2016-04-15T13:52:26-05:00 2015-06-30 861065772 Deloitte Tax LLP 250 East Fifth Street Suite 1900 Cincinnati OH 45202 990 2014-07-01 310536649 Convalescent Hospital for Children and Orphan Asylum CONV 5138031106 3333 Burnet Avenue Cincinnati OH 452293039 Michael L Bauer Treasurer 5138031106 2016-04-15 1 Alicia Jansich P00741382 5137847100 2014 2016-08-17 19:52:53Z Phillip C Long 3333 Burnet Avenue Cincinnati OH 452293039 105067244 0 X N/A X 1833 OH Support organizations dedicated to treatment & research of diseases or disorders affecting children. 16 15 0 15 0 0 4283 3509 0 0 15996400 18062397 0 0 16000683 18065906 4308228 10922274 0 0 0 0 0 0 0 336204 372573 4644432 11294847 11356251 6771059 117362288 117599723 28878 6395000 117333410 111204723 X The purpose of Convalescent Hospital for Children and Orphan Asylum is to provide financial support to organizations located in Hamilton County, Ohio that participate in the treatment of, or research into, diseases or disorders affecting children. 0 0 10922274 10922274 Convalescent Hospital for Children and Orphan Asylum ("CHCOA") was formed for the sole purpose of providing financial support to other publicly supported organizations located in Hamilton County, Ohio that participate in the treatment of, or research into, diseases or disorders affecting children. During CHCOA's fiscal year of July 1, 2014 through June 30, 2015 (the year covered by this return), CHCOA provided financial support amounting to $10,922,274 to Cincinnati Children's Hospital Medical Center ("CCHMC"), an Ohio not-for-profit pediatric hospital located in Hamilton County, Ohio. Such financial support is provided from expendable income received from investments of restricted and unrestricted funds. It is the policy of CHCOA to invest such assets, thereby increasing fund principal and enhancing future expendable income.CCHMC utilized the financial support from CHCOA to support the operating costs of its pediatric rehabilitation program, disability services program, adolescent psychiatric services program, special needs children program, psychology pain management program, psychology adherence program, adolescent psychology services program, and to support the general operations of CCHMC.Because of the direct financial support of CHCOA to CCHMC, CCHMC has been consistently able to reinvest in its programs and maintains a national position as one of the premier pediatric health care providers in the nation. 10922274 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 16 15 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X Michael L Bauer 5138031106 3333 Burnet Avenue Cincinnati OH 452293039 Robert H Anning II Trustee 1.00 0.00 X 0 0 0 C Francis Barrett Trustee 1.00 0.00 X 0 0 0 Lee A Carter Trustee 1.00 4.00 X 0 0 0 David Croall Trustee 1.00 0.00 X 0 0 0 Vallie Geier Trustee 1.00 1.00 X 0 0 0 Marian Leibold Trustee 1.00 0.00 X 0 0 0 Debbie Long Trustee (Thru 1/15) 1.00 0.00 X 0 0 0 Marianne Miller Trustee 1.00 0.00 X 0 0 0 Susan Shelton Trustee 1.00 0.00 X 0 0 0 Mark Stepaniak Trustee 1.00 0.00 X 0 0 0 Thomas Williams Trustee 1.00 0.00 X 0 0 0 Alison Zimmerman Trustee 1.00 0.00 X 0 0 0 Pamela Terp Chairman 1.00 2.00 X X 0 0 0 Phillip C Long President 1.00 0.00 X X 0 0 0 Marie Huenefeld Vice-President 1.00 0.00 X X 0 0 0 Ronald Salatin Secretary 1.00 0.00 X X 0 0 0 Michael L Bauer Treasurer 1.00 49.00 X X 0 278446 27535 0 278446 27535 0 0 1 0 Fifth Third Bank Fifth Third Center Cincinnati OH 45263 Investment Management 234927 Bahl & Gaynor 212 E 3rd Street Cincinnati OH 45202 Investment Management 137646 2 3509 3509 3319541 3319541 101744194 87001338 14742856 14742856 14742856 18065906 0 0 18062397 10922274 10922274 372573 372573 11294847 10922274 372573 0 2596166 1399597 2599623 82990 112166499 113409393 0 2707743 117362288 117599723 28878 6395000 28878 6395000 X 109943651 103605508 7389759 7599215 117333410 111204723 117362288 117599723 X 6771059 -13036277 136531 X 0 1 X 1 0 X X 1 CHMC 310833936 3 0 10922274 0 1 10922274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 0 Part IV, Section A, Line 1: The purpose of Convalescent Hospital for Children and Orphan Asylum (the