2012-06-08T09:04:39-04:00 2011-08-31 ERNST & YOUNG US LLP 155 NORTH WACKER DRIVE CHICAGO IL 60606 990 2010-09-01 363279680 PEDIATRIC FACULTY FOUNDATION INC PEDI 3125734578 2300 CHILDRENS PLAZA BOX 268 CHICAGO IL 606143394 PAULA M NOBLE 2012-06-07 3128792000 2010 2016-02-24 21:20:13Z Thomas P Green MD 2300 Childrens Plaza Box 268 Chicago IL 606143394 99124195 false X WWW.CHILDRENSMEMORIAL.ORG X 1984 IL PEDIATRIC FACULTY FOUNDATION, INC., EMPLOYS PEDIATRIC MEDICINE SPECIALISTS AND SUBSPECIALISTS WHO PRACTICE AT THE CHILDREN'S MEMORIAL HOSPITAL AND PROVIDE QUALITY HEALTH CARE TO CHILDREN IN THE COMMUNITY. 4 2 425 0 0 0 10303728 15820466 84350384 83303467 537 262 0 0 94654649 99124195 0 0 0 0 74171484 80681002 0 0 0 21023444 17722350 95194928 98403352 -540279 720843 4868553 5732780 3313130 3456514 1555423 2276266 X WE VALUE EXCELLENCE AND INNOVATION IN CLINICAL AND BASIC RESEARCH, COORDINATED AND COMPREHENSIVE PATIENT CARE, ONGOING PHYSICIAN EDUCATION, AND SOUNDLY-BASED CHILD ADVOCACY. OUR GOAL IS TO PROVIDE LEADERSHIP IN ENDEAVORS THAT PROMOTE THE HEALTH OF CHILDREN LOCALLY, NATIONALLY, AND INTERNATIONALLY. false false 93717185 0 83303467 Pediatric Faculty Foundation, Inc. ("PFF") is an Illinois not for profit corporation and an organization described under Section 501(c)(3) of the Code whose sole corporate member is The Children's Memorial Medical Center ("CMMC") (FEIN 36-3357004). PFF employs pediatric medicine specialists, subspecialists and hospitalists. Such physicians are based and practice at The Children's Memorial Hospital ("CMH"), another affiliated entity of PFF, and at CMH's outreach locations. CMH offers over 70 types of pediatric subspecialty care, more than any other Illinois hospital. PFF employs 354 pediatric medicine specialists, subspecialists and hospitalists who provide specialty services to patients of CMH in the areas of allergy, cardiology, immunology, neonatology, neurology, dermatology, emergency medicine, endocrinology, gastroenterology, general academic pediatrics, genetics, hematology and oncology, hospital-based medicine, infectious diseases, nephrology and pulmonary and critical care medicine. In addition, PFF employs approximately 34 full-time research faculty. Currently, the President of PFF also serves as the Chairman of the Department of Medicine at CMH and the Chairman of the Department of Pediatrics of Northwestern University's Feinberg School of Medicine ("NUFSM"). Virtually all of those PFF physicians who are the full-time hospital-based medical staff (excluding fellows) hold faculty appointments at NUFSM. PFF's physicians are members of the Faculty Practice Plan at CMH which is comprised of approximately 482 pediatric sub-specialists and represents the largest provider of pediatric Medicaid services in Illinois. In FY 2011, CMH's faculty physicians had approximately 111,920 combined inpatient and outpatient Medicaid patient encounters for 38,301 pediatric patients. Medicaid represents nearly 47.4% of its payor mix. CMH's pediatric-specialist physicians (which include PFF physicians) provide a substantial portion of the specialty care to children insured by the State of Illinois' All Kids program. In FY 2011, Medicaid reimbursement for physician services for specialty care to children treated by PFF physicians was over $20.7 million less than the costs associated with providing such services. In addition, CMH is the pediatric training center of NUFSM, providing residencies in both pediatrics and pediatric surgery. Each year, CMH's Department of Pediatrics, through the PFF physicians, trains approximately 200 physicians. Almost half are pediatric residents, and the remainder are fellows in various pediatric sub-specialties including cardiology, hematology/oncology and neonatology. The program ranked 18th nationally in the 2013 U.S. News & World Report's "Best Medical Schools Specialty Rankings for Pediatrics." 