STRATEGY STUDIO / PUBLIC DATA EXPLORER

CHMC OTOLARYNGOLOGIC FOUNDATION INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
CHMC OTOLARYNGOLOGIC FOUNDATION INC (EIN 04-2751258)
Tax period
2019-10-01 to 2020-09-30
Filed
2021-08-12
IRS object ID
202132249349301633
Schema version
2019v5.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-08-12T11:06:55-05:00ReturnTs
Tax Period End2020-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010494526PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Newman and Noyes LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1280 Fore StreetAddressLine1Txt
CityPortlandCityNm
State AbbreviationMEStateAbbreviationCd
ZIP04101ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN042751258EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHMC Otolaryngologic Foundation IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCHMCBusinessNameControlTxt
Phone6173556463PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 Longwood AvenueAddressLine1Txt
CityBostonCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02115ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMichael J Cunningham MD FACSPersonNm
Person TitlePresidentPersonTitleTxt
Phone6173556463PhoneNum
Signature2021-08-10SignatureDt
Discuss With Paid Preparer0DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNicholas E PortoPreparerPersonNm
PTINP01310283PTIN
Phone8002447444PhoneNum
Preparation2021-08-10PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMichael J CunninghamMDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 Longwood AvenueAddressLine1Txt
CityBostonCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02115ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$29,276,336GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1982FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionThe Foundation provides otolaryngology services primarily to patients at (see Schedule O) Boston Children's Hospital and at satellite locations. The Foundation also provides care for patients regardless of their ability to pay, as well as providing and subsidizing hospital and community based services that are either unavailable or limited elsewhere in the community.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee19TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI-$7,990TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$7,990NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$702,830CYContributionsGrantsAmt
PY Program Service Revenue$32,913,663PYProgramServiceRevenueAmt
CY Program Service Revenue$26,845,764CYProgramServiceRevenueAmt
PY Investment Income$220,491PYInvestmentIncomeAmt
CY Investment Income$967,359CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$355,039CYOtherRevenueAmt
PY Total Revenue$33,134,154PYTotalRevenueAmt
CY Total Revenue$28,870,992CYTotalRevenueAmt
PY Grants And Similar Paid$143,478PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$106,418CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$24,288,789PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$23,832,598CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,664,727PYOtherExpensesAmt
CY Other Expenses$4,855,443CYOtherExpensesAmt
PY Total Expenses$30,096,994PYTotalExpensesAmt
CY Total Expenses$28,794,459CYTotalExpensesAmt
PY Revenues Less Expenses$3,037,160PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$76,533CYRevenuesLessExpensesAmt
Total Assets BOY$45,921,972TotalAssetsBOYAmt
Total Assets EOY$48,868,963TotalAssetsEOYAmt
Total Liabilities BOY$13,027,655TotalLiabilitiesBOYAmt
Total Liabilities EOY$14,707,781TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$32,894,317NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$34,161,182NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe Foundation provides otolaryngology services primarily to patients at Boston Children's Hospital and at satellite locations. The Foundation carries on and promotes basic and applied medical research and education in the field of otolaryngology by (see Schedule O) teaching students and other medical and scientific personnel. The Foundation also provides care for patients regardless of their ability to pay.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$27,485,441ExpenseAmt
Grant$106,418GrantAmt
Revenue$26,671,163RevenueAmt
DescThe Foundation provides otolaryngology services primarily to patients at Boston Children's Hospital and at satellite locations. The Foundation may charge for patient care and other medical services, provided that any net income is used exclusively for the charitable, scientific, and educational purposes for which the Foundation was created. The Foundation also provides care for patients regardless of their ability to pay, as well as providing and subsidizing hospital and community based services that are either unavailable or limited elsewhere in the community.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$277,631ExpenseAmt
Revenue$174,601RevenueAmt
DescThe Foundation receives income from Boston Children's Hospital for providing administrative, supervision, and teaching services. The Foundation carries on and promotes basic and applied medical research and education in the field of otolaryngology by teaching students and other medical and scientific personnel; by providing, or supplementing income to research personnel through fellowships, research grants, and stipends; and by giving lectures and publishing information concerning problems and research results in the field of pediatric otolaryngology in order to educate the general public and the medical profession.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$27,763,072TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee19EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Norman DeanBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6173556463PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 Longwood AvenueAddressLine1Txt
CityBostonCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02115ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndInstitutional TrusteeInstitutionalTrusteeInd
Reza Rahbar MD
Vice President60.000.00Yes (X)Yes (X)$1,367,377$0$103,931
Sukgi S Choi MD
Director60.000.00Yes (X)$1,307,831$0$78,162
Greg R Licameli MD
Director60.000.00Yes (X)$1,178,948$0$119,308
Eelam Adil MD
Director60.000.00Yes (X)$1,170,239$0$82,642
Kenneth R Whittemore MD
Physician60.000.00$947,406$0$107,235Yes (X)
Jacob R Brodsky MD
Physician60.000.00$910,492$0$105,277Yes (X)
Michael J Cunningham MD FACS
President55.005.00Yes (X)Yes (X)$904,549$0$107,336
Gi Soo Lee MD
Physician60.000.00$825,920$0$109,140Yes (X)
Karen Watters MD
Physician60.000.00$788,988$0$113,531Yes (X)
Dennis Poe MD
Physician60.000.00$786,452$0$104,785Yes (X)
Howard Shane MD PhD
Director60.000.00Yes (X)$504,161$0$49,666
Norman Dean
Treasurer10.0050.00Yes (X)Yes (X)$0$244,352$12,674
Physicians Org at CH Inc
Institutional Trustee2.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$10,692,363TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$244,352TotReportableCompRltdOrgAmt
Total Other Compensation$1,093,687TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K18IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Wells FargoBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 Federal StreetAddressLine1Txt
CityBostonCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02110ZIPCd
FieldValueIRS element (for citing)
ServicesInvestment advisorsServicesDesc
Compensation$155,695CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Related Organizations$67,000RelatedOrganizationsAmt
Government Grants$635,830GovernmentGrantsAmt
Total Contributions$702,830TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient service revenue621500$24,710,378$24,710,378
Clinical and other541900$1,950,864$1,950,864
Education and research611710$174,601$174,601
Research revenue541700$9,921$9,921
FieldValueIRS element (for citing)
Total Program Service Revenue$26,845,764TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$508,913TotalRevenueColumnAmt
Unrelated Business Revenue-$7,990UnrelatedBusinessRevenueAmt
Exclusion$516,903ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$863,790SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$405,344SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$458,446SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$458,446TotalRevenueColumnAmt
Exclusion$458,446ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
Non-operating pension gains900099$235,439$235,439
Insurance rebate900099$119,600$119,600
FieldValueIRS element (for citing)
Other Revenue Total$355,039OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,870,992TotalRevenueColumnAmt
Related Or Exempt Func Income$26,845,764RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue-$7,990UnrelatedBusinessRevenueAmt
Exclusion$1,330,388ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$106,418TotalAmt
Program Services$106,418ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,827,142TotalAmt
Program Services$6,582,790ProgramServicesAmt
Management And General$244,352ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$12,561,909TotalAmt
Program Services$12,185,052ProgramServicesAmt
Management And General$376,857ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,698,341TotalAmt
Program Services$1,647,391ProgramServicesAmt
Management And General$50,950ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,468,966TotalAmt
Program Services$2,394,896ProgramServicesAmt
Management And General$74,070ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$276,240TotalAmt
Program Services$267,953ProgramServicesAmt
Management And General$8,287ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$735TotalAmt
Management And General$735ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$11,650TotalAmt
Management And General$11,650ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$172,018TotalAmt
Management And General$172,018ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$28,700TotalAmt
Management And General$28,700ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$16,832TotalAmt
Management And General$16,832ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$751,203TotalAmt
Program Services$742,385ProgramServicesAmt
Management And General$8,818ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$845,464TotalAmt
Program Services$845,464ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$136,292TotalAmt
Program Services$136,292ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$85,867TotalAmt
Program Services$85,867ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$366,722TotalAmt
Program Services$328,604ProgramServicesAmt
Management And General$38,118ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Billing and collections$1,141,815$1,141,815
PO management services$632,823$632,823
Coordinated specialty p$388,026$388,026
Other expenses$187,132$187,132

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$90,164TotalAmt
Program Services$90,164ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$28,794,459TotalAmt
Program Services$27,763,072ProgramServicesAmt
Management And General$1,031,387ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,397,082BOYAmt
EOY$2,044,146EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,386,932BOYAmt
EOY$6,110,356EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,147,809BOYAmt
EOY$2,330,598EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$20,000BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$190,000BOYAmt
EOY$180,000EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$242,325BOYAmt
EOY$222,945EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,208,630LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$924,453LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$345,663BOYAmt
EOY$284,177EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$21,502,815BOYAmt
EOY$22,895,029EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$9,634,391BOYAmt
EOY$10,509,906EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,054,955BOYAmt
EOY$4,291,806EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$45,921,972BOYAmt
EOY$48,868,963EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$833,066BOYAmt
EOY$88,074EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$2,823,201BOYAmt
EOY$1,862,974EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,371,388BOYAmt
EOY$12,756,733EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,027,655BOYAmt
EOY$14,707,781EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$31,853,190BOYAmt
