2024-08-15T16:20:17-05:00 2023-09-30 Forvis Mazars LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2022-10-01 455465061 El Paso Children's Physician Group % OMAR GARZA ELPA 9152985444 4845 Alameda Ave El Paso TX 79905 Cindy A Stout President & CEO 9152985444 2024-08-15 true Jeanette Verrelli P00742631 9727028262 2022 2024-08-08 14:25:15Z CINDY STOUT 4845 ALAMEDA AVE EL PASO TX 79905 886111 false X ELPASOCHILDRENS.ORG X 2012 TX EL PASO CHILDREN'S PHYSICIAN GROUP WORKS IN CONJUNCTION WITH EL PASO CHILDREN'S HOSPITAL TO PROVIDE COMPASSIONATE, COORDINATED... (CONTINUED ON SCHEDULE O) 3 1 7 1 0 0 0 0 1724168 886111 0 0 0 0 1724168 886111 0 0 0 0 1661834 3345240 0 0 0 62334 70546 1724168 3415786 -2529675 1716671 217657 75787 1106448 1640884 -888791 X NON-PROFIT CORPORATION TO PROVIDE GENERAL, SPECIALITY, AND SUB-SPECIALTY HEALTH SERVICES FOR CHILDREN AND ADULTS WITH CHRONIC DEVELOPMENTAL DISEASES; TO PROVIDE EDUCATIONAL AND OTHER OUTREACH PROGRAMS DESIGNED TO IMPROVE THE DELIVERY OF HEALTH CARE SERVICES TO THE LOCAL COMMUNITY; AND TO FOSTER AND PROMOTE MEDICAL EDUCATION AND RESEARCH, AS MAY BE APPROPRIATE. false false 3415786 886111 EL PASO CHILDREN'S PHYSICIAN GROUP IS A PEDIATRIC MULTI-SPECIALTY GROUP WHO PROVIDES MEDICAL CARE TO CHILDREN THROUGH EL PASO CHILDREN'S HOSPITAL CORPORATION, A 501(C)(3) NONPROFIT HOSPITAL. THROUGH SUCCESSFUL RECRUITMENT EFFORTS, THE ORGANIZATION HAS SIGNIFICANTLY ADVANCED PEDIATRIC SPECIALTY CARE FOR THE MEDICALLY UNDERSERVED COMMUNITY WITH THE INTRODUCTION OF THE FOLLOWING SPECIALTIES: - ALLERGY & IMMUNOLOGY - BEHAVIORAL, DEVELOPMENT & PSYCHIATRY - CARDIOLOGY - DERMATOLOGY - ENT - GENERAL SURGERY - UROLOGY AS A RESULT OF THE RECRUITMENT OF THESE ADDITONAL SPECIALISTS, THE ORGANIZATION HAS IMPLEMENTED SEVERAL MULTIDISCIPLINARY CLINICS TO FACILITATE SEAMLESS TRANSITIONS TO BENEFIT THEIR PATIENTS AND THEIR FAMILIES THROUGH THE CARE JOURNEY. 3415786 true false false false false false false false false false false false false false true false 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 0 0 7 true false false false false false false false false false false false false X 3 1 false false false false true true true true true false false false true true true true true false false false X X OMAR GARZA 9152985444 4845 ALAMEDA AVE EL PASO TX 79905 X WILLIAM SPURBECK CHAIRMAN/PHYSICIAN 39.0 1.0 X X 857289 0 22527 CINDY STOUT CHIEF EXECUTIVE OFFICER 1.0 39.0 X 0 489439 26531 RINI SAHEWALLA VICE CHAIR/PHYSICIAN 39.0 1.0 X X 334743 0 22180 OMAR GARZA CFO OF EPCH 1.0 39.0 X 0 302035 22824 Shauna E Goldman Board Secretary/Physician 39.0 1.0 X X 289835 0 14160 JONATHAN W CHIAO PHYSICIAN 39.0 1.0 X 143179 0 4725 CHETAN MOORTHY DIRECTOR 1.0 0.0 X 0 0 0 1625046 791474 112947 4 false true false 0 0 Physician Fees 621110 886111 886111 886111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 886111 886111 0 0 0 0 1540734 1540734 0 1607644 1607644 58029 58029 0 138833 138833 0 0 0 0 0 0 7430 7430 0 0 0 0 0 4543 4543 0 0 0 0 0 0 Dues and Periodicals 58573 58573 3415786 3415786 0 0 20197 0 0 0 0 0 0 217657 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1696474 0 1716671 217657 75787 343603 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 762845 75787 1106448 X 1640884 -888791 0 0 1640884 -888791 1716671 217657 -2529675 X X false true X false false X SCHEDULE A, PART I, LINE 3 REASON FOR PUBLIC CHARITY STATUS: EL PASO CHILDREN'S PHYSICIAN GROUP IS NOT A LICENSED HOSPITAL UNDER TEXAS LAW AND THEREFORE NOT REQUIRED TO COMPLETE SCHEDULE H. THE PRINCIPAL PURPOSE AND FUNCTION OF THE EL PASO CHILDREN'S PHYSICIAN GROUP IS TO PROVIDE MEDICAL CARE. 0 DUE TO AFFILIATE 751911 EST SELF-INSURANCE COSTS 10934 762845 Schedule D, Part X, Line 2 ASC 740 FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. false false false false false false false false false WILLIAM SPURBECK CHAIRMAN/PHYSICIAN 857289 0 0 14535 7992 879816 0 RINI SAHEWALLA VICE CHAIR/PHYSICIAN 334743 0 0 11762 10418 356923 0 Shauna E Goldman Board Secretary/Physician 289835 0 0 11671 2489 303995 0 CINDY STOUT CHIEF EXECUTIVE OFFICER 405231 84208 0 10842 15689 515970 0 OMAR GARZA CFO OF EPCH 257035 45000 0 7945 14879 324859 0 Schedule J, Part I, Line 3 METHOD TO ESTABLISH COMPENSATION OF CEO: THE EL PASO CHILDREN'S HOSPITAL CORPORATION, A RELATED ORGANIZATION, ESTABLISHES THE COMPENSATION FOR THE CEO USING THE FOLLOWING METHODS: - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE - COMPENSATION SURVEY OR STUDY - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT AGREEMENT FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS: EL PASO CHILDREN'S HOSPITAL CORPORATION IS THE SOLE MEMBER OF EL PASO CHILDREN'S PHYSICIAN GROUP. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS WHO MAY ELECT MEMBERS OF THE GOVERNING BOARD: NEW DIRECTORS ARE JOINTLY APPOINTED BY THE MEMBER AND A MAJORITY OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL BY THE MEMBER: THE FOLLOWING MATTERS ARE RESERVED SOLELY TO THE MEMBER AND, FOLLOWING CONSULTATION WITH THE BOARD OF DIRECTORS, SHALL REQUIRE THE AFFIRMATIVE ACTION OF THE MEMBER TO BE EFFECTIVE: (A) APPROVAL AND ADOPTION OF ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; (B) APPROVAL OF ANY FINANCIAL EXPENDITURE WHICH DEVIATES FROM THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS IF THE SUM OF SUCH FINANCIAL EXPENDITURE AND THE SUM OF ALL PRIOR FINANCIAL EXPENDITURES WHICH THEMSELVES DEVIATE FROM THE CORPORATION'S ANNUAL AND CAPITAL BUDGETS, PER FISCAL YEAR, EXCEED $25,000; (C) THE PURCHASE OR ACQUISITION OF ANY PROPERTY, REAL, PERSONAL OR MIXED BY THE