TIN:
SCHEDULE O
(Form 990)
Department of the Treasury
Internal Revenue Service
(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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Inspection
Name of the organization
AKRON CHILDREN'S HEALTH COLLABORATIVE
Employer identification number
87-0853487
87-0853487
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON IS THE SOLE MEMBER OF AKRON CHILDREN'S HEALTH COLLABORATIVE. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBER APPOINTS THE BOARD MEMBERS OF AKRON CHILDREN'S HEALTH COLLABORATIVE. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE MEMBER SHALL HAVE FINAL DECISION MAKING AUTHORITY WITH RESPECT TO THE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES: (A) TO ADOPT AND APPROVE AMENDMENTS TO THE CORPORATION'S ARTICLES AND REGULATIONS; (B) TO APPROVE ANY AMENDMENTS TO THE CORPORATION'S PURPOSE OR MISSION INCLUDING CONFLICT OF INTEREST POLICIES; (C) TO APPROVE, APPOINT OR REMOVE A MEMBER OF THE BOARD OF THE CORPORATION WITH OR WITHOUT CAUSE, IN ACCORDANCE THE PROCEDURES SET FORTH HEREIN; (D) TO CREATE ANY COMMITTEES OR SUBCOMMITTEES OF THE BOARD OR ANY ADVISORY BOARDS OR COUNCILS TO THE BOARD OR TO ANY OF ITS COMMITTEES OR SUBCOMMITTEES; (E) TO ADOPT, APPROVE, DISAPPROVE AND/OR AMEND THE OPERATING AND CAPITAL ANNUAL BUDGET AND ANY CONSOLIDATED OPERATING AND CAPITAL BUDGETS OR CONSTRUCTION BUDGETS FOR THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION, AND CHANGES IN THE BUDGETS OR THE INCURRENCE OF UNBUDGETED EXPENSES IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE MEMBER; (F) TO AUTHORIZE AND APPROVE THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT; (G) TO APPROVE ALL CONTRACTS BETWEEN THE CORPORATION AND HEALTH INSURING CORPORATIONS, MANAGED CARE ORGANIZATIONS, PAYERS, EMPLOYERS OR SIMILAR ENTITIES; (H) TO APPROVE THE CREATION, OWNERSHIP OR ACQUISITION OF OR AFFILIATION WITH, ANY OTHER ORGANIZATION BY THE CORPORATION; (I) TO APPROVE THE STRATEGIC PLAN AND LONG RANGE GOALS AND OBJECTIVES OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; (J) TO APPOINT OR REMOVE OFFICERS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; (K) TO MERGE, DISSOLVE, OR ABANDON THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION; (L) TO APPROVE THE LEASE OR SALE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY ORGANIZATION CONTROLLED BY THE CORPORATION IN EXCESS OF AN AMOUNT ESTABLISHED FROM TIME TO TIME BY THE MEMBER, AND TO APPROVE THE PURCHASE OR SALE OF ANY REAL ESTATE; AND (M) TO RECEIVE ANY FUNDING FROM AFFILIATED ENTITIES OR ANY DISBURSEMENTS TO AFFILIATED OR OTHER THIRD PARTIES; AND (N) TO MAKE DISTRIBUTIONS FROM THE CORPORATION TO THE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 8B | ACHC DID NOT FORM ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY DURING 2021. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PROVIDED TO THE AUDIT COMMITTEE OF THE CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (MEMBER) FOR REVIEW AND DISCUSSION PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE. THE AUDIT COMMITTEE IS A COMMITTEE OF THE CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON BOARD OF DIRECTORS AND EMPOWERED TO COMPLETE THE REVIEW ALL AFFILIATES ON BEHALF OF THE DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | IT IS THE POLICY OF ACHC TO FOLLOW THE APPLICABLE POLICIES OF CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (CHMCA). ALL OFFICERS, DIRECTORS, AND EMPLOYEES DISCLOSE REAL OR APPARENT CONFLICTS OF INTEREST AS A CONDITION OF BOARD MEMBERSHIP WITH ACHC. ALL OFFICERS AND DIRECTORS DISCLOSE, IN WRITING, ON AN ANNUAL BASIS, A LIST OF ALL BUSINESSES OR OTHER ORGANIZATIONS IN WHICH HE/SHE (OR AN IMMEDIATE FAMILY MEMBER) IS AN OFFICER, MEMBER, OWNER, SHAREHOLDER, TRUSTEE OR EMPLOYEE FOR WHICH HE/SHE ACTS AS AN AGENT OR MIGHT REASONABLY, IN THE NEAR FUTURE, ENTER INTO A RELATIONSHIP OR TRANSACTION IN WHICH HE/SHE COULD HAVE A DUALITY OF INTEREST. IF A SITUATION ARISES IN WHICH THERE IS A DUALITY OF INTEREST AND AS SUCH, POTENTIAL FOR A CONFLICT OF INTEREST, IT IS THE PRIMARY RESPONSIBILITY OF SUCH AN INDIVIDUAL DIRECTLY INVOLVED TO MAKE IMMEDIATE AND COMPLETE DISCLOSURE TO THE APPROPRIATE SUPERVISOR. THE CHIEF HUMAN RESOURCES OFFICER SHALL REVIEW ALL DISCLOSURE STATEMENTS AND FORWARD THOSE WITH RECOMMENDATIONS TO THE CHIEF LEGAL OFFICER. THE CHIEF LEGAL OFFICER REFERS TO SELECTED ISSUES OR MATTERS FOR CONSULTATION TO THE AUDIT COMMITTEE OF THE CHMCA BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15 | ACHC RELIES ON THE RELATED ORGANIZATION, CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON, TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON REQUEST |
| FORM 990, PART XI, LINE 9: | BEGINNING ASSET TRANSFER FROM SOLE MEMBER 1,000,000. |
| PART XII, LINE 2C | ACHC THROUGH ITS PARENT COMPANY CHILDREN'S HOSPITAL CENTER OF AKRON HAS AN AUDIT COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT, REVIEW, OR COMPILATION OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. |
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021
Additional Data
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