2011-05-09T08:05:02-05:00 2010-06-30 O'BrienFitzGeraldTaylor&Keaveney PC CPAs-85 Central St-Box 540351 Waltham MA 024540351 990 2009-07-01 043259647 CHILDREN'S HOSPITAL RADIOLOGY FOUNDATION INC CHIL 6173558347 300 LONGWOOD AVENUE BOSTON MA 02115 EDMOND REIDY 6173558347 2011-05-04 1 KENNETH F KOZIKOWSKI CPA 7818934010 2011-05-04 2009 2016-02-24 21:20:13Z GEORGE A TAYLOR MD 300 LONGWOOD AVENUE BOSTON MA 02115 38753933 0 X - N/A - X 1995 MA PROVIDES MEDICAL, SCIENTIFIC & EDUCATIONAL SERVICES FOR THE PATIENTS OF CHILDREN'S HOSPITAL BOSTON. 9 0 0 0 0 0 300000 1500000 29078727 31904129 -195374 503529 0 29183353 33907658 0 0 20005959 22630606 0 0 3417669 3088550 23423628 25719156 5759725 8188502 19807192 27274445 4648376 6125641 15158816 21148804 THE FOUNDATION WAS ORGANIZED AND OPERATES EXCLUSIVELY FOR THE BENEFIT OF CHILDREN'S HOSPITAL (THE HOSPITAL) AND HARVARD MEDICAL SCHOOL (HARVARD) LOCATED IN BOSTON, MASSACHUSETTS. THE FOUNDATION IS SUBJECT TO ESTABLISHED POLICIES, PRACTICES AND PROCEDURES OF THE HOSPITAL AND HARVARD. ORGANIZED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC AND EDUCATIONAL PURPOSES, THE FOUNDATION PROVIDES RADIOLOGY SERVICES PRIMARILY TO PATIENTS AT THE HOSPITAL AND AT OTHER HEALTH CARE FACILITIES AFFILIATED WITH THE HOSPITAL. 0 0 24972386 31904129 THE FOUNDATION PROVIDES RADIOLOGY SERVICES TO PATIENTS AT CHILDREN'S HOSPITAL. IT ALSO CARRIES ON AND PROMOTES BASIC AND APPLIED MEDICAL RESEARCH AND EDUCATION IN THE FIELD OF PEDIATRIC RADIOLOGY BY TEACHING STUDENTS AND OTHER MEDICAL AND SCIENTIFIC PERSONNEL; BY PROVIDING OR SUPPLEMENTING INCOME TO RESEARCH PERSONNEL THROUGH FELLOWSHIPS, RESEARCH GRANTS AND STIPENDS; AND BY GIVING LECTURES AND PUBLISHING INFORMATION REGARDING PROBLEMS AND RESEARCH RESULTS IN THE FIELD OF PEDIATRIC RADIOLOGY IN ORDER TO EDUCATE THE MEDICAL PROFESSION AND THE GENERAL PUBLIC. THE FOUNDATION MAY CHARGE FOR PATIENT CARE, OTHER MEDICAL SERVICES AND RELATED PRODUCTS, PROVIDED THAT ANY NET INCOME BE USED EXCLUSIVELY FOR THE CHARITABLE, SCIENTIFIC AND EDUCATIONAL PURPOSES FOR WHICH THE FOUNDATION WAS CREATED. THE FOUNDATION PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE HOSPITAL'S FREE-CARE POLICY WITHOUT CHARGE OR AT AN AMOUNT LESS THAN ITS ESTABLISHED RATES. 24972386 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 0 1 1 1 0 MA X EDMOND REIDY 6173558347 300 LONGWOOD AVENUE BOSTON MA 02115 RICHARD ROBERTSON MD 50.00 X X 479421 0 96307 KIRSTEN ECKLUND MD 40.00 X X 340948 0 89309 S TED TREVES MD 50.00 X X 467554 0 163415 CAROL BARNEWOLT MD 50.00 X 367172 0 79598 MICHAEL CALLAHAN MD 50.00 X 427112 0 74568 HORACIO PADUA MD 50.00 X 482578 0 73142 CAROLINE ROBSON MD 50.00 X 438002 0 95827 GEORGE TAYLOR MD 50.00 X 441026 0 152000 MICHELE WALTERS MD 50.00 X 262904 0 66228 EDMOND REIDY 50.00 X 11500 183216 26454 AHMAD ALOMARI MD 50.00 X 502366 0 56205 PAUL KLEINMAN MD 50.00 X 416625 0 194262 JUDY ESTROFF MD 50.00 X 378773 0 163742 SUSAN CONNOLLY MD 50.00 X 393508 0 137729 STEPHAN VOSS MD PHD 50.00 X 444059 0 98638 5853548 183216 1567424 32 0 1 0 CHILDREN'S HOSPITAL PEDIATRIC ASSOC 300 LONGWOOD AVE BOSTON MA 02115 MEDICAL CONSULTATION 208060 BRIGHAM & WOMEN'S HOSPITAL DEPT OF RADIO 75 FRANCIS STREET BOSTON MA 02115 INR SERVICES, MR PULSE SEQUENCES, ORBACH 168797 AMS PLUS 91 STILE RD SALEM NH 03079 BILLING SERVICES 121356 3 1500000 1500000 NET PATIENT SERVICE RE 621990 29386156 29386156 RESEARCH & OTHER REVEN 621990 1913340 1913340 TEACHING & SUPERVISION 621990 604633 604633 31904129 478880 478880 4870924 4846275 24649 24649 24649 33907658 31904129 0 503529 4960282 4854681 105601 13757564 13757564 1987262 1987262 1394729 1394729 530769 514268 16501 31756 31756 34110 34110 70000 70000 16206 16206 105360 105360 77999 72556 5443 123549 123549 37458 37458 MEDICAL CONSULTANTS 545785 545785 MALPRACTICE INSURANCE 384576 384576 ACADEMIC EXPENSES 349088 349088 PHYSICIANS ORGANIZATION 253382 253382 OTHER PURCHASED SERVICE 197171 180634 16537 862110 677861 184249 25719156 24972386 746770 0 2430158 1795339 6671326 7540743 236158 228132 40000 102517 823729 237258 242384 1381993 1210631 294911 171362 6876247 13106049 145340 145340 2813277 3181367 19807192 27274445 450153 461592 4198223 5664049 4648376 6125641 X 14508816 19801503 650000 1347301 15158816 21148804 19807192 27274445 X 0 1 1 X 0 X 400000 300000 1500000 2200000 16814195 20889868 25310129 29078727 31904129 123997048 16814195 20889868 25710129 29378727 33404129 126197048 0 0 0 126197048 259834 299550 382422 344178 478880 1764864 259834 299550 382422 344178 478880 1764864 17074029 21189418 26092551 29722905 33883009 127961912 0.98620 0.98590 0.01380 0.01410 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 81413 73428 7985 1087761 936230 151531 212819 200973 11846 171362 DUE FROM CHILDREN'S HOSPITAL 2397783 DUE FROM PHYSICIANS' ORGANIZATION 347517 ASSETS LIMITED AS TO USE 150546 OTHER RECEIVABLES 285521 3181367 DUE TO CHILDREN'S HOSPITAL 337749 DUE TO PHYSICIANS' ORGANIZATION 34664 ACCRUED PENSION CONTRIBUTION-DEFINED CONTRIB 346660 ACCRUED PENSION OBLIGATION-DEFINED BENEFIT 4694430 ACCRUED PENSION CONTRIBUTION-SUPPLEMENTAL 150546 PROMISES TO GIVE COMMITMENT 100000 5664049 33907658 25719156 8188502 528272 -2726786 -2198514 5989988 35238629 528272 802699 1330971 33907658 0 33907658 29248641 3529485 3529485 25719156 0 25719156 Part XI, Line 8 - Other Adjustments: DEFINED BENEFIT PENSION ADJUSTMENT: -2726786. Part XII, Line 2d - Other Adjustments: NET ASSETS RELEASED FROM RESTRICTIONS: 802699. Part XIII, Line 2d - Other Adjustments: NET ASSETS RELEASED FROM RESTRICTIONS: 802699. PENSION ADJUSTMENT FOR DEFINED BENEFIT PLAN: 2726786. X 1 1 X X 0 0 0 0 0 0 0 0 0 RICHARD ROBERTSON MD 409500 0 61243 0 8678 0 74782 0 21525 0 575728 0 245262 0 KIRSTEN ECKLUND MD 299540 0 33217 0 8191 0 66309 0 23000 0 430257 0 180237 0 S TED TREVES MD 400055 0 30738 0 36761 0 138227 0 25188 0 630969 0 253551 0 CAROL BARNEWOLT MD 321250 0 35106 0 10816 0 77858 0 1740 0 446770 0 0 0 MICHAEL CALLAHAN MD 378253 0 40324 0 8535 0 49775 0 24793 0 501680 0 230862 0 HORACIO PADUA MD 420000 0 50180 0 12398 0 51617 0 21525 0 555720 0 263780 0 CAROLINE ROBSON MD 377437 0 38897 0 21668 0 73735 0 22092 0 533829 0 230076 0 GEORGE TAYLOR MD 391958 0 32513 0 16555 0 131085 0 20915 0 593026 0 236737 0 MICHELE WALTERS MD 224100 0 32575 0 6229 0 42028 0 24200 0 329132 0 0 0 EDMOND REIDY 0 157925 11500 6500 0 18791 0 20154 0 6300 11500 209670 11500 102405 AHMAD ALOMARI MD 457500 0 36500 0 8366 0 47037 0 9168 0 558571 0 267615 0 PAUL KLEINMAN MD 358227 0 38948 0 19450 0 192652 0 1610 0 610887 0 221277 0 JUDY ESTROFF MD 334436 0 32934 0 11403 0 140217 0 23525 0 542515 0 0 0 SUSAN CONNOLLY MD 347028 0 35858 0 10622 0 111132 0 26597 0 531237 0 217839 0 STEPHAN VOSS MD PHD 398303 0 35415 0 10341 0 76193 0 22445 0 542697 0 231943 0 Part I, Line 1a HEALTH CLUB DUES ARE REIMBURSED TO SOME EMPLOYEES AND INCLUDED AS TAXABLE INCOME ON THEIR W-2'S. MICHELE WALTERS MD QUALIFYING RECRUITMENT RESIDENCE PURCHASE SECURED LOAN X 50000 40000 0 1 1 40000 Form 990, Part VI, Section A, line 7a MEMBERS OF THE FOUNDATION ELECT THE AT-LARGE DIRECTORS AND THE TREASURER AND CLERK. UNDER THE BYLAWS OF THE FOUNDATION, THE CHIEF IS AUTOMATICALLY THE PRESIDENT OF THE BOARD OF DIRECTORS AND THE DIVISION CHIEFS ARE AUTOMATICALLY DIRECTORS OF THE BOARD. Form 990, Part VI, Section B, line 11 FORM 990 IS REVIEWED BY THE PRESIDENT AND THE ADMINISTRATOR BEFORE FILING. Form 990, Part VI, Section B, line 12c ALL FOUNDATION EMPLOYEES ARE REQUIRED TO READ THE POLICY ANNUALLY AND REPORT ANY POTENTIAL CONFLICTS. Form 990, Part VI, Section B, line 15 THE PRESIDENT OF THE BOARD OF DIRECTORS' SALARY IS SET BY THE PRESIDENT OF THE HOSPITAL. OTHER OFFICERS AND DIRECTORS' SALARIES ARE SET BY THE FINANCE COMMITTEE, A SUB-COMMITTEE OF THE BOARD THAT USES A FORMULA BASED ON ACADEMIC RANK, YEARS OF SERVICE AND ADMINISTRATIVE RESPONSIBILITIES. A SECONDARY REVIEW IS DONE BY HOSPITAL SENIOR MANAGEMENT. Form 990, Part VI, Section C, line 18 FORMS 1023, 990 AND 990-T ARE AVAILABLE AT THE OFFICE OF THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. Form 990, Part VI, Section C, line 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE AT THE OFFICE OF THE SECRETARY OF THE COMMONWEALTH OF MASSACHUSETTS. ITS FINANCIAL STATEMENTS ARE AVAILABLE AT THE OFFICE OF THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST BY CALLING THE ORGANIZATION'S BUSINESS OFFICE. NO CHANGES TO THE PROCESS FOR AUDIT OVERSIGHT. CHILDREN'S HOSPITAL CORPORATION 300 LONGWOOD AVE BOSTON MA 02115 042774441 NON-PROFIT PEDIATRIC HOSPITAL MA 501(C)(3) 170(b)(1)(A)(iii) PHYSICIANS' ORGANIZATION AT CHILDREN'S HOSPITAL 300 LONGWOOD AVE BOSTON MA 02115 043266103 FUNCTIONAL SUPPORT FOR CHILDREN'S HOSPITAL & FOUNDATIONS MA 501(C)(3) 509(a)(3) 0 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 CHILDREN'S HOSPITAL CORPORATION B 100000 CHILDREN'S HOSPITAL CORPORATION C 1500000 PHYSICIANS' ORGANIZATION AT CHILDREN'S HOSPITAL INC L 253382 CHILDREN'S HOSPITAL CORPORATION O 3779420 CHILDREN'S HOSPITAL CORPORATION K 604633