2012-07-20T12:43:55-07:00 2011-09-30 990 2010-10-01 061446900 CONNECTICUT CHILDRENS SPECIALTY GROUP INC CONN 8605459000 282 Washington Street Hartford CT 06106 Gerald Boisvert 8605458557 2012-07-20 2010 2016-02-24 21:20:13Z Martin J Gavin 282 Washington Street Hartford CT 06106 50062655 0 X www.connecticutchildrens.org X 1997 CT Connecticut Children's Specialty Group provides primary care and specialty care physician services to children of Connecticut and the surrounding area. 12 0 592 0 0 0 0 0 45490813 49973264 23350 37698 31885 51693 45546048 50062655 0 0 0 0 39955217 43992625 0 0 0 14387589 16000000 54342806 59992625 -8796758 -9929970 7658257 8582265 11251605 15070286 -3593348 -6488021 Connecticut 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. 0 0 52412145 0 49973264 Physician Health Care Service: Connecticut Children's Specialty Group provides primary care and specialty physician services to children of Connecticut and the surrounding area. 0 0 0 52412145 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 60 0 1 592 1 0 0 0 0 0 0 0 0 0 0 X 12 0 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Patrick Garvey 8606105689 282 Washington Street Hartford CT 06106 Martin J Gavin 1 X 0 683017 40786 Gerald J Boisvert 1 X 0 410277 50490 Nicole Murray-Posner 40 X 281707 0 45023 Dean Rapoza 40 X X 287582 0 49243 John Makari 40 X 298338 0 45272 Fernando Ferrer 40 X X 611027 0 52086 Jeffrey Thomson 40 X X 521121 0 55853 Karen Rubin 40 X X 231408 0 52433 MaryAnn Corey 40 X X 162891 0 39484 Nate Hagstrom 40 X X 236105 0 46145 Paul Dworkin 40 X 0 455104 40443 Christine Finck 40 X 479671 0 47262 Anita Bhandari 40 X 185351 0 40551 Philip Spinella 40 X 251305 0 35325 Richard Weiss 40 X 346568 0 53107 Victor Herson 40 X X 271360 0 51042 Wendy Warring 40 X X 0 260021 26198 Scott Schoem 40 X X 357343 0 49951 Donna Zeiter 40 X X 226402 0 37899 Carol Leicher 40 X X 120335 0 29763 Marvin Culbertson 40 X 410707 0 51417 Donald Hight 40 X 404218 0 53101 Aaron Zucker 40 X 427343 0 53854 Paul Kanev 40 X 612776 0 39534 Brendan Campbell 40 X 470420 0 47553 Jonathan Martin 40 X 462409 0 47651 7656387 1808419 1181466 127 1 1 0 Hartford Hospital 80 Seymour Street Hartford CT 06102 Service Support 297061 IDEMX Inc-Medware 4 Corporate Drive Shelton CT 06484 Transcription services 372607 Lauren Staffing Agency 405 Park Ave New York NY 10022 Temporary Employees 209372 Vista Staffing Solutions Inc file 50834 Los Angeles CA 90074 Temporary employees 171732 Town Line TAS Inc 94 Whiting Street Plainville CT 06062 Answering Service 114515 0 0 Patient Service Revenue 621110 42064861 42064861 0 0 Leased Physician Services 621110 7908403 7908403 0 0 0 0 0 0 49973264 37698 0 0 37698 0 0 0 0 0 0 0 0 0 0 0 0 misc 900099 51693 0 0 51693 0 0 0 0 51693 50062655 49973264 0 89391 2942673 1922276 1020397 33794073 29637637 4156436 0 3086900 2707233 379667 0 1582930 1388241 194689 0 2586049 2267983 318066 0 0 0 0 0 200 0 200 0 5400 0 5400 0 0 0 0 0 0 0 0 0 0 0 3500169 3006049 494120 0 14375 14375 0 0 4074382 3759650 314732 0 409444 352957 56487 2168410 1661576 506834 0 33273 30698 2575 0 427780 407585 20195 0 44176 44176 0 0 0 0 0 0 592739 528569 64170 0 2639175 2630297 8878 0 Bad Debt 1319858 1319858 0 0 Dues 365031 359661 5370 0 misc 405588 373324 32264 0 59992625 52412145 7580480 0 0 0 2682121 3171593 25332 26329 51922 135071 3401253 1558274 2021783 1842979 2877099 3406293 7658257 8582265 6818652 7376550 164461 140250 4268492 7553486 11251605 15070286 X -3593348 -6488021 0 0 0 0 -3593348 -6488021 7658257 8582265 X -9929970 7035297 X 0 1 1 X 0 X 39309303 42060839 40086859 45490813 49973264 216921078 39309303 42060839 40086859 45490813 49973264 216921078 0 0 0 0 0 0 216921078 208526 43860 29773 23350 37698 343207 208526 43860 29773 23350 37698 343207 792 722 7117 9317 52158 70106 39518621 42105421 40123749 45523480 50063120 217334391 0.99810 0.98547 0.00158 0.00192 X Misc income $52,158 0 0 0 0 0 0 0 0 2204148 986770 1217378 0 1130155 571504 558651 0 66950 0 66950 1842979 Rabbi Trust 728806 Non Compete Agreement 851173 Other Receivables 1057164 Due From Affiliates 769150 3406293 Due to Third Parties 1204000 Due to Affilited Entities 2868452 Malpractice Reserve 2095000 Pension and other Defered Comp 1386034 7553486 SchD_P10_S00_L00 Schedule D, Part X Connecticut 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. X X X X X 0 1 0 0 0 0 0 0 0 Martin J Gavin 0 421779 0 217547 0 43691 0 22050 0 18736 0 723803 0 0 Gerald J Boisvert 0 298029 0 88840 0 23408 0 22050 0 28440 0 460767 0 0 Nicole Murray-Posner 265182 0 0 0 16525 0 17150 0 27873 0 326730 0 0 0 Dean Rapoza 266506 0 0 0 21076 0 22050 0 27193 0 336825 0 0 0 John Makari 281287 0 0 0 17051 0 17150 0 28122 0 343610 0 0 0 Fernando Ferrer 593609 0 0 0 17418 0 19600 0 32486 0 663113 0 0 0 Jeffrey Thomson 497413 0 0 0 23708 0 24500 0 31353 0 576974 0 0 0 Karen Rubin 207287 0 0 0 24121 0 25480 0 26953 0 283841 0 0 0 MaryAnn Corey 145909 0 0 0 16982 0 14808 0 24676 0 202375 0 0 0 Nate Hagstrom 222995 0 438 0 12672 0 19070 0 27075 0 282250 0 0 0 Paul Dworkin 0 334874 0 98668 0 21562 0 24500 0 15943 0 495547 0 0 Christine Finck 461821 0 438 0 17412 0 17150 0 30112 0 526933 0 0 0 Anita Bhandari 168245 0 0 0 17106 0 15043 0 25508 0 225902 0 0 0 Philip Spinella 206819 0 0 0 44486 0 8890 0 26435 0 286630 0 0 0 Richard Weiss 323160 0 0 0 23408 0 24500 0 28607 0 399675 0 0 0 Victor Herson 234457 0 0 0 36903 0 26950 0 24092 0 322402 0 0 0 Wendy Warring 0 113226 0 89852 0 56943 0 8763 0 17435 0 286219 0 0 Scott Schoem 332560 0 0 0 24783 0 22050 0 27901 0 407294 0 0 0 Donna Zeiter 208125 0 0 0 18277 0 20401 0 17498 0 264301 0 0 0 Carol Leicher 93242 0 6111 0 20982 0 13941 0 15822 0 150098 0 0 0 Marvin Culbertson 385929 0 146 0 24632 0 22050 0 29367 0 462124 0 0 0 Donald Hight 372422 0 0 0 31796 0 26893 0 26208 0 457319 0 0 0 Aaron Zucker 365520 0 37611 0 24212 0 24500 0 29354 0 481197 0 0 0 Paul Kanev 588144 0 0 0 24632 0 22050 0 17484 0 652310 0 0 0 Brendan Campbell 453308 0 0 0 17112 0 17150 0 30403 0 517973 0 0 0 Jonathan Martin 445358 0 0 0 17051 0 17150 0 30501 0 510060 0 0 0 SchJ_P01_S00_L03 Schedule J, Part I, Line 3 Each 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_L04 Schedule J, Part I, Line 4 The 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. F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 Fernando 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_L06 Form 990, Part VI, Section A, Line 6 Connecticut Children's Medical Center is the sole member of Connecticut Children's Speciatly Group. F990_P06_S0A_L07a Form 990, Part VI, Section A, Line 7a Connecticut 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_L07b Form 990, Part VI, Section A, Line 7b The 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_L11b Form 990, Part VI, Section B, Line 11b The 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_L12c Form 990, Part VI, Section B, Line 12c 1: 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_L15 Form 990, Part VI, Section B, Line 15 Each 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_L19 Form 990, Part VI, Section C, Line 19 The 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_L05 Form 990, Part XI, Line 5 Transfer from Affiliated organizations $7,087,745; Unrealized loss on investments $52,448 Connecticut Children's Medical Center 282 Washington Street Hartford CT 06106 060646755 Hospital CT 501(c)(3) 3 N/A 0 CCMC Corporation 282 Washington Street Hartford CT 06106 222619876 Healthcare Support CT 501(c)(3) 11b N/A 0 Children's Fund of Connecticut Inc 270 Farmington Ave Farmington CT 06032 061364513 Preventative Healthcare programs CT 501(c)(3) 11a N/A 0 Children's Health and Development Institute Inc 270 Farmington Ave Farmington CT 06032 061504725 Healthcare Services CT 501(c)(3) 7 N/A 0 CCMC Affiliates Inc 282 Washington Street Hartford CT 06106 222619870 Healthcare Services CT 501(c)(3) 9 N/A 0 Connecticut Children's Medical Center Foundation Inc 282 Washington Street Hartford CT 06106 222619869 Fundraising & Investment Mgt CT 501(c)(3) 7 N/A 0 CCMC Ventures Inc 282 Washington Street Hartford CT 06106 222619873 Healthcare services CT N/A C 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 Connecticut Children's Medical Center i 331897 Review of intercompany entries Connecticut Children's Medical Center j 608034 Review of intercompany entries Connecticut Children's Medical Center n 11936863 Review of intercompany entries Connecticut Children's Medical Center o 14452721 Review of intercompany entries Connecticut Children's Medical Center p 8159552 Review of intercompany entries Connecticut Children's Medical Center r 7087745 Review of intercompany entries To allow adequate time for board review