2018-08-15T07:44:04-05:00 2017-09-30 346565596 Ernst & Young LLP 200 Clarendon Street Boston MA 021165072 990 2016-10-01 042774441 Children's Hospital Corporation CHIL 6173556000 300 Longwood Avenue Boston MA 02115 Doug Vanderslice Treasurer & CFO 6173556000 2018-08-08 1 Jeanne M Schuster P00743154 6172662000 2016 2022-09-23 18:48:47Z Boston Children's Hospital Sandra Fenwick 300 Longwood Avenue Boston MA 02115 2062285066 0 X www.childrenshospital.org X 1982 MA Provider of pediatric healthcare, education, research & community service 24 21 13284 1514 -4277019 -4754718 342539011 444270077 1245443488 1340492453 22376694 44232111 48641844 46038894 1659001037 1875033535 4155715 4952966 0 0 831560153 884315632 903252 976945 31135645 761321586 856191863 1597940706 1746437406 61060331 128596129 4856437562 5531469270 1677206033 1963620459 3179231529 3567848811 X Boston Children's Hospital (BCH) is the nation's premier pediatric hospital and research enterprise. We serve as the community hospital for the children of Boston; provide specialty pediatric care throughout the region; and offer access to innovative, life saving care to children across the world facing rare and complex conditions. BCH's vision is to advance pediatric care and research--both in our local neighborhoods and worldwide-through a commitment to innovation, science-based care and quality improvement. All of our activities are driven by four interwoven missions: providing access to safe, high quality, compassionate and innovative clinical care to children; researching new cures and treatments for diseases and methods of care delivery; training the next generation of pediatric caregivers; and improving the health and well being of children, with a special emphasis on helping the children of Boston grow and learn in safe, healthy environment. 0 0 1110870003 4952966 1319375356 CLINICAL CARE: The services we offer - from well child visits and treatment for typical child health issues (broken bones, tonsillitis, etc.) to chronic care (asthma, diabetes, obesity, etc.) & specialty services (oncology, cardiology, neurology) - benefit from our clinicians' high level of specialization, our collaboration with research scientists (many of whom are also physicians) affiliated with the hospital, and our significant investments in equipment, facilities and clinical & support staff. Our team has a deep commitment to setting the bar for quality & safety & exceeding the expectations of our patients & their families for service, undertaking significant investments in each of these areas.Annually, BCH sees: 24,372 bedded cases at our main campus; 970 bedded cases at our satellites and 622,131 combined outpatients at main campus & satellites; 32,784 patients in our community health clinic. Of the bedded cases, more than 16.8% (CMI > 2.00) can be qualified as clinically complex. Of these patients, approximately 33% (patients on Medicaid/Medicare) are considered low income.BCH is the safety net institution for very sick children throughout the region, supporting the entire health care system for the most complex pediatric cases. We receive referrals from community hospitals as well as from other academic medical centers throughout New England. 25% of our inpatients are transferred from hospitals & medical centers across Massachusetts for care that no one else can provide.BCH is the single largest provider of care to children enrolled in the Medicaid program, caring for approximately 30% of all pediatric Medicaid patients statewide, including many of the sickest children in the state. BCH also provides clinical care for the largest number of uninsured children in the state; total free care & losses from Medicaid in FY2017 were approximately $109 million.Increasingly, we have been able to care for & improve life & health outcomes for medically complex children, many with conditions such as congenital heart conditions, childhood cancers & complex neurological & neurosurgical conditions. Our capabilities are accelerating rapidly as we develop new clinical & surgical approaches including gene therapies, stem cell transplant procedures, fetal surgical interventions, and the like.BCH is at the absolute forefront nationally in these & many other areas. As a result, we have seen significant growth in the number of complex patients served-patients who stay longer, require more resources (such as intensive care unit-level care), use a broader range of interdisciplinary specialists, and frequently require substantial support for their whole family. Some of them travel great distances, but equally many are from here in Massachusetts.We've attempted to manage these trends by delivering care in lower cost settings including community hospitals that we help support, and by transitioning inpatient care to multi-specialty outpatient settings where possible. We've built care teams that work effectively across disciplines. We've strived to create a more welcoming and family-centered environment for children & families on the Longwood campus. We need to do more.Recognizing the difficulties that community-based hospitals face in providing specialized pediatric care (which requires significant investments in staff, equipment & training), BCH has formed partnerships with 5 community hospitals throughout eastern Massachusetts, including Beverly Hospital, Winchester Hospital & South Shore Hospital. Additionally, our physicians see patients at Massachusetts General Hospital. With approximately 100 physicians serving those community hospitals, we enhance the community's-and the state's-ability to provide access to emergency, neonatal, inpatient & outpatient specialty services for children. BCH also operates satellite facilities in Lexington, North Dartmouth, Peabody & Waltham where we offer specialized care in cardiology, gastroenterology, neurology, respiratory diseases, diabetes, orthopedic surgery, urology, behavioral health and other specialties, as well as Martha Eliot Health Center, our community health center in Jamaica Plain. In addition, our physicians offer outpatient services at our Physician Office Locations in Brockton, Milford, Norwood & Weymouth. In addition, our BCH Physicians partnership is a multi-specialty, pediatric practice with strong medical & academic roots, whose more than 276 physicians serve families in 57 locations throughout New York's Metropolitan Area, the Hudson Valley, Connecticut and New Jersey.Each year, BCH improves the quality of the clinical care it provides by recruiting talented staff, investing in cutting-edge equipment & technology, undertaking safety & quality initiatives, supporting community health programs & ensuring that our facilities make the care process easier & more comfortable for all the patients & families we serve. For example:Focus on Quality and Safety: At BCH, a dedication to quality & patient safety is embedded in everything we do. We continuously measure & track our performance in order to improve the care we provide. We believe measurement is essential for providing world-class care. If we don't track how we're doing, we can't identify areas of care that need improvement. And we can't identify high-performing areas that could serve as a model throughout BCH & the health care industry as a whole. By closely watching our quality & safety outcomes, we push ourselves to get better every day & raise the standard of care everywhere. We are committed to transparency in our efforts to constantly improve quality & safety, and clinical departments at BCH publish information on both in their own sections of our website.We value the insights of parents, patients & families when it comes to quality & safety. Parents know their child best, and they often have excellent ideas about how care can be improved. Adult family members, and children who are old enough, are encouraged to voice their observations, opinions or concerns to members of the care team. Doctors, nurses, researchers & administrators throughout BCH are continually exploring new ways of improving the quality of care we provide. Whenever possible, we share our successes & breakthroughs with the wider world, so that other health care professionals can learn from our experience and join us in raising the standard of care for children everywhere.In addition, BCH is engaged in an ongoing enterprise-wide commitment, extending to all staff as well as patients and families, to be a High Reliability Organization, one where ZERO preventable harm will occur to any patient, family member or team member. In FY17, we achieved a significant goal in our work to become a High Reliability Organization, when 100% of our BoCH team members completed Error Prevention Training. Recognizing the need to sustain these efforts to make every moment matter, Error Prevention Training for New Hires began in May 2017. Error Prevention Training is now included in New Hire Orientation for all Employees.In 2017, BCH began to post weekly updates of the High Reliability metrics of days since its' last Serious Safety Event (SSE) and Employee Serious Safety Event (ESSE).Foster innovation: Through the creation of the Innovation and Digital Health Accelerator, BCH reinforces a commitment to, and investment in pediatric innovation. We are combining our data, clinical expertise, and health care technology development experience, with leading worldwide industry partners - including start-ups - to transform health care. We work to surface, support and accelerate BCH's innovations for the purpose of improving pediatric care. Today, there is a new level of investment & urgency behind accelerating innovations & expanding our reach globally.The acceleration process sources innovative ideas from industry and within BCH to vet & develop high-priority market competitive solutions with scalable impact. Leveraging extensive business & technical capabilities, Innovation Digital Health Accelerator identifies viable commercialization pathways for prioritized innovations, including digital health, medical devices, diagnostic technologies & care process innovations. The team then provides the resources, including grant funding, oversight & momentum to accelerate development & commercialization.The Accelerator provides multiple resources for BCH's employees, as well as industry startups, including:- The Innovator's Roadmap - A Commercialization Roadmap meant to help clarify the commercialization process and guide innovators towards helpful resources.- Accelerator Grant Program - Every year, up to $250,000 in aggregate funding and software development time is available for innovative ideas in clinical practice or research with commercial potential.- Innovation Office Hours -An open door when it comes to great ideas. 366045138 0 0 RESEARCH: Boston Children's is dedicated to enhancing the wellbeing of children and families by leading research and innovation around child health issues, and by seeking new approaches to the prevention, diagnosis and treatment of childhood and adult diseases.With over $368 million in annual funding-more than any other pediatric hospital-and more than 1 million square feet of research space, Boston Children's is home to the world's largest and most active research enterprise at a pediatric center. Boston Children's research mission encompasses basic research, clinical research, community service programs and the postdoctoral training of new scientists. While the National Institutes of Health is our largest sponsor, Boston Children's has made a significant investment of more than $32 million towards supporting its research activities in 2017. Our investigators hold numerous prestigious honors and awards, including many "research firsts." In our laboratories and clinics, hundreds of scientists seek to identify the factors that contribute to both childhood and adult diseases and to develop effective treatments for them. Our investigators are Harvard Medical School faculty-basic scientists, clinical researchers and epidemiologists-who are accelerating the pace of medical discovery from brainstorm to bench to bedside. Our researchers were the first to develop 10 new disease-based stem cell lines by reprogramming adult stem cells that can be used to study treatments for diseases ranging from Parkinson's to Diabetes. Clinicians and researchers at Boston Children's work with colleagues throughout the medical community to translate basic science research into applications for clinical care. These projects frequently have applications that go beyond pediatrics to impact adult care as well. For example:- A gene therapy trial to treat cerebral adrenoleukodystrophy (CALD)-a neurodegenerative disease that typically claims young boys' lives within 10 years of diagnosis-has halted the disease's progression in 88 percent of patients.- New research suggests that genetic mutations to an "epithelial sodium pathway" could protect against cystic fibrosis and its debilitating effects on the lungs.- A 30-minute mobile screening app could allow dyslexia "checkups" at age 4 or 5 during well visits, based on research-proven tests.- A gene therapy known as CAR T-cell therapy to treat pediatric acute lymphoblastic leukemia (ALL).- A study of chronic inflammation caused by lupus revealed a potential drug that could protect the brain from inflammation caused by central nervous system (CNS) diseases, infection and maybe even everyday stress.- A robotic sleeve that can help hearts pump when they are failing. The sleeve-made of material that mimics heart muscle-hugs the outside of the heart and squeezes it, mimicking the action of cardiac muscle. 37501269 0 21117097 TEACHING:Over the course of the year, 480 residents, clinical fellows and interns came to Boston Children's from around the world. These men and women are selected for their potential leadership in their respective fields and their commitment to advancing the frontiers of pediatric care. In fact, a 24-year analysis of residents who have graduated from our Department of Medicine found that roughly 40% go on to become leaders in academic medicine, filling positions such as deans, chairs and program heads across the country. Over a third of the chiefs of pediatric departments across the country trained at Boston Children's. We train individuals throughout all areas of the care continuum, including medical students, interns, residents, fellows, nursing students and community pediatricians. We provide continuing professional education for all of our clinical staff.Boston Children's offers the only training programs in Massachusetts for: Adolescent Medicine, Medical Biochemical Genetics, Neurodevelopmental Disabilities, Pediatric Cardiology, Pediatric Hematology/Oncology, Pediatric Nephrology, Pediatric Orthopedics, Pediatric Pathology, Pediatric Surgery, Pediatric Sports Medicine, Pediatric Urology, Pediatric Transplant Hepatology and Congenital Cardiac Surgery.Boston Children's offers the only training programs in New England for Adolescent Medicine, Medical Biochemical Genetics, Neurodevelopmental Disabilities, Pediatric Sports Medicine, Pediatric Urology, Pediatric Transplant Hepatology and Congenital Cardiac Surgery.Boston Children's has the largest accredited training programs in the country for Pediatric Anesthesiology, Pediatric Cardiology and Pediatric Otolaryngology. The hospital also has the largest accredited training program in Child Neurology in New England.The Pediatric Simulator Program at Boston Children's Hospital is the first hospital-based simulator at a teaching hospital in New England. It is accredited by the American Society of Anesthesiologists (ASA), the first pediatric center to be endorsed, and one of only 31 ASA Endorsed Centers Nationwide. The simulation suite is a dual-purpose simulation laboratory and procedure room with an adjacent control room and conference room located within a state-of-the-art Medical Surgical Intensive Care Unit.Boston Children's Pediatric Sports Medicine is one of only 28 accredited pediatric sports medicine programs in the country and Neurodevelopmental Disabilities is one of only 13 accredited neurodevelopmental disabilities programs in the country. Congenital Cardiac Surgery is one of 11 in the country, Pediatric Transplant Hepatology is one of 7 in the country, and Medical Biochemical Genetics is one of 16 in the country.Boston Children's Hospital is also home to one of only 7 Pediatrics/Anesthesia Combined Residencies in the country - and the only one in New England. Our combined Pediatrics/Medical Genetics Combined Residencies is one of 19 in the country, and the only one in Massachusetts.Our Clinical Informatics training program is one of only 5 pediatrics-based Clinical Informatics training programs in the country, and is the only such program in New England. In addition, Boston Children's Hospital is accredited by the Accreditation Council for Continuing Medical Education (ACCME) and designed to provide continuing education for physicians.Continuing medical education (CME) is an essential component in Boston Children's continuum of undergraduate, graduate and continuing medical education. Boston Children's, through its CME Department, offers many opportunities for health care professionals to continue their professional development education and training. Our goal is to assist health care professionals achieve the best medical outcomes for patients and families. Community:More than 25 years ago, Boston Children's Hospital (BCH) was among the first academic medical centers in the country to expand the traditional missions of patient care, teaching and research to embrace a fourth core mission-community. Through the years, BCH has strived to ensure that community health is more than just words in its mission statement. The efforts have evolved from targeted services for individual families to innovative models that have proven to advance population health approaches, promote health equity and improve health outcomes for children.BCH community mission is based on the needs of the community. It revolves around keeping children healthy through wellness and prevention efforts, ensuring that children have access to needed health care services and partnering with others to address non-health issues (social determinants) that have an impact on health such as an individual's exposure to violence or living in poverty. In all its endeavors, BCH focuses on meeting community needs and implementing programs that are aligned with the priorities of the City of Boston, the Boston Public Health Commission, the Boston Public Schools as well as other key partners and city agencies.Understanding community needsTo better understand current health needs in our community, BCH conducts a Community Health Needs Assessment (CHNA) every three years. The findings inform the direction of the hospital's community mission and the scope of its community health work. It also helps to ensure that BCH is utilizing resources and leveraging community partnerships in the most effective way. BCH's last assessment was completed in 2016. For the 2016 CHNA, BCH used a participatory, collaborative approach and examined health in its broadest context. As part of the CHNA, BCH sought input from its Community Advisory Board members and engaged youth to design, collect and analyze data on youth perceptions of needs and opportunities. The assessment process also included synthesizing existing data on social, economic and health indicators in Boston. Eight stakeholder interviews and two focus groups with community residents were also conducted to explore perceptions of the community, health and social challenges for children and families, and recommendations for how to address these concerns. Additionally, BCH collaborated with other hospitals through the Conference of Boston Teaching Hospitals to gather information on community needs via four focus groups hosted by community coalitions. BCH also gathered information on challenges faced by children with special needs and their families by attending a focus group listening session facilitated by Health Care for All. Lastly, the CHNA was informed by results from BCH's Determination of Need community engagement process. This process, which was guided by an Advisory Group that met in person six times, included conducting seven facilitated open community engagement sessions across the city of Boston. Four targeted small group discussions were also held with communities that were under-represented in the larger community sessions.Some of the key themes from the CHNA included the impact of poverty on child and community health, issues around stable and affordable housing, concerns about food access and insecurity and the importance of prevention and focus on early childhood. Health issues of concern include asthma, obesity and mental/behavioral health. More details on all the findings and our process can be found in the complete report and in the Community Health and Benefits Strategic Implementation Plan. The report and plan are available on the hospital's web site, Bostonchildrens.org/community. A formal and comprehensive needs assessment is only one part of BCH's approach to understanding the complex health needs and vital resources within the community. BCH is continually listening and learning from patient families, community leaders and staff. The staff rely on ongoing conversations with BCH's key partners-community health centers and community-based organizations, as well as the Boston Public Health Commission and the Boston Public Schools.Through the Community Advisory Board, which meets on a quarterly basis, BCH has a direct link to expertise on Boston neighborhoods, community organizations and current health needs. Members of the Community Advisory Board are instrumental in providing feedback throughout the year and play a key role in the BCH's formal assessment process. This feedback from experts, community leaders and partners as well as the Community Advisory Board informs the hospital's community mission, facilitates and strengthens the development of partnerships and helps to shape the implementation of the hospital's Strategic Implementation Plan. Serving as a safety netBCH remains committed to its local community, providing primary and preventative care, as well as inpatient care for complex illnesses. It is one of the leading providers of health care to low-income children in Massachusetts and it provides care unavailable elsewhere in the state and sometimes the nation. BCH also is a safety net provider for Boston children. This safety net is financial in that the hospital provides free care, subsidizes care for Medicaid patients, and incurs bad debt for patient families who cannot pay for the care they receive. It is programmatic in that BCH offers vital, hospital-subsidized services that are either unavailable elsewhere or available only in a very limited capacity, such as mental health and dental care.Being a community health leaderBCH has identified four priority health area-asthma, obesity, mental/behavioral health and early childhood/child development-and has a programmatic response to each. Community programs are focused where BCH has the clinical expertise, resources and partnerships to make a difference. BCH's strategy for improving community health is to: 1) address the most pressing health needs of children and families; 2) provide services through programs that can lead to improvements in health; or 3) build community capacity to better meet the needs of children and families. Some of these programs are described briefly below.- The Community Asthma Initiative (CAI) helped to improve the health of Boston children with asthma. To date, CAI has served more than 1,868 children with asthma. CAI provides case-management services, offers home visits, educates caregivers and providers, distributes asthma control supplies and connects families to local resources. The program has reduced the percentage of patients with any asthma-related hospitalizations by 81%, emergency department visits by 57%, missed schools days by 45% and missed work days for parents/caregivers by 53%.- BCH Neighborhood Partnerships Program (BCHNP) is the hospital's community-based behavioral health program. CHNP places clinicians in Boston schools and community health centers to provide a comprehensive array of services to better meet the needs of children and adolescents. Last year, more than 1,000 students received school-based services. The program also provided 1,191 hours of consultation to school staff and families and 26 workshops were held on social, emotional and behavioral health.- Fitness in the City (FIC) is a community-based approach to addressing obesity by offering prevention and intervention strategies to support children and youth who are overweight or obese, in making healthier choices and behavior changes. FIC supports 11 Boston community health centers to provide almost 1,100 children annually with case-management support, as well as access to nutrition and physical activity programs. Almost 60% of children participating in FIC have reduced their Body Mass Index. Participants also have made behavioral changes such as reducing consumption of sugar sweetened beverages and increasing the amount of time being physically active.- The Advocating Success for Kids Program (ASK) provides access to intensive and critically needed services for children experiencing school-functioning problems and learning delays through BCH's primary care clinic and in two Boston community health centers. Last year, 561 children were cared for by the ASK team.Supporting and working with community partnersBCH has relationships with an array of community partners who provide a voice for the families and neighborhoods they represent. BCH partners help to ensure that the hospital better understands the needs, uniqueness and strengths that lie within each community. In addition, BCH has three strategic partners-the Boston Public Schools (BPS), Boston Public Health Commission and community health centers. A few examples of accomplishments include: 10561848 0 0 - FY17, BCHNP's Training and Access Project (TAP) provided support to 10 schools by providing training and consultation in building sustainable systems in schools to support student behavioral health needs. - BCH supports community health centers to: 1) build capacity to provide a full range of services to provide an effective medical home for children; 2) provide pediatric services that address the most pressing health issues affecting children; and 3) demonstrate their value through effective assessment and reporting of quality outcomes. - Another example is the hospital's asthma population health management efforts working with three community health centers. This approach involves:* utilizing successful asthma management strategies and clinical best practices* leveraging the local resources of the Community Asthma Initiative and other resources related to reducing environmental asthma triggers * building upon our longstanding work and relationship with the health centers and their populationsAddressing social determinants of healthRecognizing the link between social circumstances and health issues, BCH actively participates and collaborates with its key community partners to respond to social determinants of health, which are non-medical issues that have a significant impact on individual and community health. BCH focuses on providing support at the individual, family and community levels. Based on community need and the hospital's expertise, BCH focuses its efforts and partnerships in three areas: - Education and schools. BCH partners closely with the Boston Public Schools (BPS) to support and strengthen the system as well as to work directly in school settings to reach students and help families overcome barriers that may prevent their children from functioning well in school. - Workforce Development. BCH recognizes that one of the most significant ways to support the community and help to ensure a diverse workforce is the recruitment and retention of Boston residents as employees. BCH's comprehensive workforce development efforts are in partnership with local organizations such as the Fenway Community Development Corporation. BCH also supports the pipeline of health care workers by exposing youth to careers in the health field. Programs include SCOOP for students interested in nursing careers and the COACH program, which provides opportunities for high school students to work at the hospital during the summer. - Partnering to support the health and social infrastructure in place for families. BCH is also committed to and directs resources to build capacity within the existing infrastructure of care for Boston children and families. This means supporting key partners-the Boston Public Health Commission (BPHC) and 11 Boston community health centers. BCH also has relationships with a wide array of community based organizations, which provide a voice for the families and neighborhoods they represent. Advocating for children and familiesAs the only freestanding Children's Hospital in Massachusetts, influencing public policy to improve child health is an important aspect of BCH's commitment to community health. The hospital is a leading provider of pediatric medical and behavioral services to low-income children across the Commonwealth and is s a critical component of the safety net for children throughout New England and the nation. BCH has been an organized force and an influential advocate for health and wellbeing of children for more than 20 years. BCH is an effective advocate on legislative and regulatory matters in Massachusetts that affect children's wellbeing, such as increasing access to quality pediatric mental health programs and promoting better treatment models for children with medical complexity and chronic conditions. BCH's advocacy history is rooted in the promotion of better insurance coverage for children, including major child health expansions in the 1990s, strong involvement in Massachusetts' Affordable Care Today Coalition (the catalyst behind the passage of Massachusetts's 2006 health reform law), and significant national involvement in work to promote child health access through the Children's Health Insurance Program and the Affordable Care Act. As a result, Massachusetts has achieved near universal health access for children, with less than 1 percent of children uninsured-the lowest rate in the country. In recent years, Massachusetts has emphasized payment reform and cost containment policies within the health care system. BCH played an active and vocal role in the development of the groundbreaking payment reform legislation that was signed into law in August 2012. Nationally, BCH is engaged in efforts to preserve Medicaid and the