2023-11-14T18:15:01-06:00 2022-12-31 440160260 FORVIS LLP 500 Ridgefield Court Asheville NC 28806 990 2022-01-01 630879471 Alabama Children's Hospital Foundation ALAB 2056389393 1600 7th Avenue South Birmingham AL 35233 Dawn Walton CFO 2056389393 2023-11-14 1 Dawn Walton 999009999 0 Amy Bibby P00445891 8282542254 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Coke Matthews 1600 7th Avenue South Birmingham AL 35233 42641914 0 X www.ChildrensAL.org X 1911 AL THE MISSION OF ALABAMA CHILDREN'S HOSPITAL FOUNDATION (THE FOUNDATION) IS TO SUPPORT THE ACTIVITIES AND MISSION OF THE HOSPITAL (CHA). 33 31 0 257 38917 31615 17657597 13192155 0 0 49369770 27974150 662495 754459 67689862 41920764 4377188 5305456 0 0 0 0 0 0 0 7912241 10064502 12289429 15369958 55400433 26550806 1336728368 1232417126 547637 599835 1336180731 1231817291 The mission of Alabama Children's Hospital Foundation (The Foundation) is to support the activities and mission of the Hospital (CHA). 0 0 13980990 5305456 Management and general administration of fundraising activities for the Hospital (CHA). 13980990 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 33 31 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Dawn Walton CFO 2056389901 1600 7th Avenue South Birmingham AL 35233 Thomas G Shufflebarger President & CEO (Key Employee) 1.00 40.00 X 0 1402741 24620 Dawn Walton Chief Financial Officer 1.00 40.00 X X 0 771941 23994 Ralph Frohsin Jr President of the Foundation 1.00 1.00 X X 0 0 0 Edward K Aldag Jr Vice President of the Foundation 1.00 1.00 X X 0 0 0 Beth G Dubina Secretary/Treasurer of the Foudation 1.00 1.00 X X 0 0 0 Tracey M Adams Director 1.00 1.00 X 0 0 0 Richard J Bielen Director 1.00 1.00 X 0 0 0 J David Brown III Director 1.00 1.00 X 0 0 0 Myla E Calhoun Director 1.00 1.00 X 0 0 0 Mitchell B Cohen MD Director 1.00 1.00 X 0 0 0 Derrol Dawkins MD Director 1.00 1.00 X 0 0 0 Mark E Dixon Director 1.00 1.00 X 0 0 0 Raymond J Harbert Director 1.00 1.00 X 0 0 0 William E Horton Director 1.00 1.00 X 0 0 0 Donald M James Director 1.00 1.00 X 0 0 0 Virginia Walker Jones Director 1.00 1.00 X 0 0 0 Philippe W Lathrop Director 1.00 1.00 X 0 0 0 James C Lee III Director 1.00 1.00 X 0 0 0 Thomas H Lowder Director 1.00 1.00 X 0 0 0 Anna M Manasco Director 1.00 1.00 X 0 0 0 W Charles Mayer Director 1.00 1.00 X 0 0 0 L Gwaltney McCollum Jr Director 1.00 1.00 X 0 0 0 Ann D McMillan Director 1.00 1.00 X 0 0 0 C Phillip McWane Director 1.00 1.00 X 0 0 0 W Jerry Oakes MD Director 1.00 1.00 X 0 0 0 Craft ONeal Director 1.00 1.00 X 0 0 0 Margaret M Porter Director 1.00 1.00 X 0 0 0 Frederick W Renneker III Director 1.00 1.00 X 0 0 0 Stuart A Royal MD Director 1.00 1.00 X 0 0 0 Lee J Styslinger III Director 1.00 1.00 X 0 0 0 Mark J Tarr Director 1.00 1.00 X 0 0 0 Temple W Tutwiler III Director 1.00 1.00 X 0 0 0 Marc Bryant Tyson Director 1.00 1.00 X 0 0 0 Coke Matthews EVP of Foundation 1.00 40.00 X 0 511804 18036 0 2686486 66650 0 0 1 0 0 2537819 10654336 463967 13192155 12238627 38917 12199710 1475609 0 1475609 1475609 1475609 15735523 0 15735523 15735523 15735523 0 2537819 721150 -721150 -721150 41920764 0 38917 28689692 X 5305456 5305456 1388968 1388968 2309937 2309937 91805 91805 392649 392649 181345 181345 3477 3477 71156 71156 6110 6110 307135 307135 3623 3623 Research Institute Expe 3887107 3887107 Miscellaneous 1397921 1397921 Food and Dietary 16175 16175 Unrelated Business Inco 7094 7094 15369958 13980990 1388968 0 4243639 4334862 18856460 16048740 108125 32500 523747 418449 34574750 13586018 21295867 20988732 1171351152 1061414703 120349378 129179140 1336728368 1232417126 409146 505233 138491 94602 547637 599835 X 1272473442 1168749479 63707289 63067812 1336180731 1231817291 1336728368 1232417126 X 26550806 -136681056 5766811 X X 0 1 X 1 0 X X 1 The Children's Hosptial of Alabama 630307306 3 1 2314025 0 1 2314025 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 15414282 15414282 19073349 13498899 5574450 87119 87119 0 20988732 Due From Children's Hospital 129179140 129179140 Due to Children's Harbor 94602 94602 X Part X, Line 2: The Hospital and the Foundation are exempt from federal income taxes under Section 501(a) of the Internal Revenue Code as organizations described in Section 501(c)(3). TCH Ventures is a taxable entity under the Internal Revenue Code. At present, the Government of the Cayman Islands has imposed no taxation on income or premiums of Holy Innocents. The Company adheres to the provisions of the Accounting Standards Codification relating to uncertainty in income taxes that requires entities to assess their uncertain tax positions for the likelihood that they would be overturned upon Internal Revenue Service (IRS) examination or upon examination by state taxing authorities. The Company has determined that it does not have any positions at December 31, 2022 and 2021, that it would be unable to substantiate. The Company has filed its tax returns through December 31, 2021. The tax returns for the years ended December 31, 2019, and thereafter are subject to audit by the taxing authorities. Nucor Alabama Children's Charity Cl 447796 447796 137304 Children's Illuminations Ball 2022 386539 386539 109296 30 1703484 1703484 474550 2537819 2537819 721150 721150 -721150 1 University of Alabama at Birmingham 1350 3rd Avenue South Birmingham AL 35294 636005396 Government Org 2840039 0 Endowed Chair Expense/Kaul Pediatric Research Institute Grant The Children's Hosptial of Alabama 1600 Seventh Avenue South Birmingham AL 35233 630307306 501(c)(3) 2314025 0 operations 2 Part I, Line 2: The grantees for the past several years have all been UAB faculty. Once provided to the principal investigators (PI) the monies are deposited with the UAB grants and contracts office for administration. They monitor the spending of the grant funds to ensure that the money is used in accordance with the grant budget. Any deviations from the budget or the timeline require KPRI approval. Any deviations in the research project itself require KPRI approval and the approval of the chairman of the scientific review committee. UAB grants and contracts require approval in writing before they will deviate from budget or timeline. The principal investigator (PI) is required to submit a progress report at the end of year one. The scientific review committee reviews the grant progress and communicates adequate progress to the KPRI executive committee. Adequate progress must be demonstrated before year two funding is provided. At the end of year two, a final report is due as well. X X X X 0 0 0 0 0 0 0 0 0 Thomas G Shufflebarger President & CEO (Key Employee) 0 965843 0 411691 0 25207 0 10250 0 14370 0 1427361 0 0 Dawn Walton Chief Financial Officer 0 578626 0 170430 0 22885 0 10250 0 13744 0 795935 0 0 Coke Matthews EVP of Foundation 0 372857 0 109410 0 29537 0 10250 0 7786 0 529840 0 0 X 104565 Fair Market Value X 6 79611 Fair Market Value X 4 8665 Fair Market Value X Miscellaneous 294 215898 Fair Market Value X Electronics 2 31228 Fair Market Value X Travel Ammenities 2 24000 Fair Market Value 0 1 0 Form 990, Part VI, Section A, line 2 Richard Bielen serves with Mr. Warren on the board of directors of a local insurance company. Form 990, Part VI, Section B, line 11b The completed Form 990 is reviewed in detail by the finance and audit committee. The Form 990 is then provided to the board of trustees, prior to the filing of the return. Form 990, Part VI, Section B, line 12c The Corporate Compliance Officer is responsible for monitoring compliance with the Conflict of Interest Policy. Annual disclosure requests are sent and followed up on to ensure that all are returned. Returned conflict of interest statements are reviewed by the Corporate Compliance Officer and compliance department staff as well as officers of the Organization for accuracy and completeness. Conflict of interest statements are maintained by the compliance department. The Compliance Officer reports activity related to any potential conflicts of interest, including changes in previously reported conflicts to administration, and the corporate compliance committee which is a subcommittee of the board of directors. Form 990, Part VI, Section B, line 15 The Hospital maintains oversight concerning all executive compensation action. This process is led by the Hospital board of trustees compensation committee, which is involved annually, and throughout the year as needed, in providing oversight of all executive compensation. Total compensation (i.e., base salary, incentive compensation, and executive benefits) of officers, key employees, and other vice-presidents is approved by the compensation committee prior to such compensation being paid. The total compensation that is presented for approval is determined by evaluation of market data comparisons on executive total compensation. This independent, objective market data is provided by the Hospital's independent executive compensation consulting firm, Sullivan Cotter and Associates. All compensation committee proceedings, decisions, and actions are documented in committee minutes are maintained by the Hospital. Form 990, Part VI, Section C, line 19 Governing documents are not generally made public. Separate financial statements for the Foundation are not generally available to the public. They are included in the consolidated quarterly disclosures and audited financial statements of the Children's Hospital of Alabama and are filed on the Electronic Municipal Market Access ("EMMA") section of the Municipal Securities Rulemaking Board as we maintain public debt. Audited financial statements are also filed as part of The Children's Hospital of Alabama Form 990. The Conflict of Interest policy is summarized in the Corporate Code of Conduct which is available on the Hospital's website. Form 990, Part IX, line 11g Contract Labor: Program service expenses 2,253,223. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,253,223. Other Professional Fees: Program service expenses 56,714. Management and general expenses 0. Fundraising expenses 0. Total expenses 56,714. Form 990, Part XI, line 9: Transfer from Hospital 5,118,627. Other Change 648,184. Form 990, Part XII, Line 2c: This process has not changed from the prior year. The Children's Hospital of Alabama 1600 7th Avenue South Birmingham AL 35233 630307306 Hospital AL 501(c)(3) Line 3 N/A 0 Holy Innocents Indemnity LTD PO Box 10073 APO Grand Cayman CJ 980436612 Insurance CJ N/A C 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0