CHILDRESS INSTITUTE FOR PEDIATRIC TRAUMA: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- CHILDRESS INSTITUTE FOR PEDIATRIC TRAUMA (EIN 46-3674691)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-07-14
- IRS object ID
- 202031969349301753
- Schema version
- 2018v3.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-07-14T10:47:49-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463674691 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDRESS INSTITUTE FOR PEDIATRIC TRAUMA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHIL | BusinessNameControlTxt |
| Phone | 3367131627 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BOULEVARD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27157 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRADLEY A CLARK | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 3367131627 | PhoneNum |
| Signature | 2020-07-08 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 152.11.92.106 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-07-08 | IPDt |
| IP Tm | 07:58:59 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 92F11F32722E8792293CAF8DF02A44B038BF976A | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN D MCCONNELL MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BOULEVARD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27157 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $861,465 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SAVEINJUREDKIDS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE TREATMENT FOR CRITICALLY INJURED CHILDREN IN THE UNITED STATES THROUGH RESEARCH, MEDICAL EDUCATION AND AWARENESS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,059,385 | PYContributionsGrantsAmt |
| CY Contributions Grants | $817,128 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$89,304 | PYOtherRevenueAmt |
| CY Other Revenue | -$66,169 | CYOtherRevenueAmt |
| PY Total Revenue | $970,081 | PYTotalRevenueAmt |
| CY Total Revenue | $750,959 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $266,252 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $365,999 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $316,481 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $289,161 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $54,774 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $357,718 | PYOtherExpensesAmt |
| CY Other Expenses | $366,276 | CYOtherExpensesAmt |
| PY Total Expenses | $940,451 | PYTotalExpensesAmt |
| CY Total Expenses | $1,021,436 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $29,630 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$270,477 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,104,007 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,233,970 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $92,609 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $172,915 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,011,398 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,061,055 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO DISCOVER AND SHARE THE BEST WAYS TO PREVENT AND TREAT SEVERE INJURIES IN CHILDREN. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $869,770 | ExpenseAmt |
| Grant | $365,999 | GrantAmt |
| Desc | THE ORGANIZATION STRIVES TO DISCOVER AND SHARE THE BEST WAYS TO PREVENT AND TREAT SEVERE INJURIES IN CHILDREN. ITS VISION IS TO REDUCE, BY 50%, DEATH AND DISABILITY TO SEVERELY INJURED CHILDREN NATIONWIDE BY 2020 BY:- RAISING THE LEVEL OF CARE NATIONWIDE FOR PEDIATRIC TRAUMA, LEVERAGING EXPERTISE OF LEVEL 1 PEDIATRIC TRAUMA HOSPITALS FOR THE BENEFIT OF NON-TRAUMA HOSPITALS; AND- ADDRESSING PREVENTION AND TREATMENT OF TRAUMATIC INJURY IN YOUTH (14 AND UNDER) RECREATION AND SPORTS.THE ORGANIZATION FUNDS RESEARCH, EDUCATION AND ADVOCACY TO HELP IMPROVE THE CARE AND TREATMENT INJURED KIDS RECEIVE.ITS VALUES ARE TO:- COLLABORATE: COLLABORATE ALWAYS TO CREATE THE WIN FOR ALL PARTIES.- MEASURE: PLAN AND DO WHAT CAN BE MEASURED. OUTCOMES MATTER.- LEAD: BE PRO-ACTIVE, A FAST FOLLOWER IS STILL A FOLLOWER.- CARE: VALUE AND NURTURE EVERY RELATIONSHIP.- THINK BIG: ADOPT AN EXPLORER MINDSET - BOLD, UNCHARTED, CREATIVE.- ACCENTUATE THE POSITIVE: OUR WORK IS A JOURNEY WITH DAILY PROGRESS. | Desc |
| Total Program Service Expenses | $869,770 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | AK | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | AR | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | CO | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | CT | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | HI | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | KS | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MD | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | MS | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NJ | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NM | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | OK | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | RI | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | SC | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | UT | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOSEPH DOLAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3367164445 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1Txt |
| City | WINSTON SALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27157 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| RICHARD CHILDRESS | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JOHN D MCCONNELL MD | |||||||
| DIRECTOR, PRESIDENT | 0.10 | Yes (X) | $0 | $5,552,782 | $44,771 | 39.90 | Yes (X) |
| J WAYNE MEREDITH MD | |||||||
| DIRECTOR, VP | 1.00 | Yes (X) | $0 | $828,162 | $44,693 | 39.00 | Yes (X) |
| TERRY L HALES JR | |||||||
| DIRECTOR, SECRETARY | 1.00 | Yes (X) | $0 | $579,912 | $68,917 | 39.00 | Yes (X) |
| BRADLEY A CLARK | |||||||
| DIRECTOR, TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | 39.00 | Yes (X) |
| ROBERT GFELLER | |||||||
| EXEC DIR & COO (TO 12/31/18) | 10.00 | $661,825 | $0 | $147,557 | 30.00 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $661,825 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,960,856 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $305,938 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SQUIRE PATTON BOGGS LLP | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2550 M STREET NW | AddressLine1Txt |
| City | WASHINGTON | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20037 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | HEALTHCARE CONSULTING SERVICES | ServicesDesc |
| Compensation | $128,964 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $405,070 | FundraisingAmt |
| All Other Contributions | $412,058 | AllOtherContributionsAmt |
| Total Contributions | $817,128 | TotalContributionsAmt |
| Fundraising Gross Income | $44,337 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $405,070 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $110,506 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$66,169 | TotalRevenueColumnAmt |
| Exclusion | -$66,169 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $750,959 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$66,169 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $355,446 | TotalAmt |
| Program Services | $355,446 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,553 | TotalAmt |
| Program Services | $10,553 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $283,120 | TotalAmt |
| Program Services | $212,841 | ProgramServicesAmt |
| Management And General | $42,167 | ManagementAndGeneralAmt |
| Fundraising | $28,112 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,041 | TotalAmt |
| Program Services | $4,543 | ProgramServicesAmt |
| Management And General | $899 | ManagementAndGeneralAmt |
| Fundraising | $599 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,267 | TotalAmt |
| Management And General | $762 | ManagementAndGeneralAmt |
| Fundraising | $24,505 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,727 | TotalAmt |
| Program Services | $97,727 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,839 | TotalAmt |
| Management And General | $6,839 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,474 | TotalAmt |
| Program Services | $60,869 | ProgramServicesAmt |
| Management And General | $37,605 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,324 | TotalAmt |
| Program Services | $64,485 | ProgramServicesAmt |
| Management And General | $1,839 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,669 | TotalAmt |
| Program Services | $29,715 | ProgramServicesAmt |
| Management And General | $2,396 | ManagementAndGeneralAmt |
| Fundraising | $1,558 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,029 | TotalAmt |
| Program Services | $6,618 | ProgramServicesAmt |
| Management And General | $411 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,799 | TotalAmt |
| Program Services | $18,144 | ProgramServicesAmt |
| Management And General | $2,655 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,148 | TotalAmt |
| Program Services | $8,829 | ProgramServicesAmt |
| Management And General | $1,319 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,021,436 | TotalAmt |
| Program Services | $869,770 | ProgramServicesAmt |
| Management And General | $96,892 | ManagementAndGeneralAmt |
| Fundraising | $54,774 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,100,065 | BOYAmt |
| EOY | $1,182,986 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $33,776 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $642 | BOYAmt |
| EOY | $17,208 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,300 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,104,007 | BOYAmt |
| EOY | $1,233,970 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,959 | BOYAmt |
| EOY | $161,415 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,650 | BOYAmt |
| EOY | $11,500 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,609 | BOYAmt |
| EOY | $172,915 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $994,420 | BOYAmt |
| EOY | $982,811 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,978 | BOYAmt |
| EOY | $78,244 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,011,398 | BOYAmt |
| EOY | $1,061,055 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,104,007 | BOYAmt |
| EOY | $1,233,970 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$270,477 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $320,134 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,234,965 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,387,942 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $953,930 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,059,385 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $817,128 | CurrentTaxYearAmt |
| Total | $5,453,350 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,234,965 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,387,942 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $953,930 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,059,385 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $817,128 | CurrentTaxYearAmt |
| Total | $5,453,350 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $5,453,350 | PublicSupportTotal170Amt |
| Total Support | $5,453,350 | TotalSupportAmt |
| First5 Years170 | Yes (X) | First5Years170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $97,727 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $97,727 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE CHILDRESS INSTITUTE FOR PEDIATRIC TRAUMA IS AN ADVOCATE FOR RESEARCH, EDUCATION AND PREVENTION OF TRAUMATIC INJURY TO CHILDREN. THE CHILDRESS INSTITUTE FOR PEDIATRIC TRAUMA SUPPORTS THE PEDIATRIC TRAUMA CAUCUS IN CONGRESS. THE ORGANIZATION MEETS WITH MEMBERS OF CONGRESS TO DISCUSS PEDIATRIC TRAUMA NEEDS THROUGHOUT THE UNITED STATES. THE CAUCUS PROVIDES A VEHICLE FOR CONTINUING EDUCATION FOR MEMBERS OF CONGRESS AND THEIR STAFF AND HELPS ADVOCATE FOR BIPARTISAN SOLUTIONS TO SUPPORT THE TRAUMA SYSTEMS IN THE UNITED STATES AND FIGHT THE PEDIATRIC TRAUMA EPIDEMIC. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE COMPANY IS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS GENERALLY EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS MADE IN THE FINANCIAL STATEMENTS. THE COMPANY HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS FISCAL YEARS ENDED JUNE 30, 2018 AND 2019, INCLUDING A QUANTIFICATION OF TAX RISKS IN AREAS SUCH AS UNRELATED BUSINESS INCOME AND TAXATION OF ITS FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE COMPANY'S FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2018 AND 2019. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF EVENT | Event1Nm |
| Gross Receipts Event1 | $193,563 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $186,250 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $7,313 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $500 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $459 | NonCashPrizesEvent1Amt |
| Food And Beverage Event1 | $16,278 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $400 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $22,807 | OtherDirectExpensesEvent1Amt |
| Event2 | CELEB 3-3 | Event2Nm |
| Gross Receipts Event2 | $147,703 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $122,616 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $25,087 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $150 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $2,003 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $6,065 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $12,596 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 3 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $108,141 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $96,204 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $11,937 | GrossRevenueOtherEventsAmt |
| Non Cash Prizes Other Events | $214 | NonCashPrizesOtherEventsAmt |
| Rent Fclty Costs Other Events | $2,575 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $13,740 | FoodAndBeverageOtherEventsAmt |
| Oth Direct Expnss Other Events | $32,719 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $449,407 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $405,070 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $44,337 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $500 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $823 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $4,578 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $36,083 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $400 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $68,122 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $110,506 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$66,169 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| BOSTON MEDICAL CENTER CORPORATION | |||||||
| ONE BOSTON MEDICAL CENTER PLACE | BOSTON | MA | 02118 | 043314093 | 501(C)(3) | $50,000 | RESEARCH AWARD_ADDRESSING PEDIATRIC SENTINEL EVENTS A COMPUTER BASED SIMULATION GAME FOR PEDIATRIC TRAUMA MANAGEMENT |
| CINCINNATI CHILDREN'S HOSPITAL MEDICAL | |||||||
| 3333 BURNET AVE MLC 2023 | CINCINNATI | OH | 45229 | 310833936 | 501(C)(3) | $34,598 | RESEARCH AWARD_ADDRESSING OPTICAL RESUSCITATION |
| AMERICAN COLLEGE OF SURGEONS | |||||||
| 633 NORTH SAINT CLAIR STREET | CHICAGO | IL | 60611 | 362192800 | 501(C)(3) | $25,000 | SPONSORSHIP OF CONFERENCE_TRAUMA PATIENT REPORTED OUTCOMES CONSENSUS (PROM) CONFERENCE |
| THE MEDICAL COLLEGE OF WISCONSIN | |||||||
| 8701 WATERTOWN PLANK RD | MILWAUKEE | WI | 53226 | 390806261 | 501(C)(3) | $49,094 | RESEARCH AWARD_PHASE TWO OF PEDIATRIC TRAUMA TOOLKIT DEVELOPMENT |
| VIDANT MEDICAL CENTER FOUNDATION | |||||||
| PO BOX 8489 | GREENVILLE | NC | 27835 | 581399266 | 501(C)(3) | $25,000 | EDUCATION AWARD_STOP THE BLEED CAMPAIGN AWARD |
| KIDS AND PROS INC | |||||||
| 3616 BOGAN SPRINGS DRIVE | BUFORD | GA | 30519 | 264298822 | 501(C)(3) | $21,974 | YOUTH SPORTS SAFETY CLINICS |
| UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER | |||||||
| 5323 HARRY HINES BLVD MC 9029 | DALLAS | TX | 75235 | 756002868 | 501(C)(3) | $5,000 | EDUCATION AWARD_HEAD INJURY EDUCATION FOR EMS |
| WORLDWIDE SPORTS SAFETY | |||||||
| 6118 LINCOLNSHIRE COURT | ROCKWALL | TX | 70587 | 812001671 | 501(C)(3) | $5,000 | EDUCATION AWARD_TEAMSAFE SPORTS |
| WAKE FOREST UNIVERSITY HEALTH SCIENCES | |||||||
| MEDICAL CENTER BLVD | WINSTONSALEM | NC | 27157 | 223849199 | 501(C)(3) | $105,000 | RESEARCH PROJECTS AND STUDIES RELATED TO ITAKL (FOOTBALL AND SOCCER) |
| NORTH CAROLINA BAPTIST HOSPITAL | |||||||
| MEDICAL CENTER BLVD | WINSTONSALEM | NC | 27157 | 560552787 | 501(C)(3) | $10,000 | SAFE KIDS PROGRAM |
| DAYTON CHILDREN'S HOSPITAL | |||||||
| ONE CHILDRENS PLAZA | DAYTON | OH | 454041815 | 310672132 | 501(C)(3) | $24,780 | RESEARCH AWARD_USE OF NIRS IN DIAGNOSIS OF INTRACRANIAL HEMORRHAGE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 11 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | PEDIATRIC TRAUMA ADVOCACY & EMS SEMINARS | GrantTypeTxt |
