SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
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OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
BROOMFIELD PEDIATRICS INC
 
Employer identification number

84-4927321
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6, 7A, & 7B ORGANIZATION'S MEMBERS OR STOCKHOLDERS: COMMUNITY REACH SYSTEMS, INC. IS THE SOLE MEMBER OF BROOMFIELD PEDIATRICS, INC. COMMUNITY REACH SYSTEMS, INC. APPOINTS, REMOVES AND REPLACES THE MEMBERS OF THE BOARD OF DIRECTORS AND HAS THE SOLE AUTHORITY TO ALTER, AMEND OR REPEAL THE ARTICLES OF INCORPORATION AND BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11B DESCRIBE PROCESS TO REVIEW THE FORM 990: THE FORM 990 IS PREPARED BY A THIRD PARTY PREPARER WITH A DETAIL REVIEW BEING COMPLETED BY THE SR. MANAGER OF BUDGET AND FINANCE STRATEGY AND THE CFO OF THE ORGANIZATION. A DRAFT COPY OF THE FORM 990 IS THEN EMAILED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL BEFORE THE RETURN IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C DESCRIBE HOW CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED: All staff employed will receive the Corporate Compliance Plan and Code of Conduct Handbook at hire. These will be provided to the employees in the agency's Learning Management System (LMS), Relias. The Corporate Compliance Plan highlights the Code of Ethics and Federal Requirements that the Agency is expected to adhere to. The Code of Conduct defines the scope, responsibilities, operational guidelines, control, and activities which assure ethical conduct and provide guidance to employees, volunteers, and contracted individuals about behavior and conduct in accordance with the Agency's mission. Audits shall take place within the Agency to examine and maintain Federal Requirements set forth within the Corporate Compliance Plan. The Corporate Compliance Officer or designee will review identified problems, conduct risk assessments, and report on compliance issues as outlined in the Corporate Compliance Plan. The Corporate Compliance officer is named by the board of directors and reports all findings on a quarterly basis to the board.
FORM 990, PART VI, SECTION B, LINE 15A PROCESS FOR DETERMINING CEO COMPENSATION: THE CEO RECEIVES COMPENSATION FROM COMMUNITY REACH CENTER SYSTEMS, INC., A RELATED PARTY. THE BOARD OF DIRECTORS UTILIZES THE SALARY SURVEY OF THE COLORADO COMMUNITY MENTAL HEALTH CENTERS ALONG WITH A CEO EVALUATION COMPILED BY THE BOARD OF DIRECTORS IN ITS DETERMINATION OF THE COMPENSATION FOR THE CEO. THE CEO'S COMPENSATION IS NEGOTIATED BETWEEN THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND THE CEO. THE EXECUTIVE COMMITTEE BRINGS A COMPENSATION PROPOSAL TO A SCHEDULED MEETING OF THE FULL BOARD, WHILE IN EXECUTIVE SESSION. FOLLOWING DELIBERATION, A VOTE IS TAKEN ON THE AGREED-UPON COMPENSATION. THE CEO NOTIFIES THE HUMAN RESOURCES DIRECTOR OF THE NEW COMPENSATION.
FORM 990, PART VI, SECTION B, LINE 15B PROCESS FOR DETERMINING OTHER EXECUTIVE COMPENSATION: ON AN ANNUAL BASIS, OUR HR DIRECTOR GOES THROUGH A PROCESS CALLED COMPENSATION ADMINISTRATION. COMMUNITY REACH CENTER, A RELATED PARTY, IS A MEMBER OF EMPLOYERS COUNCIL. WE PARTICIPATE IN COMPENSATION SURVEYS AND ARE ABLE TO ACCESS INFORMATION FROM OTHER NON-PROFITS TO COMPARE OUR COMPENSATION TO. ALL EXECUTIVE COMPENSATION IS APPROVED BY THE CEO. OTHER EXECUTIVE COMPENSATION WAS LAST REVIEWED IN JULY OF 2021 BY THE DIRECTOR OF HUMAN RESOURCES.
FORM 990, PART VI, SECTION C, LINE 19 DESCRIBE HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC: THE CONFLICT OF INTEREST POLICY IS NOT MADE AVAILABLE TO THE PUBLIC. THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST.
FORM 990, PART IX MANAGEMENT FEES: Broomfield PEDIATRICS PAYS MANAGEMENT FEES TO COMMUNITY REACH CENTER SYSTEMS FOR A NUMBER OF SERVICES. COMMUNITY REACH CENTER SYSTEMS ITEMIZES THESE EXPENSES FOR THEIR AFFILIATES. THE ITEMIZED EXPENSES ARE REPORTED ON THE STATEMENT OF FUNCTIONAL EXPENSE BY THE EXPENSE TYPE.
FORM 990, PART IX, LINE 5 & 7 SALARIES & WAGES: SALARIES REPORTED ON LINE 7 ARE FOR EMPLOYEES EMPLOYED BY COMMUNITY REACH CENTER SYSTEMS, INC., A RELATED EXEMPT ORGANIZATION. THE SALARIES REPORTED ARE THOSE ALLOCATED TO Broomfield PEDIATRICS, INC. A PORTION OF OFFICERS' SALARIES ARE ALSO ALLOCATED ON LINE 7, BUT CANNOT BE READILY DETERMINED TO DISCLOSE ON LINE 5.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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