CHILDRENS HOSPITAL OF CHICAGO MEDICAL CENTER: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CHILDRENS HOSPITAL OF CHICAGO MEDICAL CENTER (EIN 36-3357004)
Tax period
2010-09-01 to 2011-08-31
Filed
2012-06-08
IRS object ID
201231609349300503
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)
Timestamp2012-06-08T09:04:39-04:00Timestamp
Tax Period End Date2011-08-31TaxPeriodEndDate

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 Line1155 NORTH WACKER DRIVEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN363357004EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1The Children's Memorial Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHILNameControl
Phone3125734578Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12300 CHILDRENS PLAZA BOX 268AddressLine1
CityChicagoCity
StateILState
ZIP Code606143394ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePAULA M NOBLEName
TitleCFO & TREASURERTitle
Date Signed2012-06-07DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3128792000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPatrick M MagoonNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12300 Childrens Plaza Box 268AddressLine1
CityChicagoCity
StateILState
ZIP Code606143394ZIPCode
FieldValueIRS element (for citing)
Gross Receipts17560951GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CHILDRENSMEMORIAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1984YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionESTABLISH, DEVELOP, PROMOTE & CONDUCT EDUCATIONAL PROGRAMS, SCIENTIFIC RESEARCH, HEALTHCARE FACILITIES & OTHER CHARITABLE & EDUCATIONAL ACTIVITIES DEVOTED TO HEALTH & WELFARE SERVICES TO INFANTS & CHILDREN.ActivityOrMissionDescription
Nbr Voting Members Governing Body107NbrVotingMembersGoverningBody
Nbr Independent Voting Members99NbrIndependentVotingMembers
Total Nbr Employees86TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2553621ContributionsGrantsPriorYear
Contributions Grants Current Year743847ContributionsGrantsCurrentYear
Program Service Revenue Prior Year17544841ProgramServiceRevenuePriorYear
Program Service Revenue CY16817104ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year20098462TotalRevenuePriorYear
Total Revenue Current Year17560951TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2358107GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year13226816SalariesEtcPriorYear
Salaries Etc Current Year13181881SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4839304OtherExpensePriorYear
Other Expenses Current Year3836582OtherExpensesCurrentYear
Total Expenses Prior Year18066120TotalExpensesPriorYear
Total Expenses Current Year19376570TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2032342RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1815619RevenuesLessExpensesCY
Total Assets BOY7523416TotalAssetsBOY
Total Assets EOY5532040TotalAssetsEOY
Total Liabilities BOY2824168TotalLiabilitiesBOY
Total Liabilities EOY2648411TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4699248NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2883629NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionWE ARE DEDICATED TO THE HEALTH AND WELL-BEING OF ALL CHILDREN. AS THE PEDIATRIC TEACHING FACILITY FOR NORTHWESTERN UNIVERSITY'S FEINBERG SCHOOL OF MEDICINE, THIS COMMITMENT DRIVES US TO BE A LEADER IN: - PEDIATRIC HEALTH CARE DELIVERY - RESEARCH INTO THE PREVENTION, CAUSES AND TREATMENT OF DISEASES THAT AFFECT CHILDREN - EDUCATION FOR PHYSICIANS, NURSES AND ALLIED HEALTH PROFESSIONALS - ADVOCACY FOR CHILDREN AS A CHARITABLE ORGANIZATION, WE SERVE CHILDREN AND THEIR FAMILIES TO THE BEST OF OUR ABILITIES AND TO THE LIMITS OF OUR RESOURCES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense17862847Expense
Revenue16817104Revenue
DescriptionThe Children's Memorial Medical Center ("CMMC"), an Illinois not-for-profit corporation, engages in budget approval, asset management, resource allocation, investment oversight and strategic planning for Affiliates. Affiliates include organizations for which CMMC is either a controlling member or a controlling shareholder. Currently, CMMC has the following affiliates: The Children's Memorial Hospital, The Children's Memorial Foundation, Children's Memorial Research Center, Children's Memorial Medical Group, LLC and Pediatric Faculty Foundation, Inc. Children's Memorial Medical Group, LLC ("CMMG") is an Illinois limited liability company whose sole member is CMMC. By virtue of CMMC's tax-exempt status, CMMG is considered to be an organization described under Section 501(c)(3) of the Code. CMMG employs pathologists, radiologists, psychiatrists and dentists who practice at The Children's Memorial Hospital ("CMH"). CMMG's pathologists comprise CMH's Department of Pathology and Laboratory Medicine which provides comprehensive services in both Anatomic and Clinical Pathology, utilizing extensive expertise and state-of-the-art technology. Consultative services are provided across the country in collaboration and coordination with the CMH's medical, surgical and ancillary departments. The children encompass a cross-section of diagnoses and the department assists in the diagnosis and management of acute and chronic diseases. CMMG psychiatrists practice within CMH's Department of Child and Adolescent Psychiatry which offers children and their families specialized services in pediatric mental health. Clinicians in the department provide state-of-the art psychiatric and psychological services, education, and advocacy. CMMG psychiatrists provide national leadership in the education of mental health care professionals and advancement of knowledge through research. CMMG psychiatrists treat children of all ages and from every socioeconomic background for a wide variety of problems including adjustment disorders, emotional problems related to pediatric disorders, psychoses, mood disorders, anxiety, developmental delays, behavior disorders, ADHD, autism spectrum disorders, and learning disabilities. CMMG dentists provide comprehensive and preventive oral health care for infants, children, adolescents, and patients of CMH with special health care needs. CMH's dentistry service provides a child-centered environment and a comprehensive program emphasizing total health and prevention. CMMG dentists provide care related to infant oral healthcare with parent education; nursing and baby bottle caries; dental caries; oral trauma, anxious child; comprehensive oral healthcare for patients of CMH's medical specialties (including hematology, oncology, infectious disease, allergy, cardiology, neurology and services to address cleft lip and palate); and services requiring sedation and general anesthesia. Radiologists employed by CMMG staff CMH's Department of Medical Imaging which serves pediatric patients in a manner aimed to help minimize radiation dose used during each procedure. The Department performs approximately 109,000 procedures each year, including 9,800 MRIs of which 80 percent are done on medically complex and/or sedated children. All of the radiologists are board certified with subspecialty training in pediatric radiology, interventional radiology and/or neuroradiology. CMMG's physicians are members of the faculty practice plan at CMH, which represents the largest provider of pediatric Medicaid services in Illinois. In FY 2011, CMMG physicians had over 4,000 combined inpatient and outpatient Medicaid encounters for 2,269 patients. Medicaid represents over 43.2% of its payor mix. In FY 2011, Medicaid reimbursement for physician services for care to children treated by CMMG physicians was approximately $1.9 million less than the costs associated with providing such services. CMMC through its management and CMMG's services assists CMH, which, owns and operates the only full-service, independent, freestanding pediatric hospital in Illinois, with 270 licensed beds as well as a full range of inpatient and outpatient care and related ancillary services. This not-for-profit, tertiary care hospital, founded in 1882, provides patient care 24 hours per day, 7 days per week and provides more pediatric healthcare than any other hospital provider in Illinois in nearly every pediatric medical and surgical specialty. As a major academic tertiary care medical center, CMH has served patients from every county in Illinois, as well as patients from every state and 35 countries. CMH is a designated Level I pediatric trauma center for the City of Chicago, with a Level III neonatal nursery that serves as a regional referral center in the State of Illinois Perinatal Network. CMH's ability to treat the most critically ill infants in its neonatal intensive care unit ("NICU") is demonstrated by statistics for calendar year 2011 which show that 60% of all transports into its NICU were from other Level III nurseries in metropolitan Chicago. CMH has also been ranked among the best in the nation in a U.S. News & World Report opinion-based survey of top pediatric hospitals for the past three years. CMH is the home to the world's first pediatric center for Autonomic Medicine and was the first pediatric hospital in Illinois to perform the Berlin Heart procedure, a breakthrough technology that helps children awaiting heart transplants. In the fiscal year ending August 31, 2011, CMH, through nearly 549,700 patient visits, served more than 148,000 children who came from all over the State of Illinois and beyond to access the more than 70 specialties offered by CMH. During this period there were 465,818 visits including 315,658 outpatient visits in Lincoln Park (including 6,541 observation cases), including 61,691 emergency room visits and 88,469 outpatient visits at the satellite facilities.Description
Total Program Service Expense17862847TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
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 RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees86NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
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 Members107NbrVotingGoverningBodyMembers
Number Independent Voting Members99NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
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Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
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Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
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Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonPAULA M NOBLENamePerson
Telephone Number3125734578TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12300 CHILDRENS PLAZA BOX 268AddressLine1
CityCHICAGOCity
StateILState
ZIP Code606143394ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (118 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
John J Allen
Director1.0X000
John Amboian Jr
Director1.0X000
Sarah Baine
Ex-Officio Director w/vote1.0X000
Stephen W Baird
Director1.0X000
Peter B Bensinger
Director1.0X000
Andrew T Berlin
Director1.0X000
Barbara L Bowles
Director1.0X000
Jill Brennan
Director1.0X000
David Bunning
Director1.0X000
Gregory CCase
Director1.0X000
John A Challenger
Director1.0X000
Alan Chapman
Director1.0X000
Robert Clark
Director1.0X000
Mrs Charles F Clarke Jr
Director1.0X000
Kevin M Connelly
Director1.0X000
John D Cooney
Director1.0X000
John M Crocker Jr
Vice-Chair & Director1.0X000
Lester Crown
Director1.0X000
Paula H Crown
Director1.0X000
Leticia Peralta Davis
Director1.0X000
Susan DePree
Director1.0X000
James DeRose
Director1.0X000
William J Devers Jr
Director1.0X000
John Doerge Jr
Director1.0X000
James Donaldson MD
Ex-Officio Director w/vote40.0X5182990136176
Charles W Douglas
Director1.0X000
Dennis J Drescher
Director1.0X000
Michael Evangelides
Director1.0X000
Tyrone C Fahner
Director1.0X000
Mitchell Feiger
Director1.0X000
Diana S Ferguson
Director1.0X000
Michael W Ferro Jr
Director1.0X000
David Fox Jr
Director1.0X000
John S Gates Jr
Director1.0X000
Laurence S Geller
Director1.0X000
Bert A Getz Jr
Director1.0X000
Jeffrey Glassroth MD
Director1.0X000
Thomas P Green MD
Ex-Officio Director w/vote1.0X065369155432
Joseph Gregoire
Director1.0X000
David D Grumhaus
Director1.0X000
Arlington Guenther
Director1.0X000
Joseph D Gutman
Director1.0X000
Bruce R Hague
Director1.0X000
Paul F Hanzlik
Director1.0X000
Brett J Hart
Director1.0X000
Mary JC Hendrix PhD
EX-OFF DIR W/VOTE/PRES/SCI OFF1.0X060293344526
Daniel J Hennessy
Vice Chair & Director1.0X000
James Hickey
Director1.0X000
Gary E Holdren
Director1.0X000
Mark Hoppe
Director1.0X000
Charles H James III
Director1.0X000
J Larry Jameson MD
Ex-officio Director w/vote1.0X000
Kirk B Johnson
Director1.0X000
W Bruce Johnson
Director1.0X000
Bennet A Kaye MD
Ex-Officio Director w/vote1.0X000
George D Kennedy
Director1.0X000
Anthony K Kesman
Director1.0X000
Richard P Kiphart
Director1.0X000
Fred L Krehbiel
Director1.0X000
Adam A Kriger
Director1.0X000
Gerald R Lanz
Director1.0X000
Eric Lefkofsky
Director1.0X000
Lyle Logan
Director1.0X000
Shelley A Longmuir
Director1.0X000
Daniel TW Lum MD
Director1.0X000
Patrick M Magoon
Ex-Officio Dir/CEO, CMH/CMMC1.0X01275634598066X
Mitchell J Manassa
Director1.0X000
John F Manley
Vice Chair & Director1.0X000
Roxanne Martino
Director1.0X000
Peter D McDonald
Director1.0X000
Jack L McGinley
Director1.0X000
Andrew J McKenna
Director1.0X000
William J McKenna
Director1.0X000
James J McNulty
Director1.0X000
Louise C Mills
Director1.0X000
Robert S Murley
Vice Chair & Director1.0X000
David Neithercut
Director1.0X000
Leslie Newman
Director1.0X000
Edward Ogata MD
Ex-Officio Director/CMO, CMH1.0X0228243444336
Nancy Pacher
Director1.0X000
Chaka Patterson
Director1.0X000
Peer Pedersen
Vice Chair & Director1.0X000
Lorna S Pfaelzer
Director1.0X000
David C Pisor
Director1.0X000
Ashish Prasad
Director1.0X000
Seth Prostic
Director1.0X000
Gerald D Putnam
Director1.0X000
Mohan Rao Phd
Director1.0X000
Andrea Redmond
Director1.0X000
Susan Regenstein
Director1.0X000
Thomas R Reusche
Director1.0X000
J Christopher Reyes
CMMC/CMH Chair1.0X000
Marleta Reynolds MD
Ex-Officio Director w/vote1.0X000
Peter C Roberts
Director1.0X000
Hilary Sallerson
Ex-Officio Director w/vote1.0X000
Manuel Sanchez
Director1.0X000
Deborah M Sawyer
Director1.0X000
H William Schnaper MD
Ex-Officio Director/PFF MD1.0X028594850017
Christopher Segal
Director1.0X000
Mrs Donald Shoemaker
Director1.0X000
Stephen A Smith
Director1.0X000
Thomas S Souleles
Director1.0X000
Stephen T Steers
Director1.0X000
Edward S Traisman MD
Ex-Officio Director w/vote1.0X000
Monsignor Kenneth Velo
Director1.0X000
Matthew Walsh
Director1.0X000
Edward J Wehmer
Director1.0X000
Brian E Williams
Director1.0X000
Linda S Wolf
Director1.0X000
James Wooten Jr
Director1.0X000
Ms Jia Zhao
Director1.0X000
Paula M Noble
CFO/Treasurer/CMMC& Affiliates1.00517921139612X
Donna S Wetzler
Gen CNSL&Corp Sec/CMMC&Afflts1.0038928496604X
Tamar E Ben-Ami MD
Staff Radiologist40.0367753044355X
Elizabeth Perlman MD
Chair/Dept of Path & Lab Med40.0439219045406X
Frank M Prendergast MD
Med Director Med Imaging CDH40.0385521037714X
Cynthia K Rigsby MD
Division Head, Body Imaging40.0436555047718X
Richard M Shore MD
Staff Radiologist40.0416387044352X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2563734TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs6007845TotalReportableCompFrmRltdOrgs
Total Other Compensation1384314TotalOtherCompensation
Number Individuals GT100 K39NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Medcentrix Inc
15620 S Wood StreetHARVEYIL60426BILLING SERVICES641213
Northwestern Medical Faculty Founda
375 North St ClairCHICAGOIL60611PHYSICIAN SERVICES559146
Springfield Service Corporation
2960 Professional DriveSPRINGFIELDIL62703billing services388602
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Related Organizations743847RelatedOrganizations
Total Contributions743847TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net patient revenue6211101032332310323323
Medical Administration & Teaching62111031029363102936
Miscellaneous operating income62111015521141552114
Medicaid62111018387311838731
FieldValueIRS element (for citing)
Total Program Service Revenue16817104TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column17560951TotalRevenueColumn
Related Or Exempt Function Income16817104RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2358107Total
Program Services2358107ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total531391Total
Program Services508865ProgramServices
Management And General22526ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total10073665Total
Program Services9643706ProgramServices
Management And General429959ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total104726Total
Program Services99492ProgramServices
Management And General5234ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1705360Total
Program Services1622133ProgramServices
Management And General83227ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total766739Total
Program Services745258ProgramServices
Management And General21481ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total13500Total
Management And General13500ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total128279Total
Program Services128260ProgramServices
Management And General19ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total86227Total
Program Services28627ProgramServices
Management And General57600ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total9077Total
Program Services9077ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3716Total
Program Services3716ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total83540Total
Program Services83540ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2066Total
Program Services2066ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total217116Total
Program Services204816ProgramServices
Management And General12300ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad debt provision388105388105
Billing and collection fees867311867311
Patient expenses12778941277894
Plan tax587394587394
Dues and licenses9312993129

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total79228Total
Program Services78662ProgramServices
Management And General566ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total19376570Total
Program Services17862847ProgramServices
Management And General1513723ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6396584BOY
EOY4360044EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY561468BOY
EOY601747EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY120000BOY
EOY120000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY445364BOY
EOY450249EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7523416BOY
EOY5532040EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2824168BOY
EOY2648411EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2824168BOY
EOY2648411EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4699248BOY
EOY2883629EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4699248BOY
EOY2883629EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7523416BOY
EOY5532040EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-1815619ReconcilationRevenueExpenses
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 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (4 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
THE CHILDREN'S MEMORIAL HOSPITAL
36217083303truetruetrue$17,862,847
THE CHILDREN'S MEMORIAL FOUNDATION
36335700607truetruetrue$0
PEDIATRIC FACULTY FOUNDATION
3632796800truetruetrue$0
THE CHILDREN'S MEMORIAL RESEARCH CENTER
36335700504truetruetrue$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs4TotalNumberOfSupportedOrgs
Sum Of Amounts17862847SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM CMMC INSURANCE76025
MISCELLANEOUS374224
FieldValueIRS element (for citing)
Total Book Value Other Assets450249TotalBookValueOtherAssets

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegion
Number Of Offices0NumberOfOffices
Number Of Employees0NumberOfEmployees
Type Of Activities ConductedProgram ServicesTypeOfActivitiesConducted
Specific Services ProvidedInsuranceSpecificServicesProvided
Total Expenditures3519866TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent3519866SubtotalAmountSpent
Total Amount Spent3519866TotalAmountSpent
Transfer To Foreign CorptrueTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorptrueOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S MEMORIAL HOSPITALBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12300 CHILDRENS PLAZAAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60614ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient362170833EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant2358107AmountOfCashGrant
Purpose Of GrantNET ASSET TRANSFERPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule IIdentifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationWe review all grant funds on a monthly basis. Financial reports are generated monthly and distributed electronically to all fund directors and the Office of Sponsored Projects (OSP) for review. Expenditures are reviewed for appropriateness and against budgetary guidelines by the Finance Office (Fund Accounting). OSP and Fund Accounting work with the investigators to monitor their activity and make sure they are in compliance with the terms of the award.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgtrueCompBasedOnRevenueOfFilingOrg
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 (13 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
James Donaldson MD
4294220868900198701155390206370654475000
Thomas P Green MD
046349101894080792024500030932070912300
Mary JC Hendrix PhD
045530701471100516024500020026064745900
Patrick M Magoon
065296605871460355220583079014987018737000137833
Edward Ogata MD
04171870213082016521650196470246890232677001216586
H William Schnaper MD
02490670360890792024500025517033596500
Paula M Noble
03428460173529015460125105014507065753300
Donna S Wetzler
0256438013115901687080490016114048588800
Tamar E Ben-Ami MD
267107098813018330165300278250412108000
Elizabeth Perlman MD
36891506941008940304910149150484625000
Frank M Prendergast MD
287780096205015360148860228280423235000
Cynthia K Rigsby MD
3011030133802016500181620295560484273000
Richard M Shore MD
3047520984830131520223210220310460739000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental Compensation InformationIdentifier
Return ReferenceSchedule J, Part I, Line 3ReturnReference
ExplanationPursuant to the bylaws of The Children's Memorial Medical Center ("CMMC"), the Governance Committee of CMMC is charged to review and approve senior executive compensation for CMMC and its affiliates. Schedule J, Part I, Question 4b The following listed individuals have an amount included in Schedule J, Part II, Column (C) for an amount accrued but not vested under a supplemental executive retirement plan ("SERP"): James Donaldson, MD $ 93,402 Patrick M. Magoon $448,147 Paula M. Noble $105,908 Elizabeth J. Perlman, MD $ 14,028 Donna S. Wetzler $ 64,327 Benefits earned under the SERP are non-vested forms of deferred compensation that fund the employee's eventual retirement benefit. These benefits are provided in exchange for all of the employee's years of service to the organization, and the cost of the benefits will vary from year to year based on interest rates, age, and many other factors. The amounts are at risk and will not be paid unless and until the employee has provided substantial future services to the organization. Benefits under the SERP vest at age 62 and are forfeited if the employee leaves the organization voluntarily before age 62 (except upon the sole discretion of the Board, and only if the participant has reached at least age 55 with at least 10 years of service). Participants who voluntarily leave the organization before age 55 forfeit their entire SERP benefit upon termination. Also in response to question 4b, Edward Ogata, MD became vested in supplemental retirement benefits under the SERP, and therefore had multi-year SERP benefits of $1,623,308 included in his taxable income. The vested and taxable amount represents the value of benefits earned over many years of service to the organization, and which became vested and taxable in 2010. These benefits were subject to a substantial risk of forfeiture before 2010. Of the amount reported on Form 990, the amount already reported on Forms 990 in prior years for Dr. Ogata was, $1,216,586 and this amount is reported in Schedule J, Part II, Column (F). Schedule J, Part I, Question 5a Employed physicians are compensated on the basis of personal professional productivity that takes into account, in part, the revenues of the organization generated by the physician. Schedule J, Part II The following individuals are not compensated by the reporting organization for his or her service as a director. Rather, the compensation reported on Form 990, Part VII and on Schedule J, Part II reflects compensation paid by Pediatric Faculty Foundation for the individual's substantial and full-time services as an employee. For more details, please refer to the 2010 Form 990 of Pediatric Faculty Foundation, EIN 36-3279680. Thomas P. Green, MD Mary J.C. Hendrix, PhD H. William Schnaper, MD is not compensated by the reporting organization for his service as a director. Rather, the compensation reported on Form 990, Part VII and on Schedule J, Part II reflects compensation paid by Pediatric Faculty Foundation for the individual's substantial and full-time services as an employee. The following individuals are not compensated by the reporting organization for his or her service as a director or officer. Rather, the compensation reported on Form 990, Part VII and on Schedule J, Part II reflects compensation paid by The Children's Memorial Hospital for the individual's substantial and full-time services as an employee. For more details, please refer to the 2010 Form 990 of The Children's Memorial Hospital, EIN 36-2170833. Patrick M. Magoon Edward Ogata, MD Paula M. Noble Donna S. WetzlerExplanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
JP Morgan Chase
L. Crown is a director121640Financial Servicesfalse
JP Morgan Chase
P. Crown is a director121640Financial Servicesfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of RelationshipsForm 990, Part VI, Question 2*Gregory C. Case has a business relationship with Andrew J. McKenna. *Lester Crown has a family relationship with Paula H. Crown. *William J. McKenna has a family and business relationship with Andrew J. McKenna. *Lyle Logan has a business relationship with Charles H. James III. *William J. Devers Jr. has a business relationship with Andrew J. McKenna *William J. Devers Jr. has a business relationship with Michael W. Ferro Jr. *John M. Crocker Jr. had a business relationship with Bert A. Getz Jr. *Bert A. Getz Jr. has a business relationship with Edward J. Wehmer and Charles H. James III. *Anthony K. Kesman has a business relationship with Daniel J. Hennessy. *Adam A. Kriger has a business relationship with Andrew J. McKenna. *Stephen A. Smith has a business relationship with Peer Pedersen. *Linda S. Wolf and Eric Lefkofsky have a business relationship.
Describe the Process used by Management &/or Governing Body to Review 990Form 990, Part VI, Question 11BA PUBLIC DISCLOSURE COPY OF THE ORGANIZATION'S FISCAL YEAR 2011 FORM 990 WAS PROVIDED TO EACH MEMBER OF THE CHILDREN'S MEMORIAL MEDICAL CENTER AND THE CHILDREN'S MEMORIAL HOSPITAL ("CMMC/CMH") AUDIT COMMITTEE (OF THE BOARD). THE AUDIT COMMITTEE IS THE COMMITTEE OF THE PARENT ORGANIZATION (CMMC) CHARGED WITH THE OVERSIGHT OF AUDIT AND TAX MATTERS FOR THE PARENT AND AFFILIATES. DURING A SPECIAL AUDIT COMMITTEE MEETING, AND BEFORE THE FORM 990 WAS FILED, THE AUDIT COMMITTEE WAS PROVIDED A DETAILED REVIEW OF THE FORM 990 BY THE CHIEF FINANCIAL OFFICER ("CFO") AND THE ORGANIZATION'S DIRECTOR OF TAX COMPLIANCE. THE CFO AND DIRECTOR OF TAX COMPLIANCE ALSO RESPONDED TO THE AUDIT COMMITTEE MEMBERS' QUESTIONS AND AFFORDED THE OPPORTUNITY FOR DETAILED DISCUSSION OF THE FORM 990, PRIOR TO THE AUDIT COMMITTEE TAKING ACTION TO APPROVE THE FILING OF THE FORM 990. AS PART OF ITS ANNUAL RETURN PREPARATION PROCESS, THE ORGANIZATION ON AN ONGOING BASIS CONSULTED ITS TAX CONSULTING FIRM AND OUTSIDE TAX LEGAL COUNSEL, BOTH OF WHICH POSSESS EXPERTISE IN HEALTH CARE AND TAX-EXEMPT RETURN PREPARATION, TO ADVISE AND ASSIST IN THE PREPARATION OF THE FORM 990. THESE ADVISORS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE AND INTERNAL LEGAL PERSONNEL AND OTHER MEMBERS OF THE ORGANIZATION'S TEAM ASSEMBLED TO PARTICIPATE IN THE PREPARATION OF THE FORM 990. PRIOR TO PRESENTING THE FORM 990 TO THE BOARD'S AUDIT COMMITTEE, THE ORGANIZATION'S TEAM, INCLUDING ITS ADVISORS, MET FREQUENTLY TO DISCUSS AND REVIEW DRAFTS OF THE FORM.
Description of Process to Monitor Transactions for Conflicts of InterestForm 990, Part VI, Question 12cON AN ANNUAL BASIS, THE CHILDREN'S MEMORIAL MEDICAL CENTER AND ITS AFFILIATES ("CMMC") SUBMIT A COMPREHENSIVE QUESTIONNAIRE TO BOARD MEMBERS, SENIOR MANAGEMENT AND PURCHASING PERSONNEL REQUIRING DISCLOSURE OF ALL INTERESTS THAT COULD GIVE RISE TO ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. CMMC INITIATES FOLLOW UP CONTACT WITH THOSE WHO DO NOT RESPOND AND TO CLARIFY RESPONSES, WHERE NECESSARY. CMMC REVIEWS EACH DISCLOSURE AND PROVIDES A SUMMARY OF RELEVANT DISCLOSURES FOR THE REVIEW AND APPROVAL OF ITS GOVERNANCE COMMITTEE. Pursuant to the Conflicts of Interest Policy of The Children's Memorial Medical Center and affiliates ("Corporation"), directors, officers, physician leaders, and others who are subject to the policy are required to promptly and fully disclose in writing any actual, apparent or potential conflict of interest to the President of the Corporation and General Counsel. This disclosure shall be provided to the Governance Committee of the Corporation which shall consider all conflicts of interest issues and, if appropriate, shall provide such written disclosure to the Directors, Board committees considering the proposed transaction or other appropriate parties. In addition, on an annual basis, the Corporation surveys each individual subject to the policy as to the existence of actual or potential conflicts of interest. The Corporation will not enter into an agreement, transaction or other arrangement involving a conflict of interest unless the disinterested members of the Governance Committee of the Corporation's Board of Directors determine by a majority vote that appropriate safeguards to protect the charitable mission of the Corporation have been implemented. The subject interested person may not be present when the vote is taken. If it is determined that a conflict of interest exists, a disinterested person or committee of disinterested members may be assigned to investigate alternatives to the proposed transaction or arrangement. After exercising due diligence, the Board or committee shall determine whether the Corporation can obtain a more advantageous transaction or arrangement, with reasonable efforts, from a person or entity that would not give rise to a conflict of interest. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the Board or committee shall determine by a majority vote of the disinterested directors whether the transaction is in the Corporation's best interest and for its own benefit and whether the transaction is fair and reasonable to the Corporation, and shall make its decision as to whether to enter into the transaction or arrangement.
Offices & Positions for Which Process was Used, & Year Process was BegunForm 990, Part VI, questions 15a and 15bThe authority to review and approve executive compensation has been delegated by the organization's Board of directors to its Governance Committee. The Governance Committee has adopted a written executive compensation philosophy which it follows when it reviews and approves the compensation and benefits of the organization's senior management, including the President/Chief Executive Officer and the other senior managers. The compensation philosophy is subject to periodic review for continued appropriateness by the Governance Committee. With the assistance of a compensation consultant and information from a variety of external sources (specified on schedule J), the Governance Committee confirmed the total amounts to be paid were reasonable and comparable to amounts paid by similarly situated organizations. Outside legal counsel also serves an integral role in advising the Governance Committee with respect to federal tax requirements in setting compensation and the establishment of the rebuttable presumption of reasonableness. The process followed by the Governance Committee, including a description of the data relied upon and the Governance Committee's decisions, was thoroughly and contemporaneously documented. The Governance Committee has expressly reviewed the reasonableness of all such payments, and has concluded, as the result of a process that is designed to qualify for the rebuttable presumption of reasonableness under federal tax law, that all such amounts are reasonable and do not exceed fair market value for the services provided. The Governance Committee was comprised of members of The Children's Memorial Medical Center and The Children's Memorial Hospital Boards of Directors who were determined disinterested for these purposes. The Governance Committee conducts an ongoing and periodic review of the disinterested status of its members, and will take appropriate action with respect to anyone having an interest with respect to one or more executives so as to preserve the application of the rebuttable presumption of reasonableness.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen PublicForm 990, Part VI, Question 19THE ORGANIZATION'S FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ONLINE AT WWW.DACBOND.COM. THE ORGANIZATION'S ARTICLES OF INCORPORATION AND ANNUAL REPORTS ARE AVAILABLE THROUGH THE ILLINOIS SECRETARY OF STATE. THE ORGANIZATION ALSO MAKES ITS GENERAL GOVERNING DOCUMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST.
AVERAGE HOURS PER WEEK FOR RELATED ORGANIZATIONSFORM 990, PART VIIELIZABETH J. PERLMAN, MD AND JAMES DONALDSON, MD ARE EMPLOYEES OF THE CHILDREN'S MEMORIAL MEDICAL CENTER AND GENERALLY WORK 40 HOURS PER WEEK. APPROXIMATELY 2 HOURS OF ADDITIONAL TIME EACH WEEK IS SPENT PROVIDING SERVICES TO RELATED ORGANIZATIONS. THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF THE CHILDREN'S MEMORIAL HOSPITAL AND GENERALLY WORK 40 HOURS PER WEEK. IN GENERAL, APPROXIMATELY 2 HOURS OF ADDITIONAL TIME EACH WEEK IS SPENT PROVIDING SERVICES TO RELATED ORGANIZATIONS: PATRICK M. MAGOON PAULA M. NOBLE EDWARD OGATA, MD DONNA S. WETZLER THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF PEDIATRIC FACULTY FOUNDATION AND GENERALLY WORK 40 HOURS PER WEEK. APPROXIMATELY 2 HOURS OF ADDITIONAL TIME EACH WEEK IS SPENT PROVIDING SERVICES TO RELATED ORGANIZATIONS: THOMAS P. GREEN, MD MARY J.C. HENDRIX, PHD H. WILLIAM SCHNAPER, MD
INFORMATION ABOUT SUPPORTED ORGANIZATIONSCHEDULE A, PART IFOR A DESCRIPTION OF THE MANNER IN WHICH THE CHILDREN'S MEMORIAL MEDICAL CENTER SUPPORTS THE CHILDREN'S MEMORIAL HOSPTIAL, PLEASE SEE THE STATEMENT OF PROGRAM ACCOMPLISHMENTS INCLUDED IN SCHEDULE O.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1THE CHILDREN'S MEMORIAL MEDICAL GRP LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12300 CHILDRENS PLAZAAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60614ZIPCode
FieldValueIRS element (for citing)
EIN364187449EIN
Primary ActivitiesHEALTH CAREPrimaryActivities
Legal Domicile StateILLegalDomicileState
Total Income17117022TotalIncome
EOY Assets5336015EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CMMCBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
THE CHILDREN'S MEMORIAL RESEARCH CENTER
2300 CHILDRENS PLAZACHICAGOIL60614363357005RESEARCHIL501(C)(3)4CMMC
THE CHILDREN'S MEMORIAL HOSPITAL
2300 CHILDRENS PLAZACHICAGOIL60614362170833HOSPITALIL501(C)(3)3CMMC
PEDIATRIC FACULTY FOUNDATION INC
2300 CHILDRENS PLAZACHICAGOIL60614363279680HLTH CRE/RSCHIL501(C)(3)11 III-FICMMC
CMH SELF INSURANCE FOUNDATION
2300 CHILDRENS PLAZACHICAGOIL60614366638400INSURANCEIL501(C)(3)11 III-FICMMC
THE CHILDREN'S MEMORIAL FOUNDATION
2300 CHILDRENS PLAZACHICAGOIL60614363357006FUNDRAISINGIL501(C)(3)7CMMC

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1CMMC INSURANCE CO LTDBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12300 CHILDRENS PLAZAAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60614ZIPCode
FieldValueIRS element (for citing)
EIN366638400EIN
Primary ActivitySELF INSURANCEPrimaryActivity
Legal Domicile Foreign CountryCJLegalDomicileForeignCountry

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CMMCBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCORPORATIONTypeOfEntity
Share Of Total Income76292ShareOfTotalIncome
Share Of EOY Assets13680610ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
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 OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
The Children's Memorial Hospital
B2358107
The Children's Memorial Hospital
C743847
The Children's Memorial Hospital
O5500393
CMMC Insurance Co LTD
Q3519866

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