2022-07-21T12:32:54-05:00 2021-12-31 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2021-01-01 203169071 PEDIATRIC SPINE FOUNDATION PEDI 4844106413 PO BOX 1072 LAYTON UT 84041 DAVID SKAGGS PAST PRESIDENT 4844106413 2022-07-18 1 DAVID SKAGGS 999009999 KERRI N BOGDA CPA P00760402 7177404863 X 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z JACK FLYNN PO BOX 1072 LAYTON UT 84041 1882861 0 X WWW.PEDIATRICSPINEFOUNDATION.ORG X 2005 UT TO HELP CHILDREN WITH SPINE PROBLEMS LIVE LONGER, BETTER LIVES. 12 11 5 0 0 0 1177238 1516652 0 189255 128303 83 36199 176871 1341740 1882861 19903 90026 0 0 473854 549351 0 0 2365 317787 502667 811544 1142044 530196 740817 3509371 6289488 2049 99513 3507322 6189975 X PROVIDE STRUCTURE AND FUNDING TO SUPPORT EDUCATION, PROVIDE FAMILY SUPPORT, AND CONDUCT PROSPECTIVE AND RETROSPECTIVE STUDIES BY SURGEONS AND RESEARCHERS STUDYING COMPLEX CHEST WALL AND SPINE DEFORMITIES IN THE GROWING CHILD. 1 0 1063815 90026 189255 THE PEDIATRIC SPINE FOUNDATION LEADS A COMMUNITY OF INDIVIDUALS DEDICATED TO IMPROVING THE QUALITY OF CARE AND THE OUTCOME OF TREATMENT FOR YOUNG PATIENTS AND FAMILIES DEALING WITH COMPLEX SPINE DEFORMITY. THE PEDIATRIC SPINE FOUNDATION FOCUSES ITS EFFORTS IN THREE AREAS: RESEARCH, EDUCATION, AND PATIENT ACCESS TO CARE. IN 2021, THE FOUNDATION SUPPORTED MULTIPLE RESEARCH STUDIES ON NEW TREATMENTS, QUALITY OF LIFE, AND COMPLICATIONS, INCLUDING TWO RANDOMIZED CONTROLLED CLINICAL TRIALS. THE FOUNDATION HOSTED MULTIPLE FORUMS FOR CLINICIANS TO DISCUSS BEST PRACTICES AND TO DISSEMINATE FINDINGS, INCLUDING THE INTERNATIONAL CONGRESS ON EARLY ONSET SCOLIOSIS. THE FOUNDATION SUPPORTED MULTIPLE FAMILIES TRAVEL TO OBTAIN ACCESS TO QUALITY CARE. 1063815 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 9 0 5 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 UT X TRICIA ST HILAIRE 4844106413 PO BOX 397 VALLEY FORGE PA 19481 STEVE SCHWARTZ CHAIRMAN 3.00 X X 0 0 0 DAVID SKAGGS MD PRESIDENT 3.00 X X 0 0 0 JACK FLYNN MD PRESIDENT-ELECT 3.00 X X 0 0 0 PAUL SPONSELLER MD VICE PRESIDENT 3.00 X X 0 0 0 MICHAEL VITALE MD MPH SECRETARY 3.00 X X 0 0 0 BEHROOZ AKBARNIA MD TREASURER 3.00 X X 0 0 0 RON EL-HAWARY MD MEMBER 3.00 X 0 0 0 JOHN SMITH MD MEMBER 3.00 X 0 0 0 JEFF SAWYER MD MEMBER 3.00 X 0 0 0 AMER SAMDANI MD MEMBER 3.00 X 0 0 0 MUHARREM YAZICI MD MEMBER 3.00 X 0 0 0 TRICIA ST HILAIRE MPH EXECUTIVE DIRECTOR 40.00 X X 161473 0 4844 REGINA WOON RESEARCH MANAGER 40.00 X 112058 0 3347 273531 0 8191 2 0 1 0 0 1516652 1516652 MEETINGS REVENUE 611430 189255 189255 189255 83 83 SERVICE INCOME 900099 128621 128621 MEETING SPONSORS 541800 48250 48250 176871 1882861 189255 0 176954 X 84758 84758 5268 5268 166317 166317 313891 313891 5505 5505 26554 26554 37084 37084 29116 29116 30432 30432 181975 181345 630 3510 3510 7483 7483 2050 2050 162521 162521 1994 1994 REGISTRY EXPENSES 73208 73208 EDUCATION EXPENSES 7364 7364 FUNDRAISING DONATION FE 2365 2365 DUES & SUBSCRIPTIONS 577 577 72 72 1142044 1063815 75864 2365 293826 1084958 849543 599625 2120 39187 10000 2363882 4555718 3509371 6289488 2049 99513 2049 99513 X 3507322 6189975 3507322 6189975 3509371 6289488 X 740817 402591 1539245 X 0 0 0 X UNIVERSITY OF UTAH HEALTH SCIENCES CENTER SALT LAKE CITY UT RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 FIDELITY GOVERNMENT MONEY MARKET 1209626 F FIDELITY MULTI ASSET INDEX FUND 597304 F FIDELITY PURITAN 682944 F AMERICAN BEACON BALANCED INVST 549183 F GOLDMAN SACHS INCOME BUILDER 517087 F OAKMARK EQUITY AND INCOME 579024 F JAMES BALANCED: GOLDEN RAINBOW FUND 420550 F 4555718 1 MAYO CLINIC 201 BUILDING 4OOM 4-60 200 FIRST ST SW ROCHESTER MN 55905 416011702 501(C)(3) 6250 0 N/A N/A RESEARCH PROJECT SUPPORT DAYTON CHILDREN'S HOSPITAL 1 CHILDRENS PLAZA DAYTON OH 45404 310672132 501(C)(3) 14500 0 N/A N/A RESEARCH PROJECT SUPPORT THE NEMOURS FOUNDATION 1600 ROCKLAND RD WILMINGTON DE 19803 590634433 501(C)(3) 5625 0 N/A N/A RESEARCH PROJECT SUPPORT 3 0 FAMILY SUPPORT GRANT 1 5268 N/A N/A PART I, LINE 2: GRANT RECIPIENTS ARE REQUIRED TO PROVIDE QUARTERLY PROGRESS REPORTS TO ENSURE FUNDS ARE BEING USED FOR THEIR INTENDED PURPOSE. X X 0 0 0 0 0 0 0 0 0 TRICIA ST HILAIRE MPH EXECUTIVE DIRECTOR 161473 0 0 0 0 0 4844 0 0 0 166317 0 0 0 FORM 990, PART III, LINE 2 BEGINNING IN 2021, THE FOUNDATION HOSTED MULTIPLE FORUMS FOR CLINICIANS TO DISCUSS BEST PRACTICES AND TO DISSEMINATE FINDINGS, INCLUDING THE INTERNATIONAL CONGRESS ON EARLY ONSET SCOLIOSIS. FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE DIRECTOR REVIEWS THE FORM 990 PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE FORM 990 IS THEN SENT TO ALL BOARD MEMBERS PRIOR TO FILING THE TAX RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS AND OFFICERS OF THE FOUNDATION ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST VIA COMPLETION OF A CONFLICTS FORM. THOSE INDIVIDUALS ARE ALSO REQUIRED TO DISCLOSE ANY AND ALL ONGOING ISSUES THAT ARISE DURING THE COURSE OF THE YEAR. CONFLICT OF INTEREST DISCLOSURES ARE REVIEWED BY THE EXECUTIVE DIRECTOR. ANY INDIVIDUAL WITH A CONFLICT OF INTEREST MUST ABSTAIN FROM VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION FOR THE EXECUTIVE DIRECTOR IS APPROVED ANNUALLY BY THE BOARD BASED UPON REVIEW OF COMPARATIVE FINANCIAL INDICATORS AND MARKET TRENDS TO ENSURE COMPENSATION IS WITHIN FAIR MARKET RANGE FOR THE INDUSTRY. BOARD LEVEL DISCUSSIONS REGARDING COMPENSATION ARE RECORDED IN THE MINUTES OF THE BOARD MEETINGS. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION WILL MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND INTERNALLY-PREPARED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G STATISTICIAN: PROGRAM SERVICE EXPENSES 1,150. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,150. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 93,085. MANAGEMENT AND GENERAL EXPENSES 630. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,715. MEASURER: PROGRAM SERVICE EXPENSES 79,818. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 79,818. PAYROLL ADMIN FEES: PROGRAM SERVICE EXPENSES 7,292. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,292. FORM 990, PART XI, LINE 9: ASSET TRANSFER UPON MERGER 1,539,245.