2011-11-15T13:38:00-06:00 2010-12-31 SS&G FINANCIAL SERVICES INC 300 SPRUCE STREET SUITE 250 COLUMBUS OH 43215 990 2010-01-01 311024403 PEDIATRIC ACADEMIC ASSOCIATION INC PEDI 6147224451 555 SOUTH 18TH STREET 7TH FLOOR COLUMBUS OH 43205 MICHAEL T BRADY 6147224451 2011-11-15 1 ANNETTE L HOELZER CPA 6144883126 2011-11-15 2010 2016-03-07 17:11:31Z MICHAEL T BRADY 555 S 18TH ST 7TH FL COLUMBUS OH 43205 71330293 0 X N/A X 1981 OH PROVIDE MEDICAL CARE TO AFFILIATED HOSPITAL PATIENTS, RESEARCH TO THE HOSPITAL'S RESEARCH INSTITUTE & MEDICAL INSTRUCTION TO STUDENTS OF OSU COLLEGE OF MEDICINE. 6 2 448 2 0 0 0 0 69669518 71290698 15395 6368 0 33227 69684913 71330293 0 0 0 0 57377857 57780049 0 0 0 12386862 13795407 69764719 71575456 -79806 -245163 18133751 15718090 16331937 14161439 1801814 1556651 X PROVIDE MEDICAL CARE TO AFFILIATED HOSPITAL PATIENTS, RESEARCH TO THE HOSPITAL'S RESEARCH INSTITUTE & MEDICAL INSTRUCTION TO STUDENTS OF OSU COLLEGE OF MEDICINE. 0 0 57599120 63350036 PROVIDE MEDICAL CARE AT NATIONWIDE CHILDREN'S HOSPITAL TO ALL OF THE SICK AND INJURED CHILDREN WHO MAY COME TO THE HOSPITAL FOR DIAGNOSIS, TREATMENT, AND CARE WITHOUT REGARD TO THE ABILITY TO PAY FOR SERVICES. 5235626 5758371 PROVIDE ADMINISTRATIVE MEDICAL OVERSIGHT THROUGHOUT NATIONWIDE CHILDREN'S HOSPITAL'S MEDICAL DEPARTMENTS BY SUPERVISION AND REVIEWING STANDARD OF CARE. 2906286 2182291 PROVIDE CLINICAL AND CLASSROOM INSTRUCTION TO STUDENTS ENROLLED IN THE OHIO STATE UNIVERSITY COLLEGE OF MEDICINE AND TO THE RESIDENTS AND FELLOWS EMPLOYED AT NATIONWIDE CHILDREN'S HOSPITAL. ENGAGE IN MEDICAL RESEARCH WITH THE RESEARCH INSTITUTE OF NATIONWIDE CHILDREN'S HOSPITAL. 65741032 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 13 0 448 1 0 0 0 0 0 0 0 0 0 0 X 6 2 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 0 1 1 0 OH X KARL PRIEDEMAN 6143557452 555 SOUTH 18TH STREET 7TH FLOOR COLUMBUS OH 43205 TIMOTHY FELTES MD 50.00 X X 430711 0 199846 STEVE WELTY MD 50.00 X X 159968 0 7247 MICHAEL T BRADY MD 50.00 X X 227818 207218 54446 STEVE ALLEN MD 1.00 X 0 1006335 174372 TIM ROBINSON 1.00 X X 0 580152 151231 DOUGLAS RUND MD 1.00 X 0 0 0 CHRISTOPHER ELLISON MD 1.00 X 0 0 0 MITCHEL WHEELER 50.00 X 173239 0 49580 LESLIE K MIHALOV MD 50.00 X 309792 0 46496 CARL BACKES MD 50.00 X 344494 0 27422 JOHN CHEATHAM MD 50.00 X 573499 0 196507 CARLO DILORENZO MD 50.00 X 309041 0 24500 JONATHAN WISPE MD 50.00 X 303374 0 49422 JOHN KOVALCHIN MD 50.00 X 298335 0 41000 3130271 1793705 1022069 225 0 1 0 NATIONWIDE CHILDREN'S HOSPITAL 700 CHILDRENS DRIVE COLUMBUS OH 43205 ACCT, IS, BILLING AND OTHER SERVICES 3298818 OSU INTERNAL MEDICINE LLC 700 ACKERMAN ROAD SUITE 630 COLUMBUS OH 43202 MEDICAL SERVICES 769359 CHILDREN'S ANESTHESIA ASSOC INC 700 CHILDRENS DRIVE COLUMBUS OH 43205 MEDICAL SERVICES 448020 PREMIER HEALTHCARE SERVICES INC 332 CONGRESS PARK DRIVE DAYTON OH 45459 MEDICAL SERVICES 163800 OSU EMERGENCY MEDICINE LLC 169 MEANS HALL 1654 UPHAM DRIVE COLUMBUS OH 43210 MEDICAL SERVICES 125280 5 PATIENT CARE 900099 63350036 63350036 HOSPITAL ADMIN. 900099 5758371 5758371 TEACHING 900099 2182291 2182291 71290698 6368 6368 BENEFIT ADJUSTMENT 900099 24241 24241 MISCELLANEOUS 900099 8986 8986 33227 71330293 71323925 0 6368 1648380 1425562 222818 49471177 49211154 260023 4001789 3979844 21945 1634331 1546476 87855 1024372 990579 33793 56221 56221 192812 192812 161284 19071 142213 25747 25747 5668 5668 109579 56653 52926 43975 43975 91600 91600 146211 146211 324624 307736 16888 PURCHASED SERVICES 9984925 6404728 3580197 TRF DEANS TAX 1028599 1028599 PRACTICE PROGRAM EXP. 675823 675823 PROF. DEVELOPMENT 485243 485243 RECRUITMENT 261297 261297 201799 94807 106992 71575456 65741032 5834424 0 2228871 2144523 14209215 11055233 14060 639223 407213 351437 111812 55776 1451122 1822335 118671 1000 18133751 15718090 13190231 11281273 3141706 2880166 16331937 14161439 X 1770707 1537623 31107 19028 1801814 1556651 18133751 15718090 -245163 0 X 0 1 0 X 0 X 4360508 4420379 8780887 58367134 60126847 67528615 69669518 71290698 326982812 62727642 64547226 67528615 69669518 71290698 335763699 0 0 0 335763699 74669 119823 45925 15395 6368 262180 74669 119823 45925 15395 6368 262180 427495 57316 33227 518038 63229806 64724365 67574540 69684913 71330293 336543917 0.99770 0.99600 0.00080 0.00100 X 407213 351437 55776 55776 457(F) INVESTMENTS 1822335 F 1822335 DEFERRED COMPENSATION 1822335 NOTES PAYABLE TO RELATED PARTY 1057831 2880166 71330293 71575456 -245163 0 -245163 78612825 7282532 7282532 71330293 0 71330293 78857988 7282532 7282532 71575456 0 71575456 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: EFFECTIVE JANUARY 1, 2009, THE ASSOCIATION ADOPTED THE ACCOUNTING GUIDANCE FOR UNCERTAINTY IN INCOME TAXES. THE ASSOCIATION'S INCOME TAX FILINGS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES. THE ASSOCIATION'S OPEN AUDIT PERIODS ARE 2007 THROUGH 2009. IN EVALUATING THE ASSOCIATION'S ACTIVITIES, THE ASSOCIATION BELIEVES ITS POSITION OF TAX-EXEMPT STATUS IS CURRENT BASED ON CURRENT FACTS AND CIRCUMSTANCES. THEY FURTHER HAVE ASSESSED THAT THERE ARE NO ACTIVITIES UNRELATED TO THE PURPOSE OF THE ASSOCIATION AND THEREFORE NO TAX IS TO BE RECOGNIZED. IT IS THE POLICY OF THE ASSOCIATION TO INCLUDE IN OPERATING EXPENSES PENALTIES AND INTEREST ASSESSED BY INCOME TAXING AUTHORITIES. THERE ARE NO PENALTIES OR INTEREST FROM TAXING AUTHORITIES INCLUDED IN OPERATING EXPENSES FOR THE YEAR ENDED DECEMBER 31, 2010 AND 2009. PART XII, LINE 2D - OTHER ADJUSTMENTS: REIMBURSEMENTS REPORTED AS REVENUE ON FINANCIAL STATEMENTS 7,282,532. PART XIII, LINE 2D - OTHER ADJUSTMENTS: REIMBURSEMENTS REPORTED AS REVENUE ON FINANCIAL STATEMENTS 7,282,532. X X X 0 1 0 1 0 0 0 0 0 TIMOTHY FELTES MD 427843 0 0 0 2868 0 176661 0 23185 0 630557 0 0 0 STEVE WELTY MD 158185 0 0 0 1783 0 7247 0 0 0 167215 0 0 0 MICHAEL T BRADY MD 225010 112519 0 94699 2808 0 22501 10452 21185 308 271504 217978 0 0 STEVE ALLEN MD 0 699643 0 306692 0 0 0 158764 0 15608 0 1180707 0 0 TIM ROBINSON 0 421950 0 141702 0 16500 0 133623 0 17608 0 731383 0 0 MITCHEL WHEELER 168658 0 0 0 4581 0 17618 0 31962 0 222819 0 0 0 LESLIE K MIHALOV MD 305129 0 1417 0 3246 0 24500 0 21996 0 356288 0 0 0 CARL BACKES MD 338926 0 0 0 5568 0 24500 0 2922 0 371916 0 0 0 JOHN CHEATHAM MD 567931 0 0 0 5568 0 169121 0 27386 0 770006 0 0 0 CARLO DILORENZO MD 268295 0 37500 0 3246 0 24500 0 0 0 333541 0 0 0 JONATHAN WISPE MD 244778 0 54270 0 4326 0 24500 0 24922 0 352796 0 0 0 JOHN KOVALCHIN MD 245525 0 49996 0 2814 0 24500 0 16500 0 339335 0 0 0 PART I, LINE 4B PART I, LINE 4B: AMOUNTS PAID DURING THE YEAR: JOHN CHEATHAM, M.D. $144,621 TIMOTHY FELTES, M.D. $152,161 THE TERMS AND CONDITIONS OF THE ARRANGEMENTS: THE ASSOCIATION CONTRIBUTES TO A NONQUALIFIED 457(F) PLAN ON BEHALF OF CERTAIN KEY EMPLOYEES. UNDER THE AGREEMENTS, CONTRIBUTIONS OF 10-25% OF THE EMPLOYEES' ANNUAL SALARY WILL BE TRANSFERRED TO THE PLAN. THE EMPLOYEES' RESPECTIVE VESTED BALANCE IS PAYABLE IN A LUMP SUM AMOUNT UPON THE EMPLOYEE'S RETIREMENT OR UNEMPLOYMENT TERMINATION, AS DETERMINED IN THE AGREEMENT. THE AGREEMENTS HAVE VARYING EXPIRATION DATES. PART I, LINE 5 THE ASSOCIATION HAS AN INCENTIVE PROGRAM THAT PAYS THE PHYSICIAN .5% ON THE GROSS CHARGES GENERATED BY THE PHYSICIAN AS AN INCENTIVE PAYMENT. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 WILL BE PROVIDED TO THE ASSOCIATION'S CORPORATE BOARD MEMBERS ELECTRONICALLY PRIOR TO FILING WITH THE IRS. THE FORM 990 WILL BE PRESENTED AND REVIEWED AT THE NEXT BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS AND MEMBERS OF THE ASSOCIATION ARE REQUIRED ANNUALLY TO COMPLETE A CONFLICT OF INTEREST FORM AS A FACULTY STAFF OF THE OHIO STATE UNIVERSITY AND AS A MEDICAL STAFF OF NATIONWIDE CHILDREN'S HOSPITAL RESEARCH INSTITUTE. THESE FORMS ARE REVIEWED BY THE CHAIRMAN OF THE ASSOCIATION AND ANY ISSUE MUST BE RESOLVED BEFORE THEIR WORK CAN CONTINUE. THIS ALSO APPLIES TO ANY NEW CONTRACTS OR COMMITMENTS TO BE AGREED UPON. FORM 990, PART VI, SECTION B, LINE 15 THE DEAN OF THE MEDICAL COLLEGE AT THE OHIO STATE UNIVERSITY REVIEWS THE CHAIRMAN'S COMPENSATION. THE CHAIRMAN, ASSISTED BY THE COMPENSATION COMMITTEE (AS ADVISORY ONLY NOT APPOINTED BY THE BOARD) REVIEWS EACH INDIVIDUAL'S COMPENSATION EACH YEAR IN RESPECT TO THE NATIONAL SURVEYS OF DATA FROM THE ADMINISTRATION OF THE AMERICAN ASSOCIATION OF PEDIATRICS (AAAP) AND THE AMERICAN ASSOCIATION OF MEDICAL COLLEGES (AAMC). FORM 990, PART VI, SECTION C, LINE 19 THE ASSOCIATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC.: FORM 990, PART VI, LINE 9 DOUGLAS RUND, M.D. - 4510 CRAMBLETT HALL, 456 W. 10TH AVENUE COLUMBUS, OH 43210 CHRISTOPHER ELLISON, M.D. - 395 W. 12TH AVENUE COLUMBUS, OH 43210 NATIONWIDE CHILDREN'S HOSPITAL 700 CHILDRENS DRIVE COLUMBUS OH 43205 314379441 ENHANCING THE HEALTH OF CHILDREN OH 501(C)(3) 3 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 1 0