2026-08-14T12:02:46+00:00 2025-09-30 440160260 FORVIS MAZARS LLP 120 E PALMETTO PARK ROAD SUITE 403 BOCA RATON FL 33432 990 2024-10-01 752665759 PEDI-ORTHO HEALTH CORPORATION PEDI 2145597625 2222 WELBORN ST DALLAS TX 752193924 MICHELLE C HAYS TREASURER 2145595000 2026-08-14 true APRIL ARNOLD P01559426 5612991820 2026-08-14 2024 2025-03-06 01:10:19Z ROBERT WALKER 2222 WELBORN ST DALLAS TX 752193924 3941285 false X N/A X 1996 TX TO IMPROVE THE LIVES OF CHILDREN BY PROVIDING ORTHOPEDIC AND PEDIATRIC CARE. 18 0 25 0 0 100742 100078 4232806 3801464 59145 39743 0 4392693 3941285 0 0 5398928 5315613 0 0 481077 543123 5880005 5858736 -1487312 -1917451 7390549 7943025 6107432 6777359 1283117 1165666 PEDI-ORTHO HEALTH CORPORATION PROVIDES PHYSICIANS WHO PROVIDE PEDIATRIC ORTHOPAEDIC CARE TO CHILDREN AND INSTITUTIONS WITH WHOM THE ORGANIZATION CONTRACTS. false false 5543002 0 3801464 PEDI-ORTHO HEALTH CORPORATION PROVIDES PHYSICIANS WHO PROVIDE PEDIATRIC ORTHOPAEDIC CARE TO CHILDREN AND INSTITUTIONS WITH WHOM THE ORGANIZATION CONTRACTS. 5543002 true true false false false false false false false false false false false true true true true 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 false false true true false false false true 2 0 true 25 true false false false false false false false false false false false false X 18 0 true false false false true false true true true false false false false true true true true true true true false false X JENNIFER DEASON 2145597862 2222 WELBORN ST DALLAS TX 75219 CHRISTINE A HO MD VICE CHAIRMAN/DIRECTOR 31.0 1.0 X X 790044 13400 66433 DANIEL J SUCATO MD MS CHAIRMAN/DIRECTOR 1.0 39.0 X X 19800 1915798 187228 AMY L MCINTOSH MD DIRECTOR 1.0 39.0 X 70900 865401 58603 ANTHONY I RICCIO MD DIRECTOR 1.0 39.0 X 42600 874830 58858 BRANDON A RAMO MD DIRECTOR 1.0 39.0 X 56000 908692 62058 CHRISTOPHER M STUTZ MD DIRECTOR 1.0 39.0 X 33500 836668 62749 COREY S GILL MD DIRECTOR 1.0 39.0 X 118500 861131 48966 DAVID A PODESZWA MD DIRECTOR 1.0 39.0 X 50300 1738588 181679 ELIZABETH HUBBARD MD DIRECTOR 1.0 39.0 X 121600 863220 35763 HENRY B ELLIS MD DIRECTOR 1.0 39.0 X 124300 1191406 58858 JAYSSON BROOKS MD DIRECTOR 1.0 39.0 X 58300 863312 65081 JOHN E ARVESEN MD DIRECTOR 1.0 39.0 X 64800 869798 68979 KARL E RATHJEN MD DIRECTOR 1.0 31.0 X 12400 575357 163624 LAWSON A COPLEY MD DIRECTOR 38.0 2.0 X 866277 0 205088 MEGAN JOHNSON MD DIRECTOR 1.0 39.0 X 56600 861056 58858 PHILIP L WILSON MD DIRECTOR 2.0 38.0 X 116900 1532307 178538 ROBERT L WIMBERLY MD DIRECTOR 1.0 39.0 X 58300 858138 65858 WILLIAM Z MORRIS MD DIRECTOR 1.0 39.0 X 51600 889963 58858 LORI L DALTON SECRETARY 1.0 39.0 X 0 705572 58858 MICHELLE C HAYS TREASURER 1.0 39.0 X 0 705283 61483 ROBERT L WALKER PRESIDENT 1.0 39.0 X 0 1628072 29428 BENJAMIN S RICHARDS III MD