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ObjectId: 201932269349302823 - Submission: 2019-08-14
TIN: 74-1100555
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for the latest information.
OMB No. 1545-0047
20
17
Open to Public Inspection
Name of the organization
TEXAS CHILDREN'S HOSPITAL
Employer identification number
74-1100555
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on 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" on 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)
TEXAS CHILDREN'S WOMEN'S SPECIALISTS
PO BOX 300630
HOUSTON
,
TX
77230
26-1482195
HEALTH CARE
TX
501(c)(3)
Type II
TEXAS CHILDREN'S
Yes
(2)
TEXAS CHILDREN'S
1919 S BRAESWOOD 4TH FL
HOUSTON
,
TX
77030
76-0461578
PARENT
TX
501(c)(3)
Type II
NA
No
(3)
TEXAS CHILDREN'S PHYSICIAN GROUP
6621 FANNIN STREET
HOUSTON
,
TX
77030
26-0834681
HEALTH CARE
TX
501(c)(3)
10
TEXAS CHILDREN'S
Yes
(4)
TCH PEDIATRIC ASSOCIATES INC
PO BOX 300630
HOUSTON
,
TX
77230
76-0460242
HEALTH CARE
TX
501(c)(3)
10
TEXAS CHILDREN'S
Yes
(5)
TEXAS CHILDREN'S HEALTH PLAN
6330 WEST LOOP SOUTH SUITE 800
8TH FLOOR
BELLAIRE
,
TX
77401
76-0486264
HEALTH CARE
TX
501(c)(3)
10
TEXAS CHILDREN'S
Yes
(6)
TEXAS CHILDREN'S HOSPITAL FOUNDATION
6621 FANNIN STREET
HOUSTON
,
TX
77030
20-2380599
SUPPORTING ORG
TX
501(c)(3)
Type II
TEXAS CHILDREN'S
Yes
(7)
TEXAS CHILDREN'S HEALTH PLAN - THE CENTER
6621 FANNIN STREET
HOUSTON
,
TX
77030
46-1392824
HEALTH CARE
TX
501(c)(3)
Type I
TEXAS CHILDREN'S HEALTH PLAN INC
Yes
(8)
TEXAS CHILDREN'S URGENT CARE
1919 S BRAESWOOD BLVD
4TH FLOOR
HOUSTON
,
TX
77030
47-2029489
HEALTH CARE
TX
501(c)(3)
10
TCH PEDIATRIC ASSOCIATES INC
Yes
(9)
THE GORDON AND MARY CAIN PEDIATRIC NEUROLOGY RESEARCH FOUNDATION
9 GREENWAY PLAZA
HOUSTON
,
TX
77046
76-0246858
SUPPORTING ORG
TX
501(c)(3)
Type I
TEXAS CHILDREN'S HOSPITAL
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2017
Page 2
Schedule R (Form 990) 2017
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on 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)
CORDILLERA PRIMARY WAVE CO-INVESTMENT FUND LP
3000 SAND HILL ROAD
BUILDING 3 SUITE 100
MENLO PARK
,
CA
94025
82-1568240
INVESTMENT
CA
NA
N/A
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
Complete if the organization answered "Yes" on 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)
TCH INSURANCE COMPANY LTD
23 LIME TREE BAY AVENUE
GRAND CAYMAN
KY11102
CJ
98-0176652
INSURANCE
CJ
NA
C Corporation
Yes
(2)
CVI GVF HOLDINGS 3 LTD
UGLAND HOUSE SOUTH CHURCH STREET
GEORGE TOWN
KY11104
CJ
98-1078282
INVESTMENT
CJ
NA
C Corporation
Yes
Schedule R (Form 990) 2017
Page 3
Schedule R (Form 990) 2017
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on 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
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
Yes
o
Sharing of paid employees with related organization(s)
............................
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
............................
1p
No
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
Yes
s
Other transfer of cash or property from related organization(s)
............................
1s
Yes
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 related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
TEXAS CHILDREN'S HEALTH PLAN
L
7,578,075
COST
(2)
TEXAS CHILDREN'S HEALTH PLAN
N
27,172,722
COST
(3)
TEXAS CHILDREN'S HEALTH PLAN
Q
42,195,804
COST
(4)
TEXAS CHILDREN'S HEALTH PLAN
L
382,158,239
COST
(5)
TEXAS CHILDREN'S HEALTH PLAN
R
50,000,000
COST
(6)
TEXAS CHILDREN'S WOMEN'S SPECIALISTS
L
737,752
COST
(7)
TCH PEDIATRIC ASSOCIATES INC
L
3,000,000
COST
(8)
TCH PEDIATRIC ASSOCIATES INC
B
6,500,000
COST
(9)
TCH PEDIATRIC ASSOCIATES INC
R
110,928
COST
(10)
TCH PEDIATRIC ASSOCIATES INC
Q
30,731,104
COST
(11)
TEXAS CHILDREN'S PHYSICIAN GROUP
Q
1,000,727
COST
(12)
TEXAS CHILDREN'S PHYSICIAN GROUP
M
361,365
COST
(13)
TEXAS CHILDREN'S PHYSICIAN GROUP
R
209,329,647
COST
(14)
TEXAS CHILDREN'S HOSPITAL FOUNDATION
S
199,293,443
COST
(15)
TCH INSURANCE COMPANY LTD
S
7,000,000
COST
(16)
TCH INSURANCE COMPANY LTD
Q
2,993,469
COST
(17)
TEXAS CHILDREN'S URGENT CARE
B
2,586,091
COST
(18)
THE GORDON AND MARY CAIN PEDIATRIC NEUROLOGY RESEARCH FOUNDATION
C
755,371
COST
Schedule R (Form 990) 2017
Page 4
Schedule R (Form 990) 2017
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on 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 sections 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) 2017
Page 5
Schedule R (Form 990) 2017
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2017
Additional Data
Software ID:
17005876
Software Version:
2017v2.2