2024-08-02T10:41:37-05:00 2023-09-30 010494452 Baker Newman & Noyes LLC 280 Fore Street Portland ME 04101 990 2022-10-01 042970129 Children's Sports Medicine Foundation Inc CHIL 6173555852 319 Longwood Avenue Ste 6 Boston MA 02115 Mininder S Kocher MD President 6173555852 2024-07-30 0 0 Nicholas E Porto P01310283 8002447444 2024-07-30 2022 2024-08-08 14:25:15Z Mininder S Kocher MD 319 Longwood Avenue Ste 6 Boston MA 02115 34246935 0 X N/A X 1987 MA The Foundation provides sports injury related medical services primarily to (see Schedule O) patients at Boston Children's Hospital and at satellite locations. The Foundation also provides care for patients regardless of their ability to pay, as well as providing community based services. 10 0 22 0 15765 996 182797 16671 32113699 34190076 8318 40188 0 0 32304814 34246935 47083 1949186 0 0 25236713 26907918 0 0 0 6235253 7193076 31519049 36050180 785765 -1803245 49523391 53575173 8190908 11159370 41332483 42415803 X The Foundation provides sports related injury and medical services primarily to patients at Boston Children's Hospital and at satellite locations. The Foundation was organized exclusively for charitable, scientific, and educational purposes. The mission (See Schedule O) strives to provide comprehensive assessment, treatment, and follow up care to children, adolescents, and young adults with sports-related orthopaedic injuries. 0 0 33381502 1949186 32822473 The Foundation provides sports related injury and orthopaedic surgery services primarily to patients at Boston Children's Hospital, and at satellite locations. The Foundation carries on and promotes basic and applied medical research and education in the field of sports related injuries by teaching students and other medical and scientific personnel. Additionally, the Foundation gives lectures and publishes information concerning problems and research results in the fields of sports related injuries and orthopaedic surgery in order to educate the general public and the medical profession. The Foundation also provides care for patients regardless of their ability to pay, as well as providing hospital and community based services that are limited in the community. 1390896 1367603 The Foundation has an agreement with Boston Children's Hospital to jointly operate satellite ambulatory centers to service patients in the community. This agreement calls for a sharing of any net surplus generated by these satellite centers. 34772398 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 22 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X Cristina Murphy 6173555852 319 Longwood Avenue Boston MA 02115 Mininder S Kocher MD President 35.00 5.00 X X 1982363 0 109856 Lyle J Micheli MD Director 50.00 0.00 X 870953 0 82149 William Meehan MD Treasurer 40.00 0.00 X 485291 0 110174 Andrea Straccolini MD Director 40.00 0.00 X 698643 0 66000 Dennis Kramer MD Director 40.00 0.00 X 1137181 0 115383 Benton Heyworth MD Director 40.00 0.00 X 1352626 0 120377 Melissa Christino MD Director 40.00 0.00 X 1002995 0 84572 Bridget Quinn MD Director 40.00 0.00 X 278523 0 58750 Cristina C Murphy Clerk 40.00 0.00 X X 0 54488 0 Martha M Murray MD Director 6.00 0.00 X 758434 0 70662 Physicians Org at CH Inc Institutional Trustee 2.00 0.00 X 0 0 0 8567009 54488 817923 9 0 1 0 Thomas Vorderer DPM 100 Landsdowne Street Apt 904 Cambridge MA 02139 Medical Services 368468 Harvard Medical Faculty Physicians at BI 375 Longwood Ave 3rd Floor Boston MA 02215 Medical Services 285802 2 16671 16671 Patient Services 621300 33195304 33195304 Clinical and Other Revenue 621990 994772 994772 34190076 40188 15765 24423 34246935 34190076 15765 24423 1949186 1949186 8977334 8894741 82593 17930584 17039793 890791 3000 3000 19014 19014 242638 242638 1224441 1184695 39746 1768031 1768031 53534 53534 421555 421555 22967 22967 Fellowship expenses 924733 924733 PO management services 785333 785333 Billing services 752877 752877 BCH Support Tax 663906 663906 311047 311047 36050180 34772398 1277782 0 4925914 4301031 1454482 1523904 2884344 3469843 57468 64883 5634019 2659534 2912097 2974485 34285171 37171736 3003915 4069291 49523391 53575173 221245 201107 186624 2031560 7783039 8926703 8190908 11159370 X 41332483 42415803 41332483 42415803 49523391 53575173 -1803245 2886565 0 X X 0 1 X 1 0 X 219426 659118 1020738 182797 16671 2098750 29436467 24042562 29302678 32113699 34190076 149085482 29655893 24701680 30323416 32296496 34206747 151184232 0 0 0 151184232 84663 33077 3414 8883 24423 154460 -14475 -24738 322 -565 15765 -23691 70188 8339 3736 8318 40188 130769 22848 22848 29726081 24732867 30327152 32304814 34246935 151337849 0.99900 0.99870 0.00090 0.00110 X Schedule A, Part III, Line 12, Explanation of Other Income: Insurance rebate - 2019 Amount: $ 22,848. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 159783 159783 952023 952023 589516 589516 4901526 2190838 2710688 732493 468696 263797 2974485 PO Pooled Investment Funds 37171736 F 37171736 Right of Use Asset 3162600 Due from COSF, Inc. 408840 Due from Phys. Org. at Children's Hospital, Inc. 306916 Due from Boston Children's Hospital 176806 Other receivables 13630 Due from Boston Plastic & Oral Surgery Foundation, Inc. 499 4069291 Due to COSF, Inc. 3495534 Due to Phys. Org. at Children's Hospital, Inc. 282863 Due to Boston Children's Hospital 1864413 Accrued professional liability 30854 Lease Liability 3253039 8926703 X 37133500 2886565 2886565 34246935 0 34246935 36050180 0 36050180 0 36050180 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, 2023. 1 Children's Orthopaedic Surgery Foundation Inc 300 Longwood Avenue Boston MA 02115 042943146 501(c)(3) 11750 0 N/A N/A General support Boston Ballet 19 Clarendon Street Boston MA 02116 042312734 501(c)(3) 1921853 0 N/A N/A General support Shooting Touch 65 Sprague Street East Building 2nd Floor Boston MA 02136 611544791 501(c)(3) 10000 0 N/A N/A General Support 3 0 Part I, Line 2: Monitoring is provided by Children's Sports Medicine Foundation, Inc. (the Foundation) through oversight of the terms and conditions of a written grant agreement. Multiyear agreements require yearly progress and financial reports for continuation of the funding. During the year ended September 30, 2023, the Foundation only provided grant donations to other 501(c)(3) organizations. X X X X X 0 0 0 0 0 0 0 1 0 Mininder S Kocher MD President 608522 0 1300000 0 73841 0 66000 0 43856 0 2092219 0 0 0 Benton Heyworth MD Director 231055 0 1070000 0 51571 0 66000 0 54377 0 1473003 0 0 0 Dennis Kramer MD Director 269555 0 795000 0 72626 0 66000 0 49383 0 1252564 0 0 0 Melissa Christino MD Director 401014 0 530000 0 71981 0 66000 0 18572 0 1087567 0 0 0 Lyle J Micheli MD Director 571197 0 250000 0 49756 0 66000 0 16149 0 953102 0 0 0 Martha M Murray MD Director 702118 0 0 0 56316 0 66000 0 4662 0 829096 0 0 0 Andrea Straccolini MD Director 301143 0 350000 0 47500 0 66000 0 0 0 764643 0 0 0 William Meehan MD Treasurer 251121 0 160000 0 74170 0 66000 0 44174 0 595465 0 0 0 Bridget Quinn MD Director 151023 0 85000 0 42500 0 58750 0 0 0 337273 0 0 0 Part I, Line 7 Children's Sports Medicine Foundation, Inc. (the Foundation) paid compensation based on the patient revenues collected by their physicians. The physicians listed on Part VII or Schedule L are sub-contractors who received compensation based on percentage of the total revenue collected, minus billing fees, and foundation and clinical dues. The percentage allocation was determined by the Chief of the Foundation and approved by the board members. Part II: Various individuals listed in Form 990, Part VII are compensated by an unrelated organization, Children's Orthopaedic Surgery Foundation, Inc. for services rendered to the Foundation. Salary and benefit information reported in Form 990, Part VII and Schedule J, Part II represents compensation for services the individuals provided to both organizations. As an allocation of compensation specific to the Foundation cannot be readily performed, the respective individuals' total salary and benefits have been reported on the Foundation's Form 990 in accordance with IRS instructions. Form 990, Part VI, Section A, line 1a A majority of the Children's Sports Medicine Foundation, Inc.'s (the Foundation's) board members are physicians who are not independent from the Foundation. However, the Foundation participates in an integrated delivery system with Boston Children's Hospital (the Hospital), which does have a community board. The Foundation was organized in 1987. At that 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 to make it more responsive to the Hospital 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 details on the PO's rights. Form 990, Part VI, Section A, line 3 The Physicians Organization at Children's Hospital, Inc. (the PO) is the Class "C" member of Children's Sports Medicine Foundation, Inc. (the Foundation). The PO is responsible for providing management services to the Foundation. The PO has the power to approve the independent auditor and legal counsel for the Foundation from a list of firms mutually agreed to by the PO and the Foundation. The PO also has the right to review the annual budgets as well as review and approve by-law changes of the Foundation. Form 990, Part VI, Section A, line 6 The Children's Sports Medicine Foundation, Inc. (the Foundation) has three classes of members. The Chief of the Division of Sports Medicine (the Division) of Boston Children's Hospital (the Hospital) is the Class "A" member, serving ex officio. The Chief of the Department of Orthopaedic Surgery (the Department) of the Hospital is a Class "B" member, serving ex officio. The Physicians Organization at Children's Hospital, Inc. (the PO) is the Class "C" member of the Foundation. Form 990, Part VI, Section A, line 7a According to the Articles of Organization, the Class "A" member is the Chief of the Division of Sports Medicine (the Division) of Boston Children's Hospital (the Hospital). The Chief of the Department of Orthopaedic Surgery (the Department) of the Hospital shall be the sole Class "B" member. The Physicians Organization at Children's Hospital, Inc. (the PO) shall be the sole Class "C" member. The qualifications and rights of the members, including voting rights, shall be set forth from time to time in the by-laws of the Foundation. Form 990, Part VI, Section A, line 7b The Physicians Organization at Children's Hospital, Inc. (the PO) is the Class "C" member of Children's Sports Medicine Foundation, Inc. (the Foundation). The PO is responsible for providing management services to the Foundation. The PO has the power to approve the independent auditor and legal counsel for the Foundation from a list of firms mutually agreed to by the PO and the Foundation. The PO also has the right to review the annual budgets as well as review and approve by-law changes of the Foundation. As the Class "C" member of the Foundation, the PO attends the Foundation's annual meeting. Form 990, Part VI, Section B, line 11b The detailed review will be conducted by the President of the Foundation, Mininder S. Kocher, MD and the accountant/Clerk, Cristina Murphy. A copy of 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 12c The Physicians Organization at Children's Hospital, Inc. (the PO) and Boston Children's Hospital (the Hospital) administer an annual conflict of interest disclosure process to all of their 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 audit committee shall determine those individuals (including medical staff members) who shall be required to complete the disclosure statement. The audit committee, at its discretion, may either: 1) refer any or all 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 personally or through a designee(s). Any person not receiving a disclosure statement has an affirmative obligation to disclose to the PO President, PO General Counsel, or their supervisor whenever they believe they have 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 they believe 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 15 Faculty compensation must comply with the Boston Children's Hospital (the Hospital) Physician Compensation Guidelines. These guidelines are developed in consultation with an independent external compensation consulting firm and are approved by the independent Compensation Committee of the Board of Children's Medical Center Corporation and the Hospital. The guidelines set the maximum compensation limits based on a peer group analysis for Children's Sports Medicine Foundation, Inc. (the Foundation). The maximum compensation limits are based on pediatric specialty, sub-specialty, academic rank and approved by the independent Compensation Committee of the Board of the Hospital. Annual compensation for individual faculty members is set by the President of the Foundation, reviewed and approved by the Foundation in accordance with the Foundation's compensation policies and procedures. The Foundation's President's compensation is reviewed and approved annually on a prospective basis by the Hospital's President/Chief Executive Officer. Form 990, Part VI, Section C, line 19 The Foundation maintains all financial records, conflict of interest policies, and governing documents at its main office at 319 Longwood Avenue, Boston, MA 02115. The documents are available upon request. Form 990, Part XII, Line 2c: The audit process and scope has not changed from the prior year. Boston Children's Hospital 300 Longwood Avenue Boston MA 02115 042774441 Hospital MA 501(c)(3) Line 3 N/A 0 Physicians Org at Children's Hospital Inc 300 Longwood Avenue Boston MA 02115 043266103 Management services MA 501(c)(3) Line 12c, III-FI N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0