CORPORATION EXCEEDING $25,000. (D) THE SALE, LEASE, MORTGAGE, OR OTHER TRANSFER OR ENCUMBRANCE OF THE REAL PROPERTY OF THE CORPORATION EXCEEDING $25,000; (E) ANY SALE, LEASE, MORTGAGE OR OTHER TRANSFER OR ENCUMBRANCE (COLLECTIVELY, TRANSFER) OF THE PERSONAL PROPERTY AND ASSETS OF THE CORPORATION IF THE SUM OF SUCH TRANSFER AND THE SUM OF ALL PRIOR TRANSFERS, PER FISCAL YEAR, EXCEED $25,000; (F) ANY MERGER, ACQUISITION, CONSOLIDATION, REORGANIZATION OR DISSOLUTION OF THE CORPORATION; (G) BORROWING OR LENDING OF MONEY OR THE CREATION OF INDEBTEDNESS THROUGH THE GUARANTY OF ANOTHER'S DEBT OR SIMILAR ACTION; (H) GIVING OR SEEKING OF GRANTS; (I) CREATION, OWNERSHIP OR ACQUISITION OF (WHETHER IN WHOLE OR IN PART), OR AFFILIATION WITH, ANY OTHER ORGANIZATION; (J) APPROVAL OF ANY STRATEGIC PLAN, BUSINESS PLAN, OR MISSION PLAN OF THE CORPORATION, INCLUDING BUT NOT LIMITED TO SPECIFIC OBJECTIVES FOR PATIENT VOLUME GOALS; (K) SETTLEMENT OF CLAIMS OR LITIGATION INVOLVING THE CORPORATION OR ANY PERSON WHO MAY BE ENTITLED TO INDEMNIFICATION BY THE CORPORATION WITH RESPECT TO SUCH CLAIMS OR WHO MAY BE COVERED BY THE CORPORATION'S INSURANCE WITH RESPECT TO SUCH CLAIM OR LITIGATION. (L) ENTERING INTO CONTRACTS IN WHICH THE CORPORATION ASSUMES FINANCIAL RISK, INCLUDING BUT NOT LIMITED TO MANAGED CARE CONTRACTS, EMPLOYMENT CONTRACTS, AND PHYSICIAN PRACTICE ACQUISITION CONTRACTS; (M) DETAILS AND VARIABLES INVOLVED IN THE FINANCIAL/PRODUCTIVITY FORMULA THAT DETERMINES PHYSICIAN COMPENSATION; (P) FILING OF ANY VOLUNTARY PETITION IN BANKRUPTCY OR FOR THE APPOINTMENT OF A RECEIVER; (Q) ADOPTION OF ANY POLICY RELATING TO THE DISTRIBUTION OF NON-PROFESSIONAL AND NON-ADMINISTRATIVE RELATED REVENUES AND APPROVAL OF ANY SUCH DISTRIBUTIONS; (R) DISPOSITION OF ASSETS OF THE CORPORATION; AND (S) OBTAINING OR MAINTAINING TAX EXEMPT STATUS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. PRIOR TO FILING WITH THE IRS, THE ORGANIZATION'S ACCOUNTING STAFF REVIEWS THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR COMPLIANCE WITH CONFLICT OF INTEREST POLICY: EL PASO CHILDREN'S PHYSICIAN GROUP ("EPCPG") ADDRESSES POTENTIAL CONFLICTS OF INTEREST THROUGH EL PASO CHILDREN'S HOSPITAL'S ("EPCH") WRITTEN POLICY. EPCH REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE IN ACCORDANCE WITH THE POLICY. THE EPCH COMPLIANCE OFFICER HAS IMPLEMENTED A PROCESS WHICH REQUIRES ALL EPCPG OFFICERS, BOARD MEMBERS, AND EMPLOYEES (ALL COLLECTIVELY REFERRED TO AS "AFFECTED INDIVIDUALS") TO CERTIFY VIA AN ONLINE QUESTIONNAIRE ("CERTIFICATION FORMS")OF ALL CURRENT OR POTENTIAL SUBSTANITIAL FINANCIAL OR MATERIAL INTEREST IN ANY BUSINESS INVOLVING EPCH. THE PROCESS REQUIRES THE AFFECTED INDIVIDUALS TO ELECTRONICALLY ACKNOWLEDGE THE POLICY. THE POLICY AND THE CERTIFICATION FORMS ALSO ADDRESS OUTSIDE