| Recipient | 6 | RecipientCnt |
| Cash Grant | $10,553 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANT RECIPIENTS ARE SELECTED BASED ON SEVERAL FACTORS AND CRITERIA WITH THE OVERARCHING GOAL TO ENHANCE STANDARD PRACTICES IN PEDIATRIC TRAUMA MANAGEMENT. SUCH CRITERIA INCLUDE: THE SIGNIFICANCE OF THE PROPOSED RESEARCH TO PEDIATRIC TRAUMA AND THE IMPACT ON NATIONAL HEALTH; THE QUALIFICATION(S) OF INVESTIGATOR(S), THE STRENGTH OF LEADERSHIP PLAN AND/OR THE RESEARCH INNOVATION AND FEASIBILITY; AND THE INFRASTRUCTURE/RESOURCES TO SUPPORT THE PROJECT. AN EXTERNAL REVIEW COMMITTEE REVIEWS THE GRANT PROPOSALS AND PROVIDES RECOMMENDATIONS TO THE ORGANIZATION'S EXECUTIVE DIRECTOR AND BOARD. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN D MCCONNELL MD | ||||||||||||||
| DIRECTOR, PRESIDENT | $0 | $1,038,531 | $0 | $0 | $0 | $4,514,251 | $0 | $23,648 | $0 | $21,123 | $0 | $5,597,553 | $0 | $3,858,352 |
| J WAYNE MEREDITH MD | ||||||||||||||
| DIRECTOR, VP | $0 | $747,397 | $0 | $59,979 | $0 | $20,786 | $0 | $23,648 | $0 | $21,045 | $0 | $872,855 | $0 | $0 |
| TERRY L HALES JR | ||||||||||||||
| DIRECTOR, SECRETARY | $0 | $407,550 | $0 | $112,287 | $0 | $60,075 | $0 | $44,824 | $0 | $24,093 | $0 | $648,829 | $0 | $0 |
| ROBERT GFELLER | ||||||||||||||
| EXEC DIR & COO (TO 12/31/18) | $495,090 | $0 | $163,123 | $0 | $3,612 | $0 | $129,925 | $0 | $17,632 | $0 | $809,382 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | CERTAIN OFFICERS AND DIRECTORS OF THE FILING ORGANIZATION PARTICIPATED IN SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS (SERP) AND EXECUTIVE INCENTIVE COMPENSATION PLANS (ALL OF WHICH WAS PAID BY A RELATED ORGANIZATION, WAKE FOREST UNIVERSITY HEALTH SCIENCES, AS PART OF THE INDIVIDUALS' COMPENSATION FROM THE RELATED ORGANIZATION). THE FOLLOWING OFFICERS AND DIRECTORS RECEIVED A SERP PAYMENT DURING CALENDAR YEAR 2018: JOHN D. MCCONNELL, M.D. - $4,477,272 TERRY L. HALES, JR. - $58,815 |
| PART VII, LINE 5: COMPENSATION FROM UNRELATED ORGANIZATION | THE FOLLOWING CURRENT OFFICER WAS COMPENSATED BY WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER FOR SERVICES PERFORMED FOR THE ORGANIZATION. SEE PART VII AND SCHEDULE J, PART II FOR HIS 2018 COMPENSATION: ROBERT GFELLER |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | AS STATED IN THE FILING ORGANIZATION'S BY-LAWS, THE ORGANIZATION HAS TWO CATEGORIES OF MEMBERS; MANAGING MEMBERS WITH VOTING RIGHTS AND SUPPORTING MEMBERS WITH NO VOTING RIGHTS. THE SOLE INITIAL MANAGING MEMBER IS WAKE FOREST UNIVERSITY HEALTH SCIENCES. |
| FORM 990, PART VI, SECTION A, LINE 7A | MANAGING MEMBERS HAVE THE RIGHT TO VOTE ON THE ADMISSION OF MEMBERS, ON THE ELECTION OF DIRECTORS AND ON OTHER MATTERS FOR WHICH MEMBERS ARE ENTITLED TO VOTE ACCORDING TO THE NORTH CAROLINA NONPROFIT CORPORATION ACT. |
| FORM 990, PART VI, SECTION A, LINE 7B | GOVERNANCE DECISIONS THAT ARE RESERVED TO PERSONS OTHER THAN THE GOVERNING BODY OF THE FILING ORGANIZATION INCLUDE: AMENDMENT OF THE BYLAWS OF THE ORGANIZATION, WHICH MAY BE ACCOMPLISHED ONLY BY THE MAJORITY VOTE OF THE MANAGING MEMBERS OF THE ORGANIZATION, AND EFFECTIVE ONLY AFTER THE WRITTEN APPROVAL OF THE CEO OF WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER IS GIVEN; AND THE ELECTION AND REMOVAL OF DIRECTORS, WHICH IS ACCOMPLISHED ONLY BY THE ACTION OF THE MANAGING MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES A COPY OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES ITS OFFICERS AND DIRECTORS TO DISCLOSE CONFLICTS OF INTEREST ANNUALLY, AND AS THEY ARISE. ANY ITEMS DISCLOSED ARE REVIEWED AND MANAGED IN ACCORDANCE WITH THE ORGANIZATION'S POLICY ON CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION PAYS NO COMPENSATION TO OFFICERS OR DIRECTORS; AS THE ORGANIZATION HAS NO EMPLOYEES, ALL COMPENSATION PAID TO OFFICERS AND DIRECTORS WAS PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION'S EXECUTIVE COMMITTEE OR COMPENSATION COMMITTEE OF ITS BOARD OF DIRECTORS, OR THE GOVERNANCE & COMPENSATION COMMITTEE OF THE WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER BOARD (THROUGH AUTHORITY DELEGATED TO IT BY WAKE FOREST UNIVERSITY HEALTH SCIENCES - THE PARENT OF THE FILING ORGANIZATION) IS RESPONSIBLE FOR REVIEWING AND APPROVING MOST OFFICERS AND DIRECTORS' COMPENSATION. THE COMMITTEE UTILIZES INDEPENDENT COMPENSATION CONSULTANTS, COMPENSATION SURVEYS AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH SUCH OFFICERS' COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST. |