EOY$33,120,055EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,041,127BOYAmt
EOY$1,041,127EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$32,894,317BOYAmt
EOY$34,161,182EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$45,921,972BOYAmt
EOY$48,868,963EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$76,533ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,212,895NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$22,563OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,980CurrentTaxYearMinus4YearsAmt
Current Tax Year$702,830CurrentTaxYearAmt
Total$708,810TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$29,363,548CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$29,951,396CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$31,991,493CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$32,913,663CurrentTaxYearMinus1YearAmt
Current Tax Year$26,845,764CurrentTaxYearAmt
Total$151,065,864TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$29,369,528CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$29,951,396CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$31,991,493CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$32,913,663CurrentTaxYearMinus1YearAmt
Current Tax Year$27,548,594CurrentTaxYearAmt
Total$151,774,674TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$151,774,674PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$372,464CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$467,772CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$448,674CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$492,443CurrentTaxYearMinus1YearAmt
Current Tax Year$516,903CurrentTaxYearAmt
Total$2,298,256TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$372,464CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$467,772CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$448,674CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$492,443CurrentTaxYearMinus1YearAmt
Current Tax Year$516,903CurrentTaxYearAmt
Total$2,298,256TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,824CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,901CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years-$1,381CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year-$3,610CurrentTaxYearMinus1YearAmt
Current Tax Year-$7,990CurrentTaxYearAmt
Total-$9,256TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$111,263CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus2 Years$127,910CurrentTaxYearMinus2YearsAmt
Current Tax Year$355,039CurrentTaxYearAmt
Total$594,212TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$29,855,079CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$30,421,069CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,566,696CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$33,402,496CurrentTaxYearMinus1YearAmt
Current Tax Year$28,412,546CurrentTaxYearAmt
Total$154,657,886TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98140PublicSupportCY509Pct
Public Support PY5090.98490PublicSupportPY509Pct
Investment Income CY0.01490InvestmentIncomeCYPct
Investment Income PY0.01360InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part III, Line 12, Explanation of Other Income:FormAndLineReferenceDesc
ExplanationInsurance rebate - 2015 Amount: $ 111,263. 2017 Amount: $ 127,910. 2019 Amount: $ 119,600. Non-operating gains - 2019 Amount: $ 235,439.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,041,127BeginningYearBalanceAmt
Contributions$702,830ContributionsAmt
Other Expenditures$702,830OtherExpendituresAmt
End Year Balance$1,041,127EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,041,127BeginningYearBalanceAmt
End Year Balance$1,041,127EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,041,127BeginningYearBalanceAmt
End Year Balance$1,041,127EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,077,999BeginningYearBalanceAmt
Other Expenditures$36,872OtherExpendituresAmt
End Year Balance$1,041,127EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,236,523BeginningYearBalanceAmt
Other Expenditures$158,524OtherExpendituresAmt
End Year Balance$1,077,999EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$245,076OtherCostOrOtherBasisAmt
Depreciation$89,332DepreciationAmt
Book Value$155,744BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$948,594OtherCostOrOtherBasisAmt
Depreciation$820,161DepreciationAmt
Book Value$128,433BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,960OtherCostOrOtherBasisAmt
Depreciation$14,960DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$284,177TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescP.O. Pooled Investment Fund, LLCDesc
Book Value$10,509,906BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$10,509,906TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
Due from Boston Children's Hospital$897,618
Due from Physicains Organization at Children's Hospital, Inc.$942,768
Malpractice claims receivable$428,798
Other receivables$97,160
Due from affiliates$765
VEBA benefits$1,924,697
FieldValueIRS element (for citing)
Total Book Value Other Assets$4,291,806TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Due to Boston Children's Hospital$3,458,618
Due to Physicians Organization at Children's Hospital, Inc.$343,487
Accrued bonuses$2,196,884
Deferred compensation obligations$5,896,790
Accrued professional liability$860,954
FieldValueIRS element (for citing)
Total Liability$12,756,733TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$30,061,324TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$1,212,895NetUnrealizedGainsInvstAmt
Other Revenue-$22,563OtherRevenueAmt
Revenue Not Reported$1,190,332RevenueNotReportedAmt
Revenue Subtotal$28,870,992RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$28,870,992TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$28,794,459TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$28,794,459ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$28,794,459TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:The endowment funds represent assets that are held in trust that are temporarily restricted by the donor to be used for recruitment to advance clinical research activities and quality improvement initiatives.
