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CHILDRENS HOSPITAL PEDIATRIC ASSOCIATES INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CHILDRENS HOSPITAL PEDIATRIC ASSOCIATES INC (EIN 43-1987409)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-12
IRS object ID
201422249349301317
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-12T10:57:22-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN010494526EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Baker Newman & Noyes LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1280 Fore StreetAddressLine1
CityPortlandCity
StateMEState
ZIP Code04101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN431987409EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Children's Hospital Pediatric Associates IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHILNameControl
Phone6173551952Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line120 Overland StreetAddressLine1
CityBostonCity
StateMAState
ZIP Code02215ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGary R Fleisher MDName
TitlePresidentTitle
Phone6179192822Phone
Date Signed2014-08-05DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameNicholas E PortoName
PTINP01310283PTIN
Phone8002447444Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGary R Fleisher MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line120 Overland StreetAddressLine1
CityBostonCity
StateMAState
ZIP Code02215ZIPCode
FieldValueIRS element (for citing)
Gross Receipts331888508GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2002YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionThe Foundation provides medical, health care services, and educational services to (see Schedule O) Boston Children's Hospital and Harvard Medical School. The Foundation also provides care for patients in need of health care services, regardless of their ability to pay, as well as providing community based services.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members1NbrIndependentVotingMembers
Total Nbr Employees404TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI-1839TotalGrossUBI
Net Unrelated Business Txbl Income-1839NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2480000ContributionsGrantsPriorYear
Contributions Grants Current Year2200000ContributionsGrantsCurrentYear
Program Service Revenue Prior Year204330252ProgramServiceRevenuePriorYear
Program Service Revenue CY209998431ProgramServiceRevenueCY
Investment Income Prior Year7514638InvestmentIncomePriorYear
Investment Income Current Year16227424InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year214324890TotalRevenuePriorYear
Total Revenue Current Year228425855TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4535808GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY8479150GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year154580801SalariesEtcPriorYear
Salaries Etc Current Year162450702SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year27259042OtherExpensePriorYear
Other Expenses Current Year31545148OtherExpensesCurrentYear
Total Expenses Prior Year186375651TotalExpensesPriorYear
Total Expenses Current Year202475000TotalExpensesCurrentYear
Revenues Less Expenses Prior Year27949239RevenuesLessExpensesPriorYear
Revenues Less Expenses CY25950855RevenuesLessExpensesCY
Total Assets BOY318259044TotalAssetsBOY
Total Assets EOY351666171TotalAssetsEOY
Total Liabilities BOY49156494TotalLiabilitiesBOY
Total Liabilities EOY45799186TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY269102550NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY305866985NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe Foundation provides medical and health care services primarily to patients at Boston Children's Hospital, and other health care providers at satellite locations. The Foundation carries on and promotes basic and applied medical research and (see Schedule O) education in the field of pediatric care by teaching students and other medical and scientific personnel. The Foundation also provides care for patients regardless of their ability to pay.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense152721845Expense
Grants8479150Grants
Revenue170622207Revenue
DescriptionThe Foundation was organized exclusively for charitable, scientific, and educational purposes. The Foundation provides medical and health care services primarily to patients at Boston Children's Hospital, and other health care providers at satellite locations. The Foundation may charge for patient care, other medical services, and related products, provided that any net income be used for the charitable, scientific, and educational purposes for which the Foundation was created. The Foundation also provides care for patients regardless of their ability to pay, as well as providing and subsidizing hospital and community based services that are either unavailable or limited elsewhere in the community.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense4880157Expense
Revenue5452154Revenue
DescriptionThe Foundation receives income from Boston Children's Hospital for providing administration, supervision, and teaching services. The Foundation carries on and promotes basic and applied medical research and education in the field of pediatric care by teaching students and other medical and scientific personnel; by providing or supplementing income to research personnel through fellowships, research grants, and stipends; and by giving lectures and publishing information concerning problems and research results in the field of pediatric care in order to educate the general public and the medical profession.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense30365019Expense
Revenue33924070Revenue
DescriptionThe Foundation receives reimbursement of certain salary and fringe costs from grants from Boston Children's Hospital.Description
FieldValueIRS element (for citing)
Total Program Service Expense187967021TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109669NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees404NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members1NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1William TarvainenBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6173551952TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line120 Overland StreetAddressLine1
CityBostonCity
StateMAState