93717185 true true false false false false false false false false false false false false false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false false true 0 0 425 true false false false false false false false false false false X 4 2 false false false false true true true true true false false false true true true true true true true false IL X PAULA M NOBLE 3125734578 2300 CHILDRENS PLAZA BOX 268 Chicago IL 60614 X THOMAS P GREEN MD 40.0 X X 653691 0 55432 KIRK B JOHNSON 1.0 X 0 0 0 PATRICK M MAGOON 1.0 X 0 1275634 598066 STEVE ROSEN MD 1.0 X 0 0 0 PAULA M NOBLE 1.0 X 0 517921 139612 DONNA S WETZLER 1.0 X 0 389284 96604 MARY JC HENDRIX PHD 10.0 X 602933 0 44526 JEFFREY L LOUGHEAD MD 40.0 X 383786 0 44322 ROBIN H STEINHORN MD 40.0 X 440775 0 27561 ANNETTE WAGNER MD 40.0 X 393210 0 45344 PETER F WHITINGTON MD 40.0 X 422854 0 52341 2897249 2182839 1103808 263 false true false Springfield Service Corp 8151 W 183RD STREET SUITE B TINLEY PARK IL 60477 Billing Services 3298036 WELL CARE NEONATOLOGISTS SC 36W128 SILVER GLEN COURT ST CHARLES IL 60175 Neonatal Physicians 1083933 Northwestern Medical Faculty Founda 676 N St Clair CHICAGO IL 60611 Physician Services 144470 3 15820466 15820466 Program Service Revenue 621110 50685324 50685324 Medical Administration and Education 621110 6098248 6098248 Professional Services Provided to CMRC 621110 5980580 5980580 Other Operating Income 621110 7922281 7922281 Medicare/Medicaid Payments 621110 12617034 12617034 83303467 262 262 0 0 0 0 0 0 0 99124195 83303467 0 262 0 0 0 0 861408 861408 0 65107041 62162662 2944379 5295302 5234458 60844 5900704 5540314 360390 3516547 3368417 148130 0 0 0 0 0 0 2073432 1896454 176978 0 156639 155294 1345 0 0 2366245 2366245 16843 2925 13918 0 584959 560691 24268 0 0 0 3232068 3204386 27682 Billing and Collection 3423726 3423726 Bad Debt 3080591 3080591 Plan Tax 2465759 2465759 Transcription 40723 40723 Miscellaneous 281365 214540 66825 98403352 93717185 4686167 0 24453 74219 4365260 5129742 478840 528819 4868553 5732780 3313130 3456514 3313130 3456514 X 1555423 2276266 1555423 2276266 4868553 5732780 720843 X false true true X false X X X false false false THE CHILDREN'S MEMORIAL HOSPITAL 362170833 03 true true true 93717185 1 93717185 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false true false false false true false THOMAS P GREEN MD 463491 0 189408 0 792 0 24500 0 30932 0 709123 0 0 0 PATRICK M MAGOON 0 652966 0 587146 0 35522 0 583079 0 14987 0 1873700 0 137833 PAULA M NOBLE 0 342846 0 173529 0 1546 0 125105 0 14507 0 657533 0 0 DONNA S WETZLER 0 256438 0 131159 0 1687 0 80490 0 16114 0 485888 0 0 MARY JC HENDRIX PHD 455307 0 147110 0 516 0 24500 0 20026 0 647459 0 0 0 JEFFREY L LOUGHEAD MD 370357 0 13153 0 276 0 24500 0 19822 0 428108 0 0 0 ROBIN H STEINHORN MD 370499 0 70000 0 276 0 24500 0 3061 0 468336 0 0 0 ANNETTE WAGNER MD 247282 0 145652 0 276 0 24500 0 20844 0 438554 0 0 0 PETER F WHITINGTON MD 409851 0 12211 0 792 0 24500 0 27841 0 475195 0 0 0 Supplemental Compensation Information Schedule J, Part I, Line 3 Pursuant 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. 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 an independent compensation consultant and information from a variety of sources, such as compensation surveys, 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 under the federal tax law intermediate sanctions rules. 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, 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 to be disinterested for these purposes. The Governance Committee conducts an ongoing, regular 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. 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"): Patrick M. Magoon $448,147 Paula M. Noble $105,908 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. Schedule J, Part I, Question 5a Employed physicians are compensated in part on the basis of personal professional productivity that takes into account the revenues of the organization generated by the physician. Schedule J, Part I, Question 7 The organization provides annual incentive compensation to senior management under a senior management incentive compensation plan. These amounts are included in schedule J, Part II, Column B (ii). The plan is designed to offer opportunities for additional compensation tied to performance against pre-determined financial, patient satisfaction, patient safety and individual goals approved in advance by the Governance Committee of The Children's Memorial Hospital and The Children's Memorial Medical Center, which serves as the Compensation Committee of The Children's Memorial Hospital and Pediatric Faculty Foundation, Inc. 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. Schedule J, Part II 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 Paula M. Noble Donna S. Wetzler DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, QUESTION 6 THE CHILDREN'S MEMORIAL MEDICAL CENTER ("CMMC") IS THE ORGANIZATION'S SOLE CORPORATE MEMBER. Description of Classes of Persons and the Nature of Their Rights Form 990, Part VI, Question 7a THE ORGANIZATION'S SOLE CORPORATE MEMBER, THE CHILDREN'S MEMORIAL MEDICAL CENTER, HAS CERTAIN RESERVED POWERS, INCLUDING THE POWER TO APPOINT AND REMOVE certain DIRECTORS OF THE ORGANIZATION. Descr Classes of Persons, Decisions Requiring Appr & Type of Voting Rights Form 990, Part VI, Question 7b THE CHILDREN'S MEMORIAL MEDICAL CENTER, THROUGH ITS BOARD OF DIRECTORS OR DESIGNATED COMMITTEE, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS CERTAIN RESERVED POWERS WITH RESPECT TO APPOINTMENT AND REMOVAL OF certain DIRECTORS, APPOINTMENT OF CERTAIN OFFICERS, APPROVAL OF AMENDMENTS TO GOVERNING DOCUMENTS, APPROVAL OF FINANCIAL MATTERS, AND APPROVAL OF SIGNIFICANT TRANSACTIONS INCLUDING, BUT NOT LIMITED TO, MERGER, DISSOLUTION, DISPOSITION OF ASSETS OTHER THAN IN THE ORDINARY COURSE OF BUSINESS, AND CREATION OF SUBSIDIARIES. Describe the Process used by Management &/or Governing Body to Review 990 Form 990, Part VI, Question 11B A 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 CMMC 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 Interest Form 990, Part VI, Question 12c ON 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 CONTACTS 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 Begun Form 990, Part VI, Questions 15a & 15b On an annual basis, the Board of Directors of the organization's parent (The Children's Memorial Medical Center ("CMMC")) pursuant to its bylaws has delegated the authority to review and approve executive compensation of the CMMC affiliates to the Governance Committee of the CMMC/CMH board of directors ("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 and the other senior managers. The compensation philosophy is subject to periodic review for continued appropriateness by the Governance Committee. With the assistance of an independent compensation consultant and information from a variety of sources, such as compensation surveys, 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 rendered. 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 Public Form 990, Part VI, Question 19 THE 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. HOURS WORKED FOR RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A, LINE 1A THOMAS P. GREEN, MD is an EMPLOYEE OF PEDIATRIC FACULTY FOUNDATION AND GENERALLY WORKs 40 HOURS PER WEEK. APPROXIMATELY 2 HOURS OF additional time each WEEK is SPENT PROVIDING SERVICES TO RELATED ORGANIZATIONS. MARY J.C. HENDRIX, PHD is an employee of Pediatric faculty foundation and is an officer and director of CMRC. She generally works 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. APPROXIMATELY 2 HOURS OF ADDITIONAL TIME EACH WEEK IS SPENT PROVIDING SERVICES TO RELATED ORGANIZATIONS: PATRICK M. MAGOON PAULA M. NOBLE DONNA WETZLER Information about Supported Organizations Schedule A, Part I For a description of the manner in which Pediatric Faculty Foundation supports The Children's Memorial Hospital, please see the statement of program accomplishments included in Schedule O. The Children's Memorial Research Center 2300 Childrens Plaza Chicago IL 60614 363357005 Research IL 501(c)(3) 4 CMMC The Children's Memorial Foundation 2300 Childrens Plaza Chicago IL 60614 363357006 Fundraising IL 501(c)(3) 7 CMMC The Children's Memorial Medical Center 2300 Childrens Plaza Chicago IL 60614 363357004 Health Care IL 501(c)(3) 11 III-FI NA The Children's Memorial Hospital 2300 Childrens Plaza Chicago IL 60614 362170833 Hospital IL 501(c)(3) 3 CMMC CMH Self Insurance Foundation 2300 Childrens Plaza Chicago IL 60614 366638400 Insurance IL 501(c)(3) 11 III-FI CMMC CMMC INSURANCE CO LTD 2300 Childrens Plaza Chicago IL 60614 000000000 SELF INSURANCE CJ NA CORPORATION false false true false false false false false false true false false false false true true false false