Corporation), as determined by its Board of Trustees, is to provide financial support to Children's Hospital Medical Center (Cincinnati Children's). The Corporation provides programmatic oversight to the brain injury and mental health programs at Cincinnati Children's. Such financial support is provided primarily from expendable income received from the investment of the permanently restricted endowment, net assets and unrestricted net assets of the Corporation. It is the policy of the Corporation to invest gifts and bequests received and to reinvest net assets obtained from sales of investments to increase net assets and enhance future expendable income. Part IV, Section E, Line 2a: Convalescent Hospital for Children and Orphan Asylum (CHCOA) provides general support grants to Children's Hospital Medical Center (CCHMC) to further the purpose of CCHMC to provide pediatric health care services. CCHMC provides a budget to CHCOA of support requests and CHCOA reviews and approves the requests. These activities account for more than 96% of CHCOA's annual expenditures. 7389759 209456 7599215 6283171 1106588 7389759 3547212 2231158 504801 6283171 3454054 93158 3547212 2706528 747526 3454054 1.00000 1 0 0 X 5029629 -13036277 -13036277 18065906 0 18065906 11294847 0 11294847 0 11294847 Part V, Line 4: Explanation: Convalescent Hospital for Children and Orphan Asylum's ("CHCOA") permanently restricted endowment funds are restricted by donors to be maintained by CHCOA in perpetuity. These funds are invested and utilized to generate expendable income that CHCOA may use to provide financial support to publicly supported organizations located in Hamilton County, Ohio that participate in the treatment of, or research into, diseases or disorders affecting children, one of which is Cincinnati Children's Hospital Medical Center, a supported organization of CHCOA. Part X, Line 2: The corporation has received a determination from the Internal Revenue Service that it is recognized as exempt from federal income taxes under section 501(c)(3) of the Internal Revenue Code. The corporation follows Accounting Standards Codification 740 "Income Taxes" (ASC 740) related to the accounting for income taxes. The following are the tax years that remain subject to examination by major tax jurisdiction: Federal 2012 to 2015 State 2012 to 2015 1 Children's Hospital Medical Center 3333 Burnet Avenue Cincinnati OH 452293039 310833936 501(C)(3) 10922274 General Support 1 Part I, Line 2: Schedule I, Part I, Line 2: CCHMC senior management submits a proposal for funding to the CHCOA Board of Trustees. The CHCOA Board reviews the proposal and then makes a determination as to what research, patient care, capital and fundraising projects will be supported with CHCOA funding. Upon CHCOA Board approval, funds are distributed to CCHMC. CCHMC senior management provides periodic updates to the CHCOA Board of Trustees throughout the year indicating how donated funds are utilized in furtherance of CCHMC's charitable purposes. 0 0 0 0 0 0 0 0 0 Michael L Bauer Treasurer 0 234427 0 37470 0 6549 0 0 0 27535 0 305981 0 0 Form 990, Schedule J, Part II Convalescent Hospital for Children and Orphan Asylum relied on Cincinnati Children's Hospital Medical Center ("CCHMC"), a related organization, to establish the compensation of the individual listed on Form 990, Part VII. CCHMC used one or more of the methods described below to establish an appropriate level of compensation: Compensation committee Independent compensation consultant Form 990 of other organizations Compensation survey or study Approval by the board or compensation committee Explanation of Benefits: The employee benefit plan contribution amounts listed on Schedule J, Part II may include one or more of the following benefits provided by CCHMC, a related organization of CHCOA: 1. Elective employee deferrals under IRC Sec. 403(b) 2. Discretionary employer contributions under IRC Sec. 403(b) 3. Employer contributions to a defined benefit pension plan under IRC Sec. 401(a) (note: the specific value of any contributions made by CCHMC to the defined benefit pension plan on behalf of individuals listed on Schedule J, Part II is not determinable) In addition to the retirement plan contributions disclosed on Form 990, Part VII and Schedule J, Part II, the following non-taxable employee welfare benefits were made available to the employed, compensated officers and key employees listed on Form 990, Part VII and Schedule J, Part II: 1. Health and dental insurance benefits 2. Group life insurance (portions of which are taxed) 3. Unemployment benefits 4. Disability benefits The officers employed by CCHMC that are listed on Form 990, Part VII and Schedule J, Part II are also eligible for any other available employee benefits. Form 990, Part VI, Section A, line 2 C. Francis Barrett and Marian Leibold have a family relationship. Lee Carter and Susan Shelton have a business relationship outside of CHCOA. Form 990, Part VI, Section B, line 11 The Convalescent Hospital for Children and Orphan Asylum ("CHCOA") Form 990 is prepared by senior management from Cincinnati Children's Hospital Medical Center ("CCHMC"), a related organization. External tax consultants then review the Form 990 for completeness and accuracy. The Form 990 is then made available to all CHCOA board members in advance of filing. Form 990, Part VI, Section B, line 12c All of CHCOA's board members receive an annual questionnaire requesting information regarding family and business relationships that could potentially result in a conflict of interest under CHCOA's Conflict of Interest Policy. Once the questionnaires have been completed by all of CHCOA's board members, the questionnaires are reviewed and if CHCOA determines that a relationship exists that presents a conflict of interest, CHCOA follows the provisions set forth in CHCOA's Conflict of Interest Policy to resolve the conflict and determines the appropriate reporting to board committees and, if required, Form 990 disclosure. Form 990, Part VI, Section B, line 15 CHCOA does not have any employees. However, CHCOA does have officers that are employed by Cincinnati Children's Hospital Medical Center ("CCHMC"), a related organization. CCHMC has a compensation committee that annually reviews the recommendations of CCHMC management regarding employee performance evaluation and compensation adjustments for disqualified persons to ensure that CCHMC has complied with the provisions of the rebuttable presumption of reasonableness under IRC sec. 4958. Form 990, Part VI, Section C, line 19 CHCOA's governing documents, Conflict of Interest Policy, and financial statements are maintained on file by CCHMC senior management and are available to the public upon request either in-person, by telephone, or by written request. Form 990, Part XI, line 9: Gain in Interest in Perpetual Trust 136,531. Form 990, Part VI, Section B, Line 14 CHCOA's board of trustees has not formally adopted a written document retention and destruction policy. However, CHCOA is a related organization of Cincinnati Children's Hospital Medical Center ("CCHMC"). CCHMC has a written document retention and destruction policy and CHCOA abides by the provisions of this policy. Form 990, Part VI, Section B, Line 13 CHCOA's board of trustees has not formally adopted a written whistleblower policy. However, CHCOA is a related organization of Cincinnati Children's Medical Center ("CCHMC"). CCHMC has a written whistleblower policy and CHCOA abides by the provisions of this policy. Form 990, Part VII Michael L. Bauer is employed by Cincinnati Children's Hospital Medical Center ("CCHMC"), a related organization. Mr. Bauer devotes an average of 50 hours/week for his duties to CCHMC and affiliated entities. Children's Hospital Medical Center 3333 Burnet Ave Cincinnati OH 45229 310833936 Pediatric Healthcare OH 501(C)(3) 3 The Children's Hospital 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 Children's Hospital Medical Center B 10922274 Cash Form 990, Schedule R During the time period covered by this return, Convalescent Hospital for Children and Orphan Asylum received certain accounting and administrative services from Cincinnati Children's Hospital Medical center at no cost. The value of these services is an unspecified amount.