| PART VII, SECTION A, COLUMN B, HOURS | JOHN D. MCCONNELL, MD FILING ORG 0.1 UNRELATED ORG 39.9 J. WAYNE MEREDITH, MD FILING ORG 1.0 RELATED ORG 39.0 TERRY L. HALES, JR FILING ORG 1.0 RELATED ORG 39.0 ROBERT GFELLER FILING ORG 10.0 RELATED ORG 5.0 UNRELATED ORG 25.0 BRADLEY A. CLARK FILING ORG 1.0 RELATED ORG 6.6 UNRELATED ORG 32.4 NORTH CAROLINA BAPTIST HOSPITAL ("NCBH") AND WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC") ARE UNRELATED ORGANIZATIONS TO THE FILING ORGANIZATION. PURSUANT TO THE TERMS OF THE "MEDICAL CENTER INTEGRATION AGREEMENT" (AN AGREEMENT ENTERED INTO IN 2010 AMONG FOUR PARTIES: WAKE FOREST UNIVERSITY, WAKE FOREST UNIVERSITY HEALTH SCIENCES (BOTH RELATED ORGANIZATIONS OF THE FILING ORGANIZATION), WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER AND NORTH CAROLINA BAPTIST HOSPITAL (BOTH UNRELATED TO THE FILING ORGANIZATION), UNDER WHICH AGREEMENT THE OPERATION OF WFUHS AND NCBH, AND ALL OF THE RESPECTIVE SUBSIDIARIES OF EACH, WAS DELEGATED TO WFUBMC), THE CORPORATE OFFICERS OF WFUBMC GENERALLY SERVE ALSO AS THE CORPORATE OFFICERS OF WFUHS AND NCBH. THUS, CERTAIN OFFICERS OF THE FILING ORGANIZATION ALSO DEVOTE HOURS TO THE RELATED ORGANIZATIONS, AS WELL AS TO THE UNRELATED ORGANIZATIONS (WFUBMC AND NCBH), AS SHOWN IN THE BREAKDOWN OF HOURS ABOVE. |
| FORM 990, PART XI, LINE 9: | RELATED ORGANIZATION TRANSFERS 320,134. |
| FORM 990, PART IX, LINE 2A | THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WAKE FOREST EMERGENCY PROVIDERS | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 561903275 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | |
| WAKE FOREST UNIVERSITY HEALTH SCIENCES | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 223849199 | HEALTHCARE - CLINICAL SERVICES, RESEARCH, EDUCATION | NC | 501(C)(3) | LINE 2 | WAKE FOREST UNIVERSITY | 0 | |
| WAKE FOREST UNIVERSITY | |||||||||||
| BOX 7201 | WINSTON SALEM | NC | 27109 | 560532138 | LIBERAL ARTS, GRADUATE AND PROFESSIONAL EDUCATION | NC | 501(C)(3) | LINE 2 | 0 | N/A | |
| WAKE FOREST INNOVATION QUARTER MGMT CO | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 061818498 | RESEARCH PARK DEVELOPMENT | NC | 501(C)(3) | LINE 12A, I | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | |
| WAKE FOREST INNOVATION QUARTER - CDC | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 200177581 | RESEARCH PARK DEVELOPMENT | NC | 501(C)(3) | LINE 12A, I | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | |
| WAKE FOREST INNOVATION QUARTER DEV CO | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 562094067 | RESEARCH PARK DEVELOPMENT | NC | 501(C)(6) | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | ||
| WAKE FOREST UNIVERSITY HEALTH SCIENCES GROUP RT | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 900222618 | PROVIDE DIALYSIS TREATMENTS TO PATIENTS | NC | 501(C)(3) | LINE 12A, I | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | |
| REGENMED DEVELOPMENT ORGANIZATION | |||||||||||
| MEDICAL CENTER BLVD | WINSTON SALEM | NC | 27157 | 202710571 | ACCELERATE DEVELOPMENT OF REGENERATIVE MEDICINE THERAPY | NC | 501(C)(3) | LINE 12A, I | WAKE FOREST UNIVERSITY HEALTH SCIENCES | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| VERGER FUND II LLC | |||||||
| PO BOX 7201 | WINSTON SALEM | NC | 27109 | 352514227 | INVESTMENT | NC | N/A |
| WAKE FOREST TECHNOLOGY DEVELOPMENT PROGRAM LP | |||||||
| 2520 MERIDIAN PARKWAY | DURHAM | NC | 27713 | 475437596 | INVESTMENT | NC | N/A |
| WAKE FOREST AMBULATORY VENTURES LLC | |||||||
| MEDICAL CENTER BOULEVARD | WINSTON SALEM | NC | 27157 | 820777206 | HEALTHCARE | NC | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH DISTRICT OWNERS ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | MEDICAL CENTER BLVD | AddressLine1Txt |
| City | WINSTONSALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27157 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411128865 | EIN |
| Primary Activities | PROPERTY OWNERS ASSOCIATION | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |