2024-08-07T16:28:22-05:00 2023-09-30 010494526 Baker Newman & Noyes LLC 280 Fore Street Portland ME 04101 990 2022-10-01 042910304 Children's Urological Foundation Inc CHIL 6173557652 300 Longwood Avenue Boston MA 02115 Carlos R Estrada MD President/Treasurer 6173557652 2024-08-05 0 0 Nicholas E Porto P01310283 8002447444 2024-08-05 2022 2024-08-08 14:25:15Z Carlos R Estrada MD 300 Longwood Avenue Boston MA 02115 45866430 0 X N/A X 1986 MA The Foundation provides urological services, medical research, and (see Schedule O) educational services to Boston Children's Hospital. The Foundation also provides care for patients in need of urological 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. 11 0 22 0 0 0 3016901 214868 17835855 24649243 -373690 -149065 0 0 20479066 24715046 10208 47235 0 0 15177138 20075263 0 0 0 4121033 4575817 19308379 24698315 1170687 16731 38680814 37598545 19180124 16109041 19500690 21489504 X The Foundation provides urological 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 Foundation also provides care for (see Schedule O) patients in need of urological services, regardless of their ability to pay. 0 0 22159973 47235 24166583 The Foundation provides urological 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 in need of urological services regardless of their ability to pay, as well as providing and supporting hospital and community based services that are limited in the community. 452244 482660 The Foundation receives income from Boston Children's Hospital for providing administration services. The physicians employed by the Foundation perform medical research activities and have pioneered many developments in the field, given lectures, and published related educational articles. All of these activities play a critical role in the treatment and recovery of patients at Boston Children's Hospital and makes possible urological surgical advances for which the Hospital is renowned. 22612217 1 1 0 0 0 0 0 0 0 1 1 0 0 0 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 0 0 1 22 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X Carlos R Estrada MD 6173557652 300 Longwood Avenue Boston MA 02115 X Joseph G Borer MD Director 60.00 0.00 X 835519 0 116053 Richard S Lee MD Secretary 60.00 0.00 X X 1290725 0 129863 Bartley G Cilento Jr MD Treasurer 60.00 0.00 X X 1159718 0 119947 Caleb P Nelson MD Vice President 60.00 0.00 X X 748758 0 129784 Carlos R Estrada MD President 55.00 5.00 X X 1114881 0 131721 Richard Yu MD Director 60.00 0.00 X X 965983 0 41676 Stuart B Bauer MD Director 60.00 0.00 X 461060 0 51908 Michael Kurtz MD Clerk 60.00 0.00 X X 777859 0 126819 Erin McNamara MD Director 60.00 0.00 X 652197 0 122268 Marc Cendron MD Director (10/22-7/23) 60.00 0.00 X 221035 0 80179 Hsin-Hsiao Wang MD Director 60.00 0.00 X 431969 0 16525 Siam Oottamasathien MD Director 60.00 0.00 X 524116 0 55973 Physicians Org at CH Inc Institutional Trustee 2.00 0.00 X 0 0 0 Julia Finkelstein MD Physician 60.00 0.00 X 395204 0 84205 Melise Keays MD Physician 60.00 0.00 X 305892 0 46944 Rena Xu MD Physician 60.00 0.00 X 228278 0 27233 Hatim Thaker MD Physician 60.00 0.00 X 194036 0 12526 Jordan Kreidberg MD Researcher 60.00 0.00 X 682327 0 0 David A Diamaond MD Former President 10.00 0.00 X 131250 0 61757 11120807 0 1355381 19 1 1 0 Scribe America PO Box 417756 Boston MA 02241 Transcription Services 169971 1 214868 214868 Patient Service Revenue 621300 21392801 21392801 Clinical and Other Revenue 621990 2773782 2773782 Education and Research 611710 482660 482660 24649243 647175 647175 20355144 21151384 -796240 -796240 -796240 24715046 24649243 0 -149065 47235 47235 9139188 9139188 8786566 6867263 1919303 1396015 1396015 382868 382868 370626 370524 102 16104 16104 33863 33863 78228 78228 1056647 1056156 491 614807 614807 71582 71582 1478 1478 191574 191574 559907 521900 38007 PO management services 644924 644924 Billing expense 453752 453752 BCH Tax 427856 427856 Co-ordinated specialty 385654 385654 39441 39441 24698315 22612217 2086098 0 4495448 3004590 8394129 897323 2609072 2430657 80000 40000 580001 510382 116574 140618 392337 202903 204347 189434 21524465 29476336 676778 909205 38680814 37598545 2165053 1453179 1413245 712470 15601826 13943392 19180124 16109041 X 16933690 19312267 2567000 2177237 19500690 21489504 38680814 37598545 16731 1972083 0 X X 0 1 X 1 0 X 380244 790646 1179461 3016901 214868 5582120 15977035 15388990 19163511 17835855 24649243 93014634 16357279 16179636 20342972 20852756 24864111 98596754 0 0 0 98596754 1312307 899032 1492683 252795 647175 4603992 1312307 899032 1492683 252795 647175 4603992 134127 134127 17669586 17212795 21835655 21105551 25511286 103334873 X Schedule A, Part III, Line 12, Explanation of Other Income: Insurance rebate - 2019 Amount: $ 134,127. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2567000 50000 439763 2177237 475713 2622860 531573 2567000 431932 848214 804433 475713 431932 407172 407172 431932 410807 46125 25000 431932 0.00000 0.00000 1.00000 0 0 169390 9227 160163 34440 5169 29271 186398 186398 0 2109 2109 0 189434 Due to Boston Children's Hospital 1319160 Due to Physicians Organization at Children's Hospital, Inc. 289708 Deferred compensation 5792600 Accrued Severance Benefit Plan 5171839 Accrued Profit Sharing Plan 643623 Accrued professional liability 726192 Due to CHMC Surgical Foundation, Inc. 270 13943392 X 26610762 1972083 1972083 24638679 76367 76367 24715046 24621948 0 24621948 76367 76367 24698315 Part V, Line 4: The restricted funds represent assets held in a trust that are available for physician recruitment and research whose use has been restricted by donors to a specific time period or purpose. 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, 2023. 1 Boston Children's Hospital 300 Longwood Avenue Boston MA 02115 042774441 501(c)(3) 36946 0 N/A N/A General Support 1 Part I, Line 2: Monitoring is provided by Children's Urological Foundation, Inc. (the Foundation) through oversight of the terms and conditions of a written 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 1 1 X X X X X 0 1 0 0 0 0 0 1 0 Richard S Lee MD Secretary 758750 0 467203 0 64772 0 59250 0 70613 0 1420588 0 0 0 Bartley G Cilento Jr MD Treasurer 756250 0 338196 0 65272 0 59250 0 60697 0 1279665 0 0 0 Carlos R Estrada MD President 719500 0 360411 0 34970 0 59250 0 72471 0 1246602 0 0 0 Richard Yu MD Director 645813 0 255936 0 64234 0 0 0 41676 0 1007659 0 0 0 Joseph G Borer MD Director 654659 0 120588 0 60272 0 59250 0 56803 0 951572 0 0 0 Michael Kurtz MD Clerk 527878 0 138509 0 111472 0 59250 0 67569 0 904678 0 0 0 Caleb P Nelson MD Vice President 637875 0 35611 0 75272 0 59250 0 70534 0 878542 0 0 0 Erin McNamara MD Director 455625 0 68900 0 127672 0 59250 0 63018 0 774465 0 0 0 Jordan Kreidberg MD Researcher 658566 0 0 0 23761 0 0 0 0 0 682327 0 0 0 Siam Oottamasathien MD Director 453807 0 10037 0 60272 0 9250 0 46723 0 580089 0 0 0 Stuart B Bauer MD Director 450000 0 0 0 11060 0 0 0 51908 0 512968 0 0 0 Julia Finkelstein MD Physician 310000 0 18014 0 67190 0 34329 0 49876 0 479409 0 0 0 Hsin-Hsiao Wang MD Director 306875 0 78087 0 47007 0 0 0 16525 0 448494 0 0 0 Melise Keays MD Physician 233333 0 0 0 72559 0 20636 0 26308 0 352836 0 0 0 Marc Cendron MD Director (10/22-7/23) 221035 0 0 0 0 0 41250 0 38929 0 301214 0 0 0 Rena Xu MD Physician 198254 0 0 0 30024 0 0 0 27233 0 255511 0 0 0 Hatim Thaker MD Physician 150000 0 7601 0 36435 0 0 0 12526 0 206562 0 0 0 David A Diamaond MD Former President 131250 0 0 0 0 0 59000 0 2757 0 193007 0 0 0 Part I, Line 1a The Foundation provides gross-up payments for long-term disability insurance and parking. 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 Effective July 1, 1993, and as amended and restated as of January 1, 2013, the Foundation established a Severance Benefit Plan to supplement benefits available to certain eligible employees, and to encourage such employees to remain in employment with the Foundation. Participation, benefit amounts,and other key provisions of this non-qualified benefit plan are determined at the sole discretion of the Foundation's Board of Directors. As of September 30, 2023, the Foundation had not incurred any expenses or made any contributions under this plan. Part I, Line 7 Bonus compensation amounts are determined by the Compensation Committee of the Board of Children's Medical Center Corporation and Boston Children's Hospital (the Hospital). The amounts are discretionary based on job performance. Hsin-Hsiao Wang MD Director Recruitment X 100000 40000 0 1 1 40000 Schedule L, Part II, Loans to and from Interested Persons: Children's Urological Foundation, Inc. (the Foundation) has provided several secured and unsecured loans to employees. 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 $550,382 at September 30, 2023. Future principal amounts due are as follows $286,795 in 2024; $223,460 in 2025; and $40,127 in 2026. 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 IRS instructions. Form 990, Part VI, Section A, line 1a A majority of the Children's Urological 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 1986. 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 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 Urological 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 review and approve the 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 Urological Foundation, Inc. (the Foundation) has three classes of members. The Urologist-in-Chief, or any acting Chief, as Chief of the Department of Urology (the Department) of Boston Children's Hospital (the Hospital) is the Class "A" member. Every member of the Department (other than the Chief) who holds a medical staff appointment from the Hospital, has a full-time faculty appointment under the auspices of the Chief from Harvard University Medical School, and who is geographically full-time at the Hospital shall be a Class "B" member. Upon the recommendation from the Chief and with the approval of the President of the Hospital, exceptions may be made to permit other physicians who are members of the Department to be Class "B" members. The Physicians Organization at Children's Hospital, Inc. is the Class "C" member. Form 990, Part VI, Section A, line 7a According to the Articles of Organization, the Class "A" member is the Urologist-in-Chief of the Department of Urology (the Department) of Boston Children's Hospital (the Hospital). Any member of the Department who holds a medical staff appointment in urology at the Hospital, has a full-time faculty appointment under the auspices of the Chief from Harvard University Medical School, and who is geographically full-time at 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 in annual meetings or other elections, serve on the Children's Urological Foundation, Inc.'s Board, or 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 Urological 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 review and approve the 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. 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, Carlos R. Estrada, MD; the Executive Director, Jonthan Modest; and the Business Operations Administrator, Cynthia Bogarad. 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 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 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 officer is being compensated as a physician providing medical services to Children's Urological Foundation, Inc. and not as a former officer. 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 0 1 1 1 1 1 0 0