Part X, Line 2:The Foundation is a tax-exempt corporation as described in Section 501(c)(3) of the Internal Revenue Code (the Code), and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. In addition, the Foundation qualifies for the charitable contribution deduction under Section 170(b)(1)(A), and has been classified as an organization that is not a private foundation under Section 509(a)(2). Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. The Foundation has evaluated the positions taken on its filed tax returns. The Foundation has concluded that no uncertain income tax positions exist at September 30, 2020. The Foundation's tax years from 2018 through 2020 are potentially subject to examination.
Part XI, Line 2d - Other Adjustments:Pension adjustment -22,563.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Boston Children's HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 Longwood AvenueAddressLine1Txt
CityBostonCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02115ZIPCd
FieldValueIRS element (for citing)
Recipient EIN042774441RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$103,023CashGrantAmt
Valuation Method UsedN/AValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc
Purpose Of GrantGeneral SupportPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationMonitoring is provided by CHMC Otolaryngologic Foundation, Inc. (the Foundation) through oversight of the terms and conditions of a written grant agreement. Multiyear agreements require yearly progress and financial reports for continuation of funding. During the year ended September 30, 2020, the Foundation only provided grant donations to other 501(c)(3) organizations.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Reza Rahbar MD
Vice President$743,100$0$556,224$0$68,053$0$56,000$0$47,931$0$1,471,308$0$0$0
Sukgi S Choi MD
Director$550,000$0$680,300$0$77,531$0$56,000$0$22,162$0$1,385,993$0$0$0
Greg R Licameli MD
Director$640,000$0$470,475$0$68,473$0$56,000$0$63,308$0$1,298,256$0$0$0
Eelam Adil MD
Director$600,000$0$478,785$0$91,454$0$56,000$0$26,642$0$1,252,881$0$0$0
Kenneth R Whittemore MD
Physician$630,000$0$258,371$0$59,035$0$56,000$0$51,235$0$1,054,641$0$0$0
Jacob R Brodsky MD
Physician$600,000$0$245,022$0$65,470$0$56,000$0$49,277$0$1,015,769$0$0$0
Michael J Cunningham MD FACS
President$756,500$0$89,966$0$58,083$0$56,000$0$51,336$0$1,011,885$0$0$0
Gi Soo Lee MD
Physician$538,000$0$240,069$0$47,851$0$56,000$0$53,140$0$935,060$0$0$0
Karen Watters MD
Physician$500,000$0$211,766$0$77,222$0$56,000$0$57,531$0$902,519$0$0$0
Dennis Poe MD
Physician$575,000$0$127,035$0$84,417$0$56,000$0$48,785$0$891,237$0$0$0
Howard Shane MD PhD
Director$360,992$0$47,898$0$95,271$0$56,000$0-$6,334$0$553,827$0$0$0
Norman Dean
Treasurer$0$227,094$0$0$0$17,258$0$0$0$12,674$0$257,026$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1aThe Foundation provides gross-up payments for mortgage forgiveness, long-term disability insurance, and life insurance. These payments are included as taxable wages during the year. All permanent full-time employees of the Foundation are eligible for the gross-up payments.
Part I, Line 4bCHMC Otolaryngologic Foundation, Inc. (the Foundation) established two Supplemental Executive Retirement Plans, effective as of December 1, 2007, to reward licensed physician employees with a benefit based on service. The sources of contributions for these plans are from employer discretionary amounts, if any, severance benefits, and elective deferrals. The amounts are vested on the occurrence of any of the following events: five years of employment; attainment of normal retirement date; death; disability; or change in control.
Part I, Line 7Bonus compensation amounts are determined by the Chief of the Department of Otolaryngology, all board members, and Finance Committee members. They need to consider data such as performance for physician cost centers, their financial reports, research activities, hospital program for Patient Safety & Quality participation, and teaching activities.

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

FieldValueIRS element (for citing)
PersonEelam Adil MDPersonNm
Relationship With OrgDirectorRelationshipWithOrgTxt
Loan PurposePhysician RecruitmentLoanPurposeTxt
Loan From OrganizationYes (X)LoanFromOrganizationInd
Original Principal$100,000OriginalPrincipalAmt
Balance Due$0BalanceDueAmt
Default0DefaultInd
Board Or Committee ApprovalYes (1)BoardOrCommitteeApprovalInd
Written AgreementYes (1)WrittenAgreementInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule L, Part II, Loans To and From Interested Persons:FormAndLineReferenceDesc
ExplanationCHMC Otolaryngologic Foundation, Inc. (the Foundation) has provided secured interest free loans to a director and key employees. The loans were made for recruitment and retention purposes, to assist the physician employee in the purchase of his/her primary residence. The amount for the recruitment loans were determined by a restricted donation provided by Boston Children's Hospital for use in recruitment. The loans will be forgiven over the terms of the notes if the recipients remain employed at the Foundation or its affiliates. The amount of the loan forgiveness will be included with accrued interest, if applicable, as compensation in the year forgiven. At September 30, 2020, the balance of the loans outstanding is $180,000. Future principal balances due are $40,000 in 2021; $40,000 in 2022; $40,000 in 2023; $40,000 in 2024; and $20,000 in 2025. Loan amounts to individuals reported in Part VII have been disclosed in Schedule L, Part II, the balance of the notes receivable are with individuals who are not required to be disclosed in Schedule L per the IRS instructions.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 1The majority of the CHMC Otolaryngologic Foundation, Inc.'s (the Foundation's) board members are physicians who are not independent from the Foundation. However, the Foundation is part of an integrated delivery system with Boston Children's Hospital (the Hospital) which does have a community board. The Foundation was organized in 1982. At the time, the board was composed entirely of physicians, a board structure that was approved by the Internal Revenue Service. The Foundation has since adjusted the board structure by adding the Physicians Organization at Children's Hospital, Inc. (the PO) as a member. See Schedule O, Part VI, Questions 3, 6, 7b, and 12 for more on the PO's rights.
Form 990, Part VI, Section A, line 3The Physicians Organization at Children's Hospital, Inc. (the PO) is a Class "C" member of the CHMC Otolaryngologic Foundation, Inc. (the Foundation). The PO is responsible for providing management services to the Foundation. The PO has the power to approve the independent auditor and legal counsel of the Foundation from a list of firms mutually agreed to by the PO and the Foundation. The PO also has the right to review, but not to approve, the annual budgets and by-law changes of the Foundation. Lastly, Boston Children's Hospital has the right to review for compliance with applicable law, the general terms of and any modifications to physician compensation and benefit plans for all physician employees of the Foundation.
Form 990, Part VI, Section A, line 6The CHMC Otolaryngologic Foundation, Inc. (the Foundation) has three classes of members. The Chief of the Department of Otolaryngology (the Department) of Boston Children's Hospital (the Hospital) is the sole Class "A" member. Any member of the Department (other than the Chief) who holds a professional staff appointment in otolaryngology at the Hospital, has a full-time faculty appointment from Harvard Medical School, and who is geographically full-time at the Hospital shall be a Class "B" member. The Physicians Organization at Children's Hospital, Inc. is the Class "C" member of the Foundation.
Form 990, Part VI, Section A, line 7aAccording to the Articles of Organization, the Class "A" member is the Chief of the Department of Otolaryngology (the Department) of Boston Children's Hospital (the Hospital). Any other member of the Department who holds a professional staff appointment in otolaryngology at the Hospital, has a full-time faculty appointment from Harvard Medical School, and who is geographically full-time at the Hospital shall be a Class "B" member. Class "A and "B" members shall hold their membership as long as he/she remains qualified for membership. Only Class "A and "B" members may vote in annual meetings or other elections or serve on the CHMC Otolaryngologic Foundation, Inc.'s Board of Directors and may nominate candidates for election to the Board.
Form 990, Part VI, Section A, line 7bThe Physicians Organization at Children's Hospital, Inc. (the PO) is a Class "C" member of the CHMC Otolaryngologic Foundation, Inc. (the Foundation). The PO is responsible for providing management services to the Foundation. The PO has the power to approve the independent auditor and legal counsel of the Foundation from a list of firms mutually agreed to by the PO and the Foundation. The PO has the right to review, but not to approve, the annual budgets and by-law changes of the Foundation. Lastly, Boston Children's Hospital has the right to review for compliance with applicable laws, the general terms of and any modifications to physician compensation and benefit plans for all physician employees of the Foundation. As a Class "C" member of the Foundation, the PO attends the Foundation's annual meeting.
Form 990, Part VI, Section B, line 11bThe detailed review will be conducted by the President of the Foundation, Michael J. Cunningham, MD, FACS, and the Treasurer, Norman Dean. A copy of the Form 990 will be provided to the Board prior to filing. The Physicians Organization at Children's Hospital, Inc. will review the Form 990 with the board members. The detailed review will be conducted before filing the return with the Internal Revenue Service.
Form 990, Part VI, Section B, line 12cThe Physicians Organization at Children's Hospital, Inc. (the PO) and Boston Children's Hospital (the Hospital) administer an annual conflict of interest disclosure process to all of their member Foundations, which asks physicians (officers, top management, and highly compensated employees) and selected Foundation staff to disclose potential conflicts. A disclosure statement will be circulated annually to members of the PO. The audit committee shall determine those individuals (including medical staff members) who shall be required to complete the disclosure statement. The audit committee, at its discretion, may either: 1) refer any or all disclosure statements to the Board of Directors; 2) appoint an ad hoc committee to review and resolve any conflict of interest issues; or 3) review and resolve any conflict of interest issues personally or through a designee(s). Any person not receiving a disclosure statement has an affirmative obligation to disclose to the PO President, PO General Counsel, or his/her supervisor whenever he/she believes he/she has or may have a conflict of interest. Similarly, each person completing a disclosure statement has an affirmative obligation to update the statement any time circumstances change and/or he/she believes that a conflict of interest may exist. In the event a conflict of interest is found to exist, the Foundation prohibits the member from voting on any matter to which the conflict relates or otherwise influence the voting on such matter.
Form 990, Part VI, Section B, line 15Faculty compensation must comply with the Boston Children's Hospital (the Hospital) Physician Compensation Guidelines. These guidelines are developed in consultation with an independent external compensation consulting firm and are approved by the independent Compensation Committee of the Board of Children's Medical Center Corporation and the Hospital. The guidelines set the maximum compensation limits based on a peer group analysis for the Foundation. The maximum compensation limits are based on pediatric specialty, sub-specialty, academic rank and include productivity adjustments. Any proposed compensation that exceeds the limits must be prospectively approved by the independent Compensation Committee of the Board of the Hospital. Annual compensation for individual faculty members is set by the President of CHMC Otolaryngologic Foundation, Inc. (the Foundation), reviewed and approved by the Foundation in accordance with the Foundation's compensation policies and procedures. The Foundation's President's compensation is reviewed and approved annually on a prosepective basis by the Boston Children's Hospital Chief Executive Officer and President/Chief Operating Officer.
Form 990, Part VI, Section C, line 19The Foundation maintains all financial records, conflict of interest policies, and governing documents at its main office at 300 Longwood Avenue, Boston, MA 02115. The documents are available upon request.
Form 990, Part XI, line 9:Pension adjustment -22,563.
Form 990, Parrt XII, Line 2c:The audit process and scope has not changed from the prior year.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
Boston Children's Hospital
300 Longwood AvenueBostonMA02115042774441HospitalMA501(c)(3)Line 3N/A0
Physicians Organization at Children's Hospital Inc
300 Longwood AvenueBostonMA02115043266103Management servicesMA501(c)(3)Line 12c, III-FIN/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd