2026-07-31T09:37:26-05:00 2025-09-30 346565596 ERNST & YOUNG US LLP 200 CLARENDON STREET BOSTON MA 02116 990 2024-10-01 042767602 CHMC SURGICAL FOUNDATION INC CHMC 6173554022 300 LONGWOOD AVENUE FEGAN3 BOSTON MA 02115 STEVEN J FISHMAN MD PRESIDENT 6173554022 2026-07-31 1 0 GEORGE F PAGANO P01978122 6172662000 2024 2025-03-06 01:10:19Z STEVEN J FISHMAN MD 300 LONGWOOD AVENUE FEGAN3 BOSTON MA 02115 64286649 0 X N/A X 1982 MA THE FOUNDATION PROVIDES SURGICAL SERVICES AND EDUCATIONAL SERVICES TO BOSTON (SEE SCHEDULE O) CHILDREN'S HOSPITAL AND HARVARD MEDICAL SCHOOL. THE FOUNDATION ALSO PROVIDES CARE FOR PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, AS WELL AS PROVIDING AND SUBSIDIZING HOSPITAL AND COMMUNITY BASED SERVICES THAT ARE EITHER UNAVAILABLE OR LIMITED ELSEWHERE IN THE COMMUNITY. 7 0 32 0 -2752 0 356181 306127 46917072 49764552 1292861 1950846 899421 2860489 49465535 54882014 15000 0 0 0 40136414 42352013 0 0 0 7409246 7972515 47560660 50324528 1904875 4557486 106727513 115486816 35176940 32382836 71550573 83103980 X THE FOUNDATION PROVIDES SURGICAL SERVICES PRIMARILY TO PATIENTS AT BOSTON CHILDREN'S HOSPITAL AND AT SATELLITE LOCATIONS. THE FOUNDATION CARRIES ON AND PROMOTES BASIC AND APPLIED MEDICAL RESEARCH AND EDUCATION IN THE FIELD OF SURGERY BY TEACHING (SEE SCHEDULE O) STUDENTS AND OTHER MEDICAL AND SCIENTIFIC PERSONNEL. THE FOUNDATION ALSO PROVIDES CARE FOR PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. 0 0 41281962 39908151 THE FOUNDATION WAS ORGANIZED TO OPERATE FOR THE BENEFIT OF BOSTON CHILDREN'S HOSPITAL AND HARVARD MEDICAL SCHOOL, TO PROVIDE SURGICAL SERVICES TO PATIENTS, AND TO CONDUCT AND PROMOTE RESEARCH AND EDUCATION IN THE FIELD OF PEDIATRIC SURGERY. THE FOUNDATION MAY CHARGE FOR PATIENT CARE AND OTHER MEDICAL SERVICES, PROVIDED THAT ANY NET INCOME BE USED FOR THE CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES FOR WHICH THE FOUNDATION WAS CREATED. THE FOUNDATION ALSO PROVIDES CARE FOR MANY PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, AS WELL AS PROVIDING HOSPITAL AND COMMUNITY BASED SERVICES THAT ARE EITHER UNAVAILABLE OR LIMITED ELSEWHERE IN THE COMMUNITY. DURING THE YEAR ENDED SEPTEMBER 30, 2025, THE FOUNDATION PERFORMED 22,236 AMBULATORY VISITS AND 4,105 SURGICAL CASES. THE FOUNDATION (SEE SCHEDULE O) PROVIDED $310,005 IN FREE CARE SERVICES, HAD EXPENDITURES OF $154,841 FOR RESEARCH EFFORTS, AND PROVIDED FUNDING OF $3,642,394 FOR TEACHING OR EDUCATIONAL INITIATIVES FOR THE YEAR ENDED SEPTEMBER 30, 2025. 927684 5168573 THE FOUNDATION RECEIVES INCOME FROM BOSTON CHILDREN'S HOSPITAL FOR PROVIDING ADMINISTRATION SERVICES. THE FOUNDATION CARRIES ON AND PROMOTES BASIC AND APPLIED MEDICAL RESEARCH AND EDUCATION IN THE FIELD OF SURGERY 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 CONCERNING CONDITIONS AND RESEARCH RESULTS IN THE FIELD OF PEDIATRIC SURGERY IN ORDER TO EDUCATE THE GENERAL PUBLIC AND THE MEDICAL PROFESSION. 4174580 4687828 THE FOUNDATION PROVIDES CLINICAL SERVICES IN CERTAIN CLINICS AND SATELLITE LOCATIONS OF BOSTON CHILDREN'S HOSPITAL (THE HOSPITAL) AT AGREED UPON RATES FOR REIMBURSEMENT. 46384226 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 32 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 7 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X BIREN P MODI MD 6173554022 300 LONGWOOD AVENUE BOSTON MA 02115 STEVEN J FISHMAN MD PRESIDENT 55.00 5.00 X X 1722866 0 136237 HEUNG BAE KIM MD CLERK 60.00 0.00 X X 1223902 0 129015 TOM JAKSIC MD TREAS (10/24-3/25)/DIR (4/25-9/25) 60.00 0.00 X 664973 0 126705 SHAWN J RANGEL MD DIRECTOR 60.00 0.00 X 837037 0 224349 BIREN P MODI MD DIR (10/24-3/25)/TREAS (4/25-9/25) 60.00 0.00 X X 1048417 0 201701 BRENT WEIL MD DIRECTOR 60.00 0.00 X 1011754 0 227476 TERRY L BUCHMILLER MD DIRECTOR 60.00 0.00 X 1072000 0 108086 PHYSICIANS ORG AT CH INC INSTITUTIONAL TRUSTEE 2.00 0.00 X 0 0 0 MARC R LAUFER MD DEPT. CHIEF 60.00 0.00 X 955724 0 133777 KONSTANTINOS PAPADAKIS MD PHYSICIAN 60.00 0.00 X 934151 0 128970 CATHERINE C CHEN MD PHYSICIAN 60.00 0.00 X 897011 0 133626 BELINDA HSI DICKIE MD PHYSICIAN 60.00 0.00 X 935116 0 149856 ALIREZA ABDOLLAH SHAMSHIRSAZ MD PHYSICIAN 60.00 0.00 X 980457 0 196120 ALEX G CUENCA MD PHYSICIAN 60.00 0.00 X 899055 0 205371 13182463 0 2101289 31 0 1 0 BRIGHAM AND WOMEN'S PHYSICIAN ORGANIZATI PO BOX 3684 BOSTON MA 02241 PHYSICIAN SERVICES 453676 HMFB OBGYN AT BIDMC 333 BROOKLINE AVENUE KS 3 BOSTON MA 02215 PHYSICIAN SERVICES 288973 ASKMUELLER CONSULTING LLC 204 E LOCUST STREET LENZBURG IL 62255 BILLING SERVICES 150033 3 306127 306127 PATIENT SERVICE REVENUE 621300 39908151 39908151 EDUCATION AND RESEARCH 611710 5168573 5168573 CLINICAL AND OTHER REVENUE 621300 4687828 4687828 49764552 909553 -2752 912305 10445928 9404635 1041293 1041293 1041293 NON-OPERATING PENSION GAINS 900099 2621990 2621990 INSURANCE REBATE 900099 238499 238499 2860489 54882014 49764552 -2752 4814087 9591136 9591136 24279207 20951870 3327337 4023217 4023217 3549023 3271341 277682 909430 827581 81849 63886 63886 2900 2900 58350 58350 375475 375475 2500 2500 1319156 1237892 81264 657035 657035 18633 18633 235865 235865 3484 3484 869556 825022 44534 COORDINATED SPECIALTY P 1405387 1405387 PO MANAGEMENT SERVICES 1080324 1080324 BILLING AND COLLECTION 924960 924960 ADMINISTRATIVE FEE 798163 798163 156841 156841 50324528 46384226 3940302 0 4258172 5937543 3885812 2927239 6079736 5315643 384570 0 640832 1842484 282896 273162 65960 56375 13069 9585 48118293 48577423 21922166 24378424 21141967 26225313 106727513 115486816 2153005 6097289 33023935 26285547 35176940 32382836 X 65878428 78154780 5672145 4949200 71550573 83103980 106727513 115486816 X 4557486 3799479 3196442 X X 0 1 X 1 0 X 3623459 609215 274142 356181 306127 5169124 35545476 30233407 41330050 46917072 49764552 203790557 39168935 30842622 41604192 47273253 50070679 208959681 0 0 0 208959681 420302 406859 744656 1025915 912305 3510037 420302 406859 744656 1025915 912305 3510037 143 -265 7484 -5586 -2752 -976 1033335 2120956 919779 899421 2860489 7833980 40622715 33370172 43276111 49193003 53840721 220302722 0.94850 0.95390 0.01590 0.01550 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: INSURANCE REBATE - 2024 AMOUNT: $ 238,499. NON-OPERATING PENSION GAINS - 2020 AMOUNT: $ 1,033,335. 2021 AMOUNT: $ 2,120,956. 2022 AMOUNT: $ 919,779. 2023 AMOUNT: $ 899,421. 2024 AMOUNT: $ 2,621,990. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5672145 134000 856945 4949200 5538145 229000 95000 5672145 6194783 100000 756638 5538145 6250144 463470 518830 6194783 4474276 3552652 1776784 6250144 0.00000 0.00000 1.00000 0 0 65960 56375 9585 9585 INTEREST IN THE P.O. POOLED INVESTMENT FUND 24378424 F 24378424 DUE FROM BOSTON CHILDREN'S HOSPITAL 302211 DUE FROM PHYSICIANS ORGANIZATION AT CHILDREN'S HOSPITAL, INC. 1185834 DUE FROM DANA FARBER CANCER INSTITUTE 50800 DUE FROM HARVARD MEDICAL SCHOOL 128809 DUE FROM BOSTON MEDICAL CENTER 81892 DUE FROM NEW ENGLAND ORGAN BANK 21594 DUE FROM CHILDREN'S HOSPITAL PEDIATRIC ASSOCIATES, INC. 2050 MALPRACTICE CLAIMS RECEIVABLE 4954645 DUE FROM BRIGHAM & WOMEN'S 63293 DUE FROM CHMC OTOLARYNGOLOGIC FOUNDATION, INC. 10717 PREPAID DEFINED BENEFIT PENSION PLAN 19229699 DUE FROM BOSTON PEDIATRIC NEUROSURGICAL FOUNDATION, INC. 3173 DUE FROM CHMC CARDIOVASCULAR SURGICAL FOUNDATION, INC. 534 DUE FROM CHILDREN'S UROLOGICAL FOUNDATION, INC. 8321 DUE FROM BOSTON PLASTIC AND ORAL SURGERY FOUNDATION, INC. 28902 DUE FROM CHMC ANESTHESIA FOUNDATION, INC. 152839 26225313 DUE TO BOSTON CHILDREN'S HOSPITAL 2522302 DUE TO PHYSICIANS ORGANIZATION AT CHILDREN'S HOSPITAL, INC 756092 DUE TO BOSTON MEDICAL CENTER 18833 ACCRUED DEFERRED COMPENSATION 16272196 ACCRUED PROFESSIONAL LIABILITY 6148852 DUE TO BRIGHAM & WOMEN'S HOSPITAL 157798 DUE TO BOSTON CHILDREN'S HOSPITAL - VASCULAR BIOLOGY 111256 DUE TO CHILDREN'S ORTHOPAEDIC SURGERY FOUNDATION, INC. 3272 DUE TO CHMC ANESTHESIA FOUNDATION, INC. 18750 DUE TO CHILDREN'S UROLOGICAL FOUNDATION, INC. 2767 DUE TO BETH ISRAEL DEACONESS MEDICAL CENTER 273429 26285547 X 61819585 3799479 3196442 6995921 54823664 58350 58350 54882014 50266178 0 50266178 58350 58350 50324528 PART V, LINE 4: THE ENDOWMENT FUNDS REPRESENT ASSETS HELD IN TRUST THAT ARE AVAILABLE TO PAY FOR FUTURE BENEFITS TO PARTICIPANTS FOR A DEFERRED COMPENSATION BENEFIT PLAN AND INVESTMENTS WHOSE USE HAVE BEEN RESTRICTED BY DONORS TO A SPECIFIC TIME PERIOD AND PURPOSE. PART X, LINE 2: THE FOUNDATION IS A TAX-EXEMPT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE), AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. IN ADDITION, THE FOUNDATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A), AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(2). TAX-EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION FOR INCOME TAXES AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS, INCLUDING UNRELATED BUSINESS INCOME OR TAX STATUS. MANAGEMENT OF THE FOUNDATION HAS EVALUATED THE POSITIONS TAKEN ON THE FOUNDATION'S FILED TAX RETURNS AND HAS CONCLUDED THAT NO UNCERTAIN INCOME TAX POSITIONS EXIST AT SEPTEMBER 30, 2025. PART XI, LINE 2D - OTHER ADJUSTMENTS: PENSION ADJUSTMENT 3,196,442. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 STEVEN J FISHMAN MD PRESIDENT 1312752 0 340000 0 70114 0 69253 0 66984 0 1859103 0 0 0 HEUNG BAE KIM MD CLERK 764140 0 200000 0 259762 0 69253 0 59762 0 1352917 0 0 0 BIREN P MODI MD DIR (10/24-3/25)/TREAS (4/25-9/25) 575764 0 200000 0 272653 0 145507 0 56194 0 1250118 0 0 0 BRENT WEIL MD DIRECTOR 565067 0 200000 0 246687 0 134569 0 92907 0 1239230 0 0 0 TERRY L BUCHMILLER MD DIRECTOR 686440 0 200000 0 185560 0 69253 0 38833 0 1180086 0 0 0 ALIREZA ABDOLLAH SHAMSHIRSAZ MD PHYSICIAN 719344 0 74984 0 186129 0 154441 0 41679 0 1176577 0 0 0 ALEX G CUENCA MD PHYSICIAN 437704 0 200000 0 261351 0 148213 0 57158 0 1104426 0 0 0 MARC R LAUFER MD DEPT. CHIEF 879947 0 0 0 75777 0 69253 0 64524 0 1089501 0 0 0 BELINDA HSI DICKIE MD PHYSICIAN 500332 0 200000 0 234784 0 69253 0 80603 0 1084972 0 0 0 KONSTANTINOS PAPADAKIS MD PHYSICIAN 544560 0 130770 0 258821 0 69253 0 59717 0 1063121 0 0 0 SHAWN J RANGEL MD DIRECTOR 536152 0 71250 0 229635 0 162997 0 61352 0 1061386 0 0 0 CATHERINE C CHEN MD PHYSICIAN 495016 0 200000 0 201995 0 69253 0 64373 0 1030637 0 0 0 TOM JAKSIC MD TREAS (10/24-3/25)/DIR (4/25-9/25) 531184 0 37000 0 96789 0 69253 0 57452 0 791678 0 0 0 PART I, LINE 1A THE FOUNDATION PROVIDES GROSS-UP PAYMENTS FOR MORTGAGE FORGIVENESS, LONG-TERM DISABILITY INSURANCE, AND LIFE INSURANCE. THESE PAYMENTS ARE INCLUDED AS TAXABLE WAGES DURING THE YEAR. ALL PERMANENT FULL-TIME EMPLOYEES OF THE FOUNDATION ARE ELIGIBLE FOR THE GROSS-UP PAYMENTS. PART I, LINE 4B CHMC SURGICAL FOUNDATION, INC. (THE FOUNDATION) ESTABLISHED A DEFINED BENEFIT PENSION PLAN, EFFECTIVE OCTOBER 1, 2006, TO PROVIDE ITS EMPLOYEES WITH FAIR AND ADEQUATE RETIREMENT BENEFITS. THE PLAN CALLS FOR BENEFITS TO BE PAID TO ELIGIBLE EMPLOYEES AT RETIREMENT BASED UPON YEARS OF SERVICE WITH THE FOUNDATION AND COMPENSATION RATES NEAR RETIREMENT. CONTRIBUTIONS TO THE PLAN REFLECT BENEFITS ATTRIBUTED TO EMPLOYEES' SERVICES TO DATE, AS WELL AS SERVICES EXPECTED TO BE EARNED IN THE FUTURE. DURING THE YEAR ENDED SEPTEMBER 30, 2025, THE FOUNDATION MADE THE FOLLOWING CONTRIBUTIONS TO THE PLAN: BIREN P. MODI, MD, $76,254; BRENT WEIL, MD $65,316; SHAWN J. RANGEL, MD, $93,744; ALIREZA ABDOLLAH SHAMSHIRSAZ, MD, $85,188; AND ALEX G. CUENCA, MD, $78,960. PART I, LINE 7 BONUS COMPENSATION AMOUNTS ARE DETERMINED BY THE CHIEF OF CHMC SURGICAL FOUNDATION, INC. (THE FOUNDATION). THE AMOUNTS ARE DISCRETIONARY BASED ON JOB PERFORMANCE AND THE FINANCIAL PERFORMANCE OF THE FOUNDATION. BONUSES FOR THE CHIEF ARE REVIEWED AND APPROVED BY HOSPITAL LEADERSHIP INCLUDING THE CEO. FORM 990, PART VI, SECTION A, LINE 1A THE MAJORITY OF CHMC SURGICAL FOUNDATION, INC.'S (THE FOUNDATION'S) BOARD MEMBERS ARE PHYSICIANS WHO ARE NOT INDEPENDENT FROM THE FOUNDATION. HOWEVER, THE FOUNDATION IS PART OF AN INTEGRATED DELIVERY SYSTEM WITH BOSTON CHILDREN'S HOSPITAL (THE HOSPITAL) WHICH DOES HAVE A COMMUNITY BOARD. THE FOUNDATION WAS ORGANIZED IN 1982. AT THAT TIME, THE BOARD WAS COMPOSED ENTIRELY OF PHYSICIANS, A BOARD STRUCTURE THAT WAS APPROVED BY THE INTERNAL REVENUE SERVICE. THE FOUNDATION HAS SINCE ADJUSTED THE BOARD STRUCTURE TO MAKE IT MORE RESPONSIVE TO THE HOSPITAL BY ADDING THE PHYSICIANS ORGANIZATION AT CHILDREN'S HOSPITAL, INC. (THE PO) AS A MEMBER. SEE SCHEDULE O, PART VI, QUESTIONS 3, 6, 7B, AND 12 FOR MORE DETAILS OF THE PO'S RIGHTS. FORM 990, PART VI, SECTION A, LINE 3 THE PHYSICIANS ORGANIZATION AT CHILDREN'S HOSPITAL, INC. (THE PO) IS A CLASS "C" MEMBER OF CHMC SURGICAL FOUNDATION, INC. (THE FOUNDATION). THE PO IS RESPONSIBLE FOR PROVIDING MANAGEMENT SERVICES TO THE FOUNDATION. THE PO HAS THE POWER TO APPROVE THE INDEPENDENT AUDITOR AND LEGAL COUNSEL OF THE FOUNDATION FROM A LIST OF FIRMS MUTUALLY AGREED TO BY THE PO AND THE FOUNDATION. THE PO ALSO HAS THE RIGHT TO REVIEW THE ANNUAL BUDGETS AND REVIEW AND APPROVE THE BY-LAW CHANGES OF THE FOUNDATION. LASTLY, BOSTON CHILDREN'S HOSPITAL HAS THE RIGHT TO REVIEW FOR COMPLIANCE WITH APPLICABLE LAW, THE GENERAL TERMS OF AND ANY MODIFICATION TO PHYSICIAN COMPENSATION AND BENEFIT PLANS FOR ALL PHYSICIAN EMPLOYEES OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 6 CHMC SURGICAL FOUNDATION, INC. (THE FOUNDATION) HAS THREE CLASSES OF MEMBERS. THE CHIEF OF THE DEPARTMENT OF SURGERY (THE DEPARTMENT) OF BOSTON CHILDREN'S HOSPITAL (THE HOSPITAL) IS A CLASS "A" MEMBER. EACH PERSON WHO IS A MEMBER OF THE FOUNDATION, OTHER THAN THE CHIEF OF THE FOUNDATION, WHO HOLDS A MEDICAL STAFF APPOINTMENT UNDER THE AUSPICES OF THE CHIEF SURGEON FROM HARVARD MEDICAL SCHOOL, AND WHO IS A FULL TIME EMPLOYEE AT THE HOSPITAL, SHALL BE A CLASS "B" MEMBER. IN ADDITION, UPON THE RECOMMENDATION OF THE CHIEF SURGEON AND WITH THE APPROVAL OF THE PRESIDENT OF THE HOSPITAL OR HIS DESIGNEE, EXCEPTIONS MAY BE MADE TO PERMIT OTHER PHYSICIANS WHO ARE MEMBERS OF THE DEPARTMENT TO BE CLASS "B" MEMBERS. THE PHYSICIANS ORGANIZATION AT CHILDREN'S HOSPITAL, INC. IS A CLASS "C" MEMBER OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE ARTICLES OF ORGANIZATION, THE CHIEF OF THE DEPARTMENT OF SURGERY (THE DEPARTMENT) OF BOSTON CHILDREN'S HOSPITAL IS THE CLASS "A" MEMBER OF CHMC SURGICAL FOUNDATION, INC. (THE FOUNDATION). EACH PERSON WHO IS A MEMBER OF THE FOUNDATION, OTHER THAN THE CHIEF OF THE DEPARTMENT, IS A CLASS "B" MEMBER OF THE FOUNDATION. THE CLASS "A AND "B" MEMBERS OF THE FOUNDATION ELECT THE BOARD OF DIRECTORS FROM NOMINEES PRESENTED BY THE EXECUTIVE COMMITTEE AT THEIR ANNUAL MEETING. EACH MEMBER IS ENTITLED TO ONE VOTE UPON ANY QUESTION AT ANY MEETING OF THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE PHYSICIANS ORGANIZATION AT CHILDREN'S HOSPITAL, INC. (THE PO) IS A CLASS "C" MEMBER OF CHMC SURGICAL FOUNDATION, INC. (THE FOUNDATION). THE PO IS RESPONSIBLE FOR PROVIDING MANAGEMENT SERVICES TO THE FOUNDATION. THE PO HAS THE POWER TO APPROVE THE INDEPENDENT AUDITOR AND LEGAL COUNSEL OF THE FOUNDATION FROM A LIST OF FIRMS MUTUALLY AGREED TO BY THE PO AND THE FOUNDATION. THE PO ALSO HAS THE RIGHT TO REVIEW THE ANNUAL BUDGETS AND REVIEW AND APPROVE THE BY-LAW CHANGES OF THE FOUNDATION. LASTLY, BOSTON CHILDREN'S HOSPITAL HAS THE RIGHT TO REVIEW FOR COMPLIANCE WITH APPLICABLE LAWS, THE GENERAL TERMS OF AND ANY MODIFICATION TO PHYSICIAN COMPENSATION AND BENEFIT PLANS FOR ALL PHYSICIAN EMPLOYEES OF THE FOUNDATION. AS A CLASS "C" MEMBER OF THE FOUNDATION, THE PO ATTENDS THE FOUNDATION'S ANNUAL MEETING. FORM 990, PART VI, SECTION B, LINE 11B THE DETAILED REVIEW WILL BE CONDUCTED BY THE PRESIDENT OF THE FOUNDATION, STEVEN J. FISHMAN, MD, AND THE SENIOR DIRECTOR FOUNDATION FINANCIAL OPERATIONS AND STRATEGIC PLANNING, TODD KATZMAN. A COPY OF THE FORM 990 WILL BE PROVIDED TO THE BOARD PRIOR TO FILING. THE PHYSICIANS ORGANIZATION AT CHILDREN'S HOSPITAL, INC. WILL REVIEW THE FORM 990 WITH THE BOARD MEMBERS. THE DETAILED REVIEW WILL BE CONDUCTED BEFORE FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE PHYSICIANS ORGANIZATION AT CHILDREN'S HOSPITAL, INC. (THE PO) AND BOSTON CHILDREN'S HOSPITAL (THE HOSPITAL) ADMINISTER AN ANNUAL CONFLICT OF INTEREST DISCLOSURE PROCESS TO ALL OF THEIR MEMBER FOUNDATIONS, WHICH ASKS PHYSICIANS (OFFICERS, TOP MANAGEMENT, AND HIGHLY COMPENSATED EMPLOYEES) AND SELECTED FOUNDATION STAFF TO DISCLOSE POTENTIAL CONFLICTS. A DISCLOSURE STATEMENT WILL BE CIRCULATED ANNUALLY TO MEMBERS OF THE PO. THE AUDIT COMMITTEE SHALL DETERMINE THOSE INDIVIDUALS (INCLUDING MEDICAL STAFF MEMBERS) WHO SHALL BE REQUIRED TO COMPLETE THE DISCLOSURE STATEMENT. THE AUDIT COMMITTEE, AT ITS DISCRETION, MAY EITHER: 1) REFER ANY OR