FURP.ORG / PUBLIC DATA EXPLORER

DAYTON CHILDRENS HOSPITAL FOUNDATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
DAYTON CHILDRENS HOSPITAL FOUNDATION (EIN 31-1045247)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-04
IRS object ID
201231259349301073
Schema version
2010v3.7
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)
Timestamp2012-05-04T17:18:49-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE STE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN311045247EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1The Children's Medical Center FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHILNameControl
Phone9376413338Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Childrens PlazaAddressLine1
CityDaytonCity
StateOHState
ZIP Code45404ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDAVID MILLERName
TitleVICE PRESIDENT OF FINANCETitle
Date Signed2012-05-04DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDAVID KINSAULNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE CHILDRENS PLAZAAddressLine1
CityDAYTONCity
StateOHState
ZIP Code45404ZIPCode
FieldValueIRS element (for citing)
Gross Receipts67371731GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTHE CHILDREN'S MEDICAL CENTER FOUNDATION (THE FOUNDATION) EXISTS SOLELY TO BENEFIT THE CHILDREN'S MEDICAL CENTER, DAYTON, OHIO (CMC), AND TO ASSIST CMC IN PERFORMING ITS CHARITABLE MISSION.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year-10065347InvestmentIncomePriorYear
Investment Income Current Year8783774InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year-10065347TotalRevenuePriorYear
Total Revenue Current Year8783774TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year3305958GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY3490987GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year461692OtherExpensePriorYear
Other Expenses Current Year469319OtherExpensesCurrentYear
Total Expenses Prior Year3767650TotalExpensesPriorYear
Total Expenses Current Year3960306TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-13832997RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4823468RevenuesLessExpensesCY
Total Assets BOY150455993TotalAssetsBOY
Total Assets EOY187835397TotalAssetsEOY
Total Liabilities BOY26502TotalLiabilitiesBOY
Total Liabilities EOY14768TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY150429491NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY187820629NetAssetsOrFundBalancesEOY
Mission DescriptionTHE CHILDREN'S MEDICAL CENTER FOUNDATION (THE FOUNDATION) EXISTS SOLELY TO BENEFIT THE CHILDREN'S MEDICAL CENTER, DAYTON, OHIO (CMC), AND TO ASSIST CMC IN PERFORMING ITS CHARITABLE MISSION.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense3960306Expense
Grants3490987Grants
Revenue8783774Revenue
DescriptionThe Children's Medical Center Foundation (The Foundation) exists solely to benefit The Children's Medical Center, Dayton, Ohio (CMC) and subsidiaries, and to assist CMC in performing its charitable mission. The Foundation is funded from bequests, and deferred and planned gifts from outside donors. The Foundation assists CMC in fulfilling its charitable purpose in the following four ways: 1) The Foundation accumulates the proceeds of bequests and deferred and planned gifts as an endowment for CMC's future capital needs. The income from this endowment will be used to support CMC's year to year capital equipment needs in the future. In addition, income from the Foundation may be used to fund all or a portion of extraordinary capital projects such as additions or renovations to CMC's building and grounds. 2) The Foundation funds medical research conducted by physicians who are based at CMC. Research is funded from the income on an endowment provided for this purpose. During 2010-2011, the Foundation expended $4,113 in research grants. 3) The Foundation makes certain other periodic grants for child advocacy efforts which are related to CMC's mission. In 2010-2011, the Foundation transferred $12,345 for advocacy programs. An endowment has been established which supports the Child Care and Comfort Program within the Children's Home Care of Dayton (CHCOD - a wholly-owned subsidiary of CMC) each year. The Foundation expended $64,188 for the Child Care and Comfort Program in 2010-2011. An endowment has been established to provide annual support of CMC's Child Life Program. The Foundation expended $19,428 for the Child Life Program in 2010-2011. 4) The Foundation has established endowments, the income from which will be used each year to assist CMC to recruit and retain the top pediatric medical professionals. Current endowed medicine chairs are as follows: Child Abuse, Critical Care, Neurosurgery, Pulmonary, Developmental Pediatrics, Pediatric Neurology, General Pediatric Surgery, Pediatric Cancer and Blood Disorders, infectious diseases, and recruitment of Subspecialty Physicians who would otherwise not be available in the community. This year, an endowed medicine chair was established for anesthesia and $667,000 was added to the Cancer & Blood Disorder Chair. Expenditures for endowed medicine chairs in 2010-2011 totaled $3,379,194. Grants are directed toward activities which support CMC's mission with an emphasis on CMC's core activities. Grants are made to CMC as a whole rather than to specific physicians or individuals. Majority approval by the Board of Trustees determines whether the grant is funded by the Foundation. The Foundation Treasurer's approval is required prior to all disbursements of funds.Description
Total Program Service Expense3960306TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDAVID T MILLERNamePerson
Telephone Number9376413338TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE CHILDRENS PLAZAAddressLine1
CityDAYTONCity
StateOHState
ZIP Code454041815ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
VICKI S GIAMBRONE
TRUSTEE1.0X021592635946
DAVID KINSAUL
TRUSTEE1.0X0572819322770
ROBERT J FINK MD
TRUSTEE1.0X042783551381
NANCY R PETERSON
VICE CHAIRMAN1.0X000X
DAVID T MILLER
TRUSTEE1.0X028978348509
NATALIE KING-ALBERT
CHAIRMAN1.0X000X
DONNA HALL
Secretary1.0X000X
ROBERT L MUES
TREASURER1.0X000X
DAVID R HEPPNER
TRUSTEE1.0X000
TIMOTHY R CLARK
TRUSTEE1.0X000
LISA HARLAN
TRUSTEE1.0X000
JOHN A MACRITCHIE
TRUSTEE1.0X000
JENNI ROER
TRUSTEE1.0X000
PATTI SCHEAR
TRUSTEE1.0X000
JOHN SLAUGHENHAUPT
TRUSTEE1.0X000
JOHN W EY
TRUSTEE1.0X000
LESLIE MILLER
TRUSTEE1.0X000
DANIEL DITTMAN
TRUSTEE1.0X000
CAMERON MCGREGOR
TRUSTEE1.0X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1506363TotalReportableCompFrmRltdOrgs
Total Other Compensation458606TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonHIRTLE CALLAGHANNamePerson

Address Of Contractor AddressOfContractor

Address US AddressUS

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Address Line1300 BARR HARBOR DRIVE SUITE 500AddressLine1
CityWEST CONSHOHOCKENCity
StatePAState
ZIP Code19428ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesINVESTMENT SERVICESDescriptionOfServices
Compensation223212Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Total Contributions0TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

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Total Revenue Column4775581TotalRevenueColumn
Exclusion$4,775,581ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

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Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

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Securities62596150Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

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Gain Or Loss GainOrLoss

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Securities4008193Securities

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Total Revenue Column4008193TotalRevenueColumn
Exclusion$4,008,193ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

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Net Income From Gaming NetIncomeFromGaming

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Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

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Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

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Total Revenue Column8783774TotalRevenueColumn
Exclusion$8,783,774ExclusionAmount

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Program Services3490987ProgramServices

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Total0Total

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Total0Total

Benefits To Members BenefitsToMembers

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Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

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Total0Total

Comp Disqual Persons CompDisqualPersons

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Total0Total

Other Salaries And Wages OtherSalariesAndWages

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Total0Total

Pension Plan Contributions PensionPlanContributions

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Total0Total

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Total0Total

Payroll Taxes PayrollTaxes

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Total0Total

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Fees For Services Lobbying FeesForServicesLobbying

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Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

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Office Expenses OfficeExpenses

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Information Technology InformationTechnology

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Total0Total

Royalties Royalties

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Occupancy Occupancy

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Total0Total

Travel Travel

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Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

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Total0Total

Conferences Meetings ConferencesMeetings

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Total0Total

Interest Interest

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Total0Total

Payments To Affiliates PaymentsToAffiliates

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Total0Total

Depreciation Depletion DepreciationDepletion

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Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS EXPENSESDescription
Total73105Total
Program Services73105ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3960306Total
Program Services3960306ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY102365BOY
EOY164221EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY150353628BOY
EOY187671176EOY

Total Assets TotalAssets

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BOY150455993BOY
EOY187835397EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY26502BOY
EOY14768EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY26502BOY
EOY14768EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY149145734BOY
EOY186310801EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1283757BOY
EOY1509828EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY150429491BOY
EOY187820629EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY150455993BOY
EOY187835397EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4823468ReconcilationRevenueExpenses
Reconcilation Other Changes32567670ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (2 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
THE CHILDREN'S MEDICAL CENTER DAYTON OHIO
31067213203truetruetrue$3,896,118
CHILDREN'S HOME CARE OF DAYTON
31135603704falsetruetrue$64,188
FieldValueIRS element (for citing)
Total Number Of Supported Orgs2TotalNumberOfSupportedOrgs
Sum Of Amounts3960306SumOfAmounts

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance98416548BeginningOfYearBalance
Contributions7689808Contributions
Investment Earnings Or Losses22615932InvestmentEarningsOrLosses
Grants Or Scholarships3466629GrantsOrScholarships
Other Expenditures4113OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance125251546EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance72845221BeginningOfYearBalance
Contributions19617386Contributions
Investment Earnings Or Losses9146981InvestmentEarningsOrLosses
Grants Or Scholarships2959428GrantsOrScholarships
Other Expenditures233612OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance98416548EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance89256053BeginningOfYearBalance
Contributions1323863Contributions
Investment Earnings Or Losses-14382964InvestmentEarningsOrLosses
Grants Or Scholarships3320253GrantsOrScholarships
Other Expenditures31478OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance72845221EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierINTENDED USES OF ENDOWMENT FUNDSIdentifier
Return ReferenceSCHEDULE D, PART V, LINE 4ReturnReference
Explanation1) MEDICAL RESEARCH 2) CHILD CARE AND COMFORT - CHCOD 3) CHILD LIFE PROGRAM - CMC 4) ENDOWED MEDICAL CHAIRSExplanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
THE CHILDREN'S MEDICAL CENTER DAYTON OHIO
ONE CHILDRENS PLAZADAYTONOH45404310672132501(C)(3)3424899SUPPORT
CHILDREN'S HOME CARE OF DAYTON
ONE CHILDRENS PLAZADAYTONOH45404311356037501(C)(3)64188SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURES FOR MONITORING THE USE OF GRANTSIdentifier
Return ReferenceSCHEDULE I, PART I, LINE 2ReturnReference
ExplanationAS THE FOUNDATION'S PURPOSE IS "SOLELY TO BENEFIT CHILDREN'S MEDICAL CENTER(CMC)," THE RELATIONSHIP BETWEEN THE 2 ENTITIES IS EXTREMELY CLOSE. WITH THE EXCEPTION OF RESEARCH GRANTS AND SPECIAL ADVOCACY GRANTS, THE FUNDS PROVIDED TO CMC COVER JUST A FRACTION OF THE COST OF THE PROGRAMS FOR WHICH THEY ARE GIVEN. AS SUCH, FUNDS ARE TRANSFERRED TO CMC BUT SPECIFIC EXPENDITURES ARE NOT TRACKED. RESEARCH - EACH RESEARCH GRANT PROPOSAL FUNDED IS APPROVED BY BOTH THE FOUNDATION BOARD AND CMC'S INSTITUTIONAL REVIEW BOARD. RESEARCH PROJECTS ARE TRACKED INDIVIDUALLY AT CMC AND MONTHLY REPORTING IS GIVEN TO THE PROJECT DIRECTOR AND IS AVAILABLE TO THE FOUNDATION. IF THE PROJECT IS COMPLETED WITH UNSPENT FUNDS REMAINING, THEY ARE RETURNED TO THE FOUNDATION. SPECIAL GRANTS - ADDITIONAL GRANTS MAY BE ESTABLISHED FOR A SPECIFIC USE OR TO FULLY FUND A SPECIFIC CHILD ADVOCACY ONE-TIME COST OR PROGRAM. THESE FUNDS ARE TRANSFERRED TO CMC AND PLACED IN A SPECIFIC ACCOUNT FOR TRACKING PURPOSES. DETAILED ACTIVITY REPORTS ARE AVAILABLE TO THE FOUNDATION. UNSPENT FUNDS ARE RETURNED TO THE FOUNDATION. CHCOD ENDOWMENT - AN ENDOWMENT WAS ESTABLISHED FOR THE CHILDREN'S HOME CARE OF DAYTON (A SUPPORTED ORGANIZATION) FOR THEIR CARE AND COMFORT PROGRAM. THIS SUPPORT DOES NOT FULLY FUND THE PROGRAM AND IS TRANSFERRED ANNUALLY.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 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
VICKI S GIAMBRONE
0141902033211040813025709010237025187200
DAVID KINSAUL
038134001409530505260303602019168089558900
ROBERT J FINK MD
040102600026809026834024547047921600
DAVID T MILLER
0196787044227048769029292019217033829200

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental Compensation InformationIdentifier
Return ReferenceSchedule J, Part I, Line 4bReturnReference
ExplanationParticipants in a supplemental nonqualified retirement plan and the increase in actuarial value: DAVID KINSAUL: $264,829 DAVID T. MILLER: $9,395 VICKI S. GIAMBRONE: $9,034Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Classes of Members or StockholdersForm 990, Part VI, Question 6CHILDREN'S MEDICAL CENTER (CMC) IS THE SOLE MEMBER OF THE CHILDREN'S MEDICAL CENTER FOUNDATION.
Description of Classes of Persons and the Nature of Their RightsForm 990, Part VI, Question 7aCMC IS THE SOLE MEMBER OF THE FOUNDATION. THE BOARD OF CMC APPOINTS THE FOUNDATION BOARD MEMBERS.
Describe the Process used by Management &/or Governing Body to Review 990Form 990, Part VI, Question 11ATHE CFO REVIEWS KEY DISCLOSURES WITH APPROPRIATE COMMITTEES OF THE BOARD OF TRUSTEES. THEN PRIOR TO FILING, THE FORM 990 IS ELECTRONICALLY LOADED TO A SECURE HOSPITAL WEBSITE FOR THE ENTIRE BOARD OF TRUSTEES TO REVIEW. AN EMAIL IS SENT TO ALL MEMBERS NOTIFYING THEM THAT THE FORM IS AVAILABLE FOR THEIR REVIEW AND THAT IT WILL BE FILED ON OR BEFORE 05/15/12.
Description of Process to Monitor Transactions for Conflicts of InterestForm 990, Part VI, Question 12cAt the beginning of each meeting, the chairman of the board asks each member to identify and disclose any potential conflicts of interest based on the agenda or any changes in their business practice that might be relevant. If there are any conflicts, the member(s) recuse themselves and do not participate in the discussion and do not vote on the item. This then is noted in the minutes of that meeting. Board members annually agree to abide by written conflict of interest and confidentiality policies.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen PublicForm 990, Part VI, Question 19Children's Medical Centers conflict of interest policy is made available on our website. The financial statements and the organizing documents are made available as required by the extent of the law.
HOURS WORKED FOR RELATED ORGANIZATIONSCHEDULE J-2THE FOLLOWING ARE HOURS WORKED PER WEEK FOR THE CHILDREN'S MEDICAL CENTER DAYTON, OHIO (CMC): VICKI S. GIAMBRONE - 40 HOURS DAVID KINSAUL - 40 HOURS DAVID T. MILLER - 40 HOURS THE FOLLOWING ARE HOURS WORKED PER WEEK FOR THE CHILDREN'S CARE GROUP: ROBERT J. FINK, M.D. - 40 HOURS
RECONCILIATION OF NET ASSETSPART XI, LINE 5UNREALIZED GAIN ON SECURITIES 26,075,685 BEQUEST TRANSFER FROM HOSPITAL 136,425 ENDOWMENT TRANSFER FROM HOSPITAL 6,355,560 ---------- TOTAL FOR PART XI, LINE 5 32,567,670
DISCLOSURE RELATED TO FORM 5471DISCLOSURE STATEMENT RELATED TO FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, FILED ON BEHALF OF THE TAXPAYER UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: CHILDREN'S MEDICAL CENTER ADDRESS: ONE CHILDREN'S PLAZA DAYTON, OH 45404-1815 IDENTIFYING NUMBER OF U.S. TAX RETURN WITH WHICH THE FORMS 5471 WERE OR WILL BE FILED: 31-0672132 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
THE CHILDREN'S MEDICAL CENTER DAYTON OH
ONE CHILDRENS PLAZADAYTONOH45404310672132HEALTH CAREOH501(C)(3)3NA
CHILDREN'S HOME CARE OF DAYTON
ONE CHILDRENS PLAZADAYTONOH45404311356037HOME HLTH CREOH501(C)(3)9NA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
THE CHILDREN'S MEDICAL CENTER DAYTON OHIO
B3424899
CHILDREN'S HOME CARE OF DAYTON
B64188
THE CHILDREN'S MEDICAL CENTER DAYTON OH
C6491984
THE CHILDREN'S MEDICAL CENTER DAYTON OH
L72905