2013-08-15T11:43:12-05:00 2012-12-31 381357951 PLANTE & MORAN PLLC PO BOX 307 SOUTHFIELD MI 480370307 990 2012-01-01 320087353 CHILDREN'S HOSPITAL OF MICHIGAN FOUNDATION CHIL 3139646994 3901 BEAUBIEN CARLS BLDG 1ST FLOOR DETROIT MI 48201 ANTHONY WERNER 3139646994 2013-08-10 1 SUSAN MIENCIER P00842339 2483522500 2012 2016-02-24 21:20:13Z X DAVID K PAGE 3901 BEAUBIEN CARLS BLDG 1ST FLOOR DETROIT MI 48201 63572442 0 X WWW.CHMFOUNDATION.ORG X 2003 MI THE MISSION OF CHILDREN'S HOSPITAL OF MICHIGAN FOUNDATION IS TO SUPPORT PEDIATRIC RESEARCH, EDUCATION, COMMUNITY BENEFIT PROGRAMS, AND OTHER INITIATIVES TO IMPROVE THE HEALTH OF CHILDREN IN MICHIGAN. 24 23 17 47 0 0 95712063 5928408 0 0 765673 5015860 -10924 -119360 96466812 10824908 4671503 5246617 0 0 753786 1216506 0 0 1023154 1623482 1160560 7048771 7623683 89418041 3201225 97754052 105195612 1240807 411094 96513245 104784518 CHILDREN'S HOSPITAL OF MICHIGAN FOUNDATION SUPPORTS PEDIATRIC RESEARCH, EDUCATION, COMMUNITY BENEFIT PROGRAMS, AND OTHER INITIATIVES TO IMPROVE THE HEALTH OF CHILDREN IN MICHIGAN. 0 0 5246617 5246617 TO SUPPORT PEDIATRIC RESEARCH, EDUCATION, COMMUNITY BENEFIT PROGRAMS, AND OTHER INITIATIVES TO IMPROVE THE HEALTH OF CHILDREN IN MICHIGAN. 5246617 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 17 5 1 17 1 0 0 0 0 0 1 1 0 0 0 0 X 24 23 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MI FL NJ NY X KURT MILLER RDM ASSOCIATES 2486207100 7457 M E CAD BLVD SUITE 200 CLARKSTON MI 48348 DAVID K PAGE 1.00 X X 0 0 0 CYNTHIA FORD 1.00 X X 0 0 0 FRED MINTURN 1.00 X X 0 0 0 RITA MARGHERIO 1.00 X X 0 0 0 JONATHAN S AARON 1.00 X 0 0 0 JOHN D BAKER MD 1.00 X 0 0 0 JAMES F CARR JR 1.00 X 0 0 0 DOUGLAS M ETKIN 1.00 X 0 0 0 LARRY E FLEISCHMANN MD 40.00 X X 59141 0 0 MATTHEW A FRIEDMAN 1.00 X 0 0 0 JOHNNY GINOPOLIS 1.00 X 0 0 0 BRIAN HERMELIN 1.00 X 0 0 0 JACK KRASULA 1.00 X 0 0 0 STEVEN R LEFKOFSKY 1.00 X 0 0 0 EDWARD C LEVY JR 1.00 X 0 0 0 JEANNE M LUSHER MD 1.00 X 0 0 0 MICHAEL J MADISON CFA 1.00 X 0 0 0 LEWIS J NEDELCOFF 1.00 X 0 0 0 ANITA PENTA 1.00 X 0 0 0 DICK PURTAN 1.00 X 0 0 0 DEREK J SARAFA 1.00 X 0 0 0 LYLE M WOLBERG CFP 1.00 X 0 0 0 MABLE V JONES PHD 1.00 X 0 0 0 GLEN DONOVAN 1.00 X 0 0 0 CAMERON D HOSNER 40.00 X 169142 0 6909 SUSAN FOLEY 40.00 X 147382 0 4427 375665 0 11336 2 0 1 0 THE BERLINE GROUP INC 70 E LONG LAKE ROAD BLOOMFIELD HILLS MI 48304 PUBLISHING SERVICES 174642 RDM ASSOCIATES INC 7457 M E CAD BLVD SUITE 200 CLARKSTON MI 48348 ACCOUNTING SERVICES 147077 2 234334 5694074 303170 5928408 1356300 1356300 56160179 52500619 3659560 3659560 3659560 88500 234334 234446 -145946 -145946 8130 12469 -4339 -4339 MISCELLANEOUS 900099 30925 30925 30925 10824908 0 0 4896500 4974361 4974361 272256 272256 382132 306858 75274 645337 395993 249344 14900 11015 3885 100020 57584 42436 74117 48958 25159 90372 90372 179482 179482 309589 309589 284717 160229 124488 74382 19360 55022 168228 49460 118768 6854 5718 1136 2203 2203 17902 12595 5307 DUES & SUBSCRIPTIONS 17447 11161 6286 DONOR RELATIONS 5741 283 5458 SUBSCRIPTIONS, LICENSES 2043 1041 1002 PARKING 1600 1600 7623683 5246617 1353912 1023154 12387881 10934355 1880170 1101223 267994 12600 51407 37237 30846 2203 0 28643 49997498 48139611 31150035 44122159 2019067 819784 97754052 105195612 217387 193902 1023420 217192 1240807 411094 X 7068921 14614427 41817020 42460302 47627304 47709789 96513245 104784518 97754052 105195612 X 3201225 5117421 -47373 X X 0 1 X 1 0 X 2125857 928207 2195572 95712063 5928408 106890107 2125857 928207 2195572 95712063 5928408 106890107 106890107 116744 9851 25056 765663 1356300 2273614 71423 87219 127555 286197 109449918 0.97660 0.98800 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: SPECIAL EVENTS REVENUE MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 63347448 92660 6095870 1692041 54167 67789770 1203856 61971656 -116726 63058786 1171338 27898 4690 1203926 1171338 1171338 1171338 1171338 0.00250 0.70380 0.29370 0 0 30846 2203 28643 28643 GLOBAL ASSET ALLOCATION FUNDS 33433562 F HEDGE FUNDS 8561807 F PRIVATE EQUITY FUND 2126790 F 44122159 X 16121320 5117421 178991 5296412 10824908 0 10824908 7850047 178991 47373 226364 7623683 0 7623683 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TO SUPPORT CHILDREN'S PROGRAMS PER THE STIPULATIONS OF THE DONOR. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: FIN 48 DISCLOSURE: THE FOUNDATION IS EXEMPT FROM INCOME TAX UNDER PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3). ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FOUNDATION, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2012 AND 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FOUNDATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE FOUNDATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2009. PART XII, LINE 2D - OTHER ADJUSTMENTS: UNCOLLECTIBLE PLEDGES 58,000. CAPITALIZED ARTWORK -10,627. PART V, LINE 1A, COLUMN (A): ENDOWMENT FUNDS BEGINNING OF YEAR BALANCE DOES NOT EQUAL LAST YEAR'S ENDING BALANCE DUE TO A RESTATEMENT TO A PRIOR YEAR'S ACTIVITY. VISTEON GOLF EVENT 177410 119950 57460 3600 61056 6132 3081 LEADERS FOR KIDS RECEPTION 85451 73571 11880 3550 9736 23389 2 59973 40813 19160 98717 25185 322834 234334 88500 3600 163323 6132 9736 51655 234446 -145946 1 VANGUARD HEALTH SYSTEMS INC 20 BURTON HILLS BLVD SUITE 100 NASHVILLE TN 37215 621698183 2170658 TO SUPPORT HEALTHCARE NEEDS OF CHILDREN. WAYNE STATE UNIVERSITY 5401 CASS AVE DETROIT MI 48202 386028429 115 1719801 TO SUPPORT HEALTHCARE NEEDS OF CHILDREN. UNIVERSITY PEDIATRICIANS 3901 BEAUBIEN ROOM 1K40 DETROIT MI 48201 383336414 501(C)(3) 569341 TO SUPPORT HEALTHCARE NEEDS OF CHILDREN. THE GUIDANCE CENTER 13101 ALLEN RD SOUTHGATE MI 48195 381621700 501(C)(3) 193034 TO SUPPORT HEALTHCARE NEEDS OF CHILDREN. UNIVERSITY PHYSICIANS GROUP 550 E CANFIELD 324 DETROIT MI 48201 383474766 501(C)(3) 20444 TO SUPPORT HEALTHCARE NEEDS OF CHILDREN. DETROIT INSTITUTE OF ARTS 5200 WOODWARD AVE DETROIT MI 48202 381359510 501(C)(3) 16969 TO SUPPORT OPERATIONS OF ORGANIZATION. HAMTRAMCK PUBLIC SCHOOLS 11410 CHAREST HAMTRAMCK MI 48221 386004194 115 33900 TO SUPPORT OPERATIONS OF ORGANIZATION. SICKLE CELL DISEASE ASSOC OF AMERICA MICHIGAN CHAPTER 18516 JAMES COUZENS FWY DETROIT MI 48235 381963640 501(C)(3) 25000 TO SUPPORT HEALTHCARE NEEDS OF CHILDREN. KIDS KICKING CANCER 645 GRISWOLD SUITE 444 DETROIT MI 48226 383500655 501(C)(3) 170000 TO SUPPORT HEALTHCARE NEEDS OF CHILDREN. CARING ATHLETES TEAM FOR CHILDREN'S AND HENRY FORD HOSPITALS 223 FISHER BUILDING 3011 W GRAND BLVD DETROIT MI 48202 382746810 501(C)(3) 5000 EVENT SPONSORSHIP FESTIVAL OF TREES 2734 WEST ELEVEN MILE BERKLEY MI 48072 382785495 501(C)(3) 5825 EVENT SPONSORSHIP OPERATION GIVE 27801 HARPER AVE ST CLAIR SHORES MI 48081 264833562 501(C)(3) 21514 FMV AUCTION ITEMS NONCASH ITEMS DESIGNATED FOR AN OPERATION GIVE EVENT 11 1 GIFTS TO PEDIATRIC PATIENTS 263000 272256 DONOR VALUES BOOKS, GAMES, TOYS, ETC. PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: AT THE END OF THE GRANT PERIOD, THE ORGANIZATION REQUIRES A FINAL REPORT OF GRANT ACTIVITIES AND A FINAL FINANCIAL ACCOUNTING REPORT. ADDITIONALLY, ANY GRANTS THAT ARE ON A REIMBURSEMENT BASIS MUST BE ACCOMPANIED BY A DETAILED INVOICE FOR REIMBURSEMENT. SCHEDULE I, PART III, COLUMN B: THE NUMBER OF RECIPIENTS IS AN ESTIMATE, WHICH IS BASED ON THE NUMBER OF PEDIATRIC PATIENTS SEEN DURING THE YEAR FOR INPATIENT, OUTPATIENT, AND EMERGENCY ROOM SERVICES. X 1 1 X X X X X 0 0 0 0 0 0 0 0 0 CAMERON D HOSNER 169142 0 0 0 0 0 0 0 6909 0 176051 0 0 0 SUSAN FOLEY 147382 0 0 0 0 0 0 0 4427 0 151809 0 0 0 PART I, LINE 1A DURING THE TAX YEAR, HEALTH AND SOCIAL CLUB DUES WERE PROVIDED TO CAMERON HOSNER AND SUSAN FOLEY. THE CLUB DUES WERE NOT INCLUDED IN TAXABLE INCOME TO THE RECIPIENTS BECAUSE ATTENDANCE AT THE CLUBS WAS SOLELY FOR BUSINESS PURPOSES. X 10 9400 COMPARABLE SALES X 10466 COST X 48215 THRIFT SHOP VALUE X TOYS & CRAFTS 366 195172 COST X ELECTRONICS 10 14259 COST X ENTERTAINMENT 17 33074 MARKET RATE X GIFT CARDS 1 3000 COST X MISCELLANEOUS 8 3722 COST 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): THE FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED FORM 990, PART VI, SECTION B, LINE 11 AFTER THE FOUNDATION'S MANAGEMENT HAS REVIEWED THE FORM 990, THE RETURN IS PROVIDED TO THE BOARD CHAIR, TREASURER, AND PRESIDENT AND CEO. THESE INDIVIDUALS REVIEW THE FORM 990 WITH THE AUDIT COMMITTEE. ANY NECESSARY CHANGES WILL THEN BE UPDATED ON THE FORM. ONCE ALL NECESSARY CHANGES ARE MADE AND THE CHILDREN'S HOSPITAL OF MICHIGAN FOUNDATION BOARD CHAIR IS IN AGREEMENT WITH THE AUDIT COMMITTEE ABOUT THE FINISHED FORM 990, IT WILL BE SIGNED BY THE CHILDREN'S HOSPITAL OF MICHIGAN FOUNDATION PRESIDENT AND CEO, DATED AND SUBMITTED BY THE FILING DEADLINE. PRIOR TO FILING, A COPY OF THE APPROVED FORM 990 WILL BE MADE AVAILABLE TO ALL OF THE CHILDREN'S HOSPITAL OF MICHIGAN FOUNDATION BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO THE ORGANIZATION'S BOARD TRUSTEES, OFFICERS, KEY EMPLOYEES AND STAFF MEMBERS. THE COVERED PARTIES DISCLOSE INTERESTS THROUGH A QUESTIONNAIRE. EACH COVERED PERSON IS REQUIRED TO ACKNOWLEDGE, NOT LESS THAN ANNUALLY, THAT HE OR SHE HAS READ AND IS IN COMPLIANCE WITH THE POLICY AND MUST RE-ATTEST IN WRITING THAT THERE ARE NO CONFLICTS OR DISCLOSE ANY CONFLICTS THAT DO EXIST. AN ANNUAL REVIEW IS DONE BY THE EXECUTIVE COMMITTEE. IF A CONFLICT ARISES, THE INVOLVED PERSON(S) RECUSE THEMSELVES FROM VOTING ON THE MATTER. COVERED MEMBERS ALSO MUST DECLARE ANY CONFLICT(S) OF INTEREST THAT ARISE BETWEEN ANNUAL DECLARATIONS AS THEY EMERGE. FAILURE TO DISCLOSE, DEPENDING ON GRAVITY, CAN LEAD TO BEING REMOVED FROM THEIR POSITION. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: UNCOLLECTIBLE PLEDGES -58,000. CAPITALIZED ARTWORK 10,627. FORM 990, PART XII, LINE 2C: THE PROCESS FOR SELECTION AND OVERSIGHT HAS NOT CHANGED FROM THE PROCESS USED IN PRIOR YEARS.