Children's Health Insurance Program, which serve as a safety net for children in all fifty states, ensuring their access to high-quality, effective coverage and facilitates important quality measurement and improvement initiatives.In 2006, BCH (including its BCH Neighborhood Partnerships Program - for details see above) and a coalition of community organizations launched the Children's Mental Health Campaign (CMHC). The CMHC has converted its credibility and influence into several major policy accomplishments which have redefined the landscape of the children's mental health system in Massachusetts. In 2008, the CMHC was instrumental in securing passage of two landmark state laws. An Act Relative to Children's Mental Health (Chapter 321) creates a structure for enhancing early identification, treating children in the most appropriate settings, enhancing coordination among state health care agencies and establishing mechanisms for oversight of and input into the state children's mental health system. Chapter 256 strengthened the state's mental health parity law by expanding the categories of disorders for which health insurance plans must provide mental health benefits. The CMHC is determined to hold key stakeholders accountable for implementing the new laws secured through its advocacy efforts. Since that time, the CMHC has had a number of legislative and budget successes that have increased access to appropriate care for children and adolescents with mental health disorders and their families. A significant success during this year was the inclusion in the Substance Use Treatment, Education, and Prevention Act of a requirement for schools to screen all youth for substance use at two different grade points during their middle to high school careers. Current efforts at the state level address: access to behavioral health services, diversion from juvenile justice programs, improving mental health in schools, and adolescent substance use prevention. In addition, the CMHC is working to address mental health parity compliance (legislative and regulatory) Additionally, BCH works in collaboration with a host of public health and prevention advocates to ensure public policies work to keep children safe and healthy. This year, BCH is working to ensure the protection of children and adolescents under the state's new legalized marijuana laws by advocating for appropriate child safety packaging regulation and funding for the Poison Control Center and adolescent substance prevention efforts . The hospital also lends expertise in the effort to raise the minimum purchase age for tobacco products 21, create a tiered tax on sugar sweetened beverages, and improve child passenger safety legislation. BCH has established the over 5,000 member Children's Advocacy Network (CAN), a grassroots advocacy network that leverages the many voices of families, hospital staff, and community partners in support of child health. Since 2006, the hospital has trained hundreds of advocates through an annual in-depth, five-session training series that gives advocates a better understanding of the legislative process and the skills needed for effective advocacy. The CAN hosts monthly "Caffeinate and Advocate" forums, which offer hospital staff and community partners a monthly opportunity to learn about a current topic related to children's health policy and explore ways to advocate for children. Staff members from departments throughout the hospital regularly engage with the CAN in order to receive information about policy changes that may impact their patient population or schedule in-service presentations about current events in Washington and at the state level. 10561848 0 0 1524978258 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 1 0 0 1 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 1832 0 1 13284 1 1 1 0 0 0 1 1 1 1 0 0 0 0 X 24 21 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X Doug Vanderslice 6173556000 300 Longwood Avenue Boston MA 02115 Stephen Karp Trustee - Chairman 5.00 5.00 X 0 0 0 Douglas Berthiaume Trustee - Vice Chair 2.00 2.00 X 0 0 0 Allan Bufferd Trustee 1.00 1.00 X 0 0 0 Alex Dimitrief Trustee 1.00 1.00 X 0 0 0 Steve Fishman MD Trustee,ex officio 1.00 1.00 X 0 0 0 Gary Fleisher MD Trustee, ex officio 1.00 1.00 X 0 0 0 Winston Henderson Trustee 1.00 1.00 X 0 0 0 Paul Hickey MD Trustee,ex officio 1.00 1.00 X 0 0 0 James Kasser MD Trustee,ex officio 1.00 1.00 X 0 0 0 Steven Krichmar Trustee 1.00 1.00 X 0 0 0 Robert Langer Trustee 1.00 1.00 X 0 0 0 Harvey Lodish PhD Trustee 1.00 1.00 X 0 0 0 Gary Loveman Trustee 1.00 1.00 X 0 0 0 Sheila Marcelo Trustee 1.00 1.00 X 0 0 0 Ralph C Martin Trustee 1.00 1.00 X 0 0 0 Thomas Melendez Trustee 1.00 1.00 X 0 0 0 Kathleen Regan Trustee 1.00 1.00 X 0 0 0 Robert A Smith Trustee 1.00 1.00 X 0 0 0 Alison Taunton-RigbyPhD Trustee 1.00 1.00 X 0 0 0 Marc B Wolpow Trustee 1.00 1.00 X 0 0 0 Laura J Wood DNP MS RN CNO/Noncomp Trustee 55.00 5.00 X 610080 0 50852 Gregory Young MD Trustee, ex officio 1.00 1.00 X 0 0 0 Sandra Fenwick President & CEO, Noncomp Trustee 55.00 6.00 X X 2108086 0 75935 Kevin Churchwell MD EVP & COO/Noncomp Trustee 55.00 5.00 X X 1345722 0 50718 Douglas Vanderslice SVP, Treasurer & CFO 55.00 9.00 X 888757 0 52745 Bruce Balter Asst Treasurer/Dir Corp Finance 55.00 5.00 X 249901 0 48447 Michele Garvin Esq General Counsel & Secretary 55.00 8.00 X 771000 0 49144 Chad Cotter Asst Sec/Exec Asst 55.00 5.00 X 111029 0 26351 Demosthenes Argys SVP, & Chief Administrative Officer 55.00 5.00 X 700441 0 50070 August Cervini VP, Research Administration 55.00 5.00 X 369564 0 41885 Michael Gillespie VP, Clinical Services 55.00 5.00 X 450256 0 32553 Cynthia Haines SVP, International Services 55.00 5.00 X 570255 0 44791 Patricia Hickey PhD MBA RN NEA-BC VP, Cardiovascular Service 55.00 5.00 X 365092 0 40360 Lisa Hogarty SVP, RE Planning and Development 55.00 5.00 X 273822 0 3901 Daniel Nigrin MD SVP & Chief Information Officer 55.00 5.00 X 797390 0 45880 Philip Rotner Chief Investment Officer 55.00 5.00 X 1066631 0 53975 Wendy Warring SVP, Network Development 55.00 5.00 X 639304 0 41441 Nader Rifai PhD Director, Chemistry 55.00 0.00 X 659677 0 50053 Lynn Susman President, Children's Hospital Trust 55.00 0.00 X 602660 0 56808 Orah Platt MD Chief, Lab Medicine 55.00 0.00 X 568177 0 41911 Inez Stewart VP, Human Resources 55.00 0.00 X 529114 0 49016 Clifford Woolf Director, Neurobiology 55.00 0.00 X 503935 0 45110 Stuart Novick Esq Former General Counsel & Secretary 0.00 0.00 X 171314 0 0 Margaret Coughlin Former SVP & Chief Marketing Officer 0.00 0.00 X 490112 0 13549 Charles Weinstein Former VP, RE Planning & Development 0.00 0.00 X 496384 0 36906 15338703 0 1002401 2036 1 1 0 Suffolk Construction 65 Allerton Street Boston MA 02119 Construction Services 20167555 Turner Construction Company Two Seaport Lane Boston MA 02210 Construction Services 19800403 Shepley Bulfinch Two Seaport Lane Boston MA 02210 Architectural Services 18231848 G Greene Construction Company 240 Lincoln Street Boston MA 02134 Construction Services 15024378 The Brigham and Women's Hospital 75 Francis Street Boston MA 02115 Healthcare/Research Services 11752176 256 22704 5669286 214146883 224431204 18487957 444270077 Patient Svc Revenue 621110 1262819984 1262819984 Prog Svc Grants 621110 44376931 44376931 Graduate Medical Educa 611710 21117097 21117097 Prof Svc Revenue 621110 11738941 11738941 Lab Revenue 621500 439500 439500 1340492453 5658366 -1480484 7138850 3958706 3958706 21227600 9584230 11643370 11643370 -3236035 14879405 213661281 415981 175503517 0 38157764 415981 38573745 38573745 2175937 5669286 2163784 12153 12153 Other General Services 900099 16342032 16342032 Cafeteria Sales 722210 7094389 7094389 Parking Revenue 812930 6988244 6988244 30424665 1875033535 1340052953 -4277019 94987524 X 3081037 3081037 1871929 1871929 12026379 12026379 691701962 586897232 88726535 16078195 44144102 42996717 1147385 76828600 75082446 1746154 59614589 58065098 1549491 6522442 1161379 5361063 5005824 2608884 2396940 1787423 712815 1074608 107492 107492 976945 976945 184183202 142648498 40293251 1241453 3554737 2806781 742473 5483 93206137 73658900 13987636 5559601 26010887 4037816 21628482 344589 97461380 96146056 1315324 6176133 5131079 940822 104232 1416727 1021234 335192 60301 40591665 40591665 118915634 117909142 1006492 7874094 6021188 1852906 Lab/Medical/Pharmacy 189011721 188209123 802598 Uncollectible Accts 43240072 43240072 Asset Disposition Costs 13727797 13573179 154618 Uncompensated Care 10787203 10787203 6611293 6611293 1746437406 1524978258 190323503 31135645 482144 555487 171179592 249635384 242250110 274198901 21651265 25433859 15249170 28494947 2761030588 1647755153 1077779380 1113275435 175491262 188506751 991471487 1077697645 2160883152 2573670861 4856437562 5531469270 224949350 251571179 99802007 109685487 862157515 861592970 38235293 384673044 452061868 356097779 1677206033 1963620459 X 1817654228 2013295842 630894928 780538938 730682373 774014031 3179231529 3567848811 4856437562 5531469270 X 128596129 126486513 2544001 130990639 X 0 1 X 1 1 1 X 336637071 330383668 307902601 342539011 444270077 1761732428 336637071 330383668 307902601 342539011 444270077 1761732428 37134608 1724597820 22951120 25521020 32931142 24495716 25976961 131875959 124827 262601 264130 -270120 -4277019 -3895581 31867110 26157674 28227656 27213103 30424665 143890208 2033603014 5861377693 0.84810 0.84320 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 153121 0 0 1 493637 0 0 646758 0 Part II-B, Line 1 Children's Hospital is a section 501(c)(3) organization whose mission is fourfold - to provide the best possible pediatric health care, combining compassion with advanced technical capabilities; to be the leading source of research and discovery, seeking new approaches to the prevention, diagnosis, and treatment of childhood diseases; to educate the next generation of leadership in child health care; and to provide education and healthcare services to the community. In fulfillment of the above mission, the Hospital advocates on behalf of children and the providers who care for them at the State and Federal levels. Professional staff in the Hospital's Office of Government Relations direct these activities and coordinate the work of other Hospital staff who support the advocacy efforts on an intermittent basis. The Hospital has also sent correspondence to and met directly with Federal, State and local legislators and officials. The Hospital has also utilized a grassroots network of employees and friends to advocate on behalf of children's health issues. In Fiscal Year 2017, four Office of Government Relations staff members registered with the State as lobbyists for some or all of the fiscal year, dedicating a portion of their time to lobbying activities. In accordance with state lobbying laws, the Hospital also registered its CEO and President as a lobbyist, although her involvement in these efforts was minimal. Two Office of Government Relations staff members registered as lobbyists at the Federal level. The Hospital utilized the services of two outside consultants in Fiscal Year 2017 in either the Massachusetts General Court or the U.S. Congress. These consultants, on behalf of the Hospital, prepared written materials which are distributed to officials and met with elected and appointed officials. The following is a detailed list of lobbying expenses incurred: Josh Greenberg Registered Lobbyist Children's Hospital personnel $191,625 - Amy DeLong Registered Lobbyist Children's Hospital personnel $53,813 - Sandra Fenwick Registered Lobbyist Children's Hospital personnel $7,701 - Kathryn Audette Children's Hospital personnel $73,781 - Katherine Ginnis Children's Hospital personnel $22,497 - Jamie Gaynes Children's Hospital personnel $36,728 - Joe Grant Consultant Grant Associates 130 Bowdoin Street - Suite 1706, Boston, MA 02108 $40,000 - Nick Manetto Consultant Faegre BD 1050 K Street NW, Suite 400, Washington, DC 20001 $67,492 Total Lobbyist/Consultant Expenses = $493,637 Expenses Incurred by the Office of Government Relations for Lobbying Activities = $153,121 TOTAL LOBBYING EXPENSES = $646,758 In addition to Children's Hospital Corporation's direct and listed lobbying expenses, Children's Hospital Corporation pays dues to certain membership organizations, a piece of which may be used by such organizations for lobbying activities on behalf of this institution and other similarly situated organizations. Total direct and indirect lobbying expenditures were minimal and not substantial based on revenues. 1007240000 11924000 152501000 36883000 1134782000 939779000 33474000 77339000 43352000 1007240000 976027000 26449000 -22205000 40492000 939779000 894984000 47069000 71647000 37673000 976027000 828961000 23140000 75015000 32132000 894984000 0.59060 0.18250 0.22690 0 0 399348 399348 1805072689 998216004 806856685 790343257 643905721 146437536 165215294 5633428 159581866 1113275435 3rd Pty External Administered Trusts 58654070 F Abrams Capital 21807205 F AKO European Long-Only Fund 16992840 F Bain Capital Fund IX 1267816 F Bain Capital Fund X 1935441 F Bain Capital Venture Fund 2012 1672705 F Bain Capital Venture Fund 2014 2881963 F Baupost 57713937 F Brookside Capital 950084 F CMB Lone Cedar 13683259 F Convexity 25281615 F Crosslink Crossover Fund VI 4242637 F Crosslink Crossover Fund VII 1233561 F Davidson Kempner 51892803 F Deccan Value 22141218 F Dune Real Estate Fund III 3114885 F ECM Feeder Fund I 23636795 F Energy Capital Partners 4211461 F Energy Capital Partners III 2897596 F Fidelity Notes Payable 2180956 F Fine Points Capital II 17891834 F Flare Capital Partners I 1444433 F Gaoling Feeder, Ltd. 14441621 F Golden Gate Capital 12266445 F Highfields Capital 44036995 F Hillhouse Fund III 1881854 F HMI Capital Partners 19680146 F Holdco.Opp. Fund II 5727794 F ICHIGO Japan Fund B 13552386 F JMC Capital I-B 4637418 F JVL Energy 17347238 F King Street 64253926 F Lone Cascade 54243597 F Lone Kauri 4955762 F Lone Savin 4449273 F Lone Star Fund IX 2509520 F Lone Star Fund VIII 1624884 F Loomis Sayles Institutional High Income Fund 5276017 F Loomis Senior Loan Bank Fund 15515296 F Matrix China II 8522982 F Matrix China III 4674784 F Matrix China IV 2031339 F Matrix India II 3864320 F Matrix Partners X 1204749 F MIT Private Equity Fund 16470873 F Nalanda 15484108 F Park West Investors Ltd 27544338 F Riverstone 1137279 F Rivulet Capital Offshore Fund, Ltd. 19826258 F Sankaty Credit Opport Fund IV 1715108 F Sequoia Capital Global Equities 5378658 F Sequoia Capital Global Growth Fund II 1442354 F Sequoia Capital India IV 3182033 F Sequoia Capital India V 1414077 F Sequoia China Growth III 2935905 F Sequoia China Growth IV 1721509 F Sequoia China Venture Fund IV 782288 F Sequoia China Venture Fund V 1240211 F Sequoia China Venture Fund VI 412347 F Sequoia US Growth Fund VII 954018 F Sequoia US Venture Fund XIV 1487890 F Sequoia US Venture Fund XV 507837 F SequoiaUSGrowFund V 1474049 F SequoiaUSGrowFund VI 2147891 F Somerset 15762505 F SPUR Ventures II 5690932 F Standish Global Core Plus 16902323 F Standish Opportunistic Fund 22661821 F Steadfast 16393437 F Taris Biomedical 3926 F Underscore VC 1117532 F Walter Scott 44999160 F Wellington - Diversified Hedge 5349290 F Wellington - Emerging Small Cap 17847271 F Wellington - Energy 9009582 F Wellington - Real Asset 15631332 F Wellington EM Opportunities 29972571 F Wellington Spindrift 127519 F Wellington Ultra Short Duration 75218796 F Wellington Unconstrained Core Fixed Income 28980874 F Westbrook IX 2087020 F Westbrook X 865520 F Bain Capital Distressed & Special Situations 6484502 F Circulation, Inc. 45459 F Costanoa Ventures III, LP 144835 F Deerfield Partners, LP 8359751 F Deerfield Private Design Fund IV 539135 F Deerfield Special Situations Fund 1396000 F JMC Platform Fund II-B 3884 F Maveron Equity Partners VI 416177 F 1077697645 Interest in the Net Assets of Children's Medical Center 2515803594 Expected Insur Recoveries for Prof Liability Claims 36109796 Investment in Subsidiaries 2526026 CERNER Asset 19209049 Other Assets - Miscellaneous 22396 2573670861 Estimated Final Settlement Due to Third Party Payors & Deferred Revenue 19387832 Estimated Insured Professional Liability Losses 36109796 Salary & Other Benefits 2279881 Funds Held for Others 34530834 Reserve for Medical Malpractice 5220565 Other Liabilities - Miscellaneous 11254259 Lease Obligations 23663673 Interest Rate Swap Liability 135242447 Accrued Pension Cost 67689158 Cerner Contra Asset 20719334 356097779 X Part V, Line 4: The Children's Hospital's investment and spending policies for endowment assets are intended to provide a predictable stream of funding to support Children's Hospital's missions in pediatric patient care, education, research, and community programs. Part V, Line 1b: The Contribution line is comprised of Net Assets Reclassifications of -$25,000 and Contributions of $11,949,000. Part X, Line 2: There is no FIN48/ASC740 footnote in the organization's audited financial statements. Central America & the Caribbean 0 0 Program Services Patient Care, Research & Education 45002 East Asia & The Pacific 0 0 Program Services Patient Care, Research & Education 140623 Europe 0 0 Program Services Patient Care, Research & Education 507243 Middle East and North Africa - 0 0 Program Services Patient Care, Research & Education 39711 North America 0 0 Program Services Patient Care, Research & Education 138984 South America 0 0 Program Services Patient Care, Research & Education 35990 South Asia 0 0 Program Services Patient Care, Research & Education 38172 Sub-Saharan Africa 0 0 Program Services Patient Care, Research & Education 179718 Central America & the Caribbean 0 0 Investment 351727425 Sub-Saharan Africa 0 0 Investment 23944538 Central America & the Caribbean 0 0 Insurance 575532 Russia & the Newly Independent States - 0 0 Program Service Patient Care, Research & Education 9796 0 0 0 0 0 0 1125443 376257291 377382734 1 0 1 1 1 0 Part I, Line 2: Children's Hospital's employees may travel outside the United States to support its missions in pediatric patient care, education, research, and community services. Business travel, on behalf of Children's Hospital, must follow the Hospital's Travel Policy. The traveler must complete a Travel Expense Report (TER) form, and provide original itemized receipts as supporting documentation. TER form approval is the responsibility of the Manager of the Department/Director/VP in which that activity is budgeted and expensed. In addition, the Department Manager/Principal Investigator/Director/VP is responsible for: - Ensuring that the travel policy and procedures are clearly communicated to all authorized travelers. - Ensuring compliance with all BCH travel policy and procedures, and applicable sponsor guidelines in the case of grant-sponsored activities; including timeliness and proper documentation requirements. - Maintaining supporting documentation of travel activity and expenses for proper record keeping and auditing purposes. - Assuring that proper authorization signatures are documented on the TER form with the understanding that unauthorized expenses and/or personal expenses will not be reimbursed to the traveler. In general, the ordinary and necessary expenses incurred while traveling on hospital business are reimbursable upon presentation and authorization of a completed TER form with original receipts as supporting documentation. Reimbursable expenses include transportation, hotel/lodging, meals and other reasonable expenses incidental to travel. Personal expenses are not reimbursable. Part I, line 3: Expenditures are accounted for and reported on an accrual basis. X X X X X X X 1 Chapman Cubine Adams & Hussey 2000 15th Street North Arlington VA 22201 Direct Mail Counsel 0 952820 302933 649887 M&R Strategic Services 1901 L Street Washington DC 20036 Fundraising Counsel 0 630123 142809 487314 Bentz Whaley Flessner 7251 Ohms Lane Minneapolis MN 55439 Counsel/Reports 0 0 177648 -177648 Artsmarketing Services Inc 260 King Street East Ste 500 Toronto Ontario CA Call Center Mrkt. 0 0 17173 -17173 Connelly Partners LLC 46 Waltham Street Boston MA 02118 Fundraising Counsel 0 0 60063 -60063 ESP Properties LLC 350 North Orleans Suite 1200 Chicago IL 60654 Fundraising Counsel 0 0 52480 -52480 The Offord Group 1501-44 Victoria Street Toronto Ontario CA Fundraising Counsel 0 0 26499 -26499 Gift Strategies LLC 1539 Fall River Avenue Seekonk MA 02771 Fundraising Counsel 0 0 131340 -131340 Advizor Solutions Inc 1333 Butterfield Road Suite 280 Downers Grove IL 60515 Fundraising Counsel 0 0 46000 -46000 The Pursuant Group Inc PO Box 203421 Dallas TX 75320 Fundraising Counsel 0 0 20000 -20000 1582943 976945 605998 CT RI NH VT ME FL NY NJ NV MA Dinner/Auction 4502100 3825313 676787 0 0 0 254712 300000 752389 Investment Conference 2231874 920050 1311824 0 0 19162 106559 0 225797 3 1111249 923923 187326 0 0 16500 143154 16700 328811 7845223 5669286 2175937 35662 504425 316700 1306997 2163784 12153 Doug Vanderslice SVP of Finance 300 Longwood Avenue Boston MA 02115 1 1 X 1 X 1 X 1 1 0 1 1 23761576 15168453 8593123 0.00500 330007811 220687616 109320195 0.06420 353769387 235856069 117913318 0.06920 6184074 266756 5917318 0.00350 37501269 6454230 31047039 0.01820 28131073 24148410 3982663 0.00230 366045138 356892076 9153062 0.00540 1918000 1918000 0.00110 439779554 387761472 52018082 0.03050 793548941 623617541 169931400 0.09970 40 1985863 1985863 0.00120 8 740667 740667 0.00040 48 2726530 2726530 0.00160 0 10861662 11373352 10476468 896884 X 1 1 1 None 1 1 Boston Children's Hospital 300 Longwood Avenue Boston MA 02115 www.childrenshospital.org MA LICENSE #2139 X X X X X X Boston Children's Hospital 1 0 0 1 X X X X X X X 15 1 0 0 1 X www.childrenshospital.org X X 1 15 1 childrenshospital.org/about-us/community-mission/community-needs-assessment 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X www.childrenshospital.org/financialassistance X www.childrenshospital.org/financialassistance X X X X X X 1 X 0 X X X 1 X 0 0 Boston Children's Hospital Part V, Section B, Line 5: For the 2016 CHNA, Boston Children's Hospital used a participatory, collaborative approach and examined health in its broadest context. As part of the CHNA, Boston Children's sought input from its Community Advisory Board (CAB) members and engaged youth to design, collect and analyze data on youth perceptions of needs and opportunities. The assessment process also included synthesizing existing data on social, economic, and health indicators in Boston. Eight stakeholder interviews and two focus groups with community residents were also conducted to explore perceptions of the community, health and social challenges for children and families, and recommendations for how to address these concerns. Additionally, Boston Children's collaborated with other hospitals through the Conference of Boston Teaching Hospitals to gather information on community needs via four focus groups hosted by community coalitions. Boston Children's also gathered information on challenges faced by children with special needs and their families by attending a focus group listening session facilitated by Health Care for All. Lastly, the CHNA was informed by results from Boston Children's Determination of Need community engagement process. This process, which was guided by an Advisory Group that met in person six times, included conducting seven facilitated open community engagement sessions across the city of Boston. Four targeted small group discussions were also held with communities that were under-represented in the larger community sessions.A formal and comprehensive needs assessment is only one part of Boston Children's approach to understanding the complex health needs and vital resources within the community. Boston Children's is constantly listening and learning from patient families, community leaders and staff. The staff rely on ongoing conversations with the hospital's key partners-community health centers and community-based organizations, as well as the Boston Public Health Commission and the Boston Public Schools.Through the CAB, which meets on a quarterly basis, Boston Children's has a direct link to expertise on Boston neighborhoods, community organizations and current health needs. The CAB is instrumental in providing feedback throughout the year and in the development and execution of Boston Children's formal assessment process. Boston Children's Hospital Part V, Section B, Line 7d: A comprehensive report on Boston Children's CHNA is available on the hospital's website. In addition, a special report on the CHNA was created to share the process, top findings and Boston Children's plan to address community-identified concerns. The special report was distributed by mail and by email to key stakeholders and all external participants involved in the community process. Boston Children's also distributed the report widely to internal staff. The complete assessment and special report can be found on our website at Bostonchildrens.org/community Boston Children's Hospital Part V, Section B, Line 11: Boston Children's addresses the health and social needs identified in a comprehensive community health assessment process through our clinical care, services and programs and in collaboration with community partners. Below is a summary of the needs identified and Boston Children's efforts. For the complete Community Health and Benefits Plan, visit bostonchildrens.org/community. Behavioral health and issues related to substance abuse- Offering training and education for school and health center staff- Providing education and direct services in schools and community health locations for children and families- Advocating for changes to improve systems of careAsthma management, education and treatment- Improving health and quality of life outcomes for children with asthma through home visiting and case management services- Developing cost-effective program models that help families to better control asthma- Advocating for changes to improve asthma careObesity with a focus on healthy eating and access to physical fitness opportunities- Offering prevention and treatment efforts- Supporting children and families and connecting them to community resources.- Building capacity in community settings to help children improve nutrition and increase physical activityImpact of violence and trauma on children, families and communities- Utilizing clinical expertise to provide prevention, treatment and advocacy services- Supporting efforts to help children and families affected by violenceSupport for early childhood/child development- Building community capacity to identify and help children and families with behavioral health concerns- Supporting efforts to create integrated systems of care for families with children starting at birth- Partnering with community organizations that provide families with support and treatment servicesPrograms and opportunities for youth including workforce development efforts- Continuing support for programming related to youth-identified needs and interests- Working with partners to provide education support and recreation for youthHealth education for children and families- Building upon the health education opportunities currently provided through community programs and services- Coordinating these resources to better meet the need for health education in the communityOther issues that affect the health of children and families such as housing, jobs, food and safety- Supporting, funding and working closely with partners and coalitions working on these issues Boston Children's Hospital Part V, Section B, Line 15e: The Financial Assistance Policy provides as follows:Patients/Parents will be referred to a Hospital Financial counselor for determination of eligibility for public assistance or Charity Care programs. Under special circumstances, cases may be referred directly to the Director of Patient Financial Services. For patients not qualifying for public assistance, information collected will be provided to the Director, Patient Financial Services, for determination of eligibility in the Hospital Charity Care Program. Patients who potentially qualify for a Charity Care program will be approved by the Hospital Chief Financial Officer and/or Director, Patient Financial Services, with consultation and approval of the appropriate Foundation Chief or a designee. Boston Children's Hospital Part V, Section B, Line 16j: Children's takes the following additional steps to make patients aware of the availability of financial assitance:- Posting of signage in all patient care admission areas of the availability of financial assitance,- All billing correspondence includes language regarding the availability of financial assistance,- The Hospital web-site provides contact information for Hospital Financial Counselors who can help assist patients with applying for programs to cover medical expenses. Part V, Sec B, Reporting under IRS Revenue Procedure 2015-21 (Continued) Emergency Medical Care Policy- BCH believes that its Medical Staff Executive Committee had adopted an emergency medical care policy sometime in 2012. Through a compliance review in July of 2017, BCH discovered that it was unable to locate a record of such adoption, which is believed to result from an administrative filing error. On July 11, 2017, the BCH Medical Staff Executive Committee ratified and affirmed the prior adoption of its Emergency Medical Treatment and Labor Act Policy and approved updates thereto.- Through a compliance review in July of 2017, BCH discovered that its Emergency Medical Treatment and Labor Act Policy failed to include a statement prohibiting the Hospital Facility from engaging in actions that discourage individuals from seeking emergency medical care. On July 11, 2017, BCH revised the policy to include said statement, and such revision was approved by the Medical Staff Executive Committee.- Updating the policy addressed the failure to comply with requirements, so no additional practices or procedures were necessary to minimize the likelihood of such failures recurring. Billing & Collection Policy: - Through a compliance review in July of 2017, BCH discovered that while the Board of Trustees had been briefed on the credit and collection policy in September 2016, the minutes of such meeting were ambiguous regarding whether or not such policy had been formally adopted. - Through a compliance review in July of 2017, BCH discovered that its credit and collection policy may not have been available in translated versions and may not have sufficiently described the office, department, committee or other body with final authority or responsibility for determining that the Hospital Facility has made reasonable efforts to determine whether an individual is FAP-eligible and may therefore engage in an extraordinary collection action ("ECA") against the individual as a result of an administrative oversight. On December 17, 2017, the BCH Board of Trustees adopted a revised credit and collection policy that describes the office, department, committee or other body with final authority or responsibility for determining that the Hospital Facility has made reasonable efforts to determine whether an individual is FAP-eligible and may therefore engage in an extraordinary collection action ("ECA") against the individual. Promptly thereafter, BCH made available translations of the billing and collections policy for each limited English proficiency group that constitutes the lesser of 1,000 individuals or 5 percent of the community served by BCH or the population likely to be affected or encountered by BCH. - BCH is unaware of any individuals being adversely affected as a result of this omission and believes there were no individuals adversely affected because BCH provides any individual with limited English proficiency access to an interpreter to assist with any collections questions that may arise.- Updating the credit and collections policy as described above and posting the necessary translations on the BCH website addressed the failure to comply with requirements, so no additional practices or procedures were necessary to minimize the likelihood of such failures recurring. 6 1 - Boston Children's at Waltham 9 Hope Ave Waltham MA 02453 Outpatient Satellite Facility 2 - Boston Children's at Lexington 482 Bedford Street Lexington MA 02173 Outpatient Satellite Facility 3 - Martha Eliot Health Center 75 Bickford Street Boston MA 02130 Outpatient Community Health Center 4 - Boston Children's at Peabody 1 Essex Center Drive Peabody MA 01960 Outpatient Satellite Facility 5 - Boston Children's at North Dartmouth 500 Faunce Corner Road North Dartmouth MA 02747 Outpatient Satellite Facility 6 - Children's Clinics at 333 Longwood Ave 333 Longwood Avenue Boston MA 02115 Outpatient Pediatric Clinic Part I, Line 3c: Children's, based on its participation in the state of Massachusetts Health Safety Net, utilizes Federal Poverty Guidelines for determining eligibility for free care and discounted care to low income individuals. For purposes of discounted care, Children's offers discounts to individuals, regardless of income, who are uninsured and are ineligible for free care or other public programs. Part I, Line 6a: Children's files an annual community benefits report with the Attorney General's Office (AG) in Massachusetts. There are significant differences between the AG and IRS requirements for reporting community benefits expenditures. The IRS counts the following as community benefits while the AG does not: Medicaid shortfalls, indirect costs, health professions education, and research funded by tax-exempt and government sources. Children's AG Report is publicly available and can be accessed directly on the AG's web site, www.mass.gov/AG and Children's web site, www.childrenshospital.org. Part I, Line 7: Children's used an internal cost accounting system for purposes of reporting certain amounts on Part I, line 7. The system is designed to address all segments of patient care (inpatient, outpatient and emergency) and assigns costs to patients from all payer sources (Medicaid, Medicare, managed care, commercial, uninsured and self-pay). The cost of charity care was determined based on the overall relationship of hospital costs as a percentage of hospital charges, applied to charges that qualified as charity care.Children's provides charity care to all children in need who meet the hospital's charity care standards, which are in alignment with all state mandated regulations.Nearly 30% of children who receive their care at Children's are insured through Medicaid programs in a number of states including Massachusetts. In aggregate, Medicaid programs do not reimburse the hospital for the total costs of providing care to these children.Children's has a strong commitment to improving the health status of the children in our local community. Based on a tri-annual community needs assessment, Children's supports a variety of programs and partners both internal and external that are addressing the needs of Boston children. Children's has also identified four major health focus areas in which it concentrates its efforts. For children in Boston, asthma, mental health, obesity and child development are major concerns. Children's has community based programs in each of these issue areas. The hospital also has an Office of Child Advocacy that provides support to these programs. Children's is a leader in education and training for healthcare professionals. Children's subsidizes services that are either limited or unavailable in the broader community. Examples include psychiatry, primary care, and dental care. Children's is home to the world's largest and most active research enterprise at a pediatric center. Recognizing that Children's does not have the capacity to meet all the needs of the children of Boston, it supports (through financial contributions and in kind services) a large number of community based organizations who are providing these important services. Beneficiaries range from full service community health centers to Head Start programs for pre-school children.For more information, visit www.childrenshospital.org/community. Part I, Line 7g: Children's does not subsidize physician services; thus there are none reported in the dollar amount for subsidized health services. Part I, Ln 7 Col(f): The total bad debt expense of $43,240,072 is included in Form 990, Part IX, line 25 column (A), but subtracted for purposes of calculating the percentage in this column. Part II, Community Building Activities: In FY17, Children's reported two types of community building activities: $1,985,863 for 40 community support programs and $740,667 for community health improvement advocacy. Children's community building activities are designed specifically to address health disparities and improve the health of children, families and communities. According to public health literature (see Ambulatory Pediatrics and Health Affairs), initiatives that address disparities for children across four different levels: the individual, systemic, community and society can lead to meaningful improvements in health.As described in Form 990, Part III Program Service Accomplishments, Children's takes a multi-pronged approach to tackle the most pressing health issues facing Boston children. At the same time, Children's addresses non-health or social determinants of health issues such as violence, workforce development and education, which also impact a child's health. Therefore, Children's directs its community building activities in the following areas: - Children's public policy advocacy efforts help to improve access to health care for all individuals and ensure high-quality pediatric services.- As a major employer in Massachusetts and civic leader in Boston, Children's supports efforts to ensure a diverse and culturally competent health care workforce as well as promotes economic health in the surrounding communities. - To improve life in local neighborhoods, Children's has targeted support towards community based organizations that do not focus specifically on health, but rather on the vibrancy of the community. Contributions to groups such as the Fenway Community Development Corporation and Sociedad Latina are as important as partnerships with community health centers.For more information, visit http://www.childrenshospital.org/about-us/community-mission. Part III, Line 4: Children's Medical Center and Subsidiaries' Audited Financial Statements contain the following bad debt footnote:"The provision for uncollectible accounnts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Accounts receivable are reduced by an allowance for uncollectible accounts. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Medical Center follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the Medical Center. Accounts receivable are written off after collection efforts have been followed in accordance with the Medical Center's policies."Bad debt expense reflects patient charges that have been deemed uncollectible, converted to cost based on the ratio of patient care cost to charges from Worksheet 2. There is not any amount of bad debt reflected as charity care, because it can't be quantified accurately at this time. However, some bad debts would be charity care. Part III, Line 8: Medicare allowable costs are obtained directly from the Medicare Cost Report and are determined in accordance with Medicare principles of reimbursement. Part III, Line 9b: Children's makes reasonable and diligent efforts to collect each patient's insurance and other information and to verify coverage for health care services. Children's applies collection actions to all patients in the same manner, irrespective of their insurance status. Children's does not (and does not permit its agents to) engage in collection action of any kind, including billing, with respect to patients/guarantors that are exempt from collection action under Children's Credit and Collection Policy and under Massachusetts regulations governing the Health Safety Net program. All patients/guarantors who are not exempt from collection action are advised in all billing-related communications of the availability of free care and financial assistance, including assistance in applying for public programs and the availability of charity care. Children's does not (and does not permit its agents to) engage in legal action against patients/guarantors, including liens, wage garnishments, or lawsuits, or report patients/guarantors to credit bureaus or credit agencies without specific, case-by-case authorization by Children's Board of Trustees. No legal action occurred during the year. Children's Credit and Collection Policy is filed with the Massachusetts Division of Health Care Finance and Policy. That policy and related policies are also available to patients upon request and on the Hospital's website. Part VI, Line 2: Boston Children's assesses the community needs on an ongoing basis through continuous dialogue with the community, participation on committees, working groups, and task forces, as well as input from Community Advisory Board and partners. For more information, visit www.childrenshospital.org/about-us/community-mission/community-needs-assessment. Part VI, Line 3: Children's provides patients with information about financial assistance programs that are available through the Commonwealth of Massachusetts or through the hospital's own financial assistance program.For those patients that request financial assistance, Children's assists patients by screening them for eligibility in an available public program and assisting them in applying for the program. All patients/guarantors who are not exempt from collection action are advised in all billing-related communications of the availability of free care and financial assistance, including assistance in applying for public programs and the availability of charity care. The screening and application process for a financial assistance programs is done through either the Virtual Gateway (which is an internet portal designed by the Massachusetts Executive Office of Health and Human Services to provide an online application for the programs offered by the state) or through a standard paper application. All Virtual Gateway and paper applications are reviewed and processed by the Massachusetts Office of Medicaid. Hospitals have no role in the determination of program eligibility made by the state, but at the patient's request may take a direct role in appealing or seeking information related to the coverage decisions. Part VI, Line 4: Boston Children's conducted a community health needs assessment to ensure that it was addressing the most pressing health concerns across Boston and its four priority neighborhoods- Roxbury, Mission Hill, Fenway and Jamaica Plain. FINDINGS:The residents of Boston Children's priority neighborhoods are ethnically and linguistically diverse, with wide variations in socioeconomic levels. Minority and low-income residents are disproportionately affected by the social and economic context in which they live.Demographic Characteristics: Residents and stakeholders commented on the variety of cultures represented in the communities served by Boston Children's. Quantitative data illustrate that racial and ethnic diversity varies across Boston Children's priority neighborhoods and citywide. While the majority of residents in Roxbury/Mission Hill self-identify as Black (60.9%), Fenway and Jamaica Plain have a larger proportion of White residents (70.2% and 62.0%, respectively) compared to the city (53.9%).Poverty, Income, and Employment: Economic data demonstrate that among the priority neighborhoods, a greater proportion of families in Roxbury/Mission Hill (31.0%) were living in poverty compared to families citywide (16.0%). Additionally, nearly half of female headed households with children under five years of age in Boston were living in poverty (46.7%). Education: Quantitative data show that educational attainment across the priority neighborhoods ranges from 71.0% of Fenway residents with a bachelor's degree or higher to 25.0% of Roxbury/Mission Hill adults. Additionally, Black and Hispanic students graduate at lower rates than their White and Asian counterparts.Housing: Housing concerns disproportionately affect renters, who represent the majority in Boston; 42.4% of renters in Boston contribute 35% or more of their income to housing costs.Neighborhood Crime and Perceptions of Safety: Quantitative data validate residents' concerns; between January and June 2013, Boston Children's priority neighborhoods collectively accounted for approximately 40% of the total crimes reported citywide during this time period, the majority of which were classified as larceny or attempted larceny. Furthermore, over half of all homicides occurred in Roxbury/Mission Hill.There are 4 hospitals and 7 community health centers serving our priority neighborhoods.There are 22 Census Tracks that fall under 2 different MUA/P areas that are within the Boston Children's Hospital priority areas.Massachusetts has a low rate of uninsured children. 0-5 years 1.1% uninsured - 35.9% on Medicaid6-18 years 1.5% uninsured - 30.6% on Medicaid19-25 yrs-7% uninsured - 18.9% on Medicaid Part VI, Line 5: As the only free-standing children's hospital in the state, Children's treats 90% of the sickest kids in Massachusetts and offers a range of services that are unavailable elsewhere in the region, including pediatric transplants, critical care transport services, a level 1 Pediatric Trauma Unit and a level 3 Neonatal Intensive Care Unit. Children's also qualifies for DSH payments as the state's largest provider of pediatric care to low-income families. Approximately 30% of its patients are covered by Medicaid, including patients insured by out-of-state Medicaid programs. In addition, Children's has an open medical staff model. Children's is also a leader in education and training for healthcare professionals. It sponsors 38 Accreditation Council for Graduate Medical Education-accredited training programs, one American Dental Association accredited training program and 15 non-accredited subspecialty fellowships with 512 residents/clinical fellows enrolled in these programs. Children's partners with 27 schools of nursing throughout Massachusetts and New England to provide clinical experiences in pediatrics. Children's offers a variety of continuing education courses designed for health care professionals in pediatric practice. The courses are accredited by the Office of Continuing Education at Harvard Medical School and each hour of instruction is approved for Category 1 credits towards the AMA Physician's Recognition Award. Topics include autism, eating disorders, sports injuries, endometriosis, substance abuse, concussions, strabismus, Type II Diabetes and vascular anomalies. Children's also offers half-day programs titled Pediatric Health Care Summits that are held at local hospitals, such as Beverly Hospital, Lawrence General and South Shore Hospital (Weymouth). Additionally, Children's partners with area community hospitals such as Good Samaritan Medical Center, Holy Family, Lawrence General, South Shore, St. Anne's and St. Joseph's to sponsor Community Hospital Pediatrics Grand Rounds with monthly lectures provided by faculty in medical and surgical sub-specialties. Children's also operates "Career Opportunity Advancement Children's Hospital", a seven-week program for Boston youth to explore health care careers while having a safe and meaningful summer and the program "Student Career Opportunity Outreach Program", designed by Children's nurses to introduce young people to nursing career opportunities. Children's is home to the world's largest and most active research enterprise at a pediatric center. Children's research mission encompasses basic research, clinical research, community service programs and the postdoctoral training of new scientists.Children's has a twenty-two person voluntary Board of Trustees. Nineteen of the Board members are not direct employees of the hospital and all of them live in the hospital's service area. The Board oversees the hospital's endowment and follows a 5% spending rule in keeping with the industry standard of the responsible management of assets. Reserves are invested back into patient care, teaching, research, patient safety and quality initiatives, equipment, facilities, community benefits and to subsidize vital services that run a deficit. Part VI, Line 6: Although Children's does not have true affiliates as defined by the IRS, it does have other affiliations. As the largest pediatric referral center in the region, Children's maintains a variety of relationships with community hospitals and other smaller pediatric programs throughout New England. These relationships include seven community hospitals in eastern Massachusetts where Children's physicians have formal arrangements to provide on-site emergency medicine, inpatient, neonatal and/or outpatient pediatric specialty services. Children's also owns and operates five outpatient facilities in Waltham, Lexington, Peabody, North Dartmouth and Jamaica Plain that offer access to pediatric specialty care in a wide array of subspecialties. Children's provides assistance to other pediatric facilities (Hasbro, RI, Dartmouth Hitchcock, NH, and Boston Medical Center) in the region through training, recruitment, consultations, on-site care and referrals for care that is not otherwise available.In addition, the Pediatric Physicians Organization at Children's brings together pediatricians, pediatric medical groups and pediatric specialists at Children's. Part VI, Line 7, Reports Filed With States MA 501(r) Reporting under IRS Revenue Procedure 2015-21 Effective October 1, 2016, Boston Children's Hospital (BCH) had in place a Financial Assistance Policy, Credit & Collections Policy, Plain Language Summary and Community Health Needs Assessment that was believed to be in compliance with IRC Section 501(r). After these documents were put into place, a review of BCH's 501(r) compliance was undertaken by outside counsel in July of 2017. As a result of said review, a number of apparent omissions, errors and other failures to meet requirements, as described below, were discovered in July of 2017. BCH promptly took steps to correct these omissions, errors and failures, as described below, and the resulting updated policies were approved by the BCH Board of Trustees on December 18, 2017.Community Health Needs Assessment "CHNA" - Through a compliance review in July of 2017, BCH discovered that it had failed to solicit and take into account written comments on its most recent CHNA because it had mistakenly understood that its solicitation of oral comments was sufficient to meet requirements under IRC Section 501(r). In August 2017, BCH began soliciting written comments with respect to its most recent CHNA and the related implementation plan through a statement and email address on the website where the CHNA is posted. BCH will take into account such written comments received, if any, with regard to the most recent CHNA and the related implementation strategy in its next CHNA. The responsible parties at BCH have been made aware of the obligation to solicit written comments, which will minimize the likelihood of this type of failure recurring.Financial Assistance Policy "FAP"- Through a compliance review in July of 2017, BCH discovered that when the FAP was originally approved by the Board in September of 2016, BCH did not have a FAP application form. In March 2017, BCH began using a FAP application form in determining eligibility for financial assistance. Due to an administrative oversight at such time, BCH did not immediately update the FAP to reflect the creation of the FAP application form. BCH subsequently revised the FAP to describe how an individual applies for financial assistance under the FAP, including instructions with regard to the FAP application form, and such revision was approved by the BCH Board of Trustees on December 17, 2017.- Through a compliance review in July of 2017, BCH discovered that the FAP that was originally approved by the Board in September of 2016 did not include the contact information for a department that can provide information or assistance about the FAP or FAP application process. The contact information was provided in a different section of the FAP and BCH believed the inclusion of the contact information in the other section of the FAP would satisfy the above mentioned requirement. On the advice of outside counsel, BCH revised the FAP to include the contact information, including telephone number and physical location, of the department that can provide information about the FAP and that can provide assistance with the FAP application process, and such revision was approved by the BCH Board of Trustees on December 17, 2017.- Through a compliance review in July of 2017, BCH discovered that the FAP that was originally approved by the Board in September of 2016 only included the phone number for how an individual could obtain a copy of BCH's separate Credit and Collection Policy. BCH revised the FAP to include the web address, physical location and phone number to request the document by mail. Language was also added to indicate that the Credit and Collection policy was available free of charge and that translations are available to individuals with limited English proficiency. Such revision was approved by the BCH Board of Trustees on December 17, 2017.- BCH does not believe that any individuals have been adversely affected as result of this oversight since the contact information of the department able to provide information about the FAP and able to assist with the FAP application process was contained within another section of the FAP.- Updating the FAP addressed the failure to comply with requirements, so no additional practices or procedures were necessary to minimize the likelihood of such failures recurring. Plain Language Summary- The plain language summary that was effective October 1, 2016 did not include a brief summary of how to apply for assistance under the FAP as a result of an administrative oversight. The plain language summary was revised to include said summary, and such revision was approved by the BCH Board of Trustees on December 17, 2017.- The plain language summary of the FAP that was effective October 1, 2016 did not include a statement of the availability of translations of the FAP, FAP application form and plain language summary of the FAP in other languages as a result of an administrative oversight. The plain language was revised to include said statement, and such revision was approved by the BCH Board of Trustees on December 17, 2017.- BCH is unaware of any individuals being adversely affected as a result of this omission and believes there were no individuals adversely affected because BCH provides any individual with limited English proficiency access to an interpreter to assist in any financial assistance matters.- Updating the plain language summary of the FAP addressed the failure to comply with requirements, so no additional practices or procedures were necessary to minimize the likelihood of such failures recurring. Publicizing the FAP:- Through a compliance review in July of 2017, BCH discovered that it may not have sufficiently publicized the existence of the FAP as a result of an administrative oversight. Since July of 2017, BCH has notified and informed members of the community served by the Hospital Facility about the FAP in a manner reasonably calculated to reach those members who are most likely to require financial assistance from the Hospital Facility. On December 12, 2017, BCH hosted an educational presentation at Martha Elliott Health Center. In addition to the presentation, BCH has provided written material regarding the availability of financial assistance. - Through a compliance review in July of 2017, BCH discovered that it had not provided the appropriate translations of the FAP, the FAP application form and the plain language summary of the FAP because it had misunderstood the requirements around the population to be affected or encountered by the Hospital with limited English proficiency. In July and August of 2017, BCH reviewed the methodology for determining the required translations to be made and translated the FAP, FAP application form and plain language summary of the FAP in several additional languages and posted copies of all translations on its website.- Through a compliance review in July of 2017, BCH discovered that it did not have a copy of the FAP application form posted on its website as a result of an administrative oversight. In December 2017, BCH corrected this omission by conspicuously posting a complete and current version of the FAP application form on its website.- BCH is not aware of any individuals affected by these omissions and believes there were no individuals adversely affected because any individual applying for financial assistance or expressing concern regarding ability to pay was provided with financial counseling and made aware of the availability of financial assistance and the process for applying for financial assistance.- The parties at BCH responsible for publicizing the FAP have been made aware of the obligations to notify and inform members of the community served by the hospital facility about the FAP in a manner reasonably calculated to reach those members who are most likely to require financial assistance, which will minimize the likelihood of this type of failure recurring. In addition, BCH is continuing to engage with Community Health Centers in Boston to develop additional opportunities to better inform the community served of the availability of financial assistance.- Updating the document translations and posting all the information discussed above on the BCH website addressed the failure to comply with requirements, so no additional practices or procedures were necessary to minimize the likelihood of such failures recurring.BCH will conduct similar periodic reviews of its 501(r) policies and operational elements to monitor compliance and identify and mitigate future compliance gaps. 1 Health Resources In Action 622 Washington Street Dorchester MA 02124 042229839 501(c)(3) 104812 Community Partnership Boston Public Health Commission 1010 Massachusetts Ave Boston MA 02118 043316655 115 505000 Community Partnership Boston Public Schools 26 Court St 6th Fl Boston MA 02108 222514422 115 52500 Community Partnership Bowdoin Street Health Center Inc 230 Bowdoin Street Boston MA 02122 042529788 501(c)(3) 100000 Support of Community Health Center Community Catalyst Inc 30 Winter Street 10th Floor Boston MA 02108 043355127 501(c)(3) 65000 Advocacy Support The Dimock Center 55 Dimock Street Roxbury MA 02119 043487835 501(c)(3) 116000 Community Partnership Fenway Community Development Corporation 73 Hemenway Street Boston MA 02115 042666507 501(c)(3) 52500 Community Partnership Project RIGHT 320 A Blue Hill Avenue Dorchester MA 02121 043265420 501(c)(3) 50000 Advocacy Support Community Service Care Inc 295 Center Street Jamaica Plain MA 02130 042754281 501(c)(3) 75000 Community Partnership - JP Coalition Mattapan Community Health Center 1425 Blue Hill Ave Mattapan MA 02426 042544151 501(c)(3) 82500 Support of the Community Health Center YMCA of Greater Boston inc 316 Huntington Avenue Boston MA 02115 042103551 501(c)(3) 37500 Community Partnership - Roxbury YMCA Sociedad Latina Inc 1530 Tremont Street Roxbury MA 02120 042678255 501(c)(3) 136000 Community Partnership South Cove Community Health Center Inc 145 South Street Boston MA 02111 042501818 501(c)(3) 105000 Support of the Community Health Center South End Community Health Center Inc 1601 Washington Street Boston MA 02118 042456134 501(c)(3) 157500 Support of the Community Health Center Upham's Corner Community Center Inc 500 Columbia Road Dorchester MA 02125 042708670 501(c)(3) 70000 Support of the Community Health Center Whittier Street Health Center Committee Inc 1125 Tremont Street Roxbury MA 02120 042619517 501(c)(3) 88500 Support of the Community Health Center Nurtury Inc 95 Berkeley Street Suite 306 Boston MA 02116 042105893 501(c)(3) 40000 Community Partnership Massachusetts League of Community Health Centers 40 Court Street 10th Floor Boston MA 02108 042507409 501(c)(3) 5000 Community Partnership Dorchester Youth Collaborative 1514A Dorchester Avenue Dorchester MA 02122 042743166 501(c)(3) 10000 Community Partnership The Hyde Square Task Force Inc 375 Centre Street Jamaica Plain MA 02130 043118543 501(c)(3) 12500 Community Partnership Action for Boston Community Development 178 Tremont Street Boston MA 02111 042304133 501(c)(3) 5000 Community Partnership Massachusetts Public Health Association 101 Tremont Street Boston MA 02108 042326503 501(c)(3) 5000 Community Partnership Smart from the Start Inc 68 Annunciation Road Boston MA 02120 454952663 501(c)(3) 84000 Community Partnership Health Law Advocates 30 Winter Street 10th Floor Boston MA 02108 043298116 501(c)(3) 10000 Advocacy Support Mass Society for the Prevention of Cruelty to Children 3815 Washington Street Ste 2 Boston MA 02130 042103596 501(c)(3) 25000 Advocacy Support Greater Boston Chamber of Commerce 265 Franklin Street 12th Floor Boston MA 02110 041103090 501(c)(3) 10000 Community Partnership Fund for Parks & Recreation in Boston 10 Massachusetts Avenue Boston MA 02118 042784811 501(c)(3) 1000 Community Partnership Massachusetts Communities Action Network 50 Mt Vernon Street Boston MA 02125 042863903 501(c)(3) 2500 Community Partnership Center for Comm Health Education Research & Service Inc 320 Huntington Avenue Boston MA 02115 043286409 501(c)(3) 5000 Community Partnership Express Yourself Inc 6 Ellis Street Peabody MA 01960 043294365 501(c)(3) 2000 Community Partnership Breakthrough Greater Boston PO Box 381486 Cambridge MA 02238 043307783 501(c)(3) 2500 Community Partnership Friends of Ramler Park PO Box 231143 Astor Station Boston MA 02123 043484629 501(c)(3) 100 Community Partnership NAACP Boston 30 Martin Luther King Boulevard Roxbury MA 02119 043574060 501(c)(3) 2000 Massachusetts Voter Education Boston Municipal Research Bureau 333 Washington Street Boston MA 02108 222673755 501(c)(3) 7000 Community Partnership Mission Hill Neighborhood Housing Services 1620 Tremont Street Mission Hill MA 02120 237428011 501(c)(3) 1000 Community Partnership Louis D Brown Peace Institute 1452 Dorchester Avenue Dorchester MA 02122 263068254 501(c)(3) 5000 Community Partnership WriteBoston 2300 Washington Street Roxbury MA 02119 461255108 501(c)(3) 2500 Community Partnership Black Ministerial Alliance of Greater Boston 2010 Columbus Avenue Boston MA 02119 043499852 501(c)(3) 2500 Community Partnership Brigham and Women's Hospital Inc 3297 Washington Street Jamaica Plain MA 02130 042312909 501(c)(3) 160000 Support of Community Health Center City of Boston City Hall Plaza Boston MA 02201 046001380 115 486955 Community Partnership Charles River Community Health Inc 287 Western Avenue Allston MA 02134 237221597 501(c)(3) 105000 Support of Community Health Center Fenmway Civic Association PO Box 230435 Boston MA 02123 043312332 501(c)(3) 100 Community Partnership Friends of the Children - Boston Inc 555 Armory Street Boston MA 02130 201581289 501(c)(3) 2500 Community Partnership Massachusetts Budget and Policy Center 15 Court Square Suite 700 Boston MA 02108 042967537 501(c)(3) 20000 Advocacy Support Metropolitan Boston Housing Project 125 Lincoln Street 3rd Floor Boston MA 02111 042775991 501(c)(3) 2500 Community Partnership Rennie Center for Education Research & Policy 114 State Street Boston MA 02109 510548106 501(c)(3) 25000 Advocacy Support Urban Edge 1542 Columbus Avenue Suite 2 Roxbury MA 02119 222483475 501(c)(3) 1000 Community Partnership VietAID 42 Charles Street Boston MA 02122 043289039 501(c)(3) 250 Community Partnership Massachusetts Associtation for Mental Health 50 Federal Street 6th Floor Boston MA 02110 042104711 501(c)(3) 4000 Advocacy Support West End House 105 Allston Street Allston MA 02134 042105825 501(c)(3) 10000 Community Partnership Massachusetts Health Council 200 Reservoir Road Suite 101 Needham MA 02494 042296739 501(c)(3) 1000 Community Partnership Bridge Over Troubled Waters 47 West Street Boston MA 02111 042472126 501(c)(3) 500 Community Partnership Boston Center for Youth and Families 75 Newbury Street 3rd Flooe Boston MA 02116 042602576 501(c)(3) 80000 Community Partnership City LifeVida Urbana PO Box 300107 Boston MA 02130 042660311 501(c)(3) 10000 Community Partnership National Alliance on Mental Illness 529 Main Street Suite 1M17 Boston MA 02129 042777012 501(c)(3) 2000 Advocacy Support Dudley Street Neighborhood Initiative 504 Dudley Street Roxbury MA 02119 042859066 501(c)(3) 1500 Community Partnership Waltham Partnership for Youth 510 Moody Street Waltham MA 02453 043399437 501(c)(3) 6250 Advocacy Support Mission Hill Little League PO Box 02120 Roxbury MA 02120 043415069 501(c)(3) 2000 Community Partnership American Cancer Society 30 Speen Street Framingham MA 01701 131788491 501(c)(3) 1000 Community Partnership East Boston Neighborhood Health Center 10 Gove Street East Boston MA 02128 237425849 501(c)(3) 9840 Community Partnership Friends of St Stephen's Youth Program 419 Shawmut Avenue Boston MA 02118 261749602 501(c)(3) 10000 Community Partnership Gilbert Albert Community Center 155 Washington Street Dorchester MA 02121 300430263 501(c)(3) 9730 Community Partnership Family Nurturing Center of Massachusetts 200 Bowdoin Street Dorchester MA 02122 311626186 501(c)(3) 75000 Community Partnership Fenway Community Center 1282 Boylston Street Boston MA 02215 475582148 501(c)(3) 2500 Community Partnership The Family Exchange 964 Parker Street 274 Jamaica Plain MA 02130 814003528 501(c)(3) 15000 Community Partnership 62 3 Sibylla Orth Young Fund for Student Aid 17 32000 FMV Nursing Education Scholarship Fund 9 71124 FMV Joshua T. Shairs Cardiology Fund 7 7000 FMV Family Resource Center Fund 138 109940 FMV Educational Resources Yawkey Family Inn Fund 3108 799761 FMV Housing Assistance Devon Nicole House Operating Fund 2621 94612 FMV Housing Assistance Pet Therapy Program Fund 2812 70519 Other Theurapeutic dog visits made to inpatients Sandra & Geoffrey Fenwick Family Income Fund 88 13940 FMV Memorial services and grief conference Extraordinary Needs Fund II 145 82118 FMV Volunteer Department Fund 3000 45548 FMV Supplies, Catering and Entertainment for Patients and Patient's families. Broadway Sam Fund 1605 15212 FMV Tickets for Art and Entertainment Events Family Services Fund 2960 15210 FMV Greeting Cards and supplies for Adopt a Family Program & wellness supplies Milagros Para las Family Fund 393 134064 FMV Translation services and program support for spanish speaking families. Judith Nelson Endowment/Income Fund 205 9391 FMV Wellness Activities/Massage Therapy Expenses Knez Family Fund for Patient Family Housing 127 178175 FMV Housing Assistance Barber Family Endowment Fund 22 9118 FMV Teen Advisory Committee expenses Live4Evan Fund for Patient Family Housing 32 37297 FMV Housing Assistance Alexander Mosse Baer Entertainment Fund 25 100 FMV Patient Entertainment - Magician, Face Painting, Dog Show A. Shuman Clothing Fund 235 1000 FMV Clothing Assistance Brandano Parent Apartment Fund 117 54705 FMV Housing Assistance Hale Center for Families Endowment Operating Fund 454 69650 FMV Child Life Specialist and art supplies. Patient Care Support Services Endowment/Income Fund 90 21445 FMV Acupuncture for patients. Part I, Line 2: Children's Hospital provides three types of grants and assistance: (1) Sponsorships, (2) Scholarships, and (3) Assistance Programs. SPONSORSHIPS: Children's supports external strategic partners that enhance Children's role and reputation as (1) a good neighbor; (2) community health partner; (3) civic leader; (4) and an employer of choice. The criteria for Children's funding decisions to the requesting organization are based on the following: 1. a non-profit that promotes careers in healthcare or health services and that Children's has collaborated, or is collaborating, with 2. a non-profit located in and serving Children's target neighborhoods (Fenway, Mission Hill, Jamaica Plain, Roxbury) that address social determinants of health and that Children's has collaborated, or is collaborating, with 3. one of Children's Hospital's affiliated community health centers 4. a citywide non-profit that is a strategic partner in one or more of the Children's primary community health focus areas (asthma, mental health, nutrition/fitness, violence prevention) and that Children's has collaborated, or is collaborating, with 5. a citywide non-profit that is a strategic partner in one or more of Children's secondary community health focus areas (early intervention, early childhood/elementary education,) that Children's has collaborated, or is collaborating, with 6. a business , civic, or advocacy strategic partner that senior management is actively engaged in 7. meets the IRS and the Massachusetts Attorney General's community support or community benefit criteria 8. meets the City of Boston eligibility as a "payment in lieu of taxes' investment Records and copies of sponsorship requests and the resulting grants are kept in paper form in the Office of Child Advocacy. All sponsorships requests are commonly for general operating support. All sponsorship is sent a letter that reiterates the stated use of the grant or assistance and with any Community Partnership Grants, representatives of Children's make site visits to many of the grantees and request end-of-year reports. SCHOLARSHIPS: Children's Hospital offers several scholarship programs to support the educational goals of its employees and/or their immediate families. The Sibylla Orth Young Scholarship is available to employees and their immediate families who have worked at least six months and meet income and grade point average guidelines as well as demonstration of sincere commitment to the healthcare profession. Priority will be given to those pursuing careers in healthcare positions experiencing labor shortages (e.g., radiographer, pharmacy technician, clinical lab technician, nursing). Sibylla Orth Young Scholarship applications are reviewed and maintained by the Office of Learning and Development selection committee. The Nursing Education Scholarship is available to deserving nurses to further his or her education in patient care and the Joshua T. Shairs Cardiology Fund is a scholarship for nurses in the field of cardiology. All nursing scholarship applicants must have worked at least three months, be enrolled in an academic program leading to a degree, demonstrate a commitment to the patient care and be in good standing, both professionally and academically. Scholarship applications for the Nursing Education Scholarships and Joshua T. Shairs Cardiology Funds are reviewed and maintained by the Department of Nursing/Patient Services selection committee. All scholarship recipients are required to sign a Terms of Acceptance agreement affirming the funds will only be used for tuition, fees and/or class materials required for course instructions. ASSISTANCE PROGRAMS: Children's Hospital offers several financial assistance programs to provide funding to patients and their families burdened by the costs associated with long-term hospitalization, acute/chronic illness, disability or impairment. We recognize the significant financial and support services burdens that patients and families face when experiencing frequent ambulatory services or prolonged inpatient admissions at Boston Children's Hospital. These funds are primarily intended for use in emergent situations, and as a stop-gap intervention only. They are not intended to provide permanent or long term solutions to financial need. Essentially, these are funds of "last resort" when alternative options do not exist. All financial assistance requests are assessed by a social worker. If there appears to be significant financial hardship, the social worker does a financial assessment based on the policies and guidelines for the use of these special funds. Typical requests include assistance with transportation, utilities (a child cannot be discharged without adequate heat, electricity, telephone contact in the home), etc. Each request is reviewed by the Director of the Fund. Checks are not payable to the family, rather a payment may be made directly to the company involved via an invoice from that company, e.g., National Grid. Assessment considerations for Special Fund requests are based on: * Duration of Need * Demographic * Family Status * Income Factors * Clinical Factors * Alternate Resources Available * Funding Limits X X X X X X 1 1 0 0 0 0 0 0 0 Laura J Wood DNP MS RN CNO/Noncomp Trustee 406719 0 126800 0 76561 0 21200 0 29652 0 660932 0 0 0 Sandra Fenwick President & CEO, Noncomp Trustee 935607 0 700000 0 472479 0 26500 0 49435 0 2184021 0 0 0 Kevin Churchwell MD EVP & COO/Noncomp Trustee 682826 0 373000 0 289896 0 18550 0 32168 0 1396440 0 0 0 Douglas Vanderslice SVP, Treasurer & CFO 609752 0 150800 0 128205 0 18550 0 34195 0 941502 0 0 0 Bruce Balter Asst Treasurer/Dir Corp Finance 203985 0 15999 0 29917 0 30659 0 17788 0 298348 0 0 0 Michele Garvin Esq General Counsel & Secretary 498451 0 174300 0 98249 0 21200 0 27944 0 820144 0 0 0 Demosthenes Argys SVP, & Chief Administrative Officer 451439 0 147968 0 101034 0 23850 0 26220 0 750511 0 0 0 August Cervini VP, Research Administration 259143 0 66118 0 44303 0 18550 0 23335 0 411449 0 0 0 Michael Gillespie VP, Clinical Services 328719 0 65800 0 55737 0 18550 0 14003 0 482809 0 0 0 Cynthia Haines SVP, International Services 402303 0 102500 0 65452 0 18550 0 26241 0 615046 0 0 0 Patricia Hickey PhD MBA RN NEA-BC VP, Cardiovascular Service 291759 0 31203 0 42130 0 31800 0 8560 0 405452 0 0 0 Lisa Hogarty SVP, RE Planning and Development 110408 0 150000 0 13414 0 0 0 3901 0 277723 0 0 0 Daniel Nigrin MD SVP & Chief Information Officer 412607 0 315000 0 69783 0 23850 0 22030 0 843270 0 0 0 Philip Rotner Chief Investment Officer 626846 0 332252 0 107533 0 18550 0 35425 0 1120606 0 0 0 Wendy Warring SVP, Network Development 450685 0 109395 0 79224 0 21200 0 20241 0 680745 0 0 0 Nader Rifai PhD Director, Chemistry 447512 0 209170 0 2995 0 29150 0 20903 0 709730 0 0 0 Lynn Susman President, Children's Hospital Trust 420729 0 108700 0 73231 0 26500 0 30308 0 659468 0 0 0 Orah Platt MD Chief, Lab Medicine 467141 0 91870 0 9166 0 29150 0 12761 0 610088 0 0 0 Inez Stewart VP, Human Resources 392278 0 76190 0 60646 0 23850 0 25166 0 578130 0 0 0 Clifford Woolf Director, Neurobiology 510250 0 0 0 -6315 0 29150 0 15960 0 549045 0 0 0 Stuart Novick Esq Former General Counsel & Secretary 0 0 0 0 171314 0 0 0 0 0 171314 0 0 0 Margaret Coughlin Former SVP & Chief Marketing Officer 313237 0 0 0 176875 0 0 0 13549 0 503661 0 86221 0 Charles Weinstein Former VP, RE Planning & Development 180265 0 0 0 316119 0 26500 0 10406 0 533290 0 225896 0 Part I, Lines 4a-b Boston Children's Hospital made contributions to the supplemental non-qualified retirement plan for the individuals listed below. Contribution amounts are generally based on a percentage of compensation. Participants of the supplemental executive retirement plan are fully vested. All payments with respect to a participant's separation from service will be made in a single sum following the separation from service unless participant has elected to receive the accrued interest portion of his or her account in three annual installments. Contributions were for employee benefits and not for Boston Children's Hospital Trustee or Officer of the Board services and/or responsibilities. Demosthenes Argys, received in 2016, a contribution of $51,264 August Cervini, received in 2016, a contribution of $22,632 Kevin Churchwell, received in 2016, a contribution of $111,000 Margaret Coughlin, received in 2016, a contribution of $19,234 Sandra Fenwick, received in 2016, a contribution of $433,000 Michele Garvin, received in 2016, a contribution of $63,804 Michael Gillespie, received in 2016, a contribution of $30,480 Cynthia Haines, received in 2016, a contribution of $35,950 Daniel Nigrin, received in 2016, a contribution of $46,224 Philip Rotner, received in 2016, a contribution of $83,803 Inez Stewart, received in 2016, a contribution of $39,275 Lynn Susman, received in 2016, a contribution of $46,708 Doug Vanderslice, received in 2016, a contribution of $81,540 Wendy Warring, received in 2016, a contribution of $51,972 Charles Weinstein, received in 2016, a contribution of $8,603 Laura Wood, received in 2016, a contribution of $46,562 During Calendar Year 2016, the following individuals received supplemental executive retirement