FORMER DIRECTOR (RET 06/30/21) 0.0 0.0 X 0 138522 159952 CHARLES E JOHNSTON II MD FORMER DIRECTOR (RET 04/16/21) 0.0 0.0 X 0 189655 211891 JOHN A HERRING MD FORMER DIRECTOR (RET 08/31/20) 0.0 0.0 X 0 207283 307715 2712721 20093452 2515406 6 true true false 0 100078 100078 CONTRACT BILLING 621110 3696362 3696362 NET PATIENT REVENUE 622310 105102 105102 0 0 0 0 3801464 39743 39743 0 0 0 0 0 0 0 0 0 3941285 3801464 0 39743 4364524 4364524 322396 322396 460425 460425 168268 168268 247339 247339 50687 50687 45495 45495 0 0 6259 6259 1175 1175 135653 135653 BAD DEBT 26004 26004 CREDIT CARD FEES/BANK FEES 17708 17708 DUES & SUBSCRIPTIONS 12803 12803 0 0 0 0 5858736 5543002 315734 0 15907 1240951 843638 558076 634425 0 0 0 0 91034 107303 0 0 0 0 0 0 5500488 6341752 7390549 7943025 606944 435607 0 0 5500488 6341752 6107432 6777359 X 1283117 1165666 1283117 1165666 7390549 7943025 X -1917451 1800000 X false true true false X 91790 94704 99310 100742 100078 486624 3471417 3617196 3891532 4232806 3801464 19014415 0 0 0 3563207 3711900 3990842 4333548 3901542 19501039 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19501039 267 5204 32153 59145 39743 136512 0 267 5204 32153 59145 39743 136512 0 0 0 0 0 0 0 3563474 3717104 4022995 4392693 3941285 19637551 0.99305 0.99481 0.01 0.01 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED DEFERRED 457 PLAN ASSETS 2370551 DEFERRED FLEX PLAN - PLAN ASSETS 3971201 6341752 FEDERAL INCOME TAXES DEFFERED 457 PLAN LIABILITIES 3971201 DEFERRED FLEX PLAN - PLAN LIABILITIES 2370551 6341752 X 3915281 -26004 -26004 3941285 0 0 3941285 5832732 -26004 -26004 5858736 0 0 5858736 SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE FIN 48 (ASC 740) FOOTNOTE THE FOLLOWING IS THE TEXT FROM THE FOOTNOTES OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS: THE HEALTH CORPORATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE UNITED STATES INTERNAL REVENUE CODE ("IRC") ACCORDING TO THE UNITED STATES INTERNAL REVENUE SERVICE DETERMINATION LETTER DATED JULY 14, 1997. THEREFORE, NO PROVISION HAS BEEN MADE FOR FEDERAL INCOME TAX. GAAP REQUIRES THE EVALUATION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE HEALTH CORPORATION'S TAX RETURNS TO DETERMINE WHETHER THE TAX POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED BY THE APPLICABLE TAX AUTHORITY. TAX POSITIONS NOT DEEMED TO MEET THE MORE LIKELY THAN NOT THRESHOLD WOULD BE RECORDED AS A TAX BENEFIT OR EXPENSE IN THE CURRENT YEAR. A RECONCILIATION IS NOT PROVIDED HEREIN, AS THE BEGINNING AND ENDING AMOUNTS OF UNRECOGNIZED BENEFITS ARE ZERO, WITH NO INTERIM ADDITIONS, REDUCTIONS, OR SETTLEMENTS. HOWEVER, THE CONCLUSIONS REGARDING THE UNCERTAINTY IN INCOME TAXES WILL BE SUBJECT TO REVIEW AND MAY BE ADJUSTED AT A LATER DATE BASED ON FACTORS INCLUDING, BUT NOT LIMITED TO, ONGOING ANALYSIS OF TAX LAWS, REGULATIONS, AND INTERPRETATIONS THEREOF. THE HEALTH CORPORATION'S INFORMATIONAL RETURNS FILED IN THE U.S. FEDERAL JURISDICTION ARE GENERALLY SUBJECT TO EXAMINATION FOR THREE YEARS AFTER THE LATER OF THE DUE DATE OR FILING DATE. AS A RESULT, THE HEALTH CORPORATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEAR PRIOR TO 2022. SCHEDULE D, PART XI, LINE 2(D) OTHER REVENUES IN AUDITED FINANCIAL STATEMENTS NOT IN FORM 990 BAD DEBT EXPENSE - -26004 SCHEDULE D, PART XII, LINE 2(D) OTHER EXPENSES IN AUDITED FINANCIAL STATEMENTS NOT IN FORM 990 BAD DEBT EXPENSE - -26004 X true true false true false false false false false false false CHRISTINE A HO MD VICE CHAIRMAN/DIRECTOR 720114 13400 0 0 69930 0 20700 0 45733 0 856477 13400 0 0 DANIEL J SUCATO MD MS CHAIRMAN/DIRECTOR 19800 1421679 0 0 0 494119 0 149070 0 38158 19800 2103026 0 0 JOHN A HERRING MD FORMER DIRECTOR (RET 08/31/20) 0 31625 0 0 0 175658 0 307715 0 0 0 514998 0 0 CHARLES E JOHNSTON II MD FORMER DIRECTOR (RET 04/16/21) 0 3044 0 0 0 186611 0 211891 0 0 0 401546 0 84040 BENJAMIN S RICHARDS III MD FORMER DIRECTOR (RET 06/30/21) 0 0 0 0 0 138522 0 159952 0 0 0 298474 0 0 JOHN E ARVESEN MD DIRECTOR 64800 803500 0 0 0 66298 0 20700 0 48279 64800 938777 0 0 JAYSSON BROOKS MD DIRECTOR 58300 796214 0 0 0 67098 0 17793 0 47288 58300 928393 0 0 LAWSON A COPLEY MD DIRECTOR 701923 0 0 0 164354 0 166930 0 38158 0 1071365 0 0 0 HENRY B ELLIS MD DIRECTOR 124300 1087356 0 0 0 104050 0 20700 0 38158 124300 1250264 0 0 COREY S GILL MD DIRECTOR 118500 794365 0 0 0 66766 0 20700 0 28266 118500 910097 0 0 ELIZABETH HUBBARD MD DIRECTOR 121600 796844 0 0 0 66376 0 20700 0 15063 121600 898983 0 0 MEGAN JOHNSON MD DIRECTOR 56600 794680 0 0 0 66376 0 20700 0 38158 56600 919914 0 0 AMY L MCINTOSH MD DIRECTOR 70900 798011 0 0 0 67390 0 20700 0 37903 70900 924004 0 0 WILLIAM Z MORRIS MD DIRECTOR 51600 799942 0 0 0 90021 0 20700 0 38158 51600 948821 0 0 DAVID A PODESZWA MD DIRECTOR 50300 749232 0 0 0 989356 0 140321 0 41358 50300 1920267 0 944415 BRANDON A RAMO MD DIRECTOR 56000 828368 0 0 0 80324 0 20700 0 41358 56000 970750 0 0 KARL E RATHJEN MD DIRECTOR 12400 521048 0 0 0 54309 0 150561 0 13063 12400 738981 0 0 ANTHONY I RICCIO MD DIRECTOR 42600 806640 0 0 0 68190 0 20700 0 38158 42600 933688 0 0 CHRISTOPHER M STUTZ MD DIRECTOR 33500 769902 0 0 0 66766 0 20700 0 42049 33500 899417 0 0 PHILIP L WILSON MD DIRECTOR 116900 1173028 0 0 0 359279 0 140635 0 37903 116900 1710845 0 0 ROBERT L WIMBERLY MD DIRECTOR 58300 790748 0 0 0 67390 0 20700 0 45158 58300 923996 0 0 LORI L DALTON SECRETARY 0 645584 0 0 0 59988 0 20700 0 38158 0 764430 0 0 MICHELLE C HAYS TREASURER 0 650709 0 0 0 54574 0 20700 0 40783 0 766766 0 0 ROBERT L WALKER PRESIDENT 0 1544617 0 0 0 83455 0 0 0 29428 0 1657500 0 0 SCHEDULE J, PART I, LINE 1A TRAVEL FOR COMPANIONS SCHEDULE J, PART I, LINE 1A TRAVEL FOR COMPANIONS (INCLUDED ON SCH J, PART II, COL B (III) & W-2, BOX 5) LAWSON COPLEY, MD - $479 SCHEDULE J, PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION SEE SCHEDULE O, PART VI, LINE 15A DISCLOSURE REGARDING THE PROCESS FOR ESTABLISHING COMPENSATION. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE RESTORATION OF RETIREMENT INCOME PLAN (RRIP) IS A NON QUALIFIED PLAN PROVIDING SUPPLEMENTAL RETIREMENT BENEFITS TO ELIGIBLE EMPLOYEES THROUGH TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN, A RELATED ORGANIZATION AND SOLE MEMBER OF PEDI ORTHO HEALTH CORPORATION. THE RRIP PROVIDE SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN EMPLOYEES WHOSE BENEFITS UNDER THE TAX QUALIFIED RETIREMENT PLAN HAVE BEEN LIMITED BY THE MAXIMUM BENEFIT AND MAXIMUM COMPENSATION LIMITATIONS IMPOSED UNDER THE TAX- QUALIFIED RETIREMENT PLAN IN ORDER TO COMPLY WITH THE INTERNAL REVENUE CODE. THE TOTAL ACCUMULATED BENEFIT THAT HAS ACCRUED FOR A PARTICIPANT UNDER THE RRIP NORMALLY BECOMES VESTED AND TAXABLE TO A PARTICIPANT WHEN HE OR SHE EITHER HAS ATTAINED AGE 55 AND COMPLETED 15 YEARS OF SERVICE OR ATTAINS AGE 65. THE BENEFIT ACCRUALS FOR A PARTICIPANT AFTER THE DATE OF INITIAL VESTING ARE TAXABLE TO THE PARTICIPANT WHEN AND AS ACCRUED. RRIP BENEFITS BECOME PAYABLE AFTER TERMINATION OF EMPLOYMENT. UNDER THE TERMS OF THE RRIP, THE FOLLOWING EMPLOYEE OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN MET THE VESTING REQUIREMENTS AS A PARTICIPANT IN 2024. UPON MEETING THE VESTING REQUIREMENT OF AGE 55 AND 15 YEARS OF SERVICE UNDER THE RRIP, THE PARTICIPANT'S ACTUAL CUMULATIVE BENEFIT EARNED SINCE THEIR DATE OF HIRE IS CALCULATED UNDER THE ASSUMPTIONS PRESCRIBED BY THE RRIP AND SUBJECT TO TAXATION IN CALENDAR YEAR 2024 AS REQUIRED BY THE FEDERAL TAX LAW. THE VALUE OF THE BENEFIT LISTED BELOW IS A LUMP SUM PRESENT VALUE. HOWEVER, THE VALUE OF THE LUMP SUM WILL BE CONVERTED TO A MONTHLY ANNUITY UPON RETIREMENT BASED ON EACH PARTICIPANT'S ELECTION. THE PARTICIPANT WILL NOT RECEIVE THE AMOUNTS LISTED BELOW AS A SINGLE SUM PAYMENT. THE ESTIMATED HISTORICAL BENEFIT ACCRUAL HAS BEEN PREVIOUSLY REPORTED AS DEFERRED COMPENSATION ON A PREVIOUS FORM 990. (INCLUDED IN SCHEDULE J, PART II, COLUMN B(III) & F AND W-2, BOX 5) DAVID A. PODESZWA, MD - 944,415 UNDER THE TERMS OF THE RRIP, THE FOLLOWING EMPLOYEES OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN HAVE PREVIOUSLY VESTED AS A PARTICIPANT. THE ADDITIONAL BENEFIT ACCRUAL EARNED DURING THE CALENDAR YEAR 2024 HAS BEEN CALCULATED UNDER THE ASSUMPTIONS PRESCRIBED BY THE RRIP AND IS SUBJECT TO TAXATION AS REQUIRED BY THE FEDERAL TAX LAW. THE VALUE OF THE ADDITIONAL BENEFIT LISTED BELOW IS A LUMP SUM PRESENT VALUE. HOWEVER, THE VALUE OF THE LUMP SUM WILL BE CONVERTED TO A MONTHLY ANNUITY UPON RETIREMENT BASED ON EACH PARTICIPANT'S ELECTION. THE PARTICIPANTS WILL NOT RECEIVE THE AMOUNTS LISTED BELOW AS A SINGLE SUM PAYMENT. (INCLUDED IN SCHEDULE J, PART II, COLUMN B(III) AND W-2, BOX 5) KARL E. RATHJEN, MD - 6,767 DANIEL J. SUCATO, MD, MS - 418,883 PHILIP L. WILSON, MD - 298,213 UNDER THE TERMS OF THE RRIP, THE FOLLOWING EMPLOYEE OF PEDI ORTHO HEALTH CORPORATION HAS PREVIOUSLY VESTED AS A PARTICIPANT. THE ADDITIONAL BENEFIT ACCRUAL EARNED DURING THE CALENDAR YEAR 2024 HAS BEEN CALCULATED AND IS SUBJECT TO TAXATION. (INCLUDED IN SCHEDULE J, PART II, COLUMN B (III) & W-2, BOX 5) LAWSON A. COPLEY, MD - 117,141 UNDER THE TERMS OF THE RRIP, THE FOLLOWING FORMER DIRECTORS AND EMPLOYEES OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN HAVE RETIRED AND RECEIVED PAYMENT FROM THE RRIP DURING 2024 WHICH ARE SUBJECT TO TAXATION, IN THE FOLLOWING AMOUNT. (INCLUDED IN SCHEDULE J, PART II, COLUMN B (III) & W-2, BOX 5) CHARLES E. JOHNSTON III, MD (RET 4/16/2021) - 102,571 JOHN A. HERRING, MD (RET 08/2020) - 175,658 BENJAMIN S. RICHARDS III, MD (RET 06/30/2021) - 138,522 THE FLEXIBLE BENEFITS PLAN IS A NON QUALIFED PLAN THROUGH TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN. A RELATED ORGANIZATION AND SOLE MEMBER OF PEDI ORTHO HEALTH CORPORATION. THE PLAN PROVIDES LIFE INSURANCE, DISABILITY INSURANCE, LONG-TERM CARE INSURANCE AND/OR RETIREMENT BENEFITS TO ELIGIBLE EMPLOYEES AT THEIR ELECTION. THE INSURANCE PREMIUM AND RETIREMENT ACCOUNT CONTRIBUTION AMOUNTS ALLOCATED TO A PARTICIPANT UNDER THIS PLAN FOR EACH YEAR ARE TAXABLE TO THE PARTICIPANT FOR SUCH YEAR. THE EARNINGS ON THE RETIREMENT ACCOUNT CONTRIBUTIONS BECOME TAXABLE TO A PARTICIPANT WHEN PAID OR MADE AVAILABLE TO THE PARTICIPANT. UNDER THE TERMS OF THE FLEXIBLE BENEFIT PLAN, THE FOLLOWING EMPLOYEES OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN WERE TAXED ON THE FOLLOWING AMOUNTS FOR CALENDAR YEAR 2024. (INCLUDED IN SCHEDULE J, PART II, COLUMN B (III), AND W-2, BOX 5) JOHN E. ARVENSEN, MD - 34,696 JAYSSON BROOKS, MD - 34,696 LORI L. DALTON - 28,917 HENRY B. ELLIS, MD - 42,750 COREY S. GILL, MD - 34,696 MICHELLE C. HAYS - 29,250 ELIZABETH HUBBARD, MD - 34,696 MEGAN E. JOHNSON, MD - 34,696 AMY L. MCINTOSH, MD - 34,696 WILLIAM MORRIS, MD - 34,696 DAVID A. PODESZWA, MD - 33,687 BRANDON A. RAMO, MD - 35.960 KARL E. RATHJEN, MD - 34,494 ANTHONY I. RICCIO, MD - 34,696 CHRISTOPHER M. STUTZ, MD - 34,696 DANIEL J SUCATO, MD, MS - 63,181 ROBERT L. WALKER - 69,005 PHILIP L. WILSON, MD - 49,812 ROBERT L. WIMBERLY, MD - 34,696 UNDER THE TERMS OF THE FLEXIBLE BENEFIT PLAN, THE FOLLOWING EMPLOYEES OF PEDI ORTHO HEALTH CORPORATION WERE TAXED ON THE FOLLOWING AMOUNTS FOR CALENDAR YEAR 2024. (INCLUDED IN SCHEDULE J, PART II, COLUMN B (III), AND W-2, BOX 5) LAWSON A. COPLEY, MD - 33,687 CHRISTINE A. HO, MD - 37,236 THE MANAGEMENT BENEFIT PLAN IS A NON-QUALIFIED PLAN THROUGH TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN, A RELATED ORGANIZATION AND SOLE MEMBER OF PEDI ORTHO HEALTH CORPORATION, PROVIDING SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN ELIBIGLE EMPLOYEES WHO BECAME PARTICIPANTS PRIOR TO 1988. MONTHLY RETIREMENT INCOME BENEFITS BECOME PAYABLE UNDER THE PLAN COMMENCING AT AGE 65 (OR EARLIER DISABILITY), AND ARE TAXABLE TO PARTICIPANTS WHEN PAID. UNDER THE TERMS OF THE MANAGEMENT BENEFIT PLAN, THE FOLLOWING FORMER DIRECTOR AND EMPLOYEE OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN RECEIVED PAYMENTS IN 2024. (INCLUDED ON SCHEDULE J, PART II, COLUMN B(III) AND W-2, BOX 1 & 5) CHARLES E. JOHNSTON III, MD - 84,039 FORM 990, PART VI, LINE 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS DANIEL J. SUCATO, MD, MS; DAVID A. PODESZWA, MD; PHILIP L. WILSON, MD; HENRY B. ELLIS, MD; BRANDON A. RAMO, MD; JOHN E. ARVESEN, MD; ELIZABETH HUBBARD, MD; COREY S. GILL, MD; WILLIAM Z. MORRIS, MD; AMY L. MCINTOSH, MD; JAYSSON BROOKS, MD; ROBERT L. WIMBERLY, MD; MEGAN E. JOHNSON, MD; ANTHONY I. RICCIO, MD; CHRISTOPHER STUTZ, MD AND KARL E. RATHJEN, MD HAVE A BUSINESS RELATIONSHIP WITH ROBERT L. WALKER, LORI DALTON, AND MICHELLE HAYS IN THAT THE PHYSICIANS ARE EMPLOYED BY AN ENTITY IN WHICH THE LATTER INDIVIDUALS SERVED AS OFFICERS DURING THE 2025 FISCAL YEAR. FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN IS THE SOLE MEMBER OF THE ORGANIZATION. THE MEMBER APPOINTS THE DIRECTORS, SUBJECT TO THE APPROVAL BY AT LEAST A MAJORITY OF THE ORGANIZATION'S BOARD. CERTAIN BUSINESS, LEGAL AND FINANCIAL MATTERS ARE DEFINED IN THE BYLAWS ARE, FOLLOWING CONSULTATION WITH THE ORGANIZATION'S BOARD, RESERVED TO TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN, THE SOLE MEMBER. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS SEE LINE 6 EXPLANATION ABOVE FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY THE FORM 990 IS PREPARED INTERNALLY IN CONJUNCTION WITH OUTSIDE ACCOUNTANTS AND THEN REVIEWED BY MANAGEMENT OF THE ORGANIZATION AND MANAGEMENT OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN, THE SOLE MEMBER. A DRAFT COPY OF THE FORM 990 IS THEN PROVIDED FOR REVIEW AND DISCUSSION TO THE ORGANIZATION'S BOARD AND THE AUDIT AND COMPLIANCE COMMITTEE OF THE TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN, THE SOLE MEMBER. THE FINAL FORM 990 WAS PROVIDED TO THE GOVERNING BODY OF THE SOLE MEMBER PRIOR TO FILING. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY THE ORGANIZATION ANNUALLY REQUIRES KEY INDIVIDUALS, INCLUDING OFFICERS AND DIRECTORS AND OTHERS WITH DECISION-MAKING OR ADMINISTRATIVE RESPONSIBILITIES, TO COMPLETE A CONFLICTS OF INTEREST FORM DISCLOSING ACTUAL OR POTENTIAL CONFLICTS OF INTEREST IN COMPLIANCE WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY. THESE INDIVIDUALS ALSO ARE TO REPORT ANY NEW MATTERS THAT ARISE DURING THE YEAR IF THEY BECOME AWARE OF A TRANSACTION THAT IS UNDER CONSIDERATION THAT PRESENTS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. ADDITIONALLY, AT THE TIME A KEY INDIVIDUAL IS ELECTED TO A BOARD OR OFFICER POSITION, HIRED OR PROMOTED TO A POSITION WITH ADMINISTRATIVE OR MANAGEMENT RESPONSIBILITIES, THE ORGANIZATION PROVIDES THE INDIVIDUAL WITH A COPY OF THE CONFLICTS OF INTEREST POLICY AND THE INDIVIDUAL IS REQUIRED TO COMPLETE A CONFLICTS OF INTEREST DISCLOSURE FORM. ALL MATERIAL FACTS SURROUNDING CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS INVOLVING A CONFLICT OF INTEREST ARE TO BE DISCLOSED TO ENSURE THAT THE CONTRACT, TRANSACTION, OR ARRANGEMENT IS FAIR TO THE ORGANIZATION AT THE TIME IT IS AUTHORIZED, APPROVED, OR RATIFIED. REPORTED MATTERS ARE REVIEWED BY THE SECRETARY OF THE ORGANIZATION, AND A SUMMARY OF THE REPORTED POTENTIAL CONFLICTS OF INTEREST IS DISCLOSED TO THE BOARD OF DIRECTORS AND THE SOLE MEMBER ON AN ANNUAL BASIS. IN ADDITION, EACH DIRECTOR SHALL DISCLOSE TO THE TEXAS MEDICAL BOARD FINANCIAL RELATIONSHIPS WITH THE MEMBER, ANOTHER DIRECTOR, OR A SUPPLIER OF THE ORGANIZATION. FORM 990, PART VI, LINE 15A PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL THE PRESIDENT OF THE ORGANIZATION DOES NOT RECEIVE COMPENSATION FROM THE ORGANIZATION. THE REVIEW AND APPROVAL OF THE PRESIDENT'S COMPENSATION IS HANDLED BY THE SOLE MEMBER AS FOLLOWS: THE COMPENSATION COMMITTEE OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN, THE SOLE MEMBER OF THE ORGANIZATION, ANNUALLY REVIEWS AND APPROVES SALARIES AND OTHER BENEFITS FOR THE PRESIDENT OF THE ORGANIZATION. VARIOUS COMPENSATION SURVEYS ARE REVIEWED, AND BI-ANNUALLY, AN INDEPENDENT CONSULTANT REVIEWS SALARIES AND BENEFITS, WITH UPDATED MARKET DATA BEING PROVIDED ANNUALLY. THIS INFORMATION IS COLLECTIVELY TAKEN INTO CONSIDERATION AND PRESENTED TO THE COMPENSATION COMMITTEE WHEN DETERMINING COMPENSATION. THE VOTING MEMBERS OF THE COMMITTEE APPROVE THE COMPENSATION, WITHOUT DISCUSSION OR VOTING PARTICIPATION BY THE PERSON WHOSE COMPENSATION IS BEING APPROVED OR ANY OTHER MEMBER WITH A CONFLICT OF INTEREST, ALL OF WHICH IS DOCUMENTED IN COMMITTEE MINUTES. THE SOLE MEMBER PROVIDES EXECUTIVE AND ADMINISTRATIVE SERVICES TO THE ORGANIZATION AS NEEDED, PURSUANT TO A SERVICES AGREEMENT BETWEEN THE SOLE MEMBER AND THE ORGANIZATION. FORM 990, PART VI, LINE 15B PROCESS TO ESTABLISH COMPENSATION OF OTHER EMPLOYEES THE OFFICERS OF THE ORGANIZATION DO NOT RECEIVE COMPENSATION FROM THE