2024-11-13T16:03:42+00:00 2023-12-31 440160260 Forvis Mazars LLP 120 E Palmetto Park Road Suite 403 Boca Raton FL 33432 990 2023-01-01 461893597 COMPLEX CARE MEDICAL SERVICES CORPORATION COMP 2144567000 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 Dai Chung Business Officer 2024-11-13 true April Arnold P01559426 5612991820 2024-11-13 2023 2024-10-15 13:58:12Z DAI H CHUNG 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 1602588 false X N/A X 2012 TX TO SERVE AS THE MEDICAL HOME FOR CHILDREN WITH COMPLEX MEDICAL ILLNESSES. 2 2 0 2 0 0 1655 1398670 1598111 0 2822 1398670 1602588 0 0 1567771 1763242 0 0 1918426 2160928 3486197 3924170 -2087527 -2321582 1462260 1361634 20934733 23155689 -19472473 -21794055 To provide an exemplary model of family-centered complex care that unites the medical neighborhood to improve quality of life and community integration for children and their families. false false 3081524 1598111 To achieve the triple aim of the right care, at the right place, at the right time through centralized, coordinated, comprehensive, and compassionate care with the intent to improve the child's growth and development, the family's satisfaction, and decrease unnecessary hospital utilization. To optimize care for children with medical complexity through partnerships with caregivers and medical neighborhoods so that children can reach their greatest potential and experience life more fully. 3081524 true false false false false false false false false true false false false 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 3 0 true 0 false false false false false false false false false false false false X 2 2 false 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 Andrew Gelfand MD Director 1.0 0 X 0 0 0 Patricia Petroff MD Chairman 1.0 0 X 0 0 0 William Scott MD Director (Thru 8/31/23) 1.0 0 X 0 0 0 Dai H Chung MD President 1.0 54.0 X 0 1324008 102159 Lisa M Frenkel Secretary 1.0 53.0 X 0 471340 77290 0 1795348 179449 0 true true false UTSW HI 108 5323 Harry Hines Blvd Dallas TX 753908886 Phys & Medical Services 673930 1 1655 1655 NET PATIENT REVENUE 622110 1598111 1598111 0 0 0 0 1598111 2822 2822 0 2822 2822 0 0 0 0 0 0 0 1602588 1598111 0 2822 X 1317346 1018831 298515 88712 68610 20102 263324 203654 59670 93860 72591 21269 809467 626039 183428 0 154 119 35 8937 6912 2025 469 363 106 151545 117204 34341 123621 95608 28013 SHARED SERVICES 861161 666019 195142 MEDICAL SURGICAL SUPPLIES 205574 205574 0 0 0 0 3924170 3081524 842646 0 100 100 0 22994 0 0 0 0 2549673 1211133 1462160 1338540 0 0 0 0 1462260 1361634 133013 290873 0 0 20801720 22864816 20934733 23155689 X -19472473 -21794055 -19472473 -21794055 1462260 1361634 -2321582 0 X false true X true false X 2428181 1102640 1325541 121492 108493 12999 1338540 LT ADVANCES - AFFILIATES 22855676 LT DEFERRED RENT 9140 22864816 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote COMPLEX CARE MEDICAL SERVICES'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, 2023, 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 2020 THROUGH 2023 IN CHILDREN'S HEALTH MAIN TAXING JURISDICTIONS." false true false false false false false false false Dai H Chung MD President 0 955048 0 368181 0 779 0 81951 0 20208 0 1426167 0 0 Lisa M Frenkel Secretary 0 332042 0 98550 0 40748 0 59644 0 17646 0 548631 0 31394 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation COMPLEX CARE MEDICAL SERVICES CORPORATION (THE "CORPORATION") HAS NO EMPLOYEES. 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). THEREFORE, COMPENSATION DECISIONS FOR THE OFFICERS WERE DETERMINED BY THE RELATED ORGANIZATION FOLLOWING CHST COMPENSATION'S POLICY. IN THEIR DUTIES AS OFFICERS OF THE CORPORATION, THEY HAVE NO INFLUENCE OVER THE COMPENSATION PROCESS PERFORMED BY 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, NONEMPLOYEE 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 4b Supplemental nonqualified retirement plan EXECUTIVE DEFINED CONTRIBUTION RETIREMENT PLAN (EDCRP): EMPLOYEES WHO RECEIVED TAXABLE INCOME FROM THE EDCRP INCLUDE: LISA FRENKEL - $31,394 EMPLOYEES WHO PARTICIPATED IN AND HAVE CONTRIBUTIONS TO THE EDCRP INCLUDE: LISA FRENKEL - $40,569 Form 990, Part VI, Line 15 PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL AND OFFICERS COMPLEX CARE MEDICAL SERVICES CORPORATION (CCMSC) (THE "CORPORATION") HAS NO EMPLOYEES. 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 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 Board of Directors has established four standing committees, which have the authority to act for and on behalf of the CHST Board of Directors to fulfill the responsibilities designated in their respective committee charters. The CHST Board of Directors has established two special committees that do not have delegated authority; however, the special committees provide oversight as provided for in their respective charters. Written minutes are prepared and maintained for all Board of Directors and board committee meetings, and actions by written consent are also prepared and maintained as they occur. 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 SOLE MEMBER AND APPROVED BY THE CURRENT CCMSC BOARD OF DIRECTORS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders MEMBER RESERVE POWERS ARE SPECIFIED IN THE ORGANIZATION'S BYLAWS AND REPRESENT THOSE 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 COMPLEX CARE MEDICAL SERVICES CORPORATION HAS DELEGATED ITS OVERSIGHT AND REVIEW OF THE FORM 990 TO THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST), ITS SOLE MEMBER. A DRAFT OF THE FORM 990 IS PRESENTED TO THE CHST AUDIT COMMITTEE FOR REVIEW PRIOR TO FILING. A COPY OF THE FINAL FORM 990 IS MADE AVAILABLE TO THE CHST DIRECTORS THROUGH OUR BOARD PORTAL BEFORE IT IS FILED. Form 990, Part VI, Line 12c Conflict of interest policy OFFICERS, DIRECTORS, AND KEY EMPLOYEES 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. Form 990, Part IX, Line 11g Other Fees CONTRACT MEDICAL - Total Expense: 809467, Program Service Expense: 626039, Management and General Expenses: 183428, Fundraising Expenses: ; CHILDREN'S HEALTH SYSTEM OF TEXAS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 750800628 HOSPITAL TX 501(c)(3) 3 NA 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 DALLAS PHYS MED SVCS FOR CHILDREN INC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 810584868 PHYSICIANS TX 501(c)(3) 3 CHILDREN'S HEALTH SYSTEM OF TEXAS false 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 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 MGMT CO. (Dissolved 1.1.23) TX 501(c)(3) Type II NA false PEDIATRIC HEALTH MANAGEMENT SERVICES 1935 MEDICAL DISTRICT DRIVE DALLAS TX 752357701 844596436 PROGRAM SUPPORT TX 501(c)(3) Type I NA false LEGACY TRAIL SURGERY CENTER LLC 1939 MEDICAL DISTRICT DRIVE DALLAS TX 75239 822278618 HEALTHCARE RELATED INVESTMENTS TX na N/A ALTERNATIVE CARE SYSTEMS 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 752244475 INACTIVE TX NA C Corporation false NTPSS INC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 471036641 INACTIVE TX NA C Corporation false TEXAS BLUEBONNET INSURANCE COMPANY 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 475032893 INACTIVE TX NA C Corporation false TEXAS TRINITY RIVER ASSURANCE COMPANY 878 WEST BAY ROAD PO BOX 1159 GRAND CAYMAN CJ KY11102 981318151 SELF-INSURANCE CJ NA C Corporation false CHFH INC 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 831336111 INACTIVE TX NA C Corporation false CHILDREN'S HEALTH 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 833809987 INACTIVE TX NA C Corporation false CHILDREN'S HEALTH CARE NETWORK 1935 MEDICAL DISTRICT DRIVE DALLAS TX 75235 834560427 INACTIVE TX NA C Corporation false false false true false false false false false false true false true false true true false false false false