plan distributions: Stuart Novick, received in 2016, a distribution of $171,314 Margaret Coughlin, received in 2016, a distribution of $159,625 Charles Weinstein, received in 2016, a distribution of $316,119 During Calendar Year 2016, the following individual received severance payments: Margaret Coughlin, received in 2016, severance payments of $85,152 A MHEFA Revenue Bonds Series M 042456011 57586EMT5 2009-11-19 126110000 Purchase of med off bldg, reno & leasehold impr 0 0 0 B MHEFA Revenue Bonds Series N 042456011 57586EUJ8 2010-05-13 341590000 Refunded Series G, H, I, J & K 0 0 0 C MDFA Revenue Bonds Series O 043431814 NoneAvail 2013-12-11 200640000 Refunded Series L 0 0 0 D MDFA Revenue Bonds Series P 043431814 57583UK31 2014-05-21 136685000 New bldg construction, reno. & capital equip 0 0 0 A 124329713 1829713 122500000 2011 0 0 1 1 B 341590000 339564138 2025862 2010 1 0 1 1 C 200640000 200000000 640000 2013 1 0 1 1 D 151753430 1753430 150000000 2013 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 1 1 Goldman Sachs Mitsui Marine 30.000000000000 0 0 0 0 1 C 0 1 0 0 1 1 Goldmn SachsBOA 30.000000000000 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: MHEFA, Revenue Bonds Series M Date the Rebate Computation was Performed: 09/30/2014 Issuer Name: MHEFA, Revenue Bonds Series N Date the Rebate Computation was Performed: 09/30/2014 A MDFA Revenue Bonds Series Q 043431814 NoneAvail 2014-07-11 50255000 New building construction & renovations 0 0 0 B MDFA Revenue Bonds Series R 043431814 NoneAvail 2014-07-29 125350000 Refunded a portion of Series N 0 0 0 A 50255000 255000 50000000 2016 0 0 1 1 B 125350000 125000000 350000 2014 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 1 1 Goldman Sachs Mitsu 30.000000000000 0 0 0 0 1 A 1 B 1 X 15250 Mkt Value per Donor X 88 18008045 Mean Value on Gift Date X 20 29960 Mkt Value per Donor X Travel/Dining 7 289500 Mkt Value per Donor X Misc. Other 51 145202 Mkt Value per Donor 1 0 1 1 Part I, Line 32b: The Hospital uses an event management firm to assist in processing non-cash donations received for an event auction. Part I, Line 33: The Hospital may receive items such as books, stuffed animals and video games that are donated to the units - these items are de minimus and values are not available so they are not reported in revenues. Form 990, Part VI, Section A, line 6 Children's Medical Center Corporation is the sole Member of the Children's Hospital Corporation. Form 990, Part VI, Section A, line 7a Children's Medical Center Corporation is the sole Member of the Children's Hospital Corporation. The Children's Medical Center Corporation elects the governing body of Children's Hospital Corporation because the Board of Trustees of Children's Hospital Corporation must consist of the persons who serve from time to time as the trustees of The Children's Medical Center Corporation. Form 990, Part VI, Section A, line 7b Children's Medical Center Corporation is the sole Member of the Children's Hospital Corporation ("the Hospital"). As stated in the Hospital's By Laws, Children's Medical Center Corporation has the powers and rights: - to approve proposed operating and capital budgets of the Hospital; - to approve the sale of all or substantially all of the Hospital's assets; - to approve the establishment of all long-range plans, goals and objectives of the Hospital; - to approve any incurrence of long-term indebtedness by the Hospital; - to set executive compensation. Form 990, Part VI, Section B, line 11b The Form 990 tax return was prepared by the organization's staff and reviewed by management (including the President & Chief Executive Officer, Executive Vice President of Health Affairs and Chief Operating Officer, Chief Financial Officer, Legal and other relevant departments of the organization), along with the outside accounting firm of Ernst & Young. The Form 990 tax return was then presented to the Children's Medical Center and affiliates' Audit & Compliance Committee. Also, a copy was made available to the Board before filing. Form 990, Part VI, Section B, line 12c The Hospital's conflict of interest policy applies to all trustees, Trust Board members, members of the medical staff and employees of the Hospital. Trustees, chiefs of service and division chiefs, senior managers and others who exercise influence over important strategic, business and purchasing decisions of the Hospital are required to complete an annual conflict of interest disclosure questionnaire about their financial interests and outside activities. If an expected questionnaire is not returned, the Compliance Officer notifies the individual's supervisor or the CEO or COO, and repeated requests for the completed questionnaire are made until the questionnaire is completed. Responses are reviewed by the Compliance Officer and any potential conflicts are discussed with the Office of General Counsel and/or the individual's supervisor; any actual or potential conflicts are managed by termination of the conflict, management of the conflict, recusal, disclosure, review, or a combination thereof. Outside interests and outside activities may be permitted as long as the Hospital, Medical Center or Trust determines that such interests and activities are consistent with the best interests of the Hospital, Medical Center or Trust and the Hospital, Medical Center or Trust Board member, medical staff member or employee involved does the following: 1. discloses the fact that he has a financial interest or a consultative role in or with a person or company with which the Hospital, Medical Center or Trust is doing or is thinking of doing business; and 2. refrains from voting or exercising any personal influence whatsoever in the selection of a person or company to do business with the Hospital, Medical Center or Trust with whom or in which he has a financial interest or a consultative role; and 3. avoids any active participation in any dealings between the Hospital, Medical Center or Trust and the person or company with whom or in which he has a financial interest or consultative role; and 4. does not permit such outside interests or activities to absorb such amounts of his time and effort as to make it impractical for him to fulfill his assigned responsibilities at the Hospital, Medical Center or Trust; and 5. does not permit such outside interests or activities to compromise or appear to compromise the name or reputation of the Hospital, Medical Center or Trust. Form 990, Part VI, Section B, line 15 The Hospital has a board level compensation committee that annually reviews and approves the compensation for the following individuals: President & Chief Executive Officer Executive Vice President Health Affairs & Chief Operating Officer Senior Vice President & Chief Financial Officer Senior Vice President & General Counsel Senior Vice President, Patient Care Services & Chief Nursing Officer Senior Vice President & Chief Administrative Officer Vice President, Research Administration President, Children's Hospital Trust Vice President, Government Relations Senior Vice President & Chief Marketing and Communications Officer Senior Vice President & Chief Information Officer Senior Vice President, Human Resources Vice President, Support Services Senior Vice President, Real Estate Planning & Development Chief Investment Officer Senior Vice President, Network Development & Strategic Partnerships Vice President, Clinical Services Senior Vice President, International Services The committee is comprised of members of the board who are not employed by the organization, and no member may participate in the review and approval of compensation if the member has a conflict of interest with respect to that compensation arrangement. The committee relies on data, provided by an independent compensation consultant, which includes comparable compensation for similarly qualified persons, in functionally comparable positions, at similarly situated organizations. The deliberations and decisions of the committee are documented in minutes of the meeting. Form 990, Part VI, Section C, line 19 The Hospital posts its Code of Conduct (which incorporates the Conflict of Interest Policy) and its Compliance Manual (which includes a summary of the Conflict of Interest Policy) on its external website and these are also available from the Compliance Office or the Office of General Counsel. Governing documents are not posted publicly but are available from the Hospital upon request and are also filed with the Massachusetts Secretary of State, where they are available to the public. Audited financial statements are filed annually with the Massachusetts Office of the Attorney General as part of the Hospital's Form PC filing and are available from the organization upon request. Quarterly financial statements are filed with the Hospital's bond trustee and are available to the public through the Electronic Municipal Market Access (EMMA) website maintained by the Municipal Securities Rulemaking Board. Form 990, Part IX, line 11g Purchased Medical Services: Program service expenses 54,714,202. Management and general expenses 12,889,830. Fundraising expenses 0. Total expenses 67,604,032. Purchased Research Services: Program service expenses 35,927,697. Management and general expenses 491. Fundraising expenses 0. Total expenses 35,928,188. Consulting Services: Program service expenses 16,659,118. Management and general expenses 15,711,613. Fundraising expenses 874,621. Total expenses 33,245,352. Misc. Purchased Services: Program service expenses 20,386,904. Management and general expenses 8,890,787. Fundraising expenses 77,875. Total expenses 29,355,566. Nursing Agency Fees: Program service expenses 6,705,017. Management and general expenses 193,588. Fundraising expenses 0. Total expenses 6,898,605. Laundry Services: Program service expenses 1,675,854. Management and general expenses 199,317. Fundraising expenses 0. Total expenses 1,875,171. Security Services: Program service expenses 4,890,734. Management and general expenses 75,180. Fundraising expenses 0. Total expenses 4,965,914. Catering Fees: Program service expenses 774,468. Management and general expenses 247,322. Fundraising expenses 31,047. Total expenses 1,052,837. Collection Agency Fees: Program service expenses 57,700. Management and general expenses 1,474,488. Fundraising expenses 0. Total expenses 1,532,188. Temp Agency Fees: Program service expenses 106,080. Management and general expenses 379,737. Fundraising expenses 257,910. Total expenses 743,727. Ambulance Services: Program service expenses 165,613. Management and general expenses 0. Fundraising expenses 0. Total expenses 165,613. Environmental Services: Program service expenses 585,111. Management and general expenses 230,898. Fundraising expenses 0. Total expenses 816,009. Form 990, Part XI, line 9: Net Transfers/Support from Children's Medical Center 62,009,213. Pension Adjustment 64,987,065. Other Adjustments 86,829. Tran of Prof Svc Surplus from Net Assets to Funds Held for Others 3,907,532. CarePlex LLC 300 Longwood Avenue Boston MA 02115 472258145 Inactive MA 0 0 Children's Medical Center Corp Children's One Brookline Place LLC 300 Longwood Avenue Boston MA 02115 205850015 Real Estate Holdings MA 0 0 Children's Hospital Corporation Children's Brookline Place LLC 300 Longwood Avenue Boston MA 02115 261523020 Real Estate Holdings MA 0 0 Children's Hospital Corporation Children's Five Brookline Place LLC 300 Longwood Avenue Boston MA 02115 205850117 Real Estate Holdings MA 0 0 Children's Hospital Corporation BCH Washington Street LLC 300 Longwood Avenue Boston MA 02115 814382691 Real Estate Holdings MA -3681044 40623543 Children's Hospital Corporation BCH Pearl Street LLC 300 Longwood Avenue Boston MA 02115 817393086 Real Estate Holdings MA 0 16784286 Children's Hospital Corporation BCH Brookline Ave LLC 300 Longwood Avenue Boston MA 02115 814457294 Real Estate Holdings MA 53610 2827914 Children's Hospital Corporation Boston Children's Health International LLC 300 Longwood Avenue Boston MA 02115 814377341 Inactive MA 0 344959 Children's Medical Center Corp Children's Westland LLC 300 Longwood Avenue Boston MA 02115 262904847 Inactive MA 0 0 Longwood Research Institute BCH 819 Beacon Street LLC 300 Longwood Avenue Boston MA 02115 814382691 Real Estate Holdings MA 1315279 3913838 Longwood Research Institute Children's Fremont LLC 300 Longwood Avenue Boston MA 02115 260422409 Inactive MA 0 0 Children's Medical Center Corp Children's Waltham Medical Center LLC 300 Longwood Avenue Boston MA 02115 202076874 Real Estate Holdings MA 0 0 Children's Medical Center Corp Boston Children's Health Accountable Care LLC 300 Longwood Avenue Boston MA 02115 300991601 Accountable Care MA 0 0 Children's Hospital Corporation BCD Hospital Energy Collaborative LLC 300 Longwood Avenue Boston MA 02115 821711826 Hospital Energy MA 0 0 Children's Hospital Corporation Boston Children's Health Physicians LLP 300 Longwood Avenue Boston MA 02115 133956599 Healthcare NY 160035101 51329670 Children's Medical Center Corp Children's Medical Center Corporation 55 Shattuck Street Boston MA 02115 041174680 Holds & manages security, real estate investments for Children's Hospital MA 501(c)(3) Line 12b, II N/A 0 Longwood Research Institute Inc 300 Longwood Avenue Boston MA 02115 042781368 Medical & scientific research; holds real estate investments MA 501(c)(3) Line 12b, II Children's Medical Center Corporation 0 CHB Properties Inc 300 Longwood Avenue Boston MA 02115 043323330 Holds & manages satellite ambulatory centers; real estate investments MA 501(c)(3) Line 10 Children's Medical Center Corporation 0 Longwood Corporation 55 Shattuck Street Boston MA 02115 042779882 Holds & manages real estate investments MA 501(c)(2) Children's Medical Center Corporation 0 Physician's Organization at Children's Hospital Inc 300 Longwood Avenue Boston MA 02115 043266103 Coord & develop integrated childhlth care system w/ affil members MA 501(c)(3) Line 12c, III-FI N/A 0 New England Congenital Cardiology Research Foundation 300 Longwood Avenue Boston MA 02115 800368043 Improve patient safety & quality for children w/ heart disease MA 501(c)(3) Line 7 Children's Hospital Corporation 1 Children's Hospital League Corporation 300 Longwood Avenue Boston MA 02115 042780811 Fundraising MA 501(c)(3) Line 7 Children's Hospital Corporation 1 Blood Research Institute Inc CLSB 3rd Floor 3 Blackfan Circle Boston MA 02115 043136318 Owning & Leasing Real Estate MA 501(c)(3) Line 12b, II Children's Medical Center Corporation 0 Beth Israel Hospital and Children's Hospital Medical Corporation 300 Longwood Avenue Boston MA 02115 043200113 Pediatric Health Care, Education & Research MA 501(c)(3) Line 12a, I N/A 0 Dana-FarberChildren's Hospital Cancer Care Inc 450 Brookline Avenue BP418 Boston MA 02215 043554536 Joint program in pediatric oncology MA 501(c)(3) Line 12a, I N/A 0 New England Life Flight Inc Hangar 1727 Hanscom AFB Bedford MA 01730 222582060 Critical Care Transport MA 501(c)(3) Line 12a, I N/A 0 Marketplace LaGuardia LLC One Wells Avenue Newton MA 02459 200417454 Investment in Marketplace LaGuardia LP MA Children's Hospital Corporation 5% Investment 15661 4351 0 -1745725 0 0.65680 Longwood Associates Inc 55 Shattuck Street Boston MA 02115 042943755 Property Management MA Children's Medical Center Corporation C 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1