INTERESTS AND RELATIONSHIPS, GIFTS, RESEARCH, AND CONFIDENTIAL INFORMATION. EACH AFFECTED INDIVIDUAL COMPLETES THIS PROCESS 1) AT THE BEGINNING OF THE EMPLOYMENT RELATIONSHIP FOR EMPLOYEES, 2) AT THE BEGINNING OF APPOINTMENT FOR OFFICERS AND BOARD MEMBERS, 3) DURING CREDENTIALING AND RECREDENTIALING FOR MEDICAL STAFF MEMBERS AT EPCH, 4) AT ANY TIME A POTENTIAL OR APPARENT CONFLICT OF INTEREST ARISES FOR ANY IMPACTED INDIVIDUAL, AS WELL AS 5) ANNUALLY (CY) VIA THE ONLINE CERTIFICATION FORMS. THE EPCH COMPLIANCE OFFICER REVIEWS WITH THE PRESIDENT AND LEGAL COUNSEL ANY CONFLICT OF INTEREST CERTIFICATION FORMS THAT IDENTIFY POTENTIAL CONFLICTS. THE EPCH COMPLIANCE OFFICER MAY ASK THE INTERESTED PERSON TO DISCUSS THE TRANSACTION IN ORDER TO OBTAIN FURTHER DETAILS. THE COMPLIANCE OFFICER MAY, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO ANY TRANSACTION OR ARRANGEMENT, IF AVAILABLE, THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION C, LINE 18 TAX FORMS AVAILABLE TO THE PUBLIC: IF THE ORGANIZATION RECEIVES A REQUEST TO INSPECT ITS FORM 990, IT WILL PERMIT THE PERSON MAKING THE REQUEST TO INSPECT FORM 990 DURING REGULAR BUSINESS HOURS AT THE LOCATION WHERE SUCH RECORDS ARE KEPT. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION FURNISHES COPIES OF ANY DOCUMENTS REQUIRING LEGAL DISCLOSURE UPON REQUEST. Form 990, Part I, Line 1 SIGNIFICANT ACTIVITIES: ... (CONTINUED FROM PAGE 1) FAMILY-CENTERED CARE FOR CHILDREN WITH A DEDICATED COMMITMENT TO EXCELLENT OUTCOMES AND INCLUSIVE LEADERSHIP. Form 990, Part VI, Section B, Line 15 COMPENSATION REVIEW: THE CEO DOES NOT RECEIVE COMPENSATION FROM EPCPG. COMPENSATION OF CEO IS PAID BY THE RELATED ORGANIZATION, EL PASO CHILDREN'S HOSPITAL ("EPCH"). IN SETTING THE CEO COMPENSATION, THE EPCH BOARD OF DIRECTORS RELIES ON AN INDEPENDENT COMPENSATION VALUATION BY A SPECIALIZED FIRM. THE BOARD'S DECISION IS GUIDED BY POLICY AND REFLECTED IN WRITTEN DOCUMENTS. COMPENSATION FOR ALL EPCPG EMPLOYEES IS BASED ON CURRENT DATA AND ANALYSIS PROVIDED BY AN OUTSIDE VALUATION FIRM SPECIALIZING IN PHYSICIAN AND HEALTHCARE PROVIDER COMPENSATION VALUATION. Form 990, Part VI, Section B, Lines 13 & 14 WHISTLEBLOWER & DOCUMENT RETENTION POLICY: THE PHYSICIAN GROUP FOLLOWS THE POLICIES AS ADOPTED BY ITS MEMBER, EL PASO CHILDREN'S HOSPITAL CORPORATION. Form 990, Part XII, Line 2C OVERSIGHT OVER AUDIT OF THE FINANCIAL STATEMENTS: ALTHOUGH THE ORGANIZATION DOES NOT HAVE A SEPARATE COMMITTEE, THE RESPONSIBILITY OF THE OVERSIGHT OF THE AUDIT IS ASSUMED BY THE FULL BOARD. FORM 990, PART VII, LINE 1A WILLIAM SPURBECK, RINI SAHEWALLA, AND SHAUNA E GOLDMAN ARE ALL PHYSICIANS. THE COMPENSATION LISTED IS RELATED TO THEIR CLINICAL SERVICES, NOT THEIR BOARD POSITION OR MEMBERSHIP. 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