2023-11-14T16:39:51-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 2601 CAMBRIDGE CT STE 300 AUBURN HILLS MI 48326 990 2022-01-01 870853487 AKRON CHILDREN'S HEALTH COLLABORATIVE AKRO 3305438171 1 PERKINS SQUARE AKRON OH 44308 GORDON T EDWARDS TREASURER 3305438171 2023-11-13 1 GORDON EDWARDS 999009999 1 AMY CIMINELLO P00796388 2483757100 2023-11-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z GORDON T EDWARDS 1 PERKINS SQUARE AKRON OH 44308 285916575 0 X N/A X 2021 OH AKRON CHILDREN'S HEALTH COLLABORATIVE (ACHC) IMPROVES CHILD HEALTH THROUGH FAMILY-CENTERED CARE COORDINATION, AN ENGAGED NETWORK OF PROVIDERS, AND A UNITED FOCUS ON QUALITY, ACCESS AND HEALTH EQUITY. 14 6 0 6 0 0 0 0 73489103 285793614 0 122961 0 0 73489103 285916575 0 0 0 0 0 0 0 0 0 96144503 290224482 96144503 290224482 -22655400 -4307907 29403697 32086459 51059097 58049766 -21655400 -25963307 AKRON CHILDREN'S HEALTH COLLABORATIVE (ACHC) IMPROVES CHILD HEALTH THROUGH FAMILY-CENTERED CARE COORDINATION, AN ENGAGED NETWORK OF PROVIDERS, AND A UNITED FOCUS ON QUALITY, ACCESS AND HEALTH EQUITY. 0 0 290224482 285793614 AKRON CHILDREN'S HEALTH COLLABORATIVE (ACHC) IS A PROVIDER LED, PEDIATRIC ACCOUNTABLE CARE ORGANIZATION CURRENTLY FOCUSING ON OHIO MEDICAID PEDIATRIC MEMBERS TO IMPROVE CHILD HEALTH BY EMPOWERING PROVIDERS AND ENGAGING PATIENTS AND COMMUNITIES. ACHC WILL ACHIEVE THIS BY PARTNERING WITH OHIO MEDICAID MANAGED CARE ORGANIZATIONS AND COMMERCIAL PAYORS; PARTNERING WITH HEALTH CARE PROVIDERS, COMMUNITY ORGANIZATIONS AND OTHER KEY STAKEHOLDERS; OFFERING A NETWORK OF PROVIDERS TO DELIVER HIGH QUALITY, HIGH VALUE HEALTH CARE TO CHILDREN; AND INVESTING IN CARE MANAGEMENT AND POPULATION HEALTH CAPABILITIES THAT ADVANCE OUR MISSION OF IMPROVING CHILD HEALTH. 290224482 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 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 1 0 0 0 0 0 0 0 0 0 0 0 X 14 6 0 0 0 0 1 1 1 1 0 0 0 0 1 1 1 1 1 0 0 0 X ALICIA LAMANCUSA 3305438171 1 PERKINS SQUARE AKRON OH 44308 CHRISTOPHER GESSNER PRESIDENT/ PART YEAR BOARD MEMBER 1.00 49.00 X 0 1015692 248210 SHAWN LYDEN CHIEF STRATEGY OFFICER/BO 1.00 49.00 X 0 849365 141590 ALICIA LAMANCUSA BOARD MEMBER/TREASURER 1.00 49.00 X X 0 615367 -185457 TSULEE CHEN MD BOARD MEMBER/NEUROSURGEON 1.00 49.00 X 0 979453 38870 SHEFALI MAHESH MD CHAIR/ PEDIATRIC NEPHROLOG 12.00 38.00 X X 0 458259 40210 LAURA MARKELY MD BOARD MEMBER/CHILD ADOLES 1.00 49.00 X 0 260936 42855 ANDREA KNIGHTON DO BOARD MEMBER/ PEDIATRICIAN 1.00 49.00 X 0 313614 44231 ROBERT MCGREGOR MD BOARD MEMBER - PART YEAR 1.00 49.00 X 0 763436 127907 RODNEY ISON MD BOARD MEMBER/ VICE CHAIR 1.00 0.00 X X 0 0 0 LYNN JOHNSON MD BOARD MEMBER 1.00 0.00 X 0 0 0 ELIZABETH OLDS MD BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID SANSOTERRA MD BOARD MEMBER 1.00 0.00 X 0 0 0 DEMOND SCOTT MD BOARD MEMBER 1.00 0.00 X 0 0 0 DECEMBER WEST BOARD MEMBER 1.00 0.00 X 0 0 0 ANTHEA DANIELS CHIEF LEGAL OFFICER/SECRE 2.00 48.00 X 0 558764 103678 KRISTENE GRAYEM EXECUTIVE DIRECTOR 20.00 20.00 X 0 384136 -219347 STEVE SPALDING MD INTERIM MEDICAL DIRECTOR-PART YEAR 2.00 48.00 X 0 246124 20406 0 6445146 403153 0 0 1 0 0 PMPM PREMIUM REVENUE 900001 279624853 279624853 QUALITY INCENTIVE 900001 5289824 5289824 TRANSITION CREDIT 900001 878937 878937 285793614 122961 122961 285916575 285793614 0 122961 14690 14690 5728469 5728469 7394 7394 159931 159931 141731 141731 7596 7596 MEDICAL CLAIMS 283841828 283841828 COORDINATION OF BENEFIT 261951 261951 MEDICATION THERAPY MGMT 52093 52093 DUES AND SUBSCRIPTIONS 6517 6517 2282 2282 290224482 290224482 0 0 6811682 133448 22592015 31953011 29403697 32086459 34535105 38849722 16523992 19200044 51059097 58049766 X -21655400 -25963307 -21655400 -25963307 29403697 32086459 -4307907 0 X X 0 1 X 1 0 0 DUE TO AFFILIATES 19200044 19200044 0 1 0 0 0 0 0 0 0 CHRISTOPHER GESSNER PRESIDENT/ PART YEAR BOARD MEMBER 0 1000002 0 0 0 15690 0 214796 0 33414 0 1263902 0 0 TSULEE CHEN MD BOARD MEMBER/NEUROSURGEON 0 868613 0 110000 0 840 0 18300 0 20570 0 1018323 0 0 SHAWN LYDEN CHIEF STRATEGY OFFICER/BO 0 671235 0 145699 0 32431 0 117065 0 24525 0 990955 0 0 ROBERT MCGREGOR MD BOARD MEMBER - PART YEAR 0 588092 0 145355 0 29989 0 103850 0 24057 0 891343 0 0 ANTHEA DANIELS CHIEF LEGAL OFFICER/SECRE 0 439997 0 116853 0 1914 0 100069 0 3609 0 662442 0 0 SHEFALI MAHESH MD CHAIR/ PEDIATRIC NEPHROLOG 0 309153 0 148678 0 428 0 21350 0 18860 0 498469 0 0 ALICIA LAMANCUSA BOARD MEMBER/TREASURER 0 375003 0 231875 0 8489 0 -208698 0 23241 0 429910 0 0 ANDREA KNIGHTON DO BOARD MEMBER/ PEDIATRICIAN 0 242754 0 68008 0 2852 0 17387 0 26844 0 357845 0 0 LAURA MARKELY MD BOARD MEMBER/CHILD ADOLES 0 244721 0 15000 0 1215 0 15583 0 27272 0 303791 0 0 STEVE SPALDING MD INTERIM MEDICAL DIRECTOR-PART YEAR 0 195919 0 49600 0 605 0 9302 0 11104 0 266530 0 0 KRISTENE GRAYEM EXECUTIVE DIRECTOR 0 341062 0 41825 0 1249 0 -222371 0 3024 0 164789 0 0 PART I, LINE 3 AKRON CHILDREN'S HEALTH COLLABORATIVE RELIES ON ITS MEMBER, CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (CHMCA), TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON'S EXECUTIVE TOTAL COMPENSATION PROGRAM IS ULTIMATELY GOVERNED BY THE COMPENSATION COMMITTEE (COMMITTEE) OF THE BOARD OF DIRECTORS. AN INDEPENDENT SALARY SURVEY WAS LAST COMPLETED IN 2022 AND RECOMMENDATIONS WERE PROVIDED AND PRESENTED BY THE INDEPENDENT CONSULTANT TO THE COMMITTEE FOR APPROVAL. PART I, LINE 4B THE FOLLOWING INDIVIDUALS BECAME PARTICIPANTS IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS DURING 2018, WHEREBY THEY BECOME VESTED PER THE TERMS OF THEIR EMPLOYMENT AGREEMENT. CHMCA IS ACCRUING FOR THE BENEFIT THAT WILL OCCUR, THEREFORE THESE AMOUNTS ARE INCLUDED IN THEIR DEFERRED COMPENSATION. NO DISTRIBUTIONS TO THE FOLLOWING INDIVIDUALS WERE MADE IN 2022. SHAWN LYDEN ANTHEA DANIELS CHRISTOPHER GESSNER CHMCA HAS A SUPPLEMENTAL NONQUALIFIED PLAN OPEN TO SELECTED EMPLOYEES WHEN WAGES EXCEED THE MAXIMUM THRESHOLD FOR THE QUALIFIED RETIREMENT PLANS. THE AMOUNTS ARE CALCULATED IN THE FOLLOWING YEAR OF EARNINGS AND EITHER PAID TO THE EMPLOYEE IF THEY ARE VESTED AS TAXABLE INCOME OR PUT INTO THE PLAN UNTIL VESTED AND THEN PAID. FORM 990, PART VI, SECTION A, LINE 6 CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON IS THE SOLE MEMBER OF AKRON CHILDREN'S HEALTH COLLABORATIVE. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER APPOINTS THE BOARD MEMBERS OF AKRON CHILDREN'S HEALTH COLLABORATIVE. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER SHALL HAVE FINAL DECISION MAKING AUTHORITY WITH RESPECT TO THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES: (A) TO ADOPT AND APPROVE AMENDMENTS TO THE CORPORATION'S ARTICLES AND REGULATIONS; (B) TO APPROVE ANY AMENDMENTS TO THE CORPORATION'S PURPOSE OR MISSION INCLUDING CONFLICT OF INTEREST POLICIES; (C) TO APPROVE, APPOINT OR REMOVE A MEMBER OF THE BOARD OF THE CORPORATION WITH OR WITHOUT CAUSE, IN ACCORDANCE THE PROCEDURES SET FORTH HEREIN; (D) TO CREATE ANY COMMITTEES OR SUBCOMMITTEES OF THE BOARD OR ANY ADVISORY BOARDS OR COUNCILS TO THE BOARD OR TO ANY OF ITS COMMITTEES OR SUBCOMMITTEES; (E) TO ADOPT, APPROVE, DISAPPROVE AND/OR AMEND THE OPERATING AND CAPITAL ANNUAL BUDGET AND ANY CONSOLIDATED OPERATING AND CAPITAL BUDGETS OR CONSTRUCTION BUDGETS FOR THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION, AND CHANGES IN THE BUDGETS OR THE INCURRENCE OF UNBUDGETED EXPENSES IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE MEMBER; (F) TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; (G) TO APPROVE ALL CONTRACTS BETWEEN THE CORPORATION AND HEALTH INSURING CORPORATIONS, MANAGED CARE ORGANIZATIONS, PAYERS, EMPLOYERS OR SIMILAR ENTITIES; (H) TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION; (I) TO APPROVE THE STRATEGIC PLAN AND LONG RANGE GOALS AND OBJECTIVES OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; (J) TO APPOINT OR REMOVE OFFICERS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; (K) TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; (L) TO APPROVE THE LEASE OR SALE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE MEMBER, AND TO APPROVE THE PURCHASE OR SALE OF ANY REAL ESTATE; AND (M) TO RECEIVE ANY FUNDING FROM AFFILIATED ENTITIES OR ANY DISBURSEMENTS TO AFFILIATED OR OTHER THIRD PARTIES; AND (N) TO MAKE DISTRIBUTIONS FROM THE CORPORATION TO THE MEMBER. FORM 990, PART VI, SECTION A, LINE 8B ACHC DID NOT FORM ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY DURING 2022. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE AUDIT COMMITTEE OF THE CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (MEMBER) FOR REVIEW AND DISCUSSION PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE. THE AUDIT COMMITTEE IS A COMMITTEE OF THE CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON BOARD OF DIRECTORS AND EMPOWERED TO COMPLETE THE REVIEW ALL AFFILIATES ON BEHALF OF THE DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE POLICY OF ACHC TO FOLLOW THE APPLICABLE POLICIES OF CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (CHMCA). ALL OFFICERS, DIRECTORS, AND EMPLOYEES DISCLOSE REAL OR APPARENT CONFLICTS OF INTEREST AS A CONDITION OF BOARD MEMBERSHIP WITH ACHC. ALL OFFICERS AND DIRECTORS DISCLOSE, IN WRITING, ON AN ANNUAL BASIS, A LIST OF ALL BUSINESSES OR OTHER ORGANIZATIONS IN WHICH HE/SHE (OR AN IMMEDIATE FAMILY MEMBER) IS AN OFFICER, MEMBER, OWNER, SHAREHOLDER, TRUSTEE OR EMPLOYEE FOR WHICH HE/SHE ACTS AS AN AGENT OR MIGHT REASONABLY, IN THE NEAR FUTURE, ENTER INTO A RELATIONSHIP OR TRANSACTION IN WHICH HE/SHE COULD HAVE A DUALITY OF INTEREST. IF A SITUATION ARISES IN WHICH THERE IS A DUALITY OF INTEREST AND AS SUCH, POTENTIAL FOR A CONFLICT OF INTEREST, IT IS THE PRIMARY RESPONSIBILITY OF SUCH AN INDIVIDUAL DIRECTLY INVOLVED TO MAKE IMMEDIATE AND COMPLETE DISCLOSURE TO THE APPROPRIATE SUPERVISOR. THE CHIEF HUMAN RESOURCES OFFICER SHALL REVIEW ALL DISCLOSURE STATEMENTS AND FORWARD THOSE WITH RECOMMENDATIONS TO THE CHIEF LEGAL OFFICER. THE CHIEF LEGAL OFFICER REFERS TO SELECTED ISSUES OR MATTERS FOR CONSULTATION TO THE AUDIT COMMITTEE OF THE CHMCA BOARD. FORM 990, PART VI, SECTION B, LINE 15 ACHC RELIES ON THE RELATED ORGANIZATION, CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON, TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST PART XII, LINE 2C: ACHC THROUGH ITS PARENT COMPANY CHILDREN'S HOSPITAL CENTER OF AKRON HAS AN AUDIT COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT, REVIEW, OR COMPILATION OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. CHILDREN'S HOSPITAL MED CENTER OF AKRON ONE PERKINS SQUARE AKRON OH 44308 340714357 HOSPITAL OH 501(C)(3) LINE 3 N/A 0 AKRON CHILDREN'S HOSPITAL FOUNDATION ONE PERKINS SQUARE AKRON OH 44308 237114013 FOUNDATION OH 501(C)(3) LINE 7 CHILDREN'S HOSPITAL MED CENTER OF AKRON 1 CHILD DIMENSIONS INSURANCE COMPANY ONE PERKINS SQUARE AKRON OH 44308 030317160 INSURANCE OH 501(C)(3) LINE 12A, I CHILDREN'S HOSPITAL MED CENTER OF AKRON 1 GAMUT QUALITY IMPROVEMENT COLLABORATIVE LLC 68 RAVENNA STREET 463 HUDSON OH 44236 871832345 CONTRACT MANAGEMENT OH N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0