2013-08-15T10:00:24-05:00 2012-09-30 346565596 Ernst & Young LLP 200 Clarendon Street Boston MA 021165072 990 2011-10-01 042774441 Children's Hospital Corporation CHIL 6173556881 300 Longwood Avenue Boston MA 02115 Douglas Vanderslice 6173556881 2013-08-09 1 Jeanne M Schuster P00743154 6172662000 2011 2016-02-24 21:20:13Z James Mandell MD 300 Longwood Avenue Boston MA 02115 1697935270 0 X www.childrenshospital.org X 1982 MA Provider of pediatric healthcare, education, research & community service 21 14 11104 1070 140803 -91946 358360283 331388600 1038967616 989683001 39333015 23068790 35857830 34327240 1472518744 1378467631 10009615 2978643 0 0 680513528 696945617 1352435 1424430 26923640 624309005 609007538 1316184583 1310356228 156334161 68111403 3369546205 3698015571 1239973224 1284225947 2129572981 2413789624 X Boston Children's Hospital (Children's) is the nation's premier pediatric hospital with a commitment to advancing the health of children worldwide. We serve as the community hospital for the children of Boston, provide specialty pediatric care throughout the region and offer children across the world facing challenging medical issues with access to innovative, life saving care. Children's vision is to advance pediatric care - both in our local neighborhoods and worldwide - through a commitment to innovation and science-based care. All of our activities are driven by four interwoven missions: providing access to high quality, compassionate and innovative clinical care to children, researching new cures and treatments for diseases, training the next generation of pediatric caregivers and improving the health and well being of children with a special emphasis on helping the children of Boston grow and learn in safe, healthy environments. 0 0 806622457 2978643 944576237 CLINICAL CARE:As one of the largest pediatric hospitals in the U.S. and the only freestanding pediatric hospital in Massachusetts, Children's provides access to safe, high quality healthcare services that meet the unique needs of children and their families, regardless of their ability to pay. The range of services we offer - from well child visits and treatment for typical child health issues (broken bones, tonsillitis, etc.) to chronic care (asthma, diabetes, obesity, etc.) and specialty services (oncology, cardiology, neurology) - benefits from the high level of specialization of our experts, the collaboration with research scientists (many of whom are also physicians) affiliated with the hospital, and the significant investments in equipment, facilities and clinical and support staff. In addition, our team has a deep commitment to setting the bar for quality and safety and exceeding the expectations of our patients' and their families' for service, undertaking significant investments in each of these areas.On an annual basis, Children's sees: 24,714 inpatient/observation cases at our hospital; 144,000 inpatients at satellites; 526,606 outpatients; 53,870 patients in our community health clinic; of the hospital's bedded volume, more than 20% (CMI > 2.00) can be qualified as clinically complex. Of these patients, approximately 35% (patients on Medicaid/Medicare) are considered low income.Children's is the safety net institution for very sick children throughout the region, backing up the entire healthcare system for the most complex pediatric cases. We receive referrals from community hospitals as well as from other academic medical centers throughout New England. Children's is the single largest provider of care to children enrolled in the Medicaid program, seeing approximately 30% of all pediatric Medicaid discharges statewide, including many of the sickest children. Children's also provides clinical care for the largest number of uninsured children in the state; total free care and losses from Medicaid in FY 2012 were approximately $50 million.Recognizing the difficulties community-based hospitals face in providing specialized pediatric care (which requires significant investments in staff, equipment and training), Children's has expanded its partnerships with community hospitals throughout Eastern Massachusetts. With more than 100 physicians based at 7 community hospitals, we enhance the community's - and the state's - ability to provide access to emergency, neonatal, inpatient and outpatient specialty services for children. Children's also operates three outpatient facilities in Waltham, Lexington and Peabody that offer specialized care in cardiology, gastroenterology, neurology, respiratory diseases, diabetes, orthopedic surgery, urology and other specialties. Each year, Children's advances the quality of the clinical care it provides by recruiting talented new staff, investing in updated equipment and technology, undertaking safety/quality initiatives, supporting community health programs and ensuring that our facilities make the care process easier and more comfortable for all the patients and families we serve. For example:Focus on Quality: Children's Hospital Boston has established the Center of Excellence for Quality Measurement to improve how healthcare is delivered to children in America. In 2009, the Child Health Insurance Program Reauthorization Act called for a national Pediatric Quality Measures Program to convene experts, solicit public input, and build infrastructure to provide measures that can significantly advance the quality of children's healthcare. The Center has been established in response to that requirement. Measuring and reporting quality of health care relying on pediatric specific metrics is a key tool to try to assure that all children receive excellent care.In 2012, Boston Children's and its primary care physicians and specialists are adopted the newest version of an Alternative Quality Contract (AQC) in its contract with a major Massachusetts insurer, to both assure quality outcomes and manage the growth in health care spending. The agreement maintains the standard AQC structure, which combines a per-patient global budget with significant performance incentives based on nationally endorsed quality measures tied to quality, health outcomes, and patient experience. However, the contract with Children's and its primary care physicians and specialists includes a first-in-the-nation set of measurements developed uniquely for a population entirely composed of children and adolescents and benchmarked with appropriate national comparators.Several of the new measures focus on important clinical outcomes for children. For example, the hospital, specialists and pediatricians will be measured on how well they help children with cystic fibrosis maintain good lung function, on preventing complications after appendectomies, and on preventing blood stream infections in patients in the cardiac, neonatal and medical/surgical intensive care units.Encourage Innovation: The Innovation Acceleration Program (IAP), which offers Innovestment Grant and the FIT Awards-supercharges innovation and entrepreneurial spirit among Children's employees, by providing resources and support to empower them in developing and testing their novel ideas. In the program's first year, it funded projects ranging from technology-enhanced toys to help children with severe emotional regulation disorders, to innovative new ways to close complex ventricular septal defects; from a remote monitoring program for kids on home ventilators, to elastic multi-electrode ECG strips. Fast track Innovation in Technology (FIT) Awards offer software development resources, including a team of experienced software developers, for innovative clinical software projects. Winners have ranged from an "electronic white-board," that accurately reflects the patients on a given unit in real-time, providing essential clinical data and improved patient throughput, to a Bidirectional Electronic Alert Patient-centered Provider Encounter Record (BEAPPER) iPhone application that notifies clinicians of a lab order's progress and provides text message capabilities about their patient's current status and needs.Expanding Access: Southcoast Health System and Boston Children's Hospital created a new collaboration to provide enhanced local access to high-quality pediatric care to children and families across the South Coast region. Beginning in late summer 2012, Boston Children's and its physicians began collaborating with local physicians to provide hospital-based pediatric services for Southcoast. The pediatric program is centered at St. Luke's Hospital in New Bedford. Boston Children's pediatricians provide 24/7 onsite pediatric care working with local physicians in pediatrics, family medicine and emergency medicine. A Boston Children's onsite Medical Director is responsible for medical oversight, development and coordination of the Southcoast hospital-based pediatric care. Additionally, remote pediatric consultative services are available to the Emergency Departments at Charlton Memorial Hospital in Fall River and Tobey Hospital in Wareham.Improve Care in the Community: The Community Asthma Initiative (CAI), a community-based asthma care model targeting low-income families, was shown to dramatically reduce hospitalization and emergency department visits for asthma -- improving patient outcomes and saving $1.46 per dollar spent through reduced hospital utilization. A study reporting these outcomes and cost savings appears in the March 2012 Pediatrics (published online February 20). The CAI program includes nurse case management and care coordination combined with home visits by a bilingual nurse or Community Health Worker to educate families about asthma, assess the home for asthma triggers, and provide materials and services to improve the home environment, such as encasements for bedding, HEPA vacuums and pest control. After 12 months in the program, the children had a 68 percent decrease from baseline in asthma-related ED visits and an 85 percent drop in hospitalizations. There was a 43 percent reduction in the percentage of children who had to limit physical activity on any day, a 41 percent reduction in reports of missed school days and a 50 percent reduction in parents having to miss work to care for their child. The percentage of children with an up-to-date asthma care plan rose from 53 percent at baseline to 82 percent at 12 months. 306466000 0 143554000 RESEARCH:Children's believes we enhance the well-being of the children and families by being the leading source of research and discovery on child health issues, seeking new approaches to the prevention, diagnosis and treatment of childhood and adult diseases.With over $242 million in annual funding and 800,000 square feet of space, Children's is home to the world's largest and most active research enterprise at a pediatric center. The research mission of Children's encompasses basic research, clinical research, community service programs and the postdoctoral training of new scientists. While the NIH is our largest sponsor, Children's has made a significant investment in supporting the research activities with more than $16 million invested to support research programs in 2012. Our investigators hold numerous prestigious honors and awards, including many "research firsts." In our laboratories and clinics, hundreds of scientists seek to identify the factors that contribute to both childhood and adult diseases and to develop effective treatments for them. Our investigators are Harvard Medical School faculty - basic scientists, clinical researchers, and epidemiologists - who are accelerating the pace of medical discovery from brainstorm to bench to bedside. Our researchers were the first to develop 10 new disease-based stem cell lines by reprogramming adult stem cells that can be used to study treatments for diseases ranging from Parkinson's to Diabetes. Clinicians and researchers at Children's work collaboratively with colleagues throughout the medical community to translate basic science research into applications for clinical care. These projects frequently have applications that go beyond the pediatrics to impact adult care as well. For example:New prosthetic heart valve for children. Surgeons at Boston Children's Hospital have successfully implanted a modified version of a expandable prosthetic heart valve in several children with mitral valve disease. Unlike traditional prosthetic valves that have a fixed diameter, the expandable valve can be enlarged as a child grows, thus potentially avoiding the repeat valve replacement surgeries that are commonly required in a growing child. The new paradigm of expandable mitral valve replacement has potential to revolutionize care for infants and children with complex mitral valve disease. The care of patients with disease of the mitral valve-which controls the flow of freshly oxygenated blood from the heart's left atrium to its left ventricle-can be very complicated. If a child needs a mitral valve replacement, there are only a limited number of options available, all of which have one limitation in common: they have a fixed diameter and cannot grow with a child. To provide a novel and more permanent option for children needing mitral valve replacement, Boston Children's physicians developed and surgically implanted a modified version of an expandable prosthetic valve available from Medtronic, Inc., called the Melody valve, in two infants with congenital heart disease. Spotting dyslexia before a child starts school: A study by Boston Children's physicians found that children at risk for dyslexia show differences in brain activity on MRI scans even before they begin learning to read. Since developmental dyslexia responds to early intervention, diagnosing children at risk before or during kindergarten could head off difficulties and frustration in school, the researchers say. Findings appeared in the online Early Edition of the Proceedings of the National Academy of Sciences.Identifying epilepsy-like brain activity: Children with developmental delay or autism may have unrecognized epilepsy-like brain activity during sleep. Researchers at Boston Children's found that these nighttime electrical spikes, detectable only on EEGs, occur even in some children without known epilepsy and appear to result from early strokes or other early life injuries to the developing brain. If nighttime spiking remains undiagnosed and untreated, it may interfere with learning and development. Based on their findings, the researchers suggest that sleep EEG monitoring should be considered more often in children not meeting developmental milestones, and that bedtime medications to suppress nighttime seizures may be beneficial if heightened brain electrical activity is found. In a preliminary treatment trial, such nighttime dosing before times of greatest spike or seizure activity has been found to be beneficial. 31983934 0 18019156 TEACHING:Over the course of the year, 134 residents, 292 clinical fellows, 545 research fellows and 900 rotating residents/fellows come to Children's from around the world. More importantly, these men and women are selected for their potential leadership in their respective fields and their commitment to advancing the frontiers of pediatric care. In fact, a 24-year analysis of residents who have graduated from our Department of Medicine found that 44 percent go on to become leaders in academic medicine, including positions as deans, chairs and program heads across the country. Over a third of the chiefs of pediatric departments across the country trained at Children's. We train individuals at all parts of the care continuum, including: medical students, interns, residents, fellows, nursing students, community pediatricians and continuing professional education for all of our clinical staff.Children's offers the only training program in Massachusetts for: Adolescent Medicine; Neurodevelopmental Disabilities; Pediatric Cardiology; Pediatric Hematology/Oncology; Pediatric Nephrology; Pediatric Pathology; Pediatric Surgery; Pediatric Sports Medicine; Pediatric Urology All still correct; can also add Pediatric Orthopedics, Pediatric Transplant Hepatology and Congenital Cardiac SurgeryChildren's offers the only training program in New England for: Adolescent Medicine; Neurodevelopmental Disabilities; Pediatric Sports Medicine; Pediatric Urology; Pediatric Transplant Hepatology; and Congenital Cardiac SurgeryChildren's has the largest accredited training program in the country for: Child Neurology; Pediatric Anesthesiology; Pediatric Cardiology; and Pediatric EndocrinologyIn addition, Pediatric Sports Medicine is one of only 13 accredited pediatric sports medicine programs in the country and Neurodevelopmental Disabilities is one of only 9 accredited neurodevelopmental disabilities programs in the country. Congenital Cardiac Surgery is one of 11 in the country, Pediatric Transplant Hepatology is one of 5 in the country, Medical Biochemical Genetics is one of 11 in country (2 in MA/New England). Community:Nearly 20 years ago, Boston Children's Hospital was among the first academic medical centers in the country to expand the traditional missions of patient care, teaching and research to embrace a fourth core mission: community health. Over the years, the hospital has strived to ensure that community health is more than just words in its mission statement. The efforts have evolved from targeted services for individual families living in Boston into innovative models that have proven to address health disparities and improve health outcomes for children not only in Boston but across the state and country.Today, the hospital concentrates its community programs in core areas where it has the expertise, resources and community partnerships to improve health outcomes and address significant health needs. Boston Children's community mission is based on what the community needs. It revolves around keeping children healthy through wellness and prevention efforts, ensuring that children have access to needed health care services and partnering with others to address non-health issues that clearly impact health such as violence, employment and education. In all these endeavors, Boston Children's priorities are aligned with those of the City of Boston, the Boston Public Health Commission, the Boston Public Schools as well as other key partners and city agencies.Understanding community needsEverything Boston Children's Hospital does to fulfill its community mission is based on how it can best utilize its expertise and resources to address the health issues families experience today. Boston Children's uses both formal and informal methods to listen and learn from the community. This requires continued engagement, seeking input and having ongoing conversations with residents, community leaders and the hospital's key partners such as the City of Boston, the Boston Public Health Commission (BPHC), community health centers and the Boston Public Schools. Through the Office of Child Advocacy (OCA), the hospital regularly convenes providers and staff working on community health initiatives throughout the hospital. Internal staff members provide feedback on the current challenges and needs of families as well as input on how the hospital can best work with its partners. OCA also meets on a regular basis with leaders and staff at community health centers, community organizations and city agencies to better understand the impact of health issues and barriers to care. Through its Community Advisory Board (CAB), which meets on a quarterly basis, the hospital has a direct link to expertise on Boston neighborhoods, community organizations and current health needs. The CAB is instrumental in providing feedback throughout the year and in the development and execution of Boston Children's formal assessment process. This feedback from experts, community leaders and partners as well as the CAB informs the hospital's community mission, facilitates and strengthens the development of partnerships and helps to shape the implementation of the hospital's community strategy.Guided by the CAB, Boston Children's conducts a comprehensive community assessment every three years to "takes the pulse" in Boston neighborhoods surrounding the hospital. Focus groups with residents, interviews with key stakeholders and an analysis of data and best practice literature provides detailed insight of not just concerns and needs, but also the strengths and the assets of the community. Boston Children's last formal report was completed in 2009 and the hospital is now working on its current assessment to be completed in 2013. In addition to the Boston Children's assessment, the hospital has also partnered with the Boston Public Health Commission to complete a first-of-its kind study on the needs of Boston children. For more details on the needs assessment process, visit bostonchildrens.org/community. A copy of the last assessment completed in 2009 can also be found on the web site.Serving as a safety netBoston Children's is the leading provider of health care to low-income and underinsured children in Massachusetts and it provides care unavailable elsewhere in the state and sometimes the nation. Boston Children's also treats pediatric patients from Massachusetts regardless of their ability to pay. Boston Children's is also a safety net provider for Boston children. More than half of all Boston children hospitalized come to Children's. This safety net is financial in that the hospital provides free care, subsidizes care for Medicaid patients, and incurs bad debt for patient families who cannot pay for the care they receive. It is programmatic in that Boston Children's offers vital, hospital-subsidized services that are either unavailable elsewhere or available only in very limited capacity, such as mental health, dental and primary care.Being a community health leaderWhile the hospital has dozens of initiatives that address the health and even the non-health needs of children in the local community, Boston Children's has identified four priority health areas and developed a programmatic response to each. Community programs are focused where the hospital has clinical expertise, resources and partnerships to make a difference. The hospital's strategy for improving community health has two aims: 1) addressing the most pressing health needs of children and families; and 2) providing services through program that can lead to improvements in health care. Boston Children's has developed a performance measurement system that guides our community health programs-tracking health outcomes and then reporting progress back to hospital leadership and the community. Programs in the "Portfolio to Achieve Health and Social Impact" include asthma (Community Asthma Initiative), obesity (Fitness in the City), child development (Advocating Success for Kids Program) and mental health (Children's Hospital Neighborhood Partnerships). These programs are measured to ensure that they address health needs, reduce health disparities and engage with our community. -The Community Asthma Initiative (CAI) has helped to improve the health of nearly 1,000 Boston children with asthma. CAI provides case-management services, offers home visits, educates caregivers and providers, distributes asthma control supplies and connects families to local resources. CAI has proven to be a cost-effective solution for keeping children out of the hospital as well as helping them to stay in school and making sure their parents can go to work.-Fitness in the City (FIC) is a community-based approach to address obesity. FIC supports 11 Boston community health centers to provide almost 1,000 children annually with case-management support, as well as access to nutrition and physical activity programs. Almost 60% of children participating in FIC have reduced or maintained their Body Mass Index and have made behavioral changes such as reducing consumption of sugar sweetened beverages and increasing the amount of time being physically active. -The Advocating Success for Kids Program (ASK) provides access to intensive and critically needed services for hundreds of children experiencing school-functioning problems and learning delays through Boston Children's primary care clinic and in three Boston community health centers. ASK has successfully reduced the wait times for families seeking in-demand assessment and case management services. -Children's Hospital Neighborhood Partnerships Program (CHNP) is the hospital's community mental health program. CHNP places clinicians in Boston schools and community health centers to provide a comprehensive array of mental health services, reaching more than 2,000 children and adolescents where they live and learn. CHNP has increased access to mental health services by helping students in participating schools receive therapy services in 7 days, compared to 42 days in outpatient settings.For details on the programs mentioned above and other efforts to improve child health in Boston, visit bostonchildrens.org/communityPartnering to address social determinants of health Boston Children's has relationships with more than 60 key partners who provide a voice for the families and neighborhoods they represent. Each partner helps to ensure that the hospital better understand the needs, uniqueness and strengths that lie within each community. Recognizing the link between social issues and health issues, Boston Children's actively participates and collaborates with its key community partners to respond to social determinants of health, which are non-medical issues that have a significant impact on individual and community health such as poverty, sub-standard housing, family instability and unemployment. Based on community need and the hospital's expertise, Boston Children's focuses its efforts and partnerships in three areas: 7875373 0 0 Community (continued):Education and schools. Boston Children's partners closely with the Boston Public Schools (BPS) to support and strengthen the system as well as to work directly in school settings to reach students and help families overcome barriers that may prevent their children from functioning well in school. These programs include the Children's Hospital Neighborhood Partnerships Program, the Advocating Success for Kids Program and various efforts in the area of child development. The hospital is also the BPS' main partner to help develop and implement a behavioral health model district wide that will better identify and address mental health needs for all students.Workforce Development. Boston Children's recognizes that one of the most significant ways to provide community support and ensure a diverse workforce is the recruitment and retention of Boston residents as employees. The hospital's comprehensive workforce development efforts are in partnership with local organizations such as Sociedad Latina, Fenway Community Development Corporation and Jewish Vocational Services. Violence Prevention. Boston Children's plays a key role in helping Boston children and families cope with the impact of violence in their lives and working with communities to help prevent it, including the Jamaica Plain Violence Intervention and Prevention Collaborative, a partnership with 15 local organizations including the hospital's Martha Eliot Health Center in Jamaica Plain. Partnering to support the health care infrastructureBoston Children's is also committed to and directs resources to build capacity within the existing infrastructure of care for Boston children and families. This means supporting key partners-the Boston Public Health Commission (BPHC) and Boston community health centers. Boston Children's has been a longtime partner with the BPHC, working together on pressing health issues and supporting efforts to help children, adolescents and young adults, including:- A Boston Children's-initiated, first-of-its-kind study to assess the health status of children in Boston; the study includes a 2,500 person phone survey, an analysis of Medicaid data to assess prevalence of disease and utilization of health services, and an in depth environmental scan of several Boston neighborhoods. The results will be publicly available in 2013.- Participation in the BPHC's Tobacco-Free Hospital Initiative and Sugar-sweetened Beverage Learning Network, in addition to the formation of an internal Healthy Hospital Workgroup to analyze and make recommendations for hospital policies promoting a healthy environment for patients, families, and staff. - Provision of financial support and expertise to the BPHC to support the City's NeighborCare initiative, an effort encouraging Boston residents to receive primary care at community health centers. Boston Children's supports community health centers to: 1) build capacity to provide a full range of services in order to position them as part of providing an effective medical home for children; 2) provide pediatric services that address the most pressing health issues affecting children; and 3) demonstrate their value through effective assessment and reporting of quality outcomes. Boston Children's provides financial and programmatic support to 11 Boston community health centers: Bowdoin Street, Brookside, Dimock, Joseph Smith, Roxbury Comprehensive, South Cove, South End, Southern Jamaica Plain, Upham's Corner, Whittier Street and Mattapan as well as the hospital's own Martha Eliot. These health centers provide primary care and support, including medical, dental and mental health services, to an estimated 33,000 Boston children and their families, particularly the uninsured and underinsured. With support from Boston Children's, the health centers have been able to focus on not only the quality of care provided but how they can expand the range of services delivered, serving as part of the patient-centered medical home.Support also enables these health centers to augment current or provide new services that are in great demand, yet not always readily available. The health centers are able to reach over 1,000 children per year with case management support, nutrition and fitness education, psychiatric and developmental consultation through programs such as Owl on the Road, Fitness in the City, Advocating Success for Kids and the Children's Hospital Neighborhood Partnerships program. Advocating for children and familiesInfluencing public policy to improve child health is an important aspect of Boston Children's commitment to community health. As the leading provider of medical services to low-income children in Boston and Massachusetts as well as a critical safety net for children throughout New England, Boston Children's has been an organized force and an influential advocate for children for more than 20 years. Boston Children's is also a forceful advocate on appropriate legislative and regulatory matters in Massachusetts, such as increasing access to quality pediatric mental health programs and promoting coverage for asthma education and services. As a founding member (1993) of a statewide Children's Health Access Coalition, the hospital played a key role in two expansions of health care coverage for Massachusetts children during the 1990s. Boston Children's also worked as a lead participant in the Affordable Care Today Coalition, the catalyst behind the passage of Massachusetts' 2006 health reform law, which has served as a model for the federal law. As a result, Massachusetts has achieved near universal health access for children, with less than 1 percent of children uninsured-the lowest rate in the country. In 2010, Boston Children's worked with national partners to help explain and leverage our experience in Massachusetts to the federal health reform law, the Affordable Care Act.In 2006, Boston Children's (including its Children's Hospital Neighborhood Partnerships Program - for details see above) and a coalition of community organizations launched the Children's Mental Health Campaign (CMHC). The CMHC has achieved remarkable success in securing the passage and enactment of Yolanda's Law which ensures access to appropriate and timely treatment, requires insurers pay for the treatment, and pushes the state to play a more active role in ensuring a comprehensive continuum of services in every community. Boston Children's and the Asthma Regional Council of New England partnered together to establish a business case for pediatric asthma management. This business case was instrumental in convincing state legislators of the benefits of such an approach and led them to provide $3 million in funding for a Medicaid demonstration project to provide case management services to children with asthma. The MassHealth program has recently released a request for proposals to allow MassHealth providers throughout the state to receive bundled payments for asthma care so that they can employ a similar asthma management program. In 2012, Boston Children's played an active and vocal role in the development of the groundbreaking payment reform legislation that was signed into law in August. The hospital's advocacy resulted in numerous considerations for children including developing standards for Accountable Care Organizations and studying the impact of the law on access to high quality care for children. The law also added language to improve retention in the MassHealth program, at the hospitals urging.Boston Children's has established the 2,000 member Children's Advocacy Network (CAN), a grassroots advocacy network that leverages the many voices of families, hospital staff, and community partners in support of child health. Since 2006, the hospital has trained 275 advocates through an annual in-depth, five-session training series that gives advocates a better understanding of the legislative process and the skills needed for effective advocacy. The CAN hosts monthly "Advocacy Lunch & Learns", which offer hospital staff and community partners a forum each month to learn about a current issue related to children's health policy and explore ways to advocate for children. Staff members from departments throughout the hospital regularly engage with the CAN in order to receive information about policy changes that may impact their patient population or schedule in-service presentations about current events in Washington and at the state level. 7875373 1152947764 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 1 0 0 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 1 770 0 1 11104 1 1 1 0 0 0 1 1 1 1 0 0 0 0 X 21 14 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X Douglas Vanderslice 6173556881 300 Longwood Avenue Boston MA 02115 Stephen Karp 5.00 X 0 0 0 Douglas Berthiaume 2.00 X 0 0 0 Allan Bufferd 1.00 X 0 0 0 Steven Fishman MD 1.00 X 0 0 0 Gary Fleisher MD 1.00 X 0 0 0 William Harmon MD 1.00 X 0 0 0 Winston Henderson 1.00 X 0 0 0 Mira Irons MD 1.00 X 0 0 0 James Kasser MD 1.00 X 0 0 0 Harvey Lodish PhD 1.00 X 0 0 0 Gary Loveman 1.00 X 0 0 0 Ralph C Martin 1.00 X 0 0 0 Thomas Melendez 1.00 X 0 0 0 Robert A Smith 1.00 X 0 0 0 Robert Smyth 1.00 X 0 0 0 Eileen Sporing MSNRN 55.00 X 537365 0 49456 Alison Taunton-RigbyPhD 1.00 X 0 0 0 Ann Thornburg 1.00 X 0 0 0 Marc B Wolpow 1.00 X 0 0 0 Gregory Young MD 1.00 X 0 0 0 James Mandell MD 55.00 X X 1443499 0 60386 Sandra Fenwick 55.00 X X 989938 0 59083 David Kirshner 55.00 X 643090 0 52795 Bruce Balter 55.00 X 229582 0 50756 Stuart Novick Esq 55.00 X 635237 0 53286 Dianne Hatfield 55.00 X 95546 0 26667 Demosthenes Argys 55.00 X 531617 0 46810 Patricia BranowickiRN 55.00 X 278968 0 45512 Carleen Brunelli PhD 55.00 X 362496 0 43562 Janet Cady 55.00 X 507211 0 44034 M Laurie Cammisa 55.00 X 340629 0 35496 Margaret Coughlin 55.00 X 313121 0 19873 Patricia HickeyPhDMBA 55.00 X 309398 0 41741 Daniel Nigrin MD 55.00 X 523437 0 44932 Scott Ogawa 55.00 X 320344 0 36768 Philip Rotner 55.00 X 931706 0 47952 Inez Stewart 55.00 X 400835 0 46741 Lynn Susman 55.00 X 379816 0 42525 Henry Tomasuolo 55.00 X 362309 0 45502 Wendy Warring 55.00 X 548636 0 32437 Charles Weinstein 55.00 X 458296 0 51619 Orah Platt MD 55.00 X 515447 0 37274 David Demaso MD 55.00 X 344911 0 37414 Nader Rifai PhD 55.00 X 612000 0 48927 Clifford Woolf MB BChPhD 55.00 X 401083 0 44674 Carlo Brugnara MD 55.00 X 440865 0 48589 Melvin Glimcher MD 55.00 X 468794 0 31368 Francis Fynn-Thompson MD 55.00 X 396667 0 48705 Michelle Davis 55.00 X 440369 0 25684 14763212 0 1300568 1455 1 1 0 G Green Construction Co Inc PO Box 160 Boston MA 02134 Construction Services 24300362 Walsh Brothers Inc 210 Commercial Street Boston MA 02109 Construction Services 16078363 Harvard Vanguard Medical Associates 275 Grove Street Newton MA 02466 Healthcare Service 10887997 The Brigham and Women's Hospital 75 Francis Street Boston MA 02115 Healthcare/Research Services 10762824 William A Berry & Son Inc 99 Conifer Hill Drive Danvers MA 01923 Construction Services 8513219 204 13751 3360236 183366953 144647660 7161374 331388600 Patient Svc Revenue 621110 944500539 944500539 Prog Svc Grants 621110 22707414 22707414 Graduate Medical Educa 611710 18019156 18019156 Prof Svc Revenue 621110 4380194 4380194 Lab Revenue 621500 75698 75698 989683001 5957917 65105 5892812 1180880 1180880 14256600 0 14256600 14256600 14256600 335487438 83504 318460069 0 17027369 83504 17110873 17110873 593065 3360236 955023 -361958 -361958 437850 52547 385303 385303 Other General Services 900099 8080532 8080532 Parking Revenue 812930 5956677 5956677 Cafeteria Sales 722210 4829206 4829206 18866415 1378467631 989607303 140803 57330925 1753130 1753130 1225513 1225513 13522109 559831 12275629 686649 534771744 466491649 54571341 13708754 36592303 32851606 2489355 1251342 67031828 63572466 1545499 1913863 45027633 43403211 1624422 7807372 7807372 1853229 1850970 2259 1105501 1105501 56620 56620 1424430 1424430 152392770 133895863 18050767 446140 7606818 7340508 246564 19746 64176402 39400490 20853702 3922210 9238243 4060040 4826638 351565 67456999 65108102 1608811 740086 4680437 3989129 638488 52820 1437388 928089 459988 49311 28542626 28542626 91348159 90618116 730043 6160429 4006230 2154199 Lab/Medical/Pharmacy 124877030 124877030 Uncollecible Accts 21027904 21027904 Free Care 10925540 10925540 Uncompensated Care 8314071 8314071 1310356228 1152947764 130484824 26923640 -1 1540955 2758182 96811013 141908377 155194338 147017285 10798056 13600355 5723050 7160623 1949046424 1113701990 787028506 835344434 382195882 418564746 430807838 532642336 1499446567 1599019234 3369546205 3698015571 228112635 218359878 49961483 59065613 466043562 466906527 200000000 200000000 295855544 339893929 1239973224 1284225947 X 1231281251 1367419032 358702226 453963015 539589504 592407577 2129572981 2413789624 3369546205 3698015571 X 68111403 216105240 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 109048 0 1 72538 1 483495 0 0 665081 0 Part IV, Supplemental Information: Children's Hospital is a section 501(c)(3) organization whose mission is fourfold - to provide the best possible pediatric health care, combining compassion with advanced technical capabilities; to be the leading source of research and discovery, seeking new approaches to the prevention, diagnosis, and treatment of childhood diseases; to educate the next generation of leadership in child health care; and to provide education and healthcare services to the community. In fulfillment of the above mission, the Hospital advocates on behalf of children and the providers who care for them at the State and Federal levels. Professional staff in the Hospital's Office of Government Relations direct these activities and coordinate the work of other Hospital staff who support the advocacy efforts on an intermittent basis. The Hospital has also sent correspondence to and met directly with State and local legislators and officials. The Hospital has also utilized a grassroots network of employees and friends to advocate on behalf of children's health issues. In Fiscal Year 2012, four Office of Government Relations staff members registered with the State as lobbyists, dedicating a portion of their time to lobbying activities. In accordance with state lobbying laws, the Hospital also registered its CEO and its President as lobbyists, although their involvement in these efforts was minimal. Two Office of Government Relations staff members registered as lobbyists at the Federal level. The Hospital utilized the services of three outside consultants in Fiscal Year 2012 in both the Massachusetts General Court and the U.S. Congress. These consultants, on behalf of the Hospital, prepared written materials which are distributed to officials and met with elected and appointed officials. The following is a detailed list of lobbying expenses incurred: Josh Greenberg Registered Lobbyist Children's Hospital personnel $231,769 Karen Darcy Registered Lobbyist Children's Hospital personnel $34,632 Maria Fernandes Registered Lobbyist Children's Hospital personnel $13,118 Amy DeLong Registered Lobbyist Children's Hospital personnel $47,884 James Mandell Registered Lobbyist Children's Hospital personnel $8,414 Sandra Fenwick Registered Lobbyist Children's Hospital personnel $7,227 Melissa Shannon Children's Hospital Corporation $83,831 Ann Langley Consultant Health Policy Strategies 728 Battery Place, Alexandria, VA 22314 $21,620 Joe Grant Consultant Grant Associates 130 Bowdoin Street - Suite 1706, Boston, MA 02108 $35,000 Total Lobbyist/Consultant Expenses = $483,495 Expenses Incurred by the Office of Government Relations for Lobbying Activities = $109,048 Grant to Nat'l Assoc of Children's Hospitals for GME - Related Lobbying Expense = $72,538 TOTAL LOBBYING EXPENSES = $665,081 In addition to Children's Hospital Corporation's direct and listed lobbying expenses, Children's Hospital Corporation pays dues to certain membership organizations, a piece of which may be used by such organizations for lobbying activities on behalf of this institution and other similarly situated organizations. Total direct and indirect lobbying expenditures were minimal and not substantial based on revenues. 712896000 54490000 87370000 25795000 828961000 567567000 192306000 -11529000 35448000 712896000 474444000 63114000 48022000 18013000 567567000 446887000 22139000 25362000 19944000 474444000 0.55420 0.16750 0.27830 0 0 399348 399348 1234917585 661618800 573298785 580600044 446908418 133691626 133129447 5174772 127954675 835344434 Knott Partners 345614 F Pequot 605255 F Wellington - Trust 13323779 F Wellington - Energy 7119075 F Brookside Capital 22513939 F Lone Pine Capital 11694082 F Lone Pinon 4294024 F Standard Pacific 14801020 F Highfields Capital 33603124 F Sankaty 11699276 F Davidson Kempner 37481338 F King Street 48775049 F Baupost 45071425 F Fidelity International Stock 21900625 F Fidelity Notes Payable 2149823 F Bain IX Fund 8026158 F Bain X Fund 3569665 F Bain Arc 15284438 F Old Lane 185050 F SPUR Ventures 4376340 F Lone Cascade 24429898 F Wellington - Emerging Small Cap 15356405 F Wellington - Real Asset 19361432 F Wellington - Diversified Hedge 6535894 F TT International 9692221 F Walter Scott 19782719 F Axiom 12264907 F Sanford Bernstein 22506088 F MIT Private Equity Fund 20972184 F Energy Capital Partners 4608528 F SDK Capital 3478395 F Matrix China II 884008 F Nalanda 6148143 F Lone Dragon 6289500 F Somerset 8098634 F Sankaty COPS Fund V 246598 F Matrix India II 219887 F SequoiaUSGrowFUund V 360806 F Abrams Capital 8605134 F Bain Venture 33110 F Golden Gate Capital 2854815 F Crosslink Capital 2643394 F Sequoia Capital Global Equities 4317658 F Steadfast 8916370 F Sequoia China Venture Fund IV 16509 F Convexity 17200000 F 532642336 Unamortized Bond Issuance Fees 3944253 Interest in the Net Assets of Children's Medical Center 1564534748 Due from IRS 7078730 Expected Insur Recoveries for Prof Liability Claims 23441503 Other Assets - Miscellaneous 20000 1599019234 Estimated Final Settlement Due to Third Party Payors & Deferred Revenue 32555708 Estimated Insured Professional Liability Losses 23441503 Salary & Other Benefits 3032870 Funds Held for Others 36905445 Reserve for Medical Malpractice 5689042 Accrued Pension Cost 59961529 Other Liabilities - Miscellaneous 11319619 Lease Obligations 11407502 Interest Rate Swap Liability 155580711 339893929 Description of Intended Use of Endowment Funds: Part V, Line 4: Part V, line 4: The Children's Hospital's investment and spending policies for endowment assets are intended to provide a predictable stream of funding to support Children's Hospital's missions in pediatric patient care, education, research, and community programs. Part V, Line 1b: The Contribution line is comprised of Net Assets Reclassifications of $17,372,000, Contributions of $35,366,000 and endowments from the Immune Disease Institute merger of $1,752,000. Description of Uncertain Tax Positions Under FIN 48: Part X: Part X, Line 2: There is no FIN 48 footnote in the organization's audited financial statements. Central America & the Caribbean 0 0 Program Services Patient Care, Research & Education 25933 East Asia & The Pacific 0 0 Program Services Patient Care, Research & Education 197276 Europe 0 0 Program Services Patient Care, Research & Education 359579 Middle East and North Africa - 0 0 Program Services Patient Care, Research & Education 105961 North America 0 0 Program Services Patient Care, Research & Education 115403 South America 0 0 Program Services Patient Care, Research & Education 58532 South Asia 0 0 Program Services Patient Care, Research & Education 29386 Sub-Saharan Africa 0 0 Program Services Patient Care, Research & Education 135413 Central America & the Caribbean 0 0 Investment 23000 Central America & the Caribbean 0 0 Insurance 2929278 Russia & the Newly Independent States - 0 0 Program Service Patient Care, Research & Education 1772 0 0 0 0 0 0 1027483 2954050 3981533 1 0 1 0 0 0 Procedure for Monitoring Grants Outside the U.S.: Schedule F, Part I, Line 2: Children's Hospital's employees may travel outside the United States to support its missions in pediatric patient care, education, research, and community services. Business travel, on behalf of Children's Hospital, must follow the Hospital's Travel Policy. The traveler must complete a Travel Expense Report (TER) form, and provide original itemized receipts as supporting documentation. TER form approval is the responsibility of the Manager of the Department/Director/VP in which that activity is budgeted and expensed. In addition, the Department Manager/Principal Investigator/Director/VP is responsible for: - Ensuring that the travel policy and procedures are clearly communicated to all authorized travelers. - Ensuring compliance with all CHB travel policy and procedures, and applicable sponsor guidelines in the case of grant-sponsored activities; including timeliness and proper documentation requirements. - Maintaining supporting documentation of travel activity and expenses for proper record keeping and auditing purposes. - Assuring that proper authorization signatures are documented on the TER form with the understanding that unauthorized expenses and/or personal expenses will not be reimbursed to the traveler. In general, the ordinary and necessary expenses incurred while traveling on hospital business are reimbursable upon presentation and authorization of a completed TER form with original receipts as supporting documentation. Reimbursable expenses include transportation, hotel/lodging, meals and other reasonable expenses incidental to travel. Personal expenses are not reimbursable. X X X X X X 1 Advanced Marketing Direct 99 Thielman Drive Buffalo NY 14206 Direct mail creative & management 0 1161239 1270797 -109558 Chartiy Dynamics 3420 Executive Center Drive Austin TX 78731 Donor Survey 0 0 78434 -78434 Cygnus Applied Research 444 North Michigan Ave Chicago IL 60611 Donor Survey 0 0 34173 -34173 Marts & Lundy 370 Lexington Avenue New York NY 10017 Fundraising Counsel 0 0 35526 -35526 Pamela Starr 2441 Earl Street Los Angeles CA 90039 Fundraising Counsel 0 0 5500 -5500 1161239 1424430 -263191 CT RI NH VT ME FL NY NJ NV Dinner/Auction 3511706 2926611 585095 0 0 0 190633 0 648364 Dinner Gala 441595 433625 7970 0 0 0 61419 7700 46907 0 3953301 3360236 593065 252052 7700 695271 955023 -361958 0 0 0 0 0 0 0 0 0 0 0 0 437850 0 0 0 52547 1 0.71000 437850 52547 52547 385303 MA 1 0 0 0 1.00000 Douglas Vanderslice Sr Vice Presi 300 Longwood Ave Boston MA 02115 0 Ethridge King 0 Mr. King, Dir. of Devlopmnt Svc at Children's, was not compensated as a gaming manager. His job includes overseeing any fundraising gaming operations. X 0 1 1 1 X 0 1 1 0 1 1 14635196 3849996 10785200 0.00840 237677926 178762704 58915222 0.04570 252313122 182612700 69700422 0.05410 5915030 5915030 0.00460 31983934 5770672 26213262 0.02030 20149468 15413323 4736145 0.00370 306466000 143554000 162912000 0.12640 1494800 1494800 0.00120 366009232 164737995 201271237 0.15620 618322354 347350695 270971659 0.21030 28 1466599 1466599 0.00110 7 493744 493744 0.00040 35 1960343 1960343 0.00150 0 6494132 0 8967414 8605014 362400 X 1 1 1 None 1 1 Boston Children's Hospital

300 Longwood Avenue Boston MA 02115

X X X X X X Boston Children's Hospital 1 1 1 200.000000000000 0 1 X X 1 1 X X 1 X X X 0 1 X 0 0 5 Children's Hospital Boston-At Waltham

9 Hope Ave Waltham MA 02453

Outpatient Satellite Facility Children's Hospital at Lexington

482 Bedford Street Lexington MA 02173

Outpatient Satellite Facility Martha Eliot Health Center

75 Bickford Street Boston MA 02130

Outpatient Community Health Center Children's Hospital at Peabody

1 Essex Center Drive Peabody MA 01960

Outpatient Satellite Facility Children's Clinics at 333 Longwood Ave

333 Longwood Avenue Boston MA 02115

Outpatient Pediatric Clinic Part I, Line 3c: Children's, based on its participation in the state of Massachusetts Health Safety Net, utilizes Federal Poverty Guidelines for determining eligibility for free care to low income individuals. For purposes of discounted care, Children's offers discounts to individuals, regardless of income, who are uninsured and are ineligible for free care or other public programs. Part I, Line 6a: Children's files an annual community benefits report with the Attorney General's Office (AG) in Massachusetts. There are significant differences between the AG and IRS requirements for reporting community benefits expenditures. The IRS counts the following as community benefits while the AG does not: Medicaid shortfalls, indirect costs, health professions education, and research funded by tax-exempt and government sources. Children's AG Report is publicly available and can be accrssed directly on the AG's web site, www.mass.gov/AG and Children's web site, www.childrenshospital.org. Part I, Line 7: Children's used an internal cost accounting system for purposes of reporting certain amounts on Part I, line 7. The system is designed to address all segments of patient care (inpatient, outpatient and emergency) and assigns costs to patients from all payer sources (Medicaid, Medicare, managed care, commercial, uninsured and self-pay). The cost of charity care was determined based on the overall relationship of hospital costs as a percentage of hospital charges, applied to charges that qualified as charity care.Children's provides charity care to all children in need who meet the hospital's charity care standards, which are in alignment with all state mandated regulations.Nearly 30% of children who receive their care at Children's are insured through Medicaid programs in a number of states including Massachusetts. In aggregate, Medicaid programs do not reimburse the hospital for the total costs of providing care to these children.Children's has a strong commitment to improving the health status of the children in our local community. Based on a tri-annual community needs assessment, Children's supports a variety of programs and partners both internal and external that are addressing the needs of Boston children. Children's has also identified four major health focus areas in which it concentrates its efforts. For children in Boston, asthma, mental health, obesity and child development are major concerns. Children's has community based programs in each of these issue areas. The hospital also has an Office of Child Advocacy that provides support to these programs. Children's is a leader in education and training for healthcare professionals. Children's subsidizes services that are either limited or unavailable in the broader community. Examples include psychiatry, primary care, and dental care. Children's is home to the world's largest and most active research enterprise at a pediatric center. Recognizing that Children's does not have the capacity to meet all the needs of the children of Boston, it supports (through financial contributions and in kind services) a large number of community based organizations who are providing these important services. Beneficiaries range from full service community health centers to Head Start programs for pre-school children.For more information, visit www.childrenshospital.org/community. Part I, Line 7g: Children's does not subsidize physician services; thus there are none reported in the dollar amount for subsidized health services. Part I, L7 Col(f): The total bad debt expense of $21,027,904 is included in Form 990, Part IX, line 25 column (A), but subtracted for purposes of calculating the percentage in this column. Part II: In FY12, Children's reported two types of community building activities: $1,466,599 for 28 community support programs and $493,744 for community health improvement advocacy. Children's community building activities are designed specifically to address heath disparities and improve the health of children, families and communities. According to public health literature (see Ambulatory Pediatrics and Health Affairs), initiatives that address disparities for children across four different levels: the individual, systemic, community and society can lead to meaningful improvements in health.As described in Form 990, Part III Program Service Accomplishments, Children's takes a multi-pronged approach to tackle the most pressing health issues facing Boston children. At the same time, Children's addresses non-health or social determinants of health issues such as violence, workforce development and education, which also impact a child's health. Therefore, Children's directs its community building activities in the following areas: - Children's public policy advocacy efforts help to improve access to health care for all individuals and ensure high-quality pediatric services.- As a major employer in Massachusetts and civic leader in Boston, Children's supports efforts to ensure a diverse and culturally competent health care workforce as well as promotes economic health in the surrounding communities. - To improve life in local neighborhoods, Children's has targeted support towards community based organizations that do not focus specifically on health, but rather on the vibrancy of the community. Contributions to groups such as the Fenway Community Development Corporation and Sociedad Latina are as important as partnerships with community health centers.For more information, visit www.childrenshospital.org/community. Part III, Line 4: Children's Medical Center and Subsidiaries' Audited Financial Statements contain the following bad debt footnote:"The provision for bad debt expense is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collectionindicators. Accounts receivable are reduced by an allowance for doubtful accounts. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Medical Center follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions oncollection efforts as determined by the Medical Center. Accounts receivable are written off after collection efforts have been followed in accordance with the Medical Center's policies."Bad debt expense reflects patient charges that have been deemed uncollectible, converted to cost based on the ratio of patient care cost to changes from Worksheet 2. There is not any amount of bad debt reflected as charity care, because it can't be quantified accurately at this time. However, some bad debts would be charity care. Part III, Line 8: Medicare allowable costs are obtained directly from the Medicare Cost Report and are determined in accordance with Medicare principles of reimbursement. Part III, Line 9b: Children's makes reasonable and diligent efforts to collect each patient's insurance and other information and to verify coverage for health care services. Children's applies collection actions to all patients in the same manner, irrespective of their insurance status. Children's does not (and does not permit its agents to) engage in collection action of any kind, including billing, with respect to patients/guarantors that are exempt from collection action under Children's Credit and Collection Policy and under Massachusetts regulations governing the Health Safety Net program. All patients/guarantors who are not exempt from collection action are advised in all billing-related communications of the availability of free care and financial assistance, including assistance in applying for public programs and the availability of charity care. Children's does not (and does not permit its agents to) engage in legal action against patients/guarantors, including liens, wage garnishments, or lawsuits, or report patients/guarantors to credit bureaus or credit agencies without specific, case-by-case authorization by Children's Board of Trustees. No legal action occurred during the year. Children's Credit and Collection Policy is filed with the Massachusetts Division of Health Care Finance and Policy. That policy and related policies on Self-Pay Discounting and Charity Care and Self-Pay Collection Practices are also available to patients upon request. Boston Children's Hospital Part V, Section B, Line 9: Children's, based on its participation in the state of Massachusetts Health Safety Net, utilizes Federal Poverty Guidelines for determining eligibility for free care to low income individuals. For purposes of discounted care, Children's offers discounts to individuals, regardless of income, who are uninsured and are ineligible for free care or other public programs. Boston Children's Hospital Part V, Section B, Line 10: For purposes of discounted care, Children's offers discounts to individuals, regardless of income, who are uninsured and are ineligible for free care or other public programs. Boston Children's Hospital Part V, Section B, Line 13g: Children's takes the following steps to make patients aware of the availability of financial assitance:- Posting of signage in all patient care admission areas of the availability of financial assitance,- All billing correspondence includes language regarding the availability of financial assistance,- The Hospital web-site provides contact information for Hospital Financial Counselors who can help assist patient with applying for programs to cover medical expenses. Revising Policies Part V, Lines 8-21 Responses on Lines eight through twenty-one reflect policies and procedures in place during the fiscal year. Children's is currently revising the relevant policies to reflect changes required by the proposed Internal Revenue Code Section 501(r) regulations released by the Internal Revenue Service on June 22, 2012. Part VI, Line 2: Children's is committed to assessing the health needs of children and families living in the communities surrounding the hospital's main campus. Children's utilizes formal and informal mechanisms to listen and learn from residents as well as hospital staff, key stakeholders, community leaders and advocates. The hospital conducts a formal, comprehensive assessment every three years. Children's most recent formal assessment was completed in FY09 and the next will be completed in 2013, which will include a partnership with the Boston Public Health Commission to conduct a first-of-its-kind health study to gather data on Boston children and families. Informally, the hospital gathers information, encourages community participation and seeks input from families and partners on a regular basis. Based on the information gathered, the hospital develops a community benefit action plan for how it can best address those needs and effectively utilize its expertise and resources. A key component of the hospital's assessment is the input and guidance from the hospital's Community Advisory Board and Board Committee on Community Service. Children's also conducts ongoing yet less formal means of assessment to inform the hospital's community efforts. For more information, visit www.childrenshospital.org/community. Part VI, Line 3: Children's provides patients with information about financial assistance programs that are available through the Commonwealth of Massachusetts or through the hospital's own financial assistance program. All patients/guarantors who do not qualify for free care and thus are not exempt from collection action are advised in all billing-related communications of the availability of free care and financial assistance, including assistance in applying for public programs and the availability of charity care.For those patients that request financial assistance, Children's assists patients by screening them for eligibility in an available public program and assisting them in applying for the program. All patients/guarantors who are not exempt from collection action are advised in all billing-related communications of the availability of free care and financial assistance, including assistance in applying for public programs and the availability of charity care. The screening and application process for a financial assistance programs is done through either the Virtual Gateway (which is an internet portal designed by the Massachusetts Executive Office of Health and Human Services to provide an online application for the programs offered by the state) or through a standard paper application. All Virtual Gateway and paper applications are reviewed and processed by the Massachusetts Office of Medicaid. Hospitals have no role in the determination of program eligibility made by the state, but at the patient's request may take a direct role in appealing or seeking information related to the coverage decisions. Part VI, Line 4: As one of the largest most comprehensive pediatric medical centers in the U.S., Children's is a regional, national and global referral center. Approximately 20% of inpatients come from out of state or out of the country because of the complex care Children's is able to provide. Children's is also considered the primary community hospital for the children of Boston and the largest provider of pediatric care to low-income families in the state. Approximately 30% of Children's patients are covered through Medicaid/CHIP including a significant number insured by out-of-state Medicaid programs. State-wide, it is estimated that Children's treats 90% of the sickest children in Massachusetts.Children's main campus is located in Boston, a racially and ethnically diverse city, which is home to nearly 620,000 people. A wide range of ethnic backgrounds and countries of origin can now be found in Boston's population and people of color make up the majority of the City's population. Approximately 115,000 children under the age of 18 live in Boston representing 20 percent of the population. Children mirror Boston's emergence of "majority minority" diversity; 37 % of Boston's children are Black, 24% are Hispanic, 7% are Asian/Pacific Islander, 4% are multi-racial and 3% are other. An estimated 26% of Boston's children live in poverty. Part VI, Line 5: As the only free-standing children's hospital in the state, Children's treats 90% of the sickest kids in Massachusetts and offers a range of services that are unavailable elsewhere in the region, including pediatric transplants, critical care transport services, a level 1 Pediatric Trauma Unit and a level 3 Neonatal Intensive Care Unit. Children's also qualifies for DSH payments as the state's largest provider of pediatric care to low-income families. Approximately 30% of its patients are covered by Medicaid, including patients insured by out-of-state Medicaid programs. In addition, Children's has an open medical staff model. Children's is also a leader in education and training for healthcare professionals. It sponsors 38 Accreditation Council for Graduate Medical Education-accredited training programs, one American Dental Association accredited training program and 15 non-accredited subspecialty fellowships with 476 residents/clinical fellows enrolled in these programs. Children's partners with 27 schools of nursing throughout Massachusetts and New England to provide clinical experiences in pediatrics. Children's offers a variety of continuing education courses designed for health care professionals in pediatric practice. The courses are accredited by the Office of Continuing Education at Harvard Medical School and each hour of instruction is approved for Category 1 credits towards the AMA Physician's Recognition Award. Topics include autism, eating disorders, sports injuries, endometriosis, substance abuse, concussions, strabismus, Type II Diabetes and vascular anomalies. Children's also offers half-day programs titled Pediatric Health Care Summits that are held at local hospitals, such as Beverly Hospital, Lawrence General and South Shore Hospital (Weymouth). Additionally, Children's partners with area community hospitals such as Good Samaritan Medical Center, Holy Family, Lawrence General, South Shore, St. Anne's and St. Joseph's to sponsor Community Hospital Pediatrics Grand Rounds with monthly lectures provided by faculty in medical and surgical sub-specialties. Children's also operates "Career Opportunity Advancement Children's Hospital", a seven-week program for Boston youth to explore health care careers while having a safe and meaningful summer and the program "Student Career Opportunity Outreach Program", designed by Children's nurses to introduce young people to nursing career opportunities. Children's is home to the world's largest and most active research enterprise at a pediatric center. Children's research mission encompasses basic research, clinical research, community service programs and the postdoctoral training of new scientists.Children's has a twenty-one person voluntary Board of Trustees. Thirteen of the Board members are not direct employees of the hospital and all of them live in the hospital's service area. The Board oversees the hospital's endowment and follows a 5% spending rule in keeping with the industry standard of the responsible management of assets. Reserves are invested back into patient care, teaching, research, patient safety and quality initiatives, equipment, facilities, community benefits and to subsidize vital services that run a deficit. Part VI, Line 6: Although Children's does not have true affiliates as defined by the IRS, it does have other affiliations. As the largest pediatric referral center in the region, Children's maintains a variety of relationships with community hospitals and other smaller pediatric programs throughout New England. These relationships include seven community hospitals in eastern Massachusetts where Children's physicians have formal arrangements to provide on-site emergency medicine, inpatient, neonatal and/or outpatient pediatric specialty services. Children's also owns and operates four outpatient facilities in Waltham, Lexington, Peabody, and Jamaica Plain that offer access to pediatric specialty care in a wide array of subspecialties. Children's provides assistance to other pediatric facilities (Hasbro, RI, Dartmouth Hitchcock, NH, and Boston Medical Center) in the region through training, recruitment, consultations, on-site care and referrals for care that is not otherwise available.In addition, the Pediatric Physicians' Organization at Children's brings together pediatricians, pediatric medical groups and pediatric specialists at Children's. Reports Filed With States Part VI, Line 7 MA 1 Health Resources In Action 622 Washington Street Dorchester MA 02124 042229839 501(c)(3) 91000 FMV Community Partnership Boston Community Centers Inc 1483 Tremont St Boston MA 02120 042602576 501(c)(3) 15000 FMV Community Partnership - Boston Center for Youth & Families Boston Public Health Commission 1010 Massachusetts Ave Boston MA 02118 043316655 115 155000 FMV Community Partnership Boston Public Schools 26 Court St 6th Fl Boston MA 02108 222514422 115 321800 FMV Community Partnership Bowdoin Street Health Center Inc 230 Bowdoin Street Boston MA 02122 042529788 501(c)(3) 100000 FMV Support of Community Health Center Brigham & Women's Hospital Inc 75 Francis Street Boston MA 02115 042312909 501(c)(3) 70000 FMV Support of Brookside Community Health Center The Dimock Center 55 Dimock Street Roxbury MA 02119 043487835 501(c)(3) 130000 FMV Community Partnership Fenway Community Development Corporation 73 Hemenway Street Boston MA 02115 042666507 501(c)(3) 42500 FMV Community Partnership Project RIGHT 320 A Blue Hill Avenue Dorchester MA 02121 043265420 501(c)(3) 50000 FMV Advocacy Support Joseph M Smith Community Health Center Inc 287 Western Avenue Allston MA 02134 237221597 501(c)(3) 60000 FMV Support for the Community Health Canter Community Service Care Inc 295 Center Street Jamaica Plain MA 02130 042754281 501(c)(3) 19050 FMV Community Partnership - JP Coalition Mattapan Community Health Center 1425 Blue Hill Ave Mattapan MA 02426 042544151 501(c)(3) 42500 FMV Support of the Community Health Center Roxbury Comprehensive Community Health Center Inc 35 Warren Street Roxbury MA 02119 042501921 501(c)(3) 80000 FMV Support of the Community Health Center YMCA of Greater Boston inc 316 Huntington Avenue Boston MA 02115 042103551 501(c)(3) 17050 FMV Community Partnership - Roxbury YMCA Family Nurturing Center of Massachusetts Inc 200 Bowdoin Street Dorchester MA 02122 311626186 501(c)(3) 50480 FMV Support of City of Boston's Initiatives - Smart from the Start Sociedad Latina Inc 1530 Tremont Street Roxbury MA 02120 042678255 501(c)(3) 36500 FMV Community Partnership South Cove Community Health Center Inc 145 South Street Boston MA 02111 042501818 501(c)(3) 87500 FMV Support of the Community Health Center South End Community Health Center Inc 1601 Washington Street Boston MA 02118 042456134 501(c)(3) 85000 FMV Support of the Community Health Center Brigham & Women's Hospital Inc 75 Francis Street Boston MA 02115 042312909 501(c)(3) 80000 FMV Support of Southern Jamaica Plain Community Health Center Upham's Corner Community Center Inc 500 Columbia Road Dorchester MA 02125 042708670 501(c)(3) 80000 FMV Support of the Community Health Center Whittier Street Health Center Committee Inc 1125 Tremont Street Roxbury MA 02120 042619517 501(c)(3) 72500 FMV Support of the Community Health Center Associated Early Care and Education Inc 95 Berkeley Street Suite 306 Boston MA 02116 042105893 501(c)(3) 6600 FMV Community Partnership Massachusetts League of Community Health Centers 40 Court Street 10th Floor Boston MA 02108 042507409 501(c)(3) 5000 FMV Community Partnership Mission Hill Youth Collaborative 1481 Tremont Street Boston MA 02120 043103865 501(c)(3) 5000 FMV Community Partnership Massachusetts General Hospital 205 Portland Street 6th Floor Boston MA 02114 041564655 501(c)(3) 8000 FMV Community Partnership Bikes Not Bombs Inc 284 Armory Street Jamaica Plain MA 02130 043138753 501(c)(3) 5000 FMV Community Partnership Greater Boston Chamber of Commerce 265 Franklin Street Boston MA 02110 041103090 501(c)(6) 14050 FMV Community Partnership The Hyde Square Task Force Inc 375 Centre Street Jamaica Plain MA 02130 043118543 501(c)(3) 7500 FMV Community Partnership Mission Hill Health Movement 1534 Tremont Street Mission Hill MA 02120 042518620 501(c)(3) 5100 FMV Community Partnership 27 2 Sibylla Orth Young Fund for Student Aid 5 10000 FMV Nursing Education Scholarship Fund 19 87181 FMV Joshua T. Shairs Cardiology Fund 5 5000 FMV Frieze Social Work Fund 116 319540 FMV Camp Fund 129 39672 FMV Family Resource Center Fund 66 6720 FMV Andre Sobel River of Life Foundation Fund 1 1000 FMV Kent Street Operating Fund 3748 347937 FMV Housing Assistance Devon Nicole House Operating Fund 1694 130234 FMV Housing Assistance Pet Therapy Program Fund 180 0 Other Theurapeutic dog visits made to inpatients Brandano Parent Apartment Fund 940 40120 FMV Supplies for patient and families Matthew Puffer Parking Fund 18 3271 FMV Sandra & Geoffrey Fenwick Family Income Fund 419 7191 FMV Memorial services and grief conference; room fees & food Extraordinary Needs Fund 75 217862 FMV Judith Nelson Operating Fund For Families 266 9785 FMV Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Children's Hospital provides three types of grants and assistance: (1) Sponsorships, (2) Scholarships, and (3) Assistance Programs. SPONSORSHIPS: Children's supports external strategic partners that enhance Children's role and reputation as (1) a good neighbor; (2) community health partner; (3) civic leader; (4) and an employer of choice. The criteria for Children's funding decisions to the requesting organization are based on the following: 1. a non-profit that promotes careers in healthcare or health services and that Children's has collaborated, or is collaborating, with 2. a non-profit located in and serving Children's target neighborhoods (Fenway, Mission Hill, Jamaica Plain, Roxbury) that address social determinants of health and that Children's has collaborated, or is collaborating, with 3. one of Children's Hospital's affiliated community health centers 4. a citywide non-profit that is a strategic partner in one or more of the Children's primary community health focus areas (asthma, mental health, nutrition/fitness, violence prevention) and that Children's has collaborated, or is collaborating, with 5. a citywide non-profit that is a strategic partner in one or more of Children's secondary community health focus areas (early intervention, early childhood/elementary education,) that Children's has collaborated, or is collaborating, with 6. a business , civic, or advocacy strategic partner that senior management is actively engaged in 7. meets the IRS and the Massachusetts Attorney General's community support or community benefit criteria 8. meets the City of Boston eligibility as a "payment in lieu of taxes' investment Records and copies of sponsorship requests and the resulting grants are kept in paper form in the Office of Child Advocacy. All sponsorships requests are commonly for general operating support. All sponsorship is sent a letter that reiterates the stated use of the grant or assistance and with any Community Partnership Grants, representatives of Children's make site visits to many of the grantees and request end-of-year reports. SCHOLARSHIPS: Children's Hospital offers several scholarship programs to support the educational goals of its employees and/or their immediate families. The Sibylla Orth Young Scholarship is available to employees and their immediate families who have worked at least six months and meet income and grade point average guidelines as well as demonstration of sincere commitment to the healthcare profession. Priority will be given to those pursuing careers in healthcare positions experiencing labor shortages (e.g., radiographer, pharmacy technician, clinical lab technician, nursing). Sibylla Orth Young Scholarship applications are reviewed and maintained by the Office of Learning and Development selection committee. The Nursing Education Scholarship is available to deserving nurses to further his or her education in patient care and the Joshua T. Shairs Cardiology Fund is a scholarship for nurses in the field of cardiology. All nursing scholarship applicants must have worked at least three months, be enrolled in an academic program leading to a degree, demonstrate a commitment to the patient care and be in good standing, both professionally and academically. Scholarships applications for the Nursing Education Scholarships and Joshua T. Shairs Cardiology Funds are reviewed and maintained by the Department of Nursing/Patient Services selection committee. All scholarship recipients are required to sign a Terms of Acceptance agreement affirming the funds will only be used for tuition, fees and/or class materials required for course instructions. ASSISTANCE PROGRAMS: Children's Hospital offers several financial assistance programs to provide funding to patients and their families burdened by the costs associated with long-term hospitalization, acute/chronic illness, disability or impairment. We recognize the significant burdens related to financial and support services that patients and families face when experiencing frequent ambulatory services or prolonged inpatient admissions at Children's Hospital Boston. These funds are primarily intended for use in emergent situations, and as a stop-gap intervention only. They are not intended to provide permanent or long term solutions to financial need. Essentially, these are funds of "last resort" when alternative options do not exist. Below is a listing of our various Assistance Program Funds: Frieze Social Work Fund - provide broad financial assistance to needy children and families during their illness or hospitalization at Children's Hospital. Camp Fund - support social service's summer camp program for patients. Family Resource Center Fund - support of the family resource center's activities. Andre Sobel River Of Life Foundation Fund - to support functionally single parents & provide broad support to needy children and their families during their illness/hospitalization at Children's Hospital by releiving financial burdens. Kent Street Operating Fund - support patient family housing at Kent Street. Devon Nicole House Operating Fund - support patient family housing at Devon Nicole House. Pet Therapy Program Fund - provide pet therapy for patients. Brandano Parent Apartment Fund - to provide housing for needy parents of children receiving treatment at Children's Hospital. Matthew Puffer Parking Fund - provide discounted parking for patient families whose children are being treated for chronic diseases. Sandra & Geoffrey Fenwick Family Income Fund - support for the Center for Families especially needy patients. Extraordinary Needs Fund - cover immediate desperate needs of parents to include access to alternative therapeutic interventions. Judith Nelson Operating Fund For Families - provide support for The CHB Center For Families. All financial assistance requests are assessed by a social worker. If there appears to be significant financial hardship, the social worker does a financial assessment based on the policies and guidelines for the use of these special funds. Typical requests include assistance with transportation, utilities (a child cannot be discharged without adequate heat, electricity, telephone contact in the home), etc. Each request is reviewed by the Director of the Fund. Checks are not payable to the family, rather a payment may be made directly to the company involved via an invoice from that company, e.g., National Grid. Assessment considerations for Special Fund requests are based on: * Duration of Need * Demographic * Family Status * Income Factors * Clinical Factors * Alternate Resources Available * Funding Limits X X X X X 1 1 0 0 0 0 0 0 0 Eileen Sporing MSNRN 395888 0 80600 0 60877 0 26950 0 22506 0 586821 0 20150 0 James Mandell MD 757427 0 269000 0 417072 0 26950 0 33436 0 1503885 0 67250 0 Sandra Fenwick 549006 0 197500 0 243432 0 24500 0 34583 0 1049021 0 49375 0 David Kirshner 489394 0 80000 0 73696 0 24500 0 28295 0 695885 0 20000 0 Bruce Balter 188774 0 14280 0 26528 0 28951 0 21805 0 280338 0 0 0 Stuart Novick Esq 421457 0 86000 0 127780 0 26950 0 26336 0 688523 0 21500 0 Demosthenes Argys 390479 0 72500 0 68638 0 19600 0 27210 0 578427 0 18125 0 Patricia BranowickiRN 221483 0 18826 0 38659 0 28500 0 17012 0 324480 0 0 0 Carleen Brunelli PhD 278518 0 39150 0 44828 0 22050 0 21512 0 406058 0 9788 0 Janet Cady 320252 0 140400 0 46559 0 24500 0 19534 0 551245 0 35100 0 M Laurie Cammisa 262347 0 39100 0 39182 0 24500 0 10996 0 376125 0 9775 0 Margaret Coughlin 263571 0 0 0 49550 0 0 0 19873 0 332994 0 0 0 Patricia HickeyPhDMBA 253220 0 19022 0 37156 0 31000 0 10741 0 351139 0 0 0 Daniel Nigrin MD 383147 0 78000 0 62290 0 22050 0 22882 0 568369 0 19500 0 Scott Ogawa 262839 0 19503 0 38002 0 26000 0 10768 0 357112 0 0 0 Philip Rotner 554746 0 290250 0 86710 0 14700 0 33252 0 979658 0 35063 0 Inez Stewart 308192 0 46700 0 45943 0 22050 0 24691 0 447576 0 11675 0 Lynn Susman 360193 0 0 0 19623 0 24500 0 18025 0 422341 0 0 0 Henry Tomasuolo 275256 0 43000 0 44053 0 19600 0 25902 0 407811 0 10750 0 Wendy Warring 390860 0 78600 0 79176 0 17150 0 15287 0 581073 0 19650 0 Charles Weinstein 345158 0 53400 0 59738 0 24500 0 27119 0 509915 0 13350 0 Orah Platt MD 474928 0 32990 0 7529 0 26950 0 10324 0 552721 0 0 0 David Demaso MD 336532 0 0 0 8379 0 26950 0 10464 0 382325 0 0 0 Nader Rifai PhD 413173 0 195070 0 3757 0 26950 0 21977 0 660927 0 0 0 Clifford Woolf MB BChPhD 410620 0 0 0 -9537 0 22914 0 21760 0 445757 0 0 0 Carlo Brugnara MD 413173 0 34196 0 -6504 0 26950 0 21639 0 489454 0 0 0 Melvin Glimcher MD 395429 0 0 0 73365 0 26950 0 4418 0 500162 0 0 0 Francis Fynn-Thompson MD 405275 0 0 0 -8608 0 26950 0 21755 0 445372 0 0 0 Michelle Davis 193601 0 16587 0 230181 0 13104 0 12580 0 466053 0 0 0 Part I, Lines 4a-b Children's Hospital made contributions to the supplemental non-qualified retirement plan for the individuals listed below. Contribution amounts are generally based on a percentage of compensation. Participants of the supplemental executive retirement plan are fully vested. All payments with respect to a participant's separation from service will be made in a single sum following the separation from service unless participant has elected to receive the accrued interest portion of his or her account in three annual installments. Contributions were for employee benefits and not for Children's Hospital Trustee or Officer of the Board services and/or responsibilities. James Mandell, received in 2011, a contribution of $383,214 Sandra Fenwick, received in 2011, a contribution of $212,205 David Kirshner, received in 2011, a contribution of $54,708 Stuart Novick, received in 2011, a contribution of $109,080 Eileen Sporing, received in 2011, a contribution of $40,606 Demosthenes Argys, received in 2011, a contribution of $40,368 Carleen Brunelli, received in 2011, a contribution of $23,100 Janet Cady, received in 2011, a contribution of $27,516 M. Laurie Camissa, received in 2011, a contribution of $21,538 Margaret Coughlin, received in 2011, a contribution of $16,000 Daniel Nigrin, received in 2011, a contribution of $42,300 Philip Rotner, received in 2011, a contribution of $64,680 Inez Stewart, received in 2011, a contribution of $26,272 Henry Tomasuolo, received in 2011, a contribution of $24,025 Wendy Warring, received in 2011, a contribution of $33,624 Charles Weinstein, received in 2011, a contribution of $32,586 During Calendar Year 2011, Michelle Davis (former Vice President, Public Affairs and Marketing) received severance payments totalling $92,149. Michelle Davis received additional severance payments during Calendar Year 2012. Supplemental Information Part III Part II: Compensation is for executive/employee services; Part II, Column F (Compensation Reported in Prior Form 990): The compensation reported in Part II, column B, of this Schedule J (Form 990) is for the calendar year 2011 and a portion of it may have already been reported on a prior year Form 990 as deferred compensation. Compensation amounts in Column F reflects the compensation already reported in a prior return and needs to be taken into consideration to correct the overstatement of the cumulative compensation reported as paid to the individuals listed. MHEFA Revenue Bonds Series M 042456011 57586EMT5 2009-11-19 124329713 Purchase of med off bldg, reno & leasehold impr 0 0 0 MHEFA Revenue Bonds Series N 042456011 57586EUJ8 2010-05-13 341590000 Refunded Series G, H, I, J & K 0 0 0 124329713 1829713 122500000 2011 0 0 1 1 339925000 341590000 339564138 2025862 1 0 1 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 1 0 1 1 Goldman Sachs Mitsui Marine 30.000000000000 0 0 0 0 1 X Schedule K,Part IV,Line 1 Form 8038-T No 8038-T Filed because five years has not passed. Waters Corporation Trustee 125896 Equipment Children's Hospital Corporation received, at fair market value, equipment & supplies from Waters Corporation, where Douglas Berthiaume, a member of the hospital's Board of Trustees, is the Chief Executive Officer. All transactions above were at fair market value and negotiated at arms length in the ordinary course of business. Waters Corporation manufactures high end scientific equipment and supplies. During the year the hospital paid Waters Corporation $125,896 for equipment & supplies. 0 CRICO Director 11873792 InsuranceThe Risk Management Foundation of the Harvard Medical Institutions, Inc (CRICO/RMF) is the patient safety and medical malpractice company serving the Harvard medical community. Insurance coverage is provided to its member institutions and their affiliates by Controlled Risk Insurance Company, Ltd (CRICO/Cayman) and Controlled Risk Insurance Company of Vermont, Inc (A Risk Retention Group) (CRICO/Vermont). Both CRICO/RMF and CRICO/Cayman are owned by their member Institutions. CRICO/Vermont is wholly owned by CRICO/RMF. All CRICO/RMF and CRICO/Cayman shareholders are entities exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. Members of CRICO/RMF and CRICO/Cayman are entitled to representation on the boards of these entities. Alan Bufferd, Trustee of Children's Hospital Corporation, sits on the Boards of CRICO/RMF, CRICO/Cayman and CRICO/Vermont. See next item for continuation. 0 CRICO Director 11873792 InsuranceJames Mandell, MD, Chief Executive Officer of Children's Hospital Corporation, sits on the Board of CRICO/RMF and CRICO/Cayman. Children's Hospital pays these entities for insurance for Children's Hospital and its affiliates for the period covered by this filing. Children's Hospital paid a total of $11,873,792 to CRICO and RMF for professional, general, and directors and officers insurance coverage. 0 FedEx Director 424548 ShippingChildren's Hospital Corporation received, at fair market value, shipping services from FedEx, where Gary Loveman, a member ofthe hospital's Board of Trustees, is on the Board of Directors. Alltransactions above were at fair market value and negotiated at armslength in the ordinary course of business. During the year the hospitalpaid FedEx $424,548 for shipping services. 0 Blue Cross Blue Shield of Massachusetts Director 76436639 InsuranceChildren's Hospital Corporation received, at fair market value, employee health insurance claim administration services from Blue Cross Blue Shield of Massachusetts, where Ralph Martin, a member of the hospital's Board of Trustees, is on the Board of Directors. All transactions above were at fair market value and negotiated at arms length in the ordinary course of business. During the year the hospital paid Blue Cross Blue Shield of Massachusetts $76,436,639 for actual claims processed by Blue Cross Blue Shield of Massachusetts on behalf of the organization's employees and health claim administration fees. 0 CVSCaremark Spouse of Key Emp 9453378 Presc Drug ProgramChildren's Hospital Corporation received, at fair market value, employee prescription drug plan benefits from CVS/Caremark, where Wendy Warring's, a key employee of the hospital, spouse is an Officer. All transactions above were at fair market value and negotiated at arms length in the ordinary course of business. During the year the hospital paid CVS/Caremark $9,453,378 for employee prescription drug plan benefits. 0 X 5490 Mkt Value per Donor X 49 6856937 Mean Value on Gift Date X 12 17824 Mkt Value per Donor X 4 12273 Mkt Value per Donor X Travel/Dining 11 49440 Mkt Value per Donor X Gift Cert 12 20245 Mkt Value per Donor X Archival Papers 22 0 X Misc. Other 33 199165 Mkt Value per Donor 0 1 1 Third Party Use: Part I, Line 32b: The Hospital uses an event management firm to assist in processing non-cash donations received for an event auction. Non Reporting of Revenue: Part I, Line 33: The Hospital received contributions of Archival Papers that do not have a value outside of the Hospital. For this reason the Hospital did not recognize revenue as a result of these gifts. In addition to these contributions, the Hospital may receive items such as books, stuffed animals and video games that are donated to the units - these items are de minimus and values are not available so they are not reported in revenues. Form 990, Part VI, Section A, line 3 The Organization contracted with Navigant Consulting, Inc. for an Interim Chief Financial Officer for a portion (5/21/12-9/30/12) of the Fiscal Year. Form 990, Part VI, Section A, line 6 Children's Medical Center Corporation is the sole Member of the Children's Hospital Corporation. Form 990, Part VI, Section A, line 7a Children's Medical Center Corporation is the sole Member of the Children's Hospital Corporation. The Children's Medical Center Corporation elects the governing body of Children's Hospital Corporation because the Board of Trustees of Children's Hospital Corporation must consist of the persons who serve from time to time as the trustees of The Children's Medical Center Corporation. Form 990, Part VI, Section A, line 7b Children's Medical Center Corporation is the sole Member of the Children's Hospital Corporation ("the Hospital"). As stated in the Hospital's By Laws, Children's Medical Center Corporation has the powers and rights: - to approve proposed operating and capital budgets of the Hospital; - to approve the sale of all or substantially all of the Hospital's assets; - to approve the establishment of all long-range plans, goals and objectives of the Hospital; - to approve any incurrence of long-term indebtedness by the Hospital; - to set executive compensation. Form 990, Part VI, Section B, line 11 The Form 990 tax return was prepared by the organization's staff and reviewed by management (including the President, Chief Executive Officer, Legal and other relevant departments of the organization), along with the outside accounting firm of Ernst & Young. The Form 990 tax return was then presented to the Children's Medical Center and affiliates' Audit & Compliance Committee. Also, a copy was made available to the Board before filing. Form 990, Part VI, Section B, line 12c The Hospital's conflict of interest policy applies to all trustees, Trust Board members, members of the medical staff and employees of the Hospital. Trustees, chiefs of service and division chiefs, senior managers and others who exercise influence over important strategic, business and purchasing decisions of the Hospital are required to complete an annual conflict of interest disclosure questionnaire about their financial interests and outside activities. If an expected questionnaire is not returned, the Compliance Officer notifies the individual's supervisor or the CEO or COO, and repeated requests for the completed questionnaire are made until the questionnaire is completed. Responses are reviewed by the compliance officer and any potential conflicts are discussed with the Office of General Counsel and/or the individual's supervisor; any actual or potential conflicts are managed by termination of the conflict, management of the conflict, recusal, disclosure, review, or a combination thereof. Outside interests and outside activities may be permitted as long as the Hospital, Medical Center or Trust determines that such interests and activities are consistent with the best interests of the Hospital, Medical Center or Trust and the Hospital, Medical Center or Trust Board member, medical staff member or employee involved does the following: 1. discloses the fact that he has a financial interest or a consultative role in or with a person or company with which the Hospital, Medical Center or Trust is doing or is thinking of doing business; and 2. refrains from voting or exercising any personal influence whatsoever in the selection of a person or company to do business with the Hospital, Medical Center or Trust with whom or in which he has a financial interest or a consultative role; and 3. avoids any active participation in any dealings between the Hospital, Medical Center or Trust and the person or company with whom or in which he has a financial interest or consultative role; and 4. does not permit such outside interests or activities to absorb such amounts of his time and effort as to make it impractical for him to fulfill his assigned responsibilities at the Hospital, Medical Center or Trust; and 5. does not permit such outside interests or activities to compromise or appear to compromise the name or reputation of the Hospital, Medical Center or Trust. Form 990, Part VI, Section B, line 15 The Hospital has a board level compensation committee that annually reviews and approves the compensation for the following individuals: Chief Executive Officer President & Chief Operating Officer Senior Vice President & Chief Financial Officer Senior Vice President & General Counsel Senior Vice President, Patient Care Operations Senior Vice President & Chief Administrative Officer Vice President, Research Administration President, Children's Hospital Trust Vice President, Child Advocacy Vice President, Public Affairs & Marketing Senior Vice President & Chief Information Officer Vice President, Human Resources Vice President, Support Services Vice President, Real Estate Planning & Development Chief Investment Officer Senior Vice President, Network Development & Strategic Partnerships Vice President, Clinical Services Executive Director, Cardiovascular Program The committee is comprised of members of the board who are not employed by the organization, and no member may participate in the review and approval of compensation if the member has a conflict of interest with respect to that compensation arrangement. The committee relies on data, provided by an independent compensation consultant, which Includes comparable compensation for similarly qualified persons, in functionally comparable positions, at similarly situated organizations. The deliberations and decisions of the committee are documented in minutes of the meeting. Form 990, Part VI, Section C, line 19 Form 990, Part VI, Section C, Line 19: The Hospital posts its Code of Conduct (which incorporates the Conflict of Interest Policy) and its Compliance Manual (which includes a summary of the Conflict of Interest Policy) on its external website and these are also available from the Compliance Office or the Office of General Counsel. Governing documents are not posted publicly but are available from the Hospital upon request and are also filed with the Massachusetts Secretary of State, where they are available to the public. Audited financial statements are filed annually with the Massachusetts Office of the Attorney General as part of the Hospital's Form PC filing and are available from the organization upon request. Quarterly financial statements are filed with the Hospital's bond trustee and are available to the public through the Electronic Municipal Market Access (EMMA) website maintained by the Municipal Securities Rulemaking Board. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 73,528,509. Net Transfers/Support from Children's Medical Center 135,080,075. Pension Adjustment -14,415,091. Immune Disease Institute Merger Net Assets 13,241,504. Tran of Prof Svc Surplus from Net Assets to Funds Held for Others 8,669,641. Other Adjustments 602. Total to Form 990, Part XI, Line 5: 216,105,240. Children's Medical Center Corporation 55 Shattuck Street Boston MA 02115 041174680 Holds & manages security, real estate investments for Children's Hospital MA 501(c)(3) 11 - Type II N/A 0 Longwood Research Institute Inc 300 Longwood Avenue Boston MA 02115 042781368 Medical & scientific research; holds real estate investments MA 501(c)(3) 11 - Type II Children's Medical Center Corporation 0 CHB Properties Inc (fka Children's Extended Care Center) 300 Longwood Avenue Boston MA 02115 043323330 Holds & manages satellite ambulatory centers; real estate investments MA 501(c)(3) 9 Children's Medical Center Corporation 0 Longwood Coporation 55 Shattuck Street Boston MA 02115 042779882 Holds & manages real estate investments MA 501(c)(2) Children's Medical Center Corporation 0 Fenmore Realty Corporation 55 Shattuck Street Boston MA 02115 222478110 Holds & manages real estate investments MA 501(c)(2) Children's Medical Center Corporation 0 Physician's Organization at Children's Hospital Inc 300 Longwood Avenue Boston MA 02115 043266103 Coord & develop integrated childhlth care system w/ affil members MA 501(c)(3) 11 - Type III N/A 0 Immune Disease Institute Inc 3 Blackfan Circle Boston MA 02115 042158520 Health care, education & research in immunology & biomedical science MA 501(c)(3) 7 - 170b1Avi N/A 0 New England Congenital Cardiology Research Foundation 300 Longwood Avenue Boston MA 02115 800368043 Improve patient safety & quality for children w/ heart disease MA 501(c)(3) 7 - 170b1Avi Children's Hospital Corporation 1 Institute for Relevant Clinical Data Analytics Inc 300 Longwood Avenue boston MA 02115 383854536 Improve patient safety and quality of care MA 501(c)(3) Children's Hospital Corporation 1 Marketplace LaGuardia LLC One Wells Avenue Newton MA 02459 200417454 Investment in Marketplace LaGuardia LP MA Children's Hospital Corporation 5% Investment 57495 4780986 0 0 0.60420 Longwood Associates Inc 55 Shattuck Street Boston MA 02115 042943755 Property Management MA Children's Medical Center Corporation C 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1