2024-08-13T11:50:51-05:00 2023-09-30 010494526 Baker Newman & Noyes LLC 280 Fore Street Portland ME 04101 990 2022-10-01 042702169 CHMC Anesthesia Foundation Inc CHMC 6173556457 300 Longwood Avenue Bader3 Boston MA 02115 Joseph P Cravero MD President/Treasurer 6173556457 2024-08-07 0 0 Nicholas E Porto P01310283 8002447444 2024-08-07 2022 2024-08-08 14:25:15Z Joseph P Cravero MD 300 Longwood Avenue Bader3 Boston MA 02115 182368293 0 X N/A X 1980 MA The Foundation provides medical research and educational services to Boston (see Schedule O) Children's Hospital and Harvard Medical School. The Foundation also provides care for patients in Massachusetts regardless of their ability to pay, as well as providing and supporting hospital and community based services that are either unavailable or limited elsewhere in the community. 14 0 170 0 31191 4797 1467345 536000 114807513 141200276 9013266 12554316 -2854707 6932104 122433417 161222696 2689950 5500 0 0 109215351 126781294 0 0 0 15259306 19715590 127164607 146502384 -4731190 14720312 283048096 310453118 90095028 100322653 192953068 210130465 X The Foundation operates the Department of Anesthesia at Boston Children's Hospital and in communities throughout greater Boston. The physicians and CRNAs of the Foundation provide anesthesia services to patients at the Hospital and perform anesthesia (see Schedule O) research activities as well as lectures and publish related articles. The Foundation also provides care for patients in need of anesthesiology services regardless of their ability to pay. 0 0 136907759 5500 140296938 The CHMC Anesthesia Foundation, Inc. (the Foundation) provides anesthesia and intensive care services to the patients of Boston Children's Hospital and at satellite locations. The Foundation may charge for patient care and other medical services, where any net income generated is used exclusively for the charitable, scientific, and educational purposes for which the Foundation was created. The Foundation also provides care for patients in need of anesthesia and intensive care services, regardless of their ability to pay, as well as providing and supporting hospital and community based services that are either unavailable or limited elsewhere in the community. 2794036 903338 The Foundation receives income from Boston Children's Hospital (the Hospital) for providing administration services. The physicians employed by the Foundation perform medical research and teaching activities, give lectures, publish related educational articles, and pioneer many developments in the field. All of these activities play a critical role in the treatment and recovery of patients at the Hospital and makes possible the surgical advances for which the Hospital is renowned. 139701795 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 170 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X Joseph P Cravero MD 6173556457 300 Longwood Avenue Bader 3 Boston MA 02115 Joseph P Cravero MD President/Treasurer 54.00 6.00 X X 1000893 0 136177 Jeffrey Burns MD Director 59.00 1.00 X 840087 0 112764 John Fiadjoe MD Clerk 60.00 0.00 X X 736348 0 135232 Jue Wang MD Director 60.00 0.00 X 448819 0 103320 Anjali Koka MD Director 60.00 0.00 X 398409 0 127715 Kirsten C Odegard MD Director 60.00 0.00 X 653963 0 161459 Sally Vitali MD Director 60.00 0.00 X 501596 0 147584 Mary Landrigan-Ossar MD Director 60.00 0.00 X 671666 0 162582 Christine Greco MD Director 60.00 0.00 X 661301 0 155754 Michael L McManus MD Director 60.00 0.00 X 521396 0 112575 Cynthia Tung MD Director 60.00 0.00 X 503408 0 92402 Viviane G Nasr MD Director 60.00 0.00 X 707358 0 127580 Craig McClain MD Director (10/22-8/23) 60.00 0.00 X 585552 0 154525 Nina Deutsch MD Director (9/23) 60.00 0.00 X 0 0 0 Physicians Org at CH Inc Institutional Trustee 2.00 0.00 X 0 0 0 Aykut Bilge MD Physician 60.00 0.00 X 829918 0 136785 Pete Kovatsis MD Physician 60.00 0.00 X 773673 0 149326 Monica Kleinman MD Physician 60.00 0.00 X 826840 0 159315 Daniel Kohane MD Physician 60.00 0.00 X 777218 0 212856 Adrienne Randolph MD Physician 60.00 0.00 X 896633 0 157828 Paul R Hickey MD Former Officer 36.00 0.00 X 909249 0 100640 Soriano Sulpicio MD Former Officer 60.00 0.00 X 688754 0 105680 13933081 0 2752099 155 1 1 0 3EDGE Asset Management 225 Franklin Street 26th Floor Boston MA 02110 Investment Advisor 413272 BNY Mellon 201 Washington Street Boston MA 02108 Investment Advisor 247550 The Wagner Law Group 99 Summer Street Boston MA 02108 Legal services 198540 CapFinancial Partners LLC 4208 Six Fords Road Suite 1700 Raleigh NC 27609 Pension Advisor 162384 Fallon & Associates 84 Langley Road Brighton MA 02135 Consultant 113750 4 536000 536000 Patient Service Revenue 621300 120876758 120876758 Contract & miscellaneous revenue 621300 19414180 19414180 Research revenue 621300 909338 909338 141200276 4406611 31191 4375420 29293302 21145597 8147705 8147705 8147705 Non-Operating pension gains 900099 6932104 6932104 6932104 161222696 141200276 31191 19455229 5500 5500 14115857 14115857 73237394 68399741 4837653 13405682 13003512 402170 23353567 23353567 2668794 2628027 40767 287180 223684 63496 237625 237625 837935 837935 835334 835334 1633230 1319992 313238 334992 334992 386357 386357 153852 153852 693055 625350 67705 Coordinated Specialty P 3308244 3308244 Research and education 3282748 3282748 BCH Tax 2417535 2417535 PO management services 2395419 2395419 2912084 2912084 146502384 139701795 6800589 0 1539565 1396015 29724250 24123470 13425298 15010321 733333 1016667 1725302 3212640 488278 336513 1534474 1314759 336067 219715 127286352 146466521 84134870 85063186 23654781 33608070 283048096 310453118 21193476 11909063 2165867 332533 214813 112637 66520872 87968420 90095028 100322653 X 191514250 208584647 1438818 1545818 192953068 210130465 283048096 310453118 X 14720312 573405 1883680 X X 0 1 X 1 0 X 518133 2575062 11900967 1467345 536000 16997507 117715167 104004368 119477701 114807513 141200276 597205025 118233300 106579430 131378668 116274858 141736276 614202532 0 0 0 614202532 3107961 2630157 2435258 4037547 4375420 16586343 14322 -7432 59997 53893 31191 151971 3122283 2622725 2495255 4091440 4406611 16738314 -2972491 1608090 -2909699 6932104 2658004 121355583 106229664 135482013 117456599 153074991 633598850 0.96940 0.98370 0.02640 0.02260 X Schedule A, Part III, Line 12, Explanation of Other Income: Insurance rebate - 2019 Amount: $ 399,250. Non-operating pension losses gains - 2019 Amount: $ -3,371,741. 2020 Amount: $ 1,608,090. 2021 Amount: $ -2,909,699. 2022 Amount: $ 6,932,104. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1438818 536000 429000 1545818 312818 1467345 341345 1438818 178818 14005776 13871776 312818 111817 2575063 2508062 178818 518133 406316 111817 0.00000 0.00000 1.00000 0 0 1534474 1314759 219715 219715 PO Pooled Investment Fund, LLP 85063186 F 85063186 Due from Boston Children's Hospital 1143909 Other receivable 807222 Malpractice insurance receivable 3988472 Due from Boston Children's Heart Foundation, Inc. 180246 Due from Children's Hospital Pediatric Association, Inc. 289164 Due from Crosby Benefits 102500 Due from Physicians Organization at CH, Inc. 4603174 Prepaid defined benefit plan 22493383 33608070 Due to Harvard - Anesthesia Med Education 1690830 Due to Physicians Organization at Children's Hospital, Inc. 1126666 Due to Boston Children's Hospital 10596568 Accrued education plan obligation 34057895 Accrued SERP obligation 16693076 Accrued deferred compensation 457(b) plan 6859826 Accrued professional liability 5100816 Accrued money purchase plan 2010257 Due to CHMC Surgical Foundation, Inc. 106200 Due to Children's Hospital Pediatric Associates, Inc. 17628 Due to Brigham & Women's Hospital, Inc. 176999 Accrued earned time pay 9531659 87968420 X 162841846 573405 1883680 2457085 160384761 837935 837935 161222696 145664449 0 145664449 837935 837935 146502384 Part V, Line 4: The restricted funds represent donations that were given for physician recruitment. The use of these funds was restricted by the donor. 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. Part XI, Line 2d - Other Adjustments: Pension adjustment 1,883,680. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 Joseph P Cravero MD President/Treasurer 755750 0 115660 0 129483 0 86160 0 50017 0 1137070 0 0 0 Adrienne Randolph MD Physician 478875 0 20780 0 396978 0 102263 0 55565 0 1054461 0 0 0 Paul R Hickey MD Former Officer 295864 0 12000 0 601385 0 59160 0 41480 0 1009889 0 567301 0 Daniel Kohane MD Physician 468960 0 20000 0 288258 0 158158 0 54698 0 990074 0 0 0 Monica Kleinman MD Physician 412870 0 20000 0 393970 0 105305 0 54010 0 986155 0 0 0 Aykut Bilge MD Physician 326683 0 20000 0 483235 0 86160 0 50625 0 966703 0 0 0 Jeffrey Burns MD Director 720200 0 20000 0 99887 0 59160 0 53604 0 952851 0 0 0 Pete Kovatsis MD Physician 350622 0 20000 0 403051 0 95235 0 54091 0 922999 0 0 0 John Fiadjoe MD Clerk 565276 0 20000 0 151072 0 86160 0 49072 0 871580 0 0 0 Viviane G Nasr MD Director 418401 0 20000 0 268957 0 79660 0 47920 0 834938 0 2815 0 Mary Landrigan-Ossar MD Director 405015 0 20000 0 246651 0 114496 0 48086 0 834248 0 0 0 Christine Greco MD Director 422733 0 20000 0 218568 0 102540 0 53214 0 817055 0 0 0 Kirsten C Odegard MD Director 370142 0 20000 0 263821 0 108245 0 53214 0 815422 0 0 0 Soriano Sulpicio MD Former Officer 506021 0 20000 0 162733 0 59160 0 46520 0 794434 0 10473 0 Craig McClain MD Director (10/22-8/23) 440625 0 20000 0 124927 0 107054 0 47471 0 740077 0 0 0 Sally Vitali MD Director 320735 0 20000 0 160861 0 100078 0 47506 0 649180 0 0 0 Michael L McManus MD Director 429622 0 20000 0 71774 0 59160 0 53415 0 633971 0 5973 0 Cynthia Tung MD Director 353409 0 20000 0 129999 0 79660 0 12742 0 595810 0 13625 0 Jue Wang MD Director 227674 0 14385 0 206760 0 76243 0 27077 0 552139 0 3340 0 Anjali Koka MD Director 293067 0 20000 0 85342 0 79660 0 48055 0 526124 0 0 0 Part I, Line 1a The Foundation provides gross-up payments for mortgage forgiveness, tuition payments, and long-term disability insurance. These payments are included as taxable wages during the year. All permanent full-time employees of the Foundation are eligible for the gross-up payments. Part I, Line 4b The Foundation established the CHMC Anesthesia Foundation, Inc. 2005 Supplemental Executive Retirement Plan (SERP), effective as of January 1, 2005 to reward licensed physician employees with a benefit based on services. The plan was restated on January 1, 2016 to the CHMC Anesthesia Foundation, Inc. 2016 After-Tax Plan (the Plan). Each participant employed on June 30 is allocated 6% of base salary, excluding bonuses and clinical incentive payments, during the Plan year. For the Plan year in which an eligible employee becomes a participant, they will receive an additional contribution equal to 6% of their Plan compensation for each year of service prior to becoming a participant. The Foundation's contributions under the Plan are taxable to the participant as they are made and are not subject to forfeiture if the participant leaves before retiring. Contributions to the Plan will be included as part of taxable wages in the W-2 of each individual. During 2022, the following participants received a contribution that is recorded on the W-2: Joseph P. Cravero, MD, $45,000; Michael L. McManus, MD, $26,503; Kirsten C. Odegard, MD, $24,202; Cynthia Tung, MD, $21,620; Jeffrey Burns, MD, $43,992; Jue Wang, MD, $155,899; Anjali Koka, MD, $18,649; Sally Vitali, MD, $20,075; Mary Landrigan-Ossar, MD, $22,267; Christine Greco, MD, $27,306; Viviane G. Nasr, MD, $161,468; Craig McClain, MD, $24,676; Soriano Sulpicio, MD, $32,222; Paul R. Hickey, MD, $17,310; Aykut Bilge, MD, $21,637; Monica Kleinman, MD, $25,514; Pete Kovatsis, MD, $21,465; Adrienne Randolph, MD, $27,615; and Daniel Kohane, MD, $30,035. In addition to the regular annual contribution, the Foundation makes a one-time contribution on behalf of participants first employed by the Foundation after December 21, 2008 after completing seven years of service. The amount of the contribution is $20,000 for each of the seven years in which the participant was a full-time employee (at least 32 hours per week), and $20,000 prorated, based on the participant's full-time equivalent percentage (FTE), for each year in which the participant worked part-time. Any pre-2016 account contributions are fully vested for each participant. The vesting schedule is 50% of post-2016 earnings account amounts vest after ten years of service, 75% vest after fifteen years of service, and amounts are fully invested after twenty years of service. During 2022, distributions from the After-Tax plan accounts were made to Paul R. Hickey, MD, $567,301; Michael McManus, MD, $5,973; Viviane G. Nasr, MD, $2,815; Cynthia Tung, MD, $13,625; Jue Wang, MD, $3,340; and Sulpicio Soriano, MD, $10,473. These amounts have been reported in Schedule J, Part II, Column B(iii) for each physician. Furthermore, if any portion of these amounts were reported on previous 990s as part of total compensation earned, that portion is also being disclosed in Schedule J, Part II, Column F for the respective physician. Part I, Line 7 The Foundation provides an annual bonus to their anesthesiologist-employees. The amounts are discretionary based on the financial performance of the Foundation and on individual job performance. John Fiadjoe MD Clerk Physician recruitment X 800000 666667 0 1 1 Nina Deutsch MD Director (9/23) Physician recruitment X 350000 350000 0 1 1 1016667 Schedule L, Part II, Loans to and from Interested Persons: CHMC Anesthesia Foundation, Inc. (the Foundation) has provided several secured and unsecured loans to employees. The loans bear interest at rates up to 4.65%. The loans were made for recruitment and retention purposes to assist physician employees in the purchase of their primary residence. The amounts for the recruitment loans were determined by restricted donations provided by Boston Children's Hospital for use in recruitment. The loans will be forgiven over the terms of the notes if the recipients remain employed at the Foundation or its affiliates. The amount of the loan forgiveness will be included with accrued interest, if applicable, as compensation in the year forgiven. The balance of the loans outstanding are $4,229,307 at September 30, 2023. Future principal amounts due are as follows: $620,700 in 2024; $526,949 in 2025; $341,114 in 2026; $158,736 in 2027; and $2,431,779 in 2028 and thereafter. Form 990, Part VI, Section A, line 1a A majority of CHMC Anesthesia Foundation, Inc.'s (the Foundation's) board members are physicians who are not independent from the Foundation. However, the Foundation is part of an integrated delivery system with Boston Children's Hospital (the Hospital) which does have a community board. The Foundation was organized in 1980. 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 a Class "C" member of CHMC Anesthesia 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 of 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 and the right to review and approve by-law changes of the Foundation. Lastly, Boston Children's Hospital has the right to review for compliance with applicable law, the general terms of and any modification to physician compensation and benefit plans for all physician employees of the Foundation. Form 990, Part VI, Section A, line 6 CHMC Anesthesia Foundation, Inc. (the Foundation) has three classes of members. The Chief of the Department of Anesthesiology (the Department) of Boston Children's Hospital (the Hospital) is the Class "A" member. Each member (other than the Chief) who holds a medical staff appointment from the Hospital and a full-time faculty appointment under the auspices of the Anesthesiologist-in-Chief from Harvard Medical School (Harvard) is a Class "B" member of the Foundation. The Physicians Organization at Children's Hospital, Inc. (the PO) is a Class "C" member of the Foundation. Form 990, Part VI, Section A, line 7a According to the Articles of Organization, the Chief of the Department of Anesthesiology (the Department) of Boston Children's Hospital (the Hospital) is the Class "A" member of CHMC Anesthesia Foundation, Inc. (the Foundation). Each person who holds a medical staff appointment from the Hospital and a full-time faculty appointment under the auspices of the Anesthesiologist-in-Chief from Harvard Medical School (Harvard) is a Class "B" member. The Class "A and "B" members of the Foundation elect the Board of Directors presented by the Executive Committee at their annual meeting. Each member is entitled to one vote per question at any meeting of the members. Form 990, Part VI, Section A, line 7b The Physicians Organization at Children's Hospital, Inc. (the PO) is a Class "C" member of CHMC Anesthesia 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 of 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 and the right to review and approve by-law changes of the Foundation. Lastly, Boston Children's Hospital has the right to review for compliance with applicable laws, the general terms of and any modification to physician compensation and benefit plans for all physician employees of the Foundation. As a 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/Treasurer of the Foundation, Joseph P. Cravero, MD; the Senior Director of Foundation Financial Operations & Strategy Planning, Stacey Conrad; and the Director of Finance, Jaronid Jimenez. A copy of the Form 990 will be provided to the board prior to filing. The Physicians Organization at Children's Hospital, Inc. will review the Form 990 with the board members. 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 its 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 disclosure 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 issues personally or through a designee(s). Any person not receiving a disclosure statement nevertheless has an affirmative obligation to disclose to the PO President, PO General Counsel, or his/her supervisor whenever he/she believes he/she has 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 he/she believes 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 the Foundation. The maximum compensation limits are based on pediatric specialty, sub-specialty, academic rank and include productivity adjustments. Any proposed compensation that exceeds the limits must be prospectively approved by the independent Compensation Committee of the Board of the Hospital. Annual compensation for individual faculty members is set by the President of CHMC Anesthesia Foundation, Inc. (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 Boston Children's Hospital President/Chief Executive Officer. Form 990, Part VI, Section C, line 19 The Foundation maintains all financial statements, conflict of interest policies, and governing documents at its main office at 300 Longwood Avenue, Boston, MA 02115. The documents are available upon request. Form 990, Part XI, line 9: Pension adjustment 1,883,680. Form 990, Part XII, Line 2c: The audit process and scope has not changed from the prior year. Form 990, Part X: The prior year column of the balance sheet assets on Form 990 was updated to agree to the audited financial statements, in which the prior year reclassifications were revised. The lines that were updated are: Line 2 was updated from $46,261,609 to $29,724,250; and Line 12 was updated from $67,597,511 to $84,134,870. 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 CHMC Anesthesia Foundation Inc Retiree Medical Benefit Trust 300 Longwood Avenue Boston MA 02115 260538595 Employee Benefit Trust MA 501(c)(9) N/A 0 CHMC Anesthesia Foundation Inc Charitable Trust 300 Longwood Avenue Boston MA 02115 306692912 Employee Benefit Trust MA 501(c)(3) Line 12a, I N/A 0 0 1 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0