2025-07-01T15:57:49-05:00 2024-09-30 010494526 Baker Newman and Noyes LLC 280 Fore Street Portland ME 04101 990 2023-10-01 042751258 CHMC Otolaryngologic Foundation Inc CHMC 6173556463 300 Longwood Avenue Boston MA 02115 Michael J Cunningham MD FACS President 6173556463 2025-06-23 0 0 Nicholas E Porto P01310283 8002447444 2025-06-23 2023 2025-03-06 01:10:19Z Michael J CunninghamMD 300 Longwood Avenue Boston MA 02115 51078668 0 X N/A X 1982 MA The Foundation provides otolaryngology services primarily to patients at (see Schedule O) 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 and subsidizing hospital and community based services that are either unavailable or limited elsewhere in the community. 6 0 20 0 -3973 0 0 134000 37771351 39941241 1073188 4534250 210451 150508 39054990 44759999 39809 45885 0 0 29418407 31908706 0 0 0 7178242 8154474 36636458 40109065 2418532 4650934 61967122 68521889 17391006 25907102 44576116 42614787 X The Foundation provides otolaryngology 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 otolaryngology by (see 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 37387937 45885 39660086 The Foundation provides otolaryngology 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. 377656 281155 The Foundation receives income from Boston Children's Hospital for providing administrative, supervision, and teaching services. The Foundation carries on and promotes basic and applied medical research and education in the field of otolaryngology 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 otolaryngology in order to educate the general public and the medical profession. 37765593 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 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 20 1 1 1 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 Norman Dean 6173556463 300 Longwood Avenue Boston MA 02115 Michael J Cunningham MD FACS President 55.00 5.00 X X 1132739 0 105482 Reza Rahbar MD Vice President 55.00 5.00 X X 1694030 0 116028 Norman Dean Treasurer 10.00 50.00 X X 0 309505 39509 Sukgi S Choi MD Director 60.00 0.00 X 1406584 0 96992 Roger C Nuss MD Director 60.00 0.00 X 731269 0 126318 Laurie Ohlms MD Director 60.00 0.00 X 429400 0 125754 Physicians Org at CH Inc Institutional Trustee 2.00 0.00 X 0 0 0 Kenneth R Whittemore MD Physician 60.00 0.00 X 1170169 0 105061 Greg R Licameli MD Physician 60.00 0.00 X 1329216 0 128250 Eelam Adil MD Physician 60.00 0.00 X 1244026 0 128925 Karen Watters MD Physician 60.00 0.00 X 869357 0 128272 Gi Soo Lee MD Physician 60.00 0.00 X 877798 0 120802 10884588 309505 1221393 18 0 1 0 Wells Fargo 91 Longwater Circle Suite 300 Norwell MA 02061 Investment advisors 204472 1 134000 134000 Patient service revenue 621500 35342909 35342909 Clinical and other 541900 4317177 4317177 Education and research 611710 281155 281155 39941241 852919 -3973 856892 10000000 6318669 3681331 3681331 3681331 Non-operating pension gains 900099 150508 150508 150508 44759999 39941241 -3973 4688731 45885 45885 5984688 5635674 349014 18840009 18274809 565200 3017335 2931944 85391 3635939 2722635 913304 430735 417813 12922 14063 14063 9862 9862 220616 220616 100570 100570 8075 8075 851052 824536 26516 1174959 1174959 216028 216028 125462 125462 271892 233953 37939 Billing and collections 1477867 1477867 Administrative fee 1413708 1413708 PO management services 916795 916795 Coordinated specialty p 625797 625797 727728 727728 40109065 37765593 2343472 0 3606811 6064616 7315123 3213901 3718653 3255571 20000 100000 350948 455400 1752823 1219912 552817 532911 29389228 30103377 12506838 14804065 4506704 9992048 61967122 68521889 108277 156266 1079115 550000 16203614 25200836 17391006 25907102 X 43834989 41906660 741127 708127 44576116 42614787 61967122 68521889 X 4650934 3291605 -9903868 X X 0 1 X 1 0 X 702830 550929 3877977 134000 5265736 26845764 27062884 28372718 37771351 39941241 159993958 27548594 27613813 32250695 37771351 40075241 165259694 0 0 0 165259694 516903 480396 589216 638141 856892 3081548 516903 480396 589216 638141 856892 3081548 -7990 105 -188 5323 -3973 -6723 355039 288194 347466 210451 150508 1351658 28412546 28382508 33187189 38625266 41078668 169686177 0.97390 0.97590 0.01820 0.01680 X Schedule A, Part III, Line 12, Explanation of Other Income: Insurance rebate - 2019 Amount: $ 119,600. Non-operating pension gains - 2019 Amount: $ 235,439. 2020 Amount: $ 288,194. 2021 Amount: $ 347,466. 2022 Amount: $ 210,451. 2023 Amount: $ 150,508. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 741127 134000 167000 708127 841127 100000 741127 941127 3877977 3977977 841127 1041127 550929 650929 941127 1041127 702830 702830 1041127 0.00000 0.00000 1.00000 0 0 624806 225310 399496 1113057 979642 133415 14960 14960 0 532911 P.O. Pooled Investment Fund, LLC 14804065 F 14804065 Due from Boston Children's Hospital 325594 Due from Physicians Organization at Children's Hospital, Inc. 1281120 Other receivables 25276 VEBA benefits 8081182 Accrued Professional Liability 278876 9992048 Due to Boston Children's Hospital 6136483 Due to Physicians Organization at Children's Hospital, Inc. 538157 Accrued bonuses 4186911 Deferred compensation obligations 8423929 Accrued professional liability 659976 Lease Liability 227688 Due to Medical Center 5027692 25200836 X 47982504 3291605 151516 3443121 44539383 220616 220616 44759999 39888449 0 39888449 220616 220616 40109065 Part V, Line 4: The endowment funds represent assets that are held in trust that are temporarily restricted by the donor to be used for recruitment to advance clinical research activities and quality improvement 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. The Foundation has evaluated the positions taken on its filed tax returns. The Foundation has concluded that no uncertain income tax positions exist at September 30, 2024. Part XI, Line 2d - Other Adjustments: Pension Adjustment 151,516. 1 Boston Children's Hospital 300 Longwood Avenue Boston MA 02115 042774441 501(c)(3) 40885 0 N/A N/A General Support 1 0 Part I, Line 2: Monitoring is provided by CHMC Otolaryngologic 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 1 1 X X X X X 0 1 0 0 0 0 0 1 0 Reza Rahbar MD Vice President 865200 0 750462 0 78368 0 66000 0 50028 0 1810058 0 0 0 Sukgi S Choi MD Director 756250 0 558478 0 91856 0 66000 0 30992 0 1503576 0 0 0 Greg R Licameli MD Physician 725625 0 520855 0 82736 0 66000 0 62250 0 1457466 0 0 0 Eelam Adil MD Physician 733688 0 436263 0 74075 0 66000 0 62925 0 1372951 0 0 0 Kenneth R Whittemore MD Physician 732446 0 363411 0 74312 0 66000 0 39061 0 1275230 0 0 0 Michael J Cunningham MD FACS President 919800 0 114958 0 97981 0 66000 0 39482 0 1238221 0 0 0 Gi Soo Lee MD Physician 564900 0 257965 0 54933 0 66000 0 54802 0 998600 0 0 0 Karen Watters MD Physician 578813 0 217655 0 72889 0 66000 0 62272 0 997629 0 0 0 Roger C Nuss MD Director 578813 0 66959 0 85497 0 66000 0 60318 0 857587 0 0 0 Laurie Ohlms MD Director 202125 0 219526 0 7749 0 66000 0 59754 0 555154 0 0 0 Norman Dean Treasurer 0 257674 0 30893 0 20938 0 28241 0 11268 0 349014 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 CHMC Otolaryngologic Foundation, Inc. (the Foundation) established two Supplemental Executive Retirement Plans, effective as of December 1, 2007, to reward licensed physician employees with a benefit based on service. The sources of contributions for these plans are from employer discretionary amounts, if any, severance benefits, and elective deferrals. The amounts are vested on the occurrence of any of the following events: five years of employment; attainment of normal retirement date; death; disability; or change in control. Part I, Line 7 Bonus compensation amounts are determined by the Chief of the Department of Otolaryngology, all board members, and Finance Committee members. They need to consider data such as performance for physician cost centers, their financial reports, research activities, hospital program for Patient Safety & Quality participation, and teaching activities. Form 990, Part VI, Section A, line 1a The majority of the CHMC Otolaryngologic 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 1982. 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 the CHMC Otolaryngologic 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 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 modifications to physician compensation and benefit plans for all physician employees of the Foundation. Form 990, Part VI, Section A, line 6 The CHMC Otolaryngologic Foundation, Inc. (the Foundation) has three classes of members. The Chief of the Department of Otolaryngology (the Department) of Boston Children's Hospital (the Hospital) is the sole Class "A" member. Any member of the Department (other than the Chief) who holds a professional staff appointment in otolaryngology at the Hospital, has a full-time faculty appointment from Harvard Medical School, and who is geographically full-time at the Hospital shall be a Class "B" member. 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 Chief of the Department of Otolaryngology (the Department) of Boston Children's Hospital (the Hospital). Any other member of the Department who holds a professional staff appointment in otolaryngology at the Hospital, has a full-time faculty appointment from Harvard Medical School, and who is geographically full-time at the Hospital shall be a Class "B" member. Class "A and "B" members shall hold their membership as long as he/she remains qualified for membership. Only Class "A and "B" members may vote in annual meetings or other elections or serve on the CHMC Otolaryngologic Foundation, Inc.'s Board of Directors and 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 a Class "C" member of the CHMC Otolaryngologic 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 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 modifications 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 of the Foundation, Michael J. Cunningham, MD, FACS, and the Treasurer, Norman Dean. 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 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 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 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 Otolaryngologic 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 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 XI, line 9: Pension adjustment 151,516. Net assets transfer to affiliate -10,055,384. 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