2018-08-14T10:16:44-05:00 2017-09-30 010494526 Baker Newman & Noyes LLC 280 Fore Street Portland ME 04101 990 2016-10-01 042790699 Boston Children's Heart Foundation Inc BOST 6173554895 300 Longwood Avenue No PAV 2 Boston MA 02115 Tal Geva MD President 6173554895 2018-08-09 0 Nicholas E Porto P01310283 8002447444 2018-08-09 2016 2022-09-23 18:48:47Z Tal Geva MD 300 Longwood Avenue No PAV 2 Boston MA 02115 52774638 0 X N/A X 1983 MA The Foundation provides an extensive range of evaluation services for patients (see Schedule O) with heart diseases, medical research, and educational services to Boston Children's Hospital and Harvard Medical School. The Foundation also provides care for patients in need of cardiology services, regardless of their ability to pay, as well as providing community based services. 9 0 66 0 6369 4481 4000000 0 52227760 52382922 324290 391716 0 0 56552050 52774638 1654571 11445382 0 0 39381484 39273247 0 0 0 7721033 8246470 48757088 58965099 7794962 -6190461 82698807 87455944 35504391 34002338 47194416 53453606 X The Foundation provides cardiology 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 cardiology by teaching (see Schedule O) students and other medical and scientific personnel. The Foundation also provides care for patients regardless of their ability to pay. 0 0 56531031 11445382 51433286 The Foundation provides cardiology 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. 1043758 949636 The Foundation receives income from Boston Children's Hospital for providing administration, supervision, and teaching services. The Foundation carries on and promotes basic and applied medical research and education in the field of cardiology 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 cardiology in order to educate the general public and the medical profession. 57574789 1 0 0 0 0 0 0 0 0 1 1 1 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 8 0 1 66 1 1 1 0 0 0 0 0 0 0 0 0 X 9 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X John Triedman MD 6173554895 300 Longwood Avenue Boston MA 02115 Tal Geva MD President 55.00 5.00 X X 563512 0 181187 John Triedman MD Treasurer 55.00 5.00 X X 397784 0 158407 Sarah D de Ferranti MD Clerk 60.00 0.00 X X 279393 0 87663 Elizabeth Blume MD Director (4/17-9/17) 60.00 0.00 X 316128 0 134943 Andrew J Powell MD Director 60.00 0.00 X 334640 0 131652 William T Pu MD Director 60.00 0.00 X 289990 0 129943 Rahul Rahtod MD Director (4/17-9/17) 60.00 0.00 X 279312 0 80499 Joshua Salvin MD Director (4/17-9/17) 60.00 0.00 X 363872 0 62009 Edward P Walsh MD Director 60.00 0.00 X 597517 0 119176 Diego Porras MD Director (10/16-3/17) 60.00 0.00 X 343872 0 79754 Audrey C Marshall MD Director (10/16-3/17) 60.00 0.00 X 402623 0 148285 Ravi Thiagarajan MD Dir (end 3/17)/Dept Chief (eff 4/17) 60.00 0.00 X 419816 0 125340 Physicians Org at CH Inc Institutional Trustee 2.00 0.00 X 0 0 0 Roger E Breitbart MD Dept. Chief 60.00 0.00 X 347422 0 112189 Jane Newburger MD Dept. Chief 60.00 0.00 X 492781 0 66174 James E Lock MD Cardiologist 60.00 0.00 X 709984 0 69982 Peter Lang MD Cardiologist 60.00 0.00 X 643860 0 0 Kathy J Jenkins MD Cardiologist 60.00 0.00 X 551541 0 142184 Steven D Colan MD Cardiologist 60.00 0.00 X 465467 0 66174 David R Fulton MD Cardiologist 60.00 0.00 X 456011 0 77730 8255525 0 1973291 64 0 1 0 Child Health Foundation of Boston 771 Albany Street Boston MA 02118 Physician services 174429 Dartmouth-Hitchcock Medical Center One Medical Center Drive Lebanon NH 03766 Physician services 151630 MGH PO - Pediatric Cardiology 55 Fruit Street Boston MA 02241 Physician services 103339 3 Net Patient Service Revenue 621300 48226110 48226110 Clinical and other revenue 621990 1651861 1651861 Research Revenue 611710 1555315 1555315 Admin, Supervision, & Teaching 611710 949636 949636 52382922 391716 6369 385347 52774638 52382922 6369 385347 11445382 11445382 6898560 6898560 24428516 23695659 732857 3330988 3231058 99930 3772915 3659728 113187 842268 817106 25162 161908 161908 100022 100022 48334 48334 2055 2055 1069854 1011103 58751 64949 64949 788973 788973 23817 23817 294271 294271 6685 6685 467679 419575 48104 Bad debt expense 1763170 1763170 Billing and collection 1651701 1651701 PO Dues 1016718 1016718 Co-ordinated specialty 430331 430331 356003 356003 58965099 57574789 1390310 0 16424176 12053287 2552123 4121743 5846102 5935368 281430 196665 1541490 1920242 153127 232486 52006 52006 6685 0 27789138 30240175 22238430 26412602 5866106 6343376 82698807 87455944 2156933 2971767 0 7880278 33347458 23150293 35504391 34002338 X 43019333 49465149 4175083 3988457 47194416 53453606 82698807 87455944 X -6190461 3577365 8872286 X X 0 1 X 1 0 X 350000 1390000 194000 4000000 0 5934000 43091662 49534075 45453762 52227760 52382922 242690181 43441662 50924075 45647762 56227760 52382922 248624181 0 0 0 248624181 215471 240705 239629 319811 385347 1400963 -337 4966 8302 4479 6369 23779 215134 245671 247931 324290 391716 1424742 43656796 51169746 45895693 56552050 52774638 250048923 0.99430 0.99490 0.00570 0.00510 X 4175083 0 186626 3988457 1535098 4000000 1360015 4175083 1514292 194000 173194 1535098 622201 1390000 497909 1514292 722614 350000 450413 622201 0.00000 0.00000 1.00000 0 0 46798 46798 0 5208 5208 0 0 Interest in the P.O. Pooled Investment Fund 26412602 F 26412602 Due from Boston Children's Hospital 548616 Due from Physicians Organization 302254 Other Receivables 490882 Other Assets 3605622 Loan Receivable - Farb 1137500 Prepaid pension plan 258502 6343376 Due to Boston Children's Hospital 3009436 Accrued severance plan obligation 667748 Accrued SERP 13496713 Accrued professional liability 4066956 Deferred compensation plan 254992 Due to Physicians Organization 714036 Due to employees 1910 Due to affiliates 132561 Retention plan liability 749761 Due to others 56180 23150293 X 65224289 3577365 8872286 12449651 52774638 0 52774638 58965099 0 58965099 0 58965099 Part V, Line 4: Assets limited to use represent assets held in trust that are available to pay for future benefits to participants for deferred compensation benefit plans and investments 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. 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, 2017. The Foundation's tax years from 2014 through 2017 are potentially subject to examination. Part XI, Line 2d - Other Adjustments: Pension adjustment 3,648,460. SERP adjustment 5,223,826. 1 Boston Children's Hospital 300 Longwood Avenue Boston MA 02115 042774441 501(c)(3) 11192531 N/A N/A General support Lindberg Foundation 12554 Bellingham Road Caledonia IL 61011 472373117 501(c)(3) 240000 N/A N/A General support American Heart Association 7272 Greenville Avenue Dallas TX 75231 135613797 501(c)(3) 10500 N/A N/A General support 3 0 Part I, Line 2: Monitoring is provided by Boston Children's Heart 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, 2017, the Foundation only provided grant donations to other 501(c)(3) organizations. X 1 1 X X X X 1 1 0 0 0 0 0 1 0 Tal Geva MD President 537748 0 12500 0 13264 0 141513 0 39674 0 744699 0 0 0 John Triedman MD Treasurer 374642 0 12500 0 10642 0 118733 0 39674 0 556191 0 0 0 Sarah D de Ferranti MD Clerk 235774 0 12500 0 31119 0 47989 0 39674 0 367056 0 0 0 Elizabeth Blume MD Director (4/17-9/17) 295367 0 12500 0 8261 0 95269 0 39674 0 451071 0 0 0 Andrew J Powell MD Director 313936 0 12500 0 8204 0 91978 0 39674 0 466292 0 0 0 William T Pu MD Director 270700 0 12500 0 6790 0 90269 0 39674 0 419933 0 0 0 Rahul Rahtod MD Director (4/17-9/17) 211522 0 12500 0 55290 0 40825 0 39674 0 359811 0 0 0 Joshua Salvin MD Director (4/17-9/17) 313292 0 12500 0 38080 0 39037 0 22972 0 425881 0 0 0 Edward P Walsh MD Director 411443 0 54510 0 131564 0 75694 0 43482 0 716693 0 0 0 Diego Porras MD Director (10/16-3/17) 249193 0 12500 0 82179 0 36272 0 43482 0 423626 0 0 0 Audrey C Marshall MD Director (10/16-3/17) 386261 0 12500 0 3862 0 104803 0 43482 0 550908 0 0 0 Ravi Thiagarajan MD Dir (end 3/17)/Dept Chief (eff 4/17) 398954 0 12500 0 8362 0 102368 0 22972 0 545156 0 0 0 Roger E Breitbart MD Dept. Chief 321658 0 12500 0 13264 0 72515 0 39674 0 459611 0 0 0 Jane Newburger MD Dept. Chief 460063 0 12500 0 20218 0 26500 0 39674 0 558955 0 0 0 James E Lock MD Cardiologist 627766 0 62500 0 19718 0 26500 0 43482 0 779966 0 0 0 Peter Lang MD Cardiologist 0 0 0 0 643860 0 0 0 0 0 643860 0 0 0 Kathy J Jenkins MD Cardiologist 438999 0 101900 0 10642 0 120552 0 21632 0 693725 0 0 0 Steven D Colan MD Cardiologist 442749 0 2500 0 20218 0 26500 0 39674 0 531641 0 0 0 David R Fulton MD Cardiologist 437771 0 12500 0 5740 0 38056 0 39674 0 533741 0 0 0 Part I, Line 1a Boston Children's Heart Foundation, Inc. (the Foundation) established a Tuition Assistance Plan that superseded the previous Tuition Plan effective January 1, 2007. The plan provides annual contribution payments for eligible participants, based on years of membership service to the Foundation and number of children, to a qualified state tuition program described in Section 529 of the Internal Revenue Code 1986 as amended. The plan provides an income tax gross-up equal to 30% of such contributions to assist participants in defraying the cost of income taxes. The Plan provides for a transition for those participants who received benefits under the previous plan, or those who were Foundation members for more than three years and had at least one child who had attained age 14 as of July 1, 2007. These members will not have the same interest accrual advantage as those with younger children, and can elect to have a lump-sum contribution or can elect to have tuition reimbursement up to the amount of tuition established by Harvard University, plus an income tax gross-up based on years of membership service as an Assistant Professor or higher up to a maximum of 34%. The following participated in the plans for September 30, 2017: Rahul Rathod, MD; Joshua Salvin, MD; Sarah D. de Ferranti, MD; Edward P. Walsh, MD; and Diego Porras, MD. These amounts are included in the recipients' W-2. Part I, Lines 4a-b Part I, Line 4a: Boston Children's Heart Foundation, Inc. (the Foundation) established a Severance Benefit Plan effective July 1, 1987. The Plan was amended and restated as of May 19, 2004. On June 30, 2005, the Foundation elected to freeze the severance benefit plan. The Foundation established this plan to supplement benefits available to certain employees, and to encourage such employees to remain in employment with the Foundation. Participation, benefit amounts, and other key provisions of this nonqualified benefit plan are determined at the sole discretion of the Foundation's Board of Directors. Although the assets of the plan have been irrevocably set aside for payment of deferred compensation benefits, they are subject first to the claims of the Foundation's creditors in the event the Foundation is subject to bankruptcy proceedings. The assets of the plan are reflected in the accompanying financial statements as assets limited to use. The plan was terminated during the year ended September 30, 2017. Part I, Line 4b: The Foundation established a Supplemental Executive Retirement Plan (SERP), effective June 30, 2005, to reward licensed physician employees with a benefit based on service. All eligible employees will become participants on the date designated by the Foundation's Board of Directors. The SERP's sources of contributions are from employer discretionary amounts (if any), severance benefits, and elective deferrals. The amounts contributed at September 30, 2017 were 15% of salary for those with balances less than 130% of the maximum payout at September 30, 2017. The plan was terminated during the year ended September 30, 2017. Part I, Line 7 Bonus compensation amounts are determined by the Chief of Boston Children's Heart Foundation, Inc. (the Foundation). The amounts are discretionary based on job performance and on the financial performance of the Foundation. Andrew Powell MD Director Physician Retention X 197000 86970 0 1 1 Rahul Rathod MD Director Physician Retention X 156000 109695 0 1 1 196665 Schedule L, Part II, Loans to and from Interested Persons: Boston Children's Heart Foundation, Inc. (the Foundation) has provided several secured and unsecured loans to employees. The loans bear interest at rates up to 4.7%. 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 $2,116,907 at September 30, 2017. Future principal amounts due are as follows: $594,200 in 2018; $464,681 in 2019; $385,268 in 2020; $169,297 in 2021; $97,777 in 2022; and $405,684 thereafter. Form 990, Part VI, Section A, line 1 A majority of Boston Children's Heart 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 1983. 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 Boston Children's Heart 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 an approved 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 Boston Children's Heart Foundation, Inc. (the Foundation) has three classes of members. The Chief of the Department of Cardiology (the Chief) of Boston Children's Hospital (the Hospital) is the Class "A" member. Any member (other than the Chief) who holds a medical staff appointment from the Hospital, a full-time faculty appointment in cardiology 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 The Cardiologist-in-Chief of Boston Children's Hospital (the Hospital) is the Class "A" member of Boston Children's Heart Foundation, Inc. (the Foundation). Every member of the Foundation who holds a medical staff appointment from the Hospital, has a full-time faculty appointment under the auspices of the Cardiologist-in-Chief from Harvard University Medical School, and who practices medicine primarily at the Hospital, shall be a Class "B" member. According to the Articles of Organization, the Class "A and "B" members appoint/elect the board members of the Foundation at the annual meeting. Form 990, Part VI, Section A, line 7b The Physicians Organization at Children's Hospital, Inc. (the PO) is the Class "C" member of Boston Children's Heart 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 an approved 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. Form 990, Part VI, Section B, line 11b The detailed review will be conducted by the President of the Foundation, Tal Geva, MD; the administrator, Marissa Densmore; and the financial reporting manager, Joseph Cantlin. A copy of Form 990 will be available to the board. 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 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 All the physicians (top management, officers, and highly compensated individuals) fall under compensation guidelines determined by Boston Children's Hospital's (the Hospital's) Board of Trustees, with limitations established for certain positions/ranks within the medical school. Annually, compensation is reviewed and reported to the Hospital's Board of Trustees to ensure that total direct and indirect compensation does not exceed the pre-determined guidelines. Any new indirect benefit plan requires approval by the Boston Children's Heart Foundation, Inc.'s (the Foundation's) Board of Directors, which then must be reviewed and permitted by the Hospital. Major procedures of the approval process involve: comparing compensation data of physicians within the comparable field of medicine; indirect compensation currently being offered; and the financial stability of the Foundation. 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 3,648,460. SERP adjustment 5,223,826. 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 1 1 1 1 1 1 1 0 0