 Fannin Houston TX 77030 760182470 Health Care Investment TX N/A C Methodist International 6565 Fannin Houston TX 77030 300347273 Health Care Consulting TX N/A C Methodist Willowbrook MOB Condominium Assoc 6565 Fannin Houston TX 77030 680500294 Condo Assoc TX N/A C Methodist Willowbrook MOB Condominium Assoc II 6565 Fannin Houston TX 77030 262137993 Condo Assoc TX N/A C San Jacinto Methodist - Alexander Condominium Assoc 6565 Fannin Houston TX 77030 470921764 Condo Assoc TX N/A C SJMH Condominium Association 6565 Fannin Houston TX 77030 412096917 Condo Assoc TX N/A C The Methodist Hospital Condominium Association 6565 Fannin Houston TX 77030 861065871 Condo Assoc TX N/A C TMH Medical Office Buildings Condominium Assoc 6565 Fannin Houston TX 77030 760287893 Condo Assoc TX N/A C Wesley Insurance Company SPC Ltd 6565 Fannin Houston TX 77030 980405036 Insurance CJ N/A C Methodist West Houston Medical Office Building Condo Assoc 6565 Fannin Houston TX 77030 300655123 Condo Assoc TX N/A C 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 1