efile Public Visual Render
ObjectId: 201422279349303842 - Submission: 2014-08-15
TIN: 75-0800661
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
Attach to Form 990.
See separate instructions.
OMB No. 1545-0047
20
12
Open to Public Inspection
Name of the organization
METHODIST HOSPITALS OF DALLAS
Employer identification number
75-0800661
Part I
Identification of Disregarded Entities
(Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
Part II
Identification of Related Tax-Exempt Organizations
(Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
DALLAS METHODIST HOSPITALS FOUNDATION
1441 N BECKLEY AVE
DALLAS
,
TX
75203
75-1548343
FUND RAISING TO SUPPORT EXEMPT FUNCTIONS OF MHS
TX
501(C)(3)
BOX 7
METHODIST HOSPITALS OF DALLAS
No
(2)
NELLE NORRELL FOUNDATION
1441 N BECKLEY AVE
DALLAS
,
TX
75203
75-6034201
FUND RAISING TO SUPPORT EXEMPT FUNCTIONS OF MHS
TX
501(C)(3)
BOX 11 TYPE 1
METHODIST HOSPITALS OF DALLAS
No
(3)
PAVILION PROPERTIES
1441 N BECKLEY AVE
DALLAS
,
TX
75203
75-2284449
REAL ESTATE TITLE HOLDING
TX
501(C)(2)
BOX 11 TYPE 1
METHODIST HOSPITALS OF DALLAS
No
(4)
METHODIST TRANSPLANT PHYSICIANS
1441 N BECKLEY AVE
DALLAS
,
TX
75203
01-0612870
MEDICAL SERVICES
TX
501(C)(3)
BOX 11 TYPE 1
METHODIST HOSPITALS OF DALLAS
No
(5)
MEDHEALTH
1441 N BECKLEY AVE
DALLAS
,
TX
75203
75-2896138
MEDICAL SERVICES
TX
501(C)(3)
BOX 11 TYPE 1
METHODIST HOSPITALS OF DALLAS
No
(6)
PHYSICANS ASSOC OF SW DALLAS
1441 N BECKLEY AVE
DALLAS
,
TX
75203
75-2966610
MEDICAL SERVICES
TX
501(C)(3)
BOX 11 TYPE 1
METHODIST HOSPITALS OF DALLAS
No
(7)
ASSOC IN SURGICAL CARE
1441 N BECKLEY AVE
DALLAS
,
TX
75203
26-2126265
MEDICAL SERVICES
TX
501(C)(3)
BOX 11 TYPE 1
METHODIST HOSPITALS OF DALLAS
No
(8)
MHSR MEDICAL CENTER
1441 N BECKLEY AVE
DALLAS
,
TX
75203
26-4193362
MEDICAL SERVICES
TX
501(C)(3)
BOX 3
METHODIST HOSPITALS OF DALLAS
No
(9)
DALLAS COUNTY INDIGENT CARE CORP
1441 N BECKLEY AVE
DALLAS
,
TX
75203
26-0610562
FUNDING FOR INDIGENT CARE
TX
501(C)(3)
BOX 11 TYPE 1
N/A
No
(10)
TARRANT COUNTY INDIGENT CARE
612 E LAMAR STREET
ARLINGTON
,
TX
76011
26-0648532
FUNDING FOR INDIGENT CARE
TX
501(C)(3)
BOX 11 TYPE 1
N/A
No
(11)
CAREFLIGHT
3110 S GREATSOUTHWEST PKWY
GRAND PRARIE
,
TX
75052
75-1657155
MEDICAL TRANSPORT
TX
501(C)(3)
BOX 11 TYPE 3
N/A
No
(12)
DALLAS METHODIST PHYSICIANS NETWORK
1441 N BECKLEY AVE
DALLAS
,
TX
75203
75-2693707
MEDICAL SERVICES
TX
501(C)(6)
BOX 11 TYPE 1
METHODIST HOSPITALS OF DALLAS
No
(13)
METHODIST PATIENT CENTERED ACO
1441 N BECKLEY AVE
DALLAS
,
TX
75203
35-2436666
MEDICAL SERVICES
TX
501(C)(3)
BOX 11 TYPE 1
METHODIST HOSPITALS OF DALLAS
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Page 2
Schedule R (Form 990) 2012
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
(Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
MHS-CHC ILP
3020 W WHEATLAND RD
DALLAS
,
TX
75237
20-5000978
REHAB HOSPITAL
TX
N/A
(2)
MHS-CHC LLC
3020 W WHEATLAND RD
DALLAS
,
TX
75237
20-4921888
REHAB HOSPITAL
TX
METHODIST HOSPITAL OF DALLAS
RELATED
29,928
28,592
No
No
68.250 %
(3)
METHODIST MCKINNEY HOSPITAL LLC
11221 ROE AVE
LEAWOOD
,
KS
66211
20-8847736
HOSPITAL
TX
METHODIST HOSPITAL OF DALLAS
RELATED
3,144,168
3,996,037
No
Yes
57.520 %
(4)
MHD-USO MANAGEMENT COMPANY LP
ONE POST STREET 35TH FLOOR
SAN FRANCISCO
,
TX
94104
20-3844027
MEDICAL SERVICES
TX
NORTH TEXAS HEALTH FACILITIES MANGMT
RELATED
126,328
2,859,215
No
No
71.400 %
(5)
METHODIST MCKINNEY HOSPITAL PROPERTY
11221 ROE AVE
LEAWOOD
,
KS
66211
26-1943814
REAL ESTATE HOLDING
TX
METHODIST HOSPITAL OF DALLAS
RELATED
217,751
2,085,457
No
Yes
59.900 %
(6)
METDALSPI LLC
11221 ROE AVE
LEAWOOD
,
KS
66211
26-3195791
HOSPITAL
TX
METDALSPI HOLDING LLC
RELATED
No
Yes
(7)
METDALSPI HOLDING LLC
11221 ROE AVE
LEAWOOD
,
KS
66211
26-3207402
HOSPITAL
TX
METHODIST HOSPITAL OF DALLAS
RELATED
8,855,922
387,667,404
No
Yes
99.000 %
(8)
SRPMEDICA INVESTORS - ADDISON LP
8343 DOUGLAS AVE SUITE 350
DALLAS
,
TX
75225
26-4517265
REAL ESTATE HOLDING
TX
METHODIST HOSPITAL OF DALLAS
RELATED
215,352
-1,486,700
No
No
21.840 %
(9)
MHD-USO GENERAL LLC
ONE POST ST35TH FLOOR ATTN TAX DEPT
SAN FRANCISCO
,
CA
94104
20-3843579
MEDICAL SERVICES
TX
NORTH TEXAS HEALTH FACILITIES MGMT
RELATED
500
No
Yes
50.000 %
(10)
MHSS MOB - ADDISON LP
8343 DOUGLAS AVE SUITE 350
DALLAS
,
TX
75225
27-0216329
REAL ESTATE HOLDING
TX
NORTH TEXAS HEALTH FACILITIES MANGMT
RENTAL
217,478
7,392,066
No
No
14.600 %
(11)
LHCG XXXIII LLC
420 WEST PINHOOK RD SUITE A
LAFAYETTE
,
LA
70503
45-4894023
HOME CARE
LA
NORTH TEXAS HEALTH FACILITIES MANGMT
RELATED
-70,445
448,400
No
No
10.000 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
(Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
NORTH TEXAS HEALTH FACILITIES MANAGEMENT
1441 N BECKLEY AVE
DALLAS
,
TX
75203
75-1700994
FACILITY AND PHYSICIAN MGMT
TX
METHODIST HOSPITALS OF DALLAS
C
81,434
6,162,387
100.000 %
No
(2)
METHCATH OIL COMPANY
4833 ROYAL LANE
DALLAS
,
TX
75229
75-1974095
OIL & GAS HOLDINGS
TX
METHODIST HOSPITALS OF DALLAS
C
59,235
35,000
50.000 %
No
(3)
PAVILION PHARMACYINC
1441 N BECKLEY AVE
DALLAS
,
TX
75203
75-2321652
RETAIL PHARMACY
TX
NORTH TEXAS FACILTIES MGMT
C
100.000 %
No
(4)
COLLECTECH FINANCIAL SERVICESINC
1441 N BECKLEY AVE
DALLAS
,
TX
75203
75-2369856
BILLING & COLLECTION
TX
NORTH TEXAS FACILTIES MGMT
C
-104,254
4,150
100.000 %
No
(5)
RICHARDSON PHYSICIAN ALLIANCE
1441 N BECKLEY AVE
DALLAS
,
TX
75203
77-0591925
PHYSICIAN ORGANIZATION
TX
METHODIST HOSPITALS OF DALLAS
C
-10,458
64,707
100.000 %
No
Schedule R (Form 990) 2012
Page 3
Schedule R (Form 990) 2012
Page
3
Part V
Transactions With Related Organizations
(Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest
(ii)
annuities
(iii)
royalties or
(iv)
rent from a controlled entity
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1a
Yes
b
Gift, grant, or capital contribution to related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
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1c
Yes
d
Loans or loan guarantees to or for related organization(s)
.
.
.
.
.
.
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.
1d
Yes
e
Loans or loan guarantees by related organization(s)
.
.
.
.
.
.
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.
.
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.
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.
.
.
.
.
1e
No
f
Dividends from related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
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.
.
.
.
.
.
.
.
1f
No
g
Sale of assets to related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
.
.
.
.
1g
No
h
Purchase of assets from related organization(s)
.
.
.
.
.
.
.
.
.
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.
.
.
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.
.
1h
No
i
Exchange of assets with related organization(s)
.
.
.
.
.
.
.
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.
.
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.
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.
.
1i
Yes
j
Lease of facilities, equipment, or other assets to related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
.
.
.
1j
Yes
k
Lease of facilities, equipment, or other assets from related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
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.
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.
1k
Yes
l
Performance of services or membership or fundraising solicitations for related organization(s)
.
.
.
.
.
.
.
.
.
.
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.
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.
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.
.
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
.
1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
.
.
.
1n
No
o
Sharing of paid employees with related organization(s)
.
.
.
.
.
.
.
.
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.
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.
.
.
.
.
.
.
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.
.
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.
.
.
.
.
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
1q
No
r
Other transfer of cash or property to related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
.
.
.
.
.
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.
.
.
.
.
.
.
1r
Yes
s
Other transfer of cash or property from related organization(s)
.
.
.
.
.
.
.
.
.
.
.
.
.
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.
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
MHS-CHC ILP
A
733,332
FMV
(2)
METHODIST MCKINNEY HOSPITAL LLC
L
65,975
FMV
(3)
MEDDALSPI LLC
L
75,275
FMV
(4)
ASSOC IN SURGICAL CARE
P
812,100
FMV
(5)
METHODIST TRANSPLANT PHYSICIANS
D
2,702,000
FMV
(6)
MHSR MEDICAL CENTER
J
9,531,600
FMV
(7)
DALLAS COUNTY INDIGENT CARE CORP
B
25,761,837
FMV
(8)
TARRANT COUNTY INDIGENT CARE CORP
B
14,081,987
FMV
(9)
PHYSICIAN ASSOC OF THE SW
C
2,720,000
FMV
(10)
PHYSICIAN ASSOC OF THE SW
P
7,250,400
FMV
(11)
MEDHEALTH
D
244,212,999
INTERCOMPANY LOAN BALANCE
(12)
ASSOC IN SURGICAL CARE
D
3,029,230
INTERCOMPANY LOAN BALANCE
(13)
PAVILION PROPERTIES
J
456,000
FMV
(14)
PAVILION PROPERTIES
D
10,687,000
INTERCOMPANY LOAN BALANCE
(15)
METHODIST TRANSPLANT PHYSICIANS
D
15,452,120
INTERCOMPANY LOAN BALANCE
(16)
METHODIST TRANSPLANT PHYSICIANS
K
4,750,318
FMV
(17)
METHODIST TRANSPLANT PHYSICIANS
P
185,123
FMV
(18)
METHODIST TRANSPLANT PHYSICIANS
R
575,412
FMV
(19)
PHYSICIAN ASSOC OF THE SW
D
1,717,602
INTERCOMPANY LOAN BALANCE
(20)
PHYSICIAN ASSOC OF THE SW
P
389,520
FMV
(21)
MEDHEALTH
K
17,963
FMV
(22)
DALLAS METHODIST PHYSICIANS NETWORK
B
482,834
FMV
(23)
DALLAS METHODIST PHYSICIANS NETWORK
O
662,045
FMV
(24)
COLLECTECH FINANCIAL SERVICESINC
P
149,479
FMV
(25)
NORTH TEXAS HEALTH FACILITIES MANAGEMENT
P
38,172
FMV
(26)
COLLECTECH FINANCIAL SERVICESINC
O
372,999
FMV
Schedule R (Form 990) 2012
Page 4
Schedule R (Form 990) 2012
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
(Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V—UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2012
Page 5
Schedule R (Form 990) 2012
Page
5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier
Return Reference
Explanation
Additional Data
Software ID:
Software Version: