CONNECTICUT CHILDRENS SPECIALTY GROUP INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CONNECTICUT CHILDRENS SPECIALTY GROUP INC (EIN 06-1446900)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-07-20
IRS object ID
201222059349300242
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-07-20T12:43:55-07:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN061446900EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CONNECTICUT CHILDRENS SPECIALTY GROUP INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCONNNameControl
Phone8605459000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1282 Washington StreetAddressLine1
CityHartfordCity
StateCTState
ZIP Code06106ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGerald BoisvertName
TitleBoard memberTitle
Phone8605458557Phone
Date Signed2012-07-20DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMartin J GavinNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1282 Washington StreetAddressLine1
CityHartfordCity
StateCTState
ZIP Code06106ZIPCode
FieldValueIRS element (for citing)
Gross Receipts50062655GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.connecticutchildrens.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1997YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionConnecticut Children's Specialty Group provides primary care and specialty care physician services to children of Connecticut and the surrounding area.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees592TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year45490813ProgramServiceRevenuePriorYear
Program Service Revenue CY49973264ProgramServiceRevenueCY
Investment Income Prior Year23350InvestmentIncomePriorYear
Investment Income Current Year37698InvestmentIncomeCurrentYear
Other Revenue Prior Year31885OtherRevenuePriorYear
Other Revenue Current Year51693OtherRevenueCurrentYear
Total Revenue Prior Year45546048TotalRevenuePriorYear
Total Revenue Current Year50062655TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year39955217SalariesEtcPriorYear
Salaries Etc Current Year43992625SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year14387589OtherExpensePriorYear
Other Expenses Current Year16000000OtherExpensesCurrentYear
Total Expenses Prior Year54342806TotalExpensesPriorYear
Total Expenses Current Year59992625TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-8796758RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-9929970RevenuesLessExpensesCY
Total Assets BOY7658257TotalAssetsBOY
Total Assets EOY8582265TotalAssetsEOY
Total Liabilities BOY11251605TotalLiabilitiesBOY
Total Liabilities EOY15070286TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-3593348NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-6488021NetAssetsOrFundBalancesEOY
Mission DescriptionConnecticut Children's Medical Center is dedicated to improving the physical and emotional health of children through family-centered care, research, education and advocacy. We embrace discovery, teamwork, integrity and excellence in all that we do. As a subsidiary of Connecticut Children's Medical Center, the Connecticut Children's Specialty Group achieves the mission through primary care and specialty care physician services.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense52412145Expense
Grants0Grants
Revenue49973264Revenue
DescriptionPhysician Health Care Service: Connecticut Children's Specialty Group provides primary care and specialty physician services to children of Connecticut and the surrounding area.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense52412145TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109660NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees592NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonPatrick GarveyNamePerson
Telephone Number8606105689TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1282 Washington StreetAddressLine1
CityHartfordCity
StateCTState
ZIP Code06106ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerFormerFormerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Martin J Gavin
Board Member1X068301740786
Gerald J Boisvert
Board Member1X041027750490
Nicole Murray-Posner
Board Member40X281707045023
Dean Rapoza
President40X287582049243X
John Makari
Board Member40X298338045272
Fernando Ferrer
Surgeon in Chief40X611027052086X
Jeffrey Thomson
Vice Chair40X521121055853X
Karen Rubin
Vice Chair40X231408052433X
MaryAnn Corey
Secretary/Treasurer40X162891039484X
Nate Hagstrom
Board Member40X236105046145X
Paul Dworkin
Board Member40X045510440443
Christine Finck
Medical Director Surgery40X479671047262
Anita Bhandari
Pulmonologist40X185351040551
Philip Spinella
Board Member40X251305035325
Richard Weiss
Board Member40X346568053107
Victor Herson
Board Member40X271360051042X
Wendy Warring
Board Member40X026002126198X
Scott Schoem
Medical Director Otoloryngology40X357343049951X
Donna Zeiter
Gastroenterologist40X226402037899X
Carol Leicher
Neurologist40X120335029763X
Marvin Culbertson
Division Chief Emergency40410707051417X
Donald Hight
Surgeon40404218053101X
Aaron Zucker
Medical Director ICU40427343053854X
Paul Kanev
Department Chief Neurosurgery40612776039534X
Brendan Campbell
Surgeon40470420047553X
Jonathan Martin
Neurosurgeon40462409047651X
FieldValueIRS element (for citing)
Total Reportable Comp From Org7656387TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1808419TotalReportableCompFrmRltdOrgs
Total Other Compensation1181466TotalOtherCompensation
Number Individuals GT100 K127NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Hartford Hospital
80 Seymour StreetHartfordCT06102Service Support297061
IDEMX Inc-Medware
4 Corporate DriveSheltonCT06484Transcription services372607
Lauren Staffing Agency
405 Park AveNew YorkNY10022Temporary Employees209372
Vista Staffing Solutions Inc
file 50834Los AngelesCA90074Temporary employees171732
Town Line TAS Inc
94 Whiting StreetPlainvilleCT06062Answering Service114515
FieldValueIRS element (for citing)
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Patient Service Revenue62111042064861420648610$0
Leased Physician Services621110790840379084030$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue49973264TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column37698TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$37,698ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionmiscDescription
Business Code900099BusinessCode
Total Revenue Column51693TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$51,693ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue51693TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column50062655TotalRevenueColumn
Related Or Exempt Function Income49973264RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$89,391ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2942673Total
Program Services1922276ProgramServices
Management And General1020397ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total33794073Total
Program Services29637637ProgramServices
Management And General4156436ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3086900Total
Program Services2707233ProgramServices
Management And General379667ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1582930Total
Program Services1388241ProgramServices
Management And General194689ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2586049Total
Program Services2267983ProgramServices
Management And General318066ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total200Total
Program Services0ProgramServices
Management And General200ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total5400Total
Program Services0ProgramServices
Management And General5400ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3500169Total
Program Services3006049ProgramServices
Management And General494120ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total14375Total
Program Services14375ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4074382Total
Program Services3759650ProgramServices
Management And General314732ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total409444Total
Program Services352957ProgramServices
Management And General56487ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2168410Total
Program Services1661576ProgramServices
Management And General506834ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total33273Total
Program Services30698ProgramServices
Management And General2575ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total427780Total
Program Services407585ProgramServices
Management And General20195ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total44176Total
Program Services44176ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total592739Total
Program Services528569ProgramServices
Management And General64170ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total2639175Total
Program Services2630297ProgramServices
Management And General8878ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Bad Debt1319858131985800
Dues36503135966153700
misc405588373324322640

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total59992625Total
Program Services52412145ProgramServices
Management And General7580480ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2682121BOY
EOY3171593EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY25332BOY
EOY26329EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY51922BOY
EOY135071EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3401253LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1558274LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2021783BOY
EOY1842979EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2877099BOY
EOY3406293EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7658257BOY
EOY8582265EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6818652BOY
EOY7376550EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY164461BOY
EOY140250EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4268492BOY
EOY7553486EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY11251605BOY
EOY15070286EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-3593348BOY
EOY-6488021EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-3593348BOY
EOY-6488021EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7658257BOY
EOY8582265EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-9929970ReconcilationRevenueExpenses
Reconcilation Other Changes7035297ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years39309303CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years42060839CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years40086859CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year45490813CurrentTaxYearMinus1Year
Current Tax Year49973264CurrentTaxYear
Total216921078Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years39309303CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years42060839CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years40086859CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year45490813CurrentTaxYearMinus1Year
Current Tax Year49973264CurrentTaxYear
Total216921078Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total
FieldValueIRS element (for citing)
Public Support Total509216921078PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years208526CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years43860CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years29773CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23350CurrentTaxYearMinus1Year
Current Tax Year37698CurrentTaxYear
Total343207Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years208526CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years43860CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years29773CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23350CurrentTaxYearMinus1Year
Current Tax Year37698CurrentTaxYear
Total343207Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years792CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years722CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7117CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9317CurrentTaxYearMinus1Year
Current Tax Year52158CurrentTaxYear
Total70106Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years39518621CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years42105421CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years40123749CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year45523480CurrentTaxYearMinus1Year
Current Tax Year50063120CurrentTaxYear
Total217334391Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99810PublicSupportPercentage509
Prior Year Support Percentage0.98547PriorYearSupportPercentage
Investment Income Percentage0.00158InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00192PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509
General ExplanationMisc income $52,158GeneralExplanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Book Value0BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis2204148OtherCostOrOtherBasis
Depreciation986770Depreciation
Book Value1217378BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis1130155OtherCostOrOtherBasis
Depreciation571504Depreciation
Book Value558651BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis66950OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value66950BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1842979TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
Rabbi Trust728806
Non Compete Agreement851173
Other Receivables1057164
Due From Affiliates769150
FieldValueIRS element (for citing)
Total Book Value Other Assets3406293TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Due to Third Parties$1,204,000
Due to Affilited Entities$2,868,452
Malpractice Reserve$2,095,000
Pension and other Defered Comp$1,386,034
FieldValueIRS element (for citing)
Total Of Amounts7553486TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSchD_P10_S00_L00Identifier
Return ReferenceSchedule D, Part XReturnReference
ExplanationConnecticut Children's Specialty Group's uncertain tax positions under FIN 48 are immaterial. As such there is no footnote in the audited financial statements related to FIN 48 disclosures.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (26 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Martin J Gavin
04217790217547043691022050018736072380300
Gerald J Boisvert
0298029088840023408022050028440046076700
Nicole Murray-Posner
265182000165250171500278730326730000
Dean Rapoza
266506000210760220500271930336825000
John Makari
281287000170510171500281220343610000
Fernando Ferrer
593609000174180196000324860663113000
Jeffrey Thomson
497413000237080245000313530576974000
Karen Rubin
207287000241210254800269530283841000
MaryAnn Corey
145909000169820148080246760202375000
Nate Hagstrom
22299504380126720190700270750282250000
Paul Dworkin
0334874098668021562024500015943049554700
Christine Finck
46182104380174120171500301120526933000
Anita Bhandari
168245000171060150430255080225902000
Philip Spinella
20681900044486088900264350286630000
Richard Weiss
323160000234080245000286070399675000
Victor Herson
234457000369030269500240920322402000
Wendy Warring
011322608985205694308763017435028621900
Scott Schoem
332560000247830220500279010407294000
Donna Zeiter
208125000182770204010174980264301000
Carol Leicher
93242061110209820139410158220150098000
Marvin Culbertson
38592901460246320220500293670462124000
Donald Hight
372422000317960268930262080457319000
Aaron Zucker
3655200376110242120245000293540481197000
Paul Kanev
588144000246320220500174840652310000
Brendan Campbell
453308000171120171500304030517973000
Jonathan Martin
445358000170510171500305010510060000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchJ_P01_S00_L03Schedule J, Part I, Line 3Each year, TowersWatson conducts a market analysis of the organization's CEO, officers and other key employees. To augment their proprietary data and other data to which they have access, Connecticut Children's provides the results data from salary surveys in which we participate. The analysis and presentation of the data is performed by the TowersWatson representative to the Chief Executive Officer and the members of the Executive Committee of the Board of Directors. Annually the CEO and the Board then discuss salary recommendations for the officers and other key employees and sign off on the final recommendations. The Executive Committee of the Board of Directors meets independently with the CEO to discuss his individual performance. Following the performance evaluation, a salary recommendation is made and communicated to the Vice President of Human Resources to authorize processing.
SchJ_P01_S00_L04Schedule J, Part I, Line 4The following have contributed to the 457(b) plan: Martin Gavin $16,500; Wendy Warring $5,460; Carl Nissen $1,375; Donald Hight $1,375; Donna Zeiter $1,000; Jefferey Hyams $1,375; Juan Salazar $312; Scott Schoem $1,375; Victor Herson $10,000.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0A_L02Form 990, Part VI, Section A, Line 2Fernando Ferrer, Board member/employee of Connecticut Children's Specialty Group and Key employee for Connecticut Children's Medical Center, is married to Selina Ferrer, board member of Connecticut Children's Medical Center Foundation.
F990_P06_S0A_L06Form 990, Part VI, Section A, Line 6Connecticut Children's Medical Center is the sole member of Connecticut Children's Speciatly Group.
F990_P06_S0A_L07aForm 990, Part VI, Section A, Line 7aConnecticut Children's Medical Center as the sole member has the right to fix the number of Member appointed Directors serving on the board, appoint and fill vacancies in such Member appointed directorships, remove any Member appointed director and approve fundamental activities in accordance with the by-laws.
F990_P06_S0A_L07bForm 990, Part VI, Section A, Line 7bThe following decisions are subject to Member approval: Amending the Corporation's certificate of Incorporation; Merging the Corporations with another entity, transferring all or substantially all of the Corporation's assets to another entity or otherwise selling or mortgaging all or substantially all of the Corporations assets; Authorizing any corporate affiliation, merger, consolidation or joint venture; Acquiring any other business or entity's stock or other ownership interests or assets; Approving the Physician Directors elected by the Board; Forming any subsidiary, affiliate or related entity; and Dissolving the Corporation.
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bThe form 990 is drafted by Connecticut Children's Medical Center staff and goes through internal review. Assistance by our Attorneys and Auditors is provided as needed in completing the form. Connecticut Children's Specialty Group's board does not review the return. It is provided to the full board of directors of CCMC Corporation via our board website for review. The audit committee of the CCMC Corporation board of directors holds a committee meeting to review the return in further detail. Upon review and approval of the audit committee the return is filed.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12c1: Requirement to review Conflict of Interest Policy and disclose any conflicts is part of annual performance management process for all employed staff. All responses of "yes" are addressed by Director of Compliance. 2: Requirement to review Conflict of Interest Policy and disclose any conflicts is part of Internal Review Board (IRB) application for initial and continuation research studies. All responses of "yes" are addressed by Conflict of Interest (COI) Committee and IRB. 3: All Board members and Senior Management members (EMT) are required annually to review Conflict of Interest Policy and disclose any conflicts. All "yes" responses are addressed by COI Committee and CEO. 4: Selected committees (e.g., Credentials Committee, IRB, etc.) require all members to sign a committee specific conflict of interest form annually. All "yes" responses are addressed by committee chair. 5: New employees are educated on Conflict of Interest Policy and disclose any conflicts during New Employee Orientation. 6: Vendors are asked as part of contract process to review Conflict of Interest Policy and disclose any conflicts. 7: Director of Compliance acts upon self reported COI disclosures upon receipt.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15Each year, TowersWatson conducts a market analysis of the organization's CEO, officers and other key employees. To augment their proprietary data and other data to which they have access, Connecticut Children's provides the results data from salary surveys in which we participate. The analysis and presentation of the data is performed by the TowersWatson representative to the Chief Executive Officer and the members of the Executive Committee of the Board of Directors. Annually the CEO and the Board then discuss salary recommendations for the officers and other key employees and sign off on the final recommendations. The Executive Committee of the Board of Directors meets independently with the CEO to discuss his individual performance. Following the performance evaluation, a salary recommendation is made and communicated to the Vice President of Human Resources to authorize processing.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19The governing policies and conflict of interest policy are available to the public on the website, www.connecticutchildrens.org, or by request. The consolidated Audited Financials are available upon request.
F990_P11_S00_L05Form 990, Part XI, Line 5Transfer from Affiliated organizations $7,087,745; Unrealized loss on investments $52,448

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Connecticut Children's Medical Center
282 Washington StreetHartfordCT06106060646755HospitalCT501(c)(3)3N/A0
CCMC Corporation
282 Washington StreetHartfordCT06106222619876Healthcare SupportCT501(c)(3)11bN/A0
Children's Fund of Connecticut Inc
270 Farmington AveFarmingtonCT06032061364513Preventative Healthcare programsCT501(c)(3)11aN/A0
Children's Health and Development Institute Inc
270 Farmington AveFarmingtonCT06032061504725Healthcare ServicesCT501(c)(3)7N/A0
CCMC Affiliates Inc
282 Washington StreetHartfordCT06106222619870Healthcare ServicesCT501(c)(3)9N/A0
Connecticut Children's Medical Center Foundation Inc
282 Washington StreetHartfordCT06106222619869Fundraising & Investment MgtCT501(c)(3)7N/A0

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1CCMC Ventures IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1282 Washington StreetAddressLine1
CityHartfordCity
StateCTState
ZIP Code06106ZIPCode
FieldValueIRS element (for citing)
EIN222619873EIN
Primary ActivityHealthcare servicesPrimaryActivity
Legal Domicile StateCTLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Share Of Total Income0ShareOfTotalIncome
Share Of EOY Assets0ShareOfEOYAssets
Percentage Ownership0PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Connecticut Children's Medical Center
i331897Review of intercompany entries
Connecticut Children's Medical Center
j608034Review of intercompany entries
Connecticut Children's Medical Center
n11936863Review of intercompany entries
Connecticut Children's Medical Center
o14452721Review of intercompany entries
Connecticut Children's Medical Center
p8159552Review of intercompany entries
Connecticut Children's Medical Center
r7087745Review of intercompany entries

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationTo allow adequate time for board reviewExplanation

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