2025-06-26T11:44:59-05:00 2024-09-30 010494526 Baker Newman & Noyes LLC 280 Fore Street Portland ME 04101 990 2023-10-01 043085427 Children's Hospital Pathology Foundation Inc CHIL 6173554589 300 Longwood Avenue Bader1 Boston MA 02115 Mark D Fleming MD President 6173554589 2025-06-23 0 0 Nicholas E Porto P01310283 8002447444 2025-06-23 2023 2025-03-06 01:10:19Z Mark D Fleming MD 300 Longwood Avenue Bader1 Boston MA 02115 24707833 0 X N/A X 1990 MA The Foundation provides pathology services primarily to patients at Boston (see Schedule O) Children's Hospital and at satellite locations. The Foundation carries on and promotes basic and applied medical research and education in the field of pathology. 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 limited in the community. 6 0 20 0 0 0 250000 0 13671691 15311765 97029 503263 0 0 14018720 15815028 48696 1524133 0 0 10467778 11289766 0 0 0 1887040 2530414 12403514 15344313 1615206 470715 13815921 13135632 2427129 2749475 11388792 10386157 X The Foundation's mission is to provide pathology 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 pathology. The (see Schedule O) Foundation also provides services for patients regardless of their ability to pay. 0 0 11178529 1524133 12249412 The Foundation was organized exclusively for charitable, scientific, and educational purposes. The Foundation provides pathology 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 is used exclusively 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 hospital and community based services that are either unavailable or limited elsewhere in the community. 2794632 3062353 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 pathology 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 conditions and research results in the field of pediatric pathology in order to educate the general public and the medical profession. 13973161 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 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 3 0 1 20 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X Alyaa Al-Ibraheemi MD 6173554589 300 Longwood Avenue Boston MA 02115 Mark D Fleming MD President 55.00 5.00 X X 1067955 0 99716 Marian H Harris MD Board Member 60.00 0.00 X 377576 0 98926 Alyaa Al-Ibraheemi MD Clerk 60.00 0.00 X X 359182 0 101911 Sanda Alexandrescu MD Treasurer 60.00 0.00 X X 441895 0 99716 Jacob R Bledsoe MD Board Member 60.00 0.00 X 362095 0 98405 Juan Putra MD Board Member 60.00 0.00 X 334725 0 77604 Physicians Org at CH Inc Institutional Trustee 2.00 0.00 X 0 0 0 Jeffrey D Goldsmith MD Physician 60.00 0.00 X 551127 0 96116 Sara O Vargas MD Physician 60.00 0.00 X 400059 0 99417 Antonio R Perez-Atayde MD Physician 60.00 0.00 X 550181 0 99716 Hart GW Lidov MD Physician 60.00 0.00 X 372553 0 74172 Alanna J Church MD Physician 60.00 0.00 X 384648 0 101774 Harry PW Kozakewich MD Former Clerk/Appointed Member 30.00 0.00 X 265033 0 67411 Monica Hollowell MD Former Clerk 60.00 0.00 X 391804 0 99159 5858833 0 1214043 18 1 1 0 0 Patient Service Revenue 621300 10781789 10781789 Other Revenue 621300 3091376 3091376 Education and Research Programs 611710 1438600 1438600 15311765 368284 368284 9027784 8892805 134979 134979 134979 15815028 15311765 0 503263 1524133 1524133 3778602 3778602 5848939 4823679 1025260 758988 708788 50200 589803 569273 20530 313434 298222 15212 8551 8551 64446 64446 250243 215210 35033 296952 163371 133581 5000 5000 2479 2479 80155 61816 18339 Coordinated Specialty P 827361 827361 Research Expenses 646061 646061 PO management services 349166 349166 15344313 13973161 1371152 0 3716181 2884983 1566867 221661 1138464 1175063 140000 120000 90000 325000 49405 40788 482998 450822 7786 32176 6562644 7652650 544574 683311 13815921 13135632 73456 123795 783333 0 1570340 2625680 2427129 2749475 X 11138792 10386157 250000 0 11388792 10386157 13815921 13135632 X 470715 618418 -2091768 X X 0 1 X 1 0 X 215708 666180 250000 1131888 10107422 11874858 11966809 13671691 15311765 62932545 10323130 12541038 11966809 13921691 15311765 64064433 0 0 0 64064433 223747 191093 237279 319946 368284 1340349 223747 191093 237279 319946 368284 1340349 33386 33386 10580263 12732131 12204088 14241637 15680049 65438168 0.97900 0.97910 0.02050 0.02030 X Schedule A, Part III, Line 12, Explanation of Other Income: Insurance Rebate - 2019 Amount: $ 33,386. 250000 250000 250000 250000 666180 666180 215708 215708 0.00000 0.00000 0.00000 104189 104189 0 378809 346633 32176 32176 Due from Boston Children's Hospital 138502 Due from Harvard Medical School 125295 Due from Brigham & Women's Hospital 144666 Due from Physicians Organization at Children's Hospital, Inc. 263625 Other A/R 11223 683311 Due to Boston Children's Hospital 840742 Due to Physicians Org. at CH, Inc. 78153 Deferred Compensation 523650 Accrued Professional Liability 137251 Due to Medical Center 1045884 2625680 X 16369000 618418 618418 15750582 64446 64446 15815028 15279867 0 15279867 64446 64446 15344313 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, 2024. 1 Boston Children's Hospital 300 Longwood Avenue Boston MA 02115 042774441 501(c)(3) 1516000 0 N/A N/A General Support Pan-Mass Challenge 77 4th Avenue Needham MA 02494 042746912 501(c)(3) 5133 0 N/A N/A General Support 2 0 Part I, Line 2: Monitoring is provided by the Children's Hospital Pathology 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 funding. During the year ended September 30, 2024, 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 Mark D Fleming MD President 760812 0 288070 0 19073 0 62250 0 37466 0 1167671 0 0 0 Antonio R Perez-Atayde MD Physician 402258 0 119630 0 28293 0 62250 0 37466 0 649897 0 0 0 Jeffrey D Goldsmith MD Physician 442570 0 99154 0 9403 0 62250 0 33866 0 647243 0 0 0 Sanda Alexandrescu MD Treasurer 338119 0 95233 0 8543 0 62250 0 37466 0 541611 0 0 0 Sara O Vargas MD Physician 303534 0 85871 0 10654 0 61951 0 37466 0 499476 0 0 0 Monica Hollowell MD Former Clerk 281443 0 82135 0 28226 0 61693 0 37466 0 490963 0 0 0 Alanna J Church MD Physician 307014 0 75000 0 2634 0 64308 0 37466 0 486422 0 0 0 Marian H Harris MD Board Member 277678 0 90080 0 9818 0 61460 0 37466 0 476502 0 0 0 Alyaa Al-Ibraheemi MD Clerk 260994 0 90000 0 8188 0 64445 0 37466 0 461093 0 0 0 Jacob R Bledsoe MD Board Member 278808 0 81000 0 2287 0 60939 0 37466 0 460500 0 0 0 Hart GW Lidov MD Physician 278623 0 77333 0 16597 0 60197 0 13975 0 446725 0 0 0 Juan Putra MD Board Member 255469 0 73500 0 5756 0 63629 0 13975 0 412329 0 0 0 Harry PW Kozakewich MD Former Clerk/Appointed Member 201129 0 59815 0 4089 0 53436 0 13975 0 332444 0 0 0 Part I, Line 7 The method for calculating bonus payments is a percentage of the individual's salary. However, the Chairman can change the bonus amount based on a number of factors including but not limited to, the following: clinical workload adjustments; teaching responsibilities; academic performance; administrative responsibilities; and/or special circumstances. The bonus amounts are discretionary. Monica Hollowell MD Former Clerk Physician retention X 200000 120000 0 1 1 120000 Schedule L, Part II, Loans to and from Interested Persons: Children's Hospital Pathology Foundation, Inc. (the Foundation) has provided certain noninterest bearing loans to physicians. The loans are generally ten-year loans that are granted as part of recruitment incentives. The Foundation is allowed to forgive an amount of the loan balance for each year of continued employment of the physician. The notes are secured by a mortgage from the physician covering a personal residence. 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. The outstanding balance on the notes was $445,000 at September 30, 2024. The estimated future forgiveness for the loans is as follows: $85,000 in 2025; $85,000 in 2026; $85,000 in 2027; $85,000 in 2028; and $105,000 in 2029. Form 990, Part VI, Section A, line 1a A majority of the Children's Hospital Pathology Foundation, Inc.'s (the Foundation's) board members are physicians who are not independent of 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 1990. 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 Hospital Pathology 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, but not 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 the Class "C" member of the Foundation, the PO attends the Foundation's annual meeting. Form 990, Part VI, Section A, line 6 The Children's Hospital Pathology Foundation, Inc. (the Foundation) has three classes of members. The Chairman of the Department of Pathology (the Department) of Boston Children's Hospital (the Hospital) is the Class "A" member. Any member of the Department (other than the Chairman) who holds a medical staff appointment from the Hospital, has a full-time faculty appointment from Harvard University Medical School, and who has entered into a written agreement with and receives compensation from the Foundation shall be a Class "B" member. Individuals engaged in clinical or research matters in the field of pathology at the Hospital may request membership and can be Class "B" members if invited by the Chairman and ratified by the Class "B" members. The Physicians Organization at Children's Hospital, Inc. 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 Chairman of the Department of Pathology (the Department) of Boston Children's Hospital (the Hospital). Any member of the Department who holds a medical staff appointment from the Hospital, has a full-time faculty appointment from Harvard Medical School, and who has entered into a written employment agreement and receives compensation from the Hospital shall be a Class "B" member. Class "A and "B" members hold their membership as long as they remain qualified for membership. Only Class "A and "B" members may vote at their annual meeting or other elections, serve on the Children's Hospital Pathology Foundation, Inc.'s Board, or may nominate candidates for election to the Board. 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 Hospital Pathology 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 as well as 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 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, Mark D. Fleming, MD and the Senior Director of Foundation Operations and Strategic Planning, John Baci. A copy of Form 990 will be provided to the governing 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 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 conflicts 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 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 Children's Hospital Pathology 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 Hospital's Chief Executive Officer/President. 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 300 Longwood Avenue, Boston, MA 02115. The documents are available upon request. Form 990, Part VII, Line 1a: The former officers are being compensated as a physician providing medical services to Children's Hospital Pathology Foundation, Inc. and not as a former officer. Form 990, Part XI, line 9: Net asset transfer to affiliate -2,091,768. 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 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0