ORGANIZATION. THE REVIEW AND APPROVAL OF THEIR COMPENSATION, AS WELL AS FOR MEDICAL STAFF MEMBERS PROVIDING SERVICES TO THE ORGANIZATION, IS HANDLED BY THE SOLE MEMBER OF THE ORGANIZATION AS FOLLOWS: THE COMPENSATION COMMITTEE OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN, THE SOLE MEMBER OF THE ORGANIZATION, ANNUALLY REVIEWS AND APPROVES SALARIES AND OTHER BENEFITS FOR THE OFFICERS AND OTHER KEY EMPLOYEES, AS WELL AS THE PHYSICIANS PROVIDING SERVICES. VARIOUS EXECUTIVE/PHYSICIAN COMPENSATION SURVEYS ARE REVIEWED, IN ADDITION TO PHYSICIAN COMPENSATION DATA FROM LOCAL ACADEMIC AND PRIVATE PRACTICE SETTINGS, AND BI-ANNUALLY, AN INDEPENDENT CONSULTANT REVIEWS SALARIES AND BENEFITS OF EXECUTIVES, PHYSICIANS AND KEY EMPLOYEES, WITH UPDATED MARKET DATA BEING PROVIDED ANNUALLY. THIS INFORMATION IS COLLECTIVELY TAKEN INTO CONSIDERATION AND PRESENTED TO THE COMPENSATION COMMITTEE WHEN DETERMINING COMPENSATION. THE VOTING MEMBERS OF THE COMMITTEE APPROVE THE COMPENSATION, WITHOUT DISCUSSION OR VOTING PARTICIPATION BY THE PERSON WHOSE COMPENSATION IS BEING APPROVED OR ANY OTHER MEMBER WITH A CONFLICT OF INTEREST, ALL OF WHICH IS DOCUMENTED IN COMMITTEE MINUTES. THE SOLE MEMBER PROVIDES EXECUTIVE AND ADMINISTRATIVE SERVICES TO THE ORGANIZATION AS NEEDED, PURSUANT TO A SERVICES AGREEMENT BETWEEN THE SOLE MEMBER AND THE ORGANIZATION. FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES CONTRIBUTION CAPITAL FROM AFFILIATE - 1800000; TOTAL - 1800000; FORM 990, PART XII, LINE 2C AUDIT OVERSIGHT AND REVIEW THE ORGANIZATION'S BOARD REVIEWS THE AUDIT, AND ADDITIONALLY, THE AUDIT AND COMPLIANCE COMMITTEE OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN, THE SOLE MEMBER, REVIEWS THE AUDIT. AFTER CONSULTATION WITH THE ORGANIZATION, THE BOARD OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN, THE SOLE MEMBER, APPROVES SELECTION AND RETENTION OF THE INDEPENDENT ACCOUNTANT. TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN 2222 WELBORN ST DALLAS TX 75219 750818178 HOSPITAL TX 501(C)(3) 3 NA false TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN FOUNDATION 2222 WELBORN ST DALLAS TX 75219 460683787 SUPPORTING TEXAS SCOTTISH RITE HOSPITAL TX 501(C)(3) 7 TEXAS SCOTTISH RITE HOSPITAL true LEGACY SCHOLARSHIP PROGRAM 2222 WELBORN ST DALLAS TX 75219 752106637 SCHOLARSHIP TX 501(C)(3) 7 TEXAS SCOTTISH RITE HOSPITAL true PEG WELBORN PRIVATE EQUITY FUND LP 277 PARK AVENUE 21ST FLOOR NEW YORK NY 10172 812431328 INVESTMENTS NY NA N/A ALGERT INTERNATIONAL SMALL CAP FUND LP 101 CALIFORNIA STREET SUITE 4225 SAN FRANCISCO CA 94111 815047625 INVESTMENTS CA NA N/A CHARITABLE REMAINDER TRUST (1) CHARITABLE REMAINDER TRUST TX NA TRUST false false false true false false false false false false false false true true true true true false false true