STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

CONVALESCENT HOSPITAL FUND FOR CHILDREN: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CONVALESCENT HOSPITAL FUND FOR CHILDREN (EIN 31-0536649)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201221359349300742
Schema version
2010v3.4
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)
Timestamp2012-05-14T08:18:36-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1250 EAST FIFTH STREET SUITE 1900AddressLine1
CityCINCINNATICity
StateOHState
ZIP Code45202ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN310536649EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CONVALESCENT HOSPITAL FOR CHILDREN ANDBusinessNameLine1
Business Name Line2ORPHAN ASYLUMBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlCONVNameControl
Phone5136368778Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13333 BURNET AVENUEAddressLine1
CityCINCINNATICity
StateOHState
ZIP Code452293039ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSCOTT J HAMLINName
TitleTREASURERTitle
Phone5136368778Phone
Date Signed2012-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameALICIA JANISCHName
Phone5137847100Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPHILLIP C LONGNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13333 BURNET AVENUEAddressLine1
CityCINCINNATICity
StateOHState
ZIP Code452293039ZIPCode
FieldValueIRS element (for citing)
Gross Receipts43996698GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1833YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionSUPPORT OF CONVALESCENT HOSPITAL FOR CHILDRENActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members19NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers20TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year70283ContributionsGrantsPriorYear
Contributions Grants Current Year4033ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year4021404InvestmentIncomePriorYear
Investment Income Current Year5547004InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year4091687TotalRevenuePriorYear
Total Revenue Current Year5551037TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year2639325GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2721290GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year268360OtherExpensePriorYear
Other Expenses Current Year289560OtherExpensesCurrentYear
Total Expenses Prior Year2907685TotalExpensesPriorYear
Total Expenses Current Year3010850TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1184002RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2540187RevenuesLessExpensesCY
Total Assets BOY68724982TotalAssetsBOY
Total Assets EOY86210493TotalAssetsEOY
Total Liabilities BOY297715TotalLiabilitiesBOY
Total Liabilities EOY268395TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY68427267NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY85942098NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE PURPOSE OF CONVALESCENT HOSPITAL FOR CHILDREN AND ORPHAN ASYLUM IS TO PROVIDE FINANCIAL SUPPORT TO CONVALESCENT HOSPITAL FOR CHILDREN.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense2721290Expense
Grants2721290Grants
DescriptionCONVALESCENT HOSPITAL FOR CHILDREN AND ORPHAN ASYLUM ("CHCOA") WAS FORMED FOR THE SOLE PURPOSE OF PROVIDING FINANCIAL SUPPORT TO THE CONVALESCENT HOSPITAL FOR CHILDREN ("CHC"), AN OHIO NOT-FOR-PROFIT PEDIATRIC HOSPITAL. 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.DURING CHCOA'S FISCAL YEAR OF JULY 1, 2010 THROUGH JUNE 30, 2011 (THE YEAR COVERED BY THIS RETURN), CHCOA PROVIDED FINANCIAL SUPPORT AMOUNTING TO $1,721,290 TO CHC. THESE FUNDS WERE UTILIZED BY CHC TO SUPPORT THE OPERATING COSTS OF ITS PEDIATRIC REHABILITATION PROGRAM, ITS DISABILITY SERVICES PROGRAM, ITS ADOLESCENT PSYCHIATRIC SERVICES PROGRAM, THE SPECIAL NEEDS CHILDREN PROGRAM, ADHD INTAKE AND TRIAGE PROGRAM AND TO SUPPORT THE GENERAL OPERATIONS OF CHC.BECAUSE OF THE DIRECT FINANCIAL SUPPORT OF CHCOA TO CHC, CHC HAS BEEN CONSISTENTLY ABLE TO REINVEST IN ITS PROGRAMS AND MAINTAINS A NATIONAL POSITION AS ONE OF THE LOWEST COST PEDIATRIC HEALTH CARE PROVIDERS IN THE NATION.IN MAY 2006, CHCOA'S BOARD OF TRUSTEES MADE A REVOCABLE $5,000,000 PLEDGE OF UNRESTRICTED PRINCIPAL TO CHILDREN'S HOSPITAL MEDICAL CENTER ("CHMC") TO PROVIDE CAPITAL AND OPERATING SUPPORT OF A RESEARCH AND CLINICAL INITIATIVE KNOWN AS "CHANGE THE OUTCOME". THE PLEDGE IS FOR $1 MILLION A YEAR FOR FIVE YEARS COMMENCING IN FISCAL 2007. THE FINAL PLEDGE WAS PAID IN FISCAL 2011.IN MAY 2011, CHCOA'S BOARD OF TRUSTEES MADE A REVOCABLE $3,750,000 PLEDGE OF UNRESTRICTED PRINCIPAL TO CHMC TO PROVIDE CONTINUING CAPITAL AND OPERATING SUPPORT TO "CHANGE THE OUTCOME". THE PLEDGE IS FOR $750,000 A YEAR FOR FIVE YEARS COMMENCING IN FISCAL 2012. ADDITIONALLY, CHCOA'S BOARD OF TRUSTEES MADE A REVOCABLE PLEDGE OF $1,250,000 OF UNRESTRICTED PRINCIPAL TO CHMC TO PROVIDE SUPPORT FOR THE PERLMAN CENTER EXPANSION. THE PLEDGE IS FOR $250,000 A YEAR FOR FIVE YEARS COMMENCING IN 2012.Description
Total Program Service Expense2721290TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
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 DQP0LoanToOfficerOrDQP
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 Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
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 Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members19NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
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 Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SCOTT J HAMLINBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5136368778TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13333 BURNET AVENUEAddressLine1
CityCINCINNATICity
StateOHState
ZIP Code452293039ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
PAMELA TERP
CHAIRMAN1.00XX000
PHILLIP C LONG
PRESIDENT1.00XX000
MARIE HUENEFELD
VICE PRESIDENT1.00XX000
RONALD SALATIN
SECRETARY1.00XX000
SCOTT HAMLIN
TREASURER1.00XX0750409157058
ROBERT H ANNING II
TRUSTEE1.00X000
C FRANCIS BARRETT
TRUSTEE1.00X000
LEE CARTER
TRUSTEE1.00X000
INGRID DAOUD MD
TRUSTEE1.00X000
VALLIE GEIER
TRUSTEE1.00X000
MARIAN LEIBOLD
TRUSTEE1.00X000
DEBBIE LONG
TRUSTEE1.00X000
MARIANNE MILLER
TRUSTEE1.00X000
WILLIAM K SCHUBERT MD
TRUSTEE1.00X000
SUSAN SHELTON
TRUSTEE1.00X000
MARK STEPANIAK
TRUSTEE1.00X000
MARKAY WINSTON PHD
TRUSTEE1.00X000
ALISON ZIMMERMAN
TRUSTEE1.00X000
DAVID CROALL
TRUSTEE1.00X000
THOMAS WILLIAMS
TRUSTEE1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs750409TotalReportableCompFrmRltdOrgs
Total Other Compensation157058TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
FIFTH THIRD BANK
FIFTH THIRD CENTERCINCINNATIOH45263INVESTMENT MANAGEMENT187716
BAHL AND GAYNOR
213 EAST 3RD STREETCINCINNATIOH45202INVESTMENT MANAGEMENT101844
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions4033AllOtherContributions
Total Contributions4033TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1751475TotalRevenueColumn
Exclusion$1,751,475ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities42241190Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities38445661Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3795529Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3795529TotalRevenueColumn
Exclusion$3,795,529ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column5551037TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$5,547,004ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2721290Total
Program Services2721290ProgramServices

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total289560Total
Management And General289560ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3010850Total
Program Services2721290ProgramServices
Management And General289560ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1227073BOY
EOY1395608EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY67497909BOY
EOY84814885EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY68724982BOY
EOY86210493EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY297715BOY
EOY268395EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY297715BOY
EOY268395EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY65720739BOY
EOY82488044EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2706528BOY
EOY3454054EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY68427267BOY
EOY85942098EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY68724982BOY
EOY86210493EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2540187ReconcilationRevenueExpenses
Reconcilation Other Changes14974644ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (2 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
CHC
3109363033111$1,721,290
CHMC
3108339363011$1,000,000
FieldValueIRS element (for citing)
Total Number Of Supported Orgs2TotalNumberOfSupportedOrgs
Sum Of Amounts2721290SumOfAmounts

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2706528BeginningOfYearBalance
Investment Earnings Or Losses747526InvestmentEarningsOrLosses
End Of Year Balance3454054EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2496544BeginningOfYearBalance
Investment Earnings Or Losses209984InvestmentEarningsOrLosses
End Of Year Balance2706528EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3353546BeginningOfYearBalance
Investment Earnings Or Losses-857002InvestmentEarningsOrLosses
End Of Year Balance2496544EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Total Revenue5551037TotalRevenue
Total Expenses3010850TotalExpenses
Excess Or Deficit For Year2540187ExcessOrDeficitForYear
Net Unrealized GL On Investments14974644NetUnrealizedGLOnInvestments
Total Adjustments14974644TotalAdjustments
Excess Or Deficit Per FS17514831ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt20525681TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments14974644NetUnrealizedGainsInvestments
Revenue Not Rptd F99014974644RevenueNotRptdF990
Revenue Subtotal5551037RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9905551037TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt3010850TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal3010850ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9903010850TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4: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 CONVALESCENT HOSPITAL FOR CHILDREN, A RELATED ORGANIZATION TO CHCOA.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:ASC 740, "INCOME TAXES", CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS. ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF AN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, AND ADDITIONAL DISCLOSURES. THE CORPORATION ADOPTED THE PROVISIONS OF ASC 740 IN FISCAL 2010. THE ADOPTION OF ASC 740 DID NOT HAVE A MATERIAL IMPACT ON THE FINANCIAL STATEMENTS. THE FOLLOWING ARE THE TAX YEARS THAT REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTION: FEDERAL 2008 TO 2011 STATE 2008 TO 2011

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 GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationPurpose Of GrantPurposeOfGrant
CONVALESCENT HOSPITAL FOR CHILDREN
3333 BURNET AVENUECINCINNATIOH452293039310936303501(C)(3)1721290FAIR MARKET VALUEGENERAL SUPPORT
CHILDREN'S HOSPITAL MEDICAL CENTER
3333 BURNET AVENUECINCINNATIOH452293039310833936501(C)(3)1000000FAIR MARKET VALUEGENERAL SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

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: SCHEDULE I, PART I, LINE 2: CHMC 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, AND FUNDRAISING PROJECTS WILL BE SUPPORTED WITH CHCOA FUNDING. UPON CHCOA BOARD APPROVAL, FUNDS ARE DISTRIBUTED TO CHMC AND CHC. CHMC SENIOR MANAGEMENT PROVIDES PERIODIC UPDATES TO THE CHCOA BOARD OF TRUSTEES THROUGHOUT THE YEAR INDICATING HOW DONATED FUNDS ARE UTILIZED IN FURTHERANCE OF CHMC'S AND CHC'S CHARITABLE PURPOSES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonSCOTT HAMLINNamePerson
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs529621CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs142148BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs78640OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs133737DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs23321NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs907467TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs39430CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 4BCERTAIN OFFICERS AND KEY EMPLOYEES OF CHMC, A RELATED ORGANIZATION TO CHCOA, HAVE ARRANGEMENTS WHICH PROVIDE FOR SUPPLEMENTAL RETIREMENT BENEFITS AS DESCRIBED IN IRC SEC. 457(F). DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THESE ARRANGEMENTS ARE NON-VESTED AND THERE IS NO GUARANTEE THAT THESE OFFICERS AND FACULTY MEMBERS WILL EVER RECEIVE THESE BENEFITS. THE FOLLOWING IS A LISTING OF OFFICERS AND KEY EMPLOYEES THAT RECEIVED A DEFERRAL, SUBJECT TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, UNDER CHMC'S IRC SEC. 457(F) PLAN DURING THE YEAR (THESE AMOUNTS ARE INCLUDED IN THE TOTALS FOR SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION): 1. SCOTT HAMLIN - $109,237 THE FOLLOWING IS A LISTING OF OFFICERS AND KEY EMPLOYEES THAT RECEIVED A PAYMENT UNDER CHMC'S IRC SEC. 457(F) PLAN DURING THE YEAR: 1. SCOTT HAMLIN - $39,430
PART IIICONVALESCENT HOSPITAL FOR CHILDREN AND ORPHAN ASYLUM RELIED ON CHILDREN'S HOSPITAL MEDICAL CENTER ("CHMC"), A RELATED ORGANIZATION, TO ESTABLISH THE COMPENSATION OF INDIVIDUALS LISTED ON FORM 990, PART VII. CHMC 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 WRITTEN EMPLOYMENT AGREEMENT 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 CHMC, A RELATED ORGANIZATION OF CHCOA: 1. ELECTIVE EMPLOYEE DEFERRALS UNDER IRC SEC. 403(B) 2. DISCRETIONARY EMPLOYER CONTRIBUTIONS UNDER IRC SEC. 403(B) 3. ELECTIVE EMPLOYEE DEFERRALS UNDER IRC SEC. 457(B) 4. ELECTIVE EMPLOYEE DEFERRALS UNDER IRC SEC. 457(F) 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 CHMC THAT ARE LISTED ON FORM 990, PART VII AND SCHEDULE J, PART II ARE ALSO ELIGIBLE FOR ANY OTHER AVAILABLE EMPLOYEE BENEFITS.SUPPLEMENTAL INFORMATION

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 2C. FRANCIS BARRETT AND MARIAN LEIBOLD HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 2LEE CARTER AND SUSAN SHELTON HAVE A BUSINESS RELATIONSHIP OUTSIDE OF CHCOA.
FORM 990, PART VI, SECTION B, LINE 11THE CONVALESCENT HOSPITAL FOR CHILDREN AND ORPHAN ASYLUM ("CHCOA") FORM 990 IS PREPARED BY SENIOR MANAGEMENT FROM CHILDREN'S HOSPITAL MEDICAL CENTER ("CHMC"), 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.
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 CONFLICT OF INTEREST EXISTS, 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 12C
CHCOA DOES NOT HAVE ANY EMPLOYEES. HOWEVER, CHCOA DOES HAVE OFFICERS THAT ARE EMPLOYED BY CHMC, A RELATED ORGANIZATION. CHMC HAS A COMPENSATION COMMITTEE THAT ANNUALLY REVIEWS THE RECOMMENDATIONS OF CHMC MANAGEMENT REGARDING EMPLOYEE PERFORMANCE EVALUATION AND COMPENSATION ADJUSTMENTS FOR DISQUALIFIED PERSONS TO ENSURE THAT CHMC HAS COMPLIED WITH THE PROVISIONS OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER IRC SEC. 4958.FORM 990, PART VI, SECTION B, LINE 15
CHCOA'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MAINTAINED ON FILE BY CHMC SENIOR MANAGEMENT AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST EITHER IN-PERSON, BY TELEPHONE, OR BY WRITTEN REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 14,974,644.FORM 990, PART XI, LINE 5:
WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICYCHCOA'S BOARD OF TRUSTEES HAS NOT FORMALLY ADOPTED A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. HOWEVER, CHCOA IS A RELATED ORGANIZATION OF CHMC. CHMC HAS A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY AND CHCOA ABIDES BY THE PROVISIONS OF THIS POLICY.FORM 990, PART VI, SECTION B, LINE 14
WRITTEN WHISTLEBLOWER POLICYCHCOA'S BOARD OF TRUSTEES HAS NOT FORMALLY ADOPTED A WRITTEN WHISTLEBLOWER POLICY. HOWEVER, CHCOA IS A RELATED ORGANIZATION OF CHMC. CHMC HAS A WRITTEN WHISTLEBLOWER POLICY AND CHCOA ABIDES BY THE PROVISIONS OF THIS POLICY.FORM 990, PART VI, SECTION B, LINE 13
NUMBER OF HOURS WORKEDSCOTT HAMLIN IS EMPLOYED BY CHMC, A RELATED ORGANIZATION. SCOTT DEVOTES AN AVERAGE OF 40 HOURS/WEEK FOR HIS DUTIES TO CHMC AND AFFILIATED ENTITIES.FORM 990, PART VII
TRANSACTIONS WITH RELATED ORGANIZATIONSDURING THE TIME PERIOD COVERED BY THIS RETURN, CONVALESCENT HOSPITAL FOR CHILDREN AND ORPHAN ASYLUM RECEIVED CERTAIN ACCOUNTING AND ADMINISTRATIVE SERVICES FROM CHILDREN'S HOSPITAL MEDICAL CENTER AT NO COST. THE VALUE OF THESE SERVICES IS AN UNSPECIFIED AMOUNT.FORM 990, SCHEDULE R

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
CONVALESCENT HOSPITAL FOR CHILDREN
3333 BURNET AVECINCINNATIOH45229310936303PEDIATRIC HEALTHCAREOH501(C)(3)30
CHILDREN'S HOSPITAL MEDICAL CENTER
3333 BURNET AVECINCINNATIOH45229310833936PEDIATRIC HEALTHCAREOH501(C)(3)30N/A
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 Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
CONVALESCENT HOSPITAL FOR CHILDREN
B1721290CASH
CHILDREN'S HOSPITAL MEDICAL CENTER
B1000000CASH