2023-11-13T19:46:44+00:00 2022-12-31 350921680 Crowe LLP 5810 Tennyson Parkway Suite 450 Plano TX 750244112 990 2022-01-01 810584868 Dallas Physician Medical Services for Children Inc DALL 2144567000 1935 Medical District Drive Dallas TX 75235 Robert Fries Senior Vice President, Finance 2144567000 2023-11-14 true Robert Fries 999009999 Amy Bellanca P01572961 2147775200 2022 2023-04-26 12:10:37Z Dai H Chung 1935 Medical District Drive Dallas TX 75235 42561660 false X N/A X 2002 TX PROVIDE SERVICES TO PATIENTS AT SEVERAL HOSPITALS, INCLUDING CHILDREN'S MEDICAL CENTER DALLAS. 4 0 535 0 0 0 2030146 4082314 28854642 38479346 0 0 0 0 30884788 42561660 0 0 0 37797122 58259184 0 0 0 29535607 40326404 67332729 98585588 -36447941 -56023928 33121247 49662270 153965001 226529952 -120843754 -176867682 PROVIDE DENTAL, GENERAL PEDIATRIC, AND PEDIATRIC SUB-SPECIALTY SERVICES, INCLUDING, BUT NOT LIMITED TO EMERGENCY DEPARTMENT COVERAGE, INPATIENT COVERAGE, ORTHOPEDIC SURGERY, AND CRANIOFACIAL ORTHODONTICS REGARDLESS OF PAYOR SOURCE OR FINANCIAL STATUS. false false 42101978 0 38479346 PROVIDE PHYSICIAN SERVICES TO PATIENTS TREATED BY CHILDREN'S HEALTH CLINICAL OPERATIONS. THESE SERVICES ARE PROVIDED WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY. 42101978 true true false false false false false false false true false false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 106 0 true 535 true false false false false false false false false false false false false X 4 0 true false false false true true true true true false false false true true true true true false false false X Amy Yeager 2144567000 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 Dawn Johnson MD Director and Medical Director 40.0 0 X 290002 0 34236 Dustin Loveland MD Director and Medical Director 40.0 0 X 847726 0 53336 Michael Day MD Director and Medical Director - (Term. Date 8/12/22) 40.0 0 X 369763 0 49510 Stormee Williams MD Director (Effec. 01/01/22) / CHST Chief Health Equity Officer 1.0 54.0 X 0 395130 84016 Victoria Yang MD Director and Medical Director (Effec. 01/01/22) 40.0 0 X 307949 0 62727 Dai H Chung MD PRESIDENT 1.0 54.0 X 0 596486 0 Lisa M Frenkel Secretary 1.0 54.0 X 0 508188 72484 Peter C Perialas Jr Vice President 1.0 54.0 X 0 1825216 360477 Christopher Redman MD Physician 40.0 0 X 775452 0 53335 Israel Nosnik MD Physician 40.0 0 X 1070986 0 50257 James Pace MD Physician 40.0 0 X 679518 0 35069 Steven Copenhaver MD Physician 40.0 0 X 758866 0 58430 William Strand MD Physician 40.0 0 X 707081 0 15367 David T Berry Former Officer 0.0 55.0 X 0 2095280 51063 5807343 5420300 980307 115 true true false MEADOWS MENTAL HEALTH POLICY 2800 Swiss Ave Dallas TX 75024 Mental Health care 1200000 TCN PEDIATRIC NEUROLOGY PLLC 4032 McDermott Road Suite 100 Plano NY 75024 Physician Services 615653 UTSW HI 108 5323 Harry Hines Blvd Dallas TX 753908886 Phys & Medical Services 494969 JACKSON PHYSICIAN SEARCH LLC PO Box 745644 Atlanta GA 30374 Placement fees 369607 SIEMENS HEALTHCARE DIAGNOSTICS 511 Benedict Ave Tarrytown NY 10591 Imaging Service 268534 14 2881996 1200318 4082314 NET PATIENT REVENUE 622110 38479346 38479346 0 0 0 0 38479346 0 0 0 0 0 0 0 0 0 42561660 38479346 0 0 2015249 2015249 47068300 24929741 22138559 1962878 1039639 923239 4477058 2371275 2105783 2735699 1448964 1286735 4098534 2170790 1927744 0 1777310 941353 835957 3685615 1952087 1733528 3822259 2024461 1797798 243978 129223 114755 647944 343184 304760 183128 183128 Shared Services 23314752 23314752 Medical Surgical Supplies 2552884 2552884 0 0 0 0 98585588 42101978 56483610 0 400 2800 4947866 10172375 0 0 0 0 1007460 1285060 8670915 3593328 4452227 5077587 0 0 22713294 33124448 33121247 49662270 9204246 14052057 0 0 144760755 212477895 153965001 226529952 X -120843754 -176867682 -120843754 -176867682 33121247 49662270 -56023928 0 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1854776 697235 1157541 599833 307003 292830 4433885 2589090 1844795 1782421 1782421 5077587 Due from Affiliates 33124448 33124448 