ALL DISCLOSURE STATEMENTS TO THE BOARD OF DIRECTORS; 2) APPOINT AN AD HOC COMMITTEE TO REVIEW AND RESOLVE ANY CONFLICT OF INTEREST ISSUES; OR 3) REVIEW AND RESOLVE ANY CONFLICT OF INTEREST ISSUES PERSONALLY OR THROUGH A DESIGNEE(S). ANY PERSON NOT RECEIVING A DISCLOSURE STATEMENT NEVERTHELESS HAS AN AFFIRMATIVE OBLIGATION TO DISCLOSE TO THE PO PRESIDENT, PO GENERAL COUNSEL, OR HIS/HER SUPERVISOR WHENEVER HE/SHE BELIEVES HE/SHE HAS OR MAY HAVE A CONFLICT OF INTEREST. SIMILARLY, EACH PERSON COMPLETING A DISCLOSURE STATEMENT HAS AN AFFIRMATIVE OBLIGATION TO UPDATE THE STATEMENT ANY TIME CIRCUMSTANCES CHANGE AND/OR HE/SHE BELIEVES THAT A CONFLICT OF INTEREST MAY EXIST. IN THE EVENT A CONFLICT OF INTEREST IS FOUND TO EXIST, THE FOUNDATION PROHIBITS THE MEMBER FROM VOTING ON ANY MATTER TO WHICH THE CONFLICT RELATES OR OTHERWISE INFLUENCING THE VOTING ON SUCH MATTER. FORM 990, PART VI, SECTION B, LINE 15 FACULTY COMPENSATION MUST COMPLY WITH THE BOSTON CHILDREN'S HOSPITAL (THE HOSPITAL) PHYSICIAN COMPENSATION GUIDELINES. THESE GUIDELINES ARE DEVELOPED IN CONSULTATION WITH AN INDEPENDENT EXTERNAL COMPENSATION CONSULTING FIRM AND ARE APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE OF THE BOARD OF CHILDREN'S MEDICAL CENTER CORPORATION AND THE HOSPITAL. THE GUIDELINES SET THE MAXIMUM COMPENSATION LIMITS BASED ON A PEER GROUP ANALYSIS FOR THE FOUNDATION. THE MAXIMUM COMPENSATION LIMITS ARE BASED ON PEDIATRIC SPECIALTY, SUB-SPECIALTY, ACADEMIC RANK AND INCLUDE PRODUCTIVITY ADJUSTMENTS. ANY PROPOSED COMPENSATION THAT EXCEEDS THE LIMITS MUST BE PROSPECTIVELY APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE OF THE BOARD OF THE HOSPITAL. ANNUAL COMPENSATION FOR INDIVIDUAL FACULTY MEMBERS IS SET BY THE PRESIDENT OF THE CHMC SURGICAL FOUNDATION, INC. (THE FOUNDATION), REVIEWED AND APPROVED BY THE FOUNDATION IN ACCORDANCE WITH THE FOUNDATION'S COMPENSATION POLICIES AND PROCEDURES. THE FOUNDATION'S PRESIDENT'S COMPENSATION IS REVIEWED AND APPROVED ANNUALLY ON A PROSPECTIVE BASIS BY THE BOSTON CHILDREN'S HOSPITAL PRESIDENT/CHIEF EXECUTIVE OFFICER. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION MAINTAINS ALL FINANCIAL RECORDS, CONFLICT OF INTEREST POLICIES, AND GOVERNING DOCUMENTS AT ITS MAIN OFFICE AT 300 LONGWOOD AVENUE, BOSTON, MA 02115. THE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: PENSION ADJUSTMENT 3,196,442. FORM 990, PART XII, LINE 2C: THE AUDIT PROCESS AND SCOPE HAS NOT CHANGED FROM THE PRIOR YEAR. BOSTON CHILDREN'S HOSPITAL 300 LONGWOOD AVENUE BOSTON MA 02115 042774441 HOSPITAL MA 501(C)(3) LINE 3 N/A 0 PHYSICIANS ORGANIZATION AT CHILDREN'S HOSPITAL INC 300 LONGWOOD AVENUE BOSTON MA 02115 043266103 MANAGEMENT SERVICES MA 501(C)(3) LINE 12C, III-FI N/A 0 0 0 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0