efile Public Visual Render
ObjectId: 202133149349305853 - Submission: 2021-11-10
TIN: 58-2367819
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
20
Open to Public Inspection
Name of the organization
CHILDREN'S HEALTHCARE OF ATLANTA INC
Employer identification number
58-2367819
Part I
Identification of Disregarded Entities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
(1)
CHILDREN'S HEALTHCARE OF ATLANTA AFFILIA
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
81-2628990
AFFIL AGMTS
GA
249,039
193,734
CHOA INC
(2)
REAL ESTATE ENTERPRISES LLC
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
81-2291402
REAL ESTATE
GA
405,114
-1,959,260
CHOA INC
(3)
PEDIATRIC INFORMATICS LLC
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
81-2305602
INFO TECH
GA
320,875
0
CHOA INC
Part II
Identification of Related Tax-Exempt Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
EGLESTON CHILDREN'S HOSPITAL EMORY UNIV
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
52-0572412
HOSPITAL
GA
501(c)(3)
3
CHOA INC
No
(2)
SCOTTISH RITE CHILDREN'S MEDICAL CENTER
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
58-0572465
HOSPITAL
GA
501(c)(3)
3
CHOA INC
No
(3)
CHILDREN'S HEALTHCARE OF ATLANTA FDN
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
58-1710601
FUNDRAISING
GA
501(c)(3)
7
CHOA INC
No
(4)
MARCUS AUTISM CENTER
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
26-2809380
PED HLTH SVCS
GA
501(c)(3)
10
CHOA INC
No
(5)
EGLESTON AFFILIATED SERVICES INC
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
58-2147112
PHYS CARE
GA
501(c)(3)
3
CHOA INC
No
(6)
EGLESTON PEDIATRIC GROUP INC
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
58-2201217
PHYS MGMT
GA
501(c)(3)
3
CHOA INC
No
(7)
HSOC INC
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
20-3962330
MGMT & ADM SV
GA
501(c)(3)
3
EGLESTON
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Page 2
Schedule R (Form 990) 2020
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
MERIDIAN MARK LLC
1575 NE EXPY
ATL
,
GA
30329
01-0723254
SURGERY CENTER
GA
SCOTTISH RITE
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
THE CHILDREN CARE NETWORK INC
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
47-1373158
PHYSICIAN SRVCS
GA
CHOA INC
C CORP
-67,245
7,109,821
100.000 %
Yes
(2)
EMORY-EGLESTON CHILDREN'S HEART CENTER
1575 NORTHEAST EXPRESSWAY
ATLANTA
,
GA
30341
58-1871713
CARDIAC SERVICES
GA
CHOA INC
C CORP
55,135,510
17,016,938
100.000 %
Yes
Schedule R (Form 990) 2020
Page 3
Schedule R (Form 990) 2020
Page
3
Part V
Transactions With Related Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
No
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
No
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
Yes
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
Yes
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
No
p
Reimbursement paid to related organization(s) for expenses
............................
1p
No
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
No
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
Schedule R (Form 990) 2020
Page 4
Schedule R (Form 990) 2020
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2020
Page 5
Schedule R (Form 990) 2020
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference
Explanation
SCHEDULE R, PART V, LINE 1E
Refer to disclosure in Schedule K regarding members of the obligated group for CHOA's tax exempt bonds.
Schedule R (Form 990) 2020
Additional Data
Software ID:
Software Version: