2024-08-15T11:54:46-05:00 2023-09-30 010494526 Baker Newman & Noyes LLC 280 Fore Street Portland ME 04101 990 2022-10-01 431987409 Children's Hospital Pediatric Associates Inc CHIL 6179192800 300 Longwood Avenue Boston MA 02115 Wendy Chung MD PhD President 6179192822 2024-08-12 1 0 Nicholas E Porto P01310283 8002447444 2024-08-12 2022 2024-08-08 14:25:15Z Wendy Chung MD PhD 300 Longwood Avenue Boston MA 02115 436094320 0 X N/A X 2002 MA The Foundation provides medical, health care services, and educational services to (see Schedule O) Boston Children's Hospital and Harvard Medical School. The Foundation also provides care for patients in need of health care services, regardless of their ability to pay, as well as providing community based services. 21 2 572 0 0 0 6607270 1103880 311135950 359340833 60451418 32013511 0 0 378194638 392458224 7883167 11804666 0 0 256010745 286608024 0 0 0 49468755 64392956 313362667 362805646 64831971 29652578 526952459 614577810 73181973 97827544 453770486 516750266 X The Foundation provides medical and health care 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 pediatric care by (Schedule O) teaching students and other medical and scientific personnel. The Foundation also provides care for patients regardless of their ability to pay. 0 0 261635641 11804666 279232379 The Foundation was organized exclusively for charitable, scientific, and educational purposes. The Foundation provides medical and health care services primarily to patients at Boston Children's Hospital, and at satellite locations. The Foundation may charge for patient care and other medical services, provided that any net income be used for the charitable, scientific, and educational purposes for which the Foundation was created. The Foundation also provides care for patients regardless of their ability to pay, as well as providing and subsidizing hospital and community based services that are either unavailable or limited elsewhere in the community. 9456710 0 25983914 The Foundation receives income from Boston Children's Hospital for providing administration services. The Foundation carries on and promotes basic and applied medical research and education in the field of pediatric care by teaching students and other medical and scientific personnel; by providing or supplementing income to research personnel through fellowships, research grants, and stipends; and by giving lectures and publishing information concerning problems and research results in the field of pediatric care in order to educate the general public and the medical profession. 44131313 0 54124540 The Foundation receives reimbursement of certain salary and fringe costs from grants from Boston Children's Hospital. 315223664 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 53 0 1 572 1 0 0 0 0 0 0 0 0 0 0 0 0 X 21 2 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X Vincent Chiang MD 6179192800 300 Longwood Avenue Boston MA 02115 Gary R Fleisher MD President (10/22 to 6/23) 55.00 5.00 X X 831176 0 86584 Vincent Chiang MD Treasurer/Clerk 60.00 0.00 X X 865666 0 72729 Richard Bachur MD Trustee 45.00 15.00 X 782274 0 100611 Joel Hirschhorn MD Trustee 60.00 0.00 X 394165 0 91611 Anne Stack MD Trustee 60.00 0.00 X 427850 0 55910 Stella Kourembanas MD Trustee 60.00 0.00 X 534488 0 105611 Frederick Lovejoy MD Trustee 60.00 0.00 X 0 0 0 Joanne Cox MD Trustee 60.00 0.00 X 321906 0 85697 Christopher Landrigan MD Trustee 60.00 0.00 X 409782 0 90897 Stephen C Harrison MD Trustee 60.00 0.00 X 0 0 0 Dennis Kim MD Trustee 60.00 0.00 X 520137 0 91611 David Williams MD Trustee 60.00 0.00 X 573485 0 73611 Christopher Walsh MD Trustee 60.00 0.00 X 68489 0 66290 Friedhelm Hildebrandt MD Trustee 60.00 0.00 X 592423 0 94111 Michael Agus MD Trustee 60.00 0.00 X 505423 0 96561 William Barbaresi MD Trustee 60.00 0.00 X 390384 0 89901 Benjamin Raby MD Trustee 60.00 0.00 X 477361 0 83817 Scott Snapper MD Trustee 60.00 0.00 X 528978 0 84815 Wanda Phipatanakul MD Trustee 60.00 0.00 X 322139 0 68517 Peter Nigrovic MD Trustee 60.00 0.00 X 579594 0 54247 Amy Divasta MD Trustee 60.00 0.00 X 308082 0 69537 Wendy Chung MD President (7/23 to 9/23) 55.00 5.00 X X 0 0 0 Physicians Org at CH Inc Institutional Trustee 2.00 0.00 X 0 0 0 Gregory Beaumier Chief Financial Officer (10/22 to 7/23) 15.00 45.00 X 0 225090 47374 William Tarvainen Chief Operations Officer 60.00 0.00 X 439521 0 99815 Sara Toomey MD Physician 60.00 0.00 X 593885 0 42459 Marilyn Liang MD Physician 60.00 0.00 X 477077 0 71673 Alejandro Flores MD Physician 60.00 0.00 X 519454 0 72909 Patricia Ellen Grant MD Physician 60.00 0.00 X 524463 0 71369 Kenneth Mandl MD Physician 60.00 0.00 X 576452 0 71517 12564654 225090 2039784 530 0 1 0 Dana Farber Cancer Institute 44 Binney Street Boston MA 02115 Oncology services 3951269 Sentinel Benefits 100 Quannapowitt Parkway Wakefield MA 01880 Benefits administration 286496 Cape Cod Hospital 27 Park Street Hyannis MA 02601 Physician services 217117 Dr Neo Farrag 6408 Brigantine Lane Rockford IL 61114 Neonatology physician services 214219 Lightning Bolt Solutions Inc PO Box 79694 Baltimore MD 21279 Computer software fees 108368 8 1103880 1103880 Patient serv. rev., net of contr. 621300 259335186 259335186 Research revenue 621300 54124540 54124540 Service, research, & other revenu 611710 25983914 25983914 Contract revenue 621300 19897193 19897193 359340833 9944777 9944777 65704830 43636096 22068734 22068734 22068734 392458224 359340833 0 32013511 11804666 11804666 11541590 10729791 811799 221162932 201417063 19745869 15670489 15670489 30854569 30854569 7378444 7333856 44588 720902 720902 68727 68727 1304523 1304523 8154101 8154101 44434 44434 3128825 2027592 1101233 77133 77133 5852831 5641707 211124 281693 281693 112871 112871 37175 37175 2585734 2551331 34403 Research expenses 18501517 18501517 Billing fees 5444335 5444335 BCH Tax 5186704 5186704 Coordinated specialty p 4880724 4880724 8010727 3109815 4900912 362805646 315223664 47581982 0 16398960 14985764 10014126 93180196 22097090 23720721 698879 601896 5674589 6287619 1086497 904019 777477 763524 24640 13953 436337339 436026855 34620339 38856787 526952459 614577810 17145383 15345589 56036590 82481955 73181973 97827544 X 448854559 511580110 4915927 5170156 453770486 516750266 526952459 614577810 29652578 33327202 0 X X 0 1 X 1 0 X 2907074 5665613 5225495 6607270 1103880 21509332 286065619 267555053 288159793 311135950 359340833 1512257248 288972693 273220666 293385288 317743220 360444713 1533766580 0 0 0 1533766580 7502989 7095984 6638950 8154119 9944777 39336819 -17818 -20378 -38196 7485171 7075606 6638950 8154119 9944777 39298623 1668320 1668320 296457864 281964592 300024238 325897339 370389490 1574733523 0.97400 0.97310 0.02500 0.02450 X Schedule A, Part III, Line 12, Explanation of Other Income: Insurance rebate - 2019 Amount: $ 1,668,320. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4915927 1103881 849652 5170156 1684926 6607271 3376270 4915927 1853472 5225495 5394041 1684926 3121472 5665613 6933613 1853472 415398 2907074 201000 3121472 0.00000 0.00000 1.00000 0 0 777477 763524 13953 13953 Due from Boston Children's Hospital 21546477 Malpractice insurance receivable 6230285 Other receivables 3594126 Due from affiliates 203731 Due from Physicians Organization at Children's Hospital, Inc. 7282168 38856787 Due to Boston Children's Hospital 46009894 Due to Physicians Organization at Children's Hospital, Inc. 2490544 Deferred compensation plans 21835425 Accrued professional liability 11527294 Due to affiliates 578942 Lease liability 39856 82481955 X 424480903 33327202 33327202 391153701 1304523 1304523 392458224 361501123 0 361501123 1304523 1304523 362805646 Part V, Line 4: The Foundation has plans to use its endowment funds for the Quality and Charge Capture Project, physician recruitment expenses, education programs, and research initiatives. 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 Boston Children's Hospital 300 Longwood Avenue Boston MA 02115 042774441 501(c)(3) 11804166 0 N/A N/A General Support 1 0 Part I, Line 2: Monitoring is provided by Children's Hospital Pediatric Associates, 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 funding. During the year ended September 30, 2023, the Foundation only provided grant donations to other 501(c)(3) organizations. X X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 Vincent Chiang MD Treasurer/Clerk 564987 0 253880 0 46799 0 34986 0 37743 0 938395 0 0 0 Gary R Fleisher MD President (10/22 to 6/23) 426282 0 108080 0 296814 0 66986 0 19598 0 917760 0 0 0 Richard Bachur MD Trustee 730696 0 8447 0 43131 0 61986 0 38625 0 882885 0 0 0 Friedhelm Hildebrandt MD Trustee 431876 0 48121 0 112426 0 55486 0 38625 0 686534 0 14740 0 Kenneth Mandl MD Physician 517384 0 33231 0 25837 0 34986 0 36531 0 647969 0 0 0 David Williams MD Trustee 506567 0 49032 0 17886 0 34986 0 38625 0 647096 0 0 0 Stella Kourembanas MD Trustee 490163 0 26639 0 17686 0 66986 0 38625 0 640099 0 0 0 Sara Toomey MD Physician 484109 0 111339 0 -1563 0 34986 0 7473 0 636344 0 0 0 Peter Nigrovic MD Trustee 460125 0 60522 0 58947 0 50986 0 3261 0 633841 0 0 0 Scott Snapper MD Trustee 518919 0 8750 0 1309 0 51986 0 32829 0 613793 0 0 0 Dennis Kim MD Trustee 370508 0 26684 0 122945 0 52986 0 38625 0 611748 0 0 0 Michael Agus MD Trustee 457628 0 12688 0 35107 0 57936 0 38625 0 601984 0 0 0 Patricia Ellen Grant MD Physician 455319 0 15290 0 53854 0 34986 0 36383 0 595832 0 0 0 Alejandro Flores MD Physician 500000 0 0 0 19454 0 34986 0 37923 0 592363 0 0 0 Benjamin Raby MD Trustee 409676 0 44474 0 23211 0 50286 0 33531 0 561178 0 0 0 Marilyn Liang MD Physician 328705 0 148332 0 40 0 34986 0 36687 0 548750 0 0 0 William Tarvainen Chief Operations Officer 362364 0 2619 0 74538 0 66986 0 32829 0 539336 0 53440 0 Christopher Landrigan MD Trustee 370508 0 14756 0 24518 0 52986 0 37911 0 500679 0 0 0 Joel Hirschhorn MD Trustee 344043 0 46852 0 3270 0 52986 0 38625 0 485776 0 0 0 Anne Stack MD Trustee 350924 0 32308 0 44618 0 34986 0 20924 0 483760 0 0 0 William Barbaresi MD Trustee 370508 0 12804 0 7072 0 52986 0 36915 0 480285 0 0 0 Joanne Cox MD Trustee 270458 0 35348 0 16100 0 46986 0 38711 0 407603 0 0 0 Wanda Phipatanakul MD Trustee 302968 0 14469 0 4702 0 34986 0 33531 0 390656 0 0 0 Amy Divasta MD Trustee 260338 0 46484 0 1260 0 34986 0 34551 0 377619 0 0 0 Gregory Beaumier Chief Financial Officer (10/22 to 7/ 0 189621 0 11019 0 24450 0 20500 0 26874 0 272464 0 0 Part I, Line 1a The Foundation provides gross-up payments for mortgage forgiveness, long-term disability insurance, and life 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 Children's Hospital Pediatric Associates, Inc. (the Foundation) established the Ineligible Deferred Compensation Plan. This plan is intended to qualify under Section 457(f) of the Code, and is intended to constitute a "top-hat plan" described in Section 201(2) of ERISA. The payment of benefits under the plan is at the sole discretion of the Foundation. In meeting its funding obligation, the employer will hold employee contributions in a Rabbi Trust. Each employee who is: a) an officer or highly compensated employee of the Foundation; b) a professor at Harvard University, or its professional equivalent; and c) determined by the Foundation's President to be eligible, may participate in the plan. Additionally, each Trustee of the Foundation who is determined by the Foundation's President to be eligible may participate in the plan. Participants may elect to defer compensation by a specific amount which, for any taxable year, shall not exceed an amount established by the Plan Administrator. The Foundation may, but is not required to, contribute an amount determined at the sole discretion of the Foundation on behalf of one or more eligible participants for a plan year. Participants are fully vested in the funds credited to their accounts after seven consecutive years of service. The Foundation made the following contributions to the 457(f) plan for the employees listed on Part VII, Page 7: Michael Agus, MD, $22,950; Richard Bachur, MD, $27,000; William Barbaresi, MD, $18,000; Gary Fleisher, MD, $32,000; Friedhelm Hildebrandt, MD, $20,500; Joel Hirschhorn, MD, $18,000; Stella Kourembanas, MD, $32,000; Benjamin Raby, MD, $15,300; William Tarvainen, $32,000; Christopher Walsh, MD, $31,000; Christopher Landrigan, MD, $18,000; Dennis Kim, MD, $18,000; Scott Snapper, MD, $17,000; Peter Nigrovic, MD, $16,000; and Joanne Cox, MD, $12,000. Part I, Line 7 Bonus compensation methodology is reviewed and approved by Children's Hospital Pediatric Associates, Inc.'s (the Foundation's) finance committee. The bonuses are based on clinical and academic performance, along with individual citizenship. All final bonus amounts are approved by the applicable division chief and president of the Foundation. Dennis Kim MD Trustee Physician recruitment X 669902 401896 0 1 1 Benjamin Raby MD Trustee Physician recruitment X 200000 120000 0 1 1 Peter Nigrovic MD Trustee Physician recruitment X 100000 80000 0 1 1 601896 Schedule L, Part II: The Children's Hospital Pediatric Associates, Inc. (the Foundation) has developed a recruitment loan program for eligible employees as incentive for qualified employees to relocate to certain facilities as demands of the Foundation's practice arise. The loan proceeds are to be used for the purchase of a principal personal residence. The loans are secured by a promissory note and a second mortgage on the residence. The Foundation has provided three loans to three members of the board. However, the Foundation has provided loans to other employees. The amounts for the recruitment loans were originally funded 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. If any borrower terminates his/her employment, the remaining balance becomes immediately due. The amount of the loan forgiveness will be included with accrued interest, if applicable, as compensation in the year forgiven. At September 30, 2023, the balance of the loans outstanding is $6,889,516. Future principal balances due are $2,029,046 in 2024; $1,697,704 in 2025; $1,208,624 in 2026; $577,411 in 2027; and $1,376,731 thereafter. Loan amounts to individuals reported in Part VII have been disclosed in Schedule L, Part II, the balance of the notes receivable are with individuals who are not required to be disclosed in Schedule L per the Internal Revenue Service instructions. Form 990, Part VI, Section A, line 1a The majority of the Children's Hospital Pediatric Associates, Inc. (the Foundation) 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 2002. At the 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 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 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 Children's Hospital Pediatric Associates, Inc. (the Foundation). The PO provides management services for 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, but not to approve, the annual budgets and 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 The Children's Hospital Pediatric Associates, Inc. (the Foundation) has four classes of members. The Pediatrician-in-Chief or any Acting Pediatrician-in-Chief, as Chief of the Department of Medicine (the Department) of Boston Children's Hospital (the Hospital), is a Class "A" member. Any person who (i) is a physician-employee of the Foundation with an active medical staff appointment from the Hospital, and (ii) either (A) is a Division Chief of a Division of the Department whose faculty are on the Foundation's payroll or (B) functions as a Division Chief of a Division of the Department whose faculty are not on the Foundation payroll, or (C) has a faculty appointment from Harvard Medical School shall be a Class "B" member. The Physicians Organization at Children's Hospital, Inc. (the PO) is a Class "C" member. All other individuals who hold Harvard appointments other than the Class "A and "B" members shall be Class "D" members. Form 990, Part VI, Section A, line 7a The Pediatrician-in-Chief or any Acting Pediatrician-in-Chief, as Chief of the Department of Medicine of Boston Children's Hospital (the Hospital), is the Class "A" member of Children's Hospital Pediatric Associates, Inc. (the Foundation). According to the Articles of Organization, the Class "A" member appoints the board members of the Foundation for a 3-year term at the Foundation's annual meeting. Form 990, Part VI, Section A, line 7b The Physicians Organization at Children's Hospital, Inc. (the PO) is a Class "C" member of the Children's Hospital Pediatric Associates, Inc. (the Foundation). The PO provides management services for 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, but not to approve, the annual budgets and 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 A review is conducted by the President of the Foundation, Wendy Chung, MD, PhD; and the Director of Finance, Susan McBride. 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 Services. Form 990, Part VI, Section B, line 12c The Physicians Organization at Children's Hospital, Inc. (the PO) administers 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 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 Boston Children's Hospital. The guidelines set the maximum compensation limits based on a peer group analysis for the Foundations. The maximum compensation limits are based on pediatric specialty, sub-specialty, academic rank and include a productivity adjustment. Any proposed compensation that exceeds the limit 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 each 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 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 Organization 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 1 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0