LT ADVANCES-Affiliates 212477895 212477895 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Dallas Physician Medical Services for Children's financial information is included in the consolidated audited financial statements of Children's Health System of Texas, a related organization. Children's Health System of Texas's FIN 48 (ASC 740) footnote for the year ended December 31, 2022, reads as follows: "The authoritative guidance in ASC 740 Income Taxes, creates a single model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the accompanying consolidated balance sheets. The statute of limitations remains open for tax years 2019 through 2022 in Children's Health main taxing jurisdictions." true true false false false false false false Michael Day MD Director and Medical Director - (Term. Date 8/12/22) 219517 0 147548 0 2698 0 16810 0 32700 0 419273 0 0 0 Dawn Johnson MD Director and Medical Director 259636 0 25000 0 5366 0 17484 0 16752 0 324238 0 0 0 Dustin Loveland MD Director and Medical Director 685767 0 160000 0 1959 0 17820 0 35516 0 901062 0 0 0 Stormee Williams MD Director (Effec. 01/01/22) / CHST Chief Health Equity Officer 0 271442 0 82740 0 40948 0 58885 0 25131 0 479146 0 21702 Victoria Yang MD Director and Medical Director (Effec. 01/01/22) 271135 0 35250 0 1564 0 20758 0 41969 0 370676 0 0 0 David T Berry Former Officer 0 57012 0 388002 0 1650266 0 45681 0 5382 0 2146343 0 616905 Dai H Chung MD PRESIDENT 0 596486 0 0 0 0 0 0 0 0 0 596486 0 0 Lisa M Frenkel Secretary 0 319644 0 101602 0 86942 0 56798 0 15686 0 580672 0 77261 Peter C Perialas Jr Vice President 0 1048454 0 504726 0 272036 0 334779 0 25698 0 2185693 0 261558 Steven Copenhaver MD Physician 499648 0 250000 0 9218 0 20500 0 37930 0 817296 0 0 0 Israel Nosnik MD Physician 202112 0 865505 0 3369 0 12200 0 38057 0 1121243 0 0 0 James Pace MD Physician 642369 0 33781 0 3368 0 0 0 35069 0 714587 0 0 0 Christopher Redman MD Physician 592370 0 180000 0 3082 0 18249 0 35086 0 828787 0 0 0 William Strand MD Physician 428329 0 264244 0 14508 0 0 0 15367 0 722448 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation CHILDREN'S HEALTH SYSTEM OF TEXAS IS THE SOLE MEMBER FOR DALLAS PHYSICIAN MEDICAL SERVICES FOR CHILDREN (DPMSC). THEREFORE, DPMSC'S TOP MANAGEMENT OFFICIAL IS EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). The CHST process for determining executive compensation is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for executives. The Committee is comprised of independent, non-employee directors. A written compensation philosophy has been developed by the Human Resources Committee for timeliness and appropriateness and defines the desired peer groups for compensation surveys. The HR Committee engages the services of an independent compensation consultant for executive compensation. COMPENSATION PROGRAM COMPONENTS: The elements of total compensation provided to CHST executives include: - Cash compensation (i.e., base salary, short-term and long-term incentive compensation, and/or other cash compensation), determined in consideration of competitive market practices, organizational and individual performance, recruitment and retention considerations, and other relevant factors. - Standard benefits, assisting in each executive's medical, dental, disability, life insurance, time off, and retirement needs, reflective of the employment status (i.e., full or part time) of the executive. - Supplemental benefits, including supplemental insurance, retirement benefits, and/or other supplemental benefits determined by the Committee to be appropriate and reasonable in relation to marketplace practices. Compensation and benefits decisions are made in consideration of each executive's position, responsibilities, skills, effort, and performance, in relation to documented practices within the appropriate comparator group(s). PEER GROUP: The Committee has defined its primary peer group for executives as not-for-profit health care organizations similar in size, structure, and complexity. This group will include leading pediatric health systems as well as integrated health systems and academic medical centers. - Data will be compiled in a manner consistent with the IRS Intermediate Sanctions rules of federal tax law, to reflect what is dinarily paid to like executives by like enterprises under like circumstances." - In certain circumstances, market data from additional comparator groups (e.g., research institutions, insurance industry, and general industry companies) may also be referenced. - The specific nature of the role at CHST will be considered when adding comparator groups outside of the primary peer group, and the Committee will discuss and agree on the appropriateness of adding comparator groups whenever the specific nature of the CHST role requires additional comparator groups to be used. Schedule J, Part I, Line 4a Severance or change-of-control payment David Berry - $1,012,500 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Executive Defined Contribution Retirement Plan (EDCRP): Employees who received taxable income from the EDCRP include: Peter Perialas- $261,558 David Berry - $616,905 Lisa Frenkel - $77,261 Stormee Williams - $21,702 Employees who participated in and have contributions to the EDCRP include: Peter Perialas - $316,479 David Berry - $23,365 Lisa Frenkel - $39,110 Stormee Williams - $35,442 Form 990, Part VI, Line 15 PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL AND OFFICERS CERTAIN INDIVIDUALS IDENTIFIED HEREIN AS OFFICERS OF THE CORPORATION ARE EMPLOYED AND COMPENSATED BY A RELATED ORGANIZATION, CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). THE INDIVIDUALS PERFORM SERVICES FOR THE CORPORATION, AND IN SOME CASES OTHER RELATED ORGANIZATIONS, BY ARRANGEMENT BETWEEN CHST AND SUCH ORGANIZATION(S). AS SET FORTH IN THE SCHEDULE R, THE CORPORATION AND THE CHST ARE RELATED ORGANIZATIONS. IN THEIR DUTIES AS OFFICERS OF THE CORPORATION THEY HAVE NO INFLUENCE OVER THE COMPENSATION PROCESS PERFORMED BY CHST, WHICH IS EXPLAINED IN SCHEDULE J, PART I, LINE 3. Form 990, Part VI, Line 8b Committees Children's Health System of Texas has established seven standing Committees of the Board, which have the authority to act for and on behalf of CHST, Children's Health Clinical Operations, Children's Medical Center Foundation, and their affiliates, operating divisions and division facilities to fulfill the responsibilities designated in the respective Committee charters. Written minutes are prepared and maintained for all formal meetings of each Committee. Actions by Written Consent are also prepared and maintained as they occur. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Dai Chung and Peter C. Perialas - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders Children's Health System of Texas (CHST) is the sole member. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Directors are appointed by the member and approved by the current DPMSC Board of Directors. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Member reserve powers are specified in DPMSC's Bylaws and represent actions by the organization 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 A draft of the Form 990 is presented to the CHST Audit Committee for review. A copy of the Form 990 is made available to the directors of the organization's parent corporation, Children's Health System of Texas, through our Board portal before it is filed. Form 990, Part VI, Line 12c Conflict of interest policy Officers, directors, and key employees receive annually a copy of the Children's Health Statement of Interest form to complete. Disclosures made are reviewed by the CHST Legal Department and the Chief Compliance Officer, who are authorized under the Children's Health Conflict of Interest Policy to make determinations under the Policy regarding persons who are medical staff members or employees of Children's Health and its affiliates. Disclosures made by senior officers (as defined in the Policy) are reviewed by the Compliance Officer, the Chief Legal Officer, and CHST's President and Chief Executive Officer to determine if a conflict exists. Disclosures made by directors of CHST and its affiliates, as well as by the President and Chief Executive Officer of CHST, are discussed as necessary with the appropriate delegated Board Committee and, if required pursuant to the Policy, by the appropriate Board of Directors at meetings to determine if further action is needed. A Statement of Interest must be completed annually and Board members are requested to report changes if they occur. A Committee or Board member with a potential conflict is prohibited from participating in deliberations regarding the transaction in question and will recuse themselves from voting. Form 990, Part VI, Line 19 Required documents available to the public IRC section 6104 does not require disclosure of the financial statements, conflict of interest policy and governing documents. The Certificate of Formation, Consolidated Financial Statements, and the conflict of interest policy are made available upon request. Children's Health Clinical Operations 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 750800628 Hospital TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false 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 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) 10 CHILDREN'S HEALTH SYSTEM OF TEXAS false CHILDREN'S MED CTR RESEARCH INST AT UTSWMC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 453462044 RESEARCH INSTITUTE TX 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false PEDIATRIC PARTNERS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 461917702 CLINICALLY INTEGRATED NETWORK TX 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM OF TEXAS false ANESTHESIOLOGISTS FOR CHILDREN 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752917570 PHYSICIANS TX 501(c)(3) 10 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 SOUTHWESTERN MEDICAL DISTRICT 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 204101612 MEDICAL DISTRICT TX 501(c)(3) Type I NA false WOMEN'S AUXILIARY TO THE CHILDREN'S MEDICAL CENTER 2777 N STEMMONS FWY 700 DALLAS TX 75207 752485538 WOMEN'S AUXILIARY TX 501(c)(3) 10 CHILDREN'S MEDICAL CENTER FOUNDATION false OCH Holdings 1935 Medical District Drive Dallas TX 75235 474837308 Hospital TX 501(c)(3) 3 Children's Health Clinical Operations false CHILDREN'S HEALTH SYSTEM OF TEXAS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752062019 MANAGEMENT COMPANY TX 501(c)(3) Type II NA false Bradford Memorial Hospital for Babies 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 756067819 Hospital TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false The Children's Hospital of Texas 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 756081004 Hospital TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false Richmond Freeman Memorial Clinic 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 237079698 Hospital TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false ALTERNATIVE CARE SYSTEMS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752244475 OTHER MEDICAL SERVICES TX NA C Corporation false NTPSS INC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 471036641 PHYSICIAN SOLUTIONS TX NA C Corporation false Texas Bluebonnet Insurance Company 1935 Medical District Drive Dallas TX 75235 475032893 Insurance Company TX NA C Corporation false Texas Trinity River Assurance Company 981318151 Self-insurance CJ NA C Corporation false Children's Health 1935 Medical District Drive Dallas TX 75235 833809987 Other Medical Services TX NA C Corporation false CHFH Inc 1935 Medical District Drive Dallas TX 75235 831336111 Other Medical Services TX NA C Corporation false Children's Health Care Network 1935 Medical District Drive Dallas TX 75235 834560427 Other Medical Services TX NA C Corporation false false false true false false false false false false false false true true true true false false false false