ZIP Code02215ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationInstitutional TrusteeInstitutionalTrusteeKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Gary R Fleisher MD
President55.005.00XX767311091786
Vincent Chiang MD
Treasurer/Clerk (7/13-9/13)55.005.00XX295751065985
William E Harmon MD
Treasurer/Clerk (10/12-6/13)45.0015.00XX336358093861
Richard Bachur MD
Trustee60.00X371821078861
S Jean Emans MD
Trustee60.00X296193093861
Raif S Geha MD
Trustee60.00X302913094976
Craig Gerard MD
Trustee60.00X259631086976
Stella Kourembanas MD
Trustee60.00X334936086653
Alan Leichtner MD
Trustee60.00X332888086861
Wayne Lencer MD
Trustee60.00X324259084999
Frederick Lovejoy MD
Trustee (10/12-6/13)60.00X220268052720
Joseph Majzoub MD
Trustee60.00X262644093527
Stephen Harrison MD
Trustee60.00X000
Mark Schuster MD
Trustee60.00X514215082291
Michael Wessels MD
Trustee60.00X265246086851
David Williams MD
Trustee60.00X513621080861
Christopher Walsh MD
Trustee60.00X000
Freidhelm Hildebrandt MD
Trustee (7/13-9/13)60.00X000
Leonard Rappaport MD
Trustee60.00X347668080109
Michael Agus MD
Trustee (7/13-9/13)60.00X355201078861
Physicians' Organization at CH Inc
Institutional Trustee2.00000X
William Tarvainen
Chief Operations Officer60.00312548060044X
Patricia Ellen Grant MD
Physician60.00385259061863X
Issac Kohane MD
Physician60.00362827062905X
Luigi Notarangelo MD
Physician60.00382557058089X
Scott Snapper MD
Physician60.00390022061861X
Gary Visner MD
Physician60.00361985061861X
FieldValueIRS element (for citing)
Total Reportable Comp From Org8296122TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation1786662TotalOtherCompensation
Number Individuals GT100 K281NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Dana Farber Cancer Institute
44 Binney StreetBostonMA02115Oncology services2240562
Boston Private Bank & Trust
Ten Post Office SquareBostonMA02109Investment fees676082
Delta Dental
465 Medford StreetBostonMA02129Dental Insurance618192
Marcam Associates
396 High StreetSomersworthNH03878Billing/Collections562563
IDX Systems Corp
15724 Collections CenterChicagoIL60693Software Services195713
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K
Related Organizations2200000RelatedOrganizations
Total Contributions2200000TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient serv. rev., net of contr.621300162548477162548477
Grant revenue6213003392407033924070
Contract revenue62130080737298073729
Teaching, admin, & supervision re61171028260332826033
Service, research, & other revenu61171026261222626122
FieldValueIRS element (for citing)
Total Program Service Revenue209998431TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4456800TotalRevenueColumn
Unrelated Business Revenue-1839UnrelatedBusinessRevenue
Exclusion$4,458,639ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities115233277Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities103462653Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities11770624Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column11770624TotalRevenueColumn
Exclusion$11,770,624ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column228425855TotalRevenueColumn
Related Or Exempt Function Income209998431RelatedOrExemptFunctionIncome
Unrelated Business Revenue-1839UnrelatedBusinessRevenue
Exclusion$16,229,263ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total8479150Total
Program Services8479150ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total10072785Total
Program Services9700193ProgramServices
Management And General372592ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total131613771Total
Program Services122400807ProgramServices
Management And General9212964ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8231724Total
Program Services7820138ProgramServices
Management And General411586ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8597083Total
Program Services7307521ProgramServices
Management And General1289562ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3935339Total
Program Services3345038ProgramServices
Management And General590301ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total560578Total
Management And General560578ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total40830Total
Management And General40830ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total836951Total
Management And General836951ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total378516Total
Program Services378516ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total99985Total
Program Services99985ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2144924Total
Program Services1313520ProgramServices
Management And General831404ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total162114Total
Program Services162114ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2460495Total
Program Services2460495ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total326901Total
Program Services245176ProgramServices
Management And General81725ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total226734Total
Program Services226734ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total69852Total
Program Services69852ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total3264249Total
Program Services3150030ProgramServices
Management And General114219ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Research expenses1260393812603938
Bad debt expense46525474652547
PO dues15537011553701
Patient staff relations680747680747

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1482086Total
Program Services1316819ProgramServices
Management And General165267ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total202475000Total
Program Services187967021ProgramServices
Management And General14507979ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY10723870BOY
EOY12709797EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7146203BOY
EOY4169143EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15700126BOY
EOY15521875EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY399910BOY
EOY1385814EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY6235012BOY
EOY3847400EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY854207BOY
EOY776186EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis893538LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec526608LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY86055BOY
EOY366930EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY200987069BOY
EOY239209757EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY45676193BOY
EOY49737131EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY30450399BOY
EOY23942138EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY318259044BOY
EOY351666171EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY7100571BOY
EOY8934452EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY42055923BOY
EOY36864734EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY49156494BOY
EOY45799186EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY265178675BOY
EOY302617485EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3923875BOY
EOY3249500EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY269102550BOY
EOY305866985EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY318259044BOY
EOY351666171EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses25950855ReconcilationRevenueExpenses
Reconciliation Unrealized Invest10813580ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11081677CurrentTaxYearMinus4Years
Current Tax Year Minus2 Years6982000CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2480000CurrentTaxYearMinus1Year
Current Tax Year2200000CurrentTaxYear
Total22743677Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years176149278CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years187241007CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years191869937CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year204330253CurrentTaxYearMinus1Year
Current Tax Year209998431CurrentTaxYear
Total969588906Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years187230955CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years187241007CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years198851937CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year206810253CurrentTaxYearMinus1Year
Current Tax Year212198431CurrentTaxYear
Total992332583Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509992332583PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3861758CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3682841CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4032185CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3931452CurrentTaxYearMinus1Year
Current Tax Year4458639CurrentTaxYear
Total19966875Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-6282CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years-4634CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years-191CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6037CurrentTaxYearMinus1Year
Current Tax Year-1839CurrentTaxYear
Total-6909Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3855476CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3678207CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4031994CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3937489CurrentTaxYearMinus1Year
Current Tax Year4456800CurrentTaxYear
Total19959966Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years191086431CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years190919214CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years202883931CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year210747742CurrentTaxYearMinus1Year
Current Tax Year216655231CurrentTaxYear
Total1012292549Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98030PublicSupportPercentage509
Prior Year Support Percentage0.97890PriorYearSupportPercentage
Investment Income Percentage0.01970InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.02110PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3923875BeginningOfYearBalance
Contributions2200000Contributions
Other Expenditures2874375OtherExpenditures
End Of Year Balance3249500EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance4605309BeginningOfYearBalance
Contributions2480000Contributions
Other Expenditures3161434OtherExpenditures
End Of Year Balance3923875EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3182950BeginningOfYearBalance
Contributions6982000Contributions
Other Expenditures5559641OtherExpenditures
End Of Year Balance4605309EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance12375000BeginningOfYearBalance
Other Expenditures9192050OtherExpenditures
End Of Year Balance3182950EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2509857BeginningOfYearBalance
Contributions11081677Contributions
Other Expenditures1216534OtherExpenditures
End Of Year Balance12375000EndOfYearBalance
FieldValueIRS element (for citing)
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis67011OtherCostOrOtherBasis
Depreciation67011Depreciation
Book Value0BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis826527OtherCostOrOtherBasis
Depreciation459597Depreciation
Book Value366930BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings366930TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
BCH Pooled Investment2025124F
PO Pooled Investment Fund47712007F
FieldValueIRS element (for citing)
Total Of Book Value Securities49737131TotalOfBookValueSecurities

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
Due from Boston Children's Hospital12422294
Malpractice insurance receivable9051327
Other receivables2450319
Due from PO18198
FieldValueIRS element (for citing)
Total Book Value Other Assets23942138TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
Due to Boston Children's Hospital$11,842,358
Due to PO$920,895
Due to community hospitals$1,442,958
Deferred compensation plans$9,276,652
Accrued professional liability$13,332,871
Due to other Foundations$49,000
FieldValueIRS element (for citing)
Total Of Amounts36864734TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt242113812TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments10813582NetUnrealizedGainsInvestments
Other Revenues2874375OtherRevenues
Revenue Not Rptd F99013687957RevenueNotRptdF990
Revenue Subtotal228425855RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990228425855TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt202475000TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal202475000ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990202475000TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds:Part V, Line 4:The Foundation has plans to use its endowment funds for the Quality and Charge Capture Project, physician recruitment expenses, education programs, and research initiatives.
Description of Uncertain Tax Positions Under FIN 48:Part X, Line 2:The Foundation is a tax-exempt corporation as described in Section 501(c)(3) of the Internal Revenue Code (the Code), and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. In addition, the Foundation qualifies for the charitable contribution deduction under Section 170(b)(1)(A) and has been classified as an organization that is not a private foundation under Section 509(a)(2). Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items, including unrelated business income or tax status. Management of the Foundation has evaluated the positions taken on the Foundation's filed tax returns and has concluded that no uncertain income tax positions exist at September 30, 2013. The Foundation's tax years from 2010 through 2013 are potentially subject to examination.
Part XI, Line 2d - Other Adjustments:Net assets released from restrictions 2,874,375.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
Boston Children's Hospital
300 Longwood AvenueBostonMA02115042774441501(c)(3)843000017786BookDonation of equipmentGeneral Support
Presidents & Fellows of Harvard College
Massachusetts HallCambridgeMA02138042103580501(c)(3)25364N/AN/AGeneral Support
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: Monitoring is provided by Children's Hospital Pediatric Associates, Inc. (the Foundation) through oversight of the terms and conditions of a written grant agreement. Multiyear agreements require yearly progress and financial reports for contiuation of funding. During the year ended September 30, 2013, the Foundation only provided grant donations to other 501(c)(3) organizations.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (23 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Gary R Fleisher MD
President4895750002777360658890258970859097000
Vincent Chiang MD
Treasurer/Clerk (7/13-9/13)2289740184520483250402530257320361736000
William E Harmon MD
Treasurer/Clerk (10/12-6/13)2694300467870201410690890247720430219000
Richard Bachur MD
Trustee350277045000170440540890247720450682000
S Jean Emans MD
Trustee269430066220201410690890247720390054000
Raif S Geha MD
Trustee2475000405000149130690890258870397889000
Craig Gerard MD
Trustee24750006684054470610890258870346607000
Stella Kourembanas MD
Trustee3080550113390155420610890255640421589000
Alan Leichtner MD
Trustee32586200070260620890247720419749000
Wayne Lencer MD
Trustee291389028482043880600890249100409258000
Frederick Lovejoy MD
Trustee (10/12-6/13)194600000256680281680245520272988000
Joseph Majzoub MD
Trustee247500045000106440690890244380356171000
Mark Schuster MD
Trustee24750001869760797390560890262020596506000
Michael Wessels MD
Trustee24749908339094080620890247620352097000
David Williams MD
Trustee37233103076501105250560890247720594482000
Leonard Rappaport MD
Trustee307956045000352120560890240200427777000
Michael Agus MD
Trustee (7/13-9/13)3189090115240247680540890247720434062000
William Tarvainen
Chief Operations Officer284042000285060370890229550372592000
Patricia Ellen Grant MD
Physician365961015000042980370890247740447122000
Issac Kohane MD
Physician336672070000191550370890258160425732000
Luigi Notarangelo MD
Physician23575102000001268060354520226370440646000
Scott Snapper MD
Physician3015000224780660440370890247720451883000
Gary Visner MD
Physician3064240360555250370890247720423846000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 4bThe Children's Hospital Pediatric Associates, Inc. (the Foundation) established the Ineligible Deferred Compensation Plan. This plan is intended to qualify under Section 457(f) of the Code, and is intended to constitute a "top-hat plan" described in Section 201(2) of ERISA. The payment of benefits under the plan is at the sole discretion of the Foundation. In meeting its funding obligation, the employer will hold employee contributions in a Rabbi Trust. Each employee who is: a) an officer or highly compensated employee of the Foundation; b) a professor at Harvard University, or its professional equivalent; and c) determined by the Foundation's President to be eligible, may participate in the plan. Additionally, each Trustee of the Foundation who is determined by the Foundation's President to be eligible may participate in the plan. Participants may elect to defer compensation by a specific amount which, for any taxable year, shall not exceed an amount established by the Plan Administrator. The Foundation may, but is not required to, contribute an amount determined in the sole discretion of the Foundation, on behalf of one or more eligible participants for a plan year. Participants are fully vested in the funds credited to their accounts after seven consecutive years of service. The Foundation made the following contributions to the 457(f) plan for the employees listed on Part VII, Page 7: Gary R. Fleisher, MD, $28,800; William E. Harmon, MD, $32,000; Richard Bachur, MD, $17,000; S. Jean Emans, MD, $32,000; Raif S. Geha, MD, $32,000; Craig Gerard, MD, $24,000; Stella Kourembanas, MD, $24,000; Alan Leichtner, MD, $25,000; Wayne Lencer, MD, $23,000; Joseph Majzoub, MD, $32,000; Mark Schuster, MD, $19,000; Michael Wessels, MD, $25,000; David Williams, MD, $19,000; Leonard Rappaport, MD, $19,000; Vincent Chiang, MD, $6,000; and Michael Agus, MD, $17,000.
