| Form 990, Part VI, Section A, line 1 |
The majority of the CHMC Otolaryngologic 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 the 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 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 on 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 the CHMC Otolaryngologic 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, but not to approve, the annual budgets and 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 modifications to physician compensation and benefit plans for all physician employees of the Foundation. |
| Form 990, Part VI, Section A, line 6 |
The CHMC Otolaryngologic Foundation, Inc. (the Foundation) has three classes of members. The Chief of the Department of Otolaryngology (the Department) of Boston Children's Hospital (the Hospital) is the sole Class "A" member. Any member of the Department (other than the Chief) who holds a professional staff appointment in otolaryngology at the Hospital, has a full-time faculty appointment from Harvard Medical School, and who is geographically full-time at the Hospital shall be a Class "B" member. The Physicians Organization at Children's Hospital, Inc. is the Class "C" member of the Foundation. |
| Form 990, Part VI, Section A, line 7a |
According to the Articles of Organization, the Class "A" member is the Chief of the Department of Otolaryngology (the Department) of Boston Children's Hospital (the Hospital). Any other member of the Department who holds a professional staff appointment in otolaryngology at the Hospital, has a full-time faculty appointment from Harvard Medical School, and who is geographically full-time at the Hospital shall be a Class "B" member. Class "A and "B" members shall hold their membership as long as he/she remains qualified for membership. Only Class "A and "B" members may vote in annual meetings or other elections or serve on the CHMC Otolaryngologic Foundation, Inc.'s Board of Directors and may nominate candidates for election to the Board. |
| Form 990, Part VI, Section A, line 7b |
The Physicians Organization at Children's Hospital, Inc. (the PO) is a Class "C" member of the CHMC Otolaryngologic 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 has the right to review, but not to approve, the annual budgets and 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 modifications 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, Michael J. Cunningham, MD, FACS, and the Treasurer, Norman Dean. A copy of the Form 990 will be provided to the Board prior to filing. 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 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 influence 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 CHMC Otolaryngologic 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 prosepective basis by the Boston Children's Hospital Chief Executive Officer and President/Chief Operating 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 553,389. |
| Form 990, Parrt XII, Line 2c: |
The audit process and scope has not changed from the prior year. |
Attach to Form 990 or 990-EZ.