Part I, Line 7The Children's Hospital Pediatric Associates, Inc. (the Foundation) paid the following bonus compensation to eligible employees: a) Ambulatory Clinic Bonus - participants are eligible for this bonus if they work a minimum of 0.2 FTEs in the clinic and have an overall surplus that is greater than 2.2 times the salary charged to the Foundation or the service fund. The eligible participant can receive 22% of their first $100,000 surplus, 17% of their surplus between $100,000 and $200,000, and 24% of any surplus greater that $200,000. The bonus award is subject to the participant's total direct compensation not exceeding the Harvard Medical School's compensation guidelines; b) Academic Bonus - 7.5% of the department's surplus has been set aside to award academic bonuses. The bonus pool has been distributed to the divisions based on its revenue. The division chief may distribute his/her bonus pool at their discretion. Faculty and staff are eligible to receive this bonus as long as they are on the payroll for Boston Children's Hospital or the Foundation; and c) Bonuses for emergency, newborn, inpatient programs, and PHA are based on 13% of the division/program surplus. Bonus compensation is usually approved by the division Chiefs and the President of the Foundation.

Schedule L IRS990ScheduleL

Loan Table LoanTable (5 entries)

Relationship With OrganizationRelationshipWithOrganizationPurpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
David Williams MD
TrusteePhysician recruitmentX$650,000125000011
Isaac Kohane MD
TrusteePhysician recruitmentX$85,55017110011
Christopher Walsh MD
TrusteePhysician recruitmentX$300,000240000011
Scott Snapper MD
PhysicianPhysician recruitmentX$350,000210000011
Friedhelm Hildebrandt MD
TrusteePhysician recruitmentX$881,000793704011
FieldValueIRS element (for citing)
Total Balance Due1385814TotalBalanceDue

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
ExplanationSchedule L, Part II:The Children's Hospital Pediatric Associates, Inc. (the Foundation) has developed a recruitment loan program for eligible employees as incentive for qualified employees to relocate to certain facilities as demands of the Foundation's practice arise. The loan proceeds are to be used for the purchase of a principal personal residence. The loans are secured by a promissory note and a second mortgage on the residence. The Foundation has provided three loans to two members of the board. However, the Foundation has provided loans to other employees. The loans were made for recruitment and relocation purposes, to assist the physician employees in the purchase of their primary residence. The amounts for the recruitment loans were originally funded by restricted donations provided by Boston Children's Hospital for use in recruitment. The loans will be forgiven over the terms of the notes if the recipients remain employed at the Foundation or its affiliates. If any borrower terminates their employment, the remaining balance becomes immediately due. The amount of the loan forgiveness will be included with accrued interest, if applicable, as compensation in the year forgiven.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Section A, line 1The majority of the Children's Hospital Pediatric Associates, Inc. (the Foundation) board members are physicians who are not independent from the Foundation. However, the Foundation is part of an integrated delivery system with Boston Children's Hosiptal (the Hospital) which does have a community board. The Foundation was organized in 2002. At the time, the board was composed entirely of physicians, a board structure that was approved by the Internal Revenue Service. The Foundation has since adjusted the board structure by adding the Physicians' Organization at Children's Hospital, Inc. (the PO) as a member. See Schedule O, Part VI, Questions 3, 6, 7b, and 12 for more on the PO's rights.
Form 990, Part VI, Section A, line 3The Physicians' Organization at Children's Hospital, Inc. (the PO) is a Class "C" member of Children's Hospital Pediatric Associates, Inc. (the Foundation). The PO is responsible for all third party contracting for the Foundation. The PO has the power to select the independent auditor and legal counsel of the Foundation from an approved list of firms mutually agreed to by the PO and the Foundation. The PO also has the right to review, but not to approve, the annual operating budget and all capital budgets of the Foundation. Lastly, the PO has the right to review for compliance with applicable law, the general terms of and any modification to physician compensation and benefit plans for all physician employees of the Foundation.
Form 990, Part VI, Section A, line 6The Children's Hospital Pediatric Associates, Inc. (the Foundation) has four classes of members. The Pediatrician-in-Chief or any Acting Pediatrician-in-Chief, as Chief of the Department of Medicine (the Department) of Boston Children's Hospital (the Hospital), is a Class "A" member. Any person who (i) is a physician-employee of the Foundation with an active medical staff appointment from the Hospital, and (ii) either (A) is a Division Chief of a Division of the Department whose faculty are on the Foundation's payroll or (B) functions as a Division Chief of a Division of the Department whose faculty are not on the Foundation payroll, or (C) has a faculty appointment from Harvard Medical School shall be a Class "B" member. The Physicians' Organization at Children's Hospital, Inc. (the PO) is a Class "C" member. All other individuals who hold Harvard appointments other than the Class "A" and "B" members shall be Class "D" members.
Form 990, Part VI, Section A, line 7aThe Pediatrician-in-Chief or any Acting Pediatrician-in-Chief, as Chief of the Department of Medicine of Boston Children's Hospital (the Hospital), is the Class "A" member of Children's Hospital Pediatric Associates, Inc. (the Foundation). According to the Articles of Organization, the Class "A" member appoints the board members of the Foundation for a 3-year term at the Foundation's annual meeting.
Form 990, Part VI, Section A, line 7bThe Physicians' Organization at Children's Hospital, Inc. (the PO) is a Class "C" member of the Children's Hospital Pediatric Associates, Inc. (the Foundation). The PO is responsible for all third party contracting for the Foundation. The PO has the power to select the independent auditor and legal counsel of the Foundation from an approved list of firms mutually agreed to by the PO and the Foundation. The PO also has the right to review, but not to approve, the annual operating budget and all capital budgets of the Foundation. Lastly, the PO has the right to review for compliance with applicable laws, the general terms of and any modification to physician compensation and benefit plans for all physician employees of the Foundation. The PO is considered the compensation committee of the Foundation. As a Class "C" member of the Foundation, the PO attends the Foundation's annual meeting.
Form 990, Part VI, Section B, line 11The detailed review will be conducted by the President of the Foundation, Gary R. Fleisher, MD and the Chief Financial Officer, William Tarvainen. A copy of the Form 990 will be provided to the board prior to filing. The detailed review will be conducted before filing the return with the Internal Revenue Service.
Form 990, Part VI, Section B, line 12cThe Physicians' Organization at Children's Hospital, Inc. (the PO) administers an annual conflict of interest disclosure process to all of its member Foundations, which asks physicians (officers, top management, and highly compensated employees) and selected Foundation staff to disclose potential conflicts. A disclosure statement will be circulated annually to members of the PO. The PO audit committee shall determine those individuals (including medical staff members) who shall be required to complete the disclosure statement. The PO audit committee, at its discretion, may either: 1) refer any or all disclosure statements to the Board of Directors; 2) appoint an ad hoc committee to review and resolve any conflict of interest issues; or 3) review and resolve any conflict of interest issues personally or through a designee(s). Any person not receiving a disclosure statement nevertheless has an affirmative obligation to disclose to the PO President, PO General Counsel, or his/her supervisor whenever he/she believes he/she has or may have a conflict of interest. Similarly, each person completing a disclosure statement has an affirmative obligation to update the statement any time circumstances change and/or he/she believes that a conflict of interest may exist. In the event a conflict of interest is found to exist, the Foundation prohibits the member from voting on any matter to which the conflict relates or otherwise influence the voting on such matter.
Form 990, Part VI, Section B, line 15All the physicians (top management, officers, and highly compensated individuals) fall under compensation guidelines determined by Harvard University, with limitations established for certain positions/ranks within the medical school. Annually, compensation is reviewed and reported to Boston Children's Hospital's Board of Trustees to ensure total direct and indirect compensation does not exceed the pre-determined guidelines of Harvard University. Any new indirect benefit plan requires approval by the Foundation's Board of Directors, which then must be reviewed and permitted by the Hospital. Major aspects of the approval process involve: comparing compensation data of physicians within the comparable field of medicine; indirect compensation currently being offered; and the financial stability of the Foundation. This process was followed for the year ended September 30, 2013.
Form 990, Part VI, Section C, line 19The Foundation maintains all financial statements, conflict of interest policies, and governing documents at its main office at 20 Overland Street, Boston, MA 02215. The documents are available upon request.
Part XII, Question 2c: The audit process has not changed from the prior year.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Boston Children's Hospital
300 Longwood AvenueBostonMA02115042774441HospitalMA501(c)(3)Line 3N/A0
Physicians' Organization at Children's Hospital Inc
300 Longwood AvenueBostonMA02115043266103Physician organizationMA501(c)(3)Line 11a, IN/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg